It’s an unequivocal fact that LGBTQ+ people experience depression, anxiety, self-harm and suicidal thoughts more than our heterosexual counterparts.

Report after report tells us this. In fact, our own survey of 219 people told us that 95% of all respondents said they had experienced depression, anxiety or other mental health issues. 53% said they had thought about taking their own life, and 16% had tried to take their own life.

Although we have made significant strides in talking openly about mental health issues as a community and as a society, it’s still often taboo, and the support services available are limited and don’t cater to the LGBTQ+ experience.

What challenges do we still face? What is the main cause of our poorer mental health? What can we do to change it?


WHAT’S THE CAUSE?

The 95% of respondents who told us they experience depression, anxiety and other mental health issues, also offered us what they think are some of the root causes of their poor mental health:

  • 65% said they have low self-esteem
  • 52% told us that a relationship or relationships was the cause
  • 51% said they don’t feel attractive
  • 46% said isolation
  • 39% said it’s because of their sexuality
  • 38% said issues around their employment status
  • 33% said money worries
  • 31% said it was their sex life
  • 28% said social media pressures
  • 25% said struggling with coming out
  • 25% said dating/sex apps
  • 20% said death of loved one
  • 18% said homophobic bullying
  • 18% said bullying in general
  • 17% said rejection by family
  • 13% said rejection by community
  • 12% said prejudice
  • 8% said religious reasons
  • 8% said living with an HIV diagnosis
  • 7% said fear of HIV
  • 5% said addiction to alcohol
  • 3% said addiction to drugs

Ian Howley, Chief Executive of LGBT HERO, the parent organisation behind FS said, “These results do not surprise me one bit. All the national statistics show that LGBTQ+ people are up to five times more likely to be affected by mental health issues in comparison to the general population. We are also up to seven times more likely to try and take our own lives. This is unacceptable in this day and age and we need to be doing more to tackle the root causes of these findings.” 

DIGITALLY DANGEROUS?

Something that seems to be increasing pressure on LGBTQ+ people is the all-encompassing reach of social media platforms and dating and sex apps. While this isn’t something new to our community (we are always early adopters), it’s become ubiquitous and the ensuing pressures from these platforms reaching deeper and wider.

“I use dating and sex apps but nobody is interested in me,” Simon from Sussex tells us. “I can’t be somebody I’m not, but nobody is interested. I’ve been single for eight years. I’m happy and fulfilled in the rest of my life, but the constant going to bed alone and waking up alone gets me down big time.”

“I think, particularly in the gay community, that sex and the use of apps to find it are accepted as a necessity. Club/bar culture is faltering as a consequence so opportunities for meeting and connecting with people are more limited than before,” Mark, 31, from Scotland, says. “And with a younger generation of people who are reliant on apps for meets, people’s perceptions and expectations have changed. If you don’t adhere to a certain type of category as defined by the person on their app profile you can and will be blocked and opportunities to meet may never arise. This level of expectation and perceived rejection can undermine someone with limited self-confidence and lead to further introspection and nervousness about meeting people generally.”

“As I get older, the ways I’ve tended to find connections and partners have become less effective. Also, the over-reliance on app methods has contributed to a developing sense of social anxiety that can be crippling at times,” says Simon, 45, from London.

Sometimes, using dating and sex apps opens up the gateway to something much darker. Cam, 22, from Scotland tells us his story:

“I met with a guy on Grindr and we began to have sex until he began to forceful and manipulative of me. He knew I had never had anal sex before and used that to pressure me. The assault really messed up my mental health and made me have severe anxiety about a possible HIV diagnosis. I had a close friend who I confided in shortly afterwards who called me emotionally manipulative and she did not believe me. Major breaches in trust lead me to not trusting sexual health results, nurses and significant relationships in my life. It disrupted my ability to cope with daily life especially at a time of immense pressure at university. I know have a chronic mistrust of gay men and sex altogether. I also have struggled to access PrEP in Scotland as a method of HIV prevention as I did not my request. This has led to more anxiety about getting intimate with someone again until I get PrEP. I had never had bad mental health issues before this. It was a tough and traumatic time.”

“We know that isolation and loneliness are issues for many gay and bisexual men.” says Ian Howley of LGBT HERO. “This is why many of us use apps as a way to connect with others. You just have to look at Twitter and Instagram to see the power they have to build an online community. However, if you are not getting the same attention as others, it can really impact your self-esteem.We also know lots of gay and bisexual men engage in sexual practices, not because they want sex but as a way to connect with others. Feeling isolated or lonely can lead to some men engaging in acts that affect their health and wellbeing. There’s some research to show that men who are engaging in chemsex do so as a way to make friends.

