When the hard part is not who you are, but whether you can be yourself safely
Identity and sexual orientation are not something to be “corrected”. What becomes hard is the context in which a person is asked to live them.
Being able to be yourself without fearing that you will be judged, rejected, or that you will have to hide an important part of your identity seems self-evident.
For many LGBTQ+ people, though, it is not always so.
And here an important distinction is needed:
A person's sexual identity or sexual orientation is not a psychological problem that needs to be “corrected”.
What can become difficult is the way a person is asked to live that identity within relationships, family, work and a social environment that is not always accepting.
When you have to think about whether it is safe to be yourself
“Should I tell my parents?”
“Will our relationship change if they find out?”
“Can I talk openly about my relationship at work?”
“Why do I still feel guilty about something I know is part of who I am?”
The psychological literature uses the term minority stress to describe the additional psychological load that can build up when a person belongs to a socially stigmatised group.
Discrimination, rejection, negative remarks, fear of other people's reactions, the need to conceal one’s identity, or even the internalising of negative social messages can weigh significantly on mental health.
The difficulty, then, does not lie in the person's identity. It may lie in the conditions within which they are asked to live it.
Acceptance is not only about other people
There is also a more personal road.
A person may need time to explore their sexuality or their identity, to understand what it means for them, to manage contradictory feelings, or to gradually let go of guilt and expectations they have internalised.
They do not have to have all the answers.
Nor to choose a particular label before it feels like theirs.
Psychological support can offer a safe space in which these thoughts can be explored, without any attempt to change or question the person's identity.
The power of relationships that let us exist
Social and family support can act protectively against the effects of minority stress.
And that matters particularly.
Because when we talk about LGBTQ+ mental health we do not have to talk only about difficulties.
We also need to talk about resilience, connection, community, self-acceptance and relationships in which a person can feel they belong without having to hide.
A space where you do not have to apologise for who you are
Psychological support for an LGBTQ+ person can concern exactly the same things that might concern anyone else: anxiety, relationships, separation, self-esteem, family, loneliness, work or a difficult period of life.
Alongside that, though, there may also be a part of their experience connected to their identity: coming out, acceptance by the family, fear of rejection, discrimination, their relationship with their body, or the effort to build relationships in which they feel safe.
In a psychological setting that respects difference, the aim is not to change who a person is.
It is for them to understand themselves, their relationships and their experiences better, and to shape a way of living that is more in keeping with who they really are.
Because sometimes the most important step is not learning to become something different.
It is being able to exist as ourselves, without fear and without having to apologise for it.
Sources & references (8)
- American Psychological Association. (2021). Guidelines for Psychological Practice with Sexual Minority Persons. American Psychological Association.
- Nakamura, N., Dispenza, F., Abreu, R. L., Ollen, E. W., Pantalone, D. W., Canillas, G., Gormley, B., & Vencill, J. A. (2022). The APA Guidelines for Psychological Practice With Sexual Minority Persons: An Executive Summary of the 2021 Revision. American Psychologist, 77(8), 953–962. https://doi.org/10.1037/amp0000939
- Meyer, I. H. (2003). Prejudice, Social Stress, and Mental Health in Lesbian, Gay, and Bisexual Populations: Conceptual Issues and Research Evidence. Psychological Bulletin, 129(5), 674–697.
- Hatzenbuehler, M. L. (2009). How Does Sexual Minority Stigma “Get Under the Skin”? A Psychological Mediation Framework. Psychological Bulletin, 135(5), 707–730.
- Pachankis, J. E. (2014). Uncovering Clinical Principles and Techniques to Address Minority Stress, Mental Health, and Related Health Risks Among Gay and Bisexual Men. Clinical Psychology: Science and Practice, 21(4), 313–330.
- Pachankis, J. E., Hatzenbuehler, M. L., Rendina, H. J., Safren, S. A., & Parsons, J. T. (2015). LGB-Affirmative Cognitive-Behavioral Therapy for Young Adult Gay and Bisexual Men: A Randomized Controlled Trial of a Transdiagnostic Minority Stress Approach. Journal of Consulting and Clinical Psychology, 83(5), 875–889.
- Mezza, F., Mezzalira, S., Pizzo, R., Maldonato, N. M., Bochicchio, V., & Scandurra, C. (2024). Minority Stress and Mental Health in European Transgender and Gender Diverse People: A Systematic Review of Quantitative Studies. Clinical Psychology Review, 107, 102358. https://doi.org/10.1016/j.cpr.2023.102358
- American Psychological Association. (2015). Guidelines for Psychological Practice with Transgender and Gender Nonconforming People. American Psychologist, 70(9), 832–864. https://doi.org/10.1037/a0039906
This text is informational and psychoeducational. It is not a diagnosis and does not replace a session with a mental health professional.