How NC LGBTQ+ organizations are adjusting after Trump eliminates mental health hotline option

NC LGBTQ+ organizations adjust after the Trump administration eliminated the 988 hotline option for specialized mental health services.

by Lola Oliverio, North Carolina Health News
July 17, 2025

[CONTENT WARNING: This article references suicide. Please take caution when reading. If you need mental health support, please consult this page for resources.]

LGBTQ+ youth no longer have a specially tailored option for help at the 988 National Suicide and Crisis Lifeline.

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The Trump administration announced a month ago that beginning July 17, it would eliminate the “Press 3 option” on the free, 24/7 national hotline. The specialized service had been active for about three years.

With little explanation, the statement from the Substance Abuse and Mental Health Services Administration said it “will no longer silo LGB+ youth services,” notably leaving off the T and Q in the acronym, which stand for transgender and queer.

The statement added that $29.7 million had been allocated for the project in the federal budget for the fiscal year that began Oct. 1, 2023, and another $33 million for the next fiscal year. As of June 2025, three months before the end of the federal fiscal year, the administration contends that all of the money allocated for the “subnetwork services” has been exhausted, according to the statement.

That decision gave states and other support systems little time to plan for how to meet some of the unique needs and issues that LGBTQ+ youth encounter.

The Trevor Project, a suicide prevention and crisis intervention nonprofit for LGBTQ+ youth that had been helping provide the call service as part of a federal contract, will still offer its crisis services and 24/7 hotline.

Additionally, North Carolina has worked to train call takers and counselors within the state to fill the gaps.

“Our goal is to meet the needs of any North Carolinian, and certainly those who identify as LGBTQIA+,” Kelly Crosbie, director of the state’s Department of Health and Human Services Division of Mental Health, Developmental Disabilities, and Substance Use Services, told NC Health News during a recent interview. “We’re losing that specialized national line, but we will make sure that our 988 here is well-trained and ready.”

By the numbers

The 988 Suicide and Crisis Lifeline is a toll-free nationwide suicide prevention helpline that went live as an easy-to-remember three-digit number in July 2022. During the first year, North Carolina saw a 31 percent increase in calls, according to a state Department of Health and Human Services report. Text and chat options were added in July 2023.

From that first full month of service in August 2022 through this May, the state averaged more than 9,400 calls, texts or chats each month. More people contacted the crisis line over time, pushing the average monthly contacts even higher in recent years. In the past year alone, there were about 11,443 calls, chats and texts per month, according to the DHHS data dashboard.

The 988 line is a crucial component of providing care in what state and national health officials have called a growing mental health crisis among youth and young adults in this country. Many factors have contributed — the COVID-19 pandemic and its aftermath, social media, financial pressures and more.

The National Alliance on Mental Illness, or NAMI, notes that LGBTQ+ youth are more than twice as likely to report “experiencing persistent feelings of sadness or hopelessness than their heterosexual peers.”

“Transgender youth face further disparities as they are twice as likely to experience depressive symptoms, seriously consider suicide, and attempt suicide compared to cisgender lesbian, gay, bisexual, queer and questioning youth,” the NAMI report adds.

Sarah Mikhail, CEO of Time Out Youth, a Charlotte-based nonprofit dedicated to providing support, connection and housing for LGBTQ+ youth, told NC Health News in a recent interview when the news broke that the “Press 3 option” was being discontinued, she and others in her organization “felt really scared.”

They give out the hotline numbers to the youth that the organization serves “for safety planning,” meaning that if they need support at a time when no one at Time Out Youth can be reached, other help is available.

“While [LGBTQ+ youth] can still call 988, they won’t get a specialized person who understands the unique needs of a young, queer or trans person that’s in need of support when they’re contemplating whether they want to live or not,” Mikhail said. “And so that’s what’s really scary to us, is not caring about the need for specialized understanding of the lived experience of queer and trans young people.”

In the political crosshairs

The Trevor Project was the sole provider of LGBTQ+ support during the pilot stage of the “Press 3 option” and later served around 50 percent of individuals who called into the line. They also trained other crisis counselors and staffers.

Since its inception in 2022, the LGBTQ+ youth crisis line has routed more than 1 million calls, the organization reports. In October 2022, the dedicated line received around 24,500 calls, according to The Associated Press. The call rate has swelled since the launch; it received 69,000 calls in April 2025. On Nov. 6, 2024, after the U.S. presidential election, The Trevor Project saw an increase in contact volume of nearly 700 percent.

