2024 Disabled LGBTQ+ Youth Report

The analysis shows that disabled LGBTQ+ youth have remained steadfast and proud of their individual LGBTQ+ identities, despite challenges with rejection, mental health and overarching bias and stigma. At the end of the report, actionable guidelines are provided to help guide parents, caregivers, school administrators, educators, counselors and other youth-serving professionals on how they can support disabled LGBTQ+ youth. It is important to follow the lead of disabled LGBTQ+ youth and implement the actionable guidelines to create safe, affirming, and welcoming spaces for disabled LGBTQ+ youth.

In the Youth Survey questionnaire, disability is self-reported by participants one of two ways: self-diagnosed (“Do you consider yourself to have a disability”) and diagnosed by a provider ("Were you ever told by a doctor, healthcare provider or mental health care provider that you have a disability?")

For the purpose of this report, unless otherwise indicated, “youth with a disability” is limited to those youth who report having a disability diagnosed with a provider. The reason for focusing on provider diagnosed disability is that formal documentation of a disability is required to access specific services, resources, and/or accommodations such as Individualized Education Programs (IEP), which are used to provide disabled students the ability to thrive in school.

Overall, 29.7% of LGBTQ+ youth report a provider-diagnosed disability. This was substantially and significantly more common among trans and gender-expansive youth, with a third (33.3%) of trans and gender-expansive youth, compared with a fifth (20.6%) of cisgender LGBQ+ youth, reporting a provider-diagnosed disability (Figure 1).

However, it should be noted that the ability to access diagnostic testing and obtain an official diagnosis is not universal. Previous research has shown that youth from marginalized backgrounds, including racial or ethnic minorities and those lacking adequate health insurance, are all less likely to access diagnostic testing, and thus are less likely to be included in grouping or services that necessitates formal diagnosis.

This disparity in ability to receive a diagnosis is reflected in the fact that a slightly higher proportion of LGBTQ+ youth report a self-diagnosed disability (35.4%), than a provider-diagnosed one (29.7%; Table 1).

This discrepancy between formal diagnosis, and considering oneself to have a disability, was almost entirely driven by diagnostic differences for trans and gender-expansive youth:

• Virtually identical proportions of cisgender LGBQ+ youth reported a provider-diagnosed (20.6%) or a self-diagnosed (20.9%) disability
• Among trans and gender-expansive youth, a third (33.3%) reported a provider-diagnosed disability, compared with more than 4 in 10 (41.2%) who considered themselves to be disabled.

Disability can take many forms, including, but not limited to, physical, cognitive, intellectual, or psychiatric. In the present study, respondents were asked what type of disability they had, selecting as many as apply from the following options:

• Physical disability
• Developmental or learning disability
• Psychiatric disability/mental illness
• Another type

Those who selected “another type” were prompted to write-in their disability(ies), and these answers were back coded into existing categories (see Methodology for a full list of write-in responses, and how they were recorded). Note that no definitions or examples were provided of each type of disability, so selection relies on respondents’ own categorization of their disability(ies).

Interestingly, despite discrepancies in the prevalence of disability across diagnosis method (e.g. provider- vs. self-diagnosed), the type of disability reported did not differ substantially between these groups (Table 2).

Among LGBTQ+ disabled youth with a provider-diagnosed disability:

• Three-quarters (75.6%) have been diagnosed with a psychiatric/mental health disability such as depression or anxiety.
• Over half (59.1%) have been diagnosed with a neurodevelopmental or intellectual disability, which includes cognitive disabilities such as autism, ADHD, dyslexia and learning disabilities, and/or visual or hearing impairments (e.g. being blind, or D/deaf).
• A quarter (25.9%) have been diagnosed with a physical disability, such as a mobility issue, chronic physical illness, diabetes, asthma, and/or cardiovascular conditions (e.g. heart conditions).
• More than half (51.7%) have been diagnosed with two or more disabilities.

However, disabled trans and gender-expansive youth were significantly and substantially more likely than disabled cisgender LGBQ+ youth to have been diagnosed with each type of disability (Figure 2).

Almost 9 in 10 (88.5%) disabled LGBTQ+ youth are out about their LGBTQ+ identity to at least one member of their immediate family, including parents, guardians or siblings (Table 3). Outness is less common to extended family members such as grandparents or cousins, though more than half (55.1%) report being out to at least one member of their extended family. Transgender and gender-expansive youth are more likely than cisgender LGBQ+ youth to be out, regardless of family member type.

