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Are We All Crazy? – The Debate on Growing Mental Health Challenges in the LGBTQIA+ Community

As part of the build-up to June’s Safer To Be Me Symposium, we are proud to be sharing our Safer To Be Me: Global Voices blog series, showcasing LGBTQ+ themes from around the globe, written by ReportOUT volunteers.

Mental health of LGBTQ+ communities around the world. rarely presents anything other than a worrying picture. In this week’s blog, ReportOUT Human Rights Researcher, Evelline Sinahra Brazão Pagliarini, considers the causes of this concerning phenomenon and how we cannot see mental health in a vacuum separated from broader societal threats and prejudices.

Transforming mental health for all: this is the title of the largest and most comprehensive WHO report on mental health ever produced. The report which was made public on June 16, 2022 does not bring encouragement, only a warning. We are struggling more than ever and the current responses to this crisis is insufficient and inadequate. The document points to the problem as something global - presenting the frightening number of 1 billion people living with a mental illness - and then recommends a local focus, strengthening and remodeling environments such as schools, communities and workplaces.

Plot spoiler - our past experience tells us that when someone shouts a slogan that ends with 'for all', that we, the others, are not included in the equation. All the data and research that encompass mental health and the LGBTQIA+ population is filled with bad news: higher suicide rates, psychological distress, addictions, depression, anxiety…I could go on. Just take a read of my fellow researcher Rhulani’s blog on ‘Minority Stress’ and you’ll get the idea.

It's not just that our mental health is suffering, we're exhausted! It is easy to find the roots of this illness because it manifests itself in our community in an early and systemic way, whether through family environments and - often in an incredibly cruel way - in our education, health and work system. To name just a few:

  • The fight over the decriminalization of homosexuality is still a reality in many countries, 67 countries still outright criminalise same-sex activity – a number that continually surprises and shocks me.

  • Even in supposedly developed countries – our struggle for civil rights is always on this scale between 'we made it', 'almost' and 'we're going to lose at any moment'. Take one look at the systemic persecution of the trans community in the US and you’ll see what I mean.

  • Dealing with our expression of gender and sexuality in family and work environments is almost always a delicate equation between ‘I'm going to starve or I'm going to be palatable just a little longer’.

  • Access to healthcare deserves its own topic – how difficult and humiliating it is for most of us to go to the doctor and have our identity seen and respected.

Navigating A Panorama Of Exclusion and Discrimination

You or I could add to this list indefinitely, but how do we start the conversation about psychosocial well-being within our community? We know that this short list is more than a measure of personal success or failure, but is it not what also primarily defines us as human beings?

[...] (Depression) It is, in principle, a tiredness of doing and of being able. The lament of the depressed individual that nothing is possible only becomes possible in a society that believes that nothing is impossible. No-more-power-power leads to self-accusation and self-aggression (HAN, 2017).

We should be clear - mental illness does not occur by chance. Your origin matters. Mental health is the product of specific place and environment. Within a social panorama of exclusion and discrimination, we face a reality that not only terrifies, but also dehumanizes. It disables queer individuals from doing what qualifies them in society: their capacity to exist and to dominate and own their bodies and sexualities.

‘It’s Not Science Fiction, It Already Exists’

Therefore, without disregarding the endogenous causes of such illnesses, it is essential to look at the sociocultural expressions that create mental suffering for the LGBTQIA+ population. Or yet:

‘Imagine a society that subjects people to conditions that make them terribly unhappy, and then gives them drugs to eliminate that unhappiness. Science fiction? It already exists. Antidepressants are in fact the means of modifying an individual's internal state in order to make him able to tolerate social conditions that he would otherwise find intolerable (SOLOMON, 2010)’.

The belief that only one factor would trigger mental illness has a direct impact on people and communities like ours that need and deserve care that goes beyond medication. And, as much as common sense has taught us that mental illnesses are chemical disorders, even today, we have no proof that mental illness is the result of reduced or increased levels of any brain chemical.

As a society, we need to look at the growing number of LGBTQ+ people with some form of mental illness critically and as a plural event with multiple dimensions. Talking about mental health is also talking about access to housing, capitalism, race, food insecurity, self-determination, access to health, unemployment and class. Looking and fighting only for the right to diagnosis and treatment is not and will never be enough. Without public and social policies that ensure material conditions worthy of existence, such rights become hollow and insufficient.

I strongly believe that we start by creating, strengthening and remodeling spaces and communities that contribute and strengthen the physical and psychological integrity of individuals in their multiple and complex spheres of life.

We’re not crazy – we are products of our environment and society’s treatment of us.

KEYWORDS: mental health; psychological illness; health policies



The Trevor Project: 2022 National Survey on LGBTQ Youth Mental Health

LGBTIQ+ people: statistics | Mental Health Foundation

HAN, BYUNG-CHUL (2021). Sociedade do Cansaço. São Paulo: Editora Vozes

RODRIGUES, M.V.D. Adoecimento e cansaço na sociedade do desempenho: trabalhar é preciso; viver não é preciso. Paraná – UFPR

SOLOMON, A. (2010). O demônio do meio-dia: uma anatomia da depressão. Rio de Janeiro: Objetiva

KEHL, M. R. (2009). O tempo e o cão: a atualidade das depressões. São Paulo: Boitempo.

Evelline’s blog is part of ReportOUT’s Safer To Be Me: Global Voices series, in support of the Safer To Be Me Symposium, a joint ReportOUT-University of Sunderland project, which will take place on 22nd June 2023 at Sunderland University in the North East of England.

The symposium will create a safe space where some of the most important issues facing international LGBTQI+ human rights can be explored and discussed in great detail, as well as encouraging a call to action where all involved can identify meaningful ways to be proactive and make a powerful impact.

To find out more, visit our website

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