A spotlight on LGBTQ mental health

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May is Mental Health Awareness Month. Many in the LGBTQ community are in a mental health crisis exacerbated by the pandemic. As more people are vaccinated and life begins to trend toward normalcy, people are also discovering how hard the pandemic has hit them personally and psychologically.

PGN has reported on the pandemic and its many stages for over a year.

Recent studies from The Williams Institute at UCLA and the Movement Advancement Project show that a year of isolation has impacted LGBTQ people more than their straight and cisgender peers, with the outcome being many more mental health problems.

The National Alliance on Mental Illness (NAMI), notes, “Although the full range of LGBT+ identities are not commonly included in large-scale studies of mental health, there is strong evidence from recent research that members of this community are at a higher risk for experiencing mental health conditions — especially depression and anxiety disorders.”

NAMI states, “LGB adults are more than twice as likely as heterosexual adults to experience a mental health condition. Transgender individuals are nearly four times as likely as cisgender individuals to experience a mental health condition.”

LGBTQ people were already disproportionately impacted by mental illness before the threat of the pandemic made so many financially vulnerable and threatened their physical health as well. PGN reported on the lack of access to regular health services as well as how both LGBTQ youth and LGBTQ elders were suffering from crushing levels of isolation, cut off from the communities that helped mitigate depression and anxiety.

Substance abuse also rose exponentially during the height of the pandemic while access to help was nearly non-existent. Now that the city and state are easing restrictions on in-person gatherings, 12-step groups — often a lifeline — may be more available.

Many people may not even know how much the pandemic has impacted their mental health and stability — or how their sexual orientation and/or gender identity puts them at greater risk for mental health crises overall.

For centuries, being LGBTQ has been associated with mental illness, criminality and a crossover sociopathology. Currently there are more than 50 anti-LGBTQ bills in state legislatures. The Equality Act has yet to be debated in the Senate, despite being passed months ago in the House and despite President Biden urging its passage in his State of the Union Address. The stigma that attaches to being LGBTQ is still being codified into law with no remedy, and the subsequent trauma may not even be acknowledged by most LGBTQ people — especially older queer and trans people who have been forced to adjust to discrimination and bigotry over decades.

Maginalization is a difficult path to traverse, and for LGBTQ people who are dealing with multiple areas of discrimination, it can be an ongoing source of trauma.

Trauma therapist and social worker Dr. Jennie Goldenberg has worked with LGBTQ clients for nearly two decades. Goldenberg explained that the interconnectedness of social stigma for being LGBTQ and the social stigma for being mentally ill makes seeking help for depression or other mental illness far more difficult than for a non-LGBTQ person.

“The stressors and stigma continue to be crushing, despite high-profile celebrities and political figures like Ellen or Pete Buttigieg,” says Goldenberg. “Because LGBT folks have significantly higher levels of anxiety and depression, due to their minority status, harassment, and so forth, the challenge is for mental health providers to step up.”

She said providers must “help clients recognize that a lot of their stress is due to environmental/macro-level homophobia and transphobia, rather than internalize the negative and hurtful messages of society as personal failure and self-blame.”

Self-blame is the reason many LGBTQ people still seek out conversion therapy, even though it has been widely debunked. A survey by The Williams Institute showed that nearly half a million Americans had undergone conversion therapy as minors. Living authentic and out LGBTQ lives comes with discrimination and stigma. The concomitant trauma means LGBTQ people suffer from more mental illness. Yet discrimination means less access to crucial health care.

Queer and trans people are more likely to contemplate and/or attempt suicide than their straight and cisgender peers across all ages groups. Recent studies suggest those numbers are as many as ten times that of non-LGBTQ people.

In a 2016-2017 survey from HRC, 28 percent of LGBTQ youth and 40 percent of transgender youth said they felt depressed most or all of the time during the previous 30 days, compared to only 12 percent of non-LGBTQ youth.

When noted New York City therapist Bob Bergeron committed suicide on New Year’s Eve in 2012, it began a dialogue on issues of aging and depression in the gay male community. Bergeron was handsome, accomplished, respected in his field and at the pinnacle of his career with a new self-help book on gay male aging about to be published. His family was supportive of him as a gay man, he had an active social life, was at the gym every day working out and was known to friends as being “relentlessly cheerful.” There were no signs he was planning to take his life.

Teresa Theophano works with older adults at SAGE (Services & Advocacy for GLBT Elders) as a clinical social worker and is a co-editor of “Headcase: LGBTQ Writers & Artists on Mental Health and Wellness.” SAGE is America’s oldest and largest non-profit organization dedicated to LGBT older adults and aging. Theophano said, “Depression, anxiety, and social isolation are not uncommon among LGBT older adults. But seeking services doesn’t always feel safe for the aging population.”

Theophano explains, “While being ‘out’ as LGBT and living with a mental health condition can be challenging at any age, elders who came of age in a repressive and oppressive social environment may be all the more reluctant to seek care.” She adds, “This is exacerbated by the presence in their lives of family members, including caregivers, who may not be LGBT-affirmative.”

What can LGBTQ people do to mitigate this wave of mental health issues and the impact of the current pandemic-inspired depression and anxiety? Do an inventory of how you are feeling and seek help from a safe place where LGBTQ people are welcome, like the Mazzoni Center or private practitioners like Goldenberg.

New research out this month from the Yale School of Public Health found that LGBTQ community centers may be the best conduit for access to mental health resources for LGBTQ people, providing a safe atmosphere of community, understanding and help. 

“Our findings suggest that LGBTQ community centers are vital to the mental health of this community,” said John Pachankis, Ph.D., the Susan Dwight Bliss Associate Professor of Public Health and director of Yale’s LGBTQ Mental Health Initiative.

If you are in crisis, call the Trevor Project hotline at 1-866-499-7386 or the SAMHSA’s National Helpline 1-800-662-HELP (4357). The Mazzoni Center also has counseling available: 1-215- 563-0652.