LGBT People and Mental Health

Healing the wounds of prejudice

Al Zwiers, MSW, RSW

Reprinted from "LGBT" issue of Visions Journal, 2009, 6 (2), pp. 10-11

Imagine knowing at a young age that you are different. Imagine that you see your difference contrasted everyday in the relationships you grow up around. Imagine that your peers hurl insults defining how you are different. Imagine that the social and cultural institutions inform you that your difference is not acceptable. Imagine that you long to be with others who are also different, but don’t have a way to connect with them.

For many lesbian, gay, bisexual and transgender (LGBT) people, this has been the reality of their childhood and development into adulthood. The lasting effects of experiences with such prejudice and discrimination are profound.

Discrimination breeds ills

Research shows that LGBT people have higher rates of mental health challenges than the general population.1 LGBT people often struggle with depression, anxiety, trauma and self-acceptance as a result of facing ongoing discrimination over their lifetimes.2-3 LGBT youth are about three to four times as likely to attempt suicide as their peers.4-6

There is evidence that these higher rates of mental health challenges are due to heightened and long-term exposure of LGBT people to societal and institutional prejudice and discrimination.7 There are many similarities in the effects of discrimination and how people respond to and cope with stress directly related to prejudice. It’s important to remember, however, that not all LGBT people have lived the same experiences, and that people respond to similar experiences in different ways. It’s also important to note that issues of sexual orientation (lesbian, gay and bisexual) are very different from the issues of gender identity (transgender). Gender is about how we view and express ourselves, such as male, female or somewhere between, while sexual orientation is about who we are attracted to romantically and sexually.

LGBT people unquestionably experience long-term stress related to their sexual orientation or gender identity. They often internalize the negative messages about being different. These messages become beliefs that can fester and develop into two struggles: shame about who they are and what they feel, and guilt about what they do.8 Moreover, LGBT people witness physical assaults against others they identify with,9 which further threatens their sense of physical and emotional safety.

Experiences of verbal and physical abuse by peers based on sexual orientation and gender variation are almost universal for LGBT youth.10 In a 1998 study, LGBT students heard derogatory slurs, such as “faggot,” “dyke” and “queer,” an average of 26 times each day.11 Some youth report that these behaviours occurred in the presence of school staff, who did nothing to challenge the discrimination.12 These experiences lead to youth feeling unsafe in schools and result in higher rates of skipping school and dropping out.

Through repeated negative experiences as children and teens, LGBT people learn to anticipate and expect rejection and judgment from their families, peers and communities. These young people come to understand that they are different from what is considered normal. LGBT people are often met with rejection and violence within their own families. LGBT youth continue to be at greater risk of being kicked out of their homes or running away to the streets than their peers.13-14

Living with these various challenges to their emotional well-being can foster anxiety over rejection and abandonment. Withdrawing from a culture that threatens their safety and lives is viewed by some LGBT people as a safer option. However, isolation due to lack of a supportive family or community of peers can compound struggles with depression.15

In the not-too-distant past, even the medical community added to the emotional and physical risks to LGBT people. Before 1973, homosexuality was labeled a mental disorder and many individuals experienced prejudice and judgment from those who were supposed to help. Debate continued in the medical field through to 1987, when it was widely accepted that homosexuality was not a mental disorder.16 While the situation for LGBT folks has improved over the past few decades, many are still dealing with the effects of societal discrimination experienced during their lifetimes.

Allies . . . just imagine!

Having support in life is immensely important to a person’s mental health and overall well-being. Ongoing movements within the LGBT communities have developed alternative means for people to connect, share and heal in meaningful ways.17 Individuals have become connected through other activities and venues, such as recreational groups, political action, and peer support and discussion groups.

Community developers and researchers are recognizing the connections between the prejudice experienced by LGBT people and discrimination based on gender, race or ethnicity. LGBT individuals are tackling isolation and prejudice by developing healthy alliances with their neighbours, friends and families. Gay–straight alliances are being developed within school systems.

Anyone can be an ally and provide support and nurturance to their friends, family and community members.18 The importance of the role that allies play is acknowledged publicly, as proven by the fact that the group that consistently gets the loudest cheers at pride parades is PFLAG, the Parents and Friends of Lesbians And Gays.19

Allies move beyond pity and tolerance to lead by example. They understand that LGBT people have a right to be true to themselves in expressing their gender and sexual orientation, and in living full and proud lives as equals in society. Allies challenge discrimination against LGBT people and acknowledge the impact of historical prejudice upon mental health.

