3 ways to improve behavioral healthcare for LGBTQIA+ students

In the past year, 34% of LGBTQIA+ youth ages 18-24 have seriously considered suicide — and 9% have made a suicide attempt.1

This is a tragic reality.

Furthermore, the rate of serious suicide contemplation in the LGBTQIA+ population is nearly 10% higher than the rate among the overall population of adults aged 18-24 (25.5%).1,2

In addition, 64% of LGBTQIA+ youth aged 18-24 report feeling anxiety symptoms, and 50% report feeling depression symptoms, highlighting the need for quality behavioral healthcare to help these individuals.1

Many LGBTQIA+ students desire behavioral health support. In fact, 81% of LGBTQIA+ young people report wanting mental healthcare, but 56% of those who wanted care were unable to get it.1 In addition, 72% of LGBTQIA+ teens and young adults reported wanting professional counseling, while only 32% received it.3

These are staggering statistics that open our eyes to the importance of supporting the health and happiness of the LGBTQIA+ student population.

As a health insurer focused specifically on students, Wellfleet Student works hard to serve the unique needs of the student population, including providing quality care for LGBTQIA+ students.

In this blog, we’ll walk you through three ways to support LGBTQIA+ students – specifically focusing on behavioral healthcare.

1. Provide access to professionals who make LGBTQIA+ students feel comfortable

According to research, LGBTQIA+ young people who wanted mental healthcare but didn’t receive it lacked access for several reasons. The top reason was that they were afraid to talk about their mental health concerns with others.1 Additionally, many students felt that a provider wouldn’t understand their sexual orientation or gender identity.1 

There is a certain level of uncertainty that can burden those with mental health challenges, especially those in the LGBTQIA+ community. Therefore, LGBTQIA+ students need to feel safe and accepted, or they may not seek help.

Acceptance and kindness should be apparent across all behavioral healthcare options you provide your students, from the campus counseling center to off-campus community providers to telehealth providers.

The professionals responsible for your students should undergo a thorough screening process to ensure a welcoming and safe environment where LGBTQIA+ students can freely express their concerns and struggles.

When considering what types of behavioral healthcare services your LGBTQIA+ students should have access to, there are several types to consider:

Campus counseling center

Many campuses provide a student health center as well as a counseling center on campus. An on-campus counseling center can be a fantastic way to help LGBTQIA+ students who are struggling with behavioral health concerns. Having someone trustworthy to talk to on campus can make getting care easier and more convenient for busy students.

Action item: Ensure your counseling center staff are educated on how to support LGBTQIA+ students effectively. Stress the importance of using pronouns and names, and make sure counselors are respectful and caring toward LGBTQIA+ students who seek help. 

24/7 emergency hotline service

Another important behavioral health option for LGBTQIA+ students is access to a 24/7 mental health hotline like CareConnect by Wellfleet. Because these students have higher rates of suicidal thoughts than the general student population,1,2 having 24/7 help is even more essential for them. If one of your students is in crisis, they need immediate access to professional help.  

Action item: Provide hotline services if your campus doesn’t already. Post the hotline number widely across campus and provide information to each student. Encourage students to save the number in their phones so they have easy access if needed.

Telehealth resources

While some students prefer in-person care, others opt for telehealth care. College students see telehealth mental healthcare as convenient, accessible, easy, and helpful.4 Providing this option for all students – and specifically for LGBTQIA+ students – can lower the barrier to care, making it easier for them to get help for anxiety, depression, and other mental health conditions.

Action item: Consider adding telehealth options, such as:

Off-campus behavioral health services

Off-campus behavioral health services can also be a key component for some LGBTQIA+ students. Counseling centers sometimes refer students to specialists, so it’s important that your students’ health insurance plan offers in-network coverage for a wide variety of off-campus providers.

Action item: Review your student health insurance plan details to ensure your students can access a variety of local behavioral health providers. Specifically, focus on adding providers who are experienced in LGBTQIA+ care.

Out-of-state behavioral health coverage

The final consideration when looking to bolster your behavioral health offerings for the LGBTQIA+ student population is out-of-state coverage. When students travel during breaks or go home for the summer, it’s important that they can still access quality care.

