
LGBTQ INFORMATION NETWORK │ RAINBOW OF RESOURCES
MENTAL HEALTH
Mental Health Tips for LGBTQ People Under Lockdown
Coping Tips for Coronavirus Fears and Anxiety
Here's How You
Can Support the LGBTQ Community

Recent Poll: 40% of LGBTQ Youth Considered Suicide
Mental Health Support Hotlines
On the Job: LGBTQ People and Mental Health Issues
NAMI:
How Mental Health Conditions Affect LGBTQ Community
Anxiety and
Depression Association of America: LGBTQ Community
2018 Survey: LGBTQ Youth
and Suicide
Family Doctor: LGBTQ Mental Health Issues
Mental Help: Mental Health in the LGBTQ Community
Info: Addiction
and Recovery
Guide: Depression and Anxiety in LGBTQ People
BBC Video: LGBTQ People and Mental Health Problems
Counseling Today: Promoting LGBTQ Wellness
High Rates
of Depression Among Rural LGBTQ
Population
Scientific Report: Gay Couples are Less
Stressful
Honoring Richard Friedman:
Groundbreaking Psychoanalytic
Perspective of Homosexuality
Foundation for Better
Understanding: The Health of LGBTQ
People
Gay Man and His Psychologist
Inclusion:
Better Mental Health for the LGBTQ Community
The LGBTQ
community knows all too well what it’s like to be a
minority. In a world full of subdued colors dominating
the cultural and political landscapes, those bolder
shades of pink and orange and lavender (or whatever
colors of the rainbow a person feels represents them)
are often sorely absent.
Not being represented can make a person feel
disconnected, at best. Or reviled, excluded, or outright
rejected, at worst.
That’s a big reason why inclusion and representation are
so important for psychological health. We already know
discrimination can make a person more vulnerable to
mental disorders like anxiety, stress, and depression.
Mental disorders in turn can make a person more likely
to misuse or abuse drugs and alcohol. Or become
addicted. That’s when a person repeatedly uses the same
substance or performs the same behaviors despite the
negative effect on health and everyday life.
LGBTQ
teens are six times more likely to experience symptoms
of depression than their heterosexual counterparts.

Members of the LGBTQ community face countless obstacles
everyday. Discrimination. Prejudice. Civil and human
rights issues. Harassment. Rejection. Bakers who refuse
to bake a gay couple’s wedding cake.
As if all that isn’t enough, LGBTQ adults are more than
twice as likely to experience mental health struggles
compared to heterosexual counterparts. LGBTQs are also
at greater risk for suicidal thinking and suicide
attempts. High schoolers who are gay, lesbian, or
bisexual are five times more likely to attempt suicide
compared to straight teens.
Nearly half of transgender adults also have admitted
they’ve contemplated suicide. (In comparison, 4% of the
total US population has pondered ending their lives.)
That kind of oppression can lead a person to binge drink
and experiment with drugs. As a result, LGBTQ persons
enter rehab with more severe substance use problems.
There’s a problem here, most definitely. The LGBTQ
community needs support. It needs representation. It
needs visibility. And it needs to be heard.

For Backstage magazine, actress Holly Mallett wrote
about the importance of LGBTQ representation in TV,
film, and theater. For the audience member who feels
underrepresented, they feel shamed, invisible, less
than. That same lack of representation at the hands of
writers and producers, it frequently leads to
one-dimensional stereotypes. (Yasss Kween, we’re
fabulous, but not all of us need the platforms and fake
lashes, or the Birkenstocks and Subaru Outback, thank
you very much.)
By offering more characters for the LGBTQ audiences, it
resonates with the young viewer. They feel less alone,
less out of place in the world when they see something
of themselves in the glow of the screen or on stage. And
for the so-called average Joe or Josephine who watches a
storyline that includes multidimensional LGBTQ
characters who aren’t there just for comic relief or to
become a sad, sorry statistic, this humanizes them in
their eyes. It builds a bridge instead of a barrier.
Plus, don’t we want books, movies, TV shows and plays to
at least somewhat mirror the real world? It’s
healthier. It’s happier. It’s important for those who
are out and proud. But it’s even more vital for that
Timothy who knows deep down they’re a Tina. Or that
football player with a really big secret who’s not sure
anyone will understand.
It obviously won’t fix all of society’s woes, but it’s a
good place to start. That’s not an unreasonable ask.
[Source: Heidi Bitsoli, Content Writer, Sunshine
Behavioral Health. Her interests include addiction,
psychology, pop culture, and arguing for the underdog]
Anxiety and
Depression Association of America: LGBTQ Community
Mental Health America: LGBTQ Mental Health Notes
Research: Unique Stressors for Gay Men
Info:
Addiction and Recovery
What I Be:
Insecurities and Images
Mental Help: Mental Health in the LGBTQ Community
APA: Psychologist Guidelines for Working With LGBTQ
Clients
Jamie Feldman Video: Health Promotion Strategies for
LGBTQ People
Psychology Help: Best
LGBTQ Friendly On-Line Counseling
Why is
the LGBTQ Community so Anxious?
Video: Sociocultural and Behavioral Detriments to LGBTQ
Health
Why is Depression More Prevalent in the LGBTQ Community?
Info:
Domestic Violence
Best On-Line Therapy
Services for the LGBTQ Community
NAMI: LGBTQ Mental Health
LGBTQ Issues:
Counselor Ethics
Counseling Today: Promoting LGBTQ Wellness
High Rates
of Depression Among Rural LGBTQ
Population
Talk Space: On-Line LGBTQ Therapy
LGBTQ People and
Mental Health
Issues in the Workplace
Most LGBTQ people have had mental health issues
because of their jobs. Mental health issues in the
workplace are a common occurrence for LGBTQ people,
according to a poll conducted by YouGov on the behalf of
Business in the Community and Mercer.
72% percent of LGBTQ employees have experienced mental
health issues as a result of their workplace.

