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SAMHSA Releases New Data on Lesbian, Gay and Bisexual Behavioral Health

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The Substance Abuse and Mental Health Services Administration (SAMHSA) today released a new data report Lesbian, Gay, and Bisexual Behavioral Health: Results from the 2021 and 2022 National Surveys on Drug Use and Health (PDF | 2.1 MB), indicating that lesbian, gay, and bisexual adults are more likely than straight adults to use substances, experience mental health conditions including major depressive episodes, and experience serious thoughts of suicide.

“We know that statistically, lesbian, gay and bisexual Americans face increased risks for mental health and substance use issues, which is often related to stress caused by stigma, discrimination and harassment,” said HHS Assistant Secretary for Mental Health and Substance Use Miriam E. Delphin-Rittmon, Ph.D., and the leader of SAMHSA. “SAMHSA is committed to addressing this issue by increasing services and supports for LGBTQI+ individuals.”

SAMHSA’s approach to addressing the behavioral health needs of LGBTQI+ people with, affected by, or at risk for mental health and substance use conditions, builds on the President’s Executive Order on Advancing Equality for Lesbian, Gay, Bisexual, Transgender, Queer, and Intersex Individuals (EO 14075).

Since 2020, SAMHSA has funded a Center of Excellence for LGBTQ+ Behavioral Health Equity, which is designed to support the implementation of change strategies within mental health and substance use disorder treatment systems to address disparities impacting the LGBTQ+ community.

In fall 2022, the 988 Suicide & Crisis Lifeline launched a pilot service for LGBTQI+ youth offering 24/7 call, text and chat access to specially trained crisis counselors.

The report released today covers adults aged 18 or older. Age adjusted findings include:

  • Lesbian and bisexual females were more likely than straight females to have engaged in binge drinking in the past month, and about twice as likely to have engaged in heavy drinking in the past month.
  • Gay and bisexual males and females were two to three times more likely than their straight counterparts to have used illicit drugs other than marijuana in the past year.
  • About one third of bisexual females, bisexual males, 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.
  • Bisexual females were three times more likely than straight females to have had an opioid use disorder in the past year.
  • The prevalence of serious mental illness (SMI) in the past year was more than three times higher among bisexual males than among straight males and more than twice as high among gay males than among straight males.
  • More than one in four bisexual females and more than one in seven lesbian females had a major depressive episode (MDE) in the past year. Sexual minority males were two to three times more likely than straight males to have had an MDE in the past year.
  • Bisexual females were six times more likely to have attempted suicide in the past year than straight females.

The 2023 survey asks all respondents their sex at assigned at birth and their gender identity, including whether they identify as male, female, transgender, or another identity.

If you or someone you know is struggling or in crisis, help is available. Call or text 988 or chat 988lifeline.org. To learn how to get support for mental health, drug, and alcohol issues, visit FindSupport.gov.

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Reporters with questions should send inquiries to media@samhsa.hhs.gov.


The Substance Abuse and Mental Health Services Administration (SAMHSA) is the agency within the U.S. Department of Health and Human Services (HHS) that leads public health efforts to advance the behavioral health of the nation. SAMHSA’s mission is to lead public health and service delivery efforts that promote mental health, prevent substance misuse, and provide treatments and supports to foster recovery while ensuring equitable access and better outcomes.

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