While a rising percentage of young adults identify as LGBTQ+, they simultaneously face increasing systemic challenges. In 2023, the Human Rights Campaign declared a state of emergency after 75 anti-LGBTQ+ bills became law. By 2024, 672 anti-transgender bills were proposed nationwide, many targeting youth. Today, the future of LGBTQ+ rights remains uncertain as the Trump administration rolls back protections against discrimination and dismantles DEI initiatives across schools and workplaces.
What we know is that the mental health impact of systemic discrimination on young adults is real and measurable. 90% of LGBTQ+ youth report that state laws restricting the rights of transgender people have impacted their mental health negatively. And our team witnesses first hand the impact of system oppression on mental health, especially for clients without a supportive network in place.
“The political climate of a country can be traumatic for young adults without a supportive community, especially for those living in certain states,” explains Partner & Chief Clinical Officer Amanda Fialk, PhD, LCSW, LICSW.
What can Mental Health Professionals Do to Address the Current Political Climate?
As a proudly-affirming organization, in which 43% of our clients identify as lesbian, gay, bisexual, transgender, queer, intersex, asexual or another gender or sexual orientation, we’ve covered practical steps for creating an inclusive healthcare environment, but we also understand the importance of consistent self-education about the ever-changing landscape in which our clients live. This population has more mental health and substance use problems, survey finds, including substance use, eating disorders, suicidal ideation, and suicide are significantly higher among LGBTQ+ individuals in the US than their straight, cisgender counterparts, it’s also critical that we do so.
Below, we learn from one of our clinical supervisors on how our team approaches the complexities of the impact of systemic discrimination on youth mental health.
Understanding The Impact of Discrimination on Multiple Levels: The Ecological Model
“At The Dorm we sometimes look at discrimination as an ecological model,” explains Director Amie DiTomasso, LICSW, MPH (she/her). “We can zoom closely into someone’s microcosm, and talk about their self acceptance or acceptance within the family, or we can think about our community at large, and then even the nation or world at large. Within each of these spaces you can see some real challenges specific to LGBTQ+ youth.”
Finding Self Acceptance on an Individual Level
In the context of discrimination, ranging from hate crimes to micro-aggressions, therapists find that self acceptance can be particularly challenging for LGBTQ+ people just launching into adulthood, explains Amie. “Especially if you’ve been raised with a different pronoun or assumed sexuality. For example, you may have grown up always hearing ‘Oh, you’re going to have so many girlfriends when you grow up!’ instead of ‘Oh, so many people are going to like you when you grow up.’”
The messages you hear over a lifetime, even if they’ve had no malicious intent, are hard to process and align with changing identities, making the shift to understanding your authentic identity is an enormous task.
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Navigating Family Life & Personal Relationships
Many young adults in the U.S. face estrangement or ostracism when it comes to coming out to their families. Over two-thirds of LGBTQ+ adolescents have reported family members making negative comments about their sexuality. (Almost two-thirds (63.1%) of LGBTQ+ youth reported at least one positive experience of parental support.) This can be particularly damaging to LGBTQ+ youth who are beginning the process of coming out and fear losing their sense of safety, or even the security of home.
Familial discrimination can lead to devastating outcomes. One study found that young adults experiencing high levels of parental rejections are eight times more likely to report attempting suicide and according to True Colors United LGBTQ+ youth have a 120% higher risk of homelessness. This is most often the result of abuse at home, or being kicked out after coming out to their family.
Finding Community Acceptance
In a recent survey of LGBTQIA+ teenagers, 49% of LGBTQ+ young people ages 13-17 reported being bullied in-person within the past year, and 26% of those ages 18-24 reported the same. (In 2023, and transgender and nonbinary students reported higher rates of bullying compared to cisgender LGBTQIA+ students.) Bullying or other peer-based trauma have been shown to lead to higher rates of suicide amongst teens.
Community acceptance and integration, however, can have a profound impact on LGBTQIA+ mental health. Transgender and nonbinary young people reported lower rates of attempting suicide when all of the people they live with respected their pronouns and/or they had access to a gender-neutral bathroom at school. Additionally, trans and nonbinary young people who had access to binders, shapewear, and gender-affirming clothing reported lower rates of attempting suicide in the past year compared to those who did not. These affirming and supportive adults don’t even have to be a parent – a trusted friend, therapist, coach or mentor can make a life-saving difference.
Societal: Facing Discrimination and Systemic Barriers to Care
On a societal level, LGBTQ+ young adults face immense barriers in every facet of life, to name a few: participating in school sports, running small businesses, expressing their authentic identities and fighting for their right to marriage.
Systemic barriers are also particularly frightening for Black LGBTQ+ youth, who are less likely to receive and access life-saving mental health. (50% of LGBTQ+ young people who wanted mental health care in the past year were not able to get it, including nearly half of transgender and nonbinary young people (49%) and more than half of cisgender young people (52%).)
“Considering the current political climate in the United States, we’re in the midst of a step back when it comes to being able to provide and access affirming care,” notes Amie.
Facing discrimination on a societal level takes consistent self-education, activism, advocacy, and voting. It’s important to stay abreast of policy changes in your area, for starters. Organizations like HRC, Them, The Trevor Project, and the ACLU can help you stay knowledgeable about the issues that impact our community. And for trans rights in particular, Track Trans Legislation is a great option.
How does Inclusive Care and Affirming Mental Health Treatment Make a Difference?
LGBTQ+ individuals have a higher likelihood of seeking mental health services such as psychotherapy, counseling, substance use disorder treatment, and inpatient mental health service. And accessing treatment that is validating, affirming and LGBTQ+ inclusive can be life-saving.
Clients are more likely to grow and flourish as their full, authentic selves when they feel seen and believe their therapist authentically understands their lived experiences.
Organizations and therapists can take several steps to combat the risks facing LGBTQ+ youth, including:
- Implementing groups specifically for lesbian, gay, bisexual, transgender, asexual and/or intersex individuals. At The Dorm, we frequently survey our community to continually evolve along with our clients’ needs and offer a trans-nonbinary process and identity group specifically for this population.
- Conduct regular diversity trainings with vetted professionals. For example, our team participates in diversity training with organizations such as Choice Points Learning and BCG Bridge.
- Hire a diverse team. Representation matters, and while self-disclosure must always be done with care, it’s essential that LGBTQ+ young adults see themselves in the population they are looking to for care.
Learn additional actions mental health providers can take to provide inclusive care in the following post: LGBTQ+ Mental Health Treatment: What Inclusive Care Looks Like in Action.
