Most lesbian, gay, bisexual, (LGB) youth are happy and thrive during their adolescent years. Having a school that creates a safe and supportive learning environment for all students and having caring and accepting parents are especially important. Positive environments can help all youth achieve good grades and maintain good mental and physical health. However, some LGB youth are more likely than their heterosexual peers to experience negative health and life outcomes.

For youth to thrive in schools and communities, they need to feel socially, emotionally, and physically safe and supported. A positive school climate has been associated with decreased depression, suicidal feelings, substance use, and unexcused school absences among LGB students.

Experiences with Violence

Compared with other students, negative attitudes toward LGB persons may put these youth at increased risk for experiences with violence. ‘Violence’ can include behaviors such as bullying, teasing, harassment, and physical assault.

According to data from the 2015 national Youth Risk Behavior Survey (YRBS), of surveyed LGB students:

• 10% were threatened or injured with a weapon on school property
• 34% were bullied on school property
• 28% were bullied electronically
• 23% of LGB students who had dated or went out with someone during the 12 months before the survey had experienced sexual dating violence in the prior year
• 18% of LGB students had experienced physical dating violence
• 18% of LGB students had been forced to have sexual intercourse at some point in their lives.

Effects on Education and Mental Health

Exposure to violence can have negative effects on the education and health of any young person and may account for some of the health-related disparities between LGB and heterosexual youth. According to the 2015 YRBS, LGB students were 140% (12% v. 5%) more likely to not go to school at least one day during the 30 days prior to the survey because of safety concerns, compared with heterosexual students.  While not a direct measure of school performance, absenteeism has been linked to low graduation rates, which can have lifelong consequences.

A complex combination of factors can impact youth health outcomes. LGB youth are at greater risk for depression, suicide, substance use, and sexual behaviors that can place them at increased risk for HIV and other sexually transmitted diseases (STDs). Nearly one-third (29%) of LGB youth had attempted suicide at least once in the prior year compared to 6% of heterosexual youth. In 2014, young gay and bisexual men accounted for 8 out of 10 HIV diagnoses among youth.

What Schools Can Do

Schools can implement evidence-based policies, procedures, and activities designed to promote a healthy environment for all youth, including LGB students. For example, research has shown that in schools with LGB support groups (such as gay-straight alliances), LGB students were less likely to experience threats of violence, miss school because they felt unsafe, or attempt suicide than those students in schools without LGB support groups. A recent study found that LGB students had fewer suicidal thoughts and attempts when schools had gay-straight alliances and policies prohibiting expression of homophobia in place for 3 or more years.

To help promote health and safety among LGB youth, schools can implement the following policies and practices (with accompanying citations)

• Encourage respect for all students and prohibit bullying, harassment, and violence against all students.
• Identify “safe spaces”, such as counselors’ offices or designated classrooms, where LGB youth can receive support from administrators, teachers, or other school staff.
• Encourage student-led and student-organized school clubs that promote a safe, welcoming, and accepting school environment (e.g., gay-straight alliances or gender and sexuality alliances, which are school clubs open to youth of all sexual orientations and genders).
• Ensure that health curricula or educational materials include HIV, other STD, and pregnancy prevention information that is relevant to LGB youth (such as ensuring that curricula or materials use language and terminology.
• Provide trainings to school staff on how to create safe and supportive school environments for all students, regardless of sexual orientation or gender identity, and encourage staff to attend these trainings.
• Facilitate access to community-based providers who have experience providing health services, including HIV/STD testing and counseling, social, and psychological services to LGBTQ+ Youth.

What Parents Can Do

Positive parenting practices, such as having honest and open conversations, can help reduce teen health risk behaviors. How parents engage with their LGB teen can have a tremendous impact on their adolescent’s current and future mental and physical health. Supportive and accepting parents can help youth cope with the challenges of being an LGB teen. On the other hand, unsupportive parents who react negatively to learning that their daughter or son is LGB can make it harder for their teen to thrive. Parental rejection has been linked to depression, use of drugs and alcohol, and risky sexual behavior among teens.

To be supportive, parents should talk openly and supportively with their teen about any problems or concerns. It is also important for parents to watch for behaviors that might indicate their teen is a victim of bullying or violence―or that their teen may be victimizing others. If bullying, violence, or depression is suspected, parents should take immediate action, working with school personnel and other adults in the community.