The survey
also showed that a little more than a quarter of LGBTQ
employees are not open about their sexual orientation in
the workplace, and 28% of LGBTQ upper management and
owners have been encouraged to hide their sexual
orientation.
What’s more, people of color who were also LGBTQ were
twice as likely to face negativity from customers and
clients than their white LGBTQ counterparts.
Customers or colleagues have physically attacked 7% of
LGBTQ workers, with that number rising to 13% among
blue-collar workers. That also includes 15% of people of
color, 20% of non-binary identified people, and 30% of
seniors.
Additionally, 9% felt that being seen as LGBTQ prevented
them from getting a job or a promotion, with 6% saying
that it as a significant factor losing a job in the past
year.
According to the report, good employee mental health is
crucial to running a successful, sustainable
organization. These numbers point to failures in
handling employee mental health, particularly for LGBTQ
and other minority populations in the workplace.
The report, titled “Seizing the Moment,” is Business in
the Community’s 2018 report on mental health at work.
[Source: Gwendolyn Smith, LGBTQ Nation, October 2018]
Huff Post: LGBTQ Wellness
Pride Counseling
NAMI:
How Mental Health Conditions Affect LGBTQ Community
Jennifer Potter Video: Health Promotion Strategies for
LGBTQ People
Mental
Health Challenges for LGBTQ Youth
Why is Depression More Prevalent in the LGBTQ Community?
What Doesn't Kill You Makes You Stronger
Research: Unique Stressors for Gay Men
Info: Healthcare
On the Job: LGBTQ People and Mental Health Issues
Good Therapy for LGBTQ Persons
Family Doctor: LGBTQ Mental Health Issues
BBC Video: LGBTQ People and Mental Health Problems
Talk Space: On-Line LGBTQ Therapy
Unique Strengths of LGBTQ Community
Pride
Counseling: On-Line Therapy
LGBTQ Issues:
Counselor Ethics
You Are Beautiful

Promoting LGBTQ
Student Well-Being
Research shows that LGBTQ youth are disproportionately
bullied (whether in person or via cyberbullying),
verbally and physically harassed, and assaulted in
schools by peers and staff. Such hostility has been
correlated to lower school performance and psychological
and emotional distress, including suicidal ideation and
attempt, depression and anxiety.
In the 2015 GLSEN (Gay, Lesbian & Straight
Education Network) National School Climate Survey, LGB
students reported higher levels of verbal, physical and
sexual violence and bullying than did their heterosexual
counterparts. Specifically, 98.1 percent of LGB students
heard the word “gay” used in a derogatory manner, 85.2
percent reported verbal harassment, and 34.7 percent
reported being physically harassed in the past year. In
addition, a 2017 meta-analysis of 27 empirical
studies on the effects of cyberbullying on LGBTQ youth
revealed that compared with their heterosexual and
cisgender counterparts, these students are
disproportionately harassed online and through other
technology-based means. Such harassment has been
correlated to a range of behavioral and emotional
difficulties, including suicidal ideation (with some
studies suggesting rates as high as 40 percent among
LGBTQ youth) and suicide attempts (with rates as high as
30 percent).

Many LGBTQ students identify school counselors as the
one school staff member to whom they are most likely to
disclose concerns related to their sexual and gender
identity. Given this reality, school counselors are
uniquely positioned to address myths about LGBTQ youth,
to advocate for these students and to effect change.
[Source: Counseling Today / Abreu, McEachern, Hall,
Kenny / October 2018]
On the Job: LGBTQ People and Mental Health Issues
NAMI:
How Mental Health Conditions Affect LGBTQ Community
2018 Survey: LGBTQ Youth and Suicide
Scott Leibowitz Video: Health Promotion Strategies for
LGBTQ People
Family Doctor: LGBTQ Mental Health Issues
Info: Alcohol/Drug Abuse
NAMI: LGBTQ Mental Health
Psychology Help: Best
LGBTQ Friendly On-Line Counseling
Mental Help: Mental Health in the LGBTQ Community
Ethical Guidelines for Professionals Working With LGBTQ
Clients
Mental Health Issues Lesbian Women Cope With
Bolstering Resilience in LGBTQ Youth
Gay Man and His Psychologist
Best On-Line Therapy
Services for the LGBTQ Community
Video: Stress and Resilience in the LGBTQ Community
Counseling Today: Promoting LGBTQ Wellness
APA: LGBTQ Health Disparities
How Do
Mental Health Conditions Affect the LGBTQ Community?
Without mental health we cannot be healthy. We all
experience emotional ups and downs from time to time
caused by events in our lives. Mental health conditions
go beyond these emotional reactions to specific
situations. They are medical conditions that cause
changes in how we think and feel and in our mood.
The lesbian, gay, bisexual, transgender, queer and
questioning (LGBTQ) community faces mental health
conditions just like the rest of the population.
However, you may experience more negative mental health
outcomes due to prejudice and other biases. Knowing what
challenges you may face as a member of the LGBTQ
community and how to find and work with LGBTQ-inclusive
providers can help ensure more positive outcomes.

