Mental health concerns for LGBTQ+ youth

By Elizabeth Burke, LCSW
Camino a Casa Clinical Program Manager

While mental health challenges can occur at any age and in any population, LGBTQ+ youth are at greater risk of suffering from depression, anxiety, substance abuse, and even suicidality. A 2018 study published in Pediatrics, “Sexual Orientation and Depressive Symptoms in Adolescents” demonstrated that LGBTQ+ teens and young adults more likely to experience depression than their heterosexual peers.  Transgender and gender non-binary youth are three to 13 times more likely to be diagnosed with conditions like anxiety, ADHD and depression than youth whose outward presentation matched their sex assigned at birth, according to another study in the same Pediatrics issue (Mental Health of Transgender and Gender Nonconforming Youth Compared With Their Peers, 2018). Other studies have shown 30%-50% of transgender youth have seriously considered suicide, and 14% have actually attempted to end their lives (Transgender Adolescent Suicide Behavior, 2018).

To me, these staggering numbers are unacceptable. We must do better for our youth. I want to live in a society where all SOGIEs (Sexual Orientation, Gender Identity and Expression) are accepted as totally normal in the range of spectrums and that diversity is celebrated. Unfortunately, many of the LGBTQ+ youth I have treated are suffering, not because of any direct impact of being LGBTQ+ but because they are not accepted by our society.

Mental health problems among these youth are attributed to being LGBTQ+ but are actually related to the ongoing experiences of discrimination, marginalization, rejection, and isolation these youth face. A large study of almost 82,000 high school students in Minnesota found LGBTQ+ youth were much more likely to be victims of abuse, bullying, mistreatment, and victimization than their heterosexual peers (Disparities for LGBTQ and Gender Nonconforming Adolescents, 2018). These factors are known risks for mental health problems. The same study also identified that unmet medical needs and victimization in cyberspace were two additional sources of risk for LGBTQ+ youth.

Another huge risk factor for LGBTQ+ youth is lack of family support. In a study done by the Family Acceptance Project in San Francisco, only 35% of LGBTQ+ youth with unsupportive families believed they could be happy as an adult, whereas 92% of LGBTQ+ youth with supportive families thought that they would grow up to be happy. Even worse, another study showed that 46% of runaway LGBTQ+ youth left home because their SOGIE was rejected by their family. In my experience, many parents may be trying to protect their child, thinking if their child can just choose to be heterosexual and gender conforming, they will have a better life. Research and experience has shown that rejecting parents are actually putting their children at increased risk of abuse and poor mental health outcomes.

I am the Clinical Program Manager at Camino a Casa by Casa Pacifica, a program that serves youth ages 9-17 who struggle with emotional dysregulation and high-risk behaviors that jeopardize their safety at home, school and/or the community. Due to the factors discussed above, we do see an overrepresentation of LGBTQ+ youth in our programs.  We use an affirmative approach, where we believe youth to be who they say they are and support their SOGIEs accordingly.

In the 13 years that I have been a clinician, I have found LGBTQ+ youth to be incredibly resilient in the face of extreme adversity and I know we can do better for these youth. The more we work to reduce discrimination, promote acceptance, and move families towards acceptance, we can make a difference in the mental health and overall wellbeing of these youth.


Ryan,C. (2009). Supportive families, health children: Helping families with lesbian, gay, bisexual&transgender children.
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