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## Other Youth Topics

## Breadcrumb

            -  Youth Topics 
            -           Behavioral Health      

# Behavioral Health

“Behavioral health” is an umbrella term that includes issues and services related to mental health, suicide, and substance use/misuse. This section discusses information relevant to these two subject areas as they intersect with LGBTQ+ youth.

### Mental Health and Suicide

As the Institute of Medicine has noted, LGBT youth are typically well adjusted and mentally healthy.1 However, they experience higher rates of mental health challenges and increased health complications arising from these challenges compared to their heterosexual peers.2 Research on transgender youth outcomes as separate from lesbian, gay, and bisexual youth outcomes is more limited, though growing. Some recent nonrandom surveys of self-identified transgender people indicate that up to one-third reported attempting suicide at least once, with higher rates for youth and young adults than for older adults.3 Moreover, suicide is the third leading cause of death among youth ages 15 to 24, and LGBT youth are more likely to attempt suicide than their peers.4 This does not mean, however, that LGBT identity itself is the cause of these challenges. Rather, these higher rates may be due to bias, discrimination, family rejection, and other stressors associated with how they are treated because of their sexual identity or gender identity/expression.5 These challenges, which researchers refer to as “microaggresions,”6 can contribute to anxiety, depression, and other mental health challenges, as well as to suicide and self-harming behavior.

Research has found that lesbian, gay, and bisexual youth have much higher levels of suicidal ideation than their heterosexual peers.7 Also, recent population-based studies suggest that the reported rates of suicide attempts for high school students who identify as LGBTQ+ are two to seven times higher than rates among high school students who describe themselves as heterosexual.8 LGBTQ+ youth are also twice as likely to have thoughts about suicide.9

The Trevor Project’s 2021 National Survey on LGBTQ Youth Mental Health surveyed nearly 35,000 LGBTQ youth ages 13-24 and found several revealing insights on the state of LGBTQ+ youth mental health in the U.S.:
                      - 42 percent of LGBTQ youth seriously considered attempting suicide in the past year, including more than half of transgender and nonbinary youth.
                      - 31 percent of  Native/Indigenous  youth attempted suicide, 21 percent of Black youth did so, 21 percent of multiracial youth, 18 percent of Latinx youth, 12 percent of Asian/Pacific Islander youth, and 12 percent of white youth.
                      - More than 80 percent of LGBTQ youth stated that  COVID-19  made their living situation more stressful.
                      - 70 percent of LGBTQ youth stated that their mental health was "poor" most of the time or always during the COVID-19 pandemic.
                      - Nearly half of LGBTQ youth reported they wanted counseling from a mental health professional, but were unable to receive it in the past year.

There were also findings that support the importance of welcoming and safe environments, resources, and services for LGBTQ+ youth and their mental health:
                      - Transgender and nonbinary youth who were able to change their name and/or gender marker on legal documents, such as driver’s licenses and birth certificates, reported lower rates of attempting suicide.
                      - LGBTQ youth who had access to spaces that affirmed their sexual orientation and gender identity reported lower rates of attempting suicide.
                      - Transgender and nonbinary youth who reported having pronouns respected by all the people they lived with attempted suicide at half the rate of those who did not have their pronouns respected by anyone with whom they lived. 10

Strategies to improve mental health and prevent self-harming behavior and suicide include:
                      - providing safe and supportive environments, particularly through affirming relationships with family and peers 11
                      - enacting legislation to protect the safety of LGBTQ+ youth
                      - re-evaluating institutional practices that undermine  positive youth development
                      - building community awareness and capacity to understand and address stressors that LGBT youth may experience 13

### Substance Use

LGB youth may be more likely to use substances to cope with bias and stress and may be more likely to experience increased rates of depression and anxiety than their non-LGB peers.13 Challenges such as family rejection of, or anticipated reaction to, one’s LGBT identity are also associated with substance use.14 National prevalence data show that high school students in the U.S. who identify as LGB engage in substance use at significantly higher rates than their heterosexual peers.15

