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Fact sheet 22

Depression and anxiety in young people who are gay, lesbian, bisexual, transgender or intersex (GLBTI)

Adolescence is a turbulent time for most young people. For young people who are same-sex attracted (gay, lesbian or bisexual), transgender or intersex, the challenges can be even greater. They might find their feelings difficult to talk about, they may feel that nobody else is in their situation and they may also experience bullying and abuse – all of which can increase the risk of mental health problems such as depression and anxiety disorders.

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Same-sex attraction and gender identity

It’s important to understand the differences between sexual orientation and gender identity.

  • Being gay, lesbian or bisexual means that you have romantic and sexual attractions for people of the same gender. It does not mean that you question your identity as a man or a woman.
  • Being transgender means that your inner sense of gender (being a male or female) is different from your sex (biology). Transgender people have the same range of sexual orientations as the rest of the population, so they may be gay, lesbian, bisexual or straight.
  • Intersex people are people who have genetic, hormonal, and physical features that may be typical of both males and females at once – you may be thought of as being male with female features, female with male features, or have no clearly defined sexual features at all. Intersex does not indicate gender or sexuality.

While many issues for gay, lesbian, bisexual, transgender and intersex (GLBTI) people are different, prejudice and misunderstanding can be a common experience. There is enormous pressure in our society for everyone to adopt the behaviours typically associated with being male or female (including pressure to be heterosexual), and people can be subjected to ridicule, intimidation and even violence just because they don’t fit into someone else’s ideal of a man or a woman.

For a young person realising that they are ‘different’, feelings about sexuality or gender can be confusing and difficult to deal with:

  • you may feel such a pressure to conform to society that you question or deny your sexual attraction or gender questioning even to yourself, and this can affect your self-esteem
  • you may feel torn between wanting to let others know about your feelings and denying or suppressing them, because of fear that you may be rejected
  • you may already be feeling sadness, if you think you might lose the respect and love of family and friends.

It can be even harder if you are from a culture where homosexuality is taboo, or have been brought up in a culture or religion that rejects homosexuality.

It may be difficult for you to talk about your feelings and experiences – especially if people at school or work use words about sexuality in a derogatory way, such as labelling people or objects ‘gay’ even if they have nothing to do with same-sex attraction.

The fact is, same-sex attraction is a normal aspect of human sexuality. Today, there is much greater awareness and acceptance than there used to be of same-sex attraction and gender questioning, and same-sex attracted and transgender people are much more visible in the media and public life. But young people who are known to be gay, lesbian, bisexual, transgender or intersex are still far more likely to experience bullying, verbal and physical abuse at school, work and in social situations.

Many same-sex attracted, transgender or intersex young people manage well, alone or with the support of others, until they are confident they can ‘come out’ and seek more support from other young people and their families. Many young people feel great relief when they feel safe enough to tell someone about their feelings and get some support and reassurance.

The impact of homophobic and transphobic abuse

Unlike those who are discriminated against for a characteristic they share with their family or community, such as race or religion, many GLBTI young people have frequently made this journey alone and in secret. They may have not been taught strategies for coping with prejudice, and are less likely to call on (and perhaps be given) family and community support if they are victimised.

Any type of homophobic or transphobic discrimination can have a negative impact on a person’s mental health, and it’s not surprising that many young people react to this sort of stress and anxiety by feeling anxious or down. Research shows us that compared with young people who have not experienced abuse, young people who have experienced homophobic or transphobic abuse:

  • experience more feelings of depression and anger
  • feel less safe at school, home, on social occasions and at sport
  • are more likely to skip school or drop out completely
  • are more likely to experience homelessness, to have unsafe sex, to use alcohol and drugs and to deliberately self-harm.

It’s important to know that help and support are availble (see below).

What is the connection with depression and anxiety?

All these challenges and stresses make some same-sex attracted, transgender and intersex young people more vulnerable to symptoms of depression and anxiety.

Depression is more than just a low mood – it’s a serious illness. People with depression find it hard to function every day and may be reluctant to participate in activities they once enjoyed. Depression has serious effects on physical and mental health. Depression is common – around 160,000 young people live with depression every year.

