William Dempsey: Supporting LGBTQ+ Youth Mental Health, Safety, and Resilience

William Dempsey, LICSW, is a Boston-based clinical social worker and LGBTQ+ mental-health advocate. He founded Heads Held High Counselling, a virtual, gender-affirming group practice serving Massachusetts and Illinois, where he and his team support clients navigating anxiety, depression, trauma, ADHD, and gender dysphoria. Clinically, Dempsey integrates EMDR, CBT, IFS, and expressive modalities, with a focus on accessible, equity-minded care. Beyond the clinic, he serves on the board of Drag Story Hour, helping expand inclusive literacy programming and resisting censorship pressures. His public scholarship and media appearances foreground compassionate, evidence-based practice and the lived realities of queer communities across North America.

In this interview, William Dempsey, a Boston-based clinical social worker, discusses the persistent realities facing LGBTQ+ youth across generations. Speaking with Scott Douglas Jacobsen, Dempsey explains how stigma, concealment, and family rejection contribute to elevated anxiety and depression, while housing insecurity and employment discrimination compound risk. He emphasizes affirming care, patient decision-making around gender exploration, and the importance of legal protections. Dempsey also highlights the loss of intergenerational queer spaces and argues for mentorship by queer elders as a stabilizing force, helping young people develop autonomy, resilience, and hope in the face of structural and social barriers.

Scott Douglas Jacobsen: Gay youth! They were here in the 1950s. They were here in the 2000s. They were here up to 2025. In fact, they are still here. So America’s gay youth factories are still working. The assembly lines are still productive. With regard to gay youth today, let’s not jump into what is wrong with youth today. Let’s focus on what issues they are facing today and how we can maybe help them develop autonomy, self-sufficiency, and resilience, in spite of some of the additional difficulties some of them are statistically more likely to experience than the norm.

Will Dempsey: I think it is important to remember that feeling like you cannot be out for who you are can bring about things like anxiety and depression. This is part of why LGBTQ+ youth report mental health challenges at higher rates than their cisgender and heterosexual counterparts.

Part of it is a continuation of trying to evolve society into a place that can be accepting of queer youth and instill in them that it is okay to be whoever you are, as cheesy as that may be. That can translate over to other populations as well; that is not limited to sexuality and gender. Who has not, at some point in their life, been embarrassed to share something about themselves that they thought they would be judged for? It is a lesson that we can instill in youth on a greater scale that is going to help queer youth specifically, but is still a great lesson for all kids to be aware of.

There are also the logistics: oftentimes kids might be kicked out of their homes, or experience housing instability, because of their sexuality or gender—especially in families that are strongly non-affirming, including some religious conservative families. Constantly trying to provide access to basic human rights—housing, food, et cetera—is always going to be important, not only to combat some of the aforementioned mental health challenges, but also safety. Practically, some queer youth—especially some trans youth who are homeless or housing-insecure—can end up in survival sex or other unsafe practices to survive and make sure that they have a place to live and sustain things like nutrition.

Having community activism in addition to legal protections, whatever those may look like, is going to ensure further safety for people. The last thing that I always encourage for the community at large, and I can start with queer youth, is having queer elders in some sort of mentorship program.

A lot of what we talk about is how, as the queer community has moved away from the bar scene, thanks to apps—where bars were typically big on cruising and now with apps, whether Grindr, Tinder, whatever they are called, Sniffies—Sniffies. You have that in Canada? Yes, it is available in Canada. It sounds like a moot. Sounds like sex. Imagine the headless torsos, but even more graphic. It is very right to the point.

The bar scene is dying. That is where a lot of younger gay men and other queer people would meet up with elders and learn from them. A lot of that art, in a way, is dissolved. And so, by continuing to have spaces in which up-and-coming queer folks can be speaking with those who have been in their shoes before them—especially, but not limited to, political persecution—it is helpful to be reminded that there is a proverbial light at the end of the tunnel and why we continue to advocate for equality.

Jacobsen: What is a typical gay young man who comes to you? What are the problems?

Dempsey: I think that the problems are typically the same. If we are talking from a sexuality lens, it is things like dating, or challenges around wanting to be who they are and feeling judged for it, which again is not limited to queer and trans youth. I think all of us at some point have felt judged by our peers at a young age, like middle school, high school. Challenges around dating and, being unsure how to ask someone out that you like—these things are all normalized. They are not unique to the community. Where it can become more specific is with challenges around dating related to logistics: not having other people who are out, not wanting to be the first one, or not being confident that your immediate circle—family, friends, religious community, or others—is going to be accepting of you for who you are.

We also have a lot of trans youth in our practice. Then the question often becomes: how do you want to explore your gender? Is it through clothing? Do you want to eventually start hormone replacement therapy at a certain age? What steps do you want to be taking? There is also a lot of education involved in trying to support youth around these questions.

Have you thought about whether, down the line, you might want biological children? There are considerations—such as, but not limited to, fertility preservation options like freezing eggs—before making certain gender-related medical decisions. That can be very difficult to think about when you are so young.

We try, as best we can, to help them navigate these decisions and remember that they are not decisions that have to be made now. That is also a common challenge for any of us as teens: that sense of impulsivity, wanting change now, wanting to grow up. There is a feeling many of us have experienced of being almost trapped under the authority of adults in our lives—teachers, parents, and others.

There is a desire to push out of that, but we also have to remind them that, like any decision, there are consequences. It is important to slow down and be intentional about what those look like for them. That is something we come across a lot, particularly with some of the medical decisions they may be considering.

Jacobsen: Thank you very much for the opportunity and your time, Will.

Scott Douglas Jacobsen is the publisher of In-Sight Publishing (ISBN: 978-1-0692343) and Editor-in-Chief of In-Sight: Interviews (ISSN: 2369-6885). He writes for The Good Men Project, International Policy Digest (ISSN: 2332–9416), The Humanist (Print: ISSN 0018-7399; Online: ISSN 2163-3576), Basic Income Earth Network (UK Registered Charity 1177066), A Further Inquiry, and other media. He is a member in good standing of numerous media organizations.