LGBTQIA+ Mental Health: A Complete Guide

Updated on 9/13/2022

Mental health in the LGBTQIA+ community (formerly known as the LGBT community before recognizing the full spectrum) is something we need to talk about. Why? The answer is simple. The lesbian, gay, bisexual, transgender, queer or questioning, intersex, and asexual or allied (LGBTQIA+) population has staggering statistics surrounding mental health and wellness. In fact, according to recent studies:

With all of these alarming statistics, we need to talk aboutLGBTQIA+ mental health. We can’t afford to keepnot talkingabout it. Where and how you can find mental health services or help is important, and we’re dedicated to ensuring you know as much as possible about common issues and conditions, risk factors, andLGBTQIA+ therapyresources.

Common LGBTQIA+ Mental Health IssuesThere are several LGBTQIA+ mental health issues to be aware of. Many of them stem from the discrimination and oppression that those who identify as LGBTQIA+ experience throughout their lives.LGBTQIA+ affirmative therapy can help.Looking for a LGBTQIA+ affirmative therapist? Find an experienced therapistLearn moreBefore we begin to discuss what types of mental health struggles the LGBTQIA+ community may face, the most important thing to note is that theydo nothave a mental illness or disorder.That said, there are a number of mental health struggles that the LGBTQIA+ community may experience. For example, a person in the LGBTQ community may feel fear or shame that can add to their struggles with mental health. It’s also common for the LGBTQ community to:Deal with depressionor depressive symptomsHave anxietyHave suicidal thoughts, tendencies, or attemptsLooking at factors that can impact LGBTQIA+ mental health can help us better understand what we can do and where to find mental health services or help.

Common LGBTQIA+ Mental Health Issues

There are several LGBTQIA+ mental health issues to be aware of. Many of them stem from the discrimination and oppression that those who identify as LGBTQIA+ experience throughout their lives.

LGBTQIA+ affirmative therapy can help.Looking for a LGBTQIA+ affirmative therapist? Find an experienced therapistLearn more

LGBTQIA+ affirmative therapy can help.Looking for a LGBTQIA+ affirmative therapist? Find an experienced therapist

LGBTQIA+ affirmative therapy can help.

Looking for a LGBTQIA+ affirmative therapist? Find an experienced therapist

Learn more

Before we begin to discuss what types of mental health struggles the LGBTQIA+ community may face, the most important thing to note is that theydo nothave a mental illness or disorder.

That said, there are a number of mental health struggles that the LGBTQIA+ community may experience. For example, a person in the LGBTQ community may feel fear or shame that can add to their struggles with mental health. It’s also common for the LGBTQ community to:

Looking at factors that can impact LGBTQIA+ mental health can help us better understand what we can do and where to find mental health services or help.

