04/28/2025
Understanding the Unique Mental Health Needs of the LGBTQIA+ Community
By Aaron Sahle, MSN, APRN, PMHNP-BC, FNP-BC, FNP-C - Dual-Certified Family and Psychiatric-Mental Health Nurse Practitioner
Mental health concerns such as depression, anxiety, substance use disorders, and su***de are significant public health issues. However, these challenges affect the LGBTQIA+ community at disproportionately higher rates — and they often present differently than what many clinicians are traditionally trained to recognize.
Research consistently shows that individuals who identify as LGBTQIA+ are at an elevated risk for depression, anxiety, post-traumatic stress, and substance abuse. According to The Trevor Project’s 2024 National Survey, 41% of LGBTQIA+ youth seriously considered attempting su***de in the past year, with rates even higher among transgender and nonbinary individuals. Adults within the community also face alarming statistics, reporting higher instances of mood disorders and substance use compared to their heterosexual and cisgender counterparts.
Depression among LGBTQIA+ individuals often presents not only with the classic symptoms — sadness, hopelessness, withdrawal — but also through intense internalized shame, struggles with identity, and persistent fear of rejection. This emotional burden is frequently compounded by societal stigma, family rejection, discrimination, and sometimes outright violence — all of which contribute to what is termed “minority stress.” As a result, substance use may become a coping mechanism, further complicating the clinical picture.
Additionally, rates of interpersonal violence, including emotional, physical, and sexual abuse, are substantially higher in LGBTQIA+ populations. Traumatic experiences, often beginning in adolescence, can alter brain development, emotional regulation, and future relational patterns, leading to chronic mental health issues if left unaddressed.
These realities underscore a critical truth: LGBTQIA+ patients require providers who are not only compassionate but also specifically trained to understand their unique experiences. Standard assessment tools and treatment approaches often miss the nuanced presentation of mental health concerns in this group. Without specialized training, even well-meaning providers may unintentionally cause harm through microaggressions, misgendering, or failure to create a safe, affirming space.
Mental health care must be tailored — not generalized — when working with LGBTQIA+ individuals. This means screening for minority stress, acknowledging the impact of systemic oppression, integrating trauma-informed care principles, and using inclusive, affirming language.
As providers, it is not enough to be “welcoming.” We must be affirming, skilled, and proactive in addressing the distinct mental health risks faced by the LGBTQIA+ community. Early, sensitive intervention can save lives.
In my practice, I am committed to creating an environment where every individual feels seen, heard, and supported — exactly as they are.
— Aaron Sahle, MSN, APRN, PMHNP-BC, FNP-BC, FNP-C
Dual-Certified Family and Psychiatric-Mental Health Nurse Practitioner
