Monique Ortiz seemed to be carefree and happy on the night of Sanger High School's prom in May 2009. She clowned around with friends and made goofy faces in photos.
But not long after attending the dance with her good friend Jose, and two weeks before graduation, 17-year-old Monique shocked her family and friends by fatally shooting herself in the head on the patio of her Fresno home.
No one can say for sure what led her to her suicide. But those who were close to her said the standout soccer player -- a pretty girl with her mother's dimples -- was dealing with relationship problems and also had struggled for years to reconcile her family's strict Christian values with her homosexuality.
Monique's suicide is not an isolated event. In the Valley and across the nation in recent months, teen suicides have raised questions about the extra pressures facing nonheterosexual young people.
Among the local cases was Justin Lacey, a transgender teen who grew up in Clovis and took his life in September as he struggled with his sexual identity.
Research by the Massachusetts Department of Health concluded that gay youths are four to six times more likely than straight youths to attempt suicide. And a new study of lesbian, gay, bisexual and transgender young adults concluded they are eight times more likely to be suicidal if their families reject them, compared to gay teens who are not rejected.
Some of these suicides have captured widespread attention. Rutgers University freshman Tyler Clementi, 18, killed himself Sept. 22 after his roommate posted video on the Internet of him having sex with another man. In Tehachapi, Seth Walsh, 13, who was bullied for being gay, died Sept. 27 -- eight days after hanging himself from a backyard tree.
Experts say the problem won't go away unless the issue of bullying in schools is addressed and parents learn how to help their gay children.
It's not easy growing up gay, said Jeffery Robinson, 48, a social worker who leads a weekly support group in Fresno for gay, lesbian, bisexual, transgender and questioning youths.
He started the group nearly 23 years because of his own struggles in a family that was not supportive when he came out.
Robinson said he realized he was gay in seventh grade. He was teased in school and had a mental breakdown his junior year in high school. "I couldn't believe why God had made me that way," he said.
Afraid to talk
Life is difficult for gay teens, many of whom face bullying from their peers. But they also can face turmoil and despair as they struggle for acceptance by family, friends and society.
Monique, the oldest of three children, was raised in southeast Fresno near Sanger. In her Baptist church, she heard sermons about the sins of homosexuality. When she was 11, Monique made the decision to accept God and was baptized, said her mother, Renee Robles.
Robles said she is still dealing with her daughter's death and hasn't completely come to terms with Monique's sexual orientation.
But she is sure about one thing: She loved her daughter.
"I'm just wishing she would have talked to me," Robles said. "She might still be here."
She cries when she discusses her daughter. She wants to share Monique's story and help other families, but she fears people will vilify her own family. It's a struggle that many families can face, experts said.
"There's the stigma of suicide and then the parents who are dealing with this and all of the grief and guilt," said Stan Griffith, president of Greater Boston PFLAG (Parents, Families and Friends of Lesbians and Gays). "Parents don't want to be talking about this, and nobody wants to talk about the fact that their [child] was gay."
Robles was suspicious about some of her daughter's friends, and asked Monique whether she was gay. But Monique, who knew her mother considered homosexuality wrong, said she wasn't.
Angel Moreno, a close friend and classmate of Monique's, was one of the first people she told about her sexual orientation. He said she was nervous when she said she had something important to tell him. His response to her: "That's cool."
She began to confide in him about girl problems as well as fights with her mother. He was her cover when she wanted to do things with her girlfriends, picking her up at her house so her family wouldn't raise questions.
When he asked Monique what she wanted for her birthday one year, she told him a prepaid cell phone -- one that her mother couldn't monitor.
Most of her close friends knew she was gay, said Sam Hernandez, who played soccer with Monique since the age of 10. She cries when she speaks of the girl she grew up with.
She wishes Monique had reached out more and is angry that she killed herself. "But I don't think you can help someone unless they want to be helped," Hernandez said.
Monique's mother said no one can say for sure that the teen's homosexuality and problems with her family's acceptance contributed to her death. "No one knows but her," she said.
However, Moreno and Hernandez are convinced it played a part.
"She was afraid they would disown her," Moreno said. "That's why she struggled."
Experts said that while there seems to be more recent attention on suicides of gay youths, it's difficult to know whether more are occurring or they are just receiving more media coverage.
Tracking the suicide rate of gay youths isn't easy. "There are some teens who kill themselves and no one ever knows they are gay" until later, said Caitlyn Ryan, director of the Family Acceptance Project at San Francisco State University.
Ryan and her team just written a report that establishes a link on how family attitudes affect the health of gay and lesbian youths and young adults. Released this month, it shows elevated risks for suicide, depression and drug use in early adulthood for those whose families failed to support and accept them. The report also offers tips for families on how to help.
