Background
Sexual violence occurs at alarming rates in the United States (U.S.) and can have devastating impacts on survivors’ mental health. The Centers for Disease Control and Prevention (CDC) reports that over half of women and nearly one-third of men have experienced some form of violent sexual contact in their lives (CDC, 2022). Similarly, in a large survey of American transgender adults, nearly half of the participants (including transgender women, transgender men, and nonbinary individuals) experienced sexual assault at some point in their lives (James et al., 2016). Existing research has also documented disproportionately high rates of experiencing sexual violence among LGBTQ+ young people when compared to their heterosexual and cisgender peers (Atteberry-Ash et al., 2022). Among the general population of young people in the U.S., a history of forced sexual intercourse is associated with increased odds of other forms of sexual victimization (Baiden et al., 2021). In addition, sexual violence, like other forms of trauma, is associated with poorer mental health outcomes, including higher rates of depression and suicidality among survivors (Dworkin, 2020; Dworkin et al., 2022). There has also been scholarship documenting associations between sexual violence and higher odds of depression and suicide attempts among LGBTQ+ young people, specifically (Atteberry-Ash et al., 2022). In recognition of April as Sexual Assault Awareness Month, this brief uses a large, diverse, and recent sample of LGBTQ+ young people ages 13-24 from The Trevor Project’s 2023 U.S. National Survey on the Mental Health of LGBTQ Young People to examine the prevalence of sexual violence in LGBTQ+ youth, as well as demographic differences and associations with depression, anxiety, and suicide risk.
Results
LGBTQ+ young people report higher rates of sexual violence than the general population. Nearly two in five LGBTQ+ young people (39%) reported that they had ever been forced to do “sexual things” that they did not want to do. Among those who reported forced sexual contact, 13% of LGBTQ+ young people reported that it had happened once in the past year, 14% reported it had happened two or three times, 5% reported it had happened four or five times, and 6% reported that it happened six or more times in the past year. Rates of forced sexual contact in the past year among LGBTQ+ young people were higher than those in the general population of young people in the U.S. Nearly half of LGBTQ+ young people ages 13-18 (49%) reported that they had been forced to do “sexual things” that they did not want to do in the past 12 months, compared to only 11% of the general population of 13-18 year olds in the U.S. The latter is defined as those who reported experiencing sexual violence from anyone in their life in the past year, as measured by the CDC’s Youth Risk Behavior Survey (Centers for Disease Control and Prevention, 2023). Respondents who reported ever having experienced forced sexual contact were also asked specifically about forced sexual intercourse, with 45% reporting forced sexual intercourse. Of those, 22% reported experiencing forced sexual intercourse in the past year.
Demographic differences were observed in the reported rates of sexual violence among LGBTQ+ young people, with older individuals, gender diverse youth, and young people of color generally reporting higher rates. LGBTQ+ young people ages 18-24 reported significantly higher rates of having ever experienced forced sexual contact (46%). Of those individuals, 53% experienced forced sexual intercourse. In comparison, their LGBTQ+ peers ages 13-17 reported lower overall rates of forced sexual contact (33%) and forced sexual intercourse (37%). However, among those who had experienced forced sexual intercourse, a higher proportion of the younger age group (13-17) reported such incidents in the past year (28%), compared to 18% of the 18-24 age group. Additionally, transgender, nonbinary, and gender questioning young people reported significantly higher rates of having ever experienced forced sexual contact (44%) compared to their cisgender LGBQ peers (31%). Nearly half of transgender boys and men (49%) reported having ever experienced forced sexual contact, followed by nonbinary young people (45%), gender questioning young people (37%), cisgender girls and women (37%), transgender girls and women (33%) and cisgender boys and men (22%). LGBTQ+ young people who reported just meeting their basic economic needs reported significantly higher rates of having ever experienced forced sexual contact (56%) than their LGBTQ+ peers not struggling economically (36%). LGBTQ+ young people of color reported significantly higher rates of having ever experienced forced sexual contact (42%) compared to their White LGBTQ+ peers (36%). More specifically, three out of five Native/Indigenous LGBTQ+ young people (60%) reported such experiences followed by multiracial LGBTQ+ young people (46%), Latinx LGBTQ+ young people (40%), Middle Eastern and North African LGBTQ+ young people (37%), Black LGBTQ+ young people (37%), White LGBTQ+ young people (36%), and Asian American and Pacific Islander LGBTQ+ young people (26%).
