First and foremost, however, we must remember that being gay, lesbian, bisexual, or transgender is not a mental illness in and of itself. Just because someone is LGBT does not automatically mean that they will experience a mental illness. According to the American Psychological Association:
“Homosexuality per se implies no impairment in judgment, stability,
reliability, or general social and vocational capabilities. Further, the
American Psychological Association urges all mental health profes-
sionals to take the lead in removing the stigma of mental illness that
has long been associated with homosexual orientations .”
However, LGBT people may face unique risks to their mental health and well-being, which mental health providers should be aware of.
Most research suggests that LGBT people are likely to be at higher risk for depression, anxiety, and substance use disorders. 3-5 One study found that LGBT groups are about two-and-one-half times more likely than heterosexual men and women to have had a mental health disorder, such as those related to mood, anxiety, or substance use, in their lifetime.
In a national study comparing LGBT and heterosexual groups, researchers found that gay and bisexual men were more likely to report major depression and panic disorder in the previous twelve month period. Lesbian and bisexual women were more than three times as likely to have experienced generalized anxiety disorder.
The reason for these disparities is most likely related to the societal stigma and resulting prejudice and discrimination that LGBT face on a regular basis, from society at large, but also from family members, peers, co-workers and classmates.
In terms of more serious mental illnesses, such as those that are long-term and require hospitalization or in-patient care, unfortunately we don’t know very much. However, of the approximately 18 million people with serious mental illness, a reasonable estimate suggests that about 720,000 are gay, lesbian, bisexual, or transgender.
In one of the few studies of serious or major mental illness among LGBT people, researchers found that LGBT men were less likely to report psychotic disorders, such as schizophrenia, but more likely to report mood disorders, such as depression and bi-polar disorders. They found no differences between LGBT and heterosexual women.
Dual or Double Stigma
Mental illness is regrettably still stigmatized in our society. So, too, is being lesbian, gay, bisexual or transgendered. A LGBT person with mental illness may be in the unfortunate position, then, of having to contend with both stigmas. It is often the case that LGBT people experience a mental health care system that is not comfortable with or sensitive to issues related to sexual orientation, while the LGBT community is not sensitive to or educated about serious mental health issues.This societal stigma can contribute to and exacerbate existing mental health problems.
People with mental illness often rely on family for support. However, for some LGBT people, families are not accepting of their sexual orientation or gender identity. In extreme cases, GLBT people are disowned
or kicked out of their homes, which leaves them without an important source of support. Such situations may contribute to more vulnerability among this population, and they suggest just how important it is for LGBT people to have access to affirming, supportive, and culturally appropriate
mental health services.
The societal stigma and prejudice against LGBT people take many forms. Too often, they can take the form of verbal or physical violence. Experiences of violence can have significant and enduring consequences for mental health. A recent study found that 25% of GB men and 20% of LB women had experienced victimization as an adult based on their sexual orientation. 9 In turn, these groups also reported more symptoms of depression, anxiety, and post-traumatic stress. Mental health providers need to be aware of this issue and the potential negative effects it can have on LGBT peoples’ mental health.
Homophobia refers to irrational fear or hatred of gay people. Sometimes, LGBT people turn society’s negative view about them inward, or internalize it. This can affect psychological well-being and can have consequences for healthy development, particularly among youth. 10 Again, mental health providers need to be aware of this issue and how it may affect mental health and well-being among their LGBT clients and patients.
In sum, LGBT people do not by definition have a mental illness, but they have to contend with societal stigma and negative experiences that likely contribute to an increased vulnerability to mental illness. It is important to note, however, that despite this, most LGBT people ultimately live happy and health lives!