LGBTQ individuals are almost 3 times more likely than
others to experience a mental health condition such as
major depression or generalized anxiety disorder. This
fear of coming out and being discriminated against for
sexual orientation and gender identities, can lead to
depression, posttraumatic stress disorder, thoughts of
suicide and substance abuse.
LGBTQ people must confront stigma and prejudice based on
their sexual orientation or gender identity while also
dealing with the societal bias against mental health
conditions. Some people report having to hide their
sexual orientation from those in the mental health
system for fear of being ridiculed or rejected. Some
hide their mental health conditions from their LGBTQ
friends.
As a community, LGBTQ individuals do not often talk
about mental health and may lack awareness about mental
health conditions. This sometimes prevents people from
seeking the treatment and support that they need to get
better.
[Source:
National Alliance on Mental Illness]
Mental Health America: LGBTQ Mental Health Notes
Research: Unique Stressors for Gay Men
Info:
Reparative Therapy
Talk Space: On-Line LGBTQ Therapy
What I Be:
Insecurities and Images
Mental Help: Mental Health in the LGBTQ Community
APA: Psychologist Guidelines for Working With LGBTQ
Clients
Jamie Feldman Video: Health Promotion Strategies for
LGBTQ People
Why is
the LGBTQ Community so Anxious?
Pride Counseling
Video: Sociocultural and Behavioral Detriments to LGBTQ
Health
Why is Depression More Prevalent in the LGBTQ Community?
Info:
Domestic Violence
LGBTQ Issues:
Counselor Ethics
Counseling Today: Promoting LGBTQ Wellness
High Rates
of Depression Among Rural LGBTQ
Population

LGBTQ Health
Report
The
Division of Gender, Sexuality & Health, at the New York
State Psychiatric Institute and the Columbia University
Department of Psychiatry, wrote this report regarding
LGBTQ health issues.
Background
Over the past decade, and especially in the past few
years, there have been sweeping changes in US society,
law, and public policy, including the following:
--In 2003, the Supreme Court invalidated all remaining
anti-sodomy laws in its ruling in Lawrence v. Texas.
--In 2004, individual states began adopting same-sex
marriage.
--In 2010, the “It Gets Better” online campaign was
launched, a signal of growing societal support for LGBTQ
youths, parents, and families. It now has over 50,000
videos and 50 million views on YouTube.

--In 2011, the federal government repealed the “Don’t
Ask, Don’t Tell" policy in the military and articulated
LGBTQ rights as a foreign policy goal.
--In 2011, the Institute of Medicine (IOM) released a
report on the health of LGBTQ people. Federal agencies
such as CDC, SAMHSA, and others have also highlighted
the issue.
--In 2012, marriage equality was endorsed by President
Obama, the Democratic Party’s platform, and a plurality
of poll respondents.
--In 2013, President Barack Obama, in his second
inaugural address, articulated equality for a LGBTQ
people as a priority area of his administration.
--In 2013, the Supreme Court allowed the restoration of
marriage equality in California and struck down the
provision of the Defense of Marriage Act (DOMA) that
prohibited the federal government from recognizing
married same-sex couples.
--In 2014, a range of challenges to state same-sex
marriage bans are being pursued and the federal
government continues to proactively implement the
Supreme Court's partial overturning of DOMA.
--In 2015,
the US Supreme Court legalizes same-sex marriage
nationwide.
Troubling
Statistics
Despite these advances, the health and mental health of
lesbian, gay, bisexual, transgender, and queer (LGBTQ)
individuals has emerged as a major concern across the
nation. Numerous examples of stigmatization,
discrimination and health inequities have been
documented, including the following:
--Increased rate of suicide attempts and of homelessness
among LGBTQ youth (Estimates indicate that as many as
40% of homeless youth are LGBTQ).
--Decreased utilization by lesbians of preventive
services for cancer and increased risk factors and
elevated rates of cancer (Estimated relative risk of
invasive breast cancer among lesbians is 1.74).
--Higher risk of HIV and STDs among gay men, especially
in communities of color (From 2006-2009, gay men
accounted for 56-61% of all new HIV infections; MSM
13–29 represented more than 27% of all new HIV
infections; among MSM 13-29, HIV among black MSM was up
48%).
--High prevalence among transgender individuals of
HIV/STDs, victimization, mental health issues, and
suicidal ideation (41% of trans respondents reported
suicide attempt vs. 1.6% of the general population; 23%
were impacted by at least three major life-disrupting
events due to bias.)
--Barriers to health faced by elderly LGBTQ individuals
because of isolation, and lack of social services and
culturally competent providers (Older LGBTQ people are 2
times as likely to live alone; 1/3 plan to hide LGBTQ
status if in long-term care).

