Negative health outcomes (Reading)
Internalised homophobia is one of the main risk factors of the LG population leading to negative physical, mental, and well-being health outcomes (e.g., Berg et al., 2016). Studies have shown, for example, that internalised homophobia is positively associated with depression and anxiety (e.g., Mereish&Poteat, 2015), suicidal thoughts and behaviors, especially in LGB adolescents and the elderly (e.g., Livingston et al., 2015), substance abuse and risky sexual behavior (e.g., Herrick et al., 2013), as well as interpersonal challenges such as reduced social connectivity, lack of sexual desire, and difficulty in conjugal intimacy (Meyer &Dean, 1998; Wight, LeBlanc, &Badgett, 2013).
Although the studies reviewed thus far focused largely on the experiences of lesbian and gay individuals, recent data of bisexual persons suggest that internalized biphobia is correlated positively and uniquely with psychological distress (Brewster &Moradi, 2010; Brewster et al., 2013). There is also evidence that expectations of stigma and internalized biphobia are negatively connected with psychological wellbeing for bisexual people (Balsam & Mohr, 2007; Sheets & Mohr, 2009).
Transgender people are a highly-stigmatized population. For this reason, they might internalise society’s normative gender attitudes and develop negative mental health outcomes. Also, transgender persons can also be lesbians, gays or bisexual, and thus experience additional stigmatization and internalized homo/bi/transphobia. Bockting et al. (2013) found a positive association between social stigma and depression, anxiety, and somatization at transgender people. Internalized transphobia increases the likelihood of suicide attempts (Perez-Brumer et al., 2015). Specifically, shame about one’s own transgender identity was found to be positively associated with perceived stress, depressive symptoms, and social anxiety symptoms (Testa et al., 2015), while alienation from other transgender people was found to be positively associated with perceived stress, depressive symptoms, and anxiety (Scandurra et al., 2017).
Research also suggest that the presence of protective factors (such as coping strategies, community connection, disclosure of sexual orientation to friends, and social support) can ameliorate the effects of IH on the psychological suffering of LGBTQI+ persons.
Internalised homophobia/biphobia/transphobia is not a disease, or a personality trait, much less a condition of a single individual. It is a response to the social circumstances of external oppression and marginalisation of LGBTQI+ persons. Indeed, overcoming internalized homophobia is an important developmental task in the coming out process that lesbian, gay, and bisexual individuals undergo and is seen by clinicians as a necessary step toward achieving good mental health and well-being.
Counselling or individual psychotherapy could alleviate the negative effects of internalised homo/bi/transphobia on self-perception. Counsellors and therapists should work on feelings of shame about one’s own sexual orientation or identity, helping clients to reshape negative emotions associated with stigmatizing experiences and assist them in developing a self-image freer from binary notions of gender. They should also consider group approach as a valid alternative to individual work. Indeed, by its nature, the group encourages mirroring processes that facilitate reshaping one’s self-image in an innovative and potentially creative way (Amodeo et al., 2017), increasing self-empowerment processes and resilience strategies (Amodeo et al., 2018).
Mental health risks for LGBTQI+ persons
Lesbian, gay, bisexual and/or trans persons may be more susceptible to mental health problems than heterosexual people due to a range of factors, including discrimination and the inequalities they face in everyday life. As the participants might have different depths of knowledge on the following topics, the trainer has to adjust their presentation of this part of the module. Here are some of the most important areas that should be addressed when talking about the mental health of LGBTIQ+ persons. A trainer can add local and up-to-date data on the prevalence of these mental health issues when presenting this section to the participants.
