The Unique Mental Health Challenges Faced by the LGBTQIA+ Community

But it's important to be clear: being LGBTQIA+ doesn't cause mental health problems. The stress, stigma, and barriers people face from society are what can make things harder. And when you add factors affected by other parts of a person's identity, like their race, religion, where they live, or their age, things can get even more complicated.

At the same time, embracing your identity can be a powerful source of strength. Finding language for your experiences, connecting with supportive communities, and living authentically can boost mental health, build resilience, and create a deep sense of belonging.

In this article, we'll explore how mental health and queer experiences can intersect, and why society needs to do better to support LGBTQ+ people. We’ll also share some tips on how to be a good ally for someone you love if they're navigating mental health challenges or questioning their identity.

LGBTQIA+ Mental Health Landscape

Across the world, LGBTQIA+ folks face unique challenges that put them at higher risk for mental health struggles. Discrimination, stigma, social exclusion, systemic inequalities, and barriers to affirming healthcare all contribute to persistent mental health disparities. In countries like the United States, Canada, the UK, Australia, and beyond, LGBTQIA+ people consistently report higher rates of anxiety, depression, suicidal ideation, and substance use compared to their heterosexual and cisgender peers.

• In the United States, around 39% of LGBTQ+ adults experienced mental illness in the past year, compared to 21% of the general adult population.
• In the UK, a Stonewall study from 2018 found that half of LGBTQIA+ people experienced depression in the past year, and three in five faced anxiety. Alarmingly, one in eight LGBTQIA+ youth aged 18–24 had attempted suicide.
• In Canada, LGBTQ2S+ youth are nearly five times more likely to attempt suicide compared to their heterosexual peers.
• In Australia, LGBTQIA+ folks are at least three times more likely to experience high or very high levels of psychological distress compared to the general population.
• In many other countries — particularly where homosexuality, gender diversity, or same-sex relationships are criminalized — mental health risks are even higher due to fear of violence, legal repercussions, and social rejection (UNAIDS, 2023).

As Jeff Day, DNP, AGPCNP-BC, CNEcl — an expert in LGBTQ+ care — explains, members of the LGBTQ+ community face a greater risk of mental health challenges because of factors like minority stress. "It's a type of stress that people in minority groups experience daily — sometimes hourly or even minute by minute," he says. "Over time, it adds up, becoming a social determinant of health and leading to poorer outcomes for LGBTQ+ folks."

Let's take a closer look at some of the specific mental health challenges that different members of the LGBTQIA+ community may face.

Gay and Lesbian Mental Health

Gay and lesbian folks often encounter both overt and subtle forms of homophobia, which can contribute to chronic stress, anxiety, depression, and feelings of isolation. Growing up with compulsory heterosexuality (or "comphet") — the assumption that everyone is straight — may delay self-acceptance and create feelings of shame or confusion. Religious beliefs, cultural expectations, and fears around family-building or public affection can also impact mental health over time.

Bisexual Mental Health

Bisexual people face challenges like biphobia, bi-erasure, and comphet. Bi-erasure happens when people dismiss bisexuality as "just a phase" or claim someone is "really" straight or gay, while comphet pressures people to default to heterosexuality. Bisexual folks are often judged based on who they’re dating, and many experience the "bi-cycle"—the natural shifts in attraction to different genders, which can make it harder to feel secure in your identity. This invalidation can come from both straight and LGBTQIA+ spaces, which may increase feelings of invisibility, mistrust, and isolation. As a result, bisexual folks are often at higher risk for anxiety, depression, and suicidal ideation compared to their gay and straight peers.

Transgender and Non-Binary Mental Health

Trans and non-binary folks can face some of the most significant mental health disparities, shaped by systemic discrimination, lack of gender-affirming care, and social hostility. Constant changes to government policies, threats to healthcare access, misgendering, deadnaming, and body dysmorphia can all contribute to high rates of anxiety, depression, and suicidality. A lack of positive representation and fears of societal regression — like the recent UK Supreme Court ruling — may further intensify mental health challenges.

