Peer-reviewed Publications
2025
Nath, R., Matthews, D.D., & DeChants, J,P. (2025). Crisis Line Use and Mental Health Care Access Among LGBTQ+ Young People in the United States. Cambridge Prisms: Global Mental Health, 12, e140. https://doi.org/10.1017/gmh.2025.10099
🔓 Open Access
Abstract: Youth who are lesbian, gay, bisexual, transgender, queer or questioning, and other diverse sexual and gender identities (LGBTQ+) experience disproportionately high rates of suicidal thoughts and behaviors compared to heterosexual and cisgender peers, yet many face barriers to care. Data came from a national online survey of 18,663 LGBTQ+ youth aged 13–24 years in the United States (September–December 2023). Analyses focused on participants who reported wanting mental health care in the past year and assessed access, barriers, service modalities and suicidal ideation/attempts. Half of LGBTQ+ youth who wanted mental health care did not receive it. The most common barrier was fear of talking about mental health concerns (42%). Among those who received care, one-on-one therapy was most common (69% in-person and 53% online). Suicidal ideation was lower among youth in therapy (46% in-person and 40% online) compared to those using crisis lines (75%). After adjusting for demographics, hotline use remained strongly associated with elevated risk: adjusted odds ratio (aOR) = 3.77 (95% confidence interval [CI]: 3.11–4.56) for suicidal ideation; aOR = 3.21 (95% CI: 2.62–3.94) for attempts. Despite strong willingness to seek care, structural and identity-related barriers leave many needs unmet. Expanding culturally competent services is essential to reducing suicide risk.
McDermott, E., Cahill, L., Nath, R., Reid, B., Schaub, J., Stander, W. J., & Taylor, A. (2025). Understanding protective and risk factors in preventing suicide among LGBTQ+ youth in the UK. International Journal of Mental Health, 1-21. https://doi.org/10.1080/00207411.2025.2575422
🔓 Open Access
Abstract: LGBTQ+ youth are more likely to attempt suicide in comparison to their cisgender, heterosexual peers. Despite a UK national suicide prevention strategy, there have been minimal efforts to address this mental health inequality. Our aim was to provide evidence to guide suicide prevention strategies by examining risk and protective factors. Our LGBTQ+ youth advisory group were involved in all aspects of the study. We conducted an online self-complete, cross-sectional questionnaire. Participants were recruited via social media. The resulting sample (N = 9,666) comprised UK LGBTQ+ youth aged 13–24 years old. Logistic regression analysis was used to assess associations between our predictor variables and our mental health outcomes. Random forest classification modeling was used to rank predictors. We found a positive LGBTQ+ school environment and social support and acceptance were significant protective factors; victimization and discrimination and food insecurity were significant risk factors. The most important ranked predictor variables of suicidality were having a trusted adult, experience of LGBTQ+ victimization, food insecurity, conversion therapy, and all school variables. This is the first large-scale UK study to examine protective and risk factors for LGBTQ+ youth suicide. Results suggest key to prevention is providing LGBTQ+ affirming and safe environments and relationships in school, at home, and in communities, alongside measures to address food insecurity.
Hobaica, S., Matthews, D. D., DeChants, J. P., & Nath, R. (2025). Perceived life expectancy and life purpose mediate relation between discrimination and suicide attempts in LGBTQ+ youth. Nature Mental Health, 3(9), 1070-1077. https://doi.org/10.1038/s44220-025-00483-7
Abstract: Discrimination related to one’s sexual orientation or gender identity (SOGI) is associated with suicide risk in LGBTQ+ youth, and protective factors, such as greater perceived life expectancy and life purpose, are associated with reduced risk. However, no research has examined the relationship between SOGI-based discrimination, life purpose, and perceived life expectancy in LGBTQ+ youth, especially considering suicide risk. After implementing a conditional process modeling approach with LGBTQ+ youth (N = 28,524; cross-sectional), we found that life purpose and perceived life expectancy partially mediated the relationship between SOGI-based discrimination and attempting suicide in the past year. Perceived life expectancy also partially mediated the relationship between life purpose and attempting suicide, with lower life purpose being associated with lower perceived life expectancy. Recommendations for researchers, providers, policymakers and other LGBTQ+ facing adults are included that can inform policy and crisis intervention, as well as methods of improving the perceived life expectancy and life purpose of LGBTQ+ youth.
