In a time in which our society is divided on so many issues, one common agreement is the desire to keep our children and teens safe from harm. While communities have rallied to create awareness about “stranger danger” and supported the “D.A.R.E. to keep kids off drugs,” program, many parents are only recently becoming aware of the increased risk of children harming themselves. So let’s briefly discuss suicide risk and prevention for LGBTQ+ teens.
What does LGBTQ+ mean?
Chances are, you’ve heard someone in the media use the term “LGBTQ+” before. You might have also noticed that the acronym is hardly ever explained. Don’t be discouraged if you feel a little out of the loop, especially as the term has broadened over recent years.
LGBTQ stands for Lesbian, Gay, Bisexual, Transgender (or trans), and Queer (or Questioning). Queer” is a slang term for being gay or bisexual. It is generally meant to encompass anyone who is non-heterosexual.
Depending on how it is used, “queer” can be a statement of pride or a way to ridicule someone. Generally, it should be used only when individuals identify with this term themselves. “Questioning” is often used for those individuals who are unsure of their sexual orientation or gender identity.
What does cisgender mean?
A term you may not be familiar with is “cisgender.” It’s pronounced sis-gender, and it means “on the same side as.” People who are cisgender identify now as the same gender they identified with at birth. Conversely, people who are not cisgender sometimes identify as “queer.”
Recently, the “+” sign has been tacked on to the LGBTQ label. The plus sign is meant to recognize that the range of sexual orientations and gender identities people may use is unlimited. To understand why this plus sign is so important, read on.
Children’s mental health is in crisis
Suicide is a significant public health concern for all ages. Unfortunately, in recent years, we’ve seen significant increases in certain mental health disorders in youth, including depression, anxiety, and suicidal ideation. In fact, the American Psychological Association (A.P.A.) has stated that, as a whole, children’s mental health is in crisis.
The A.P.A.’s concern is represented by some alarming statistics. In 2020, the Centers for Disease Control and Prevention reported that suicide was the second leading cause of traumatic death in children ages 10 to 14 on a national level. And in 2021, Cook Children’s Medical Center reported that suicide was the leading cause of traumatic death cases they handled.
LGBTQ+ teens are more likely to experience feeling suicidal than their heterosexual peers.
Source: https://unsplash.com/photos/MW7ru0BdTFM (CC0)
Facts about LGBTQ+ youth and suicide
Suicide is an alarming matter for all children, but it’s even more of a concern for our LGBTQ+ youth. A 2021 national survey by an organization called The Trevor Project found that 45 percent of LGBTQ youth seriously considered suicide. Further, young people are more than four times more likely nationally to attempt suicide than their peers.
The situation is just as serious in our state. Key statistics about Texas LGBTQ+ high school students:
- Nearly 50 percent reported that they seriously considered attempting suicide. In comparison, only 13.5 percent of heterosexual or “straight” students reported seriously considering suicide.
- Almost 30 percent of LGBTQ+ reported making a plan about how they would attempt suicide. In comparison, only 12.4 percent of straight youth made this report.
- 28 percent of these respondents attempted suicide one or more times in the previous 12 months. This figure is about three times higher than the data for heterosexual students.
Suicidal behavior appears to be increasing among teens
Amit Paley, the executive director of The Trevor Project, said their organization’s research shows that “suicidal thoughts have trended upward among LGBTQ young people over the last three years.” He attributes this increase to the pandemic and “relentless political attacks.”
The American Academy of Pediatrics, The American Psychiatric Association, and the National Institute of Mental Health all have published works discussing the increased risk of suicide among LGBTQ+ teens.
The findings of these organizations are supported by our own organization’s work, as we have seen an increasing number of teens coming to us to discuss issues of sexuality and gender.
Being LGBTQ+ is not a sign of mental illness
We know that the rate of suicide attempts and suicidal thoughts among these teens is significantly more prevalent than among teens in general. But we also know something else: Being gay or trans is NOT caused by mental illness.
Instead, many LGBTQ+ teens must deal with what is known as “minority stress.” This means the person is living as a stigmatized minority. The young person may face a constant barrage of discrimination, harassment, and online bullying. The mistreatment can come from their peers, the health care system, and even from their parents.
Anyone who faces prolonged and intense stigma may suffer from developmental disorders or suicidal thoughts. And academic researchers have concluded that the abundance of mental health problems among LGBT youth can almost always be attributed to one thing: Stigmatization and/or discrimination.