Risk Factors That Can Impact LGBTQIA+ Mental HealthThere are multiple risk factors that can have a significant effect and impact on those in the LGBTQIA+ community.“LGBTQIA+ individuals are at higher rates for depression, anxiety, suicidality, substance use disorder, homelessness, and unemployment. Thecoming outprocess can be difficult, especially for a LGBT youth. This process can be very anxiety-provoking, and it can be very difficult if the young person does not have supportive friends or family members to navigate work, school, and relationships. Additionally, mental health outcomes for this community are poorer than for heterosexual individuals. There can be issues of bias and discrimination in treatment. LGBTQ therapists can offer useful guidance, reassurance, and advice to help you navigate difficult situations without causing further anxiety.”Talkspace therapist Reshawna Chapple, Ph.D., LCSWSome of the most important risk factors to recognize are listed below.The decision to come outDespite the fact that we see increased societal acceptance for the LGBTQIA+ community, much work still needs to be done. Many still feel that the social experiences they have after coming out contribute to a negative mental health impact. This is especially true for those who aren’t in supportive or accepting environments.Making the decision to come out as a young person might be one of the bravest things you’ll ever do in life. For many people, it doesn’t come easy. However, therapy can help you feel confident and give you the strength you need to live an authentic life and be true to yourself.TraumaMany young adults in the LGBTQIA+ community report experiencing some form of discrimination in their life. Homophobia, transphobia, biphobia, LGBTQ bullying, and more can all contribute to identity-based shame that’s traumatic for individuals.People report feeling labeled, being denied opportunities, being stereotyped, or experiencing mental, verbal, or physical abuse as a result of their identity. Many times, this trauma can result in severe mental health conditions such aspost traumatic stress disorder(PTSD).Trauma can contribute to many mental health conditions. Through in-person oronline therapy, you can learn how to handle harmful thoughts or behaviors and heal from trauma you’ve experienced in your life.Rejection or fear of rejectionThe fear of rejection after coming out, or actually being rejected after coming out, would be difficult for anybody. Particularly if it’s family members or close friends who aren’t accepting, the mental health impact of rejection can be traumatic and extremely difficult to navigate.Whether you’ve recently come out and are facing rejection, or you want to come out but are afraid of being rejected, a good therapist can help you set boundaries and heal from your fear or pain.“Navigating relationship stress is difficult enough without having to explain what it feels like to be part of this community. There can also be guilt, shame, or embarrassment associated with their sexual orientation. LGBTQ-friendly therapists can offer useful guidance, reassurance, and advice to help you navigate difficult situations without causing further anxiety,” Chapple said.HomelessnessIt’s a staggering statistic: it’s estimated that LGBTQIA+ youth have a120% higher chance of becoming homelessin their lifetime.Some of the challenges members of the LGBTQIA+ community face that often contribute to homelessness include family rejection, discrimination at work, school, or home, and an increased chance of abuse and harassment in their social and living environments.Support and therapy is available and can be helpful if you’re having trouble finding housing or need resources to find a safe space.Substance use or abuseSubstance use or abuse can be overwhelming for members of the LGBTQIA+ community. The following statistics aroundLGBTQ substance abusespeak volumes.Adults who identify as LBG are more thantwice as likelyto have a substance use disorder.Those who identify as transgender are almost4 times as likelyas those who are cisgender to have a substance abuse disorder.School-aged LGBTQIA+ youth who identify as LGB, or those who are not sure about their identity, report amuch higher instanceof illicit drug use than peers who identify as heterosexual do.Group or individual therapy can be helpful in managing addiction. It can help you learn better, healthier coping techniques if you’re using substances to mask any pain.Mental health care that’s inadequate or ineffectiveUnfortunately, inadequate or inappropriate mental health care is common for the LGBTQIA+ community. The biggest issue comes from the fact that often the approach taken in addressing sexual orientation orgender identity and mental healthis lumped together as one large issue. Yes, it’s true that some challenges do tend to overlap across identities. But there are separate, specific, and important needs that are within each individual group.Everything from the challenges faced, to the conditions experienced, should be addressed and treated from a unique and individual standpoint. Treatment and therapy should be directly based on each person’s own needs and goals when seeking mental health resources.Barriers to proper mental health careOther important factors when addressing mental health concerns for the LGBTQIA+ community are the barriers they’re likely to face simply even accessing care. Economic status, race, and other identity factors can all have a strong impact on what type of care someone receives. It’s essential that we address these barriers and focus on LGBTQIA+ inclusive mental health care that’s specific to individual identities and needs.Therapy can help you on a number of fronts. Finding the right therapist will be instrumental in how effective your treatment is.SuicideThis is the mental health problem that perhaps demands the most urgent attention. The LGBTQIA+ population is at a higher risk than cisgender or heterosexual populations when it comes to thoughts of suicide or direct suicide attempts. Depression, anxiety, isolation, a history of mental health struggles, and other mental health conditions are all contributing factors to the increased risk for suicide.Therapy can offer a much-needed outlet to learn coping techniques and strategies to handle suicidal ideation and thoughts you may be experiencing.

