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Home » Behavioral & Mental Health Concerns in the LGBTQ+ Community

The United States has developed a broader acceptance of LGBTQ+ people. Yet, statistically, this group suffers from higher rates of behavioral and mental health conditions such as depression, addiction and PTSD. Newer studies are exploring these statistical correlations and providing healthcare providers with valuable answers.

Researchers and other healthcare professionals have noted that individuals in the LGBTQ+ community have higher rates of behavioral health conditions. The American Psychological Association states that members of this community are at greater risk of harassment, victimization and violence. These risk factors create a greater risk for developing mental health problems and substance abuse disorders. This is especially true when comparing LGBTQ+ youth to their heterosexual peer group.

Other health data shows that, when compared to heterosexual women, lesbians and bisexual women are at greater risk for becoming obese. The prevalence of obesity when combined with other risk factors such as increased alcohol use and smoking, may contribute to higher rates of breast cancer for lesbian and bisexual women.

A Brief Overview:

When studies look at Lesbian, gay and bisexual (LGB) adults, data seems to indicate higher rates of mental illness when compared to all adults. According to data from SAMHSA.org, nearly 40 percent of LGB adults had a mental illness from 2015 to 2016. In comparison, just over 18 percent of all adults had a mental illness during the same time period. Fourteen percent of LGB adults had SMI (serious mental illness) compared to four percent of all adults who had SMI.

The origins of these mental health conditions likely are connected to the fact that LGBTQ individuals are twice as likely to experience hate crimes as compared to any other minority group per a Federal Bureau of Investigation report in 2011.

In 2015, there was a 20% increase from the year before in the number of hate crimes and violence-related homicides of LGBT and human immunodeficiency virus (HIV)- infected individuals (National Coalition of Anti-Violence Programs). Most common types of violence towards individuals in the LGBTG community are verbal harassment, discrimination, physical violence, and threats/intimidation.

PTSD in the LGBTQ+ Community:

Research shows that there is a higher occurrence of post-traumatic stress disorder (PTSD) in the LGBTQ+ community. Some studies argue that the occurrence of PTSD is a symptom of the general social stress that LGBTQ individuals experience as minorities. Researchers argue that there are unique stressors that people in the LGBTQ+ community experience in life. These stressors create higher levels of anxiety, fear and depression. This, in turn, can encourage the development of PTSD.

A 2012 study by the Harvard School of Public Health (HSPH) and Boston Children’s Hospital, researchers found a higher prevalence of post-traumatic stress disorder (PTSD) in young adults who identified as gay, lesbian or bisexual. These findings were especially evident when compared to individuals who identify as heterosexual. They discovered that differences in PTSD by sexual orientation already exist by age 22. Previous studies had identified more PTSD symptoms in a group of sexual minorities aged 40-60.

Suicide, Mental Health and Substance Abuse:

Research from the Substance Abuse and Mental Health Services Administration also indicates that the LGBTQ+ populations experience greater rates of suicide, mental health and substance abuse. Here is a summary of the behavioral health statistics for individual groups within this overall community.

Transgender Individuals:

  • Suicide: The data shows that suicide attempts among transgender people can range from 16 to 32 percent. Access to culturally-sensitive suicide prevention resources and supportive services for transgender people remains a critical priority.
  • Mental Health: Data on the prevalence of mental health disorders such as depression, anxiety, and other clinical conditions among transgender people are extremely limited. Most studies that have focused on mental health disorders among transgender people use nonprobability samples. Few studies actually compare the mental health of transgender to non-transgender people. The few recent studies that have compared the mental health status of transgender people to non-transgender people have yielded mixed results.
  • Substance Abuse: Alcohol and drug abuse have been identified as a major concern among transgender people in the United States. Some studies show marijuana, crack cocaine, and alcohol are the most commonly used drugs by transgender people. Other studies have also found alarming rates of methamphetamine and injection drug use. High rates of tobacco use, has also been found among transgender people. Studies have suggested that barriers to treatment services often include discrimination, provider hostility and insensitivity, strict binary gender (male/female) segregation within programs, and lack of acceptance in gender-appropriate recovery groups.

Lesbian Women:

  • Suicide: Research indicates that lesbian and bisexual women who were “out” experienced more emotional stress as teenagers.  They were also 2 to 2.5 times more likely to experience suicidal thoughts in the past 12 months, when compared to heterosexual women. Lesbian and bisexual women who were not “out” were more likely to have attempted suicide than heterosexual women.
  • Mental Health: Some research has found that adverse, punitive, and traumatic reactions from parents and caregivers in response to their children’s sexual orientation were closely correlated with poor mental health and an increase in substance use. Among adults, from 2015 to 2016, the risk of psychiatric disorders among individuals with same-sex partners found that women with same-sex partners experienced more mental health disorders than did women with opposite-sex partners. These mental health conditions include such major depression, phobia and post-traumatic stress disorder.
  • Substance Abuse: Lesbians are between 1.5 and 2 times more likely to smoke than heterosexual women. A number of studies have also suggested that lesbians are significantly more likely to drink heavily than heterosexual women. Specifically, exclusively heterosexual women tend to have lower drinking rates than all other women, while bisexual women report more hazardous drinking than heterosexual or lesbian women.

              Gay Men:

  • Suicide: Factors such as verbal and physical harassment, negative experiences related to “coming out,” substance use and isolation all contribute to higher rates of suicidal attempts and completions among gay men and youth than among other populations.
  • Mental Health: Multiple studies have shown that depression and anxiety affect gay men at a higher rate than the general population, and are often more severe for men who remain “in the closet.” Problems with body image are more common among gay men than among their straight counterparts. In addition, gay men are much more likely to experience an eating disorder such as bulimia or anorexia nervosa.
  • Substance Abuse: More recent studies have shown that gay men use substances, including alcohol and illicit drugs, at a higher rate than the general population. Research indicates that gay men use tobacco at much higher rates than straight men, in some cases nearly reaching a 50 percent difference in usage rates.

              Bisexual Individuals:

  • Suicide: In the United States, research shows that lesbian and bisexual women who are “out” had experienced more emotional stress as teenagers. Bisexual and lesbian women were 2 to 2.5 times more likely to have experienced suicidal thoughts in the past 12 months than heterosexual women. Meanwhile, lesbian and bisexual women who are not “out” were more likely to have attempted suicide than heterosexual women. Other research suggests that bisexuals are much more likely to report higher levels of self-harm, thoughts of suicide, and suicidal attempts than heterosexuals, gay men, and lesbians.
  • Mental Health: Many factors, similar to those that affect lesbian women and gay men, affect the mental health of bisexuals. However, some studies have suggested that the quality of life and available support for bisexual adults is similar to or lower than that of lesbian women or gay men. Researchers have suggested that bisexual adults have the lowest level of emotional well-being among people of other sexual orientations. Recent studies have also shown that bisexual men and women report consistently higher levels of depression and anxiety than heterosexuals. In some studies, bisexual adults were twice as likely (37.2 percent) to report depression-related symptoms than heterosexual adults (17.2 percent).
  • Substance Abuse: Bisexual men and women seem to have the highest smoking rates of any subgroup for which data set are readily available. These rates range between 30 and 40 percent. Data indicates that differences in smoking rates are most significant between bisexual women (39.1 percent) and heterosexual women (19.4 percent). The data also shows that bisexual adults exhibit higher rates of binge drinking (22.6 percent) versus heterosexual adults (14.3 percent).

A Safe Environment:

These findings suggest that prevention and treatment programs aimed at addressing substance use among this population must also address experiences of gay-related stress and emotional distress. For these reasons, it is critical for mental health providers to discuss with clients their life experiences. Building a safe environment for individuals to share sensitive information, such as sexual orientation and/or sexual behaviors, could lead to more opportunities for the screening and monitoring of critical behavioral health indicators. Culturally-sensitive mental health services for LGBTQ+ community are more effective in the prevention, early detection and treatment of mental health conditions.

About Emerald Psychiatry & TMS Center:

The staff at Emerald Psychiatry & TMS Center understand that as a psychiatry practice, they are here to meet the needs of their patients. They create a trusting relationship with their patients which facilitates healing. By forming a trusting partnership with their patients, Emerald Psychiatry generates a comprehensive treatment plan that is customized to an individual’s unique needs. For more information, contact Emerald Psychiatry & TMS Center.

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Contributor:  ABCS RCM