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As a member of the LGBTQ community and a future educator, seeing stories like Nex's is heartbreaking. This student felt they had no other choice because of the bullying and belittlement they experienced at school and in their community. All students, regardless of ANY differences, should always feel heard and supported so things like this do not occur. Nex's story is just one of hundreds of thousands of students nation-wide and over the world who turn to suicide because they feel as though it's their only option. We must do better as a society in protecting students of all backgrounds.

Nex's story resonates with me because I too experienced very real and very scary thoughts of suicide growing up due to bullying for being gay as well as traumatic experiences that occurred during my childhood. These thoughts began in Jr. high school and continued through college. I was lucky enough to have a supportive network of people to turn to both within the LGBTQ community here in Rhode Island as well as teachers and friends I could confide in. Some students however, don't have this luxury, so it's important to focus on interventions and education about tolerance for all students. This padlet will explore suicide prevention and interventions that can be put in place to help counter the rising rates of negative thoughts among this vulnerable population of students.

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Whisenhunt, J., Biber, D., & Heidorn, B. (2022). On the Front Line: The Role of Physical Educators in Preventing Student Suicide. Journal of Physical Education, Recreation & Dance, 93(3), 25–31. https://doi-org.ric.idm.oclc.org/10.1080/07303084.2021.2022039

Whisenhunt et al. conducted a study in which they explored the causes of suicide among school-age students as well as preventative measures that educators can take in order to ensure their students are safe and have structures in place in case they are experiencing suicidal thoughts (2022). Although this article is for physical educators, the ideas around adolescent suicide and prevention are relevant to educators of other disciplines as well as other members of the school staff such as nurses and administration. With suicide rates dramatically increasing over 30% from 1999-2016, it's imperative that we take the steps necessary to ensure that students are safe and the adults are aware of the warning signs. Recognizing suicide warning signs is crucial for effective intervention. Educators are urged to be vigilant for behavioral and emotional changes in students, which may indicate heightened distress. Immediate intervention is necessary when signs such as seeking access to means, talking about death or suicide, or exhibiting extreme mood swings are observed. Promoting protective factors against suicide is equally important. Building strong relationships with students, fostering a supportive school environment, and encouraging healthy coping mechanisms through physical activity are all strategies that educators can employ to mitigate suicide risk. The article also underscores the importance of suicide prevention programming in schools, advocating for comprehensive training that empowers educators to identify at-risk students and effectively intervene. Gatekeeper training, in particular, equips educators with the skills to recognize warning signs, engage in empathetic conversations with students, and facilitate referrals to mental health professionals.

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LGBTQ adolescents are at an increased risk for mental health problems and suicide

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LGBTQ adolescents are at an increased risk for mental health problems and suicide

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Jadva, V., Guasp, A., Bradlow, J. H., Bower-Brown, S., & Foley, S. (2023). Predictors of self-harm and suicide in LGBT youth: The role of gender, socio-economic status, bullying and school experience. Journal of Public Health (Oxford, England), 45(1), 102–108. https://doi.org/10.1093/pubmed/fdab383

Jadva et al. discuss in this article the contributing factors that may lead to mental health problems as well as suicide in adolescents who are part of the LGBTQ community. Some of these factors include bullying, SES (socio-economic status) and gender/orientation expression (2023). In this study, 3713 LGBTQ students responded to a survey and 65.3% claimed to have reported in self harm. 73.8% of those students had suicidal ideations and 25.7% reported to have attempted suicide. These numbers are horrifying. Students are dying because they feel like they have no other choice. They are constantly being bombarded with negative information about themselves because of who they are at the core. LGBTQ students experience bullying at a higher rate than students who do not identify as such and these numbers are absolutely asinine. As educators, we must be vigilant and make sure to support our LGBTQ students, but also be on the look out for when these students may be being bullied. Students can be stealthy in their bullying tactics, so knowing what to look out for and how to prevent it with open conversations can be a game changer. With an overgrowing accessibility to social media platforms and online communication, students are experiencing bullying due to their identity not only in the classroom, but when they go home and surf the web. In addition to school faculty, workshops and discussions among parents and other students can be helpful in litigating these dangerous statistics.

