An estimated 9 million Americans identify as lesbian, gay, bisexual, transgender, or queer (LGBTQ), according to the National LGBT Health Education Center.1 Although this is a large number of people, the LGBTQ population has important health needs that are often under-served and misunderstood by others.
For example, LGBTQ individuals are more likely to experience health disparities or differences from the general population. Examples of these health disparities include:
•Higher rates of HIV and sexually transmitted infections
•Higher rates of substance abuse and smoking
•Higher rates of depression and anxiety
•Higher rates of unhealthy weight control
•Lower rates of papsmear screenings and mammography
While LGBTQ individuals are more likely to experience healthcare disparities, they are unfortunately less likely to access care and are more likely to experience problems accessing healthcare.
At one time, the APA had even designated homosexuality as a mental health disorder in the DSM. The APA removed homosexuality as a mental illness designation in 1973 when 58 percent of voting members voted to overturn homosexuality’s inclusion in the manual. However, its previous appearance in the manual had already affected how mental health experts viewed and treated those in the LGBTQ community seeking care.
History of Discrimination
Fighting for Rights and Recognition
Issues Faced by LGBTQ Populations
The LGBTQ population is subject to the same mental illnesses and physical health conditions as everyone else. Researchers have also identified certain mental health concerns that are more prevalent in the LGBTQ community compared to others. This section will explore different issues that challenge the LGBTQ community.
According to the National Alliance on Mental Illness (NAMI), LGBTQ people are three times more likely to experience a mental health condition compared to those who are not. Examples of mental health disorders a person may face include generalized anxiety disorder, post-traumatic stress disorder, and major depression.
Greater Risk of Suicide in the LGBTQ Community
Higher Rates of Serious Mental Illness
Increased risks for mental health disorders unfortunately, also mean those in the LGBTQ community are at greater risk for suicide. According to NAMI, suicide is the leading cause of death for those ages 10 to 24 in the LGBTQ community. Sadly, LGBTQ youth are most affected by suicide rates that are four times higher than young people who aren’t in the LGBTQ community. Researchers have also identified that a person who didn’t have support after coming out to their family is eight times more likely to attempt suicide than a person who does have a supportive family.
How Common is Adderall Addiction in the US?
LGBT individuals can be subject to traumatic events that can shape their life and outlook. According to the HRC, transgender students who were denied access to the bathroom of the sex they identify with were 45 percent more likely to attempt suicide than those who are not.
LGBT individuals may also be victims of hate crimes, which can include physical and verbal abuse.6 One organization that helps LGBTQ students is Parents, Families, and Friends of Lesbians and Gays (PFLAG). You may visit their website at www.pflag.org.
LGBTQ individuals, unfortunately, face not only social isolation but also family rejection. Some families may throw out an LGBTQ child from their home. This may explain higher rates of homelessness among LGBTQ youth.
Being an LGBTQ person in a family who does not have another LGBTQ family member can be challenging in terms of helping family members understand the person’s lifestyle. Family members may react in a variety of ways, from concern and worry for the individual to rejection and blame, wondering if the family member did something to cause a person to identify as LGBTQ. As advocates make greater strides, more families are becoming accepting and have greater access to resources to help them process the information and support their loved ones.
The LGBTQ community faces higher rates of homelessness compared to those who do not identify as LGBTQ, according to the National Coalition for the Homeless (NCH). Some of the contributing factors to homelessness in this community is discrimination, family rejection, and social stigma.(7)
Homeless members of the LGBT community also face greater challenges in finding homeless shelters who understand and accept their lifestyle. As a result, they are more vulnerable to violence and abuse when seeking shelter. Of particular concern is the transgender community, which may be turned away from shelters due to their physical appearance.
Rates of homelessness among young LGBTQ people also occur at higher rates than in young heterosexuals. Unfortunately, there are no current federally supported programs specifically aimed at assisting LGBTQ homeless youth, according to the NCH.
Addiction in the LBTQ Community
According to NAMI, an estimated 20 to 30 percent of those in the LGBTQ population struggle with substance abuse, while 9 percent of the general population suffers from substance abuse.
Alcohol and Cocaine Abuse Rates in the LGBTQ Community
Some data is available regarding addiction in individual LGBT populations. The Substance Abuse and Mental Health Services Administration (SAMHSA) reports as many as 30 percent of lesbians suffer from an alcohol abuse problem. Lesbians are also more likely to abuse cocaine at higher rates compared to heterosexual women. Another study from SAMHSA found that gay men and lesbians have a 20 to 25 percent rate of alcohol abuse, compared to an estimated 3 to 10 percent of heterosexuals.
Drug Use and LGBTQ Culture
Gay men and men who have sex with men (MSM) also abuse certain medications and drugs at higher rates than the heterosexual population. Gay men and MSM are more likely to use marijuana, hallucinogens, stimulants, sedatives, cocaine, MDMA, and barbiturates than heterosexual individuals. This statistic also makes relapse prevention efforts difficult in gay men, and MSM as the social scene and party culture are often a part of their lifestyle and where they have found acceptance, according to SAMHSA. (8)
Several risk factors exist in the LGBTQ community that may make a person more vulnerable to suffer from substance abuse compared to heterosexuals. Examples include:
•Lack of education
•Living in an area that is traditionally unaccepting of LGBT individuals
•Poor self-esteem/negative self-concept
•Reliance on bars and clubs to find social support
SAMHSA Guidelines on Treatment
SAMHSA published a report titled “A Provider’s Introduction to Substance Abuse Treatment for Lesbian, Gay, Bisexual, and Transgender Individuals” after extensive research and polling of medical experts to help aid in the treatment of LGBT individuals who struggle with substance abuse.
According to SAMSHA, some of the key aspects of care a therapist should provide their LGBT client include:
•Respect the client and his or her frame of reference
•Recognize the importance of collaboration with the client
•Maintain professional objectivity
•Recognize the need for flexibility and be able to adjust strategies according to the client’s needs
•Appreciate their own role and power within the group
•Be non-judgmental and respectfully accepting of the client’s different values, culture, and behavior
Levels of LGBT-Sensitive Treatment for Recovery
The Trevor Project and the It Gets Better Campaign offer a 24/7 confidential suicide hotline (866-488-7386) for struggling LGBTQ youth.
There are many other resources for those in the LGBT community who may not have access to LGBT-affirming treatments in their area. Examples of websites to visit include:
The National LGBT Health Education Center: www.lgbthealtheducation.org
The Center of Excellence for Transgender Health: www.transhealth.uscf.org
World Professional Association for Transgender Health: www.wpath.org
These resources can provide an excellent start to helping you or a loved one find the care and support you need in your recovery and beyond.
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