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Trevor Project Study: LGBTQ youth in small towns & rural areas

Nearly half of LGBTQ youth in rural areas and small towns reported that their community was somewhat or very unaccepting of LGBTQ people

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Cover of 'WHERE WE CALL HOME: LGBT PEOPLE IN RURAL AMERICA' April 2019 (Photo Credit: Movement Advancement Project)

NEW YORK – Among the broader population of youth ages 10–24 in the U.S., suicide rates are higher in rural than in urban communities. Further, data from GLSEN’s National School Climate Survey indicate that LGBTQ youth from small towns or rural areas are more likely to hear anti-LGBTQ remarks and experience discrimination in schools than those from urban and suburban schools.

However, little research has specifically examined differences in mental health and suicide risk based on whether LGBTQ youth live in urban or rural areas.

One study of lesbian, gay, bisexual, and questioning (LGBQ) youth found that, although both rural and non-rural LGBQ youth reported significantly greater risk of depression compared to their non-LGBQ peers, there were no significant differences in depression when comparing rural LGBQ youth to LGBQ youth from urban and suburban areas.

Further, a study of lesbian, gay, and bisexual (LGB) youth in Canada also found similar rates of depression among rural and urban youth; however, they found that rural LGB boys, but not rural LGB girls, were more likely to consider and attempt suicide than those from urban and suburban areas.

Given the mixed findings on LGBTQ youth in rural areas and small towns, there is a need for additional research, particularly among transgender and nonbinary youth.

Using data from The Trevor Project’s 2021 National Survey on LGBTQ Youth Mental Health, this research brief examines depression and suicide risk among LGBTQ youth from rural areas and small towns compared to urban and suburban areas.

Key Finding: Nearly half of LGBTQ youth in rural areas and small towns reported that their community was somewhat or very unaccepting of LGBTQ people compared to just over a quarter of those in urban and suburban areas. The data also shows that LGBTQ youth living in rural areas and small towns had slightly greater odds of depression and attempting suicide.

Results 

Nearly half (49%) of LGBTQ youth in rural areas and small towns stated that their community was somewhat or very unaccepting of LGBTQ people compared to just over a quarter (26%) of those in urban and suburban areas. In total, only 4% of rural LGBTQ youth reported that their community was very accepting of LGBTQ people.

Approximately half of the sample lived in urban (15%) or suburban (34%) areas, with the other half living in a small city/town (41%) or rural area (10%). LGBTQ youth in rural areas and small towns also reported higher rates of experiencing LGBTQ-based discrimination (61% vs. 56%) and physical harm (21% vs. 17%) in the past year compared to those in urban and suburban areas.

LGBTQ youth in rural areas and small towns had slightly greater odds of experiencing symptoms of depression, considering suicide and attempting suicide compared to those in urban and suburban areas. Generally, rates were only slightly higher among those in small towns and rural areas than those in urban and suburban areas.

While transgender and nonbinary youth generally had worse mental health and suicide risk compared to cisgender LGBQ youth, those from small towns and rural areas reported only slightly higher rates of depression (71% vs 69%), considering suicide (53% and 48%), and attempting suicide (21% vs 19%) compared to those from urban and suburban areas. 

Differences between small towns/rural areas and urban/suburban areas were also relatively comparable within gender identity (e.g., cisgender boy/man, cisgender girl/woman, transgender boy/man, transgender girl/woman, and nonbinary youth). 

Access to LGBTQ-affirming schools in small towns and rural areas is associated with lower suicide risk. Although LGBTQ youth from small towns and rural areas had less access to LGBTQ-affirming schools (48% vs. 56%) than those in urban and suburban areas, those with affirming schools had 35% lower odds of attempting suicide in the past year.

Further, among transgender and nonbinary youth, access to schools that were gender-affirming was associated with an over 25% lower risk of a past-year suicide attempt.

However, transgender and nonbinary youth in small towns and rural areas had less access to gender-affirming schools (40% vs. 46%) than those in urban and suburban areas.

Methods 

Data were collected from an online survey conducted between October and December of 2020 of 34,759 LGBTQ youth recruited via targeted ads on social media.

To determine the type of area where youth resided, they were asked, “Which of the following best describes the area you live in?” with response options of 1) In a large city, 2) Just outside of a large city (such as in a suburb), 3) In a small city or town, or 4) In a rural area (such as out in the country).

For the current report, those who selected large city or just outside the city were considered urban or suburban, while those who selected small city, town, or rural area were considered rural or small town.

Items on considering and attempting suicide in the past 12 months were taken from the Centers for Disease Control and Prevention’s Youth Risk Behavior Survey.

All LGBTQ youth in the sample were asked to endorse whether or not their school (if enrolled) was LGBTQ-affirming. Transgender and nonbinary youth were also asked whether their school (if enrolled) was gender-affirming.

Note: Adjusted logistic regression models controlled for race/ethnicity, socioeconomic status, sex assigned at birth, gender identity, and sexual identity. 