Through national surveys, LGB high school students and young adults recently reported two to three times greater rates of ever using hard drugs (e.g., cocaine, ecstasy, methamphetamine, heroin), compared to their heterosexual peers.16

Transgender youth have a high risk for developing substance dependency issues. Transgender individuals have higher rates of usage for some drugs and may have higher rates of methamphetamine, injectable drugs, and tobacco usage.17

Reducing the rates of bias, discrimination, and victimization that LGBTQ+ youth experience can help reduce substance use. A related strategy includes creating safe spaces for LGBTQ+ youth in drug-free environments, such as community centers. Also, accepting/positive family behaviors toward LGBTQ+ youth during adolescence can protect against not only suicide and depression but also substance use.18

## Resources

**National Suicide Prevention Lifeline: 800-273-TALK (8255)** The National Suicide Prevention Lifeline is a 24-hour, toll-free, confidential suicide prevention hotline available to anyone in suicidal crisis or emotional distress. When you call 1-800-273-TALK (8255), you are connected to the nearest crisis center in a national network of more than 150 that provide crisis counseling and mental health referrals day and night. The Lifeline also provides informational materials, such as brochures, wallet cards, posters, and booklets. Prestamos servicios en español (1-888-628-9454). Translators speaking approximately 150 languages are available.

**A Guide for Understanding, Supporting, and Affirming LGBTQI2-S Children, Youth, and Families****(PDF, 8 pages)**This guide provides information for service providers, educators, allies, and community members who seek to support the health and well-being of children and youth who are lesbian, gay, bisexual, transgender, questioning, intersex, or two-spirit (LGBTQI2-S) and their families. This guide can support efforts to promote full and affirming inclusion of LGBTQI2-S youth and families in communities and provider settings (e.g., child welfare, juvenile justice, mental health, schools). The guide includes a section for organizations to add their endorsement electronically. Both the National Association of School Psychologists (NASP) and the National Association of Social Workers (NASW) have endorsed the guide.

**Gender-Affirming Care and Young People (PDF, 2 pages)**This resource provides information on gender-affirming care, what it looks like, why it matters, and offers additional resources related to transgender and gender diverse children and adolescents. A glossary of common terms to know when providing gender-affirming care is also included. 

**The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding**This report concludes that future research and data collection must address LGBT individuals because current lack of research yields an incomplete picture of the health status and needs of LGBT people.

**Healthy People 2030 Goal: Improve the Health, Safety, and Well-Being of Lesbian, Gay, Bisexual, and Transgender People**This goal focuses on collecting data on LGBT health issues and improving the health of LGBT adolescents in particular.

**Lesbian, Gay, Bisexual, and Transgender Health**This webpage contains specific health topics for the LGBT community, with specific resources for gay and bisexual men, youth, lesbian and bisexual women, transgender persons, and health services.

**Lesbian, Gay, Bisexual, and Transgender Health: Youth**This webpage focuses on information for LGBT youth, highlighting the experiences that LGBT youth face and providing information for schools and parents related to responding to violence against LGBT students.

**Medline Plus: Gay, Lesbian, and Transgender Health**This website provides resources and information for the specific health issues related to gay, lesbian, bisexual, and transgender individuals.

**National Workgroup to Address the Needs of Children and Youth Who Are LGBTQI2-S and Their Families**The *National Workgroup to Address the Needs of Children and Youth Who Are LGBTQI2-S and Their Families* supports and enhances services for children and youth who are LGBTQI2-S. The workgroup guide federal efforts to develop policies, programs, materials, and other products that address the needs of children and youth who are LGBTQI2-S. The workgroup has developed a system of care toolkit of more than 150 resources from various organizations and has delivered learning events at conferences/meetings and in communities to build capacity to improve services and outcomes for LGBTQI2-S youth and their families.

**Practice Brief 1: Providing Services and Supports for Youth Who Are Lesbian, Gay, Bisexual, Transgender, Questioning, Intersex, or Two-Spirit****(PDF, 8 pages)**This practice brief outlines key information for working with, and providing culturally and linguistically competent services to LGBTQI2-S youth.

