On July 17, the option shut down for LGBTQ+ youth to access specialized mental health support from the national 988 Suicide & Crisis Lifeline.
The Substance Abuse and Mental Health Services Administration said a month earlier that it would no longer “silo” services and would instead “focus on serving all help seekers.” That meant the elimination of the “Press 3” option, the dedicated line answered by staff specifically trained to handle LGBTQ+ youth facing mental health issues ranging from anxiety to thoughts of suicide.
Now, states such as California, Colorado, Illinois, and Nevada are scrambling to backfill LGBTQ+ crisis support through training, fees, and other initiatives in response to what advocates say is the Trump administration’s hostile stance toward this group. In his first day back in the White House, President Donald Trump issued an executive order recognizing only two sexes, male and female, and while campaigning, he condemned gender ideology as “toxic poison.” And the administration omitted “T” for transgender and “Q” for queer or questioning in announcing the elimination of the 988 Press 3 option.
“Since the election, we’ve seen a clear increase in young people feeling devalued, erased, uncertain about their future, and seeing resources taken away,” said Becca Nordeen, senior vice president of crisis intervention at The Trevor Project, a national suicide prevention and crisis intervention nonprofit for LGBTQ+ youth.
Nordeen and other advocates for at-risk kids who helped staff the dedicated line said it has never been more critical for what The Trevor Project estimates are 5.2 million LGBTQ+ people ages 13-24 across the U.S. About 39% of LGBTQ+ young people seriously consider attempting suicide each year, including roughly half of transgender and nonbinary young people, according to a 2023 survey, reflecting a disproportionately high rate of risk.
The use of the dedicated line for LGBTQ+ youth had steadily increased, according to data from the federal substance abuse agency, with nearly 1.6 million calls, texts, or online chats since its rollout in October 2022, out of approximately 16.7 million contacts to the general line. The Press 3 option reached record monthly highs in May and June. In 2024, contacts to the line peaked in November, the month of the election.
Call-takers on the general 988 line do not necessarily have the specialized training that the staff on the Press 3 line had, causing fear among LGBTQ+ advocates that they don’t have the right context or language to support youth experiencing crises related to sexuality and gender.
“If a counselor doesn’t know what the concept of coming out is, or being outed, or the increased likelihood of family rejection and how those bring stressors and anxiety, it can inadvertently prevent the trust from being immediately built,” said Mark Henson, The Trevor Project’s interim vice president of advocacy and government affairs, adding that creating that trust at the beginning of calls was a critical “bridge for a youth in crisis to go forward.”
The White House’s Office of Management and Budget did not immediately respond to questions about why the Press 3 option was shut down, but spokesperson Rachel Cauley told NBC News that the department’s budget would not “grant taxpayer money to a chat service where children are encouraged to embrace radical gender ideology by ‘counselors’ without consent or knowledge of their parents.”
Emily Hilliard, a spokesperson for the Department of Health and Human Services, said in a statement: “Continued funding of the Press 3 option threatened to put the entire 988 Suicide & Crisis Lifeline in danger of massive reductions in service.”
When someone calls 988, they are routed to a local crisis center if they are calling from a cellphone carrier that uses “georouting” — a process that routes calls based on approximate areas — unless they select one of the specialized services offered through the national network. While the Press 3 option is officially no longer part of that menu of options, which includes Spanish-language and veterans’ services, states can step in to increase training for their local crisis centers or establish their own options for specialized services.
California is among the states attempting to fill the new service gap, with Democratic Gov. Gavin Newsom’s office announcing a partnership with The Trevor Project to provide training on LGBTQ+ youth issues for the crisis counselors in the state who answer calls to the general 988 crisis line. The state signed a $700,000 contract with the organization for the training program.
The Trevor Project’s Henson said the details still need to be figured out, including evaluating the training needs of California’s current 988 counselors. The partnership comes as the organization’s own 24/7 crisis line for LGBTQ+ youth faces a crisis of its own: The Trevor Project was one of several providers paid by the federal government to staff the Press 3 option, and the elimination of the service cut the organization’s capacity significantly, according to Henson.
Gordon Coombes, director of Colorado’s 988 hotline, said staff there are increasing outreach to let the public know that the general 988 service hasn’t gone away, even with the loss of the Press 3 option, and that its call-takers welcome calls from the LGBTQ+ population. Staff are promoting services at concerts, community events, and Rockies baseball games.
Coombes said the Colorado Behavioral Health Administration contracts with Solari Crisis & Human Services to answer 988 calls, and that the training had already been equipping call-takers on the general line to support LGBTQ+ young people.
The state supports the 988 services via a 7-cent annual fee on cellphone lines. Coombes said the department requested an increase in the fee to bolster its services. While the additional funds would benefit all 988 operations, the request was made in part because of the elimination of the Press 3 option, he said.
Nevada plans to ensure that all 988 crisis counselors get training on working with LGBTQ+ callers, according to state health department spokesperson Daniel Vezmar. Vezmar said Nevada’s $50 million investment in a new call center last November would help increase call capacity, and that the state’s Division of Public and Behavioral Health would monitor the impact of the closure of the Press 3 option and make changes as needed.
The Illinois Department of Human Services announced after the Press 3 option’s termination that it was working to train existing call center counselors on supporting LGBTQ+ youth and promoting related affirming messages and imagery in its outreach about the 988 line. A July increase in a state telecommunications tax will help fund expanded efforts, and the agency is exploring additional financial options to fill in the new gap.
Kelly Crosbie, director of North Carolina’s Division of Mental Health, Developmental Disabilities and Substance Use Services, said the division has recently invested in partnerships with community organizations to increase mental health support for marginalized groups, including LGBTQ+ populations, through the state’s 988 call center and other programs.
“We’ve wanted to make sure we were beefing up the services,” Crosbie said, noting that North Carolina’s Republican legislature continues to restrict health care for transgender youth.
Hannah Wesolowski, chief advocacy officer for the National Alliance on Mental Illness, said Congress could put the funding for the LGBTQ+ line in any final appropriations bill it passes. She also said states could individually codify permanent funding for an LGBTQ+ option, the way Washington state has created and funded a “Press 4” option for its Native American population to reach crisis counselors who are tribal members or descendants trained in cultural practices. The state created the option by carving out some of its 988 funding. No state has publicly announced a plan to make such an investment for LGBTQ+ populations.
Federal lawmakers from both sides of the aisle have spoken out against the closure of the LGBTQ+ 988 option and urged that it be reinstated. At a July press conference alongside Democratic colleagues, Rep. Mike Lawler, a Republican who represents part of New York’s Hudson Valley, said he and Republican Rep. Young Kim of Orange County, California, wrote to Health and Human Services Secretary Robert F. Kennedy Jr., urging him to reverse course and keep the LGBTQ+ line.
“What we must agree on is that when a child is in crisis — when they are alone, when they are afraid, when they are unsure of where to turn to, when they are contemplating suicide — they need access to help right away,” Lawler said. “Regardless of where you stand on these issues, as Americans, as people, we must all agree there is purpose and worth to each and every life.”
This article was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.
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