Sexual violence is associated with higher suicide risk among LGBTQ+ young people. LGBTQ+ young people who had ever experienced any forced sexual contact reported more than twice the odds of seriously considering suicide in the past year (adjusted odds ratio [aOR] = 2.22, 95% Confidence Interval [CI] = 2.08-2.36, p < 0.001), and over three times the odds of attempting suicide in the past year (aOR = 3.11, 95% CI = 2.85-3.41, p < 0.001) compared to LGBTQ+ young people who did not report these experiences. Additionally, the more occurrences of forced sexual contact were reported, the higher suicide risk was (aOR = 1.32, 95% CI = 1.26-1.38, p < 0 .001), with each increase in frequency (categorized as “0 times,” “1 time,” “2 or 3 times,” “4 or 5 times,” and “6 or more times”) associated with a 32% higher odds of a past-year suicide attempt. Specifically, 15% of those who reported never experiencing forced sexual contact also reported a suicide attempt in the past year, compared to 40% of those who reported six or more occurrences of forced sexual contact. Furthermore, having ever experienced forced sexual intercourse was associated with one and a half times greater odds of seriously considering suicide in the past year (aOR = 1.50, 95% CI = 1.37-1.66, p < 0.001) and nearly two and a half times the odds of attempting suicide in the past year (aOR = 2.42, 95% CI = 2.15-2.73, p < 0 .001).
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. Questions that assess considering or attempting suicide were taken from the Centers for Disease Control and Prevention’s Youth Risk Behavior Survey (Johns et al., 2020). Experiences of forced sexual contact were assessed by asking respondents, “Has anyone ever forced you to do sexual things that you did not want to do? (Count such things as kissing, touching, or being physically forced to have sexual intercourse.)” Response options included “No” and “Yes.” If a respondent replied “Yes,” they were then asked, “During the past 12 months, how many times did anyone force you to do sexual things that you did not want to do? (Count such things as kissing, touching, or being physically forced to have sexual intercourse.)” with response options including, “0 times,” “1 time,” “2 or 3 times,” “4 or 5 times,” and “6 or more times.” Experiences of forced sexual intercourse were assessed by asking respondents, “Have you ever been physically forced to have sexual intercourse when you did not want to?” Response options included “No” and “Yes.” If a respondent replied “Yes,” they were then asked, “During the past 12 months, have you been physically forced to have sexual intercourse when you did not want to?” Response options included “No” and “Yes”. Chi square tests were used to examine significant differences among demographic groups. Data comparisons between LGBTQ+ young people and the general population of 13-18 year olds in the U.S. are descriptive and based on results from different surveys, without statistical significance testing conducted between the two datasets. 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 past-year considerations of suicide, past-year suicide attempts, and experiences of forced sexual contact or forced sexual intercourse. These models further included age, socioeconomic status, sexual orientation, race, gender identity, and Census region as control variables.
Looking Ahead
These findings align with other scholarship that has found alarmingly high rates of sexual victimization among LGBTQ+ young people (Atteberry-Ash et al., 2022). Specifically, LGBTQ+ young people ages 13-18 report three times the rates of both forced sexual contact and forced sexual intercourse than the general population of youth ages 13-18 in the U.S. Risk of sexual violence is also different for LGBTQ+ young people with multiple marginalized identities — LGBTQ+ young people who report struggling economically, LGBTQ+ young people of color, and transgender and nonbinary young people all report higher rates of experiencing sexual violence than their more resourced, White, or cisgender peers. These demographic differences highlight the need for training organizations that serve survivors of sexual violence in racial/cultural humility and LGBTQ+ cultural competency. LGBTQ+ young people ages 13-17 also reported higher rates of experiencing forced sexual intercourse in the past year than their peers ages 18-24, suggesting the need for LGBTQ+-inclusive sexual violence prevention services for middle and high school-aged youth.
Our findings also align with the larger literature in documenting associations between experiencing sexual violence and higher suicide risk (Atteberry-Ash et al., 2022; Dworkin, 2020; Dworkin et al., 2022). LGBTQ+ young people in our sample who reported having ever experienced forced sexual contact had twice the odds of seriously consider suicide in the past year and three times the odds of reporting a suicide attempt in the past year, compared to their LGBTQ+ peers who had not had these experiences. Additionally, suicide risk increased with the number of forced sexual contact experiences among LGBTQ+ young people. Given that other research shows that experiences of sexual violence are associated with increased risk of future sexual violence (Baiden et al., 2021), mental health practitioners working with LGBTQ+ young people must be well-versed in screening for and treating trauma resulting from sexual violence.