Risk Factors That Can Impact LGBTQIA+ Mental Health

There are multiple risk factors that can have a significant effect and impact on those in the LGBTQIA+ community.

“LGBTQIA+ individuals are at higher rates for depression, anxiety, suicidality, substance use disorder, homelessness, and unemployment. Thecoming outprocess can be difficult, especially for a LGBT youth. This process can be very anxiety-provoking, and it can be very difficult if the young person does not have supportive friends or family members to navigate work, school, and relationships. Additionally, mental health outcomes for this community are poorer than for heterosexual individuals. There can be issues of bias and discrimination in treatment. LGBTQ therapists can offer useful guidance, reassurance, and advice to help you navigate difficult situations without causing further anxiety.”

Talkspace therapist Reshawna Chapple, Ph.D., LCSW

Some of the most important risk factors to recognize are listed below.

The decision to come out

Despite the fact that we see increased societal acceptance for the LGBTQIA+ community, much work still needs to be done. Many still feel that the social experiences they have after coming out contribute to a negative mental health impact. This is especially true for those who aren’t in supportive or accepting environments.

Making the decision to come out as a young person might be one of the bravest things you’ll ever do in life. For many people, it doesn’t come easy. However, therapy can help you feel confident and give you the strength you need to live an authentic life and be true to yourself.

Trauma

Many young adults in the LGBTQIA+ community report experiencing some form of discrimination in their life. Homophobia, transphobia, biphobia, LGBTQ bullying, and more can all contribute to identity-based shame that’s traumatic for individuals.

People report feeling labeled, being denied opportunities, being stereotyped, or experiencing mental, verbal, or physical abuse as a result of their identity. Many times, this trauma can result in severe mental health conditions such aspost traumatic stress disorder(PTSD).

Trauma can contribute to many mental health conditions. Through in-person oronline therapy, you can learn how to handle harmful thoughts or behaviors and heal from trauma you’ve experienced in your life.

Rejection or fear of rejection

The fear of rejection after coming out, or actually being rejected after coming out, would be difficult for anybody. Particularly if it’s family members or close friends who aren’t accepting, the mental health impact of rejection can be traumatic and extremely difficult to navigate.

Whether you’ve recently come out and are facing rejection, or you want to come out but are afraid of being rejected, a good therapist can help you set boundaries and heal from your fear or pain.

“Navigating relationship stress is difficult enough without having to explain what it feels like to be part of this community. There can also be guilt, shame, or embarrassment associated with their sexual orientation. LGBTQ-friendly therapists can offer useful guidance, reassurance, and advice to help you navigate difficult situations without causing further anxiety,” Chapple said.

Homelessness

It’s a staggering statistic: it’s estimated that LGBTQIA+ youth have a120% higher chance of becoming homelessin their lifetime.

Some of the challenges members of the LGBTQIA+ community face that often contribute to homelessness include family rejection, discrimination at work, school, or home, and an increased chance of abuse and harassment in their social and living environments.

Support and therapy is available and can be helpful if you’re having trouble finding housing or need resources to find a safe space.

Substance use or abuse

Substance use or abuse can be overwhelming for members of the LGBTQIA+ community. The following statistics aroundLGBTQ substance abusespeak volumes.

Group or individual therapy can be helpful in managing addiction. It can help you learn better, healthier coping techniques if you’re using substances to mask any pain.

Mental health care that’s inadequate or ineffective

Unfortunately, inadequate or inappropriate mental health care is common for the LGBTQIA+ community. The biggest issue comes from the fact that often the approach taken in addressing sexual orientation orgender identity and mental healthis lumped together as one large issue. Yes, it’s true that some challenges do tend to overlap across identities. But there are separate, specific, and important needs that are within each individual group.

Everything from the challenges faced, to the conditions experienced, should be addressed and treated from a unique and individual standpoint. Treatment and therapy should be directly based on each person’s own needs and goals when seeking mental health resources.

