Research Archives – The Trevor Project

Landmark Study Finds 39 Percent of LGBTQ Youth and More Than Half of Transgender and Non-Binary Youth Report Having Seriously Considered Suicide in the Past Twelve Months

June 11, 2019

New Research from The Trevor Project Represents Largest LGBTQ Youth Survey Sample Ever and Signals Immediate Call-to-Action for More LGBTQ Inclusive Policies

Two-thirds of LGBTQ youth reported that someone attempted to convince them to change their sexual orientation or gender identity
42 percent of LGBTQ youth who underwent conversion therapy reported a suicide attempt in the last year
LGBTQ youth who experienced discrimination related to their sexual orientation or gender identity were twice as likely to attempt suicide

NEW YORK — The Trevor Project, the world’s largest suicide prevention and crisis intervention organization for lesbian, gay, bisexual, transgender, queer & questioning (LGBTQ) young people, today released the results of its inaugural National Survey on LGBTQ Youth Mental Health. The survey found that 39 percent of LGBTQ youth surveyed have seriously considered suicide in the past twelve months, with more than half of transgender and non-binary youth having seriously considered suicide. Nearly 1 in 5 LGBTQ youth in this study attempted suicide in the past twelve months, with nearly 1 in 3 transgender and non-binary youth having attempted.

The study also found that conversion therapy is impacting LGBTQ youth across the country and putting them at higher risk of negative mental health outcomes. Two out of every three LGBTQ youth report that someone attempted to convince them to change their sexual orientation or gender identity, with youth who have undergone conversion therapy more than twice as likely to attempt suicide as those who did not. 42 percent of LGBTQ youth who underwent conversion therapy reported a suicide attempt in the last year, with 57 percent of transgender and non-binary youth who have undergone conversion therapy reporting a suicide attempt over the past 12 months. Conversion therapy is the dangerous and discredited practice aimed at changing an individual’s sexual orientation or gender identity and is still legal in 33 states across the country.

“Suicide is an ongoing public health crisis for young people in the U.S., especially among LGBTQ youth. Better understanding the mental health experiences of LGBTQ young people is a major step in addressing their significantly higher risk for attempting suicide,” said Amit Paley, CEO & Executive Director of The Trevor Project. “The Trevor Project’s new data underscores the need for LGBTQ inclusive and life affirming policies, environments, families, and communities — especially in support of transgender and non-binary youth. Together, we can ensure that LGBTQ young people know their lives have value, and that they are heard, loved, and never alone.”

The Trevor Project’s National Survey on LGBTQ Youth Mental Health is the largest survey ever conducted on the mental health of LGBTQ youth. The survey included nearly 35,000 LGBTQ youth respondents between the ages of 13 and 24 from every state in the United States.

The study found that rates of suicide attempts were twice as high among respondents who reported being discriminated against or physically threatened due to their sexual orientation or gender identity, compared to those who did not. Further, 76 percent of the respondents felt that recent politics impacted their mental health or sense of self.

“It’s important to note that LGBTQ youth are not at higher risk of suicide because of their sexual orientation or gender identity–they are at a higher risk because they face harmful rejection and discrimination from friends, families and communities that can make them feel their lives are worth less than their straight or cisgender peers,” added Paley. “That is why it is so important that we work tirelessly to let LGBTQ youth know that they are beautiful as they are, that they are deserving of respect, and that they are not alone.”

Additional findings from the survey include:

Conversion Therapy and Change Attempts

Two-thirds of LGBTQ youth report that someone attempted to convince them to change their gender identity or sexual orientation.

Fifty-seven percent of transgender and non-binary youth who have undergone conversion therapy report a suicide attempt in the last twelve months.
Thirty-two percent of cisgender LGBQ youth who have experienced conversion therapy report a suicide attempt in the past year.

In developing and releasing this report, The Trevor Project hopes to elevate the voices and experiences of LGBTQ youth while providing insights that can be used to end conversion therapy, including through The Trevor Project’s 50 Bills 50 States campaign and by the many organizations working to support LGBTQ youth around the world.

Discrimination and Victimization

71% of LGBTQ youth reported being discriminated against due to their sexual orientation or gender identity and 20% reported being physically threatened or abused. Those same LGBTQ youth reported more than double the rate of suicide attempts.

Twenty-three percent of youth who experienced discrimination due to their sexual orientation reported a suicide attempt in the past year, compared to 11 percent who did not, and 33 percent of transgender and non-binary youth who experienced discrimination due to their gender identity reported a suicide attempt in the past year, compared to 17 percent who did not.
Forty-seven percent of transgender and non-binary youth who were physically threatened or abused in the past year due to their sexual orientation or gender identity reported a suicide attempt in the past 12 months, compared to 20 percent who did not. For cisgender LGBQ youth, the rate was 27 percent among those who were physically threatened or abused compared to 11 percent among those who were not.
58% percent of transgender and non-binary youth reported being discouraged from using a bathroom that corresponds to their gender identity.
More than one in three transgender and non-binary youth who were prevented from using a bathroom that corresponds to their gender identity reported a suicide attempt in the past year, compared to one in five who did not experience this type of discrimination.

Disclosure and Acceptance

LGBTQ youth share their sexual orientation more often than their gender identity. Both sexual orientation and gender identity are disclosed most often with peers, particularly LGBTQ friends.

