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988 Lifeline and Crisis Services Use Among LGBTQ+ Young People

Hotline or crisis services were used by LGBTQ+ young people reporting higher rates of anxiety, depression, suicidal thoughts, and suicide attempts compared to those who used other psychological or emotional counseling services. Additionally, more than half of surveyed youth had heard of the 988 LGBTQ+ Youth Specialized Services.
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Key Findings

  • LGBTQ+ young people who used hotline or crisis services reported over twice the rate of a past-year suicide attempt than those who used other psychological or emotional counseling services (26% vs. 10%).
  • Most LGBTQ+ young people have heard of the 988 Suicide & Crisis Lifeline (84%), and of those, most (61%) had heard of the 988 LGBTQ+ Youth Specialized Services.
  • The 988 LGBTQ+ Youth Specialized Services was more likely to be used by LGBTQ+ young people ages 13-17, people of color, those with fewer economic resources, and those living in rural areas.
  • More than two-thirds (68%) of LGBTQ+ young people who had used the 988 LGBTQ+ Youth Specialized Services found it at least moderately helpful; nearly 4 in 10 (38%) found it very or extremely helpful.

Background

LGBTQ+ young people use a wide range of strategies to care for their mental health, including therapy, peer support, online communities, and crisis services.1  Willingness to seek help is an important strength among adolescents: prior research has shown that help-seeking is protective against the development of mental health difficulties,2,3 and longitudinal evidence suggests that adolescents with lower intentions to seek help may be at greater risk of poorer mental health over time.4 Research further underscores that many LGBTQ+ young people are actively trying to access care, even as too many still encounter unmet need.1

At the same time, LGBTQ+ young people continue to face higher risk for poor mental health outcomes because of the stigma, discrimination, victimization, and structural barriers they face, not because of their identities themselves. Research shows that many LGBTQ+ young people who want mental health care do not receive it,1 and that barriers include fear of talking about mental health concerns, affordability, concerns about being mistreated, and difficulty finding care that is affirming of their sexual orientation or gender identity.1,5,6

Within this broader landscape of care, hotline and crisis services play a distinct role. These services can provide immediate, lower-barrier support during moments of acute distress, while also offering options that may feel more private, accessible, or manageable than traditional in-person care. Prior research by The Trevor Project has found that LGBTQ+ youth often value text- and chat-based support because these modalities can offer confidentiality, greater control over disclosure, and a reduced fear of being misunderstood or misgendered.7 Importantly, prior work suggests that crisis services are often being used by LGBTQ+ young people with especially high levels of need. For example, youth who used hotline or crisis services had substantially higher rates of suicidal thoughts and suicide attempts than youth using other forms of mental health care,7 underscoring that crisis lines are reaching young people in some of their most acute moments of distress. This makes it especially important to expand our understanding beyond whether LGBTQ+ young people are using crisis services to also examine which services they are actually turning to.

The 988 Suicide & Crisis Lifeline has become a major part of the crisis-care landscape in the United States. Introduced nationwide in July 2022, the 988 Suicide and Crisis Lifeline replaced the National Suicide Prevention Lifeline and created a simpler point of entry for immediate mental health assistance via phone- and text-based crisis services.8 Emerging evidence suggests that the launch of 988 may have had important public health effects for adolescents and young adults: a recent study found that suicide mortality among people ages 15 to 34 was 11% lower than expected after the Lifeline’s rollout, with larger reductions in states that had greater uptake of 988.9 Later in 2022, a specialized LGBTQ+ option for youth under age 25 – often referred to as the “Press 3” option – was added in partnership with The Trevor Project, allowing young people to connect with counselors specifically trained to provide affirming support by phone, text, and chat.10 After a successful pilot, this service was incorporated into the formal LGBTQ+ subnetwork in 2023.11 An analysis of data from December 2023 through March 2024 found that the service accounted for about 10% of all 988 contacts, including 19% of all 988 texts.12 However, SAMHSA announced in June 2025 that the subnetwork would be discontinued, with the change taking effect in July 2025.11 Upon its dissolution, the subnetwork served nearly 1.6 million contacts during this three year period.13

