There is increasing attention paid to the elevated mental health risks for lesbian, gay, bisexual, transgender, and questioning (LGBTQ) adolescents. Evidence shows elevated risk of mental health or substance use disorders when LGBTQ adolescents become adults. The recent increase in attention began over ten years ago, with the well-known public-awareness campaign “It Gets Better.” This campaign featured celebrities sharing stories to help stop bullying of LGBTQ youth. One important message is that when things get difficult, treatment helps.
This type of positive public exposure is necessary. It addresses a persistent problem: LGBTQ youth and young adults face an elevated level of risk for depression, alcohol and substance use disorders, and other mental health disorders. One study found young adults who identify as LGBTQ have significantly higher rates of major depression, post-traumatic stress disorder (PTSD), suicide attempts, and other mental disorders, when compared to national samples.
Discrimination based on sexual orientation correlates with lower life satisfaction, issues with mental and physical health, and a high incidence of suicidal ideation and suicide attempts. Data suggests that one-third of people who identify as lesbian or gay attempt suicide at some point in their lives, a number much higher than the general population.
Positive public attention can help. It’s important to realize, though, that, while campaigns to raise awareness about bullying LGBTQ teens are often successful, bullying includes many behaviors. These may involve simple teasing and name-calling, to more extreme behaviors such as harassment and assault, bullying takes Some bullying experiences fade in memory, while others cause trauma — and that can have lasting effects. This can include PTSD symptoms and other negative outcomes that extend well into adulthood.
Alcohol and Substance Use Disorder in LGBTQ Adults
Early trauma is widely recognized as a contributing factor to alcohol and substance use disorder and the need of treatment later in life. Early trauma includes bullying and discrimination experienced by LGBTQ adolescents based on sexual orientation.
The 2023 Youth Risk Behavior Survey shows that, over the course of a school year:
- 23% of LGBTQ youth report being bullied at school
- 27% report being bullied online – i.e. cyberbullying
- 14% of LGBTQ youth report not going to school for safety concerns
This survey becomes more relevant in light of the following data from the 2015 National Survey on Drug Use and Health, The Substance Abuse and Health Services Administration (SAMHSA) published this report every year. This data from 2015 confirms the idea that trauma experienced LGBTQ adolescents by adolescents increases risk of AUD or SUD later in life. Experiencing early trauma increases the need for professional treatment.
LGBTQIA+ Adults and AUD/SUD
- Adults who identify as lesbian or gay:
- Twice as likely to have an alcohol use disorder than those who identify as heterosexual
- Adults who identify as bisexual:
- Three times as likely to have a substance use disorder as those who identify as heterosexual
- Adults who are unclear about their sexual identity:
- Five times more likely to have a substance use disorder than people who identify as heterosexual
When we connect the dots between these two data sets, we learn something important. Members of the LGBTQ population who report experiencing bullying as adolescents often report developing alcohol and/or substance use disorders – and may need treatment – as adults. Early trauma associated with bullying, discrimination, and a general lack of support and understanding by families, peers, and society at large plays a significant role in this phenomenon. We’ll repeat this because it’s important. LGBTQ people who report experiencing bullying as adolescents needed support as teens, and likely need targeted treatment and support as adults.
Seeking Treatment for LGBTQ Adolescents
It’s important to bear in mind that intense victimization during the teenage years can manifest in symptoms that can persist for years or even decades. Bullying may fade from the mind or memories of some bullying victims. It may seem less serious as the years pass. However, people who identify as LGBTQ experience an elevated level of targeting and bullying that can cause real harm.
This type of targeted, anti-LGBTQ bullying may include persistent harassment or even assault.
If the targeting behavior persists over years, it may take professional support to heal and move forward. Trauma during the teen years correlates with negative mental and physical health effects. These effects can manifest years later. Higher rates of depression, anxiety, and other mood disorders are also common in LGBTQIA+ adults report experiencing targeted bullying as teenagers.
The bottom line here is simple. People who identify as LGBTQIA+ who were bullied during their adolescent years are at increased risk of the need for AUD or SUD treatment later in life. Professional support, community, compassion, treatment, and care make a real and lasting difference. Therapeutic intervention for feelings of alienation and loneliness can have positive effects at any age. Support in the face of bullying helps. It helps teens and young adults devise positive coping skills and strategies. These techniques help them deal with trauma and stress. Treatment also helps LGBTQIA+ adults with alcohol and/or substance use problems. When they understand how their teen experiences affect them as adult, things change. This understanding forms an important piece of the treatment puzzle. In most cases, it helps them make significant strides on their recovery journey.