Introduction
Every person’s experience of mental health and healthcare is different. For members of the LGBTQIA+ community, there are often challenges that heterosexual and cisgender individuals (people who identify with the sex and gender they were assigned at birth) might not face. For example, lesbian, gay, and bisexual adults are more than twice as likely as heterosexual adults to experience a mental health condition. Meanwhile, transgender individuals are almost four times as likely to experience a mental health condition compared to cisgender individuals, according to the National Alliance on Mental Illness.
Thus leading to the question, Why is the LGBTQIA+ experience of mental health often different from the experiences of heterosexual and cisgender people?
The Impact of Discrimination
First, it is important to clarify that being part of the LGBTQIA+ community is not a mental illness or disorder. LGBTQIA+ identities have a history of being misunderstood, and are still misunderstood by many people today. Nonetheless, homosexuality was removed from the Diagnostic and Statistical Manual of Mental Disorders in 1987 and from the World Health Organization’s International Classification of Diseases in 1992 (Drescher, 2015). Additionally, “gender identity disorder” was finally removed from the International Classification of Diseases in 2019 and is no longer considered a mental disorder (BBC, 2019). LGBTQIA+ stigma remains prevalent, but mental health professionals are recognizing that LGBTQIA+ identities are a normal part of society.
The cause of poor mental health within the LGBTQIA+ community is primarily the discrimination, prejudice, and harassment that many members face.
The National Alliance on Mental Illness documents examples as well as psychosocial studies of this discrimination, including stereotyping, bullying, denial of opportunities, and hate crimes in extensive detail. This treatment can result in a heightened risk of post-traumatic stress disorder and substance abuse, and an increased likelihood of suicide. LGBTQIA+ youth face even bigger challenges. An unsafe home or school environment means increased discrimination and makes it harder to access the care needed. According to the Trevor Project, which surveys American LGBTQIA+ youth, 60% of youth who wanted mental health care in 2022 could not get it (The Trevor Project, 2022).
Additionally, most health care and research are not designed to suit people of diverse backgrounds, including members of the LGBTQIA+ community. Often, they are rendered invisible by health researchers and practitioners who assume that they are heterosexual and cisgender. This lack of consideration for LGBTQIA+ identities, along with the presence of discrimination, can make finding adequate healthcare difficult for LGBTQIA+ youth and adults.
Multiple Factors Impact LGBTQIA+ Mental Health
It is important to remember that there are many different identities and experiences included under the LGBTQIA+ umbrella. Even people who use the same label may have led very different lives. Some people understand their gender or sexuality at a young age, while others take years to understand their identity. In addition, the environment a person grows up in greatly shapes their relationship to their identity. Between home and school, these environments can be accepting, dangerous, or a mix of the two.
Further, LGBTQIA+ mental health is an intersectional issue, and such individuals are also impacted by their membership in other identities. These identities include people of color, those dealing with mental health conditions, or people living with disabilities, all of whom may face discrimination within different healthcare systems. Just as heteronormative and cisnormative healthcare renders LGBTQIA+ identities invisible, LGBTQIA+ oriented care that emphasizes the similarities of all community members while ignoring their intersecting identities renders the experiences of other minority groups invisible.
To help members of the LGBTQIA+ community get the care they need, it is important to consider their unique experiences and the challenges.
In an article on heteronormativity in health research, Jane Ussher (2009) suggests that LGBTQIA+ healthcare needs its own area of research that considers their experiences and challenges (p. 562). Further, the Trevor Project found that youth who live in communities that are accepting of LGBTQIA+ people are significantly less likely to attempt suicide, while affirming school and home environments also helped significantly (The Trevor Project, 2022).
Conclusion
We have a long way to go when it comes to helping care for the mental health of LGBTQIA+ individuals. However, decreasing discrimination and increasing the availability of LGBTQIA+ oriented healthcare systems are crucial for improving mental health within the community. For anyone outside the community, it may be difficult to understand why healthcare must be adapted to meet LGBTQIA+ needs. However, despite our differences, if we work toward including each other in conversations about mental health and accepting that each individual will have different needs, we can move toward better mental healthcare for everyone.
References
BBC. (2019). Transgender no longer recognised as a ‘disorder’ by WHO. British Broadcasting Corporation. https://www.bbc.com/news/health-48448804
Drescher J. (2015). Out of DSM: Depathologizing homosexuality. Behavioral Sciences, 5(4), 565–575. https://doi.org/10.3390/bs5040565
The Trevor Project. (2022). 2022 National Survey on LGBTQ Youth Mental Health. https://www.thetrevorproject.org/survey-2022/
Ussher, J. M. (2009). Heterocentric practices in health research and health care: Implications for mental health and subjectivity of LGBTQ individuals. Feminism & Psychology 19(4), 427-568. https://doi-org/10.1177/0959353509342933
Author Bio
Nora is an international student from the USA. She was studying in the Czech Republic for her master’s. Her focus is on the School of Humanities and Social Sciences. She is especially interested in exploring how self-talk and self-awareness affect mental health within queer communities.
“Through my experience as a student living abroad, I’ve learned a lot about taking care of my mental health and handling big life changes. In my free time, I’m an avid reader, knitter, and artist. At WHJ Online Therapy Centre, I worked as a content writing intern, expanding my knowledge of mental health and self-help tools.” – Nora Zapalac
Published under the Creative Commons Attribution 4.0 International (CC BY 4.0) license for mental health awareness with editorial review.