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Abstract

Introduction

The increased risk of self-harm, suicide attempts and suicide among lesbian, gay and bisexual (LGB) young people compared with heterosexual youth is well-established, yet we still know very little about which factors contribute additional risk or protection. Most studies have focused only on lesbian and gay youth., The few studies of trans people's experiences report higher rates of suicidal thoughts, suicide attempts and suicide compared with cisgender people. One UK survey of trans adults reported lifetime suicidal ideation of 84% and attempted suicide of 48%. In contrast, a survey conducted in England reported lifetime rates of suicidal thoughts and attempted suicide as 20.6 and 6.7%, respectively, among adults aged >16 years. Furthermore, a wide range of identities fall under the umbrella term of trans, including non-binary and binary trans identities. It has been suggested that as non-binary individuals (who do not identify as exclusively male or female) do not fit the classic binary transition narrative, they may experience more stress than binary trans individuals (trans men and trans women). In accordance with this notion, one Spanish study found that non-binary young people experienced higher online bullying and lower levels of support from family and friends than cis or binary trans young people. However, research that distinguishes between groups under the trans umbrella is scarce.

The high prevalence of mental health difficulties within the LGB population has been explained using Meyer's minority stress theory. This theory suggests that the stigma, prejudice and discrimination (minority stress) associated with being a sexual minority are responsible for higher rates of mental health issues within this population. The model asserts that there are distal and proximal stressors associated with being LGB. Distal stressors are external to the person, including homophobic and biphobic discrimination, prejudice and violence; proximal stressors are internal to the person, including expectation of rejection, concealment of LGB identity and internalized homophobia and biphobia. The theory also contests that protective factors exist at both the community and individual levels, including social support and individual resilience.

This model has since been extended to the trans population, due to similarities between homophobia, biphobia and transphobia, and used within LGBT youth populations. For example, a US longitudinal study found that LGBT youth with low social support experienced higher distress throughout late adolescence than those with high social support. A Canadian study of trans youth found that experiences of discrimination, harassment and violence were related to poorer mental health outcomes. In terms of protective factors, the 2004 Minnesota Student Survey, which included data from 2255 LGB students, showed that family connectedness, support from other adults and school safety acted as protective factors for suicidal risk. Similarly, an American study of LGBT young people found school connectedness acted as a protective factor for suicidal ideation.

The present study aimed to examine risk and protective factors for mental health problems among a large sample of young people self-identifying as LGBT in the UK. Specifically, the study examined the role of distal variables, specifically bullying, low socioeconomic status (SES) and school experience, on suicidal ideation, suicidal attempts and self-harm. In line with minority stress theory, we hypothesized that bullying and low SES would be associated with poorer outcomes, while perceived support from schools would act as protective factors. In light of the lack of research into trans and non-binary young people, we explored whether different risk and protective factors affect each group in the same way. In the present study, respondents could select their gender from three options: 'male', 'female' or 'prefer to use own term'. We examined differences between young people who used their own gender term (also referred to in this paper as falling under the non-binary umbrella) to those who identified as male or female. Young people were asked if they were trans and could respond as 'yes', 'no' or 'unsure'. For the present study, young people who selected 'yes' to that question were defined as trans.

Methods

Procedures

Survey data were collected in collaboration with Stonewall, a UK-based charity that supports the rights of lesbian, gay, bisexual and trans people across Britain. The survey was promoted widely through Stonewall's extensive networks with hundreds of schools and youth organizations throughout England, Scotland and Wales. The survey was also distributed through social media, including Stonewall's own social media channels, and other influencers to gain as wide a reach as possible. Young people aged 11-19 years who identified as LGBT and who lived in the England, Scotland or Wales opted themselves into the survey. Data were collected between November 2016 and February 2017. The survey was available to complete online and on paper. Ethical approval for the study was obtained from (University of Cambridge Psychology Research Ethics Committee). A waiver of parental consent was granted to protect young people who may be harmed if their LGBT identity was disclosed to their parents or guardians. Contact details for support groups and services were provided to respondents alongside the questions on mental health and at the end of the survey.

