Mental Health Risk and Protective Factors For Transgender, Nonbinary, and Gender-Diverse Youth

In 2022 a record number of anti-LGBTQIA+, and particularly anti-transgender, legislation was introduced in the United States. The Human Rights Campaign estimated that more than 300 anti-LGBTQ+ bills were either passed or introduced in at least 36 states, and the vast majority of those efforts targeted already vulnerable young people.

 These bills were introduced and, in some cases passed, despite opposition from nearly every major medical and mental health organization (including the American Medical Association, The National Association of Social Workers, The American Psychiatric Association, and the American Academy of Pediatrics).

Unsurprisingly, these bills were introduced and laws were passed in opposition to research informing best practice and best care in gender-affirming mental health and medical practices. This article will review some of the research discussing mental health risk and protective factors for Transgender, Nonbinary, and Gender-Diverse Youth.

Mental Health Concerns for Queer, Transgender, Nonbinary, and Gender-Diverse Youth

Consistently, research has found that suicide is the second leading cause of death among young people aged 10 to 24, and that lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) youth are at significantly increased risk. Some research has noted that LGBTQ youth are more than four times as likely to attempt suicide than their peers.

The Trevor Project’s 2022 National Survey on LGBTQ Youth Mental Health demonstrates that rates of suicidal thoughts have trended upward among LGBTQ young people over the last three years. The Survey examined the experiences of nearly 34,000 LGBTQ youth ages 13 to 24 across the United States, with 45% of respondents being LGBTQ youth of color and 48% being transgender or nonbinary. In doing so, the following key findings are offered:

• 45% of LGBTQ youth seriously considered suicide in the past year, including more than half of transgender and nonbinary youth (53%) and 1 in 3 cisgender youth (33%).

• 14% of LGBTQ youth attempted suicide in the past year, including nearly 1 in 5 transgender and nonbinary youth (19%) and nearly 1 in 10 cisgender youth (9%).

• 73% of LGBTQ youth reported experiencing symptoms of anxiety, including more than three-quarters of transgender and nonbinary youth (78%) and nearly two-thirds of cisgender youth (65%).

• 58% of LGBTQ youth reported experiencing symptoms of depression, including nearly two-thirds of transgender and nonbinary youth (65%) and nearly half of cisgender youth (47%).

• Among all LGBTQ youth, 82% wanted mental health care and 18% did not.

• 60% of LGBTQ youth who wanted mental health care in the past year were not able to get it including nearly 3 in 5 transgender and nonbinary youth (58%) and more than 3 in 5 cisgender youth (62%).

Among those who wanted mental health care but were unable to access it noted the following as their top three reasons: Fear of discussing mental health concerns (48%), concerns with obtaining parent/caregiver permission (45%), and fear of not being taken seriously (43%).

• 56% of LGBTQ youth reported that their mental health was poor most of the time or always due to the COVID-19 pandemic including more than 3 in 5 transgender and nonbinary youth (62%) and nearly half of cisgender youth (49%).

Political and Community Influences on Mental Health Outcomes for Queer, Transgender, Nonbinary, and Gender-Diverse Youth

Continuing on, The Trevor Project found:

• 93% of transgender and nonbinary youth said that they have worried about transgender people being denied access to gender-affirming medical care due to state or local laws.

• 91% of transgender and nonbinary youth said that they have worried about transgender people being denied access to the bathroom due to state or local laws.

• 83% of transgender and nonbinary youth said that they have worried about transgender people being denied the ability to play sports due to state or local laws.

• Only 37% of youth report that their home is LGBTQ-affirming. Fewer than 1 in 3 transgender and nonbinary youth found their home to be gender-affirming.

• 51% of youth found their school to be affirming. LGBTQ youth who found their school to be LGBTQ-affirming reported lower rates of attempting suicide.

• LGBTQ youth who live in a community that is accepting of LGBTQ people reported significantly lower rates of attempting suicide than those who do not.

Although the data continues to show high rates of mental health and suicide risk among LGBTQ young people, it is critical to emphasize that these rates vary widely based on how queer, transgender, nonbinary, and gender-diverse youth are treated in their home, school, and community environments. The Trevor Project’s research consistently finds that LGBTQ young people report lower rates of attempting suicide when they have access to LGBTQ-affirming spaces.

See the full study and results here.

Creating Affirming Spaces for Transgender, Nonbinary, and Gender-Diverse Teens in North Carolina

A few examples of what you can do to provide an affirming space for your queer, transgender, nonbinary, and gender-diverse child:

• Using and respecting their name and pronouns. Practice when your child is not around, to improve the chances of using their correct name and pronoun when they are in front of you! Practice makes progress.
• Being welcoming to their LGBTQ friends or partners
• Talking with them respectfully about their LGBTQ identity.
• Support their gender expression (i.e., choices relating to hair, clothing, accessory, body sprays, cologne, perfume, body hair, makeup).
• Educating yourself about LGBTQ people and issues
• Allowing youth to authentically and openly explore toys, books, clothing choices, hairstyles and being mindful of our own biases and the messages that we, and those around us, may be unintentionally sending our kids. Phrases like, “boys don’t cry,” or “you throw like a girl,” or even telling a child to “go play with the other [insert sex that is the same sex as your child].”

It is okay if this feels new and scary. If you are feeling overwhelmed, anxious, or just have questions and want support, seek help from a gender-affirming therapist in North Carolina. Additionally, check out Be BOLD Psychology and Consulting’s resource page! A full list of resources for transgender, nonbinary, and gender-diverse adolescents, adults, and families can be found on our Trans/Gender-Diverse Resource Page, updated intermittently!

Additional Resources for Transgender, Nonbinary, and Gender-Diverse Teens in North Carolina

We have several amazing resources for transgender, nonbinary and gender-diverse youth in North Carolina. A few to highlight include:

• Youth Outright – Located in Western North Carolina/Asheville North Carolina – Supporting queer, transgender, nonbinary, and gender-diverse youth  ages 11-20
• Time Out Youth – Charlotte, NC . Time Out Youth Center serves queer, transgender, nonbinary, and gender-diverse youth ages 11-20. (currently hosting programs via Q Chat Space Discord)
• LGBT Center of Raleigh – Groups and resources for queer, transgender, nonbinary, and gender-diverse adolescents, adults, parents, and family members.
• LGBT Center of Durham – Groups and resources for queer, transgender, nonbinary, and gender-diverse adolescents, adults, parents, and family members.
• Duke Child and Adolescent Gender Care
• UNC Pediatric and Adolescent Gender Clinic

Other resources for transgender, nonbinary, and gender-diverse youth include:

• The Trevor Project
• TrevorSpace; An affirming international community for LGBTQ young people ages 13-24. https://www.trevorspace.org

Affirming Therapy for Transgender, Nonbinary, and Gender-Diverse Teens in North Carolina

Be BOLD Psychology and Consulting specializes in providing affirming therapy for transgender, non-binary, and gender-diverse clients as well as therapy for the broader queer+ community! Our queer and trans-identified and LGBTQIA+ allied clinicians offer individual therapy, family therapy, couples therapy, relationship therapy, and group therapy services for queer+, transgender, non-binary, and gender-diverse folx.

To start receiving online therapy with a therapist specializing in gender-affirming queer-affirming, inclusive therapy and letter-writing services, follow these steps:

• Send an email to info@beboldpsychnc.com or submit a request for a free 20-minute consultation here!
• Schedule your first appointment for online LGBTQIA+ affirming therapy
• Start getting the support your deserve in a safer space, affirming ALL parts of you.