The Queer Mental Health Movement

Progress (and Regress) In LGBTQ Rights

It’s been 50 years since Stonewall, the moment that launched the queer civil rights movement, and there is a lot to celebrate. In the areas of work, housing, marriage, and access to queer-sensitive health care and HIV treatment, our progress has been nothing short of astounding. 

At the same time, there are reminders that these hard-won gains rest on fragile foundations. A ban on transgender soldiers has been reinstituted in the military. There is still no federal law prohibiting discrimination against LGBTQ individuals. The U.S. Department of Health and Human Services has proposed limiting health-care protections to transgender individuals. LGBTQ people often experience homophobia and discrimination, which at times turns violent. Many people feel like queer mental health is under attack—and it’s up to us to make a change.

Social Rejection and the Epidemic of Loneliness

LGBTQ people often find themselves living within a narrative that doesn’t accept them – one written by their families, schools, neighbors, congregations, government, and society at large. This narrative has deemed LGBTQ individuals as deviant, immoral and a threat to the very fabric of society. As a consequence, many queer folk are unable to feel safe or to express themselves fully, even (and sometimes, especially) within their own homes.

The existence and practice of conversion therapy is one of the most blatant examples of social rejection. Conversion therapy – which seeks to cure LGBTQ individuals of their same-sex attractions and non-binary or trans identities – is still legal in 32 states. Its methods are harsh, at times involving “electric shocks” and “nausea-inducing drugs,” along with denial and shaming. The message it sends — that one’s identity is “wrong” and will not be accepted by their loved ones — is upsetting in and of itself.

As humans, our brains are biologically wired for social connection. This makes experiences of social rejection, like conversion therapy, all the more harmful. A lack of acceptance, bullying, and the forced concealment of identity, are just a few of the factors that contribute to an epidemic of loneliness within the queer community. 

Early experiences of rejection can make it harder to develop healthy relationships in adulthood. A recent study of more than 700 queer adults showed that internalized shame led to difficulties within relationships and increased feelings of loneliness. The study noted that “shame leads individuals to feel unworthy in relationships. This is especially harmful to sexual minorities,” because social support is such an important part of emotional wellness. 

Violence, Bullying, and Trauma

LGBTQ individuals also face high rates of violence and discrimination. Queer youth are twice as likely as their heterosexual counterparts to be bullied both verbally and physically. In addition, queer youth are more likely to miss school out of concerns for their safety. Their fears are understandable; in 2017, nearly a fifth of all hate crimes in the US were linked to sexual orientation or gender identity.

Given these hardships, it’s unsurprising that LGBTQ youth experience higher rates of trauma than their peers. What’s more, queer people experience disproportionate rates of suicide, depression, anxiety and substance abuse when compared to their cis, straight peers. Data indicate that as many as 38-65 percent of transgender individuals have contemplated suicide. An estimated 20-30 percent of LGBT individuals engage in unhealthy substance use. LGBT youth are four times as likely as their straight counterparts to attempt suicide or engage in self-harm.

These statistics are upsetting enough on their own. When one takes into account how, historically, healthcare providers have failed when it comes to recognizing and treating the unique concerns faced by queer people, the issue is exacerbated.

A Mental Health Movement

The above factors make one thing clear: it is our responsibility, as mental health providers, to  create queer-positive services and spaces. We must normalize people’s experiences around gender and sexual orientation, support their self-determination, and recognize the impact of LGBTQ discrimination on their lives.

For clients in search of queer-positive mental health services, some things to consider include:

1. Do the promotional, educational, and informational materials include queer images and information? Do they use gender-inclusive terminology?
2. Are there specific indicators that the practice is welcoming? (e.g. queer publications in the waiting room, gender-neutral bathrooms)
3. Do the intake forms carry inclusive language?
4. Does the therapist ask you for your preferred pronouns?
5. Does the therapist see you as a whole person, not just your queer identity?
6. Does the therapist encourage and validate your right to self-identify?
7. Is the atmosphere free of judgment, assumptions and heteronormative messaging?
8. Does your therapist have experience working or training with queer individuals? If not, do you sense you will have to educate them more than you’d like to?

Many people find that their needs are best met by clinicians who specialize in working with gender and sexuality. It is perfectly normal and acceptable to prioritize this criteria while searching for a provider.

Here at Viva, we are proud to offer queer-affirmative services, which you can learn more about here. One of us (Nicole Armistead-Williams) was lucky enough to be featured in the Washington Blade’s “40 Under 40: Queer Women of Washington” for 2019! You can also check out our free identity and discrimination resources at the Resilient Brain Project.

Let’s make progress together.

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Regina Tosca, LICSW, is a therapist at the Viva Center in Washington, DC. She works with people experiencing grief and loss, including loss of companion animals, as well as those who experience grief and trauma from their work in animal welfare. Other blogs by Regina include “Grieving the Loss of a Pet” and “The Power of Mind-Body Approaches in Trauma Recovery.”