May 17th is International Day Against Homophobia, Transphobia and Biphobia. To celebrate, I have written an article about LGBTQ people and mental health.
What factors influence LGBTQ mental health?
Social determinants of health play a large role in determining the physical and mental health of individuals, and this is especially true when we examine the mental health of LGBTQ and other marginalized individuals. Some important factors which lead to positive mental health and well-being include:
- Social inclusion and freedom from discrimination
- Income and employment security
- Access to safe and affordable housing
However, LGBTQ individuals, in particular trans* individuals, face significant barriers when it comes to these determinants of health:
- LGBTQ individuals experience stigma, prejudice and discrimination at a higher rate than the general population. This is especially true for trans* individuals, as well as individuals with intersectional identities (individuals identifying with more than one marginalized group).
- Hate crimes motivated by sexual orientation more than doubled between 2007 and 2008, and were the most violent of all hate crimes.
- An Ontario-based study of trans* people found that 20% had experienced physical or sexual assault due to their identity, and that 34% were subjected to verbal threats or harassment.
- LGBTQ people are over-represented among low-income Canadians. An Ontario-based study found that 50% of trans* individuals were living on less than $15,000 a year.
- 20% of homeless youth in Toronto identify as LGBTQ.
Additional factors affecting mental health in LGBTQ people include the ‘coming out’ process, internalized stigma and oppression, gender transition, isolation and alienation, loss of family support, and the impact of HIV/AIDS.
What is the current status of mental health in LGBTQ individuals?
- Studies have shown that LGBTQ people have higher rates of depression, anxiety, obsessive-compulsive and phobic disorders, self-harm, and substance abuse.
- LGBTQ people have double the risk for post-traumatic stress disorder (PTSD) than non-LGBTQ people.
- Research suggests that use of tobacco, alcohol and other substances may be 2 to 4 times higher among LGBTQ people than non-LGBTQ people.
- A Toronto-based study found significantly higher rates of tobacco use among LGBTQ people (36%) than other adults (17%).
- Studies have shown that approximately 33% of LGB youth have attempted suicide compared to 7% of youth in general.
- In an Ontario-based study, 77% of trans* respondents had seriously considered suicide and 45% had attempted suicide.
How can we reduce the risk factors and improve mental health in the LGBTQ community?
- Reduce homophobia, biphobia, and transphobia through education and awareness
- Create supportive and inclusive workplaces and neighbourhoods
- Encouragepeople to connect with other LGBTQ individuals to develop a sense of community and belonging
- Address the social determinants of health such as employment security and affordable housing
- Eliminate the stigma of mental health as well as the stigma of being LGBTQ
How can health providers play a role in improving LGBTQ mental health?
- Recognize and acknowledge the impact of internalized stigma and discrimination on mental health
- Become familiar with the social determinants of health
- Promote family acceptance of LGBTQ youth and encourage them to connect with LGBTQ communities and organizations
- Provide equity and inclusivity training to ensure front-line mental health professionals interact with LGBTQ clients without stereotypes or discrimination
- Understand intersectionality and its relationship to mental health
- Increase familiarity with resources to support LGBTQ individuals at greatest risk for suicide, particularly youth and trans* individuals.
References and Additional Resources
Egale Canada: http://egale.ca/backgrounder-lgbtq-youth-suicide/
LGBTQ Mental Health Factsheet: http://lgbtqpn.ca/wp-content/uploads/woocommerce_uploads/2014/08/LGBT%20Mental%20Health.pdf
Rainbow Health Ontario: http://www.rainbowhealthontario.ca/