Higher rates of mental health morbidities and tobacco,
alcohol, other drug use (Alcohol abuse and smoking are
more than 2 times greater among LGBTQ people).
--A significant proportion of people with serious mental
illness (SMI) in the US are LGBTQ (Estimates suggest
that about 720,000, or about 4% of people with SMI, are
LGBTQ).
At the same time, new areas of concern are also emerging
across the lifespan, such as:
--children "coming out" at ever-younger ages.
--schools trying to tackle the problem of bullying.
--early medical interventions becoming available for
transgender youth.
--new family dynamics emerging among same-sex couples
who are legally married and/or who are raising children.
--the first large cohort of openly LGBTQ people becoming
senior citizens.
These are
no longer merely potential or emerging issues with
regard to mental and physical health. Rather, they are
immediate and pressing needs demanding focused efforts
in research, clinical practice, education, and public
policy. Yet far too few LGBTQ individuals, particularly
from within poor and marginalized communities have
access to the quality services they need. Through the
LGBTQ Health Initiative, we aim to address these and
many other related issues.
Unique Strengths of LGBTQ Community
HHS: LGBTQ Health and Wellbeing
Talk Space: On-Line LGBTQ Therapy
HRC: Healthcare
Equality Index 2018
Guide: Depression and Anxiety in LGBTQ People
Gay Man and His Psychologist
Scientific Report: Gay Couples are Less Stressful
Ethical Guidelines for Professionals Working With LGBTQ
Clients
Psychology Help: Best
LGBTQ Friendly On-Line Counseling
US Health & Human Services Reports: LGBTQ Health and
Wellbeing
Info: Addiction
and Recovery
Research: Unique Stressors for Gay Men
Best On-Line Therapy
Services for the LGBTQ Community
Foundation for Better Understanding: The
Health of LGBTQ People
Huff Post: LGBTQ Wellness
Video: Sociocultural and Behavioral Detriments to LGBTQ
Health

LGBTQ Wellness
Notes: Risk Factors
Some of the health concerns and risk factors that are
relevant to LBGTQ individuals may be shared by the
general population, while others are more specific to
the LGBTQ community, and still others are specific to
different subgroups of LGBTQ individuals. These health
concerns may be grouped into the following areas of
concern:
Sexual behavior issues: STDs such as human
immunodeficiency virus (HIV) and acquired immune
deficiency syndrome (AIDS), hepatitis A virus (HAV),
hepatitis B virus (HBV), bacterial vaginosis, gonorrhea,
chlamydia, and genital warts (human papillomavirus or
HPV); anal, ovarian, and cervical cancer.
Cultural issues: body image, nutrition, weight, and
eating disorders; drug and alcohol abuse; tobacco use;
parenting and family planning.
Discrimination issues: inadequate medical care;
harassment at work, school, or home; difficulty in
obtaining housing, insurance coverage, or child custody;
violence.
Sexual identity issues: conflicts with family, friends,
and work mates; psychological issues such as anxiety,
depression, and suicide; economic hardship.
Unique Strengths of LGBTQ Community
Guide: Depression and Anxiety in LGBTQ People
BBC Video: LGBTQ People and Mental Health Problems
What Doesn't Kill You Makes You Stronger
US Health & Human Services Reports: LGBTQ Health and
Wellbeing
Foundation for Better Understanding: The
Health of LGBTQ People
Why is Depression More Prevalent in the LGBTQ Community?
Video: Sociocultural and Behavioral Detriments to LGBTQ
Health
On the Job: LGBTQ People and Mental Health Issues
NAMI:
How Mental Health Conditions Affect LGBTQ Community
What I Be:
Insecurities and Images
Mental Help: Mental Health in the LGBTQ Community
High Rates
of Depression Among Rural LGBTQ
Population
LGBTQ Issues: Counselor Ethics

Resilience in
LGBTQ Youth
Challenges LGBTQ Youth Confront
--Some 6%-10% of youth identify themselves as LGBTQ.
Youth are “coming out” at earlier ages; as early as 13
years of age.
--80% of LGBTQ high school students report being
verbally harassed, teased and 70% report being targets
of sexual harassment and recipients of threats of
physical harm because of their sexual orientation.
--80% report having been the target of mean rumors or
lies. Some have been physically harmed.
As a
result, they experience school as a “hostile
environment,” and they are more likely to miss days
attending school.
--63% felt
unsafe at school because of their sexual orientation.
--29% skipped a day of school in the past month because
of safety concerns. 28% of LGBTQ youth drop out of
school due to harassment.
--LGBTQ youth often feel stigmatized, marginalized,
excluded, ridiculed, victimized and fear disclosure
(outing).
--The impact of such verbal and physical assaults are
lower self-esteem, loneliness, isolation, lower academic
performance, increased risk of anxiety, depression and
suicide attempts.
--LGBTQ youth have a greater risk for suicide ideation
and higher rates of suicide attempts than their
heterosexual peers.
--LGBTQ youth are more than twice as likely to attempt
suicide as their heterosexual peers, according to the
Center for Disease Control and Prevention. The presence
of comorbid psychiatric disorders such as depression,
conduct disorders and substance abuse significantly
increase suicidal risk.

