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National Estimate of LGBTQ Youth Seriously Considering Suicide

EXECUTIVE SUMMARY

About The Trevor Project

The Trevor Project is the world's largest suicide prevention and crisis intervention organization for lesbian, gay, bisexual, transgender, queer & questioning (LGBTQ) young people. The Trevor Project offers a suite of 24/7 crisis intervention and suicide prevention programs, including TrevorLifelineTrevorText, and TrevorChat as well as the world’s largest safe space social networking site for LGBTQ youth, TrevorSpace. Trevor also operates an education program with resources for youth-serving adults and organizations, an advocacy department fighting for pro-LGBTQ legislation and against anti-LGBTQ rhetoric/policy positions, and a research team to discover the most effective means to help young LGBTQ people in crisis and end suicide. If you or someone you know is feeling hopeless or suicidal, our trained crisis counselors are available 24/7 at 1-866-488-7386 via chat www.TheTrevorProject.org/Help, or by texting START to 678678.

About this Work

Suicide is the 2nd leading cause of death among young people (Hedegaard, Curtin, & Warner, 2018), with LGBTQ youth being 4 times more likely to seriously consider suicide, to make a plan for suicide, and to attempt suicide than their peers (Kann et al., 2018; Johns et al., 2019). Understanding the number of LGBTQ youth who seriously considered killing themselves each year will aid in prevention strategies, improve our ability to advocate for LGBTQ supportive policies, and advance future research endeavors.

Findings

  • Overall, more than 1.8 million LGBTQ youth between the ages of 13 and 24 in the U.S. seriously consider suicide each year.
  • We estimate that at least 1.2 million LGBTQ youth aged 13–18 in the U.S. seriously consider suicide each year.
  • We further estimate that at least 693,000 LGBTQ youth aged 19–24 in the U.S. seriously consider suicide each year.

Methodology

To compute our estimates, we utilized multiple data sources including the U.S. Census, The Centers for Disease Control and Prevention’s Youth Risk Behavior Survey, The Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System Survey, The Gallup Daily tracking survey, the National Survey of Family and Growth, Substance Abuse and Mental Health Services Administration’s National Survey on Drug Use and Health, The Trevor Project’s National Survey on LGBTQ Youth Mental Health, and national peer-reviewed studies examining suicidality among LGBTQ populations. Our methodology and estimates were reviewed by an external panel of seven national experts on either LGBTQ youth or suicidology. Experts included psychologists, psychiatrists, and epidemiologists across academic settings and non-profit organizations.

BACKGROUND

Lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) youth often face disparities in suicide risk compare to their non-LGBTQ peers. Research has documented that LGBTQ youth report significantly higher rates of having seriously considered suicide, making a plan to attempt suicide, and attempting suicide compared to heterosexual and/or cisgender youth (Kann et al., 2018; Marshal et al, 2013; Toomey, Syvertsen, & Shramko, 2018). These disparities in suicidality are thought to be due to stressors and discrimination associated with being in a socially stigmatized position in society (Meyer, 2003), as opposed to being LGBTQ in and of itself.

Though it is clear that LGBTQ youth are at a higher risk for suicide, there is no current population estimate of the number of LGBTQ youth who seriously consider suicide each year in the United States (U.S.). For example, the Center for Disease Control and Prevention’s national level Youth Risk Behavior Surveillance Survey (YRBS) only samples in-school high-school age youth and, until 2017, did not include a measure that would allow the reporting of findings by gender identity. Additionally, there are few population based estimates on the percentage of the U.S. adult population who identify as LGBTQ or the percentage of adults who seriously consider suicide each year.

A clear understanding of the number of LGBTQ youth who seriously consider suicide is necessary to develop national prevention strategies, advocate for policy changes, and advance research efforts. To provide a strong basis for future work, we utilized diverse, reliable sources of data to compute an estimate of the number of LGBTQ youth ages 13–24 who seriously consider suicide in the U.S. each year to improve efforts to end LGBTQ youth suicide.

