"Coming out" is a lifelong journey of understanding, acknowledging and sharing one’s gender identity and/or sexual orientation with others. It may be quick and easy for some, or longer and more difficult for others.
It is important for parents of lesbian, gay, bisexual, transgender, and questioning (LGBTQ) teens to remember each child is unique and will have their own experiences and feelings along the way.
What to know about sexual orientation and mental health in youth
Young people within LGBTQIA+ communities are more likely to experience challenges with their mental health. This is largely due to the oppression and discrimination they may encounter at school, at home, and in their wider community.
Lesbian, gay, bisexual, transgender, and other self-identified queer (LGBTQ) youth have higher rates of mental health issues than people in the general population.
Research suggests that these mental health challenges correlate with factors such as family acceptance and bullying. This indicates that stigma and discrimination, and not being LGBTQ itself, may predict LGBTQ youth mental health difficulties.
In this article, we will discuss statistics on mental health conditions prevalent in LGBTQIA+ communities, and where people can find support.
"i feel different from other kids…"
Feelings of being "different" emerge throughout childhood, although it may not be clear to the child what the feelings means. Children may begin exploring gender and relationships before kindergarten, so "coming out" and sharing these feelings of being different with others may happen at any time. For many kids, gender identity becomes clear around puberty as they develop gender characteristics and stronger romantic attractions. However, many LGBTQ teens have said, in retrospect, that they began to sense something "different" about themselves early in life, and for gender diverse youth, sometimes as far back as preschool. See Gender Diverse & Transgender Children.
It is common for LGBTQ teens to feel scared or nervous during this stage. Some can start to feel isolated from their peers, especially if they feel that they don’t fit in or are given a hard time for being different. Just remember that children who feel loved and accepted for who they are have a much easier time.
"i think i might be gay (or lesbian, bi, or trans), but i’m not sure, and i don’t know how i feel about that…"
Beyond just feeling "different," young people begin to wonder if they might be "gay" (or lesbian, bi or trans) or some other label they may prefer. Many teens have mixed feelings when they first try on a new way of identifying. It can be a mix of excitement, relief, and worry.
Many children may try to suppress these feelings to meet societal expectations, to fit in, or even to avoid upsetting their parents or families. In some cases, teens might be overwhelmed by all these feelings, which increases the risk for depressionmental health issues. For example, they may isolate themselves from others for fear of being exposed, or "outed." Some teens may feel very alone, especially if they live in a community that doesn’t have an active LGBTQ-youth support system. Having a supportive and helpful environment at home and good relationships with friends and will help teens to manage their feelings and deal with any discrimination they may face.
"i accept that i’m gay, but what will my family and friends say?"
Teens may accept that they are LGBTQ but not yet ready to start sharing this information with anyone yet. Some will feel comfortable being open about their identity, while other teens may not tell anyone for a long time. Teens may look for clues on how you feel about their gender identity and sexual orientation. Speaking positively about LGBTQ celebrities or current events you will let them know you are supportive of their identity.
Society has become more open and accepting of LGBTQ individuals, and young people are beginning to come out at earlier ages than they did a generation ago. Children may first come out to online communities or peers they perceive as safe and accepting before telling their family.
"i’ve told most of my family and friends that i’m gay (or lesbian, bi, or trans)."
Teens feel secure enough in who they are and share that information with loved ones. It takes courage and strength for a young person to share who they are inside, especially for teens who are unsure of how their families will respond. They may be afraid of disappointing or angering their families, or in some instances may fear being physically harmed or thrown out of their homes. Again, parents usually need time to deal with the news. While it may take them days, weeks or many months to come to terms with their child’s sexuality or gender identity, it is important for parents to show love and support for their child, even if they don’t fully understand everything.
Coming out to others can be a liberating experience, especially for those teens who are embraced by their communities and families. LGBTQ teens may feel free to speak openly about their feelings and possibly romantic relationships for the first time. For transgender and gender diverse teens, they may finally feel free to begin expressing themselves genuinely as the gender they feel inside.
Even if you are having trouble understanding your child’s identity or feelings, not withdrawing from your role as a parent is probably one of the most important ways to help a child continue to feel a sense of being cared for and accepted. Feeling loved has been shown to be critical to overall health and development of all children regardless of gender or sexual orientation. Many parents do need their own supports to help them understand and cope with their own difficult emotions and concerns during a child’s "coming out."
Lgbtq youth and mental health
Suicide rates are suggests that lesbian, gay, and bisexual youth consider suicide at nearly three times the rate of heterosexual youth.
The Trevor Project’s 2019 National Survey on LGBTQ Youth Mental Health found that 39% of LGBTQ youth seriously contemplated suicide in the prior year, with 71% of LGBTQ youth feeling sad or hopeless.
Click here to learn more about LGBTQIA+ youth and depression.
A 2018 study found that transgender youth experience mental health diagnoses at higher rates than their peers. They are also more likely to report abuse.