Barriers to proper mental health care

Other important factors when addressing mental health concerns for the LGBTQIA+ community are the barriers they’re likely to face simply even accessing care. Economic status, race, and other identity factors can all have a strong impact on what type of care someone receives. It’s essential that we address these barriers and focus on LGBTQIA+ inclusive mental health care that’s specific to individual identities and needs.

Therapy can help you on a number of fronts. Finding the right therapist will be instrumental in how effective your treatment is.

Suicide

This is the mental health problem that perhaps demands the most urgent attention. The LGBTQIA+ population is at a higher risk than cisgender or heterosexual populations when it comes to thoughts of suicide or direct suicide attempts. Depression, anxiety, isolation, a history of mental health struggles, and other mental health conditions are all contributing factors to the increased risk for suicide.

Therapy can offer a much-needed outlet to learn coping techniques and strategies to handle suicidal ideation and thoughts you may be experiencing.

The Importance of LGBTQIA+ Friendly TherapyAs we discussed previously, therapy can be intrusive and ineffective — even harmful — if it’s not coming from a productive and skilled place. If you’re looking for aLGBTQIA+ friendly therapistto help you navigate your identity, you might want to actively try to find someone who understands your specific needs and goals. An LGBTQIA-competent therapist will be skilled at working with the LGBTQIA+ community.“LGBTQ individuals can have poor mental health outcomes and difficulty connecting with therapists, especially if the therapist they’re working with is not culturally responsive. “A therapist who has a background working with this population can generally connect more quickly  to get to the root of the problem to establish a better connection in therapy.”Talkspace therapist Reshawna Chapple, Ph.D., LCSW

The Importance of LGBTQIA+ Friendly Therapy

As we discussed previously, therapy can be intrusive and ineffective — even harmful — if it’s not coming from a productive and skilled place. If you’re looking for aLGBTQIA+ friendly therapistto help you navigate your identity, you might want to actively try to find someone who understands your specific needs and goals. An LGBTQIA-competent therapist will be skilled at working with the LGBTQIA+ community.

“LGBTQ individuals can have poor mental health outcomes and difficulty connecting with therapists, especially if the therapist they’re working with is not culturally responsive. “A therapist who has a background working with this population can generally connect more quickly  to get to the root of the problem to establish a better connection in therapy.”

How to Help Yourself or Someone You Know

If you or someone you love is looking for an LGBTQIA+ therapist, or needs help navigating any mental health struggles, youcanfind the help you’re looking for. Finding the right therapist may not be as difficult as you might expect. And,resources for LGBTQ teensand adults are more accessible.

Sources:1. LGBTQ+ Communities and Mental Health. Mental Health America.https://www.mhanational.org/issues/lgbtq-communities-and-mental-health. Accessed September 5, 2021.2. LGBTQ+ Mental Health: Insights from MHA Screening. Mental Health America.https://www.mhanational.org/lgbtq-mental-health-insights-mha-screening. Accessed September 5, 2021.3. 9. LGBTQI | NAMI: National Alliance on Mental Illness. Nami.org.https://www.nami.org/Your-Journey/Identity-and-Cultural-Dimensions/LGBTQI. Accessed September 5, 2021.4. Mason, MA, LPCC S. Mental health challenges in the LGBTQ community | HealthPartners Blog. HealthPartners Blog.https://www.healthpartners.com/blog/mental-health-in-the-lgbtq-community/. Accessed September 5, 2021.5. Missed Opportunities: LGBTQ Youth Homelessness in America. Voicesofyouthcount.org.https://voicesofyouthcount.org/wp-content/uploads/2018/05/VoYC-LGBTQ-Brief-Chapin-Hall-2018.pdf. Published 2018. Accessed September 5, 2021.6. Medley G, Lipari R, Bose J. Sexual Orientation and Estimates of Adult Substance Use and Mental Health: Results from the 2015 National Survey on Drug Use and Health. NSDUH Data Review. https://www.samhsa.gov/data/sites/default/files/NSDUH-SexualOrientation-2015/NSDUH-SexualOrientation-2015/NSDUH-SexualOrientation-2015.htm. Published 2016. Accessed September 5, 2021.7. Wanta J, Niforatos J, Durbak E, Viguera A, Altinay M. Mental Health Diagnoses Among Transgender Patients in the Clinical Setting: An All-Payer Electronic Health Record Study. Transgend Health. 2019;4(1):313-315.doi:10.1089/trgh.2019.0029.8 YOUTH RISK BEHAVIOR SURVEY DATA SUMMARY & TRENDS REPORT. Cdc.gov.https://www.cdc.gov/healthyyouth/data/yrbs/pdf/trendsreport.pdf. Published 2017. Accessed September 5, 2021.9. Suicide Risk and Prevention for LGBTQ People. Lgbtqiahealtheducation.org.https://www.lgbtqiahealtheducation.org/wp-content/uploads/2018/10/Suicide-Risk-and-Prevention-for-LGBTQ-Patients-Brief.pdf. Published 2018. Accessed September 5, 2021.

