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According to her suicide note, Alcorn had felt "like a girl trapped in a boy's body" since she was four, and came to identify as a transgender girl from the age of fourteen, when she became aware of the term. She rejected the name she was given by her parents, and in her suicide note signed herself "(Leelah) Josh Alcorn". According to her note, she immediately informed her mother, who reacted "extremely negatively" by claiming that it was only a phase and that God had made her a male, so she could never be a woman. She stated that this made her hate herself, and that she developed a form of depression. Her mother sent her to Christian conversion therapists, but Alcorn later related that there she only encountered "more Christians" telling her that she was "selfish and wrong" and "should look to God for help". Aged sixteen, she requested that she be allowed to undergo transition treatment, but was denied permission: in her words, "I felt hopeless, that I was just going to look like a man in drag for the rest of my life. On my 16th birthday, when I didn't receive consent from my parents to start transitioning, I cried myself to sleep."

Within 48 hours of the posting of her suicide note, it had attracted 82,272 views, and by the morning of December 31, it had been reposted on Tumblr 200,000 times. Writing for the Boston Globe, the reporter Maura Johnston described it as a "passionate post". The suicide note was later deleted after Alcorn's parents asked for it to be removed, and the blog was made inaccessible to the public. According to the family minister, the Alcorn family decided to hold the funeral privately after receiving threats. Alcorn's body was reportedly cremated. The Ohio State Patrol completed their investigation into Alcorn's death on April 30, 2015, officially ruling it a suicide.

On January 1, 2015, the Cincinnati-based LGBT rights group Support Marriage Equality Ohio hosted a vigil for Alcorn outside Kings High School. A candlelight vigil in Goodale Park, Columbus, was held on January 2 by a group called Stand Up 4 Leelah. A further vigil was organized by both The Diverse City Youth Chorus in partnership with the Cincinnati chapter of the Gay, Lesbian and Straight Education Network at the Clifton Cultural Arts Center for January 10. The vigil location at the Clifton Cultural Arts Center was moved to the Woodward Theater, to make way for a larger setting. The event was attended by over 500 people.

A January 3 vigil was scheduled for Trafalgar Square in London; an organizer was quoted as saying that "[Alcorn's] death was a political death. When a member of our community is brutalised at the hands of oppression we must all fight back". Those who spoke at the event included politician Sarah Brown and novelist and poet Roz Kaveney. Marches were carried out in honor of Alcorn in both Northwest, Washington, D.C., and Queen Street, Auckland, on January 10. The same day, a candlelight vigil was held in New York City's Columbus Circle. A memorial protest against conversion therapy and in memory of Alcorn took place in Lynchburg, Virginia, on January 24, 2015.

Among the transgender celebrities who publicly responded to the incident were Janet Mock, Andreja Pejić, and Laverne Cox, while the musician Ray Toro released a song, "For the Lost and Brave", in dedication to Alcorn. Jill Soloway, the writer of the television show Transparent, dedicated their Golden Globe Award for Best Television Series to Alcorn. During Diane Sawyer's interview with Caitlyn Jenner (then Bruce), which confirmed Jenner's transgender identity, Alcorn was mentioned by name and the message "Fix society. Please" was broadcast. In June 2015, the singer Miley Cyrus founded the Happy Hippie Foundation, an organization to raise awareness of homelessness and LGBT issues among young people, partly in response to Alcorn's death. To promote the organization, she released a new series of Backyard Sessions videos, the second of which, Dido's "No Freedom" was dedicated to Alcorn. After reading about Alcorn's death, British musician Declan McKenna was inspired to write a song, "Paracetamol", which was included on his debut album What Do You Think About the Car? and discusses the media's representation of LGBT communities.

A Facebook group called "Justice for Leelah Alcorn" was established, while a petition calling for "Leelah's Law", a ban on conversion therapy in the United States, was created by the Transgender Human Rights Institute to raise awareness of the psychologically harmful effects of such practices; by January 24 it had 330,009 signatures, and was named the fastest growing change.org petition of 2014. A second appeal demanding the enactment of "Leelah's Law" was posted to the We the People section of WhiteHouse.gov on January 3, 2015, which garnered more than 100,000 signatures as of January 30. In response to the petition, in April 2015 President Barack Obama called for the banning of conversion therapy for minors.

In December 2015, Cincinnati became the second U.S. city after Washington, D.C., to ban the practice of conversion therapy outright; council member Chris Seelbach cited Alcorn's suicide as an influence in the decision and stated that "she challenged us to make her death matter, and we're doing just that". By October 2018, four cities across Ohio had banned conversion therapy, leading journalist Nico Lang to comment that "the Buckeye State has become an unlikely leader in banning conversion therapy at the local level."