More disabled LGBTQ+ youth report experiencing parental support, than parental rejection, for their LGBTQ+ identity, defined as at least one positive or negative experience from a list of prompts (see Table 4 and 5). However, many still face rejection, an experience that is far more common an experience for disabled transgender and gender-expansive youth than it is for disabled cisgender LGBQ+ youth (Figure 3).

It should be noted that the survey only assessed instances of parental rejection and support for youths’ LGBTQ+ identity, but not for any other aspect of their identity. Disabled LGBTQ+ youth, however, can face rejection from parents because of their disability as well. For example, parents may feel shame for their child’s disability, feel shame about their LGBTQ+ identity, or feel both at once. Some parents might also view their child’s LGBTQ+ identity as a disability, even though being an LGBTQ+ person is not a disability or mental illness. At the same time, many disabled LGBTQ+ youth grow up in households where their parents and caregivers support and affirm all aspects of their identity—including their disability. It is therefore important to keep in mind that many of the youth in this sample may have still experienced parental rejection—or support-- for their disability, which is not reflected above.

Transgender and gender-expansive youth living with a disability often do not have their gender identity affirmed at home, especially when it comes to having their pronouns used correctly (Table 6).

However, transgender and gender-expansive youth living with a disability are slightly more likely than trans youth overall to report their family is affirming their gender identity and expression. For example, among all transgender and gender-expansive youth in the survey, 41% report their family never uses their chosen name, and 49.5% report their family never uses their chosen pronoun.

Virtually all disabled LGBTQ+ youth were out about their LGBTQ+ identity to someone at school (Figure 4). Similar trends are seen for transgender and gender-expansive youth and cisgender LGBQ+ youth (Table 7).

As with LGBTQ+ youth overall, disabled LGBTQ+ youth are more likely to be out to their peers rather than an adult like a teacher or coach—though outness was common for both. Interestingly, disabled LGBTQ+ youth are more likely to be out to adults than non-disabled LGBTQ+ youth, or LGBTQ+ youth as a whole.

• Three-quarters (73%) of disabled LGBTQ+ youth are out to at least one teacher/staff member at school, compared with two-thirds (63.9%) of all LGBTQ+ youth

More than half (55.1%) of disabled LGBTQ+ youth feel unsafe in at least one school setting—defined as feeling unsafe “sometimes”, “usually,” or “always” (Table 8; Table 9).

Disabled LGBTQ+ youth are more likely to feel unsafe than LGBTQ+ youth generally (Figure 5).

This is particularly true for disabled transgender and gender-expansive youth, who are twice as likely as disabled cisgender LGBQ+ youth to feel unsafe at school.

Disabled LGBTQ+ youth can feel unsafe in school due to hostility toward their LGBTQ+ identities, and/or their disability, LGBTQ+ youth are significantly more likely than cisgender and straight youth to experience bullying at school, and to experience violence and physical and verbal harassment from their peers. Being bullied for a disability is also among one of the most common types of bullying in school.

Results from this survey show that disabled LGBTQ+ youth are at increased risk for bullying, harassment, and violence:

In the past month, the vast majority—over six in ten (62.5%)—disabled LGBTQ+ youth experienced some form of verbal or physical harassment and victimization at school at least once (Table 10). For example:

Further, disabled LGBTQ+ youth may experience bullying, harassment, and violence that specifically targets their identity as LGBTQ+, as disabled, or as both (Table 11).

In the past year alone,

• Over half (59.6%) of disabled LGBTQ+ youth were bullied for their LGBTQ+ identity (Figure 6)
• Over a third (37.9%) were bullied for their disability

Despite the frequency of bullying, many disabled LGBTQ+ youth do not disclose bullying to teachers or staff at school.

• Only one-third (32.4%) of disabled LGBTQ+ youth have disclosed bullying to a teacher or staff member at school (Table 12).

However, lack of staff responsiveness to reported bullying may be playing a role:

• Half (49.7%) of disabled LGBTQ+ youth who reported bullying to a teacher or staff at school, said they helped only a little—or not at all.

Disabled people are no strangers to inaccessible spaces. For example, a study by the U.S. Government Accountability Office found that two-thirds of school districts they studied had facilities that were not conducive for use by people with physical disabilities.

At the same time, gender-inclusive restrooms, locker rooms and other spaces are a rarity. As a result, disabled trans and gender-expansive youth face heightened access barriers to bathrooms and facilities that both match their gender identity, and which accommodate their disability.