LGBTQ youth disclosed their sexual orientation and gender identity (SOGI) status to their friends at the highest rates, but they are also disclosing to adults in their lives, including parents, teachers, doctors, and more.
Less than half of LGBTQ respondents, however, were out to an adult at school, with youth much less likely to disclose their gender identity than sexual orientation.
LGBTQ youth are finding acceptance most from their friends, but overall acceptance is lower for gender identity than sexual orientation.

“We believe this research can save lives,” said Dr. Amy Green, Director of Research, The Trevor Project. “This data will help The Trevor Project to continue to improve and expand our life-saving services for LGBTQ youth. It will also provide our team on the ground in legislatures across the country data they need to support what we know to be dangers associated with conversion therapy and other forms of discrimination and victimization. This report also highlights the need for increased education and training to prepare support networks to best help LGBTQ who experience thoughts of suicide. We plan to leverage these findings to help advocate for LGBTQ youth for years to come.”

The Trevor Project launched the first ever National LGBTQ Youth Mental Health Survey as part of its commitment to use research and data to continually improve its life-saving services for LGBTQ youth and expand the knowledge base for organizations around the globe. This survey builds upon critical research done by many partner organizations over the years and is inclusive of youth of more than one hundred sexual orientations and more than one hundred gender identities from all fifty states across the country.

If you or someone you know is feeling hopeless or suicidal, trained crisis counselors are available 24/7/365 at 1-866-488-7386 and www.TheTrevorProject.org/Help

METHODOLOGY

This survey was conducted through an online platform between February 2, 2018 and September 30, 2018 among 34,808 respondents ages 13–24 who resided in the United States. Respondents were defined as being LGBTQ if they identified with a sexual orientation other than straight/heterosexual, a gender identity other than cisgender, or both. The study uses “transgender and non-binary” as an umbrella term to encompass a wide variety of gender identities. The survey is not based on a probability sample. For additional information on methodology such as sample description and comparability, filters and exclusions, question development, and more please visit https://www.thetrevorproject.org/LGBTQYouthMentalHealth.

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ABOUT THE TREVOR PROJECT

The Trevor Project is the world's largest suicide prevention and crisis intervention organization for lesbian, gay, bisexual, transgender, queer & questioning (LGBTQ) young people. The Trevor Project offers a suite of 24/7 crisis intervention and suicide prevention programs, including TrevorLifeline, TrevorText, and TrevorChat as well as the world’s largest safe space social networking site for LGBTQ youth, TrevorSpace. Trevor also operates an education program with resources for youth-serving adults and organizations, an advocacy department fighting for pro-LGBTQ legislation and against anti-LGBTQ rhetoric/policy positions, and a research team to discover the most effective means to help young LGBTQ people in crisis and end suicide. If you or someone you know is feeling hopeless or suicidal, our trained crisis counselors are available 24/7 at 1-866-488-7386 via chat www.TheTrevorProject.org/Help, or by texting START to 678678.

MEDIA CONTACT

Kevin Wong
The Trevor Project
646.576.7044
[email protected]

Research Brief: Fostering the Mental Health of LGBTQ Youth

May 30, 2019

Introduction

May is Mental Health Awareness Month in the United States. At The Trevor Project, we are well aware of the many struggles endured by LGBTQ youth. Through our pivotal work in suicide prevention, we come face-to-face with the fact that millions of LGBTQ youth are at risk for suicide and other poor mental health outcomes.¹ However, many LGBTQ youth show incredible resiliency,² and there are numerous protective factors that may promote wellness for these youth. The existing research shows that there is enormous opportunity for LGBTQ youth to thrive. This brief provides a summary of existing research on resilience among LGBTQ youth and, in line with Trevor’s life-saving mission, suggests ways that individuals and groups can enhance protective factors to foster positive development for LGBTQ youth.

Understanding Resilience

Resilience involves the ability to overcome adversity and can be facilitated by the presence of protective factors that reduce the negative impact of challenges and risk factors. For LGBTQ youth, risk factors such as stigma, discrimination, victimization, and rejection may make them vulnerable to experiencing a range of outcomes such as anxiety, depression, and suicidal ideation.³ However, the presence of known protective factors can interact with risk factors to facilitate resilience. Resilience is not rare, and has been described as “ordinary magic,”⁴ as it arises from normal human adaptive abilities. Studies of resilience have consistently challenged negative assumptions about youth development, highlighting the ability of youth to thrive even in the face of adversity.⁴

Protective Factors in Action

Given the importance of protective factors in navigating through the challenging period of development from ages 13–24, we synthesize here some of the main research on significant protective factors for LGBTQ youth. Importantly, we also discuss what individuals and groups can do to foster increased resilience among LGBTQ youth.

