Kathleen M. Pike, PhD


Last week, the United States Supreme Court decided a landmark civil rights case. In a 6-3 ruling, the court determined that federal anti-bias law, already on the books for decades, covers millions of gay, lesbian and transgender workers. It is being heralded as another milestone for the gay rights movement. But it is more than that. It is a beacon for humanity.

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Only a few days later, Sarah Hegazi died by suicide. Ms. Hegazi was an Egyptian woman who was granted asylum in Canada following imprisonment and torture for “inciting debauchery” in Egypt simply because she was gay. The traumas she endured led to serious mental health problems that led to suicide. Sadly, Ms. Hegazi’s story is not unique. The LGBTQ+ community has been fighting violence and discrimination around the globe with variable success and support forever. The fate of this fight has profound implications for mental health for the LGBTQ+ community – and for us all.

1. What happened last week? The US Supreme Court decision last week takes us back to the landmark 1964 Civil Rights Act that prohibits discrimination based on race, color, religion, sex, or national origin. Last week’s decision affirms that federal anti-bias law applies to gay, lesbian, and transgender individuals as well. The  6-3 decision was written by Justice Neil Gorsuch who said that the “message” of the law is “simple and momentous: An individual’s homosexuality or transgender status is not relevant to employment decisions. That’s because it is impossible to discriminate against a person for being homosexual or transgender without discriminating against that individual based on sex.”

2. Pride. This Sunday marks the fiftieth anniversary of the first Pride March, which commemorated the 1969 Stonewall Riots that spawned the Gay Rights Movement. Pride is both a time to celebrate progress and a promise to continue the march towards social justice and equality. US Supreme Court victories in recent years have been hard fought against a long history of discrimination and marginalization of LGBTQ+ individuals. And one of the costs is in mental health. Compared to people who identify as straight, LGBTQ individuals are 3 times more likely to experience a mental health issue. The stigma surrounding LGBTQ individuals underpins poorer mental health as negative feelings of homophobia and discrimination can negatively impact individual wellbeing.

3. Prejudice, Discrimination, and Violence. Data from a wide range of studies, including those focused specifically LGBTQ+ individuals, indicate that stigmatized minority groups are at dramatically increased risk of mental health problems. This is true for the LGBTQ+ community. It is true for the black American communityIt is true for the transgender community. Time and again, the data affirm that the mental health issues of marginalized minority groups are largely a function of prejudice, discrimination, and violence perpetrated simply because of their sex, gender orientation or skin color. When the rejection starts at home, the mental health impact is profound. Compared to LGBTQ+ youth who have supportive families, LGBTQ+ youth who experience strong rejection from their families are 8 times more likely to have tried to commit suicide, 6 times more likely to report high levels of depression, 3 times more likely to use illegal drugs, and 3 times more likely to have risky sex.

4. Validation and Support. The experience of feeling validated and supported by our community and society serves as a protective factor for mental health and wellbeing for all of us. All the more so for LGBTQ+ individuals. Social support from family, friends, and the wider community is associated with higher self-esteem, more positive group identity, and more positive mental health. For individuals of minority communities, validation of one’s equal rights and belonging regardless of the minority status translates into an experience of validation and positive mental health. A 2015 study of 27,715 trans Americans found that those whose identity documents matched their gender were much less likely to experience mental health issues, something cisgender individuals take for granted.

5. Disclosure. Social change moves in fits and spurts. Daily life is like living among the trees, and it is only when the days are strung together that the larger story emerges and we see the forest for the trees. This is the extraordinary brilliance and eloquence of the Netflix documentary, Disclosure. Director Sam Feder has achieved a tour de force. Disclosure is an eye-opening look at transgender depictions in film and television over the past century. Original interviews with leading figures in the trans community today provide further depth and analysis. Disclosure captures the big picture brilliantly, beautifully, painfully. It calls on each of us to confront unexamined assumptions about gender and sexuality and “decades-old stereotypes, memes, and tropes in the media that both form and reflect our understanding of trans issues.”

Last week the US Supreme Court affirmed the civil rights of the LGBTQ+ community. Only a few days later, Sarah Hegazi died by suicide – a tragic ending to a life traumatized by prejudice, discrimination, and violence due to sexual orientation. Marginalization of minority groups – in this case the LGBTQ+ community – in the form of prejudice, discrimination, and violence extract extraordinary mental health costs. It’s a price no one should pay. It is a price no one can afford. It’s a price no society should allow.

Picture of Kathleen M. Pike, PhD

Kathleen M. Pike, PhD

Kathleen M. Pike, PhD is Professor of Psychology and Director of the Global Mental Health WHO Collaborating Centre at Columbia University.

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