Important to recognize challenges faced by the LGBTQ+ community

By Tony Poland, LegalMatters Staff • While society has made tremendous strides in recognizing the rights of the LGBTQ+ community, more needs to be done to help those suffering from functional health problems, mental health issues and substance abuse, says Ontario disability insurance lawyer Courtney Mulqueen.

Mulqueen, principal lawyer of Mulqueen Disability Law Professional Corporation, pointed to a recent Statistics Canada study that found lesbian, gay and bisexual (LGB) people aged 18 and older reported experiencing more functional health difficulties than their heterosexual counterparts.

“Understanding the challenges and barriers that some LGB individuals may experience in their daily lives is an important step toward creating a more equitable and inclusive society,” states StatsCan in the November 2023 report that surveyed people in 2017-18.

Mulqueen also referenced a U.S. report from the same time that found adults who identify as gay, lesbian or bisexual are more likely than those who identify as heterosexual to experience mental health issues and serious thoughts of suicide. As well, they are more likely to misuse alcohol or drugs.

‘Sexual minorities experience unique stressors’

“Sexual minorities experience unique stressors that can contribute to adverse substance use and mental health outcomes,” according to the report prepared for the Substance Abuse and Mental Health Services Administration (SAMHSA). “People who identify as bisexual may experience additional problems with substance use and mental health due to sexual orientation-based discrimination, bisexual invisibility and erasure, and a lack of bisexual-affirmative support.

“Challenges faced by members of sexual minorities can be further compounded by the experience of being female or a person of color.”

Mulqueen says while the findings are “disheartening” they could be an impetus to find ways to help those struggling in the LGBTQ+ community.

“I was surprised at some of the statistics,” she tells LegalMattersCanada.ca. “Certainly, there will always be those who are less accepting but I prefer to believe we have become a more enlightened society. Like most, I treat people with respect regardless of their sexual orientation. But perhaps the point here is that there are people who are potentially worse off or struggling more than the average person. That disparity needs to be addressed.”

According to Statistics Canada, LGB adults, particularly bisexual women, “were more likely to report poorer mental health and show a higher prevalence of mood and anxiety disorders than their heterosexual counterparts.” As well, a larger share of bisexual individuals than heterosexual and gay or lesbian people believed their general health to be fair or poor.

More likely to be diagnosed with chronic conditions

“Research indicates that LGB individuals are more likely to be diagnosed with chronic conditions, such as cardiovascular disease, asthma and diabetes, and are at a greater risk for cancer, relative to their heterosexual counterparts,” the StatsCan report states. “Minority stress is a common explanation for health disparities. Studies suggest that the physical and mental health disparities seen among the LGB population may be linked to stress related to the internalization of negative societal attitudes.”

Mulqueen says a report in Psychiatric Times found members of the LGBTQI community are at increased risk for mental health issues associated with “minority stress.”

“Many grapple with feelings of shame, rejection, and depression. They are the target of abuse, trauma, and bullying. As a result, they experience higher rates of homelessness, substance abuse, and suicide,” the Times states.

Mulqueen says the report also found that “clinicians may both consciously and subconsciously discriminate against members of the LGBTQI community, causing many to forgo needed care.”

“Almost one-sixth of LGBTQI adults have felt discriminated against at a doctor’s office, while one-fifth say they avoid medical care altogether due to their fear of discrimination,” according to the Psychiatric Times, quoting a Harvard University poll.

The results shouldn’t come as a surprise, Mulqueen says.

‘Numerous barriers and socioeconomic inequalities’

“Research has identified numerous barriers and socioeconomic inequalities that can impact the health of this community,” she says. “The danger is ignoring these important studies and failing to improve a system that is failing a significant group of people. The ultimate goal should be creating a more equitable and inclusive society.”

Minority stress is an added burden on the LGBT+ community, psychiatrist Jeremy Kidd told CNN.

• Proactive approach to mental health issues by employers is encouraging
• Ontario government’s health-care investment ‘a great step forward’
• Don’t confuse seasonal affective disorder with the winter blues

“Individuals experience additional stress as a result of discrimination and stigma, stigma both at the societal level but also the way that living in a society that privileges heterosexuality that has homophobic laws and policies comes to sort of teach LGB people even to view themselves as inferior,” said Kidd, who has worked on studies to improve health outcomes for lesbian, gay, bisexual, transgender and queer populations.

He told CNN that studies such as the one conducted by SAMHSA are vital in helping to shape policy and treatment, adding Pride Month is also important because it can send a message that those in the LGBTQ+ community are supported for who they are.

Acceptance can play an important role

“Knowing they have that acceptance could well encourage people who are facing issues to get the help they need,” Mulqueen notes.

She says advancements have been made in recent years. For example, gender identity and expression were added as grounds for discrimination under Ontario’s Human Rights Code (HRC) in 2012.

“We have robust laws prohibiting discrimination of any kind and case law protecting people’s human rights,” Mulqueen says. “Of course, there is always more than can be done.”

She says because those in the LGBTQ+ face ongoing discrimination they may be reluctant to seek help with a functional health problem, a mental health concern or a substance abuse issue.

There are organizations, such as Friends of Ruby and The LifeLine Canada Foundation, that offer support for the community, Mulqueen says.

She says people should not be afraid to take time off work to deal with an issue.

“They may be concerned about job security,” says Mulqueen. “What is important for them to understand is that they can file a long-term disability claim if they are insured and know their employment cannot be terminated while they are off work. As well, employers must also make accommodations for protected workers under the HRC.”

She also reminds those filing disability claims that insurance companies are legally obligated to comply with human rights standards.

‘They should feel some sense of security’

“They should feel some sense of security in the fact that whoever they are dealing with has a duty to not discriminate against them in the course of assessing their claims,” Mulqueen says.

“Even with something like personal pronouns, people should be ensuring insurance providers are complying with those policies when communicating with them as claimants. 

She suggests that insurers further educate themselves on issues such as minority stress if they haven’t already done so.

“I was shocked by some of the Statistics Canada findings,” Mulqueen says. “I didn’t realize the health and substance abuse issues the LGTBQ+ community faced were so much more pronounced than those experienced by their heterosexual counterparts.

“I question whether insurers necessarily know that. Perhaps more of an onus is needed on behalf of the insurance companies to further educate themselves,” she adds. “The more knowledge we have and the more empathy we show can play a role in helping someone recover and return to work.”