LGBTQIA+ people’s mental health

Being LGBTQIA+ doesn’t automatically mean you will experience a mental health problem but LGBTQIA+ people are more likely to develop a mental health problem or experience poor mental health, due to their life experiences.  On this page we’ll look at issues people in these communities may face, and how you can manage your mental health as part of these communities.

What it means to be LGBTQIA+

LGBTQIA+ stands for lesbian, gay, bisexual, transgender. queer, intersex, asexual and plus. Different people prefer the use of different acronyms as they identify themselves in different ways and some people may prefer a different term to LGBTQIA+.

What does trans mean?

Trans is a term that describes people who have a gender that’s different from the sex they were assigned at birth, either male, female or intersex.

What does the ‘+’ stand for?

The plus (+) recognises that many people don’t identify as LGBTQIA+, but do not fit into traditional categories of gender or sexuality.

What is pansexual?

Bisexual people may identify as ‘Pansexual’ or ‘Pan' as they feel romantic and sexual attraction to people regardless of their gender identity or sex.

LGBTQIA+ and mental health

A review of studies on mental health issues in LGBTQIA+ communities found that LGBTQIA+ people are more likely to experience poor mental health or a mental illness than those who do not identify as being LGBTQIA+.

  • LGBTQIA+ people are at more risk of suicidal behaviour and self-harm than non-LGBT+ people.
  • Gay and bisexual men are 4 times more likely to attempt suicide across their lifetime than the rest of the population.
  • LGBTQIA+ people are 1½ times more likely to develop depression and anxiety disorder compared to the rest of the population.
  • 67% of trans people had experienced depression in the previous year and 46% had thought of ending their life.
  • Stonewall’s ‘Prescription for Change’ report found lesbian and bisexual women had higher rates of suicidal thoughts and self-harm compared to women in general.
  • Of all the common sexual identity groups, bisexual people most frequently have mental health problems, including depression, anxiety disorder, self-harm and suicidality.

The reasons why there are higher rates of mental health issues among LGBTQIA+ people are complex. There are many experiences that LGBTQIA+ people will often have to deal with as a minority community, such as stigma, prejudice, and discrimination.

Types of discrimination

Experiencing discrimination can negatively impact mental health, and there are some types of discrimination that people in LGBTQIA+ communities are more likely to face in their life experience.

How members of LGBTQIA+ communities are treated and written about in the medical field has drastically changed over time, and is still changing today. Different communities have different views on what terminology should be used to describe themselves in medicine. The history of how LGBTQIA+ people were treated in medicine can still impact mental health of communities today and may influence how people trust, and access medical facilities. It’s important that LGBTQIA+ people should be able to refer to themselves medicinally in a way that they feel comfortable with.

  • Some early medical professionals thought being lesbian, gay or bisexual was a mental illness and only in 1990 did  the World Health Organisation remove homosexuality from their list of mental illness.
  • Up until recently the International Classification of Disease listed gender identity disorders, such as people who have had gender confirmation surgery, as being a mental health disorder. The term ‘gender identity disorders’ has been removed from being within the mental health category, a positive step for the trans community as being trans is no longer medically categorised as a ‘mental illness’.
  • Gender dysphoria today is listed in the Diagnostic and Statistical Manual. Gender dysphoria refers to the distress people feel when their sex doesn’t match their gender identity. When this causes a lot of distress, it can be defined as a mental disorder . There is controversy over whether gender dysphoria should be classed as a mental health disorder.
  • Conversion therapy refers to therapy practice that aims to stop or suppress someone from being gay, or from living as a different gender to their sex recorded at birth. The government has now banned conversion therapy aimed at changing a person’s sexual orientation – but not their gender identity.

Workplace discrimination and bullying can take place in many forms including direct discrimination, indirect discrimination, harassment and victimisation. Experiencing any form of bullying, discrimination or harassment at work can make you less likely to want to go to work and more likely to experience poor mental health.

  • LGBTQIA+ employees are more likely to experience conflict and harassment at work compared to their heterosexual and cisgender colleague.
  • A study of more than 15,000 workers found that 40% LGBTQIA+ employees and more than 55% of trans workers experienced conflict in the workplace over the last 12 months. This is compared to 29% of heterosexual and cisgender employees.
  • The same study also found that 16% of LGBTQIA+ workers and 18% of trans employees felt mentally unsafe in the workplace. This is compared to 10% of heterosexual workers.
  • 19% of LGBTQIA+ employees have experienced verbal bullying from colleagues, customers or service users because of their sexual orientation in the last 5 years.
  • 5% of trans employees are made to use an inappropriate toilet in the workplace, or provided with none at all, during the early stages of transition.

More than half of younger LGBTQIA+ people experience homophobic, biphobic or transphobic bullying in Britain’s schools. Although many schools now teach pupils about different sexualities, lack of LGBTQIA+ education on a whole, means young people within these communities often feel isolated, fearful and targeted in school settings.

  • Verbal, physical and sexual abuse is more commonly reported in transgender youth compared to cisgendered youth.
  • One third of LGTBTQIA+ pupils drop out of education after 16 years of age. The impact of bullying is thought to be one of the reasons discouraging LGBTQIA+ young people from continuing their education.
  • Nearly half of pupils who experience bullying have symptoms of depression.

Navigating teenage years and young adulthood can impact the mental health of anybody, but young people who identify as part of LGBTQIA+ communities are more likely to face challenges and discrimination which can further impact their mental wellbeing.

