Being LGBTQ+ and emotional wellbeing
This LGBTQ+ History Month, Assistant Psychologist Ruth Spencer-Lewis writes about emotional wellbeing in the LGBTQ+ community, how this has been affected during lockdown, and what young people who identify as LGBTQ+ can do to seek support and connection.
This is the first of a two-part series for LGBTQ+ History Month, with the second article looking at how LGBTQ+ young people and their carers can improve their mental wellbeing.
LGBTQ+ people and emotional wellbeing: The statistics
Lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ+) people are at higher risk of psychological distress, including depression and anxiety, when compared to straight and cisgender people. Research by Stonewall in 2018 (1) found that 31% of lesbian, gay and bisexual (LGB) people, and 47% of transgender people had experienced suicidal thoughts in the last year, with 12% of transgender people having attempted suicide. Attempted suicide for LGB people overall was 2%, but for young people (aged 18-24) this was 13%.
These statistics show there is a clear difference between sexual minorities and gender minorities when it comes to psychological distress. Both groups experience more emotional wellbeing challenges than cis and straight people, with transgender people at even higher risk of suicidal thoughts and emotional distress. This is a concerning picture. When added to the fact that LGBTQ+ people also experience physical health inequalities compared to straight and cis people (2), the case to support both mental and physical health of LGBTQ+ people, and to ensure that services are welcoming and accessible to them, is compelling.
Why are there increased mental health issues among the LGBTQ+ community?
Even today, with more connection to other LGBTQ+ people, support, and more mainstream representation in the media, straight and gender conforming people are still seen as the norm. This may lead LGBTQ+ people to potentially feel “other” or vulnerable to discrimination. Living in a society where you are seen, or worry about being seen as ‘other’, ‘different’, or ‘unacceptable’ means LGBTQ+ people experience stressors in life which straight and cisgender people do not (3). These stress factors can be categorised into both external, and internal stressors.
External stressors are those coming from other people and the outside world (e.g. the media) which includes discrimination, prejudice, or hate crime towards the community.
In 2017, Stonewall’s report on discrimination in Britain (4) found that during a 12-month period 16% of LGB people and 41% of trans people had experienced a hate crime. In 2020, The Transphobic Hate Crime report (5) found that 80% of trans people had experienced a hate crime in the last 12 months. This would suggest that discrimination is becoming more common for the trans community. Stonewall (6) also reported that 45% of LGBT young people still experience homophobic bulling in school, and hear homophobic language used as an insult. These statistics demonstrate there are still parts of society that are overtly or covertly homophobic or transphobic. Experiencing discrimination or hate crime understandably has a negative impact on LGBTQ+ people’s mental health.
Internal stressors can come from struggling with your identity in a world where LGBTQ+ people are exposed to experiences of prejudice. Internalised homophobia/transphobia is very common among LGBTQ+ people and refers to turning negative societal attitudes inwards towards oneself (7) which can lead to feelings of shame and worthlessness. Shame is a particularly difficult emotion as it is associated with secrecy and concealment of a person’s true thoughts and feelings, and a sense of disconnection from other people (8).
For LGBTQ+ people that also belong to other minority groups such as BAME people, and those from religious communities, there are increased complexities in the discrimination they may experience or worry about experiencing (9). This can create more barriers to feeling part of a community, increase social isolation and negatively affect mental wellbeing (10).
The impact of the current COVID-19 pandemic on the LGBTQ+ community
COVID-19 has affected all of us, but for LGBTQ+ people COVID has built upon pre-existing challenges with mental health and social isolation. Out Life reported 79% of LGBTQ+ people believe the pandemic has negatively impacted their mental health and The LGBT Foundation (2020), found that physical and mental health of LGBT people has been disproportionately affected by COVID-19, partially as LGBTQ+ people are less likely to seek medical help quickly due to the fear of discrimination.
