With June being Pride Month, there are many things to celebrate. However, it is also important to consider the importance of LGBTQIA+ affirming care, not only in our actual work but also in how we interact with people daily. Our previous post was a quick primer on identities and terms common in the LGBTQIA+ community. This post felt like a natural progression from the previous one.
While there are many good things about being part of a community as rich and diverse as the LGBTQIA+ community, we also cannot ignore the statistics that are available that show the impact of prejudice, bias, and bigotry on the lives of many people. This is why affirming care for these individuals is so important. It is important to remember that there is no inherent link between being LGBTQIA+ and having a mental illness but that it is the way that the world treats individuals in this community that contributes to mental illness. This is where the importance of LGBTQIA+ affirming care comes in.
Statistics
According to a 2022 survey by SAMHSA (Substance Abuse and Mental Health Services Association), LGBTQIA+ adults are more likely to use substances, experience mental health disorders, and experience serious thoughts of suicide.
The Trevor Project Shows us Why LGBTQIA+ Affirming Care is Needed
The Trevor Project also releases a survey every year that asks thousands of LGBTQIA+ youth about their experiences. It covers many topics, including experiences with mental health, abuse and bias, and what their home and school (or work) lives are like. Their most recent 2023 survey is an incredibly detailed look into what it is like to experience the world in the United States as an LGBTQIA+ youth. According to the Trevor Project:
- 41% of LGBTQ young people seriously considered attempting suicide in the past year.
- 56% of LGBTQ young people who wanted mental health care in the past year were not able to get it.
- At least some of those 56% of LGTBQ young people stated that one of the reasons they could not access care was because of a lack of LGBTQIA+ affirming care providers.
- Transgender and nonbinary young people who reported that all of the people they live with respect their pronouns reported lower rates of attempting suicide, however fewer than 40% of LGBTQ young people found their home to be LGBTQ-affirming.
- Roughly half of transgender and nonbinary young people found their school to be gender-affirming, and those who did reported lower rates of attempting suicide, however a majority of LGBTQ young people reported being verbally harassed at school because people thought they were LGBTQ.
- Nearly 1 in 3 LGBTQ young people said their mental health was poor most of the time or always due to anti-LGBTQ policies and legislation.
- Nearly 2 in 3 LGBTQ young people said that hearing about potential state or local laws banning people from discussing LGBTQ people at school made their mental health a lot worse.
NAMI
NAMI (the National Alliance on Mental Illness) gives some insight to some of these statistics. According to them there are a variety of reasons that individuals in this community are more likely to experience mental illness. These include:
- Coming out – This is an experience that can be either positive or negative for people. If coming out was voluntary, it is more likely to be positive, however it can still come with some negative ramifications depending on how those around them react. If someone is outed (having their identity told to others without their consent), it can often be a negative and traumatizing experience.
- Rejection – Many LGBTQIA+ plus, especially youth and young adults, experience rejection from loved ones upon coming out (or being outed). They can also be rejected by peers and are more likely to experience bias and prejudice at work or in school.
- Trauma – Unfortunately, due to the way many in our society still treat those who are LGBTQIA+, many individuals end up experiencing trauma throughout their lives, especially as adolescents.
Extra Risks for LGBTQIA+ Individuals
They also discuss some risks that LGBTQIA+ individuals are more likely to experience as a result of their identities, such as:
- Homelessness – LGBTQIA+ youth have an estimated 120% higher risk of experiencing homelessness in comparison to their non-LGBTQIA+ peers. This is especially high for Black and Indigenous youth.
- Suicide – As we saw from the Trevor Project’s survey, 41% of LGBTQIA+ youth have had serious thoughts of suicide. Suicide completion is also high in this group as a result of their experiences.
- Inadequate mental health care – the Trevor Project noted that 56% of LGBTQIA+ youth who wanted mental health care could not access it due to a variety of factors. However, it is also important to note that not all mental health practitioners are informed in this type of work and may accidentally contribute to some of the distress their clients may face or end up providing substandard care (either due to ignorance or to their own biases).
While many of the statistics available focus on youth, we have to remember that adults, especially older adults, also face difficulties. According to SAGE, 53% of older adults who identify as LGBTQIA+ experience loneliness and they are twice as likely to live alone in comparison to non-LGBTQIA+ peers. We know that loneliness can contribute to mental illness, especially depression.
What We Can Do
These statistics are distressing, but what can we do about them? As people, just showing kindness and understanding can go a long way to changing someone’s day or even life. When we keep in mind our language and how we talk about different groups of people, we take into consideration the impact we have on other people every day. But what about as clinicians?
Don’t assume someone’s gender or sexual orientation. If you’re able to have your own intake forms, look into making sure they are as inclusive as possible. If you work for a group practice that has the same forms for everyone, advocate for the LGBTQOA+ community by approaching whoever is in charge of the forms and suggesting more inclusive language and changes to them. It can be the best way to set up a safe environment almost immediately before a client even meets with you. Also remember to include a third gender option of your forms, if you ask for a client’s gender.
Provide a space for them that makes them feel safe. There are many ways you can do this both during intake and going forward. It’s not appropriate to ask about medical transitioning unless the individual brings it up first as medical transition can be an especially sensitive topic for many people. You wouldn’t ask a cisgender person details about their genitals and you shouldn’t ask a transgender individual about this, either.
Make sure to use their pronouns; a good way to know them is to have this included on your intake form or to make a point of asking every client during the first appointment what their pronouns are. It’s important to ask all clients because there is no way to know just by looking at someone what their gender or pronouns are.
Don’t use their deadname if it is still their legal name; giving an option for a chosen name on your intake form alongside the legal name can help you know how best to refer to your clients.
Learn how they want to refer to their partners. Understand the most up to date terms to avoid using outdated, now offensive words to describe identities.
Be prepared with resources that are tailored for LGBTQIA+ individuals. For example:
There are many more than these, however! Look for ones local to you, as well, as sometimes having local communities can be more helpful than online ones.
The way we come prepared to handle the needs of clients who may be different than us can make a world of difference for how much they’re able to get out of the care they come to us for. Focusing on LGBTQIA+ affirming care can make a world of difference for individuals in this community and can greatly improve their quality of life.
Resources:
https://www.nami.org/Your-Journey/Identity-and-Cultural-Dimensions/LGBTQ
https://www.sageusa.org/news-posts/startling-mental-health-statistics-among-lgbtq-are-a-wake-up-call