LGBTQ+ mental health

These are events and conditions in the world around you: name-calling, bullying, being treated unfairly at school or work, threats or violence, or laws and rules that leave you out.

In The Trevor Project’s 2024 survey, 60% of LGBTQ+ young people said they had felt discriminated against in the past year because of their sexual orientation or gender identity.

If you have been hurt before, or seen others hurt, it makes sense to stay alert: scanning a room, guessing who is safe, watching what you say. Researchers describe this as expecting rejection.

This alertness is a way of protecting yourself. But being on guard all the time is tiring, and it can keep the body’s stress response running long after the moment has passed.

Sometimes hiding your identity is the safest choice, and that is okay. But concealing who you are can carry a mental and physical cost over time.

Constantly editing your stories, pronouns or plans can feel lonely, as if people only know part of you.

Growing up around negative messages about LGBTQ+ people can lead some people to feel shame or dislike toward themselves. Researchers call this internalized stigma.

It might sound like “Something is wrong with me” or “I’d be easier to love if I were different”. These thoughts come from the world around you, not from the truth about you.

Minority stress is only half the story. The same research describes how group belonging, solidarity and a positive sense of identity can buffer stress and protect mental health.

That is why acceptance makes such a big difference. LGBTQ+ young people in very accepting communities reported far fewer suicide attempts (8%) than those in very unaccepting ones (20%).

Many LGBTQ+ people feel real joy in who they are, and still have days when the world feels heavy. Both are normal. A hard week does not cancel out your pride or your progress.

Stress often spikes at turning points: coming out to someone new, starting a job or school, a relationship ending, a family event, or news about laws and politics. In The Trevor Project’s 2024 survey, 90% of LGBTQ+ young people said their wellbeing was negatively affected by recent politics.

What helps

• Limit news and social media when it gets heavy
• Plan extra support around big moments
• Spend time with people who see you
• Talk to an affirming counselor if it keeps building

Being outed means someone shares your identity without your permission. Even the fear of it can be a constant stress. In the 2024 Trevor Project survey, 24% of young people who wanted mental health care but couldn’t get it said fear of being outed was one reason.

What helps

• Ask a counselor or clinic how they keep your information private
• Check privacy settings and who can see your posts and photos
• If you are outed, reach out to a safe person or LGBTQ+ helpline the same day
• Tell people clearly who else knows, and who doesn’t

For trans and nonbinary people, hearing an old name or the wrong pronoun can feel like being erased, especially when it keeps happening. It can show up at school roll call, on medical forms, on bank cards or from family.

What helps

• Ask an ally to correct others for you, so you don’t always have to
• Decide which battles to pick: a quick correction, a later chat, or letting it go to stay safe
• Keep a note of affirming messages to reread on hard days
• Update names on accounts and documents where you safely can

Holidays, weddings and family events can mean going back into the closet, hearing an old name, or fielding questions like “So, when are you getting a girlfriend?” Even in loving families, one relative’s comment can sting for days.

What helps

• Bring an ally, or have a friend on text standby
• Decide ahead what you will and won’t share, and with whom
• Have a simple line ready: “I’d rather not talk about that today.”
• Plan a short visit with your own way to leave
• Plan something restoring afterwards with chosen family

In The Trevor Project’s 2024 survey, 35% of LGBTQ+ young people aged 13–17 said they had been cyberbullied in the past year, compared with 24% of those aged 18–24. Among those bullied in person or online, 18% attempted suicide in the past year, compared with 6% of those who weren’t bullied.

What helps

• Block, mute and report, without replying
• Curate your feed: follow affirming creators, unfollow accounts that drain you
• Make your accounts private if you are being targeted
• Screenshot serious threats and show a trusted adult or the platform
• Take a screen break and spend time with people who see you

Some people face pressure from family, school or community to change their sexual orientation or gender identity, sometimes called conversion therapy. In the 2024 Trevor Project survey, 13% of LGBTQ+ young people said they had been threatened with or subjected to it. Among them, 27% attempted suicide in the past year, compared with 9% of those who were not.

Your identity is not an illness and does not need fixing. Many faith communities are affirming, and it is possible to hold onto both faith and identity.

What helps

• Connect with others who have been through it
• Find an affirming counselor or faith leader
• If you are a minor, tell a trusted adult at school
• Reach out to The Trevor Project or another LGBTQ+ helpline

In The Trevor Project’s 2024 survey, 23% of LGBTQ+ young people said they had been physically threatened or harmed in the past year because of their sexual orientation or gender identity. Among those threatened or harmed, 25% attempted suicide in the past year, compared with 8% of those who were not.