Looking Ahead 

Supporting previous research, these findings show that despite higher levels of rejection, discrimination, and victimization experienced by LGBTQ youth in small towns and rural areas, the resulting disparities in depression and suicide risk are relatively small.

For example, in our data, LGBTQ youth in small towns and rural areas reported more than double the rate of living in a community that was unaccepting of LGBTQ people compared to those in urban and suburban areas, yet the odds of experiencing depression, considering suicide, or attempting suicide were only 10–20% greater.

Together, these findings indicate that there are likely protective factors that operate to minimize disparities in mental health and suicide risk in small towns and rural regions. Future research should explore positive experiences and/or strengths reported by LGBTQ youth in small towns and rural regions to determine which factors facilitate well-being even in environments that are less accepting of LGBTQ people. 

Although LGBTQ youth in small towns and rural regions had lower rates of reporting their schools to be LGBTQ- or gender-affirming spaces, those who had access to affirming schools reported significantly lower rates of attempting suicide in the past year.

Such findings, along with higher rates of LGBTQ-based discrimination and victimization in small towns and rural areas, point to the need for greater investment in school policies and practices that support LGBTQ youth in small towns and rural areas.

Although implementing school policies and practices to support LGBTQ youth in small towns and rural areas is often fraught with barriers such as fewer LGBTQ-specific community resources and greater anti-LGBTQ sentiment in the community making these changes at the school level can allow youth to be supported in their identity, and perhaps thrive in ways beyond their LGBTQ peers in urban and suburban areas, given other potential protective factors found in small towns and rural areas.

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The Trevor Project is the world’s largest suicide prevention and crisis intervention organization for LGBTQ (lesbian, gay, bisexual, transgender, queer, and questioning) young people.

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Research/Study

New study on resilience & mental health among LGBTQ youth

LGBTQ youth with high resilience had 59% lower odds of reporting a suicide attempt- 69% lower odds of considering suicide in the past year

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Los Angeles Blade graphic

NEW YORK – The Trevor Project observing the 53rd anniversary of the riots at the Stonewall Inn that sparked a greater movement for LGBTQ+ rights and equality this week, released new data that examines resilience and mental health among LGBTQ youth.

“As we celebrate Pride Month and commemorate the Stonewall Riots, there is often discussion of the ‘resilience’ of the LGBTQ community and the ways in which members are able to bounce back in the face of adversity. These data highlight the fact that resilience is not just an admirable quality – but one that can be associated with improved mental health among LGBTQ youth,” said Dr. Jonah DeChants, Research Scientist at The Trevor Project.

“Higher resilience in our sample was consistently associated with better mental health outcomes including decreased risk for anxiety, depression, and suicide attempts in the past year among LGBTQ youth. Moving forward, we should invest further research into understanding how LGBTQ youth can successfully develop high resilience. Additionally, we should work to dismantle systems of oppression and implement LGBTQ-inclusive anti-discrimination protections  so that LGBTQ youth are not required to possess resilience to excel and thrive.” 

Key Findings:

  • LGBTQ youth with high resilience had 59% lower odds of reporting a suicide attempt, and 69% lower odds of considering suicide in the past year, compared to LGBTQ youth with low resilience. 
  • LGBTQ youth with high resilience reported 81% lower odds  of anxiety symptoms, compared to LGBTQ youth with low resilience. 
  • LGBTQ youth with  high resilience reported 79% lower odds of recent depression, compared to LGBTQ youth with low resilience. 
  • LGBTQ youth who have supportive families and  are in supportive environments have higher resilience.
  • LGBTQ youth ages 18 to 24 reported significantly higher resilience than LGBTQ youth ages 13 to 17. 

Read the report:

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Research/Study

150 people on Tennessee’s sex offender registry for HIV-related conviction

Nearly one-half of HIV registrants on the SOR were women and over three-quarters of HIV registrants were Black

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Los Angeles Blade graphic

LOS ANGELES – At least 154 people have been placed on Tennessee’s sex offender registry (SOR) for an HIV-related conviction since 1993, according to a new report by the Williams Institute at UCLA School of Law.

Enforcement of HIV crimes in Tennessee disproportionately affects women and Black people. Nearly one-half of HIV registrants on the SOR were women and over three-quarters of HIV registrants were Black.

Tennessee’s two primary HIV criminalization laws—aggravated prostitution and criminal exposure—make it a felony for people living with HIV to engage in sex work or other activities, such as intimate contact, blood donation, or needle exchange, without disclosing their status. Both are considered a “violent sexual offense” and require a person convicted to register as a sex offender for life.

Examining Tennessee’s sex offender registry, researchers found that Shelby County, home to Memphis, accounts for most of the state’s HIV convictions. Shelby County makes up only 13% of Tennessee’s population and 37% of the population of people living with HIV in the state, but 64% of HIV registrants on the SOR. Moreover, while Black Tennesseans were only 17% of the state’s population and 56% of people living with HIV in the state, 75% of all HIV registrants were Black.

In Shelby County, 91% of aggravated prostitution convictions resulted from police sting operations in which no physical contact ever occurred. In addition, the case files showed that 75% of those convicted were Black women. When it came to criminal exposure case files, all of those convicted except one person were Black men.

