LGBTQIA+ and mental health
LGBTQIA+ people are more likely to experience mental health problems compared to their non-LGBTQIA+ peers.
Importantly, it does not mean that being LGBTQIA+ causes poor mental health. Rather, these difficulties often arise from living in a society that is not always accepting. The minority stress theory and available research suggest that this increased risk of poor mental health experienced by LGBTQIA+ people is due to the increased level of social stress. This can include stigma, discrimination, prejudice and victimisation.
In Scotland, 88% of participants in LGBT Youth Scotland’s Health Report (2023) reported that they experienced at least one mental health condition or related behaviour. The most common mental health problems include depression, self-harm, alcohol and drug abuse and suicidal thoughts.
Let’s explore what it means to be part of the LGBTQAI+ community and how we can create and develop spaces that are more inclusive and supportive.
Language is important
- Sexual identity (or orientation) refers to who someone is romantically or sexually attracted to.
- Gender identity is a person’s innate sense of their own gender whether male, female or another, which may or may not correspond to the sex assigned at birth.
People use many ways to define their sexual and gender identity and while we were not able to encompass them all, please use this Stonewall glossary if you want to learn more about the different terms.
What is LGBTQIA+?
LGBTQIA+ is an umbrella term that encompasses both sexual and gender identities, recognising that not everyone identifies as heterosexual and/or cisgender.
- Lesbian: refers to a woman/woman-aligned person who is attracted to only people of the same/similar gender.
- Gay: refers to men/men-aligned individuals who are only attracted to people of the same/similar gender. Gay is also a generic term for lesbian and gay sexuality.
- Bisexual: refers to someone who is attracted to more than one gender.
- Transgender: a term that indicates that a person’s gender identity is different from the gender associated with the sex they were assigned at birth.
- Queer or Questioning: often considered an umbrella term for anyone who is non-cisgender or heterosexual. The term queer was historically used as a slur (as is still viewed by some as such).
- Intersex: refers to individuals who are born with variations of sex characteristics that do not fit with binary definitions of male or female bodies.
- Asexual: refers to a person who does not experience sexual attraction.
- +: All of the sexual and gender identities that are not specifically covered by the other seven initials.
life experiences and mental health
Members of LGBTQIA+ communities are more likely to face experiences in their lives that can negatively impact their mental health:
Hate crimes
The most common type of hate crime people in LGBTQIA+ communities experience is verbal abuse. Another problem can be increased rates of bullying that LGBTQIA+ youth experience. The UK National LGBT Survey has shown that 40% of people identifying as LGBTQIA+ experienced verbal harassment or physical violence in the past 12 months.
Furthermore, transgender people are around twice as likely to experience threats of physical or sexual harassment or violence compared with the other LGBTQIA+ communities. Experiencing hate crimes, or even just anticipating a hate crime, can lead to Post-Traumatic Stress Disorder (PTSD), depression and anxiety.
Coming out
Coming out is when a person first tells someone about their sexual and/or gender identity. To some people, it may feel liberating and bring feelings of happiness because they don’t have to conceal their true identity anymore. However, it can also be a very challenging time. There can be a lot of anxiety around not knowing how others will react, which can lead to stress and isolation. Coming out might also increase experiencing discrimination.
Body image
Body image concerns are increasingly common across the population, but they can have a particularly profound impact on members of the transgender community. For transgender individuals, body dissatisfaction and risk of body dysmorphic disorder (BDD) may be intensified by societal gender norms and the incongruence between their gender identity and physical appearance. Many experience heightened levels of body objectification and dissatisfaction with body weight or shape. Research also indicates rising rates of eating disorders among LGBTQ+ individuals.
Accessing healthcare
People in LGBTQIA+ communities may experience discrimination in a healthcare setting. For example, they might be misgendered, not listened to or a healthcare professional may ‘out’ someone without their prior consent. This can lead to a reluctance to seeking support, which can increase symptoms of poor mental health.
Family problems
Family acceptance and support is a big protecting factor for the mental health of LGBTQIA+ people. Nevertheless, some family members may react negatively to their relative coming out and familial rejection is a significant factor for compromised LGBTQIA+ mental health. This is also signified in the disproportionate number of homeless LGBTQIA+ people.
Misgendering
Misgendering is the deliberate or accidental use of incorrect pronouns, using former names and arguing with a person about their pronouns or gender. Prolonged exposure to misgendering can seriously impact a person’s mental health. Lack of social acceptance lowered self-esteem, and recurrent stressors are the leading causes of higher rates of depression, anxiety, suicidal thoughts, trauma-related concerns, disordered eating and substance use.