What factors might increase the risk of suicide among LGBTQ+ teens?
Unfortunately, it is nearly impossible to know the exact suicide and homicide-suicide rates experienced by LGBTQ+ teens, as death records do not mention someone’s sexual orientation or gender identity. However, we can identify the factors that increase the risk of these outcomes among LGBTQ+ youth.
An academic journal recently published a paper on the predictors of self-harm and suicide in LGBT youth. These include:
- Stressful life events or trauma in the past
- A history of depression or anxiety
- A family history of suicide
- Access to a firearm or other lethal means
- Victims of bullying or online bullying
- Previous suicide attempt
Gay and trans young people may face rejection from their families
One of the most substantial risk factors for suicide among these young people is being rejected by those who are closest to them. A teen who has “come out” and is made to feel unaccepted or abandoned has suffered significant emotional harm. They’re also at risk for physical rejection.
For example, one woman spoke with us about her daughter’s best friend. The girl had come out as gay, and her parents had responded in a very harsh way: They were refusing to provide her with food.
The concerned woman had spoken to the teen about reporting the situation to Child Protective Services. But the girl begged her not to do it. Her reason? She had younger siblings, and she was afraid that CPS would remove them from the house as well.
Long-term effects of untreated mental health concerns for LGBTQ+ teens
Despite the heartbreak of this story, this teen was, in some ways, lucky: At least she had a supportive adult in her life. We can only wonder what might have happened if the woman had not taken an interest in the girl’s well-being.
On the other hand, someone who is facing constant and complete rejection can suffer long-term consequences. These include:
Substance abuse problems
Excessive alcohol consumption
Frequent disruptions in employment
Relationship or marital issues in adulthood.
If there is already a family history of mental health disorders or mood disorders, then this could increase the risk of these issues developing, or the youth attempting suicide.
Some teens may simply internalize this hostility. In other words, they begin to despise themselves. This decreases the likelihood they will seek out support — which, in turn, increases the chances they will develop a mental health disorder.
No wonder then, that the U.S. Surgeon General has concluded, “Mental health challenges are the leading cause of disability and poor life outcomes in young people.”
Preventing suicide among LGBTQ+ teens means understanding their struggles.
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What are the warning signs that someone is considering suicide?
These short-term and long-term risks highlight the importance of knowing the indicators that someone — teenager or adult — may be thinking about suicide. Before we can take action, we must have awareness.
An academic journal recently published a paper on the predictors of self-harm and suicide in LGBT youth. I tell people to look for extremes outside of the individual’s normal behavior. For example, the person may show:
· A significant change in sleep habits
· A significant change in appetite
· A loss of interest in activities, hobbies, and friends
· A tendency to isolate themselves more
Teens, of course, are notorious for being “moody.” It’s true that they are dealing with hormones. But parents know their kids and know how they operate. So if your teen’s disturbing behaviors go on for more than two weeks, it’s probably not just a “mood” they’re going through; it may be a change in their mental health. Take the Recognize and Rise survey, “Are You Depressed?”
What can be done to help LGBTQ+ youth?
One of the best ways to help LGBTQ+ youth is to take them to counseling. Young people need a place where they can feel emotionally and physically safe as they address their concerns.
However, therapy will be of no help if the counselor is not sincerely accepting of the youth. I have a colleague who shared his difficult experience as a teen. After he “came out” to his parents, they took him to a counselor who did “conversion therapy.” This is an attempt to change the person’s sexual orientation or gender identity. Conversion therapy is not evidence-based and is banned in many states.
This counselor was supposed to be helping people. Instead, the counselor made things worse for my colleague and probably made him less trusting as well. This may explain why the World Health Organization reported that LGBTQ+ teens are less likely to access health services and engage with healthcare workers.
Families of LGBTQ can benefit greatly from counseling
Counseling isn’t just for young people: Parents who may be struggling with how to embrace their teen’s sexuality can also benefit.
We are well aware that many people are leery about mental health services. We believe the goal of any kind of therapy should not be to “fix” you; that’s because you are NOT “broken.” Instead, we believe the purpose of counseling is simply to help individuals and families thrive. This explains why counselors frequently say, “Counseling is for everyone, and we can all benefit from therapy.”
In therapy, we frequently tell parents that while we are the experts on mental health, they are the experts on their children. We encourage them to be aware of their child’s mental health and stay alert for any significant changes in their sleep, appetite, social activities, or general mood.
