A Complete Guide — Talkspace

A Complete Guide — Talkspace

Risk Factors That Can Impact LGBTQIA+ Mental Health

There are multiple risk factors that can have a significant effect and impact on those who are LGBTQIA+. 

“LGBTQIA+ individuals are at higher rates for depression, anxiety, suicidality, substance use disorder, homelessness, and unemployment. The coming out process can be difficult, especially for a LGBT youth. This process can be very anxiety-provoking, and it can be very difficult if the young person does not have supportive friends or family members to navigate work, school, and relationships. Additionally, mental health outcomes for this community are poorer than for heterosexual individuals. There can be issues of bias and discrimination in treatment. LGBTQ therapists can offer useful guidance, reassurance, and advice to help you navigate difficult situations without causing further anxiety.”

Talkspace therapist Reshawna Chapple, Ph.D., LCSW

Some of the most important risk factors to recognize are listed below.

The decision to come out

Despite the fact that we see increased societal acceptance for the LGBTQIA+ community, much work still needs to be done. Many still feel that the social experiences they have after coming out contribute to a negative mental health impact. This is especially true for those who aren’t in supportive or accepting environments.

Making the decision to come out as a young person might be one of the bravest things you’ll ever do in life. For many people, it doesn’t come easy. However, therapy can help you feel confident and give you the strength you need to live an authentic life and be true to yourself.


Many young adults in the LGBTQIA+ community report experiencing some form of discrimination in their life. Homophobia, transphobia, biphobia, LGBTQ bullying, and more can all contribute to identity-based shame that’s traumatic for individuals. 

People report feeling labeled, being denied opportunities, being stereotyped, or experiencing mental, verbal, or physical abuse as a result of their identity. Many times, this trauma can result in severe mental health conditions such as post traumatic stress disorder (PTSD).

Trauma can contribute to many mental health conditions. Through therapy, you can learn how to handle harmful thoughts or behaviors and heal from trauma you’ve experienced in your life.

Rejection or fear of rejection

The fear of rejection after coming out, or actually being rejected after coming out, would be difficult for anybody. Particularly if it’s family members or close friends who aren’t accepting, the mental health impact of rejection can be traumatic and extremely difficult to navigate.

Whether you’ve recently come out and are facing rejection, or you want to come out but are afraid of being rejected, a good therapist can help you set boundaries and heal from your fear or pain. 

“Navigating relationship stress is difficult enough without having to explain what it feels like to be part of this community. There can also be guilt, shame, or embarrassment associated with their sexual orientation. LGBTQ-friendly therapists can offer useful guidance, reassurance, and advice to help you navigate difficult situations without causing further anxiety,” Chapple said.


It’s a staggering statistic: it’s estimated that LGBTQIA+ youth have a 120% higher chance of becoming homeless in their lifetime. 

Some of the challenges members of the LGBTQIA+ community face that often contribute to homelessness include family rejection, discrimination at work, school, or home, and an increased chance of abuse and harassment in their social and living environments. 

Support and therapy is available and can be helpful if you’re having trouble finding housing or need resources to find a safe space. 

Substance use or abuse

Substance use or abuse can be overwhelming for members of the LGBTQIA+ community. The following statistics around LGBTQ substance abuse speak volumes.

  • Adults who identify as LBG are more than twice as likely to have a substance use disorder.
  • Those who identify as transgender are almost 4 times as likely as those who are cisgender to have a substance abuse disorder. 
  • School-aged youth who identify as LGB, or those who are not sure about their identity, report a much higher instance of illicit drug use than peers who identify as heterosexual do.

Group or individual therapy can be helpful in managing addiction. It can help you learn better, healthier coping techniques if you’re using substances to mask any pain. 

Mental health care that’s inadequate or ineffective

Unfortunately, inadequate or inappropriate mental health care is common for the LGBTQIA+ community. The biggest issue comes from the fact that often the approach taken in addressing sexual orientation or gender identity and mental health is lumped together as one large issue. Yes, it’s true that some challenges do tend to overlap across identities. But there are separate, specific, and important needs that are within each individual group. 

Everything from the challenges faced, to the conditions experienced, should be addressed and treated from a unique and individual standpoint. Treatment and therapy should be directly based on each person’s own needs and goals when seeking mental health treatment. 

Barriers to proper mental health care

Other important factors when looking at mental health care for the LGBTQIA+ community are the barriers they’re likely to face simply even accessing care. Economic status, race, and other identity factors can all have a strong impact on what type of care someone receives. It’s essential that we address these barriers and focus on LGBTQIA+ inclusive mental health care that’s specific to individual identities and needs. 

Therapy can help you on a number of fronts. Finding the right therapist will be instrumental in how effective your treatment is. 


The LGBTQIA+ population is at a higher risk than cisgender or heterosexual populations when it comes to thoughts of suicide or direct suicide attempts. Depression, anxiety, isolation, a history of mental health struggles, and other mental health conditions are all contributing factors to the increased risk for suicide.

Therapy can offer a much-needed outlet to learn coping techniques and strategies to handle suicidal ideation and thoughts you may be experiencing. 

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