MENTAL HEALTH GUIDE
Supporting LGBTQIA+ Youth
One in five youth under age 20 identify as part of the LGBTQIA+ community. Due to social stigma and discrimination, these youths are at higher risk of mental health issues, including depression, self-harm and suicidal ideation. However, the support of family and friends can make a big difference, and access to community and positive role models can help build resilience. This guide provides resources for parents, caregivers, educators and other allies to help support the LGBTQIA+ youth in their lives.
Crisis Resources
If your child expresses thoughts of wanting to harm themselves or others, call 9-1-1 or visit the nearest emergency department.
988 Suicide and Crisis Lifeline:
Call 9-8-8
Text any message to 9-8-8
Chat online at 988lifeline.org/chat
Crisis Text Line:
Text “HOME” to 741741
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External resources
The Trevor Project
thetrevorproject.org
National Institute of Mental Health
www.nimh.nih.gov
GLAAD
glaad.org
Learn more about CHOC’s pediatric mental health services
At CHOC, we specialize in providing a full spectrum of pediatric mental healthcare, including inpatient, intensive outpatient and outpatient program services.
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Overview
Like any human trait — such as height or hair color — gender and sexual orientation exists along a spectrum and is a normal part of the world’s diversity.
What does it mean to be LGBTQIA+?
LGBTQIA+ is an inclusive term that includes people of all genders and sexualities, including lesbian, gay, bisexual, pansexual, transgender, queer, intersex and asexual. It is often abbreviated as LGBTQIA+, or as a variation of the acronym.
LGBTQIA+ youth can come from any ethnicity, race, religion, culture or socioeconomic background. They can also hold multiple identities at once, as well as very different experiences from one another, so it is important not to over-simplify or generalize their experiences.
Protective factors for LGBTQIA+ youth
Although LGBTQIA+ may face mental health concerns from discrimination, bullying or minority stress, they are resilient. The following are some factors that help increase resilience among LGBTQIA+ youth.
- Support from caregivers, friends and community
- Presence of school protections for LGBTQIA+ youth
- Respecting pronouns for trans/non-binary youth
- Access to desired clothing, accessories and shapewear (binders) for trans and nonbinary youth
- Access to gender-affirming medical care for trans/non-binary youth.
Learn more about how to help protect LGBTQIA+ youth.
Risk factors for LGBTQIA+ youth
- Being rejected by family after coming out
- Lack of school protections for LGBTQIA+ youth
- Experiencing peer victimization due to being LGBTQIA+
- Belonging to multiple marginalized groups.
Learn more about the risk factors LGBTQIA+ youth may experience.
The dos and don’ts of supporting LGBTQIA+ youth
A CHOC psychologist offers the following dos and don’ts for caregivers and parents seeking to support their child and help them build resilience.
Don’t:
- Don’t assume that you can tell who is closeted or questioning; anyone can be closeted or questioning.
- Don’t force someone to come out if they are not ready.
- Don’t expect young people to answer questions that you wouldn’t be able to answer (or would never be asked) about yourself like, “How do you really know your gender?”
- Don’t tell an LGBTQIA+ youth that they are confused or might change their mind later.
- Don’t try to hide their identity or persuade them to change it.
- Don’t try to use bribes or rewards to pressure the child into changing their identity.
Learn how to respond if your child comes out.
Do:
- Do speak positively about the LGBTQIA+ community.
- Do welcome your child’s LGBTQIA+ friends or partners.
- Do defend them against others’ prejudice and advocate for their rights. Caregivers think by staying quiet that they are supporting their youth, but their silence is unnerving for their youth, who might think they’ll be rejected at any time.
- Do try to help your youth’s school or place of worship be more accepting and inviting.
- Do help them access LGBTQIA+-affirming spaces either in-person through support groups or in online chat rooms and virtual groups.
- Do immerse yourself and your child in positive representation of LGBTQIA+ individuals online, on social media and/or in the media (follow GLADD and the It Gets Better Project).
- Do understand that as caregivers, you can be accepting while also experiencing your own journey of loss or grief. You are important!
Learn more about CHOC’s Pediatric Mental Health Services
CHOC Hospital was named one of the nation’s best children’s hospitals by U.S. News & World Report in its 2024-25 Best Children’s Hospitals rankings and ranked in the behavioral health specialty.
