Roughly 5.8 million LGBTQ+ individuals in the United States have reported experiencing mental illnesses in the past year — nearly 40% of the US LGBTQ+ population in total.1 Pride Month is a time to celebrate the vast span of identities within the LGBTQ+ community, but it is also a time to offer support. This includes mental health support.
Navigating mental health is important for everyone, but there are unique challenges that the LGBTQ+ community faces when navigating mental health challenges. In this blog, we’ll shine a light on these issues and explain how a psychiatrist can help.
Understanding Mental Health Challenges in the LGBTQ+ Community
A 2018 study conducted by Stonewall, an LGBTQ+ resource company in the United Kingdom, found that 52% of LGBTQ+ individuals in Britain had depression, and three in five had an anxiety disorder.2 More concerningly, the same study found that one in eight LGBTQ+ youths between the ages of 18 and 24 had attempted suicide, and half of the trans population had thought about taking their lives.
Of course, being LGBTQ+ does not automatically mean that you will be depressed or anxious. There is no genetic or chemical disposition that LGBTQ+ individuals have towards mental illness compared to anyone else. However, there are often additional external factors that those not in the LGBTQ+ community don’t face. Numbers tend to be especially high for trans individuals in recent years given the debates about trans identities and the heightened discrimination against the trans community.
External Mental Health Challenges in the LGBTQ+ Community
Although support for the LGBTQ+ community has risen in recent years, LGBTQ+ individuals still face discrimination and stigma that can have a significant negative impact on mental health. Some of the external mental health challenges within the LGBTQ+ community include:
Shame Over Identity
No one should be made to feel shame over their gender or sexual orientation. However, LGBTQ+ individuals who have grown up in communities that were less accepting of their identity often feel a sense of shame. They may struggle with internalized bigotry, believing many of the things they’ve grown up hearing about themselves. This leads to low self-esteem, which is never good for mental health. It can also increase the likelihood of depression and anxiety.
Hate Crimes and Trauma
Trans individuals are over four times more likely than cisgender individuals to be victims of violent crime such as assault, rape, or attempted murder.3 These experiences are obviously deeply traumatic and can lead to mental health conditions like anxiety or PTSD. Hate crimes can occur throughout the LGBTQ+ community, however, such as assault on LGBTQ+ couples or corrective rape.
Some LGBTQ+ individuals also face trauma from abusive households, either those where they did not feel safe to come out or those who reacted poorly to them coming out. For instance, physical abuse or getting kicked out can constitute traumatic experiences and be the beginning of mental illnesses. Religious trauma is also common amongst LGBTQ+ individuals.
Lack of a Support Network
It can be difficult for LGBTQ+ individuals to find a support network of people with whom they can truly be themselves. They may live in a more rural or conservative area, in which LGBTQ+ matters are typically viewed negatively. Without a support network that accepts them fully, they may find themselves suffering in silence when it comes to mental health. This isolation can be deeply depressing and may worsen mental health.
They may also feel deeply lonely due to struggles with dating. For instance, trans individuals may struggle to find partners who accept and validate their identity. Bisexual individuals may have negative experiences with partners who felt betrayed by their bisexuality. Asexual individuals who experience romantic attraction may be frustrated with attempts to date that don’t involve sex, and aromantic individuals who crave sexual experience may struggle to find those connections.
Political Tensions
LGBTQ+ issues seem to be in the news frequently. As anti-trans bills go into effect across a number of states and many LGBTQ+ books are being banned from schools, it can seem as though LGBTQ+ individuals are inundated with bad news. With such divisive state and federal elections on LGBTQ+ matters, stress can run high. Too much time “doomscrolling” through the news can also lead to feelings of depression.
Lack of Access to Mental Healthcare
Access to mental healthcare is also an important issue for the LGBTQ+ community. Some of it is a matter of socioeconomic status. LGBTQ+ individuals — especially visibly trans or openly LGBTQ+ individuals — often struggle to get hired or may face discrimination at work, leading to earning less than their cisgender or heterosexual counterparts. This can make it difficult to get insurance or to afford mental healthcare.
For those who can afford mental healthcare, there is also a matter of finding providers who are affirming and competent in LGBTQ+ matters. If a mental health provider does not include affirming care as part of the mental health support they offer, it can actually worsen your mental health.
How a Psychiatrist Can Help
If you experience mental illness, the important thing is to get the right mental health support. This usually comes in the form of therapy and/or medication management. Some may choose one over the other, while others may benefit from taking both treatments concurrently. Here’s how a good psychiatrist can help combat the mental health challenges in the LGBTQ+ community.
Diagnosis and Treatment Plan
A psychiatrist can help validate that your mental health struggles are not just “for attention,” and that in fact they deserve attention. You can schedule an evaluation, receive a diagnosis, and begin a treatment plan with a psychiatrist. This can be a breath of relief for LGBTQ+ individuals who have struggled with their mental health but haven’t known what to do about it.
Medication Management
Only a psychiatrist can prescribe medication. Once you have your diagnosis, you can discuss your symptoms and the types of medication that you’d like to try with your psychiatrist. Typically, they will start you on a low dose and then meet with you in a month or three months to see how the medication is working. If it seems to be working well, you can continue on it. If it seems to be going poorly, they may adjust or change the medication.
Therapy
Psychiatrists can also provide therapy to their patients. For some LGBTQ+ individuals, therapy can be one of the first places where they are accepted as themselves and able to be truly honest about their identity and their feelings. This allows the therapist to understand the context of your mental health and to help you come up with coping strategies, whether it’s dealing with an unsupportive family or struggles with the dating scene.
Affirming Care
As a patient, you can specifically request a psychiatrist who works with the LGBTQ+ community — or even an openly LGBTQ+ psychiatrist themselves. By choosing a provider who knows and cares about the LGBTQ+ community, you can receive support and validation that a psychiatrist with no experience working with LGBTQ+ individuals might not be able to provide. They may have insight into the issues specific to your identity. They can offer more sympathy and give more specific mental health suggestions.
Rivia Mind offers LGBTQ+ affirming psychiatry, both in the form of therapy and medication management. Contact us today to learn more about how we can help you or to find a provider for yourself.
Resources:
- LGBTQ+ Communities and Mental Health – Mental Health America
- LGBT in Britain – Health (2018) – Stonewall
- Transgender people over four times more likely than cisgender people to be victims of violent crime – Williams Institute
