For many LGBTQ+ college students, university life brings more than academic pressures and the challenges of adulthood. Discrimination on campus and barriers to health care can take a serious toll on their mental health, according to a major national study involving nearly 18,000 students across the United States.
Conducted by researchers at Columbia University Mailman School of Public Health, Boston University School of Public Health and Harvard Pilgrim Health Care Institute, the study examined 17,942 LGBTQ+ students aged 18 to 24 attending 119 colleges and universities across 34 states. Published in Behavioral Medicine, it is the largest study of its kind examining discrimination, mental health and health care access among LGBTQ+ college students.
The findings paint a troubling picture. One in ten LGBTQ+ students reported experiencing discrimination on campus during the previous year. Compared with their peers who did not report such experiences, these students were 84% more likely to meet criteria for depression, 87% more likely to meet criteria for anxiety and 78% more likely to report suicidal thoughts.
Discrimination involving health care was particularly concerning. Students who had been denied medical care because of their sexual orientation or gender identity were more than three times as likely to report suicidal thoughts. Transgender and nonbinary students were more than twice as likely as LGBQ+ students to report being denied health care.
“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 Dr. Sarah McKetta, assistant professor of epidemiology at Columbia Mailman and co-first author of the study.
Mental health challenges were widespread even beyond those reporting discrimination. More than half of participants met criteria for depression, while anxiety affected nearly half of LGBQ+ students and more than half of transgender and nonbinary students. Suicidal thoughts were reported by nearly one in five LGBQ+ students and more than one in four transgender and nonbinary students.
Access to care remains another major concern. Although more than half of participants sought mental health counselling, nearly 5% of LGBQ+ students and 13% of transgender and nonbinary students reported avoiding necessary medical care. Researchers suggested that campus counselling services could play a vital role in identifying distress and connecting students with supportive health services.
The research drew on the 2024–2025 Healthy Minds Study, conducted during and immediately after a national election year marked by heightened political debate over LGBTQ+ rights. Researchers examined discrimination on campus, denial of health care and denial of other services, alongside students’ mental health and health care experiences.
“Particularly troubling were our findings on suicidal ideation,” McKetta said. Across every student subgroup and type of discrimination examined, discriminatory experiences were associated with a greater likelihood of suicidal thoughts, reinforcing the need for comprehensive campus suicide prevention strategies.
Researchers called for stronger protections against discrimination, improved LGBTQ+ health training for clinicians and campus providers, and greater access to affirming care. They also stressed the importance of sustained research investment to understand disparities better and develop effective solutions during this critical stage of young adulthood.
More information: Sarah Ketchen Lipson et al, LGBTQ+ College Students’ Exposure to Discrimination and Relationships to Mental Health and Healthcare Utilization: Findings from a National Survey, Behavioral Medicine. DOI: 10.1080/08964289.2026.2633344
Journal information: Behavioral Medicine Provided by Columbia University’s Mailman School of Public Health