“Tennessee’s HIV criminal laws were enacted at a time when little was known about HIV and before modern medical advances were available to treat and prevent HIV,” said lead author Nathan Cisneros, HIV Criminalization Analyst at the Williams Institute. “Tennessee’s outdated laws do not require actual transmission or the intent to transmit HIV. Moreover, the laws ignore whether the person living with HIV is in treatment and virally suppressed and therefore cannot transmit HIV.”

KEY FINDINGS

  • Incarcerating people for HIV-related offenses has cost Tennessee at least $3.8 million.
  • Of the 154 people who have been placed on Tennessee’s SOR for an HIV-related conviction, 51% were convicted of aggravated prostitution, 46% were convicted of criminal exposure, and 3% were convicted of both.
  • Women account for 26% of people living with HIV in Tennessee and 4% of people on the SOR, but 46% of the SOR’s HIV registrants.
  • Black people account for 17% of people living in Tennessee, 56% of those living with HIV, 27% of people on the SOR, but 75% of the SOR’s HIV registrants.
  • Black women were the majority of aggravated prostitution registrants (57%), while Black men were the majority of criminal exposure registrants (64%).
  • People with an HIV-related offense are more economically vulnerable when compared to others on the state’s SOR.
    • One in five (19%) HIV registrants were homeless compared to 9% of all SOR registrants.
    • 28% of HIV registrants reported an employer address compared to about half (49%) of all SOR registrants.
  • Shelby County has one aggravated prostitution conviction for every 115 people living with HIV in the county, and Black people were 90% of all people convicted for aggravated prostitution.
    • Over 90% of aggravated prostitution convictions in Shelby County were the result of police sting operations.
    • Only 3% of aggravated prostitution convictions in Shelby County alleged any intimate contact.
    • Nearly all (95%) people arrested in Shelby County for criminal exposure were Black men, compared to 64% of people statewide.  

The Williams Institute has conducted research on HIV criminalization in numerous U.S. states.

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Research/Study

New Pew Research Center poll: Americans at odds over Trans issues 

Strong majorities favor non-discrimination protections but weaker support for access to transition-related care among minors

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Texas trans activist Landon Richie speaking at Texas Capitol against trans youth sports bill (Los Angeles Blade file photo)

WASHINGTON – A new survey from a leading non-partisan research center reveals Americans have mixed views on transgender issues at a time when states are moving forward with measures against transgender youth, with strong majorities favoring non-discrimination protections but weaker support for access to transition-related care among minors and participation in school sports.

The Pew Research Center issued the findings on Tuesday as part of the results of its ongoing study to better understand Americans’ views about gender identity and people who are transgender or non-binary. The findings are based on a survey of 10,188 U.S. adults from data collected as part of a larger survey conducted May 16-22.

A majority of respondents by wide margins favor non-discrimination protections for transgender people. A full 64 percent back laws or policies that would protect transgender people from discrimination in jobs, housing, and public spaces, while roughly 8-in-10 acknowledge transgender people face at least some discrimination in our society.

Additionally, nearly one half of Americans say it’s extremely important to use a transgender person’s new name after they undergo a transition, while an additional 22 percent say that is somewhat important. A smaller percentage, 34 percent, say using a transgender person’s pronouns is extremely important, and 21 percent say it is somewhat important.

But other findings were less supportive:

  • 60 percent say a person’s gender is determined by sex assigned at birth, reflecting an increase from 56 percent in 2021 and 54 percent in 2017, compared to 38 percent who say gender can be different from sex assigned at birth.
  • 54 percent say society has either gone too far or been about right in terms of acceptance, underscoring an ambivalence around transgender issues even among those who see at least some discrimination against transgender people.
  • About six-in-ten adults, or 58 precent, favor proposals that would require transgender athletes to compete on teams that match the sex they were assigned at birth as opposed to teams consistent with their gender identity, compared to 17 percent who oppose that and 24 percent neither favor nor oppose it.
  • 46 percent favor making it illegal for health care professionals to provide transition-related care, such as hormones or gender reassignment surgery, to someone younger than 18, compared to 31 percent who oppose it.
  • Americans are more evenly split when it comes to making it illegal for public school districts to teach about gender identity in elementary schools (which is favored by 41 percent, and opposed by 38 percent) and investigating parents for child abuse if they help someone younger than 18 obtain transition-related care (37 percent are in favor and 36 percent oppose it).

Young adults took the lead in terms of supporting change and acceptance. Half of adults ages 18 to 29 say someone can be a man or a woman even if that differs from the sex they were assigned at birth, compared to about four-in-10 of those ages 30 to 49 and about one-third of respondents 50 and older.

Predictably, stark differences could be found along party lines. Democrats by 59 precent say society hasn’t gone far enough in accepting people who are transgender, while 15 percent say it has gone too far and 24 percent say it’s been about right. For Republicans, 10 percent say society hasn’t gone far enough, while 66 percent say it’s gone too far and 22 percent say it’s been about right.

Read the full report here.

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