**A Practitioner's Resource Guide: Helping Families to Support Their LGBT Children****(PDF, 18 pages)**This resource offers information and resources to help practitioners throughout health and social service systems implement best practices in engaging and helping families and caregivers to support their LGBT children.

**A Provider’s Introduction to Substance Abuse Treatment for Lesbian, Gay, Bisexual, and Transgender Individuals****(PDF, 214 pages)**This manual seeks to inform administrators and clinicians about appropriate diagnosis and treatment approaches that will help the development or enhancement of effective LGBT-sensitive programs. A 22-module training curriculum accompanies this publication.

**Recommended Actions to Improve the Health and Well-Being of Lesbian, Gay, Bisexual, and Transgender Communities**This statement addresses recommended actions to address and improve the health and well-being of the lesbian, gay, bisexual, and transgender communities.

**SAMHSA Office of Behavioral Health Equity**This website provides a variety of LGBT-focused data and resources on substance abuse and mental health.

**Suicide Risk and Prevention for Lesbian, Gay, Bisexual, and Transgender Youth****(PDF, 63 pages)**This report highlights the higher risk of suicidal behavior among LGBT youth and provides recommendations for youth services (e.g., schools, health practices, suicide prevention programs) and funders to promote the health, safety, and inclusion of LGBT youth.

**Talking about Suicide and LGBT Populations****(PDF, 4 pages)**This guide provides key recommendations for talking about suicide in safe and accurate ways with LGBT youth. Learn more about how the mental health system can support LGBT youth by reading endever*'s story.

**Top Health Issues for LGBT Populations Information and Resource Kit****(PDF, 100 pages)**This toolkit presents an overview of current health issues among LGBT populations. Although many challenges exist regarding the availability of data, this toolkit aims to create awareness among prevention specialists and healthcare providers of the needs, experiences, and health status of LGBT Americans.

**The Trevor Project**The Trevor Project provides crisis and suicide prevention services to LGBT and questioning young people ages 13 to 24. It operates the only accredited, nationwide, around-the-clock crisis and suicide prevention helpline for youth who are LGBTQ at **866-4-U-TREVOR (866-488-7386)**;******TrevorChat**, an online messaging service that allows youth in crisis to live chat with volunteers who can provide support; and **TrevorText**, a free, confidential messaging service. The Trevor Project also facilitates TrevorSpace, a peer social networking site for LGBTQ youth and their allies; AskTrevor, an online forum through which youth can anonymously ask experts questions about sexuality and gender issues; the Lifeguard Workshop Program, which educates participants through a structured curriculum about recognizing and responding to the warning signs of depression and suicide; and additional resources for youth, families, and educators.

## References

1 Institute of Medicine, 20112 American Psychological Association, 2011; National Alliance on Mental Illness, 20113 Lombardi & van Servellen, 20004 Centers for Disease Control and Prevention, 20195 Almeida, Johnson, Corliss, Molnar, & Azrael, 2009; Haas et al., 2011; U.S. Department of Health and Human Services, n.d.6 Sue, 20107 Suicide Prevention Resource Center, 20088 Haas et al., 20119 Haas et al., 201110 The Trevor Project, 202111 Mustanski & Newcomb, 201112 Horvath, Remafedi, Fisher, & Walrath, 201213 Marshal et al., 200814 Ryan, 200915 Kann et al., 201816 SAMHSA, 2019; Kann et al., 201817 Xavier, Honnold & Bradford, 200718 Ryan, 2009

