LGBTplus mental health
LGBT+ people are at a greater risk of poor mental health and wellbeing. As a minority, you may have to deal with difficult experiences like discrimination because of your sexuality or gender identity. This can have an impact on your mental health. This information looks at issues that may affect LGBT+ people and how to get support. This section is for LGBT+ people who’re over 18 and live in England, and anyone interested in LGBT+ people mental health.
If you would like more advice or information you can contact our Advice and Information Service by clicking here.
- LGBT+ stands for lesbian, gay, bisexual and trans. The ‘+’ is an inclusive term for people who don’t fit into traditional categories of gender or sexuality.
- Research shows that mental health problems, like depression and anxiety, are more common in the LGBT+ community.
- There are specialist LGBT+ charities and mental health services that you may be able access for support.
- The Equality Act 2010 states that no service provider or employer may discriminate against anyone because they are lesbian, gay, bisexual, trans, gender-fluid or non-binary.
What does LGBT+ mean?
What does LGBT+ mean?
‘LGBT+’ stands for lesbian, gay, bisexual, transgender (trans) and others.
The LGBT+ community is diverse, and the plus aims to include all identities.
We have used the term LGBT+ in our factsheet. But we realise that people identify themselves in many ways and that some people may prefer a different term to what we have chosen.
Sometimes you might see organisations describing themselves as ‘LGBTQ+’ or ‘LGBTQIA’ instead.
What does gay, lesbian, and bisexual mean?
A man or non-binary person who is romantically or sexually attracted to men. Some women prefer the term gay and will use it instead of lesbian.
A woman or non-binary person who is romantically or sexually attracted to women.
A person who is romantically attracted to more than 1 gender. Bisexual people often refer to themselves as ‘bi.’
Bi people have lots of different terms to identify themselves, such as ‘pansexual’ or ‘pan.’ This refers to someone who feels romantic and sexual attraction to people regardless of their gender identity or sex.
What does trans mean?
Trans is a term that describes people who have a gender that’s different from the sex they were assigned at birth, either male, female or intersex.
Many people who identify as transgender will have gender confirmation surgery or take hormones to help their body and appearance match with their gender identity. But not all transgender people will want or feel the need for medical support.
Transgender people can identify as a woman, man, a combination of the 2, or something completely different.
What does the ‘+’ stand for?
The plus (+) recognises that many people don’t identify as LGBT, but do not fit into traditional categories of gender or sexuality.
Gender is increasingly being understood as being on a spectrum, rather than being binary. More and more people are identifying themselves as being on a spectrum between man and woman or as non-gendered.
Lots of people have their own words to describe themselves rather than being defined as a man or a woman. You may hear people refer to themselves as gender neutral, gender fluid or non-binary.
What does LGBTQ+ or LGBTQIA mean?
- The ‘Q’ stands for ‘queer’ or ‘questioning’. Queer used to be used as an insult, but some younger LGBT+ people have reclaimed the word for themselves. Other people who identify as LGBT+ find the term ‘queer’ is a slur.
- The ‘I’ stands for intersex. It’s a term used to describe a person who may have the biological attributes of both sexes. Or whose biological attributes don’t fit with society’s assumptions about what constitutes male or female. Intersex people may identify as male, female, or non-binary. Many intersex people don’t see themselves as part of the LGBT+ community.
- The A stands for asexual. This is a term used to describe people who don’t feel any sexual attraction.
LGBT+ and mental illness
Why are LGBT+ people more likely to have a mental illness?
Being LGBT+ doesn’t automatically mean you will have mental health issues. But you may be more likely to develop them. A review of studies on mental health issues in the LGBT+ community found the following:
- LGBT+ people are at more risk of suicidal behaviour and self-harm than non-LGBT+ people.
- Gay and bisexual men are 4 times more likely to attempt suicide across their lifetime than the rest of the population.
- LGBT+ people are 1½ times more likely to develop depression and anxiety disorder compared to the rest of the population.
- 67% of trans people had experienced depression in the previous year and 46% had thought of ending their life.
- Stonewall’s ‘Prescription for Change’ report found lesbian and bisexual women had higher rates of suicidal thoughts and self-harm compared to women in general. Of all the common sexual identity groups, bisexual people most frequently have mental health problems, including depression, anxiety disorder, self-harm and suicidality.
