It is the summer of 1993. I am twenty‑three. I am standing in a brand-new bar in Soho. The chrome is polished and the men are beautiful. The juke box is turned up high. And Gabrielle is loud in my ear: ‘Dreams can come true?’.
And a few metres away, someone is calling me fat.
Not to my face. That would require a different kind of courage. It is said to a friend, just audible, with a small laugh that signals I am fair game. I experience a momentary confusion. I have worked out who I am. I came out. And I found my tribe. Yet I am being diminished by one of my own.
I did not have a name for it then. I do now. It is called lateral violence, and it is one of the least discussed aspects of mental health in LGBTQ+ communities.
The numbers
The numbers are bleak. Lesbian, gay and bisexual people are two and a half times more likely to self‑harm and twice as likely to die by suicide than the general population. Over half of LGBTQ+ people experience depression in any given year, rising to two thirds among trans people. 61 percent report anxiety, compared with one in six in the wider population. We quote these figures often. What we talk about far less is how much of the harm comes from inside our own communities.
Pride and shame
Before we go further, something uncomfortable needs saying. Pride and shame are not opposites. They sit close together.
For LGBTQ+ people, shame has been a constant presence. Families, schools, churches, and for decades the law itself delivered the same message: you are wrong, you are broken, you do not belong. Pride challenges that. It makes visibility a source of strength rather than fear.
But shame does not vanish the moment we claim our place in the world. It settles in different corners. It turns inward and sideways. And when it lands on others in our own communities, it can cause real harm. This is not a personal failing. It is the long reach of structural oppression working through us.
Body shaming
Body shaming is one of the oldest cruelties in gay male culture. The apps, the gym, the constant stream of idealised bodies: all of it creates a hierarchy of who is valued and who is not. Fat men, older men, disabled men, femme men are often pushed to the bottom. The shame this produces can feed directly into depression, disordered eating, and drug and alcohol use.
Racism
Racism inside LGBTQ+ spaces can often be strong yet infrequently named. For LGBTQ+ people from racialised communities, there may be nowhere that fully holds them: racism in LGBTQ+ spaces, homophobia in their own communities. A Black gay man in a predominantly white environment may be dealing with two forms of threat at once. That persistent sense of not belonging anywhere, of experiencing multiple exclusions daily in several directions, can cause lasting damage. These patterns reflect wider racial hierarchies and oppression, not isolated incidents.
HIV stigma
HIV stigma works through shame too, and I know this personally because I am HIV positive. A positive diagnosis today is a manageable medical condition. But the stigma persists, and much of it comes from inside our own communities: the ignored message on the app, the man who loses interest when you tell him, the insistence on being ‘clean’, the friend group where someone’s status becomes gossip. For older gay men this cuts especially deep. We grew up in a world that criminalised us, watched our friends and lovers die, and saw it as punishment or just deserts. We learned that we were dangerous. Some of us absorbed that lesson so completely that we now repeat it to each other.
Transphobia
Transphobia dressed up as feminism threatens to split our communities at the moment they most need to hold together. When the claim circulates that trans women are a threat to other women, the effects are felt across whole communities. Solidarity weakens. Trust thins. And the mental health of trans people, already under strain, deteriorates further. Trans men, trans women, and non‑binary people already face some of the highest rates of violence, including sexual violence, and discrimination of any group. The mental health consequences, compounded by rejection from within communities that should offer solidarity, may be more severe than we yet understand.
Misogyny
Misogyny operates inside LGBTQ+ communities too. In some parts of gay male culture, contempt for women sits just beneath the surface: in the dismissal of lesbian spaces, in jokes that treat women as lesser, in the assumption that gay men’s experiences are the default queer story. Bisexual women and lesbians often find themselves overlooked in communities that claim to represent them.
How does this happen?
How do communities built on surviving persecution end up harming their own? Shame does not simply fade. It gets redirected. People who have been told for years that they are not good enough do not automatically become generous to the next person they can look down on. The structures that harmed us are absorbed and repeated through new forms: the app, the door policy, the culture that decides whose history matters. Lateral violence is not just a cause of poor mental health. It is also a symptom of deeper, older harms.
And yet
The same communities that cause harm also save lives. LGBTQ+ people with strong community ties tend to have significantly better mental health than those who are isolated.
Found family, the friendships built in community centres, support groups, and group chats, often because our families and communities of origin could not hold us, carries real protective power. It can buffer the impact of discrimination and provide something statutory mental health services have often struggled to offer. Much of this support is held by the voluntary and community sector: small, underfunded organisations led by people with lived experience, offering crisis support, peer groups, counselling, and a place to belong. They act as a counterweight to the failures of the systems around us.
Growing up outside the mainstream can also build something lasting: a capacity for complexity, for reading the room, for imagining life differently. Queer culture at its best has always been a space for new ways of living, loving, and looking after each other. The emerging stories of how lesbians rolled up their sleeves and nursed dying men in the AIDS crisis, when no one else would, is but one example.
What needs to change
None of this cancels the harm: the body shaming, the racism, the HIV stigma, the transphobia, the misogyny. These deserve honest attention. But naming lateral violence is not the same as blaming LGBTQ+ people for their own poor mental health. The roots run far deeper: through decades of criminalisation, pathologisation, and abandonment by the state; through housing and employment discrimination; through hostile media; through healthcare systems that have too often treated LGBTQ+ lives as a problem to manage rather than a population to serve.
This is not a call for LGBTQ+ communities to do better in isolation. It is a full-throated demand that systems to do better: properly funded mental health services that understand LGBTQ+ lives; workplaces and schools with real protections; legal frameworks that treat LGBTQ+ people as full citizens; and sustained investment in the voluntary organisations that have always filled the gaps the state left behind.
