LGBT+ mental health

Some people identify as lesbian, gay, bisexual and trans. Other people don’t feel that they fit into traditional categories of gender and sexuality. Some people who identify as LGBT+ may experience difficulties that affect their health and well-being. This page looks at some of the issues affecting LGBT+ people and how to get support.

Overview

  • LGBT+ stands for lesbian, gay, bisexual and trans. The ‘+’ is an inclusive term for people who do not feel that they fit into traditional categories of gender or sexuality.
  • Research shows that mental health problems, like depression and anxiety are more common in the LGBT+ community.
  • There are specialist LGBT+ charities and mental health services that you may be able access for support.
  • The Equality Act 2010 states that no service provider or employer may discriminate against anyone because they are lesbian, gay, bisexual or trans.

What does LGBT+ Mean?

‘LGBT+’ stands for lesbian, gay, bisexual, trans and others. We use the phrase LGBT+ to describe people who may fit under this general term. You may not feel you fit into one of those terms. We recognise that everyone is different.

Lesbian, gay and bisexual

A person who is sexually attracted to people of their own gender or both genders.

Trans

Trans is a term that includes people who identify as transgender, or transsexual. Transgender people have a gender identity or gender expression that differs from the one given at birth.

Transgender is sometimes called transsexual if the person wants medical help to transition from one sex to another. These are separate issues but for the purpose of this factsheet we use the word trans to cover both terms. There are also many other terms used in the transgender community.

Others (+)

The plus (+) is included to recognise that many people do not identify as LGBT, but do not fit into traditional categories of gender or sexuality.

Sometimes you might see organisations describing themselves as ‘LGBTQ+’ or ‘LGBTQIA’ instead.

The ‘Q’ stands for ‘queer’ or ‘questioning’. This term used to be used as an insult, but some younger people who identify as LGBT+ have reclaimed the word for themselves. Other people who identify as LGBT+ find the term ‘queer’ offensive.

The ‘I’ stands for intersex. Intersex people may identify as male, female or non-binary. Including the ‘I’ can also be controversial as some intersex people do not identify as LGBT+ and do not want to be part of the community.

The A stands for asexual. This is a term used to describe people who do not feel any sexual attraction.

Some people describe themselves as ‘pansexual’. This refers to someone who feels romantic and sexual attraction to people regardless of their gender identity or sex.

As society becomes more aware of peoples differences, there are more terms to describe people. The LGBT+ community is diverse and the plus aims to include all identities.

We realise that people identify themselves in many different ways and that some people may find certain terms offensive. Because of this, we have used the term LGBT+ on this page. 

What issues might LGBT+ people face?

There are different issues that LGBT+ people may have to face.

Mental health issues

Being LGBT+ does not automatically mean you will have mental health issues. However, mental health issues have been found among people who identify as LGBT+. One review of studies on mental health issues in the LGBT+ community found the following:

  • LGBT+ people are at more risk of suicidal behaviour and self-harm than non-LGBT+ people.
  • Gay and bisexual men are four times more likely to attempt suicide across their lifetime than the rest of the population.
  • LGBT+ people are 1½ times more likely to develop depression and anxiety compared to the rest of the population.

The reasons why there are mental health issues among LGBT+ people are complex.

Lesbian, gay and bisexual

Early medical professionals felt being LGB was a mental illness. Homosexuality was seen as ‘part of the problem’ and people needed psychiatric treatment. But this changed in 1990 when the World Health Organisation removed homosexuality from their list of mental illnesses.

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, self-harm and suicidality.

LGBT+ people under 26 were found to be more likely to attempt suicide and to self harm.

Transgender

The situation for the transgender community is more complex.

The International Classification of Diseases (ICD-10) is a guideline doctors use to diagnose mental health conditions. The ICD-10 lists Gender Identity Disorders as a mental disorder. This includes Transsexualism and Dual-role transvestism.

Gender dysphoria is listed in the Diagnostic and Statistical Manual (DSM-5). This is another guideline doctors use to diagnose mental health conditions. Gender dysphoria refers to the distress people feel when their sex does not match their gender identity. When this causes a lot of distress, it can be defined as a disorder.

There is controversy over whether Gender Identity Disorder and Gender dysphoria should be classed as mental health disorders.