Sample

The sample consisted of 3713 adolescents ( M age = 16.42 years, standard deviation (SD) = 1.79). As illustrated in Table 1, over half of the sample identified as female ( n = 1996, 53.8%), a third identified as male ( n = 1241, 33.4%) and a substantial minority used their own term, hereafter referred to as non-binary, the most common being non-binary, agender and genderqueer ( n = 467, 12.6%). In terms of trans status, 16% of the sample ( n = 594) identified as trans.

With regards to sexual orientation, over a third identified as gay or lesbian ( n = 1418, 38.2%), a similar proportion identified as bisexual ( n = 1357, 36.5%) and a smaller number used their own term (such as pansexual or queer), were unsure or identified as heterosexual (respectively, n = 632, 17%; n = 247, 6.7%; n = 49, 1.3%). Participants attended schools in England, Scotland and Wales (respectively; 82%, 10.8% and 7.2%), 84.7% were White British and 9% were from Black, Asian and minority ethnic backgrounds and 9.5% were in receipt of free school meals (i.e. from low-income family backgrounds).

Measures

Self-harm and suicide

Participants indicated yes or no to whether they had ever (i) deliberately harmed themselves; (ii) thought of taking their own life or (iii) tried to take their own life.

Demographics

Participants provided information about their age, ethnicity, gender (male, female, own term), trans identity (yes/no/unsure), sexuality (lesbian/gay, bisexual, heterosexual, unsure, own term) and free school meal status (i.e. proxy for low household income).

Bullying

Participants responded yes or no to whether they had experienced any of the 11 different forms of bullying for being LGB and/or T (e.g. verbal, physical and sexual assault) and any of the 8 forms of online bullying (e.g. mean/embarrassing messages/videos, threatening messages or filming/photography without consent). Two homophobic, biphobic, transphobic (HBT) bullying scores, reflecting 'traditional' and 'online' bullying, were created by summing across each item, with a high score indicating more experiences of bullying.

School experiences

Using a 4-point scale (1 = 'strongly agree' to 4 = 'strongly disagree'), participants rated the extent to which they agreed with six statements regarding the positivity of their school experience (e.g. 'I enjoy going to school', 'I feel safe in my school', 'I feel able to be myself at school', 'I worry about being bullied at school', 'I feel part of my school community', 'There is an adult at school who I can talk to about being lesbian, gay, bisexual, trans'). A mean score was created, with a high score indicating a more positive experience of school, Cronbach's α = 0.81.

Analytic strategy

Three sets of logistic regressions were conducted in Mplus to examine the association between self-harm, suicidal ideation and suicide attempts and risk and protective factors (including demographic, bullying and school measures). We specified a maximum likelihood estimator and report odds ratios (OR), 95% confidence intervals (CIs) and significance levels to provide an estimate of the increased likelihood of adolescents endorsing the outcome compared with adolescents with and without the specific characteristic. To avoid loss of data, we used a full information approach so that all participants who provided partial data could be included in the analysis ( n = 49 had missing items for some positive school experience items).

Results

Prevalence of self-harm, suicidal ideation and suicide attempts

A high proportion of the sample endorsed self-harm (65.3%, n = 2423), suicidal ideation (73.8%, n = 2423) and suicide attempts (25.7%, n = 955). Bullying was common; 45% of adolescents reported at least one incident of HBT bullying (e.g. physical/verbal) and 39% reported at least one incident of online HBT bullying.

Predictors of self-harm, suicidal ideation and suicide attempts

We used logistic regression analysis to examine predictors of adolescents' reports of self-harm, suicidal ideation and suicide attempts. Specifically, we regressed self-harm, suicidal ideation and suicide attempts on demographic measures, including female gender identity (no = 0, yes = 1), non-binary gender identity (no = 0, yes = 1), trans identity (none = 0, yes = 1), bisexual (where lesbian, gay, heterosexual, unsure and own term was the reference group = 0) and free school meal status (no = 0, yes = 1), alongside other continuous risk and protective measures, including HBT bullying, online bullying and reporting a positive school experience. We also included adolescent age as a background control measure.

