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Discrimination among Black LGBTQ+ Young People and Suicide Risk

Just over one in five (21%) Black transgender, nonbinary, or questioning young people reported a suicide attempt in the past year.

Background

There is a large body of research that links experiences of discrimination to adverse mental health outcomes and suicide attempts (Vargas et al., 2020). Though there is well-documented evidence of its harm, there is a lack of research focused on groups who routinely experience discrimination on the basis of their multiple marginalized identities, such as Black lesbian, gay, bisexual, transgender, queer or questioning (LGBTQ+) young people (Bowleg, 2021; Bowleg et al., 2017). This gap in knowledge is critical because of the possible additive effects of repeatedly experiencing discrimination. For example, while Black Americans on average have lower rates of suicide compared to the general population in the United States (U.S.; Stone et al., 2023), much of this research does not consider the experiences of Black LGBTQ+ young people, who experience discrimination related not only to their race/ethnicity, but also their sexual orientation and gender identities. Furthermore, this characterization fails to acknowledge that the rate of discrimination among younger Black Americans has been steadily increasing and may be detrimental to their mental health (Sheftall et al., 2022). Black LGBTQ+ young people specifically report high rates of discrimination and victimization, as well as high rates of anxiety, depression, and suicide (The Trevor Project, 2023). Using data from The Trevor Project’s 2023 U.S. National Survey on the Mental Health of LGBTQ Young People, this brief will highlight the specific context around experiencing multiple forms of discrimination, suicide, as well sources of support for Black LGBTQ+ young people.

Results

Just over one in five (21%) Black transgender, nonbinary, or questioning young people reported a suicide attempt in the past year. This number is more than double the number of Black cisgender LGBQ young people (8%) who reported the same. Additionally, nearly a third (32%) of Black cisgender LGBQ young people reported having seriously considered suicide in the past year, compared to just over half (51%) of Black transgender, nonbinary, or questioning young people.

Black LGBTQ+ young people experience high rates of discrimination related to their race/ethnicity, as well as their LGBTQ+ identities. Over two-thirds (70%) of Black cisgender LGBQ young people experienced at least one form of discrimination related to their race, sexual orientation, or gender identity or expression in the past year, while even more Black transgender, nonbinary, or questioning young people (83%) experienced the same. Of those who experienced discrimination related to their race, sexual orientation, or gender identity or expression in the past year, the majority (58% for cisgender LGBQ, 72% for transgender, nonbinary, or questioning) experienced two or more forms of discrimination. 

Black transgender, nonbinary, and questioning young people who reported experiencing discrimination related to their gender identity or expression in the past year had nearly two times the odds of reporting a suicide attempt in the past year (aOR = 1.96, 95% CI = 1.18 – 3.28, p = .01) compared to Black transgender and nonbinary young people who did not experience discrimination related to their gender identity or expression. Similarly, Black cisgender LGBQ young people who reported experiencing discrimination related to their sexual orientation in the past year had almost two and half times the odds of reporting a suicide attempt in the past year (aOR = 2.38, 95% CI = 1.07 – 5.31, p = .04) compared to their Black cisgender LGBQ peers who did not report experiencing discrimination due to their sexual orientation. Additionally, 45% of Black cisgender LGBQ young people and 64% of Black transgender, nonbinary, or questioning young people reported experiencing these forms of discrimination in the past year. Racial discrimination was not independently associated with suicide attempts in the past year. However, the effects of multiple types of discrimination were associated with an increased odds of suicide attempts, especially among Black transgender, nonbinary, and questioning young people. Of those who reported experiencing none of these forms of discrimination, 9% reported a suicide attempt in the last year; this number increased to 15%, 21%, and 30% with each additional type of discrimination experienced.Most (55%) Black LGBTQ+ young people who experienced discrimination on the basis of their sexual orientation or gender identity did report having received support from someone about that discrimination. The most common sources of support were from friends (43%), a partner or someone they were dating (15%), a counselor or therapist (11%), a sibling (10%) or a parent or caregiver (7%).

Methods

Data were collected through The Trevor Project’s 2023 U.S. National Survey on the Mental Health of LGBTQ Young People. In total, 28,524 LGBTQ+ young people between the ages of 13 to 24 were recruited via targeted ads on social media. This analysis was limited to those who responded “Black/African American” when asked what best describes their race or ethnicity (inclusive of multiracial individuals), a total of 1,504 respondents.

Questions that assess suicide attempts and consideration were taken from the Centers for Disease Control and Prevention’s Youth Risk Behavior Survey (Johns et al., 2020). Experiences of discrimination were assessed by asking respondents, “During the past 12 months, have you felt discriminated against for any of the following reasons? Please select all that apply.” A response of “Your actual or perceived race, ethnicity, or national origin” was coded to indicate having experienced racial discrimination. A response of “Your actual or perceived sexual orientation” was coded to indicate having experienced discrimination on the basis of sexual orientation. A response of either “Your actual or perceived gender” or “How you express your gender” was coded to indicate having experienced discrimination on the basis of gender identity. Two additional questions were asked elsewhere in the survey: “In the past 12 months, have you felt discriminated against because of your sexual orientation?” and “In the past 12 months have you felt discriminated against because of your gender identity?” If these were responded to affirmatively, then respondents were considered to have experienced discrimination on the basis of sexual orientation or gender identity, respectively. Support for discrimination on the basis of sexual orientation or gender identity was assessed by asking, “Have you ever gotten support from anyone about the discrimination you experienced due to your sexual orientation or gender identity? Please select all that apply.” If “No, I have not talked to anyone about it” or “No, nobody I have talked to has been supportive” were selected, respondents were considered to not have received support from anyone regarding discrimination. Other options included friend, parent or caregiver, sibling, a partner or someone they were dating, another family member, police officer, a doctor or medical professional, a counselor or therapist, a crisis or support hotline, or someone else.

