ROANOKE, Va. (WFXR) — The Center for Disease Control and Prevention (CDC) says suicide is the second leading cause of death in people ages 10 to 24.

Sarah Harig, clinical director of Family Service of Roanoke Valley, says the COVID-19 pandemic played a big role, as kids were isolated from each other and couldn’t take part in self-esteem building activities like sports or theater.

“They’re just not having that opportunity anymore, so because of that, they’re not having chances to experience and see themselves as capable, as responsible,” she said.

On top of fewer opportunities to build self-esteem, social media also gives them impossibly high standards to compare themselves to, says Harig.

“So, not only does my life not look as good as theirs, but I don’t have any concept in my mind that I’m good without comparison,” she explained.

Harig notes that LGBTQ+ youth are four times more likely to either contemplate or die of suicide. They have increased stress about being accepted by friends and family. They may also experience more bullying.

The U.S. Office of Population Affairs says gender-affirming care — such as social acceptance at any age; puberty blockers and hormone therapy during adolescence; or surgery, typically in adulthood — can help prevent suicide.

“It’s not hyperbolic to say that gender-affirming care is life-saving,” said Harig.

Especially for those who may not have accepting adults at home, Haring says having open conversations about gender and sexuality in schools can provide LGBTQ+ youth with a safe space.

“Being able to say, ‘I believe you,’ ‘I know that’s who you are,’ and ‘I’m going to treat you with respect the same I would anybody else,'” Harig explained.

Harig says research shows talking about suicide to someone you’re concerned about gives them a safe person with whom they can speak.

“Being able to say ‘are you thinking about killing yourself’ — not hurting, killing. Being direct about that is really important,” said Harig, adding that it shows your loved one that you can handle that information and you’re ready to help.

If you or someone you know is struggling with suicidal thoughts, there are two free resources ready to help. You can call or text the following numbers 24/7 for assistance: