Lesbian/Gay/Bisexual/Transgender Communities and Mental Health

Mental Health America works nationally and locally to raise awareness about mental health and ensures that those at-risk for mental illnesses and related disorders receive proper, timely and effective treatment. MHA incorporates culturally competent strategies to ensure that it is effectively addressing the treatment and psychosocial needs of consumers and families with diverse values, beliefs, sexual orientations and backgrounds that vary by race, ethnicity and/or language.

Statistics

Demographics/Societal Issues

• Among all U.S. adults aged 18 and over, 96.6% identify as straight, 1.6% as gay or lesbian, 0.7% as bisexual, and the remaining 1.1% as “something else.” [1]
• There appears to be no difference between the number of women and men that identify as lesbian or gay. However, there are more transgender women (0.9%) than transgender men (0.4%). [1]
• Research suggests that LGBT individuals face health disparities linked to societal stigma, discrimination, and denial of their civil and human rights. Discrimination against LGBT persons has been associated with high rates of psychiatric disorders, substance abuse, and suicide. [2]
• Personal, family, and social acceptance of sexual orientation and gender identity affects the mental health and personal safety of LGBT individuals. [2] [1]

Attitudes

• More than 1 in 5 LGBT individuals reported withholding information about their sexual practices from their doctor or another health care professional.  [3]
• Nearly 30 percent of transgender individuals reported postponing or avoiding medical care when they were sick or injured, due to discrimination and disrespect. Over 30 percent delayed or did not try to get preventive care. [3]
• Approximately 8 percent of LGB individuals and nearly 27 percent of transgender individuals report being denied needed health care outright. [3]

Prevalence

• As compared to people that identify as straight, LGBT individuals are 3 times more likely to experience a mental health condition. [4]
• LGBT youth are 4 times more likely to attempt suicide, experience suicidal thoughts, and engage in self-harm, as compared to youths that are straight. [4]
• 38-65% of transgender individuals experience suicidal ideation. [4]
• An estimated 20-30% of LGBT individuals abuse substances, compared to about 9% of the general population. 25% of LGBT individuals abuse alcohol, compared to 5-10% of the general population. [4]
• 2.5 times more likely to experience depression, anxiety, and substance misuse. [5]

Access/Insurance

• In a survey of LGB people, more than half of all respondents reported that they have faced cases of providers denying care, using harsh language, or blaming the patient’s sexual orientation or gender identity as the cause for an illness. Fear of discrimination may lead some people to conceal their sexual orientation or gender identity from providers or avoid seeking care altogether. [5]
• In 2011, the Joint Commission, an independent non-profit national organization that accredits and certifies more than 20,000 health care organizations and programs in the U.S., began to require that hospitals prohibit discrimination based on sexual orientation, gender identity, and gender expression in order to be accredited. [5]

Treatment Issues

• In mental health care, stigma, lack of cultural sensitivity, and unconscious and conscious reluctance to address sexuality may hamper effectiveness of care. [6]
• Evidence suggests that implicit preferences for heterosexual people versus lesbian and gay people are pervasive among heterosexual health care providers. [6]
• LGBT individuals that keep their sexuality hidden are at an increased risk of psychological distress. This also prevents them from accessing group-based coping resources that buffer against the negative effects of stigma. [7]

Educational Materials

MHA has developed unique materials for the LGBT audience:

Brochures

• “What Does Gay Mean?” How to Talk with Kids about Sexual Orientation and Prejudice

Fact Sheets

• Bullying in Schools: Harassment Puts Gay Youth At Risk

Partnerships and Resources

• Human Rights Campaign (HRC)
  http://www.hrc.org

• Gay, Lesbian and Straight Education Network (GLSEN)
  http://www.glsen.org/

Sources 

[1] Ward, B. W., Dahlhamer, J. M., Galinsky, A. M., & Joestl, S. S. (2014). Sexual orientation and health among U.S. adults: National health interview survey, 2013. National Health Statistics Report, 77. Retrieved from http://www.cdc.gov/nchs/data/nhsr/nhsr077.pdf

[2] Office of Disease Prevention and Health Promotion. (2016). Lesbian, gay, bisexual, and transgender health. Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/lesbian-gay-bisexual-and-transgender-health

[3] National Women’s Law Center. (2014). Health care refusals harm patients: The threat to LGBT people and individuals living with HIV/AIDS. Retrieved from https://nwlc.org/resources/health-care-refusals-harm-patients-threat-lgbt-people-and-individuals-liv...

[4] National Alliance on Mental Illness. (2016). LGBTQ. Retrieved from https://www.nami.org/Find-Support/LGBTQ

 [5] Kates, J., Ranji, U., Beamesderfer, A., Salganicoff, A., & Dawson, L. (2016). Health and access to care and coverage for lesbian, gay, bisexual, and transgender individuals in the U.S. Retrieved from http://kff.org/report-section/health-and-access-to-care-and-coverage-for-lesbian-gay-bisexual-and-transgender-health-challenges/

[6] Sabin, J. A., Riskind, R. G., & Nosek, B. A. (2015). Health care providers’ implicit and explicit attitudes toward lesbian women and gay men. American Journal of Public Health 105(9), 1831-1841. doi 10.2105/AJPH.2015.302631

[7] McLaughlin, K. A., Hatzenbuehler, M. L., & Keyes, K. M. (2010). Responses to Discrimination and Psychiatric Disorders Among Black, Hispanic, Female, and Lesbian, Gay, and Bisexual Individuals. American Journal of Public Health,100(8), 1477–1484. http://doi.org/10.2105/AJPH.2009.181586