Protective factor	Research synthesis	Actions and impact
Social support	Social support is one of the most important factors for LGBTQ youth well-being.⁵ Support from parents and family,6–8 teachers,⁹ and friends and classmates¹⁰ are all influential in LGBTQ mental well-being. Moreover, having relationships with others who share in the lived experience of being LGBTQ provides an opportunity for youth to feel less alone. Building relationships with LGBTQ adults and peers, and also non-LGBTQ allies, increases resiliency among LGBTQ youth.¹¹ LGBTQ youth who are particularly resilient actively seek and cultivate these relationships.¹¹	Friends, classmates, parents, family members, teachers, doctors, mental health professionals, and others can actively provide resources and emotional support for LGBTQ youth. In many situations, youth may not reach out directly. Through the recognition of potential hardships, identifying their individuals needs, and offering relevant support, LGBTQ youth lives can be saved. Youth who reported high levels of family acceptance were 2/3 less likely to report suicide ideation and suicide attempts compared to those with low family acceptance.⁷
Role models	Access to LGBTQ or LGBTQ-supportive role models improves mental well-being among LGBTQ youth. Positive portrayals of LGBTQ people in the media help to reduce feelings of social isolation and invisibility. For example, research has found that portrayals of LGBTQ characters in popular media evoke hope and foster positive attitudes among LGBTQ youth.¹² Additionally, LGBTQ politicians and comic book characters have been cited as positively influencing LGBTQ identity formation.¹³ Further, as the climate around sports participation among LGBTQ youth is becoming increasingly more inclusive,¹⁴ coaches of sports teams may also serve as positive role models to help youth navigate their sexuality and provide support.¹⁵	The entertainment industry and youth- serving organizations, as well as LGBTQ and allied adults, can increase LGBTQ youth access to role models. Executives, writers, and other creators of media can do more to ensure that diverse LGBTQ experiences are represented. Particularly, positive portrayals of LGBTQ youth who are doing well are needed. Organizations can create mentorship programs that pair LGBTQ youth with LGBTQ or allied adults. LGBTQ individuals can also volunteer at local youth centers or with youth-oriented programming at LGBT Centers. Even without formal mentoring programs, LGBTQ individuals and allies can be there for younger LGBTQ people at work, within family settings, and even on social media by being visible.
Environment	Supportive environments positively impact the mental well-being of LGBTQ youth. Positive school climates have been found to improve mental health outcomes.^10,16 Specifically, LGBTQ youth who attend schools with anti-bullying policies inclusive of specific protections for LGBTQ youth,¹⁰ who can use the bathroom that corresponds with their gender identity,¹⁷ and who can use their chosen name,¹⁸ report better mental health outcomes. Furthermore, LGBTQ youth attending schools with a Gender and Sexualities Alliance (GSA) showed lower psychological distress and more favorable school experiences.¹⁹ LGB youth residing in more supportive regional environments, including increased proportions of same-sex couples within the region, were found to have a 20% reduced risk of suicide compared to unsupportive environments.²⁰ A stable and supportive home environment can also prevent homelesness in LGBTQ youth.²¹	A supportive environment can be facilitated by anyone. School officials can support youth in the creation of GSAs, the establishment of all-gender bathrooms, and the implementation of comprehensive anti-bullying policies. Anyone can join efforts by showing public support for policies that protect LGBTQ individuals and rejection of those that do not. While there have been many LGBTQ issues addressed in local-, state- and federal-level policies in recent years, discriminatory policies remain and new legislation continues to be introduced that can harm LGBTQ youth. Transgender youth who were able to use their chosen name at either home, school, work, or with friends had a 56% decrease in suicidal behavior.¹⁸
Coping	LGBTQ youth can also take actions to support their mental well-being. One mechanism is when youth carefully assess their personal, social, psychological, and financial safety in all contexts and use this information to make an informed decision about coming out as LGBTQ or not.¹¹ LGBTQ youth also develop individual coping mechanisms. For example, although rejection and victimization may happen, LGBTQ youth often find ways to shape their future through personal decisions, such as staying or leaving home or exploring their gender expression in ways that feel safe to them.¹¹ Finally, coping strategies, such as seeking out LGBTQ youth resources, are associated with,better mental health compared to other types of coping (e.g. imagining a better future).²²	Anyone can support youth in their coping strategies. Individuals who work with youth, including educators, counselors, and health professionals, can make it clear that their office is a safe space for youth by perhaps displaying affirming posters and LGBT-friendly paraphernalia. It may also be useful to help LGBTQ youth explore positive coping skills such as seeking out LGBTQ resources, practicing mindfulness, and talking to supportive individuals in their life. Almost 50% of LGBTQ youth selectively decide which parents and teachers and in what contexts they disclose their sexual orientation or gender identity.²³

Looking Ahead

Future research should do more to acknowledge and identify positive factors in the lived experiences of LGBTQ youth in order to provide the knowledge necessary for improving their real-world outcomes. Currently, there is a dearth of studies that examine how LGBTQ youth experience life beyond their negative experiences. Research shows that LGBTQ youth are disproportionally impacted by poor mental health outcomes, yet many LGBTQ youth are resilient and thriving. By understanding not just what places LGBTQ youth at risk, but also what reduces their risk, we can better understand their experiences and support their mental health.

The Trevor Project is committed to leveraging our crisis services, peer support, advocacy, education, and research programs to better understand and foster resilience to support the mental health of LGBTQ youth. For example, our 24/7 TrevorLifeline, TrevorText, and TrevorChat can provide youth with high quality support in moments of crisis, while our peer-support network TrevorSpace offers a supportive environment as well as role models. Our education and advocacy teams work to improve school and community environments for youth through targeted trainings and promotion of inclusive policies. And our research team will also be increasing our focus on understanding resilience among LGBTQ youth through initiatives such as our national surveys of LGBTQ youth.

