LGBTQIA+ and mental health
Everyone has a gender identity and sexual orientation. For some people, this may mean identifying as LGBTQIA+. LGBTQIA+ people are more likely to face mental health challenges such as depression, anxiety or suicidal thoughts because of stigma, discrimination and lack of acceptance.
Being LGBTQIA+ does not cause poor mental health. Rather, these difficulties often arise from living in a society that is not always accepting of people who diverge from the ‘norm’. The minority stress theory suggests that the increased risk of poor mental health for LGBTQIA+ people is due to the increased level of social stress. Social stressors include stigma, discrimination, prejudice and victimisation.
In Scotland, almost 9 in 10 young people identifying as LGBTQIA+ experienced at least one mental health condition or related behaviour. The most commonly faced include depression, self-harm, alcohol and drug abuse, and suicidal thoughts.
This resource will 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.
being LGBTQIA+ is a mental illness
Historically, being LGBTQIA+ was wrongly seen as a mental illness due to prejudice and misunderstanding. Today, medical and mental health organisations recognise that being LGBTQIA+ is a normal part of human diversity.
trauma causes people to become LGBTQIA+
There is no evidence that being LGBTQIA+ is caused by trauma. Sexual orientation and gender identity are not the result of abuse or adverse experiences.
questioning your gender identity or sexual orientation means you have poor mental health
Exploring your gender identity or sexual orientation is a normal part of self-discovery and is not simply a ‘phase’ or a sign of poor mental health.
key terms
When talking about topics relating to LGBTQIA+ individuals, there are a couple of key terms to define first and foremost:
- 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 nonbinary, which may or may not correspond to the sex assigned at birth.
For further information and explanations of different terms relating to sexual and gender identity, read the Stonewall glossary to find out more.
what does LGBTQIA+ mean?
LGBTQIA+ stands for lesbian, gay, bisexual, transgender, queer (or questioning), intersex, asexual and plus. It is an umbrella term that describes an individual’s sexual orientation or gender identity, 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, but has been reclaimed by the community in modern times.
- 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.
how does being LGBTQIA+ impact mental health?
Identifying as LGBTQIA+ can increase the risk of facing mental health challenges. Did you know?
- 32% of LGBTQIA+ people globally live with depression
- 1 in 3 LGBTQIA+ individuals have attempted suicide
- 43% of LGBTQIA+ youth say they have self-harmed
- Only 1 in 4 rate their mental health positively.
These statistics reflect that members of LGBTQIA+ communities are more likely to face experiences in their lives that can negatively impact their mental health. Below are six types of negative experiences LGBTQIA+ people may face:
Hate crimes
The most common type of hate crime people in LGBTQIA+ communities experience is verbal abuse. A 2023 report by Just Like Us found that 6 in 10 LGBT+ young adults have been subjected to verbal abuse in the last 12 months, rising to nearly 3 in 4 for those identifying as transgender. Even if they don’t experience verbal abuse, young people identifying as LGBTQIA+ face higher levels of bullying at school or in their everyday life.
Furthermore, transgender people are around twice as likely to experience threats of physical or sexual harassment or violence compared with 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. Some people may feel liberated because they don’t have to conceal their true identity any longer. 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 common within the LGBTQIA+ community. For example, research indicates there are rising rates of eating disorders among LGBTQIA+ people. For some individuals, unhealthy eating habits can develop as a way of coping with feelings of shame, stigma or discrimination related to their LGBTQIA+ identity.
Transgender individuals often face body dissatisfaction and are particularly vulnerable to body dysmorphic disorder (BDD) This may be because of the clash between their gender identity and physical appearance, further intensified by societal gender norms. Many experience heightened levels of body objectification and dissatisfaction with body weight or shape.
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 be a very distressing experience which can result in a reluctance to seek support, increasing the risk of poor mental health.
Family dynamics
Family acceptance and support are a big protecting factor for the mental health of LGBTQIA+ people. Nevertheless, some family members may react negatively to their relative coming out. Rejection by family members can have a profound impact on mental health and is also reflected in the disproportionately high number of LGBTQIA+ people experiencing homelessness.
Misgendering
Misgendering is when someone deliberately or accidentally uses the wrong pronouns or refers to them by a former name (known as deadnaming). Repeated experiences of misgendering can have a serious impact on mental health, lowering self-esteem and causing people to withdraw or isolate themselves because they feel unsupported or unaccepted. Rather than making assumptions about someone’s gender identity, it is always best to politely ask for their preferred pronouns.
LGBTQIA+ in rural areas
Being part of the LGBTQIA+ community can be even more challenging for those living in rural communities. Only 50% of LGBTQIA+ people living in rural Scotland feel comfortable coming out to their doctor, compared with 67% in urban areas. Rural communities may also have fewer LGBTQIA+ resources, less visibility and lower levels of acceptance. This can lead to people feeling isolated, misunderstood or unsupported because of their sexual orientation or gender identity.
At the same time, rural communities are often close-knit and can provide a strong sense of support and belonging. While some LGBTQIA+ individuals may find comfort and acceptance within their community, others may still experience stigma or discrimination for being different.
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
I’m LGBTQIA+, how can I help my mental health?
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 very important to look after your wellbeing and protect your safety. Below are some helpful tips:
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 important that those not in the LGBTQIA+ communities are good allies and support those who are. Here are some ways to be a good ally:
- Be respectful and listen: If a LGBTQIA+ person tells you their sexuality, gender and/or pronouns, make sure you listen to what they say and respect it. 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 National Advice and Support Service can help you and people you care for with mental health concerns and money worries.
We can link and signpost you to relevant local and national support, including our own Change Mental Health services, as well supporting with debt, grants and benefits.
The service is open Monday to Friday, 10am to 4pm (closed for lunch between 12.30pm to 1.30pm). Contact 0808 8010 515, email advice@changemh.org or fill in the form on the service webpage.
For full details about the service, visit the National Advice and Support Service webpage.
other support
Switchboard LGBT+ Helpline – Switchboard 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 the helpline on 0800 0119 100 (open 10am–10pm every day) or email. 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 Lothian 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.
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.