Change needs to continue to occur within society to challenge systemic oppression on all levels. It’s important for everyone to recognize the strength and courage required for LGBT people to stand up in the face of discrimination. It’s also important to acknowledge the enduring capacity for people to heal from the wounds of prejudice. Change is always possible.

Imagine knowing at a young age that you are different. Imagine you learn that being different is okay. Imagine that you feel safe and nurtured in your families, culture and society. Imagine that you develop a strong sense of connection to a diverse community. Imagine that you are taught to love what makes you different. Just imagine...

 
About the author

Al is a Registered Social Worker. He has worked with Vancouver Coastal Health as an addictions counsellor for the past decade, with a special focus on sexuality and gender identity. Al considers himself fortunate to be able to work within the LGBT community to nurture healing, understanding and growth.

Footnotes:
  1. Fergusson, D.M., Horwood, J.L. & Beautrais, A.L. (1999). Is sexual orientation related to mental health problems and suicidality in young people? Archives of General Psychiatry, 56(10), 876-880.

  2. Vincke, J. & Bolton, R. (1994). Social support, depression, and self-acceptance among gay men. Human Relations, 47(9), 1049-1062.

  3. Oetjen, H. & Rothblum, E.D. (2000). When lesbians aren’t gay: Factors affecting depression among lesbians. Journal of Homosexuality, 39(1), 49-73.

  4. Nicholas, J. & Howard, J. (1998). Better dead than gay? Depression, suicide ideation and attempt among a sample of gay and straight-identified males aged 18 to 24. Youth Studies Australia, 17(4), 28-33.

  5. Garofalo, R., Wolf, R.C., Wissow, L.S. et al. (1999). Sexual orientation and risk of suicide attempts among a representative sample of youth. Archives of Pediatrics and Adolescent Medicine, 153(5), 487-493.

  6. Clements-Noelle, K., Marx, R. & Katz, M. (2006). Attempted suicide among transgender persons: The influence of gender-based discrimination and victimization. Journal of Homosexuality, 51(3), 53-69.

  7. Meyer, I. (2003). Prejudice, social stress and mental health in lesbian, gay and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin, 129(5), 674-697.

  8. Neisen, J.H. (1993). Healing from cultural victimization: Recovery from shame due to heterosexism. Journal of Gay and Lesbian Psychotherapy, 2(1), 49-63.

  9. Mays, V.M. & Cochran, S.D. (2001). Mental health correlates of perceived discrimination among lesbian, gay, and bisexual adults in the United States. American Journal of Public Health, 91(11), 1869-1876.

  10. D’Augelli, A.R. (2002). Mental health problems among lesbian, gay, and bisexual youth ages 14 to 21. Clinical Child Psychology and Psychiatry, 7(3), 433-456.

  11. Bart, M. (1998, September). Creating a safer school for gay students. Counseling Today.

  12. D’Augelli, A.R. (1992). Lesbian and gay male undergraduates’ experiences of harassment and fear on campus. Journal of Interpersonal Violence, 7(), 383-395.

  13. Cochran, B.N., Stewart, A.J., Ginzler, J.A. et al. (2002). Challenges faced by homeless sexual minorities: Comparison of gay, lesbian, bisexual and transgender homeless adolescents with their heterosexual counterparts. American Journal of Public Health, 92(5), 773-777.

  14. Savin-Williams, R.C. (1994). Verbal and physical abuse as stressors in the lives of lesbian, gay male and bisexual youths: Associations with school problems, running away, substance abuse, prostitution, and suicide. Journal of Consulting and Clinical Psychology, 62(2), 261-269.

  15. Bradford, J., Ryan, C. & Rothblum, E.D. (1994). National lesbian health care survey: Implications for mental health care. Journal of Consulting and Clinical Psychology, 62(2), 228-242.

  16. Drescher, J. & Merlino, J.P. (Eds.). (2007). American psychiatry and homosexuality: An oral history. Binghamton, New York: Haworth Press.

  17. Harper, G.W. & Schneider, M. (2003). Oppression and discrimination among lesbian, gay, bisexual and transgendered people and communities: A challenge for community psychology. American Journal of Community Psychology, 31(3-4), 243-252.

  18. Riddle Homophobia Scale from Wall, V. (1995). Beyond tolerance: Gays, lesbians and bisexuals on campus. A handbook of structured experiences and exercises for training and development. Washington, DC: American College Personnel Association.

  19. Parents, Families and Friends of Lesbians and Gays (PFLAG): http://blog.pflag.org/2009/09/rachel-maddow-loves-pflag-pride-parade.html.

 

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