References

1. Kann L, McManus T, William H, et al. Youth Risk Behavior Surveillance — United States, 2017. MMWR Surveill Summ. 2018;67(SS-8):1-114.
2. Russell ST. Beyond Risk: Resilience in the Lives of Sexual Minority Youth. J Gay Lesbian Issues Educ. 2005;2(3):5-18. doi:10.1300/J367v02n03_02
3. Meyer IH. Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence. Psychol Bull. 2003;129(5):674-697. doi:10.1037/0033-2909.129.5.674
4. Masten A. Ordinary Magic: Resilience in Development. New York, NY, US: Guilford Press; 2014.
5. Liu RT, Mustanski B. Suicidal Ideation and Self-Harm in Lesbian, Gay, Bisexual, and Transgender Youth. Am J Prev Med. 2012;42(3):221-228. doi:10.1016/j.amepre.2011.10.023
6. Mustanski B, Newcomb ME, Garofalo R. Mental Health of Lesbian, Gay, and Bisexual Youths: A Developmental Resiliency Perspective. J Gay Lesbian Soc Serv. 2011;23(2):204-225. doi:10.1080/10538720.2011.561474
7. Ryan C, Russell S, Huebner D, Diaz R, Sanchez J. Family Acceptance in Adolescence and the Health of LGBT Young Adults. J Child Adolesc Psychiatr Nurs. 2010;23(4):205-213. doi:https://doi.org/10.1111/j.1744-6171.2010.00246.x
8. Needham BL, Austin EL. Sexual orientation, parental support, and health during the transition to young adulthood. J Youth Adolesc. 2010;39(10):1189-1198.
9. Murdock T, Bolch MB. Risk and protective factors for poor school adjustment in lesbian, gay, and bisexual (LGB) high school youth: Variable and person-centered analyses. Psychol Sch. 2005;42(2):159-172. doi:10.1002/pits.20054
10. Kosciw J., Greytak EA, Zongrone AD, Clark CM, Truong NL. The 2017 National School Climate Survey: The Experiences of Lesbian, Gay, Bisexual, Transgender, and Queer Youth in Our Nation’s Schools. New York: GLSEN; 2018:1-168.
11. Asakura K. Paving Pathways Through the Pain: A Grounded Theory of Resilience Among Lesbian, Gay, Bisexual, Trans, and Queer Youth. J Res Adolesc. 2017;27(3):521-536. doi:10.1111/jora.12291
12. Gillig T, T Murphy S. Fostering Support for LGBTQ Youth? The Effects of a Gay Adolescent Media Portrayal on Young Viewers. Int J Commun. 2016;10:3828-3850.
13. Gomillion SC, Giuliano TA. The Influence of Media Role Models on Gay, Lesbian, and Bisexual Identity. J Homosex. 2011;58(3):330-354. doi:10.1080/00918369.2011.546729
14. Griffin P. LGBT equality in sports: Celebrating our successes and facing our challenges. In: Cunningham GB, ed. Sexual Orientation and Gender Identity in Sport: Essays from Activists, Coaches, and Scholars. College Station, TX: Center for Sport Management Research and Education; 2012:1-12.
15. Iannotta JG, Kane MJ. Sexual stories as resistance narratives in women’s sports: Reconceptualizing identity performance. Sociol Sports J. 2002;19(4):347-369.
16. Hatzenbuehler ML, Birkett M, Van Wagenen A, Meyer IH. Protective school climates and reduced risk for suicide ideation in sexual minority youths. Am J Public Health. 2014;104(2):279-286. doi:10.2105/AJPH.2013.301508
17. Weinhardt LS, Stevens P, Xie H, et al. Transgender and Gender Nonconforming Youths’ Public Facilities Use and Psychological Well-Being: A Mixed-Method Study. Transgender Health. 2017;2(1):140-150. doi:10.1089/trgh.2017.0020
18. Russell ST, Pollitt AM, Li G, Grossman AH. Chosen name use is linked to reduced depressive symptoms, suicidal ideation, and suicidal behavior among transgender youth. J Adolesc Health. 2018;63(4):503-505.
19. Heck NC, Flentje A, Cochran BN. Offsetting Risks: High School Gay-Straight Alliances and Lesbian, Gay, Bisexual, and Transgender (LGBT) Youth. Sch Psychol Q. 2011;26(2):161-174.
20. Hatzenbuehler ML. The social environment and suicide attempts in lesbian, gay, and bisexual youth. Pediatrics. 2011;127(5):896-903.
21. Durso LE, Gates GJ. Serving Our Youth: Findings from a National Survey of Service Providers Working with Lesbian, Gay, Bisexual, and Transgender Youth Who Are Homeless or at Risk of Becoming Homeless. Los Angeles, CA: The WIlliams Institute with True Colors Fund and The Palette Fund; 2012.
22. Toomey RB, Ryan C, Diaz RM, Russell ST. Coping With Sexual Orientation-Related Minority Stress. J Homosex. 2018;65(4):484-500. doi:10.1080/00918369.2017.1321888
23. Human Rights Campaign Foundation. 2018 LGBTQ Youth Report. Washington, DC https://assets2.hrc.org/files/assets/resources/2018-YouthReport-NoVid.pdf?_ga=2.92754269.1758005609.1558478278-1737775507.1556739719.

For more information please contact: [email protected]

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Research Brief: Digital Support for Youth in Crisis

April 24, 2019

Summary

As technology continues to rapidly shift in the U.S., youth are often at the forefront of its adoption. A Pew Research Center Survey (2018) found that 95% of teens had, or had access to, a smartphone; this rate was similar across race, gender, ethnicity, and income. LGBTQ youth in particular often choose digital resources when exploring their identities and forming relationships (Craig & McInroy, 2014). Research examining online and text message-based crisis services suggest that youth may prefer texting or chat platforms for crisis interventions compared to in person or phone platforms (Nesmith, 2018). However, despite their increased rate of suicide, published research has yet to explore crisis intervention preferences specifically among LGBTQ youth. This research brief used data from The Trevor Project’s 2018 National Survey of LGBTQ Youth and a 2017 formal evaluation to explore youth’s likelihood of reaching out during a crisis across modalities as well as reasons for their preferences.