## Other Resources on this Topic

### Announcements 

                          - Brief: Discriminatory Transgender Health Bills Have Critical Consequences for Youth
                          - Fact Sheet: System Involvement Among LBQ Girls and Women
                          - LGBTQ Inclusivity in Schools
                          - Online Training: Healthy Sexuality for Youth in Foster Care: An Online Training for Parents and Caregivers of Youth in Foster Care
                          - Pride Month Census Data
                          - Report: Experiences of LGBTQ People in Four-Year Colleges and Graduate Programs
                          - Report: Homelessness and Housing Instability Among LGBTQ Youth
                          - Report: Moving Beyond Change Efforts: Evidence and Action to Support and Affirm LGBTQI+ Youth
                          - Report: Multiracial LGBTQ+ Youth Face Heightened Suicide Risk
                          - Report: The GSA Study: Results of National Surveys About Students’ and Advisors’ Experiences in Gender and Sexuality Alliance Clubs
                          - Report: Violent Victimization by Sexual Orientation and Gender Identity, 2017–2020
                          - Research: Examining the Relationship Between LGBTQ-Supportive School Health Policies and Practices and Psychosocial Health Outcomes of Lesbian, Gay, Bisexual, and Heterosexual Students
                          - Resource: 2023 International Transgender Day of Visibility
                          - Resource: 2SLGBTQ Community Readiness Survey
                          - Resource: Adoption Triad - Supporting LGBTQ+ Youth Who Are Adopted
                          - Resource: AFFIRM Caregiver: Affirmative Cognitive Behavioral Therapy for Caregivers of Lesbian, Gay, Bisexual, Transgender & Questioning (LGBTQ+) Populations
                          - Resource: Affirming and Supporting LGBTQ Children and Youth in Child Welfare
                          - Resource: Core Youth Outcomes in Youth of Color
                          - Resource: FAQ Update on 988 Services for LGBTQI+ Youth
                          - Resource: Federal Evidence Agenda on LGBTQI+ Equity
                          - Resource: Federal Funding to Support LGBTQIA2S+ Children, Youth, Young Adults, and Families
                          - Resource: Gender-Affirming Care and Young People
                          - Resource: Inclusive Practices Help All Students Thrive
                          - Resource: LGBTQ Inclusivity Tool
                          - Resource: LGBTQ+ Glossary of Terms
                          - Resource: LGBTQ+ Youth Engagement Virtually and In-Person
                          - Resource: LGBTQIA2S+ Youth Experiencing Homelessness
                          - Resource: Measuring the Impact of Professional Development
                          - Resource: Mental Health Promotion and Suicide Prevention for LGBTQIA2S+ Youth
                          - Resource: Most Kids with Parent in Same-Sex Relationship Live with Female Couple
                          - Resource: National Clearinghouse on Homeless Youth and Families (NCHYF)
                          - Resource: NCFY
                          - Resource: Podcast Series: Collecting Data on Sexual Orientation, Gender Identity, and Expression
                          - Resource: Preventing Suicide Requires a Comprehensive Approach
                          - Resource: Protecting the Rights and Providing Appropriate Services to LGBTQIA2S+ Youth in Out-of-Home Care
                          - Resource: Providing Culturally Competent Mental Health Care to LGBTQIA+ Youth & Young Adults
                          - Resource: Sexual Health Resource Toolkit for Parents and Caregivers of Youth with Intellectual and Developmental Disabilities
                          - Resource: Supporting LGBTQI+ Students Experiencing Homelessness
                          - Resource: Supporting the Health and Well-Being of Transgender and Gender Diverse Youth
                          - Resource: The National Center for Youth with Diverse Sexual Orientation, Gender Identity & Expression (The National SOGIE Center) 
                          - Resource: Toolkit for Implementing Authentic Youth Engagement Strategies Within State Advisory Groups
                          - Resource: Toolkit: Creating Inclusive and Nondiscriminatory School Environments for LGBTQI+ Students
                          - Resource: Voices Amplified
                          - Resource: What Does it Mean to be Two-Spirit?
                          - Resource: Working Virtually With Families of LGBTQ+ Youth.
                          - Resource: Youth Acceptance Project
                          - Resource: Youth Advisory Councils
                          - Resource: Youth AFFIRM: Affirmative Cognitive Behavioral Therapy for Lesbian, Gay, Bisexual, Transgender & Questioning (LGBTQ+) Populations
                          - Share with Youth: Complete GLSEN 2019 National School Climate Survey
                          - Share with Youth: LGBT Resources — Learn More, Get Involved, and Be Proud of Who You Are!
                          - Supporting LGBTQ+ Youth: A Guide for Foster Parents
                          - Toolkit: Celebrating our Magic: Resources for American Indian/Alaska Native Transgender and TwoSpirit Youth, Their Relatives and Families, and their Healthcare Providers
                          - Webinar Recording: The Impact of Bias, Inequities, and Injustices in Supporting Students Impacted by Human Trafficking
                          - Webinar Series: Supporting Gender Diverse Indigenous Youth
                          - Working With LGBTQ+ Families in Foster Care and Adoption
                          - Youth Voices Have Moved to YE4C