Approximately 30% of LGBTQ youth attempt suicide at
least once. Among those, approximately half have
reported that the suicide attempt was related to their
sexual orientation. Rates for suicide attempts in this
population are commonly higher for male teenagers
compared to their female peers. Factors associated with
LGBTQ-related suicide attempts include early openness
about sexual orientation, being considered gender
atypical in childhood by parents, and parental efforts
to discourage gender atypical behaviors. In a
longitudinal study of specific risk factors in LGBTQ
youth ages 16 to 20, a history of suicide attempts,
impulsive behaviors, LGBTQ victimization and low social
support were associated with greater suicidal ideation.
This higher rate of suicide attempts occurs, especially
if their gender identity has remained secret and there
is accompanying anxiety over disclosure.
In a typical high school class of 30 students, one
student will seriously consider suicide, 2 or 3 (one boy
and two girls) will attempt suicide, and one student
will make an attempt sufficiently harmful to require
medical attention.
The challenges and impact vary for different subgroups,
whether the youth is gay, lesbian, bisexual or
transgender. For instance, transgender youth have the
highest risk of self-harm and can be more stigmatized by
peers than gay and lesbian youth. Sexual minority youth
are particularly vulnerable. There is a need not to lump
all of the LGBTQ youth into one group and a need to
address their unique challenges.
It has been estimated that 1 in 8 youth in the US run
away from home before age 18, and 40% do not return
home. 40% of homeless youth are LGBTQ. The families’
rejection of the youth’s sexual orientation is often a
major factor contributing to runaways.
In a recent study of LGBTQ youth who live on the streets
of New York City , Meredith Dank reported that they
often use "survival sex" in order to cope with
homelessness and poverty.
--20-60% of youth in Child Welfare identify themselves
as LGBTQ.
--13% of the detention population identify themselves as
LGBTQ.
--20-33% of girls in the juvenile justice system have
self-identified as being homosexual.
--LGBTQ youth are less likely to receive
psychotherapeutic treatment, where it is indicated. For
instance, one half of those who are clinically depressed
do not receive any treatment.

Resilient Behaviors of LGBTQ Youth
In spite
of these cumulative stressors, LGBTQ youth evidence a
wide range of resilient-engendering behaviors:
--Resistance to Stereotypes
--Connectedness with Supportive Others
--Self-care Behaviors
--Social Activism
--Cognitive and Behavioral Flexibility
Examples of Coping Strategies Used by LGBTQ Youth
Resistance to Stereotypes
--Resist stereotypes associated with sexual attitudes of
what it is to be masculine or feminine.
--Consider what is good about being LBGTQ.
--Experiment with gender roles. The ability to display
both masculine and feminine traits. Free oneself from
ideas of what it means to be a “man” or a “woman.”
--Belief in being who I am. Find enjoyment in being
LGBTQ.
--Have a sense of freedom. Feel stronger for rejecting
stereotypes.
--Not conceal sexual orientation and gender identity
behind something or someone.
"The
presence of at least one caring, emotionally available
person at some point (even briefly) in the person’s life
is a necessary
prerequisite to the development of resilience."
-Dyer &
McGuiness
Connectedness with supportive others
--Have
someone to share daily experiences. Develop a supportive
network. Find an “ally” at school and at home.
--Seek support from others (school, counselor,
psychologist, social worker, supportive minister), or
from a website that provides advice from teens.
--Feel connected with others who are going, and who have
gone through, similar experiences. Benefit from others’
experiences.
--Be a member of social support group. Hang around with
other LGBTQ people.
--Visit websites, read books, attend concerts and
meetings that help you become more resilient.
--Contribute to websites, social media, blogs, and chat
lines.
--Join Gay-Straight Alliance Club and “It gets better”
groups at school.
--Attend local support centers and related activities.
--Identify a "chosen family" to connect with when
biological family has rejected them.
--At school, find an ally (teacher, coach, counselor,
peer) who can be supportive and non-judgemental

Self-care
--Be safe and responsible to take care of one-self.
--Make “smart” decisions about sexual activities. Use
condoms, avoid risky situations to avoid
sexually-transmitted diseases and HIV.
--Engage in physical self-care. Avoid “high risk”
activities such as drug use, risky sexual activities,
antisocial delinquent activities, and the like.
--Avoid unsafe places.
--Be careful who you disclose to about your sexual
orientation. The world is filled with homophobic and
transphobic individuals and groups. Be vigilant and
cautious when necessary. Use your risk assessment
skills.
--Check to see if your personal space is safe and
positive. Sometimes you may need to hide who you are and
be safe, and that is “okay”.
--Engage in emotional self-care (seek help when needed,
use relaxation, mindfulness and meditation procedures,
seek opportunities to experience positive emotions of
empathy, compassion, forgiveness, joy, gratitude, and
the like.)
Engage in Social Activism
--Have a desire to be knowledgeable about issues that
affect the LGBTQ community.
--Learn about the history of the LGBTQ community
activities and sacrifices of others. Collect a list of
names of famous people who are gay, lesbian, bisexual
and transgender in the past and present. Look to them as
role models.
--Educate and support other LGBTQ individuals. Promote
well-being in younger LGBTQ youth.
--Educate others about the need to fight stereotypes,
myths and misconceptions.
--Participate in community activities such as political
rallies, public forums, gay activities, educational
endeavors. Gain strength through advocacy. Engage in
empowerment projects.
--Be assertive, where you think it is appropriate. For
example, how do you respond when you hear people say,
“That’s so gay”, or when you witness discrimination
because of sexual orientation and gender?
Cognitive and Behavioral Flexibility
Resilient LGBTQ youth demonstrate flexibility in
selecting from the various coping strategies in meeting
varied demands and challenges. They evidence
meta-cognitive executive skills of “noticing, planning,
monitoring, evaluating, reflecting, sharing with others,
enlisting help, and engaging inbehaviors that contribute
to their acceptance and self-care.”
[Source: Donald Meichenbaum, PhD, Distinguished
Professor Emeritus, Univ of Waterloo, Ontario, Canada
Research Director of Melissa Institute for Violence
Prevention, Miami, Florida]