All statistical tests were at least significant at p < 0.05. This means that there is less than a 5% likelihood the observed results occurred by chance. After checking all appropriate statistical assumptions, adjusted logistic regression models were run to examine the associations between a suicide attempt in the past year and having experienced discrimination on the basis of race, sexual orientation, or gender identity. These models further included age, socioeconomic status, sexual orientation, and Census region as control variables. Gender identity was used as a stratifying variable in these analyses such that cisgender respondents were in one group, and transgender, nonbinary, and questioning respondents were in another.

Looking Ahead

Both the prevalence and effect of discrimination in the lives of Black LGBTQ+ young people cannot be overstated. The responsibility for ameliorating, and ultimately eliminating, discrimination from the lives of LGBTQ+ young people is one that requires engagement from all sectors in society. Black LGBTQ+ young people by virtue of their multiple marginalized identities may be especially vulnerable to various types of discrimination. Because of the intersectional nature of discrimination experienced by Black LGBTQ+ young people and its consequences for their mental health, we cannot silo efforts to combat racial discrimination in one place, and anti-LGBTQ+ discrimination in another. The rates of Black LGBTQ+ young people reporting a suicide attempt in the past year increased as they experienced additional forms of discrimination. This finding is consistent with prior research that links LGBTQ+-based cumulative minority stress with increased odds of attempting suicide (Green et al., 2022).

Although over half (55%) of all Black LGBTQ+ young people in our sample reported experiencing racial discrimination in the past year, we did not find any association with experiences of racial discrimination and suicide attempts. There are many possible explanations, one being that Black Americans have a long history of support systems within families, organizations, and communities designed to both prepare and protect them from the harmful effects of racial discrimination (DeLapp & Williams, 2019). Unfortunately, this may not necessarily hold true when it comes to experiencing discrimination on the basis of sexual orientation or gender identity or expression. The lack of a statistically significant association between racial discrimination and past-year suicide attempts may also simply reflect the difficulty in representing experiences of intersectional discrimination in quantitative research (Bowleg, 2008; Bowleg & Bauer, 2016). As we demonstrated earlier, most people who experienced discrimination reported facing more than one form; 76% of those who reported racial discrimination also reported having experienced discrimination based on their sexual orientation, gender identity, or both. 

Although these results can be dispiriting, we encourage all LGBTQ+ youth-facing people to use these findings to bolster efforts to both end discrimination and address its effects head on. Black LGBTQ+ young people themselves have not only acknowledged the role of intersectional discrimination in their own lives, but have shaped their activism to be intersectional to combat it as well (Shaheed et al., 2022). Adults working with Black LBGTQ+ young people should ensure that they are prepared to support all aspects of Black LGBTQ+ young people’s identities as they navigate the combined effects of racism, anti-LGBTQ bigotry, and other forms of bias. Fortunately, we already have examples of supportive relationships from which to learn. The overwhelmingly most common source of support Black LGBTQ+ young people reported when they experienced discrimination related to their sexual orientation or gender identity was from friends, a finding consistent with research which shows how potent the protection that friends and chosen family have in buffering both racial trauma and anti-LGBTQ+ oppression among Black LGBTQ+ young people  (Hailey et al., 2020).

While there will always be a role for providing services to help Black LGBTQ+ young people cope with the effects of living in a discriminatory social environment, we must also not lose sight that the goal must always be to reduce exposure to discrimination in the first place. We should celebrate the resilience of Black LGBTQ+ young people for thriving, but that cannot absolve us of a collective responsibility to move closer to a world where that resilience is not a necessary part of survival. Qualitative and quantitative research that explores how structural sources of discrimination are inherently tied to the health of Black LGBTQ+ persons represent a useful step forward (Whitfield et al., 2014).The Trevor Project is committed to improving the mental health of Black LGBTQ+ young people and ending the discrimination they face. We have resources available to provide guidance for those looking to support Black LGBTQ+ young people, including ways to have conversations about the intersection of race/ethnicity and LGBTQ+ identities. The Trevor Project also seeks to uplift stories of the magic of Black queerness, as well as continuing to conduct research which centers the diverse experiences of Black LGBTQ+ young people (The Trevor Project, 2022; 2023). At The Trevor Project, our Crisis Services team works 24/7 to help LGBTQ+ young people in crisis, including Black LGBTQ+ young people. We also focus on prevention efforts in order to limit the need for crisis resources in the future and eventually end suicide for LGBTQ+ young people. Additionally, we provide LGBTQ+ cultural competency training to LGBTQ+-facing adults, including professionals who work with young people (e.g., counselors, educators, nurses, social workers), as a means to increase understanding of LGBTQ+ people and provide guidance on trauma-informed suicide prevention efforts that are applicable to individuals of various identities and experiences.

Recommended Citation: The Trevor Project. (2024). Discrimination among Black LGBTQ+ Young People and Suicide Risk. 

References

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  • Bowleg, L. (2021). Evolving Intersectionality Within Public Health: From Analysis to Action. American Journal of Public Health, 111(1), 88–90. https://doi.org/10.2105/AJPH.2020.306031
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  • The Trevor Project. (2022). Black LGBTQ Youth Mental Health. https://www.thetrevorproject.org/research-briefs/black-lgbtq-youth-mental-health/
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  • Whitfield, D. L., Walls, N. E., Langenderfer-Magruder, L., & Clark, B. (2014). Queer Is the New Black? Not So Much: Racial Disparities in Anti-LGBTQ Discrimination. Journal of Gay & Lesbian Social Services, 26(4), 426–440. https://doi.org/10.1080/10538720.2014.955556

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