A new US analysis spanning more than 800,000 students finds that middle and high school students who participate in sports are significantly less likely to report suicidal thoughts or behaviors—even as youth suicide rates have climbed nationwide.

Yet sports participation has declined for a number of reasons, potentially limiting access to this important protective factor.

The analysis appears in the Annals of Epidemiology.

Massy Mutumba, an assistant professor at the School of Public Health at Washington University in St. Louis, led the study.

“Historically, organized sports have been an important protective factor against suicidal thoughts and behaviors, and they still are,” Mutumba says.

“But fewer students are participating, especially in middle school, and we need to find new ways to expand access and integrate mental health into sports settings.”

Suicide is rising at an alarming rate among children and teens in the US, creating a serious public health crisis. It is the second-leading cause of death for kids ages 10-14 and the third for youth ages 15-24.

In this study, researchers analyzed Youth Risk Behavior Survey data from 2007 to 2023 drawing on responses from 326,085 middle schoolers and 508,737 high schoolers across 41 states. Among middle school students, 20.5% had seriously considered suicide, 13.5% had made a plan and 8.6% had attempted it. Among high school students, 16.6% reported suicidal thoughts in the past year, 13.5% had made a plan and 9.2% had attempted suicide.

As part of the analysis, researchers explored the link between suicide risk and past-year participation in organized sports—a protective factor that could be leveraged more broadly.

Key findings

• Suicide risk (rates of suicide ideation, planning and attempts) increased sharply among youth between 2007 and 2023.
• Sports participation dropped from 57.4% of high school students in 2019 to 49.1% in 2021 and has remained consistently lower than before the pandemic.
• This decline was exacerbated by increasing costs (which disproportionately affect students from low-income households), the COVID-19 pandemic and growing psychosocial challenges. These challenges—including depression, generalized and social anxiety, and body image issues—often emerge around puberty and may prevent students from participating in organized sports.
• For high schoolers, the protective link between sports and mental health remained strong both before and after the pandemic.
• Among middle schoolers, the link between sports participation and reduced suicide risk was slightly weaker in 2023 than before the pandemic—a pattern that may reflect developmental differences. Psychosocial challenges tend to intensify with age, which could explain why this association is stronger in high school students, Mutumba notes.

The study is among the first to track these trends before, during and after the pandemic across nationally representative samples. Additionally, the study gives careful focus to middle schoolers. Despite rising suicide rates among younger kids, most large-scale studies have focused on older teens, leaving a major gap in research and prevention efforts, Mutumba says. Suicide is still widely viewed as a concern primarily for older teens.

Sports participation has numerous physical and mental health benefits, such as reduced depressive and anxiety symptoms, lower stress, enhanced general well-being and improved self-esteem, the researchers assert.

The findings underscore sports as an accessible, scalable, and sustainable public health strategy for suicide prevention, but indicate that taking full advantage of the power of sports may require new approaches.

The authors call for greater investment in equitable access to sports opportunities—especially in communities where risk is highest. Adolescents in marginalized communities particularly have elevated odds of suicidal behavior and reduced access to mental health services. To help close these gaps, the report outlines concrete strategies such as subsidizing or fully covering fees for school and community-based programs, investing in local facilities (green spaces, basketball courts, and baseball fields) and implementing sliding-scale fee models. These efforts are particularly important in middle school, when early engagement in sports can build lasting habits and offer critical mental health protection.

The authors also advocate for incorporating evidence-based mental health programs into organized sports programs. This aligns with Mutumba’s ongoing efforts to develop scalable, community-embedded strategies that integrate mental health support into systems that serve adolescents.

“Sports offer more than physical activity,” Mutumba says. “They create structure, social connection, and a sense of belonging that can help buffer the intense pressures that adolescents face today.”

Mutumba completed the research while at the University of Michigan. Additional coauthors are from the University of Michigan.

Source: Washington University in St. Louis

Newswise — At 9:45 a.m. on a rapidly warming June day in East Hollywood, Dr. Mo is on the blacktop courts of Lemon Grove Recreation Center cooking these young fellas good. Why this 45-year-old clinical psychologist is playing basketball on a Wednesday morning with five other guys who have yet to cross 30 is some kind of story, but it will have to wait till the doctor has finished the lesson he’s supplying out here free of charge.

One-on-one at the edge of the free throw line, he gives his defender a herky-jerky move that’s as old school as a paper check, bursts by him with a tight right-hand dribble, and then scoops in a shot off the backboard that has both sides whooping. “Doc is in his bag!” a teammate exclaims.

That he is. This is where Dr. Mo does some of his best work. Each week at this park and three others like it across East and South L.A., Moises “Dr. Mo” Rodriguez, PhD, runs the therapeutic exercise program he created in his role as Mental Health Director of the Children’s Hospital Los Angeles Homeless Adolescent Wellness Clinic, a support group for young people who are experiencing some level of homelessness or housing insecurity.

