It’s difficult to talk about personal issues with a virtual stranger. Professional mental health support requires deep personal reflection and the ability to be honest with yourself and your therapist. Sadly, feeling intimidated or fearing stigma prevents many people from getting the care they need.
People in the LQBTQ+ community have an even more difficult time finding healthcare professionals and spaces they feel they can trust. The search for affirming care can be challenging, but a lack of this care can have serious consequences for those seeking help.
What Is Affirming Care?
Stigmas surrounding the LGBTQ+ community combined with stigmas about mental health are a powerful combination.
The importance of and common misunderstandings about gender-affirming care have been in the news lately, but LGBTQ+ issues extend far beyond this issue.
Heterosexist bias — the belief that heterosexuality is the only so-called normal way to express sexuality — creates a barrier between people in the LGBTQ+ community and the high-quality healthcare they deserve.
Even when researchers do not want to ignore or disparage non-heterosexual people, the prevalence of heterosexist bias in medical and psychological research can harm queer-identified people.
By not including research questions, methods, or interpretations of results that relate to the experience of being LGBTQ+, scientific studies may fail to produce information that is helpful to those who are gay, lesbian, bisexual, or transgender. The same is true when an LGBTQ+ person enters a therapist’s office.
Affirming care can be as simple as including nonbinary pronouns on an intake form. In this and other small ways, therapists who show that they respect the dignity of LGBTQ+ clients can create a safe environment for healing.
According to Mental Health America, nearly 40% of those who identify as lesbian, gay, or bisexual report that they have struggled with mental health in the past year. Over half report being threatened and feeling that they have fewer employment opportunities than heterosexual people. In addition, around 22% of transgender individuals report that they avoid healthcare because of discrimination concerns.
The need for affirming care is obvious. While being LGBTQ+ is not a mental illness, living with the prejudice, fear, and isolation that many members of the community encounter can lead to depression and anxiety.
Regardless of a client’s sexual or gender identity, a therapist must cultivate a feeling of safety before entering the emotionally difficult territory required to address mental health concerns. Finding small and large ways to let LGBTQ+ clients know they are welcome, respected, and fully accepted is care that affirms their humanity and builds trust.
A Note on Gender-Affirming Care
Gender-affirming care falls under the larger umbrella of affirming care. The term refers specifically to healthcare for anyone whose internal gender identification is different from the identification that was assigned to them at birth.
Mental health professionals might provide gender-affirming care in individual or family therapy sessions or offer age-appropriate education on the topics of gender and sexuality. Additionally, a mental health evaluation is required for those who choose gender-affirming surgeries.
Many transgender people live with anxiety, depression, and other mental health concerns. According to the Anxiety and Depression Association of America, members of the LGBTQ+ community have up to a 2.5 times higher risk for anxiety and depression than straight and gender-conforming people.
A therapist who understands that these conditions are part of a more complex issue is better equipped to support their clients.
Recognizing Affirming Care
What does affirming care look like, and how do you know when a health professional offers the care you need?
A therapist who offers affirming care is one who has familiarized themselves with issues that are important to the LGBTQ+ community. They may use customized medical forms with multiple and nonbinary gender pronoun options or display versions of the pride flag in their waiting room.
If you’re not fortunate enough to have an LGBTQ-friendly therapist or program recommended to you, it’s hard to know where to start. One option is to ask when you call for an appointment. Any healthcare professional who offers affirming care will be happy to share that information with you.
5 Benefits of Affirming Care for the LGBTQ+ Population
Because those who identify as LGBTQ+ are at greater risk for developing mental health disorders, they might consider making their mental health a priority. Stressors related to work, family, and addiction disorders are universal, but these stressors may be exacerbated by being part of a marginalized group.
For example, in addition to worrying about his sick parent, a gay man might also worry about reaching for his spouse’s hand for comfort in the hospital waiting room. These extra stressors add a significant mental health burden over time.
Other stressors that members of the LGBTQ+ community may face include:
- Rejection from family or peers
- Social exclusion
- Discrimination in the workplace
- Bullying
- Violence and harassment
- Stigma
- Lack of access to affirming support and therapy
Working with a therapist who supports their identity and recognizes the unique challenges they face can improve treatment outcomes for LGBTQ+ clients. That is the primary goal of affirming care.
1. Build Resilience
Resilience is how people cope with psychological stress and adversity. Because LGBTQ+ clients face extra stressors and adversity that the straight community does not, therapists who provide affirming care are better prepared to help their clients build resilience.
Coping strategies may include involving oneself in supportive organizations or connecting with LGBTQ+ peers. Cognitive behavioral therapy can help clients reframe negative thoughts and behaviors to build resilience.
2. Offer Realistic Coping Strategies
Regardless of sexual orientation or gender identity, human beings need coping strategies to deal with life’s everyday problems. Those in the LGBTQ+ community face additional stressors such as harassment for simply being who they are.
Affirming therapists can provide effective and specific strategies for marginalized people. Group therapy programs designed for LGBTQ+ members allow participants to share strategies and learn from the successes of others. The Queer Trauma Recovery Program, for example, focuses on issues that are specific to queer clients as they learn new ways to cope with trauma.
3. Boost Self-Acceptance
LGBTQ+ individuals face discrimination and societal stigma from an early age. It’s nearly impossible not to internalize these negative thoughts and impressions to some degree. It’s even harder for those who lack appropriate support networks or positive role models.
