Mental health and suicidality among Black lesbian, gay, bisexual, transgender, and queer youth

Suicide is a growing public health concern among youth. Despite historically reporting low rates of suicidality, Black youth now represent the fastest growing suicide rate, warranting immediate attention for salient and culturally-relevant prevention and intervention strategies. Because Black youth populations consist of diverse groups who bring distinct risk and protective factors shaped by their lived experiences, the goal of the present study was to better understand mental health and suicidality among Black lesbian, gay, bisexual, transgender, and queer (LGBTQ+) youth using a strengths-based intersectional approach. Responses were analyzed from a national U.S. sample of 3,008 Black LGBTQ+ youth aged 13 and 24 years, including 1,717 Black transgender and nonbinary (TGNB) youth. The rates of mental health and suicide indicators were high among Black LGBTQ+ youth, with nearly half (49%) reporting seriously considering suicide in the past year. However, there were significant disparities between Black TGNB youth and their cisgender LGBQ+ peers. Structural influences were associated with all mental health indicators and this did not differ as a function of gender identity. Additionally, disparities in other mental health indicators between Black TGNB youth and their Black cisgender LGBQ+ peers were mitigated when Black TGNB youth had access to a gender-affirming home. The findings highlight the need to directly address the unique issues facing Black LGBTQ+ youth, and specifically Black TGNB youth, by advancing antiracism alongside gender-inclusive policies, while also finding ways to build upon existing strengths within the Black community to support youth.