Ways Parents Can Influence the Health of Their LGB Youth

More research is needed to better understand the associations between parenting and the health of LGB youth. The following are research-based steps parents can take to support the health and well-being of their LGB teen:

Talk and listen.

Parents who talk with and listen to their teen in a way that invites an open discussion about sexual orientation can help their teen feel loved and supported.  Parents should have honest conversations with their teens about sex and how to avoid risky behaviors and unsafe situations.

Provide support.

Parents who take time to come to terms with how they feel about their teen’s sexual orientation will be more able to respond calmly and use respectful language. Parents should develop common goals with their teen, including being healthy and doing well in school.

Stay involved.

Parents who make an effort to know their teen’s friends and know what their teen is doing can help their teen stay safe and feel cared about.

Be proactive.

Parents can access many organizations and online information resources to learn more about how they can support their LGB teen, other family members, and their teen’s friends.

Sexual minority youth (SMY) refers to youth who identify as lesbian, gay, or bisexual (LGB), who are not sure of their sexual identity, or who have any same sex partners. CDC’s 2017 Youth Risk Behavior Survey data show substantial health disparities that exist among an estimated 2.6 million sexual minority students, placing them at risk for negative health outcomes, including HIV infection and other sexually transmitted diseases (STDs).

Students who have sexual contact with both sexes are at higher risk than students with only same-sex sexual contact for multiple sexual risk behaviors.

Many LGBTQ youth thrive during adolescence, but, stigma, discrimination, and other factors put them at increased risk for negative health and life outcomes. CDC works with education and public health partners to address health risks and disparities among LGBTQ youth. Together, we can improve the health and lives of sexual minority youth so they achieve their social, emotional, and academic potential.

Compared to their heterosexual peers, sexual minority students are more likely to have:

Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) youth are part of every community, come from all walks of life, and are present in every racial, ethnic, socioeconomic, and geographical group. While many LGBTQ youth transition from childhood to adulthood successfully and become healthy and productive adults, others are negatively impacted as a result of many factors; for LGBTQ youth, social stigma about their sexual choices or identities can be particularly difficult. Stigma comes in many forms, such as discrimination, harassment, family disapproval, social rejection, and violence. This puts LGBTQ youth at increased risk for certain negative health outcomes. For example, young gay and bisexual males have disproportionately high rates of HIV, syphilis, and other sexually transmitted diseases (STDs); adolescent lesbian and bisexual females are more likely to have ever been pregnant than their heterosexual peers; and transgender youth are more likely to have attempted suicide than their cisgender peers.

Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) youth are more likely to experience poor health than their heterosexual (straight) or cisgender peers. Supporting the health of LGBTQ youth has usually involved trying to understand and reduce factors that increase their risk. Much less attention has been paid to protective factors—the characteristics, conditions, and behaviors that directly improve positive health outcomes or reduce the effects of stressful life events and other risk factors.

What factors are protective?

Given the limits of existing research, it is hard to say what factors promote sexual health and positive outcomes among  LGBTQ youth. However, some factors had protective effects in multiple studies.

For gay and bisexual young men, these include:

• Positive attitudes about condoms, such as thinking that condoms are pleasurable or important for healthy relationships.
• Increased peer group acceptance of safer sex, meaning that friends support condom use and other behaviors that reduce risk.

For transgender youth, these include:

• Acceptance and support from parents and peers, particularly when it comes to sexual orientation and gender identity.
• Gay-straight alliances, which are student-led clubs that provide a safe place for students to support each other around issues related to sexual orientation and gender identity.

Transgender and other gender diverse youth experience stigma and discrimination that put them at increased risk for poor mental health and suicide, substance use, experiencing violence, risky sexual behaviors, and other health risks.

Yet, adolescents are resilient. Quality sexual health education, access to health care services, and safe and supportive environments can help all youth thrive in the face of risk and are critically important for transgender and other gender diverse youth.

Understanding the experience of transgender youth will help improve school environments, parental relationships, health services, and sexual health education and help to create more supportive environments for transgender youth.

Key Findings

School Environments

• Transgender youth report feeling isolated and excluded in school environments.
• Transgender youth express resilience by actively coping with these stressors through advocating for their needs and seeking out (and finding) connection with supportive staff and friends.