The reasons why there are higher rates of mental health issues among LGBT+ people are complex. There are many experiences that LGBT+ people will often have to deal with as a minority community, such as stigma, prejudice, and discrimination.
Some of the common issues are shown below.
Stigma from the medical field
Some early medical professionals thought being lesbian, gay or bisexual was a mental illness. Homosexuality was seen as ‘part of the problem’ and people needed psychiatric treatment. In 1990 the World Health Organisation removed homosexuality from their list of mental illnesses.
The situation for the trans community is more complex. There are 2 main set of guidelines that doctors use to diagnose mental health conditions. One of these is called the International Classification of Diseases (ICD-11). The other is called the Diagnostic and Statistical Manual (DSM-5).
Up until recently the ICD listed gender identity disorders, such as people who have had gender confirmation surgery, as being a mental health disorder. In ICD 10 this was known as transsexualism. This is one of the reasons why the term transsexual may be offensive for some people.
But in ICD-11 the term ‘gender identity disorders’ has been removed from the mental health category. And a new section on ‘gender incongruence’ has been included in the ‘conditions related to sexual health’ chapter.
This is a positive step for the trans community as ‘being trans is no longer medically categorised as a mental health illness.
Gender dysphoria is listed in the DSM-5. Gender dysphoria refers to the distress people feel when their sex doesn’t match their gender identity. When this causes a lot of distress, it can be defined as a disorder. But there is controversy over whether gender dysphoria should be classed as a mental health disorder.
Discrimination and bullying
In 2018, the Government Equalities Office published the National LGBT survey. This survey showed that 40% of 108,100 respondents had experienced a negative incident in the previous 12 months. The incident happened because they were part of the LBGT+ community. This statistic doesn’t include incidents from people they live with.
The most common types of incidents are verbal abuse. 91% of LGBT+ people either didn’t report an incident at all or didn’t report it themselves. People said that they didn’t report the incident because they felt:
- that nothing would happen or change,
- it isn’t serious enough, or
- it happens all the time.
Transgender people were around twice as likely to experience threats of physical or sexual harassment or violence compared with the overall LGBT community. The figures are 11% for those that identify as transgender, compared to 5% for the whole LGBT community. 6% of transgender people say they have been physically assaulted.
Experiencing a hate crime can greatly increase the risk of mental health issues. It was found that 69% of LGBT+ people who had been the victim of a hate crime experienced depression and 76% reported episodes of anxiety.
Workplace discrimination and bullying
LGBT+ employees are more likely to experience conflict and harassment at work compared to their heterosexual and cisgender colleagues. A person who is cisgender has a gender identity that matches their sex assigned to them at birth.
- A study of more than 15,000 workers found that 40% LGB+ employees and more than 55% of trans workers experienced conflict in the workplace over the last 12 months. This is compared to 29% of heterosexual and cisgender employees.
- The same study also found that 16% of LGB+ workers and 18% of trans employees felt mentally unsafe in the workplace. This is compared to 10% of heterosexual workers.
- 19% of LGB employees have experienced verbal bullying from colleagues, customers or service users because of their sexual orientation in the last 5 years.
- 15% of LGB employees have experienced verbal homophobic bullying from their colleagues in the last 5 years.
- 25% of trans employees are made to use an inappropriate toilet in the workplace, or provided with none at all, during the early stages of transition.
School discrimination and bullying
More than half of younger LGBT+ people experience homophobic, biphobic or transphobic bullying in Britain’s schools.
Verbal, physical and sexual abuse is more commonly reported in transgender youth compared to cisgendered youth.
Nearly half of pupils who experience bullying have symptoms of depression.
See our webpage on Discrimination and mental health for more information.
For some people ‘coming out’ for the first time can be exciting and liberating. For others it can be difficult. It could be a combination of the two. It may not be a one-off event but something you do many times during your life.
If you come out and experience rejection, you may not want to come out again. You may feel that you have to hide your real self, which can affect your mental wellbeing and cause stress.
If you experience homophobia, biphobia or transphobia, you may turn these feelings inwards. This may lead to negative feelings about your own sexuality or gender identity. This can be called ‘internalised homophobia or transphobia’.
Coming out to at least one supportive person, such as a friend or a work colleague, may lessen feelings of depression. It can increase your overall sense of wellbeing and self-esteem, compared to someone who doesn’t come out at all.
But it’s up to you to decide if, when and how you want to come out.