Intersex Mental Health

Intersex people often experience trauma linked to non-consensual medical interventions in childhood, as well as secrecy and stigma around their bodies. These experiences may lead to long-term mental health impacts, including anxiety, depression, and isolation. Protecting bodily autonomy, promoting informed consent, and increasing public awareness are key steps toward improving mental health outcomes for intersex folks.

Asexual and Aromantic Mental Health

Asexual (“ace”) and aromantic (“aro”) people may face stigma and misunderstanding in societies that often center romantic and sexual relationships as essential to happiness. This lack of recognition — even within some LGBTQIA+ spaces — can contribute to feelings of loneliness, self-doubt, and exclusion. Affirming Ace and Aro's identities and creating spaces where they are seen and respected are crucial for supporting mental health.

Barriers to Mental Health Access for the LGBTQIA+ Community

For many LGBTQIA+ folks, seeking mental healthcare can be challenging in ways that go beyond logistics. While anyone might struggle to find the right support, queer and trans people often face additional barriers — from discrimination and stigma to a shortage of therapists who truly understand their identities and experiences.

Societal pressures like internalized homophobia, biphobia, and transphobia can also leave deep marks on mental well-being. Growing up in environments where queerness is stigmatized — or not even acknowledged — can lead to feelings of shame and fear that aren't easily shaken, even in adulthood.

As Elana, a 26-year-old lesbian and Feeld member, put it: "I had to unlearn all my internalized homophobia and homophobia from the outside world as well."

For many, these struggles show up not just internally but in relationships, too. Mio, a 19-year-old gender-nonconforming lesbian, shared about a partner: "She had a lot of internalized homophobia that made the relationship difficult. We didn't really talk about that. I also remember it was the first time I felt scared/paranoid holding hands in public, even though I had no problem doing it with my platonic friends. I was afraid they [the public] could see me and my girlfriend's gayness, and would act hatefully towards us."

Internalized stigma can shape how LGBTQIA+ people connect with one another, adding tension and complexity to dating and community building. Niomi, 33, reflected on the challenges she faced while navigating polyamorous relationships within lesbian communities: "I think my biggest challenge as a poly lesbian was navigating metamours. There are so many dynamics stated and unstated, and being careful to get all of the information on a person's relationships before initiating something new with them was a hard lesson. I also struggled while dating studs who had a form of toxic masculinity that needed to be addressed through healthy conversation and therapy. Thankfully, those I've met have been willing to deal with the childhood traumas many of us faced and make an effort towards healing themselves."

For trans and nonbinary people, the layers of difficulty often deepen. As Zabrina, a 33-year-old trans-Feeld member, explained: "For me, it hasn't been a challenge too much. Hetero same-sex friends can be uncomfortable with the fact that you can be attracted to them if they have internalized homophobia. But for me, as a trans person, people are much more likely to be uncomfortable with that. Being trans and those challenges kind of override the challenges of being bi."

Even within the LGBTQIA+ community, experiences of exclusion and insecurity can persist. Tagdh, a 25-year-old non-binary Feeld member, spoke to a quiet fear many nonbinary people share: "I have mostly only felt discrimination based on my gender, never my sexuality. This has never happened within the LGBTQ+ community. But something I am personally insecure about is that if I am dating someone who is attracted to women or AFAB individuals, they will always prefer dating people of those identities over me as an AMAB individual."

Some of the most painful barriers aren't from outside communities but within queer spaces themselves. Rob, a 30-year-old bisexual Feeld member, shared a common frustration: "Some people would have you believe bisexuality is transphobic inherently, which is complete bullshit and just a complete misunderstanding of both language and how people work."

Family expectations and religious backgrounds also continue to shape the mental health journeys of many LGBTQIA+ people. Jas, 31, reflected: "I grew up religious, my mum is still very religious and so being gay in any sort of way wasn't something that was fully accepted in my home. It was when I was around 15 I began to feel as though my ideology around religion came with hurtful and problematic issues such as sexism and homophobia and I removed myself from the church."