Sexual Health Education

• Transgender youth consider school-based sexual health education unhelpful due to a lack of relevant information, inadequately trained teachers, and a perceived negative tone toward sexuality.
• Transgender youth rely upon alternate sources of sexual health information, particularly online, where they found relevant information and a sense of community.

Parental Relationships

• Transgender youth report receiving parental support generally in the form of housing, advice, affirmation, and expressions of love or caring.
• Transgender youth report parents struggled to provide support specific to their gender identity, such as
  • being emotionally supportive when youth came out to their parents as transgender,
  • chosen name and pronoun usage, and
  • assistance with social, legal, and medical gender affirmation processes.

Health Services

• Transgender youth report facing challenges to accessing culturally competent and gender affirming health care, such as a lack of provider knowledge of transgender issues and inconsistent use of chosen name and pronouns.

Significance for Schools, Parents, and Healthcare Providers

We all have a role in supporting transgender youth.

Schools can:

• Review and implement policies and practices to ensure inclusivity,
• Take steps to affirm gender identity,
• Intervene in bullying on campus, and
• Provide or refer students to comprehensive, affirming, sexual health services.

Parents can:

• Seek out resources and programming to assist with understanding, accepting, and gender-affirming behaviors.

Healthcare providers and office staff can:

• Take part in transgender cultural competency trainings, and
• Establish clinic protocols relating to confidentiality and chosen name and pronoun use.

Resilience and Transgender Youth Project Overview

CDC worked with and funded ICF (a research and evaluation firm) to design and implement the Resilience and Transgender Youth Project in order to better understand the lives of transgender adolescents and young adults.

Racially diverse transgender youth and parents of transgender youth participated in interviews and focus groups over a three-year time period. In these conversations, they discussed their definitions of gender and health, as well as protective factors at individual, relationship, school, and community levels.

Key Takeaways

• Adolescence is a time for young people to have a healthy start in life.
• The number of adolescents reporting poor mental health is increasing. Building strong bonds and connecting to youth can protect their mental health.
• Schools and parents can create these protective relationships with students and help them grow into healthy adulthood.

Some groups are more affected than others.

• These feelings were found to be more common among LGBQ+ students, female students, and students across racial and ethnic groups.
• Nearly half (45%) of LGBQ+ students in 2021 seriously considered attempting suicide—far more than heterosexual students.
• Black students were more likely to attempt suicide than students of other races and ethnicities.

Why Is This a Big Deal?

Poor mental health in adolescence is more than feeling blue. It can impact many areas of a teen’s life. Youth with poor mental health may struggle with school and grades, decision making, and their health.

Mental health problems in youth often go hand-in-hand with other health and behavioral risks like increased risk of drug use, experiencing violence, and higher risk sexual behaviors that can lead to HIV, STDs, and unintended pregnancy.

Because many health behaviors and habits are established in adolescence that will carry over into adult years, it is very important to help youth develop good mental health.

The Good News

The good news is that teens are resilient, and we know what works to support their mental health: feeling connected to school and family.

• Fortunately, the same prevention strategies that promote mental health—like helping students feel connected to school/family—help prevent a range of negative experiences, like drug use and violence.
• Building strong bonds and relationships with adults and friends at school, at home and in the community provides youth with a sense of connectedness.
• This feeling of connectedness is important and can protect adolescents from poor mental health, and other risks like drug use and violence.
• Youth need to know someone cares about them. Connections can be made virtually or in person.

There is a Role for Everyone in Supporting Teen Mental Health

As we’ve learned nationally during the COVID-19 pandemic, schools are critical in our communities to supporting children and families. While the expectation is that schools provide education, they also provide opportunities for youth to engage in physical activity and academic, social, mental health, and physical health services, all of which can relieve stress and help protect against negative outcomes.

However, the pandemic disrupted many school-based services, increasing the burden on parents, increasing stress on families, and potentially affecting long-term health outcomes for parents and children alike, especially among families already at risk for negative health outcomes from social and environmental factors.

Critical supports and services need to be comprehensive and community wide and should include:

What schools can do:

• Help student cope with emergencies and their aftermath
• Helping schools provide safe and supportive environments—whether in person or virtually—is critical to students’ wellbeing.
  • Linking students to mental health services.
  • Integrating social emotional learning.
  • Training staff.
  • Supporting staff mental health.
  • Reviewing discipline policies to ensure equity.
  • Building safe and supportive environments.

