New Studies Say LGBTs Suffer Anxiety, Depression, and Substance Abuse, Oh My

Slowly but surely, a body of research is being built up about LGBT people and their needs as people and as patients. We already know that many doctors and medical students don’t have specific training on how to treat LGBT populations; many don’t even know that specific training is required, or that we have unique health needs.  We know that discrimination, and incidents like anti-gay bullying, negatively impact our mental health and well-being. We know that LGBT populations face high levels of psychological and emotional stress as a stigmatized group, which factors into heightened levels of substance abuse.

Now, a study from Australia tells us that beyond just suffering from higher levels of mental health problems than the average population, almost 80% of LGBT people have suffered “intense anxiety” in the past year. Maybe that’s related to the fact that that apparently “almost half of the more than 4000 GLBT people surveyed said they hid their sexuality or gender identity in a range of situations for fear of heterosexist violence or discrimination,” and some reported feeling like they had to keep their sexual orientation a secret from even their medical practitioner. Less than 70% of those surveyed said that their general practitioner knew their sexual orientation, and roughly 25% didn’t even have a regular GP.

not everyone can have a therapist like ellen

Young people aged 16-24 were described as “more likely than any other age group to hide their sexuality or gender identity.” This may help explain why in another study conducted at the University of Michigan in fairly liberal Ann Arbor, LGBT students are “significantly more likely to report[...] alcohol or drug use and problematic drinking and problematic drug use.” The study found an explicit correlation between experiences of discrimination and substance abuse, indicating that even in the supposedly safe atmosphere of a college campus, anti-gay hostility and discrimination is seriously affecting the ability of queer students to live healthy, happy lives. The research indicated that even “sexual minority students who knew others who were subjected to hostility were at increased risk for having a drinking problem.” Overall, it suggests that while we’ve already more or less established that experiencing anti-gay harassment is damaging to mental health and well-being, the general atmosphere of inequality and microaggressions that queer people experience also add up to a significant impact on psychological health, even for young people.

Looking at the various factors that make up someone’s health status is always complicated. For instance, it seems like LGBT people’s substance abuse is correlated with stigma and anti-gay discrimination; but it may also be compounded by the fact that LGBTs (and other marginalized populations) are less likely to have health insurance or equal access to healthcare, as substance abuse can function as an attempt to self-medicate for people with anxiety or depression. Given that when LGBT people try to access counseling services there’s a chance that their therapist may try to “treat” their sexual orientation rather than their anxiety, they may not see counseling as an option — which in turn would lead to anxiety as a reaction to experiencing stigma and discrimination. It’s a difficult problem to disentangle, but the more studies we have that can point to specific correlations in the experience of LGBT people, the better chance we’ll have at making life better for our community.

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Rachel is Autostraddle's Senior Editor and the editor who presides over books and news & politics coverage. Originally from Boston, MA, Rachel now lives in the Midwest. Topics dear to her heart include bisexuality, The X-Files and tacos. Her favorite Ciara video is probably "Ride," but if you're only going to watch one, she recommends "Like A Boy."

Rachel has written 752 articles for us.

73 Comments

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    related: I just started seeing a counselor, and I don’t really know how to come out to her, but I feel like I should since it’s almost definitely related to some of my issues w/r/t parents, etc. Should I just look for an opportunity to mention it in passing, or what?

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      If you’ve just started seeing them, don’t sweat it – in my experience, it’s something that eventually comes out naturally when they try to get a bit of history from you over the first few sessions. I know it’s stressful, especially since it’s caused issues for you before, but counselors/therapists are legitimately the least judging people you could ever come across and she likely won’t even bat an eye.

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      ahhh i totally disagree that counsellors/therapists are the least judging!! that’s exxxactly what’s being referenced in this article. sometimes counsellors/therapists are homo-/transphobic assholes. in my experience the best bet is to get referrals from friends or to ask the therapist right off the bat if they’re queer & trans positive — before i get myself into a potentially unsafe situation — and determine whether or not to follow through after that. i even ask a few probing questions in my first session to suss out whether that person actually knows their shit or is just like, “oh ya, gays are cool, whatever” but then has a bunch of unchecked privilege they need to work out.