And when parents are ready to consider therapy, we encourage them to start the conversation positively. They might say something like, “Let’s go to counseling so we can figure out some ways to support you on this journey.” Just as important, the participation of parents can also help remove any hesitancy the teen has about seeking therapy — because, as we said, you are NOT broken.
Medical intervention may also help struggling teens
Counseling is just one step that can help these young people. For example, a young person who has experienced extreme hostility could be suffering from Post-Traumatic Stress Disorder (PTSD). They also may be dealing with issues like chronic pain, substance abuse, bipolar disorder, and more.
Helping the teen deal with these conditions may require medical intervention and prescribing antidepressants and other medications. As with therapy, any medical care must be inclusive and accepting of the LGBTQ+ community. Appropriate care will assess the young person’s vital signs and may include medication that can help with withdrawal symptoms and reduce active suicidal ideation.
Accepting LGBTQ+ teens
One of the most important things we can do for suicide prevention is also one of the easiest: We need to simply accept these young people, just as they are.
Acceptance starts with having compassion for the sexual orientation and gender identity issues these teens are facing. It includes acknowledging the life stresses they may be facing and the mental health conditions they are experiencing.
And yet so often, the opposite happens. For example, research has shown that a supportive school environment can positively impact suicidal behavior. But I know of one gay student whose teacher openly threatened to “out” her to her parents.
Is it illegal to have transgender youth in Texas?
You may be aware that the Texas Attorney General recently issued a formal opinion concluding that performing certain “sex-change” procedures on children and prescribing puberty-blockers to them, is considered child abuse under Texas law. But you may not know that the National Association of Social Workers (NASW) also published a statement on this matter recently. The NASW has condemned the Attorney General’s efforts to define gender-affirming care as child abuse.
More important, the NASW emphasizes that the Attorney General’s document is a non-legally binding opinion. There is nothing —nothing — in the Texas Family Code at this time that criminalizes transgender treatment. Further, a Texas District Judge has issued a temporary restraining order to suspend any child abuse investigations related to gender-affirming care.
For our part, our organization maintains that if someone refuses to consider providing treatment for a young person who is struggling with gender and sexuality issues, that itself may be a form of mental health neglect.
Parents must take the initiative in talking with their kids about difficult topics, including sexuality and suicide.
Signs of progress in supporting LGBTQ+ youth
As we have seen, LGBTQ+ teens are at a higher risk of substance abuse, suicidal thoughts, and suicide attempts. And the problem may be getting worse. Even so, I firmly believe that we have reason to remain hopeful.
Many of us grew up in homes where we did not discuss sensitive topics like sexuality and religion. But things are changing. Parents today are aware that these topics are not as clear-cut as we learned when we were growing up, and they are having more open dialogue with their children. That’s definitely a change for the better.
Also, despite the disappointing political situation in Texas, our society as a whole is becoming more accepting and more supportive of diversity.
The work is not done. We need more legislation supporting LGBTQ+ youth, so they will know that their existence is embraced and they have some legal protection. But we are moving in the right direction. This progress, in turn, can help reduce the victimization they experience and, hopefully, reduce the suicide rates among this group. Keep Your Mind Grounded – Recognize & Rise
Are you worried an LGBTQ+ youth may be at risk for suicide?
Of course, you can’t tell if someone is ready to attempt suicide just by looking at the person. This can put adults in a difficult situation, because you never want to look back and think, “I should have done more.” But you also don’t want to overreact. Fortunately, there are several ways for us to support LGBTQ+ teens and reduce the chances that they will attempt suicide.
It starts with being willing to have a difficult conversation. We understand that suicide prevention is an uncomfortable topic, but you have to be proactive with the teen. Ask: Do you sometimes wish you were not alive? Have you contemplated suicide? Are you making a plan now to hurt yourself?
People are sometimes afraid to ask these questions because they worry that they will “plant” an idea in the young person’s head. But that’s not how it works. Kids don’t really want to die, they just don’t want to hurt anymore. So when they are genuinely feeling hopeless and don’t see any other options, they go to the only option they think will solve their pain.
In short, you do not have to be a therapist or counselor to support someone experiencing thoughts about death or suicide. A list of suicide prevention resources is provided at the conclusion of this article.
Parents can make a critical difference in helping LGBTQ+ teens
Respected national organizations such as the Centers for Disease Control and Prevention and the American Psychiatric Association have made suicidal precautions a priority. A mental health professional and suicide prevention resource center can provide assistance to teens in crisis. However, the most critical support and recognition begin at home.
