LGBTQIA and Sexuality Topics

What are challenges around sexual and gender identity?

Sexual and gender identity are two different spectra. Sexual identity refers to an individual’s sexual orientation, which is an inherent romantic or sexual attraction to other people and can include a broad range of identities including gay, straight, bisexual, queer, and asexual. Gender identity is, to quote the nonprofit Human Rights Campaign, “one's innermost concept of self as male, female, a blend of both or neither—how individuals perceive themselves and what they call themselves. One's gender identity can be the same or different from their sex assigned at birth.” The acronyms LGBTQIA and LGBTQ+ are often used to refer to the broad group of individuals who identify as lesbian, gay, bisexual, transgender, queer or questioning, intersex, and asexual or allied.

Sexual and gender identity are often sources of strength and support in individuals’ lives, but they can also contribute to mental health challenges. For example, discrimination or even violence based on sexual or gender identity are common in many parts of the world. Sometimes, sexual or gender identity can also be a factor in family, workplace, or peer group difficulties. Additionally, restrictive cultural norms can be a source of stress for individuals whose gender or sexual identities do not align with those norms. 

Challenges around sexual and gender identity vary enormously, but in some cases, they can cause common mental health conditions such as anxiety and depression. In particular, gender dysphoria, which refers to the distress caused when an individual’s assigned birth gender does not match the one with which they identify, is a specific diagnosable mental health condition.

 sexual and gender identity.jpg

How common are challenges around sexual and gender identity?

Aside from gender dysphoria, challenges around sexual and gender identity are not clinically defined mental health conditions, so it is difficult to know exactly how common these issues are.

However, the fields of psychology and social science generally acknowledge that sexual and gender identity can contribute to mental health challenges. For example, the CDC reports that LGBTQ+ youth are at higher risk for negative mental health outcomes, while the American Journal of Public Health reports that lesbian, gay, and bisexual adults may be more likely to attempt suicide than heterosexual adults.

Regarding gender dysphoria specifically, some sources estimate that this disorder occurs in less than one percent of the population, but the true figure is likely higher because these estimates are based only on those individuals who seek treatment.

What are some symptoms of challenges around sexual and gender identity?

Symptoms associated with sexual and gender identity issues vary widely, but some common examples are as follows:

  • Anxiety: You may find yourself feeling worried, preoccupied, or unable to relax.

  • Sadness or feelings of hopelessness: You might feel persistently unhappy, lacking in energy, or struggling to face day-to-day challenges.

  • Fear or anger that feels difficult to manage: While fear and anger can be rational and even helpful responses to discrimination on the basis of sexual or gender identity, you may be overwhelmed by these feelings and find that they interfere with your daily life.

  • Feeling isolated: Sexual and gender identity challenges often involve a struggle to figure out how one fits into various, sometimes conflicting, communities and social roles.

  • Desire to change one’s assigned gender identity: For gender dysphoria specifically, the defining symptom is a desire to resolve a mismatch between one’s assigned birth gender and the gender with which one identifies.

Different types of challenges around sexual and gender identity

Again, sexual and gender identity issues come in many forms. Some common challenges include:

  • Gender dysphoria: Gender dysphoria is a clinically defined disorder in which an individual experiences significant distress due to a mismatch between their assigned birth gender and the gender with which they identify. Many argue that gender identity should never be considered a disorder, but the definition exists in part to aid individuals in receiving mental health treatment for this kind of distress.

  • Uncertainty around sexual or gender identity: Many people experience mental health symptoms in reaction to questioning or redefining their sexual or gender identities.

  • Challenges around coming out: Coming out as LGBTQ+ can sometimes prompt anxiety or other difficult emotions.

  • Challenges around gender transition: Individuals who identify as transgender sometimes choose to make concrete changes to bring their outward gender expression into alignment with their internal knowledge of their gender. These changes range from social changes like using a different name to physical changes like hormone therapy or surgery. For some, the process of transitioning can come with mental health symptoms.

  • Interpersonal discrimination: Some LGBTQ+ individuals experiences stress or trauma as a result of discrimination on a direct, personal level.

  • Structural discrimination: Large-scale discrimination against LGBTQ+ is entrenched in many modern-day societies. Understanding and facing these broader forms of discrimination can also lead to mental health challenges.

What to do if you’re experiencing challenges around sexual and gender identity

If any aspect of your sexual and/or gender identity is causing you distress, you have a range of options at your disposal. Some common choices include:

  • Therapy: Find a sex-positive therapist who is familiar with LBGTQ+ issues and can help you explore and alleviate your challenges. (See more tips below on selecting a therapist.)

  • Resource centers: Many communities have resource centers devoted to supporting LGBTQ+ individuals. These organizations can help you get involved in your community and meet other people who share your challenges. Because feeling isolated is a common challenge around sexual and gender identity, you may find that an increased sense of interpersonal connection lessens your challenges. Try searching the internet for “LGBTQ resource center” and your zip code to see what’s available in your area. You can also find online support and resources through The Lesbian, Gay, Bisexual & Transgender Community Center and GLAAD.

  • Creative pursuits: Visual arts, performing arts, and creative writing can all be powerful ways to explore your identity and find an increased sense of peace in your day-to-day life.

  • Hotlines: If you’re having thoughts of suicide or need immediate support, you can always call the National Suicide Prevention Hotline at at 1-800-273-8255. The Trevor Project also offers a hotline and other resources for LGBTQ+ young people.

What should I look for in a therapist for challenges around sexual and gender identity?

Therapists differ in their approaches to treating challenges around gender and sexual identity, but no matter which approach you choose, you’ll want to make sure that your therapist is sex-positive and has experience working with LGBTQ+ individuals. Common therapeutic approaches include:

Find therapists specializing in sexual and gender identity near you