This article has been updated.

Throughout the last year, Jacqueline Gomez harbored doubts that she or her loved ones would make it out of 2020 alive.

An 18-year-old high school senior living in Nebraska, Gomez’s daily routine was turned upside down by the pandemic. She found herself particularly distraught by the news.

“It seemed every month, the world was burning,” Gomez said. “You thought it couldn’t get worse, but then the next month came and then something worse happened.”

The daughter of a meatpacker, Gomez worried for her family’s safety when covid outbreaks were reported in meatpacking plants. As a Mexican American who is genderfluid and bisexual, she was also troubled by relentless reports of police brutality and racial trauma; the election, too, reminded her that to some, she was just a rallying point on a political campaign.

“You weren’t somebody, you were just a promise — something to get rid off,” she said.

Her mental health suffered greatly, Gomez said, and there were times when she wasn’t sure she’d “make it.” When talking about these experiences, her voice lowers, especially when she recalls friends who also experienced depression. Unlike her, she said, some of them are no longer here.

A survey released earlier this month from the Trevor Project, a nonprofit that supports LGBTQ youth experiencing mental health crises, found the last year was devastating for young people like Gomez.

The LGBTQ Youth Mental Health Survey, which has been released annually since 2019, found that 42 percent of respondents seriously considered attempting suicide in the last year.

Although the Trevor Project survey was based on nearly 35,000 online interviews, results may not be representative of LGBTQ youth more broadly because the sample was not recruited using random sampling nor weighted to population estimates. The survey’s report noted that a recent Centers for Disease Control and Prevention survey found a similar rate of lesbian, gay and bisexual youth had considered committing suicide.

The pandemic brought a long-simmering mental health crisis among young people to a boil last year. According to the CDC, 2020 saw a growing share of children visiting emergency rooms because of mental health issues. Between March and October, the number of kids seeking emergency mental health treatment jumped 31 percent among kids 12 to 17 years old, compared with the same period in 2019.

Teachers and mental health professionals say this crisis has largely been fueled by feelings of isolation and hopelessness, as schools shut down and access to friends, mentors and group activities were severed because of lockdown protocols.

But these dynamics were even more pronounced for many LBGTQ youth, according to Amit Paley, chief executive of the Trevor Project.

“The past year has been incredibly difficult for so many LGBTQ young people because of multiple crises, from the COVID-19 pandemic to the hostile political climate and repeated acts of racist and transphobic violence,” Paley said in a statement. “This data makes clear that LGBTQ youth face unique mental health challenges and continue to experience disparities in access to affirming care, family rejection, and discrimination.”

Jack Drescher, a New York-based psychoanalyst and professor at New York University who has been working with LGBTQ patients since the 1980s, says young LGBTQ people are uniquely vulnerable if they do not live with a supportive family. He was struck by a comparison one of his patients had made: Unlike other minority groups, who learn to navigate the world and its prejudices from their parents, many LGBTQ kids are “born into the enemy camp,” living among family members with whom they do not share gender or sexual identities, and who may hold homophobic and transphobic beliefs. He pointed to elevated rates of homelessness among LGBTQ youth as a key indicator of this marginalization.

The recent survey’s findings also suggest current events amplified feelings of isolation and vulnerability: 94 percent of LGBTQ youth said recent politics had hurt their mental health; 70 percent noted that their mental health was “poor” most of the time or always during the pandemic.

Members of marginalized groups, Drescher noted, pay close attention to the news as a way of “taking the temperature of the world that you live in.” Throughout the pandemic, he’s had older patients come in and cite headlines as sources of stress.

Chase Anderson, a child and adolescent psychiatry fellow at the University of California at San Francisco, works with kids who have depression, anxiety and other psychiatric illnesses.

He’s noticed that many children and young adults pay avid attention to the news, even if it’s traumatic, such as the recent spike in bills targeting trans youth in state legislatures.

“They are made to feel as though they actually have to stay on top of everything just to make sure that they can get through the day,” he said. “A lot of them are also wondering … can I be safe in this America that has actually normalized hatred against LGBTQ+ people?”

As Anderson put it: “Kids are having to grow up very quickly, and that doesn’t give them space to actually be kids.”

This is even more pronounced for children and young adults of color, he said.

Anderson said that these groups often experience marginalization within the broader LGBTQ community. They were also dealing with an influx of racial trauma over the last year — whether it was watching viral videos of police brutality and anti-Asian attacks, or seeing news of trans people being killed, most of whom were women of color.

Micah, who is being identified by only their first name to protect their privacy, found themselves more isolated over the last year.

A 19-year-old Black, nonbinary college student, Micah says they’re naturally socially awkward, but that feeling of marginalization has been more prominent. They recalled a visit to their hometown to recognize the death of their great uncle.

“It was a good time to reconnect with everyone, but in the end, I still felt distant,” they said. “I am not really out to most of my family, so it’s that feeling of having to be a certain version of yourself for the sake of others.”

When Micah started their freshman year of college last year, they carried a different sense of unease. Attending a school made up of mostly White students made Micah wary of whom they could trust.

“The way I was raised, you kind of have to guard yourself until White people can prove to you that they are a safe person,” Micah said.

The Trevor Project survey noted several ways to support LGBTQ youth experiencing mental health crises: having access to safe spaces, for example, and having pronouns respected by people they live with.

Anderson emphasized data showing that just one accepting adult can make a difference to a young LGBTQ person who feels isolated in their identity.

Micah says they found support in small ways — by playing games, like chess, with one or two people on their iPhone. They like that it doesn’t require much energy.

“It’s like a little way to feel their presence. It’s not even really having a conversation,” they said.

Deborah Levine directs LGBT Youth Link, a network of youth centers and programs under the umbrella organization CenterLink. One of their programs is Q Chat, which provides moderated, anonymous online discussions for LGBTQ teens.

Levine saw participation in the chat forums spike threefold at the beginning of the pandemic, and engagement has remained high in the months since. She sees less discussion about the news and more “escapism”: chats about TV, food or pets, for example.

“They’re using it as an escape to just be themselves, [to] have fun because they don’t have an access to that anywhere else,” Levine said.

Drescher said he encourages his patients to turn away from the news if they’re feeling overwhelmed, though he added that positive current events also have a profound impact on young people. When the Supreme Court legalized same-sex marriage in 2015, researchers found a link between the landmark decision and decreased suicide rates among LGBTQ youth, even if they weren’t directly affected by the ruling.

Ultimately, it’s important for any patient to focus on the things they can control, Drescher said.

Gomez, the high school senior, appreciated hearing from politicians who support the rights of LGBTQ youth and people of color. She also found herself moved by the cross-racial solidarity of the Black Lives Matter protests, a movement that young people helped galvanize. They were important reminders of the power she and other young people have, she said.

“It made us, and made a lot of people, feel like they were alive once more.”