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Why are the LGBTI Community so over represented in mental health statistics? »
Zahra talks about the impact of living in a heteronormative society.
There are some issues that are specific to the LGBTI Community, that may play a part in our mental health and wellbeing. Their impact can be direct or more subtle and can leave an impact over time.
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Social norms
Social norms - Many LGBTI community members have experienced negative, ignorant, or unsolicited reactions from the general public in the form of exclusionary or discriminatory behaviour, rude or thoughtless comments or questions. These experiences are often not coming from a place of a 'phobic' reaction or fear but are done without hostile intent or fear. This does not, however, diminish their impact over time.
These behaviours often result from worldviews described as 'heterosexism/heteronormativity' or 'cisgendersim', Heteronormativity is the belief that everyone is, or should be heterosexual and that other types of sexuality are 'abnormal', unnatural or a threat to society. It assumes that heterosexual status is superior and holds a higher position in our society.
Cisgenderism is the view that people's own descriptions of their gender are less valid than those assigned to them by other people based on their assigned sex at birth. It assumes that people have strictly 'female' or 'male' bodies and that Trans* or intersex status are again 'abnormal', unnatural or a threat to society.
People who do not fit this model are therefore set aside as different, and it is this 'othering' (and the invisibility of LGBTI people that results from this view) that causes people to feel excluded, and not valued by society.
There is increasing growing agreement among both researchers and community members that the mental health disparities seen among LGBTI communities are in large part a consequence of homophobic/heterosexist or transphobic/cisgenderist societal attitudes and their cultural consequences.
Many LGBTI people have had negative experiences with service providers, which has left some people with feelings of distrust and a reticence to reconnect with any type of service provider, particularly when considering support for mental and emotional health issues. It might be helpful when seeking out a suitable service to ask trusted service providers if they can recommend someone, or consult with organisations like Oii, ACON or the Gender Centre for more information. -
Social phobia
Social phobia - Many LGBTI people have experienced homophobic, or transphobic or reactions from other people across a wide spectrum of situations, in schools, at work, on public transport, or while socialising. These "phobic" reactions, which are held by only a minority of the broader community, are based on fear. Fear of difference and of others who are different from themselves, people who do not meet their own understanding and expectation of "normal".
These reactions range from physical attack, verbal abuse, excluding people, staring at them, bullying at school or in the workplace.
In a range of Australian research papers it was found that:- In Victoria, one in seven GLBT people report living in fear of heterosexist violence.
- One in four GLBT respondents had been subject to physical violence or the threat of physical violence in the past two years.
- In Queensland, 92 per cent of trans women and 55 per cent of trans men report verbal abuse.
- 10.3 per cent of GLBT Australians report that they have been refused employment or denied promotion because of their sexuality or gender identity.
These acts of hostility and exclusion are also reinforced currently under laws which deny equitable recognition of relationships or gender identities.
Homophobia and Transphobia and ignorance about intersex people can have a huge impact on the emotional and physical health and wellbeing of our community members who have experienced them first hand. -
Self stigma
Self stigma - internalised homo/bi/trans/intersexphobia, self-hatred and loathing. This can be as a result of societal attitude by a community that does not value or accept sex and gender diversity, and can be compounded by negative attitudes from unsupportive family or social peers.
The overall impact of internalised homo/bi/trans/intersexphobia can, for some people, lead to poor life choices, unhealthy behaviours (eg smoking, over use of drugs or alcohol for example) and sometimes poor relationship choices. -
Minority stress
Minority stress - the consistent daily stress of feeling threatened, or different, or being on your guard with your words, actions and activities can make some people feel hyper vigilant, which can build up and become very stressful over a period of time and can make people very anxious.
Having a series of negative reactions over time can affect our emotional wellbeing, which can lead us to feeling anxious and unsafe. -
Negative trauma
Negative trauma - Trauma that is experienced through Homo/bi/trans or intersex negative attitudes and behaviour such as vilification or abuse, bullying, unsafe environments, violence, alienation from family and friends and discrimination.