The Homeless Adolescent Wellness Clinic is a component of Adolescent and Young Adult Medicine at Children’s Hospital Los Angeles.

Consider the basketball court an outdoor wing of Dr. Mo’s practice. It’s suited for the population he is serving, which he says is more easily reached through a looser, informal approach that doesn’t start with a lengthy set of intake questions or heavy explorations of past traumas. Since the program began in 2008, hundreds of young men—and many women, too—have participated. A game of pickup basketball offers Dr. Mo a side entrance into their personal histories.

“I’m not probing,” Dr. Mo says, noting how that might be resisted. “They’d look at me like, ‘This person’s going to ask about all my intimate moments and whether I’ve been abused or whether I’ve been assaulted, or whether I’ve seen stuff happen with my parents.’ You have to be receptive to that kind of conversation, and not everybody’s there. It’s just too much. This helps people come around on their own terms.”

Putting their nervous system at ease

Dr. Mo began seeing the benefits of a less structured style of therapy in the course of his training at the NYU Child Study Center. While performing home visits, he would take his young patients on walks around the neighborhood. He repeated the practice during his internship at a facility in Santa Monica.

“I saw that their comfort level increased and they became more balanced, grounded, and open and warm,” he says.

Though it may seem unsystematic, his approach was rooted in scientific theory and neurobiology—though he didn’t find that out until after he was already applying it.

“I didn’t go theory first,” Dr. Mo says. “It was more of, ‘This seems like a cool outlet for connecting with people.’  backed into finding all kinds of stuff that was evidentiary in nature about why it’s so beneficial.”

He discovered the Neurosequential Model, which broke down the science behind what he had arrived at intuitively. The model explains that the brains of individuals who have experienced trauma and are focused entirely on finding their next meal or a safe place to stay are often operating in the limbic system—survival mode—and don’t have the luxury of using the brain’s frontal lobe, which performs our more advanced executive functioning.

By providing a physical outlet to these patients—he also brings boxing gloves and pads, a jump rope, a deck of cards, a chess board, and other activities—Dr. Mo lightens their immediate struggle and frees them to use their higher faculties.

“I put their nervous system a bit more at ease,” he says. “Then you can access the other parts of the brain, and then you might open up. You might just start sharing. Giving that person an outlet helps us build a relationship.”

A bond between doctor and patient

Two of the four recreation centers where Dr. Mo and his group gather are located across from homeless shelters, so those who wish to join just have to walk on over. At the other two sites, they’re driven in.

Albert comes by bus. He goes by AMoney—big A, big M, no space, per his instructions. A longtime patient of Dr. Mo’s, he’s a regular at Lemon Grove. “I’ll always keep coming,” he says.

AMoney became homeless when he was 18, the same age he met Dr. Mo. He turns 26 in July. He’s cheerful and optimistic, against expectations. He takes a bus from Carson to join Dr. Mo twice a week for basketball, bearing witness to the effects of therapeutic exercise.

“It has really impacted me mentally,” AMoney says. “I don’t think about anything but basketball, and it makes me feel good. A couple of hours. That’s all I need.”

He says Dr. Mo helped turn his life around, giving him resources and leads that have led to employment, educational, and housing opportunities. He’s now out of the shelter and in a transitional housing facility, which hopefully will next lead to a fixed residence. This is a place of peace. As long as you can find that, you can get whatever you need to get done. You can manifest your life.

In September, he starts at West Los Angeles College, again with a boost from Dr. Mo, who clued him into a local work-study program called Angeleno Corps.

“It’s all due to Doc,” AMoney says. “I got my student ID and I’m in the student portal.”

He’s enrolled in a course in game design. “So pray for me,” he says with a small laugh. “That’s always been my goal—to be a video game programmer. I’m good at computers.”

As AMoney looks on, Dr. Mo sinks another shot. “Doc’s still got it, surprisingly. He has it. He’s cookin’ everybody, man. He can’t be stopped!” He considers what Dr. Mo has meant to him. “Without Doc, I don’t know where I’d be right now. Me and him got a bond. He made that bond. I never had a person who’s so consistent.”

The word seems to have revealed something to him. It is perfectly chosen. “That’s what I’m saying—consistency. I don’t have a lot of people like that. He gives you a toothbrush, toothpaste. He helps me out with hygiene! Nobody does that.”

He explains the effect of the basketball outings in a way that bears out the neurological benefit Dr. Mo described. They free up a part of his brain that the daily striving to survive cuts him off from.

“I got a lot on my plate,” he says. “This is a place of peace. As long as you can find that, you can get whatever you need to get done. You can manifest your life.”

‘Micro-moments’ that lead to breakthroughs

For all of his 17 years at CHLA, Dr. Mo has run the therapeutic exercise program. Patients cycle through. Some come once, others repeatedly. He gains their trust because they share “a similar flavor dynamic,” he says.

