Mental Health Concerns and Disparities in Suicide Risks Among LGBTQ+ Adults

Dr. Kristyn Gregory

| 4 min read

Dr. Kristyn Gregory, D.O., is a medical director of ...

Members of the Lesbian, Gay, Bisexual, Transgender, Queer, Questioning Plus (LGBTQ+) community are not inherently prone to mental health issues or suicide risk because of their sexual orientation or gender identity. However, these conditions can develop as a result of the stigmatization and mistreatment they experience every day.
While belonging to the LGBTQ+ community can be a source of strength, it can also present unique challenges to one’s mental health. LGBTQ+ adults are more than twice as likely as heterosexual adults to experience a mental health condition, according to the National Alliance on Mental Illness (NAMI), while transgender individuals are nearly four times as likely as cisgender individuals (people whose gender identity corresponds with their birth sex) to experience a mental health condition. 

Important risk factors of LGBTQ+ mental health

Socioeconomic and cultural conditions contribute to mental health issues among many LGBTQ+ people. The following risk factors can lead to worsened symptoms among this community:
Harassment and discrimination: The LGBTQ+ population regularly experience homophobia, biphobia, transphobia and bullying as early as grade school and often in the workplace as they age. They are one of the most targeted communities by perpetrators of hate crimes in the United States. A 2019 school climate survey showed that 86% of LGBTQ+ youth reported being harassed or assaulted at school, which can significantly impact their mental health. Institutional sources of trauma are a factor as well, as LGBTQ+ people who grow up in religious settings can be especially traumatized by their faith’s condemnation of homosexuality and non-binary gender identities. These experiences can lead to negative health outcomes like anxiety, hopelessness, social isolation, alcohol and drug abuse and incarceration.
Denial of civil and human rights: Several states and the federal government have proposed or enacted laws that permit residents to discriminate against LGBTQ+ individuals, also contributing to the negative health outcomes mentioned above.
Family rejection and isolation: Though “coming out” is embraced more by society than in years past, family rejection is still a traumatic risk factor for LGBTQ+ individuals that can lead to other risk factors, such as homelessness. This in turn can make it difficult to stay in school or hold a job. Rejection by family members or close friends can have long-term psychiatric ramifications as well.
Health disparities and barriers to mental health care: A lack of cultural competence, congruence and sensitivity by health care providers, along with socioeconomic barriers like low income, lack of transportation, and inadequate housing can prevent LGBTQ+ individuals from receiving adequate health care. According to Mental Health America (MHA), a survey of LGBTQ+ people, more than half of all respondents reported that they have faced cases of providers denying care, using harsh language, or blaming the patient’s sexual orientation or gender identity as the cause for an illness.
Transgender patients are at high risk of negative health outcomes with much higher rates of HIV infection, smoking, drug and alcohol use, and suicide attempts than the general population, according to the American Psychiatric Association. And though federal law prohibits most public and private health plans from discriminating against transgender individuals, exclusions of transition-related care and transition-related procedures can occur despite being illegal forms of discrimination
Substance use: LGBTQ+ adults are nearly twice as likely as heterosexual adults to experience a substance use disorder, according to research, which has also found transgender individuals to be four times likelier than cisgender individuals to experience a substance use disorder. Illicit drug use among LGBTQ+ high school-aged youth is also typically much higher than their peers.
Suicide: The LGBTQ+ population is at a higher risk than the heterosexual and cisgender populations for suicidal thoughts and suicide attempt. According to NAMI, 40% of transgender adults have attempted suicide in their lifetime, compared to less than five percent of the general U.S. population.

Treatment and support

As is the case for everyone, it’s important for members of the LGBTQ+ population to advocate for the best mental health care possible. NAMI lists a step-by-step process in seeking LGBTQ+-competent care, including thinking about what you’re looking for, gathering referrals, asking questions and building a relationship with a provider once you’ve identified a good match.
The following LGBTQ+ crisis/suicide prevention hotlines are also available for those in need:
Transgender Community
  • Trans Lifeline - 877-565-8860
LGBTQ+ Adults
  • Lifeline* - 1-800-273-8255
  • Crisis Text Line* - Text HOME to 741741
All Ages
  • LGBTQ+ National Hotline - 1-888-843-4564
Dr. Kristyn Gregory, D.O., medical director of behavioral health at Blue Cross Blue Shield of Michigan. For more health tips and information, visit
Photo credit: Getty Images
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