The LGBTQIA+ community faces many difficulties due to discrimination and the stigma built around their identities. Transgender and gender non-conforming individuals often deal with a lack of acceptance and support from their families, schools, places of employment, and the government. This discrimination can lead to mental health crises, substance use, homelessness, and assault for LGBTQIA+ adults and children, which occurs in higher rates for BIPOC and trans and gender non-conforming individuals.
This community also experiences many issues with health care providers due to the ongoing legislation around their rights to gender affirming care, and the treatment LGBTQIA+ people have received from the medical system in the past.
Transgender and gender non-conforming people are about four times as likely to experience mental health issues than cisgender people due to the varying levels of discrimination that they face. Yet, LGBTQIA+ people have a harder time getting access to mental health care. "60% of LGTBQ youth who wanted mental health care in the past year were not able to get it," (Trevor Project, 2022 (Opens New Window)).
Like many aspects of gender non-conforming health, further research is needed on the rates of anxiety and depression in transgender adults. There has been some work in studying the rates of mental health issues in youth and how gender impacts that health, but very few have been done on adults. Those studies and surveys that have be done focus on LGBTQIA+ community as a whole, rather than just the impacts of gender.
Trevor Project, 2022 Survey U.S. Census Bureau, 2022 (Opens New Window)
The transgender and gender non-conforming community has higher rates of suicidal thoughts and attempts due to the lack of acceptance from family and community, lack of access to gender affirming care, and more.
As of June 2023, there is not a lot of research available on the substance use of transgender and gender non-conforming individuals. Most of the research around transgender people and substance use focuses on syringe use and the spread of HIV, rather than understanding the populations substance use as a whole.
The following charts are from the 2015 Transgender Survey from the National Center for Transgender Equality, and are limited by the time frame, careers, or ages, and have inconsistent variable usage. We anticipate that the 2022 survey from the National Center for Transgender Equality will be available later this year and hope that it will contain more detailed information on substance use in the transgender community.
U.S. Transgender Survey, 2015 (Opens New Window)
Some studies on substance use in transgender and gender non-conforming populations tend to focus on a small sample or specific regions. In a Massachusetts study observing substance use trends in transgender adults, participants reported having abused alcohol, marijuana, and other illicit drugs (stimulants, heroin, hallucinogens, painkillers, and club drugs) (Keuroghlian et al., 2015 (Opens New Window)).
Another study compared substance use among transgender and cisgender youth in California (De Pedro et al., 2016 (Opens New Window)). In every category of substance, transgender youth reported higher percentages of lifetime use AND recent use (within 30 days of the survey) than their cisgender peers.
To learn how to find more studies related to trans substance use, review the Articles, Journals, & Databases page here (Opens New Window).
Gender non-conforming and trans youth and young adults face homelessness at higher rates due to a lack of acceptance from their families. Homelessness contributes to the rates of mental health crises, physical and sexual assault, and substance use in the LGBTQIA+ community.
In 2021, it was found that 1 in 3 transgender adults have experienced homelessness.
National Alliance to End Homelessness, 2019 (Opens New Window)
While there are shelters to temporarily provide housing for the homeless, many transgender and gender non-conforming people are uncomfortable or feel unsafe in these spaces.
LGBTQIA+ people experience assault at all ages in a variety of situations. The following charts will explain some of the statistics around physical and sexual assault on the LGBTQIA+ community.
U.S. Transgender Survey, 2016 (Opens New Window)
Gender non-conforming and trans people experience a wide range of difficulties in the medical system, from being misgendered to being refused gender affirming care to health care providers not knowing anything about transgender patients. These experiences can be traumatic and build a distrust between trans patients and the medical community.
Medical distrust is defined as a lack of trust or suspicion of medical organizations, and is a fairly common occurrence in marginalized groups. This distrust can lead to people avoiding seeing health care professionals when they need treatment.
One of the largest incidents of the medical system failing to support and care for the LGBTQIA+ community is the AIDS epidemic. The HIV/AIDS epidemic began in the United States in the 1980s and is still considered an epidemic today.
While there were initiatives in health care around syringe exchange programs and promoting the usage of condoms in the 80s and 90s, these initiatives were predominantly led by community groups and non-profits. There were no large scale public health initiatives to help people fight, prevent, or cure HIV or AIDS, until the 2000s. The few initiatives that were sent out by government organizations during the peak of the epidemic only stigmatized HIV positive people further by setting strict requirements around which states can access emergency funds, and stigmatized the LGBTQIA+ community further by not allowing gay men to donate blood.
This history of poor management and lack of care options contributes to the distrust that many transgender and gender non-conforming people have towards the medical community
