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Serious but common medical conditions such as anxiety and depression affect LGBTs at higher rates than the general population. A number of factors may contribute to this, from living in an often homophobic society to facing family rejection to being closeted in some or all aspects of life. Mental disorders are not symptoms of sexual orientation, but rather they are symptoms of discrimination and fear of discrimination.
Prevalence: Most likely due to violence, social rejection, and isolation, the LGBT community experiences higher rates of anxiety, mood and substance use disorders, and suicidal thoughts among people ages 15-54 (Cochran 2001). Possibly due to rejection from both gay and straight communities, bisexual women have been found to have significantly poorer mental health than either lesbians or heterosexual women.
Experiences that could negatively impact mental health:
- Hostility from or rejection by loved ones or religious groups
- Bullying at school, harassment by neighbors, danger of violence in public places
- Casual homophobic comments on everyday basis
- Prejudice/embarrassed response from professionals
- No protection against discrimination at work, housing, pensions, etc.
- Childhood sexual abuse
- Verbal harassment, greater fear of physical violence and discrimination
Possible effects on mental health:
- Difficulty accepting sexual orientation (could exist as conflicts, denial, alcohol or drug abuse, isolation)
- Keeping secrets (lying, pretending, leading a double life)
- Low self-esteem (damaged due to constant editing or hiding parts of one’s life)
- Increased risk of self-harm and suicide attempts
- Damaged relationships with family/friends; lack of support
- PTSD and depression from long-term effects of bullying
Barriers to Care: Heterosexist assumptions can adversely affect the quality of treatment, and fear of a negative experience keeps many LGBTs from seeking help. Organizations and individual therapists are not always LGBT friendly, and some therapists may not even recognize their own heterosexism. Staff can be judgmental toward LGBT sexuality, or be misinformed/uninformed about LGBT resources. LGBTs may experience discrimination against partners in favor of family of origin. In one UK study, over 40% of lesbians recounted negative/mixed reactions from mental health professionals when they were open about sexuality (including instances of overt homophobia, discrimination, and perceived lack of empathy). (King & McKeown 2003).
Cultural and ethnic groups also have their own views of homosexuality and psychotherapy. African Americans have difficulty accepting LGBTs and are reluctant to seek psychiatric help. In Latino culture, Catholicism and family are central, while sex and women are hidden. Such cultural views make it more difficult for an individual to accept that they need to seek help.
Benefits of Therapy: There are LGBT-friendly therapists and mental health resources. Finding the right psychotherapist can create a safe environment in which individuals can explore their mental health issues; focus on healthy mirroring, as well as the client’s sense of personal integrity, goals, vitality, and well-being rather than choosing/rejecting an identity (Freedman 1999). A therapist’s sensitivity may help a client understand that immediate/permanent identity within one group is not urgent. Along with improving self-esteem, therapy can give a client the strength and courage to work toward rebuilding support networks, re-establishing relations with family, or building a new group of family and friends.
References:
Cochran, Susan PhD. (2001). Connecticut Network of Care. American Psychologist, 56(11).
http://connecticut.networkofcare.org/mh/text/library/detail.cfm?id=390&cat=42
Freedman, F. Kenneth. (1999). Gay and Lesbian Mental Health (Part 1).
http://www.alaska.net/~fken/GayHealth_1.htm
King, Michael & McKeown, Eamonn. (2003). LGB Report: Mental health and social wellbeing of gay men,lesbians and bisexuals in England and Wales. Mind, 5.
http://www.pcsproud.org.uk/SummaryfindingsofLGBreport.pdf
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