The Trevor Project highlight how rejection and discrimination affect the mental health of LGBTQ youth:
The also emphasize this hostile climate, drawing on data from the 2015 Youth Risk Behavior Survey:
A 2013 National School Climate Survey by the Gay, Lesbian, and Straight Education Network also highlights that schools can be unsafe learning environments and can expose LGBT youth to anti-LGBT behavior and discriminatory practices.
Lgbtq youth and anxiety
Most studies suggest that LGBTQ youth experience higher rates of anxiety and depression. A 2020 Trevor Project survey indicates that the COVID-19 pandemic may have been particularly challenging for the mental health of self-identified queer youth.
LGBTQ youth were 1.75 times more likely than their peers to experience symptoms of anxiety and depression. The figure was even higher among trans and nonbinary youth, as they were 2.4 times more likely to face anxiety or depression.
Respondents report that due to lockdown procedures, many felt more exposure to stigma. In many cases, quarantining with unsupportive family members exacerbated their anxiety.
Around a third said they were unable to be themselves at home, while 16% said they felt unsafe at home. About 1 in 4 also said they were unable to access mental health care.
Lgbtq youth and stress
LGBTQ youth face all the same stressors as other teenagers, such as:
They must also grapple with a society that may reject or stigmatize them.
A 2018 Human Rights Campaign report drawing on national survey data found much higher stress rates among LGBTQ youth. Some highlights include the following findings:
Lgbtq youth and substance misuse and abuse
According to the Human Rights Campaign, LGBTQ youth are less likely to have family to whom they can turn for help, which can make it difficult to get treatment for substance abuse. Some may turn to alcohol or drugs to self-medicate or to manage the pain of rejection and bullying.
A found that rejection at school correlated with a higher risk of substance abuse for LGBTQ teens.
Lgbtq youth and low self-esteem
Anti-LGBTQ messages, family rejection, and fear can all affect self-esteem. A 2018 Human Rights Campaign survey reports that although most (91%) LGBTQ youth report pride in their identity, 70% reported feelings of worthlessness or hopelessness during the previous week.
Additionally, 67% of respondents said that they heard members of their family make anti-LGBTQ statements.
Feelings of rejection were highest among LGBTQ youth of color. A mere 11% of whom said people view their racial or ethnic group positively.
Lgbtq youth and disordered eating
Eating disorders are a way of coping with emotional pain, and some people use them to gain a sense of control when life feels out of control.
A 2020 analysis suggests that 54% of LGBT people received a diagnosis with at least one eating disorder at some point during their lives. An additional 21% suspect they may have an eating disorder.
Where to find support
While mental health issues are common among LGBTQ populations, a person does not have to suffer in silence. Some options for getting support include:
People may also be able to seek help online via several organizations that provide support and advice. LGBTQIA+ youth resources include:
LGBTQIA+ youth can try accessing free, confidential assistance from trained professionals via national hotlines. These hotlines are available 24 hours per day and may benefit anyone experiencing difficulties with their mental health or those who want or need to talk about their feelings.
If anyone believes that a person is at immediate risk of suicide, they should call 911 or a local emergency number immediately. People should try to provide as much accurate information as emergency services need.
Rejection, isolation, bullying, and safety issues can all conspire to make it more difficult for LGBTQIA+ youth to feel safe and supported. This can result in mental health issues and may account for the higher rates among those in LGBTQIA+ communities.
LGBTQIA+ youth can try to access online support services or find support networks in their local community that may be able to provide identity-affirming care and support.
Parents and families can:
When your child discloses their identity to you, respond in an affirming, supportive way. Understand that although gender identity is not able to be changed, it often is revealed over time as people discover more about themselves.
Accept and love your child as they are. Try to understand what they are feeling and experiencing. Even if there are disagreements, they will need your support and validation to develop into healthy teens and adults.
Stand up for your child when they are mistreated. Do not minimize the social pressure or bullying your child may be facing. See How You Can Help Your Child Avoid & Address Bullying.
Make it clear that slurs or jokes based on gender, gender identity, or sexual orientation are not tolerated. Express your disapproval of these types of jokes or slurs when you encounter them in the community or media.
Be on the look out for danger signs that may indicate a need for mental health support such as anxiety, insecurity, depression, low self-esteem, and any emotional problems in your child and others who may not have a source of support otherwise.
Connect your child with LGBTQ organizations, resources, and events. It is important for them to know they are not alone.
Celebrate diversity in all forms. Provide access to a variety of books, movies, and materials—including those that positively represent gender diverse individuals. Point out LGBTQ celebrities and role models who stand up for the LGBTQ community, and people in general who demonstrate bravery in the face of social stigma.
Support your child’s self-expression. Engage in conversations with them around their choices of clothing, jewelry, hairstyle, friends, and room decorations.
Reach out for education, resources, and support if you feel the need to deepen your own understanding of LGBTQ youth experiences. See Support Resources for Families of Gender Diverse Youth.