According to the American Psychiatric Association, LGBTQ+ individuals are more likely to experience mental health issues in their lives than individuals who are heterosexual and cisgender. In the case of depression and anxiety, LGBTQ+ individuals are 2.5 times more likely to experience these conditions than heterosexual individuals.
There are a variety of stressors specific to the LGBTQ+ community that contribute to the heightened risk of mental health conditions, including:
- Coming out: The act of coming out, or openly living as an LGBTQ+ individual, can be a stressful experience. During the coming out process, LGBTQ+ individuals may face rejection from family and friends, discrimination in the workplace, or even violence.
- Violence and trauma: LGBTQ individuals are at a higher risk of becoming victims of violent attacks than their non-LGBTQ counterparts. This high risk, and the trauma responses that can come after an attack, can lead to a variety of mental health conditions, including post-traumatic stress disorder (PTSD) and depression.
- Lack of mental health care: The number of facilities offering mental health care specific to LGBTQ+ individuals has only increased by 3 percent in the last ten years. For many of those in the LGBTQ+ community, finding mental health professionals who can provide LGBTQ+-conscious support is a difficult process.
- Homelessness: According to the National Coalition for the Homeless, LGBTQ+ people face discrimination and harassment when seeking housing. Dealing with unstable housing situations and harassment from other residents and staff at homeless shelters can create high levels of stress for LGBTQ+ individuals.
Each of these life events and stressors contributes to the mental health of those in the LGBTQ+ community. Those dealing with mental health conditions must be connected to the resources and LGBTQ-friendly mental health professionals that can help them to heal and thrive.
Prominent mental health concerns in the LGBTQ+ community
People who are a part of the LGBTQ+ community are at a higher risk of developing mental health conditions.
These conditions, including depression, anxiety and substance misuse, can have a long-lasting impact on a person’s quality of life, especially if they do not receive the mental healthcare they need.
Stress
The stress felt within the LGBTQ+ community as a result of discrimination, prejudice, rejection, and violence is referred to as minority stress. These stressors are shared with other minority groups.
On top of these causes of minority stress, LGBTQ+ individuals also experience stress from years of concealing their identity and battling internalized homophobia.
LGBTQ+ people of color have additional stressors to cope with stemming from the effects of racism. The intersectional nature of minority stress can cause additional physical and mental health struggles to take hold.
Anxiety
According to the Anxiety and Depression Association of America, 30 to 60 percent of all LGBTQ+ individuals live with anxiety or depression during their lifetime.
Anxiety can cause physical and mental symptoms that can impact a person’s quality of life, according to the Cleveland Clinic. Physically, individuals may experience heart palpitations, dry mouth and numbness in the hands and feet during anxiety attacks. Mentally, anxiety can cause panic, fear, obsessive thoughts and nightmares.
Depression
Compared to other mental health conditions, depression is one of the more common conditions with which LGBTQ+ individuals are diagnosed. According to the 2022 National Survey on LGBTQ Youth Mental Health, 58 percent of LGBTQ youth report experiencing depressive feelings in their day-to-day lives.
Depression can have a significant impact on a person’s physical and mental health. Depressed individuals often experience persistent feelings of sadness and hopelessness, decreased appetite, trouble concentrating, limited memory and headaches among other symptoms.
Disordered eating
Eating disorders can be brought on by some of the common stressors faced by LGBTQ+ individuals, such as:
- Rejection from friends and family,
- Discrimination and violence,
- Anxiety and depression.
These stressors put LGBTQ+ individuals at higher risk for developing disordered eating and facing limited treatment options. While there are specific, diagnosed eating disorders such as anorexia nervosa and bulimia nervosa, the term disordered eating is used to describe harmful eating habits beyond these diagnoses.
Frequent dieting, food restriction, food guilt and other harmful habits may not warrant a diagnosis with an eating disorder, but those dealing with these habits can still benefit from mental health treatment.
