LGBTQ+ Youth Mental Health: Why Support Can Be Life Saving

Growing up is hard, from managing academic pressure to navigating new social situations. Youth who identify as LGBTQ+ (lesbian, gay, bisexual, transgender, queer, or questioning) often face additional issues, like stigma, bullying, and discrimination—and those stressors can lead to serious mental health crises.

Alarmingly, one in 10 LGBTQ+ youths aged 13-24 attempted suicide in 2025, according to the U.S. National Survey on the Mental Health of LGBTQ+ Young People; over a third seriously considered attempting suicide.

“The statistics are incredibly concerning,” says Jae Sevelius, PhD, a clinical psychologist and behavioral health researcher at Columbia. “They aren’t just numbers—they represent real young people with their whole lives ahead of them.” Research also shows that LGBTQ+ people are at higher risk of developing psychiatric disorderslike anxiety, depression, and OCD compared to their non-LGBTQ+ peers.

However, higher risk doesn’t mean inevitable. Dr. Sevelius and their colleague, Columbia clinical psychologist Jeffrey Cohen, PsyD, say the issue is social, not inherently psychological.

“The increased risks of suicide and psychiatric disorders aren’t baked into LGBTQ+ identities,” says Dr. Cohen. Many LGBTQ+ people lead joyful and fulfilling lives when they’re supported and accepted for who they are.

Drawing from their many years working with LGBTQ+ communities, Drs. Sevelius and Cohen break down the factors that affect the health of LGBTQ+ youth, offer evidence-based ways to support them and their families, and share resources for affirming mental health care and community support.

Why LGBTQ+ youth face higher mental health risks

Our social environment plays an important role in our mental health. When people are discriminated against for who they are, they may internalize messages that they are “less-than” or that something is wrong with them.

For LGBTQ+ people, the data shows a strong and consistent pattern: stigma, victimization, barriers to health care, and politicized social environments lead to worse mental health outcomes. These factors are magnified for children and teens, who are still developing their sense of self-worth and learning to navigate the world.

“Young people don't yet have the capacity and the resources to provide and care for themselves in the way that adults would, which makes them incredibly vulnerable,” Dr. Sevelius says.

When LGBTQ+ children and teens are not in supportive school systems or home environments, they’re much more likely to be victims of violence, harassment, isolation, neglect, and homelessness. On a broader scale, LGBTQ+-related policies, laws, and debates are key factors contributing to increased stress and anxiety.

These experiences can have serious impacts on mental and physical health. In addition to mood and anxiety disorders, LGBTQ+ youth are at increased risk of developing substance use disorders and HIV.

“LGBTQ+ young people may feel that their lives are not worth protecting, or seek affirmation and acceptance in risky ways,” says Dr. Sevelius. “What happens in someone's youth can influence their mental health outcomes for a long time to come.”

Not all LGBTQ+ youth experience these challenges in the same way. Factors like race, ethnicity, religion, and gender identity can shape how people experience the world and interact with their communities. For example, LGBTQ+ people of color may face both racism and homophobia or transphobia. Others may struggle to reconcile their LGBTQ+ identity with messages they receive from their faith or cultural communities.

For some young people, these overlapping challenges can also make it harder to access support and health care.

Why getting mental health care can be difficult

Many LGBTQ+ young people actively seek mental health care, but finding it can be challenging.

Part of the problem is access: Although cost, insurance coverage, and provider shortages can create barriers for anyone, LGBTQ+ people have additional needs.

“LGBTQ+ people need not only affirming care, in which their identities are supported, but also evidence-based care that’s supported by scientific research,” says Dr. Cohen, such as dialectical behavior therapy, cognitive behavioral therapy, and exposure therapy for depression, anxiety, and OCD. Some transgender and nonbinary people also struggle to access gender-affirming medical care, such as hormone therapy, due to local laws banning or restricting treatments.

A related problem is fear for personal safety. According to the 2025 survey, around one in three LGBTQ+ young people couldn’t access mental health care because they felt uncomfortable asking for their parents’ or caregivers’ permission or were afraid of involuntary hospitalization or police involvement.

“There are a lot of compounding factors that create barriers for LGBTQ+ young people seeking mental health care that are above and beyond what the general population faces,” says Dr. Sevelius. These obstacles themselves can worsen depression and anxiety, creating a dangerous feedback loop.

What helps LGBTQ+ youth thrive

Despite the unique challenges many LGBTQ+ young people face, there are several approaches that can improve their mental health and that of their families.

“We have an exciting opportunity to shift the trajectory of these health disparities,” says Dr. Cohen. “If we can meet that need by providing access to mental health care that's both affirming and evidence-based, we can improve outcomes for this at-risk population.”

Beyond health care settings, supportive social environments are known to significantly reduce the risk of psychiatric disorders and suicide in LGBTQ+ people. LGBTQ+ youth and their families can find and build these environments through:

• Structured social support: In-person or online support groups, trained peer health navigators, drop-in spaces, clubs and organizations, and group activities can be especially effective for youth, who may feel more comfortable interacting with people their own age.
• Age-appropriate conversations about sexual orientation and gender identity: Proactively discussing these topics with children and teens can educate them on and normalize diverse identities, relationships, and family structures.
• Respecting LGBTQ+ identities: Using your child’s chosen pronouns and name, welcoming their LGBTQ+ friends into your home, and supporting how they choose to present themselves to the world are powerful ways of showing affirmation.
• Active listening: Listen to your child talk for 15 minutes, uninterrupted. You’ll learn a lot about them and show that you value what they have to say.

Supporting and accepting LGBTQ+ youth sets them up for long-term success. “I want LGBTQ+ young people to know that you are absolutely wonderful the way that you are,” says Dr. Sevelius. “Keep surrounding yourself with people who recognize that in you, and internalize that message—not the negative ones.”

Jae Sevelius, PhD, is a professor of medical psychology (in psychiatry) at the Vagelos College of Physicians and Surgeons.

Jeffrey Cohen, PsyD, is an associate professor of medical psychology (in psychiatry) at the Vagelos College of Physicians and Surgeons.