Unique Strengths of LGBTQ Community
Guide: Depression and Anxiety in LGBTQ People
BBC Video: LGBTQ People and Mental Health Problems
What Doesn't Kill You Makes You Stronger
US Health & Human Services Reports: LGBTQ Health and
Wellbeing
Foundation for Better Understanding: The
Health of LGBTQ People
Why is Depression More Prevalent in the LGBTQ Community?
Video: Sociocultural and Behavioral Detriments to LGBTQ
Health
On the Job: LGBTQ People and Mental Health Issues
NAMI:
How Mental Health Conditions Affect LGBTQ Community
What I Be:
Insecurities and Images
Mental Help: Mental Health in the LGBTQ Community
High Rates
of Depression Among Rural LGBTQ
Population
LGBTQ Issues: Counselor Ethics
LGBTQ
Psychological Concerns
Mental health practitioners are seeing a new cadre of
psychological concerns in their work with lesbian, gay,
bisexual and transgender clients. In the 32 years since
patrons of the Stonewall Inn challenged police who
raided the now-famous gay nightclub, lesbians, gays and
bisexuals have grown in personal and political power,
creating their own communities and finding acceptance in
traditional ones as well.
Conversations taking place in today's therapy offices
reflect this change. Although many LGBTQ people still
bring issues of discrimination and fear of rejection to
their psychologists' offices, they are just as likely to
discuss such mainstream issues as parenting and fears
about aging. Meanwhile, new trends have emerged in
therapy, too, as younger generations of LGBTQ people
wrestle with problems such as a resurgence of HIV
infection among gay male youth and changing identity
issues. Likewise, groups that have been more closeted,
including transgender people, are finding their voice
and appearing more often in treatment to work on
identity and relationship concerns.
"Some issues haven't changed much at all since
Stonewall, and others have changed dramatically,"
comments Doug Haldeman, PhD, a clinical faculty member
at the University of Washington and an APA Council
representative. "People still need help with coming
out--when, how and to whom. Some cultures within our
culture are still very homophobic." At the same time,
Haldeman says, psychologists are seeing "a whole host of
other issues related to the creation of LGBTQ families,
LGBTQ people in the workplace, generational differences
and the reality of multiple-minority identities--issues
that demand our best research and clinical skills."

Generation gaps
Psychologists working with LGBTQ clients are finding the
need to tune in to generational differences, experts
note--whether it's understanding young LGBTQ clients'
new ways of thinking about their sexuality or assessing
reasons for depression in older gay men.
Many LGBTQ youth, for instance, now call themselves
"queer" as a blanket term for their community, and
they're more likely to accept variations in their ranks
than previous generations, says Beth Firestein, PhD, a
private practitioner in Loveland, Colo., and editor of
"Bisexuality: The Psychology and Politics of an
Invisible Minority", a compendium of research on
bisexuality. In communities that include lesbians and
bisexual women, for example, "there's more unity and
community, cooperation and friendly relationships now
than there was 10 or 15 years ago," she says.
Esther D. Rothblum, PhD, a professor of psychology at
the University of Vermont, agrees it's more common for
today's young LGBT people to express and accept fluid
gender and sexual identities. "In the generation before
mine, if you went to a lesbian bar and didn't identify
as either butch or femme, they'd think you were an
imposter," she says. "Now young lesbians are just as
likely to say they feel butch one day and femme the
next."
Another strong feature that distinguishes younger
lesbians from their Baby Boomer counterparts is their
lack of identification with the feminist movement, says
sex therapist Suzanne Iasenza, PhD, a professor of
counseling at the John Jay College of Criminal Justice
in New York. "Their attitude is, 'What does my sexuality
have to do with politics?'" says Iasenza. "You're not
likely to find them saying they're lesbian as a
statement against patriarchy or because they don't like
the way men take over their bodies or their lives."

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Gay men, young and aging
Some young gay men are presenting a serious challenge
for practitioners. Since protease inhibitors were
introduced in the mid-1990s, researchers have reported a
surge in the number of young gay men who practice unsafe
sex, known these days as "barebacking," in part because
they thought the drugs would protect them from HIV's
worst effects.
Columbia University HIV-prevention researcher and
clinician Alex Carballo-Dieguez, PhD, says that in
addition to barebacking, he's spotting a body-image
problem among his young gay clients. "Twenty years ago,
your body image was about what you wore, how you wore
your hair and so on," Carballo-Dieguez says. "Now, it's
about the transformation of the body itself. These guys
want to reshape their bodies to make them look a certain
way"--muscled and perfectly toned. "A lot of times
that's achieved with chemicals, hormones and even
surgery," he says. This obsession becomes especially
problematic when it comes to partner-shopping, with
clients looking for Mr. Right only if he's also Mr.
Buff, Carballo-Dieguez says.
To combat this problem, he has clients walk through
their own sexual and emotional histories and take a
realistic look at themselves. "They get to see that
they've never been satisfied with the guys they score
with," he says. "They're never certain that they're
attractive enough or that the other person's attractive
enough." This insight can help them stop the
appearance-obsessed merry-go-round, he says. Gay men in
their 40s and 50s also bring a "looks" challenge into
therapy, says Haldeman.
"Middle-aged gay men face tremendous challenges because
we grew up in such a youth-oriented gay culture," says
Haldeman, who's 50. "Thirty-five is seen as old, and 50
is ancient! That's a blow to our narcissism. Not only
are we not the pretty things when we walk into the bar,
we're the age of the parents of the pretty things."
Haldeman urges such clients to take a life inventory, to
look at the past and see what's valuable there. "They
need to ask themselves, 'Am I on a path where, when I
look back, I'll be satisfied with my life?'" he says.
The silver lining to their aging regrets: "Thank God
we're aging," Haldeman adds. "We buried so many of our
generation years ago. So we have a special joy and
appreciation of life that we might not otherwise have
had."

