WASHINGTON, July 12, 2025 — The federal government last month announced it will eliminate specialized services for LGBTQ+ callers to the 988 Suicide & Crisis Lifeline on July 17, a move that pulls a vital support system away from some of the nation’s most vulnerable young people. The decision isn’t simply a political one; it represents a significant public health failure.
A Critical Lifeline Is Being Cut
The move to end specialized LGBTQ+ services on the 988 hotline raises serious concerns about access to culturally competent mental health care.
- Nearly 40% of LGBTQ+ young people seriously considered suicide in the past year, according to The Trevor Project.
- LGBTQ+ youth often avoid seeking mental health care due to fear of discrimination or being misunderstood.
- A 2019 survey revealed that a quarter of callers to an LGBTQ+-specific helpline wouldn’t have contacted another service.
- Culturally competent care—care that understands and respects individual experiences—improves access, engagement, and outcomes.
- The U.S. Department of Veterans Affairs recognizes the need for tailored care and has implemented LGBTQ+ veteran care coordinators nationwide.
Culturally competent care acknowledges and responds to the lived experiences of high-risk populations, offering an effective approach to suicide prevention. This targeted support works because it addresses the specific challenges facing groups like veterans and LGBTQ+ youth. Abruptly removing these services during a mental health crisis for LGBTQ+ youth is both dangerous and deeply out of touch with clinical best practice.
What percentage of LGBTQ+ youth have seriously considered suicide? According to The Trevor Project’s 2024 U.S. National Survey on the Mental Health of LGBTQ+ Young People, 39% seriously considered suicide in the past year. The rates are even higher among transgender and nonbinary youth. Half of LGBTQ+ youth surveyed reported wanting mental health care in the past year but were unable to access it, with “fear”—fear of judgment, being outed, or not being taken seriously—being the primary barrier.
Those working in suicide prevention and crisis response have seen firsthand the power of care that reflects and respects the individual. When LGBTQ+ youth in crisis are met with understanding and validation, they are more likely to reach out for help, trust the care offered, and ultimately, survive and thrive.
A 2019 survey found that approximately 25% of 12- to 25-year-old callers to an LGBTQ+-specific national service provider said they would not have contacted another helpline. Nearly half—particularly transgender, nonbinary, queer, and pansexual youth—specifically called because of the affirming counselors.
Evidence-Based Support Is Now at Risk
The LGBTQ+ services within 988 weren’t merely symbolic. The specialized service was built on evidence and evaluated for its impact as part of the 988 system. Since its launch in 2022, these services have connected over 1.3 million LGBTQ+ youth in crisis with counselors trained to understand their specific risk factors, trauma, and strengths. For many, this was their first—and only—experience with person-centered care.
Now, that option is slated to disappear. The argument from federal officials is that “all counselors are trained to help everyone.” However, general training is insufficient. LGBTQ+ youth face unique, well-documented disparities in mental health outcomes and access to care. The government’s rationale overlooks the fact that generalized training isn’t a substitute for culturally competent care designed to improve outcomes.
Culturally competent care improves access, engagement, and outcomes. When people feel seen, they are more likely to reach out, disclose with greater depth, adhere to care plans, and return to health professionals. Research shows that LGBTQ+ individuals, despite facing higher rates of psychological distress, often delay or avoid care due to fear of discrimination or negative experiences. Cultural competence directly addresses this.
The American Psychiatric Association and other organizations have long championed tailored mental health approaches for underserved groups. A 2019 review found that culturally informed care helps clinicians understand the social context of mental illness and is crucial to addressing health inequities and achieving better health outcomes.
The U.S. Department of Veterans Affairs, for example, recognizes the unique stressors and barriers to care faced by LGBTQ+ veterans. That’s why the VA has implemented LGBTQ+ veteran care coordinators at every medical center nationwide.
As a nonbinary Black leader in the mental health space, it’s clear how much it matters to see yourself reflected in the care you receive. Having to explain one’s identity to a provider before even addressing the reason for seeking help delays actual care and increases stress and discomfort.
When young people—or anyone—reach out and find someone who doesn’t just tolerate them but truly understands them, it can be lifesaving. A 2023 study concluded that culturally tailored services increased trust and retention across diverse populations.
We urge Congress to provide oversight, pass legislation supporting culturally competent, evidence-based mental health services, and hold agencies accountable for following best practices to achieve better mental health outcomes. The most effective mental health care is rooted in connection, understanding, and trust. Cultural competence isn’t an option; it’s essential.
If you or someone you know may be considering suicide, contact the 988 Suicide & Crisis Lifeline: call or text 988 or chat 988lifeline.org. For TTY users: Use your preferred relay service or dial 711 then 988.
