1. LGBTQ+ Identity Does Not Cause Depression — Discrimination Does
An LGBTQ+ identity doesn’t make someone more susceptible to MDD on its own, says Lex Pulice-Farrow, PhD, an assistant professor of clinical and counseling psychology at Muhlenberg College in Allentown, Pennsylvania, who identifies as transmasculine nonbinary. “Being queer or trans doesn’t directly cause depression,” says Dr. Pulice-Farrow, who uses they and he pronouns.
“But the stigma, discrimination, worries about whether I can use the bathroom safely or whether I can access medical care can all increase the risk, and so can just anticipating these stressors,” they say. “Know that it’s not who you are that’s the issue.”
2. It’s Crucial to Find an LGBTQ-Affirming Therapist
It can be really hard to take the first step to get help when you have depression, and it’s even harder when you’re worried about whether a therapist will respect and understand your identity, says Choi.
Not all mental health care services are affirming, as one review of studies on transgender and gender-diverse adults found. And prior negative experiences with healthcare professionals can dissuade people from these groups from seeking mental health care, the researchers noted.
Helpful resources for finding an affirming therapist include referral services like the LGBTQ+ Healthcare Directory, the Association of LGBTQ+ Psychiatrists, and OutCare’s OutList LGBTQ+ Affirming Healthcare Directory to find one near you. Psychology Today, which lets you search for LGBTQ-affirming therapists by ZIP code or city, is another good place to start, Choi says. These providers may note whether they have specific training in LGBTQ+ health, identify themselves as allies, share their pronouns and encourage others to do the same, or work for organizations whose missions and values align with affirmative care, Choi says.
3. It’s Key to Vet a Therapist Beforehand
Once you find a therapist who seems like a good fit, reach out and ask them specific questions about their experience with and treatment approach for LGBTQ+ clients before you book an appointment, says Megan Sutter, PhD, a health research scientist in Atlanta who researches LGBTQ+ health.
“It’s one thing to check a box on an online profile to indicate you can treat LGBTQ+ people, but the way someone speaks about their work is more telling,” says Dr. Sutter, who uses they and she pronouns. “There are unfortunately some providers who say they do gender exploration work and what they’re really talking about is being anti-trans or not acknowledging how gender-affirming care can be potentially lifesaving, especially for someone with depression.”
It’s a red flag, for instance, if a therapist doesn’t want to answer questions about their own pronouns or discuss their approach to supporting people who are exploring their gender identity or sexual orientation, Sutter says.
4. If Depression Treatment Is Affirming, You’ll Be More Likely to Stick With It
Care that’s affirming boosts your odds that you’ll keep up with it (and therefore better manage your depression), Sutter says. “If this means finding a new provider or finding new supports in your community, you need to prioritize that, because MDD isn’t really something you can fix all on your own.”
Also, don’t lose focus on mood-boosting lifestyle strategies like exercise, good nutrition, and plenty of sleep, Pulice-Farrow says. “This isn’t the sexy part of recovery, but it is necessary,” they say.
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