Research shows that young LGBT+ people are at more risk of mental health issues compared to people who don’t identify as LGBT+:
- Young LGBT+ adults are more likely to self-harm. ,
- 13% of those who identify as LGBT+ who are aged 18-24 have attempted to take their own life in the last year.
- Symptoms of depression are more common and severe in young people who identify as LGBT+.
- Young LGBT+ adults are more likely to show symptoms of eating disorders. ,
Many older LGBT+ people have experienced ill-treatment because of their sexual orientation or gender identity in the past. This could have been at work, from authority figures or their own family.
Some feel that their sexual orientation has, or will have, a negative effect on them when getting older. Their concerns are around future care needs, independence, mobility, health and housing.
Age UK have a section on their website for older members of the LGBT+ community. You can find the details for Age UK in the ‘Useful Contacts’ section below.
In a report, 16% of LGBT+ people said that they drank alcohol for more than 5 days per week in a 12-month period. This is compared to 10% of the non-LGBT+ community.
The report also showed that drinking increased for people aged 65+. Gay, bisexual and trans men are more likely to be affected compared with LGBT women and people who are non-binary.
LGBT+ people may be more likely to use drugs than heterosexual people. This is especially true for LGBT+ people between the ages of 18 – 24. Lesbian and bisexual women are more at risk of substance dependence than the rest of the population.
Heavy drinking or drug use can make existing mental health problems worse and potentially trigger new ones.
See our webpage on Drugs, alcohol and mental health for more information.
Culture and identity
Black, Asian or minority ethnic (BAME) LGBT+ people may face additional barriers when accessing support. This is shown in the following statistics about the BAME LGBT+ community:
- 62% are more likely to experience depression than the general population,
- 8% fall under communities that are higher risk of attempting to take their own life,
- 18% have had trouble trying to access healthcare services,
- 51% have experienced discrimination because of their ethnicity from others in their local LGBT community, and
- this rises to 61% for black people who identify as LGBT+.
See our webpage on Black, Asian and Minority Ethnic and mental health for more information.
You may feel pressure to look a certain way. 40% of adults who identify as LGBT are more likely to experience shame due to their body image, compared to 18% of non-LGBT people. Concern over body image can lead to an eating disorder or body dysmorphic disorder.
An eating disorder is a term used to cover mental illness’ such as anorexia, bulimia and binge eating disorder. Eating disorders are quite common for LGBT+ people. The following statistics show how many people from the LGBT+ community have experienced an eating disorder over a 12-month period.
- 12% LGBT
- 24% non-binary
- 19% trans
22% of people who experienced an eating disorder were from the BAME LGBT community, compared to 11% white LGBT community.
Body dysmorphia disorder (BDD)
BDD is a type of anxiety disorder. People who live with BDD will:
- be very distracted with perceived flaws in their physical appearance. These flaws will usually not exist or be very minor,
- have repetitive behaviours, such as mirror checking, excessive grooming or seeking reassurance from others, and
- have repetitive mental acts, such as comparing themselves to others.
The thoughts, feelings and behaviours can be difficult to manage and have a big effect on daily life. Such as issues with relationships, social situations and being able to function at work.
Muscle dysmorphia is a type of body dysmorphia. Most people affected by muscle dysmorphia are men. Muscle dysmorphia means that someone is very distracted with thoughts that their body is too small or lean. People with this form of the disorder often have a very normal looking body or are even very muscular.
Most people with muscle dysmorphia diet, do too much exercise and lift weights too often. This can sometimes cause bodily damage.
Some people with the disorder use potentially dangerous steroids and other substances to make their body bigger.
Many gay and bisexual men report problems with eating disorders, with their weight, or their eating, in general.
For more information see our webpages on the following:
HIV and medication
LGBT+ people living with HIV can find that their medication affects their emotional wellbeing. However, there are now many different anti-HIV drugs available. You could speak to your doctor for a medication review. There may be another type of medication that suits you better.
HIV specialists are very experienced in working with people who have depression and anxiety. If you have had any mental health problems, you can tell your HIV consultant when you start discussing treatment options.
Some anti-HIV medications and medication for mental illness can’t be taken together. But there are some which you can take together. You should discuss any medication issues with your HIV consultant and your psychiatrist or GP.
LGBT+ people can experience more social isolation than the general population. This could make it harder to access support and treatment.
