by Clemens Egger (he/him), 30 May 2023

That was concluded by a recent German study from 2021. Further research comes to similar conclusions. Whether it’s mental disorders like depression, mood and anxiety disorder or just the feeling of loneliness. LGBTQIA+ people are at higher risk. In the following article we will unpack the question why that is the case.

The scientific landscape on the disparity between LGBT youth and cis-gendered heterosexual youth concerning mental health issues is vast. For example: LGBTQIA+ people are three times more likely to suffer from depression or burnout, the German Institute for Economic Research (Deutsches Institut für Wirtschaftsforschung e.V.) concluded. Additionally, 26% of these participants have already been diagnosed with a depressive disorder. That is two and a half times more than the rest of the population. But the mental health disparities are not only present between queer and heterosexual people. Also, within the LGBTQIA+ community the risk differs. Therefore, 40% of transpeople within the study’s population suffered from anxiety disorder, in comparison to only 6% of cis-gendered LGBTQIA+ participants. In addition, 11% of trans people reported that they have been diagnosed with an eating disorder. This is three times the frequency of cis-gendered people within the LGBTQIA+ group. Disparities in depressive symptoms were also found between individuals from different ethnic groups. These findings might already seem very drastic, which they are of course. But, it get’s worse if we dare to look through the database of the Risk Behavior Surveillance System (YRBSS).

This data indicated that in 2019 almost 47% of American LGB (study only included participants identifying as lesbian, gay & bisexual; didn’t include transpeople) adolescents have seriously considered suicide. Even 40% of the participants made a suicide plan and around 23% actually attempeted suicide. In comparison, ‘only’ 6% of the heterosexual participants reported attempting suicide. A study in the Journal of Interpersonal Violence conducted that 82% of transgender individuals have considered killing themselves and 40% have attempted suicide, with suicidality highest among transgender youth. Additionally, there are differences in the rates of substance use among LGBT youth, a meta-analysis from 2014 concluded. Compared to their heterosexual peers, they often consume more cigarettes, alcohol, marijuana, cocaine and ecstasy. These results are also reflected in the YRBSS where sexual minority youth have elevated rates of substance use, compared to their heterosexual peers. So to conclude: LGBTQIA+ people are more likely to suffer from mental disorders which can then lead to either higher usage of drugs or even worse - lead to suicide. Sounds depressing? Well it is.

But, all those numbers aside. Why is it, that LGBTQIA+ people are at higher risk to suffer from mental disorders, substance use and suicidality? Well, the Minority Stress Theory by IIan Meyer has the answer.

The Minority Stress Theory (short MST) was developed by IIan H. Meyer who is an American psychiatric epidemiologist and a senior scholar for public policy and sexual orientation law at the University of California, Los Angeles. He proposes that mental health disparities for LGBTQIA+ people can be explained in large part by stress. Factors that lead to stress are defined as stressors which can be understood as a stimulus, that threatens the optimal functioning of a person’s cognitive perception. The underlying assumption of the concept according to Meyer is that minority stress is unique. This means that minority stress adds to the general stressors experienced by all people and thus requires stigmatized individuals to make an adjustment effort that is beyond the level of effort of people who are not stigmatized have to make. A general stressor could be work related stress, for instance.

Moreover, minority stress is chronic and socially based. In other words, the Minority Stress Theory suggests that LGBTQIA+ people experience distinct and chronic stressors that are related to their stigmatized sexual orientations and gender identities. Experiencing continuous discrimination, prejudice, rejection, victimization, harassment and oppression can lead to the feeling of stigmatization which places LGBTQIA+ people consequently at the risk of developing a mental health disorder. Studys show that external stress based on factors like expectations of rejection, internalised trans- and homophobia, and concealment are significantly associated with increased depression, suicidal ideation, and suicide attempt. A meta-analysis on the question if minority stress predicts substance use in sexual minority adolescents concluded that negative disclosure reactions were significantly related to higher rates of substance use among LGBTQIA+ youth. Negative disclosure reactions can be understood as the lack of support from parents, friends or the overall societal rejection after coming out. There is reason to believe that people who take longer to disclose their sexual or gender identity deviate from more traditional gender norms and heterosexism, which leads consequently to higher levels of internalized homophobia. And people with higher levels of internal homo- and transphobia will be more likely to suffer from minority stress and consequentely substance abuse. Other risk factors for substance abuse, in addition to negative disclosure reactions are the experience of victimization, threats or violence. As already mentioned in the beginnning of this article, the scientific research concerning minority stress and its consequences is far-reaching. But all studys share one bottom line: The life of queer people in a heteronormative society is fraught with risks.

The discrimination and violence that LGBTQIA+ people continue to experience today has extensive psychological consequences, as science shows. Discrimination can take many different forms. From insensitive use of language, to exclusion and bullying or structural discrimination. But they are all rooted within a heteronormative foundation. In this regard, the question arises as to what we can do to prevent or reduce minority stress. Firstly, addressing the root causes of these stressors is key when it comes to preventing minority stress. This can include the promotion of cultural competence and inclusivity through education and training programs. It is important to encourage an open and honest dialogue about differences, biases, and discrimination and by engaging in advocacy and activism you can achieve that and consequently promote social and political change. Implementing anti-discrimination policies and enforcement mechanisms can help to prevent minority stress on a structural level. On an individual level we need to provide support and resources for members of minority groups, which can include therapy or counseling. Ultimately, preventing minority stress requires a collective effort from individuals, organizations, and communities to create a more just and equitable society.

The experience of minority stress can be debilitating and overwhelming, leaving individuals feeling isolated, hopeless, and powerless. But it is important to remember that we are not alone in this struggle, and that there are people and resources available to support us. By working together to address the root causes of minority stress, we can create a more just and inclusive world, free from the burden of prejudice, discrimination, and social injustice.