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  • Rosie Sharville

Reflections Of A Queer Psychologist: Mental Health In The Lgbtq+ Community

Let me introduce myself. I am Rosie. In my professional life, I am a Trainee Clinical Psychologist for the NHS. Over the past six years, I have worked as a therapist for children, teenagers, and adults in a variety of different teams, from mental health hospitals, to physical health charities, to learning disability community teams, to my current role as a psychologist in an HIV service.

In my personal life, I am a queer woman, in my late twenties, living in London. I’m that @n.a.s.tee person on Instagram (terrible name, I know) making queer t-shirts and drawings. I’m also somebody with personal experience of mental health difficulties, of panic attacks and depression.

I share that last part because, if you are struggling, I want you to know that you are not alone. For many of you, it will not be news that the rates of difficulties like low mood, anxiety, drug and alcohol dependency, and suicide, are particularly high in the LGBTQ+ community.

However, to understand why this is the case, we need to think about the causes of distress in general. But the question of “What causes unhappiness?” is, unsurprisingly, not a question that has a clear or simple answer.

In psychology, we talk about different ways of understanding distress, like biological, cognitive, behavioural, or socio-political explanations. For some people, it is helpful to think about chemical imbalances, such as the serotonin hypothesis of depression. For others, it is helpful to question the way that they think about things or the actions that they take, and whether or not there is room for change in these. For others still, it is helpful to draw upon spiritual or religious explanations of wellbeing. And, for yet others, it is helpful to look outward, to social or political causes of unhappiness.

It is my belief that all ways of understanding distress are valid. However, over the years that I have worked in the NHS, I can no longer ignore the contributions of society and of politics to the distress of the individual. So, it is this last explanation of distress that I want to draw upon.

I have sat with people in a physical health service as they cried about their carer allowance being cut and no longer knowing how they will feed and wash themselves safely.

I have called housing crisis centres and written letters to help young families who are homeless but being questioned by the authorities as to whether they have done so “intentionally”.

I have supported people who, for reasons of abuse, have not left their house for long periods of time. I have seen them work tirelessly to build up the courage to start venturing out, only to see them attend an interview to prove that they are worthy recipients of their benefits, and find this so humiliating and stressful that they struggle to go out again.

I have heard countless people talk about the impact of unrealistic media images on the way they view their body, and of constant advertising that implies that if you just buy this cream, or change this thing about your appearance, you’ll be instantly happier.

And, it pains me to say this, but I have seen mental health services that claim to help people, only to restrain people, or force medication on them against their will.

What do all of these examples have in common? It is that the cause of distress was external. It was social. It was political.

These experiences are, of course, not specific to LGBTQ+ people. However, they remind us that the causes of distress do not just come from within us. They remind us to look outward.

In our heteronormative society, queerness is viewed as difference, as ‘other’. Homophobia and transphobia, both overt and covert, are real and have real consequences. It will be not be news to you that somebody whose identity exists outside of ‘the norm’ can be subject to verbal and physical abuse. But, as well as these more outward displays of hostility, a queer person is also subjected to the more invisible effects of our society. The fear of rejection, of what people might think of you, of isolation, of not being believed – these are all distressing experiences too.

To give an example: when the Australian marriage equality vote came in last year, I did not celebrate. Yes, Australians had voted in favour of ‘gay marriage’. But four in every ten people had voted against it. Four out of every ten people held the view that, because of who we love, we are not deserving of the same rights. In the weeks that followed, I could not help but wonder: do four out of every ten people think that I am wrong?

It is these external sources of distress that have just as much impact, if not more, than my biology, or my thinking patterns, or the actions that I take.

But I am not here just to spread doom and gloom. I want to share what I have found to be helpful. Learning about the social and political causes of distress was an incredibly powerful experience for me, and it may be for you too. There is relief in knowing that we are not simply broken, but that our distress is understandable. And, crucially, there is empowerment through collective action.

Once you step away from the individualistic idea that your distress is your responsibility, you can start to engage with activism. Not everybody feels comfortable or able to shout from the rooftops, but there is power in discussion with those around you, in signing petitions, in going to talks, and sharing books and ideas. If you are able, seek out your politicians, campaign, or just start with a critical read of the news.

We live in this individualistic culture, yet if there is one thing that I have learnt, it is that humans crave connectedness. When you meet an ally to your cause, keep hold of that person, because meaningful connections are rare but life-changing.

If someone you know is struggling, ask them how they are. Ask them twice. People often think they are a burden, so make sure they know that they can share with you.

Listen to them. One of the most common misconceptions is that you have to know the solution to somebody’s distress. You don’t. Just being there is enough.

And if you are struggling? Remember that you are not broken. Your strength through adversity is what makes you beautiful. You may not see it now, but it is exactly these experiences of distress that will help you to connect with the experiences of others, and to say:

“I have been there too. You are not alone.”


If you would like mental health support, your GP is usually the first step. They will be able to refer you on to other places, if you decide that is what you would like.

Another NHS option, for those looking for help with mild to moderate low mood or anxiety, is to look up your local IAPT (Improving Access to Psychological Therapies) service. Most of these services now take self-referrals.

If you are interested in private therapy, your best bet is to google ‘Find a Therapist’. Two websites, a BACP one and a UKCP one, will come up. You can use their search engines to find local private therapists.

Are you worried about your safety or the safety of others? Are you in a mental health crisis? If so, consider booking an emergency GP appointment, visiting your local A&E, or phoning your local crisis team (Google should help you find their number).

Need to talk, right now? Call the Samaritans on 116 123. They are a great confidential service to speak to, at any time of day or night.

Rosie is the Queer Angel behind the amazing brans N.A.S.Tee, follow them and spread the love.


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