Hobaica, S., DeChants, J. P., Matthews, D. D., & Nath, R. (2025). Relationship structures among LGBTQ+ young people. Psychology & Sexuality, 16(3), 895-905. https://doi.org/10.1080/19419899.2025.2478456
Abstract: People of all ages engage in diverse relationship structures. Consensual non-monogamy (CNM) is a relationship structure that consists of having multiple consensual partnerships at the same time, which has been documented among adults. Very little research has documented CNM practice among lesbian, gay, bisexual, transgender, and queer (LGBTQ+) young people, despite research suggesting they are interested in CNM and participate in concurrent relationships. This study is an initial documentation of CNM practice among LGBTQ+ young people and associated risk and protective factors. Using a national online survey conducted in 2023, we collected data from 28,524 LGBTQ+ young people aged 13 to 24. Among the overall sample, 70% (n = 12,923) reported having relationship experience, and of those, 28% (n = 3,619) identified with CNM. The majority (65%; n = 2,365) of these young people reported having experience practicing CNM. LGBTQ+ young people who practiced CNM reported higher rates of discrimination (71% vs. 68%), bullying (64% vs. 57%), and conversion therapy exposure or threats (21% vs. 18%) than those who only identified with CNM. However, CNM practice was associated with greater belongingness and support. Future research should continue studying CNM among LGBTQ+ young people, given its prevalence and possible impact on health.
Nath, R., Hobaica, S., & DeChants, J. P. (2025). The Relationship Between Parental and Caregiver Support and Suicide Among LGBTQ+ Youth of Color. Journal of Adolescent Health, 76(4), 606-612. https://doi.org/10.1016/j.jadohealth.2024.11.242
🔓 Open Access
Abstract
Purpose: This study examines the relationship between parental/caregiver support and suicide risk among LGBTQ+ youth, with a focus on transgender, nonbinary, or gender questioning (TGNBQ) youth of color.
Methods: Data from 28,524 LGBTQ+ young people aged 13–24 years were collected through a 2022 national online survey. Parental/caregiver support and acceptance were assessed through participants’ self-reported experiences of LGBTQ+ supportive actions taken by their parents/caregivers related to their LGBTQ+ identities. Suicide risk was evaluated based on self-reported suicide consideration and attempts over the past year.
Results: Seventy three percent of White LGBTQ+ youth reported acceptance for their sexual orientation, compared to 65% of LGBTQ+ youth of color (χ2 = 174.12, p < .001). White TGNBQ youth reported a higher rate of gender identity acceptance (55%) from parents/caregivers compared to TGNBQ youth of color (47%; χ2 = 63.83; p < .001). For LGBTQ+ youth of color, sexual orientation acceptance was associated with 33% lower odds of attempting suicide in the past year (adjusted odds ratio = 0.67, 95% confidence interval = 0.58–0.75, p < .001). Acceptance for gender identity among TGNB youth of color was linked to 36% lower odds of a past-year suicide attempt (adjusted odds ratio = 0.64, 95% confidence interval = 0.55–0.75, p < .001).
Discussion: The study underscores the protective role of parental/caregiver acceptance against suicidal attempts, emphasizing the need for acceptance across diverse family dynamics. These findings call for culturally competent interventions and policies that enhance parental/caregiver support, recognizing the intersectional challenges faced by LGBTQ+ youth.