Yet even after working through those early struggles, Jas noted that bi+ people often face dismissal from within the LGBTQIA+ community too: "I've had LGBTQ people tell me I'm not bisexual, to my face, which is hurtful after having such a complex relationship with my sexuality growing up. I don't need someone to confirm my identity, I've done that many times myself, but I think it's a real issue within the community, so much so that I don't even feel comfortable in saying I'm part of it because I don't feel as though I am."

All of these experiences remind us that barriers to mental health aren't just external — they can live inside relationships, communities, and even within ourselves.

When LGBTQIA+ folks do seek help, the system isn't always there to meet them. According to The Trevor Project's 2024 survey, 50% of LGBTQ+ young people who wanted mental healthcare in the past year couldn't get it. Among transgender and nonbinary young people, nearly half (49%) were unable to access the care they needed.

The reasons are heartbreaking but unsurprising:

• 42% were afraid to talk about their mental health concerns.
• 40% said they couldn't afford care.
• 37% didn't want to have to get a parent or caregiver's permission.
• 34% were afraid they wouldn't be taken seriously.
• 24% were afraid of being outed.

Access to truly supportive, gender-affirming care shouldn’t be a luxury for LGBTQIA+ folks — it's essential for survival, healing, and joy.

Resources and Support Systems

Finding support can feel overwhelming, especially when you're already navigating so much. But the right help does exist, and you deserve care that truly sees and affirms all of who you are.

If you're looking for mental health support, it's crucial to connect with a therapist who is LGBTQIA+-affirming. Someone who understands the complexities of queer and trans experiences and who will hold space for you without judgment.

Many therapists offer a free 15-minute consultation before you commit to working with them. It's a great opportunity to find out how they work and see if you're a good fit for one another. 

Psychology Today has a great guide on how to find an LGBTQ+-friendly therapist and suggests asking some of your own questions beforehand. As much as a therapist is trying to get to know you, you also want to get to know them. Here are some simple questions you could ask:

• Have you worked with LGBTQ+ clients before?
• Have you supported transgender or nonbinary people in your practice?
• Do you have experience helping people who question their sexuality or gender identity?
• Have you helped clients come out?
• Have you helped someone transition?

Choosing a therapist who truly affirms your identity can make a huge difference. It's okay and important to advocate for yourself until you find someone who feels safe and supportive.

Beyond one-on-one therapy, LGBTQIA+ community support groups can be a powerful source of connection and healing. Whether you're looking for peer support, specialized help, or just a reminder that you're not alone, there are spaces built with you in mind. Some great places to start:

• The Trevor Project (thetrevorproject.org) offers 24/7 crisis support via text, chat, or phone for LGBTQIA+ young people.
• Trans Lifeline (translifeline.org) is a peer-run support and crisis line by and for trans people.
• Switchboard (switchboard.lgbt) provides confidential helplines and resources for LGBTQ+ folks in the UK.
• MindOut (mindout.org.uk) offers mental health support specifically for LGBTQ+ communities.
• Feeld community spaces — including roundtables and workshops — are also designed to offer a safe, affirming place for exploration, discussion, and solidarity.

Support doesn't always have to look like formal therapy. Sometimes, it's a late-night text to a friend who gets it or an online forum where you can speak your truth without fear. The important thing is knowing that you are not alone and that seeking support is a radical, powerful act of self-care.

How Can Mental Health Services for the LGBTQIA+ Community Be Improved?

While progress has been made, there's still a long way to go when it comes to creating mental health services that truly meet the needs of the LGBTQIA+ community. Right now, too many LGBTQIA+ folks still face barriers — from a lack of affirming therapists to services that don't recognize the unique challenges they experience.

So, how can we build a system that better supports LGBTQIA+ mental health?