Anxiety is a normal human experience of worry or fear that can’t be brought under control easily. An anxiety disorder is different from feeling occasionally anxious or stressed – it’s a serious condition that makes it hard for the person to cope from day to day. One in four people will experience an anxiety disorder at some stage of their lives.

In many cases, mental health problems may be preventable. They are always treatable. It is important to know that it is not a young person’s sexuality or gender issues that are the contributing factors for depression or anxiety, it can be other people’s discriminating attitudes, homophobia and transphobia. Social isolation is also a risk factor.

Taking action

Mental health problems are just like any other illness – you need ways to address them and stop them happening again later on. Even if you’re worried about what people think, or you’re unsure of what to do about it, start by talking to someone you trust – maybe a parent, teacher, school counsellor, family member or friend.

Remember you can talk to people about how you are feeling and concerns you have about being depressed without having to discuss your sexuality or feelings about your gender.

It may be very useful to find a support group, and there are many of these groups in both urban and rural areas in Australia (see list of websites below). Seeing a GP is also a good start when you’re after help and information – they can help you work out whether what you are feeling is depression or anxiety and help you make a plan to get help. This may involve organising talking (psychological) therapy.

The doctor may also talk to you about other ways to tackle depression and anxiety, such as managing stress and tips on how to improve your sleep patterns. For some people, the doctor may think that antidepressant medication is also necessary, but only if the depression is severe or it isn’t improving with other treatments. If you do start taking an antidepressant, your doctor will monitor you closely for a while. See Youthbeyondblue Fact sheet 5 – Antidepressants for the treatment of depression in children and adolescents for more information.

It’s important to keep going with your treatment, even after you start feeling better – overcoming depression and anxiety can take time, especially if you have been experiencing symptoms for a long time.

Key points to remember

The following things can help you stay healthy if you are same-sex attracted, transgender or intersex, and feeling depressed or anxious.

  • Don’t put pressure on yourself to make big decisions about your life – take all the time you need to think through who you are and how you feel.
  • Spend time and stay connected with people you like and trust.
  • If you think you are depressed or anxious, take action early.
  • Eat a healthy and varied diet.
  • Stay physically active.
  • Take time out to do something you enjoy.
  • Don’t stress (or don’t stress too much).
  • Get enough sleep.
  • Avoid drinking alcohol or taking drugs.
  • Remember that some days will be better than others.
  • Find a support group so you can talk to other young people who may be experiencing similar feelings and emotions.
  • There is help available. See the list of websites and help lines below.

We all have the right to be treated fairly and equally but it can be hard to stand up for yourself if it means telling someone that you are gay or questioning your gender. Remember that you can speak up and seek help for being teased, bullied or abused without having to give any reason.

Where to get help

Whether it’s you or someone else that needs help, you could try talking to a trusted family member, friend, doctor or counsellor. The websites listed below can help you get in touch with other same-sex attracted,
transgender or intersex young people.

Sources

This fact sheet is based on the following sources, which provide more detailed information on depression and anxiety in same-sex attracted, gender questioning and intersex young people:

  • Corboz J, Dowsett G et al (2008) Feeling queer and blue: A review of the literature on depression and related issues among gay, lesbian, bisexual and other homosexually active people. Melbourne: Australian Research Centre in Sex, Health and Society, La Trobe University prepared for beyondblue: the national depression initiative.
  • Hillier L, Jones T et al (2010) Writing Themselves In 3: the third national study on the sexual health and well being of same sex attracted and gender questioning young people. Melbourne: Australian Research Centre in Sex, Health and Society, La Trobe University.
  • POSH booklet http://www.latrobe.edu.au/ssay/posh.html
  • beyondblue (2009) Mental health, depression and anxiety in same-sex attracted people. Issues paper 2 – www.beyondblue.org.au
  • Response ability (2005) Same-sex attraction and mental health (available at http://www.responseability.org/client_images/778680.pdf)
  • Trans Melbourne Gender Project and Gay and Lesbian Health Victoria. Gender questioning (available at www.glhv.org.au/files/GQv2.pdf)
  • Organisation Intersex International (2009). Response to the Department of Health and Ageing discussion paper on a New National Woman’s Health Policy.(available at http://oiiaustralia.com/files/submissions/submission-federal-department-health-ageings-national-womens-health-policy/)
 
 
 
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