Lee, W. Y., Hobbs, J. N., Hobaica, S., & Nath, R. (2025). Toward accurate measurement of sexual orientation: A text analysis of sexual orientation self-descriptions among LGBTQ+ youth. Psychology of Sexual Orientation and Gender Diversity. https://doi.org/10.1037/sgd0000805
Abstract: Sexual orientation can be an important part of a person’s identity, often being categorized into predefined labels (e.g., lesbian, gay, bisexual, and queer). However, little research has been performed on self-descriptions of sexual orientation, which could capture a more nuanced understanding compared to restrictive categories. In this study, we formed a novel corpus of sexual orientation open-response self-descriptions (N = 32,061) from lesbian, gay, bisexual, transgender, queer or questioning, intersex, asexual, and more (LGBTQ+) youth in the United States in 2021. We performed a text analysis on this corpus to investigate the trends of self-descriptions of sexual orientations and labels among LGBTQ+ youth. We found that single-select sexual orientation questions often failed to fully capture participants’ sexual identities, as nearly a quarter of respondents used more than one sexual orientation label in their self-description. In addition, the importance and usage of a specific sexual orientation label varied for LGBTQ+ young people, with those ages 13–17 using different terms than those ages 18–25. Furthermore, we found that participants regularly used cause conjunctions (e.g., because) and words that could indicate uncertainty (e.g., possibly) when describing their sexual orientation. Based on these findings, we make several recommendations to improve sexual orientation measurement, such as routinely examining and improving the representativeness of sexual orientation label options, allowing participants to select multiple sexual orientation labels, including a self-description open textbox that allows participants to share their interpretations of chosen labels, and continuing to consider other novel ways of measuring sexual orientation in the future, such as the use of spectrums.
DeChants, J. P., Price, M. N., Nath, R., Hobaica, S., & Green, A. E. (2025). Transgender and nonbinary young people’s bathroom avoidance and mental health. International Journal of Transgender Health, 26(2), 351–359. https://doi.org/10.1080/26895269.2024.2335512
Abstract
Background: Transgender and nonbinary young people report disparities in both physical and mental health due to negative experiences associated with their identity. Despite bathrooms being an everyday necessity, transgender and nonbinary young people may avoid using them due to previous negative experiences or anxieties surrounding them, which may be related to poor health. This study examines the association of avoiding public bathrooms and mental health indicators among transgender and nonbinary young people.
Methods: Data were collected in 2021 via a cross-sectional survey of 33,993 lesbian, gay, bisexual, transgender, queer, and questioning young people ages 13–24, including 12,596 transgender or nonbinary young people. Bivariate analyses were used to examine the prevalence of avoiding public bathrooms and the health issues associated with that avoidance. Adjusted logistic regression models examined whether sometimes or always avoiding public bathrooms was associated with higher rates of anxiety symptoms, depression symptoms, and suicide risk.
Results: In the past year, 49% of transgender and nonbinary young people reported sometimes avoiding public bathrooms due to concerns around using them and 22% always avoided them. Respondents reported a number of negative physical effects from avoiding public bathrooms: 67% reported “holding it” when they needed to use the bathroom and 38% abstained from drinking or eating to avoid using these facilities. Transgender and nonbinary young people who reported sometimes or always avoiding public bathrooms reported significantly higher odds of all assessed mental health indicators. Notably, those who reported always or sometimes avoiding public bathrooms had almost twice the odds of attempting suicide in the past year (aOR = 1.95, 95% CI = 1.77–2.16, p < .001) compared to their transgender and nonbinary peers who never reported avoiding public bathrooms.
Conclusions: These findings highlight the need for policies protecting transgender and nonbinary young people’s safety and access to public bathrooms, which align with their gender identity.
Implications and contributions: Transgender and nonbinary young people report poorer mental health and higher suicide risk than their cisgender peers. Avoiding public bathrooms when one needs to use them can result in negative physical health problems and, in our sample, is associated with worse mental health and higher suicide risk. These findings demonstrate that implementing inclusive bathroom policies may improve physical and mental health and decrease suicide risk among transgender and nonbinary young people.
2024
Lee, W. Y., Hobbs, J. N., Hobaica, S., DeChants, J. P., Price, M. N., & Nath, R. (2024). State-level anti-transgender laws increase past-year suicide attempts among transgender and non-binary young people in the USA. Nature Human Behaviour, 8(11), 2096-2106. https://doi.org/10.1038/s41562-024-01979-5
Abstract: From 2018 to 2022, 48 anti-transgender laws (that is, laws that restrict the rights of transgender and non-binary people) were enacted in the USA across 19 different state governments. In this study, we estimated the causal impact of state-level anti-transgender laws on suicide risk among transgender and non-binary (TGNB) young people aged 13–17 (n = 35,196) and aged 13–24 (n = 61,240) using a difference-in-differences research design. We found minimal evidence of an anticipatory effect in the time periods leading up to the enactment of the laws. However, starting in the first year after anti-transgender laws were enacted, there were statistically significant increases in rates of past-year suicide attempts among TGNB young people ages 13–17 in states that enacted anti-transgender laws, relative to states that did not, and for all TGNB young people beginning in the second year. Enacting state-level anti-transgender laws increased incidents of past-year suicide attempts among TGNB young people by 7–72%. Our findings highlight the need to consider the mental health impact of recent anti-transgender laws and to advance protective policies.
