Lesbian, Gay, Bisexual, Transgender, Queer, and Intersex (LGBTQI+)

Key Data

A higher prevalence of substance use and mental health issues has been well documented among people who identify as lesbian, gay, or bisexual (also referred to as sexual minorities) than among those who identify as heterosexual or straight. Results from the 2021 and 2022 National Surveys on Drug Use and Health (NSDUH) indicate that for LGB adults:

• Bisexual females were more than 3 times as likely as straight females to have misused opioids in the past year.
• About one third of bisexual males, bisexual females, and gay males had a substance use disorder (SUD) in the past year. About one fourth of lesbian females had an SUD in the past year.
• The prevalence of Serious Mental Illness (SMI) in the past year was more than 3 times higher among bisexual males than among straight males and more than twice as high among gay males than among straight males. Bisexual males also were more likely than gay males to have had SMI.
• Sexual minority adults were at least twice as likely as straight adults to have misused methamphetamine in the past year.
• Bisexual females were the most likely to have attempted suicide in the past year, followed by lesbian females, then by straight females. The prevalence among bisexual females was 6 times higher than among straight females. The prevalence of past year suicide attempts was higher among bisexual males than among straight males.

The 2023 NSDUH shows that for youth:

• LGB+ male youths were about twice as likely as straight male youths to have used marijuana.
• LGB+ female youths were about 3 times more likely than straight female youths to have misused prescription drugs in the past year.
• LGB+ youths were about twice as likely as straight youths to have had a SUD in the past year. About 1 in 6 LGB+ female youths and about 1 in 7 LGB+ male youths had an SUD.
• More than 1 in 3 LGB+ female youths had serious thoughts of suicide and LGB+ male youths were about 5 times as likely than straight youths to have had serious thoughts of suicide, about 4 times as likely to have made a suicide plan, and about 9 times as likely to have attempted suicide.

The Transgender Behavioral Health Fact Sheet from the Center for Financing Reform and Innovation states that, compared to cisgender individuals, transgender individuals are:

• 1.8 times more likely to have any mental illness
• 1.6 times more likely to have a substance use disorder