Introduction
Mental health plays a critical role in determining the wellbeing of people regardless of colour, race and perceived identity. Experienced identity and sexual orientation is an important part of life that may contribute to distress and struggles navigating and fulfilling one’s life.
Psychological support from experienced and understanding psychologists can be a relieving path to self-acceptance, solving partnership issues and living a rich and meaningful life.
Counselling helps LGBTQ+ individuals – and everyone else – understand and explore their own identity, relationships, and social limitations. An experienced psychologist can offer a place of self-exploration, fortification and the acquisition of skills to cope with these challenges.
Below we have tried to identify some of the challenges we often help with.
You can also reach out to us and book an appointment with one of our experienced LGBTQ+ psychotherapists.
Identity and Self-Acceptance and the perception of being “different”
Recognition of one’s identity has an important impact on the experienced fulfillment of life. It is not unusual that LGBTQ+ individuals feel different and struggle to fully understand and accept one’s identity as well as sexual preferences. Some individuals luckily have a smooth transition in finding and expressing oneself. However, the journey is unfortunately often paved with obstacles such as cultural norms, family opinions, social expectations, and religious beliefs. The perceived difference to the “norm” may lead to feelings of guilt, shame, self-doubt and inhibitions. Times are definitely changing for the better; however, media and some societies and cultures have not yet become fully understanding of how diverse identity, sexual orientation and preferences can be. That there is no “better” or “worse” – there are just as many ways to identify as people can imagine.
A nonjudgmental, supportive and transcultural psychologist can assist LGBTQ+ individuals to explore their identity, defying negative internal beliefs while promoting self-esteem and a rich and meaningful life.
- Affirmative and non-judgmental counselling acknowledges and supports individuals’ identities by creating a validating environment for them.
- Various forms of therapies can be useful; for example, person-centered psychotherapies are explorative forms that help clients express and talk about desires and fears. Acceptance and Commitment Therapy (ACT) can help clients accept emotions and thoughts in a manner where they do not become barriers to living the life one desires.
- Couples counselling and therapy for LGBTQ+ couples helps tackle challenges experienced within the relationship – ranging from communication to sex and everything in between.
- Family counselling may provide support, understanding and acceptance.
- Ultimately, the purpose is to systematically help the client deal with challenges and live a richer and more meaningful life.
Coming Out
When one has become aware of one’s identity, the next phase is to put it into life. Coming out is synonymous with disclosing one’s sexual identity/orientation to others including family, friends and colleagues. It is often an important stage in the life of LGBTQ+ individuals when sexual orientation is shared with others. It is often accompanied by anxiety, emotional and psychological challenges. It is often the fear of rejection, lack of acceptance from relationships, and discrimination that can stimulate stress and anxiety around the process.
Coming out to family, friends and colleagues could be an overwhelming experience, especially if there are apprehensions about how they will react. It may lead to positive outcomes, for instance, showing acceptance or support. On the other hand, it may lead to negative outcomes, such as rejection, criticism, hostility or other forms of discrimination. In practice this is fortunately very rare – especially in Western countries such as Denmark, where such behaviour would be punished.
The fear of the outcome of coming out often means that LGBTQ+ individuals choose to come out gradually, selectively or not at all. Many factors explain this. Overall it can be regarded as a form of fear and perceived “workability”, where factors such as the age of an individual, cultural background or the level of social support from the community also direct an individual’s decision to come out.
Friends, networks – and sometimes psychologists – are often invaluable support during the coming out phase. The counsellor can help weigh possible risks and benefits of coming out, probing strategies for managing difficult conversations during the coming out process and building a support network when going through tough times.
- Family and couples counselling could assist in dealing with emotions after the coming out phase – whether acceptance or rejection. Addressing strained family relationships in a supportive environment leads to better family dynamics.
- Group therapy offers a sense of belonging, decreases feelings of isolation, and provides a space to share experiences and probe valuable coping strategies.
Couples and Relationships Dynamics
When two individuals live together in a relationship, they will face challenges when differences meet. The challenges faced by LGBTQ+ individuals are similar to the challenges heterosexual couples face. However, romantic and intimate relationships within the LGBTQ+ community do not necessarily follow the norms of a conservative heterosexual couple – they may be more complex and multifaceted.
