2023 U.S. National Survey on the Mental Health of LGBTQ Young People

Explore the Survey

Introduction

The Trevor Project’s 2023 U.S. National Survey on the Mental Health of LGBTQ Young People amplifies the experiences of more than 28,000 LGBTQ young people ages 13 to 24 across the United States. This survey gives a voice to LGBTQ young people — at a time when their existence is unfairly at the center of national political debates and state legislatures have introduced and implemented a record number of anti-LGBTQ policies.

For the fifth consecutive year, these data underscore that anti-LGBTQ victimization contributes to the higher rates of suicide risk reported by LGBTQ young people and that most who want mental health care are unable to get it.

Importantly, this research also points to ways we can all support the LGBTQ young people in our lives by highlighting protective factors like creating affirming spaces and respecting pronouns, as well as the topics about which LGBTQ young people wish those in their lives knew more.

This year, for the first time ever, we also asked respondents to describe a world where all LGBTQ people are accepted. Despite the prevalence of unique challenges, barriers to care, and relentless political attacks, LGBTQ young people remain hopeful and resilient, and The Trevor Project is committed to helping them create the world they deserve.

Thank you to the LGBTQ young people who bravely shared their experiences. We hope this survey will equip fellow researchers, policymakers, and other youth-serving organizations with the data necessary to celebrate and uplift LGBTQ young people and advocate for policies that support their health and work to end the public health crisis of suicide.

- The Trevor Project

Want to help support The Trevor Project?

Your donation helps to support future, meaningful research about LGBTQ youth and power the life-saving services we provide.

Donate

Key Findings

41% of LGBTQ young people seriously considered attempting suicide in the past year—and young people who are transgender, nonbinary, and/or people of color reported higher rates than their peers.

56% of LGBTQ young people who wanted mental health care in the past year were not able to get it.

Transgender and nonbinary young people who reported that all of the people they live with respect their pronouns reported lower rates of attempting suicide.

Fewer than 40% of LGBTQ young people found their home to be LGBTQ-affirming.

Roughly half of transgender and nonbinary young people found their school to be gender-affirming, and those who did reported lower rates of attempting suicide.

A majority of LGBTQ young people reported being verbally harassed at school because people thought they were LGBTQ.

Nearly 1 in 3 LGBTQ young people said their mental health was poor most of the time or always due to anti-LGBTQ policies and legislation.

Nearly 2 in 3 LGBTQ young people said that hearing about potential state or local laws banning people from discussing LGBTQ people at school made their mental health a lot worse.

Mental Health & Suicide Risk

LGBTQ young people are not inherently prone to suicide risk because of their sexual orientation or gender identity but rather placed at higher risk because of how they are mistreated and stigmatized in society.

Mental Health & Suicide Risk:

Suicide Risk

41% of LGBTQ young people seriously considered attempting suicide in the past year

including half of transgender and nonbinary young people and nearly 3 in 10 cisgender young people.

14% of LGBTQ young people attempted suicide in the past year

including nearly 1 in 5 transgender and nonbinary young people and nearly 1 in 10 cisgender young people.

Rates of considered and attempted suicide among LGBTQ young people

Explore Data by:

11% of white young people attempted suicide in the past year

compared to…

  • 22% of Native/Indigenous young people
  • 18% of Middle Eastern/Northern African young people
  • 17% of Multiracial young people
  • 16% of Black young people
  • 15% of Latinx young people
  • 10% of Asian American/Pacific Islander young people

Anxiety & Depression

67% of LGBTQ young people reported experiencing symptoms of anxiety

including nearly three-quarters of transgender and nonbinary young people and nearly 3 in 5 cisgender young people.

54% of LGBTQ young people reported experiencing symptoms of depression

including more than 3 in 5 transgender and nonbinary young people and more than 2 in 5 cisgender young people.

Anxiety & depression symptoms reported among LGBTQ young people

Explore Data by:

Access to Care

Despite the prevalence of anxiety, depression, and suicide risk among LGBTQ young people, a majority could not access the mental health care they desired. And among the small percentage of transgender and nonbinary young people who receive gender-affirming medical care, nearly 2 in 3 were worried about losing access to this care.

Mental Health Care

Among all LGBTQ young people, 81% wanted mental health care.

56% of LGBTQ young people who wanted mental health care in the past year were not able to get it

including nearly 3 in 5 transgender and nonbinary young people and more than 2 in 5 cisgender young people.

Desire for and access to mental health care

Desire for mental health care

  • 81% Yes
  • 19% No

Access to mental health care

  • 56% wanted but did not receive care
  • 44% wanted & received care

LGBTQ young people who wanted mental health care but were unable to get it cited the following top ten reasons:

Gender-Affirming Medical Care

Among transgender and nonbinary young people, 11% reported being on gender-affirming hormones, and 2% reported taking puberty blockers.

