LGBTIQ+ communities

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There is a higher risk of suicidal behaviours among LGBTIQ+ communities, compared with the broader population.1

Data from LGBTIQ+ Health Australia indicate:2

  • LGBTIQ+ young people aged 16 to 27 are five times more likely to have attempted suicide, compared with the general population
  • transgender people aged 14 to 25 are 15 times more likely to have attempted suicide, compared with the general population
  • 57% of respondents to a national survey of LGBTIQ+ people reported high or very high psychosocial distress in the previous four weeks, compared with 13% of the general community.

About acronyms

  • LGBTIQ+ is used to describe lesbian, gay, bisexual, transgender and gender diverse, intersex and queer individuals. The + represents people of other diverse sexualities and genders not captured in the letters of the acronym, as recognised in the NSW LGBTIQ+ Health Strategy 2022–2027.3
  • LGBTQ+ is used where the content does not necessarily include people who are intersex. People with innate variations of sex characteristics (intersex) are often not included in research and may not identify as part of LGBTQ+ communities.4

Risk factors and challenges

Below are some common risk factors and challenges LGBTIQ+ people may experience, and examples of what this looks like in practice. This is not an exhaustive list.

Risk or challenge What this can look like
Stigma and discrimination
  • Not recording LGBTIQ+ experience in data collection processes, e.g. intake forms
  • Refusal to use correct name and pronouns
  • Homophobia and transphobia

Gatekeeping of services

  • Restricting access to supports and services based on gender and sexual identity, e.g. gender-affirming care

Past negative experiences or trauma

  • Experiencing homophobia, transphobia or endosexism* when accessing health services by health professionals
  • Experiences of conversion practices

Application of restrictive practice in health settings

Isolation

  • Sustained exposure to stigma and discrimination, leading to social isolation
  • Effects of forming and maintaining relationships due to fear of rejection or judgement

Assumptions

  • Assuming sexual identity on presentation at a health service
  • Sexual orientation, innate variation of sex characteristics or gender identity is viewed as a mental illness

* Endosexism means treating endosex bodies (bodies which are not intersex) as valid, and bodies with innate variations of sex characteristics as disordered or in need of ‘fixing’.

More about LGBTIQ+ language and terminology

Considerations

When supporting LGBTIQ+ people, be aware of your language, approach and their personal experiences.

Provide affirming care

  • Use the person's correct pronouns and name. Ask them how they would like to be referred to and what their pronouns are.
  • Create a safe, welcoming environment, e.g. flags, posters, inclusive language.
  • Validate experiences of stigma, discrimination and stereotyping.
  • Be clear on consent and privacy, to abate fears of being prejudiced for identity or being 'outed' if not already out to family, friends, carers or kin.
  • For people living with an innate variation of sex characteristics, their experience might not be necessary to disclose. If a person chooses to disclose, respect consent and confidentiality agreements about how they want to be understood.
  • Respect the person's right to choose how they live their life; and be professional, respectful and kind.
  • Build trust through clear and transparent communication; and follow through on what you say you will do. There can be fear and lack of trust between LGBTIQ+ people and health services due to previous negative experiences.

Understand the person's needs

  • Adapt service delivery to meet the person's needs, e.g. modes of delivery, length of sessions, and considerations for people who are neurodiverse.
  • Recognise and value a person’s chosen family and support people. For many LGBTIQ+ people, there may be conflict or disconnection with family of origin.
  • Don’t make assumptions about relationships, and avoid cis heteronormative thinking, e.g. acknowledging polyamorous relationships.
  • Don’t assume that a person's sexuality, gender or sex characteristics are related to their experience of suicidality or need to be a focus of their support – ask what is important for them.
  • Be aware of the potential impact of police and justice services, due to previous negative experiences.5 If using emergency services due to a mental health crisis, engage services such as suicide prevention outreach teams, if possible.

Recommended resources

ACON
Promotes inclusivity and provides mental health resources, counselling services and care coordination for LGBTQ+ people with complex needs. Key resources to support suicide prevention include:

  • Here – digital suicide prevention hub: connecting the LGBTQ+ community, loved ones and service providers to care support and resources.
  • Transhub: digital and resource platform for all trans and gender diverse people in NSW, loved ones, allies and health providers.

How can I support a LGBTIQA+ person with a mental health condition?
Information about supporting LGBTIQA+ individuals with mental health conditions, using a recovery-oriented, holistic, person-centred and trauma-informed approach.
Source: NSW Health

InterAction for Health and Human Rights
A national organisation supporting people with innate variations of sex characteristics; advocating for their health, human rights and bodily autonomy. It provides education, advocacy, and psychosocial and peer support.

Interlink peer support
Connects people to share experiences of living with innate variations in sex characteristics, supported by trained counsellors and intersex peer workers.

LGBTQ+ inclusive and affirming practice guidelines
Provides support to alcohol and other drugs and mental health service providers to ensure LGBTQ+ inclusive, affirming practice.
Source: Network of Alcohol and other Drugs Agencies

LGBTIQ+ people from CALD communities and mental health
Information for LGBTIQ+ CALD communities about where to find assistance; and for service providers about delivering culturally appropriate mental health and healthcare to LGBTIQ+ CALD communities
Source: Transcultural Mental Health Centre

Rainbow resource for mental healthcare
Offers guidance for mental health clinicians to understand the needs of LGBTIQ+ young people and effectively support their mental health and wellbeing through affirming, best-practice care.
Source: NSW Agency for Clinical Innovation

Twenty10 community education and support for the LGBTIQA+ community
Provides free mental health and psychosocial support programs, events, safe spaces and training to support the LGBTIQA+ community.

Workforce resources to support LGBTIQ+ people
Resources to enhance the capacity of professionals and organisations to support LGBTIQ+ individuals. Topics include mental health, suicide prevention, aged care, disability inclusion and workplace diversity.
Source: LGBTIQ+ Health Australia

References

  1. LGBTIQA+ Communities: Priority Populations in Suicide Prevention. Newcastle (AU): Life in Mind Australia; 2023 [cited 25 Sept 2024].
  2. National LGBTIQ+ Mental Health and Suicide Prevention Strategy 2021-2026. Sydney (AU): LGBTIQ+ Health Australia; 2021 [cited 29 Sept 2024].
  3. LGBTIQ+ Health Strategy 2022-2027. Sydney (AU): NSW Health; 2022 [cited Sept 2024].
  4. Rainbow resource for mental healthcare. Sydney (AU): Agency for Clinical Innovation; 2025 [cited January 2025].
  5. Dwyer A, Ball M, Lee M, et al. Barriers Stopping LGBTI People Accessing LGBTI Police Liaison Officers: Analysing Interviews with Community and Police. Sydney (AU): Taylor & Francis; 2021.
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