A recent study from the UCLA Center for Health Policy Research (CHPR) has found that transgender and bisexual adults in California are more likely than other LGBT adults to report serious thoughts of suicide and experience moderate or serious psychological distress.
The research, which analyzed data from the 2023 California Health Interview Survey, revealed that nearly two-thirds (64%) of transgender adults and 55% of bisexual adults in California had ever seriously considered suicide. In comparison, 48% of all LGBT adults and 17% of non-LGBT adults reported having such thoughts at some point in their lives. The prevalence was higher among transgender adults compared to cisgender men who identify as gay or bisexual (36%), and higher among bisexual adults than gay or lesbian adults (35%).
The study also showed that almost half (49%) of LGBT adults experienced moderate or serious psychological distress in the past year. This figure was even higher for specific groups: 66% for transgender adults, 55% for cisgender lesbian or bisexual female adults, and 61% for bisexual adults overall.
“While many people are aware that LGBT adults report serious thoughts of suicide and psychological distress more than non-LGBT adults, our report shows the range of mental health experiences among different groups within the LGBT population,” said study author Imelda Padilla-Frausto, a research scientist at the UCLA CHPR.
California is home to the largest LGBT population in the United States. In 2023, an estimated 2.2 million California residents identified as LGBT, making up about 10% of the state’s adult population. Cisgender women identifying as lesbian or bisexual accounted for 44%, cisgender men identifying as gay or bisexual made up 41%, while transgender adults represented 15%.
Despite California’s progressive reputation, LGBT individuals continue to face stressors such as stigma, rejection, discrimination, mistreatment, violence, and homicides targeting their community. Padilla-Frausto noted that these challenges extend into mental health care settings where individuals may encounter stigma or discrimination when seeking services.
The study further found that nearly two-thirds (65%) of LGBT adults reported any need for mental health care in the past year—more than double the rate seen among non-LGBT adults (30%). For this analysis, “any need for mental health care” included those experiencing moderate or serious psychological distress regardless of whether they self-identified a need for care.
“By using a definition of ‘any need for mental health care’ that includes people with distress, but who didn’t explicitly perceive they needed mental health care, we can see more clearly how many individuals might be struggling and not getting the care that would benefit them,” Padilla-Frausto said.
Additionally, the research indicated that most LGBT adults with significant psychological distress but no perceived need for care had not visited a mental health practitioner or primary care physician regarding their mental health over the last year—81% did not seek such help.
The likelihood of having ever seriously thought about suicide also varied by age group: a majority of younger LGBT adults aged 18–24 (59%) and ages 25–34 (55%) reported lifetime suicidal ideation. Among older age groups, nearly one-third (32%) aged 50–64 and almost one-quarter (24%) aged 65 and over had ever seriously considered suicide. The data suggest that LGBT individuals aged 50 and older were nearly two-and-a-half times more likely to have contemplated suicide compared to their non-LGBT peers.
Based on these findings, the report recommends supporting ongoing data collection and research focused on understanding higher rates of poor mental health among transgender and bisexual populations within the broader LGBT community. It also suggests implementing routine screenings for suicidal ideation and poor mental health to provide better support.
“This study can serve as a catalyst for better policies informed by the rigorously collected data of the California Health Interview Survey,” Padilla-Frausto said. “These data can help lawmakers and service providers address the distinct mental health challenges faced by the diverse members of the LGBT community, in particular transgender and bisexual individuals.”