LGBT+ people and their carers may experience discrimination. This may affect their ability to access services and receive the most appropriate support.
A survey found that in gay and bisexual men who have accessed healthcare services in the previous year:
- 17% experienced inappropriate curiosity by healthcare professionals, and
- 10% of gay men and 40% of bisexual men weren’t ‘out’ to anyone about their sexual orientation when seeking general medical care.
In the same survey it was found that:
- 30% of lesbians and 23% of bisexual women, have experienced inappropriate curiosity from healthcare staff,
- 27% of trans people have been ‘outed’ by healthcare staff without their consent, and
- 23% of LGBT+ people have heard negative or discriminatory remarks about people who identify as the same by healthcare staff.
Where can I get help?
It is important to seek help and support if you or someone you know is experiencing mental health issues.
Here are some suggestions about where to get support:
Specialist LGBT+ mental health services
There are often free, or low cost, counselling services available for members of the LGBT+ community. You can find these by searching online or by asking your local LGBT+ service.
Some LGBT+ organisations also provide mental health support groups, mentoring and helplines. You can find local services by searching online for LGBT+ organisations in your area.
Some of these services are listed in the ‘Useful contacts’ section at the bottom of this page.
General mental health services
GPs and NHS talking therapy services
Going to see your GP is the main way to get support and treatment for mental health issues.
NHS talking therapy services provide therapies such as cognitive behavioural therapy (CBT), group therapy and counselling and other help.
You can self-refer to your local service. This means that you can contact them directly to get an appointment, so you don’t have to go through your GP.
You can find your local NHS talking therapy service by searching on the following NHS website: www.nhs.uk/mental-health/talking-therapies-medicine-treatments/talking-therapies-and-counselling/nhs-talking-therapies
You may have had problems accessing healthcare. But there are steps being taken to improve things. The government introduced the NHS Constitution, which says that we all have the right ‘not to be unlawfully discriminated against in the provision of NHS services.’ This includes sexual orientation and gender reassignment. All NHS services must comply with this principle.
Some NHS trusts have published their own LGBT+ guides for medical professionals.
For more information see our webpages on the following:
Social care and direct payments
Older or disabled people may need social care support. In line with Care Act people with eligible needs for social care will be able to get support. Some people get this support for free, other people will need to pay for all or towards the cost of care.
If you are entitled to social care support, you can ask for direct payments. This means that your local authority gives you the money to buy the services you want. Direct payments give you more freedom to organise your own care. This means that you can choose a carer who understands and respects your lifestyle and who you feel comfortable with.
For more information see our webpages on the following:
LGBT+ support services
There are many organisations offering social and practical support to the LGBT+ community. There may be LGBT+ social groups, sports clubs or activities in your area that you could become involved in.
Many areas have services for younger people that can help with advice, support and meeting other LGBT+ people. Some areas also have services for older LGBT+ people to help them feel less isolated.
You can search online to find suitable services in your area.
Problems accessing services
What if I have problems accessing services?
Accessing general health services can be a difficult experience for someone who is LGBT+. People can be worried about disclosing their sexual orientation or gender identity to health professionals. This may be in case they are misunderstood, or the service can’t meet their needs.
You may decide to come out to your GP or another medical professional. It may help to talk this through with someone beforehand. You could practice the conversation with a friend. You may prefer to do this with someone you don’t know. For example, you could talk it through with someone on an LGBT+ helpline. Some helplines are listed in the ‘Useful contacts’ section at the end of this factsheet.
What are my rights as an LGBT+ person?
Under the Equality Act 2010, it is illegal for a service provider to directly, or indirectly, discriminate against anyone who identifies as LGBT+. The NHS and any other organisation that offers services is a service provider.
Stonewall has a guide called ‘Protecting Patient Rights’ with the General Medical Council. This is about protecting the rights of LGBT+ people in health services. You can find it at:
What if I’m not happy with my treatment?
If you aren’t happy with your treatment, you can:
- talk to your doctor about your treatment and ask for a second opinion,
- get an advocate to help you speak to your doctor,
- contact Patient Advice and Liaison Service (PALS) and see whether they can help, or
- make a complaint.
There is more information about these options below.
If you aren’t happy with your treatment, you can talk to your doctor and see if you can resolve the situation with them. The National Institute for Health and Care Excellence (NICE) produces guidelines for the treatment of different mental health conditions. You can refer to these guidelines if you feel your doctor isn’t offering you the right treatment.
