Between colorful pride parades, joyous celebrations, educational workshops, and countless LGBTQ+ events, Pride Month, commemorating the 1969 Stonewall riots, ignites love, acceptance, and diversity around the world.

As we celebrate LGBTQIA+ people, create visibility in LGBTQIA+ spaces, and work towards a future where all people have equal rights without restrictions, it’s crucial to address the challenges and barriers that  LGBTQIA+ people face when it comes to their mental health. 

“ LGBTQIA+ individuals are at a higher risk for depression, anxiety, Post-Traumatic Stress Disorder (PTSD), low self-esteem, suicidal ideation, suicide attempts, self-harm behavior, and substance use disorders (SUD),” says Cari Chapderlane-Cox, LICSW.

According to Mental Health America, 

• Over 39% of Americans who identify as  LGBTQIA+ report having a mental health condition in the past year.
• LGBTQ+ people are more likely to experience depression, anxiety, substance abuse, and other mental health disorders compared to their heterosexual counterparts.

The Trevor Project’s 2024 U.S. National Survey on the Mental Health of LGBTQIA+ Young Peoples shows that:

• 39% of  LGBTQIA+ young people seriously considered attempting suicide in the past year, including 46% of transgender and nonbinary young people.
• More than 1 in 10 LGBTQIA+ young people attempted suicide in the past year. 
• Nearly half of LGBTQIA+ young people ages 13-17 experienced bullying in the past year, and those who did reported significantly higher rates of suicide attempts. 
• 50% of LGBTQIA+ young people who wanted mental health care in the past year were not able to get it. 

Sarah Presson, LICSW explains that LGBTQIA+ people are not inherently prone to mental health conditions and/or higher rates of suicide because of their sexual orientation and gender identity.

“Those of us who are LGBTQIA+ often face adversities like social stigma and discrimination, putting us at a higher risk of experiencing mental health issues,” says Sarah. 

We sat down with Cari Chapderlane-Cox, LICSW and Sarah Presson, LICSW, who are both trained in providing LGBTQIA+ counseling, to learn more about the unique stressors and mental health challenges specific to the LGBTQIA+ community. 

Cari and Sarah also discuss why it’s equally imperative for those within the LGBTQIA+ community to work with clinicians who specialize in LGBTQIA+ counseling. We’ve also listed free and supportive resources for LGBTQIA+ people to access anytime, anywhere.

Challenges which may negatively impact LGBTQIA+ people’s mental health:

The LGBTQIA+ community faces unique challenges when it comes to mental health. Stressors such as discrimination, prejudice, social stigma, can all contribute to mental health issues, such as:

• Depression
• Anxiety
• Post-Traumatic Stress Disorder (PTSD)
• Addiction/Substance Use Disorder (SUD)
• Eating Disorders
• Suicidal ideation/suicide
• Self-Harm/Self-Injurious Behavior

If you or someone you know is considering suicide, contact the 988 Suicide & Crisis Lifeline by dialing 9-8-8, or the Crisis Text Line by texting HOME to 741741.

Intersecting identities:

People within the LGBTQIA+ community come from all different backgrounds, ethnicities, environments, nationalities, genders, and sexual preferences. Each of these identities manifests in its own unique way, and many people within the LGBTQIA+ community claim more than one of these identities. 

When an individual’s experiences and challenges are shaped by multiple intersecting social identities, they can impact their mental health in significant ways. 

For instance, when a person identifies as a member of multiple oppressed populations, such as a Black transgender woman, they may face even greater discrimination, prejudice, or systemic inequalities, resulting in poor mental health.

Coming out:

Coming out can be a challenging experience that LGBTQIA+ people face. For many, coming out to loved one’s, who assume they’re the “norm” of heterosexual and cisgender identity, can be a stressful and isolating experience. When LGBTQIA+ people don’t have a supportive home, school, workplace, or community environment, expressing their identity can have high consequences and lead to poor mental health. 

“An overwhelming sense of feeling ‘different’ may lead individuals to isolate and withdraw, resulting in poor mental health outcomes,” says Cari.

Hate crimes:

Members of the LGBTQIA+ community may face hate crimes: crimes committed against people because of their sexual orientation, gender identity, race, religion, socioeconomic status, or disability. 

“Safety concerns and the fear that comes along with experiencing hate crimes, such as sexual or physical assault, can manifest in anxiety, depression, trauma, or other mental health disorders,” says Cari.

Rejection and isolation:

“Many people in the LGBTQIA+ experience higher levels of adversity, life stressors, and difficulty with finding support, as well as rejection from their loved ones,’’ says Cari.  

Homophobia, transphobia, stigma, and identity-specific bullying- whether at home, in school, or at the workplace- can be traumatic. Exposure to trauma can also contribute to an increased risk of developing Post-Traumatic Stress Disorder (PTSD) among LGBTQIA+ people.

Substance use:

According to the National Institute on Drug Abuse, LGBTQIA+ people face higher rates of substance misuse and substance use disorders (SUD). In fact, LGBTQIA+ adults are nearly twice as likely than heterosexual and cisgender adults to develop a SUD. 

Social stigma, harassment, microaggressions, systematic inequality, and traumatic experiences are detrimental to a person’s mental health and people from these groups may turn to substances to cope with the emotional, mental, and physical stressors.