  • Young LGBTQIA+ adults are more likely to self-harm.
  • 13% of those who identify as LGBTQIA+ who are aged 18-24 have attempted to take their own life in the last year.
  •  Symptoms of depression are more common and severe in young people who identify as LGBTQIA+.
  • Young LGBTQIA+ adults are more likely to show symptoms of eating disorders

A hate crime is a criminal offense against a person or property motivated in whole or in part by an offender’s bias against a race, religion, disability, sexual orientation, ethnicity, gender or gender identity. Being a victim of any form of  hate crime can increase chances of experiencing poor mental health and can lead to mental health problems such as anxiety disorders, panic disorder and post traumatic stress disorder. The most common type of hate crime incident reported by LGBTQIA+ communities is verbal abuse.

  • 91% of LGBTQIA+ people either didn’t report an incident of hate crime at all, or didn’t report it themselves.
  • People said that they didn’t report the incident because they felt that nothing would happen or change, it isn’t serious enough, or it happens all the time.
  • Transgender people are around twice as likely to experience threats of physical or sexual harassment or violence compared with the other LGBTQIA+ communities.
  • It was found that 69% of LGBTQIA+ people who had been the victim of a hate crime experienced depression and 76% reported episodes of anxiety or panic.

Experiences in life

Members of LGBTQIA+ communities are more likely to face experiences in their life that may impact their mental health negatively.

Coming out

For some people ‘coming out’ for the first time can be exciting and liberating. For others it can be difficult. It could be a combination of the two. It may not be a one-off event but something you do many times during your life. Experiences of a result of ‘coming out’ can go on to impact mental health negatively.

Culture and identity

Black, Asian or minority ethnic (BAME) LGBTQIA+ people may face additional barriers when accessing support. This is shown in the following statistics about the BAME LGBTQIA+ community as 62% are more likely to experience depression than the general population and 8% fall under communities that are higher risk of attempting to take their own life.

Experience in healthcare

A survey found that in gay and bisexual men who have accessed healthcare services in the previous year, 17% experienced inappropriate curiosity by healthcare professionals, and 30% of lesbians and 23% of bisexual women have experienced inappropriate curiosity from healthcare staff. 27% of trans people have been ‘outed’ by healthcare staff without their consent.

Body image and eating disorders

In adults who identify as LGBTQIA+ 40% are likely to experience shame due to their body image. Concern over body image can lead to an eating disorder or body dysmorphic disorder. 12% of LGBTQIA+ people have experienced an eating disorder over a 12 month period, including 24% of non binary people and 19% of trans.

Substance abuse

Studies have shown LGBTQIA+ communities are more likely to experience problems with substance abuse. 16% of LGBTQIA+ people say they drink alcohol for more than 5 days per week in a 12-month period. This is compared to 10% of the non-LGBTQIA+ community. Lesbian and bisexual women aged 65+ are more at risk of substance dependence than the rest of the population.

Getting older

Many older LGBTQIA+ people have experienced ill-treatment because of their sexual orientation or gender identity in the past. Some feel that their sexual orientation or identity has, or will have, a negative effect on ageing, and are concerned about future care needs, mobility, health and housing.

Getting support

It is important to seek help and support if you or someone you know is experiencing mental health issues. There are many forms of support from general mental health support to specialised support for LGBTQIA+ people.

General services

Under the Equality Act 2010, it is illegal for a service provider to directly, or indirectly, discriminate against anyone who identifies as LGBTQIA+. The NHS and any other organisation that offers services is a service provider that must adhere to this act. Going to your GP is often the first step to gain support and access mental health services such as talking therapy, cognitive behavioural therapy and group therapy.
You can also self-refer yourself to your local service. You can find your local NHS talking therapy service by searching on the following NHS website. You can also find local support for your mental health on our website.

Local support

LGBTQIA+ support services

Although general services are there to help anyone, many people may find specialist services feel more inclusive, welcoming and positive to access. There are many organisations offering social and practical support to the LGBTQIA+ community, including mental health support as well as social groups, sports clubs or activities in your area that you can become involved in. For the full list of charities and organisations that offer specialist support to LGBTQIA+ people, visit our support page.

Find support

Feeling unhappy with support

If you feel unhappy with how you have been treated or with medical or mental health support provided, there are different actions you can take.

If you aren’t happy with your treatment, you can talk to your doctor and see if you can resolve the situation with them. The National Institute for Health and Care Excellence (NICE) produces guidelines for the treatment of different mental health conditions. You can refer to these guidelines if you feel your doctor isn’t offering you the right treatment. You may feel that your treatment needs to be changed. If your doctor doesn’t agree, you could ask for a second opinion. You aren’t legally entitled to a second opinion, but your doctor might agree to it if it would help with treatment options.

An advocate is someone who in independent of the NHS but understands the system and your rights. They can come to a meeting with you and your doctor and make sure you get what you are entitled to. Advocates help you make sure your voice is being heard. Some organisations may have specialist LGBT+ advocacy services. You can search online to see if there are any local advocacy services in your area.

The Patient Advice and Liaison Service (PALS) at your NHS trust can try to help you with any problems or issues you have with an NHS service.

You can complain using the NHS complaints procedure. The GP practice or mental health trust should be able to give you a leaflet about their complaint procedure. You can then find more information about second opinions, advocacy and complaining about the NHS or social services at Rethink or call their General Enquiries team on 0121 522 7007 and ask them to send you a copy of the factsheet.