A federal mental health agency is signaling that specialized suicide prevention services for LGBTQ+ youth through the 988 Suicide & Crisis Lifeline could return after their abrupt shutdown last year, but advocates say the details matter.
In a letter sent to members of Congress, the Substance Abuse and Mental Health Services Administration, or SAMHSA, said it is evaluating how to restore LGBTQ+ youth specialized services within the 988 system while complying with President Donald Trump’s Executive Order 14168.
The move marks one of the first public indications that the administration may revisit the elimination of the program known nationally as the “Press 3” option.
The specialized pathway connected LGBTQ+ young people to crisis counselors trained to support their specific experiences and needs. The service launched nationally in 2022 and became a widely used entry point for youth seeking immediate mental health support.
What The Federal Letter Says
The letter, signed by Christopher Carroll, principal deputy assistant secretary for mental health and substance use, was sent in response to congressional outreach urging the Department of Health and Human Services to restore the service.
According to the letter, Congress included language in the fiscal year 2026 Labor, Health and Human Services appropriations legislation directing SAMHSA to restore $33.1 million for specialized services for LGBTQ+ youth.
The language also instructs the agency to continue providing training in LGBTQ+ youth cultural competency and maintain an integrated transfer system that connects callers with a specialty organization.
“SAMHSA is currently assessing the most appropriate approach to implementing this congressional directive for the ‘Press 3’ option within the 988 Suicide and Crisis Lifeline, while ensuring compliance with Executive Order 14168,” the letter states.
Executive Order 14168, signed in January 2025, is titled “Defending Women From Gender Ideology Extremism And Restoring Biological Truth to the Federal Government.” The order has drawn criticism from LGBTQ+ advocacy organizations over concerns about how transgender people are recognized across federal policy.
The agency added that the broader 988 Lifeline would continue serving all callers with 24/7 crisis support.
The Trevor Project Responds
The Trevor Project welcomed the possibility of reinstatement but questioned whether the service could remain effective under the framework outlined by the administration.
“We are grateful to see preliminary indication that the 988 Lifeline’s LGBTQ+ youth specialized services (known as the ‘press 3’ option) may be reinstated after the program was abruptly shuttered last July,” said Jaymes Black, CEO of The Trevor Project.
“However, we remain skeptical as the administration has now plainly said the lifeline must ensure compliance with President Trump’s January 2025 anti-transgender executive order.”
Black argued that specialized services exist because some populations experience higher suicide risk and benefit from counselors with targeted training.
“The point of the 988 Lifeline’s specialized services is to provide tailored support to groups placed at highest risk for suicide in this country, including veterans and LGBTQ+ young people,” Black said.
“The reality is that transgender youth face some of the highest rates of suicide risk of any group in the U.S. The administration’s executive order rejects these youth entirely; they cannot be supported if they are not included.”
The organization said it handled more than half of the LGBTQ+ specialized contacts while the program operated through July 2025 and emphasized that its own crisis services remain available.
“In order to support a young person through crisis, you must first support who they are,” Black said.
Why Advocates Are Watching Closely
The debate over restoring “Press 3” extends beyond whether the option returns. For advocates, the central question is how specialized support will function in practice.
The Trevor Project points to its research showing elevated mental health risks among transgender and nonbinary youth in the United States.
According to the organization’s data, 40% of transgender and nonbinary young people reported seriously considering suicide in the past year, while roughly 11% reported attempting suicide.
The group also found lower rates of suicide attempts among youth who had access to supportive communities, affirmation of their pronouns at home and gender-neutral bathrooms at school.
At this stage, SAMHSA has not outlined how the service would be structured or whether changes would affect counselor training, eligibility or the experience for transgender callers.
For now, the possibility of restoration offers cautious optimism, alongside renewed scrutiny over whether a specialized service can maintain its original purpose under new federal guidance.