As shown in Table 2, the greatest demographic risk factor for self-harm, suicide ideation or suicide attempts was reporting a trans or non-binary gender identity. Specifically, trans adolescents, compared with non-trans young people, were almost four times more likely to report self-harm, over three times more likely to report suicidal ideation and two and a half times as likely to report an attempted suicide. Compared with those who identified as male or female, adolescents who identified as non-binary were four times more likely to self-harm, twice as likely to report suicidal ideation and 20% more likely to report attempting suicide. In addition, females were at a greater risk for each outcome: a four times greater likelihood of reporting self-harm, 60% more likely to report suicidal ideation and 75% more likely to have attempted suicide. The model was re-run excluding females who identified as trans. This showed that females were still ~4× more likely to self-harm (OR 4.67), >50% more likely to report suicidal ideation (OR 1.56) and almost twice as likely to report having attempted suicide (OR 1.95). In addition, compared with their peers, adolescents who were in receipt of free school meals were 70% more likely to report attempted suicide and almost 40% more likely to report suicide ideation. While compared with gay or lesbian young people, there was a modest (25%) but increased likelihood of self-harm or suicide attempts in young people identifying as bisexual.

With regards to risk factors, adolescents who experienced more HBT bullying were 17% more likely to report self-harm or report suicidal ideation, and 20% more likely to report an attempted suicide (see Table 2). Slightly stronger results were found for online bullying; adolescents who experienced more online bullying were 25% more likely to report self-harm and suicide ideation and 22% more likely to report an attempted suicide.

In terms of protective factors, adolescents who reported a more positive school experience were ~40% less likely to report self-harm or attempted suicide, and 65% less likely to report suicidal ideation.

Post-hoc analyses were conducted to explore moderation effects between trans and non-binary gender identities, and risk and protective factors, in relation to mental health outcomes. Each risk (e.g. bullying and online bullying) and protective factor (e.g. positive school experience) was centred within Mplus and subsequently multiplied with trans and non-binary gender identity to create interaction terms. The additive impact of each interaction term was examined one at a time (e.g. bullying by trans) for self-harm, suicidal ideation and suicide attempts. The lack of significant results suggests that the main effects hold across the sample as a whole and do not differ according to whether adolescents identify as trans or non-binary.

Discussion

Main findings of this study

Our study adds to the literature on risk and protective factors for self-harm, suicidal ideation and suicide attempts among LGBT young people, in important ways. Crucially, the large sample of young people identifying as trans and non-binary allowed a comparison of these different subgroups. We found extremely high rates of self-harm, suicidal ideation and suicide attempts among trans youth compared with their non-trans peers, consistent with previous studies of trans people. Building on this, the results also extend previous findings by showing that risk and protective factors for trans young people are similar to those of LGB young people. In addition, young people who were not trans, but who used their own term to define their gender (referred to as non-binary in this paper) showed similarly high rates of self-harm (over four times more likely) as well as being twice as likely to have suicidal thoughts and more likely to have attempted suicide compared with their male or female counterparts. This is consistent with the idea that gender non-conformity may lead to greater minority stress and highlights the importance of recognizing and acknowledging non-binary gender identity to increase awareness and to improve health care.

