Project SPARK Interim Report

Executive Summary

Project SPARK (Studying Protective And RisK factors: A Longitudinal Mental Health and Experiences Study among LGBTQ+ Young People) is a longitudinal study, currently planned for five waves, following 1,689 LGBTQ+ youth (ages 13–24) across the United States (U.S.). The analyses in this report draw on data collected every six months between September 2023 to March 2025.

This report presents interim findings over one study year, based on data from the first three waves (Waves 1 through 3) tracking the mental health, well-being, and lived experiences of LGBTQ+ youth. The sample is diverse across race/ethnicity (68% youth of color), sexual orientation (23% bisexual, 15% pansexual, 11% queer, 8% asexual), and gender identity (53% transgender, nonbinary, or gender-questioning). The study’s primary goal is to understand how risk and protective factors – including family support, access to mental health care and transgender health care, and experiences of discrimination – shape the mental health trajectories of LGBTQ+ youth over time.

These results highlight the urgent and ongoing mental health crisis facing LGBTQ+ youth in the U.S., particularly those who are transgender, nonbinary, or questioning; younger; or marginalized by the multiple effects of anti-LGBTQ+ sentiment and racism or economic challenges. The study period overlapped with a surge in anti-LGBTQ+ legislation and rhetoric, which likely contributed to worsening mental health and increased barriers to  necessary care. At the same time, the data underscore the powerful protective effects of family support, affirming environments, and access to culturally competent mental health and transgender health care.

The findings are critical for families, educators, health care providers, policymakers, and community organizations seeking to support LGBTQ+ youth. They emphasize the need for targeted interventions to reduce mental health concerns and suicide risk, expand access to mental health care and transgender health care, and foster supportive environments at home, in schools, and in communities.

As the study continues, future analyses will explore long-term trends, causal relationships, and intersectional experiences in greater depth. We recognize these data are being collected during a period of significant sociopolitical change and heightened attention on LGBTQ+ issues; subsequent analysis will explore how such events may have an enduring impact on the health and wellness of LGBTQ+ young people. These ongoing data collection efforts will be vital for informing evidence-based policy, resource allocation, and the design of interventions to improve the lives and well-being of LGBTQ+ youth nationwide.

Key Findings

Worsening Mental Health Indicators: Mental health distress increased markedly in the first year of data collection. The proportion reporting recent anxiety symptoms rose from 57% at baseline to 68% at Wave 3; depressive symptoms climbed from 48% to 54%; and suicidal ideation grew from 41% to 47%. While past-year suicide attempts declined from 11% to 7%, this rate remains higher than national estimates for cisgender heterosexual peers. Transgender, nonbinary, and gender-questioning youth and participants ages 13 to 17 reported the poorest mental health outcomes and represented the highest risk for suicide.

Persistent Minority Stress: Experiences of victimization and discrimination remained widespread. At both baseline and one year later, about one-third of participants reported being physically harassed or threatened because of their sexual orientation, and approximately two-fifths of transgender and nonbinary respondents said they were physically harassed or threatened because of their gender identity. Sexual-orientation discrimination was high and held steady at roughly 55% across the year, while gender-identity discrimination among transgender and nonbinary respondents remained higher, with approximately two-thirds experiencing discrimination both at baseline and a year later. Economic insecurity was common. At baseline, 14% of participants said they were unable to meet basic needs such as food, housing, or clothing; by the one-year follow-up, 21% had faced this hardship during the preceding year. Houselessness showed a similar pattern: 21% reported ever being unhoused at baseline, and 10% reported experiencing houselessness at some point in the year that followed.

Conversion Therapy Exposure: Exposure to conversion therapy – attempts to change a person’s sexual orientation or gender identity – remains a significant and harmful experience for LGBTQ+ youth. Across the first year of the study, reports of conversion therapy harm rose sharply: conversion therapy threats increased from 11% at baseline to 22% after one year, while actual exposure climbed from 9% to 15%.

Barriers to Care: While 80% of youth who wanted mental health care were able to access it at baseline, this dropped to 60% the following year. The top barriers included affordability, fear of not being taken seriously, and fear of involuntary hospitalization. Access to transgender health care improved for some transgender and nonbinary youth, but significant disparities by age and identity persisted.

Protective Factors and Affirming Environments: Over the course of the year, more LGBTQ+ youth reported feeling supported at school, with school affirmation of LGBTQ+ identities increasing from 53% at baseline to 58% one year later. However, LGBTQ+ affirmation at home remained unchanged at 51%, indicating that many LGBTQ+ young people continued to lack support in their home environments.

Help-Seeking and Support Networks: One year after baseline, LGBTQ+ youth reported significantly higher rates of seeking help during suicidal crises. The proportion of LGBTQ+ youth turning to a mental health professional during suicidal crises doubled from 32% at baseline to 64% one year later. Seeking support from friends also rose substantially, from 45% to 73%. Despite improving from 27% at baseline to 20% a year later, the number of young people (1 in 5) who sought help from no one during suicidal crises remains a concerning gap.

Longitudinal Associations: Longitudinal analyses over the first year demonstrated that risk factors such as discrimination, unmet basic needs, and physical threats significantly increased the likelihood of anxiety, depression, and suicidal ideation; houselessness predicted an increased likelihood of anxiety and suicidal ideation, and exposure to conversion therapy predicted increased likelihood of depression and suicidal ideation. On the other hand, protective factors including helpful mental health care, family and friend support, affirming home environments, and access to transgender health care were associated with reductions in these mental health symptoms and suicide risk.