The Health Divide: Black LGBTQ+ youth are facing a suicide crisis

An alarming number of Black LGBTQ+ young people tried to end their lives in the past year.

According to a national survey by The Trevor Project, 19% of Black LGBTQ+ youth reported attempting suicide compared with 8% of white LGBTQ+ youth. Among Hispanic LGBTQ+ youth, the number was 12%.

The disparities become even more alarming when looking at transgender and nonbinary youth. Nearly one in four Black transgender and nonbinary youth report attempting suicide during the past year.

A health disparity exists when some groups face greater health risks and worse outcomes because of social conditions beyond their control. That is what appears to be happening here. Black LGBTQ+ youth are not attempting suicide at higher rates because of individual choices. They are navigating discrimination, social isolation, bullying, family rejection, housing instability, and barriers to mental health care at higher rates than many of their peers.

Those conditions have real health consequences.

Yet suicide remains one of the most difficult topics to discuss, even though it is the second-leading cause of death among people ages 10 to 34.

Why are Black LGBTQ+ young people attempting suicide at significantly higher rates than many of their peers?

According to Chris Allen, president and CEO of Diverse and Resilient, a southeastern Wisconsin advocacy organization serving the LGBTQ+ community, the answer is rooted in the messages many young people receive every day about who they are and whether they belong.

“There are a lot of political debates right now on whether LGBTQ+ individuals should have certain rights,” Allen said. “There are hundreds of bills across this country targeting LGBTQ+ people, especially transgender individuals.”

“When people constantly hear that they are unworthy of equal rights or somehow less than others, it takes a toll on their mental health,” he said. “The minority stress we experience can lead to unhealthy coping mechanisms, thoughts of suicide, and suicide attempts.”

When discrimination becomes a health risk

A survey by The Trevor Project, which provides crisis intervention and suicide prevention services for LGBTQ+ youth, found that nearly half of LGBTQ+ young people who wanted mental health care were unable to get it.

For some LGBTQ+ youth, a mental health emergency can coincide with being rejected by family members, losing housing, or finding themselves in unsafe environments. At the very moment they need support the most, many don’t know where to turn.

“We have seen a lot of this rhetoric that can make it hard for people to even seek treatment,” said Angela Lang, co-executive director of Black Leaders Organizing for Communities, or BLOC.

Lang said constant political attacks and negative messaging about LGBTQ+ people can leave young people fearful of being judged, rejected or misunderstood when seeking help. In some cases, that fear can discourage them from reaching out for counseling or other mental health services altogether.

More than half of LGBTQ+ young people said the current political climate has negatively affected their well-being. Many LGBTQ+ young people feel as though their future is uncertain.

They hear debates about whether they should have equal rights or whether transgender people should have access to gender-affirming care. For many young people, those debates aren’t abstract political conversations. They are conversations about their lives. 

A separate national survey conducted by Hopelab and Born This Way Foundation found that nearly nine in 10 LGBTQ+ young people said recent political debates and policies affecting LGBTQ+ rights had negatively affected their sense of well-being, and one-third said the political climate had caused them or their families to consider moving to another community or state. Mental health experts say that constant uncertainty about one’s rights, safety and ability to access health care can create chronic stress, anxiety and hopelessness.

Public health researchers have long found that chronic exposure to discrimination, rejection and violence can increase stress, contribute to depression and anxiety, and negatively affect both mental and physical health.

For Black transgender and nonbinary youth, those pressures are often magnified.

Lang said that while the country has made progress on LGBTQ+ rights, Black transgender people are still disproportionately affected by discrimination and violence.

“We saw broad support for same-sex marriage, but Black trans people were often left out of those conversations,” Lang said. “We continue to see high rates of violence against Black trans women, and there is an extra layer of oppression when you have intersecting identities.”

Being Black, transgender, and queer means experiencing multiple forms of discrimination simultaneously, she said. “When every aspect of political rhetoric, messaging, and policy discussions seems directed at who you are as a person, it can wear you down mentally and physically,” Lang said.

Research suggests that support and acceptance can be powerful protective factors. LGBTQ+ young people who have accepting adults in their lives report significantly lower odds of attempting suicide. Research has found that transgender and nonbinary youth with access to at least one gender-affirming space reported 25% lower odds of attempting suicide than those without one.

The mental health toll of uncertainty

The statistics do not exist in a vacuum.

The Trevor Project survey found that nearly one-third of LGBTQ+ youth of color experienced racial or ethnic discrimination. Transgender and nonbinary youth who wanted gender-affirming hormone therapy but could not access it were nearly twice as likely to attempt suicide as those who received the care.

Bullying remains another major concern.

Nearly 60% of LGBTQ+ youth ages 13 to 17 reported being bullied during the past year. Those who experienced bullying reported significantly higher rates of suicide attempts than those who did not.

Discrimination. Rejection. Bullying. Lack of access to care. Housing instability. Violence.

These are public health risk factors.

They increase stress, anxiety, depression and hopelessness. For some young people, they also increase the risk of suicidal thoughts and behaviors.

What health journalists should be asking

For health journalists, the challenge is reporting on suicide without reducing it to a statistic. That means finding the people, families, and communities behind the numbers while examining the conditions that place some young people at greater risk.

Suicide among Black LGBTQ+ youth is not simply an individual mental health issue. It is a health equity issue.

Journalists should explore whether there are enough mental health providers in communities where Black LGBTQ+ youth live. Are young people able to find therapists who understand both racial trauma and LGBTQ+ identity? What happens when a young person is rejected by family members, bullied at school or denied access to affirming health care?

Those are urgent public health questions.

It is also important to highlight what works. Research consistently shows that supportive adults, affirming schools, stable housing, access to culturally competent mental health care, and gender-affirming spaces can reduce suicide risk. Coverage should examine not only the factors contributing to a crisis but also the interventions helping young people survive and thrive.

Because nearly one in five Black LGBTQ+ young people are attempting suicide, the question is no longer whether there is a crisis.

The question is whether we are paying enough attention.