Stepping Up and Affirming LGBTQI+ Youth

At the beginning of March, Health and Human Services (HHS) Secretary Xavier Becerra released a statement reaffirming HHS support and protection for LGBTQI+ children and youth. The statement was made in response to state legislatures enacting an unprecedented number of anti-LGBTQ+ policies in 2021. According to the Human Rights Campaign, 2021 saw the highest number of anti-LGBTQ+ state laws passed in recent history, with a similar wave already underway in 2022. Sadly, this is not without consequence. A recent poll by The Trevor Project found two-thirds of LGBTQ+ youth said their mental health has deteriorated because of these recent efforts to restrict access to services like gender-affirming care for transgender youth.

How is this related to suicide prevention work? Our mission is to reduce suffering and lives lost to suicide. Transgender people have similar risk factors for suicide as cisgender people but also face factors such as discrimination or lack of access to gender-affirming health care. These added risk factors are associated with higher rates of suicidal thoughts and suicide attempts among transgender people than their cisgender peers. Studies have found roughly 40% of transgender adults have attempted suicide in their lifetimes and 30% of transgender youth have attempted suicide in the past year. Yet, research suggests that experiencing respect, affirmation, and support can help lower that risk.

Socioeconomic stressors are common among transgender people and are associated with a higher risk of suicidal thoughts and suicide attempts. Such stressors include experiencing discrimination, mistreatment, or violence in a variety of settings that should be safe, such as at home, school, or work, and in places of public accommodation, housing, health care, or law enforcement. Transgender people who need access to gender-affirming health care, such as hormone therapy or surgical care, may experience barriers to receiving that care, including high cost, lack of providers, and prohibitive policies, which are compounded by recent laws.

As of 2021, over 45,000 transgender youth lived in states where legislation had passed or been proposed to prohibit them from accessing gender-affirming health care. A study published that year found more than 3 in 4 transgender and nonbinary youth reported symptoms of generalized anxiety disorder and more than 2 in 3 reported symptoms of major depressive disorder. Providing transgender and nonbinary youth with gender-affirming care can help reduce their risk of mental health issues. As we continue to pursue suicide prevention and well-being for all, we must educate ourselves on these issues and stand with the transgender community.

Reducing suicide among transgender individuals requires implementing laws, policies, and programs that aim to reduce discrimination, increase family and social support, and improve access to gender-affirming care. In addition, filling gaps in official data collection systems, like the National Violent Death Reporting System, to improve the accuracy of data on transgender populations can also help inform prevention planning.

March 31 is the International Transgender Day of Visibility, an annual awareness day celebrating transgender and gender-nonconforming people while advocating for increased efforts to achieve equity and justice. In addition to celebrating Transgender Day of Visibility, we encourage you to consider the following ways of getting involved:

• Support your local GSA Network and PFLAG chapters.
• Educate yourself on how to be an ally to transgender and nonbinary youth, including in schools.
• Make your support visible with graphics and posters.
• Follow organizations that share current information and resources for transgender youth and for those who love and work with them, such as The National SOGIE Center, The Trevor Project, GLSEN, Transgender Law Center, and the National Center for Transgender Equality.
• Reach out to the Center of Excellence on LGBTQ+ Behavioral Health Equity, which provides practitioners with information on supporting people identifying as LGBTQI+, two-spirit, and other diverse sexual orientations, gender identities, and expressions, including free webinar sessions. 
• Check out A Practitioner’s Resource Guide: Helping Families to Support Their LGBT Children from the Substance Abuse and Mental Health Services Administration that offers guidance for practitioners throughout health and social service systems.

Now more than ever, supportive action is critical. As always, we appreciate your continued work to make suicide prevention efforts effective, equitable, and accessible to all community members.

Alex Karydi, PhD, LMFT, CAC, CASAC II 

SPRC Director of State and Community Initiatives

Education Development Center

This piece was produced with support from SPRC Co-directors Dolores Subia BigFoot, PhD, and Beverly W. Funderburk, PhD, as well as SPRC communications staff Jesse Danielle Gass, MPH, Helle Lord-Elliott, BA, and Linda Sobottka, BS, MLIS.