The Lesbian, Gay, Bisexual, Transgender, Queer, Questioning, and Intersex (LGBTQI - This list of initials is not an exhaustive list of identities included in this community and related groups. We want to be explicit in our support of all people who identify as community members, whether their identity is commonly acknowledged or not) community represents a diverse range of identities and expressions of gender and sexual orientation. In addition to these identities, members of the community are diverse in terms of race, religion, ethnicity, nationality, and socioeconomic class.
This intersectionality — the combined and overlapping aspects of a person’s identity — brings a diversity of thought, perspective, understanding, and experience. This complexity is important to understand as a unique and valuable aspect of the LGBTQI community that can result in a strong sense of pride and resiliency.
While belonging to the LGBTQI community can be a source of strength, it also brings unique challenges. For those who identify as LGBTQI, it’s important to recognize how your experience of sexual orientation and gender identity relates to your mental health.
Although the full range of LGBTQI identities is not commonly included in large-scale studies of mental health, there is strong evidence from recent research that members of this community are at a higher risk for experiencing mental health conditions — especially depression and anxiety disorders. LGB adults are more than twice as likely as heterosexual adults to experience a mental health condition. Transgender individuals are nearly four times as likely as cisgender individuals (people whose gender identity corresponds with their birth sex) individuals to experience a mental health condition.
LGB youth also experience a greater risk for mental health conditions and suicidality. LGB youth are more than twice as likely to report experiencing persistent feelings of sadness or hopelessness than their heterosexual peers. Transgender youth face further disparities as they are twice as likely to experience depressive symptoms, seriously consider suicide, and attempt suicide compared to cisgender lesbian, gay, bisexual, queer, and questioning youth.
For many LGBTQI people, socioeconomic and cultural conditions negatively impact mental health conditions. Many in the LGBTQI community face discrimination, prejudice, denial of civil and human rights, harassment, and family rejection, which can lead to new or worsened symptoms, particularly for those with intersecting racial or socioeconomic identities.
Important Risk Factors Of LGBTQI Mental Health
Coming Out Positive changes in societal acceptance of LGBTQI people act as a protective factor for mental health. However, this shift in acceptance has meant that many LGBTQI youths “come out” or share their sexual orientation or gender identity at younger developmental ages, which can impact their social experiences and relationships. This can have negative mental health impacts, particularly for youth who are not in supportive environments.
Rejection For many in the LGBTQI community, coming out can be a difficult or even traumatic experience. It can be difficult to cope with the rejection of something as personal as one’s identity from family or close friends, within the workplace, or in a faith community.
According to a 2013 survey, 40% of LGBT adults have experienced rejection from a family member or a close friend. A 2019 school climate survey showed that 86% of LGBTQ youth reported being harassed or assaulted at school, which can significantly impact their mental health.
Trauma Homophobia, biphobia, transphobia, bullying, and feeling identity-based shame is often traumatic for people.
The LGBTQI community faces many forms of discrimination, including labeling, stereotyping, denial of opportunities or access, and verbal, mental, and physical abuse. They are one of the most targeted communities by perpetrators of hate crimes in the country.
Such discrimination can contribute to a significantly heightened risk for PTSD among individuals in the LGBTQI community compared to those who identify as heterosexual and cisgender.
Substance Use Substance misuse or overuse, which may be used as a coping mechanism or method of self-medication, is a significant concern for members of this community. LGB adults are nearly twice as likely as heterosexual adults to experience a substance use disorder. Transgender individuals are almost four times as likely as cisgender individuals to experience a substance use disorder. Illicit drug use is significantly higher in high school-aged youth who identify as LGB or are unsure of their identity, compared to their heterosexual peers.
Homelessness It is estimated that LGBTQI youth and young adults have a 120% higher risk of experiencing homelessness — often the result of family rejection or discrimination based on gender identity or sexual orientation. This risk is especially high among Black and Native American/Alaska Native LGBTQI youth. Many members of the LGBTQI community face the added challenge of finding homeless shelters that will accept them, and experience elevated rates of harassment and abuse in these spaces.
Suicide Many people in this community struggle in silence — and face worse health outcomes as a result.
The LGBTQI population is at a higher risk than the heterosexual, cisgender population for suicidal thoughts and suicide attempts.
High school students who identify as lesbian, gay, or bisexual are more than four times as likely to have attempted suicide compared to their heterosexual peers.
40% of transgender adults have attempted suicide in their lifetime, compared to less than 5% of the general U.S. population.
Inadequate Mental Health Care The approach to sexual orientation and gender identity in mental health care often groups together anyone in the LGBTQI community, when these communities are considered at all. This method can be problematic as each sub-community faces unique challenges, rates of mental illness, and experiences.
The LGBTQI community encompasses a wide range of individuals with separate and overlapping challenges regarding their mental health. Other identity factors including race and economic status can affect the quality of care they receive or their ability to access care.
Additionally, members of this community may face harassment or a lack of cultural competency from potential providers. These experiences can lead to a fear of disclosing sexual orientation and/or gender identity due to potential discrimination or provider bias.
Confronting these barriers and mental health symptoms with an LGBTQI-inclusive mental health provider can lead to better outcomes, and ultimately recovery.
Choosing A Mental Health Professional
Wellmore supports the belief that every client served deserves programming that is effective, supports individual values, beliefs, and cultures, as well as identifies the role that dual disorders, gender, trauma, lifespan development, and socio-economic status factor in the way that services are facilitated and practiced.
In identifying best practices and keeping current with the modern behavioral health climate, Wellmore has identified and continuously works to implement a culturally competent, linguistically supportive, gender-sensitive, and developmentally appropriate continuum of care treatment within outpatient and intensive outpatient groups offered.
The American Psychological Association (APA) Provides educational and support resources on a range of LGBTQ topics.
PFLAG is the United States' first and largest organization uniting parents, families, and allies with people who are lesbian, gay, bisexual, transgender, and queer. PFLAG National is the national organization, which provides support to the PFLAG network of local chapters.
The Association of Gay and Lesbian Psychiatrists Offers many resources for LGBT individuals experiencing mental health conditions and psychiatric professionals with LGBT clients.
The Gay and Lesbian Medical Association's Provider Directory A search tool that can locate an LGBTQ-inclusive health care provider.
The LGBT National Help Center Offers confidential peer support connections for LGBT youth, adults, and seniors, including phone, text, and online chat.
The National Center for Transgender Equality Offers resources for transgender individuals, including information on the right to access health care.
The Trevor Project A support network for LGBTQ youth providing crisis intervention and suicide prevention, including a 24-hour text line (text “START” to 678678).
Society for Sexual, Affectional, Intersex, and Gender Expansive Identities (SAIGE) Delivers educational and support resources for LGBTQ individuals, as well as promotes competency on LGBTQ issues for counseling professionals.
Depression Looks Like Me Depression Looks Like Me is a program – sponsored by the Johnson & Johnson Company and supported by an alliance of other partners – that aims to educate and empower LGBTQ+ people with depression.