• Only one in five (22.8%) disabled transgender and gender-expansive youth report ALWAYS being able to use a school restroom that matches their identity, whereas over half (54.3%) are NEVER able to do so (Table 13).

Similarly, many disabled transgender and gender-expansive youth rarely have their gender presentation, correct pronouns, or chosen names used at school.

Since the start of the 2023 state legislative session, multiple states have passed laws restricting transgender youth’s access to bathrooms and locker rooms in K-12 schools, requiring them to use facilities that match their sex assigned at birth, rather than their gender identity. Furthermore, state legislatures are passing laws forbidding and criminalizing teachers and staff from using chosen names and correct pronouns for transgender and gender-expansive youth.

As a result, it is likely that disabled transgender and gender-expansive youth have had their gender identity affirmed at school even less frequently than was observed in this survey, which was conducted in 2022 before these laws were introduced.

Participating in school sports and other extracurricular activities can have numerous positive benefits for youth.

Disabled LGBTQ+ youth may be more likely to participate in non-sport extracurricular activities because they are more accommodating to their disabilities or LGBTQ+ identity. For example, according to the National Center on Health, Physical Activity and Disability (NCHPAD), 1.5 million students in public and secondary schools with a physical disability are excluded from access to participate in athletic competitions.

Transgender and gender-expansive youth also are often excluded from participating in sports, as many states have outright banned them from participating in school sports and competing on sports teams in accordance with their gender identity.

As a result, disabled LGBTQ+ youth, and disabled trans and gender-expansive youth in particular, are far more likely to participate in a non-sports extracurricular activity, than to play sports (Table 14).

In comparison, two-thirds (66.2%) of disabled LGBTQ+ youth, including two-thirds each of cisgender LGBQ+ (66.4%) and transgender and gender-expansive youth (66.1%), are participating in some sort of non-sport extracurricular activity.

The majority of disabled LGBTQ+ youth screened positive for depression and anxiety (Table 15).

Disabled LGBTQ+ youth were significantly more likely than non-disabled LGBTQ+ youth, and LGBTQ+ youth in general to screen positive for both, a trend that was observed in both cisgender LGBQ+ and transgender and gender-expansive youth. (Figure 7).

While disabled LGBTQ+ youth have high rates of depression and anxiety, they also have high rates of obtaining high quality mental health care.

• Two-thirds (66.4%) of disabled LGBTQ+ youth received therapy in the last year.
• Three-quarters of disabled LGBTQ+ youth who received therapy viewed their therapist as very (40.2%) or somewhat (38.8%) LGBTQ+ informed.

Disabled LGBTQ+ youth are also more likely than the general LGBTQ+ youth to have received therapy in the past year, reported by less than half (48.9%) of all LGBTQ+ youth in the survey. This may be compounded, however, by our definition of “disability,” which required a diagnosis by a health care provider—and thus everyone in this report has had access to at least one type of provider in the past.

However, more than 8 in 10 (81.4%) of disabled LGBTQ+ youth who did not receive therapy had an unmet need -- defined as wanting therapy but being unable to receive it (Table 16).

Despite growing hostility many disabled LGBTQ+ youth feel proud of their LGBTQ+ identities.

However, many disabled LGBTQ+ youth simultaneously hold negative feelings about their identity (Table 17).

The vast majority of disabled LGBTQ+ youth are considering attending college (Table 18). However, disabled LGBTQ+ youth are wary of what experiences they will have when they matriculate.

• More than 9 in 10 (95.7%) disabled LGBTQ+ youth feel it is somewhat or very important for them to attend a school with an LGBTQ+ inclusive non-discrimination policy and/or resource center.
• A third (34.4%) fear that their LGBTQ+ identity will negatively impact their higher education experiences and opportunities.

This is substantially more common among transgender and gender-expansive youth than cisgender LGBQ+ youth.

While not directly measured in this study, disabled LGBTQ+ prospective students may also think their disability could negatively impact their higher education opportunities, specifically as it comes to degree completion. Overall, 23% of undergraduates who reported a disability in 2012 eventually graduated with a bachelor’s degree by 2017, while 38% of undergraduates who did not report a disability graduated. This gap in degree attainment between disabled and non-disabled collegegoers, could be due to disabled students lacking the resources and accommodations needed to fully thrive in higher education settings.

Three-quarters (78.9%) of disabled LGBTQ+ youth want to be out about their LGBTQ+ identity at their future job (Table 19).

