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

SAMHSA’s Office of Behavioral Health Equity (OBHE) works to improve access to quality behavioral health services and supports for historically underserved and under-resourced populations. This includes support for lesbian, gay, bisexual, transgender, queer, and intersex populations. OBHE strives to embed equity in SAMHSA’s grantmaking, training and technical assistance, and publications and products. OBHE manages the LGBTQ+ Behavioral Health Center of Excellence (CoE) which provides training, workforce development, and culturally-informed and linguistically responsive approaches across the behavioral health continuum of care, from prevention to recovery.

LGBTQI+ Hero Image

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
Publication Cover for Behavioral Health Care Access Among Lesbian, Gay, and Bisexual (LGB) Populations

Featured Resource

Behavioral Health Care Access Among Lesbian, Gay, and Bisexual (LGB) Populations
Highlights findings from the 2023 SAMHSA publication Lesbian, Gay and Bisexual Behavioral health: Results from the 2021 and 2022 National Surveys on Drug Use and Health on elevated rates of substance use, suicidality, and mental illness among LGB individuals compared to straight individuals.

Resources

LGBTQ+ Behavioral Health Equity, Center of Excellence banner

The LGBTQ+ CoE provides behavioral health practitioners with vital information to support the LGBTQ+ population. Here are some recently created resources:

Need Help?

  • LGBTQI+ people under 25 can access 24/7 LGBTQI+ support via the 988 Lifeline. To call an LGBTQI-trained crisis counselor, dial 988 and then press 3. To text, send the word PRIDE to 988. To chat, you can opt-in on the Pre-Chat Survey above by checking off the box for LGBTQI+ support.
  • FindTreatment.gov. Millions of Americans have mental and substance use disorders, find treatment near you.
  • For mental or substance use disorders, call SAMHSA’s National Helpline at 1-800-662-HELP (4357), TTY: 1-800-487-4889, or text your zip code to 435748 (HELP4U)
Last Updated: 04/24/2023