A transgender mental health study showed that 88% of transgender people had experienced depression and 84% had thought of ending their life.

Discrimination and bullying

More than half of younger LGBT+ people experience homophobic, biphobic or transphobic bullying in Britain’s schools. Nearly half of pupils who experience bullying have symptoms of depression.

In 2013, one in six LGBT+ adults had experienced a hate crime or incident in the last 3 years.

In a survey:

  • 19% of LGB employees have experienced verbal bullying from colleagues, customers or service users because of their sexual orientation in the last five years.
  • 15% of LGB employees have experienced verbal homophobic bullying from their colleagues in the last five years.
  • 25% of trans people are made to use an inappropriate toilet in the workplace, or none at all, during the early stages of transition.
  • Over 10% of trans people experienced being verbally abused and 6% were physically assaulted.

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.

If you come out and experience rejection, you may not want to come out again. You may feel that you have to hide your real self, which can affect your mental wellbeing and cause stress.

If you experience homophobia, biphobia or transphobia, you may turn these feelings inwards. This may lead to negative feelings about your own sexuality or gender identity. This can be called ‘internalised homophobia or transphobia’.

Coming out to at least one supportive person, such as a friend or a work colleague, may lessen feelings of depression. It can increase your overall sense of wellbeing and self-esteem, compared to someone who does not come out at all.

Getting older

Many older LGBT+ people have experienced ill-treatment because of their sexual orientation or gender identity in the past. This could have been at work, from authority figures or their own family.

Some feel that their sexual orientation has, or will have, a negative effect on them when getting older. Their concerns are around future care needs, independence, mobility, health and housing.

Age UK have a guide for older members of the LGBT+ community. You can find the detailed of Age UK in the ‘Useful Contacts’ section below.

Substance abuse

LGBT+ people may be more likely to use drugs than heterosexual people. Lesbian and bisexual women are more at risk of substance dependence than the rest of the population.

 A recent Crime Survey showed:

  • drug use by gay and bisexual men was three times higher than for heterosexual men, and
  • illegal drug use by gay and bisexual women was four times higher than among heterosexual women.

Heavy drinking or drug use can make existing mental health problems worse and potentially trigger new ones.

You can find more information about 'Drugs, alcohol and mental health' here.

Culture and identity

You may feel pressure to look a certain way as an LGBT+. Many LGBT+ people worry about how they look and wish they thought about it less.

HIV and medication

LGBT+ people living with HIV can find that their medication affects their emotional wellbeing. However, there are now many different anti-HIV drugs available. You could try another one that suits you better.

HIV specialists are very experienced in working with people who have depression and anxiety. If you have had any mental health problems, you should tell your HIV consultant when you start discussing treatment options.

Some anti-HIV medications and medication for mental illness cannot be taken together. But there are some which you can take together. You should discuss any medication issues with your HIV consultant and psychiatrist.

Accessing Healthcare

LGBT+ people, especially trans people, can experience more social isolation than the general population. This could make it harder for LGBT+ people who have mental health problems to get support and treatment.

LGBT+ people and their carers may experience discrimination. This may affect their ability to access services and receive the most appropriate support.

A survey found that in gay and bisexual men who have accessed healthcare services in the last year:

  • 34% have had a negative experience related to their sexual orientation,
  • 26% felt that healthcare workers had given them information relevant to their sexual orientation, and
  • only 9% found their GP surgery welcoming.

In a survey of lesbian and bisexual women:

  • half reported a negative experience of healthcare in the last year,
  • two in five found practitioners assumed they were heterosexual and were not given appropriate advice, and
  • one in five felt they had no opportunity to discuss their sexual orientation.

What if I have problems accessing services?

 

What if I have problems accessing services?

Accessing general health services can be a difficult experience for someone who is LGBT+. People can be worried about disclosing their sexual orientation or gender identity to health professionals. This may be in case they are misunderstood, or the service cannot meet their needs.

You may decide to come out to your GP or any other medical professional. It may help to talk this through with someone beforehand. You could practice the conversation with a friend. You may prefer to do this with someone you do not know. For example, you could talk it through with someone on an LGBT+ helpline.

What are my rights as an LGBT+ person?

