Mental health and sexual orientation: What the evidence says

It’s no secret that being different than other people — whether it means your race, gender, or sexual orientation — is often a source of stress in our society. People of minority sexual orientations often feel that stress most acutely. And it’s no surprise.

It wasn’t until 2015 that a federal judge ruled that the 1964 Civil Rights Act protects sexual minorities from employment discrimination. In 31 states, there is still no law that protects employment for people who identify as transgender. And employment discrimination is just one issue.  Rights surrounding relationships and parenting, using public spaces such as restrooms and schooling also create stressful situations.

Two systematic reviews published over the past two years document the emotional and psychological effects of being a sexual minority in American society today.

First, a systematic review published in The American Journal of Public Health in 2016 finds sexual minorities are more likely to attempt suicide during their lifetimes. The analysis combined data from 30 studies including a total of more than 21,000 sexual minority adults. While the results of individual studies varied by their methodology, community-based surveys included in the analysis revealed that 20 percent of sexual minority adults have attempted suicide. By comparison, about 4 percent of the general public attempts suicide.

A second systematic review published in 2015 in the International Review of Psychiatry found that adults who identify as lesbian, gay, or bisexual suffer from depression at significantly higher rates than those who identify as heterosexual; the risks are even higher for homosexual and bisexual youth.

The review included 199 studies investigating the mental health of sexual minorities compared to heterosexual people. Ninety-eight percent of the studies found lesbian, gay and bisexual people, and even those who are questioning their sexuality, are at an increased risk for attempting suicide.

There is also evidence that sexual minorities suffer from anxiety disorders at higher rates and are more likely to abuse alcohol and drugs compared to heterosexual people.

Challenges such as the stigma associated with sexual minorities, discrimination, family disapproval, social rejection, and violence are among the factors that can lead to mental health problems, said Janis Whitlock, a research scientist in the Bronfenbrenner Center for Translational Research and Director of the Cornell Research Program on Self-Injury and Recovery.

“It is increasingly clear that sexual orientation and identity are important factors in understanding health and other well-being outcomes,” she said. “Although the reasons for this are unclear, sensitivity to the relationship between these are critical for protecting vulnerable people and populations.”

The U.S. Centers for Disease Control has recognized the problem, and sponsors research and programs designed to address it, including training for teachers, school clubs for sexual minority students and classroom teaching about sexual orientation.

The take-home message here is incredibly clear: sexual minorities and people questioning their sexuality suffer from mental health problems at higher rates than the general public. This evidence demands new approaches to the ways our society addresses the challenges and needs of lesbian, gay, bisexual, and transgender individuals.

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