The RaRE Research Report: LGB&T Mental Health - Risk and Resilience Explored

The RaRE Study research project 2010 – 2015 is a 5-year collaboration between PACE, the LGBT+ mental health charity and an academic panel drawn from three UK universities. The study looked at risk and resilience factors for three mental health issues that affect LGBT+ people disproportionally:
1. Suicide attempts and self-harm for young LGBT+ people under 26
2. Alcohol misuse in lesbian and bisexual women
3. Body image issues for gay and bisexual men

Young LGB and Trans* people under 26 are more likely to attempt suicide and to self-harm than their heterosexual and cisgender peers.People who attempted suicide while young reported factors that appear to correlate closely with suicidal thoughts or attempts. These were: negative experiences of coming out; homophobic and transphobic bullying; and struggles about being LGB or Trans* within the family, at school and in peer groups.
In addition, participants reported that a lack of awareness and
training means responses from medical or professional staff can feel inadequate. Inclusive resources, which reflect the lives and issues of young LGB&T people, are sparse outside of LGBT+ specialist services.

Participants reported that support and understanding from family and significant others helped them to develop self-worth. In addition, connection to other LGB&T people and communities create a sense of belonging, which helps build resilience. Positive interventions and responses from medical and professional staff are crucial, to help young LGB&T people recover more quickly after a suicide attempt.

No significant differences in dependent alcohol use or hazardous drinking were found when comparing lesbian and bisexual women with heterosexual women. Some minor differences in patterns of drinking were found. The study found that the risk of problematic drinking amongst lesbian and bisexual women is often associated with prevailing heterosexism. It appears lesbian and bisexual women use alcohol in an attempt to manage feelings of fear, anxiety and guilt about their sexual orientation. Negative reactions from professionals can limit lesbian and bisexual women’s engagement with treatment and support, including causing them to disengage with treatment altogether. The study found that recovery from alcohol abuse is helped by good support from partners, family and others. It appears that an important strategy to regain control is creating life structures. Interaction with practitioners who are knowledgeable, aware and inclusive in their approach is key, as are LGBT-specific resources such as support groups.

The study found that gay and bisexual men are more dissatisfied with their bodies and their health than heterosexual men. RaRE found that early experiences of ‘feeling different’ appear to create vulnerability and are a key factor in developing low self-worth for gay and bisexual men. Gay and bisexual men experience significant pressure to conform to the ‘ideal’ body type; they are also more sensitive towards social and media messages about this ideal when compared with heterosexual men. These messages are internalised from peers at school, family, media and other men on the scene.
Gay and bisexual men reported that before they can make positive changes about their body image or eating concerns, they need to acknowledge that there is an issue and this is sometimes triggered by a crisis in their life. Self-motivation and support from people who understand is essential to recovery. Also important is more formal therapy, self-help and organised programmes, including specifically for gay and bisexual men.