After a threat, it is common to feel jumpy, on guard in public, or scared to go back to certain places. These are normal reactions to danger.

What helps

• Get to a safe place and tell someone you trust
• Plan safer routes or travel with a friend for a while
• Talk with an affirming counselor about the fear that lingers
• Write down what happened, with dates, in case you want to report it

If you depend on someone for a home, money or school, think carefully about how they are likely to react. If you are unsure, it may be safer to wait or to tell someone else first.

It can help to listen to how people talk about LGBTQ+ topics, like a news story or a TV show, to get a sense of their views.

Starting with someone you are confident will be supportive can build your confidence. It also means you have someone on your side if later conversations are harder.

That might be a friend, a sibling, a school counselor, a teacher or an LGBTQ+ support group.

In The Trevor Project’s 2024 survey, 78% of LGBTQ+ young people in school said they had at least one supportive, affirming adult there.

You do not need a speech. Something like “I want to share something important with you. I’m gay, and I wanted you to know because you matter to me” is plenty.

Choose a calm, private time. Some people prefer writing a letter or message so the other person can take a moment before replying.

Some people react with surprise, silence or worry at first, and become more supportive with time. Others are wonderful straight away.

If someone reacts badly, it says more about their beliefs than about your worth. Lean on the people who do support you.

Some people understand themselves later in life, after a marriage, children or a long career. That is just as valid as knowing young. Coming out as an adult can bring big relief, along with worries about family, faith communities or work.

Things that can help

• Check whether your workplace has an LGBTQ+ staff network or inclusive policies
• Find others who came out at a similar stage of life, in person or online
• Start with one trusted colleague or friend
• Talk it through with an affirming counselor first if you like

For some, faith communities have been a source of hurt. For others, they are a source of strength. Many faith communities today are openly welcoming of LGBTQ+ people.

You do not have to choose between parts of yourself. An affirming counselor or faith leader can help you work through these feelings at your own pace.

Some groups bring together people who share more than one identity, like LGBTQ+ people of color, LGBTQ+ people of faith, or LGBTQ+ people with disabilities.

Being with people who understand several parts of your life can feel like a relief. You do not have to explain yourself as much.

Where you live shapes how safe and seen you feel. In smaller places, there may be fewer openly LGBTQ+ people, clubs or affirming providers nearby.

Ways to stay connected

• Join online groups from trusted LGBTQ+ organizations
• Look for telehealth counselors who are LGBTQ+-affirming
• Plan occasional trips to a Pride event or community center
• Find one local ally you can be fully yourself with

Younger people may be working out who they are while living at home. Adults may be balancing work, partners and children. Older LGBTQ+ adults may carry memories of times when it was far less safe to be out.

Connecting across generations can be powerful: elders share history and resilience, and younger people share energy and new language.

Many LGBTQ+ people build a “chosen family”: close friends, partners, mentors and community members who offer the love and belonging a family can give.

Chosen family can celebrate holidays together, show up in hard times and cheer for each other’s wins. For many people, it is life-changing.

Many cities have LGBTQ+ community centers with support groups, youth nights, social events, sports, arts and help finding affirming services.

Pride events, book clubs, choirs, sports leagues and volunteer groups are other ways to meet people and feel part of something bigger.

A strong, positive sense of your identity can help buffer the effects of stress.

Learning LGBTQ+ history, finding role models, and celebrating your own journey can all help build pride. You belong to a long line of people who have lived bravely and loved fully.

Volunteering at a center, mentoring someone younger, or simply being the friend you once needed can turn hard experiences into connection. Solidarity, people looking out for each other, is one of the ways communities protect their members.

• Asks for and uses your name and pronouns
• Does not assume your partner’s gender or your history
• Has inclusive forms and a welcoming space
• Has training or experience working with LGBTQ+ people
• Lets you lead on what you want to work on
• Treats your identity as a part of you, not a problem to solve

• Blames your mental health on being LGBTQ+
• Keeps using the wrong name or pronouns after being told
• Makes jokes or comments that make you uncomfortable
• Suggests your identity can or should be changed

Any approach that tries to change a person’s sexual orientation or gender identity is harmful. A good therapist will never do this.