What is already known on this topic

A previous UK study of 889 trans adults reported high rates of suicidal ideation and suicidal attempts. That study found that having a supportive environment and timely access to gender reassignment were key protective factors, while factors such as social stigma, gender dysphoria and treatment delays and fears over gender reassignment increased the risk of suicide. Many of the adults reported having had increased feelings of gender dysphoria during adolescence, due to experiencing physical changes during puberty that were unwanted. A representative US study of 31 896 youth (398 identifying as transgender) found that transgender youth were more likely to miss school, experience bullying and perceive their school negatively than non-transgender youth. A small number of studies have compared the experiences and mental health outcomes of non-binary and binary-trans youth, and preliminary findings are mixed. A Spanish study of 782 young people aged between 14 and 25 years, of whom 180 identified as transgender and 70 as non-binary, found that young people identifying as non-binary were more likely to experience online bullying and received lower levels of support from family and friends compared with cis or binary trans young people. A UK study looked at mental health outcomes in 16- to 25-year-old trans and non-binary people, and the study found that non-binary and binary participants experienced high levels of mental health problems and that binary participants reported lower life satisfaction than non-binary individuals. However, another study of 16- to 25-year-olds in the UK (331 binary trans and 57 non-binary) found that the non-binary youth experienced significantly more anxiety and depression and had significantly lower self-esteem than the binary group, although similar rates of self-harm. Studies from the general population have found significant though comparatively lower rates of self-harm. Data from the UK's millennium Cohort Study found 7.4% of 17-year-olds had attempted suicide. This study also found 55.8% of LGB+ young people reported self-harm in the past year compared with 20.5% of heterosexual young people, and 21.7% had attempted suicide compared with 5.8% of heterosexual young people.

Peer victimization has been found to be associated with an increased risk of suicidal ideation and suicidal attempts among children and adolescents. A large body of research now shows the relationship between peer victimization and adolescent suicide, with ~20% of adolescents considering suicide., A meta-analysis found that children and adolescents who had been bullied were 2.2 times more likely to experience suicidal ideation and 2.6 times more likely to attempt suicide than students who had not been bullied. Our study found that young people who used a binary term to define their gender showed high rates of self-harm and suicidal ideation compared with young people identifying as male or female. This finding adds to our limited understanding on the unique experiences of non-binary/binary-trans youth. Most preliminary studies have found that non-binary youth experience worse outcomes than binary-trans youth, although Rimes et al (2017) found that binary-trans youth experienced lower life satisfaction than non-binary youth, a finding the authors suggest may be due to limited access to medical treatment for binary-trans youth. However, the findings from this study support previous suggestions that non-binary individuals may experience more minority stress and thereby experience greater mental health problems than binary trans individuals as there is less societal understanding of non-binary identities.

What this study adds

Our study examined risk and protective factors for mental health problems among LGBT young people. Notably, young people who had experienced HBT bullying-including online bullying-were more likely to report self-harm, suicidal ideation and attempted suicide, whereas protective factors, such as a having a positive experience at school, reduced the likelihood of these harmful behaviours. This finding is consistent with minority stress theory and emphasizes the importance of improving young people's experiences in schools to reduce negative outcomes. Given that a history of mental health problems increases the likelihood of later problems, it is important to extend the developmental scope of research on LGBT mental health into young adulthood and beyond.

The finding that participants from low-income families were at greater risk of suicide ideation and suicide attempts adds to the literature on LGBT youth and demonstrates a need for greater support of LGBT young people who are experiencing financial hardship. Similar findings of increased rates of suicide have been reported more generally, with suicide risk among adults being two to three times higher in the most deprived areas of the UK compared with the most affluent. Other data have found similar trends with males working in the lowest skilled occupations having a 44% higher risk of suicide than the male national average. Among young people, the most disadvantaged 40% of the Millennium Cohort Study were almost twice as likely to attempt suicide (almost 12% compared with around 6% of young people with higher family incomes). This study however did not find differences by family income for rates of self-harm. The combination of financial hardship and being LGBT may exacerbate risk for poor outcomes. A small number of young people who identified as trans or non-binary also fell into this low-income category; however, our ability to examine outcomes for these distinct groups was limited due to sample size. Further research is warranted to test the independent contribution of factors associated with low SES, such as family stress, on explaining the increased risk of attempted suicide.

It is important for schools and colleges to be aware that teaching about LGBT people, families and relationships and tackling HBT bullying needs to be accompanied with fostering an atmosphere of inclusivity, so that all LGBT young people feel safe and enjoy being at school and college. Bullying continues to be a risk factor for poor mental health for LGBT young people, and schools as well as online platforms need to do more to reduce rates of bullying. The increased risk of poor outcomes among young people identifying as trans and non-binary suggests that schools and colleges need to proactively address the barriers these groups may face. Indeed, while two-thirds of young people in the current study reported that their school said homophobic bullying was wrong, only a third reported their school said bullying based on a person's gender or being trans was wrong.