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        Yeah… I went to a therapist once in a regular medical office, nothing funny or specialized… and he kept telling me to just not be anxious and to just to read my Bible and turn my stresses and worries over to God. I mean, I’m a Christian and all so I wasn’t like, completely horrified by the suggestion, but I was like, this is not helping. At all. Yeah, didn’t go back for a second appointment.

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          I went to a regular doctor once for a referral to a therapist* and possibly some anti-anxiety meds. He refused and amongst other things and then told me what yours told you, to pray and read the Bible and turn to God.

          I later found out my friend had gone to see the same doctor to ask for the pill. He didn’t give it to her and instead advised her “don’t let your boyfriend pop your cherry!”

          Finding good mental health care is harder than I thought before I tried to get some myself.

          *Where I live if you do this the state subsidises your therapy.

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          At least you subscribed to that chosen belief system. Here in the Bible Belt, queer atheists like me have it the worst. I’ve had a lot of bad experiences with religion, so that would have sent me off a cliff.

          Just WOW. Is that even legal? How is such a person licensed?

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          I don’t know if it’s legal… but it was a reputable office. I mean, it was where I met with my regular PCP (who was awesome). And I was still totally taken aback and amazed at what was coming out of his mouth, Christian or not. ;)

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          Well there are two kinds of Christians. the ones who know how to use modern technology, common sense, and logic to fit their religious views into modern life, and then there’s the nutsos who really take the book literally and would shoot their neighbors for working on Sunday if it wouldn’t land them in prison.

          The former ones are cool as hell. The latter?Scary.

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      I too have to disagree with the counsellors/therapists being the least judging people thing, because my experience has been completely the opposite. (Granted, I probably come from a more conservative background than most here.) Not saying you should keep it from your counsellor, but I’d definitely test the waters first — there are few things worse than being shut down or attacked by someone you should be able to trust in a situation in which you’re inevitably vulnerable.

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      I looked up the therapists at my school months before coming, and specifically chose to request the counselor who mentioned that she worked with LGBT issues (among my other somewhat specialty issues). Turns out she’s gay, and helped me a LOT when I was freaking out re: coming out as gay instead of bi. I’ve met her partner, and she’s pretty much the best therapist I’ve ever had. I’ve met some of the other counselors on campus and basically just hated them, and recommended all of my gay friends to see mine if they’re looking. She’s gotten to the point where she’s booked solid nearly a month in advance.

      So yea. If you can’t get referrals from friends, google the shit out of them first to see what experience they have with LGBT stuff, or bring it up ASAP.

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      I agree on getting referrals or lightly testing their level of acceptance before jumping in. I got lucky with my previous counselor who was very kind and accepting of my sexuality and the pain I was going through with it. He even told me that if I wanted to see a female and/or LGBT-specific counselor, that he wouldn’t be offended at all and would find me the best among his colleagues. I stayed with him anyway, but still, it never hurts to do a bit of homework before hand. And if you feel that your counselor is even a smidge uncomfortable, thank him/her and leave.

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      I’m studying to be a counselor, and, at least where I go to school, we have classes devoted to diversity. So most people in that field are pretty open. If he/she reacts badly, move on to a different counselor.

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      Thanks so much for all the responses! I don’t know anything about my counselor personally, but I do know that -officially- the university counseling center is accepting of LGBT+ individuals and the website acknowledges that many hesitate to seek counseling due to reasons in this article…I see my counselor again tomorrow, and I’ll keep an eye out for an opportunity to bring it up depending on how things feel. I don’t expect any problems with her, I just wasn’t sure how/when to breach the subject.

      I really appreciate all the advice and stuff from everyone.

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    When I read this headline, I thought, “No shit, Sherlock”. Just about every queer I know has some sort of history with/current mental health issue. Therapy is one’s friend, if one can get it.
    In related news, one of my coworkers is working on a project to create curriculum to train hospital and prison chaplains to more effectively counsel LGBT populations. This is a hopeful step.

