Mental‌ ‌health‌ ‌challenges‌ ‌and‌ ‌addiction‌ ‌in‌ ‌ the‌ ‌LGBTQ+‌ ‌Community‌

If you have seen enough Bollywood films, you would have at some point come across this particular side character. A young male in his early twenties with pronounced feminine traits. He is often hypersexualized and is shown chasing after every male in his immediate surroundings.  He is often ridiculed and at times even assaulted by the other leading characters in the movie. His only role is to be the butt of all jokes.

Homophobia has existed for decades in India. It’s just not in the movies but in everyday life also that people from the LGBTQ+ community face ridicule and discrimination. This has, for decades, made it difficult for people from the LGBTQ+ community to accept their sexual identity themselves and even harder with their friends, family and society in general. 

This lack of empathy and understanding from society towards members of the LGBTQ+ community can and often leads to addiction and mental health problems. Before we delve further into this topic, let’s familiarize ourselves with the term LGBTQ+. 

What Does LGBTQ+ Stand For? 

The LGBTQ+ acronym stands for Lesbian, Gay, Bisexual, Transgender, Queer. The addition of “+” sign to the acronym acknowledges that there are people of non-cisgender and non-straight identities that are not included in the current acronym. These terms are constantly evolving as we understand more about sexual identities and orientations. 

In 2018, the Supreme Court’s final verdict with respect to section 377 decriminalized homosexuality. Moreover, Justice Chandrachud in his verdict about section 377 highlighted the role of mental health professionals to offer responsible mental health care and advocacy. 

Why Are the Members of the LGBTQ+ Community More Vulnerable to Addiction and Mental Health problems? 

As per a report released by Multinational research firm Ipsos during the LGBT+ Pride 2021, 3% of the Indian Population identify as homosexual (Including Gay and Lesbian), 9% identify as bisexual, 1% identify as pansexual and 2% identify as asexual. Totally, 17% identify as not heterosexual (excluding ‘do not know’, and ‘prefer not to answer’). We do not have the exact statistics on the number of people belonging to the LGBTQ+ community as the sample size for this research was only 500 Indians. The real number could be much higher, so it is a bit disheartening to know that the United Nation identified the LGBTQ+ community as, one of 12 groups, least represented in health equity research in India. 

There are very few studies conducted on mental health and substance abuse issues among the LGBTQ+ community in India. Some of the studies are state-based and some are pan India studies. A comparison of all of these studies reveals that on average over 50% of people who identify as gay or trans have experienced depression, 30% of the lesbians go through depression at least once in their lifetime, over 40% of the people in this community have had suicidal tendencies and over 50% have experienced addiction to alcohol/ tobacco and other illicit substances. 

There are many reasons why the LGBTQ+ community is vulnerable to mental health problems and addiction. The Indian society predominantly displays a homophobic culture. There are hundreds of cases of parents disowning children who are gays, lesbians or queer. Many have even suffered violence and faced brutal “conversion therapy”.  It tries to change a person’s sexual orientation often without consent and can at times involve physical and emotional torture. 

Overall, there is a lot of stigmas and a lack of acceptance towards the LGBTQ+ community. These negative experiences can lead them to have depression, anxiety issues, suicidal thoughts, social phobia, post-traumatic stress disorder and alcohol or drug dependence. 

Mental Health and Addiction Issues in the LGBTQ+ Community

There are no nationwide surveys or statistics about the mental health or addiction problems faced by LGBTQ+ individuals. However, many therapists and counsellors have found that there are certain mental conditions that are higher in this community.

It’s important to note that homosexuality does not lead to any mental health disorders. It’s a gender orientation and it is completely normal. However, it is the stigma associated with being an LGBTQ+ person that can lead to many problems. Some of the most common ones are: 

Depression – This is one of the most common mental health issues faced by this community. There are several reasons; not being able to reveal their true sexual identity, difficulty in finding someone to speak to about their problems, losing family and friends after “coming out”, discrimination in the workplace and sometimes even mental and physical abuse. This can lead them into an abyss of hopelessness and depression.  

Anxiety – people in the LGBTQ+ community who have yet not told their family and friends about their sexual identity constantly worry about being discovered. While trying to come out they are likely to experience anxiety and fear of not being accepted or of being stigmatised by them. All this can lead to anxiety issues, which may also lead to frequent panic attacks. 

Adjustment issues – Many people from the LGBTQ+ community would say this is what they struggle with the most. Many have spent years trying to adjust to a gender role they don’t identify with. After coming out, people around them resist accepting their new identity. This often causes problems at the workplace or social gatherings. For e.g. Dress codes in offices are often very gender stereotypic. 

Body image related issues- Imagine being born in the sex that you don’t relate to, and to have to dress, behave and live in that gender role. Many transgenders have fought this battle for years, some since they were little children. Before transitioning many don’t feel comfortable in their own bodies, especially the physical signs of their biological sex. This can also be termed as Gender dysphoria, a psychological condition experienced by LGBTQ+ individuals whose gender identity does not match with the gender assigned at birth.

Fear of abandonment issues – People from the LGBTQ+ community often worries about people leaving them. Many may have parents or friends who may have abandoned them after they came out. They may have lost important people in their lives and this may cause them to have abandonment issues.  They may have difficulty making new friends or trying to have a romantic relationship for fear of losing them all over again, or some may try to hold on too strongly to the friends and partners they already have, in an effort to make sure they don’t leave them. All these issues can lead to a lot of conflicts.  

Romantic relationship issues – When it comes to love in the LGBTQ+ community, it is very complex. Many may find it difficult to navigate the world of romance for fear of being called out or rejected. Some may have been forcefully married off to a person of a gender they are not attracted to and may be forced to start a family. Some may have partners who have not come out and would be forced to hide their relationship. All these complications can lead to communication problems and rifts in the relationship. 

Substance Use – Although there are no definite nationwide studies and statistics, reports by therapists and local research suggest that people from the LGBTQ+ community are twice as likely as heterosexual people to have substance use disorder.  Transgendersare almost four times as likely as cisgender people to have a substance use disorder. A few people from this community abuse alcohol and recreational drugs like marijuana as a coping mechanism.   

How Can You Make a Difference for the LGBTQ+ Community? 

If you have a friend or a relative who has come out, then the first thing you need to do is offer your unconditional support and acceptance. Start by educating yourself on the different gender terms that are there. 

• A Cisgender is an individual whose gender identity matches with their biological sex. 
• A Transgender is an individual whose gender identity doesn’t match with their birth sex. 
• Non-binary gender is a term used to define gender identities that are not strictly male or female. There are many types of non-binary gender, but a few common ones are:

• Genderqueer – An umbrella term for individuals with non-binary gender identities.

• Agender – Not having a specific gender identity or having a gender identity that is neutral.

• Genderfluid – Moving between two or more gender identities or expressions.

If you are conversing with someone from the LGBTQ+ community, start by asking what pronouns they would like to be addressed with. Pronouns are words that replace nouns. The ones that we are addressing are personal pronouns. For e.g., he, she, it, they. It can be disconcerting for a man who identifies as a woman to be addressed as he/him. In the beginning, you may often accidentally misgender a person, however, a quick apology will help the other person know that you are sensitive and have accepted their true gender. Using correct pronouns shows respect and acceptance on your part. It also helps to create a more inclusive environment.  

You can also show your support by being part of the ‘PRIDE’ parade. Every year in June, many countries around the world celebrate the LGBTQ+ community and support and demand their rights to live a life with dignity and equality. The parade is also about raising legal and social issues facing the community and the need for more inclusion both in the legal and social framework of the country.

Strive to create inclusivity in your workplace, home and society. If you see someone misgender anyone from the LGBTQ+ community, or being abusive or insulting, then do your bit to be supportive. If you cannot confront the person being abusive directly, then report them to a higher authority. 

In closing, we have to understand that a person’s sexual identity is not strictly limited to physical attributes but also through feelings, thoughts and emotions. The dreams and desires of people from the LGBTQ+ community, their fantasies and their attractions are just as valid as yours. They have the same rights as cisgender people; to pursue the jobs they desire, to dress the way they like, to express the way they feel and to live a life that’s true to their gender identity. 

If we all do our bit, we will help in alleviating their mental stress and substance abuse problems. Every small action will help make our society kinder and more inclusive. 

Sources

GLAAD Media Reference Guide – 10th Edition. (2018, May 4). GLAAD. https://www.glaad.org/reference

Ipsos. (2021, April). LGBT+ PRIDE 2021 GLOBAL SURVEY. https://www.ipsos.com/sites/default/files/ct/news/documents/2021-06/LGBT%20Pride%202021%20Global%20Survey%20Report_3.pdf

LGBTQI. (n.d.). National Alliance on Mental Illness. Retrieved July 20, 2021, from https://www.nami.org/Your-Journey/Identity-and-Cultural-Dimensions/LGBTQI

Ravindran, T. S., & Seshadri, T. (2018). A health equity research agenda for India: results of a consultative exercise. Health Research Policy and Systems, 16(S1). https://doi.org/10.1186/s12961-018-0367-0

Roy, D. (2020, March 3). Mental health issues among the LGBTQ. Deccan Herald. https://www.deccanherald.com/opinion/panorama/mental-health-issues-among-the-lgbtq-810246.html

Times Now Digital. (2018, September 7). Section 377 verdict: 6 common mental health challenges & other issues faced by the LGBT community. Times Now News. https://www.timesnownews.com/health/article/section-377-verdict-6-common-mental-health-issues-faced-by-the-lgbt-community/281102

Wandrekar, J. R., & Nigudkar, A. S. (2020). What Do We Know About LGBTQIA+ Mental Health in India? A Review of Research From 2009 to 2019. Journal of Psychosexual Health, 2(1), 26–36. https://doi.org/10.1177/2631831820918129

When is Pride Month and why is it celebrated at this time? History, significance and more. (2021, June 1). The Free Press Journal. https://www.freepressjournal.in/india/when-is-pride-month-and-why-is-it-celebrated-at-this-time-history-significance-and-more