In many places, society has become more open and inclusive, and in others it has moved backward. Either way, LGBTQIA+ people still face real challenges every day. Stories of discrimination, harassment and violence haven’t gone away, and in recent years a wave of laws and political attacks, many aimed at transgender people, has made life feel less certain for a lot of people in the community.
It’s also worth remembering that in some countries, being LGBTQIA+ can still mean prison or worse. For this article, though, I’m focusing on the challenges the community faces here in the US, what they do to mental health, and what the rest of us can do about them. As an LGBTQIA+ affirming therapist in Los Angeles, these are things I hear about often, from individuals and from couples.
The LGBTQIA+ community
The community includes, but isn’t limited to, lesbian, gay, bisexual, transgender, queer, intersex, asexual, nonbinary and two-spirit people. The plus sign at the end is there because sexuality and gender are experienced differently by everyone. They’re better understood as a spectrum than as fixed, separate boxes, and the words people use for themselves keep growing and changing. When in doubt, use the words a person uses for themselves.
What challenges do LGBTQ people face?
1) Bullying and harassment
Some people believe bullying someone for their sexuality or gender is a thing of the past. It isn’t. National surveys by organizations like GLSEN and The Trevor Project have consistently found that LGBTQ+ young people experience bullying and harassment at school and online far more often than their peers, and that many don’t feel safe at school. Much of it now happens on phones and social media, which means it can follow someone home.
The effects of bullying often last well into adulthood. Many people who were bullied grow up carrying low self-esteem, self-doubt and difficulty trusting others. These experiences can also shape adult relationships, showing up as fear of being rejected or a habit of hiding parts of yourself.
Therapy can help people work through what happened and how it still lives in their body and their relationships. It can feel hard to find a therapist who truly understands, and I don’t want that to stop anyone from looking.
2) Rejection
Rejection from family, friends, a faith community or society can be deeply painful, emotionally and psychologically. Unconditional love and openness aren’t always taught at home, and family norms and beliefs often carry prejudice from one generation to the next.
Every human needs to belong. We’re wired for connection, and rejection by the people we love can hurt our self-worth and mental health more than almost anything else. Research from the Family Acceptance Project at San Francisco State University has found that LGBTQ+ young people who experience strong family rejection face much higher risks of depression and suicide attempts, while family acceptance is protective. That’s reason enough to take family acceptance seriously.
Many LGBTQIA+ people build chosen family: friends and partners who become the people they turn to. Chosen family can be a real source of strength and belonging, and it deserves to be treated with the same seriousness as any other family.
3) Discrimination at work
Federal and California law protect people from employment discrimination based on sexual orientation and gender identity. In 2020, in Bostock v. Clayton County, the US Supreme Court ruled that firing someone for being gay or transgender violates federal civil rights law. California’s own protections go further.
Laws on paper don’t always match what happens in practice, though. LGBTQIA+ people still report being passed over, harassed, or feeling they have to hide who they are at work, especially in parts of the country with fewer protections or more hostile politics. Transgender and nonbinary people often face the most discrimination in hiring and in the workplace.
4) Depression and anxiety
Depression and anxiety affect many people, and LGBTQIA+ people experience them more often. That isn’t because there’s anything wrong with being LGBTQIA+. Psychologist Ilan Meyer described it as minority stress: the extra, ongoing stress of living with stigma, discrimination and the need to stay on guard. Over time, that stress wears on mental health.
On top of outside pressure, many people also carry the inner work of understanding their identity, deciding when and how to come out, and sometimes absorbing the negative messages they grew up with. None of that is easy, and it can be heavier when the news cycle feels hostile.
If you or someone you love is in crisis, call or text 988, any time. LGBTQ+ young people can also reach The Trevor Project’s 24/7 lifeline at 1-866-488-7386.
What now?
Now that we’ve looked at some of the most common challenges the LGBTQIA+ community faces, the question is: where do we go from here?
Education
Families, schools and workplaces need to take these issues seriously. Teaching both children and adults about inclusion and diversity helps build a safer world. It also helps to encourage curiosity and honest reflection. Ask yourself where your beliefs about gender and sexuality came from, and whether they hold up when you look at them closely.
Emotional support
We all need connection, respect, validation and support from others. LGBTQIA+ people especially need it from family, friends and allies, because so much of the world may not offer it.
The first step is validation. Acknowledge what the person is going through and let them know you’re there. Something like, “I see what’s happening to you, and I’m sorry. I want you to know I’m here for you no matter what,” is a good place to start.
Then listen, and don’t make assumptions. Everyone’s experience is their own. When you show up for someone in the community, try not to project your own worldview onto them. Focus on what’s true for them.
Social justice
If you’re part of the community, or an ally, there are many ways to show up for equality: supporting LGBTQIA+ organizations, speaking up when you hear something harmful, voting, volunteering, or simply being visibly supportive in your family and workplace. Showing up matters, and it doesn’t have to be big to count.
Therapy
The mental health field has changed a lot. Being LGBTQIA+ is not something to be treated or fixed, and major professional organizations recognize so-called conversion therapy as harmful. Many therapists today identify as LGBTQIA+ or work as affirming allies. You shouldn’t have to educate your therapist about your life or worry that they’re working from outdated beliefs.
If you’re looking for an LGBTQIA+ affirming therapist, a few tips:
- Check that they’re licensed and have relevant experience.
- Notice how they respond when you mention your sexuality, gender or relationship structure.
- Ask directly about their experience with LGBTQIA+ clients.
- Schedule a consultation to see if they’re a good fit.
- If it doesn’t feel right, keep looking until you find someone who does.
I’m an LGBTQIA+ affirming, sex-positive therapist, and I also work with polyamorous and non-monogamous relationships. I see adults in individual therapy, and I work with queer couples and partners on the things that come up in relationships, including minority stress, coming out at different paces, family acceptance and building a life together. You can read more about that in LGBTQ+ couples therapy and on my page about polyamory and non-monogamy.
If you’d like to see whether we’re a good fit, you can book a free 20-minute consultation. No pressure, just a conversation.