“I’m not pretending to be something. I’m a psychologist providing a service, but I’m also just another dude who likes to play basketball. That’s where that shorthand, that cultural connection, comes in. These are mostly young Black and Latino men. We get along a certain way that builds community and camaraderie. What it provides is a respect for accessing more privileged information.”

Just as these sessions don’t begin with a traditional intake, they don’t end with a dramatic self-awakening or an emotional outpouring. Advances are made in smaller, practical sizes.

“I’ll have these little micro-moments with someone who got to the park before anybody else showed up,” Dr. Mo says. “We have time to shoot around and chat, and life stuff comes out. ‘How’s work going?’ ‘Do you know a place where I can get a job interview?’ ‘Yeah, I know a place.’ ‘Can you help me with housing?’ ‘Yeah, I can help you with that.’ We might chat for seven minutes, but it’s a valuable seven minutes.”

Occasionally those conversations are followed up in private for those who wish to share something away from basketball.

“It’s a starting point. ‘Do you have some time afterward? I wanted to ask you something. Maybe we can have a phone call later.’ But some people are very straightforward. ‘No, no, I don’t need all that. I just want to play ball.’ And some take what they need and then you’re just someone along their way, someone who contributed along their path, hopefully something positive to their life.”

Former Transportation Secretary Pete Buttigieg offered one of the most carefully worded responses yet to the debate over transgender youth participation in sports on Monday morning in an NPR interview.

“The approach starts with compassion,” Buttigieg, who is gay, told Morning Edition host Steve Inskeep. “Compassion for transgender people, compassion for families, especially of young people who are going through this, and also empathy for people who are not sure what all of this means for them.”

Asked whether a parent concerned about their child facing a trans kid in girls’ sports “has a case,” Buttigieg said, “Sure.” But he rejected blanket policies like the federal bans being enacted by the Trump administration, saying, “These decisions should be in the hands of sports leagues and school boards and not politicians, least of all politicians in Washington trying to use this as a political pawn.”

Buttigieg’s remarks came days after Rahm Emanuel, former President Joe Biden’s ambassador to Japan, former mayor of Chicago, and a potential 2028 presidential candidate, told Megyn Kelly that “a man can’t become a woman,” a comment that directly contradicted party orthodoxy and sparked fresh divisions over how Democrats should approach transgender rights.

“I think most reasonable people would recognize that there are serious fairness issues if you just treat this as not mattering when a trans athlete wants to compete in women’s sports,” Buttigieg told NPR.

The political stakes are high. A June 2025 Gallup poll found that 69 percent of U.S. adults believe trans athletes should only be allowed to play on teams matching their gender assigned at birth, including 91 percent of Republicans, 66 percent of independents, and 45 percent of Democrats. Support for transgender athletes’ inclusion has declined steadily since Gallup first asked the question in 2021.

Since returning to the Oval Office in January, President Donald Trump has signed executive orders eliminating federal recognition of gender identity, banning trans military service, restricting access to gender-affirming care, and prohibiting transgender girls and women from playing on female sports teams.

The United States Supreme Court will weigh in on the legalities of banning transgender people from sports by next summer. The court has agreed to hear two cases involving transgender athletes next term, which begins in October.

LGBTQ+ rights groups have warned that such bans are not only discriminatory but also dangerous. A July 2025 fact sheet from GLAAD noted that fewer than 10 transgender student-athletes are competing among the NCAA’s 510,000 athletes. It also pointed to documented cases of cisgender girls being falsely accused of being trans, harassed, or subjected to invasive screening, consequences not limited to trans youth.

In March, California Gov. Gavin Newsom, a fellow Democrat, received harsh backlash for telling far-right operative Charlie Kirk that trans kids’ participation in sports is “deeply unfair.”

Pressed on Trump’s repeated slogan, “No boys in girls’ sports,” Buttigieg declined to echo the rhetoric. “I think that chess is different from weightlifting, and weightlifting is different from volleyball, and middle school is different from the Olympics,” he said. “So that’s exactly why I think that we shouldn’t be grandstanding on this as politicians. We should be empowering communities, organizations, and schools to make the right decisions.”

Watch Pete Buttigieg discuss trans athletes on NPR’s Morning Edition below.

– YouTube youtu.be

This article originally appeared on Advocate: Pete Buttigieg weighs in on ‘fairness’ of transgender kids playing girls’ sports

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Hannah Quintera shoots a 3-pointer during the opening round of pool play against the Lady Akichita at Alhambra High School during the Native American Basketball Invitational. (Photo by Travis Bradley/Cronkite News)

PHOENIX — One thing is for certain, when the Native American Basketball Invitational (NABI) comes to town, there are no shortages of fascinating storylines and compelling narratives to explore.

