The Trevor Project 2021 Survey

The Trevor Project started in 1998 as a suicide prevention hotline for LGBT youth. Besides directly supporting youth through its phone and text hotlines, the Trevor Project has become a major force in advocating for better social conditions and more accessible mental health care for LGBTQ young people.

This month, the Trevor Project released the results of its third annual survey on LGBTQ youth mental health. Thirty-five thousand young people throughout the United States, aged 13-24, were included in this study. Thirty-eight percent reported identifying as transgender or non-binary. Participation by youth of color was 45%, a sign that the survey reached diverse social groups. The geographic distribution of participants was in proportion to the distribution of the US population.

The results show that the situation of LGBTQ youth has not improved as much as those of us who live in more liberal areas might think. A large majority (72%) had signs of anxiety or depression. Nearly half reported that they wanted counseling from a mental health professional in the past year, but could not get it. Conversion therapy is still occurring.

Suicidal Thoughts and Attempts

The rate of suicidal thinking among LGBTQ youth remains very high. Forty-two percent seriously considered suicide in the past year. For transgender and non-binary youth, the rate of suicidal thinking was over 50%.

Considering actual suicide attempts, rather than suicidal thoughts, attempts were much more common among youth of color. Thirty-four percent of Native American youth, 21% of Black youth, 21% of multiracial youth, and 18% of Latinx youth attempted suicide compared to 12% of white youth.  

Conversion Therapy

Thirteen percent of LGBTQ youth reported they experienced conversion therapy. Transgender and nonbinary youth reported being subjected to conversion therapy at twice the rate of cisgender LGBQ youth. LGBTQ youth who reported conversion therapy were an average of 15 years old at the time. Youth who experienced conversion therapy had more than twice the rate of attempting suicide in the past year compared with those who did not undergo conversion therapy.  

Issues specific to trans and non-binary youth

Transgender and nonbinary youth who were able to change their name and/or gender marker on legal documents, such as driver’s licenses and birth certificates, reported less than half the rate of attempting suicide (11%) than those who were not able to change their documents (25%.) This may be in part a measure of family support.

In an additional source of stress, discriminatory legislation targeting transgender youth has been introduced in more than 33 US states so far in 2021. In 21 states, the proposed laws would make it illegal for physicians to provide appropriate medical care to transgender youth.  Other proposed laws target the ability of transgender children and youth to use the appropriate bathrooms in schools and other public places and deny their ability to participate in sports on an equal basis.

Sources of Support

LGBTQ youth who had access to support for their sexual orientation and gender identity reported lower rates of attempting suicide. The commonest sources of support were online resources (70%), followed by school (50%), then home (30%.)

Social media had mixed effects: most LGBTQ youth said that social media has had both positive (96%) and negative (88%) impact on their mental health and well-being.  “Only” half of all LGBTQ youth said that their school was LGBTQ-affirming.  “Only” one in three LGBTQ youth found their home to be LGBTQ-affirming.

On the other hand: 1 in 3 LGBTQ youth found their home to be LGBTQ-affirming! Half of all LGBTQ youth said that their school was LGBTQ-affirming! These numbers are much better than they were 20 years ago. However, 20 years is unimaginably long – a lifetime- to a teenager, and a comparison like this does not help youth who are suffering today.

If you would like to be part of the effort to support young LGBTQ people, there are several places you can start. Either the national website or your local chapter of Parents and Friends of Lesbians and Gays (PFLAG) is a good source for finding ways to assist. If your community has a LGBT community center or advocacy organization, they will know of local resources. The Trevor Foundation trains volunteers to be online crisis counselors from home, or at their call centers in New York and California.

More detailed information about the study is available at the

Trevor Project’s trained crisis counselors are available 24/7 at 1-866-488-7386, via chat at, or by texting START to 678678.

Author Profile

Dr. Eva Hersh, MD
Dr. Eva Hersh, MD
Eva Hersh is a family physician. Send your comments and questions to her by email at