Understanding LGBTQIA+ mental health
Keynote · PA LGBTQIA Health Summit, Bradbury-Sullivan LGBT Community Center · May 2023 · 1 hr 27 min
In this keynote for the 2023 Pennsylvania LGBTQIA Health Summit, presented with the Bradbury-Sullivan LGBT Community Center, Rahim offers a framework he calls “same labels, different determinants.” A queer person and a straight person may both live with depression, he explains, but the social, environmental and systemic forces that drive it, and the ways it shows up, are shaped by different contexts.
He begins with Canada’s twelve social determinants of health and the Canadian Mental Health Association’s three key contributors to mental health: freedom from discrimination and violence, social inclusion and access to economic resources. He then makes the case for adapting these for LGBTQIA+ communities, pointing to ongoing persecution of trans people, disparities within the community by income, age and gender expression, internal hierarchies such as femmephobia, racism, fatphobia and HIV stigma, and a caution against homonationalism. Determinants, he stresses, are not problems to resolve but terrain people move through.
On internalized shame, Rahim describes a deep sense of inferiority, drawing on his own childhood as a South Asian boy policed for femininity who wanted to be seen as one of the white boys. On body image, he unpacks fatphobia and diet culture, noting that fat can be feminized, that trans men face particular pressures, and that many clients hope a changed body will bring closeness that weight loss alone cannot deliver.
He describes how the socially sanctioned party lasts longer for queer and trans people, whose celebrations and mourning often happen at the bar, and frames problematic substance use as a possible adaptive trauma response, calling for kinder drug-using spaces rather than purely individualized recovery. He explores the “landscape of connection seeking,” from casual sex and exclusion on apps to attachment norms and romantic minorities, and touches on milestone heteronormativity, boundary violations, aging and the neglect of queer and trans women in sexual health messaging.
The recording continues with findings on mental health from the 2022 Pennsylvania LGBTQ Health Needs Assessment and a community discussion moderated by Dr. Tyler Titus. There Rahim calls for mentorship and opportunities to thrive, not just survive, warns against superficial displays of inclusion such as banks draped in Pride flags, and suggests committing to one issue that affects you directly and one broader issue such as housing or poverty reduction.
What it covers
- Social determinants of mental health
- Internalized shame
- Body image and fatphobia
- Substance use norms
- Landscape of connection seeking
- Milestone heteronormativity
Related on this site
Archived record: doi.org/10.5281/zenodo.19166940
