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A strong network of supportive family and friends can bolster one’s mental health. Unfortunately, lesbian, gay, bisexual, transgender and queer/questioning individuals may lack family support and often confront daily discrimination based on their sexual orientation or gender identity — factors that can increase their risk for mental health problems.
Those who are LGBTQ are nearly three times more likely to develop a mental health disorder such as depression or anxiety, according to the National Alliance on Mental Illness (NAMI). They are also significantly more likely to attempt suicide and abuse substances. The risks are especially high for young people: LGBTQ youth ages 10-24 are four times more likely to attempt suicide than their peers.
“There’s a unique feature of sexual and gender minorities that doesn’t apply to other populations, and that’s that you can be part of these minority groups while your family isn’t,” explains James Lehman, MD, MPH, a psychiatry resident with UW Health. “Usually people from disadvantaged groups find support from other community members or their own family, but that’s not always the case with LGBTQ people, whose families may be unsupportive.”
Depression and generalized anxiety disorder are the most common mental health risks for the LGBTQ population.
“Those are more stress-sensitive conditions,” Lehman explains. “Some people are at higher risk for bipolar disorder, schizophrenia, and even depression and anxiety because of genetics. But, depression and anxiety can also be attributable to social conditions and how people treat you. At this point in history we have an understanding that there’s nothing intrinsically mentally wrong with being the minority in sexual orientation or gender identity; it’s how the world views and treats that.”
The mental health risks are even higher for transgender people: About 40 percent report attempting suicide, according to the National Transgender Discrimination Survey. “Transgender people get hugely overlooked,” Lehman says. “Poverty, physical assault and sexual assault are all more common in transgender or gender nonconforming people.”
Stress, depression and anxiety — as well as targeted marketing campaigns — might also explain why LGBTQ people are significantly more likely to use tobacco, alcohol and other drugs. Nearly a quarter of LGBTQ individuals abuse alcohol, compared with 5-10 percent of the general population.
But when it comes to increased suicide risk, a strong support network can make a lifesaving difference. “A supportive family almost entirely mitigates the risk,” Lehman notes.
It’s not just the support of close family and friends that can make a difference: General societal acceptance might also help. A large study recently published in JAMA Pediatrics found a significant reduction in suicide attempts among lesbian, gay and bisexual adolescents in 32 states after those states legalized same-sex marriage, before the U.S. Supreme Court legalized same-sex marriage nationwide in June 2015.
Health and Wellness Advice for LGBTQ Patients
Lehman shares this health and wellness advice for LGBTQ patients:
Look for a Provider You Can Trust
Unfortunately, not every medical provider may be knowledgeable or comfortable with issues that affect sexual and gender identity minorities. Your best bet is to ask around to get recommendations on LGBTQ-friendly providers, Lehman suggests. The Gay and Lesbian Medical Association’s online provider directory, while not comprehensive, is another resource.
Be Open and Honest With Your Doctor
“There tends to be health care avoidance in these communities, in everything from cancer screenings to not being forthcoming about sexual risks when talking to primary care physicians,” Lehman says. “Many LBGTQ patients aren’t even out to their primary care physicians. Obviously, your sexual orientation or gender identity doesn’t affect every aspect of your health, but that information can help your doctor better understand your life and potential risk factors. And if you’re experiencing depression, anxiety or substance abuse, your doctor can recommend resources.”
If You’re Struggling, Talk to a Mental Health Professional
While the psychiatry field was “once at the forefront of demonizing sexual and gender minorities,” there has been a near-complete reversal, Lehman says. “Today, many mental health professionals tend to be farther ahead in terms of understanding your full experiences, social stresses, and feeling lost in unaccepting populations.” If you are wanting to speak with a mental health provider, your healthcare provider should be able to help connect you someone who is affirming and supportive.
If You’re Considering Self-harm, Get Help Right Away
Call 866-488-7386 to be connected to the Trevor Project’s 24-hour confidential suicide hotline for LGBTQ youth, or text “Trevor” to 202-304-1200. The National Suicide Prevention Lifeline is 1-800-273-TALK.
How to Provide Support
Local PFLAG Chapters
PFLAG is a national organization committed to providing education, support and advocacy for the LGBTQ community. There are local chapters across Wisconsin, including Madison and Mt. Horeb. Find a chapter near you
For loved ones of LGBTQ people, Lehman suggests the following:
The support of family and friends is known to lower suicide risk. Consider the impact of your words and actions. “Sometimes the way people are mistreated is not in the form of a huge threat, but in a bunch of little paper cuts that add up over time,” Lehman says. If your loved one is transgender, be supportive of their desire to transition hormonally or surgically to the gender with which they identify.
Be a Good Listener
“Pay very close attention and ask questions like, ‘Do you feel like you belong? Do you feel physically safe? How do people treat you?’ And don’t be dismissive when you hear the truth,” Lehman says.
Watch for Warning Signs
“If someone is talking more about the idea of being dead or not wanting to be around, or escaping life, or actually starting to do specific forms of self-harm, these are all good reasons to bring up your concerns,” Lehman says. Urge your loved one to see a mental health professional and/or call the National Suicide Prevention Lifeline at 1-800-273-TALK.
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