There are many stresses that come with being an LGBTQ+ youth: fear, isolation, bullying, feeling as if the world hates you, loved ones pressuring you to change.

Those realities come into sharper view in the first release of findings from an ongoing study by the Trevor Project to track the mental health of about 1,700 youth across the U.S. over an extended period of time.

Researchers from the West Hollywood-based nonprofit saw a sharp increase in mental distress among the participants. Over the course of one year, the proportion of participants who reported anxiety symptoms rose from 57% to 68%.

As political rhetoric in the last couple of years has boiled over on issues such as teaching about LGBTQ+ identity in schools, transgender students playing on sports teams and whether to allow gender-affirming care, the share of youth who said they’d experienced symptoms of depression rose from 48% to 54%. Those reporting having suicidal thoughts went from 41% to 47%.

Transgender and nonbinary youth were nearly twice as likely to say they’d struggled with anxiety and suicidal thoughts than their cisgender peers — a pattern that held steady throughout the first year of data collection on participants in this group.

“This allows us to clearly and unequivocally document what we know to be true: The manner in which LGBTQ+ youth are treated in this country harms their health and risks their lives, and it is only getting worse,” Trevor Project CEO Jaymes Black said in a statement.

Even in California, a state that’s considered a haven for trans people, the climate seems to be shifting. In a surprising move for an elected official who has proclaimed support for the trans community, Gov. Gavin Newsom recently vetoed a bill that would have required 12 months of hormone therapy coverage for transgender patients in California, citing cost concerns.

Another striking finding in the study: An increase in the proportion of youth who said they’ve faced pressure to undergo “conversion therapy,” a controversial and scientifically dubious counseling process that its advocates claim can suppress or erase same-sex desire, change the gender identity of youth who identify as trans and discourage those are questioning.

The National Alliance on Mental Illness calls conversion therapy “discredited, discriminatory, and harmful,” and supports bans on a practice it says can damage, not improve, the mental health of those who undergo it. California became the first state to ban the practice in 2012.

But reports of being threatened with conversion therapy doubled in the first year of tracking, with 22% of respondents saying they experienced this intimidation, up from 11% at the start of the study. The percentage of those who said they’d been exposed to conversion therapy in some way climbed from 9% to 15%.

The findings come as the Supreme Court hears arguments in one of the most closely watched cases of its current term. In Chiles vs. Salazar, a Christian counselor has argued that Colorado’s ban on conversion therapy for LGBTQ+ youth violates her free speech rights in voluntary therapy sessions with questioning minors. Members of the court’s conservative majority, who prevailed earlier this year in a decision upholding a Tennessee ban on gender-affirming care for minors, openly voiced skepticism about the Colorado ban in hearings this week. The court’s decision is expected to rule in case by the end of its session in June.

“Many people believe it to be a relic of the past, but the data indicate that these dangerous practices are still happening,” said Dr. Ronita Nath, Trevor Project’s vice president of research. She added that threats of and exposure to conversion therapy contributed to future depression and suicidal thoughts among study participants.

The researchers started recruiting in September 2023. Each participant filled out mental health surveys every six months after joining the study.

This is the first time that the Trevor Project has monitored changes in queer youth mental health over such a long period. Nath said this type of sophisticated, long-range study is important for public health providers and policymakers alike because it provides fresh evidence of a cause-and-effect link between societal risk factors — such as pressure to undergo conversion therapy and a lack of access to affordable mental health services — and future crises.

“Societal and structural conditions are driving these mental health outcomes, not just coinciding with them,” Nath said.

The study did identify some positives: The percentage of LGBTQ+ youth who reported feeling supported at school rose from 53% to 58% over the course of the first year. Also, 73% of participants said they sought help from friends, up from 45% at the beginning of the first year.

Many who took part in the study, however, said they avoided seeking care either because they couldn’t afford it or because they worried they’d be stigmatized for having a mental health crisis.

Only 60% of respondents said they had access to mental health services by the end of their first year in the study, down from the 80% at the start of their tracking.

On the other hand, 75% of those who did get counseling over the course of their first year in the study said they benefited from it, up from 61% at the start.

The proportion of youths who said they sought help during suicidal episodes doubled to 64% in that time frame, though, which points to the increased level of distress youths experienced in that span, Nath said.

Last year’s flu season was the worst California had seen in years — and state health officials warn this year could potentially be just as bad.

While forecasting disease isn’t an exact science, there are some troubling signs. In Asia, the flu has made an early comeback, and quickly swelled to epidemic proportions in Japan and Taiwan.

