LGBTQ+ women face disproportionate rates of mental health issues and barriers to care

A leading national survey finds that 22% of LGBTQ+ women respondents have attempted suicide, and 66% reported seeking treatment for trauma.

“The trauma burden in this community is enormous,” said Jaime Grant, one of the researchers who conducted the survey.

These findings are included in a report released Tuesday from the Urvashi Vaid National LGBTQ+ Women’s Community Survey, named after the late lesbian activist. The report comes from analysis of a national survey of 5,000 LGBTQ+ respondents who previously or currently identify as a woman, conducted between June 2021 and June 2022.

The analysis finds that LGBTQ+ women experience substantial health disparities, mental illness and barriers to care.

These findings come more than a decade after Grant’s earlier research found that transgender people had attempted suicide at a rate nine times higher than the national average. Grant, who also led the National Transgender Discrimination Survey in 2011, said those data helped improve medical treatment for transgender people. She hopes this report will do the same for LGBTQ+ women. 

If you or someone you know may be considering suicide, contact the 988 Suicide & Crisis Lifeline by dialing 9-8-8, or the Crisis Text Line by texting HOME to 741741.

The survey found that respondents experience higher rates of mental illness than the general population. Nearly half of respondents live with anxiety (44%) or depression (51%). The National Association on Mental Illness reports 19% of U.S. adults have an anxiety disorder and the Center for Disease Control and Prevention reports 18% of U.S. adults have depression. The survey also found differences among race — respondents of color reported higher rates of disability and attempted suicide.

“It’s distressing to see such high trauma rates, but it’s consistent with what we’ve seen in the past,” says Christina Dyar, an assistant professor at the Ohio State University who studies health disparities in LGBTQ+ communities and wasn’t involved in this report.

Under-utilization of health care system

The survey also sought to identify barriers to health care for LGBTQ+ women. Research shows that 77% of the U.S. population has a primary care physician, but just over half of LGBTQ+ women in the survey reported being under the care of one. Respondents of color were twice as likely to say they lacked access to quality health care.

Respondents cited cost and discrimination as the leading reasons for why they put off or didn’t seek out medical care when they were sick or in need. Dyar says there’s been limited research done to determine what exactly limits access to care for LGBTQ+ women. “These numbers are great to have.”

“Historically, medical spaces have not been safe for us,” says Savy Elahian, who led the data analysis for this report and serves as a program coordinator with the National LGBTQ Institute of Intimate Partner Violence.

“There’s been experimentation [on people], there’s been medical racism. It’s important to understand the historical impacts, especially for LGBTQ+ people of color.”

Elahian says the medical field is behind on understanding how to fully serve LGBTQ+ people, which can leave patients feeling unaffirmed and uncomfortable. This discomfort can impact how likely it is they’ll return to a provider when they’re in need, which can be especially dangerous when thinking about preventative care.

According to the survey, 14% of respondents had never had a pap smear and all respondents were nearly twice as likely to have cervical cancer than women in the general U.S. population. A 2022 study found that nearly 1 in 3 lesbian, gay, and bisexual women were overdue on cervical cancer screenings.

“LGBTQ+ women and gender-diverse people are really missing out on preventative care and holistic wellness,” says Elahian. While community-oriented care can help address certain health disparities, community centers and organizations can sometimes lack sufficient resources.

“[LGBTQ+ people] still need to operate in these larger health systems,” they add. “It’s a bit inevitable.”

Institutional change and community care

Report authors Grant and Elahian say they hope the medical field will learn from these findings.

“This is powerful data that people need to listen to,” Elahian said, “from the U.S. Department of Health and Human Services to doctor’s offices to medical universities.”

Grant noted how the 2011 National Transgender Discrimination Survey and follow-up surveys helped to put numbers to suffering, reshape medical school curricula, and served as a model and resource for other researchers. She hopes the same thing will happen here.

While the Urvashi Vaid National LGBTQ+ Women’s Community Survey has been led by community activists and researchers, it’s moving to a more prominent organization in an effort to boost its reach and impact. The survey will now be housed at the National Center for Lesbian Rights, the group announced on Tuesday.

“This is enormous for us,” says Imani Rupert-Gordon, the organization’s president. “We aren’t able to fully advocate for our community if we don’t know what’s happening in our community.”

The Center, which serves as a litigation organization, will look to include the survey’s findings in their policy recommendations.

Grant and her team want these findings to go beyond just the doctor’s office and courtroom, though. “This data needs to go to our own people, so they can know the current state of our health,” says Elahian. To do that, they’ve made the findings free and accessible to all and hope to disseminate the research through LGBTQ+ community groups.

Dyar emphasizes community-led surveys are often more accessible and tend to reach more respondents. Academic health disparity research “often ends up behind a paywall,” she says. “It can be really frustrating when our findings don’t get out there.”

Elahian hopes that community education will foster people’s ability to self-advocate in medical settings -- yet another example of how community support helps strengthen this resilient group.