Warning: this article contains content that some readers may find triggering including references to hate crime, ‘conversion therapy’ and healthcare inequalities.
Some of us identify as LGBTQIA+. This means we might be lesbian, gay, bisexual, trans, intersex, non-binary, queer or questioning. Or we might define our gender and sexuality in different ways. Have a nosey here for tons more terms. It’s also important to bear in mind that not all LGBTQIA+ people will choose to use labels, for all sorts of reasons.
Whilst mental illnesses can affect anyone, it’s been almost constantly reported in the UK that the LGBTQIA+ community experience more mental health problems, and more severe ones to boot, than our heterosexual counterparts [1]. According to numerous studies and research, transgender and non-binary peeps are also more at risk of suicide and suicidal thoughts [2].
So, does this mean we’re destined for a life of sadness, hopelessness, and mental health issues? Hell, no! What it does mean is that although hard-won LGBTQIA+ rights introduced in the last 30-odd years have improved life for many, there are still unique challenges that we face. We can refer to these issues as minority stress. Minority stress can affect the mental health of LGBTQIA+ people directly, but for others it can be simmering in the background, pulling at emotional strings that are hard to ignore.
Here are just some of them:
Hate crime!
For centuries, the LGBTQIA+ community has been stigmatised, criminalised, and persecuted. ‘Coming out’ came with threats of violence and social isolation. It’s not at all surprising that experiencing discrimination greatly increases the risk of mental health problems. A 2018 survey found that 41% of transgender people and 31% of non-binary people have experienced hate crimes because of their gender identity [3]. Minority LGBTQIA+ groups are at even higher risk of hate crime, including violence, sexual assault and hostility, particularly people of colour and those with disabilities.
Anxiety is also common for LGBTQIA+ people, often due to constantly being in a state of high alert. We’ve all seen homophobic, transphobic and many other discriminatory attitudes or behaviours on the internet (which itself can bring trauma) - but the people spouting hate online also walk the streets! Many LGBTQIA+ couples must continuously scan their environment for threats before deciding to act in one way or another. This stress becomes even worse when you know little about the people in the place you’re going. For example, 69% of countries still criminalise LGBTQIA+ identities. In Dubai being LGBTQIA+ carries the death penalty and Poland have recently introduced ‘LGBT-free zones’ in areas of the country. It can be incredibly distressing to have your freedom threatened so intensely, and to be constantly wary of surroundings can be utterly exhausting and emotionally draining.
Conversion therapy
It’s still (currently) legal in the UK for LGBTQIA+ people to be emotionally and mentally abused through so-called ‘conversion therapy’ which attempts to change someone's sexual orientation or gender identity. Say, what!? In the past ‘conversion therapy’ has taken the form of coercion, chemical castration, electric shocks, psychoanalytical therapy, nausea-inducing drugs, ice-pick lobotomies, group prayer and ‘corrective rape’.
In May 2021, the Queen’s Speech shared government plans to ban the "abhorrent practices" of conversion therapy. However, this pledge was already made 3 years ago by the government in its ‘LGBT equality plan’- and it’s currently still legal in the UK! It's easy to see how someone LGBTQIA+ can feel hopeless or devalued.
“The psychiatrist told my mum: ‘Homosexuality is just like all the other mental diseases, like depression, anxiety, or bipolar. It can be cured. Trust me, leave him here, he is in good hands.’ Wen (pseudonym)
It was only in 1990 that the World Health Organisation removed homosexuality from their list of mental illnesses!
Healthcare inequalities
13% of LGBTQIA+ people have experienced some form of unequal treatment from healthcare staff because they are LGBTQIA+ and 23% have witnessed it [4]. Diagnosis Homophobic (1995) set out a variety of harrowing narratives from lesbian, gay and bisexual mental health services users about their experiences of the NHS [4]. Sadly Stonewall’s Unhealthy Attitudes Report highlighted recent experiences of discrimination in the NHS too, suggesting that although progress has been made, many LGBTQIA+ NHS staff and patients still experience and perceive discrimination in NHS settings [5].
“I’ve known I was queer since about 2010. When being assessed for therapy following the death of my sister in 2018, the therapist implied that my same-sex relationship choices were me ‘looking to replace the relationship that I had with her’. Having a professional attempt to pathologise one of the only behaviours that gave me happiness at that time, and relating it to my grief was incredibly upsetting - and plain wrong.” Lucy (pseudonym)
A 2020 BBC article reported there were over 13,500 transgender and non-binary adults on waiting lists for NHS gender identity clinics in England (which provide much-needed support to those experiencing gender identity issues). The average waiting time is 18 months and some people even reported having to wait a staggering 3 years before their first appointment. Furthermore, transgender people have reported stigma and discrimination from healthcare professionals, and some individuals have been given inappropriate or abusive treatment because of their gender identity or even refused treatment altogether [6]. Imagine feeling like you don’t belong in your own skin and then being abandoned in it by the only people who are licensed to help you. It’s not a hard step to understand why many trans people will self-harm or even attempt suicide.