Results

More than three-quarters of youth reported being somewhat to extremely likely to reach out via text, chat, or instant message (i.e., digital services) if they were in a crisis. This rate is almost double the percentage of youth who indicated that they would be somewhat to extremely likely to reach out via phone (43%). Transgender and gender diverse youth were more likely to report being somewhat to extremely likely to use digital services (80%) compared to cisgender LGBQ youth (75%).
Youth pointed to factors around authenticity and privacy as their reasons for preferring digital outreach. Confidentiality (68%), ease of being oneself (63%), and reduced fears of being misgendered for transgender youth (45%) were listed as primary reasons for digital service preferences.

Methodology

National Survey Data. A quantitative cross-sectional design was used to collect data using an online survey platform between February and September 2018. A sample of LGBTQ youth ages 13–24 who resided in the United States were recruited via targeted ads on social media. A total of 34,808 youth consented to complete the online survey, with full results to be released this year. Youth were asked about a variety of issues related to their mental health and support. Questions reported on in this brief asked youth, “If you needed to reach out to a crisis intervention organization for support, how likely are you to reach out via” with responses relating to phone, chat/instant messaging, and text messaging.
Evaluation Data. The Trevor Project’s formal evaluation took place between September 2015 and April 2017. Eligible youth were referred to the evaluation project one to two weeks after their initial crisis service contact. Several hundred youth served by The Trevor Project’s Lifeline and several hundred youth served by The Trevor Project’s text and chat counseling services, TrevorText and TrevorChat, completed the evaluation. This sample of youth was found to be representative compared with the broader population served by The Trevor Project (e.g., in terms of suicide risk, age, gender identity, and race/ethnicity). Our representative sample allows for a nuanced evaluation of Trevor’s crisis services, and provides valuable insights about the LGBTQ youth that Trevor serves. Youth who reached out via TrevorChat/TrevorText were asked why they chose to use those platforms, rather than the phone. Youth were able to select multiple reasons, so results are not mutually exclusive. Findings related to fear of being misgendered were analyzed separately for transgender youth.

Looking Ahead

National studies find that the majority of youth are accessing digital spaces to meet diverse needs. Given the more than 1.5 million LGBTQ youth who are at risk for suicide in the U.S. each year, reaching youth where they are and in ways that they want to interact is vital for prevention. The Trevor Project is filling this need by expanding our services to include 24-hour chat and text support for youth whenever and wherever they are in need. Going forward, it is vital that Trevor and other organizations serving vulnerable populations engage in continuous quality improvement by conducting needs assessments and evaluations of service preferences. By tailoring services to match connectivity trends, caregivers and providers can best support vulnerable populations.

References

Craig, S. L., & McInroy, L. (2014). You can form a part of yourself online: The influence of new media on identity development and coming out for LGBTQ youth. Journal of Gay & Lesbian Mental Health, 18(1), 95–109.

Nesmith, A. (2018). Reaching young people through texting-based crisis counseling: Process, benefits, and challenges. Advances in Social Work, 18(4), 1148-1164.

Pew Research Center (2018). Teens, Social Media & Technology 2018, Washington, DC.

For more information please contact: [email protected]

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Research Brief: Bisexual Youth Experience

March 26, 2019

Summary

This March marks the 6th Annual Bisexual Health Awareness Month. Bisexual youth comprise a substantial proportion of youth who are part of the LGBTQ community. An analysis of national data from the 2015–2017 Center for Disease Control and Prevention’s Youth Risk Behavior Survey (YRBS) found that 7% of youth identified as bisexual, compared to 2% as gay or lesbian and 4% as not sure. Bisexual youth may be exposed to more stigma from both the majority population, for not being heterosexual, and by the gay and lesbian communities for not having exclusive same-gender relationships and attractions. Despite the prevalence of bisexual identities among youth, there is currently a lack of information on outcomes specific to bisexual youth in the United States. This research brief focuses on understanding mental health and victimization associated with bisexual youth using national data from the YRBS.

Results

Mental health disparities exist for bisexual youth, with almost half seriously considering suicide in the past 12 months. Nearly 2 in 3, (66%) of bisexual youth felt sad and hopeless for two or more weeks in a row in the past 12 months, compared to 27% heterosexually-identified youth, 49% gay and lesbian youth, and 46% of youth who were not sure of their sexual identity. Further, 48% of bisexual youth seriously considered suicide, 40% have made a plan for how they would attempt suicide, and 27% have attempted suicide.

More than one in three bisexual youth reported being bullied at school, and one in five reported being forced to have sexual intercourse. Among bisexual youth, 21% (24% female and 8% male) reported having been forced to have sexual intercourse. This is compared to 5% of heterosexually-identified youth (9% female and 2% male), 16% gay and lesbian (15% female and 17% male), and 12% youth who were not sure of their sexual identity (11% female and 13% male). Additionally, 36% and 30% of bisexual youth reported having been bullied on school property and electronically bullied, respectively, in the past 12 months.

