Black Queer Youth in America Are Struggling to Access Mental Health Care. Here’s Why.

"A lot of [Black] families are in survival mode and trying to navigate a system where they don’t know how to advocate for themselves."

A groundbreaking report shows that Black LGBTQ youth are less likely than their non-Black peers to access mental health care, even though they experience depression and suicidal ideation at similar rates.

According to findings from the national youth suicide prevention organization The Trevor Project, 39% of Black LGBTQ youth sought out care from a mental health professional within the past year, while 47% of young people overall said the same. The discrepancy becomes even more apparent when examining the data concerning young people experiencing a mental health crisis: Of this demographic, 60% of queer youth overall sought out treatment, while just 51% of Black LGBTQ young people did the same.

This is despite the fact that Black queer people had roughly analogous mental health outcomes to the general population, according to the study. Thirty-five percent of Black LGBTQ young people experienced suicidal ideation in the past year, as compared to 39% of queer youth overall, and Black LGBTQ youth were slightly more likely to attempt to end their lives: 19% to 18%.

More than 34,000 young people participated in the survey, which The Trevor Project claims is the largest of its kind ever conducted on LGBTQ youth. Of those respondents, 668 youth identified themselves as “Black or African-American.”

Dr. Amy Green, director of research at The Trevor Project, says conducting this research was critically important in understanding the needs of Black LGBTQ youth. The issue of youth suicide has been long been incorrectly assumed to be a “white youth problem,” meaning this data simply hasn’t been available to advocates and mental health professionals.

“This is not just a problem among white LGBTQ youth,” she tells NewNowNext. “This is impacting the Black community just as much, if not more, because they’re actually not getting the care.”

According to experts, the reasons that Black queer youth aren’t getting mental health treatment when they are in crisis are extremely multi-faceted, many of which are rooted in legacies of mistrust of medical and psychological fields. Dr. Thomas Vance, a postdoctoral fellow at The New School in New York City, cites the history of experimentation on Black bodies—including the infamous syphilis tests on 600 impoverished Black men by the United States Public Health Service between 1932 and 1972.

“That’s a traumatic experience that might happen to one person, but intergenerational trauma is still a trauma that gets passed down,” Vance tells NewNowNext. “At a family gathering, people might say, ‘Don’t go and talk to those people or tell them our business.’ It’s actually a means of protection, of survival, and not being taken advantage of.”

Aside from the historical context, many Black LGBTQ youth aren’t able to seek mental health treatment because their parents simply can’t afford it. Despite President Donald Trump’s frequent exaggerations about falling rates of unemployment in Black communities, Black Americans remain twice as likely as white individuals to live below the poverty line. According to the Kaiser Family Foundation, those gaps are also evident in rates of uninsurance among U.S. racial groups: Black non-elderly people are 57% more likely than their white counterparts to lack insurance.

Vance claims these economic barriers only further the message to Black communities that mental health is a “white people treatment that only the rich can afford.”

“A lot of families are in survival mode and trying to navigate a system where they don’t know how to advocate for themselves,” he says. “They don’t even know where to go to actually ask for these resources.”

These factors are exactly why Erica Woodland created a nationwide support network to help Black LGBTQ people navigate a system that simply isn’t designed for them. Woodland, who is based in Oakland, founded the National Queer and Trans Therapists of Color Network (NQTTCN) in 2016 after getting requests from individuals looking for affordable mental health treatment in places like the South and not knowing where to tell them to go for assistance.

“Because we’re in deep relationship with people across the country, we can put out a request and somebody might actually be able to help this person,” Woodland tells NewNowNext. “That’s a really different experience than interfacing with a system where you’re like, These people don’t actually care about me, or The way that this whole thing is structured is not humane.”

The health care system in the U.S. is burdensome and complicated for even the average patient, so individuals who have additional roadblocks in their path need these resources to guide them, Woodland says. “If you add layers of oppression onto that,” he adds, “it just makes things virtually impossible.”

Experts believe that there are a multiplicity of ways in which medical professionals and even LGBTQ nonprofits can help ensure the mental health care system better meets the needs of Black queer and transgender youth. In a 2019 report from HRC, it outlined five action items to address these issues; these included expanding resources for Black LGBTQ youth and consulting members of the community when developing these materials, as well as providing greater visibility for Black narratives in the LGBTQ community.

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Green believes that The Trevor Project report is a call to action for mental health practitioners to take a look at the services and information they provide for Black LGBTQ youth and their parents. This work is critical, she says, to make sure professionals are responsive to the particular and unique needs of this population—rather than merely repurposing white narratives and experiences.

“It’s totally possible that the services that we’re providing are not applicable or useful for black LGBTQ youth,” she says. “I couldn’t tell you, ‘Here’s a treatment that has a strong evidence base for decreasing depression among black LGBTQ youth’ because that work just really hasn’t been done.’

While experts stress that more research is needed to fully understand the challenges facing Black LGBTQ youth, Woodland says that the work of rewriting the narratives surrounding Black mental health often begins in his office. The core of Woodland’s work, he says, is “reminding people that some of the ways that they feel about themselves that are deeply rooted in dehumanization.” Many of his patients have “internalized negative beliefs about themselves that they’ve gotten from other therapists and from the mental health system more broadly,” and it’s his job to help unpack that.

“Even as a Black practitioner, I’d be irresponsible to sit in a room with someone and not ever talk about those things,” he says. “Personally when I’ve had therapists who are able to say, ‘Your depression is tied to you having to navigate patriarchy, transphobia, queerphobia, and white supremacy,’ that was really a central part of my healing. We have a right to heal in a way that is dignified.”

Read The Trevor Project’s report in full here.

Nico Lang is an award-winning journalist and editor. His work has been featured in INTO, Rolling Stone, The Guardian, Esquire, and the L.A. Times.
@Nico_Lang