Two-Year Study on LGBTQ+ Youth: Support Saves Lives, Anti-LGBTQ+ Stigma Drives Suicide Risk

The Trevor Project published two-year findings from Project SPARK, an ongoing longitudinal study of nearly 1,700 LGBTQ+ young people across the U.S.

October 20, 2026 – Today, The Trevor Project, the leading suicide prevention and crisis intervention organization for LGBTQ+ young people, published the two-year findings of its ongoing longitudinal study, “Project SPARK Two-Year Findings: A Longitudinal Study of Protective and Risk Factors in LGBTQ+ Youth Mental Health.”

The report released today includes results from the first two years of data collection, taking place over five waves of the ongoing study that surveyed 1,689 LGBTQ+ youth (ages 13-24) every six months from September 2023 through March 2026. This two-year report builds on the interim one-year findings published in October 2025. 

The two-year findings from Project SPARK reveal that while LGBTQ+ youth continue to face persistent mental health challenges—including high rates of anxiety, depression, and suicidal ideation driven by ongoing discrimination, economic insecurity, and barriers to care—rates of self-harm and suicide attempts have decreased over this time period. 

The results also highlight increases in several  protective factors, as participants reported increased gender euphoria, more affirming home environments, more helpful mental health care experiences, and greater access to gender-affirming resources over time. Several of these supports were linked to better mental health outcomes over time.

“This research affirms what we have long known to be true: creating welcoming and supportive environments for LGBTQ+ youth is a life-saving intervention,” said Dr. Ronita Nath (she/her), Vice President of Research at The Trevor Project. “As these young people navigate a challenging sociopolitical landscape with escalating anti-LGBTQ+ stigma and systemic barriers, the data from Project SPARK show that intentional support – things like family acceptance, gender euphoria, and access to care – can play a powerful role in protecting LGBTQ+ young people from  suicide risk over time. Showing up for LGBTQ+ youth in this moment means addressing the risk factors that lead to harm, while building safe, supportive spaces that allow these young people to fully be themselves.”

The report further demonstrates that, beyond clinical interventions alone, addressing the public health crisis of suicide among LGBTQ+ youth requires a multi-level approach that increases access to affordable, LGBTQ+-competent care and addresses structural and cultural harms caused by anti-LGBTQ+ discrimination, politics, and stigma.

Key Results: Largest associations from the two-year longitudinal models

Several risk and protective factors were consistently associated with participants’ mental health outcomes, self-harm, and suicidal ideation over time. Some of the largest adjusted associations include:

Largest associations – Risk factors:

• LGBTQ+ youth exposed to or threatened with conversion therapy had nearly 3x higher odds of suicidal ideation.
• Houselessness was associated with more than 2x higher odds of self-harm and suicidal ideation.
• Gender identity-based victimization was associated with more than 2x higher odds of self-harm and suicidal ideation.

Largest Associations – Protective Factors:

• LGBTQ+ youth who reported family support had 45% lower odds of suicidal ideation and 42% lower odds of self-harm.
• Gender euphoria was associated with 50% lower odds of suicidal ideation and 49% lower odds of depression.
• Transgender and nonbinary youth who reported they had changed their identity documents to match their gender identity reported 45% lower odds of suicidal ideation.
• Hormone access was associated with 38% lower odds of depression among transgender and nonbinary youth. 

Study participants completed secure, confidential online surveys of up to 139 questions. All participant information was collected following strict ethical guidelines approved by an Institutional Review Board. Of the 1,689 LGBTQ+ youth who participated in the ongoing study, 68% were youth of color and 53% were transgender, nonbinary, or gender-questioning (TGNB). 

Key Results (Continued): Mental Health, Risk Factors, and Protective Factors:

Mental Health Challenges: The below findings indicate observed differences among LGBTQ+ youth surveyed at baseline (the initial survey completed by each participant) and at their two-year follow-up.

• Anxiety: Anxiety increased from 54% to 63%.
• Depression: Depression increased from 43% to 51%.
• Suicidal Ideation: Suicidal ideation remained consistently high (38% to 40%).
• Self-Harm: Self-harm decreased from 39% to 34%.
• Suicide Attempts: Suicide attempts decreased from 9% to 7%.

Risk Factors: The below findings indicate observed differences among LGBTQ+ youth surveyed at baseline (the initial survey completed by each participant) and at their two-year follow-up.

• Discrimination: 55% reported past-year sexual orientation-based discrimination (compared to 56% at baseline). Among TGNB youth, gender identity-based discrimination increased from 57% to 67%.
• Victimization: 31% reported past-year physical threats based on sexual orientation (compared to 30% at baseline). TGNB youth reported a slight increase in gender identity-based physical threats (38% to 41%); however, neither change was statistically significant.
• Conversion Therapy: Reports of ever being threatened with conversion therapy increased from 12% to 22%, and being subjected to it increased from 9% to 16%.
• Economic Insecurity: Past-year houselessness increased from 7% (one-year follow-up) to 13% (two-year follow-up). Unmet basic needs rose from 13% at baseline to 19% at the two-year follow-up.
• Bathroom Access (TGNB): Being prevented from using a gender-affirming bathroom increased from 33% (lifetime at baseline) to 40% (past-year access at the two-year follow-up).

Protective Factors: The below findings indicate observed differences among LGBTQ+ youth surveyed at baseline (the initial survey completed by each participant) and at their two-year follow-up.

• Mental Health Care: Receipt of desired care remained steady at 80% both at baseline and at the two-year follow up (though it dipped to 61% at the one-year follow-up). Perceived helpfulness of this care surged from 64% at baseline to 91% at the two-year follow-up.
• Hormone Access (TGNB): Desire for hormones rose from 59% to 71%. Access among those who wanted them increased from 34% to 62% (73% for those 18+ vs. 33% for minors).
• Gender Expression Tools (TGNB): Access to desired tools (e.g., binders, clothing) increased from 62% to 75%.
• Affirming Environments: LGBTQ+-affirming home environments increased from 53% to 61%.
• Gender Euphoria: On a 1–5 scale, average gender positivity increased from 3.09 to 3.33 (3.07 to 3.37 for TGNB youth).
• Crisis Help-Seeking: During suicidal crises, youth primarily sought help from friends (44% to 42%). Helpline usage increased from 22% to 30%, while 32% (up from 29%) sought help from no one.

“Behind every data point in the Project SPARK report is an LGBTQ+ young person navigating a deeply difficult climate in this country,” said Jaymes Black (they/she/he), CEO of The Trevor Project. “This two-year study makes it undeniably clear that we cannot let them weather this storm alone. The decline in self-harm and suicide attempts amid rising anti-LGBTQ+ discrimination is a testament to the life-saving power of community and connection. We must continue to fiercely protect young people’s access to care, support them exactly as they are, and ensure that LGBTQ+ young people know they are never, ever, alone.” 

The findings of this study are intended for families, educators, healthcare providers, policymakers, and community organizations seeking to support LGBTQ+ youth. As the study continues, future analyses will explore long-term trends and causal relationships to dive deeper into risk and protective factors and their impact on participants. These ongoing data collection and analysis efforts are vital for informing evidence-based policy and designing interventions that support and protect the mental health and well-being of LGBTQ+ young people nationwide.

To view the complete report, visit https://www.thetrevorproject.org/project-spark-two-year-report-a-longitudinal-study. 

If you or someone you know needs help or support, The Trevor Project’s trained crisis counselors are available 24/7 at 1-866-488-7386, via chat at TheTrevorProject.org/Get-Help, or by texting START to 678678.