Under the Equality Act 2010, it is illegal for a service provider to directly, or indirectly, discriminate against anyone who identifies as LGBT+. The NHS and any other organisation that offers services is a service provider.

Stonewall have a guide called ‘Protecting Patient Rights’ with the General Medical Council. This is about protecting the rights of LGBT+ people in health services. You can find it here

What if I am not happy with my treatment?

If you are not happy with your treatment, you can:

  • talk to your doctor about your treatment and ask for a second opinion,
  • get an advocate to help you speak to your doctor,
  • contact Patient Advice and Liaison Service (PALS) and see whether they can help, or
  • make a complaint.

There is more information about these options below.

Second opinion

If you are not happy with your treatment, you should 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 is not offering you the right treatment.

You may feel that your treatment needs to be changed. If your doctor does not agree, you could ask for a second opinion. You are not legally entitled to a second opinion but your doctor might agree to it if it would help with treatment options.

Advocacy

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. Or you could call our Advice Service so we can search for you.

'PALS'

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 find your local PALS’ details here.

Complaints

If you have no success using an advocate or PALS you could complain using the NHS complaints procedure. The GP practice or mental health trust should be able to give you a leaflet about their complaints procedure.

You can find more information about:

  • Second opinions
  • Advocacy
  • Complaining about the NHS or social services

Useful contacts

Age UK

An organisation that offers guidance and support for older people who may be experiencing difficulties in accessing services or care. Their guide for older LGBT+ people can be found here

Telephone: 0800 678 1174

Email via website: www.ageuk.org.uk/contact-us/information-and-advice//

Website: www.ageuk.org.uk

Antidote

A service that offers information and support exclusively to LGBT+ people around drugs, alcohol and addiction. Part of London Friend's service.

Telephone: 0207 833 1674 Monday - Friday, 10am – 6pm)

Address: London Friend, 86 Caledonian Rd, London, N1 9DN

Website: www.londonfriend.org.uk/get-support/drugsandalcohol

The Asexual Visibility and Education Network

Hosts the world's largest online asexual community as well as a large archive of resources on asexuality. Provides email to support to people who identify as asexual and their friends and family.

Email: aven.pt@gmail.com

Website: www.asexuality.org

Being Gay is Okay

A service that gives online information and advice for under 25 year olds.

Telephone: 01483 727667 (Tuesday and Sunday only, 7:30pm – 10pm)

Email via website: www.bgiok.org.uk/contact/contact_main.html

Website: www.bgiok.org.uk

The Beaumont Society

A national transgender support network offering emotional support via a weekly helpline, as well as general information and support groups

Telephone: 01582 412220 (open 24 hours a day, 365 days a year)

Address: The Beaumont Society, 27 Old Gloucester St, London, WC1N 3XX

Website: www.beaumontsociety.org.uk

Birmingham LGBT Centre

Voluntary organisation providing advice and support to LGBT+ people in Birmingham. Offers counselling, well-being services and wide range of support groups.

Telephone: 0121 643 0821 (Monday – Friday, 8am – 9pm, Saturday – Sunday, 11:30am – 7pm)

Address: Birmingham LGBT Centre, 38/40 Holloway Circus, Birmingham, B1 1EQ

Email: hello@blgbt.org

Website: www.blgbt.org

ELOP (East London Out Project)

A London based LGBT mental health and wellbeing centre offering a holistic approach. They offer counselling, support groups, and young people’s services.

Telephone: 020 8509 3898

Address: 56-60 Grove Rd, Walthamstow, London, E17 9BN

Email: info@elop.org

Website: www.elop.org

Equality Advisory and Support Service

An organisation that provides advice on discrimination and human rights issues

Telephone: 0808 800 0082, (9am–7pm Monday to Friday, 10am-2pm Saturday)

Textphone: 0808 800 0084

Address: FREEPOST EASS HELPLINE FPN6521

Email via website: here

Website: www.equalityadvisoryservice.com

GIRES (Gender Identity Research and Education)

A charity that provides information for transgender people and medical professionals, including research and links to support groups

Telephone: 01372 801554

Address: The Gender Identity Research and Education Society, Melverley, The Warren, Ashtead, Surrey, KT21 2SP

Email via website: http://www.gires.org.uk/contact-us/

Website: www.gires.org.uk

GMFA (Gay Men Fight Aids)

A gay men’s health charity and have booklets and workbooks that you can download for free. They are written by counsellors and cover topics exploring self-esteem and relationships. They also have information on HIV medication and offer a UK social, leisure and sports activities handbook called ‘The Guide’.

