The unending arguments about access to public washrooms; the introduction of literally hundreds of pieces of legislation that invoke religious belief as a grounds to refuse service; the widely publicized presidential decree that bans trans people from serving in the military. The real and practical implications that these things have on the everyday lives of people in the LGBTQ+ community is clear.

What’s less obvious are the ways this kind of unrelenting intolerance impacts mental health. How do you measure the kind of mental and emotional strain that’s the result of constantly having to fight for the same basic rights that the rest of society has handed to them, just for being straight and cisgender?

The stats show that LGBTQ+ people are far more likely to experience mental health issues like depression, anxiety, and suicidal thoughts than other populations. The levels of depression and anxiety found inside the LGBTQ+ community are three times higher than outside. Thirty percent of transgender youth have attempted suicide, while 42 percent admit to practicing self-harm.

“Anti-LGBTQ policies further the internalized homophobia and transphobia that queer people already experience,” explains Eric Yarbrough, director of Psychiatry at New York’s Callen-Lorde Community Health Center. “Part of the symptomatology associated with higher rates of depression, anxiety, and substance use in the queer population is due to invalidating environments. Queer people are being repeatedly told that their ‘non-traditional lifestyle’ is not valid. Being bombarded with messages that your love and life is not valid has long-term effects.”

For some young people, especially those who are not yet confident in their queer identity, that feeling of invalidation can contribute to the idea that they’re not worthy of help or treatment — that their mental health issue, like their queerness, is “just another problem.”

“For most of my childhood, I felt like I couldn’t speak up for myself,” says queer artist and activist Dior Vargas. “I felt silenced and it made me feel helpless. I experienced a lot of domestic violence growing up and at one point, we were on welfare. We had no money and barely anything to eat. I felt like a burden. I felt unworthy. When I acknowledged my queer identity to myself and my family it was hard because I felt like there was another thing that was wrong with me. It was something else to explain why I was a bad person and I was being punished.”

The stigma surrounding mental health issues remains strong despite recent, powerful campaigns to end it. Seeking mental health help requires courage, but for the LGBTQ+ community, seeking help can also pose risks.

“There is always a danger that a queer person will not find an affirming provider, or worse, one that tries to do sexual conversion therapy to ‘cure’ them,” says Yarbrough. “Attempting to change a person’s sexual orientation or gender identity can be quite dangerous and have devastating results.”

“It’s also hard to find someone who can fit your budget,” adds Vargas, “like [a mental health care provider] who offers [payment on a] sliding scale. If you’re lucky enough to have health insurance, that can help a bit, but even then you might not find someone who takes your insurance or maybe your health insurance doesn’t even cover mental health services. Then it’s about finding someone who ‘fits’ — there aren’t enough LGBTQ+ individuals in the mental health field. Language barriers and undocumented status can be another factor. There are so many things that can make it harder to take care of yourself.”

Which is why it’s so important, says Yarbrough, that people have access to designated queer-friendly mental health services. “Queer people need to know their provider will help treat any symptoms they might be having but in an environment supportive of their identity. Having LGBTQ+ clinics will likely reinforce adherence and engagement in treatment. Patients tell me that one of the main reasons they love coming to Callen-Lorde is that they feel safe and know they are around members of the community. They can seek care without fear of judgment. Queer people have so much stress on them already. We should do what we can to make their seeking care easier.”

Friends, family, and other allies can also be a really important source of support. Dr. Arielle Salama, a psychiatrist at St Michael’s Hospital and Sherbourne Health Centre in Toronto, says that, “For specific LBGTQ+ needs, there may be extra concerns around sensitivity from the viewpoint of the caregivers and the person in need, even if their gender/sexuality is not an active part of the crisis. If the caregiver doesn’t know much about these issues and how they impact the person, be open to listening, researching, and not making assumptions. They can accompany the person in crisis to LGBT-friendly mental health supports. Knowing that parts of the system can be less friendly to LGBT people, helping the person find an appropriate fit for them, and being supportive if this causes discouragement is something else to be aware of.”

If you’re searching for help to deal with a mental health issue, a good place to start is the National Alliance on Mental Illness. NAMI is clear in their commitment to ensure that LGBTQ+ people receive queer-inclusive counselling and services and their site includes information on finding a mental health provider and tips on talking to them about what you’re going through. They also recommend organizations like the It Gets Better Project and The Trevor Project, which provides anonymous phone, chat, or text message-based support for queer youth. Trans Lifeline is another resource staffed exclusively by transgender volunteers who are available for mental health crisis peer counselling, an important resource for anyone who needs to talk to someone whose experiences line up with their own.

“It’s nice to have that commonality, that familiarity. People want to be seen and want to be heard,” says Vargas, whose own photography project is about representation and mental health. “Seeing yourself reflected in others can help with that. You feel less alone.”

What are you doing to take care of your own mental health? Tell us about it on Twitter.

(Photos via Freestocks + Levi Saunders/Unsplash)