September is National Suicide Prevention Month, and part of the mission of this featured month is increasing awareness for suicide prevention. Suicide is the second leading cause of death among young people ages 12-18 years old in the United States. With 20 percent of teens admitting to seriously considering suicide, the teenage mental health crisis continues to be one of the most pressing challenges of our time. Many times, youth who are contemplating suicide give warning signs of their distress. Because of this, parents, teachers, healthcare providers and coaches are in a key position to notice these signs of risk for suicide and provide help and support for people who are experiencing suicidal ideation as well as for survivors of suicide loss and the unique grieving process that they experience.
What Are Suicidal Thoughts?
For every person who attempts or completes suicide, many more suffer from suicidal ideation. Suicidal ideation is defined as having thoughts about ending one’s life. Experiencing suicidal ideation is much more common than many people may imagine.
However, thinking about suicide does not necessarily mean that a teen will make an actual suicide attempt. Many teens may think about suicide, but their suicidal thoughts and emotions do not progress to suicide plans or suicide attempts.
Having said this, suicidal thoughts can quickly escalate to a suicide attempt. In fact, recent research shows that for most young people who make a suicide attempt, the time between deciding and acting is less than 20 minutes. Because of this, teens experiencing suicidal ideation need treatment in their lives before any actual planning begins. Suicide prevention in youth is most effective when signs are caught early, and effective mental health support is received immediately.
Teenager Suicide Facts
According to the CDC, between 2000 and 2018, the suicide rate among youth ages 10 to 24 rose from 6.8 per 100,000 to 10.7 per 100,000.
In addition:
- 20% of teens have seriously considered attempting suicide in the past year.
- Additionally, 16 percent of high school students made a suicide plan.
- Minnesota has a higher suicide rate (15.5 per 100,000) than the national rate (14.5 per 100,000).
Why Are LGBTQ+ Teens Vulnerable to Suicide?
Research shows that LQBTQIA+ youth are at an even higher risk of suicide and consider suicide and make suicide attempts at about four times the national rate for all adolescents.
In 2022, 43% of LGBTQIA+ youth in Minnesota seriously considered suicide in the past year. 13% of LGBTQIA+ youth in Minnesota attempted suicide in the past year including 17% of transgender and nonbinary youth.
Nationally, LGBTQ+ youth who experience rejection at home are 8.4 times as likely to have attempted suicide as LGBTQ+ peers who reported no or low levels of family rejection.
In addition, in 2022, 70% of LGBTQIA+ youth in Minnesota reported experiencing symptoms of anxiety and 56% of LGBTQ youth in Minnesota reported experiencing symptoms of depression. These percentages are even higher for transgender and nonbinary youth.
Based on the statistics listed above, it is clear that LGBTQIA+ youth are at a higher risk for mental health issues such as depression, anxiety and suicide compared to their heterosexual and cisgender counterparts. Which leads us to the question of why? 
The Trevor Project explains why: “LGBTQIA+ young people are more than four times more likely to die by suicide than their peers—not because there is any predisposition in their identity, but because of the tremendous stressors and resulting emotions, rejection, and antagonism that many of them face in society.” Most profoundly, they experience rejection or lack of support from their family members much more often than their heterosexual peers. Nonbinary and transgender family rejection statistics are particularly striking: The 2023 survey found that less than 40 percent of transgender and nonbinary youth say they live in a gender-affirming home.
Moreover, stigma and threats of violence from peers and society at large further impact their mental health and well-being. LGBTQIA+ youth who experienced anti-LGBTQ+ victimization, including physically threats or harm and discrimination reported more than twice the rate of attempting suicide in the past year.
Hence, the feelings of isolation or “otherness” that often accompany adolescence are magnified for LGBTQIA+ teens. These challenges can be particularly overwhelming for younger adolescents and very much impact health and rates of suicidal ideation and suicide attempts overall.
All of these risk factors mentioned above stem from the stress created by living as a stigmatized minority, which is often referred to as minority stress.
What is Minority Stress /Minority Stress Theory?
The minority stress theory suggests that sexual minorities, underrepresented gender identities as well as queer and other sexual identities (LGBTQIA+) commonly experience distinct and chronic stressors that are related to their stigmatized sexual orientation and gender identities. This stigmatization includes victimization, prejudice and discrimination. Having to experience continuous discrimination, rejection, harassment and oppression can lead to the feeling of stigmatization. This stigmatization and prejudice places LGBTQIA+ youth at risk for developing a mental health disorder and increases the risk for suicidal ideation and suicide overall.
Suicide Prevention: Recognizing Suicide Warning Signs
There’s no single cause for suicide. Suicide most often occurs when stressors and health issues converge to create an experience of hopelessness and despair, leading a person to feel trapped with no way out of their emotional pain.
Listed below are some of the most common warning signs of suicidal thoughts or depression:
- Persistent changes in eating and sleeping behaviors
- Expressing feelings of hopeless or being trapped
- Increasing use of drugs and/or alcohol
- Withdrawal from friends and family members
- Neglect of personal appearance/health choices
- Irritability/drastic change of emotional states
- Sadness or crying spells
- Posts on social media suggesting feelings of isolation or depression
- Talking about death or dying or otherwise indicating plans to die by suicide
- Trouble concentrating and/or a drop in academic performance
- Risk-taking or self-destructive behavior
- Suddenly becoming calm or cheerful after a long period of depression.