Methodology

Beginning in 1991, the CDC collected data representative of students in grades 9–12 attending U.S. high schools through the YRBS. State, territorial, tribal, and large urban school districts that receive funding from CDC provide data representative of high school students or middle school students. Ongoing surveys, conducted biennially February–May of each odd-numbered year, is self-administered to youth in their schools. The current data are combined weighted national survey data from 2015 and 2017. Youth were identified as bisexual based on their response to the YRBS question “Which of the following best describes you?” with options: heterosexual (straight), gay or lesbian, bisexual, and not sure. The 2015 and 2017 YRBS national level data does not include questions focused on youth gender identities.

Looking Ahead

While previous large-scale studies on LGBTQ youth have included bisexual youth in their samples, they often fail to capture the unique stressors faced by bisexual youth and in doing so, further alienate an already vulnerable population. Our analysis of the YRBS data highlighted the increased rates of depressed mood, suicidality, and victimization among bisexual youth. These disparities could be due to fewer protective factors in the lives of bisexual youth (Saewyc et al., 2009) and the increased stigma thought to be faced by bisexual individuals (Callis, 2013) that were highlighted in theoretical and less representative work.

The Trevor Project remains committed to understanding and addressing the needs of bisexual youth across our research, advocacy, and crisis service departments. For example, over 34,000 youth took part in The Trevor Project’s own National Survey focused on better understanding the lives of LGBTQ youth. Our large sample size will allow us to further explore the individual needs of subgroups of LGBTQ identities, including bisexual youth.

References

Callis, A. S. (2013) The black sheep of the pink flock: Labels, stigma, and bisexual identity, Journal of Bisexuality, 13(1), 82-105, doi: 10.1080/15299716.2013.755730

Centers for Disease Control and Prevention. 2015-2017. Youth Risk Behavior Survey Data. Available at: www.cdc.gov/yrbs. Accessed on March 12, 2019.

Saewyc, E., Homma, Y., Skay, C. L., Bearinger, L., Resnick, M. D., & Reis, E. (2009). Protective factors in the lives of bisexual adolescents in North America. American Journal of Public Health, 99(1), 110-7.

For more information please contact: [email protected]

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Research Brief: Data on Transgender Youth

February 22, 2019

Summary

The inclusion of sexual identity measures in large scale national surveys have added to our knowledge about the lives of lesbian, gay, bisexual, and questioning youth (LGBQ). For example, the Center for Disease Control and Prevention’s Youth Risk Behavior Survey (YRBS) has highlighted adverse mental health indicators among LGBQ students, including greater depressive symptoms, increased rates of seriously considering suicide, and higher rates of attempted suicide (Zaza et al., 2016). Until now, there has been a lack of nationwide data on risk factors and negative outcomes associated with transgender youth in the U.S. (diGiacomo et al., 2018). This brief report highlights newly released data from the 2017 YRBS which focuses on transgender high school students (Johns et al., 2019).

Results

Overall, 1.8% of youth identified as transgender. The almost 2% prevalence rate is more than double the previously available estimate of 0.7%. The prior estimate was based on the patterns of transgender identity among adults (Herman et al., 2017). However, it was noted that the 0.7% estimation would be inaccurate if younger cohorts identify as transgender at a sharply higher rate than 18–24 year olds. This YRBS data reveals that younger youth are indeed identifying as transgender at an increased rate.

Transgender youth reported significantly increased rates of depression, suicidality, and victimization compared to their cisgender peers. Notably, in the past year, one in three transgender youth reported attempting suicide, almost one-third reported being a victim of sexual violence, and more than half reported a two-week period of depression.

Methodology

This data represented the largest ever federal effort to capture data on transgender youth by surveying 118,803 high school students in ten states (Colorado, Delaware, Hawaii, Massachusetts, Maryland, Maine, Michigan, Rhode Island, Vermont, Wisconsin) and nine large urban school districts (Boston, Cleveland, District of Columbia, Detroit, Broward County, Los Angeles, New York City, San Diego, San Francisco). Youth gender identity was based on their response to the YRBS question, “Some people describe themselves as transgender when their sex at birth does not match the way they think or feel about their gender. Are you transgender?” In this report, prevalence rates are based on youth who indicated “Yes, I am transgender” or “No, I am not transgender.” Youth who indicated that they were “not sure” if they were transgender or who indicated that they did not understand the question were excluded from this analysis.

Looking Ahead

This new data provides key insights about transgender youth. However, our knowledge is still incomplete as only 10 states and 9 large urban school districts included a question on gender identity in the 2017 YRBS. Additionally, we do not have information about other youth who do not identify as cisgender including gender fluid, non-binary, and agender youth. The Trevor Project and partner agencies have long advocated for the inclusion of sexual orientation and gender identity and expression questions in population based surveys, including the YRBS. We will continue our efforts to ensure that this valuable data is collected from all states and large urban school districts to best understand and support these youth.

References

diGiacomo, E., Krausz, M., Colmegna, F., Aspesi, F., & Clerici, M. (2018). Estimating the risk of attempted suicide among sexual minority youths: A systematic review and meta-analysis. JAMA Pediatrics, 172(12),1145-1152

Herman, J.L., Flores, A.R., Brown, T.N.T., Wilson, B.D.M., & Conron, K.J. (2017). Age of individuals who identify as transgender in the United States. Los Angeles, CA: The Williams Institute.

