Naturally, people from the LGBT communities have the same kinds of struggles and difficulties as everyone else. This page highlights some of the added pressures or problems faced by those belonging to these groups. Many of these difficulties have at their source homophobia and transphobia.
Lesbians and Gay Men
Much has changed for gay people in the UK over the last few years. Same sex marriage came into force as a legislation in 2014. Lesbians and gay men are far more represented in the media and in other sections of public life, including political parties and government.
This development has improved the lives and presumably mental health of many lesbians and gay men in this country. However, it is important to recognise the freedom and acceptance in much of the west is not necessarily reflected elsewhere in the world and that in this country attitudes towards lesbians and gay men range in terms of geography and other differences such as generation and culture.
In addition to direct violence or bullying, homophobia in the UK is experienced on more subtle levels. This can manifest in various ways but is most commonly described as heteronormativity. This is the dominant assumption in our society that sexual and relationship norms are heterosexual. Heteronormativity is pervasive and often unconscious and so hard to tackle and confront directly.
As members of society, gay men and women will have internalised homophobia and notions of heterosexual normativity, along with everyone else. This is hard, perhaps impossible, to entirely rid oneself of and can be disguised by and complicate difficulties around self-esteem, self-worth and intimacy. There is some evidence that internalised homophobia underlies the higher rate of mental health problems seen in gay populations compared to heterosexual equivalents, including above average suicide rates, and drug and alcohol addictions.
These continuing social norms and attitudes complicate and at times can still inhibit ‘coming out’ as gay. The added difficulty for gay people is that coming out is a never-ending experience. For many lesbians and gay men this is not so much a problem about who knows their sexual orientation but rather that it gets declared at times in settings, situations or relationships where trust has not yet been established.
Another change for lesbians and gay men in the last several years is the growing options and support available for starting a family. See family issues for a more detailed look at some of the implications and challenges for gay parenting.
Much of what is discussed above in relation to difficulties for lesbians and gay men also can apply to people who identify as bisexual. In the past bisexual people tended to experience mistrust from the gay community while also suffering from the impact of homophobia in society generally. This situation has perhaps changed as our society has become more accepting of sexuality as fluid. The last few years has seen around a 45% increase of people identifying bisexual perhaps indicating that it is increasingly acceptable to identify as bisexual.
However, this does not mean that the complications and difficulties of being outside the more fixed identifications of gay or straight are entirely of the past. While bisexuality is generally more accepted in the gay community there can still be certain amount of distrust and anxiety held towards those who hold a more fluid orientation and identity. And as homophobia and heteronormativity continue to operate socially, people identifying as bisexual will struggle with these prejudices in much the same way as those identifying as gay.
‘Trans’ here refers to transgender. This is an umbrella term that generally includes those who identify or express a gender opposite from the one they were assigned at birth; those who identify as gender fluid or non-binary; and those who identify as transvestite or cross-dresser.
People who identify as trans may also experience, or have experienced, gender dysphoria. This term describes an intense unease with the gender assigned at birth and might include a sense of disconnect or even disgust towards the body or body parts associated with the birth gender. Gender dysphoria can be experienced at different levels and to different degrees. For some it can be very distressing and lead to depression and other problems. Some people with gender dysphoria may seek medical interventions such as hormones or surgery. Not everyone, however, who seeks interventions suffers from gender dysphoria and not everyone with gender dysphoria seeks interventions.
The decision whether to change gender identity for some people can feel straightforward and clear but for others it isn’t. Psychotherapy and counselling can help the individual make sense of their feelings towards the gender they have been given and the one they feel more identified with.
Sometimes gender can, understandably, have become so preoccupying that other difficulties can get pushed to the side. Psychotherapy and counselling can give the space and support to explore meaningfully the individual’s relationship to gender but also other important aspects of their lives, self and relationships, and how all these elements might connect.
Trans-awareness has become more mainstream in very recent years and this, along with protective legislation, has helped to lessen some of the stigma of the past. However, transphobia is certainly not something of the past and can often be overt. Transphobia is very much thought to be a primary reason for trans people’s mental health problems and much higher than average suicide rates. It is particularly directed it seems at those who have undertaken some form of gender identity change.
Gender transition impacts on relationships and loved ones may also need therapy or counselling to process their own experience of the changes involved. Trans-people who are already a parent as one gender face an often difficult task in helping their children deal with the transition. Partners are also affected as the change impacts on their sense of their own identity. Parents and siblings of children, teenagers, or indeed adults, who are questioning their gender, gender dysphoric and/or in the process of transitioning may also need therapy and counselling to help adjust and make sense of the impact on themselves and their family.