Action item: Look at your plan’s network and see if students can access behavioral healthcare specialists nationwide.

2. Enhance coverage for gender-affirming care services

Another important way to support the mental health and wellness of LGBTQIA+ students on campus is to provide gender-affirming care services nearby. Offering coverage for services like hormone therapy, medical visits, and gender-affirming procedures can help students thrive in their identity.

Research in LGBTQIA+ youths has shown that gender-affirming medical care is associated with reduced odds of depression and suicide over 12 months.5

Therefore, access to qualified, experienced healthcare providers who can offer the right gender-affirming care for each student can help these students feel happier and healthier.

Common gender-affirming services may include:

  • Medical care and preventative care services
  • Prescription medications, such as hormonal therapy
  • Behavioral healthcare
  • Surgical treatments, when applicable, such as tracheal shave, top surgery, and bottom surgery

Action item: Review your student health insurance plan coverages for gender-affirming care, and ensure the coverages align with what your institution desires to cover for your students. Consider talking with your SHIP carrier about adding more coverage or qualified providers to your network.

3. Bolster your student formulary for the LGBTQIA+ population

The third important aspect of behavioral healthcare support for LGBTQIA+ students is ensuring your student health insurance plan includes prescription coverage relevant to this population.

The two main areas of prescription medications you want to pay attention to are hormonal therapies, behavioral health medications, and STI prevention medications like HIV PrEP.

Hormone therapy

Research has shown that hormone therapy can improve the physical and psychological health of transgender and nonbinary individuals.6 Taking hormone therapy has also been associated with a lowered risk for anxiety and depression in this population.6

Action item: Review your current pharmacy plan to see whether hormone therapy is covered when appropriate. Adjust your pharmacy plan as needed to improve accessibility and lower costs.

Behavioral health medications

In addition to hormone therapy, it’s also important to remember that LGBTQIA+ students may also deal with behavioral health struggles. Therefore, they can benefit from the right medications to help treat symptoms of depression, anxiety, and other behavioral health conditions.

Action item: Review your current pharmacy plan to see whether various behavioral health medications are included at a low cost. Be sure your plan covers treatments for anxiety, depression, and other common mental health conditions.


Preventing sexually transmitted infections is important for students, including those in the LGBTQIA+ population. One notable example is providing coverage for pre-exposure prophylaxis (PrEP), which is a medication taken to prevent HIV infection.7 When taken properly, PrEP reduces the risk of sexually-transmitted HIV by 99%.7

Action item: Ensure your student formulary provides coverage for PrEP.

Learn more about Wellfleet

Now that you know how to help support the mental health of your LGBTQIA+ students, remember that there is always more that can be done. Survey your students about their mental health and ask if there are additional resources LGBTQIA+ students would find beneficial.

As a student health insurance carrier focused on delivering the best care for students, we are hyper-aware of what’s most important to the student population. We strive to provide inclusive care for all — while improving access to quality care at an affordable cost.

Connect with us to learn how Wellfleet can create an inclusive health insurance solution tailored to your students and campus.


1 The Trevor Project. (2023). 2023 U.S. National Survey on the Mental Health of LGBTQ Young People.

2 The Jed Foundation. (2022, February 18). Mental Health and Suicide Statistics.,Suicide%20Rates,group%20(CDC%2C%202020).

3 The Jed Foundation. (2021, October). Proud and Thriving Report and Framework: Supporting the Mental Health of LGBTQ+ High School, College and University Students.

4 Hadler, N, et al. (2021, January 6). College Student Perspectives of Telemental Health: a Review of the Recent Literature. Curr Psychiatry Rep.

5 Tordoff, D, et al. (2022, February 1). Mental Health Outcomes in Transgender and Nonbinary Youths Receiving Gender-Affirming Care. JAMA Netw Open.

6Moustakli, E, and Tsonis, O. (2023, Nov 29). Exploring Hormone Therapy Effects on Reproduction and Health in Transgender Individuals. Medicina.

7 CDC. (2022, 5 July). Pre-Exposure Prophylaxis (PrEP).


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