News Release

Interpersonal and structural stigma toward sexual minority youth create mental health challenges, increased suicide risk

CHOP researchers suggest more targeted intervention against discrimination, particularly in states with higher rates of structural stigma

Peer-Reviewed Publication

Children's Hospital of Philadelphia

Philadelphia, July 6, 2023 – Researchers from Children’s Hospital of Philadelphia (CHOP) and the University of Pennsylvania found that lesbian, gay and bisexual (LGB) youth experienced more interpersonal discrimination based on others perceiving them as lesbian, gay, or bisexual and were four times more likely to attempt suicide. Additionally, LGB youth living in areas of the country with more structural stigma experienced a larger mental health burden than their peers. These findings stress the urgency for addressing interpersonal discrimination and structural stigma toward LGB youth.

The findings were published online today by the Journal of the American Academy of Child and Adolescent Psychiatry.

Several studies have demonstrated mental health disparities between LGB youth and their heterosexual peers. Previous studies have focused on how individuals’ experience of discrimination or specific policy changes impact the mental health of LGB youth. Much less is known about how structural stigma – societal-level conditions, cultural norms, and policies affecting opportunities and wellbeing of the LGBTQ+ community – in aggregate, affects the mental health of LGB youth.

“We wanted to better characterize the mental health disparities of sexual minority youth and the impact of interpersonal and structural stigma, as well as how this discrimination may help explain what is causing these mental health disparities,” said senior study author Ran Barzilay, MD, PhD, a psychiatrist with the Youth Suicide Prevention, Intervention and Research Center at CHOP.

The researchers utilized data from the Adolescent Brain and Cognitive Development Study, in which more than 11,000 adolescents from across the U.S. were followed between the ages of approximately 10 to 13 years old. In total, 1,051 adolescents identified as either lesbian, gay or bisexual, considered a “sexual minority,” and 10,571 identified as heterosexual.

According to the study, approximately 29.5% of those in a sexual minority faced interpersonal discrimination based on their sexual orientation in the past 12 months, more than six times as much as the 4.6% of those in the heterosexual group. Those in the sexual minority group were also more than twice as likely to report having thoughts of suicide compared to their heterosexual peers (38.2% vs. 15.1%) and almost four times as likely to attempt suicide (9.2% vs. 2.4%). “These data highlight the mental health disparities affecting sexual minority youth, who are already experiencing greater mental health burden at early adolescence,” says Joshua H. Gordon, MD, PhD, a resident psychiatrist at the University of Pennsylvania Perelman School of Medicine and first author of the study.

Additionally, after the researchers adjusted for factors such as age, race, sex and ethnicity, the study found that identifying as a sexual minority was associated with greater overall mental health issues, and that interpersonal experiences of discrimination significantly contributed to the disparities in LGB mental health.

“Our findings provide us with evidence that we need to develop interventions targeted at reducing discrimination to help reduce the risk of youth suicide among those in a sexual minority,” Barzilay said. “Additionally, parents, educators and clinicians working with young adolescents should be aware of the increased mental health burden of LGB youth, especially in areas with higher degrees of structural stigma.”

Gordon et al, “The role of individual discrimination and structural stigma in the mental health of sexual minority youth.” J Am Acad Child Adolesc Psychiatry. Online July 6, 2023. DOI: 10.1016/j.jaac.2023.05.033.

About Children’s Hospital of Philadelphia: A non-profit, charitable organization, Children’s Hospital of Philadelphia was founded in 1855 as the nation’s first pediatric hospital. Through its long-standing commitment to providing exceptional patient care, training new generations of pediatric healthcare professionals, and pioneering major research initiatives, the 595-bed hospital has fostered many discoveries that have benefited children worldwide. Its pediatric research program is among the largest in the country. The institution has a well-established history of providing advanced pediatric care close to home through its CHOP Care Network, which includes more than 50 primary care practices, specialty care and surgical centers, urgent care centers, and community hospital alliances throughout Pennsylvania and New Jersey, as well as an inpatient hospital with a dedicated pediatric emergency department in King of Prussia. In addition, its unique family-centered care and public service programs have brought Children’s Hospital of Philadelphia recognition as a leading advocate for children and adolescents. For more information, visit 

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