Price, M. N., Lee, W. Y., Hobbs, J. N., DeChants, J. P., & Davis, C. K. (2024). Middle and High School LGBTQ Students Report What Makes School LGBTQ‐Affirming Across Race/Ethnicity and Gender Identity, a Topic Modeling Method. Journal of School Health, 94(7), 601-609. https://doi.org/10.1111/josh.13460
Abstract
Background: Affirming spaces have been associated with improved mental health outcomes for lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) adolescents.
Methods: With data from adolescents currently enrolled in middle or high school across the United States, this study used topic modeling methods to examine students’ reports of what they were looking for in LGBTQ-affirming schools and, separately, the association of LGBTQ-affirming schools with suicide risk reduction.
Results: Topic models demonstrated consistent themes in how students determined that their school was affirming, such as LGBTQ clubs, teachers requesting pronouns, pride flags, and accepting peers. Students of color uniquely looked for actionable responses in addressing LGBTQ issues. Transgender and nonbinary students required explicit mention of support for transgender issues. Quantitatively, LGBTQ students who reported that their school was LGBTQ-affirming had 20% lower odds of attempting suicide in the past year (adjusted odds ratio = 0.80).
Conclusions: These findings suggest that schools must be safe for all youth and implementing policies that make LGBTQ students feel seen and supported in their identities is a protective factor for mental health.
Implications: School policies must ensure that youth have access to supportive people, symbols of support, and LGBTQ clubs and that they are also salient to LGBTQ students of color and transgender and nonbinary students.
Hobaica, S., Price, M. N., DeChants, J. P., Davis, C. K., & Nath, R. (2024). Justice involvement and mental health in LGBTQ young people. Children and Youth Services Review, 160, 107571. https://doi.org/10.1016/j.childyouth.2024.107571
Abstract: Lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) young people experience higher rates of justice involvement (e.g., arrests, detainment) and poor mental health compared to their peers. This study examined the relationship between justice involvement and mental health among 33,993 LGBTQ young people (ages 13–24) from the United States. Being from particular regions, experiencing housing instability, and holding specific racial/ethnic, sexual, and gender identities were related to higher rates of justice involvement. Multivariate logistic regression analyses revealed that past arrests and detainment were each associated with greater odds of attempting suicide in the past year, as well as depression and anxiety symptoms, self-harm, and considering suicide. LGBTQ young people who had been arrested (aOR = 6.54, 95% CI = 5.17, 8.26) or detained (aOR = 6.33, 95% CI = 4.19, 9.57) in the past year had more than six times greater odds of attempting suicide in the past year compared to peers who had never been arrested or detained. Better understanding the association between justice involvement and mental health among LGBTQ young people can provide important insights on how to reduce mental health risks and suicide in a particularly vulnerable community.
2023
DeChants, J. P., Price, M. N., Nath, R., & Davis, C. K. (2023). Losing a Close Friend or Family Member Due to COVID-19 and Mental Health among LGBTQ Youth. International Journal of Environmental Research and Public Health, 20(12), 6129. https://doi.org/10.3390/ijerph20126129
🔓 Open Access
Abstract: This study examines the association between having lost a close friend or family member to COVID-19 and mental health outcomes among lesbian, gay, bisexual, transgender, or queer (LGBTQ) youth. Data come from 33,993 respondents in the United States, ages 13 to 24, who completed an online survey of LGBTQ youth mental health. Multivariate logistic regression was used to determine the adjusted odds of recent anxiety, depression, considering, or attempting suicide in the past year based on whether or not the youth reported having lost a close friend or family member to COVID-19. Among the full sample, experiences of COVID-19 loss were associated with recent anxiety (adjusted odds ratio (aOR) = 1.29, 95% confidence interval (CI) = 1.20–1.40), recent depression (aOR = 1.23, 95% CI [1.15, 1.32]), seriously considering suicide in the past year (aOR = 1.22, 95% CI (1.14, 1.30)), and attempting suicide in the past year (aOR = 1.55, 95% CI (1.41, 1.69)). These findings highlight the urgent need for investment in low-barrier, affirming mental health services for LGBTQ youth who have experienced COVID-19 loss to support their grief, overall mental health, and healthy development.