Limitations of this study

This study had a number of limitations including its cross-sectional design, which meant we could not examine causality. It is important to acknowledge that the UK does not have a nationally representative survey of LGBT youth, and thus we do not know how our sample would compare with this. While existing surveys that use a random probability design can give an overall prevalence of LGBT young people (for example the Child and Adolescent Mental Health Survey, Health Survey for England), the LGBT sample is too small to use for analytical purposes. This survey uses an opt-in approach to achieve a large enough sample to enable comparison with and across LGBT groups. Finally, the use of survey methodology meant that responses were self-reported.

Acknowledgements

We wish to thank all the young people who completed the survey.

Funding

Data collection for this study was funded by Stonewall.

Conflict of interest

April Guasp and Josh Bradlow work for Stonewall and were involved in the design of the survey. All other authors have no conflict of interest to declare. This paper was drafted by Dr Vasanti Jadva with the assistance of Dr Susie Bower-Brown and Dr Sarah Foley. The analysis of data was conducted by Dr Sarah Foley. All authors have read and approved the final version of the manuscript.

Data availability statement

The data underlying this article cannot be shared publicly due to ethical and privacy reasons.

V. Jadva, Lecturer, Principal Research Associate

A. Guasp, Former Head of Research

J. H. Bradlow, Former Head of Policy

S. Bower-Brown, Research Associate

S. Foley, Lecturer

References

This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

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Predictors of self-harm and suicide in LGBT youth: The role of gender, socio-economic status, bullying and school experience

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AbstractBackground. Lesbian, gay and bisexual (LGB) young people's increased risk of self-harm, suicidal attempts and suicide compared with heterosexual yo

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Homophobia in society and suicide among LGBTQ adolescents

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Homophobia in society and suicide among LGBTQ adolescents

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Marzetti, H., McDaid, L., & O’Connor, R. (2022). “Am I really alive?”: Understanding the role of homophobia, biphobia and transphobia in young LGBT+ people’s suicidal distress. Social Science & Medicine, 298. https://doi.org/10.1016/j.socscimed.2022.114860

Marzetti et al. explores the idea of homophobia and other phobias of people who identify as LGBTQ and how this affects the youth who identify as such (2022). Suicide is the 4th leading cause of death among adolescents and part of this percentage comes from individuals who identify as LGBTQ. This study is qualitative in nature and interviews 24 students who are part of the LGBTQ community. Some of the records include individuals who experienced classmates being "queerphobic" which can also encompass transphobia as well as others. The interviewees explained how this constant bullying at all stages of their education knocked them further down each time it happened. Many students described that there is an expectation in society to follow the norms and when people go against the grain, they are exposed to much more hatred and bias. Because there is not much discussion on supporting individuals of the LGBTQ community, there lacks support and spaces where they feel safe. Since there are heteronormative expectations, students who are different discuss having an almost tunnel-like vision to suicide as they see if as a way out. The statistics are scary and much needs to be done to ensure our youth is protected.

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doi: 10.1016/j.socscimed.2022.114860.

Affiliations

¹ School of Health in Social Science, University of Edinburgh, UK; MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, UK. Electronic address: hazel.marzetti@ed.ac.uk.

² MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, UK; Institute for Social Science Research, University of Queensland Australia, Australia. Electronic address: l.mcdaid@uq.edu.au.

³ Institute of Health and Wellbeing, University of Glasgow, UK. Electronic address: Rory.OConnor@glasgow.ac.uk.

doi: 10.1016/j.socscimed.2022.114860.

Affiliations

¹ School of Health in Social Science, University of Edinburgh, UK; MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, UK. Electronic address: hazel.marzetti@ed.ac.uk.

² MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, UK; Institute for Social Science Research, University of Queensland Australia, Australia. Electronic address: l.mcdaid@uq.edu.au.

³ Institute of Health and Wellbeing, University of Glasgow, UK. Electronic address: Rory.OConnor@glasgow.ac.uk.

Abstract

Suicide is the fourth leading cause of death amongst young people aged 15-29 globally and amongst this young population, lesbian, gay, bisexual and trans (LGBT+) young people have higher rates of suicidal thoughts and attempts than their cisgender (non-trans), heterosexual peers. However, despite well-established knowledge on the existence of this health inequality, in the UK there has been a paucity of research exploring why this disparity exists, and this is particularly the case in Scotland. This paper aims to address this gap, reporting on the first study specifically seeking to understand LGBT+ young people's suicidal thoughts and attempts in Scotland. We used a qualitative methodology to explore how young people with lived experience of suicidal distress make sense of the relationship between homophobia, biphobia and transphobia, and suicidal thoughts and attempts. We undertook in-depth, narrative interviews with twenty-four LGBT+ people aged 16-24, and analysed them using reflexive thematic analysis. Drawing on this analysis, we argue that suicide can be understood as a response to stigma, discrimination and harassment, made possible by a cultural climate that positions LGBT+ people as different or other, reinforcing norms regarding gender conformity and sexuality. We suggest in turn, that this cultural climate provides fertile ground from which more explicit acts of homophobia, biphobia and transphobia, such as bullying and family rejection are able to grow. In response to this, LGBT+ young people could begin to experience senses of entrapment, rejection and isolation, to which suicidal thoughts and attempts can be understood as responses. Consequently, we propose that these stigma experiences must be taken seriously and tackled directly in order to reduce LGBT + suicide in the future.

Keywords: LGBT; Qualitative; Self-harm; Sexuality; Stigma; Suicide; Transgender; Youth.

PubMed Disclaimer

Conflict of interest statement

Declaration of competing interest

We have no conflicts of interest to declare.

Cited by

Immigration Status, Legal Vulnerability, and Suicidal/Self-harm Ideation Disparities Among Immigrant-Origin Latinx Young Adults in the U.S.

Hagan MJ, Hernandez MM, Enriquez LE, Ayón C. Hagan MJ, et al. J Racial Ethn Health Disparities. 2023 Jun 22. doi: 10.1007/s40615-023-01682-7. Online ahead of print. J Racial Ethn Health Disparities. 2023. PMID: 37349669

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national center for biotechnology information

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"Am I really alive?": Understanding the role of homophobia, biphobia and transphobia in young LGBT+ people's suicidal distress - PubMed

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Suicide is the fourth leading cause of death amongst young people aged 15-29 globally and amongst this young population, lesbian, gay, bisexual and trans (LGBT+) young people have higher rates of suicidal thoughts and attempts than their cisgender (non-trans), heterosexual peers. However, despite we ...

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American Institutes for Research. (n.d.). AFFIRM. LGBTQ Equity. Retrieved June 8, 2024, from https://lgbtqequity.org/affirm/#:~:text=There%20are%20two%20AFFIRM%20interventions,for%20caregivers%20of%20LGBTQ%2B%20youth.&text=AFFIRM%20Youth%20is%20an%20evidence,risks%20experienced%20by%20LGBTQ%2B%20populations.

AFFIRM is an evidence-based intervention for LGBTQ individuals both adults and adolescents. AFFIRM can be utilized in a variety of settings such as a school, medical faculty, community centers and at home. Specifically for the youth portion of AFFIRM, trained individuals in this intervention work on assisting the youth in all settings in feeling safe and understood. Some of the benefits of learning with AFFIRM include validating student's experiences and identifications related to the LGBTQ experience, ways to help mitigate harmful thoughts as they arise and ways to cope and navigate discrimination. There are free resources on their website including forums and information on how to become AFFIRM trained and what you can do if you are not trained and still be a positive influence in a student's life.

