Recent attention has increasingly been drawn to the rapidly escalating rates in suicide attempts or suicide completion by adolescents nationwide. What has often been underreported or used as a footnote, however, is the unique vulnerability of the LGBTQ community of adolescents and teens to both suicidal attempts and completions, as well as self-harm. While there are positive indicators of change, significant modifications are needed in the way that we protect, support and provide healthy outlets for LGBTQ youth in our community.
The LGBTQ youth community has been shown consistently to have higher rates of self-injury, suicide attempts and suicide completions. One study found that non-cisgendered youth were two to seven times more likely to have suicide attempts compared to their cisgendered counterparts. The “2019 North Carolina Child Health Report Card,” published by NC Child and the NC Institute of Medicine, showed gay, lesbian and bisexual students were three times as likely to attempt suicide as their straight-identifying peers.
Another concern facing LGBTQ youth is the practice of self-harm. Roughly 18 percent of the overall adolescent population report actively participating in self-harm. LGBTQ youth, however, are almost six times as likely to engage in self-harm. While mental health professionals generally distinguish between self-harm and suicide attempts, self-harm is a sign of deep emotional pain and, in LGBTQ youth, one researcher has suggested that rates of self-harm might be elevated due to concerns about societal rejection and lack of emotional regulation.
What we don’t know or have solid data about is the rates of risk for LGBTQ youth who are bisexual, transgender, identify as any other more gender-expansive term or who are also persons of color. Studies and surveys have not focused on the wider range of sexual orientations beyond the traditional gay/straight to isolate bisexuality or other identifications. Similarly, it is known that rates of depression and suicide are exponentially higher in persons of color when examined generally, but we do not know how people of color who also identify within the LGBTQ community might affect these rates.
What statistics can’t show, will never show, however, is the individual person. The teenager reading this article. The LGBTQ adolescents and teenagers I work with as a mental health therapist. They will always be specific, and their needs unique. If you are someone who has suicidal thoughts, or loves someone who does, there are ways to help. Be aware of warning signs, which you can learn by following some of the links in the resource list below. Ask the person directly if he/she/they are suicidal. Use the word “suicide,” and use it calmly. Contrary to many fears, saying “suicide” doesn’t make someone more likely to commit suicide: it opens up dialogue and lets them know you are with them and okay with what they say. Listen. Don’t offer advice. Your job is to be with them and hold space. Know when you are in over your head and get professional help. Start with a trusted adult. Start with a help line.
If you’re suicidal and wondering how you are going to continue to get through this day, much less the next, know that there are a lot of us: therapists, teachers, coaches, positive adults who accept you and your gender orientation and sexual orientation no matter what and who want to hear your story. Our job isn’t to fix you or your life: you’re not broken. Our job is to listen to what you have to say and provide companionship when it seems very dark and lonely, and to help you look for guard rails that might keep you from acting on your thoughts. You see, the world is still waiting for your gifts, and it’s my job, the job of this entire community, to provide support and acceptance so that you can thrive. You can absolutely get better.
If you’re a member of the community, wondering how to help, LGBTQ youth surveyed by the Human Rights Campaign in 2012 identified absences of support in their families, religious leaders and places of worship, elected leaders, state and local government, movies/tv/radio and community leaders. They were more likely to report bullying or physical victimization in their schools and were twice as likely to describe alienation from their peers. Many reported not having any supportive adult to go to with problems. I would personally add to this list that medical professionals, from primary care doctors to mental health therapists, need significant additional LGBTQ-specific training to increase their comfort and knowledge in working with sexual minority youth. Go out and find a place to make a difference somewhere in that list.
There’s work and hope for all of us.
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SAVE — Warning Signs of Suicide
Suicide Prevention Lifeline — LGBTQ Suicide Factors
The Trevor Project
It Gets Better
Suicide Prevention Resource Center
Family Acceptance Project
Atrium Health Behavioral Health Help Line
National Crisis Text Line
Text HOME to 741741
National Suicide Prevention Lifeline
Time Out Youth Center, Charlotte
Elizabeth Kerr is a licensed mental health therapist in practice at Green Leaf Counseling Group in Charlotte, N.C. To learn more about her, visit newleafcounselinggroup.com.