Mental health outcomes for LGBTQ+ youth had been improving for years — until now

Researchers at the LGBTQ+ advocacy organization The Trevor Project have been following nearly 1,700 young people for the last two years, measuring their mental health amid an unprecedented rise in anti-LGBTQ legislation.

Their latest results are out now — and they're not good.

The report found worsening mental health distress among these young people — anxiety symptoms rose to 68%, depression to 54%, and those thinking about suicide is up to 47%. Transgender and non-binary teens ages 13 to 17 are feeling the worst, according to the report.

It’s a downward trend Dr. Joshua Kellison is seeing firsthand. He's a licensed clinical psychologist and the founder of the Sexual Orientation & Gender Institute of Arizona.

Kellison joined The Show and said, up until recently, things had been getting better for LGBTQ+ youth.

Full conversation

DR. JOSHUA KELLISON: So one of the best books that came out, I think, earlier on was like “The New Gay Teenager”, and it was talking about how these youth are no longer experiencing internalized homophobia and are coming out sooner and all these wonderful things. T

hen you start to see a switch, that pendulum swinging back. And here in the Valley, we saw a lot more kids feeling more suicidal, engaging in high-risk behaviors like substance use or alcohol use, or engaging in high-risk sexual behaviors and things like that.

So that pendulum swung back, and as the current administration continues, we start to see that increase again.

LAUREN GILGER: So tell us what you think is behind that. We’ve seen community centers, resources close, lose funding, completely shut down. I mean, it sounds like your referrals are going up because of this.

KELLISON: Yeah. So what we saw for any federally funded hospital, for example, if they are in fear of losing their funding, they may need to shut down services that might have been, for example, gender affirming medical care. And so for example, Phoenix Children’s Hospital and several other institutes and things of that nature had to reduce access to those forms of care.

That being said, we rallied, and we supported our youth in terms of being able to have access to care from other agencies. At the same time, there is a current crisis in mental health where there’s not enough providers, and there’s not enough resources in terms of insurance.

And then the fear of access to care for youth and the stigma of going and getting that kind of help, that professional help feels wrong or bad. And so unfortunately, those cases tend to then isolate, and we see these problems occur.

GILGER: Tell us about some of the folks that you work with and what you’re hearing from these kids.

KELLISON: The worst that I’m seeing — there’s a few things that I’ve been seeing. Well, first of all, the amount of people that are considering leaving not just the state to go to a state where there’s access to medical care for their gender nonbinary or gender diverse youth, but they’re going off out of the country.

And so recently I had three families make that very challenging and difficult decision to leave the country. And in fact, I just actually got an update from one of my families who chose to move to Ireland. And they’re now waiting to get their asylum.

GILGER: They applied for asylum in Ireland based on the changes in transgender care in the United States?

KELLISON: Yeah, the issue is because it’s not just the states that are having some of these difficulties, but the federal government is putting fear in not just the families, but the providers. So in Texas, we saw that for a while. People could report that these families were gaining access to care for their children and those neighbors or family members would report them and get paid.

That was short-lived, but the idea that these kinds of things can happen was so fearmongering — and rightly so, by the way — that these families had to make the decision, like, before it gets too bad, the writing’s on the wall, we have to get out of here before it’s too late. And so selling their homes, leaving their careers, leaving their families, leaving their religious institutions, all kinds of resources, and we as psychologists have to prepare those families for that transition.

And so that has been learning on the ground, because we weren’t — there was no training for that.

GILGER: Right. Like this is new territory for somebody like you. One of the things I wanted to ask you about is confusion among parents.

There used to be sort of a script like, or a path that they could follow if they had a kid who’s transgender to get care and to do what the medical establishment recommends. And that’s sort of questioned now.

KELLISON: Yes, unfortunately, because of some of the science deniers and health deniers and medical establishment deniers, and now parents are questioning, like, do you really know what you’re kind of talking about? Is this really true? Is this the best care that we can provide our kids? Are they really suicidal? Are you sure about that?

So just kind of going over the results of some of the assessments that we give. But these measures are tried and true and are evidence-based. So scientifically proven to work with various populations at different ages.

GILGER: Is the whole conversation around conversion therapy coming up again?

KELLISON: Yes, and I always tell people that I will not do that. I follow the client where they are, and they lead me on their journey. I’m just there as a participant to supporting them. I’ve had some family members talk about those kinds of things. And part of the grief response when a child comes out for some parents is sometimes negotiation, which is one of those Kübler Ross stages of grief, where we negotiate or bargain when we learn about death.

And so, if you go to this conversion therapy place, then I can support you in terms of getting a car or something else. If you go through this really painful experience of trying to change you into something that you may or may not be but something that could cause more problems and long term mental health challenges that increase that internalized transphobia.

GILGER: Did you ever think we’d be back here? It sounds like this is a lot of stuff that was put to bed for some time that was not acceptable, and now it’s back in the debate.

KELLISON: Not in my lifetime. I mean, I’ll get emotional things just thinking about it, having gone through some of those things myself as a youth, and then thinking that we had surpassed and we had gotten so far that I did not think that this would come back as it has now, in this such a profound and fast, unrelenting way that it just, every day there’s another thing that these youth then come in and we’re talking about.

And I have to support them in digesting this information and helping them to cope with social political distress rather than coping with just being a teenager. Just being a teenager is hard enough. And now we have to talk about what the current administration has said and/or doing and the threats that they’re making and all that fear and all of that is just a sense of control. So I again continue to encourage them to live their best lives and as authentic as they can possibly be.

GILGER: I wonder if there’s a silver lining in this report at all. Like, were there any tidbits in here that you felt like this is good?

KELLISON: There were a few hopeful signs that I saw, and one of them that was really inspiring was the fact that even though there was this higher increase in folks that felt like they did not have access to care just due to costs and in terms of people having open slots and just some of the stigma that they were feeling about that, at the same time, there was a statistically significant amount of youth that reported wonderful results in terms of their experience of therapy.

So they felt good after leaving those sessions. They felt less suicidal in leaving those sessions. And the other thing is that those that have attempted suicide have actually gone down. It was 11% to 7%. So the actual ones that have attempted has reduced in a significant way.

GILGER: Last question for you, Dr. Kellison. I wonder if there’s a client, a story, a moment in all of this that really stands out to you that you’d like to tell folks about.

KELLISON: I have lots of stories, and there’s a lot of youth who come to mind over the past 15 years that I’ve been working in this area. But one that comes to mind that I think about all the time, they came to me early on with such significant distress and they were actively suicidal, actively attempting suicide.

And as they began to accept themselves and their family members were also in the full model DBT, or Dialectical Behavioral Therapy program, that we offer at our institute. And then the youth started accepting themselves, and the parents were doing such an excellent job of providing that support to that youth. That youth no longer engages in self-harm.

They now are at a university doing very well, and they’re loving themselves, and they’re in a relationship that they thought they would never have. I’m just so proud of them because they were able to turn their lives around through that self acceptance and also the skills-based work that they learn from a treatment program.