• June marks Pride month – here therapist Silva Neves explores nine ways in which LGBTQ+ populations might experience emotional and psychological stress

  • If the below resonates with you and you would benefit from support, find your therapist here

On the surface it appears that the people from the LGBTQ+ community have now achieved equal rights in the UK and there are no more specific considerations to take into account when working with these populations. This is not the case. Whilst the law has changed and now protects LGBTQ+ people, homophobia, biphobia and transphobia are still rife.

LGBTQ+ people have to navigate every day of their lives through a heteronormative world which most often excludes them. Some of these stressors can be undetected by the heterosexual population. These every day stressors are what we call minority stress. Some of the common issues that LGBTQ+ people have to think about on a daily basis that their heterosexual counterparts have the privilege to never even think about are:

1. Holding the hand of their same-sex partner in the street

There are some streets that are safe to do so, like, for example, Soho in London. But there are many streets in Britain where it would be unsafe to do so. People who have same-sex partners have to continuously scan their environment for threats before deciding to behave in one way or another with their partner(s). 

2. Choosing carefully where to go on holiday

Whilst the entire world is open to heterosexual people, there are currently 71 jurisdictions that criminalise consensual same-sex activity. Most of these countries are in Africa and the Middle East. For example, it is not safe for LGBTQ+ people to have that lovely sunny holiday in Dubai that is so popular with heterosexual people, given that the United Arab Emirates’ punishment for LGBTQ+ people is the death penalty.

3. Repeatedly coming out

LGBTQ+ people have to come out because of our heteronormative world. Nobody says ‘hello I’m John, I’m straight’. Or ‘I’m planning my straight wedding’. 

Coming out is stressful. LGBTQ+ don’t only come out once, they continuously come out because of living in a world that assumes heterosexuality as ‘normal’. It is stressful and draining. For example, when starting a new job, or getting new neighbours, or meeting new people at a birthday party, or having a new colleague, or when there is an awkward question from a shop assistant or anybody assuming heterosexuality (what does your wife/ husband do? Do you have a girlfriend/ boyfriend?).

4. Dealing with uncomfortable questions

Once you come out, there is an entitlement from heterosexual people to ask private, and sometimes inappropriate, questions that would never be asked to heterosexual people, especially to do with people’s sex lives. (Who is the man and the woman in bed? Are you really monogamous? Do you have a lot of sex?)

5. And inappropriate assumptions

Gay men are HIV+. Lesbians are cat lovers. Bisexuals are greedy. Transgender people are weird. Gay men love Kylie Minogue. Lesbians don’t wear make up. Bisexuals are gays in the closet. Or: ‘I don’t mind transgender people as long as it’s not happening to my children’.

6. Receiving different medical treatment

Some LGBTQ+ people do not receive the right medical services they deserve. For example, many doctors are unable to hear that gay men have anal sex and the anus is an important sexual pleasure body part for them. Transgender people are consistently mis-gendered and they are also dismissed. For example, they have to remind their own doctors that a male-appearing person may menstruate.

7. Higher likelihood of being the victim of crime or bullying

There are still a lot of homophobic crimes happening in the UK. Many homophobic insults or ‘jokes’ are still unchallenged. Stereotypes (the effeminate gay man or the ‘butch’ lesbian) are still widespread. Schools still turn a blind eye to homophobic bullying. LGBTQ+ people don’t feel safe and are consistently living in vigilance.

8. Rejection from religious groups

Whilst a lot of the everyday homophobia now happens covertly in the UK, the LGBTQ+ people are still being overtly attacked by most religious groups, sending messages of rejection, abuse, and hate. Some LGBTQ+ people have been refused services on the basis of ‘conflicts with religious values’, which is illegal in the UK, yet still happening.

LGBTQ+ people are still offered ‘Conversion Therapy’ from various religious groups. ‘Conversion Therapy’ is associated with the Christian faith but it is also practised by other religions too. Although ‘Conversion Therapy’ has been recognised as an unethical and harmful practice, it is not yet illegal in the UK. It looks like the Government is about the change the law on this matter (May 2021).

9. Experiencing vicarious trauma

LGBTQ+ people also suffer from vicarious trauma. Although they may not have a direct threat to death on their doorstep in the UK, they will hear every day some LGBTQ+ people being hunted or killed in other countries. Those stories are personal to the LGBTQ+ population and they affect the worldwide communities.

When you provide therapy for a LGBTQ+ person it is crucial to remember that they will come with minority stress. Often, the mental health of the LGBTQ+ people is directly affected by minority stress, but for other people, minority stress is simmering in the background, more quietly pulling some emotional strings. The best way to help these populations is by remembering that there are LGBTQ+ specific considerations that may not apply to heterosexual people.

Pride is an important time of the year when LGBTQ+ people can be visible. It is a time when the LGBTQ+ communities can celebrate the social and legal progress, and also remind everyone that there is still much work to do in the UK and aboard. Pride is still very much needed until all LGBTQ+ people feel truly safe in this world.

Silva Neves is a therapist and author. This article was originally published in the National Counselling Society's magazine. 

Further reading

This is why it isn't as simple as 'coming out' for some in the LGBTQ+ community

Being an LBGTQ+ affirmative therapist

Anti-LGBTQ+ abuse and how to respond to it