Black Sexual Minorities and Behavioral Health Justice
• June 2023 •
From Juan Navarro, Executive Director
Los Angeles Centers for Alcohol and Drug Abuse
Executive Director’s Message: June is Pride Month
The LGBTQ+ rights movement has made some significant strides since its start with the Stonewall Uprising of 1969. Still, I always find myself asking, are we doing enough?
In 2011, a study reported that the harassment, discrimination and negative feelings about homosexuality that Black gay and bisexual men and trans women experience contributes significantly to mental health disorders such as depression and anxiety. Most of the men surveyed said that both race and sexuality play a part in their experiences of discrimination and harassment. Ten years later — when advancement was expected — a local survey found that only one in three Black people in L.A. County who need mental health services receives them. In fact, Black adults are the least likely of any racial or ethnic group to seek mental health treatment. It’s worse for Black people who identify as LGBTQ+. In fact, gender non-conforming Black youth are significantly less likely to receive professional care when needed.
Why are Black LGBTQ+ people still underserved in 2023? As they say, ‘it’s complicated’. This population faces multiple intersectional and structural adversities linked to their sexual orientations, gender identities, and racial identities. As racially marginalized people, Black individuals already face biased policies and systems for housing, jobs, places of leisure, and health care. As part of the LGBTQ+ community, they have an even greater likelihood of receiving unfair treatment linked to their sexual, gender, and racial identities.
Past acts of dehumanization and oppression in America have led to systemic racism, fueling public distrust of formal systems for marginalized Black people. The lack of Black mental health professionals, especially LGBTQ+ professionals, is another treatment barrier. Data from the American Psychiatric Association shows that only 2% of the estimated 41,000 psychiatrists in the U.S. are Black, and just 4 % of psychologists are Black. We can only imagine how few Black LGBTQ+ mental health professionals are available. Stigma is yet another factor. Many L.A. CADA patients tell us that there is an expectation in Black communities that the family should serve as the primary “safety net” in addressing mental health needs. Subjecting a vulnerable family member to mental health treatment can be seen as rejection of the family member and ultimately bring ‘shame and guilt to the family name.’
Yes, more must be done to achieve behavioral healthcare equity. L.A. CADA is here in the trenches, working to add more Black and sexual minority healthcare professionals to our workforce, and to design services that provide Black LGBTQ+ affirming care. Call us if you want help: (562) 906-2676.
Watch: Black LGBTQ+ Mental Health
Client's Corner
Tonya
“ My name is Tonya, and I’m an alcoholic. A grateful alcoholic is recovery. I come from a very Afrocentric family, I guess you could say. My uncle teaches Black studies, my parents are activists, my cousin is a cultural competency trainer. So, I was raised to be proud of who we are. Until they found out I’m a lesbian. I can tell you straight out, there was no family pride in that. My mom thought it was something I learned in school, is how she put it. None of my family believed me. Like a stage I would get over. It’s hard not being accepted by your own family and the way I coped was with drinking. It started with high school and continued after that. I got to where I couldn’t hold a steady job. So, more shame to the family. I was also arrested many times, and it was so bad that my parents wouldn’t even talk to me. I was homeless at that point, when an outreach worker referred me to treatment. Sheer luck that I wound up at a facility that was affirming to my sexual identity. For me, 100%, it made all the difference.”
SPOTLIGHT – THE EVIDENCE IS IN ON:
Trauma-Informed LGBTQ+ Care
The Center of Excellence on LGBTQ+ Behavioral Health Equity is a great resource for treatment providers serving sexual minority people. One of the evidence-based practices they recommend is Trauma-Focused LGBTQ+ Care. This practice is based on principles of trauma-informed care set forth by the Substance Abuse and Mental Health Services Administration (SAMHSA). These principles guide practitioners in creating the program safety, trust, transparency, collaboration, and patient empowerment needed to ensure that treatment does not re-traumatize vulnerable people.
For LGBTQ+ patients, this means:
Safety. Demonstrate a proactive affirming stance to honor and celebrate sexual, gender, and cultural diversity through affirming language, visual signals, and LGBTQ+ staff.
Trustworthiness and Transparency. Listen openly and own your own mistakes. Create opportunities for patients to share about their identity and authentically affirm their experiences.
Peer Support. LGBTQ+ peer groups naturally enable mutual aid — processing similar experiences allows for external validation and helps challenge our negative self-beliefs.
Collaboration and Mutuality. Individualized goal planning respects the individual while coaching the patient to explore alternatives, options, and decision-making strategies on the path to self-acceptance.
Empowerment, Voice, and Choice. Create opportunities for LGBTQ+ clients to take the lead in framing their own life story & treatment-related needs, beginning with service planning.
Cultural, Historical, Gender Issues. Make services culturally relevant and responsive to the unique feelings and treatment needs of transgender and gender-diverse clients.
Learn more about: Trauma and LGBTQ+ Youth
Comments (0)