### Briefs 

                          - Recommended Actions to Improve the Health and Well-Being of Lesbian, Gay, Bisexual, and Transgender Communities

### Collaboration Profiles 

                          - Providing Unbiased Services for LGBTQ Youth Project
                          - Y2CONNECT.org

### Data Sources 

                          - 2011-2021 YRBS Data Summary and Trends Report

### Feature Articles 

                          - June is LGBT Pride Month
                          - Just Launched! Redesigned YE4C
                          - New Brief Highlights the Needs of Lesbian, Gay, Bisexual, Transgender, and Questioning Youth in Child Welfare Settings
                          - New Reports Highlight Human Service Needs of Lesbian, Gay, Bisexual, & Transgender Populations
                          - New Reports Highlight the Human Service Needs of Lesbian, Gay, Bisexual, & Transgender (LGBT) Populations

### Publications 

                          - A Practitioner’s Resource Guide: Helping Families to Support Their LGBT Children
                          - A Provider’s Introduction to Substance Abuse Treatment for Lesbian, Gay, Bisexual, and Transgender Individuals
                          - How Are the Lives of LGBTQ Youth Improved by Gay-Straight Alliances?
                          - Identifying and Serving LGBTQ Youth: Case Studies of Runaway and Homeless Youth Program Grantees
                          - Key Policy Letters from the Education Secretary and Deputy Secretary
                          - Learning from the Field: Listening Tour of Programs Serving Youth who are LGBTQI2-S and Experiencing Homelessness
                          - Meeting the Needs of Transgender and Gender Non-Conforming Youth
                          - Online Sexual Health Resources
                          - Parents’ Influence on the Health of Lesbian, Gay, and Bisexual Teens: What Parents and Families Should Know
                          - Pride in Our Progress
                          - Primary Sources: Learning How Service Providers and Policy Makers Can Help LGBTQ Homeless Youth
                          - Q&A: Meeting the Needs of Transgender and Gender Non-Conforming Youth
                          - Report: Health-Related Behaviors among Students
                          - Sexual Risk Behavior Differences Among Sexual Minority High School Students — United States, 2015 and 2017
                          - The Economic Well-Being of LGB Youth Transitioning Out of Foster Care

### Resources 

                          - 5 Online Resources to Help Domestic Violence Programs Offer Inclusive Services to LGBTQ People
                          - Brief: the Needs of Lesbian, Gay, Bisexual, Transgender, and Questioning (LGBTQ) Youth in Child Welfare Settings
                          - Ending Housing Discrimination against Lesbian, Gay, Bisexual, and Transgender Individuals and Families
                          - LGBT Populations: A Snapshot of the Knowledge Base and Research Needs
                          - LGBT Youth Resources
                          - Report: Recommendations of the LGBT Subcommittee: Advancing the Reform Process for LGBQ/GNCT Youth in the Juvenile Justice System
                          - Report: Surviving the Streets of New York: Experiences of LGBTQ Youth, YMSM, and YWSW Engaged in Survival Sex
                          - Research: Does Sexual Orientation Affect Teen Pregnancy Risk?
                          - Resource: Guidance to Help Schools Ensure the Civil Rights of Transgender Students
                          - Resource: Helping Youth Prevent Suicide Among Their LGBTQ Peers
                          - Resource: LGBTQ Youth: Voices of Trauma, Lives of Promise
                          - Resources for Serving Lesbian, Gay, Bisexual and Transgender Youth
                          - Safe Spaces. Safe Places: Creating Welcoming and Inclusive Environments for Traumatized LGBTQ Youth
                          - Share with Youth: This Free Life
                          - The Equal Access to Housing Rule and Youth