65% who were on gender-affirming hormones were somewhat or very concerned about losing access to this care.

Anti-LGBTQ Policies

A record number of anti-LGBTQ policies have been introduced and implemented in the last year—and they’re having a negative impact on LGBTQ young people’s mental health. However, laws that protect LGBTQ young people from the dangerous and discredited practice of conversion therapy made them feel better.

Nearly 1 in 3 LGBTQ young people said their mental health was poor most of the time or always due to anti-LGBTQ policies and legislation.

Nearly 2 in 3 LGBTQ young people said that hearing about potential state or local laws banning people from discussing LGBTQ people at school made their mental health a lot worse.

Conversely, 79% of LGBTQ young people said hearing about potential state and local laws trying to ban conversion therapy made them feel a little or a lot better.

To what extent do you pay attention to media reports about rights for people who are LGBTQ?

  • 85% Somewhat or a lot
  • 15% Not at all or a little bit

Anti-LGBTQ Victimization

LGBTQ young people who experienced anti-LGBTQ victimization—including being physically threatened or harmed, discriminated against, or subjected to conversion therapy—reported more than twice the rate of attempting suicide in the past year compared to those who did not have any of these anti-LGBTQ experiences.

Negative Experiences at School

Among those enrolled, LGBTQ young people reported that these negative experiences happened to them while in school:

Physical Harm

24% of LGBTQ young people reported that they have been physically threatened or harmed in the past year due to their sexual orientation or gender identity.

18% of LGBTQ young people reported that they have been physically threatened or harmed in the past year due to their sexual orientation.

27% of transgender and nonbinary young people reported that they have been physically threatened or harmed in the past year due to their gender identity.

LGBTQ young people who have been physically threatened or harmed in the past year

Explore Data by:

LGBTQ young people who attempted suicide in the past year, comparison across those who:

Discrimination

60% of LGBTQ young people reported that they have felt discriminated against in the past year due to their sexual orientation or gender identity.

51% of LGBTQ young people reported that they have felt discriminated against in the past year due to their sexual orientation.

64% of transgender and nonbinary young people reported that they have felt discriminated against in the past year due to their gender identity.

Rates of LGBTQ young people who have felt discriminated against in the past year

Explore Data by:

LGBTQ young people who attempted suicide in the past year, comparison across those who:

Conversion Therapy

LGBTQ young people who reported being threatened with or subjected to conversion therapy:

  • 85% Not threatened with or subjected to conversion therapy
  • 10% Threatened with conversion therapy
  • 5% Subjected to conversion therapy

15% of LGBTQ young people reported being threatened with or subjected to conversion therapy

including nearly 1 in 5 transgender and nonbinary young people and nearly 1 in 10 cisgender young people.

LGBTQ young people who were subjected to conversion therapy

Explore Data by:

LGBTQ young people who attempted suicide in the past year, comparison across those subjected to conversion therapy:

Ways to Support LGBTQ Young People

LGBTQ young people report lower rates of attempting suicide when they have access to affirming spaces—and they want the people in their lives to learn more about how to support them and the basics of LGBTQ identities.

LGBTQ young people who had access to affirming homes, schools, community events, and online spaces reported lower rates of attempting suicide compared to those who did not.

Affirming gender identity among transgender and nonbinary young people is consistently associated with lower rates of attempting suicide.

LGBTQ young people reported that the following LGBTQ topics would be helpful for the people in their lives to know more about:

Access to Affirming Spaces

Affirming spaces among LGBTQ young people:

Affirming spaces among transgender and nonbinary young people:

LGBTQ young people who attempted suicide in the past year, comparison across access to LGBTQ-affirming spaces:

Transgender and nonbinary young people who attempted suicide in the past year, comparison across access to LGBTQ-affirming spaces:

*There was no significant difference in the suicide attempt rate among transgender and nonbinary young people who had access to gender-affirming online spaces and community events compared to those who did not.

Supporting Transgender and Nonbinary Young People

Transgender and nonbinary young people who reported that all of the people they live with respect their pronouns reported attempting suicide less than those who lived with others who did not respect their pronouns.

How many of the people you live with respect your pronouns?

  • 50% None of the people I live with
  • 23% Some of the people I live with
  • 27% All of the people I live with

Transgender and nonbinary young people who attempted suicide in the past year, comparison across the number of people they live with who respected their pronouns:

Transgender and nonbinary young people who reported having access to a gender-neutral bathroom at school reported attempting suicide less than those who did not.

Is there a gender-neutral bathroom at your school?

  • 63% No
  • 37% Yes

Transgender and nonbinary young people who attempted suicide in the past year, comparison across access to a gender-neutral bathroom at school:

Transgender and nonbinary young people who had access to binders, shapewear, and gender-affirming clothing reported lower rates of attempting suicide in the past year compared to those who did not.*

*Binders and shapewear refer to undergarments, such as tank tops or bodysuits, that help young people who are experiencing gender dysphoria align the appearance of their body with their gender identity.