Trust, open communication and curiosity about the other are important components of any healthy relationship. The unique stressors faced by the LGBTQ+ community impact the relationship dynamics, for example, social stigma, rejection, prejudice, and lack of representation in society. These factors may influence one partner’s willingness to come out as a couple. Also, many couples learn more about themselves and orientation while in a relationship, putting an extra demand on the other to see and experience changes.
As mentioned earlier – Denmark is a relatively good and safe place for different sexual orientations. However, it is not perfect, and couples may experience stigma where societal expectations and cultural values discriminate against a desired relationship. It can lead to social isolation as well as conflicts within the relationship when the partners perceive the “threat” from others differently.
Self-prejudice owing to homophobia or transphobia has been seen to impact LGBTQ+ couple relationships. Unpleasant past experiences or social rejection could be the reason for these prejudices, which later bring challenges in building trust and vulnerability in relationships. In other words, it is important to notice whether one’s own history interferes disproportionately with current life. A disproportionate response could be termed a form of self-sabotage of the relationship.
Counselling can help couples accept and limit the reactions from one’s previous experiences, improve communication, build trust, and navigate through conflicts in a constructive manner.
- Couple therapy can facilitate LGBTQ+ couples to explore the impact of social stigma, internalized prejudice and discrimination on relationships – thereby exploring potential strategies to deal with them.
- A psychologist can help each partner take ownership of own history and “triggers” and disarm them in the current relationship.
- Sex therapy can help partners open up and voice desires and create a safe environment where fantasies can be fantasies and partners can agree on what to explore.
- Children in same-sex couples: family therapy can help identify roles and parenting challenges as well as handle perceived challenges towards others. When children are grown-ups, there may be a need to answer difficult questions in a safe environment.
Family Acceptance and Rejection
Family acceptance and relationship with family members remarkably affect one’s future relationships. Research evidence shows that LGBTQ+ couples, when accepted by their families, showed reduced risk of depression, anxiety and substance abuse. Contrarily, couples who are not accepted by their families showed an increased risk of suicide ideation and substance abuse.
Family rejection is a problem commonly encountered by LGBTQ+ couples – in particular in non-Western cultures. It may vary in intensity; for example, some couples may face complete disownment or continuous hostility, negative judgment, or consistent attempts to convince them to change sexual orientation. Family rejection is an extremely painful experience leading to feelings of abandonment, resentment, worthlessness and guilt.
Surprisingly, LGBTQ+ individuals struggle with the coming out process even when the families are accepting. On the part of family members, it is also challenging for them to understand and embrace their loved one’s sexual orientation, causing tension or conflict. In some cultures the idea of not having a “traditional” identity and sexual orientation is estranged to the level that some family members may desire or pressurize the LGBTQ+ individual to comply with traditional gender roles, creating strained family relationships.
During family counselling, the LGBTQ+ couple can safely explore the experience of coming out (acceptance or rejection) with their families. The therapist can propose strategies to cope with difficult family interactions.
- Family therapy can be favourable in helping family members to work through their differences, enhance understanding and improve the quality of their relationships.
Discrimination and Social Stigma
Discrimination and social stigma are the apparent challenges faced by LGBTQ+ individuals. It could be manifested in the form of verbal abuse, physical abuse, and discrimination at institutional levels such as employment, healthcare, education and housing. Social stigma and discrimination can negatively affect an individual’s mental health leading to continuous distress, anxiety, depression, and substance abuse. Remember that these fears need not be real – even the imagined thought of discrimination can have the same effect.
Continuous fear of discrimination can lead to a sense of hyper-vigilance; it stimulates a constant alert state to protect oneself against (real or imagined) threat, abuse or violence. Increased hyper-vigilance often causes stress and may result in burnout. Once the stress has reached the peak of burnout, an individual’s self-esteem and self-worth come at stake. Confidence can feel far away.
The societal pressure to conform to traditional gender roles compels LGBTQ+ individuals to hide their identity, leading to isolation and feelings of loneliness. People may struggle to find a community which accepts them and comprehends things from their perspective.
A psychotherapist experienced in working with all groups of people can facilitate strategies to cope with discrimination, for instance, building resilience, handling stressors, and giving feedback on client strategies.
- Resilience helps to deal with the negative emotional impact of discrimination or stigma by encouraging a mindset which focuses on personal strengths and the ability to overcome adversity.
