The mental health system is failing queer kids of color—and we're letting it happen

Jayden is a 16-year-old Black queer teenager living in a low-income neighborhood on Atlanta's west side. When he was unable to attend school because of his worsening panic attacks, he finally asked for help, but his cries went unanswered. The mental health system in this country wasn't made for queer kids of color, which is why even when they go out to search for mental health care, too many are met with doors closed or closed minds.

Jayden isn't real, but his story is. It is built from interviews, national survey data, and the experiences of BIPOC LGBTQ+ youth in low-income communities who tried, but failed, to access mental health care. Half of LGBTQ+ youth who said they wanted mental health care in the past year have been unable to get access to such resources and treatment.

The result is an escalating crisis in which the young people who most stand to benefit from treatment for depression, anxiety, and suicidal thoughts are the least likely to get it.

According to the Trevor Project, Transgender and nonbinary (TGNB) youth in 2023 were nearly twice as likely to report anxiety (70% vs. 42%) and suicidal ideation (53% vs. 28%) compared to cisgender peers. This pattern persisted a year later in 2024.

This isn't a story about lack of awareness or "kids being silent." It is a piece that raises awareness and a call-to-action about systems designed at the intersections of racism, poverty, and anti-LGBTQ+ bias that determine who receives care, waits for it, or never gets access to it in the first place.

The Barriers No One Talks About

For some BIPOC queer young people, the obstacle to mental health care isn't cost or access, it's safety. For some, coming out to a therapist can result in being inadvertently (or directly) outed at home, judged by a provider, or being treated as if their identity is something that needs "fixing."

When it comes to counseling, some young queer people of color say they steer clear not because they don't believe in therapy, but because they've learned that medical spaces are not made for them. Instead, they're there to observe, diagnose, or discipline them.

When mental health care professionals don't understand racism, culture, or queerness, the burden changes. When receiving assistance, young people are expected to either explain themselves, defend themselves, or remain silent. In communities where therapy is looked down upon, the risk of it being misunderstood and punished far outweighs the possibility that it might be understood and helped.

It's not that these kids don't want help. It's just that they are being asked to put themselves in harm's way to get it.

The Provider Problem

There's a shortage of qualified, affirming, and multicultural competent therapists for LGBTQ+ youth of color, where mental health services are available.

The vast majority of providers are trained to focus on treating white, cisgender, middle-class patients, leaving BIPOC LGBTQ+ youth in challenging positions of having to "translate" their identity and their traumatic experiences for someone who doesn't share or may not fully comprehend their world.

Instead of getting relief, many young people say therapy is yet another place where they're misgendered, stereotyped, or corrected, or where their life experience is talked about as if it were something that exists only in a dusty textbook.

Some youths have reported not sharing their whole self because the emotional labor of educating a therapist felt heavier than whatever mental health issue brought them in the door. The takeaway is this: representation in mental health care isn't a bonus; it's a barrier when absent.

The Cost of Care

For low-income LGBTQ+ youth of color, therapy isn't just emotionally out of reach; it's financially unfeasible. Even a "cheap" therapist charges $80 to $120 per session, but treatments can go for months, so that adds up.

For many families, Medicaid is the only insurance available. Yet, most private therapists won't accept it, and those who will are often so booked up that they can't take new patients for months.

According to the Trevor Project, forty percent of LGBTQ+ youth cannot afford mental health care. For children who don't have access to their own money, health insurance, or even transportation, the idea of 'just finding a therapist' is more than an inconvenient privilege masquerading as advice.

Mental health care costs don't stop after the session fee is paid. There are prices of drugs, bus fares, telehealth data costs, and the psychological cost of soliciting help from a system that already doesn't include you.

When your family is deliberating whether to spend on groceries or rent, a $100 therapy hour is not "care," it's math.

Why Intersectionality Matters

BIPOC LGBTQ+ youth inhabit the intersection of both race and sexuality, and it's at that crossroad where systems leave them out in the cold. The mental health care system in the United States is designed around whiteness, wealth, and heteronormativity, which means that anyone who doesn't fit into those categories will have to fight their way into a system that was never meant for them.

Multiple systems of oppression influence Queer POCs' lives. "The most relevant social systems of oppression for an individual, group, or community depend on their unique identity intersections … and the social contexts in which they are embedded." They experience racism not separate from queerness; poverty not separate from identity. These facts pile up, overlap, and compound one another.

A queer youth are traversing medical racism, class barriers, and a broader culture of silence all at once. By flattening identities, we flatten the harm and erase the very youth who are most affected.

What's Being Done (and What Isn't)

There are people and programs committed to closing the gap, but not in sufficient quantity to meet the crisis. Community-based organizations, particularly those run by queer people of color, are among the service providers that fill in where the mental-health system won't go.

Many programs intended to provide support are underfunded and understaffed. They are forced to function like Band-Aids on a systemic gaping hole. Meanwhile, state and federal-level funding continues to pour into other institutions. The solutions exist. What's needed is investment and scale, and political will.

The reality is that communities have been doing the work all along. It's the system that won't catch up. The true crisis isn't that BIPOC LGBTQ+ youth are suffering. Instead, it's the structures designed to help them that are choosing not to.

Whenever care is denied to a BIPOC LGBTQ+ youth, the country is asking them to be "strong," "hang on," or "reach out again." Resiliency is not a treatment plan, and access to mental health care should not depend on your zip code, race, insurance status, or whether a provider thinks your identity is valid.

The question now is not whether this crisis is real, but whether we're willing to fix it, and it starts by revamping the system that keeps on shutting them out.

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