What parents and families can do:

• Communicate openly and honestly, including about their values.
• Supervise their adolescent to facilitate healthy decision-making.
• Spend time with their adolescent enjoying shared activities.
• Become engaged in school activities and help with homework.
• Volunteer at their adolescent’s school.
• Communicate regularly with teachers and administrators.

What healthcare providers can do:

• Ask adolescents about family relationships and school experiences as a part of routine health screenings.
• Encourage positive parenting practices.
• Engage parents in discussions about how to connect with their adolescents, communicate effectively, and monitor activities and health behaviors.
• Educate parents and youth about adolescent development and health risks.

If you are part of the LGBTQ+ community, you likely have seen tobacco ads in magazines, newspapers, and websites directed at you. Tobacco companies are focusing their advertising on your communities.

Several factors connect commercial tobacco with higher levels of disease, disability, and death in different population groups. Learn more about health disparities related to commercial tobacco use that affect LGBTQ+ people.

Smoking among lesbian, gay, and bisexual adults in the United States is much higher than among heterosexual/straight adults.

• About 1 in 6 (15.3%) of lesbian, gay, and bisexual adults smoke cigarettes, compared with about 1 in 9 (11.4%) of heterosexual/straight adults.
• Cigarette smoking is also higher among transgender adults (35.5%), than among adults whose gender identity corresponds with their birth sex (cisgender).

Smoking increases your risk for lung cancer, heart disease, chronic bronchitis, and other smoking-related diseases.

People who identify as lesbian, gay, bisexual, transgender, or questioning (LGBTQ) often face social stigma, discrimination, and other challenges not encountered by people who identify as heterosexual. They also face a greater risk of harassment and violence. As a result of these and other stressors, sexual minorities are at increased risk for various behavioral health issues.

People who identify as lesbian, gay, bisexual, transgender, or questioning (LGBTQ) often face social stigma, discrimination, and other challenges not encountered by people who identify as heterosexual. They also face a greater risk of harassment and violence. As a result of these and other stressors, sexual minorities are at increased risk for various behavioral health issues.

Many federally funded surveys have only recently started to ask about sexual orientation and gender identification in their data collections. Surveys thus far have found that sexual minorities have higher rates of substance misuse and substance use disorders (SUDs) than people who identify as heterosexual. Therefore, it is not yet possible to establish long-term trends about substance use and SUD prevalence in LGBTQ populations. 

Substance Use and Misuse

Data from the 2020 National Survey on Drug Use and Health (NSDUH) suggest that substance use patterns reported by sexual minority adults differ from those reported by heterosexual adults. (In this survey, sexual minority adults include individuals who describe themselves as lesbian, gay, or bisexual.) In 2020, approximately 41.3% of sexual minority adults 18 and older reported past-year marijuana use, compared to 18.7% of the overall adult population (2020 DT 1.3B). Approximately 6.7% of sexual minority adults in 2020 misused opioids (prescription opioids or heroin use) in the past year, compared to 3.6% of the overall adult population (2020 DT 1.19B).

The NSDUH survey also found that, in 2020, approximately 21.8% of sexual minority adults had an alcohol use disorder in the past year, compared to 11.0% in the overall population.

Vaping and Tobacco Products

A recent review on the use of tobacco products by LGBT individuals show elevated rates of smoking and ever e-cigarette use compared to their heterosexual counterparts. Among LGB adults, bisexual women report greater use of ever trying e-cigarettes compared to heterosexual women and greater dual use of tobacco cigarettes and e-cigarettes compared to both lesbian and heterosexual women. Bisexual men were more likely to report ever or current e-cigarette use, compared to heterosexual men. Taken together, these findings suggest that targeted health messages may be needed.

Substance Use Disorders and Comorbidities

LGBTQ individuals often enter treatment with more severe SUDs. Some common SUD treatment modalities have been shown to be effective for gay or bisexual men, including motivational interviewing, social support therapy, contingency management, and cognitive-behavioral therapy (CBT).