Price, M. N., Green, A. E., DeChants, J. P., & Davis, C. K. (2023). Physical dating violence victimization among LGBTQ youth: Disclosure and association with mental health. Journal of Interpersonal Violence, 38(15-16), 9059-9085. https://doi.org/10.1177/08862605231162655
Abstract: Youth dating violence and youth suicide are both major public health concerns. However, little research examines the intersection of these issues among lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) youth. The current study examined the association between physical dating violence victimization and mental health using online survey data collected from 39,126 LGBTQ youth of ages 13 to 24 in the United States. Overall, 11% of LGBTQ youth who were in a relationship in the past year experienced physical dating violence victimization, with 4% having experienced it once and 7% having experienced it multiple times. Rates of experiencing physical dating violence victimization varied based on a number of youth characteristics and environmental factors. Past-year physical dating violence victimization was associated with nearly four times the odds of attempting suicide in the past year. Given the intersection of suicide risk and dating violence among LGBTQ youth, dating violence prevention organizations must be LGBTQ-inclusive, and suicide prevention must be equipped to address dating violence victimization. The higher rates of physical dating violence victimization among multiple marginalized and socioeconomically disadvantaged LGBTQ youth suggest the need for an intersectional approach that addresses the structural factors that place LGBTQ youth at risk for physical dating violence.
Price, M. N., & Green, A. E. (2023). Association of gender identity acceptance with fewer suicide attempts among transgender and nonbinary youth. Transgender Health, 8(1), 56-63. https://doi.org/10.1089/trgh.2021.0079
🔓 Open Access
Abstract
Purpose: Transgender and nonbinary (TGNB) youth report more than four times greater rates of suicide attempts compared with their cisgender peers. Gender identity acceptance from others can reduce the risk for these youth.
Methods: Using data from a 2018 cross-sectional survey of LGBTQ youth, the current study examined the association of gender identity acceptance from others with suicide attempts among 8218 TGNB youth. Youth reported gender identity acceptance levels from parents, other relatives, school professionals, health care professionals, friends, and classmates to whom they were “out.”
Results: Each category of adult and peer gender identity acceptance was associated with lower odds of a past-year suicide attempt, with the strongest associations within each individual category being acceptance from parents (adjusted odds ratio [aOR]=0.57) and other family members (aOR=0.51). The TGNB youth who reported gender identity acceptance from at least one adult had one-third lower odds of reporting a past-year suicide attempt (aOR=0.67), and acceptance from at least one peer was also associated with lower odds of a past-year suicide attempt (aOR=0.66). Peer acceptance was particularly impactful for transgender youth (aOR=0.47). The relationship between adult and peer acceptance remained significant after controlling for the association of each form, suggesting unique relationships for each on TGNB youth suicide attempts. Acceptance was more impactful for TGNB youth assigned male at birth compared with TGNB youth assigned female at birth.
Conclusion: Interventions aimed at suicide prevention for TGNB youth should include efforts aimed at leveraging gender identity acceptance from supportive adults and peers in their lives.