METHODOLOGY

We used a three-step methodology that estimated: 1) the number of youth ages 13–24 in the United States, 2) the number of youth ages 13–24 who identify as LGBTQ, and 3) the percentage of LGBTQ youth ages 13–24 who responded affirmatively to a question about whether they seriously considered suicide in the past 12 months. We nuance the methodology based on age ranges and provide outputs for these specific age groups in addition to the total. Our methodology and estimates were reviewed by an external panel of seven national experts on either LGBTQ youth or suicidality. Experts included psychologists, psychiatrists, and epidemiologists across academic settings and non-profit organizations.

Notes on terminology

Throughout the report, we used the acronym LGBTQ to refer to youth who identify as lesbian, gay, bisexual, transgender, queer, and/or questioning. However, there are times when we used a variation of the acronym LGB, without transgender or queer/questioning, when those groups are not specifically included in the sources of data from which we are basing our estimate.

Data point selection

We utilized a conservative approach to estimate the number of LGBTQ youth who seriously consider suicide each year. First, we selected youth between the ages 13–24, because there are no reliable national estimates on the sexual orientation and gender identity or levels of suicide ideation for youth under age 13. Second, our estimates are based on sexual orientation and gender identity self-identification questions, rather than more generally focusing on related constructs such as sexual attraction, sexual behaviors, and gender expression. Our focus on identity is due in large part to the national-level data that is available on both youth and young adult populations in the U.S. Third, when more than one national prevalence estimate was available, we elected to use the lowest of the numbers.

Estimated number of youth ages 13–18 and 19–24 in the U.S.

The total number of youth ages 13–18 and 19–24 was estimated using the U.S. Census Bureau’s Annual Estimates of the Resident Population 2017 population estimates (U.S. Census, 2018). The Census data provides estimates for youth ages 10–14, 15–19, and 20–24; therefore, we used calculations to determine estimates for the ranges of interest.

Estimated number of youth ages 13–18

The U.S. Census estimates the number of youth ages 10–14 to be 20,778,454. If equal distribution is assumed across all five ages, an estimated 8,311,382 youth would be between 13 and 14 years old. Additionally, the Census estimates 21,131,660 youth to be ages 15–19. Similarly, if equal distribution is assumed across all five ages, an estimated 16,905,328 youth are 15–18. Therefore, 25,216,710 youth are estimated to be ages 13–18 years old in the U.S.

Estimated number of youth ages 19–24

As mentioned above, Census data estimates that 21,131,660 youth are 15–19 and, again, if equal numbers are assumed, 4,226,332 youth are estimated to be 19 in 2017. Further, the estimate of youth ages 20–24 was 22,118,635 in 2017. Therefore, 26,344,967 youth are estimated to be ages 19–24 years old in the U.S.

Estimated percentage of youth ages 13–24 in the U.S. who identify as LGBTQ

As there is currently no single national prevalence data to serve as a reference, several sources were used to estimate the percentage of youth between ages 13 and 24 who identify as LGBTQ. Estimating the percentage of youth who identify as LGBTQ comes with many challenges. After sampling concerns are considered (e.g., nationally representative, random sample), youth must be willing to disclose their identity on a survey. Additionally, researchers may define “LGBTQ” differently from one study to the next (i.e., identity vs. behavior vs. attraction). As such, our estimates used the best available data to date.