“Sexual assault is also an issue within the community. It happens more often than we think, however many gay and bisexual men don’t reach out for support afterwards. It’s important that if you have been sexually assaulted in any way that you seek support, as it can lead to long term issues with trust, confidence and mental well-being issues.” 

Ian continues, “Feeling isolated or lonely can have a huge impact on our health and wellbeing and can lead to many feeling lost, alone, unworthy and not part of a community. We need to find a solution to this as it will only lead to more health and social inequalities for LGBTQ+ people.”

AESTHETIC PRESSURE

Body image issues run deep, particularly in the gay community, with 51% of you telling us that you don’t feel attractive enough.

“There is constant pressure in the gay community to look a certain way. It makes me regularly feel unattractive. Having to constantly battle with my weight prevents me from going out on the scene,” says Cris, 50, from London.

“Since coming out I’ve been invisible in the gay community,” believes Richard, 41, from London. “I’m average looking, which means I’m easily overlooked. I’m not rich or hung, so I don’t exist on the apps. I always crave attention, but push people away.”

“The pressure to look good, ‘live your best life’, and be everything that someone should be is too much. I just feel like I fail all the time. My last relationship ended and I don’t feel strong enough to get hurt again but I hate being alone. I look for sex all the time for validation but no matter who I sleep with I still feel worthless. I can hook up with hot guys but if one rejects me, then I take it very personally. If I feel like I’m about to become depressed again, I just start crying because I’m so worried about being so low again and the path I may go down,” Thomas, 34, shares with us.

Ian Howley of LGBT HERO, says: “The pressures of body image are certainly not a new phenomenon. Social media and apps have replaced magazines as the main cause for someone to develop body image issues and we all see it all the time. We celebrate abs and muscles more than academic achievements. That shirtless selfie gets far more engagement than winning an award. This is something we all need to accept and we’re never going to be able to change that. What we need to do is work on our own issues with body image so that the sight of seeing someone with their shirt off does not impact our own self-esteem and self-worth, however I know saying that is easy, putting it into reality is another thing.

Ian continues, “Self-esteem and self-worth are words thrown around a lot lately. But what do they actually mean? It doesn’t mean that you are an all confident super-human being who isn’t affected by others. It’s about being in a place where you can manage those feelings in a productive manner where it doesn’t lead to health and wellbeing issues. We all need to work to get there.” 

GROWING UP

Much of the trauma and hurt that can affect our mental health stems from our childhood and teenage years. Many of you told us that your experiences growing up have severely impacted the way you are today.

“My father rejected me and chucked me out of home when found out I was gay,” Ken, 58, from Hertford tell us. It took me ten years to come to terms with coming out. I didn’t have parents to help when finance was tough. The upshot is that I’m probably stronger, but several times I wanted to end it all and felt that everyone would be better if I was dead. My friends got me through it.”

Chris from London shares his experience: “I first felt depressed and suicidal while at secondary school, where I was bullied, and then it has returned when struggling academically at university, then later with employment. Sexuality has never been overtly an issue but I feel it contributed to me being perceived as different and therefore a target for bullying. Also, I’ve always felt isolated from both the straight world but also the LGBT community which I’ve never found a comfortable place in.”

“When I was younger, I was bullied for being strange and not fitting in. As I went into secondary school I was bullied for being feminine and gay. Going to university, I felt that I didn’t fit in with the gay community or the rest of society. Even when I moved to Brighton I struggled to fit in until I accepted myself more and spent a year in therapy dealing with childhood and relationship trauma,” says Jack, 23, from Brighton.

"It was due to bullying and struggling to make friends and fit in,” explains Harry, 31, from Newport. “At that time, I did not realise I was trans, but knew (and everybody else seemed to know too) that I was ‘different’. I was especially badly bullied in PE in the changing rooms as the girls seemed to pick up on me being different, and would say things like ‘I’m not changing by the lesbian’. I wasn’t a lesbian, but clearly, they picked up on something masculine about me. When I got to university, I realised I was trans, and had a breakdown, culminating in self-harming and a diagnosis of depression and anxiety. I had a four year wait for hormones, and during this time, I didn’t always pass and had very low self-esteem. My family struggled to accept me as a trans man. As well, I had financial difficulties, doubtless influenced by the fact that as a pre-T trans man, I looked very young and inexperienced, which didn’t help me when trying to get a job. All this made my mental health very poor. Since being on T and having top surgery, my mental health is generally much better, although currently I am struggling due to the intense media focus on trans people.” 

