LGBTQ Youth Mental Health & the Role of Trusted Adults
Americans live in a time of growing societal rifts. One significant divide is how society treats and views members of the LGBTQ community. The people most harmed by the backlash against queer and transgender communities are often children. Discriminatory practices and laws already disproportionately impact LGBTQ youth. Many now face a growing LGBTQ youth mental health crisis—especially those who need mental health for teens, access to gender affirming care, and adults who are willing to support LGBTQ identities without fear or hesitation.
As parents, teachers, and society, there is a collective responsibility to do better. Here are actionable steps on how to improve mental health outcomes and well-being for LGBTQ youth.
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The Crisis in LGBTQ Youth Mental Health
Understanding LGBTQ Youth Mental Health Risks
Addressing LGBTQ youth mental health requires understanding the social and political pressures that put young people at risk.
The landscape of support for LGBTQ students in schools has significantly changed over recent years. Schools commonly host Gay-Straight Alliance clubs (GSAs), and students now typically identify by the names and pronouns they choose rather than those assigned at birth. Importantly, staff and students visibly demonstrate support and celebrate Pride Month.
Importantly, celebrating and embracing LGBTQ young people remains crucial to their mental health. The Trevor Project’s 2024 U.S. National Survey found that 39% of LGBTQ youth seriously considered suicide. Among transgender and nonbinary youth, the rate rose to 46%. Additionally, the survey found, “12% of LGBTQ youth attempted suicide in the past year, and 14% of transgender and nonbinary youth attempted suicide.” Moreover, “50% of LGBTQ youth who wanted mental health care were unable to access it,” and “90% reported that recent politics negatively impacted their well-being.”
A “State of Emergency” for LGBTQ People
Recent events highlight a troubling national trend limiting support for LGBTQ youth, driven by political actions and executive orders.
In May 2025, Penn Medicine announced it would no longer perform gender-affirming surgeries for patients under the age of 19. This decision aligns with Executive Order 14187, signed by President Trump, restricting federal funding for gender-affirming care for minors.
Penn Medicine emphasized its continued commitment to comprehensive LGBTQ medical and behavioral care; however, advocates expressed serious concerns. Major medical organizations stress that gender affirming care is essential to improving LGBTQ youth mental health.
Penn Medicine’s decision reflects a broader nationwide trend. Similar institutions now limit services in response to restrictive federal policies. Advocates raise concerns that this shift reduces care access for vulnerable youth. This includes Florida’s “Don’t Say Gay” bill and similar measures nationwide, which illustrate the increasing anti-LGBTQ sentiment, turning schools into political battlegrounds rather than safe havens.
In June 2023, the Human Rights Campaign officially declared a “national state of emergency for LGBTQ Americans.” The group cited an unprecedented wave of anti-LGBTQ legislation across the country. A peer-reviewed study published in Nature Human Behaviour, and reported by The Trevor Project, found a 72% increase in suicide attempts among transgender and nonbinary youth. These spikes followed state-level anti-trans laws that legislators passed between 2018 and 2022.
This underscores the critical importance of maintaining safe spaces. According to The Trevor Project, “LGBTQ youth who found their schools affirming reported lower rates of suicide attempts,” highlighting the significant impact adult actions have in protecting youth.
What’s Blocking LGBTQ Youth Mental Health Care?
The need for mental health care among LGBTQ youth is urgent—but access to care remains far from equitable. According to The Trevor Project’s 2020 report Breaking Barriers to Quality Mental Health Care for LGBTQ Youth, structural, financial, and interpersonal barriers continue to limit access to effective, affirming care.
Despite elevated rates of depression, anxiety, and suicidal ideation among LGBTQ youth, many do not receive the help they need. In fact, nearly half of LGBTQ youth who wanted mental health services reported being unable to access them. Understanding why is essential to closing this gap.
Financial and Logistical Barriers
For many families, cost is the first and most immediate barrier. While therapy can be life-changing, the financial burden often makes it feel out of reach—especially when working with providers who specialize in LGBTQ youth mental health. Insurance companies often provide inconsistent coverage, especially for gender affirming care or family-based interventions. In some cases, insurance companies deny claims for care related to gender identity altogether.
Geography can also play a significant role. Youth in rural or underserved areas may have limited options for therapists who provide inclusive, evidence-based care. Even in urban centers, long waitlists and transportation challenges can delay access. These logistical hurdles become even more complex for teens who rely on adults for support—and those adults may not always be affirming of their child’s identity.
Interpersonal Barriers and Stigma
Beyond the logistical concerns, LGBTQ youth often face interpersonal obstacles that make seeking care emotionally difficult. One of the most significant is fear: fear of being rejected by a therapist, fear of being misunderstood, and fear of being “outed” if they aren’t already safe to share their identity at home or school. These concerns are especially potent for transgender and nonbinary youth. They often encounter providers who lack training or use outdated or pathologizing language.