LGBTQ+ people are more likely to experience domestic abuse than cis and straight people, and during COVID-19 there has been a rise in domestic abuse, with BAME LGBTQ+ people particularly affected (11). Social isolation in lockdown is impacting everyone, but the LGBTQ+ community are more likely to experience social isolation with key LGBTQ+ community groups and venues, which the community may rely on as safe spaces, closed for a prolonged period of time.
The impact of the COVID-19 pandemic on young LGBTQ+ people
All young people need the love, support and acceptance of a caregiving adult (or adults), family, and friends. This is particularly important whilst they’re discovering their identity and how to express themselves. Young people who are discovering their sexuality and gender identity may fear a lack of support in their families, homes and communities, which may be increased by being locked down at home without the support of peers. Albert Kennedy Trust (AKT) report that 24% of homeless young people identify as LGBT, and that they have become homeless mostly as a result of coming out to families who then rejected them.
Sky News reported that the AKT had suggested that young people may wish to delay coming out during lockdown in case a lack of support leaves them vulnerable to psychological distress or homelessness. If a young person decides that the safest immediate option is to conceal their LGBTQ+ identity at home, this can put an increased strain on their mental health and can lead to further disconnection from others, at a time when we they are already isolated due to COVID-19 lockdowns.
With schools being closed and learning moving online, young people are missing out on social interaction and key opportunities to practice how to relate to others and have fun (12). The uncertainty of living in a situation where there is no clear end date to restrictions, can increase feelings of anxiety, depression, and powerlessness.
So, what can young people, and those supporting them, do to help ease these feelings and support their emotional wellbeing? Read the second part of this series to find out more about how LGBTQ+ young people and their carers can improve their mental wellbeing.
(1) Bachmann, C.L., & Gooch, B. (2018) LGBT in Britain: Health report. Stonewall. (2) Zeeman, L., Sherriff, N. et al. (2019). A review of lesbian, gay, bisexual, trans and intersex (LGBTI) health and healthcare inequalities. European Journal of Public Health, 29(5), 974-980. doi:10.1093/eurpub/cky226
(3) Meyer, I. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin; Psychol Bull, 129(5), 674-697. doi:10.1037/0033-2909.129.5.674
(4) Bachmann, C.L., & Gooch, B (2017). LGBT in Britain: Hate Crime and Discrimination. Stonewall.
(5) Bradley, C. (2020). Transphobic Hate Crime Report 2020: The scale and impact of transphobic violence, abuse and prejudice. Galop.
(6) Bradlow, J., Bartram, F. et al. (2017) School Report: The experiences of lesbian, gay, bi and trans young people in Britain’s schools in 2017. Stonewall.
(7) Meyer, I. H. (1995). Minority stress and mental health in gay men. Journal of Health and Social Behavior; J Health Soc Behav, 36(1), 38-56. doi:10.2307/2137286
(8) Tracy, J. L., Robins, R. W., & Tangney, J. P. (Eds.). (2007). The self-conscious emotions: Theory and research. Guilford Press. (9) Weber, A., Collins, S., Robinson-Wood, T., Zeko-Underwood, E., & Poindexter, B. (2018). Subtle and severe: Microaggressions among racially diverse sexual minorities. Journal of Homosexuality; J Homosex, 65(4), 540-559. doi:10.1080/00918369.2017.1324679
(10) Sutter, M., & Perrin, P. B. (2016). Discrimination, mental health, and suicidal ideation among LGBTQ people of color. Journal of Counseling Psychology; J Couns Psychol, 63(1), 98-105. doi:10.1037/cou0000126
(11)Kenny, O. (2020) https://gcn.ie/lgbtq-charities-domestic-violence-lockdown/.
(12) Salerno, J. P., Devadas, J., et al. (2020). Sexual and gender minority stress amid the COVID-19 pandemic: Implications for LGBTQ young persons’ mental health and well-being. Public Health Reports (1974); Public Health Rep, 135(6), 721-727. doi:10.1177/0033354920954511