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      Basically every queer I know has a therapist too, besides my girlfriend, but both her parents are therapists, so I think that counts. Then again, I think at least 80% of my friends have been to therapy at some point in their lives, and if not, they def. have issues about which they need it. What does that say about me?

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    As a therapist in training, I ask this question in my first session with all my clients, no matter what, because our sexual orientation is an important part of us. I would say broach the subject sooner rather than later; there are CERTAINLY very homophobic/biased therapists/counselors out there, and if you’re dancing around the topic, you’re not getting the most out of your time. From where I sit, it’s better to know that you’re safe with your therapist, and if you’re not, get outta there ASAP.

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      that’s interesting. what if the person isn’t ready to talk about it, or wants to build up trust with you first? I look back to the counselling I underwent and I would have been pretty uncomfortable with being asked that to start off with, even with the therapists I would end up trusting.

      For me at any rate I’d rather hear a therapist say “you don’t have to tell me anything about yourself you don’t want to, but I want you to know we are supportive of sexual and gender diversity” or something like that.

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    I have had the benefit of a lot of very expensive therapy. For me it was like my therapist was like having a very expensive friend. She called me on by bullshit. Listened when I needed it. Held me when I cried. And agreed my ex was a douche nozzle.I still miss those weekly sessions.

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    I wish therapy was more readily available to queer/minority groups because I wholeheartedly believe it helps. I went to therapy first as an undergraduate for severe depression stemming from childhood abuse. Can honestly say that it probably saved my life. Once I recovered a bit, I then stayed in therapy to deal with anxiety about being queer. Now that I am a graduate student, I am again taking advantage of very affordable talk therapy. But the only reason I was/am able to do therapy is because I am at a university.

    And on somewhat related note, once I graduate and settle down where ever it is I find a job, I am going to seek out how to become a mentor for queer youth/young adults. It won’t be a substitute for therapy, but I figure someone safe for a young adult to vent to would be better than nothing. My roundabout way of paying it forward.

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    It really does depend on the therapist and the relationship. Before my last therapist I had two that were just so so. I would have never felt comfortable coming out to them. However, I felt like deep down inside my therapist knew. I had not accepted it AT ALL and never told a soul. After I had been seeing her two months, two sessions in a row she pushed saying she knew there was something more going on. Long story short, I came out to her and said, “I’m not so sure I’m straight.” That was one year ago March 30. From that point on she was the most supportive, understanding, and giving person ever. From there I was able to accept myself as gay, come out to tons of friends, and ultimately my parents so I could live as a happy, out gay person. I have never been happier in my life so I can definitely say therapy changed my life for the better. I also miss our weekly sessions.

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    Anxiety and depression. Oh yeah, I know them well. I believe that queers have more of these issues because we tend to just deal with more issues. It is what it is.

    I recently started a new job and the people are so nice and I love the work, but I have been so stressed since starting. Not because it is a new job (none of those typical issues stress me), but because I work in a professional office, all of my co-workers are straight women, and I look super straight. They know I’m married because of the huge rock on my left hand (ha), but I knew they were assuming I had a husband, instead of a wife… I hate when people don’t know I’m gay but I hate having to make an issue out of it out of the middle of nowhere, like an unnecessary disclaimer statement at the beginning of a relationship that is supposedly strictly professional anyway. So do I keep my mouth shut and let everyone just assume I’m straight until it naturally comes up in conversation, even though I absolutely hate that feeling?? I hate feeling like I’m hiding it, I hate feeling like I’m pushing it.

    Recently, though, I mentioned my wife to a coworker a lil while ago and she didn’t bat an eye… and I’m pretty sure she outed me to everyone else, which is actually a huge relief. I have mentioned my wife or dropped her name in the last couple of days and the conversation just moves on knowingly, like they all already know and accept it as fact. This is actually absolutely fab for me and removes one stress. I have no desire to hide… but I hate that stupid introductory conversation.

    The other issue that makes me so anxious is that I feel like they don’t really try to relate to me. Like, they all talk about their husbands and kids, husbands and kids, husbands and kids… and I feel awkwardly out of things. And I feel… weird. And it makes me like, anxious and depressed. Like, crying and stressed at home.

    Am I alone in this? Ha. Or do people know how I feel? Living in a society where everyone is assumed to straight until proven otherwise… and working in an environment where I’m the only queer around, even though I so easily “pass”… is like, upsetting to me. :/ I have been super out for 12 years. I’ve never hid it. I’m very out and radical and completely unashamed. But now that I’m being an actual adult and working in a super-professional environment, I feel like I don’t know how to act. And even though it seems like it shouldn’t be a big deal, it is. (And to say to find other work in a different environment is impractical. I work in the field I went to school for in a medical office in fricken Portland, Oregon.)

    My point: yes, being in the closet is stressful but being out of the closet is stressful and having to repeatedly do it is still a lil anxiety-inducing at times. Just the fact that you are queer and even have to have these issues on your radar and have these decisions to make all the time… ugh, no fair. Ideally, we would all live in a place where no one gave a shit and we didn’t have to worry about the professional or social repercussions that may come along with just being ourselves.

    Until then… pass the xanax, please.

    I know this was long but I needed this post today. Ha. Any feedback at all?

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      I totally identify with this! Admittedly, I’m a bit younger, but in my work life I am always struggling with whether to come out, and when, since I do “pass” as heterosexual and my co-workers freely talk about boys, boyfriends, and more boys during time off. When I worked at a camp, I came out to my supervisor (I wasn’t sure the camp owners weren’t homophobic and I needed to cover my butt) and she said that it basically wasn’t a big deal and found it very weird that I had anxiety around hiding my gayness and that I felt uncomfortable and othered when all the chit chat was often about boys or flirting with male staff.

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      Yeah, busy. I know how you feel. Most people assume I’m straight, even gay and lesbian people. There’s nothing straight about me so there’s no way I’m exuding straight energy. I wear birkinstocks and no make up! I don’t even like strait people so I really don’t like when they think I’m one of them. It just goes to show there is no such thing as good gaydar. I try not to guess whether someone is gay or straight because you CAN’T TELL. And straight until proven gay sucks. I was just daydreaming today about how nice it would feel if people just magically knew I’m a lesbian without me having to come out over and over.

      It’s also awkward when male coworkers ask me on dates. They either don’t believe I’m a lesbian, or they proceed to tell me all the gory details of their sex lives, then try to invite me over to “watch a movie” anyway. So, yes, work place politics are a minefield for gays. And feeling alienated is not healthy.

      When I was first coming out, I was suffering through severe depression and anxiety. It was the most difficult challenge of my life and I’ve had many. My psychiatrist gave me a checklist of stressful events to check off and coming out is not even on the list! And this was in NYC, not some back water! So clearly professionals do not acknowledge the stress we experience.

      Luckily my therapist was a lesbian. She was a lifeline. So all you in therapy now, do not underestimate the real need you have for help. Find a gay or friendly therapist. You need it. Also lucky for me, I did not have a car during that time. I drank like a fish every day. Anything for relief.

      On the upside, and I don’t mean to sound polyanna, depression and anxiety are a thing of the past for me. I could barely manage to eat or sleep or even function and frequently wished for death. I was a sick puppy and now I feel content and comfortable almost all the time. No meds, little drinking, and even if I miss my morning coffee I feel fine. It took years of hard work to figure out how to be happy, but I hope to give encouragement to those in the pit. You’ll get better if you work at it.

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        The easy way to avoid the workplace shit is to be like “I don’t play where I work.” That is inoffensive, and it’s an easy way to make sure people have to respect that decision whether you are out at work or not. Simple, effective. That’s how I handle it. I am beyond butch, so that part isn’t an issue for me…but I can imagine that this must be frustrating as all get out.

        Anyway, I’ve learned that a coy “I don’t play where I work,” said in a slightly husky voice, in front of as many co workers as possible (SANS any cute dykes, of course), can help one easily avoid that awkwardness of dudes at work trying to get down with you. I also avoid social environments with straights, so that solves any after work cocktail-in-hetero-bar type situations as well.

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          I agree, making it clear you don’t date/mingle with co-workers is an easy and effective means of diverting the attention of men at work.

