You Aren’t Depressed Because You’re Queer
I’m certainly not the first person to tell you that there has been a long history of queer people being perceived as mentally ill. There are plenty of people out there who believe that being attracted to someone of the same sex, or identifying with a gender different than what you were assigned at birth, means that there is something wrong with you.
Obviously that’s bullshit.
It is true that LGBTQ+ identifying people experience mental health challenges at higher rates, but that isn’t because of the person that they are. Being queer does not make you depressed, but living in a culture where you have to hide part of who you are, are made to feel ashamed of yourself, or are bullied? That can make you depressed.
It isn’t the identity that creates mental health challenges, it is the way that society and culture treats LGBTQ+ individuals that contributes to poor mental health outcomes.
A brief history of queerness as a mental disorder
The Diagnostic and Statistical Manual of Mental Disorders, commonly referred to as the DSM, listed homosexuality as a mental disorder (labeled as “Sexual Deviation”) in its first two iterations. In 1980 the DSM-III removed homosexuality as a disorder, but left in a diagnostic code for people who are anxious or depressed about their sexual orientation - “Ego-Dystonic Homosexuality.” It wasn’t until 1987 that homosexuality was eliminated completely from the DSM.
In 1980 when the DSM-III was published, “transexualism” was included as a mental disorder. In 1994 this was replaced with “gender identity disorder in adults and adolescence” and in 2013 that was replaced with “gender dysphoria” in the DSM-5. The diagnosis is focused on the distress that trans individuals may experience, not intending to say that being trans is a mental health disorder. The DSM-5-TR (the current version as of the writing of this post) now explicitly states that the term gender dysphoria “refers to the distress that may accompany the incongruence between one’s experienced or expressed gender and one’s assigned gender.” Although the diagnosis and term is not intended to imply that being trans is a mental disorder, there is still plenty of confusion in the general population about what all of this means.
I’m not going to blame the DSM for the widespread ideologies that queer people are mentally unwell, but we can’t ignore that this idea has been perpetuated by therapists and mental health systems. I’m grateful that we have made strides in de-stigmatizing, but there has been damage done and we still have a long way to go. This history is also way too modern for my comfort. Therapists still need to make active efforts to correct the harm that our field has caused to the LGBTQ+ community.
The actual problem
We know that your identity isn’t the issue here, so why are queer people seeking therapy? A lot of the time it’s the same thing that brings anyone else into therapy. Bad things happen to people of all identities and some mental health disorders are influenced genetically. A lot of the time, queer identity is just a small part of what is actually being discussed in therapy. It isn’t a problem, so we don’t need to make it the focus.
Other times, someone’s lived experience as a queer person has contributed to their emotional experience in a pretty harmful way. Family rejection, discrimination, chronic microaggressions, or cis-heteronormative expectations; all of it can weigh heavily on a person and become overwhelming. Because LGBTQ+ people experience all of those stressors at far higher rates than their cis/hetero peers, we see higher rates of mental health needs for the LGBTQ+ people. It’s not their identity, it’s the environment.
It’s not the flower’s fault
When you are planting a garden, you have to consider the environment and how it will impact the plants. How much sunlight do they need? How much water? Is it the right time of year? If that seed doesn’t grow, we don’t blame the seed. We look at the environment and consider what might have gone wrong to cause that flower to not thrive. We take into consideration everything that may have impacted that seed so that we can learn and do better next time.
We can (and should) apply the same concept to mental health. If someone isn’t thriving, we shouldn’t blame that person. We can look at what is happening around them, the environment they were brought up in, who they are currently surrounded by, what pressures they are facing, and use all of that information to help us understand how to actually help the person. If you starve your garden of light and water, it won’t thrive. We don’t ask the sunflower to become a hydrangea or a tomato to become an apple tree. If we starve a human of love and acceptance, of course they don’t thrive. And we shouldn’t ask them to change who they are, we should help them thrive by providing the conditions that they need.
Why LGBTQ+ affirming therapy matters
We can’t take away the pain of being abandoned by your family because of who you love. We can’t stop bigots from calling out slurs and focusing on bathroom bills instead of the actual problems in our country. But we can find safe and LGBTQ+ affirming spaces where you can safely explore your mental health needs without your identity being pathologized. You can honor the complexity of your lived experience and not feel like you have to explain yourself. If we need to process your queer experience, we can do that without trying to shrink your experience down. If your identity is important but not the whole point, we can hold space for it while really focusing on what you need help with right now.
As a queer identified woman who has had my own mental health journey, I understand how identity and mental health are connected, and where the paths can diverge. We can approach your identity and mental health journey with the nuance and care that it deserves. After all, you’re a whole person, you deserve to be seen for every part of you.