Benefits of Teletherapy for 2SLGBTQIA+ Youth in CA

The mental health landscape for youth in the United States is facing a critical juncture, with alarming rates of anxiety, depression, and suicidal ideation among young people. This crisis is even more pronounced among Two Spirit, Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, and Asexual (2SLGBTQIA+) adolescents, who encounter unique challenges stemming from stigma, discrimination, and a lack of culturally concordant mental health services. These young individuals often grapple with feelings of isolation and fear, compounded by the difficulty of finding supportive environments where they can express their true selves without judgment.  

Amid these daunting challenges, teletherapy has emerged as a lifeline. By leveraging digital health solutions, teletherapy offers a flexible, accessible, and confidential means of providing mental health support to those who need it most. This is particularly vital for 2SLGBTQIA+ youth in California, where geographic and social barriers can hinder access to traditional in-person therapy. Teletherapy not only bridges these gaps, but also ensures that care is delivered in a manner that is inclusive and affirming of diverse identities.  

The California Telehealth Resource Center (CTRC) is at the forefront of this movement, dedicated to advancing health equity through evidence-based innovative digital health solutions. CTRC’s commitment to providing free, unbiased digital health resources empowers both patients and providers, fostering an environment where equitable healthcare is not just a goal, but a reality.  

The Youth Mental Health Crisis: California and Beyond 

The mental health crisis among adolescents in California is reaching unprecedented levels, with 2SLGBTQIA+ youth facing some of the most significant challenges.  

The Trevor Project’s National Survey on 2SLGBTQIA+ Youth Mental Health found that a staggering 44% of 2SLGBTQIA+ youth in California seriously considered attempting suicide in the past year, with 14% attempting it. Additionally, 69% of 2SLGBTQIA+ youth in California reported experiencing symptoms of anxiety, including 75% of transgender and nonbinary youth. Depression levels follow a similar pattern, with 58% of 2SLGBTQIA+ youth in California reporting experiencing symptoms of depression, including 65% of transgender and nonbinary youth. These figures highlight the drivers of mental health crisis 2SLGBTQIA+ young individuals face such as stigma, bullying, lack of acceptance, and more.  

Despite these concerning statistics, 62% of 2SLGBTQIA+ youth in California who wanted mental health care in the past year were not able to get it. This gap in care underscores the urgent need for accessible, affirming mental health services for these vulnerable populations. 

2SLGBTQIA+ Adolescent Mental Health: A Nationwide Snapshot 

On a national level, the picture is equally grim. Amidst the troubling mental health landscape, nearly four out of ten 2SLGBTQIA+ youth reported seriously considering suicide within the last year. This distressing figure escalates among transgender and nonbinary young people, with almost half grappling with suicidal thoughts. The crisis deepens for 2SLGBTQIA+ youth of color, who face even higher rates of suicidal ideation compared to their White peers, reflecting the compounded pressures of racial and sexual identity discrimination.  

In spite of facing significant rates of anxiety, depression, and suicide risk, half of 2SLGBTQIA+ youth in the United States were unable to access the mental health care they needed. The situation is particularly dire for transgender and nonbinary young people; even among the few who received gender-affirming medical care, nearly 60% feared losing access to these vital services. These concerns reflect the critical gaps in mental health support and the pervasive uncertainty surrounding gender-affirming care for these underserved populations.  

How Teletherapy Can Help Address the 2SLGBTQIA+ Youth Mental Health Crisis 

Teletherapy, or the delivery of mental health services via digital platforms, can transform how we approach mental health care, particularly for 2SLGBTQIA+ youth. The flexibility, accessibility, and confidentiality of teletherapy make it a promising solution to many of the barriers faced in accessing traditional in-person therapy. 

Bridging the Accessibility Gap 

One of the most significant advantages of teletherapy is its ability to bridge the accessibility gap. For 2SLGBTQIA+ adolescents, geographic and socio-economic barriers often limit access to inclusive and culturally concordant mental health services. Virtual care eliminates the need for physical travel, allowing young people to connect with therapists from the comfort of their own homes or another location where they feel safe. This is particularly important in rural or underserved areas, where specialized 2SLGBTQIA+ mental health services may not be readily available. According to a 2023 study found in the Journal of Clinical Psychology, digital mental health interventions have shown substantial promise in increasing accessibility and providing timely care to 2SLGBTQIA+ people in need.  

Providing Confidential Care 

Confidentiality is a crucial concern for 2SLGBTQIA+ youth, many of whom may not be open about their sexual orientation or gender identity. Teletherapy offers a level of privacy that in-person visits cannot always guarantee. For example, teletherapy allows 2SLGBTQIA+ youth to seek help without fear of being outed, creating a safer space for them to discuss their issues openly.  

Providing Affirming Care 

According to the Trevor Project’s National Survey on 2SLGBTQIA+ Youth Mental Health, 2SLGBTQIA+ adolescents who reported living in “very accepting” communities attempted suicide at less than half the rate of those who reported living in “very unaccepting” communities.  

Affirming care involves recognizing and validating the identities of 2SLGBTQIA+ youth, which is vital for their mental and emotional well-being. Ensuring high-quality care requires providers to understand both the principles of caring for 2SLGBTQIA+ individuals and the general needs of young people. Teletherapy platforms can connect underserved communities with therapists who are trained in providing affirming and culturally concordant care. This is particularly important for transgender and nonbinary youth, who may struggle to find knowledgeable providers.  