Ian Howley, says, “Your teenage years are supposed to the time where you develop coping mechanisms to deal with the issues adult life will bring. However, many LGBTQ+ people do not have those in place or have to deal with major life issues at such a young age. This is why people who have to parse their sexuality or gender identity struggle, and this can lead to mental health issues.

Ian adds, “Many of us try to find our place in the community only to come up against walls and boundaries. It’s not what we first expect. We are told that we are part of a wider community and our identities and sexuality should bring us together and support one another. Though, as we often see, this can be the exact opposite. I think that we as a community do need to become better at opening up to others but also we must understand that people are people and not everyone will be nice or welcoming. As a community need to find better ways to support these people as they are going through their issues, while laying down the foundations of better support for future generations.”

THROUGH THE AGES

Our survey highlighted many generational commonalities and differences with mental health.

96% of 18-34 year olds said they had experienced experienced depression, anxiety or other mental health issues. Their main concerns were:

  • Low self-esteem – 63%
  • Relationships – 61%
  • Not feeling attractive – 58%
  • Isolation – 45%
  • Social media pressures – 42%
  • Dating/sex apps – 42%

In comparison, 95% of 25-54 year olds said they had experienced experienced depression, anxiety or other mental health issues, with the leading factors being:

  • Low self-esteem – 69%
  • Isolation – 52%
  • Relationships – 48%
  • Not feeling attractive – 45%
  • Sexuality – 40%
  • Employment – 40%

91% of people aged 55+ said they had experienced experienced depression, anxiety or other mental health issues. The top concerns included:

  • Rejection by family – 50%
  • Low self-esteem – 50%
  • Sexuality – 37%
  • Relationships – 37%
  • Not feeling attractive -37%
  • Isolation -25%

Many of the issues facing us seem to be universal, with low self-esteem appearing prominently across every age group. However, social media pressures factor more for people under 34-years-old, whereas general life concerns, such as employment, weigh more heavily on older people. The most notable generational difference is being rejected by family for people 55 and over. This may indicate we are now more accepting as society in issues regarding sexuality, thereby impacting the mental health of younger people less. 

SUICIDE

We asked in our survey: Have you ever had suicidal thoughts or tried to take your own life? 53% of respondents said they had thought about it and 17% said they had tried to take their own life.

The main reasons were:

  • Low self-esteem – 45%
  • Isolation – 44%
  • Relationships – 34%
  • Money worries – 31%
  • Employment – 27%
  • Not feeling attractive – 24%
  • Bullying – 21%
  • Sexuality – 19%

“It happened fourteen years ago, if I remember correctly,” Ante from London tells us. “I met up with a lot of my high school mates who had since gone on to do great things, with some getting paid internships abroad or just earning a lot of money. Most of them were in happy relationships. And there I was, a uni dropout, in the closet, forever single. As I was on my way home, the only thing I could think about was that I would be better off gone, and I fantasised about just disappearing quietly.”

“I struggled with suicidal thoughts from the age of 13. It wasn’t necessarily ‘I want to kill myself’ but it was a growing and reinforced feeling that I had no way to exist the way I was. I couldn’t explore any life I might want and the one that was determined by society wasn’t an option either. I think I was around 15 when I was experiencing really bad insomnia. I would stay awake watching telescoping channels all night long. I had watched TV shows like The Bill with my mum so I knew what suicide was. I never connected it with how I felt about my life but it made me realise that I could just stop existing. So, I went down to the kitchen while my parents were sleeping and took a knife back to my bedroom. I stared at it for ages and then every time I picked it up I cried. I couldn’t do it for some reason,” Jack, 23, from Brighton shares with us.

“In my second year at university, I realised I was trans, after a lifetime of trying to put the jigsaw together of why I was different. In the same year, my nan died, who I had been very close to. I also had a relationship (which looking back on it, was abusive) end. My mental health spiralled out of control and in the first term of my third year at uni, I had a breakdown and got as far as laying out the paracetamol on my desk to take an overdose before I managed to stop myself,” says Harry, 31, from Newport.