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BRING AFFIRM TO YOUR ORGANIZATION! AFFIRM: Evidence-Based InterventionS for LGBTQ+ Individuals & their Families Congratulations to the New AFFIRM Adult Sites After a competitive application process, the LGBTQ+ Center of Excellence has selected five sites to implement AFFIRM Adult in their communities. Please join us in welcoming the AFFIRM Adult sites!

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The Trevor Project. (n.d.). The Trevor Project. Retrieved June 12, 2024, from https://www.thetrevorproject.org/

The Trevor Project is a non-profit organization that strives to educate and facilitate change within society to create a more accepting society. Since their start, they have helped hundreds of individuals both youth and adults navigate a world which can be unforgiving and stigmatized. This project provides interventions such as a 24/7 call line where people can call in and talk to a trained person in crisis intervention. Their suicide prevention includes workshops, resources, videos, outreach and education to make more people aware and tolerating of different genders and identities. People can get trained in becoming a youth ally which is geared towards adults who want to become allies to LGBTQ youth. It focuses on creating supportive environments, understanding LGBTQ identities, and learning how to intervene effectively in crisis situations. In addition, they also provide a lifeguard workshop for people who want to become an advocate and bring these ideas of tolerance to their schools or other community settings.

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The Trevor Project | For Young LGBTQ Lives

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The Trevor Project provides 24/7 crisis support services to LGBTQ young people. Text, chat, or call anytime to reach a trained counselor. Free and confidential.

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CAST Coping and Support Training (CAST) is an evidence-based intervention designed to support individuals in managing stress, improving coping skills, and fostering emotional well-being. It targets individuals experiencing psychological distress, anxiety, depression, or other mental health challenges, and can be adapted for different age groups and settings such as schools, community organizations, or clinical settings. The primary objective of CAST is to equip participants with effective coping strategies and skills to navigate stress and enhance emotional resilience. The intervention typically includes structured sessions covering stress management techniques, cognitive-behavioral strategies, mindfulness practices, problem-solving skills, and social support systems. These components are designed to be interactive, allowing participants to actively learn and practice coping skills. Trained mental health professionals, counselors, educators, or facilitators typically deliver the intervention, adapting it to individual or group settings based on participants' needs. The impact of having more people trained in this intervention would be huge. As educators and people working with youth, it's imperative that we have tools and resources such as CAST, AFFIRM and The Trevor Project to ensure that our youth is safe. Making sure that students learn is just one small piece of what it takes to be a successful educator. If more students and faculty are on board on the ins and outs of mental health and suicide, only better things can come from that.

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CAST has been shown to reduce suicide-risk behaviors, depression, hopelessness, anxiety, anger, and drug involvement; while increasing school bonding and social support resources (including family support).

Increased Mood Management - depression, hopelessness, anxiety, and anger

Decreased Drug Involvement - alcohol, marijuana, and hard drug use, drug use control problems and adverse drug use consequences

Decreased Suicide Risk Factors - global suicide risk behaviors, ideation, threats, attempts and positive attitudes toward suicide

Increased Protective Factors - personal control, problem-solving and coping, family support, and decreases in school problems (dropouts, absenteeism, and dissatisfaction with school)

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Coping and Support Training - A Road Map for Teen Groups Get Started Now! What is CAST? Coping and Support Training (CAST) is a proven prevention program

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Focusing on the mental health of LGBTQ youth is crucial due to the unique challenges they often face, including stigma, discrimination, and lack of acceptance. These factors significantly increase their risk of experiencing mental health issues such as depression, anxiety, and suicidal ideation. By prioritizing their mental well-being, we can create supportive environments that foster resilience and reduce the negative impacts of social and emotional stressors. Educators play a pivotal role in this process as they interact daily with students and are in a position to recognize signs of distress or isolation among LGBTQ youth. Training in suicide prevention equips educators with the knowledge and skills to identify warning signs, initiate conversations about mental health, and connect students with appropriate resources and support networks. This approach not only saves lives but also promotes a culture of inclusivity and empathy within educational settings. We can make a change, but it starts with us. Tolerance, acceptance and education will be the driving factor to making a change in the lives of students we teach.