June is Pride Month, commemorating the historic Stonewall riots, which occurred in June of 1969. The Stonewall riots are one of the LGBTQIA+ community's most defining moments in fighting systemic oppression and discrimination.
You may ask yourself, "What are all the letters for, and what do the extra letters mean (yes, there are more)?" The standard seems to settle around Lesbian, Gay, Bisexual, Transgender, Queer, or Questioning Intersex and Allied (meaning supportive of the movement) or Asexual.
While much of the present-day political and social landscape is becoming more supportive and inclusive, the long history of discrimination and harassment has left its mark. Recent studies show that individuals who identify as LGBTQIA+ or transgender are more prone to mental health challenges, including anxiety, depression, PTSD, and suicidality.
Unique Risks That Can Affect the Mental Health of LGBTQIA+ Individuals
Inclusivity is crucial given this community's broadening visibility and importance and the clear need to ensure that our practices and policies in life, particularly in healthcare, recognize this community's issues and needs.
Nowhere is this more visible than in two landmark US Supreme Court decisions. The first one was in June 2015, which struck down individual state prohibitions on same-sex marriages. Barack Obama personally reminisced on his memories of that day and how it felt to witness the emotional impact of that change on couples who had previously not been able to recognize their relationships legally. Then on June 15, 2020, the US Supreme Court ruled that the Title VII Civil Rights Act of 1964 and banned discrimination based on race, religion, national origin, and sex and also protected gay and transgender workers from workplace discrimination. The June 2020 Supreme Court ruling came as the result of a 6-3 vote, with the majority opinion written by Trump-appointed Justice Neil Gorsuch. This decision marks a dramatic change in the civil rights of the LGBTQIA+ population, whose ability to be fired based on sexual orientation was, until then, very real.
Counter to that and a setback for the LGBTQIA+ population was a decision by the Trump administration earlier in June 2020 to roll back a provision implemented by the Obama administration, which had extended healthcare protection under the Affordable Care Act (also known as Obamacare) to the transgender population. Obamacare prohibited providers who received Federal funds from discriminating based on gender identity. This provision has since been removed, which, according to Health and Human Services, resulted in an anticipated $2.9 billion in savings over the subsequent few years.
All in all, June 2022 felt bittersweet for many reasons. As PRIDE celebrations have taken place globally since COVID19, violent outbreaks have occurred, such as the shooting in OSLO, Norway at the capital's Pride festival, and the Supreme Court ruling that overturned Roe vs. Wade which will have an outsized impact on poor and marginalized populations. Supreme Court Justice Clarence Thomas has also spoken about his goals for future potential cases, foreshadowing overturning precedents on contraceptives and LGBTQIA+ rights.
Aside from these challenges, significant progress in the LGBTQIA+ arena continues to be meaningful. Strides in civil rights associated with employment, the right not to be fired based on your sexual orientation or declared gender, represents a huge step not only in identity but in their ability to advance above poverty and retain healthcare benefits.
In the case of older LGBTQIA+ adults, Human Rights Campaign (HRC) also points out that they face isolation and lack of support to a greater degree than non-LGBTQIA+ adults due to various issues. Since older adults, in general, were at risk of increased isolation, mental health issues, and a higher risk of COVID19 during the pandemic, it stands to reason that this problem would increase even more for older LGBTQIA+ adults who face additional obstacles.
At even greater risk are LGBTQIA+ youth, according to HRC. There is a very high percentage of homelessness among LGBTQIA+ youth, as well as an increased risk of suicide and other mental health issues. LGBTQIA+ youth frequently face family rejection, with close to 70% indicating that their family makes negative comments about LGBTQIA+ people. Since LGBTQIA+ youth are extremely likely to experience homelessness, they often rely on schools and public programs for food. School closings due to COVID19 took away much of their support. This is one reason that New York City public schools stayed open as long as they did in the early stages of the pandemic, recognizing that they were often the source of meals for a large portion of homeless youth.
Aside from medical issues, the LGBTQIA+ population faces unique mental health needs. As is often true in a population that has been marginalized and discriminated against, identity and support issues have already created significant mental health and substance abuse treatment needs in this population well before the onset of COVID19. Fortunately, in recent years many treatment providers who specialize in supporting this population have emerged, often offering specialized services focusing on things like identity development, substance abuse, trauma work, etc. There are several organizations that have arisen in an effort to provide support for these youth. They offer people that those in need can talk to who understand what they are going through and can help them before it is too late. One such organization is the Trevor Project which offers crisis intervention approaches and other programs, along with training programs and links other organizations together in different locales. As was true of many people who struggle with mental health and substance abuse, many of the LGBTQIA+ population who already faced these issues found that the COVID19 crisis exacerbated any mental health or substance abuse struggles they have had. Meaning that things have been extra difficult since March of 2020.
Seeking Support When Needed
As we commemorate Pride Month and celebrate diversity, we can also seek to normalize conversations surrounding mental health. Seeking mental health support and treatment can positively impact one's life and provide support for day-to-day stress factors resulting from mental health issues.
If you are facing mental health challenges as an LGBTQIA+ person, it is important to know that you are not alone and that abundant support and helpful resources are available to you. Sometimes, taking the first step in identifying ways to reduce stress factors and finding ways to promote healing is the hardest part.
If you know someone who identifies as LGBTQIA+, your support can be a positive influence in their life. Showing your support can make a big difference in the life of someone who may be facing mental health challenges and let them know that they are not alone in their journey. Facing the unique challenges associated with mental health can feel scary, stressful, and at times, isolating.
As allies, friends, and family members, we can educate ourselves on the unique risk factors listed above, find ways to support and recognize mental health challenges, and increase our knowledge and awareness of helpful resources. Additionally, simply showing up and creating a space for open dialogue and communication can be an incredible way to show support.
As a Health Advocate and a human being, it is important to me that everyone is recognized and respected as an individual regardless of their sexual orientation. I am proud to say that I have clients and friends who are members of this community. For my clients, it is critical that I advocate for them and ensure that they receive the attention and care they need with appropriate respect. I will not settle for less.
Live chat with trained volunteer Crisis Counselors, many of whom have shared lived experiences.
Provides crisis intervention and suicide prevention services to LGBTQI+ people under 25.
Nonprofit organization dedicated to the well-being of transgender people, staffed by transgender people for transgender people.
24/7 support for chemical dependency, mental health referrals, and an information hotline for the LGBTQI+ Community. Phone: 1.800.547.7433
A national nonprofit organization working towards securing civil rights of LGBTQIA+ individuals through impact litigation and public policy work.
You may also search the Healthcare Equality Index to find local support resources.
Take care. Sending you calm & healthy wishes.
- Lee (she/her/hers)
Disclaimer: The contents of HealthACR Insights are intended to provide information we hope you find interesting, timely and useful. We carefully research the topics using reliable, highly regarded sources. Citations are provided. We in no way intend to offer clinical advice that you should use to make treatment decisions. Please consult appropriate professionals. HealthACR, LLC is available to help you identify potential options and find providers to meet your needs.