Sources:

1. LGBTQ+ Communities and Mental Health. Mental Health America.https://www.mhanational.org/issues/lgbtq-communities-and-mental-health. Accessed September 5, 2021.

2. LGBTQ+ Mental Health: Insights from MHA Screening. Mental Health America.

https://www.mhanational.org/lgbtq-mental-health-insights-mha-screening. Accessed September 5, 2021.

3. 9. LGBTQI | NAMI: National Alliance on Mental Illness. Nami.org.https://www.nami.org/Your-Journey/Identity-and-Cultural-Dimensions/LGBTQI. Accessed September 5, 2021.

4. Mason, MA, LPCC S. Mental health challenges in the LGBTQ community | HealthPartners Blog. HealthPartners Blog.https://www.healthpartners.com/blog/mental-health-in-the-lgbtq-community/. Accessed September 5, 2021.

5. Missed Opportunities: LGBTQ Youth Homelessness in America. Voicesofyouthcount.org.https://voicesofyouthcount.org/wp-content/uploads/2018/05/VoYC-LGBTQ-Brief-Chapin-Hall-2018.pdf. Published 2018. Accessed September 5, 2021.

6. Medley G, Lipari R, Bose J. Sexual Orientation and Estimates of Adult Substance Use and Mental Health: Results from the 2015 National Survey on Drug Use and Health. NSDUH Data Review. https://www.samhsa.gov/data/sites/default/files/NSDUH-SexualOrientation-2015/NSDUH-SexualOrientation-2015/NSDUH-SexualOrientation-2015.htm. Published 2016. Accessed September 5, 2021.

7. Wanta J, Niforatos J, Durbak E, Viguera A, Altinay M. Mental Health Diagnoses Among Transgender Patients in the Clinical Setting: An All-Payer Electronic Health Record Study. Transgend Health. 2019;4(1):313-315.doi:10.1089/trgh.2019.0029.

8 YOUTH RISK BEHAVIOR SURVEY DATA SUMMARY & TRENDS REPORT. Cdc.gov.https://www.cdc.gov/healthyyouth/data/yrbs/pdf/trendsreport.pdf. Published 2017. Accessed September 5, 2021.

9. Suicide Risk and Prevention for LGBTQ People. Lgbtqiahealtheducation.org.https://www.lgbtqiahealtheducation.org/wp-content/uploads/2018/10/Suicide-Risk-and-Prevention-for-LGBTQ-Patients-Brief.pdf. Published 2018. Accessed September 5, 2021.

Our goal at Talkspace is to provide the most up-to-date, valuable, and objective information on mental health-related topics in order to help readers make informed decisions.

Articles contain trusted third-party sources that are either directly linked to in the text or listed at the bottom to take readers directly to the source.

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