Address: 11 Ebenezer St, London, N1 7NP

Email via website: www.gmfa.org.uk/Pages/Contact.aspx

Website: www.gmfa.org.uk

Leicester LGBT Centre

Voluntary organisation providing support to LGBT+ people in Leicester, Leicestershire and Rutland. Offers counselling and wide range of support groups.

Telephone: 0116 254 7412 (Monday – Thursday 9am – 5pm, Friday 9am – 2pm)

Address: 15 Wellington St, Leicester, Leicestershire, LE1 6HH

Email via website: www.leicesterlgbtcentre.org/contact-us/

Website: www.leicesterlgbtcentre.org

LGBT Foundation

A Manchester based charity offering mental health services and resources to the gay community. This includes befriending, free counseling and a support helpline.

Telephone: 0345 3 30 30 30 (Monday – Friday, 10am - 10pm, Saturday hours vary)

Address: 5 Richmond St, Manchester, M1 3HF

Email: helpline@lgbt.foundation

Website: www.lgbt.foundation

London Friend

A long-running LGBT+ charity which offers low-cost counselling, drug and alcohol services as well as social and support groups. Based in North London.

Telephone: 020 7833 1674 (Monday – Friday, 9am – 5pm)

Address: London Friend main office, 86 Caledonian Rd, London, N1 9DN

Email: office@londonfriend.org.uk

Website: www.londonfriend.org.uk

Metro

Provides health, community and youth services across London and the south east of England. Mental health support includes counselling, mental health drop-in, sexual health counselling and advocacy.

Telephone: 020 8305 5000

Email: hello@metrocharity.org.uk

Website: www.metrocentreonline.org

Mind Out

A mental health service for LGBT+ people which provides advice, information, advocacy, peer support groups, mentoring and wellbeing events.

Telephone: 01273 234 839

Address: Community Base, 113 Queens Rd, Brighton, BN1 3XG Email: info@mindout.org.uk

Website: www.mindout.org.uk

Opening Doors London

Provides a range of services and activities for LGBT+ people over 50 in London.

Telephone: 0207 239 0400

Address: Tavis House, 1-6 Tavistock Square, London, WC1H 9NA

Email via website: www.openingdoorslondon.org.uk/contact-us/

Website: www.openingdoorslondon.org.uk

Outcome

An LGBT+ mental health service run through Mind in Islington, offering psychotherapy, counselling, art therapy, alternative therapies and activities.

Telephone: 020 7272 5038

Address: Outcome, Mind Spa, 35 Ashley Rd, London, N19 3AG

Email: sigal.avni@islingtonmind.org.uk

Website: https://www.islingtonmind.org.uk/our-services/outcome/www.islingtonmind.org.uk/outcome.asp

Pink Therapy

Pink Therapy has a directory listing qualified therapists throughout the UK who work with the LGBT+ community from a positive stance.

Telephone: 07971 205323

Address: BCM 5159, London, WC1N 3XX

Email: admin@pinktherapy.com

Website: www.pinktherapy.com

Stonewall

A charity for all LGBT+ people both in the UK and abroad. They can provide information and advice. They have a database that can help you find local lesbian, gay and bisexual community groups or services.

Telephone: 020 7593 1850

Address: 192 St John Street, London, EC1V 4JY

Email: info@stonewall.org.uk

Website: www.stonewall.org.uk

Switchboard LGBT+

A service that gives national information and a listening service over phone and email and instant messaging. All volunteers identify as LGBT+ so the person answering the telephone will have an understanding of your situation. They are based in London but do take calls from the whole of the UK.

Telephone: 0300 330 0630 (10am-10pm every day)

Address: Switchboard, PO Box 7324, London, N1 9QS

Email: chris@switchboard.lgbt

Website: www.switchboard.lgbt

You can also take a look online to see if there is an LGBT+ centre in your local town or city. There are lots of different centres all across England, and we have not listed them all here. If you need help doing this, then please feel free to contact our Rethink Mental Illness Advice Service on 0300 5000 927. They can help you find services local to you.

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