Talking therapies give you a safe space to explore your feelings, build coping skills and work through painful experiences.

Approaches you might hear about

• Cognitive behavioral therapy (CBT), including versions adapted for LGBTQ+ people
• Family therapy to help families understand and support each other
• Group therapy or support groups with other LGBTQ+ people
• Trauma-focused therapy for people who have experienced violence or abuse

For anything medical, consult with your clinical provider.

In The Trevor Project’s 2024 survey, the top reasons LGBTQ+ young people did not get care they wanted included fear of talking about their mental health (42%), cost (40%) and not wanting to ask a parent’s permission (37%).

Questions you can ask

• “Do you offer a sliding scale or free sessions?”
• “Do you offer video sessions?”
• “What do you keep private, and when would you have to share?”

If someone comes out to you, thank them for trusting you. Listen without interrupting, and avoid questions that feel nosy or about their body.

Believe people when they tell you about discrimination they have faced. Being doubted adds to the hurt.

Using someone’s chosen name and pronouns tells them they are seen. For trans and nonbinary young people, having their pronouns respected at home is linked with fewer suicide attempts.

If you slip up, correct yourself and keep going. Practise in your head if it helps.

Silence can feel like agreement. A simple “That’s not okay” or “Let’s not talk about people like that” can change the mood in a room.

Bullying is a real problem: in 2023, 29% of LGBTQ+ high school students said they had been bullied at school, compared with 16% of their cisgender, heterosexual classmates.

Read from trusted LGBTQ+ organisations, listen to LGBTQ+ voices, and learn about terms and history. It is okay not to know everything.

If you make a mistake, own it, apologise briefly, and do better next time.

LGBTQ+ young people with affirming spaces at home, school and community events reported fewer suicide attempts.

Small signals help: inclusive language, a rainbow sticker, inclusive forms, and making it clear that bullying will not be tolerated.

Try to avoid

• “Are you sure? Maybe it’s a phase.”
• “I always knew!” (it can make the moment about you)
• “I’m fine with it, just don’t make it a big deal.”
• “What was your old name?”
• “You don’t look trans.”
• Questions about someone’s body or medical history

Instead, try: “Thank you for telling me.” “How can I support you?” “Is there anything you’d like me to know?”

Parents, partners and friends may feel worry, confusion or grief while still loving the person deeply. Those feelings are human. Working through them somewhere else, like with a counselor or a family support group, protects your loved one from carrying them.

Ideas

• Join a support group for families and friends of LGBTQ+ people
• Keep up your own sleep, movement and friendships
• Learn from trusted LGBTQ+ organisations, at your own pace
• Share the load with other supportive people

Family acceptance is strongly linked to better health for LGBTQ+ young people, so your effort really matters.

Higher rates of depression and self-harm are linked to discrimination, bullying, rejection and isolation, not to identity itself.

That is hopeful news: when people are accepted and supported, their mental health is better.

Some people know who they are from a young age. Others understand themselves later in life. Both are valid.

Calling someone’s identity “a phase” can feel dismissive and make them less likely to open up. Respect works better than doubt.

Family acceptance is linked to higher self-esteem and lower rates of depression and suicidal thoughts. Affirming schools and communities are linked to fewer suicide attempts.

Good therapy helps you cope with stress and live well as yourself. It does not try to change your sexual orientation or gender identity.

Bisexual people are attracted to more than one gender. It is not confusion or a stop on the way somewhere else. Among LGBTQ+ adults in the U.S., more than half say they are bisexual, making it the most common LGBTQ+ identity.

Being doubted by both straight and LGBTQ+ people can feel isolating. Believing people about who they are is a simple way to help.

Call or text 988, or chat at 988lifeline.org, any time of day or night. It is for anyone in emotional distress or thinking about suicide, and for people worried about someone else.

988 also offers Spanish text and chat services.

• Call: 1-866-488-7386
• Chat: thetrevorproject.org/get-help
• Text: START to 678-678

Free, confidential and available 24/7, 365 days a year, from anywhere in the U.S.

• U.S.: (877) 565-8860
• Canada: (877) 330-6366

Calls are answered by a trans person, and they do not call emergency services without your consent. Hours are limited, so check their website for current times.

Text HOME to 741741 in the U.S. to reach a live, trained crisis counselor. It is free and confidential.

Find A Helpline lists free, confidential helplines around the world, and you can search by country and topic.