A number of environmental factors may contribute to LGBTQ+ young people’s elevated risk. Previous Trevor research has found that only 15% of LGBTQ+ young people have access to sexual education that includes discussions about LGBTQ+ people and experiences in school (The Trevor Project, 2023). This lack of inclusive, consent-based sexual education may place LGBTQ+ young people at higher risk of experiencing sexual violence, as they may be less equipped to identify coercive sexual encounters. LGBTQ+ young people may also experience sexual violence as a form of coercion meant to change their LGBTQ+ identity. While this phenomenon is frequently called “corrective rape” when referring specifically to lesbian or bisexual women, the use of sexual violence as a form of gendered or sexual punishment against LGBTQ+ individuals can span all gender identities (Doan-Minh, 2019). Sexual violence is also frequently associated with other risks disproportionately faced by LGBTQ+ young people, including homelessness, physical victimization, and harassment (Choi et al., 2015; Johns et al., 2020; Kosciw, et al., 2022). Increased access to safe homes, schools, and workplaces may mitigate LGBTQ+ young people’s vulnerability to sexual violence. More research is needed to understand the causes for LGBTQ+ young people’s elevated risk of experiencing sexual violence, especially because the findings in this brief are from a single time point and cannot be used to determine causation.
The Trevor Project is committed to improving the mental health of LGBTQ+ young people and ending all forms of violence they face. Adults working with LGBTQ+ young people can access our guide, “How to Support LGBTQ Victims and Survivors of Sexual Violence” at our Resource Center. At The Trevor Project, our Crisis Services team works 24/7 to help LGBTQ+ young people in crisis, including those who have experienced sexual violence. 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 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). Sexual Violence and Mental Health among LGBTQ+ Young People.
References
- Atteberry-Ash, B., Walls, N. E., Kattari, S. K., Peitzmeier, S. M., Kattari, L., & Langenderfer-Magruder, L. (2020). Forced sex among youth: Accrual of risk by gender identity, sexual orientation, mental health and bullying. Journal of LGBT Youth, 17(2), 193–213. https://doi.org/10.1080/19361653.2019.1614131
- Baiden, P., Panisch, L. S., Kim, Y. J., LaBrenz, C. A., Kim, Y., & Onyeaka, H. K. (2021). Association between First Sexual Intercourse and Sexual Violence Victimization, Symptoms of Depression, and Suicidal Behaviors among Adolescents in the United States: Findings from 2017 and 2019 National Youth Risk Behavior Survey. International Journal of Environmental Research and Public Health, 18(15), 7922. https://doi.org/10.3390/ijerph28157922
- Centers for Disease Control and Prevention. (2022, June 22). Fast facts: Preventing sexual violence. Centers for Disease Control and Prevention: Violence Prevention. https://www.cdc.gov/violenceprevention/sexualviolence/fastfact.html
- Centers for Disease Control and Prevention (2023). 1991-2021 High School Youth Risk Behavior Survey Data. Available at http://yrbs-explorer.services.cdc.gov/ . Accessed on 2/1/24.
- Choi, S.K., Wilson, B.D.M., Shelton, J., & Gates, G. (2015). Serving our youth 2015: The needs and experiences of lesbian, gay, bisexual, transgender, and questioning youth experiencing homelessness. The Williams Institute with True Colors Fund.
- Doan-Minh, S. (2019). Corrective Rape: An Extreme Manifestation of Discrimination and the State’s Complicity in Sexual Violence. Hastings Women’s Law Journal, 30(1), 167–198.
- Dworkin, E. R. (2020). Risk for Mental Disorders Associated With Sexual Assault: A Meta-Analysis. Trauma, Violence, & Abuse, 21(5), 1011–1028. https://doi.org/10.1177/1524838018813198
- Dworkin, E. R., DeCou, C. R., & Fitzpatrick, S. (2022). Associations between sexual assault and suicidal thoughts and behavior: A meta-analysis. Psychological Trauma: Theory, Research, Practice, and Policy, 14(7), 1208–1211. https://doi.org/10.1037/tra0000570
- James, S. E., Herman, J. L., Rankin, S., Keisling, M., Mottet, L., & Anafi, M. (2016). The Report of the 2015 U.S. Transgender Survey. National Center for Transgender Equality.
- Johns, M. M., Lowry, R., Haderxhanaj, L. T., Rasberry, C. N., Robin, L., Scales, L., Stone, D., & Suarez, N. A. (2020). Trends in violence victimization and suicide risk by sexual identity among high school students—Youth Risk Behavior Survey, United States, 2015–2019. MMWR Supplements, 69(1), 19. https://doi.org/10.15585/mmwr.su6901a3
- Kosciw, J. G., Clark, C. M., & Menard, L. (2022). The 2021 National School Climate Survey: The experiences of LGBTQ+ youth in our nation’s schools. GLSEN.
- The Trevor Project. (2023). School-Related Protective Factors for LGBTQ Middle and High School Students.
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