### Technical Assistance 

                          - Runaway and Homeless Youth Training and Technical Assistance Centers

### Tools & Guides 

                          - 3 Bold Steps for School Community Change
                          - Top Health Issues for LGBT Population Information and Resource Kit

### Videos & Podcasts 

                          - NCFY Voices: Does It Get Better for LGBTQ Teens?
                          - Podcast: Teen Pregnancy Prevention for LGBTQ Youth
                          - Voices from the Field: LGBT-Friendly Teen Pregnancy Prevention

### Websites 

                          - Healthy People 2020

### Youth Topics 

                          - Sexual Orientation and Gender Identity
                          - Suicide Prevention

## Youth Briefs

How Individualized Education Program (IEP) Transition Planning Makes a Difference for Youth with Disabilities
Youth who receive special education services under the Individuals with Disabilities Education Act (IDEA 2004) and especially young adults of transition age, should be involved in planning for life after high school as early as possible and no later than age 16. Transition services should stem from the individual youth’s needs and strengths, ensuring that planning takes into account his or her interests, preferences, and desires for the future.

Youth Transitioning to Adulthood: How Holding Early Leadership Positions Can Make a Difference
Research links early leadership with increased self-efficacy and suggests that leadership can help youth to develop decision making and interpersonal skills that support successes in the workforce and adulthood. In addition, young leaders tend to be more involved in their communities, and have lower dropout rates than their peers. Youth leaders also show considerable benefits for their communities, providing valuable insight into the needs and interests of young people

How Trained Service Professionals and Self-Advocacy Makes a Difference for Youth with Mental Health, Substance Abuse, or Co-occurring Issues
Statistics reflecting the number of youth suffering from mental health, substance abuse, and co-occurring disorders highlight the necessity for schools, families, support staff, and communities to work together to develop targeted, coordinated, and comprehensive transition plans for young people with a history of mental health needs and/or substance abuse.

Young Adults Formerly in Foster Care: Challenges and Solutions
Nearly 30,000 youth aged out of foster care in Fiscal Year 2009, which represents nine percent of the young people involved in the foster care system that year. This transition can be challenging for youth, especially youth who have grown up in the child welfare system.

Coordinating Systems to Support Transition Age Youth with Mental Health Needs
Research has demonstrated that as many as one in five children/youth have a diagnosable mental health disorder. Read about how coordination between public service agencies can improve treatment for these youth.

Civic Engagement Strategies for Transition Age Youth
Civic engagement has the potential to empower young adults, increase their self-determination, and give them the skills and self-confidence they need to enter the workforce. Read about one youth’s experience in AmeriCorps National Civilian Community Corps (NCCC).

## Main navigation

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### Briefs

Recommended Actions to Improve the Health and Well-Being of Lesbian, Gay, Bisexual, and Transgender Communities

### Collaboration Profiles

Y2CONNECT.org

Providing Unbiased Services for LGBTQ Youth Project

### Data Sources

2011-2021 YRBS Data Summary and Trends Report

2011-2021 YRBS Data Summary and Trends Report

2011-2021 YRBS Data Summary and Trends Report

### Feature Articles

Just Launched! Redesigned YE4C

New Brief Highlights the Needs of Lesbian, Gay, Bisexual, Transgender, and Questioning Youth in Child Welfare Settings

June is LGBT Pride Month

### Publications

Sexual Risk Behavior Differences Among Sexual Minority High School Students — United States, 2015 and 2017

Report: Health-Related Behaviors among Students

The Economic Well-Being of LGB Youth Transitioning Out of Foster Care

### Resources

Report: Recommendations of the LGBT Subcommittee: Advancing the Reform Process for LGBQ/GNCT Youth in the Juvenile Justice System

Resource: Helping Youth Prevent Suicide Among Their LGBTQ Peers

Resource: LGBTQ Youth: Voices of Trauma, Lives of Promise

### Youth Topics

Sexual Orientation and Gender Identity

Suicide Prevention