“I just knew it was severe enough that I would need to seek professional help, and so I did. I wasn’t afraid of taking meds. I asked a family friend to recommend me a good therapist, which they did and I underwent therapy for a couple of years. It’s the reason why I’m alive now. I am glad I didn’t go through with it because so many good things have happened in the last ten years, especially the last year I’ve spent here in London, that I have to pinch myself. It is that good. Life is good. Never forget that,” says Ante.

“I looked for help. I had a breakdown at work and my company paid for 30 sessions of therapy. It was incredibly supportive and generous and I was lucky. It doesn’t need to be therapy, there’s your GP, friends, charities or helplines. Mental health charities, sexual health, counselling and relationship therapy is all there. You completely have all the power you will ever need to change your life. It’s okay to be scared and to feel stuck. Try to reach out and try to keep going. There’s genuine beauty in life and you can find it,” says Jack.

“I went to my GP and told him about my thoughts and feelings. He prescribed me medication which was helpful in the short term, so my feelings were less intense and more manageable. I also went to my university counselling service, who I was able to talk to about the fears about transition which had probably been the catalyst for my suicidal thoughts. They were supportive and gave me the help I needed to make the decision to transition. I no longer have suicidal thoughts,” Harry tells us.

Ian Howley of LGBT HERO says, “There is a silent epidemic happening in our community and we are losing too many to suicide. This has been going on for decades but it’s only in the last several years that we are starting to tackle this. But we need to go beyond encouraging people to talk or seek support. We need to drill down into the causes and figure out how we can best solve them. We are never going to exist in a world where we can control how society views us but we can get better at supporting one another and helping younger generations to build their self-esteem and self-worth. We should reach a place where issues linked to sexuality or gender identity do not affect LGBTQ+ people so severely that they see no other option than to end their own lives.”

WHAT’S CHANGED?

FS ran a similar survey back in 2016 (‘Gay men and the battle to be happy’ – FS #149) with a lot of the same issues around mental health coming to the forefront: low self-esteem, relationships, isolation, not feeling attractive, sexuality and finances leading the way as major issues.

In 2019, these issues remain, seemingly further compounded by pressures and concerns from social media and sex and dating apps. In 2016, 91% said they experienced anxiety, depression and other mental health issues, compared to 95% today, while 55% said they thought about taking their own life and 24% attempted to take their own life, compared to 53% and 17% respectively in 2019.

So, are things getting better or worse for our mental health?

“I can’t say if it’s getting better or worse, but we know that some of the challenges are still the same,” says Ian Howley of LGBT HERO, “but we are also faced with new ones as society and technology improves. What I can say for sure is that we are now starting to address these issues in a way we haven’t seen before. We are a long way from tackling the root causes of mental health issues and suicide in our community but we can do much more to support those currently battling health and wellbeing inequalities while laying down the foundation for future generations.”


WHERE TO GET HELP AND SUPPORT

London Friend

London Friend offers new online video counselling as part of a pilot. While some people prefer counselling in person, for others it might be difficult to come to our premises or they feel more comfortable in the environment of their own home. They currently offer six free online counselling sessions (plus the first assessment).

For more information about referrals visit, londonfriend.org.uk/online-video-counselling

ELOP

ELOP is a holistic lesbian and gay centre that offers a range of social, emotional and support services to LGBT communities, and their core services include counselling and young people’s services.

If you’d like to talk with ELOP about their video counselling service call, 020 8509 3898  or email them on [email protected] For more info about ELOP and what they can offer visit, elop.org.

OutLife

OutLife provides a safe and non-judgemental space for LGBTQ+ people to talk to one another about their issues and life experience. You can talk about anything that worries you such as mental health, sexual health, coming out and family or relationship issues. OutLife’s forums are designed to compliment existing services and should not replace your relationship with your GP or counsellor. Visit: https://outlife.forums.net.

Emergency contacts

If you are in crisis and need support or someone to talk to right now, Samaritans is there for you no matter where you are or what age you are. Samaritans provides confidential, non-judgemental support, 24 hours a day for people experiencing feelings of distress or despair, including those which could lead to suicide. Call: 08457 90 90 90, or email: [email protected]

You can contact the London Lesbian & Gay Switchboard on 0300 330 0630 or www.llgs.org.uk, or find details of local switchboards and organisations that offer face-to-face counselling at www.turingnetwork.org.uk.


Read all the articles from FS 173: