To Be Queer, Black, and “Sick”

Disclaimer: The usage of the word “sick” in this article is to reflect the problematic, social stigma around mental illness, and not as a moral or social indictment of people with mental illnesses or disorders.

The first woman I ever loved told me that when you’re queer and Black, illness is a shadow that always follows you but that no one ever acknowledges. She sang the words “I’m fine” every day, and sometimes I wasn’t sure if it was the world or herself that she was trying to convince. You know, she wanted to convince herself that if she simply followed the advice of well-intentioned friends and strangers to smile a little more and to “cheer up,” that she truly would be fine.

I find my loved ones in the gossamer pages of dictionaries. I find myself when I read between the lines. We are a series of bullet points and over-simplified definitions. The New Oxford American Dictionary defines “sick” as:

1. Affected by physical or mental illness
2. of or relating to those who are ill
3. (of an organization, system, or society) suffering from serious problems, esp. of a financial nature
4. pining or longing for someone or something


It took 19 years for me to see a therapist. I squirmed on an ugly love-seat that looked more comfortable than it felt, surrounded by posters that championed ways to feel happy. I didn’t know where to start when the doctor asked me what was wrong, so I blurted out my laundry list of despair all at once, just put it all out there. When I told the doctor that sometimes life feels too heavy, when I told the doctor that death looked more inviting, she replied, “Nothing’s wrong with you. I think you’ll be okay.” A box of tissues and a plastic smile prescribed to yet another queer Black kid.

To be queer and Black and unwell is to live in silences.

Like the doctor’s silence in a room too sanitized to hold my pain.


Like my mother who cried wordlessly when she found the suicide notes I wrote in case I needed them.


After that first appointment with the therapist, I was too ashamed to tell my family that I tried to get help.



My chosen family consists of many Black queers the world deems “sick.” I was privileged enough to get better. No unpronounceable names were issued to define the way my mind works (or doesn’t work), or the way my body moves (or doesn’t move). In time, I found myself on the upside of a downward spiral. I was finally… okay. I didn’t understand that not everyone is fortunate enough to “get better,” especially as easily as I did. I held other people to unreasonable standards. I held and sometimes still hold my family to unreasonable standards. I held the woman I loved to unreasonable standards.

In a given year, one in every four US Americans experience a mental illness, according to the National Alliance on Mental Illness (NAMI). NAMI also confirms that LGB populations are two-and-a-half times more likely to have a mental disorder than heterosexual populations, while a survey conducted in 2010 reported that 41% of trans* individuals have attempted suicide.

One study explains, “In mainstream mental health settings, [LGBT folks] often feel compelled to hide their sexual orientation or gender identity; conversely, in the LGBT community, mention of their mental health status is often unwelcome.”

We tell each other to “come as you are” into a big, rainbow-decorated family, but we, who are neuro-typical, do not always make proper accommodations for our neuro-diverse siblings, or don’t always check our privileges. We may even roll our eyes when one of our queer siblings “forgets” to leave their depression, anxiety, PTSD, OCD, bipolarity, or other illness at home. I too have rolled my eyes before, reducing another person’s struggle to “extreme sensitivity” or “unnecessary drama”.

To be Black means to be 20% more likely to report having psychological distress than white US Americans. The disparity is compounded when socioeconomic class factors into the reports. Narrowing the categories complicates the results because the number and types of illnesses and/or disorders increase in proportion to the number of marginalized identities a person has. A study done from February of 2004 to January of 2005 details that 60% of Black LGBTQ people have some type of mental disorder.


My family used to joke that only white people need therapy. Black people go to church instead, find remedies on their knees in prayer, sing their sorrows away. Meanwhile, white academics told me that African-Americans merely fabricated ungrounded stigma around psychiatric help. As absurd as these two viewpoints may sound, these myths actually point to a greater phenomenon.

As of 2012, 15% of the US American population without health insurance was African-American. Considering the role economic status plays in healthcare sheds light on the racial discrepancy with respect to treating mental illness. Many people with health insurance find that their companies don’t cover the cost of mental illness treatment, and those without any health insurance find themselves facing incredibly high prices to pay for medical care, or opting not to pursue treatment at all. These obstacles often lead Black folks in the states to “rely on family, religious and social communities for emotional support rather than turning to health care professionals, even though this may at times be necessary,” states NAMI’s fact sheet on African American Community Mental Health.

Even if able to pay for treatment, many Black folks encounter prejudices and biases from medical caregivers. Black people, especially Black men, are frequently misdiagnosed when it comes to mental illness. For example, most prominently in the 1960s, white doctors institutionalized Black men involved in civil rights protests (particularly in Detroit) on the grounds that the behaviors these men defended as political activism was really schizophrenic rage and volatility. Also, medical practitioners’ prescriptions sometimes reflect discriminatory and generally racial assumptions that Black people do not need as much medicine as white people. Studies conducted by the University of Michigan’s School of Public Health discovered that Black US Americans are 1.5 times as likely to be denied antidepressant treatment. No one wants tell you that the system is sick. No one wants to tell you that the healthcare system intentionally keeps historically marginalized groups like queer folks, and Black folks, and people who happen to find themselves at the intersection of queerness and Blackness sick.


The first woman I ever loved was always just out of reach, every inch of her slipping through my careless hands, every word she spoke barely intelligible. I held her as if she were simultaneously fragile and lethal to convince myself that I wasn’t the one falling apart. Loving her meant learning to love the parts of me that sometimes cannot get out of bed, that sometimes feel broken for no apparent reason, that make me unwell. She said, “I’m not a fucking statistic,” but I could only see her through percentage signs and medical dictionary definitions. The first woman I ever loved told me that when you’re queer and Black, illness is a shadow that always follows you, but that no one ever acknowledges. I walked away because I didn’t know how to see it.

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Helen McDonald is a 20-something Black lesbian feminist living off of pizza, social justice and a lil snark. By day, she's a community educator, teaching young people about healthy relationships. She also discusses the intersections of race, gender, and sexuality on her personal blog and is a contributing writer at

Helen has written 40 articles for us.


  1. This was amazing and I relate it so much. What was frustrating for me was my mom works in a rehabilitation center and had the attitude “not my daughter!” When she more or less understood I was queer she always assumed the worst in me when I forget to call her (once a week) or something more serious due to my own flaws with “THIS *LIFESTYLE* IS NOT HEALTHY!!!” She pretty much says that being gay is ruining my life, ughhhh! It’s really exhausting so I do not talk to her as much. My dad is just there in all this and I just gone cold into trying to make him understand.

    I try to love myself and get help which I know is a huge privilege in itself. It’s always a journey that I take one day at a time.

  2. “The first woman I ever loved told me that when you’re queer and Black, illness is a shadow that always follows you, but that no one ever acknowledges.”

    ugh. this struck so close to home. thank you for this! i still struggle with going to therapy, even though i’ve been privileged enough to have health insurance that has always covered it because of many of the reasons highlighted in this piece. this was just so, so, so, good and so what i needed to read RIGHT NOW.

  3. ‘Black US Americans are 1.5 times as likely to be denied antidepressant treatment’.


    Thank you for sharing, esp. your words in Part One.

    It’s articles like this that keep me coming back to Autostraddle!

  4. so true,depression and anxiety are thought of as “luxury” ails in my family or code for being lazy. My aunt used to say “if anyone tells you they are depressed just give them a good slap and they’ll snap out of it.” seating down and talking away ones problems, who has the money to waste on that. “Considering the role economic status plays in healthcare sheds light on the racial discrepancy with respect to treating mental illness.” i think that few in the african/immigrant community can “afford” to be physically sick, a lost paycheck away from all shit going wrong. so to say that one needs help for something that they can’t see boggles the mind. which is so sad, because its such a dangerous toxic way of isolating people who are hurting greatly. your article hit me in the feels

    • Yes! I loved that about this piece, too. In fact, I love that about a lot of the writing here on Autostraddle. I love the way emotions and personal experiences are as highly valued here as statistical figures and logical arguments.

      One of the things I love is seeing how each individual writer brings these different elements together. Helen totally hit it out of the park with this one!

      • Agreed, 100% I really love this style of writing too. So coherent and informative but also beautiful to read, thank you Helen!

  5. I went through a rough patch during my senior year of high school. My family was attending church regularly and that place was homophobic and my family was going through something I’d rather not get in to right now. I now realize that I was seriously depressed. I regularly thought about killing myself and the only thing that kept me was the fact that my mom had her troubles, and I had 7 and 8 year old siblings and I didn’t want put them through my death.Fellow church members saw that I was down and all I got was a “pray on it”. No one offered a therapist’s number or any kind of professional help. “Just pray on it and the lawd will see you through!”I was also told that anxiety and depression were “white people disorders”. So I suffered in silence and prayed to a lord that I thought hated me. All that I was going through and I just had to be attracted to girls on top of it.

    I’m a lot better now and I congregate with a qpoc inclusive church group.I worked my way through it reading therapy sessions on the internet. I didn’t even get a “Well Dr.Phil is on at 5 on ABC.”from the church. Help a sista out damn

  6. I feel like women of color are much more likely to have more struggles than our white counterparts. I could be wrong for saying that but for me it is true.

  7. Articles like this are the reason why I love this website so much. I was unaware of this issue. I thank you for your perspective Helen. It was very well written, informative and had character. I felt your pain even though I have a different life experience.

    I am not a WOC but have suffered through depression. I was lucky enough to have a mother who understood and convinced me to go to the doctor and get treated. The same with my father. My siblings were less supportive due to their own personalities. My brother actually thought it was funny and my sister seemed to think that I had nothing to be depressed about because I was living at home rent free while going to school.

    You never really realize how deep your privilege is until you hear from the people who are negatively effected from your privilege. For that I thank you deeply.

  8. On a “normal” day, I’d say something relevant but ridiculous like “the struggle is real” just to nod to the fact that I understand this completely and simultaneously laugh it off. At this point in my life though, all I can say is thanks. I loved everything about this.

  9. Great article. Really beautifully written at the same time as being interesting and informative.

    Have you heard of ‘Drapetomania’ – it was the supposed mental illness invented in 1851 to explain enslaved black people wanting to run away. I thought of this when you mentioned black men being incarcerated for participating in civil rights. The dominant culture deems ‘Other’ to be ‘crazy’ and uses pseudoscience to back it up.

    As you can probably tell, mental health is a subject close to my heart. I sometimes wonder how many other ‘illnesses’ will be proven false in time.

  10. I’m a bit uncomfortable with the way neurodiversity is being conflated with mental disorders like PTSD. First of all because the term neurodiversity was invented by disability activists trying to minimize (specifically) the stigma attached to developmental disorders, such as autism spectrum disorders and this isn’t mentioned / acknowledged. Secondly, because the concept of neurodiversity stresses the fact that neurological differences are something positive, which should be respected and celebrated not stigmatized and medicated. I only have pretty low level PTSD, but I definitely don’t think that my life is enriched by it because it allows me to experience things differently and have a different perspective etc – the same way an autistic person might think about being autistic. Autism spectrum disorders are not inherently bad or painful, whereas PTSD is a response to trauma so it’s not just a neutral neurological difference.

  11. Great article. Hit close to home. But now what? What can we do as a community to make things better? Is there anything that can be done?

  12. Wow. Excellent article. I’m sorry your therapist totally minimized what you were going through. Any therapist who doesn’t take suicidal ideation or plans seriously is unethical. I’m a therapist, and I will share this with my office, if you don’t mind.

    I didn’t know about the Detroit protesters being institutionalized. I also did not know Black people are frequently denied antidepressants. WTF?! I do know that black people are more likely to be wrongly diagnosed as schizophrenic (cuz white therapists can’t read their emotions, and see healthy paranoia or anger as delusional, I think). Kids on Medicaid and in foster care and lock-up in Massachusetts are prescribed way more antipsychotic drugs than kids on private insurance. Medicating for compliance…

    Sometimes, as a therapist, I don’t WANT to diagnose someone with a mental illness if obviously they are reacting to being bullied, injured, ignored, etc by the dominant culture. Because…the system is sick, not the person, sometimes. I have to make a diagnosis to get the person therapy. But you make a great point, that no matter where the pain is coming from, people in pain need CARE. Not to be told, “There’s nothing wrong with you, go be a Strong Black Woman on your own time, out of my office, next, thanks.”

    I’ve had a hard enough time getting a good queer-friendly therapist, and I AM a damn therapist, white and middle-class too, so this should be EASY. The mental health profession in the US is mostly white people, making rules and diagnoses based on white standards. I can only imagine how therapy can suck if your therapist is constantly misreading you because of your race / culture.

  13. thank for the education you gave me on the issues above.
    you are an amazing person

    *sends hug*

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