In this context, it is important to understand how LGBTQ+ young people engaged with hotline and crisis services during 2025, particularly as data collection spanned the termination of the 988 Suicide & Crisis Lifeline’s specialized LGBTQ+ pathway. Using data from The Trevor Project’s 2025 U.S. National Survey on the Mental Health of LGBTQ+ Young People, this research brief explores patterns of hotline and crisis service use among LGBTQ+ young people, including the services they most commonly named in open-text responses, as well as awareness, use, and perceived helpfulness of the 988 Suicide & Crisis Lifeline’s specialized LGBTQ+ service during a period of major policy change.

Results

Sixty percent of surveyed LGBTQ+ young people reported accessing any form of psychological or emotional counseling in the past year. Of those, 14% (n = 1,419) had used a hotline or crisis service. These respondents were prompted to describe which hotline or crisis service they used, with most (67%) naming at least one organization or service. The three most common responses were the 988 Suicide & Crisis Lifeline (56%), The Trevor Project (40%), and Crisis Text Line (6%).

Demographic differences in hotline or crisis service use
Those ages 13-17 were more likely to use a hotline or crisis service than those ages 18-24 (20% vs. 12%). LGBTQ+ young people of color were more likely to use a hotline or crisis service (16%) than their White peers (14%). LGBTQ+ young people whose basic financial needs were just met or not met were also more likely to use a hotline or crisis service (18%) than those whose basic financial needs were more than met (13%). Sexual orientation was associated with use, with pansexual (17%), not sure (17%), and asexual (15%) LGBTQ+ young people being the most likely to use a hotline or crisis service. There were also differences by gender identity, with nonbinary (16%), questioning (16%), and transgender boys/men (16%) reporting the highest usage rates.

Hotline or crisis service use, mental health, and suicide
Compared to those whose use of psychological or emotional counseling services in the past year did not include a hotline or crisis service, those who had used a hotline or crisis service had higher levels of distress. LGBTQ+ young people who used a hotline or crisis service were more likely to report recent symptoms of anxiety (76% vs. 63%) and depression (66% vs. 47%). They were also more likely to have reported seriously considering suicide (69% vs. 35%) or attempting suicide (26% vs. 10%) in the past year.

Hotline or Crisis Service Use and Mental Health Among LGBTQ+ Young People chart

Awareness of the 988 Suicide & Crisis Lifeline LGBTQ+ Youth Specialized Services
All LGBTQ+ young people, regardless of their personal use of any psychological or emotional counseling, were asked if they were aware of the 988 Suicide & Crisis Lifeline’s LGBTQ+ Youth Specialized Services, or the “Press 3” option. Most LGBTQ+ young people surveyed were aware of the 988 Suicide & Crisis Lifeline (84%). Of those, a majority (n = 8,652; 61%) were additionally aware of the “Press 3” option.

Use of the 988 Suicide & Crisis Lifeline LGBTQ+ Youth Specialized Services
Among those who were aware of the LGBTQ+ Youth Specialized Services, 18% had used it for support via text (n =1,079), chat (n = 684), or phone (n = 627). LGBTQ+ young people ages 13-17 were more likely to have used “Press 3” than those ages 18-24 (25% vs. 15%). LGBTQ+ young people of color were more likely to have used “Press 3” (21%) than their White peers (17%). LGBTQ+ young people whose basic financial needs were just met or not were also more likely to use “Press 3” (22%) than those whose basic financial needs were more than met (17%). There were differences in “Press 3” use by sexual orientation, with the most likely users being gay (23%) and the least likely being lesbian (15%). There were also differences by gender identity, with transgender boys/men being the most likely users of “Press 3” (24%) and transgender girls/women being the least likely (12%). Additionally, LGBTQ+ young people who lived in rural areas were more likely than those in other areas to use “Press 3” (23%).