Johns M.M., Lowry R., Andrzejewski J., et al. (2019). Transgender identity and experiences of violence victimization, substance use, suicide risk, and sexual risk behaviors among high school students — 19 states and large urban school districts, 2017. MMWR Morb Mortal Wkly. 68, 67–71. DOI: http://dx.doi.org/10.15585/mmwr.mm6803a3

Zaza, S., Kann, L., & Barrios, L. C. (2016). Lesbian, gay, and bisexual adolescents: population estimate and prevalence of health behaviors. Journal of the American Medical Association, 316(22), 2355-2356.

For more information please contact: [email protected]

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New Federal Survey Shows 2% of Us High School Students Identify As Transgender

January 24, 2019

The Trevor Project commends the CDC for counting transgender youth

The Centers for Disease Control and Prevention today released a report that shows almost 2 percent of high school students identify as transgender, and 35 percent attempted suicide in the past year. The research was included in the CDC’s latest Morbidity and Mortality Weekly Report (MMWR): “Transgender Identity and Experiences of Violence Victimization, Substance Use, Suicide Risk, and Sexual Risk Behaviors Among High School Students — 19 States and Large Urban School Districts, 2017.”

Amit Paley, CEO & Executive Director of The Trevor Project, the world’s largest suicide prevention and crisis intervention organization for LGBTQ young people, commented on the importance of the report:

“The CDC’s new groundbreaking report shows that transgender youth exist in much greater numbers than researchers previously estimated¹. By collecting data inclusive of gender identity, the report shows the very real health risks faced by transgender and gender non-conforming youth. The CDC’s findings highlight the need for even more policies to protect transgender and gender nonconforming youth, as well as additional support for LGBTQ-affirming organizations like The Trevor Project.

“The Trevor Project has worked with other groups for years to advocate for the CDC’s inclusion of transgender youth in its Youth Risk Behavior Survey (YRBS), and we commend them for acknowledging the needs of transgender young people in the only federal survey of youth health. Transgender and gender nonconforming youth contact The Trevor Project every day with questions about health, mental wellness, gender expression, and more. Now with inclusive health data that reflects the wide spectrum of gender identities, The Trevor Project can better inform its suicide prevention, risk detection, and response programs.

“We know the work is not over. This new YRBS data is game-changing, but still incomplete as long as only 10 states and 9 large urban school districts are choosing to ask about gender identity and expression. The Trevor Project will continue to educate and encourage decision-makers across the country to adopt the gender identity and expression questions in the next round of YRBS surveys. Only by understanding who our youth are and how they identify can we craft policies to allow every young person to thrive.”

The CDC released its latest Youth Risk Behavior Survey on June 14, 2018.

If you or someone you know is feeling hopeless or suicidal, contact The Trevor Project’s TrevorLifeline 24/7/365 at 1-866-488-7386. Counseling is also available via chat every day at TheTrevorProject.org/Help, or by texting 678-678.

¹ Previously, the Williams Institute estimated that .7 percent of youth ages 13–17 identify as transgender (2017).

Research Brief: Holiday Crisis Trends

January 14, 2019

Summary

Contrary to popular media reports, the notion that overall rates of suicide increase around the holiday season has been unfounded (Annenberg Public Policy Center, 2017). In fact, data collected from the U.S. Centers for Disease Control and Prevention between January 1999 and December 2017 indicate that the months of November and December have consistently had the lowest rates of suicide (Centers for Disease Control and Prevention, 2018). Declines in suicide rates during this time period have been attributed to increased affiliation with family and friends and an increased sense of belonging (Ajdacic-Gross et al., 2003, Vanorden et al., 2008). However, this time period may be associated with increased crisis levels for LGBTQ youth who experience lower levels of family support and heightened levels of rejection compared to their straight, cisgender peers (Needham & Austin, 2010). This research brief focuses on trends in youth contacting The Trevor Project during the 2018 holiday season.

Results

Youth reached out to The Trevor Project at 20–40% lower rates on holidays compared to our typical contact volume, followed by a rate that was 20% higher than average in the two days after each holiday. More specifically, on the Thursday of and Friday following Thanksgiving, we saw contact volume that was 70% of our expected Thursday/Friday volume, followed by a sharp increase in the weekend that followed compared to a typical weekend. We saw similar reductions in volumes during Christmas Eve/Christmas Day (40%) and New Year’s Eve/New Year’s Day (20%), followed by a 20% elevated rate in the two days that followed compared to our typical volume on those days of the week.

Several factors might account for the observed trend. For example, youth may be unable to directly reach out to The Trevor Project for support on the days in which they are most likely to be in closest contact with family members and, therefore, increase contact with The Trevor Project in the days following these interactions. Alternatively, some youth may be enjoying close connections on the holidays and experiencing loneliness on subsequent days. Overall, these data point to the potential for seasonal trends for LGBTQ youth that are not being captured by current national data collection efforts on holiday suicide rates.

Methodology

The current analyses compared incoming volume data from the 4 weeks prior to each holiday. We used ratios for average volume for the same days of the week in the previous 4 weeks compared to each two day holiday period and the subsequent two days to control for impact of the weekday on the analysis.

Looking Ahead

Currently, seasonal trends in suicide rates cannot be examined by sexual orientation and gender identity (SOGI) as these data are not rigorously and systematically collected as part of national reporting systems on mortality such as the National Violent Death Reporting System. The Trevor Project advocates for enhanced training related to the collection of SOGI mortality data, as this data is imperative to better understanding and preventing suicide among LGBTQ youth. Additionally, although the current analyses focus on Thanksgiving, Christmas, and New Year’s holidays in order to expand on existing research centered on these holidays, The Trevor Project recognizes that we serve a diverse set of youth who may celebrate holidays other than those described in this report. Further analyzing trends in our crisis services volume will allow Trevor to continue improving the services and support offered to all LGBTQ youth who reach out to Trevor every day.