The difference between teens who experienced some rejection and those who faced a lot of rejection was substantial, according to the report. Highly rejected teens were more than eight times as likely to have attempted suicide compared to twice as likely if they faced only moderate rejection.
It's the first time such a clear link has been established, Ryan said.
Family acceptance is critical, she said: "Who is the one that is supposed to be in your corner above and beyond everyone else? Your family."
Ties to support network
But even where there is family acceptance, teens like Justin "Chloe Anne" Lacey still struggle.
Justin grew up in conservative Clovis and graduated from Buchanan High School in 2009. He liked snowboarding, hunting and fishing and was the only child of a single mom, Allison Murphy.
There were typical teen struggles between mother and son, including confrontations over his marijuana use. Justin also had bouts of anxiety.
He had confided in his mother that he felt different but could never really pinpoint why.
It wasn't until he was about 16 that she learned more: Justin wrote a letter asking her to buy him girls' clothing. He wrote it at the suggestion of an online doctor he had asked for help.
"I thought maybe this was some sort of sexual fantasy," Murphy said.
She told Justin, "No matter what, I love you, and we are going to get through this." But Justin refused to discuss it later and told her it was "just a phase."
But the issue didn't go away after high school; Justin suffered from panic attacks that Murphy now believes were intermingled with his fears and confusion about his sexuality.
It wasn't until he moved to Eureka with a friend to take college classes that Justin began to open up more to Murphy. He told her he was transgender in a series of text messages sometime after Christmas 2009.
"I was relieved because now I had an answer to her struggles," Murphy said.
With a new start in a new town, Justin began dressing as a woman in Eureka and decided he wanted to physically transform into one. But he was still struggling to find a job, which is much tougher for a man dressing as a woman, Murphy said.
Murphy said she will never know exactly why 18-year-old Justin shot himself on Sept. 24. She believes the struggles with his sexual identity and worrying about society's acceptance -- along with the pressures of being on his own -- overwhelmed him.
"A huge portion was tied to sexual identity, which had been bottled up for years," she said. "It's devastating to me that we are in such a judgmental world."
Experts said there are things parents can do to help their gay or lesbian children. For example, even if they don't condone homosexuality, they should reaffirm their love for their children and let them know they won't be abandoned. They should also reach out to other parents and find support groups so they know they are not alone.
Meanwhile, more schools are trying to provide a safe place for gay and lesbian students.
About 830 California high schools now have Gay-Straight Alliance clubs, including most high schools in the Valley. Nationwide, there are more than 4,000.
"The formation of a Gay-Straight Alliance can be lifesaving," said Carolyn Laub, executive director of the Gay-Straight Alliance Network in San Francisco.
Some gay youths overcome the pressures they face, ultimately realizing that life does get better. The "it gets better" mantra is also the title of a national campaign that has celebrities delivering video messages of hope to gay youths as a reminder that they can overcome the struggles they face today.
Pedro Martinez did.
He grew up in a large Hispanic Catholic family in Fresno knowing he was different from other boys. By age 12, he realized he was gay.
His mother suspected it, but he repeatedly denied it when confronted. He eventually came out to his mother at age 15.
"When I first told her, she didn't want to believe it. She said it's just a phase you are going through, you will get over it and move on."
She forbade him from having boyfriends over, thinking she could put a stop to it.
High school was torture. "Instead of eating lunch, I would get it thrown at me," said Martinez, now 21. He was beaten up in the school bathroom at Fresno High by four boys who intentionally flooded the floors with toilet water and shoved his face in it.
His mother marched down to the school and demanded action. Knowing she was on his side -- even though she didn't accept his homosexuality -- helped, but Martinez still struggled. Feeling isolated, he contemplated suicide and turned to drugs to ease the pain. Drug possession landed him in juvenile hall -- where he met Robinson, who heads the support group for gay and lesbian youths.
Martinez said attending the group has helped him. And his relationship with his mother is better today.
"It's like I can tell her anything," he said. "But it took two years for her to realize I wasn't going to change."
Robinson said a young man who came to the group meeting this summer was struggling with his family's inability to accept him as gay. He later died when he was hit by a train. "There are indications that he committed suicide," Robinson said.
But Fresno, unlike San Francisco, Los Angeles and Sacramento, still lacks resources to help these families. Fresno does not have a dedicated center for gay teens, something some experts said it needs.
For Robles, it's too late. She wishes she could have done things differently for her daughter Monique. With time, she said, she may have been able to accept her daughter's sexual orientation.
If she could have her daughter back again today, "I would hug her and tell her I love her."