Addiction treatment programs offering specialized groups for gay and bisexual men showed better outcomes for those clients compared to gay and bisexual men in non-specialized programs; but in one study, only 7.4 percent of programs offered specialized services for LGBT patients. Research is currently limited on rates of SUD among transgender populations, although research shows that transgender individuals are more likely to seek SUD treatment than the non-transgender population. Current research suggests that treatment should address unique factors in these patients' lives that may include homophobia/transphobia, family problems, violence, and social isolation.

Sexual minorities with SUDs are more likely to have additional (comorbid or co-occurring) psychiatric disorders. For example, gay and bisexual men and lesbian and bisexual women report greater odds of frequent mental distress and depression than their heterosexual counterparts. Transgender children and adolescents have higher levels of depression, suicidality, self-harm, and eating disorders than their non-transgender counterparts. Thus, it is particularly important that LGBT people in SUD treatment be screened for other psychiatric problems (as well as vice versa), and all identifiable conditions should be treated concurrently.

LGBTQ people are also at increased risks for human immunodeficiency virus (HIV) due to both intravenous drug use and risky sexual behaviors. HIV infection is particularly prevalent among gay and bisexual men (men who have sex with men, or MSM) and transgender women who have sex with men.15 SUD treatment can also help prevent HIV transmission among those at high risk. For example, addiction treatment is associated not only with reduced drug use but also with less risky sexual behavior among MSM, and those with HIV report improvements in viral load.

LGBT youth are typically well adjusted and mentally healthy. However, they experience higher rates of mental health challenges and increased health complications arising from these challenges compared to their heterosexual peers. Research on transgender youth outcomes as separate from lesbian, gay, and bisexual youth outcomes is more limited, though growing. Some recent nonrandom surveys of self-identified transgender people indicate that up to one-third reported attempting suicide at least once, with higher rates for youth and young adults than for older adults. Moreover, suicide is the third leading cause of death among youth ages 15 to 24, and LGBT youth are more likely to attempt suicide than their peers. This does not mean, however, that LGBT identity itself is the cause of these challenges. Rather, these higher rates may be due to bias, discrimination, family rejection, and other stressors associated with how they are treated because of their sexual identity or gender identity/expression. These challenges, which researchers refer to as “microaggresions,” can contribute to anxiety, depression, and other mental health challenges, as well as to suicide and self-harming behavior.

Research has found that lesbian, gay, and bisexual youth have much higher levels of suicidal ideation than their heterosexual peers. Also, recent population-based studies suggest that the reported rates of suicide attempts for high school students who identify as LGBTQ+ are two to seven times higher than rates among high school students who describe themselves as heterosexual. LGBTQ+ youth are also twice as likely to have thoughts about suicide. 

The Trevor Project’s 2021 National Survey on LGBTQ Youth Mental Health surveyed nearly 35,000 LGBTQ youth ages 13-24 and found several revealing insights on the state of LGBTQ+ youth mental health in the U.S.:

• 42 percent of LGBTQ youth seriously considered attempting suicide in the past year, including more than half of transgender and nonbinary youth.
• 31 percent of Native/Indigenous youth attempted suicide, 21 percent of Black youth did so, 21 percent of multiracial youth, 18 percent of Latinx youth, 12 percent of Asian/Pacific Islander youth, and 12 percent of white youth.
• More than 80 percent of LGBTQ youth stated that COVID-19 made their living situation more stressful.
• 70 percent of LGBTQ youth stated that their mental health was "poor" most of the time or always during the COVID-19 pandemic.
• Nearly half of LGBTQ youth reported they wanted counseling from a mental health professional, but were unable to receive it in the past year.

There were also findings that support the importance of welcoming and safe environments, resources, and services for LGBTQ+ youth and their mental health:

• Transgender and nonbinary youth who were able to change their name and/or gender marker on legal documents, such as driver’s licenses and birth certificates, reported lower rates of attempting suicide.
• LGBTQ youth who had access to spaces that affirmed their sexual orientation and gender identity reported lower rates of attempting suicide.
• Transgender and nonbinary youth who reported having pronouns respected by all the people they lived with attempted suicide at half the rate of those who did not have their pronouns respected by anyone with whom they lived.

