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Mental Health Treatment for LGBTQI+ Teens

Written by Evolve's Behavioral Health Content Team​:

Alyson Orcena, LMFT, Melissa Vallas, MD, Shikha Verma, MD, Ellen Bloch, LCSW, Lianne Tendler, LMFT, Megan Johnston, LMFT
Meet The Team >

Do LGBTQI+ Teens Get the Mental Health Support They Need?

When we talk about treatment and support for people with mental health, behavior, or addiction disorders, one subject we often address is the treatment gap. It’s an easy concept to explain and understand. The treatment gap is the difference between the number of people who need treatment for a mental health, behavior, or addiction disorder and the number of people who receive treatment for their disorder.

In the past, stigma around mental health and addiction disorders went a long way to explaining the treatment gap. There was not only stigma around the disorders themselves, but also stigma around treatment for mental health and addiction disorders. This society-wide stigma caused thousands of people each year to avoid seeking the treatment they needed. People feared judgment and discrimination at home, at work, and from peers. This fear of judgment and discrimination led to decades of people hiding their emotions, keeping their diagnoses secret, and avoiding the professional support that, in some cases, is lifesaving.

The Mental Health/Addiction Treatment Gap

Source: 2017-2019 MTF/Child Mind Institute

Since the widespread acceptance of the medical model of addiction and the medical model of mental health, the level of stigma around mental illness/addiction/treatment in our society has decreased, but it has not disappeared. In addition, there’s a community of people in our society who experience stigma for another reason: their gender and/or sexual identity. When members of the LGBTQI+ community develop a mental health disorder, they face two levels of stigma: the remaining stigma around mental health/addiction/treatment and stigma around their gender or sexual identity.

This default situation begs the question:

Do LGBTQI+ teens with mental health/addiction disorders get the support they need?

This article addresses the mental health side of that question. We do not have data on rates of addiction and addiction treatment for LGBTQI+ teens – yet. When we do, we’ll write about it.

Mental Health Support for LGBTQI+ Teens: Facts and Figures

In early 2021, The Trevor Project published an important report called The National Survey on LGBTQ Mental Health 2021. The report is important because it’s the only report of its kind and size. It focuses on LGBTQI+ youth and analyzes a sample of over thirty thousand individuals. That’s a significant development, which allows us to understand the mental health circumstances of the young LGBTQI+ community with a level of detail and specificity we’ve never had before.

Let’s get right into the statistics, with a focus on the treatment gap:

  • 48% of wanted but did not receive support from a mental health professional
  • 36% wanted and did receive support from a mental health professional
  • 16% did not want support

That’s a big number: almost half of the LGBTQI+ teens who wanted care did not receive it. As we mention above, stigma-based discrimination is a primary reason many people with a mental health disorder do not seek or receive treatment.

The survey also asked questions about discrimination among LGBTQI+ youth, which allows us to connect the dots between discrimination and treatment. Here’s what they found:

  • 75% said they’d experienced discrimination based on their gender/sexuality at least once in their lifetime
  • 52% said they’d experienced discrimination based on their gender/sexuality in the past year
  • 21% of LGBTQI+ youth who attempted suicide reported past year discrimination based on their sexual orientation
  • 24% of transgender and nonbinary youth who attempted suicide reported past year discrimination based on their gender orientation

That’s the raw data, which gives us real insight into the facts on the ground. If three-quarters of LGBTQI+ youth experience discrimination in their lives, half experienced discrimination in the past year, and one-fifth of those who attempted suicide experienced discrimination, the treatment gap makes logical sense, and begs this question:

If our LGBTQI+ teens expect to experience discrimination, why would they seek treatment?

It also leads us to ask, of ourselves, this question:

How can we better support our LGBTQI+ teens?

The survey asked that question – and we’re about to share how LGBTQI+ teens answered.

How To Support LGBTQI+ Youth – According to Them

A primary concern for LGBTQI+ youth is finding a safe space simply to be themselves, openly and honestly.

Where are those safe spaces?

Here’s what they said:

  • 69% say their safe space is online
  • 50% say school is a safe space
  • 34% say their safe space is at home
This data tells us in no uncertain terms that one thing we can do to support them is to create more safe spaces.

Next, LGBTQI+ teens say they need support in the form of crisis lines and resources.

Here’s what they said about crisis lines:

  • 80% say crisis lines need to include a line dedicated to LGBTQ youth
  • What Crisis Lines Need:
    • 94% said they need to be available 24/7
    • 94% said they need to be available by text
    • 78% said they need to be available via webchat
    • 77% said they need to be available by phone
    • 61% said they need to be available by another messaging system (e.g. social media/other direct message options)
This data tells us a second thing we can do is provide transgender teens support in the form of crisis lines designed to serve them.

A primary concern for transgender teens – and a primary way in which we, as a society, are failing our transgender teens – is the use of their chosen name and chosen pronouns. We have data from another source on that specific topic. For transgender teens:

With that knowledge, let’s look at the results of the Trevor Project survey on this topic:

  • 49% of transgender teens say no one in their life uses their chosen name/pronouns
  • 29% say all the people in their life use their chosen name/pronouns
  • 22% say some of the people in their life use their chosen name/pronouns
This data tells us we can support our transgender teens
by using their chosen name and pronouns.

Now let’s circle back to the question we posed at the end of the first section of this article. We asked if our LGBTQI+ youth get the support they need. The answer is clear: they do not. They neither receive the professional support they need nor receive the acceptance they need at home. They get support online and they get support at school from peers.

Here’s our take on that: we can do better.

But how?

The Trevor Project asked them.

Where LGBTQI+ Youth Find Joy – According to Them

Okay, full disclosure.

The survey did not ask “How can the adults in your life better support you?” It asked, “Where do you find joy and strength in your life?”

We think that if we – meaning parents, teachers, and anyone involved in the life of an LGBTQI+ teen – learn more about what gives our LGBTQI+ teens joy and strength, we can work to provide more of that in their lives. If we do that, they’re likely to feel supported. With that in mind, we’ll end this article with their answers – and encourage you, whenever possible, to provide any and all of the following to any and all LGBTQI+ teens you know.

The Top 29 Ways LGBTQI+ Teens Find Joy and Strength

  1. Affirming parents
  2. Anime
  3. Art & creative expression
  4. Celebrities coming out with pride
  5. Chosen family
  6. Connection to others who are LGBTQ
  7. Educational opportunities
  8. Escaping through reading & writing
  9. Faith & spirituality
  10. Feeling seen
  11. Finding community online
  12. Caring for a pet
  13. Having a supportive partner
  14. Having supportive & accepting friends
  15. LGBTQ support in school
  16. Learning more about LGBTQ history
  17. Moving away from unsupportive conditions
  18. Music
  19. Online LGBTQ chat groups
  20. Representation in media
  21. Seeing rainbow flags & stickers in public
  22. Seeing so much pride from others in being LGBTQ
  23. Self-identity & finding others who identify in similar ways
  24. Theatre
  25. Therapy
  26. Unapologetic embracing of full self
  27. Video games
  28. Watching LGBTQ people on TikTok & YouTube
  29. Working out

Our Behavioral Health Content Team

We are an expert team of behavioral health professionals who are united in our commitment to adolescent recovery and well-being.

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