December 15, 2016

Sexual and Gender Minorities: The Silent Majority in the World of Mental Health

By Natalia Gurevich, SWHR Communications Intern

This past year mental health has been at the forefront of national coverage, especially with the recent presidential election, where both nominees acknowledged mental health as an issue of public health concern. For one group in particular, sexual and gender minorities, mental health is an issue compounded by additional stressors that can occur daily. Sexual and gender minorities are affected by more discrimination and stigma throughout their lives than the general population [1]. As a result, mental health issues also disproportionately affect this group [1].

Sexual and gender minorities are a group whose sexual identity, orientation, or practices differ from the majority of the population [2]. Sexual and gender minorities usually comprise of lesbian, gay, bisexual, and transgender (LGBT) individuals [2]. The term sexual and gender minority is fairly new, and is currently used by the National Institutes of Health, which established the Sexual & Gender Minority Research Office in September 2015. While many studies and groups still use LGBT or LGBTQ, for the purposes of inclusion and for this post, SWHR will use the term sexual and gender minority.

The population is probably slightly larger than reported, but those who publicly identify as a sexual and gender minority only make up about 3.4 percent of the U.S. population [3]. However, for this small minority group, suicide is one of the leading causes of death among those aged 10–24 years. Sexual and gender minority youth contemplate or attempt suicide 4 times more frequently than the general population [1].

Sexual and gender minorities are also more affected by disorders, like depression and substance abuse. Most of these disorders affect sexual and gender minority adolescents at a higher rate than their cis gender, heterosexual peers [4]. A lot of internalized disorders (mental health) and external disorders (drug and alcohol addiction) that begin to develop in teenage years often manifest themselves into deeper issues continuing into adulthood [5]. Therefore, many researchers focus on adolescence in sexual and gender minorities in an effort to better understand the root cause of mental health issues within this group.

A study published in 2008 by the Journal of Child Psychology and Psychiatry, found that stress was the main compounding factor [4] to higher rates of mental health issues in sexual and gender minorities compared to the rest of the population. Chronic stress leads to dysregulated emotions and sexual and gender minorities face multiple stressors during adolescence, including peer victimization, and in some cases, physical assault and rejection from their family [4]. Coping with these extraneous stressors, along with various other issues facing adolescents in general, potentially keep sexual minorities from developing emotional maturity and adaptability relative to their heterosexual peers [4], which can extend into adulthood.

Another study published in 2010 by the American Journal of Public Health found that three categories for discrimination—gender, race/ethnicity, and sexual orientation—were often compounded together, and when combined, led to higher rates of substance abuse [6], particularly in adulthood. An estimated 20-30 percent of sexual and gender minorities abuse substances, compared to about 9 percent of the general population [1].

Substance abuse is an external disorder that often goes hand-in-hand with internal disorders. Because sexual minorities face discrimination and social stigma on a higher basis than other subpopulations, daily stressors often increase their risk for anxiety, depression, panic attacks, suicidal ideation, psychological distress, body image disturbance, and eating disorders [2]. While the president-elect has spoken on mental health in the past, he has yet to announce a formal platform on the issue [7]. SWHR hopes that the new administration will recognize the current issues surrounding mental health and develop new policies to combat this public health concern.

Education and awareness on sexual and gender minorities and mental health should be addressed as early as possible in adolescents and continue into adulthood. If you are a member of the sexual and gender minority community or even if you are not, talk to your healthcare provider if you have any questions relating to mental health.

At SWHR, we believe that mental health is an important issue that affects members of every community, either personally or through a loved one. Everyone is entitled to receive the proper care and support they deserve, regardless of sexual orientation, gender, or race/ethnicity. Sexual and gender minorities belong to a group greatly affected by mental health issues, but are vastly underrepresented in research. All the mental health implications will remain relatively unknown without more research and education on this minority group. Learn more about SWHR and the work we do on mental health here.