We asked LGBTQ young people to describe what a world would look like where all LGBTQ people are accepted.

Size of each word or phrase indicates its frequency as a response.

Methodology

The content and methodology for The Trevor Project’s 2023 U.S. National Survey on the Mental Health of LGBTQ Young People were approved by an independent Institutional Review Board.

A quantitative cross-sectional design was used to collect data through an online survey platform between September 1 and December 12, 2022. A sample of individuals ages 13 to 24 who resided in the United States was recruited via targeted ads on social media. No recruitment was conducted via The Trevor Project’s website or social media channels. Respondents were defined as being LGBTQ if they identified with a sexual orientation other than straight/heterosexual, a gender identity other than cisgender, or both. In order to ensure the representativeness of the sample, targeted recruitment was conducted to ensure adequate sample sizes with respect to geography, gender identity, and race/ethnicity. Qualified respondents completed a secure online questionnaire that included a maximum of 158 questions. Questions on considering and attempting suicide in the past year were taken from the Centers for Disease Control and Prevention’s Youth Risk Behavior Survey to allow for comparisons to their nationally representative sample. Each question related to mental health and suicide was preceded by a message stating, “If at any time you need to talk to someone about your mental health or thoughts of suicide, please call The Trevor Project at 1-866-488-7386.”

Although 98,023 individuals from unique IP addresses began the survey, 1,784 were ineligible due to sampling inclusion requirement, 35,830 did not complete the initial demographic screening questions, and 25,201 were pathed out of the sample because they did not meet recruitment requirements based on the demographic screening questions. This resulted in an eligible sample of 35,208 LGBTQ young people ages 13 to 24. Of those young people, a total of 1,495 (4%) failed the study’s validity check, indicated that they weren’t honest in their responses, and/or were identified as mischievous based on written responses. Additionally, 5,189 (15%) young people did not reach the mid-point of the survey, which included our questions on suicidal thoughts and attempts. This results in a final analytic sample of 28,524 LGBTQ young people ages 13 to 24 who resided in the United States. Chi-square tests were used to examine differences between groups. All reported comparisons are statistically significant at least at p<0.05. This means there is less than a 5% likelihood these results occurred by chance.

This report uses “transgender and nonbinary” as an umbrella term to encompass non-cisgender young people, which includes young people who identify as transgender and nonbinary as well as other labels outside of the cisgender binary, including genderqueer, agender, genderfluid, gender neutral, bigender, androgynous, and gender non-conforming, among others.

Comparability

In order to better understand how our sample compares to a national probabilistic sample, we included questions regarding considering and attempting suicide that were identical to those used by the Centers for Disease Control and Prevention (CDC) in their Youth Risk Behavior Survey (YRBS).

Analyses were conducted to compare rates of seriously considering suicide and attempting suicide in the past 12 months among young people ages 13 to 18 in our sample to the 2021 YRBS sample of high school students who identify as lesbian, gay, bisexual, questioning, or another non-heterosexual identity (LGBQ+).

YRBS prevalence rates among LGBQ+ young people for seriously considering suicide (45%) were identical to rates among the same age range in our sample of LGBTQ young people (45%).

Additionally, 22% of LGBQ+ young people in the 2021 YRBS reported a suicide attempt in the past 12 months compared to 16% in our sample of LGBTQ young people ages 13 to 18.

Comparability to the CDC’s Youth Risk Behavior Survey (YRBS)

Sample Breakdown of Respondents’ Demographics

By age

  • 61% 13–17
  • 39% 18–24

By sexual orientation

  • Straight/Heterosexual: less than 1%
  • 13% Gay
  • 14% Lesbian
  • 29% Bisexual
  • 19% Pansexual
  • 11% Queer
  • 4% Questioning
  • 10% Asexual

By gender identity

  • 29% Girl or Woman
  • 27% Boy or man
  • 36% Nonbinary, bigender, genderfluid, or genderqueer
  • 8% Not sure or questioning

By transgender & nonbinary identity

  • 41% Cisgender
  • 8% Questioning if transgender or nonbinary
  • 51% Transgender or nonbinary

By race/ethnicity

  • 1% Middle Eastern/Northern African
  • 1% Native/Indigenous
  • 6% Asian American/Pacific Islander
  • 5% Black
  • 14% Hispanic/Latinx
  • 23% More than one race/ethnicity
  • 50% White

By socioeconomic status

  • 79% More than meets basic needs
  • 21% Just meets basic needs or less

By region

  • 15% Northeast
  • 36% South
  • 22% Midwest
  • 27% West

Suggested citation:

The Trevor Project. (2023). 2023 U.S. national survey on the mental health of LGBTQ young people. [PDF]