Keygan Miller, Senior Advocacy Associate for The Trevor Project, spotlights the wide disparity in suicide risk for LGBTQ youth compared to straight cisgender youth.

In a presentation, “From Equality to Equity in LGBTQ Youth Suicide Prevention,” to the Suicide Prevention Center of New York’s “AIM for Zero: Suicide Care is Healthcare” symposium September 28-30, Miller cited Trevor Project research indicating that 42 percent of LGBTQ youth—as many as 1.8 million young people—seriously considered taking their own lives in the past year.

That’s four times greater than their peers, they said.

“Most of us know that youth suicide in general is a problem,” Miller explained. “It’s the second leading cause of death amongst young people ages 10 to 24. But for LGBTQ youth in particular, this is dire.”

Miller explained that various aspects of the lives of LGBTQ youth such as discrimination and bullying help explain the disparity. They said that 75 percent reported that they had experienced discrimination based on sexual orientation or gender identity. “Discrimination comes from adults in their lives, peers in their lives, and outside authorities,” they said.

For example, Miller said, 48 percent of LGBTQ youth reported wanting counseling from a mental health professional but were unable to receive it in the past year. Discrimination is felt even when it comes to using basic services. Miller said that 58 percent of transgender non-binary youth reported being discouraged from using restrooms that correspond with their gender identity.

Part 8 in a Series about the Zero Suicide Model for Healthcare

Miller cited social pressures experienced by LGBTQ youth. They said two in three reported that someone had tried to convince them to change their sexual orientation or gender identity. “Or it could be something as terrible as ‘conversion therapy,’ which is the idea that we can change someone’s sexual orientation or gender identity through a variety of means, which is a discredited and dangerous practice,” they said.

LGBTQ youth are also affected by the nation’s politics, Miller said. They said that three-quarters felt that the recent political climate has impacted their mental health or sense of self—”everything from something in your day-to-day life such as using the bathroom all the way up to the narratives that are being woven by people in the highest of power in this country.”

All this, Miller explained, affects the “crisis threshold” of LGBTQ youth. “We have to look at baseline vulnerability,” they said. “If someone has a lower baseline vulnerability when a stressor is introduced, they are not as likely to meet that crisis threshold as someone who has a higher baseline vulnerability. This is where we end up with a lot of suicidality.”

Miller said that vulnerability is particularly important for people who hold multiple marginalized identities. They noted that while Black LGBTQ youth suffer similar rates of depression as their LGBTQ peers, they are significantly less likely to receive care.

Mental health providers and other adults can take a number of actions to support LGBTQ youth, Miller said. They pointed to research indicating that having just one supportive adult in their life lowers the risk of suicide by 40 percent. “Imagine if they had multiple supporting adults in their lives and how much impact that could have,” they said.

Understanding identity issues, and the value of using preferred pronouns, enables adults to be more supportive, Miller said. “One of the things that our young people face in the mental health space is having to educate their mental health providers about their identity from a very baseline level,” they said. “So, if we have that baseline understanding, then we can really dive into what that identity means for that young person as opposed to having a 101-level conversation.”

Miller called for supportive and inclusive public policies to raise the baseline vulnerability level of LGBTQ youth, tackling challenges such homelessness, economic instability, and access to physical healthcare and mental health care. In schools, they said, this involves training teachers in mental health and suicide prevention, having crisis services in place, and educating students about mental health.

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If you or someone you know feels the need to speak with a mental health professional, you can contact the National Suicide Prevention Lifeline at 1-800-273-8255 or contact the Crisis Text Line by texting HOME to 741-741. For LGBTQ youth support from The Trevor Project, call 1-866-488-7386 or text ‘START’ to 678-678.