However, they have concerns about their ability to do so—particularly transgender and gender-expansive youth

Many disabled people, including disabled LGBTQ+ people, go without workplace accommodations and protections. Disabled LGBTQ+ people must approach their future careers keeping in mind how both their LGBTQ+ identities and their disabilities can impact their potential opportunities.

Disabled LGBTQ+ youth can face a series of challenges that are shaped by both their LGBTQ+ identities and disabilities. At home, disabled LGBTQ+ youth may have parents that are ashamed of their LGBTQ+ identity or disability, lacking affirmation and support that is critical to their development and well-being. However, many disabled LGBTQ+ youth find that their parents can also be supportive of them regarding their LGBTQ+ identities. At school, violence and bullying are all to common for disabled LGBTQ+ youth. This is due to both how peers and staff at schools treat them as well as how the broader political system is targeting LGBTQ+ youth is states across the country. Given this, it is unsurprising that disabled LGBTQ+ youth have elevated challenges with mental health and concerns about future opportunities in areas such as higher education. Parents, caregivers, educators and youth-serving professionals must come together to meet the needs of disabled LGBTQ+ youth, and lawmakers must end the attack on LGBTQ+ kids in America.

• Seek out professional development and clinical training to support LGBTQ+ youth and specifically transgender and gender-expansive youth, as well as disabled youth.
• Believe disabled youth, including youth with developmental disabilities, when they come out or invite you in about their sexual orientation and/or gender identity.
  • Learn from and contribute to the growing research on the potential connection between neurodiversity and gender-diversity. To learn more check out the National LGBT Health Education Center’s “Neurodiversity & Gender-Diverse Youth: An Affirming Approach to Care” - lgbtqiahealtheducation.org
  • Assist parents, caregivers, and other adults in the youth’s life understand, believe, and affirm their disabled youth’s LGBTQ+ identity.
  • Consistently use the name and pronoun a youth goes by and encourage their parents, caregivers, and family members in doing the same.
  • Work with youth to explore their experiences with the possibility of them having a disability. Provide resources and information for youth and families to learn more about disabilities, including invisible disabilities. Learn more about invisible disabilities from the Invisible Disabilities Association - invisibledisabilities.org
• Uplift the autonomy and self-determination of disabled youth by working with them on needed accommodations that they are comfortable with and affirm their identity. Ensure disabled youth have a say in their treatment and work with parents and caregivers to ensure disabled youth’s voices, experiences, and expressed needs are taken seriously when developing accommodations for youth.
• Ensure you have local in-person and virtual referral organizations and resources to support and affirm LGBTQ+ youth such as support groups where they are able to connect with youth with similar identities. Additionally, ensure the accessibility of these resources for disabled youth, particularly youth with physical disabilities.

Respondents could either select a single sexual identity from a presented list, or write in a second or alternative identity by selecting something not listed; write-in answers were back coded to existing categories if available (or new categories were created if >30 people wrote in an identity). Respondents were allowed to select as many identity groups as applied (e.g. a person could identify as both “bisexual” and “asexual”), so numbers will not sum to 100%

Most disabled LGBTQ+ youth, identified as either gay or lesbian (28.1%), bisexual/biromantic (25.5%), or pansexual/panromantic (16.3%). Additionally, one in ten were asexual (12.1%) or queer (11.7%).

One –fifth (19.9%) of disabled LGBTQ+ youth in the sample identified their gender identity as cisgender or as questioning, meaning their sex assigned at birth matches the gender /gender identity they identify with; this group is presented as "cisgender LGBQ+” throughout the report.

As with sexual identity, respondents could select more than one gender identity. Among transgender and gender-expansive youth, half (49.8%) identified as transgender in some way, including transgender girl/transfem(me), transgender boy/transmasc, and/or simply as “trans.” A little over four in ten (41%) identified as non-binary. A third (35.5%) identified as genderqueer, gender non-conforming, and/or gender fluid. And a fifth (21.6%) identified as some other gender identity, including agender, bigender, demigirl/boy, and others.

Most respondents were in high school (76.5%), compared to elementary or middle school (7.2%) as well as college or trade school (10.9%). Few were out of school (5.4%).

Respondents were somewhat evenly distributed across Census geographic regions, though a small plurality of respondents were from the South (32.5%).

Most respondents were white (87%), followed by Hispanic/Latine (13.8%), and then Black or African American (7.2%). Respondents were able to select more than one race or ethnicity.