These experiences predominantly stem from members of the wider community. However, just as in the broader community, our own communities may also comprise of individuals who express attitudes that are, for example, racist, sexist, ageist or cisgenderist. These attitudes that reinforce exclusionary or discriminatory attitudes towards other community members can compound the impact of sex, sexuality and gender based social exclusion, resulting in poorer mental health outcomes for some.
There has been some great progress in changing the attitudes of service providers to better cater to our communities' needs, but some deeply held cultural norms amongst our own community members have taken longer to shift. As a community we need to better understand and support all of our members.
Reflection
Before you move to the next section, how would you answer these questions?
How anxious or stressed does a new situation make you feel? How do you feel about going into a new social setting where you might have to disclose your sexuality, gender identity or history, or intersex status?
How do you feel about seeing a new service provider or GP perhaps? Do you consider disclosing to them or only tell them if it's related to your health issues.Some ways to think about this
Reflect on what steps you go through before you decide to disclose in a new situation. Do you assess for personal safety, and formulate an escape plan in case you get a bad reaction? -
Social norms
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How do we react to ourselves or our loved ones when we experience mental distress? »
Our reactions to an episode of mental distress will be as a result of a number of different influences. These determinants can be separated into different areas:
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Biological/Medical
Biological or medical - looking at genetic factors that contribute to who you are, the type of personality you have, and the mental health / medical history of your family.
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Psychological
Psychological factors - that reflect personal and professional past experiences, and your own upbringing around mental health.
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Family
Family experiences - how did your family talk about or react to mental illness, (if at all)?
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Social
Social determinants - societal acceptance, legal recognition, our own education, this may be geographically influenced, (regional NSW compared to Sydney Metro region).
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Cultural
Cultural - cultural acceptance and understanding of mental distress We are quite based in a medical model in Australia, where we see either illness or wellness. Other cultures view mental distress very differently. Our religious and cultural values and norms will also shape our personal understanding of 'mental distress'.
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Life Stressors
Life stressors - the usual stresses of everyday life. Bereavement, redundancy, job stress, relationship break up, financial worries. Others that affect us may be involuntary outing, delay/denials of medical gender affirmation, involuntary or coerced 'normalising' medical procedures on intersex people, personal safety, phobic, discriminatory or exclusionary attitudes towards LGBTI people.
Reflection
Before you move to the next section, how would you answer these questions?
Reflect on your own past experiences of being around someone with mental distress. This may have been a friend, work colleague or family member.
How did you react to them?
What were your feelings around their mental health?Some ways to think about this
Our past experiences of mental ill health, whether it is our own or someone else's, will play a part in determining our responses in the future. The more we learn and understand about the impact of mental distress within our communities, the better able we are to support those who are experiencing it.
The next 2 chapters will provide an opportunity to learn more about depression and anxiety, how to support a loved one, and how to look after yourself. -
Biological/Medical
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More information and resources »
Factors affecting LGBTI People.
Useful insights in to factors that affect the mental health and wellbeing of LGBTI from beyondblue.
http://www.beyondblue.org.au/resources/for-me/gay-lesbian-bi-trans-and-intersex-glbti-people/factors-affecting-glbti-peopleBeyondblue National Campaign against discrimination.
Stories of other LGBTI Community members who have experienced depression and anxiety.
http://www.beyondblue.org.au/resources/for-me/gay-lesbian-bi-trans-and-intersex-glbti-people/glbti-national-campaignNational LGBTI Health Alliance Inclusive Language Guide on People of Intersex, Trans and Gender Diverese Experience.
Practical guidance for respect and inclusion of intersex, trans and gender diverse people in service delivery and care.
http://www.lgbtihealth.org.au/sites/default/files/Alliance%20Health%20Information%20Sheet%20Inclusive%20Language%20Guide%20on%20Intersex%2C%20Trans%20and%20Gender%20Diversity.pdf
