Key Domains Measured

Key Domains Measured

To understand how well-being changed for LGBTQ+ young people over time, we tracked key areas spanning mental health, risk factors, and sources of support. Below is a summary of each domain assessed in Waves 1 to 3.

Mental Health Outcomes

1. Suicidal ideation: Assessed with the Depressive Symptom Index–Suicidality Subscale (DSI-SS) (Joiner et al., 2002), which measures the frequency, intensity, and controllability of suicidal thoughts over the past two weeks.

2. Attempted suicide: Reports of past-year suicide attempts, based on items from the CDC’s Youth Risk Behavior Survey (YRBS; CDC, 2023).

3. Anxiety: Anxiety symptoms captured using the Generalized Anxiety Disorder 2-item (GAD-2) screener (Plummer et al., 2016), which measures how often participants felt nervous or unable to control worrying over the past two weeks.

4. Depression: Depressive symptoms captured using the Patient Health Questionnaire 2-item (PHQ-2) screener (Richardson et al., 2010), which measures how often participants experienced low mood or loss of interest or pleasure over the past two weeks.

Risk Factors

1. Victimization: Experiences of being physically threatened or abused based on one’s sexual orientation or gender identity.

2. Discrimination: Experiences of being treated unfairly or excluded based on one’s sexual orientation or gender identity.

3. Conversion therapy: Threats of or actual attempts to change one’s sexual orientation or gender identity, reported separately. These include experiences with healthcare professionals and religious or spiritual leaders.

4. Economic security: Unstable housing and difficulty meeting basic needs like food, housing, and clothing.

Protective Factors

1. Access to mental health care: Ability to obtain counseling or therapy when needed, perceived helpfulness of mental health care, and experiences with mental health-related hospitalization, as well as common barriers that prevent them from accessing desired care.

2. Access to transgender care: Ability of TGNB youth to access the care and resources they wanted to support their gender identity – including clothing and binders, puberty blockers, hormones, surgeries, and/or updated identity documents.

3. Family support and supportive environments: Levels of acceptance and affirmation from family, peers, schools, and the broader community.

4. Gender euphoria: Degree of affirmation and comfort TGNB youth feel in expressing their gender and being seen as their gender, based on their agreement with statements from the Trans Youth CAN! Gender Positivity Scale (Bauer et al, 2021).

5. Help-seeking behaviors: Support sought by participants who seriously considered suicide in the past year — including from friends, family members, professionals, and crisis services.