Plan of Action When Warning Signs are Present
Teens who feel suicidal are not likely to seek help directly; however, parents, school personnel, and peers can recognize the warning signs and take immediate action to keep the youth safe. When a youth gives signs that they may be considering suicide, the following steps should be taken:
- Check in with yourself and take any needed steps to help you remain calm.
- Ask the teen directly if they are thinking about suicide (e.g., “Are you having thoughts of suicide?”). If this is an uncomfortable question for you to ask, take time to practice asking this question with a trusted friend or partner to increase your comfort.
- Focus on your concern for their health and well-being and avoid being accusatory.
- Listen.
- Reassure them that there is help and they will not feel like this forever.
- Provide constant supervision. Do not leave the young person alone.
- Remove any means for self-harm, including access to knives, pills and fire arms.
- Get help: No one should ever agree to keep a youth’s suicidal thoughts a secret. Parents should seek help from school or community mental health resources such as the US National Suicide Prevention Lifeline at 1-800-273-TALK (8255) as soon as possible.
- Take the person to an emergency room if needed or seek help from a health/medical or mental health professional.
What Parents Can Do to Counteract LGBTQIA+ Youth Suicide Rates
Along with risk factors, there are also factors that assist in the prevention of suicide in teens. Research
has consistently shown that support from parents, family and peers leads to better mental health, greater self-acceptance, and enhanced well-being among LGBTQIA+ youth. In fact, research has found that LGBTQIA+ youth who feel high social support from their family attempt suicide at less than half the rate of those who feel low or moderate social support. Additionally, transgender and nonbinary youth who feel their gender identity is accepted by at least one adult are less likely to make a suicide attempt compared to those who do not feel accepted.
Here’s how to offer this support:
Communicate often
Frequent, open conversations about sexual orientation and gender identity allow teens to share their feelings. At this age, their emotions may shift from day to day, and talking with a caring parent can have a stabilizing effect. Parents should listen closely to what their adolescents share.
Respect their process
The teenage years are a time of immense physical and emotional change and identity formation. Consequently, it can sometimes be easy for parents to write off changes in a teen’s sexual orientation or gender identity as “experiments” or “going through a stage.” It’s vitally important to respect your teen’s experience and feelings and to do your best to use their preferred name as well as gender-affirming pronouns. Trevor Project research shows that transgender and nonbinary youth whose pronouns are respected by the people they live with were 50 percent less likely to attempt suicide as those whose pronouns were not respected. 
Stay tuned into what’s going on in their life
Parents of LGBTQIA+ teens need to stay involved, so they learn what their child’s experience at school is like. Moreover, they need to watch for signs of bullying (including cyberbullying) or other discrimination at school.
Find resources to support suicide prevention in LGBTQ+ youth
Organizations like the The Trevor Project offer resources and support, in person and online, for LGBTQIA+ teenagers and their families. As a parent, take time to become familiar with the health resources available both online and in your community. Finding a mental health provider for your teen is crucial in helping them regain and sustain stability and safety.
Finally, parents of LGBTQIA+ teens need to remind their children often that they are unconditionally loved, and they will always be there to support them in their lives. As with all teenagers, feeling accepted and loved will make a positive impact on their lives, now and into the future.
Blog written by Sentier therapist Becky Lawyer, LPCC, LPC
Sources
U.S. Centers for Disease Control and Prevention (CDC) . (2024, April 25). Facts About Suicide. Retrieved September 1, 2024, from: https://www.cdc.gov/suicide/facts/index.html
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U.S. Centers for Disease Control and Prevention (CDC) . (2024, August 16). Youth Risk Behavior Survey Data Summary & Trends Report: 2013–2023 Retrieved September 1, 2024, from: https://www.cdc.gov/yrbs/dstr/index.html
The Trevor Project 2024 U.S. National Survey on the mental health of LGBTQ+ Young People CDC Supplements. 2020 Aug; 69(1): 47–55.
The Trevor Project. 2022 National Survey on LGBTQ Youth Mental Health Minnesota. Retrieved September 1, 2024, from: https://www.thetrevorproject.org/wp-content/uploads/2022/12/The-Trevor-Project-2022-National-Survey-on-LGBTQ-Youth-Mental-Health-by-State-Minnesota.pdf
Ryan C, Russell ST, Huebner D, Diaz R, Sanchez J. Family acceptance in adolescence and the health of LGBT young adults. J Child Adolesc Psychiatr Nurs. 2010 Nov;23(4):205-13.
The Trevor Project. (2024, January 1). Facts About Suicide Among LGBTQ+ Young People. Retrieved September 1, 2024, from: https://www.thetrevorproject.org/resources/article/facts-about-lgbtq-youth-suicide/
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Miller CT, Major B. Coping with stigma and prejudice. In: Heatherton TF, Kleck RE, Hebl MR, Hull JG, editors. The social psychology of stigma. New York: Guilford Press; 2000. pp. 243–272.
Toomey, R. B., Ryan, C., Diaz, R. M., & Russell, S. T. (2018). Coping With Sexual Orientation-Related Minority Stress. Journal of homosexuality, 65(4), 484–500. https://doi.org/10.1080/00918369.2017.1321888
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