May 17th marks the International Day Against Homophobia, Biphobia, Intersexphobia and Transphobia (IDAHOBIT), highlighting the ongoing need to combat discrimination and promote equality. LGBTQIA+ people face significant challenges in accessing quality healthcare, particularly in mental health services. Discrimination, whether overt or subtle, can have a profound impact on their well-being and overall healthcare experience. As healthcare professionals, it is essential to understand these challenges and the steps we can take to foster a more inclusive, supportive environment for all patients, regardless of sexual orientation or gender identity.
Research has shown that LGBTQIA+ individuals experience higher rates of mental health issues compared to their heterosexual, cisgender counterparts1. Such rates can be attributed to many factors, including the systemic, institutionalised and everyday experiences of discrimination, harassment and violence that LGBTQIA+ people experience2. Unfortunately, this discrimination does not necessarily end when they seek help for their mental health. In fact, many LGBTQIA+ individuals continue to face bias and exclusion within healthcare settings.
Discrimination in healthcare is evident, as research has revealed that LGBTQIA+ people experience higher levels of mistreatment and discrimination in these settings compared to the general population3, 4. These experiences may include verbal harassment, denial of care, and refusal to treat individuals based on their sexual orientation or gender identity5. As a result, many individuals may hesitate to seek treatment, further deepening the mental health struggles faced by the LGBTQIA+ community.
It is also important to remember that LGBTQIA+ individuals who also belong to other marginalised groups, such as people of colour, people with disabilities, or those from low socioeconomic backgrounds, face compounded barriers to care. This intersectionality can lead to more severe health disparities, as individuals are subjected to multiple forms of discrimination simultaneously6. Intersectional discrimination is particularly important for healthcare professionals to understand, as it can shape the unique experiences and needs of LGBTQIA+ individuals in clinical settings.
So, what can you do?
As health practitioners, we have a responsibility to address and reduce discrimination in mental health services. Here are several practical steps that can help:
1. Education and Training
Make inclusivity a priority by regularly engaging in LGBTQIA+ training. This includes learning about the specific mental health challenges faced by the LGBTQIA+ community and understanding the importance of using affirming language, such as using patients’ preferred pronouns. Check out Wavelength, GPEX or ThinkGP for free training.
2. Creating an Inclusive Environment
Health facilities should ensure that they are safe spaces for LGBTQIA+ individuals. This involves not only the use of inclusive language but also the creation of physical environments that reflect LGBTQIA+ identities, such as displaying non-discrimination policies and providing reading materials relevant to LGBTQIA+ mental health.
3. Developing Cultural Competence
It is important for mental health professionals to understand the intersectionality of LGBTQIA+ discrimination and how other factors, such as race, socioeconomic status, and disability, may compound experiences of exclusion. Resources like BlaQ, 2 Spirits and LGBTIQintersect may be a good place to start.
4. Implementing LGBTQIA+ Affirmative Practices
Tailoring care to meet the specific needs of LGBTQIA+ individuals is vital. This includes offering gender-affirming care, understanding the unique challenges faced by LGBTQIA+ people, and adopting therapeutic approaches that foster inclusivity and respect. There are a number of services offering guidelines for inclusive care; read the “LGBTQ+ inclusive and affirming practice guidelines” developed by ACON, Mental Health Coordinating Council, NADA, and the Central Eastern Sydney Primary Health Network, “Guidance to support gender affirming care for mental health” from the ACT Government, or “Gender-Affirming Mental Health Care” from Orygen.
5. Improving Access to Digital Resources
Digital mental health resources are a valuable tool for individuals who may face barriers to in-person care. By integrating online resources into treatment plans, health professionals can support their LGBTQIA+ clients in managing symptoms and enhancing their mental well-being. There are a number of digital resources tailored to the unique needs and experiences of LGBTQIA+ people, which can be explored in our referral sheet.
Take a moment to reflect on the changes you can make in your practice or the resources you can explore to better support LGBTQIA+ individuals in your care. Whether it’s through further education, implementing inclusive practices, or using affirming language, every action counts. Speak up, advocate for inclusive policies, and commit to fostering an environment where all patients feel seen, respected, and supported.
1 Lu, J. A., Soltani, S., Austin, S. B., Rehkopf, D. H., Lunn, M. R., & Langston, M. E. (2025). Mental health disparities by sexual orientation and gender identity in the All of Us Research Program. JAMA Network Open, 8(1), e2456264-e2456264.
3 McLaughlin, A. J., Nonoyama, S., Glupe, L., & Bosse, J. D. (2025). Systemic transphobia and ongoing barriers to healthcare for transgender and nonbinary people: A historical analysis of# TransHealthFail. PLOS Digital Health, 4(3), e0000718.
4 Medina-Martínez, J., Saus-Ortega, C., Sánchez-Lorente, M. M., Sosa-Palanca, E. M., García-Martínez, P., & Mármol-López, M. I. (2021). Health inequities in LGBT people and nursing interventions to reduce them: A systematic review. International journal of environmental research and public health, 18(22), 11801.
5 Ayhan, C. H. B., Bilgin, H., Uluman, O. T., Sukut, O., Yilmaz, S., & Buzlu, S. (2020). A systematic review of the discrimination against sexual and gender minority in health care settings. International Journal of Health Services, 50(1), 44-61.
6 Agénor, M., Geffen, S. R., Zubizarreta, D., Jones, R., Giraldo, S., McGuirk, A., … & Gordon, A. R. (2022). Experiences of and resistance to multiple discrimination in health care settings among transmasculine people of color. BMC Health Services Research, 22(1), 369.
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