LGBTQI+ in rural areas
Being part of the LGBTQIA+ community can be even more challenging for those living in rural communities. The LGBT Youth Scotland’s Health Report (2023) highlights that only 50% of rural-based participants feeling feel comfortable to come out to their doctor, as compared with 67% of urban-based participants. This further highlights the intersection between rural communities and mental health, where being part of small, close-knit communities can be a “double-edged sword”, providing both comfort to some and stigma to others.
The report further mentions a lack of visibility, acceptance and resources for LGBTQIA+ individuals in rural areas compared to urban communities. The prevailing attitudes in these settings may be less understanding of diverse sexual and gender identities, which leads to increased feelings of isolation, discrimination and a lack of support for those who identify as LGBTQIA+.
Further Out
In partnership with Equality Network, Change Mental Health explored the key themes behind understanding the poor mental health of many in Scotland’s LGBTQIA+ community across the rural landscape. You can read more about it here.
“I have reported hate crimes to the police in the past, when I was younger and dealing with them I was often not believed or they didn’t think it was that big of a deal. I was told several times that if I “didn’t shove it in people’s faces” then I’d be fine; I was a young teenager who didn’t talk to people or go out, the most “flaunting” I did was wear a badge and host a lunch group when I was in school.”
Participant of the LGBT Youth Scotland survey
In partnership with Equality Network, Change Mental Health explored the key themes behind understanding the poor mental health of many in Scotland’s LGBTQ community across the rural landscape. You can read more here.
getting support
It might feel overwhelming and daunting to seek support if you are experiencing mental health problems and are part of LGBTQIA+ communities, however it is so important to look after your wellbeing and ensure your safety.
Know your rights
Under the Equality Act 2010 it is illegal to discriminate against anyone who is part of LGBTQIA+ communities. To learn more about your rights, you can talk to a trusted health professional, visit support services or do your own research on the internet.
Don’t feel pressured to talk
Make sure you feel completely comfortable with someone before you talk to them. Don’t let anyone make you have conversations you don’t want to have.
Get an advocate
An advocate is someone independent of healthcare services who will stand up for you and your rights. They can accompany you to meetings and appointments to ensure your voice is being heard and listened to.
Access services
Getting help when you need it is very important. There are many organisations that offer mental health advice, support and services tailored for LGBTQIA+ people. For example, Pink Therapy has an online directory of therapists who work with people who are LGBTQIA+.
being a good ally
It is so important that those not in the LGBTQIA+ communities are good allies and support those who are in communities. Here are some ways to be a good ally:
- Be respectful and listen: If someone in a LGBTQIA+ communities tells you their sexuality, gender and/or pronouns, make sure you listen to what they say and respect it going forward. For example, if someone tells you their preferred pronouns, make sure you use them even when they’re not around.
- Don’t make assumptions: Avoid assuming you know someone’s sexuality or gender. For example, use ‘partner’ when referring to someone they are in a relationship with.
- Take discrimination seriously: If someone tells you they have been discriminated against, ask them what they are comfortable telling you and then take the necessary steps to ensure their welfare. Make sure you are consulting the person who has confided in you if you take any action and listen to their thoughts.
- Stand up for people: Even if there is no one around from a LGBTQIA+ community, make sure you do not use discriminatory language or support anyone that does.
support
Our Advice and Support Service is open Monday to Friday, 10am to 4pm (closed for lunch between 12.30pm and 1.30pm), where advisers can signpost you to local support that most fits your needs, including our Change Mental Health services. We offer initial advice on money worries and help to deal with emergencies.
Contact 0808 8010 515, email us at advice@changemh.org or fill out the enquiry form on the Advice and Support Service page.
Who else can I contact?
- Switchboard LGBT+ Helpline provides a listening service for LGBT+ people over the phone, via email and online chat. It can also provide you with contact details of an LGBT-friendly therapist.
Call 0800 0119 100, open 10am–10pm every day or email support: hello@swicthboard.lgbt. Online chat is also available through their homepage. - Mindout is a Lesbian, Gay, Bisexual, Trans & Queer Mental Health Service – call 01273234839 or email info@mindout.org.uk or contact directly through their Online Support service.
- CAPS individual advocacy for LGBTQIA+ individuals is a service for individuals who leave in East and Midlothian. They can help you to have your voice heard in all sorts of issues. You can use phone number: 0131 273 5118 or email: advocate@capsadvocacy.org
- LGBT Youth Scotland is Scotland’s national charity for LGBTQ+ young people, aged 13-25.
- LGBT Health and Wellbeing is Scotland’s national charity promoting the mental health of LGBT+ adults.
- LGBTQ+ Scottish Older People’s Network is an initiative by Age Scotland aimed to protect the rights of LGBTQ+ individuals aged 50 and above
- Mermaids is a British charity that supports non-binary and transgender youth.
