I’m a clinical psychologist and a staunch advocate of traditional psychotherapy, but it’s not going to be the solution that solves the mental health and suicide crisis among LGBTQ+ young people. It certainly wasn’t for Mia, a 15-year-old I met about 10 years ago.
Mia (her actual name and small details have been changed to protect her confidentiality) had just experienced her first romantic relationship and the wide range of emotions that come with adolescent love and heartbreak. Her friends at school were supportive, but when a teacher found out about the relationship, she thought it was best to inform Mia’s parents.
Suddenly, Mia’s world was ripped away from her. Her parents grounded her indefinitely after screaming at her that it was wrong to be gay, and the relationship ended when her girlfriend became concerned that Mia’s parents might contact hers. Whatever trust Mia had in her school and teachers was badly eroded.
I met Mia soon after this episode at a crisis center where she was escorted by school police after attempting suicide at school. Her face lit up when I told her that there was nothing wrong with her and empathized with her experience of first love and heartbreak. But when we conducted a family session, her parents made it clear that having a lesbian daughter was unacceptable to them – and they were not interested in therapy that would support her.
I don’t know what happened to Mia, but I know from my work at The Trevor Project that stories like hers continue to happen across the country every day. Rates of depression and suicide for LGBTQ+ young people remain extraordinarily high, despite recent progress on some fronts.
In 2015, it seemed like the world was beginning to change for the better for LGBTQ+ youth and adults. That year, a landmark U.S. Supreme Court decision granted same-sex couples in all 50 states the right to marry. It was a turning point in the fight for LGBTQ+ equality, a sign to young people that they had the right to love and marry whomever they wanted – and an apparent boon to their mental health. A study based on data gathered before the Supreme Court decision found that in states that approved same-sex marriage on their own, suicide attempts among lesbian, gay, and bisexual adolescents declined by 14% in the following year. Policy and acceptance matters.
LGBTQ+ characters have become much more visible on TV and in movies in recent years too. In the 26 years since GLAAD began counting, the number of LGBTQ+ characters appearing in television, cable and streaming programs increased from 12 in 2006 to 637 in 2022.
With all this positive change, why are LGBTQ+ young people still four times more likely than their peers to attempt suicide? And what can we do to reverse the trend and affirm LGBTQ+ young people?
The increased visibility of LGBTQ+ people in popular culture and progress on the policy front has allowed young people to define themselves at an earlier age and to feel more confident expressing their identity to others. Research shows that the mean age when LGBTQ+ people first experience same-sex attraction has remained relatively stable – between 11 and 12 years of age.
What has changed dramatically: In recent years, people are acknowledging their sexual identity to themselves and coming out to others at much younger ages. Indeed, one recent study found that over the past 50 years or so, the average age of coming out decreased from the mid-20s to mid-adolescence.
That’s a great development, but here’s the downside: Most LGBTQ+ adolescents still come out to a hostile and rejecting world, with the majority reporting that their home is not an LGBTQ+-affirming space. Adolescents remain reliant on families to meet their basic physical, emotional, and financial needs, and parental rejection is one of the strongest and most consistent predictors of poor mental health and suicide risk.
In an ideal world, all LGBTQ+ young people would be able to come out to parents who accept them as they are and help them get the support they need. Instead, the current crisis in LGBTQ+ youth mental health is in many ways the result of a frightening cycle: Parental rejection worsens the mental health of LGBTQ+ adolescents and that in turn makes it hard for them to access mental health resources that require parental permission and financial support.
And that’s where digital tools and technologies can really help. Today, kids like Mia who aren’t getting support from their parents can use the internet to connect with a number of online supports and resources. Here are a few examples:
imi is a free, science-backed mental health and identity affirmation tool featuring resources and personal stories that help LGBTQ+ youth discover and affirm their identity.
Other digital services like TrevorSpace and Q Chat Space provide access to safe, online spaces for LGBTQ+ youth to connect with supportive peers. Each of these solutions was created within the nonprofit sector – largely because most for-profit digital mental health startups have paid little attention to the needs of LGBTQ+ youth and devoted few resources to tech solutions aimed at their needs.
As an impact investor and social innovation lab at the intersection of tech and youth mental health, Hopelab works to advance health equity outcomes and increase social impact. We do this by investing in promising tech-enabled mental health solutions and by providing advisory services to entrepreneurs that are working to co-create digital tools that enhance the lives of young people. In doing so, we work to ensure that the needs of LGBTQ+ and BIPOC young people are included in the R&D activities of for-profit technologists and entrepreneurs.
As interventions get smarter and digital mental health solutions advance, LGBTQ+ youth cannot be left behind. To leverage technology for good, tech companies in the mental health space need to find ways to tailor their products to the needs of LGBTQ+ young people. Doing so requires working with LGBTQ+ young people in a process of co-creation and a focus on access and equity as outcomes.
Since most mental health start-ups are more focused on creating tools for large potential markets than meeting the unique needs of smaller groups, there is a need to provide extra support to people working in academic and nonprofit spaces. Strategic partnerships that provide funding, technology, marketing, and design assistance to people in the academic and nonprofit sectors can boost innovation and create tools that LGBTQ+ young people like Mia actually want to use.
Amy Green, PhD, is a clinical psychologist and the head of research at Hopelab, a social innovation lab and impact investor at the intersection of tech and youth mental health.