“Suicide prevention is about people, not politics,” Jaymes Black, CEO of The Trevor Project, said in a statement on the organization’s website. “The administration’s decision to remove a bipartisan, evidence-based service that has effectively supported a high-risk group of young people through their darkest moments is incomprehensible.”

This funding cut was just one of a flurry of executive-level decisions directed at LGBTQ+ youth and young adults during President Donald Trump’s second term. Trump has signed a wave of executive orders seeking to limit the rights of transgender Americans, including banning transgender athletes from women’s sports, restricting transgender people from serving in the military, prohibiting the recognition of gender identity in schools and directing federal agencies to withhold funding from hospitals that provide gender-affirming care to people younger than 19.

The actions, some of which have been challenged in the courts, sparked anxiety across North Carolina’s transgender and nonbinary communities, parents and advocates of LGBTQ+ youth have told NC Health News.

North Carolina’s Republican-led General Assembly also has adopted legislation in recent years targeting the LGBTQ+ population — perhaps the most highly publicized of which was HB2, or the 2016 so-called “bathroom bill” that limited people to only using public restroom facilities affiliated with the gender on their birth certificates. Though a huge public outcry and negative response from businesses across the country led to the repeal of that law, much political rhetoric, legislative action and cyberbullying have been directed at the LGBTQ+ population.

Two years ago, state lawmakers passed legislation that established more restrictions for transgender youth participating in school sports, while also initiating other requirements for teachers and counselors who encounter students exploring their gender identity in their presence. Lawmakers also prohibited health care and mental health care professionals from providing gender-affirming care to minors, including puberty-blocking drugs, cross-sex hormones and surgeries.

Legislation has been passed this session to recognize only two sexes; the bill was vetoed by Gov. Josh Stein. Lawmakers passed a different bill that would prevent abuse or neglect allegations from being based on a parent not accepting a child’s gender identity, which Stein did sign. 

“We know that LGBTQ youth have been facing so many obstacles,” Holly Savoy, executive director of Charlotte Trans Health, told NC Health News. “I mean, folks of all ages are, but our youth especially with all the attacks.”

Vulnerable population

LGBTQ+ youth historically experience higher rates of suicidality, primarily because of stigmatization and fear of rejection from family and peers, according to The Trevor Project.

In 2023, 41 percent of LGBTQ+ youth in North Carolina considered suicide, and 12 percent attempted it, according to a 2024 report by The Trevor Project. Nationwide, almost half of the LGBTQ+ youth who wanted mental health support were not able to get it, according to the report.

Additionally, 90 percent of the LGBTQ+ youth surveyed in 2024 told The Trevor Project that recent politics had a negative impact on their well-being, which was reflected in an influx of calls to crisis hotlines by transgender youth after Trump’s election.

“I’ve had to sit with youth and even adults and adolescents who are so fearful of something as devastating as their parents wanting to kick them out and simply not even having a place, especially if you look at, perhaps in North Carolina, more rural communities where they already don’t have access to go into an office… and all they have is a crisis line,” Christine Pontes, a licensed clinical social worker in Raleigh who serves LGBTQ+ clients, told NC Health News in an interview. “And now they don’t have that.”

Amy Brundle, director of marketing and communications with NAMI North Carolina, wants to make it clear that the LGBTQ+ population can still get care from the national hotline even if the “Press 3 option” has been eliminated.

“This is an extremely disappointing turn of events, because one thing that you know NAMI really tries to spread is information about the importance of culturally responsive care of people being able to identify themselves in the care services that they see around them,” Brundle told NC Health News. “This is a loss of a source of specialized community-responsive care for an underserved group of people who are all already too often more vulnerable to these conditions. And so, you know, basically we just kind of made a hard thing harder.”

Brundle is optimistic about the proactive steps that North Carolina public health officials took to prepare for the change in service options.

“This is a good example of North Carolinians still knowing what the mission is and finding ways around policies that we consider detrimental to our work,” Brundle said.

Nonetheless, Mikhail at Time Out Youth and others worry about the immediate message the loss of the LGBTQ+ tailored option sends to a vulnerable population.

“The message here — that has an extreme impact on mental health — is that if you want to die, our government doesn’t care,” Mikhail said.

Crosbie, who oversees the state’s mental health services, hopes LGBTQ+ youth will not be thrown into alarm or crisis because of the service change. “We just want them to know we are here,” Crosbie said. “988 is here, that will not change. They’re very important, and they matter.”

“We don’t feel good that it was eliminated,” Crosbie added. “We want people to know we’re prepared and that they matter.”

This article first appeared on North Carolina Health News and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.