Editor’s note: This story mentions suicide and sexual abuse.

Gizelle Hernandez knows it’s OK to cry. Sometimes, her depression makes her feel like she’s outside of her own body. Crying brings her back in.

The Marine Creek Collegiate High School senior has spent the past few years in therapy learning how to cope with anxiety and depression. 

The 988 Suicide & Crisis Lifeline is a hotline for people in crisis or for those looking to help someone else. When people call, text, or chat 988, they will be connected to trained counselors who will listen and provide resources and support.

A few miles away, at Lake Worth High School, Jenni Hernandez writes to quiet her mind. Sometimes, she meditates. Both practices help the senior cope with the trauma of sexual abuse in her childhood. 

The young women, 18, aren’t related, but they’re a part of a growing group of teenagers across the U.S. who report feeling persistently sad or hopeless — so much so that they stop doing their usual activities, according to 2021 data from the recently released Youth Risk Behavior Survey. 

The survey, conducted by the U.S. Centers for Disease Control and Prevention every two years, monitors behaviors among high school students that can lead to illness, injury and death.

When it comes to experiences of poor mental health, suicidality, bullying and sexual violence, teen girls and students who identify as lesbian, gay or bisexual reported worse outcomes across every metric than their male or straight peers.

‘A whole perfect storm’ for teenagers

The problem of despair is not new, and it extends to teenagers more globally, said Dr. Debra Atkisson, an adolescent psychiatrist and professor at the Burnett School of Medicine at TCU. 

“We were already in a mental health pandemic before the pandemic happened,” she said. “Our teenagers today are just in a world of hurt.”

At baseline, adolescence is a season of self-construction, she said – “figuring out your identity, who you are, and how you fit into the world.” 

The external pressures of social media further complicate that journey, Atkisson said. 

Last year, 95% of teens 13-17 said they use YouTube. Nearly 70% said they use TikTok. 

Heightened social media activity means students are always connecting, and that can be harmful in some ways, Young Women’s Leadership Academy intervention specialist Kaity Stone said.

Then, the COVID-19 pandemic ushered in school shutdowns, social isolation, economic hardship and fear of illness and loss. For teens, the resulting disconnectedness happened during a developmentally critical time, Atkisson said. 

“There’s just been a whole perfect storm here,” she said.

Those challenges affected teenagers across the board, regardless of identity. But for girls and teens who identify as lesbian, gay or bisexual, the troubles compound.

A female body in the world

In mid April, the skincare company Dove released a short film about social media’s effects on female body image. Atkisson cried when she watched. In her 30-year career, she said she’s treated many girls and some boys with eating disorders. 

The film captures the struggle, she said.

YouTube video

Not only does society, through many messaging campaigns, work to shape a girl’s body, but also to possess it. Atkisson points to the national prevalence of sexual assault against women. 

One in five American women have experienced rape or attempted rape, according to the National Sexual Violence Resource Center. For one in three of those women, the event took place for the first time when they were between 11 and 17 years old. 

And the prevalence seems to be worsening. In 2011, 12% of teen girls reported that they had ever been forced to have sex. In 2021, the number was 14%. 

For Jenni, the senior at Lake Worth High, her experience of sexual assault came early. She was 8 or 9, she remembers. Afterward, she moved through the world differently. Quietly. 

“​​That (experience) kind of caused me to become more quiet in a sense, because I didn’t really want to talk about it,” she said. “And I guess me being quiet has also isolated me.”

In the years since, depression has, at times, hung over her like a dark cloud. She wonders if genetics play a role, or simply “life in general.” 

Even so, she’s among the top of her class at her school, and she’s developed her own set of coping skills to help her navigate: Writing, reading, yoga and meditation. Mostly, she said, she writes. “Writing is the most expressive for me.” 

Her resources must come from within, in part because her Hispanic family doesn’t often discuss mental health.

When mental health treatment is ‘for crazy people’

Around the time she turned 14, Gizelle, the Marine Creek Collegiate High senior, started experiencing symptoms of depression. 

She’s learning how to cope with it and her anxiety, but getting to that point in therapy was not easy, especially in her Hispanic household.

“They label it as something crazy, as something that’s not really known. They label it for crazy people,” Gizelle said. “It was hard for me to get that told to my face, especially since I was the oldest. I had to go through the worst so my siblings could go through the better. But that was hard on me because I’m already trying to do enough and still not receiving support.”

The stigma Gizelle experienced is common among Hispanic and Latino families. According to the National Alliance on Mental Illness, only 35.1% of Hispanic or Latino adults in the United States with mental illness receive treatment each year compared to the U.S. average of 46.2%.

But students like Gizelle and Jenni are pushing back against that stigma, and a younger generation is working toward overcoming those barriers. 

