Mental health risk factors facing the LGBTQ+ community

California State of Mind Essentials

By Katie Dineen

In middle school, Juan Acosta was teased about his sexuality, something he didn’t fully understand yet. As a consequence, he struggled with his mental health and at one point even contemplated suicide. In an interview for our My Mental Health Journey series, Juan says, “I felt like such a big part of my being was intruded by assumptions that although were not wrong, made me feel ashamed for being who I was.”

Only when Juan gained a support system could he fully embrace his sexuality and discover his ability to make systemic change. Now a mental health advocate, he knows how important it is to provide LGBTQ+ youth with resources and support.

The safety and health of LGBTQ+ youth are often threatened, with 73% report experiencing discrimination based on their sexual orientation or gender identity. There are several risk factors that highlight this discrimination and explain why LGBTQ+ individuals are twice as likely to experience a mental health condition.

Coming Out and Rejection

Disclosing sexuality or gender identity can be a vulnerable experience. But for people whose family, friends, culture or faith community reject their sexual orientation or gender identity, coming out can be traumatic. Without a support system or positive environment when coming out LGBTQ+ youth often face ostracism alone, with 2 in 5 youth living in a community that is unaccepting of LGBTQ+ people.

Without support from loved ones, LGBTQ+ youth must look elsewhere for mental health care. But safe spaces are few and far between.

Despite California’s legislative protections, LGBTQ+ youth can be overwhelmed by the cost of healthcare, as insurance restrictions limit their access. Some LGBTQ+ youth face bias and find their sexuality or gender identity blamed for their mental illness. Others struggle to find providers that understand them or their stories. Discrimination silences LGBTQ+ youth causing them to avoid care or hide their sexual orientation or gender identity. Some are even forced into unsafe living situations or habits.

Statistics from the 2022 Trevor Project National Survey on LGBTQ Youth Mental Health

Homelessness and Substance Use

There are two key consequences of rejection and discrimination that LGBTQ+ youth experience at higher rates than their peers who are heterosexual: homelessness and substance use. LGBTQ+ youth have a 120% higher risk of experiencing homelessness, a risk that is even greater for Black and Native American/Alaskan Native youth. Many become homeless because of poverty or being kicked out of an unaccepting home. Homeless LGBTQ+ youth can find it difficult to locate inclusive homeless shelters and regularly face harassment when there.

Many turn to illicit drugs to mask the depression and anxiety that develop as a result of discrimination, rejection, and isolation. LGBTQ+ adults are nearly twice as likely as heterosexual adults to experience a substance use disorder, while drug use is significantly higher among LGBTQ+ teenagers compared to heterosexual peers. If intervention and prevention resources are not provided to LGBTQ+ youth, mental illness can worsen and lead to hospitalization or suicide. To better support LGBTQ+ youth we must create safe and affirming spaces where they have access to mental health resources and can be open about who they are.

Once Juan Acosta learned about mental health and came to understand his own, he was able to open up to his family. “I learned about their own struggles and to this day I have a relationship with my parents that we are open about what we’ve gone through,” he reflected. Juan’s journey is an urgent reminder of the importance of providing youth with resources so these conversations are safe and possible.


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