By: Erin McGinn
No, it’s not because they go against the natural order of the world. LGBT+ people have to go through a lot of bullying, internalized phobia, medical discrimination, and misdiagnosis.
LGBT+ people attempt suicide 14 times more than the cis and heterosexual population (Moagi et al., 2021). People who are cis or cisgender are the same gender the doctor deemed them at birth. Depression rates are extremely high among LGBT+ people with rates at 31% in 2016 (Yarns et al.; Russell & Fish). Transgender people, specifically trans women, received the most diagnoses. In 2016, around 52% of New York City trans women had depression at least once in their life (Yarns et al.). The reasons below contribute to a poor mental health epidemic among the LGBT+ community.
Medical Discrimination and LGBT+ Mental Health
Before 2015, in the U.S., same-sex partners could not apply health insurance from one partner’s job to their spouse, which is something straight couples could do (Yarns et al., 2016). In many countries, same-sex marriage is still illegal, and this is still a problem. This limits their access to physical and mental health, for healthcare is exorbitantly expensive out of pocket. Denying trans and nonbinary people access to the hormones and surgeries they require can negatively impact their mental health. It can even cause suicide. Aside from physical health needs, LGBT+ people are less likely to receive mental health support:
Transgender women in Canada were 1.6 times more likely to report untreated depression and 2.4 times as likely to report an unmet need for mental healthcare compared with cisgender heterosexual women. Bisexual women were 1.8 times as likely to report an unmet need for mental healthcare compared with cisgender heterosexual women. (Moagi et al., 2021)
It doesn’t help when they finally get mental healthcare and their therapist stereotypes them.
For older LGBT+ adults, there is another problem. Say your grandpa has trouble doing basic things for himself because he’s old or he needs to be in a nursing home. He is assigned a nurse called Kyleighann, who finds out he was married to another man and she is homophobic. Who’s gonna be the patient she leaves unattended in his room for hours?
This is terrible for two reasons. First, the nurse might neglect their basic needs, the thing you paid her to help him with. Second, older people need to make and maintain friendships as they age to stay mentally healthy (Yarns et al., 2016). They can form friendships with grandchildren, other patients, or nurses to keep the loneliness at bay.
Until 1973, being gay in and of itself was considered a mental illness (Yarns et al., 2016). This was later corrected during the sexual revolution as more people were accepting of lesbian, gay, and bisexual people.
UK transgender people must have a diagnosis of gender dysphoria to have transition surgeries covered by their health care plan. This means transgender people fit themselves into the diagnosis to afford surgeries. Meanwhile, doctors will come back and use this data to refine the diagnosis (Thorn, 2022). But, since acquiring the diagnosis is a barrier to healthcare, it corrupts the data. Doctors in the UK will not be getting an actual idea of what gender dysphoria is causing them to over or under diagnose people.
External Bullying and LGBT+ Mental Health
Bullying gets put under different labels today, like homophobia, transphobia, and other discrimination. It can be the neighbor down the street calling people names or your local congressional representative passing laws to ban people from bathrooms. This boils down to bullying, picking on someone you don’t don’t like.
Let me pass you some statistics:
- “…10.3% of LGBT youths in Chicago experienced significant increases in victimisation and 5.1% maintained high levels across time” (Moagi et al., 2021).
- “In 2016 the most common forms of victimization were verbal insults (68%), threats of physical violence (43%), being hassled or ignored by the police (27%), having an object thrown at them (23%), damage or destruction of personal property (20%), physical assault including being punched, kicked or beaten (19%) and being threatened with a weapon (14%),” (Yarns et al., 2016).
- Only 19 states and D.C. have anti-bullying laws that protect sexual and gender minorities (Russell & Fish, 2016).
LGBT+ people have poor mental health because they deal with more of the risk factors that would make most people’s health worse. They tend to have tumultuous relationships with their parents, experience child abuse and substance abuse. Plus, LGBT+ specific risks like being disowned, governments taking away their rights, and queer directed bullying (Russell & Fish, 2016).
Is it any wonder that people feel worse when they have to deal with so much nonsense?
Internalized Bullying and LGBT+ Mental Health
When a kid gets told they’re ugly enough times, they believe it. The same for LGBT+ people being told they are unnatural, weird, fake, etcetera. It’s like their own brain betrays them and joins in with everyone else.
For bisexual people, there’s something called the bi-cycle. It starts with people telling them to “pick a side.” If a bi person dates one gender for a long time, they might start to doubt themselves and wonder if they are actually gay or straight. This is, for the most part, internalized bi phobia.
The “internalization of negative societal views can lead to stress, isolation, low self-esteem and negative mental health outcomes…” (Moagi et al., 2021). Older LGBT+ people internalize more negative societal views and concealed their true-selves for longer. Even between adults, this is worse for an 80-year-old compared to a 45-year-old (Yarns et al., 2016).
There are a couple of ways people can work to end this epidemic. Mental health clinics can provide training and guidelines for therapists and psychiatrists to treat LGBT+ patients respectfully. They can also provide psychoeducation services for their spouses or partners and workplaces (Moagi et al., 2021).
Outside of clinics, regular people can advocate for more anti-bullying policies to protect minorities and lobby against discriminatory laws. Plus, they can start gay-straight alliances (Russell & Fish, 2016). Having spaces where people respect their identities is crucial.
LGBT+ support groups are beneficial, but scarce in conservative regions. The Love Story is a borderless support group that can provide a non-judgmental space to vent and compare experiences. LGBT+ people can openly write about their romantic experiences and work through trauma in Mirror Darkly sessions. Click the link below to join a session or share this resource with someone who might need it.
Charak, R., Villarreal, L., Schmitz, R. M., Hirai, M., & Ford, J. D. (2019). Patterns of childhood maltreatment and intimate partner violence, emotion dysregulation, and mental health symptoms among lesbian, gay, and bisexual emerging adults: A three-step latent class approach. Child Abuse & Neglect, 89 (89), 99–110. Science Direct. https://doi.org/10.1016/j.chiabu.2019.01.007
Moagi, M., Van Der Wath, A., Jiyane, P., & Rikhotso, R. (2021). Mental health challenges of lesbian, gay, bisexual and transgender people: An integrated literature review. Health SA Gesondheid.
Russell, S. T., & Fish, J. N. (2016). Mental Health in Lesbian, Gay, Bisexual, and Transgender (LGBT) Youth. Annual Review of Clinical Psychology, 12 (1), 465–487. PMC PubMed Central. https://doi.org/10.1146/annurev-clinpsy-021815-093153
Thorn, A. [@PhilosophyTube] (2022, November 11). I Emailed My Doctor 133 Times: The Crisis In the British Healthcare System [Video]. YouTube; Philosophy Tube. https://youtu.be/v1eWIshUzr8
Yarns, B. C., Abrams, J. M., Meeks, T. W., & Sewell, D. D. (2016). The mental health of older LGBT adults. Current Psychiatry Reports, 18 (6), 1–46. eScolarship.org. https://doi.org/10.1007/s11920-016-0697-y