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      “The other issue that makes me so anxious is that I feel like they don’t really try to relate to me. Like, they all talk about their husbands and kids, husbands and kids, husbands and kids… and I feel awkwardly out of things. And I feel… weird. And it makes me like, anxious and depressed.”

      yeah, I feel this, in a big way. It’s obviously a sexual orientation thing but also a life path thing. I’m not a white picket fence and a mortgage kind of person. As much as I try to smile and ask questions when people tell me about their children’s dietary requirements, I don’t feel that people do the same with me if I mention roller derby or travel plans or poetry or the various things that keep me breathing. People act like what I love is weird and alien, and therefore I feel weird and alien. It’s not exactly conducive to good mental health.

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        I so relate to this! I used to think I was a let’s settle down-buy-a-house-do-the-whole-imitation hetero-2000’s- gay- Lloyd- and June Cleaver- thing- and then I realized that isn’t me AT ALL. I have never wanted kids, I like my time and my money to myself. I wasted some time, and I am 31 now and I want to find a nice girl, preferably one who is ok with the open relationship thing, move back to a gayborhood where I can find a juicing and pilates buddy, eat vegetarian goodness, hang out in coffee houses and spoken word venues with other dykes, etc etc etc…just live my life being a lesbian sans all the societal expectations and bs.

        It isn’t that I don’t care about husbands and kids of straight people. No, I really, really do. However, I don’t relate. At all. That life is not for me.

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        I agree that it’s a life path thing, too.. I mean, my wife and I totally could have a mortgage and a white picket fence and a minivan and 2.5 children… But like is mentioned below, we like our time and money too much for that, which sounds kinda terrible but is at least very honest.

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      I have so been there, especially with the whole “talk about the husband and kids” thing. I’ve been able to find people who are willing to talk to me about other stuff than that, though – I recommend feeling people out. Not necessarily about gayness, of course, but about books or internet culture or whatever. And then eat lunch with the cool people. :)

      People are often surprised to find out I’m queer, and I definitely know how exhausting constantly coming out can be!

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      Def not alone here. I study at a ballet school, where the girls are all sooo straight and the guys all gay and no way I can come out to more than a few of my friends who won’t tell either. I was pretty traumatized at age 16 when a girl came out as bi because she was kissing a girl at a party, and after she was an outcast..one girl even said she wouldn’t want to stand in front of her at the barre (in a leotard and tights) because she might check out her ass….also, the director of my school told a gay boy that he needed to learn to like women, he had had that sort of phase himself, and it’s a sin to be homosexual. the only good thing about that is now I know to keep my mouth shut or loose my scholarship, the only thing keeping me away from my home… therapy please? lol

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    Hell, I’m anxious about the therapy at which I discuss being anxious, because a) it costs A LOT; b) insurance won’t cover it; c) I’m trying to sneak it into my work schedule without telling my boss “I need this morning off once every couple weeks so I can talk to someone about how I think I’m trans” because I’m not out at work.

    I’ve reached a whole ‘nother meta level of queer anxiety, basically.

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    How I came out to my boss:

    Boss: “So, I know you’re looking for a place. What would you think of moving in with -female coworker- here at the farm?”

    (Background: I met her in the hayloft. I was immediately smitten. My first words to her, upon seeing the most deliciously muscled arms I’d ever laid eyes upon, covered in sweat and hay chaff, were, “you have HOT arms.” We’d started carpooling, since we lived in the same town forty minutes from work. We had everything in common. EVERYTHING. We’d also just spent our first night together. This had all gone down in the past week, and no one suspected anything. We both pass as straight, we’d both just started working there, and our new bosses were prone to use the phrase “that’s gay,” keeping us pretty firmly shut in our closets. Until we met, of course. To say I was anxious about my word choice, now that my boss had me backed into a corner, is an understatement!)

    Me: “Um… Errrr… We’ll see how it goes, I guess? I mean we just… Ummmmmmm… … … We’re dating.”