Estimated percentage of youth 13–18 who identify as LGBTQ

With regards to sexual orientation, the 2017 YRBS found that 10.5% of high school students identified as LGB: 2.5% identified as gay or lesbian and 8.0% as bisexual, (Kann et al., 2018). The YRBS also found that 5% of youth 13–18 identified as unsure of their sexual orientation. However, as part of our approach to avoid overestimating the proportion of the youth population who identify as LGBTQ and in order to create consensus in the field, respondents who identified as “not sure” were not included in our estimate. Currently, the YRBS does not provide a national dataset that includes both sexual orientation and gender identity. The available estimate of transgender high school students, based on select states and districts, is 1.8% (Johns et al., 2019). However, this 1.8% may not be unique from those who identify as LGB. For example, in our national survey of LGBTQ youth aged 13–24, a minority of transgender and gender diverse youth selected “straight” as their sexual orientation. Additionally, The Williams Institute (2019), estimated that .3% of youth age 13–17 identify as transgender and straight. Given our approach to provide a more conservative estimate, and the level of identity overlap in our sample, we utilized the 2017 YRBS LGB data to estimate that 10.5% of 13–18 year old youth identify as LGBTQ.

Estimated percentage of youth 19–24 who identify as LGBTQ

A report by the National Survey of Family and Growth (NSFG) found that 9.6% of youth ages 18–24 identified as LGB: 1.8% identified as homosexual/gay/lesbian and 7.8% identified as bisexual (Copen, Chandra, & Febo-Vazquez, 2016). Additionally, a 2017 Gallup Daily tracking survey estimated that 11.3% of 18–24 year old youth identified as LGBT (K. Conron, personal communication, May 30, 2019). Finally, The Behavioral Risk Factor Surveillance System (BRFSS) estimated that 10.4% of youth ages 18–24 identified as LGB (CDC, 2017). Based on the desire to provide a conservative estimate, we elected to use the NSFG estimate of 9.6% for the prevalence of LGBTQ identity among youth ages 19–24 in the U.S.

Estimated percentage of LGBTQ youth ages 13–24 in the U.S. who seriously consider suicide

Similar to the number of youth who identify as LGBTQ, there is not yet a single national prevalence dataset estimating the number of LGBTQ youth between the ages of 13 and 24 years old who seriously considered suicide in the in the past 12 months; therefore, we used several different sources.

Estimated percentage of 13–18-year-old LGBTQ youth who seriously consider suicide

The 2017 YRBS found that 47.7% of LGB youth ages 14–18 seriously considered suicide in the past 12 months (Kann, 2018). Additionally, The Trevor Project’s 2019 National Survey on LGBTQ Mental Health found that 45.3% of LGBTQ youth ages 13–18 seriously considered suicide in the past 12 months. As such, we conservatively estimated that 45.3% of LGBTQ youth ages 13–18 seriously considered suicide in the past year. Both surveys assessed suicide by asking “During the past 12 months, did you ever seriously consider attempting suicide?”

Estimated percentage of 19–24-year-old LGBTQ youth who seriously consider suicide

Substance Abuse and Mental Health Services Administration’s 2017 National Survey on Drug Use and Health assesses suicidality by asking respondents at any time in the past 12 months “did you seriously think about trying to kill yourself?” An analysis of the data found that 27.4% of LGB youth ages 18–25 seriously thought about trying to kill themselves in the past 12 months (SAMHSA, 2017). The Trevor Project’s 2019 National Survey on LGBTQ Youth Mental Health found that 29.0% of LGBTQ youth ages 19–24 seriously considered attempting suicide in the past 12 months. We selected the more conservative prevalence rate and estimated that 27.4% of LGBTQ youth ages 19–24 seriously considered attempting suicide in the past year.

Estimated Number of LGBTQ youth between 13 and 24 in the U.S. who seriously consider suicide

To compute this figure, we multiplied the estimated number of youth 13–18 and 19–24 in the U.S. by the percentage of youth in those age groups estimated to be LGBTQ in the U.S. That result was then multiplied by the estimated percentage of LGBTQ youth ages 13–18 and 19–24 in the U.S. who seriously considered suicide. For the overall number, we combined these two figures.

RESULTS

More than 1.8 million LGBTQ youth ages 13–24 in the U.S. are estimated to have seriously considered suicide in the past year. We estimate that 1,199,000 LGBTQ youth ages 13–18 in the U.S. have seriously considered suicide in the past year. We further estimate that 693,000 LGBTQ youth ages 19–24 have seriously considered suicide in the past year. In total, our estimate includes 1,892,000 youth ages 13–24.

LOOKING AHEAD

While previous research efforts have extensively documented that LGBTQ youth are more likely to experience suicidal ideation compared to their straight and/or cisgender peers, it remained unclear just how many youth in the U.S. were at risk each year. The Trevor Project filled this important gap by using multiple sources of national data to estimate the number of LGBTQ youth in crisis.

With more than 1.8 million LGBTQ youth ages 13–24 seriously considering suicide each year, it is imperative that we act now. Below we outline implications for research, advocacy, and practice based on our findings. We also highlight implications specific to The Trevor Project.

Implications for Research. It is important to note that there is a lack of available data examining suicidality across the lifespan, particularly specific to LGBTQ youth. Similarly, the studies that do provide estimates have their own shortcomings with respect to how sexual identity was assessed and the inclusion of gender identity. These shortcomings, in addition to our use of conservative figures, likely resulted in an underestimate of the number of LGBTQ youth who seriously consider suicide each year. Enhanced national data collection on sexual orientation and gender identity, as well as suicidality, would allow future estimates to provide nuance related to rates across different LGBTQ youth identities, including attention to how the intersectionality of multiple marginalized identities impacts suicidality.

Implications for Advocacy. Our ability to document that more than 1.8 million LGBTQ youth seriously consider suicide each year also provides important data for youth advocates who work to ensure that local, state, and federal policies are supportive of vulnerable youth. For example, these data highlight the need for LGBTQ-specific suicide prevention policies as well as the need to dedicate funding streams to clinical and research initiatives that address suicide prevention among LGBTQ populations.

Implications for Practice. This number also signals that, although we may have made important strides in advancing public opinion and LGBTQ rights in the U.S., there is still an astoundingly high number of LGBTQ youth who seriously consider suicide each year. With this deeper understanding, organizations should consider the needs of LGBTQ youth in programmatic and outreach efforts. Future initiatives should examine ways to systematically assess and prevent suicide in youth populations while attending to disparities in suicide rates by identity. Additionally, these findings highlight the need to increase the prevalence of and access to LGBTQ-affirming mental health treatment.

Implications for Trevor. For The Trevor Project specifically, these results motivate our continued commitment to save young LGBTQ lives. It should be noted that an additional 5% of youth identified as “not sure” of their sexual orientation on the 2017 YRBS (Kann, 2018), and The Trevor Project serves all LGBTQ youth in crisis, including those who are questioning or who are unsure of their sexual orientation or gender identity. Thusly, this estimation is only a subset of those who would benefit from The Trevor Project’s services. Understanding the sheer breadth of the mental health crisis for LGBTQ youth allows us to better position ourselves to fully address the needs of LGBTQ youth through crisis intervention, advocacy, education, and research. Most importantly, this estimate fully supports our continued expansion of our crisis intervention services to meet the needs of even more youth. Additionally, we are better positioned to advocate for policy changes that can ameliorate the mental health adversitites among LGBTQ youth. These estimates will also be used to inform training and education initiatives aimed at equipping others to support LGBTQ youth. These results can serve as a catalyst for increasing Trevor’s research on suicide among LGBTQ youth, so that we may better understand risk and protective factors and measure the impact of our efforts to end LGBTQ youth suicide.

This report is a collaborative effort from the following individuals at The Trevor Project:
Amy Green, PhD
Director of Research

Amit Paley
CEO & Executive Director

Jonathan Silberman
Senior Marketing Designer and Webmaster

Myeshia Price-Feeney, PhD
Research Scientist

Samuel Dorison, LLM, MSc
Chief of Staff

Kevin Wong
Head of Communications

 

We would like to acknowledge the following people for their review of our methodology:
Kerith Conron, Sc.D., MPH,
Blachford-Cooper Distinguished Scholar and Research Director
The Williams Institute