Homelessness:

According to one research study, sexual minority adults are twice as likely as the general population to have experienced homelessness in their lifetime. Moreso, 20% of sexual minorities experienced homelessness before the age of 18. 

“Many LGBTQIA+ youth face higher risk for housing instability and homelessness, due to being rejected by their family or deciding they are unable to live in an environment in which they are not accepted,” says Cari.

Discrimination and microaggressions:

Discrimination and microaggressions can have major adverse effects of LGBTQIA+ people’s mental health. The consequences may result in fear, depression, anxiety, PTSD, and maladaptive coping strategies, such as self-harm/self-injurious behaviors, eating disorders, and/or substance use disorders. 

Microaggressions, such as assuming a person’s gender or neglecting to address someone by their correct pronouns, may encourage LGBTQIA+ people to self-isolate, hide their opinions, thoughts, and feelings in an effort to conform.

Accessing healthcare:

“LGBTQIA+ individuals are often hesitant to seek assistance from mental health professionals for fear that they will be judged and misunderstood by providers,” says Cari. 

In fact, one in every six LGBTQIA+ adults reports avoiding healthcare due to anticipated discrimination, and 16% report facing discrimination in healthcare. 

In spaces where there is no direct discrimination based on gender or sexuality, there are many circumstances where the LGBTQIA+ community is neglected. For instance, a gynecologist’s office may not make space for transgender, non-gender, or gender-nonconforming individuals. 

This absence of recognition across public spaces, specifically in healthcare, can result in LGBTQIA+ people feeling unheard, uncomfortable, and unseen.

Mental Health Resources for LGBTQIA+ People:

If someone you know is struggling with their mental health, active listening is a good place to start. If they don’t feel comfortable opening up with their loved one’s or peers or if they don’t have anyone to talk to, let them know that there are many free resources for people who identify as LGBTQIA+. 

Free resources include: 

• 988 Suicide & Crisis Lifeline – Phone counseling any time, day or night by dialing 988.
• LGBT National Help Center – Hotlines based on age groups: 800-246-7743 for youth, 888-843-4564 for adults and 888-688-5428 for seniors. Weekly chatrooms for youth and online peer support are also available.
• Trevor Project Lifeline – 24/7 phone, text and online support for LGBTQ+ youth.
• Trans Lifeline – Trans peer support available by calling 877-565-8860.

What is LGBTQIA+ counseling?

LGBTQIA+ counseling is a form of therapy that fits within the framework of LGBTQIA+ affirming care. It specifically recognizes and validates the experiences of all LGBTQIA+ people and is designed to meet the needs and challenges they may face.

“Like traditional therapy, LGBTQIA+ counseling offers a safe space for discussing mental health concerns, building healthy coping techniques, and developing a better understanding of self,” says Sarah Presson, LICSW. 

LGBTQIA+ therapy also specifically focuses on the intersection of sexual orientation, gender identity, and mental health.

How does LGBTQ+ therapy differ from therapy for heterosexual and/or cisgender individuals?

Cari Chapderlane-Cox, LICSW says that LGBTQIA+ counseling in essence may be very similar to counseling that heterosexual and/or cisgender individuals receive. 

“Many of the ‘traditional’ evidence-based treatment modalities, such as Cognitive-Behavioral Therapy (CBT), Dialectical-Behavioral Therapy (DBT), Mindfulness-Based therapy, Motivational Interviewing, and Psychodynamic informed Psychotherapy are effective in addressing mental health concerns that LGBTQIA+ individuals struggle with,” says Cari. 

However, when seeking LGBTQIA+ counseling, it’s important to work with an experienced therapist who has received specialized training in working with the LGBTQIA+ population. An experienced therapist can provide a safe space, as well as a deep understanding of the mental health issues that LGBTQIA+ individuals often face.

Why is LGBTQ+ counseling important?

“Having access to LGBTQIA+ counseling services is absolutely essential when it comes to addressing the unique needs and challenges faced by individuals who identify as LGBTQIA+,” says Cari. 

 LGBTQIA+ counseling offers a safe space for individuals to discuss their thoughts, feelings, and life experiences concerning their gender identity or sexual orientation in an affirming and nonjudgmental environment. From identity issues to relationship struggles and family dynamics,  LGBTQIA+ counseling helps individuals address the unique societal, familial, and internal struggles they may face.  

The supportive framework of LGBTQIA+ counseling helps individuals develop effective coping techniques and forge new insights into their thoughts, emotions, and behaviors with curiosity and compassion. The tools that LGBTQIA+ counseling offers will help individuals navigate all stages of their life and mental health journey.

Start working with an LGBTQIA+ counselor at HBH today:

The journey through LGBTQIA+ counseling is a profound experience of personal growth, discovery, acceptance, and empowerment. 

If you or someone you know needs LGBTQIA+ counseling in Massachusetts, Handel Behavioral Health is here to help. Our team of LGBTQIA+ mental health professionals understand the unique struggles specific to the LGBTQIA+ community, and are here to safely support you throughout your journey. 

To start working with one of our experienced therapists in our offices in Franklin, Amherst, West Springfield, Wilbraham, Natick, or online throughout the state of Massachusetts, contact us today at (413) 343-4357 to schedule an appointment!

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