Efficacy of Teletherapy for 2SLGBTQIA+ Youth: A Literature Snapshot 

• Risk Assessment and Crisis Intervention for Youth in a Time of Telehealth: This study evaluates the effectiveness of telehealth interventions in crisis situations, particularly for at-risk youth. It underscores the potential of telehealth to provide immediate, life-saving interventions and continuous support for youth facing mental health crises. 

• Digital Intervention in Improving the Outcomes of Mental Health Among LGBTQ+ Youth: This systematic review underlines the transformative role of digital interventions in the mental health landscape for 2SLGBTQIA+ youth. The review illustrates that such interventions significantly decrease symptoms of depression and anxiety. Furthermore, the study notes improvements in overall well-being and self-esteem, demonstrating the effectiveness of tailored digital mental health resources in meeting the specific needs of 2SLGBTQIA+ adolescents. This supports the broader adoption of digital approaches in mental health strategies for groups who are underserved and face structural barriers to care. 

• Associations of LGBTQ+ Identities with Acceptability and Efficacy of Online Single-Session Youth Mental Health Interventions: This study explores how 2SLGBTQIA+ youths perceive and benefit from single-session online mental health interventions. It specifically examines the acceptability and efficacy of these interventions, noting that tailored approaches can enhance engagement and outcomes for 2SLGBTQIA+ participants. The findings suggest that inclusively designed online interventions could play a crucial role in addressing the unique mental health needs of 2SLGBTQIA+ youth. 

• Randomized Evaluation of an Online Single-Session Intervention for Minority Stress in LGBTQ+ Adolescents: This study assesses the effectiveness of a single-session online intervention tailored for reducing minority stress among 2SLGBTQIA+ adolescents. The findings indicate that the intervention not only reduced symptoms of stress but also significantly improved coping strategies in dealing with discrimination and stigma related to their identity. This suggests the potential for brief, targeted online interventions to make a meaningful impact on the mental health of 2SLGBTQIA+ youth. 

Providing Care to 2SLGBTQIA+ Adolescents: Best Practices 

Delivering effective mental health care to 2SLGBTQIA+ youth requires a nuanced approach centered on cultural competency and inclusivity. Practitioners should engage in comprehensive training curricula, such as those offered by the Substance Abuse and Mental Health Services Administration (SAMHSA), The National LGBTQIA+ Health Education Center, and the Whitman-Walker Institute. These culturally informed trainings help providers understand the unique needs and challenges faced by these youth. Creating a welcoming clinical environment is crucial and includes respecting each individual’s preferred names and pronouns, ensuring strict confidentiality, and using inclusive language.  

Furthermore, digital health services should be optimized to maintain privacy and prevent discrimination, fostering a safe space for 2SLGBTQIA+ adolescents to express themselves without fear. Addressing the broader social determinants of health – including family acceptance, bullying, and potential homelessness – is also essential for holistic care. By implementing these best practices, healthcare providers can significantly improve the accessibility and quality of their services for 2SLGBTQIA+ youth.  

To learn more about providing care for 2SLGBTQIA+ youth, explore these guidelines from the American Psychological Association, which outline best practices for psychological practices with sexual minority persons. For a deeper look into rural 2SLGBTQIA+ populations, listen to this podcast episode from the Heartland Telehealth Resource Center. 

Navigating Mental Health Resources for 2SLGBTQIA+ Youth 

California Advancing & Innovating Medi-Cal (CalAIM) Behavioral Health Initiative 

The California Department of Health Care Services has launched the CalAIM initiative, a multi-year effort to enhance the quality of life and health outcomes for Californians under the Medi-Cal program. CalAIM focuses on broad delivery system reforms, including significant improvements to behavioral health services. These reforms are designed to provide integrated, whole-person care and simplify the administration of behavioral health to improve access and outcomes. For more details on CalAIM and its ongoing implementation through 2027, visit their website and access their fact sheet document here. 

To learn more about CalAIM, check out our blog on value-based delivery transformation here. 

Finding a Therapist for 2SLGBTQIA+ Youth 

Identifying the right therapist is crucial for 2SLGBTQIA+ youth who require supportive mental health care. Online platforms such as Psychology Today and the Psychologist Locator from the American Psychological Association offer directories to find local mental health professionals. Additionally, for remote care options, the Telehealth Provider Map can help locate telehealth services appropriate for 2SLGBTQIA+ adolescents. 

Additional Resources for Patients 

• The Center of Excellence on LGBTQ+ Behavioral Health Equity provides resources aimed at improving healthcare for LGBTQ+ individuals. 

• The Healthcare Equality Index from the Human Rights Campaign helps find LGBTQ+-friendly healthcare facilities. 

• The National Queer & Trans Therapists of Color Network offers a directory of therapists focusing on the needs of queer and trans people of color. 

• The Trevor Project and the LGBTQIA Resource Center from the University of California Davis both provide mental health resources tailored specifically for LGBTQ+ youth, offering support and information to navigate mental health challenges effectively. 

How the CTRC Can Help Your Digital Health Practice 

As we navigate the complex landscape of youth mental health the urgency of addressing the unique challenges faced by 2SLGBTQIA+ youth in California becomes increasingly clear. Teletherapy emerges as a powerful tool, offering accessible, confidential, and culturally concordant care to those who might otherwise face significant barriers to receiving life-saving support.  

The CTRC is dedicated to advancing health equity and championing advanced digital health solutions. By providing essential no-cost resources, trainings, and technical support, our team can assist in transforming your digital health practice so that it serves everyone, regardless of gender or sexual identity.  

Do you have questions about this topic? Contact our team at CalTRC@ochin.org and we will get back to you right away.