Background

Study Rationale

LGBTQ+ young people experience significant mental health disparities, including higher rates of poor mental health and suicidal thoughts and behaviors, compared to their cisgender heterosexual peers (Centers for Disease Control and Prevention [CDC], 2023). However, much of the existing research relies on data collected at a single point in time (Real & Russell, 2025), limiting our understanding of how these challenges evolve throughout adolescence and early adulthood. Gaps are especially stark for transgender, nonbinary and gender-questioning youth, whose developmental trajectories and needs for mental health support and related services remain under-examined, and for youth whose sexual or gender minority status intersects with other salient identities such as race/ethnicity, culture, and religion (Russell & Fish, 2016). Understanding mental health in this intersectional context is essential, because stressors and supports often operate differently across dimensions of gender, race/ethnicity, and class.

This longitudinal study, Project SPARK, addresses these gaps by examining how the experiences and mental health of a diverse sample of LGBTQ+ young people change over time. Long-term data are essential for developing targeted, evidence-based interventions and policies, and ensuring that resources and supports effectively reach the young people who need them most. Ultimately, these findings can inform educators, policymakers, health care providers, and community leaders, guiding efforts to build more supportive environments for LGBTQ+ youth.

Throughout this report, the acronym “TGNB” is used to refer to participants who are transgender, nonbinary, or gender-questioning.

Study Design Overview

Project SPARK (Studying Protective And RisK factors: A Longitudinal Mental Health and Experiences Study among LGBTQ+ Young People) is a longitudinal study that tracks 1,689 LGBTQ+ young people ages 13 to 24 from across the U.S., surveying them every six months over a span of at least two years. Participants complete comprehensive online surveys that explore their mental health, experiences of discrimination and victimization, family and peer support, access to mental health and transgender health care, and their overall well-being. This report presents interim findings over one study year, based on data from Waves 1 (often referred to in this report as the baseline) through 3.

Methodology

Participant recruitment and eligibility: The study recruited U.S. residents ages 13 to 24 who self-identified as LGBTQ+ through paid social media advertisements. This occurred online during two recruitment windows: September 13 – December 12, 2023 and January 8 – February 17, 2024. Quota limits kept the baseline sample diverse by race/ethnicity and sex assigned at birth; once a quota filled, additional entries from that stratum were closed. To be enrolled, respondents had to (1) provide electronic consent, (2) pass an honesty screen, and (3) submit unique email and phone information. Weekly reviews resolved possible duplicates or malicious responders, yielding a final analytic cohort of 1,689 participants.

Survey administration: To ensure accessibility and safety, data collection occurred via secure, confidential online surveys that included a maximum of 139 questions. All participant information was collected following strict ethical guidelines approved by an Institutional Review Board (IRB). Baseline and Wave 2 questionnaires were administered in the survey platform Qualtrics; Wave 3 was administered in the survey platform REDCap. Surveys were available in English and waves opened at six-month intervals.

Data analysis: This interim report presents descriptive statistics and generalized linear mixed models. For descriptive results that present one-year follow-up data, we combined the 6-month recall windows used in the Wave 2 and 3 surveys, so that a “yes” response in either wave was indicative of exposure during the full 12-month follow-up. Generalized linear mixed models used data from all three available waves, controlling for the different recall window at baseline (i.e., 12 months), in order to examine the association of risk and protective factors on observed changes in anxiety, depression, suicidal ideation, and suicide attempts. Models additionally controlled for age, sexual orientation, gender identity, and race/ethnicity. Because suicide attempts were relatively rare events during the first year of the study, statistical models examining changes in suicide attempts over time did not reliably converge and are not included in this report; we still report descriptive percentages for suicide attempts.

Unless otherwise noted, all analyses are statistically significant at p<0.05, meaning results as extreme as those observed would be expected less than 5% of the time if there were no true difference (i.e., under the null hypothesis). Due to rounding, some presented percentages may not precisely add up to reported totals.

Waves and Timeline

The following timeline summarizes the study’s progress: