These are tough times for LGBTQ+ people, amongst the toughest I have known. After several years of what felt like steady progress, in the UK, at least, the picture is changing – rapidly and dramatically. We are living in a climate of mounting hostility, where fear-mongering rhetoric fuels violence and disgust, especially for transgender people, who represent less than 1% of the entire population.
The recent recriminalisation of sex between men in Trinidad and Tobago; the UK Supreme Court’s ruling relating to biological sex and the swiftness of the Equality & Human Rights Commission’s resulting directives; the state banning of Pride in Hungary; and widespread anti-Trans measures in the US all point to a worsening picture.
Long-standing daily challenges persist. Homophobic bullying in schools is widespread. LGBTQ+ young people are frequently excluded by friends and family after coming out. Violence in public places and verbal abuse on public transport are also common, as is discrimination and harassment at work. Couples fear showing affection. And for many people, the challenges can be even more complex. LGBTQ+ people of colour, for example, are discriminated against in multiple ways as they simultaneously face racism and hostility for their sexual differences.
What are the long-term impacts of enduring hate, not just on us as individuals but on the many and various LGBTQ+ communities we belong to? And perhaps more fundamentally, how do we survive, let alone thrive, in a world that questions our existence?
The impacts on mental health
The consequences of homophobia, biphobia, and transphobia can have direct consequences on mental health, including anxiety and depression. They can, in turn, increase someone’s desire to withdraw from life and remain at home. These challenges contribute to feelings of exclusion, isolation and hopelessness, ultimately perpetuating cycles of poor mental health.
It is notable that financial instability – linked to discrimination in employment, housing, and access to education – can be a relentless stressor, compounding feelings of insecurity, and exacerbating poor mental health, including for older people.
LGBTQ+ suicide
Just days before the Supreme Court made its ruling about the legal definition of sex, the Office for National Statistics (ONS) released figures that showed that suicide amongst lesbian, gay and bisexual people in England and Wales is more than double that of heterosexual people. Young people and women, they reported, are particularly affected.
The loss to society when someone takes their own life is profound: dreams unfulfilled, potential contributions forever lost. The impacts of suicide tear through communities, families, and friendships, leaving behind disbelief, anger, and shame, with consequences impossible to quantify.
The latest figures confirm what many of us from LGBTQ+ communities already know. But they are, nonetheless, shocking. They sit alongside a raft of published health data that are similarly concerning, not least the evidence that suggests we experience high levels of alcohol and substance use, sexually transmitted infections, and HIV disease.
Personal testimonies
I have interviewed many LGBTQ+ people over many years for a range of studies, and they have always generously shared their insights.
Jaimie*, an Irish bisexual woman in her 30s who lived in Manchester, spoke candidly about the layers of stigma she faced. “You think you’ve come out, you’ve won — but it’s every day, isn’t it? People assuming things, questioning things, looking at you differently. It’s like I live in a world that’s full of little walls all around me.” Jaimie shared how she turned to alcohol as a way to block out her emotions.
Alex*, a young trans woman from Cardiff with a physical disability, spent years enduring both subtle and overt exclusion — from inappropriate sexual comments and persistent misgendering at work, to physical barriers when trying to access social spaces. These experiences left her lonely and battling depression, which was compounded by feelings of invisibility.
Ruchit*, a gay man in his 20s from India who lived in west London, faced numerous challenges. “It’s like fighting on two fronts,” Ruchit told me. “In mental health services, I often feel overlooked or misunderstood”. In gay meeting places, he encountered racist microaggressions that excluded him further. He was left isolated and battled anxiety and depression.
For many like Jaimie, Alex and Ruchit, the intersection of systemic prejudice and personal struggles creates a vicious cycle. To improve mental health in general – and reduce suicide in particular – actions have to be taken in parallel.
What can be done?
The law is critical in setting a tone for equality, compassion and care. Policies in health, education, housing, criminal justice, and beyond should include routine scrutiny to ensure the most vulnerable in society are protected from discrimination.
Building on networks of friendships and community assets is crucial for LGBTQ+ mental health. These connections foster a sense of belonging and support, helping people navigate challenges and promoting mental wellbeing and collective healing.
Key to success are community-based voluntary sector organisations like LGBT Foundation and London Friend. They provide tailored therapeutic services, peer-led support, and a safe space to address the manifold challenges that lesbian, gay, bisexual, and trans people face. Whether it is supporting with addiction, offering counselling, or fostering resilience, their work is essential in breaking down barriers and offering pathways to healing.
For instance, Taylor*, a 25-year-old non-binary person, had been struggling with feelings of isolation and anxiety but found support in a peer-led support group. “The friends I made changed my life,” Taylor said. “They gave me strength and hope.”
The NHS plays a significant role. Primary care and well-resourced mental health services can offer accessible and comprehensive support, ensuring that LGBTQ+ people can receive the support and care in environments that make them feel included and valued.
Conclusions
The stakes have never been higher. As we navigate these pressing questions, it becomes clear that mental health advocacy must be at the forefront of LGBTQ+ justice movements, and vice versa. We have to find common ground with each other, and with our many allies. If we do so, the consequences will be many, and the stark inequalities that LGBTQ+ people experience will be reduced. People will live. The devastation of suicide will be minimised. And progress will return.
*Names and identifying details have been changed to protect privacy.
LGBTQ+ helplines
- England and UK-wide: Switchboard – call 0800 0119 100
- Northern Ireland: LGBTQI+ Switchboard – call 0808 8000 390
- Scotland: LGBT Helpline Scotland – call 0800 464 7000
- Wales: LGBT+ Cymru Helpline – call 0800 917 9996
Samaritans – call 116 123