- Counselling can help individuals to challenge and restructure internalized negative beliefs, thus encouraging stronger self-esteem.
Intersectionality
Intersectionality refers to the interconnectedness of social categories, for example, gender, race, class, sexual identity, and socioeconomic status. It looks into how these identities create sources of discrimination for marginalized groups. These social categories among LGBTQ+ individuals sometimes add to the challenges faced by them.
Consider the example of a transgender (Muslim) woman of colour; she may experience being different not only on the basis of her gender identity but also on her race and religion. These overlapping forms of discrimination create a unique set of challenges for LGBTQ+ individuals.
Intersecting identities also affect relationships among LGBTQ+ individuals as they navigate through varying cultural expectations, family dynamics, and social norms. For example, an LGBTQ+ individual from a conservative religious background may face more challenges in comprehending one’s identity, coming out, and getting along with relationships in a religious or cultural community.
Counselling can help individuals and families to navigate the complexities of intersecting identities, building resilience, and practicing assertiveness to deal with multiple forms of discrimination.
- An intersectional counselling approach can provide clients with an opportunity to explore intersecting identities and how they influence their relationships, and to develop adequate strategies for building healthy and fulfilling relationships.
Mental Health Issues
Even with the attention and support society and certain governments are trying to supply, there is unfortunately still a disproportionately high number of individuals from the LGBTQ+ communities that face mental health issues such as anxiety, depression, and post-traumatic stress disorder (PTSD). These issues are often paired with other unique stressors such as discrimination, prejudice, stigma, and social rejection. The role of psychotherapy in addressing these mental health issues is critical in improving mental health among LGBTQ+ individuals. Here is an overview of how these communities are affected disproportionately.
Depression: The origin of hopelessness and giving up may arrive with issues stemming from social rejection, isolation and discrimination – for example, if a gay teenager is badly bullied at school and also rejected by family members due to their sexual orientation.
The individual may internalize feelings of worthlessness, meaninglessness, and hopelessness. Moreover, the lack of acceptance by society and lack of representativeness make it difficult to feel a sense of belonging and connectedness. These negative feelings contribute to the development of depressive symptoms.
Anxiety: It is closely related to the above and often difficult to distinguish, as it is also derived from fear of judgment, rejection, hostility, and discrimination. It is a constant worry about how others will judge, how they will react when one’s identity is disclosed, and what they will think. It can feel like always being on the edge, in a state of hyper-vigilance coupled with anticipation of negative outcomes.
This physical and psychological state leads to extreme distress, disturbed sleep, poor attention and concentration. These symptoms greatly impact daily functioning and overall wellbeing.
Post-traumatic stress disorder (PTSD): LGBTQ+ individuals who experience violence, abuse, harassment, bullying or any form of trauma related to sexual orientation are likely to experience PTSD symptoms. For example, a transgender person who experiences physical violence due to their identity may experience flashbacks, nightmares, and extreme anxiety. The continued presentation of these symptoms may impact an individual’s social functioning, ability to engage in relationships, work, and other areas of functioning.
Various actions can help individuals to mitigate mental health issues:
- Self-care plays an important role here by encouraging individuals to step out of their negative sphere and take a leap to maintain a positive mental state. Self-care includes showing an increased interest in the activities you used to like, exercise, hobbies, practicing mindfulness and some time to relax.
- Connecting with others: finding communities where one can meet other like-minded people and engage in rewarding social activities.
- Online communities can provide a basis for talking about one’s challenges and desires.
- Psychotherapy and counselling: exploring and understanding the impact of stress, challenging negative internalized beliefs and developing strategies for dealing with depression and anxiety.
Conclusion
Navigating the challenges of LGBTQ+ individuals such as identity, coming out, relationships, and mental health is a complex process, as there are potentially many challenges such as understanding oneself, imagined or real discrimination from others, social stigma, rejection and hostility. Counselling and psychotherapy with an experienced psychologist with knowledge of the challenges can be a life-changing experience as an individual, couple and family.
We at EGOLAB have worked with couples and individuals with many different backgrounds, identities and sexual orientations. We are committed to helping you understand how you can live as fully as possible without setting up artificial barriers for intimacy and the life you want.
Contact us if you are looking for a psychologist or couple counsellor who can help you move forward.