Satisfaction with the 988 Suicide & Crisis Lifeline LGBTQ+ Youth Specialized Services
Satisfaction with the 988 Suicide & Crisis Lifeline’s LGBTQ+ Youth Specialized Services was generally positive among LGBTQ+ young people who used it. More than two-thirds of users found “Press 3” at least moderately helpful, including 30% who found it moderately helpful, 23% who found it very helpful, and 15% who found it extremely helpful. At the same time, one-third reported lower levels of helpfulness, with 22% finding it slightly helpful and 11% finding it not at all helpful. This satisfaction varied greatly by the characteristics of the LGBTQ+ young people who used “Press 3.” LGBTQ+ young people of color were more likely to find “Press 3” moderately, very, or extremely helpful (70%) than White users (65%). In terms of sexual orientation, gay and lesbian users were the most likely to find “Press 3” moderately, very, or extremely helpful (73%), with not sure (61%) and asexual (58%) users being the least likely. Cisgender boys/men (78%) and cisgender girls/women (75%) who used “Press 3” found it moderately, very, or extremely helpful. Rates were lower among TGNB users, with 62% of transgender boys/men and 56% of transgender girls/women who used “Press 3” finding it moderately, very, or extremely helpful. The difference by gender identity remained even after controlling for other participant characteristics, with TGNB young people being 31% less likely to find “Press 3” moderately, very, or extremely helpful than their cisgender peers (adjusted odds ratio [aOR] = 0.69, 95% CI: 0.50 – 0.93, p<0.05).

Looking Ahead

These findings underscore the importance of hotline and crisis services as part of a broader continuum of mental health support for LGBTQ+ young people. Consistent with prior research,7 while most LGBTQ+ young people who accessed psychological or emotional counseling did so through forms of care other than hotline or crisis services, those who used a hotline or crisis service reported substantially higher levels of anxiety, depression, suicidal thoughts, and suicide attempts than peers who only received other forms of psychological or emotional counseling. This suggests that crisis services are reaching many LGBTQ+ young people during moments of acute need, making their availability, accessibility, and quality critical. It also aligns with recent research showing that states with greater uptake of 988 experienced larger reductions in suicide mortality among young people than states with lower uptake,9 further supporting the idea that crisis services may play an important role in reducing deaths by suicide.

The findings also highlight the need for crisis services that are not only available, but delivered by trained professionals who can provide identity-affirming, responsive support that reflects the diverse experiences of LGBTQ+ young people. Prior research on LGBTQ+ young people who used an LGBTQ+-affirming suicide crisis prevention service found that, if that service had not existed, nearly half (48%) were unsure whether they would have contacted another helpline, and more than one in four (26%) said they would not have contacted another helpline at all.14 Removing “Press 3” may deter LGBTQ+ young people from accessing help altogether, a particularly troubling concern when we found in our own data that not only were most LGBTQ+ youth aware of the 988 Suicide & Crisis Lifeline (84%), but that among those who used a hotline or crisis service in the last year, it was also the most commonly named service. Furthermore, youth ages 13–17, LGBTQ+ young people of color, those living in rural areas, and young people with fewer economic resources were more likely to use the 988 LGBTQ+ Youth Specialized Services, suggesting that this pathway may have been particularly important for young people facing heightened distress or greater barriers to traditional mental health care. Use also varied by sexual orientation and gender identity, with gay young people and transgender boys/men reporting the highest use, and lesbian young people and transgender girls/women reporting the lowest use. Together, these findings underscore the importance of ensuring that crisis services are accessible, trusted, and experienced as helpful across LGBTQ+ communities, especially given that many LGBTQ+ young people face barriers to traditional mental health care, including cost, privacy concerns, family rejection, and difficulty finding affirming providers.

Although many young people who used the 988 LGBTQ+ Youth Specialized Services found it at least moderately helpful, satisfaction was not consistent across groups. In particular, transgender and nonbinary young people were less likely than cisgender young people to report that the service was very or extremely helpful, even after controlling for other characteristics. Current and future crisis-response systems should prioritize not only access to LGBTQ+-affirming care, but also ongoing training, quality monitoring, and youth-centered feedback mechanisms to ensure that services are experienced as supportive, respectful, and effective, particularly for transgender and nonbinary young people.

