Beyond the Stigma: Peer Mentors Support At-Risk Sexual and Gender Diverse Youth

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Tran, J. T., Webster, J., Wolfe, J. R., Ben Nathan, J., Mayinja, L., Kautz, M., Oquendo, M. A., Brown, G. K., Mandell, D., Mowery, D., Bauermeister, J. A., & Brown, L. A. (2025). Experiences of peer mentoring sexual and gender minority emerging adults who are at risk for suicide: Mixed methods study. JMIR Formative Research, 9, e67814. https://doi.org/10.2196/67814

Introduction

Sexual and Gender Diverse Youth (SGDY) face disproportionately high suicide risk, yet often avoid formal mental health services due to stigma. Peer support is a promising, underutilized strategy. This study evaluated the experiences of peer mentors (PMs) trained for the “Supporting Transitions to Adulthood and Reducing Suicide” (STARS) intervention, a 6-week virtual program designed to support at-risk SGDY (ages 18-24).

Methods

This mixed-methods study collected data from 5 PMs and 64 mentees. PMs, who identified as part of the sexual and gender minority community, received 16+ hours of training in motivational interviewing and cognitive behavioral therapy (CBT) content from licensed clinicians. Researchers assessed implementation via PM-reported comfort/distress surveys, fidelity monitoring, and post-intervention qualitative interviews with PMs. Mentees reported confidence in their PMs.

Results

The intervention was highly feasible and acceptable. PMs reported high mean scores for feasibility (16.40/20), appropriateness (18.40/20), and acceptability (18.40/20). Fidelity to the manualized content (95.7%-100%) and style (92.1%-97.4%) was excellent. PMs reported high comfort (M=8.52/10) and low distress (M=1.93/10) during sessions, which remained stable over time. Qualitatively, PMs valued the role-play training and weekly clinical supervision.

Discussion

The findings strongly suggest that a structured peer mentoring model for high-risk SGDY is viable. With robust, skills-based training and consistent clinical oversight, peers can comfortably deliver a manualized suicide prevention intervention with high fidelity. The low distress ratings are particularly noteworthy, indicating this model is sustainable for mentors.

Implications for Mentoring Programs

For programs serving high-risk populations, this study highlights the necessity of intensive, skills-based training (e.g., role-playing) combined with consistent, ongoing clinical supervision. A structured manual is crucial for maintaining fidelity, though mentors may require support in balancing scripted content with the need for flexible, rapport-building conversation.

Read the full paper here.