Strategies to improve mental health and prevent self-harming behavior and suicide include:

• providing safe and supportive environments, particularly through affirming relationships with family and peers
• enacting legislation to protect the safety of LGBTQ+ youth
• re-evaluating institutional practices that undermine positive youth development
• building community awareness and capacity to understand and address stressors that LGBT youth may experience

Substance Use

LGB youth may be more likely to use substances to cope with bias and stress and may be more likely to experience increased rates of depression and anxiety than their non-LGB peers. Challenges such as family rejection of, or anticipated reaction to, one’s LGBT identity are also associated with substance use. National prevalence data show that high school students in the U.S. who identify as LGB engage in substance use at significantly higher rates than their heterosexual peers.

Through national surveys, LGB high school students and young adults recently reported two to three times greater rates of ever using hard drugs (e.g., cocaine, ecstasy, methamphetamine, heroin), compared to their heterosexual peers.

Transgender youth have a high risk for developing substance dependency issues. Transgender individuals have higher rates of usage for some drugs and may have higher rates of methamphetamine, injectable drugs, and tobacco usage.

Reducing the rates of bias, discrimination, and victimization that LGBTQ+ youth experience can help reduce substance use. A related strategy includes creating safe spaces for LGBTQ+ youth in drug-free environments, such as community centers. Also, accepting/positive family behaviors toward LGBTQ+ youth during adolescence can protect against not only suicide and depression but also substance use.

Although many youth experience a smooth transition into adulthood and the workforce, some encounter challenges in finding or maintaining employment. Because LGBTQ+ youth may experience less supportive school environments than their non-LGBT peers, they may struggle in school and, in turn, have higher school dropout rates or have lower aspirations for postsecondary education than other populations of youth These potentially negative school experiences can affect the postsecondary outcomes of LGBTQ+ youth as they transition into employment or postsecondary education. Also, LGBTQ+ youth may have difficulty finding, and need support identifying, jobs and higher education opportunities that are affirming and safe.

Colleges and Universities

In looking for postsecondary educational opportunities, LGBT youth may want to consider a college’s or university’s climate relative to the experiences of LGBTQ+ students. The Campus Pride Index is a resource for youth to find higher-education learning environments that are welcoming to LGBTQ+ youth. The index assesses eight factors:

1. LGBTQ+ Policy Inclusion
2. LGBTQ+ Support and Institutional Commitment
3. LGBTQ+ Academic Life
4. LGBTQ+ Student Life
5. LGBTQ+ Housing
6. LGBTQ+ Campus Safety
7. LGBTQ+ Counseling and Health
8. LGBTQ+ Recruitment and Retention Efforts

As of July 2021, the index has data for 435 campuses. Also, the Consortium of Higher Education LGBT Resource Professionals maintains a directory of colleges and universities that have an office dedicated to LGBTQ topics.

Employment

LGBTQ+ employees experience harassment and discrimination at greater levels than their non-LGBTQ+ colleagues. One survey found that 44 percent of LGBTQ adults experienced some form of discrimination on the job because of their sexual orientation. In June of 2020 the U.S. Supreme Court ruled that the 1964 Civil Rights Act protects gay, lesbian, and transgender employees from discrimination based on sex.

Employers can benefit from policies and programs (including state laws) that support LGBTQ+ employees. Protections for LGBTQ+ employees have been found to attract other diverse applicants and fair-minded job seekers. For example, one survey showed that more than 80 percent of respondents, including those who identified as members of LGBTQ+ community and those who identified as allies, were more likely to buy goods and services from a company that outwardly supports the LGBTQ+ community. 72 percent of respondents in the same study reported being more likely to accept a job at a company that outwardly supports LGBTQ+ employees than one that did not or one that took no public stance. Outward support for and inclusion of the LGBTQ+ community within an organization may look like:

• Following inclusivity guidelines created by the United Nations’ Human Rights Commission (UNHCR) standards of corporate conduct;
• Writing explicit organization-wide policies related to LGBTQ+ matters such as guidelines to advise managers as they navigate supporting employees who are undergoing a gender transition;
• Providing inclusive benefits that cover both same-sex and different-sex partners, transgender-inclusive health plans, and/or additional specialized benefits for LGBTQ+ employees to accommodate undue burden and discrimination experienced elsewhere.

When seeking employment, LGBTQ+ youth may likewise consider the policies and practices of an organization, an agency, or a company before pursuing employment there. The Human Rights Campaign’s Corporate Equality Index provides information on LGBTQ equality at U.S. businesses, which can provide guidance as LGBTQ youth transition into the workforce.