Addressing myths about LGBTQIA+ youth
As a supportive LGBTQIA+ parent or caregiver, you have the power to dispel myths about LGBTQIA+ youths in your community. Below, a CHOC psychologist discusses how the following myths provide opportunities to correct others’ misconceptions.
“LGBTQIA+ people are confused.”
It’s much more accurate to say the world is confused about them, says Dr. Alpern.
“A child couldn’t possibly know their gender or sexual orientation … their brains are still developing.”
If we can let cisgender young children tell us their gender, then LGBTQIA+ children can too. The world expects LGBTQIA+ kids to justify and defend their identities in ways that other people don’t have to. Some kids can verbalize their gender identity by age three. Some trans youth don’t have the words or concepts until they are older, and their gender is still real and valid.
“A child or teen couldn’t possibly make decisions about who they are.”
In many situations, they are not deciding who they are. They are deciding what to do about it.
“Teens are claiming to be trans because it’s trendy and they are trying to fit in.”
It may seem sudden to outsiders, but to them, it was probably not sudden. They may have tried hard to make their assigned gender work for them and may have experienced stress that was not visible to others until it reached a critical point. They may finally be discovering terminology online that explains what they are feeling. Increased social acceptance and tolerance allows youth to be able to say who they are. They have the community and the language to speak up.
Important terms about the LGBTQIA+ community
You may hear several terms related to the LGBTQIA+ community. Proper use of these terms helps youths feel understood and respected — but it can feel overwhelming if they are unfamiliar to you. The following are some terms you may encounter.
Sex – this is also referred to as “assigned sex at birth,” based on anatomy. It’s what is printed on a birth certificate.
Gender identity – the internal sense of one’s own gender. There is no medical test for this.
Gender expression – how someone advertises or wears their gender through their hairstyle, clothing, voice and mannerisms.
Sexual orientation – the sexual attraction and behaviors towards others (or no one) and how someone sexually identifies – like gay, lesbian, pansexual and asexual.
Transgender (trans) – when someone’s true inner gender experience doesn’t match the assigned sex at birth. People may identify as trans male or trans masculine and trans female or trans feminine. They may also not identify as either trans male or trans female and rather identify as gender fluid, nonbinary, genderqueer or gender expansive.
Cisgender – when one’s gender identity matches their sex assigned at birth.
Pronouns – she/her, he/him, they/them, ze/zir. These pronouns used to be referred to as “preferred” pronouns, but that has fallen out of favor. It is essential to be called by the pronouns that match your gender.
For more helpful terms, visit PFLAG’s glossary.
Learn more about resources for CHOC youth and teens
At CHOC, we specialize in providing a full continuum of pediatric mental healthcare, including inpatient, crisis, intensive outpatient and outpatient program services.
How schools can support LGBTQIA+ students
The following resources are for school educators and administrators seeking to better understand and support LGBTQIA+ students.
It Gets Better Project | Free-to-download EduGuides
Welcoming Schools | A Checklist for a Welcoming and Inclusive School Environment
Welcoming Schools | Gender Support Checklist for Transgender & Non-Binary Students
Welcoming Schools | Diverse Books to Create LGBTQ+ Inclusive Classrooms & Schools
CA Dept of Education | Educator Excellence: Supporting LGBTQ+ Students
Print this sectionAdditional LGBTQIA+ recommended resources
Print this sectionRelated guides
Mental health challenges, such as depression, anxiety, self-harm and suicidality, are more common amongst LGBTQIA+ youth. For more information on these conditions, please visit our other mental health guides.
Additional Resources
For parents and caregivers
For youth and teens
- Q Chat Space
- Gender Spectrum
- TrevorSpace
- The Trevor Project Coming Out Handbook
- The Trevor Project Resource Center
For everyone
The guidance on this page has been clinically reviewed by CHOC pediatric experts.
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The contents of this webpage, including text, graphics, audio files, and videos (“Materials”), are for your general information only. The Materials are not intended to substitute qualified professional or medical advice, diagnoses, or treatments. CHOC does not recommend or endorse any specific tests, physicians, products, procedures, or other information that may be mentioned on or linked to this webpage. Always call your physician or another qualified health provider if you have any questions or problems. If you think you may have a medical emergency, call your doctor, go to the nearest emergency department, or call 911.
For more health information for your family visit health.choc.org