You may feel that your treatment needs to be changed. If your doctor doesn’t agree, you could ask for a second opinion. You aren’t legally entitled to a second opinion, but your doctor might agree to it if it would help with treatment options.
An advocate is someone who in independent of the NHS but understands the system and your rights. They can come to a meeting with you and your doctor and make sure you get what you are entitled to. Advocates help you make sure your voice is being heard.
Some organisations may have specialist LGBT+ advocacy services. You can search online to see if there are any local advocacy services in your area.
The Patient Advice and Liaison Service (PALS) at your NHS trust can try to help you with any problems or issues you have with an NHS service. You can find your local PALS’ details at:
You can complain using the NHS complaints procedure. The GP practice or mental health trust should be able to give you a leaflet about their complaint procedure.
You can find more information about:
An organisation that offers guidance and support for older people who may be experiencing difficulties in accessing services or care. They have a section on their website which is written for older people of the LGBT+ community. It can be found using this link: www.ageuk.org.uk/information-advice/health-wellbeing/relationships-family/lgbt/
Telephone: 0800 678 1602 or 0800 055 6112
Email via website: www.ageuk.org.uk/contact-us/information-and-advice//
The Asexual Visibility and Education Network
Hosts the world's largest online asexual community as well as a large archive of resources on asexuality. Provides email to support to people who identify as asexual and their friends and family.
Being Gay is Okay
A service that gives online information and advice for under 25-year olds.
The Beaumont Society
A national transgender support network offering emotional support via a weekly helpline, as well as general information and support groups
Telephone: 01582 412220
Address: The Beaumont Society, 27 Old Gloucester St, London, WC1N 3XX
Equality Advisory and Support Service
An organisation that provides advice on discrimination and human rights issues
Telephone: 0808 800 0082
Text phone: 0808 800 0084
Address: FREEPOST EASS HELPLINE FPN6521
Email via website: www.equalityadvisoryservice.com/app/ask/session/L3RpbWUvMTQ5Nzg3MDY0MS9zaWQvRFh2ZE92bG4%3D
GIRES (Gender Identity Research and Education)
A charity that provides information for transgender people and medical professionals, including research and links to support groups.
GMFA (Gay Men Fight Aids)
A gay men’s health charity with lots of useful information on their website.
Pink Therapy has a directory listing qualified therapists throughout the UK who work with the LGBT+ community from a positive stance.
A mental health service for LGBT+ people which provides advice, information, advocacy, peer support groups, mentoring and wellbeing events.
A charity for all LGBT+ people both in the UK and abroad. They can provide information and advice. They have a database that can help you find local lesbian, gay and bisexual community groups or services.
A service that gives national information and a listening service over phone and email and instant messaging. All volunteers identify as LGBT+ so the person answering the telephone will have an understanding of your situation. They are based in London but do take calls from the whole of the UK.
Local support. This list does not include local support in all areas of the country.
A service that offers information and support exclusively to LGBT+ people around drugs, alcohol and addiction. Part of London Friend's service.
Birmingham LGBT Centre
Voluntary organisation providing advice and support to LGBT+ people in Birmingham. Offers counselling, well-being services and wide range of support groups.
ELOP (East London Out Project)
A London based LGBT mental health and wellbeing centre offering a holistic approach. They offer counselling, support groups, advocacy and young people’s services.
Leicester LGBT Centre
Voluntary organisation providing support to LGBT+ people in Leicester, Leicestershire and Rutland. Offers counselling and wide range of support groups.
A Manchester based charity offering mental health services and resources to the LGBT community. This includes befriending, free counseling and a support helpline.
A long-running LGBT+ charity which offers low-cost counselling, drug and alcohol services as well as social and support groups. Based in North London.
Provides health, community and youth services across London and the south-east of England. Mental health support includes counselling, mental health drop-in, sexual health counselling and advocacy.
Opening Doors London
Provides a range of services and activities for LGBT+ people over 50 in London.
An LGBT+ mental health service run through Mind in Islington, offering psychotherapy, counselling, art therapy, alternative therapies and activities.
Leading lesbian, gay, bisexual and transgender (LGBTQ+) help and support service based in the south east of England.
Telephone: 0118 321 9111
Address: 15 Castle Street, Reading. RG1 7SB