As an aging member of the LGBTQ community, I have witnessed first hand the strides we have made as a nation toward sexual identity equality. However, even in this new found time of tolerance, there remain significant obstacles for us members of the LGBTQ community from gaining full acceptance from our peers, family, colleagues, government officials, and spiritual leaders which can and do show up as microaggressions. These systemic obstacles and peer-driven misconceptions of who we are have led to a disproportionate amount of substance use, abuse, and addiction among many members of our community.

Even though the Supreme Court legalized same-sex marriage in 2015, heterosexism and transphobia have remained one of the most menacing impacts on the LGBTQ community’s mental health. Unfairness and discrimination exhibited through many governmental systems have driven us to self-medicate. For instance, the absence of federal protection from discrimination in the workplace, the supreme court allowing retailers to refuse service to gay couples, and state policies that forbid transgender people from using public facilities that correspond with their gender identities have inflamed a culture of intolerance and have caused the LGBTQ people to feel less than.

Similarly, heterosexism and transphobia also persist through our day-to-day lives ranging from blatant bullying and hate crimes to the more indirect forms of media and cultural bias referred to as microaggressions. Microaggressions are insidious and remain as subtle varieties of judgment. For example,  sayings and questions such as; “that’s so gay,” “I’m not being homophobic you’re being too sensitive,” “so who is the man in the relationship?” “you’re bisexual, doesn’t that make your partner feel insecure? and “you’re gay? …what a waste” are usually unintentionally hurtful but they convey intimidating and/or insulting messages that continue to diminish our self-esteem, self-worth, and they can lend to our declining mental health. Hence we party.

According to the Substance Abuse and Mental Health Services Administration’s (SAMHSA) 2015 National Survey on Drug Use and Health (NSDUH), results indicated the following:

• 4.3 percent of adults aged 18 or older identified as a sexual minority, including 1.8 percent who identified as being lesbian or gay and 2.5 percent who identified as being bisexual.
• Members of the LGBTQ community were more likely than their Non-LGBTQ counterparts:
  • To have substance use and mental health issues.
  • To use illicit drugs in the past year
  • To be current alcohol drinkers
  • To use marijuana at higher rates
  • To Misuse prescription painkillers
• Sexual minority adults were also more likely than sexual majority adults to have substance use disorders in the past year, including disorders related to their use of alcohol, illicit drugs, marijuana, or misuse of pain relievers.
• Members of the LGBTQ community were more likely than their Non-LGBTQ counterparts to have in the past year:
  • A form of a mental illness
  • Suffered from a Major Depressive episode with or without major impairment
  • At increased risk for various behavioral health issues
• Additional data from the US Census Bureau found that a higher percentage of LGBTQ adults between 18 and 64 reported past-year binge drinking than Non-LGBTQ-adults.
• LGBTQ people in treatment for substance use disorder initiated alcohol consumption earlier than their non-LGBTQ counterparts.

These results show that it is imperative that the LGBTQ  community embrace support from the mental health community. It is natural for members of the LGBTQ community to feel guarded during the traditional talk-therapy process. Many individuals have faced judgment their whole lives and are inherently reluctant to open up to strangers. That is why it is important to find a counselor that has the power to break down emotional barriers and allow clients to confront potentially traumatic experiences in a safe and positive manner.

It is also important for a counselor to remain mindful of the stressors and microaggressions that lead a person from the LGBTQ community to utilize substances to cope. Accordingly, a counselor should provide personalized, empathetic and effective treatment that allows a person to safely address the origins of their substance use and/or mental health issues. An effective counselor accomplishes this through unconditional positive regard and knowing how to help. Whether it be through proper referrals or through a combination of traditional treatments that include talk therapy, mindfulness, and cognitive behavior therapy; an effective counselor should understand the LGBTQ individual’s struggles with substances and mental health as they help an individual center themselves, access unexpressed emotions, and help them discover a healthier perspective because they are worth it and far from less than.