Substance misuse
According to the National Institute on Drug Abuse, lesbian, gay and bisexual adults misuse opioids at nearly double the rate of the general population. Similarly, 21% of LGBTQ+ adults have an alcohol use disorder, compared to 11% of the general population.
For some individuals who feel they cannot seek mental healthcare, or have restricted access to mental healthcare, substance misuse can be a form of self-medication. However, substance misuse can lead to long-lasting mental and physical health issues.
Suicide
One in every five transgender and nonbinary youth have attempted suicide in their lives. Close to half of all LGBTQ+ youth have thought about committing suicide, a trend that is currently being addressed by counselors, nonprofits, and educators around the country.
These numbers are startling, and they are indicative of a widespread problem in the LGBTQ+ community. Untreated mental health conditions, discrimination, violence and barriers to treatment create situations where suicide occurs. However, even for those who cannot attend therapy, there are options, discussed in this article, that can provide emergency support for those considering suicide.
Does age impact mental health concerns in the LGBTQ+ community?
Age can greatly impact an LGBTQ+ individual’s life experiences. Older LGBTQ+ adults are more likely to face poverty and mental health struggles than their heterosexual and cisgender counterparts. Some seniors end up hiding parts of their identity to avoid abuse and neglect when living in nursing homes.
Age also has an impact on young LGBTQ+ people, including those in middle school, high school, and college. LGBTQ+ kids, from an early age, can experience discrimination and violence in the form of bullying. As they age, these experiences can cause trauma and mental health conditions that follow them through high school and college and into adulthood, leading to self-harm and suicide.
Barriers to mental health care for the LGBTQ+ community
While healthcare options for the LGBTQ+ community are always improving, there are still barriers that many people face.
These barriers to mental health care can lead to LGBTQ+ individuals suffering alone or in silence with mental health conditions.
Access
Financial and physical access to therapy and mental health services can be limited for some individuals. These access barriers include:
- According to a study from 2021, 12.7% of LGB+ individuals did not have health insurance coverage compared to 11.4% of the general population.
- Rural residences may have limited mental health professionals in the local area.
- Employment discrimination and mental health struggles can cause situations of unstable income and financial constraints that limit access to mental healthcare.
- Transportation limitations and the impact they can have on access to regular medical appointments.
While telehealth services have helped to overcome some of these accessibility barriers, even access to telehealth can be limited due to other factors, such as limitations in insurance coverage.
Insurance
Not every insurance plan covers the costs of mental health services. For individuals living in rural areas, there are additional limits in coverage. Many health insurance plans don’t cover telehealth services, including virtual therapy appointments.
The costs of therapy, especially when not covered by insurance, can act as an insurmountable barrier for some LGBTQ+ people looking for mental health help.
Societal issues and attitudes
While therapy is becoming generally more socially accepted, there are still some subconscious barriers to overcome for some people as they consider seeking mental health services.
Some LGBTQ+ people fear judgment from friends and family if they attend therapy, and may even view it as a sign of weakness within themselves.
Seeking treatment for mental health challenges
When seeking treatment for mental health challenges, there are a variety of types of mental health professionals to choose from. These professionals offer different services, so understanding the differences between them is important for finding the best possible care. These professionals include:
- Therapists: Therapists are trained to provide therapeutic services to their clients through graduate degrees and licenses in psychology or social work.
- Psychologists: Psychologists are trained in specific sub-fields of psychology and have earned a doctoral degree in psychology or education.
- Psychiatrists: Psychiatrists are mental health professionals who have completed medical school and residency. Unlike therapists and psychologists, psychiatrists can prescribe psychiatric medications as part of a patient’s treatment plan.
Starting work with a therapist or psychologist can be an uncertain time, but it can provide many benefits and opportunities for growth. Additionally, your therapist or psychologist can refer you to a psychiatrist if you want to explore options such as psychiatric medication.