    Boss: “Oh, yeah, I figured. Ahhhh, barn love… I remember meeting my wife at the old farm…”

    Five minutes later, he pretty much had my co-worker and I living on the hill with a white picket fence in his head. He told us to be as open as we wanted (in a very honest and not-at-all creepy way) and has never been anything but supportive. Our relationship, which we neither flaunt nor hide, has been a non-issue with everyone at the farm, except for one very old-world middle-aged European student (but that isn’t even the half of it with that guy. I wrote him off long before my sexual orientation became an issue).

    The other anxiety-inducing moment was during my last physical with a new (European) doctor in a small town… When the question, “so are you on the pill?” inevitably came up, since that’s the biggest motivator for most women to get their physical yearly. My doctor is female, and we’re in a room alone together, and I am very femme. I worry it will be awkward when I come out of left field with my answer.

    “Um, I’m not on the pill.”

    “What do you use for contraception?” (I was glad she said ‘contraception’ and not ‘protection,’ because that’s a whole other half-rehearsed speech I wasn’t ready to delve into)

    “Ummmmmm… I’m… with a girl… So, I don’t have to worry about that.”

    The doctor simply smiled, nodded, and asked me how school was going. WHEW.

    But, yeah, it’s moments like that where you come out and don’t know what you’ll be met with that can be anxiety-inducing. Nevermind coming out to the parents over the phone and just hearing SILENCE for a beat too many o____O

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    You can’t generalize that ALL therapist are tolerant or ALL therapist are homophobic assholes. They’re all individuals. I think those that are associated with larger medical centers where they see people from all walks of life and every kind of background, things tend to not shock them as much as someone in a nice little private practice in a nice suburb.

    Our Pride center has a listing of LGBT-friendly therapists. Some are LGBT themselves, others have just been doing it long enough that they have developed a rapport with the LGBT community.

    Personally, I have been going to a therapist through my company’s EAP (Employee Assistance Program) on and off for a couple years. I hadn’t seen her for over a year and in that time I had come out. Although she is of the predominent religion here in Utah I didn’t even think twice about coming out to her. She had always been professional and non-judgemental before. When I told her I could tell it sort of shocked her and she was speechless for a total of about 2 seconds. Then she was all “so what did your mom say?” “What did your dad say?” etc.

    I think you have to have a rapport with your therapist and you have to feel you can trust them. This may mean trying a few before you find one you’re comfortable enough with to be able to open up to them.

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    I have bipolar disorder. I had a break down and that is how I wound up back in SC. OMFG. I wound up at this community clinic. I had this awful counselor who told me to go back into the closet because my parents “didn’t need to know all that.” It was just terrible. I am terrified of going to therapists now.

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      Where in SC? I’m from Conway, outside of Myrtle Beach, but lived in Charleston up until a year ago. SC can be such a terribly conservative hell hole, but I’ve usually managed to find bright spots here and there. I’m sorry you had such a shitty counselor, they ruin what should be a healing experience.

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        Rock Hill. I was born and raised here, went to the University of SC, dropped out, went to Buffalo, NY, NYC, LA, SF, then briefly back to NY where a series of events led to homelessness and a breakdown, where I had to crawl back home. I got an IT degree, took time off dating, started a blog ( A WHOLE LOT MORE HEALING THAN THAT FUCKING THERAPIST), just got an IT degree in January, planning to move back to SF this summer when I can afford it.

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          Wowzer, that sounds intense. Glad you’re doing better though. I’ve never spent any real time in the upstate but I have plenty of friends from up that way so I know it’s not the happiest place to be a gay. Good luck getting to SF sooner rather than later! Us Carolina folks gotta stick together :)

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    Oh, as a queer person who suffers from anxiety among other things and also does things that are maybe not so good for herself… I can maybe relate to this study.

    And as for therapist discussion, there *are* good therapists out there. I went to a therapist here in Denver who specializes in queer/gender/trans/* therapy and she was really cool. Very straightforward and down to earth and non-judgmental. If anyone wants I can give you her contact info.

