2025 LGBTQ Youth Report
Healthy Bodies, Healthy Minds: How Providers Can Best Support LGBTQ Youth
This blog post is co-authored with Advocates for Trans Equality (A4TE).
Everyone deserves access to quality health care when they need it. For LGBTQ youth, achieving a healthy life must include being accepted and affirmed for who they are.
A recently released report from the Movement Advancement Project — in partnership with A4TE, Advocates for Youth, Equality Federation, GLSEN, PFLAG National, and The Trevor Project— highlights perspectives of LGBTQ youth who speak to the importance of affirming and culturally competent health care.
The following recommendations draw from MAP’s new report and provide a summary of how medical and behavioral health providers can best support the overall health of LGBTQ youth, which includes both their physical and mental well-being.
Understanding the health care landscape
“I don’t want politicians trying to control my body, my life, and my family’s lives.”
— An anonymous LGBTQ young person in Idaho
Like all youth, LGBTQ youth need access to quality, affirming medical care. This includes transgender youth, who deserve access to competent health care deemed medically necessary by their health providers.
Yet, medically necessary transition-related care, the health care transgender youth may access to affirm their gender identity, is under attack based on increasing political stigma, misunderstanding, disinformation, and discrimination. As a result, many transgender young people across the country are suddenly living in places that ban this best practice, evidence-based medical care. In response, some states have enacted “shield” laws, which protect patients, families, and the health care professionals providing this care.
Yet, since 2021, the number of states banning best practice medical care has grown from zero to 27 — more than half the country in just a few short years.
Safe and affirming medical care
Creating an affirming health care experience for LGBTQ youth begins from the moment they first encounter a provider’s practice and extends well beyond the end of their visit. Safe space signage and affirming intake forms, for example, can make youth feel more comfortable and confident about speaking openly and honestly about their medical concerns and potentially disclosing their sexual orientation or gender identity to a medical provider.
However, some LGBTQ youth may still not be comfortable sharing personal information with providers or certain members of the health care team. They may fear that people who do not know their sexual orientation or gender identity will find out if they share it in a medical setting, or they may fear potential discrimination and harassment should providers and their team become aware. Providers can reassure youth by sharing what precautions are taken to ensure their health information and any disclosures are confidential and informing them of any nondiscrimination policies the practice has in place. This is why it is crucial for providers not to rely solely on statutory protections and to ensure that they develop internal policies intended to create a safe and affirming environment for LGBTQI+ youth.
Even with the best policies in place and a welcoming team, patients may still not be comfortable sharing information about their identities at first. For this reason, invitations to update this information should be made proactively and often, as youth may feel more comfortable disclosing this information only after developing trust with providers and a sense of safety within the clinical environment.
Once patients do open up regarding their identities, they will likely have questions. They are also just as likely to have done independent research into their own health care needs, especially if they are seeking some form of transition-related care. For these reasons, it is critical that providers consider this field of care, often called gender-affirming care to be a core aspect of the potential care a patient may seek, and should take any and all measures necessary to ensure they are as knowledgeable about this field of care as they are about other routine forms of pediatric medicine.
Making space for conversation
As children enter adolescence, conversations about sexual health become both developmentally appropriate and medically necessary. Youth, regardless of sexual orientation or gender identity, are often hesitant to begin conversations about sex with medical staff or caregivers. If adolescents feel like they will be judged or shamed, this will make it even less likely that they will be forthcoming with this information.
Providers can support LGBTQ youth by starting these conversations from a place of cultural competence, curiosity, and without judgment. By not presuming that their patients are heterosexual or cisgender, providers can better understand and account for the sexual and reproductive health needs of youth patients, regardless of their present sexual orientation or gender identity.
Removing barriers to mental health care
Mental health is an important dimension to overall health and well-being for all young people. This is especially true for LGBTQ youth in particular — who often want mental health care but cannot access it or may be hesitant to seek it out. LGBTQ youth may engage in “avoidance of care” for any number of reasons, such as a feeling that they are expected to be “resilient” or “tough it out,” or they may fear being subjected to conversion practices by providers who are not affirming. Regardless the case, providers must do all that they can to encourage LGBTQ youth to seek out this care.
According to The Trevor Project’s 2024 National Survey on the Mental Health of LGBTQ+ Young People:
- LGBTQ youth overwhelmingly (84%) reported wanting emotional or psychological counseling, but half of those who desired care could not get it.
- When asked what stopped them from being able to get mental health care, some of the reasons that LGBTQ youth gave included being scared of talking about their mental health, the cost of care, and not wanting to have to get a parent’s permission.
- Nearly a quarter of LGBTQ+ youth cited fears of being outed or not having their identity understood as barriers to care.
Mental health care is significant for LGBTQ youth: it can help them better understand themselves and think through their identities. In turn, such care can be vital in navigating the experience of coming out, disclosing to family and friends that they are LGBTQ, or asking for support at home or at school.
Like all youth, LGBTQ youth need medical care providers who can support them from a place of knowledge, openness, and cultural competence about all aspects of their health and their identities. If providers can ensure that care is safe, affirming, responsive to their needs and concerns, and attends to both their physical and mental well-being, LGBTQ youth will be given a better chance to lead healthy lives and thrive.
To learn more about how health care, home, education, and community inform the lives of LGBTQ youth, read MAP’s new partner report.
