October 23, 2026-- LGBTQ+ college students who experience discrimination are significantly more likely to experience depression, anxiety, suicidal thoughts, and avoid needed health care, according to a new national study by Columbia University Mailman School of Public Health, Boston University School of Public Health and Harvard Pilgrim Health Care Institute. The findings underscore the profound impact of discrimination on student mental health during a critical stage of life. The results are published in the journal Behavior Medicine .
The study, based on nearly 18,000 LGBTQ+ students at 119 colleges and universities across 34 states, is the largest to examine how discrimination affects the mental health and health care experiences of LGBTQ+ college students. It is also the first to assess these associations during and immediately following a national election year, a period marked by heightened political debate over LGBTQ+ rights.
"Addressing discrimination among college students is essential to support student well-being, reduce mental health disparities, and ensure all students have equitable access to care," said Sarah McKetta, MD, PhD, assistant professor of Epidemiology at Columbia Mailman, and co-first author.
Researchers found that one in 10 LGBTQ+ students experienced discrimination on campus during the previous year. Those students were: 84 percent more likely to meet criteria for depression; 87 percent more likely to meet criteria for anxiety; and 78 percent more likely to report suicidal thoughts in the past year.
Students who experienced discrimination in the form of health care or service denial faced even greater risks. Among LGBTQ+ students, denial of health care was associated with a more than 200 percent higher likelihood of suicidal ideation.
"In addition to an increasingly hostile federal climate, many states have enacted legislation aiming to curtail LGBTQ+ rights," said McKetta. "In 2025 alone, more than 1,000 bills were introduced that would limit transgender people's access to health care, education, or legal recognition."
Emerging adulthood is a pivotal period for lifelong health. It is also when many young adults transition from pediatric to adult health care, often losing established providers and facing new barriers to care.
"Behavioral health during emerging adulthood is a strong predictor of health later in life," said McKetta. "Improving access to affirming health care and reducing discrimination during this transition can have lasting benefits."
Overall, mental health needs among LGBTQ+ students were striking. More than half of participants met criteria for depression. Nearly half of LGBQ+ students and more than half of transgender and nonbinary students met criteria for anxiety. Nearly one in five LGBQ+ students and more than one in four transgender and nonbinary students reported suicidal thoughts during the previous year.
Although more than half of participants sought mental health counseling, many continued to avoid health care because of concerns about discrimination. Nearly 5 percent of LGBQ+ students and 13 percent of transgender and nonbinary students reported avoiding needed medical care.
Researchers found that counseling services may represent an important point of intervention. LGBTQ+ students reported utilizing therapy and counseling services from mental health professionals at high rates, suggesting that counseling settings offer an opportunity to identify psychological distress, provide affirming care, and connect students with broader health services.
The researchers analyzed responses from 17,942 LGBTQ+ students ages 18 to 24 who participated in the 2024–2025 Healthy Minds Study, an annual national survey of college student mental health to examine three types of discriminatory experiences: interpersonal discrimination on campus, past denials of healthcare, or past denials of other services on the basis of sexual orientation and/or gender identity. They also assessed how these discriminatory experiences were associated with mental health outcomes: flourishing, depression, anxiety, suicidal ideation; and healthcare utilization.
"Particularly troubling were our findings on suicidal ideation," noted McKetta. "Across every subgroup of students and every type of discrimination we examined, experiencing discrimination increased the likelihood of suicidal thoughts. These findings highlight the urgent need for colleges to address discrimination as part of comprehensive suicide prevention efforts."
The researchers note that transgender and nonbinary students were more than twice as likely as LGBQ+ students to report being denied health care. Because many transgender people rely on medical services for gender-affirming care, such barriers may have especially serious consequences for both physical and mental health.
"Improving training in LGBTQ+ health for clinicians and campus providers can reduce discriminatory experiences, strengthen trust in health care systems, and improve outcomes for students during this pivotal stage of life," said McKetta.
The authors also emphasize the importance of continuing to support large-scale, high-quality research on LGBTQ+ health.
"Understanding how discrimination affects health depends on rigorous data collection and sustained investment in research," said McKetta. "Without these resources, it becomes much more difficult to identify disparities and develop effective solutions."
Co-authors are Sarah K. Lipson (co-first author), Allegra R. Gordon , Sangeeta Subedi, and Alexa L. Bowerfind, Boston University School of Public Health ; Erin Voichoski, University of Michigan ; Adison Hicks, Boston University Chobanian & Avedisian School of Medicine; Kimberly M. Nelson, Boston University School of Public Health and Boston University Chobanian & Avedisian School of Medicine; and Brittany M. Charlton, Harvard Medical School and Harvard Pilgrim Health Care Institute .
The study was supported by the National Institutes of Health, R61HD117134 (grant was terminated in March 2025); R00AA031316; K01MH121515; and the William T. Grant Foundation Scholars Program.
Columbia University Mailman School of Public Health
Founded in 1922, the Columbia University Mailman School of Public Health pursues an agenda of research, education, and service to address the critical and complex public health issues affecting New Yorkers, the nation and the world. The Columbia Mailman School is the third largest recipient of NIH grants among schools of public health. Its nearly 300 multi-disciplinary faculty members work in more than 100 countries around the world, addressing such issues as preventing infectious and chronic diseases, environmental health, maternal and child health, health policy, climate change and health, and public health preparedness. It is a leader in public health education with more than 1,300 graduate students from 55 nations pursuing a variety of master’s and doctoral degree programs. The Columbia Mailman School is also home to numerous world-renowned research centers, including ICAP and the Center for Infection and Immunity. For more information, please visit www.mailman.columbia.edu .
Behavioral Medicine
LGBTQ+ College Students’ Exposure to Discrimination and Relationships to Mental Health and Healthcare Utilization: Findings from a National Survey
22-Oct-2026