The Trevor Project’s report found that nearly 60% of LGBTQ youth reported being discouraged or dissuaded from seeking mental health care. This reflects not only systemic barriers but also a broader culture of stigma that still surrounds both mental health and LGBTQ identities. When mental health for teens is framed in a way that excludes or dismisses the experiences of LGBTQ youth, those youth are less likely to reach out for help.
Why Affirming Care Matters
Affirming care—care that validates and supports a person’s gender identity, sexual orientation, and lived experiences—is not just a “nice to have.” It’s a mental health necessity. LGBTQ youth who have access to affirming care experience better outcomes, including lower rates of depression, anxiety, and suicide attempts.
Supporting LGBTQ youth means removing these barriers. It means providing insurance coverage for gender affirming care, ensuring therapists are trained in culturally responsive practices, and fostering environments where youth feel safe to ask for help.
We all have a role to play in creating systems where mental health support is accessible, inclusive, and life-saving.
How Adults Can Strengthen LGBTQ Youth Mental Health
Support LGBTQ Youth in Schools and at Home
Teachers and school staff play a critical role in supporting LGBTQ youth and improving their mental health.
Everyone has a role in ensuring schools remain safe and inclusive for all students, especially LGBTQ youth.
If you are a parent or guardian of an LGBTQ child:
- Get involved in school board meetings and advocate for inclusive sex education and policies supporting LGBTQ students.
- Push for inclusive curricula covering gender identity, sexual orientation, and LGBTQ history.
- Demand continuing education for school staff on supporting LGBTQ students.
- Advocate for safe spaces like GSAs to foster community and support.
If you are a teacher or school staff member:
- Demonstrate clearly that you are a safe, supportive person. Use inclusive language and respect students’ chosen names and pronouns.
- Be a role model by correcting mistakes, addressing discrimination immediately, and offering education to colleagues.
- Seek support if you struggle to support LGBTQ students, whether personally or professionally.
- Attend school board meetings to advocate for inclusive policies and curricula.
- Be knowledgeable about local and national LGBTQ resources, such as GLSEN, PFLAG, The Trevor Project, The Attic Youth Center, and The Pride Center of NJ.
As a result, when LGBTQ youth feel accepted, celebrated, loved, and safe, their mental health thrives, contributing positively to society as a whole.
How CFR Improves LGBTQ Youth Mental Health
We are deeply committed to ensuring LGBTQ youth and their families can access inclusive therapy and psychiatry services that affirm their identities and experiences. At CFR, inclusive care is the best care.
Through our Children, Adolescents & Family Services (CAFS) program, we provide specialized care tailored to the needs of LGBTQ youth. Our CAFS clinicians provide child and adolescent psychiatry, individual counseling, play therapy, and family therapy—especially for those seeking mental health for teens in the LGBTQ community. Our clinicians are trained to provide affirming support in emotion regulation, coping skills, and communication skills, using creative interventions such as art and play therapy. They also provide gender affirming care and inclusive therapy that affirms each child’s identity. Additionally, therapists support families and caregivers, fostering an affirming environment where all youth can thrive.
We also demonstrate our commitment to diversity and inclusion through our Clinical Internship Program in Marriage & Family Therapy. This program includes the Diversity Scholarship for Emerging Clinicians, which supports future therapists from marginalized communities, including those identifying as LGBTQ. CFR awards this scholarship to clinicians from marginalized communities, including those identifying as LGBTQ, to help build a more diverse and effective therapeutic community.
If your school or organization could benefit from CAFS, please complete our contact form. CAFS services include child & adolescent psychiatry, play therapy, individual therapy, family therapy, and collaborative support with significant life systems like schools and communities.
About Council for Relationships
Council for Relationships is a nonprofit organization that has been strengthening relationships and supporting mental health since 1932. With more than 80 therapists and psychiatrists across Pennsylvania and New Jersey, CFR provides expert, inclusive care for individuals, couples, families, children, and adolescents.
CFR is nationally recognized for its commitment to clinical excellence, equity, and innovation. In addition to therapy and psychiatry, CFR offers continuing education for mental health professionals and operates a premier Clinical Internship Program in Marriage & Family Therapy.
Looking for support? Whether you’re seeking mental health for teens, support LGBTQ youth in your family, or access gender affirming care, CFR can help you find the right fit.
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Editor’s Note: This blog was originally published in 2023 by Danielle Silverman, LCSW, MEd, a former CFR Staff Therapist. It has since been updated by CFR’s editorial team to reflect current research, policy developments, and services.