References

Ajdacic-Gross, V., Wang, J., Bopp, M., Eich, D., Rössler, W., & Gutzwiller, F. (2003). Are seasonalities in suicide dependent on suicide methods? A reappraisal. Social Science & Medicine, 57(7), 1173-1181.
Annenberg Public Policy Center (2017). Suicide rate is lower during holidays, but holiday-suicide myth persists. Available at: https://cdn.annenbergpublicpolicycenter.org/wp-content/uploads/2017/12/Holiday-suicide_myth_2017.pdf
Centers for Disease Control and Prevention, National Center for Health Statistics. Underlying Cause of Death 1999-2017 on CDC WONDER Online Database, released December, 2018. Data are from the Multiple Cause of Death Files, 1999-2017, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at http://wonder.cdc.gov/ucd-icd10.html on Mar 28, 2019
Needham, B. L., & Austin, E. L. (2010). Sexual orientation, parental support, and health during the transition to young adulthood. Journal of Youth and Adolescence, 39(10), 1189-1198.
Van Orden, K. A., Witte, T. K., James, L. M., Castro, Y., Gordon, K. H., Braithwaite, S. R., … & Joiner Jr, T. E. (2008). Suicidal ideation in college students varies across semesters: The mediating role of belongingness. Suicide and Life-Threatening Behavior, 38(4), 427-435.

For more information please contact: [email protected]

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The Trevor Project Responds: CDC Report Shows Increased Suicide Rates Lower U.S. Life Expectancy

November 29, 2018

The Trevor Project, the world’s largest suicide prevention organization for LGBTQ young people, responded to the CDC’s “Suicide Mortality in the United States, 1999–2017” report. Released today, the study is one in a series of three government reports and shows a drop in US life expectancy.

“Today’s CDC report highlights the significant increase in suicide rates over time, proving that it is a continued public health crisis. For 10 years suicide has been the 10th leading cause of death in the U.S., but we know that young people, specifically LGBTQ youth, are particularly impacted. Suicide is the second leading cause of death for all young people. Lesbian, gay, and bisexual youth are more than four times more likely to attempt suicide than their straight peers, and nearly half of all transgender people have attempted suicide — many before the age of 25.

It’s now more important than ever to provide dedicated resources, in-depth research, legislation, and access to healthcare and education that supports LGBTQ youth and their wellness. The Trevor Project will continue fighting to save LGBTQ young lives, and will always be here for them to make sure they know that their life has value, and that they are loved and never alone.”
—Amit Paley, CEO & Executive Director, The Trevor Project

If you or someone you know is feeling hopeless or suicidal, contact The Trevor Project’s TrevorLifeline 24/7/365 at 1-866-488-7386. Counseling is also available via chat from 3-10 p.m. EST every day at TheTrevorProject.org/Help, or by texting 678-678 from Monday-Friday, 3-10 p.m. EST.

Report: Protecting LGBTQ Youth Through Inclusive School Suicide Prevention Policies in California

November 19, 2018

School policies are an important part of suicide prevention, especially because of the amount of time young people spend at school. Released today, The Trevor Project’s new report shows that implementing legislation like California Assembly Bill 2246, which requires schools serving grades 7–12 to establish student suicide prevention policies, dramatically increases the number of policies that address the needs of high-risk populations including LGBTQ youth.

After reading hundreds of school suicide prevention policies from all across the state, The Trevor Project’s researchers found that only 3% of policies implemented before passage of AB 2246 in 2016 included LGBTQ youth, compared to more than 90% of those written afterwards. Today, 25% of California’s school suicide prevention policies still do not address LGBTQ students.

It is vital that all California policies be updated to comply with AB 2246, because studies show that lesbian, gay, and bisexual youth are more than four times more likely to attempt suicide than their straight peers, and nearly half of all trans people have made a suicide attempt — many before the age of 25. A third of all lesbian, gay, and bisexual youth are bullied at school, and almost half of them seriously consider attempting suicide, almost 4 times more likely than their straight peers.

Learn more about the powerful impact of laws requiring LGBTQ inclusion in school suicide prevention policies.

The Trevor Project Reviews California Schools’ Suicide Prevention Policies

October 4, 2018

The Trevor Project, the world’s largest suicide prevention and crisis intervention organization for LGBTQ youth, released a report about California Department of Education schools’ compliance with AB 2246, which requires schools serving grades 7–12 to establish student suicide prevention policies.

The organization contacted all 478 school districts and local education agencies in California which serve youth in grades 7–12. After multiple attempts at contact, 86% of the school districts were found to have a student suicide prevention policy. 70% of the school districts without a suicide prevention policy were rural, defined as more than 40 miles from a major city; and 80% of school districts without a suicide prevention policy were smaller than average.

School policies are an important part of suicide prevention, especially because of the amount of time young people spend at school. Suicide is the 2nd leading cause of death among young people. Lesbian, gay, and bisexual youth are more than four times more likely to attempt suicide than their straight peers, and nearly half of all trans people have made a suicide attempt. 1/3 of all lesbian, gay, and bisexual youth are bullied at school, and almost half of them seriously consider attempting suicide, almost 4 times more likely than their straight peers.

Read the full report.