The UCLA Center for Health Policy Research has released a new policy brief showing that LGBT adults in California experience disproportionately high rates of mental health challenges compared to their non-LGBT peers. The study, published in September 2025, draws on data from the 2023 California Health Interview Survey.
According to the findings, nearly half of LGBT adults in California reported seriously considering suicide at some point in their lives. That figure was almost three times higher than among non-LGBT adults, who reported a rate of 17 percent. The disparities are even more severe for transgender adults, with 64 percent reporting suicidal thoughts, and bisexual adults, who reported a rate of 55 percent.
Researchers found that in the past year alone, about 49 percent of LGBT adults experienced serious or moderate psychological distress. More than half said they felt they needed mental health care, and roughly two-thirds had some level of need for mental health services. By comparison, only 30 percent of non-LGBT adults reported similar needs.
Despite these high levels of distress, barriers to care remain widespread. Forty-one percent of LGBT adults who recognized a need for care said they did not receive it. The situation was even worse for those without insurance, where three in four had unmet needs. Income also played a role, as individuals living just above the federal poverty line were among the most likely to go without care.
The report emphasizes that sexual orientation and gender identity themselves are not the cause of these disparities. Instead, ongoing experiences of stigma, discrimination, and exclusion place a significant burden on LGBT people. The lack of culturally competent providers further limits access to care. A troubling finding is that many LGBT adults experiencing distress do not recognize their need for support. Among those in distress who did not perceive a need for care, more than 80 percent went without mental health services.
The UCLA researchers recommend several steps to address these disparities. These include targeted interventions focusing on transgender and bisexual adults, routine screening for suicidal ideation and psychological distress in clinical settings, and public education campaigns to help people identify mental health needs earlier. Expanding access to affordable, LGBT-affirming care is also a priority, particularly for uninsured populations and those with moderate incomes.
The brief concludes that these findings reflect a broader systemic crisis. Without significant reforms to how mental health care is delivered, the risks to LGBT adults will continue to grow.
If you or someone you know is in crisis or considering self-harm, call or text 988 in the United States to connect with immediate support.