And stateside, some experts are sounding the alarm about continued lower uptake of the flu vaccine. There’s also the possibility of a seasonal COVID-19 wave — the likes of which didn’t materialize last winter, but had been commonplace since the pandemic — as well as a simultaneous rise in respiratory syncytial virus, or RSV.

California health officials have previously forecast that this fall-and-winter’s respiratory virus season is expected to be similar to last year’s. If that’s the case, flu would again be the dominant virus fueling hospital admissions compared to COVID-19 and RSV. During the winters of 2022-23 and 2023-24, COVID made up the majority of California hospital admissions caused by respiratory viruses.

“Having people get vaccinated is going to be really key for influenza,” said Dr. Peter Chin-Hong, a UC San Francisco infectious diseases expert.

While flu, COVID and RSV are currently at low levels in California, there are signs that respiratory virus season is starting to gear up as temperatures drop and people spend more time indoors.

Compared to rates recorded in the summer, the Los Angeles County Department of Public Health has seen increases in people reporting cough, fever, chills, aches, sore throat and runny nose, officials said, citing a text-based health survey. The test positivity rate for rhinoviruses and enteroviruses, which typically cause the common cold, is 19.87%. That’s higher than that of the virus that causes COVID-19, 4.2%; or the flu, 1.04%.

In San Francisco, doctors have seen the number of colds being reported in the hospital double, Chin-Hong said. Some workplaces in the Bay Area have seen a number of employees call out sick.

With RSV, flu and COVID-19 rates expected to climb by the holidays, “this is a perfect time to get immunized,” the L.A. County Department of Public Health said in an email.

The fall and winter of 2024-25 brought the nation’s worst flu season in many years, according to the U.S. Centers for Disease Control and Prevention.

The number of children who died from flu last season was the highest since the H1N1 swine flu pandemic season of 2009-10, according to a recent report published in the CDC’s Morbidity and Mortality Weekly Report. Officials reported 280 confirmed deaths among children last season, and about 9 in 10 of those kids were not vaccinated.

Health officials became particularly concerned about reports of a rare, severe complication that targets the brain — influenza-associated encephalopathy, or IAE, which was reported in 109 children nationally last season.

Three in four children with IAE needed intensive care treatment. The median age of children with IAE was 5, and 55% of those diagnosed with the condition had no underlying health conditions.

Of those children, 37 had acute necrotizing encephalopathy, or ANE, a particularly severe form of the disease that results in rapid neurologic decline. Two in five children with ANE died.

Only 1 in 6 of the kids with IAE who were eligible to be vaccinated had gotten the flu shot, health officials say.

The CDC recommends that everyone age 6 months and up get a flu vaccine. New this year, officials are allowing people to order FluMist to be mailed to them at home. FluMist is approved for people ages 2 through 49 and administered by nasal spray rather than injection.

Doctors have been concerned about declining flu vaccination levels. As of late April, just 49.2% of children had gotten a flu shot, lower than the 53.4% who had done so at the same point the previous season, according to preliminary national survey results. Both figures are much lower than the final flu vaccination rate for vaccine-eligible children during the 2019-20 season, which was 63.7%.

Among adults, 46.7% had gotten their flu shot, slightly down from the 47.4% at the same point last season, according to the preliminary survey results.

“Before the COVID-19 pandemic, flu vaccination coverage had been slowly increasing; downturns in coverage occurred during and after the pandemic. Flu vaccination levels have not rebounded to pre-pandemic levels,” the CDC said.

Early data from the Southern Hemisphere indicate that the flu shot’s effectiveness was decent this season — cutting the risk of hospitalization by 50%.

Asia is already reporting plenty of flu cases.

“For influenza right now, it’s raging in Asia,” Chin-Hong said.

Flu is considered to be at epidemic levels in Japan — where news reports say this was the second-earliest start to the season in 20 years — and in Taiwan. Hong Kong health officials have described the flu situation in September and October, before shots became widely available, as “relatively severe.”

The situation there could provide a glimpse of how the flu season will play out in California and beyond.

In the San Francisco Bay Area, officials are also closely monitoring “high” levels in wastewater of a specific kind of cold virus — enterovirus D68, or EV-D68. In rare cases, that virus can cause polio-like paralysis in children called acute flaccid myelitis, or AFM. High levels were reported in a large swath of the Silicon Valley and San Francisco, according to WastewaterSCAN. High levels have also been found in sewage in western San Bernardino County, including Ontario, Chino and Fontana.