Bullying
Young people may face further discrimination in the form of bullying at school. A survey by Metro Youth Chances found 83% of young transgender people experienced name-calling, 35% experienced physical attacks and 32% missed lessons due to fear of discrimination [7].
In the UK, a study found that LGBT+ inclusive teaching has a positive effect on students' mental health. The researchers found that pupils whose schools had positive messaging about being LGBT+ also had reduced suicidal thoughts and feelings – regardless of whether they were LGBT+ or not [8]. This pushes for inclusivity in Pride celebrations, showing that teaching respect for individuality, benefits everyone.
It’s not all bad news
Whilst statistically being LGBTQIA+ increases our risk of mental health issues, it’s important to note that embracing being LGBTQIA+ can have a positive impact on our wellbeing. Embracing who we are unapologetically can give us more confidence, a sense of belonging to a community, feelings of relief and self-acceptance, and better relationships with friends and family.
“I decided to come out as bisexual to my family and friends, one by one, which really helped me grow in my confidence. Things are getting better with my mental health too." Stella (pseudonym)
The decision to medically transition to the gender with which we identify can be stressful, however, studies show that once a transition is completed, it can have immensely beneficial effects. A UK survey found that whilst 67% of transgender people thought about suicide before transitioning, only 3% thought about suicide after [8].
And suicide rates in LGBTQIA+ people in Sweden and Denmark dropped by 46% after same-sex marriage was legalised. The researchers suggested that along with other rights, same-sex marriage may have reduced feelings of social stigmatisation [9].
So, am I destined to be depressed?
You gorgeous, glorious human being… no! Okay as LGBTQIA+ there are more challenges that can lead to mental health problems, but we’re not alone. There are tons of great resources, support, LGBTQIA+ affirmative therapists, and communities. Here are just some of them:
Stonewall is a charity offering help and advice to LGBT communities. Their information-service lines are open from 9:30am – 4:30pm, Monday to Friday: 0800 0502020.
IMAAN is a charity that supports Muslims who identify as LGBTQ+.
Gendered Intelligence is a charity that aims to increase understandings of gender diversity and improve the quality of life of young transgender people in particular. They run youth groups across the UK and offer resources.
Mermaids is a charity offering family and individual support for young people who are transgender or gender-diverse. Their helpline is open from 9am to 9pm Monday to Friday: 0808 801 0400. Text chat is available 24/7 for free crisis support: 85258.
Albert Kennedy Trust supports young LGBTQIA+ people aged 16 to 25.
Switchboard LGBT helpline offers information and support. All their volunteers are LGBTQIA+.
The Beaumont Society are a national transgender support network offering emotional support via a weekly helpline, as well as general information and support groups.
GIRES (Gender Identity Research and Education) is a charity that provides information for transgender people and medical professionals, including research and links to support groups.
Mind Out is a mental health service for LGBT+ people which provides advice, information, advocacy, peer support groups, mentoring and wellbeing events.
Samaritans provide emotional support to anyone in emotional distress, struggling to cope, or at risk of suicide. Call 116 123.
Families and Friends of Lesbians and Gays (FFLAG) offer support to parents, friends and family members of those who identify as LGBT+.
Pink Therapy has a directory listing qualified therapists throughout the UK who work with the LGBT+ community from a positive stance.
British Association for Counselling and Psychotherapy (BACP) is a professional body for talking therapy and counselling, which provides information and a list of accredited therapists.
A final note about therapy from our lovely Life Coach, Grace: Remember, you don’t have to stick with the first therapist you find if you don’t gel with them or feel supported by them. Even though it can be time-consuming and frustrating, please persevere because it’s so important for your wellbeing to find the right person or people for you.
#LGBT #LGBTQIA #wellbeing #mentalhealth #stonewall #inclusion #comingout #copingwell #wellness #identity
References:
1. Mental health challenges within the LGBT community (2017). Henderson, G., & Varney, J.
2. LBGT in Britain Health Report (2018). Stonewall.
3. LBGT in Britain Health Report (2018). Stonewall.
4. LBGT in Britain Health Report (2018). Stonewall.
5. Diagnosis Homophodic (1995). Mindout.org.uk
6. Unhealthy Attitudes Report (2015). Stonewall.
7. Transphobic bullying (2020). Beyond Bullying.
8. Growing up LGBT+ Report (2021). Just Like Us.
9. Transgender people face NHS waiting list ‘hell’ (2020). BBC report.
10. Suicide risk in the UK trans population and the role of gender transition in decreasing suicidal ideation and suicide attempt (2014). ResearchGate.
11. Suicide among persons who entered same-sex and opposite-sex marriage in Denmark and Sweden (2016). BMJ Journals.