Prior to her death on December 28, 2014, Alcorn scheduled for her suicide note to be automatically posted on her Tumblr account at 5:30 pm. In the note, she stated her intention to end her life, commenting:

Some of Alcorn's sympathizers publicly criticized the teen's mother, Carla Alcorn, for misgendering her daughter in the Facebook post announcing the teenager's death. Some individuals—termed "the Internet's self-appointed vigilantes" in The Washington Post—subsequently doxed and harassed Carla via her Facebook account "in revenge" for Leelah's death. On Twitter, American gay rights activist Dan Savage argued that Alcorn's parents should be prosecuted for their role in bringing about their daughter's death, commenting that through their actions they "threw her in front of that truck". He cited the successful prosecution of Dharun Ravi following the suicide of Tyler Clementi as a legal precedent for such an action. He added that legal action should also be brought against the conversion therapists who had counseled Leelah, and suggested that the Alcorns should lose custody of their other children.

The day after Alcorn's suicide note was published online, Chris Seelbach, the first openly gay councilman on Cincinnati City Council, shared it as part of a Facebook message in which he stated that her death showed how hard it was to be transgender in the U.S. His post was shared over 4,700 times and increased public awareness of the incident. By December 30, Alcorn's death had attracted worldwide attention. News outlets across the world had picked up the story, and the hashtag #LeelahAlcorn had topped Twitter. According to British newspaper The Independent, the incident "triggered widespread anguish and raised a debate about the rights of transgender people". The U.S.-based Boston Globe stated that it "served as a flashpoint for transgender progress in 2014", while The New Republic referred to it as having "sparked a national conversation about the plight of transgender kids and the scanty rights and respect our society affords them."

Carolyn Washburn, editor of the Ohio newspaper The Cincinnati Enquirer, stated that the incident "raises important issues we hope will prompt conversations in families throughout our region". Washburn had also received letters that derided the newspaper's use of Alcorn's chosen name in covering her death. When contacted by The Cincinnati Enquirer, Shane Morgan, the founder and chair of transgender advocate group TransOhio, stated that while 2014 witnessed gains for the trans rights movement, Alcorn's death illustrated how "trans people are still being victimized and still being disrespected", highlighting the high rate of transgender people who had been murdered that year. Since the incident, TransOhio received letters from parents of transgender children describing how Alcorn's death had affected them. Morgan stated that while he understood the anger directed toward Alcorn's parents, "there's no excuse for threats to the family."

Under Ohio's Adopt-a-Highway program, a group adopted the interchange of Interstate 71 South and Ohio State Route 48—which was where Alcorn died—and dedicated it to her memory. As a result, the Ohio Department of Transportation erected signs stating "In Memory of Leelah Alcorn" along the road. Members of the group affixed a wreath to one of these signs; group member Lisa Oravec informed press that "We don't want Leelah to be forgotten... We want people in Cincinnati, or anybody driving down 71 to see the wreath. See the highway. If they don't know who Leelah is they'll google it, educate it, and learn from what happened." As of December 2018, the "Leelah Alcorn Highway Memorial" group continued to meet four times a year to clean that stretch of road. The highway memorial formed the basis of a short documentary, Leelah's Highway, which was screened at the 2018 Cindependent Film Festival in Cincinnati's Woodward Theater. Its creator, Elizabeth Littlejohn of Toronto, stated that "as a human rights activist who believes [in] the right for gender self-determination, I believe this story needed to be told."

Allison Woolbert, executive director of the Transgender Human Rights Institute, informed The Independent that Alcorn's case was "not unique"; the newspaper highlighted research from the US Centers for Disease Control and Prevention indicating that LGBT youth are about twice as likely to attempt suicide than heterosexual, cisgender teenagers. Newsweek similarly placed Alcorn's suicide within its wider context of transphobic discrimination, highlighting that the Youth Suicide Prevention Program reports that over 50 percent of transgender youths attempt suicide before the age of 20, and that the National Coalition of Anti-Violence Programs recently published a report indicating that 72 percent of LGBT homicide victims in 2013 were transgender women. Kevin Jennings of the Arcus Foundation also situated Alcorn's death within wider problems facing young LGBT people. In his view, she became "an international symbol of the ongoing challenges faced by LGBT youth", adding that her death "reminds us of a basic lesson still being taught to young people across America: When it comes to gender identity, it's best to be cisgender; and when it comes to sexual orientation, it's best to be straight."

Alcorn was one of several children. She described herself as being raised in a conservative Christian environment; she and her family attended the Northeast Church of Christ in Cincinnati, and she had been featured in a profile of that church published in a 2011 article in The Christian Chronicle. As of 2014, the family lived in Kings Mills, Ohio.

Leelah Alcorn (November 15, 1997 – December 28, 2014) was an American transgender girl whose suicide attracted international attention. Alcorn had posted a suicide note to her Tumblr blog, writing about societal standards affecting transgender people and expressing the hope that her death would create a dialogue about discrimination, abuse and lack of support for transgender people.