Understanding the Needs of Lesbian, Gay, Bisexual, and Transgender People Living With Mental Illness

Christian Huygen, PhD

Disclosures
In This Article

Prevalence of Psychiatric Disorders Among LGBT Populations

Empirical research on the prevalence of psychiatric disorders among gay and lesbian populations is in its infancy. Similar research on bisexual and transgender populations is virtually nonexistent,[1] despite repeated calls for research that focuses on the treatment issues of these populations.[2,3,4] A few important existing resources are Cabaj and Stein's Textbook of Homosexuality and Mental Health[5]; Perez, DeBord, and Bieschke's Handbook of Counseling and Psychotherapy with Lesbian, Gay, and Bisexual Clients[6]; and the Handbook of LGBT Issues in Community Mental Health (Hellman and Drescher, eds.).[7]

Several studies indicate that gay men and lesbians are at greater risk for psychiatric morbidity than heterosexuals. Ramafedi and colleagues[8] found a higher risk for suicide attempts in lesbian, gay, and bisexual-identified youth, with 28.1% of young bisexual/homosexual boys, 20.5% of young bisexual/homosexual women, 14.5% of young heterosexual women, and 4.2% of young heterosexual men reporting suicide attempts. Russell and Joyner[9] reported similar results in a study of same-sex sexually oriented (SSSO) youth, with 15.4% of SSSO and 9.7% of non-SSSO participants reporting suicidal thoughts in the previous 12 months; and 5% of SSSO and 2% of non-SSSO participants reporting suicide attempts in the previous 12 months.

The same pattern has been found among adults. Using data from the National Comorbidity Survey, Gilman and his associates[10] found that people reporting same-sex sexual partners have consistently greater odds of experiencing psychiatric and suicidal symptoms compared with their heterosexual counterparts. Among men reporting same-sex sexual partners, the odds of experiencing an anxiety disorder were 1.3 times higher, the odds of experiencing a mood disorder were 1.7 times higher, and the odds of experiencing a substance abuse disorder were 1.5 times higher than odds for their heterosexual counterparts. Among women reporting same-sex sexual partners, the odds of experiencing an anxiety disorder were 1.8 times higher, the odds of experiencing a mood disorder were 2.0 times higher, and the odds of experiencing a substance abuse disorder were 2.4 times higher than odds for their heterosexual counterparts. Participants also had higher odds of reporting suicide symptoms. Among men reporting same-sex sexual partners, the odds of having thought about suicide in their lifetimes were 2.2 times higher, the odds of having made a plan for committing suicide were 1.6 times higher, and the odds of having attempted suicide were 2.4 times higher than odds for their heterosexual counterparts. Among women reporting same-sex sexual partners, the odds of having thought about suicide in their lifetimes were 2.0 times higher; the odds of having made a plan for committing suicide were 2.6 times higher; and the odds of having attempted suicide were 1.5 times higher than odds for their heterosexual counterparts.

Cochran and Mays[11] studied men with same-sex partners, using data from the National Health and Nutrition Examination Survey, and found a markedly higher prevalence of suicide symptoms during their lifetimes than men reporting only female partners. Among men reporting any male sex partners during their lifetimes, 18.5% reported having experienced a desire to die, compared with 7.6% of those with female partners only and 1.9% of those reporting no sexual intercourse. Suicidal ideation was described by 41.2% of men reporting any male partners during the course of their lifetimes, compared with 17.2% of those with female partners only and 13.0% of those reporting no sexual intercourse. Suicide attempts were reported by 19.3% of men reporting any male partners over the course of their lifetimes, compared with 3.6% of those with female partners only and 0.5% of those reporting no sexual intercourse.

However, research on this population and the prevalence of psychiatric conditions is in its early phases, and some studies have found similar rates of psychiatric hospitalizations, and even somewhat lower rates of psychotic disorders among LGBT people compared with the general population.[12] Some LGBT people may have greater resilience because of the stresses and challenges that they experience. Although these possibilities are certainly worthy of further study, pursuing them is beyond the scope of this article.

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