The L.A. County Department of Public Health has not yet detected increased signals of EV-D68, and no cases of AFM have been reported this year in Los Angeles or Orange counties.

That virus can transmit through an infected person’s saliva and mucus and likely spreads “when an infected person coughs, sneezes or touches a surface that is then touched by others,” the CDC said.

Parents should call a doctor if their child suffers any symptoms of AFM, which include slurred speech, difficulty swallowing, difficulty moving the eyes, drooping eyelids, pain in the neck, back, arms or legs, weakness in the arm or legs or facial droop.

To protect yourself against respiratory viruses, experts recommend getting vaccinated, washing your hands often, keeping rooms well-ventilated, wearing face masks in crowded indoor public settings, and staying away from sick people.

The California Department of Public Health recommends updated COVID-19 vaccines for everyone age 6 months to 23 months, seniors age 65 and up; as well as older children, teenagers and adults who either have risk factors for severe COVID, or are in close contact with at-risk people.

Children who have never been inoculated against COVID-19 should also get the vaccine, as should pregnant women and anyone else who wants to get the shot, the state says.

RSV immunizations are recommended for everyone age 75 and up, babies younger than 8 months, and pregnant women between 32 weeks to 36 weeks of gestation.

The immunizations are also recommended for adults age 50 to 74 with risk factors, as well as babies with risk factors between 8 months and 19 months. Older adults who have been previously immunized against RSV generally don’t need to get another vaccine, according to current guidelines.

An estimated 40,000 children avoided peanut allergy diagnoses after the guidelines for when to first expose kids to the food allergen changed, according to new research.

The dramatic drop in childhood peanut allergies arrives a decade after a watershed study found that feeding peanut products to babies reduced their chances of developing an allergy by over 80%.

For decades, parents were advised to avoid feeding common allergens, such as peanuts, to infants. In 2015, guidance shifted around peanuts for high-risk kids and expanded two years later.

A study published Monday in the journal Pediatrics found that peanut allergy rates in children under the age of 3 dropped by roughly 43% after the recommendations were expanded in 2017. Rates for all food allergies dropped by about 36%.

“What I was surprised by was the magnitude of the results,” said Dr. David Hill, an attending allergist at the Children’s Hospital of Philadelphia and senior author of the study. Even being able to say that allergy rates plateaued “would be huge news, but the fact that we actually saw a reduction in the onset of new food allergy in kids under 3 is incredible.”

Hill and his colleagues analyzed electronic health records from nearly 50 pediatric practices to track diagnoses of food allergies in about 120,000 children between 0 and 3. Fifteen months marks the peak onset of peanut allergy, according to the study.

Kids were deemed newly allergic if they received a diagnosis code by a provider for a food allergy and were prescribed an EpiPen, Hill said.

The reductions in diagnoses were found even though only about 29% of pediatricians and 65% of allergists reported following the expanded guidance issued in 2017, surveys found.

Confusion and uncertainty about the best way to introduce peanuts early in life led to the lag, according to a commentary that accompanied the study. Early on, medical experts and parents alike questioned whether the practice could be adopted outside of tightly controlled clinical settings.

Sung Poblete, chief executive of the nonprofit Food Allergy Research and Education, who was not involved in the study, hailed it for its focus on real-world data.

While it’s clear that the practice of “eat early, eat often” for foods that can provoke allergic reactions works in a clinical setting, “it’s really important to know that in the real world, this can also decrease incidence and prevalence for the infant population,” she said.

When a person has a peanut allergy, their body responds to the proteins in peanuts as though they’re dangerous. The immune system tries to fight them off, triggering symptoms ranging from hives and diarrhea to anaphylaxis, a life-threatening condition.

Poblete said that the findings highlight the need to change policy to further drive down life-threatening allergy diagnoses. That could include the U.S. Department of Agriculture including peanut products in their infant food packages, she said.

Food allergy prevalence has been on the rise, with 2.2% of U.S. children having a peanut allergy, according to commentary on the new study. Besides delayed introduction of allergenic foods, other risk factors include cesarean section births and antibiotic exposure, according to Hill.

“This is just a call to double down our efforts to understand why it is that children develop food allergies and how we can better treat and ultimately cure these diseases,” Hill said.

Since the period the researchers studied, children’s food guidelines have expanded further. In 2021, the Academy of Pediatrics recommended introducing major food allergens, including peanuts and egg, to all infants between four to six months of age.

The Associated Press contributed to this report.