The Lesbian, Gay, Bisexual, Transgender, Intersexed, Asexual, Queer, and Questioning (LGBTIAQ++) community represents a diverse collection of subjectivities and expressions of gender and sexual identity as well as sexual orientation. Furthermore, members of this community are defined, in both personal and socio-structural ways, by identifiers and markers of ‘race’, cultural and religious affiliation, dis/ability status, ethnicity, as well as class. It is the inherently intersectional nature of these identities that also brings with it diverse ways of thinking about, and experiences of the world in which we live and, in particular, our everyday life in South Africa. These intersectional identities and complex positionalities, although forging a diverse and ever-expanding community of gendered and sexually diverse people, are nonetheless unique and valuable aspects which underpin and underwrite a deeply-rooted sense of community solidarity, pride, love, and care for one another, as queer people.

However, while being a member of the LGBTIAQ++ community can be a source of resilience and strength, it also brings unique challenges and psycho-social stressors. For those who identify as LGBTIAQ++, it’s important to recognise how your experience of your gendered and sexual sense of self relates to your mental health and wellbeing.

While not all LGBTIAQ++ identifiers and markers of subjectivity are included in large-scale studies of queer mental health, there continues to be growing evidence from recent research that LGBTIAQ++ people are often at a higher risk for experiencing mental health stressors and conditions – especially depression, anxiety, and suicidality – when compared against heterosexual and heteronormative counterparts. It is important to state from the outset that this is not because there are (biological or psychological) factors inherent to being LGBTIAQ++ that make one more susceptive to mental health distress. Rather, it is because being LGBTIAQ++ in a heterocentric and heteronormative world is often met with a range of implicit and explicit violences, which one is subjected to as they grow, live, and become into themselves and their relationships with other LGBTIAQ++ people.

Even in a country like South Africa, where constitutional protections against discrimination on the basis of one’s gendered and sexual identity as well as sexual orientation exists, the fact remains that these legal protections do not always translate into the psychological, social, and material experiences of everyday life. It is, for example, well known that queer youth are still rejected by their families and forced to flee to places of safety, shelters, or the street after coming out; that many public and private schools resist recognition of gender diverse students; that queer people continue to face stigma and discrimination when accessing sexual and gender-affirming healthcare; that queer couples are often met with resistance from institutional office bearers and other role players in the context of marriages, partnerships, and efforts to adopt; and that queer people, especially more socio-economically marginal queer womxn, black and brown lesbian womxn, as well as trans people of colour, are subjected to higher rates of sexual and physical harassment, violence, and hate crimes.       

It is the grinding effect of this everyday reality, that is the reality of homophobic discrimination, prejudice, harassment and family rejection, as well as physical violence, which causes many LGBTIAQ++ people to develop and face varying forms of psychological and emotional distress. It is therefore no surprise that both global and local health studies regularly show that LGBTIAQ++ people have to deal with feelings of isolation, shame, and rejection – which often lead to a range of other poorer mental health outcomes and conditions.

It is for these very reasons that the need to proactively protect, safeguard, and care for one’s mental health is recognised, as well as the mental health and wellbeing of all members of the queer community. Some basic strategies include:   

Strategy 1: Affirmative knowledge is power.

Given the hostile and pejorative ways in which LGBTIAQ++ people, relationships, and communities are constructed and treated in heteronormative and mainstream discourse, the first strategy for proactive queer mental health care is accessing and acquiring accurate and affirmative knowledge. For this, you will need to access reputable sources of information which draw on affirmative experience and expertise in helping you make sense of how you are feeling in terms of both your LGBTIAQ++ identity and your mental health. A useful resource to check out is the Triangle Project: https://triangle.org.za/.

Strategy 2: You are not alone, and you will never be alone – link-up and get connected.

Given the experience of shame and the fear of rejection that many LGBTIAQ++ people face, this often results in further retreat into our ‘psychological closets’. The sense of isolation we experience can be especially harmful to our mental health as it further reinforces experiences of loneliness. In this regard, accessing an affirmative and supportive community of LGBTIAQ++ people (as well as allies) is a vital strategy in proactive mental health self-care. Sharing our experiences, hopes, and anxieties about being LGBTIAQ++ with fellow queers who understand, relate to, and affirm our life experiences can be an important dimension of social support. A useful resource is the OUT-LGBT Well-being NGO: https://out.org.za/ or 012 430 3272.

Strategy 3: When in distress, do not keep quiet.

It is important to recognise that sometimes our experiences of shame, isolation, rejection, and violence can become very overwhelming. When this happens, it is quite easy for us to slip into depression or even develop suicidal thoughts. If this happens, you must make contact with affirmative mental health professionals and support services which can help talk you through some of the more difficult and distressing moments of being LGBTIAQ++. A useful resource is the South African Depression and Anxiety Group (SADAG), who render emergency counselling and consultations (https://www.sadag.org/ or 0800 567 567) or LifeLine’s 24-hour counselling line (011 422 4242 or 0861 322 322). 

Strategy 4: Counselling. 

Perhaps a longer-term strategy to proactively safeguard our mental health as LGBTIAQ++ people is to explore the possibility of psychotherapy and counselling with a (clinical or counselling) psychologist or counsellor registered with the Health Professions Council of South Africa. It is important to stress that any kind of psychotherapy or counselling you consider embarking on should affirm your LGBTIAQ++ identity and that your psychologist or counsellor has adequate knowledge and experience in working with LGBTIAQ++ people. This kind of queer-affirmative psychotherapy and counselling can be an immensely rewarding, to confidentially explore inner anxieties, fears and concerns as well as target and build psychological resources, strengths, and resiliencies. This is particularly important if you are needing help to navigate coming out to family and friends. A useful resource in this regard is the Psychological Society of South Africa’s Sexuality and Gender Division: https://www.psyssa.com/divisions/sexuality-and-gender-division-sgd/. 

In addition to the above, LGBTIAQ++ members of the UP community make use of institutional resources and support systems. These resources provide not only well-informed advice, guidance, and advocacy information, but also psycho-social support and counselling. These include:

• The Student Counselling Unit: https://www.up.ac.za/student-counselling
• The Centre for Sexualities, AIDS & Gender: https://www.csagup.org/
• The Centre for Human Rights: https://www.chr.up.ac.za/about/overview
• UP&OUT Student Society: https://www.up.ac.za/student-representative-council/

Dr Jarred H Martin, Programme Manager and Clinical Psychologist in the Department of Psychology at the Faculty of Humanities.