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LGBTQ+ youth are four times more likely to attempt suicide compared to their cisgender/heterosexual peers. There is extensive research on the distinct protective and risk factors that influence suicidality among LGBTQ+ youth (e.g., de Lange et al., 2022; Wange et al., 2023), including family rejection, lack of affirming care, bullying, and societal stigma.
From a health equity perspective, the removal of the “Press 3” option represents a significant rollback in identity-affirming care for one of the most vulnerable youth populations in the U.S. National surveys from The Trevor Project and others show that access to affirming mental health providers significantly reduces suicide risk among LGBTQ+ youth.
The directive was made during LGBTQ+ Pride Month (June) and framed the target population as “LGB+ youth,” excluding transgender and queer youth, groups that face even higher rates of suicide attempts and mental health disparities.
This action not only removes a life-saving, identity-affirming support pathway, but also symbolically erases gender-diverse youth from national suicide prevention efforts, compounding harm and reinforcing systemic exclusion. Additionally, some mental health providers have expressed concern that frontline 988 staff without LGBTQ+-specific training may lack the cultural responsiveness training needed to de-escalate crisis situations involving gender-diverse youth, particularly Black and Brown LGBTQ+ youth who face layered marginalization.
From a systems equity standpoint, the removal of tailored services disproportionately harms LGBTQ+ youth of color, youth in rural areas with limited access to affirming care, and those already reluctant to seek help due to fear of discrimination. It also runs counter to federal mental health equity priorities and suicide prevention strategies that emphasize culturally and linguistically appropriate services.