These data were collected during a period of major policy change, as the 988 Suicide & Crisis Lifeline’s specialized LGBTQ+ pathway was terminated in July 2025. Although most responses in the current survey were collected before the termination took effect, they were all fielded after the 2024 federal election and during a period of heightened public attention to LGBTQ+ rights and policies. This context may be important for interpreting use and helpfulness of the 988 LGBTQ+ service, as some young people may have viewed a federal crisis line as less safe or less relevant during a politically charged period, even as the need for support remained high. TGNB young people may have been particularly impacted given the amount of targeted animus, illustrated by a day one executive order that attacked the very legitimacy of transgender and nonbinary identities.15 The Trevor Project crisis service data show that LGBTQ+ young people reached out to its classic crisis services (lifeline, chat, and text) for help at sharply elevated rates following the 2024 election.16 In that context, the continued awareness and use of the 988 LGBTQ+ service in this study suggest that it remained an important source of support for many LGBTQ+ young people during a period of heightened uncertainty.

These findings underscore that crisis services are not peripheral, but a critical part of suicide prevention – particularly for LGBTQ+ young people, who face elevated suicide risk and may encounter greater barriers to affirming care. While it was available, the 988 LGBTQ+ service provided an important specialized point of support within a broader crisis-support landscape. Ensuring that LGBTQ+ young people can access timely, confidential, and affirming crisis support will remain essential going forward.

Data Tables

Characteristics of LGBTQ+ Young People Who Used 988 Suicide & Crisis Lifeline LGBTQ+ Youth Specialized Services (“Press 3”), Among Those Who Had Heard of It (n = 8,652)

Characteristics of LGBTQ+ Young People Who Used 988 Suicide & Crisis Lifeline LGBTQ+ Youth Specialized Services table

Methods

Sample
Data were collected through The Trevor Project’s 2025 U.S. National Survey on the Mental Health of LGBTQ+ Young People. In total, 16,667 LGBTQ+ young people between the ages of 13 and 24 were recruited via targeted ads on social media, posts from various LGBTQ+ “influencers,” state and national organizations that serve LGBTQ+ young people, and The Trevor Project’s direct outreach efforts (e.g., e-mail listservs).

Measures
Demographics (i.e., age, race/ethnicity, sexual orientation, gender identity) were collected by asking participants to select a single category from a provided list.1

Use of any psychological or emotional counseling in the past year was assessed by asking participants, “In the past 12 months, have you received psychological or emotional counseling in any of the following ways? Please select all that apply.” Those who selected any answer other than “I have not received psychological or emotional counseling in the past 12 months” were considered to have received these services. Use of a “hotline/crisis service” was indicated via one of the response options in the checklist. LGBTQ+ young people who selected this option were prompted with an additional question: “What hotline or crisis service did you use?” and could respond in an open-text box.

Awareness and use of the 988 Suicide & Crisis Lifeline and its associated LGBTQ+ Youth Specialized Services were assessed by asking participants, “Are you aware of the 988 Suicide & Crisis Lifeline’s LGBTQ+ service? (Select all that apply)” Response options included: “I’ve never heard of it”; “I’ve heard of 988 but not the LGBTQ+ service”; “I’ve heard of it but haven’t used it”; “I’ve used it for phone support”; “I’ve used it for text support”;”I’ve used it for chat support”; “I’ve recommended it to others.”

Satisfaction with the LGBTQ+ Youth Specialized Services was assessed by asking participants, “How helpful did you find the 988 Suicide & Crisis Lifeline’s LGBTQ+ service?” Responses included “Not at all helpful”, “Slightly helpful”, “Moderately helpful”, “Very helpful”, and “Extremely helpful.”

Recent symptoms of anxiety and depression were assessed using the GAD-217 and PHQ-2,18 respectively, and dichotomized with recommended cutoffs. Past-year suicide consideration and attempt were each assessed with items from the CDC’s Youth Risk Behavior Survey.19

Analysis
Chi-square tests were run to examine differences between groups. Logistic regression models controlled for age, race/ethnicity, socioeconomic status, sexual orientation, and U.S. census region. Unless otherwise noted, all analyses are statistically significant at p<0.05, meaning documented differences would be expected less than 5% of the time if there were no true difference in the population (i.e., under the null hypothesis).