To help her parents see the importance of getting help, Jenni said she showed her parents how her mental health ties to her physical health.

She started developing bad stomach aches and painful headaches. Jenni told her parents she started experiencing these physical health issues because of her mental health.

Therapy helped Gizelle manage her depression. “The treatment was really hard to get at first,” she said. But she let her school counselor know how she felt, and that pushed her parents to seek out therapy for her.

She still experiences hard days, but her mental health is getting better, she said.

Rejection, politics heightens struggle for LGBTQ teens 

For young people within the LGBTQ community, a lack of support from family and friends can put them “in a precarious place,” Atkisson, the TCU professor, said. 

They’re more likely to experience homelessness than their straight peers, mostly because their families reject them, or they experience abuse and discrimination. They represent up to 40% of homeless youth in the U.S., according to youth.gov.

Teens who identify as lesbian, gay or bisexual are more likely to report being bullied — both electronically and at school, and they’re less likely than straight students to feel close to people at school. Transgender teens aren’t included in the Youth Risk Behavior Survey data because the survey didn’t ask about gender identity. The CDC will include a gender identity question in the next survey.

Still, about one in two trans teens also identify as lesbian, gay or bisexual, according to 2020 estimates from the University of California, Los Angeles.

Austen McDonald-Scott, who serves on the board of Finn’s Place, a community center in Fort Worth for the trans and gender-diverse people, said legislation that strips people of personal choice serves as a dehumanizing force — both for women and the LGBTQ community. 

“When you turn somebody into a political football, they’re not human anymore. They’re a statistic or a news story or a fascination or curiosity,” McDonald-Scott said. “They’re not real people.”

Stone, at Young Women’s Leadership Academy, said the divisive political climate has made discussions about sexuality, gender and pronouns off the table for school employees, because of legislation attempting to restrict conversations on sexuality

Still, she often notices families accept their children as they are. When they don’t, she said, the children “find their people.” Safe space stickers or Gay Straight Alliance clubs at schools are crucial to mental health, Stone said.

“It’s a fine line of supporting kids, families and really working on that together so everyone feels safe and included.”

‘These kids are still achieving a lot’

School counselors are having to encourage parents to get treatment for their children more than in previous years, specifically around suicide risk, said Brandi Williams, lead counselor at O.D. Wyatt High School.

“It’s just, it’s been a lot,” she said. 

Teen girls and students who identify as lesbian, gay or bisexual were more likely to report considering, planning for and attempting suicide at least once in the past year than their male and straight peers, according to the Youth Risk Behavior Survey.  

The trauma she’s navigating with students ranges from depression to sexual violence, which Williams said is increasing. 

The COVID-19 pandemic changed everything, and no one really knows how to navigate the sudden increase in mental illness, Stone said. 

“I’ve been in this school eight years, and this is the hardest year I’ve ever had,” she said. “Everyone’s trying, and no one has answers right now.”

When she notices a student struggling, Williams starts checking in with them weekly. 

“Even with the hurdles they’re facing mentally, these kids are still achieving a lot,” Williams said. “That in itself says how resilient they are.”

Just a few years ago, students wouldn’t have identified mental health issues, Williams said. The recognition and seeking help alone shows progress. 

She hopes increased awareness will bring more resources for young people.

As for Atkisson, awareness requires relationship. She recommends adults “be active, be available, be willing to listen” to the teens in their lives. She recommends they become mentors, and choose kindness — especially toward teens within the LGBTQ community. 

“One of the things that I’ve seen here with children is, they’re already struggling, and they feel strongly judged and condemned,” she said. “But I think judging and condemning never helps anybody.”

She’s thankful for the Youth Risk Behavior Survey and for the knowledge that stems from it. Early intervention for teens matters, she said. The sooner they get help, “the more likely they turn around,” she said. 

As for the teens who fall through the cracks for a year, two years, three years, the journey to mental health becomes even more layered.

“It’s not hopeless,”Atkisson said. “But it’s harder.”

Kristen Barton is an education reporter for the Fort Worth Report. Contact her at kristen.barton@fortworthreport.org

Alexis Allison is the health reporter at the Fort Worth Report. Contact her at alexis.allison@fortworthreport.org or via Twitter. Her position is supported by a grant from Texas Health Resources. 

At the Fort Worth Report, news decisions are made independently of our board members and financial supporters. Read more about our editorial independence policy here.

Creative Commons License

Noncommercial entities may republish our articles for free by following our guidelines. For commercial licensing, please email hello@fortworthreport.org.

Alexis Allison covers health for the Fort Worth Report. When she can, she'll slip in an illustration or two. Allison is a former high school English teacher and hopes her journalism is likewise educational....

Kristen Barton is an education reporter for the Fort Worth Report. She has previous experience in education reporting for her hometown paper, the Longview News-Journal and her college paper, The Daily...