Recommendations and Next Steps

The patterns emerging from Waves 1-3 underscore the importance of policy, practice, and research initiatives that move beyond crisis response to structural prevention. States that already offer comprehensive nondiscrimination protections for LGBTQ+ people show measurably lower rates of depressive symptoms and safer school climates among LGBTQ+ adolescents, validating calls for federal and state action to codify such protections across education, housing, employment, and health care sectors (Moran et al., 2025). Parallel legislative priorities include explicit statutory bans on conversion therapy for minors. Economic-evaluation modeling indicates that conversion therapy practices not only double the odds of suicide attempts but also impose billions of dollars in avoidable humanistic and health-system costs in the U.S. each year (Forsythe et al., 2022).

Clinical access must keep pace with policy change. Prospective and cohort evidence continues to demonstrate that timely, guideline-concordant transgender health care – whether puberty blockers during early adolescence or gender-affirming hormone therapy in later adolescence and young adulthood – produces clinically meaningful reductions in moderate-to-severe depression and suicidal thoughts and attempts (Reisner et al., 2025; Turban et al., 2020). Ensuring that such care remains legally protected, financially affordable, and geographically accessible is therefore a suicide prevention imperative.

Schools remain a daily context in which this cohort lives, learns, and, too often, experiences victimization. Large statewide datasets show that the mere presence of a Gender Sexuality Alliance (GSA) corresponds with better school functioning, lower substance use, and improved mental health for all students, with the largest benefits among LGBTQ+ youth themselves (Baams & Russell, 2021). Investment in GSAs, LGBTQ+-inclusive curricula, and staff-wide training in trauma-informed, affirming practices should be integrated into every district’s continuous improvement plan. Outside of school, culturally responsive mental health services must be scaled. Hybrid and fully web-based models are particularly well suited to rural areas and to youth who face stigma-related barriers to in-person care (Chaiton et al., 2023).

Family environments exert a particularly important influence. Long-term follow-ups show that specific parental acceptance behaviors in adolescence – such as using a youth’s chosen name and pronouns – cut the odds of suicide attempts by more than half and promote higher self-esteem and general health (Ryan et al., 2010). Public health agencies should therefore prioritize dissemination of empirically tested family-acceptance curricula, with outreach tailored to families of color and faith-based communities.

Economic insecurity and housing instability magnify all other risks. National survey data reveal that LGBTQ+ young people who experience houselessness or unstable housing have two to three times the odds of considering or attempting suicide compared with peers in stable housing (DeChants et al., 2021). Sustainable funding for LGBTQ+-inclusive rapid rehousing programs, drop-in centers, and basic needs stipends must accompany any mental health strategy, and mental health supports should be embedded directly into these programs to reduce access barriers.

Community level safety nets also matter. Twenty-four-hour crisis lines, chat, and text services staffed by LGBTQ+-affirming responders must be preserved as core public health infrastructure. In July 2025, federal officials ended the 988 Suicide & Crisis Lifeline’s national “Press 3” pathway that routed LGBTQ+ youth to specially trained counselors – removing a dedicated option at the very moment need is rising. 988 is a tool in a broader suicide prevention system: round-the-clock call, text, and chat services must be adequately funded and staffed, with rigorous training, so responders can deliver best-practice care for high-risk populations. States and the federal government should restore and sustain specialized services for at-risk populations within 988. Given the clear growth in help-seeking in our data, ensuring that youth who reach out actually reach someone equipped to help is both urgent and achievable.

In addition to the recommendations outlined above, it is important to emphasize that this report represents interim findings in The Trevor Project’s ongoing longitudinal study, with additional waves of data collection still to come. As the study progresses through additional waves, we will be able to track participants’ experiences over a longer period, allowing for more robust analyses of how risk and protective factors change over time. This deeper understanding will be invaluable for informing policies and programs that can make a lasting difference in the lives of young people.

We want to reinforce the critical value of continued participation from our cohort. Consistent involvement from participants ensures that the study’s findings are as accurate and meaningful as possible, capturing the full range of experiences and changes that occur over time. Every voice matters, and ongoing engagement will help ensure that the final report reflects the diversity and resilience of LGBTQ+ youth across the country. We encourage all participants to remain involved through the final waves, as their contributions will directly inform future resources, advocacy, and support for LGBTQ+ young people nationwide.

By staying engaged, participants are not only helping to advance scientific understanding but are also supporting a stronger, more informed movement for LGBTQ+ youth well-being. The Trevor Project is deeply grateful for the commitment and honesty of everyone involved, and we look forward to sharing more comprehensive and actionable insights once the study is complete.