References

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    2. Fenwick-Smith, A., Dahlberg, E., & Thompson, S. (2018). Systematic review of resilience-enhancing, universal, primary school-based mental health promotion programs. BMC Psychology, 6, 1–17. https://doi.org/10.1186/s40359-018-0242-3

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    8. Substance Abuse and Mental Health Services Administration. (2025, December 3). 988 Lifeline Timeline. Available at: https://www.samhsa.gov/mental-health/988/lifeline-timeline (accessed 4 May 2026).

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    10. The Trevor Project. (2025, June 18). Trump Administration Orders Termination of National LGBTQ+ Youth Suicide Lifeline, Effective July 17th. Available at: https://www.thetrevorproject.org/blog/trump-administration-orders-termination-of-national-lgbtq-youth-suicide-lifeline-effective-july-17th/ (accessed 16 August 2025).

    11. Substance Abuse and Mental Health Services Administration. (2025, June 17). SAMHSA Statement on 988 Press 3 Option. Available at: https://www.samhsa.gov/about/news-announcements/statements/2025/samhsa-statement-988-press-3-option (accessed 4 May 2026).

    12. Dawson, L., & Saunders, H. (2024, May 23). Utilization of the 988 Suicide & Crisis Lifeline’s LGBTQ Service. KFF. Available at: https://www.kff.org/lgbtq/utilization-of-the-988-suicide-crisis-lifelines-lgbtq-service/ (accessed on 18 April 2026)

    13. Substance Abuse and Mental Health Services Administration. (2025, September 26). 988 Lifeline Performance Metrics. Available at: https://www.samhsa.gov/mental-health/988/performance-metrics (accessed 30 April 2026).

    14. Goldbach, J. T., Rhoades, H., Green, D., Fulginiti, A., & Marshal, M. P. (2019). Is There a Need for LGBT-Specific Suicide Crisis Services? Crisis, 40(3), 203-208. https://doi.org/10.1027/0227-5910/a000542 

    15. Redfield, E., & Chokshi, I. (2025). Impact of the Executive Order Redefining Sex on Transgender, Nonbinary, and Intersex People. Williams Institute, UCLA School of Law. Available at: https://williamsinstitute.law.ucla.edu/wp-content/uploads/Sex-Definition-EO-Jan-2025.pdf (accessed 4 May 2026).

    16. The Trevor Project. (2024, November 6). The Trevor Project Shares Post-Election Day Crisis Contact Volume Data. Available at: https://www.thetrevorproject.org/blog/the-trevor-project-shares-post-election-day-crisis-contact-volume-data/ (accessed 12 April 2026).

    17. Plummer, F., Manea, L., Trepel, D., & McMillan, D. (2016). Screening for anxiety disorders with the GAD-7 and GAD-2: a systematic review and diagnostic metaanalysis. General Hospital Psychiatry, 39, 24-31. https://doi.org/10.1016/j.genhosppsych.2015.11.005

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    19. Mpofu, J. J., Underwood, J. M., Thornton, J. E., Brener, N. D., Rico, A., Kilmer, G., Harris, W. A., Leon-Nguyen, M., Chyen, D., Lim, C., Mbaka, C. K., Smith-Grant, J., Whittle, L., Jones, S. E., Krause, K. H., Li, J., Shanklin, S. L., McKinnon, I., Arrey, L., Queen, B. E., & Roberts, A. M. (2023). Overview and Methods for the Youth Risk Behavior Surveillance System—United States, 2021. MMWR Supplements, 72(1), 1–12. https://doi.org/10.15585/mmwr.su7201a1

The Trevor Project. (2026). 988 Lifeline and Crisis Services Use Among LGBTQ+ Young People. https://doi.org/10.70226/GCMI2271

For more information please contact: [email protected]

© The Trevor Project 2026

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