Coming
out, parenting
LGBTQ clients of all ages are still likely to face
coming-out issues, clinicians report. Young people,
though, are more likely to face a host of
post-coming-out problems, since many are likely to
already have come out to their parents, says Marny Hall,
PhD, a psychotherapist and researcher in the San
Francisco Bay area. While that's often good news, she
observes, often their parents' acceptance is
conditional. "Parents tend to display a sort of limited
tolerance for their 'queer' kids--what I call tolerance
without equality," Hall says. "The clients I see are
constantly confronted with issues like this."
LGBTQ clients are also dealing with the flip side of
that equation: being parents themselves. Many lesbians
and gay men are the first generation of homosexuals to
have children who are becoming teens. Some have found
that while as younger children they had no problem
accepting their gay parents, as they move into
adolescence, some teens start to feel embarrassed by
their parents' homosexuality, says Haldeman. "Some young
people are really conflicted and may try to hide the
fact they have two same-sex parents by having the
parents pick them up from school in some secret
location," he says--dynamics that affect the child's
relationship with parents and peers and the parents'
relationship.
Another spin on the parenting issue is that today, gays
and lesbians have children not only from dissolved
heterosexual marriages, but from broken-up gay
relationships as well, Hall adds. Conflicts involving
children of same-sex unions present particular
difficulties because the legal ground for same-sex
couples and their child-custody rights "is shifting all
the time," she says. "When there are no clear
guidelines, what often substitutes are conflicts within
the couple," Hall says. "Relationship problems can
really get played out in this arena." Psychologists are
helping these clients separate parenting problems from
relationship problems and devising solutions that don't
require legal structures to implement, she says.
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Gender-blending and fluid identities
A final theme clinicians report in their practices is
more questioning and fluidity around gender identity and
sexual attraction. While these issues are central in the
lives of transgender people, others are questioning
these elements of identity and expression too,
therapists report.
"Gender identity and sexual identity issues have frayed
more and more around the edges," says Hall. And there's
a greater emphasis on the "questioning" category. On one
hand, there's a push for LGBTQ young people to come out
at earlier ages, she notes; on the other, more young
people are pausing indefinitely in what she calls the
"lingering" category. "There are no more givens about
gender identity," she says. "Young people don't take
sexual identity for granted."
Bisexuals represent another group that turns
conventional thinking on its head, says Firestein.
"Often bisexuals want to label themselves as lesbian or
gay because occupying a middle ground is so difficult in
a culture that dichotomizes sexual orientation and
gender identity," she says. Conventional thinking has it
that if bisexuals are attracted to people of both sexes,
they must have more than one partner, and that defies
society's value on monogamy. Bisexuals tend to
internalize this social tension, Firestein says, so a
common therapeutic question is, "If I identify as
bisexual, what does that mean about my choice of
partners?"
To help bisexual clients face this concern, Firestein
conducts an exercise demonstrating that the number of
partners you have and your sexual orientation exist on
different dimensions. As two examples, you can be
monogamous and bisexual, and you can be heterosexual and
have more than one sexual partner.

For transgender folks (people who have nontraditional
gender identity or expression) issues include coming to
terms with their feelings about their true gender and
then deciding whether and how to act on those feelings.
In her work with transgender people, New York City
private practitioner and gender expert Katherine Rachlin,
PhD, notes that transgender people struggle not so much
with who they are as with finding ways to fit into a
society that doesn't understand them. She says that
transgender people, who do not identify as either male
or female, sometimes work on accepting a fluid gender
identity. More often, Rachlin says, they choose to
identify as one gender or the other because it's too
challenging to live in a gender-dichotomous society
otherwise.
Therapy with transgender people requires extra education
and perception, Rachlin believes. She spent hundreds of
hours with this community before she had a good
understanding of how to work with "trans" clients, she
says. In her 15 years of being involved with the trans
community, Rachlin has appreciated learning a new and
different way of looking at gender. "There's a great
mystery that underlies transgenderism, and it does
change the way you see the world," she says. "I had to
redefine male and female, man and woman, for myself.
These concepts are now disproven to me."
[Source: Tori DeAngelis, Syracuse, NY, Feb 2002]
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Unique Strengths of the LGBTQ
Community
In the face of
oppression, minority groups develop unique LGBTQ
strengths and character traits.
It sometimes feels like
every day brings with it a new study about minority
stress, reports about public policy that neglects or
harms LGBTQ Americans, or a news item about the horrific
treatment of transgender people in the workplace. And
while it’s hugely important to identify and discuss the
microaggressions and overt discrimination that all LGBTQ
people face, this continued emphasis on the negative
aspects of being an LGBTQ individual is ultimately an
incomplete picture of what it means to be queer these
days and can lead to self-perpetuating patterns of
defeatism.
The persistence that’s
been required of the LGBTQ community in the face of
continued oppression has actually given way to a unique
set of strengths. While our backgrounds are as distinct
and varied as our personalities, LGBTQ individuals are
strong, creative, funny, interesting, and above all,
resilient. Research shows that for the queer community,
what doesn’t kill us really does make us stronger.

