As many of us know, June is Pride Month. For many, Pride represents joy, liberation, and love. It’s often seen as a time for celebration, and this is truly beautiful. For a time, it can feel like we live in a world free of fear and injustice, but for far too many of us it will forever remain a dream and never reach reality. Although the LGBTQ+ community has made significant progress over the last 50 years since the Stonewall Riots and currently holds historic levels of support in the United States [1], there are still severe attacks on LGBTQ+ rights across the country. How often do you see an article casually discussing the latest bill stripping away transgender rights? How often does someone famous trend for using a homophobic slur? How many times do you hear someone on the news shouting, “why do they get an entire month when [insert ‘more deserving’ group] only gets a day or gets nothing”? What can be even worse at times is how many people we see in our lives who are entirely complacent in the face of these atrocities.
This blatant discrimination has a clear link to poor mental health outcomes. In addition to the trauma associated with discrimination and stigma, LGBTQ+ individuals have unique factors that can weigh on their mental health, including “coming out” and rejection by friends, family, and other loved ones. As expected, these additional stressors can lead to worsened mental health. Members of the LGBTQ+ community are at a heightened risk for mental diseases, particularly anxiety and depression. Studies have shown that lesbian, gay, and bisexual adults are twice as likely as their straight counterparts to experience a mental disease [2]. Transgender adults experience an even greater disparity: they are nearly four times as likely to experience a mental disease compared to cisgender individuals [3]. Among young members of our community, those identifying as lesbian, gay, or bisexual are twice as likely to report persistent feelings of sadness or hopelessness than their straight peers [4]. Furthermore, transgender youth are twice as likely to report depressive symptoms, seriously consider suicide, and attempt suicide when compared to their cisgender peers [5].
Taking a closer look, the LGBTQ+ community contains a vast amount of diversity. Many of the most prominent leaders in the fight for LGBTQ+ rights were individuals of color, including Sylvia Rivera and Marsha P. Johnson. There is pronounced racial and ethnic diversity within the community: 42% of LGBTQ+ individuals identify as people of color [6]. A majority (54%) of LGBTQ+ people of color battle poor mental health, and this proportion increases when focusing on transgender people of color (61%) [7]. The vast majority of LGBTQ+ youth of color report feelings of depression (79%), hopelessness (73%), and/or nervousness or anxiety (82%) [7]. In addition, between 30% and 40% of the LGBTQ+ community reports living with a disability [8]. However, there is a lack of data on the mental health of LGBTQ+ individuals living with disabilities.
With these astonishing statistics on mental health among the LGBTQ+ community, you would expect to see higher rates of healthcare-seeking behavior. In this case, you would be correct. LGBTQ+ individuals seek mental health services at 2.5 times the rate of straight counterparts [9]. While this number might seem like we’re able to reach mental health services when we want them, LGBTQ+ people face a plethora of barriers to care. From our healthcare providers actively engaging in discrimination to a lack of antidiscrimination protections, LGBTQ+ people have to contend with an elevated risk of trauma and abuse when seeking healthcare. We also see unequal treatment for LGBTQ+ people of color: 29% of LGBTQ+ adults of color report that they have received a diagnosis versus 39% of LGBTQ+ adults overall [7]. What we see is a healthcare system that is permitted to discriminate against the LGBTQ+ community and actively chooses to do so.
As Pride Month comes to an end for this year, we have to make sure that we keep the injustices we face front and center. The rates of mental diseases among LGBTQ+ individuals are horrifying, and there’s a lot of work to be done. The discrimination may evolve and, in some ways, become more sinister, but we have to evolve to fight back as well. Just as for those who came before us, Pride should not only be a celebration of who we are but a protest. During Pride Month and all throughout the year we have to expose the injustices in our systems and fight for change. None of us are liberated until we all are.
References
New Survey Shows Strong Support for LGBTQ Rights Championed in the Equality Act [Internet]. PRRI. [cited 2021 Jun 21]. Available from: https://www.prri.org/press-release/new-survey-shows-strong-support-for-lgbtq-rights-championed-in-the-equality-act/
Sexual Orientation and Estimates of Adult Substance Use and Mental Health: Results from the 2015 National Survey on Drug Use and Health | CBHSQ Data [Internet]. [cited 2021 Jun 21]. Available from: https://www.samhsa.gov/data/report/sexual-orientation-and-estimates-adult-substance-use-and-mental-health-results-2015-national
Wanta JW, Niforatos JD, Durbak E, Viguera A, Altinay M. Mental Health Diagnoses Among Transgender Patients in the Clinical Setting: An All-Payer Electronic Health Record Study. Transgender Health. 2019 Nov 1;4(1):313–5.
Youth Risk Behavior Survey - Data Summary & Trends Report: 2007-2017. :91.
Price-Feeney M, Green AE, Dorison S. Understanding the Mental Health of Transgender and Nonbinary Youth. Journal of Adolescent Health. 2020 Jun 1;66(6):684–90.
LGBT Data & Demographics – The Williams Institute [Internet]. [cited 2021 Jun 21]. Available from: https://williamsinstitute.law.ucla.edu/visualization/lgbt-stats/?topic=LGBT&characteristic=hispanic#demographic
Human Rights Campaign Foundation. THE STATE OF MENTAL HEALTH IN LGBTQ COMMUNITIES OF COLOR. p. 4.
Movement Advancement Project | LGBT PEOPLE WITH DISABILITIES [Internet]. [cited 2021 Jun 21]. Available from: https://www.lgbtmap.org/lgbt-people-disabilities
Platt LF, Wolf JK, Scheitle CP. Patterns of Mental Health Care Utilization Among Sexual Orientation Minority Groups. J Homosex. 2018;65(2):135–53.