Affirming care includes therapeutic support that helps clients overcome negative self-views. Having a better self-image can increase a person’s confidence and strengthen their personal relationships. Techniques in which therapists advocate for and validate the needs of their LGBTQ+ clients can promote self-acceptance.
4. Connect With Resources
Whether a person is seeking support for depression caused by chronic pain or a substance use disorder, recovery is an ongoing process. Finding LGBTQ+-friendly resources can be difficult, and a client may be concerned about privacy when seeking treatment.
An affirming therapist can put their clients in touch with a myriad of resources, both in-person and online.
5. Address Intersectionality Issues
“Intersectionality” refers to the ways a person’s identities affect their opportunities or lack thereof.
For example, a Black transgender woman raising children alone must overcome obstacles that differ from those of a gay white man with no children. While they are both members of the LGBTQ+ community and must deal with the stressors of marginalization, they face very different challenges.
Affirming care involves understanding and acknowledging these differences. A therapist who practices affirming care recognizes the diverse experiences within the LGBTQ+ community and provides a safe space to explore individual concerns.
Affirming Care and Suicide
A 2023 national survey conducted by the Trevor Project found that 41% of LGBTQ+ youth had considered suicide in the previous 12 months. The number was even higher for nonbinary and transgender youth. Some of the risk factors associated with suicide among this group include:
- Minority stress (marginalization)
- Rejection
- Lack of social support
- Bullying
- Assault
- Discrimination
A lack of affirming spaces is also a risk factor. Providing affirming care may literally be a life-saving action. The Trevor Project’s report indicates that LGBTQ+ youth who have trusted adults in their lives have a lower rate of suicide and a higher rate of self-acceptance.
Young people aren’t the only ones at risk for suicide. However, a study by the Williams Institute at UCLA School of Law found that a majority of suicide attempts among the LGBTQ+ community occurred within five years of the individual first identifying their sexuality.
Therapists who practice affirming care must acknowledge this risk of suicide for clients of all ages. Coming out presents unique challenges that young people may not be prepared to handle emotionally or intellectually. However, years of isolation and discrimination also pose a threat to LGBTQ+ adults.
Affirming Care and Substance Use Disorder
The Substance Abuse and Mental Health Services Administration states that gay, lesbian, and bisexual adults have a higher risk of substance use than straight adults. Adult members of the LGBTQ+ community are two to three times more likely to use illicit drugs and develop a substance use disorder.
Like the higher risk of suicide, the higher risk of a substance use disorder may be related to the stigma, rejection, and trauma LGBTQ+ people face. Some may turn to drugs or alcohol to find temporary relief from these stressors or relief from depression and anxiety.
Concerns about facing discrimination in a recovery program are valid, especially for transgender people. Slurs and microaggressions like misgendering create a hostile environment that prevents healing and may worsen feelings of rejection and isolation.
Addiction treatment programs that are tailored to the LGBTQ+ community provide hope and a safe space for healing to begin.
The Need for Affirming Care
Approximately 7.6% of U.S. adults identify as members of the LGBTQ+ community, according to the most recent Gallup poll. That number represents around 20 million people, and it has doubled since 2012, when Gallup first measured LGBTQ+ identification.
Affirming care involves recognizing that members of the LGBTQ+ community face different challenges than those who are heterosexual. The goal is to create a safe environment for LGBTQ+ clients to receive mental health treatment from professionals who understand the stressors and issues gay, lesbian, bisexual, transgender, and queer people are dealing with.
There are multiple benefits to care that affirms an individual’s lived experience. It enables them to find community resources, improve their confidence, and learn new coping strategies for dealing with challenges. Affirming care may also help reduce suicide rates and assist those seeking recovery from addiction disorders.
Affirming care helps create a healthier society. It does not encourage people to question their gender or offer any agenda except one: access to better healthcare for all.
If you or someone you love is a member of the LGBTQ+ community and needs support for a substance use disorder or another mental health concern, call us at 855.510.4585 or fill out our confidential contact form today.
References
- Brenner, Brad. “Understanding Anxiety and Depression for LGBTQ People.” Adaa.org, 2019, adaa.org/learn-from-us/from-the-experts/blog-posts/consumer/understanding-anxiety-and-depression-lgbtq.
- Matouk, Kareen, and Melina Wald. “Gender-Affirming Care Saves Lives.” Columbia University Department of Psychiatry, Columbia University, 30 Mar. 2022, www.columbiapsychiatry.org/news/gender-affirming-care-saves-lives.
- Mental Health America. “LGBTQ+ Communities and Mental Health.” Mental Health America, 2020, www.mhanational.org/issues/lgbtq-communities-and-mental-health.
- “More than 60% of Suicide Attempts among LGBQ People Happen within Five Years of Realizing They Are LGBQ.” Williams Institute, 1 July 2021, williamsinstitute.law.ucla.edu/press/suicide-coming-out-press-release/.
- The Trevor Project. “Facts about LGBTQ Youth Suicide.” The Trevor Project, 1 Jan. 2024, www.thetrevorproject.org/resources/article/facts-about-lgbtq-youth-suicide/.
- SAMHSA. “SAMHSA Releases New Data on Lesbian, Gay and Bisexual Behavioral Health.” Www.samhsa.gov, 6 June 2023, www.samhsa.gov/newsroom/press-announcements/20230613/samhsa-releases-new-data-lesbian-gay-bisexual-behavioral-health.
- “What Percentage of Americans Are LGBT?” Gallup.com, 3 Mar. 2021, news.gallup.com/poll/332522/percentage-americans-lgbt.aspx.