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    sigh
    i feel this.
    I went to a therapist for the first time a few days ago, because i’ve dealt with a lot of violent homophobia that has resulted in anxiety and eating issues shitiness. I was trying to explain, and she cut me off and told me to think about if my “sexual deviance” was giving out negative vibes that encouraged people to attack me, and i should really not blame other people without considering how it might be my fault.
    i don’t know if i can go back, i really want to feel better, but i don’t think i can deal with other people telling me that homophobia is my fault.
    bleh.

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      DO NOT GO BACK TO THIS THERAPIST. And report this person if licensed, to the American Psychological Association. the idea that there is something wrong with being anything other than straight has been roundly condemned for decades. Report.

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      Boo! No! Do not go back. If the cause of your anxiety and eating issues is violent homophobia, then you need to be able to talk that through in therapy in order to feel better. If she is just going to feed you crazy talk about how it’s your fault, then it sounds like she will make you feel worse, not better.

      Whoever this person is she is completely unprofessional! NO VICTIM OF VIOLENCE SHOULD BLAME THEMSELVES FOR WHAT HAPPENED. That is like principle number one of trauma counselling! Was she asleep in class that day or something?? As @Shannon1981 says above, it’s open to you to report her to the relevant professional association, those comments likely amount to professional misconduct.

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        thank you both so much. <3
        the thing is, though, i'm 15, and my parents really really want/need me to go to this therapist. I can't explain why it's a really damaging thing for me to do, as i'm not out to them, and wouldn't feel safe or okay being so, at least for now.
        so umm, if anyone has suggestions for what i should do, or how to stop going to her without outing myself to my parents, that would be really great.

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          Talk to a school counselor. Tell them you feel unsafe with this therapist. If that doesn’t work- contact PFLAG or the local LGBT center.

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    Just today at my school the Dean if my nursing program was saying that LGBT training is very underdeveloped and that he is now in the process of integrating more training on LGBT patients into our curriculum. This made me think back to Jamie’s last post on doctors and med student training and it made me feel proud that my school was taking steps in enhancing LGBT health issues to new nurses entering into the medical field. How crazy that when I come home and check autostraddle that this post had been written.

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    I struggle with anxiety/depression AND I’m a recovering alcoholic, but strangely enough, none of those things stem from my sexual orientation. I sort of look at them as two separate things–the fact that I was a very idealistic preteen/teenager when I realized I was gay contributed, plus I grew up in a fairly liberal area, so I had a lot of privilege in my coming out experience. I’ve been seeing my therapist for about ten years now (since I was 14) and came out to her almost immediately. Thankfully, she wasn’t all “pray the gay away” on me; if she had been, I do think it would have severely affected me. At that point in my life, I was too idealistic to think she would have been anything other than fine with it.

    One of my best friends (another dyke) was looking for a new therapist, and found a referral for a woman on a queer website. She turned out to be of the douchebag variety, and insisted that there “was no way for her to know what her sexuality was, because she was only twenty-two.” Thankfully my friend can smell bullshit from a mile away, so she didn’t take it in. We were both upset that this woman is referred by a queer outreach center in our area, because this woman was absolutely NOT queer-friendly by any means. I think it’s important to double-check things like that beforehand.

    As for substance abuse counseling–when I went to rehab, I came out to the woman who did my psycho-social evaluation (she ended up being my counselor as well) off the bat, just to get it out of the way. She asked if I thought that somehow had an effect on my drinking, but because I wasn’t drinking due to any internalized homophobia that was pretty much as far as the conversation went. Twelve-step programs can be difficult for some queers (at least, I’ve had issues with them in my own experience) because they can be extremely heteronormative and sexist. Thankfully, there are more queer AA meetings popping up, which helps a lot for people whose substance abuse problems are linked to some kind of internalized homophobia.

    tl;dr: More sensitivity training is fucking crucial.

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      I’ve had major mental health issues for years – raging bulimia and my psychiatrist thinks I’m an alcoholic (I say I have tendencies but not abuse, my therapist thinks I’m mostly fine, it’s college). Absolutely zero of it has anything to do with internalized homophobia/stress about coming out/etc. Rehab is what got me to come out to myself, and I came flying out after that. I kind of find it weird that a therapist would automatically assume personal struggle.

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