2022
DeChants, J. P., Price, M. N., Green, A. E., Davis, C. K., & Pick, C. J. (2022). Association of updating identification documents with suicidal ideation and attempts among transgender and nonbinary youth. International Journal of Environmental Research and Public Health, 19(9), 5016. https://doi.org/10.3390/ijerph29095016
🔓 Open Access
Abstract: Youth dating violence and youth suicide are both major public health concerns. However, little research examines the intersection of these issues among lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) youth. The current study examined the association between physical dating violence victimization and mental health using online survey data collected from 39,126 LGBTQ youth of ages 13 to 24 in the United States. Overall, 11% of LGBTQ youth who were in a relationship in the past year experienced physical dating violence victimization, with 4% having experienced it once and 7% having experienced it multiple times. Rates of experiencing physical dating violence victimization varied based on a number of youth characteristics and environmental factors. Past-year physical dating violence victimization was associated with nearly four times the odds of attempting suicide in the past year. Given the intersection of suicide risk and dating violence among LGBTQ youth, dating violence prevention organizations must be LGBTQ-inclusive, and suicide prevention must be equipped to address dating violence victimization. The higher rates of physical dating violence victimization among multiple marginalized and socioeconomically disadvantaged LGBTQ youth suggest the need for an intersectional approach that addresses the structural factors that place LGBTQ youth at risk for physical dating violence.
Green, A. E., DeChants, J. P., Price, M. N., & Davis, C. K. (2022). Association of gender-affirming hormone therapy with depression, thoughts of suicide, and attempted suicide among transgender and nonbinary youth. Journal of Adolescent Health, 70(4), 643-649. https://doi.org/10.1016/j.jadohealth.2021.10.036
🔓 Open Access
Abstract: Youth dating violence and youth suicide are both major public health concerns. However, little research examines the intersection of these issues among lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) youth. The current study examined the association between physical dating violence victimization and mental health using online survey data collected from 39,126 LGBTQ youth of ages 13 to 24 in the United States. Overall, 11% of LGBTQ youth who were in a relationship in the past year experienced physical dating violence victimization, with 4% having experienced it once and 7% having experienced it multiple times. Rates of experiencing physical dating violence victimization varied based on a number of youth characteristics and environmental factors. Past-year physical dating violence victimization was associated with nearly four times the odds of attempting suicide in the past year. Given the intersection of suicide risk and dating violence among LGBTQ youth, dating violence prevention organizations must be LGBTQ-inclusive, and suicide prevention must be equipped to address dating violence victimization. The higher rates of physical dating violence victimization among multiple marginalized and socioeconomically disadvantaged LGBTQ youth suggest the need for an intersectional approach that addresses the structural factors that place LGBTQ youth at risk for physical dating violence.
Green, A. E., Price, M. N., & Dorison, S. H. (2022). Cumulative minority stress and suicide risk among LGBTQ youth. American Journal of Community Psychology, 69(1-2), 157-168. https://doi.org/10.1002/ajcp.12553
Abstract: Exposure to minority stress is the primary mechanism through which lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) youth experience a greater risk for suicide. The current study examines the association of LGBTQ-based cumulative minority stress with suicide risk using online survey data collected from 39,126 LGBTQ youth ages 13–24 in the United States. Youth who reported four types of minority stress had nearly 12 times greater odds of attempting suicide compared to those who reported none. Transgender and nonbinary youth and American Indian/Alaskan Native youth had higher odds of reporting three or more minority stress experiences. The strong association of cumulative risk with attempted suicide and disproportionate exposure among marginalized members of the LGBTQ community highlight the need for suicide prevention to prioritize those at greatest risk and for research examining LGBTQ suicide risk to employ cumulative risk models.
2021
Green, A. E., Taliaferro, L. A., & Price, M. N. (2021). Understanding risk and protective factors to improve well-being and prevent suicide among LGBTQ youth. In R. Miranda & E. L. Jeglic (Eds.), Handbook of Youth Suicide Prevention (pp. 177-194). Springer. https://doi.org/10.1007/978-3-030-82465-5_11
Abstract: Lesbian, gay, bisexual, transgender and nonbinary, queer, and questioning (LGBTQ) youth face disparities in suicide risk compared to their non-LGBTQ peers. These disparities are linked to experiences of rejection, discrimination, and victimization associated with being in a socially stigmatized position in society, as opposed to being LGBTQ in and of itself. Using the Minority Stress Model as a framework, this chapter reviews existing research on factors that are associated with suicidal thoughts and behaviors among LGBTQ youth, focusing on risk and protective factors at the individual, relational, and community levels. Documented risk factors include LGBTQ-based discrimination and victimization, family rejection, and internalized LGBTQ stigma while protective factors include positive LGBTQ identity development, support and acceptance from others, access to LGBTQ role models, and policies designed to protect LGBTQ youth and support LGBTQ equality. LGBTQ youth are incredibly diverse with respect to intersecting identities and experiences; thus, this review also highlights within-group differences in suicidal thoughts and behaviors among LGBTQ youth. Suicide prevention efforts need to account for the unique lived experiences of LGBTQ youth, particularly those with multiple marginalized identities. Doing so will require the involvement of community stakeholders, including LGBTQ youth themselves, in the development, testing, and implementation of effective strategies to reduce suicide risk and improve well-being.