First, services need to be built around affirmation, not assumption. Therapists, counselors, and healthcare providers must actively affirm their LGBTQIA+ clients' identities — using correct names and pronouns, respecting fluid or evolving identities, and understanding the real impact of societal stigma and discrimination. Mental health spaces should feel safe, welcoming, and free of judgment from the moment someone walks through the door — or logs into a session.

Training and education are key, too. Research shows that LGBTQIA+ cultural competency training makes a measurable difference: when therapists and healthcare professionals are properly educated about LGBTQIA+ identities and mental health needs, people report feeling more respected, understood, and safe during sessions (Journal of Homosexuality, 2018). This kind of affirming care can be the difference between someone seeking help or avoiding it altogether out of fear of discrimination.

Community-led initiatives are another crucial piece. Programs and services designed by and for LGBTQIA+ people are more trusted, more accessible, and ultimately more effective at improving mental health outcomes (NIH LGBTQ+ Health Disparities Research). When LGBTQIA+ folks see themselves reflected in leadership, policies, and practices, it builds trust — and trust supports healing.

On a larger scale, stronger policies and protections are urgently needed. We need mental health systems that prioritize accessibility and affordability for LGBTQIA+ communities and actively fund LGBTQIA+-specific support programs. Advocacy efforts must push for comprehensive insurance coverage — including transition-related services and therapy that affirms, rather than pathologizes, LGBTQIA+ identities.

The Role of Community and Ally Support

When it comes to mental health, no one thrives alone — and for LGBTQIA+ people, having a supportive community can be truly life-saving.

According to The Trevor Project's 2024 National Survey, young LGBTQ+ people who had access to affirming homes, schools, communities, and online spaces reported lower rates of attempted suicide than those who didn't. Simply being surrounded by people who respect and affirm who you are can make all the difference.

For transgender and nonbinary youth, affirmation of their gender identity is especially powerful, and linked to even lower rates of suicide attempts. It doesn't take a whole system to create change either: 78% of LGBTQ+ students said they had at least one adult at school who was supportive of their identity — and that alone was associated with better mental health outcomes.

Support isn't just about reducing harm — it's about helping people truly flourish.

Research from the University of Texas at Austin found that LGBTQ+ young people who felt supported and affirmed by parents and guardians reported fewer symptoms of depression than those who faced rejection at home.

Family and friends can play a valuable role in supporting the mental health and well-being of LGBTQ+ people. Here are some simple yet effective ways you can help:

• Learn and stay curious. Take time to understand LGBTQIA+ identities, the challenges folks face, and the warning signs of mental health struggles. Keep learning — even when it's uncomfortable.
• Listen with real compassion. Sometimes the most powerful thing you can do is simply listen — without judgment, assumption, or trying to fix anything. Just being there matters.
• Affirm and respect identities. Use the names and pronouns someone shares with you. Respect their journey, even if it's different from what you expected or understood before.
• Help create safe, welcoming spaces. Whether it's at home, at school, at work, or online, make sure LGBTQIA+ folks feel safe, included, and celebrated — not just tolerated.
• Support access to care and community. Help connect people to LGBTQ+-affirming mental healthcare, peer groups, or community spaces. Sometimes, just knowing supportive options exist can lift a huge weight.

You don't have to be an expert to make a difference — you just have to be willing to show up, listen, and learn. 

Society still has a long way to go when it comes to fully embracing and supporting LGBTQIA+ people. That's why it's so important to keep pushing for spaces where everyone feels safe, seen, and valued — and to keep having conversations that break stigma and build understanding.

If you're figuring things out yourself — whether it's your sexuality, gender, or simply your next step — you're not alone. You might find this guide on navigating dating as a closeted person is helpful if you're moving through dating and questioning your identity at the same time.

And if you're thinking about mental health support, therapy can be a powerful tool. Hearing from others can make it feel a little less intimidating — you can read five therapists talk about therapy and what it's really like here.

Above all, remember: you deserve love, care, and support — from others and from yourself — exactly as you are.