“We Need to Talk About It”: The Mental Health Crisis Facing LGBTQI+ Youth

In recent years, awareness of mental health has grown, and conversations about depression, anxiety, and self-harm are slowly becoming less taboo. But for LGBTQI+ youth—those who identify as lesbian, gay, bisexual, transgender, queer/questioning, or intersex—these conversations are often overshadowed by stigma, silence, and misunderstanding.

Behind the statistics lies a much deeper, more personal reality. A recent systematic review by Clare Wilson and Laura Cariola offers a crucial perspective that goes beyond the numbers. Rather than focusing solely on data points and prevalence rates, this review gathers an

he words, emotions, and lived experiences of LGBTQI+ youth themselves.

What emerges is a powerful call to action.

What the Research Tells Us

Wilson and Cariola reviewed 34 qualitative studies published between 2008 and 2018, a period marked by significant legal and social shifts for LGBTQI+ people around the world. These studies spanned various contexts—from schools and community centers to online forums and healthcare services—and focused on the mental health experiences of youth aged 12 to 24.

Five recurring themes emerged from this body of research:

1. Isolation, Rejection, and the Urgent Need for Support

Many LGBTQI+ youth feel cut off—from their families, schools, and broader communities. Some are rejected outright after coming out, while others face subtle but persistent exclusion. Silence, denial, or avoidance from those around them can be just as damaging as overt hostility.

This lack of affirmation leaves young people feeling invisible and unsupported. It creates emotional barriers to seeking help, even when they’re in distress. Shame and fear of stigma often prevent them from turning to mental health services—especially when they believe those services may not understand or accept their identity.

2. Marginalization in Everyday Life

Discrimination doesn’t always appear as dramatic events. It often unfolds through everyday interactions: being misgendered by a teacher, hearing homophobic jokes go unchecked, or watching others avoid the topic of gender and sexuality entirely. These microaggressions accumulate, shaping a sense of not belonging.

Structural marginalization—from school policies to healthcare access—deepens the divide. For LGBTQI+ youth living in rural areas, experiencing homelessness, or using substances, these barriers are even more pronounced.

3. Mental Health Struggles: Depression, Self-Harm, and Suicidality

The emotional consequences of rejection and marginalization are profound. LGBTQI+ youth experience higher rates of depression, anxiety, self-harm, and suicidal ideation than their heterosexual, cisgender peers. In some studies, up to one in five had attempted suicide. Many more had seriously considered it.

What’s important to recognize is that these mental health challenges are not inherent to being LGBTQI+. They are the result of external pressures—discrimination, exclusion, fear, and lack of support.

4. Policy and Environment: Systems That Help or Harm

Environments can either be protective or harmful. Supportive schools, inclusive policies, and affirming healthcare services can significantly reduce mental health risks. Programmes like Gender and Sexuality Alliances (GSAs) in schools, for example, have been shown to improve psychological and social outcomes for LGBTQI+ students.

But when these systems are hostile or unresponsive, they reinforce the sense of being unwelcome. The research highlights the importance of embedding inclusivity not just in culture, but in concrete practices and policies that directly affect youth.

5. The Power of Connection

Above all, LGBTQI+ youth thrive when they feel connected—to families, peers, communities, and safe adults. Support doesn’t have to be perfect. What matters is feeling seen, accepted, and valued.

Qualitative studies consistently point to the importance of affirming relationships. Even a single supportive teacher, parent, or friend can make a profound difference. And for those without support at home, online communities and peer networks often become critical lifelines.

Why Qualitative Research Matters

So much of the existing research on LGBTQI+ mental health is quantitative—counting risk factors, tracking outcomes, and identifying disparities. That work is essential, but it rarely tells us what these experiences feel like. It doesn’t ask what youth are saying, or what they need.

This review fills that gap. By analyzing interviews, focus groups, online posts, and personal narratives, Wilson and Cariola highlight the voices of LGBTQI+ youth. These voices reveal not only pain, but also resilience, clarity, and a deep understanding of what needs to change.

It’s not just about numbers. It’s about being heard.

What Needs to Happen

The findings from this review are not abstract—they are actionable.

For families:

• Affirm and accept your child’s identity.

• Talk about gender and sexuality openly and without judgment.

• Be a safe person, even if you don’t have all the answers.

For schools:

• Implement inclusive policies and training.

• Support programmes.

• Address bullying and microaggressions directly.

For mental health services:

• Create culturally competent, LGBTQI+-inclusive care models.

• Reduce barriers to access, especially for marginalized youth.

• Include LGBTQI+ youth voices in service design and evaluation.

For policymakers:

• Invest in LGBTQI+ youth programmes.

• Protect rights through anti-discrimination legislation.

• Develop policies in consultation with LGBTQI+ communities.

A Final Thought

Mental health challenges among LGBTQI+ youth are not inevitable. They are the result of environments that either affirm or deny a young person’s identity. The good news? These environments can change. And change begins when we listen.

This review doesn’t offer a single solution. Instead, it presents a chorus of voices—honest, vulnerable, and urgent—calling for visibility, respect, and support.

Scotland‑Specific Resources & Support for LGBTQ+ Youth

• LGBT+ Helpline Scotland  Call: 0800 464 7000  Hours: Tuesdays, Wednesdays, Thursdays (12pm–9pm) and Sundays (1pm–6pm) LGBT Health+2LGBT Health+2 They offer emotional support, information, live chat, and email support across Scotland for LGBTQ+ individuals, as well as for families, friends, and professionals.

• LGBT Youth Scotland offers live chat, one‑to‑one support, youth groups, and online services. LGBT Youth Scotland+2LGBT Youth Scotland+2

Wilson, C., & Cariola, L. A. (2019). LGBTQI+ Youth and Mental Health: A Systematic Review of Qualitative Research. Adolescent Research Review. https://doi.org/10.1007/s40894-019-00118-w