Price-Feeney, M., Green, A. E., & Dorison, S. H. (2021). Impact of bathroom discrimination on mental health among transgender and nonbinary youth. Journal of Adolescent Health, 68(6), 1142-1147. https://doi.org/10.1016/j.jadohealth.2020.11.001
🔓 Open Access
Abstract
Purpose: Nascent research has found that transgender and/or nonbinary (TGNB) youths experience higher rates of poor mental health outcomes than cisgender youths. The minority stress model highlights experiences of rejection and discrimination on mental health disparities for TGNB individuals.
Methods: Using data from a quantitative cross-sectional survey of TGNB youth aged 13–24 years, we examined the association between experiencing bathroom discrimination and depressive mood, seriously considering suicide, and attempting suicide.
Results: Overall, 58% of TGNB youths in this sample reported being prevented or discouraged from using a bathroom that corresponds to their gender identity. Among the TGNB youth who experienced bathroom discrimination, 85% reported depressive mood and 60% seriously considered suicide. Furthermore, 1 in three TGNB youths who experienced bathroom discrimination reported a past-year suicide attempt, with 1 in five reporting multiple suicide attempts. After adjusting for demographic variables and general discrimination due to one’s gender identity, bathroom discrimination significantly increased the odds of reporting depressive mood (adjusted odds ratio [aOR] = 1.34), seriously considering suicide (aOR = 1.40), a suicide attempt (aOR = 1.66), and multiple suicide attempts (aOR = 1.71).
Conclusions: These findings suggest that preventing TGNB youths from accessing appropriate bathrooms is associated with harmful mental health indicators. Addressing the suicide disparities for TGNB youths requires structural change. Policies and procedures need to be in place to ensure that all youths have equal access to appropriate bathrooms.
Green, A. E., Price-Feeney, M., & Dorison, S. H. (2021). Association of sexual orientation acceptance with reduced suicide attempts among lesbian, gay, bisexual, transgender, queer, and questioning youth. LGBT Health, 8(1), 26-31. https://doi.org/10.1089/lgbt.2020.0248
🔓 Open Access
Abstract
Purpose: This study examined the relationship between sexual orientation acceptance from others and suicide attempts among lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) youth.
Methods: We analyzed data from a 2018 cross-sectional survey of LGBTQ youth between the ages of 13 and 24 years across the United States. Youth reported sexual orientation acceptance levels from parents, other relatives, school professionals, health care professionals, friends, and classmates to whom who they were “out.” Adjusted logistic regression analyses were used to examine the association between sexual orientation acceptance and a past-year suicide attempt.
Results: All forms of peer and adult acceptance were associated with reduced reports of a past-year suicide attempt, with the strongest associations found for acceptance from parents (adjusted odds ratio [aOR] = 0.52) and straight/heterosexual friends (aOR = 0.54). Youth who reported high levels of acceptance from any adult had nearly 40% (aOR = 0.61) lower odds of a past-year suicide attempt compared with LGBTQ peers with little to no acceptance. Youth with high levels of acceptance from any peer also had significantly lower odds of reporting a past-year suicide attempt (aOR = 0.55). These relationships remained significant even after controlling for the impact of each form of acceptance, suggesting unique associations with suicide risk for both peer and adult acceptance.
Conclusions: Interventions aimed at increasing sexual orientation acceptance from supportive adults and peers have strong potential to address the public health burden of LGBTQ youth suicide.