In more than one instance, we’ve told parents that their child is struggling with thoughts of committing suicide, only to have the parents dismiss this information. They say that the teen is just doing it for attention, or that their friends at school are driving the conversation. In those situations, our task is to try and work with the parents, while we are trying to keep a kid alive.
When kids finally have the courage to say how they’re feeling, only to be rejected by their parents, that’s a really, really hard thing for us to see — both as mental health professionals and as parents.
Parents must be proactive in having hard conversations with teens
How can we avoid getting to that point? We encourage parents and adults to actively verbalize their acceptance of LGBTQ+ youth. We also encourage you as parents to actively pursue conversations with your kids — about everything.
I know many parents who have told their children, “I’m here to answer any questions you might have.” That’s commendable, but it’s not enough. Most kids are not going to go to their parents with hard questions about relationships, sex, or mental health unless there is a clear understanding that these issues are not taboo and can be commonplace subjects.
When you are the one to initiate these challenging talks, you can guide the narrative. Move away from simply asking your children, “How was your day?” Instead, consider asking them more pointed questions:
- “What have you heard from other kids at school about…?”
- “What do you believe about…?”
- “What would you do if…?”
Last, be aware of your off-hand jokes and comments. Children listen to us, even when we are not talking to them. Read the Recognize & Rise article, How Well Do You Bounce Back?
A new perspective on LGBTQ+ people
In some ways, sexuality is not that different from being right-handed or left-handed. We naturally have a dominant hand. So you can “force” people to use their non-dominant hand, but when you do that, they are not being true to themselves.
The beauty of children is that they are born as a blank slate, without bias. We can use this to their benefit. As a community and as parents, we should want to raise kids to be true to themselves. Read the Recognize & Rise article, “Dealing with Change.”
Suicide Risk and Prevention for LGBTQ+ Teens is a challenge we can overcome
As we’ve said, LGBTQ+ teens are at a much greater risk of attempting suicide. But we also need to say again that the problem is not they are gay, trans, or queer – the problem is how they are treated by others.
This is why it is essential to focus on creating a comprehensive strategy that incorporates good public health services, sensible legislation, robust counseling support, and healthy, accepting communities. We must do this work for all of our children, but especially for our LGBTQ+ youth. Working together, we can improve their quality of life — and ours.
Anastasia Taylor is a Licensed Clinical Social Worker-Supervisor and the CEO of Alliance Child & Family Solutions.
Resources in Tarrant County and nationally for LGBTQ+ Teens
- LGBTQ Saves: Provides support by hosting meetings and community dinners for LGBTQ youth and their families. Also offers resources, scholarships, and a chat.
- TrevorLifeline: Provides confidential support for LGBTQ youth in crisis, 24 hours a day, 7 days a week, 365 days a year. 1-866-488-7386
- TrevorChat: Confidential instant messaging with a counselor, available 24/7/365. https://www.thetrevorproject.org/get-help-now
- TrevorText: Confidential text messaging with a counselor, available 24/7/365; standard messaging rates may apply. Text START to 678-678.
- Trans Lifeline: Hotline staffed by transgender people for transgender people, available 24/7/365. 1-877-565-8860.
- Resource Center: Dallas-based organization offering free, year-round programming to support LGBTQIA+ and allied youth ages 12-18.
- National Suicide Prevention Lifeline: General suicide prevention support, available 24/7/365. 1-800-273-TALK (8255).
- Crisis Text Line General suicide prevention support by text, available 24/7/365. Text TALK to 741-741.
Read the Recognize and Rise blog, “Is the Pandemic Affecting the Mental Health of Someone You Love?”
See more support options from Recognize and Rise.
Anastasia “Stas” Taylor, MSSW is a Licensed Clinical Social Worker with more than 15 years of professional experience. She is the founder and CEO of Alliance Child & Family Solutions, with offices in North Fort Worth and on the Near Southside. Anastasia is trained in a variety of therapeutic models and has made numerous media appearances, including on NBC-DFW, KTVT, KERA, The Dallas Morning News, and Fort Worth Magazine.
She has also been recognized by the Fort Worth Business Press and DFW Child Magazine, and has repeatedly been included on an annual list of “Best Marriage Counselors in Fort Worth.” Her specialties include working with foster and adoption families, life transitions in late adulthood, social-emotional learning, and trauma. She also is fluent in Spanish. Contact Alliance Child & Family Solutions.