We’re Socially
Intelligent
Studies show that LGBTQ
people tend to possess high levels of social
intelligence and the skills related to perceiving and
using emotional information to make decisions in social
interactions. LGBTQ people have the ability to get along
with others, get them to cooperate with you, and
successfully navigate complex interpersonal
interactions.
Researchers suggest that
the experience of being a sexual or gender minority
actually fosters social and emotional intelligence. For
example, it was found that bisexual people are more
capable of modifying their behavior to address unique
situations and problems compared to both their
heterosexual and homosexual counterparts — a trait that
researchers describe as “cognitive flexibility.” Another
study found that trans men and women had high levels of
social intelligence, based on insights into what it
means to experience life beyond the gender binary.
Because LGBTQ individuals
are statistically more likely to be minorities in group
settings, they learn to modify their behaviors and
reactions in order to minimize aggression or suspicion
from their peers. This generally results in the ability
to “read a room” and evaluate the “correct” social
responses. And while these motivations are symptoms of
an insidious, culturally enforced intolerance, they’ve
given way to an adaptive social skill set that
cisgendered heterosexual people are less likely to
possess.

We’re Courageous
Research shows that,
because LGBTQ individuals are essentially required to
cope with near-constant minority stress, bravery is
likely to be an LGBTQ strength. In a culture where
threats of physical violence, job discrimination, social
exclusion, and political inequality are condoned by the
federal government, the LGBTQ community encounter
near-constant risks that their heterosexual counterparts
rarely face. The process of coming out and confronting
heteronormativity on a daily basis requires bravery on a
daily basis.

We’re Empathetic
When surveyed, LGBTQ
people indicate that the process of coming out involves
a tremendous amount of personal insight and reflection —
exercises that ultimately improved their ability to
empathize with others. This self-reinforcing chain
positively reclaims power for individuals and reinforces
good stereotypes while disrupting negative ones. LGBTQ
people transform reactions to institutionalized
oppression and stigmatization into empathy and social
activism.

We’re Authentic
LGBTQ people feel less
pressure to conform to societally defined roles and
narratives like getting married or having children on a
certain timeline — or at all. Other themes included
freedom from gender-specific roles within relationships
or society at large, freedom to explore sexuality and
relationships, and freedom to enjoy egalitarian
relationships, which all lead to authenticity being a
particular LGBTQ strength. One lesbian explained that
being lesbian allows us to choose to have children and
how to raise children in ways not claimed by straight
women. One gay man noted that there is less pressure on
gay men to have children and, as such, the decision for
a gay man to have or not to have children may involve a
healthier process.

We’re Resilient
On a daily basis, LGBTQ
people are faced with oppression from political and
social forces and have to find construction ways to
cope. When LGBTQ individuals are actively involved as
change agents they are better insulated against the
damage wrought by anti-LGBTQ politics and legislation.
Becoming involved enhances individuals’ ability to cope
and builds resilience for the future. Nearly three
quarters of LGBTQ individuals demonstrated at least one
of five “resilience factors” that helped them in coping
with adversity, including social support, connection
with the LGBTQ community, emotional coping,
self-acceptance, and positive reframing.
Because LGBTQ individuals
are more likely to face identity-related discrimination
and accompanying emotional hardships than their straight
counterparts, they often have no choice but to develop
resilience. This breeds a unique strength of character
that is not so ubiquitously present in majority groups.

We’re Highly Creative
The experiences of LGBTQ
individuals have not only necessitated heightened social
awareness and resilience, but creativity in how queer
people choose to craft their own stories and invent
themselves. Without established narratives against which
to chart their experiences, members of the LGBTQ
community have been liberated to form tight-knit social
circles, families of choice, and safe spaces that
celebrate shared identity traits. Creativity is largely
seen as an LGBTQ strength, and there is quite a bit of
evidence to support that LGBTQ people tend to be
creative.
Focusing on the Positive
It’s imperative that
research into the LGBTQ experience look beyond the
negative aspects of belonging to a sexual or gender
minority group. Ultimately, only looking at the
hardships we face ignores the incredible things we’ve
built despite those hardships. And while raising
awareness into the realities of both the systemic and
social discrimination that we face on a daily basis is
necessary, so too is examining the ways in which our
community has persevered and grown.
Equipped with empathy,
resilience, strength of character, and a tight-knit
community support system, there’s no telling what we’ve
yet to accomplish.
[Source: Lighthouse 2018, Michelle D. Vaughan & Eric M. Rodriguez 2014, Julie Konik & Mary Crawford 2014, Laura Brown 1989]
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