Price-Feeney, M., Green, A. E., & Dorison, S. H. (2021). Suicidality among youth who are questioning, unsure of, or exploring their sexual identity. The Journal of Sex Research, 58(5), 581-588. https://doi.org/10.1080/00224499.2020.1832184
Abstract: Many studies have found that lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) youth are disproportionately impacted by poor mental health outcomes. However, there remains a gap in understanding factors associated with the mental health of youth who are questioning, unsure of, or exploring (QUE) their sexual identity. Using data from The Trevor Project’s 2019 National Survey on LGBTQ Youth Mental Health, a quantitative cross-sectional survey of LGBTQ youth between 13 and 24, we explored suicidality among 801 QUE youth. Significantly more QUE youth were younger, nonwhite, and transgender and nonbinary compared to other LGBTQ youth. QUE youth reported higher rates of suicidality compared to other LGBTQ youth; however, this increased risk was related to the overrepresentation of younger and transgender and nonbinary youth among QUE youth. In adjusted models, being transgender and nonbinary, hearing parents use religion to say negative things about being LGBTQ, and experiencing physical threat or harm based on sexual orientation or gender identity were significantly related to seriously considering suicide and attempting suicide among QUE youth. Given the intricate relationship between the two, researchers should assess both gender identity and sexual identity when determining the risk of suicidality among LGBTQ youth.
2020
Green, A. E., Price-Feeney, M., Dorison, S. H., & Pick, C. J. (2020). Self-reported conversion efforts and suicidality among US LGBTQ youths and young adults, 2018. American Journal of Public Health, 110(8), 1221-1227. https://doi.org/10.2105/AJPH.2020.305701
🔓 Open Access
Abstract
Objectives: To explore associations between undergoing sexual orientation or gender identity conversion efforts (SOGICE) and suicidality among young LGBTQ (lesbian, gay, bisexual, transgender, and queer or questioning) individuals.
Methods: Data were derived from a 2018 online cross-sectional study of young LGBTQ individuals (13–24 years of age) residing in the United States. Multivariate logistic regression was used to determine the relative odds of suicidality among young LGBTQ individuals who experienced SOGICE (in comparison with those who did not) after adjustment for age, race/ethnicity, geography, parents’ use of religion to say negative things about being LGBTQ, sexual orientation, gender identity, discrimination because of sexual orientation or gender identity, and physical threats or harm because of sexual orientation or gender identity.
Results: Relative to young people who had not experienced SOGICE, those who reported undergoing SOGICE were more than twice as likely to report having attempted suicide and having multiple suicide attempts.
Conclusions: The elevated odds of suicidality observed among young LGBTQ individuals exposed to SOGICE underscore the detrimental effects of this unethical practice in a population that already experiences significantly greater risks for suicidality.
Price-Feeney, M., Green, A. E., & Dorison, S. (2020). Understanding the mental health of transgender and nonbinary youth. Journal of Adolescent Health, 66(6), 684-690. https://doi.org/10.1016/j.jadohealth.2019.11.314
🔓 Open Access
Abstract
Purpose: Currently, there is a lack of nationwide data examining the mental health of transgender and nonbinary youth. Furthermore, relatively little is known about how the mental health of transgender and nonbinary youth compares to that of their cisgender lesbian, gay, bisexual, queer, and questioning peers or differences within subgroups of transgender and nonbinary youth. The goal of the present study was to better understand the mental health of transgender and nonbinary youth.
Methods: We analyzed responses from a national quantitative cross-sectional survey of more than 25,000 lesbian, gay, bisexual, transgender, queer, and questioning youth, aged between 13 and 24 years, in the U.S.
Results: Transgender and nonbinary youth were at increased risk of experiencing depressed mood, seriously considering suicide, and attempting suicide compared with cisgender lesbian, gay, bisexual, queer, and questioning youth. Controlling for sexual orientation–based or gender identity–based experiences of perceived discrimination and physical threats or harm reduced the disparities but did not fully account for them. Within-group analyses highlighted particularly increased risk for negative mental health outcomes among transgender males and nonbinary youth assigned female at birth.
Conclusions: Findings point to the need to directly address the needs of transgender and nonbinary youth in prevention and intervention programs and to advance policies that reduce discrimination and victimization based on sexual orientation or gender identity.