The Queer Mental Health Movement

How Have LGBTQA Rights Progressed?

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, progress has been nothing short of astounding. 

At the same time, there are reminders that these hard-won gains rest on shaky ground. A ban on transgender soldiers has been reinstituted in the military. There is still no federal law prohibiting discrimination against LGBTQA individuals. The government has proposed limiting health-care protections to transgender individuals. LGBTQA 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.

What Issues Are We Still Facing?

Social Rejection and Loneliness

Queer 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 deems LGBTQ individuals as deviant, immoral and a threat to society. As a consequence, many folk are unable to feel safe or to express themselves fully, even (and sometimes, especially) within their own homes.

Conversion therapy is one of the most blatant examples of social rejection. Conversion therapy – which seeks to cure LGBTQA 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 wired for social connection. This makes experiences of social rejection all the more harmful. A lack of acceptance, bullying, and the forced hiding of one’s identity, are just a few 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. 

Want to discuss LGBTQA mental health with a professional?

Violence, Bullying, and Trauma

LGBTQA individuals also face high rates of violence and discrimination. Queer youth are twice as likely 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. Queer people experience disproportionate rates of suicide, depression, anxiety and substance abuse. Data suggests 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 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 concerns faced by queer people, the issue is made worse.

The Queer 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 journeys, 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 an organization’s promotional materials include queer images and information? Do they use gender-inclusive words?
2. Are there signs that the practice is welcoming? (e.g. queer publications in the waiting room, gender-neutral bathrooms)
3. Do their intake forms carry inclusive language?
4. Does the therapist ask you for your preferred pronouns?
5. Do you feel that your therapist sees 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 and heteronormative messages?
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 therapists who specialize in working with gender and sexuality. It is perfectly normal and acceptable to prioritize this 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.”