The number of suicides among young people have been rising dramatically – reaching the highest levels since 2000, according to a 2019  JAMA paper – and that was before COVID. In fact, suicide is the second leading cause of death for those aged 15 to 29. And for young members of the LGBTQ community, the story is even grimmer: according to NAMI, they are five times more likely than their straight counterparts to attempt suicide at some point – which is where The Trevor Project comes in.

What is the Trevor Project

The organization was founded in 1988 by the creators of the Academy Award-winning short film, TREVOR, which chronicles a coming-of-age story about a 13-year-old boy who has a crush on the most popular boy at school. When his secret gets out, he’s teased and mocked. Feeling sad and alone, Trevor decides that everyone would be better off if he killed himself. It’s a story about love, loss, conquering fear, and gaining self-acceptance. When TREVOR was scheduled to air on HBO in 1988, the filmmakers wanted to share an appropriate lifeline number, since some of the young viewers watching might be facing the same kind of crisis as Trevor—but no such number existed—so on August 8, 1988, The Trevor Project was born. The Trevor Project has since gone on to become the world’s largest crisis intervention and suicide prevention organization for LGBTQ youth.

Alexis Chavez, MD, medical director for The Trevor Project at the time of this interview (she’s now at the VA), was responsible for keeping The Trevor Project’s programs evidence-informed and up to date with all the latest research in the field – and she had a lot to say about the state of mental health for the LGBTQ community.  

Why is the suicide rate so high in the LGBTQ community? 

Dr. Chavez: Discrimination has a quantifiable effect on mental health. Much—if not all—mental health disparity in the LGBTQ community is directly attributable to the discrimination experienced every day. Since there is such systemic discrimination, the rates of depression and suicidal thoughts are far higher due to the constant stress. There are more physical problems as well, like high cholesterol, high blood pressure, and issues around obesity.

How does chronic stress contribute to these physical and mental problems?

Dr. Chavez: Chronic stress results in high levels of cortisol, which can help in times of duress fueling our fight/flight reflexes, but the body isn’t meant to be in such high periods of stress all the time. High levels of cortisol impact weight, the way the body stores nutrients, and heart health. There’s not one thing that’s affecting the community—it’s everything.

Every time an LGBTQ person is a victim of physical harassment or verbal abuse, they are 2.5 times more likely to hurt themselves. Why is that? 

Dr. Chavez: Social stigma, discrimination, and harassment lead to restrictions across the board—job access, education, housing, and health care. In our National Survey on LGBTQ Youth Mental Health 2019, 71% of LGBTQ youth reported discrimination due to either their sexual orientation or gender identity. Of the respondents who reported discrimination, 22% attempted suicide—more than double the rate of attempted suicide from respondents who hadn’t reported discrimination (9%).

How does conversion therapy impact the community?

Dr. Chavez: Two in three LGBTQ youth reported in our National Survey that someone tried to convince them to change their sexual orientation or gender identity—and those who have undergone conversion therapy are more than twice as likely to attempt suicide as those who did not.

Amy Green, our Research Director, is leading the research on how many LGBTQ youth have undergone conversion therapy—and what impact it has had on them. Conversion therapists use a variety of emotionally traumatic, shaming, or physically painful stimuli to have their patients associate those stimuli with their LGBTQ identity.

These types of programs aim to make those enrolled internalize that there is something deeply wrong with them because of their LGBTQ identity, which can cause much harm. Taken in combination with the minority stress model, in which LGBTQ people experience all sorts of problems—from discrimination to having challenges doing regular things like buying a cake—these messages can create feelings of worthlessness. LGBTQ young people who come from families that reject or do not accept them are more than eight times more likely to attempt suicide than those whose families accept them.

What’s the impact of politics on mental health for the LGBTQ community?

Dr. Chavez: According to our research, 76% of LGBTQ youth felt that the recent political climate impacted their mental health or sense of self. After the last presidential elections, we had a spike in calls to our suicide and crisis prevention hotlines. After roll-back of gay rights protections, we had a spike in calls. These situations are exacerbating current challenges. There is well-established research that shows that when you have policies in place that protect equality, the mental health of everyone in the community is improved—even if an individual is not personally affected. Why? Because it affirms that a person is worthwhile from a societal perspective. When policies are not in place to protect equality, it’s called structural discrimination.

How does The Trevor Project help young LGBTQ people in crisis?

Dr. Chavez: We offer free, confidential crisis intervention and suicide prevention resources—which includes a 24/7 Lifeline (866-488-7386), a secure instant messaging service called TrevorChat, and a crisis text line—TrevorText. Also, we have life-affirming services like TrevorSpace—the nation’s largest, secured social media space for LGBTQ youth. We also offer guidance and resources to parents and educators to foster safe, accepting, and inclusive environments for all youth—at home and school.

Is The Trevor Project just for those who are suicidal or in crisis?

Dr. Chavez: No—we offer a way to reduce isolation, which can contribute to not feeling so well. Knowing that there is someone else who is having the same issues, facing the same challenges can make a huge difference.

How can people outside the LGBTQ community help?

Dr. Chavez: You don’t need to be a mental health expert to support the LGBTQ youth in their lives every day by listening, lending an empathetic ear, showing that you care, and by referring them to resources like The Trevor Project. You can even be a Trevor Project volunteer. The crisis counselors get extensive training on concepts around LGBTQ topics and gender identity, suicidology, and understanding risk; they also complete a variety of roleplays to prepare them to interact with youth in crisis.

Editor’s Note: This article was originally published on

Last Updated: Oct 29, 2020