The 22nd annual all-native basketball tournament — the largest of its kind in North America — brought more than 200 teams from across the United States to several Valley arenas last week. The tournament is not simply about basketball; it is also about celebrating cultural diversity, Native identities and heritage.

With over 160 tribal nations represented across both the girls and boys divisions, high school and soon-to-be college athletes took to the courts to hopefully distinguish themselves as the best Native basketball teams in the country.

From the Athabascan tribes of Alaska to the Otoe-Missouria of Oklahoma, basketball reigns as one of the premier sports for Native youth.

New faces, same expectations

More than 80 of the teams in the 2025 NABI tournament were representatives of the 22 federally recognized tribes in Arizona.

The Spartans, a boys division team composed of young Navajo and Mohave players from Northern Arizona, were led into the tournament by Farin Nez, who recently took over the coaching position.

Nez said the Spartans were united under the cause of making their former coach Samuel David proud. David, a “lifelong friend” to Nez, died in July.

“Coach Sam really put a good foundation underneath them, such as rebounding and trust moving the ball,” said Nez, tears welling in his eyes as he reminisced about his now-deceased mentor. “This is our first tournament since his passing, and I’m just trying to continue what he started.”

The Spartans defeated War Paint at the Phoenix College gymnasium, 61-18, in the Native American Basketball Invitational. (Photo by Travis Bradley/Cronkite News)

The Spartans were led offensively by Jacoby Che, a 14-year-old point guard. Che is Navajo from Winslow, Arizona, and he’s heading into ninth grade in the fall.

Despite his stature and youth, Che’s offensive output led the Spartans to the second round of tournament play before eventually falling to the Snowbirds of the Native Village of Scammon Bay in Alaska.

“We learned to play more physically because we’re always playing against bigger, older guys.” Che said.

Che will team up with several of the Spartan players this winter once the high school basketball season begins.

Age-old rivalries are renewed

With basketball as prevalent as it is throughout the Native tribes in Arizona, it can be difficult to isolate just one roster of talented players per tribe.

The White Mountain Apache Tribe had five teams representing their community in the girls division, and another nine teams in the boys division.

After a last-second victory over the Lady Akichita from North Dakota last Wednesday, WMA Squad coach Tyrell Clawson said that one motivating factor for the players was the opportunity to compete against teammates and high school rivals from other White Mountain teams at a national level.

“They support each other, the communities are always behind them, and there’s some really big crowds here to watch,” Clawson said.

Clawson is only 25, and this is his first season as a head basketball coach. With the way his team responded to his direction, it was impossible to tell that he was one of the least-experienced coaches in the tournament.

Clawson attributed the sisterhood between teammates as an essential part of the team’s success in the early stages of pool play. Though they lost in the first round of the tournament 41-37, the female athletes remained united by their common love for the game.

“They always encourage each other,” Clawson said. “Before, they came as teammates, now they’re basically a family.”

A dynasty is forged

No team has had nearly the same success in the recent years of the tournament as the Rezbombers in the girls division.

Represented by athletes from the Navajo Nation, Samoan, Laguna Pueblo, Hualapai, Paiute and Oglala Sioux tribes, the players barrelled through much of their competition last week, posting scores as lopsided as 110-20 throughout pool and tournament play.

Rezbombers coach Brian Kaye addresses his team during halftime of a pool play game at Central High School on Thursday, July 24, 2025. (Photo by Travis Bradley/Cronkite News)

Rezbombers coach Brian Kaye brings a level of intensity to the game that is often unmatched by his opponents. Having won the tournament in 2024, he knew there was a very narrow margin of error for the players if they wanted to become repeat champions.

“This is by far the biggest tournament we’ll play in this year, and we take extreme pride in playing in this tournament,” Kaye said. “It’s one way for us to represent our culture, and we just want outsiders to know that Native Americans can play basketball.”

Kaye said that the main ingredient for the team’s success is discipline, especially on the defensive side of the ball. And when you’re beating a team 75-5 in pool play, it goes without saying that the players maintained that discipline throughout the tournament.

Led mainly by the Benally sisters, Sydney and Kaiyah, the Rezbombers surged their way to the championship on Saturday evening, claiming their third NABI title since 2022.

Kaiyah, the younger of the two sisters, is a 5-foot-6 point guard and one of the most talented female basketball players in New Mexico. Her older sister, Sydney, is a two-time New Mexico Gatorade Player of the Year, and she’s heading to BYU in the fall to join the Cougars’ women’s basketball team.

“It means a lot (to play in this tournament),” Sydney said. “Not only am I playing with such great players, but I’m playing with my sister one last time before I head off to college.”

When the trio of Kaye and the two Benally sisters were asked what it meant to them to play together one last time, their answers were all the same:

“It’s been a blessing” they said, echoing the theme that was prevalent throughout Valley arenas.