A survey of more than 40,000 LGBTQ+ youths finds that almost half of the respondents had engaged in acts of self-harm over the past year. Among transgender and nonbinary youths, more than 60% responded in this way.

Since 2019, the nonprofit organization The Trevor Project, who offer mental health and suicide prevention support to LGBTQ+ youths in the United States, have been running a nationwide mental health survey.

The results of their 2020 survey paint a stark picture. They have revealed that a large number of LGBTQ+ youths have encountered discrimination and adversity and experienced mental health issues such as generalized anxiety disorder (GAD).

Amit Paley, CEO and executive director of The Trevor Project, writes that the “need for robust research, systematic data collection, and comprehensive mental health support [for LGBTQ+ youths] has never been greater,” since “suicide is […] consistently the second leading cause of death among young people and continues to disproportionately impact LGBTQ youth[s].”

For the survey, The Trevor Project received responses from 40,001 people aged 13–24 who live in the U.S. and belong to the LGBTQ+ community.

Among the participants:

• more than 4,000 were Hispanic or Latinx
• over 1,500 were Black or African American
• more than 1,500 were Asian or Pacific Islander
• over 500 were American Indian or Alaskan Native

Survey responses indicated that 48% of LGBTQ+ youths had engaged in self-harming behaviors over the previous 12 months, with more than 60% of transgender or nonbinary respondents reporting acts of self-harm.

Also, 34% of cisgender respondents said that they had experienced suicidal ideation over the past year, while 52% of transgender or nonbinary youths indicated that they had seriously contemplated suicide.

As many as 68% of respondents said that they had experienced symptoms of GAD in the 2 weeks before the survey. This was also true for more than 75% of transgender or nonbinary respondents.

The fact that so many LGBTQ+ youths experience mental health struggles may come as no surprise, given the fact that a large number of the survey respondents also reported experiencing discrimination, harassment, or adversity tied to their gender identity or sexual orientation.

Around 10% percent of respondents said that they had undergone conversion therapy. According to the Substance Abuse and Mental Health Services Administration, this is a practice that “perpetuates outdated views of gender roles and identities, […] [putting] young people at risk of serious harm.” It is still legal in a number of U.S. states.

Of the respondents who had undergone this intervention, 78% said that they had done so when they were under the age of 18.

Also, as many as 29% of respondents said that they had experienced housing instability, including homelessness, and around 30% reported having “been physically threatened or harmed in their lifetime due to their LGBTQ identity.”

Transgender or nonbinary respondents had also experienced other forms of abuse. For example, 61% said that they had been “prevented or discouraged from using a bathroom that corresponds with their gender identity,” and only around 20% said that people in their lives consistently respected their correct pronouns.

This is in stark contrast with the fact that, according to the survey results, transgender and nonbinary people who are able to affirm their correct identity are less likely to attempt suicide than those who are unable to affirm their correct identity.

Specifically, the survey results indicate that “transgender and nonbinary youth[s] who report having their pronouns respected by all or most of the people in their lives attempted suicide at half the rate of those who did not have their pronouns respected.”

Although they make up some of the demographics who encounter higher mental health risks, many LGBTQ+ youths also reported being unable to access formal support.

In fact, “46% of LGBTQ youth[s] report they wanted psychological or emotional counseling from a mental health professional but were unable to receive it in the past 12 months.”

Some of the most important deterrents the respondents reported were:

• concerns about parental permission to access care
• lack of financial resources
• concerns about care providers’ LGBTQ+ competences

However, the survey also highlights some silver linings. Around 78% of respondents said that they were able to access “at least one in-person LGBTQ-affirming space,” and 86% of respondents said that they received “high levels of support from at least one person” in their lives.

“Given the lack of LGBTQ-inclusive data nationwide, we hope this report will provide valuable insights that can be used by researchers, policymakers, and the many organizations working alongside The Trevor Project to support LGBTQ young people everywhere,” says Paley.