Finding an LGBTQ-friendly mental health provider
For LGBTQ+ individuals, it is important to find a mental health provider who is LGBTQ+-friendly. This can mean a mental healthcare provider who identifies as a part of the LGBTQ+ community or a provider who has experience working with and supporting LGBTQ+ individuals.
With thorough research, you can find a therapist, psychologist or psychiatrist who focuses in LGBTQ+ mental health.
What are you looking for?
Most LGBTQ+-friendly therapists, psychologists, and psychiatrists will indicate their experience working with LGBTQ+ individuals on any online profiles and pages they may have.
They may simply make a note of being “LGBTQ+-friendly”, or they may note that they specialize in working with minority populations or helping individuals dealing with issues such as gender dysphoria.
Where to look for referrals?
When looking for referrals for LGBTQ+-friendly mental health providers, it is best to look for information from current patients and LGBTQ+ individuals.
Local LGBTQ+ centers will certainly have resources and information about local mental healthcare providers. You can also check online groups, social media, and reviews left in online directories.
Contacting a provider
When you have found a provider you would like to work with, you can contact them to ask clarifying questions and determine if they are the right fit for you. Some questions to ask a potential provider include:
- What experiences do you have working with LGBTQ+ people?
- What are your specialties and research focuses?
- What types of therapy do you use in sessions with clients?
There are some red flags to keep an eye out for when starting with a new mental healthcare provider. If the provider suggests conversion therapy, this is a strong indication that they are not LGBTQ+-friendly. Conversion therapy is widely viewed as an unethical practice geared towards changing a person’s sexual orientation or gender identity.
Supporting an LGBTQ+ loved one who is struggling
If you have an LGBTQ+ loved one who is struggling, there are many ways you can support them, as well as actions to avoid.
In conversations with your LGBTQ+ loved one, do not:
- Express judgment about the person’s LGBTQ+ experiences.
- Refer to your own religious or moral beliefs about people who are LGBTQ+.
- Give the person the impression that being LGBTQ+ is a deviation from the norm.
- Say things that are intended to reassure but are mostly unhelpful or patronizing.
Your focus when providing support for an LGBTQ+ individual should be to show respect, even if you don’t understand or feel uncomfortable with their identity. Always respect their clothing, name, and pronoun choices. If your loved one is lacking a sense of community or needs the help of resources or trained professionals, you can provide suggestions for helpful organizations and community events in your area.
LGBTQ+ crisis and suicide prevention hotlines
While discrimination and violence are still serious issues faced by the community, there is a wide range of organizations and trained professionals who can provide support for LGBTQ+ people in crisis situations or those who are considering suicide.
These LGBTQ+-inclusive organizations include:
- LGBT National Youth Talkline: 1-800-246-7743
- Lifeline: 1-800-273-8255
- LGBT National Hotline: 1-888-843-4564
Calling these hotlines can provide you with a source of support in crisis situations. The trained professionals who answer these hotlines can talk you through hard situations and refer you to additional resources that can help you cope with suicidal ideation.
Additional LGBTQ+ resources
Beyond crisis and suicide prevention hotlines, there are many different resources available to the LGBTQ+ community. These resources include:
- Human Rights Campaign (HRC): The HRC provides resources for LGBTQ+ individuals interested in learning about sexual health, advocacy, and options for long-term care.
- The Gay and Lesbian Medical Association’s Provider Directory: This directory is free to use and provides information on LGBTQ-friendly healthcare professionals in the United States and Canada.
- The Trevor Project: This project provides a 24/7 hotline, as well as educational resources about LGBTQ+ mental health.
- Trans Lifeline: This helpline is operated by transgender people, and is built to provide ongoing support for transgender people in crisis.
- The LGBT National Help Center: This center provides chat rooms, call lines, and informational lists created to help educate LGBTQ+ people about mental health, LGBTQ+ history and media, and so much more.
These resources help LGBTQ+ people to find mental healthcare providers and other trained professionals and resources who can help them to live and thrive with their mental health conditions.