Colleen Creighton, MA
Executive Director
American Association of Suicidology

Madelyn Gould, PhD, MPH
Irving Phillips Professor of Epidemiology in Psychiatry
Columbia University Medical Center/New York State Psychiatric Institute

Jill Harkavy-Friedman, PhD
Vice President of Research
American Foundation for Suicide Prevention

Aron Janssen, M.D.
Vice Chair, Pritzker Department of Psychiatry and Behavioral Health
Ann and Robert H. Lurie Children’s Hospital of Chicago

Christine Moutier, M.D.
Chief Medical Officer
American Foundation for Suicide Prevention

Dan Reidenberg, Psy.D., FAPA
Executive Director
Suicide Awareness Voices of Education

Recommended Citation: Green, A.E., Price-Feeney, M. & Dorison, S.H. (2019). National Estimate of LGBTQ Youth Seriously Considering Suicide. New York, New York: The Trevor Project.

Media inquiries, please contact: 

Kevin Wong
Head of Communications
[email protected]
212.695.8650 x407

For research-related inquiries, please contact: 

Amy Green, PhD
Director of Research
[email protected]
310.271.8845 x242

References

Centers for Disease Control and Prevention (2017). Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention.

Conron, K. (2019, May 30). Email communication with K. Conron.

Copen CE, Chandra A, Febo-Vazquez I. (2016). Sexual behavior, sexual attraction, and sexual orientation among adults aged 18–44 in the United States: Data from the 2011–2013 National Survey of Family Growth. National Health Statistics Reports; 88. Hyattsville, MD: National Center for Health Statistics.

di Giacomo, E., Krausz, M., Colemegna, F., et al. (2018). Estimating the risk of attempting suicide among sexual minority youths: a systematic review and meta analysis. JAMA Pediatrics, 172(12), 1145-1152.

Gibbs, J. J., & Goldbach, J. (2015). Religious Conflict, Sexual Identity, and Suicidal Behaviors among LGBT Young Adults. Archives of Suicide Research : Official Journal of the International Academy for Suicide Research, 19(4), 472–488.

Hedegaard H., Curtin S.C., & Warner M. (2018). Suicide mortality in the United States, 1999–2017. National Center for Health Statistics Data Brief, 330, Hyattsville, MD: National Center for Health Statistics.

Johns, M.M., Lowry, R., Andrzejewski, J., Barrios, L.C., Zewditu, D., McManus, T., et al. (2019). Transgender identity and experiences of violence victimization, substance use, suicide risk, and sexual risk behaviors among high school student–19 states and large urban school districts, 2017. Morbidity and Mortality Weekly Report, 68(3), 65-71.

Kann, L, McManus, T., Harris, W.A., et al. (2018). Youth Risk Behavior Surveillance — United States, 2017. Morbidity and Mortality Weekly Report Surveillance Summaries, 67(8).

Marshal, M.P., Dermody, S.S., Cheong, J., et al. (2013). Trajectories of depressive symptoms and suicidality among heterosexual and sexual minority youth. Journal of Youth and Adolescence, 42(8), 1243-1256.

Meyer, I.H. (2003) Prejudice, social stress, and mental health in lesbian, gay, bisexual populations: Conceptual issues and research evidence. Psychological Bulletin, 129(5), 674-697.

Substance Abuse and Mental Health Services Administration (2017). 2017 National Survey on Drug Use and Health Data. Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration.

The Trevor Project (2019). National Survey on LGBTQ Mental Health. New York, New York: The Trevor Project.

The Williams Institute (2019). LGBT People in the United States Not Protected by State Nondiscrimination Statutes. The Williams Institute, UCLA: Los Angeles, CA.

Toomey, R.B., Syvertsen, A.K., Shramko, M. (2018). Transgender adolescent suicide behavior. Pediatrics, 142(4) e20174218.

U.S. Census Bureau (2018). Annual estimates of the resident population for selected age groups by sex for the United States, states, counties and Puerto Rico Commonwealth and Municipios: April 1, 2010 to July 1, 2017.

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