The Promise of Ketamine-Assisted Therapy in Addressing Mental Health Concerns within the LGBTQ Community
Over the past two decades, there has been an increase in public and scientific awareness of Lesbian, Gay, Bisexual, Transgender, Queer, Questioning, Intersex, and Asexual (LGBTQIA+) lives and issues.
This heightened awareness can be attributed to sociocultural shifts in understanding sexual and gender identities.
While everyone has a sexual orientation and gender identity, people who identify as LGBTQIA+ often face higher mental health risks.
Why is that?
And what makes ketamine-assisted therapy (KAT) an effective tool for the LGTBQ community?
The State of Mental Health in the LGBTQ Community
Prevalence of different mental health disorders within the LGBTQIA+ community
Numerous studies conducted in the United States and internationally have found that LGBTQ youth report higher rates of symptoms of psychological distress compared to heterosexual and cisgender youth.
- Emotional distress
- Symptoms of mood and anxiety disorders
- Substance abuse and dependence
- Suicidal ideation and behavior
Of course, mental health patterns not only vary across sexual and gender identities. They also extend to racial and ethnic backgrounds, cultural influences, and social class identities.
From “pathology” to the unique stressors contributing to mental health challenges
Historically, the understanding of homosexuality and same-sex attraction has evolved within the field of psychology.
Prior to the 1970s, homosexuality was pathologized and listed as a “sociopathic personality disturbance.”
However, shifting attitudes and pioneering studies led to the removal of homosexuality as a mental disorder in 1973.
Over the past five decades, the focus has moved away from perceiving homosexuality as inherently linked to poor mental health. Instead, researchers have turned their attention to understanding the social factors that influence the mental well-being of the LGBTQ community.
We are currently seeing similar debates about gender identity diagnoses that still remain in the Diagnostic and Statistical Manual of Mental Disorders (DSM).
The minority stress theory
According to Dr. Alex Belser, a psychedelic researcher at Yale University who studies psychedelic use among LGBTQ people, “Young gay people are taking their own lives because of the sort of stress, pressure, bullying, and rejection they received in their families, religious communities, schools, and broader political experience in the world.”
This fits with Dr. Illan Meyer’s minority stress theory, which suggests that sexual minorities face unique, chronic stressors related to their stigmatized identities, including victimization, prejudice, and discrimination. Combined with everyday or universal stressors, these distinct stressors can greatly impact the mental health and well-being of LGBTQ individuals.
Meyer further identifies three stress processes, progressing from external factors to internal conflicts:
- Objective or external stressors (such as discrimination or prejudice)
- Expectations of victimization or rejection and the vigilance related to these expectations
- The internalization of negative social attitudes (often referred to as internalized homophobia)
Current Mental Health Treatment Landscape for LGBTQ Individuals
The mental health treatment landscape for the LGBTQ community presents a series of hurdles, making access to appropriate care a complex journey.
Limitations of current therapeutic approaches
Traditional therapeutic modalities to treat mental health concerns often do not fully address the unique experiences and needs of LGBTQ individuals.
These approaches usually operate within a heteronormative framework, which can overlook or minimize the impact of societal prejudice, discrimination, and minority stress experienced by LGBTQ individuals.
Existing therapeutic interventions
Realizing people from the LGBTQ community have specific needs that tend to go unmet in traditional therapeutic approaches, clinicians have set out to create programs that work better.
These modalities validate rather than pathologize queer identities. They are, therefore, called ‘affirmative treatments’.
Below are some examples of LGBTQ-affirmative mental health treatments:
- LGBTQ-affirmative cognitive behavioral therapy (CBT). This can include several types of interventions, including EQuIP and AFFIRM. EQuIP (Empowering Queer Identities in Psychotherapy) specifically addresses someone’s reactions to stressors while AFFIRM focuses on reducing depression and promoting healthy coping through collaborative group therapy.
- Support groups specifically designed for people from the LGTBQIA+ community. These offer a safe haven where people can share their struggles and triumphs.
- Online affirmative counseling platforms. These provide convenient and accessible mental health services that break down geographical barriers.
- Ketamine-assisted psychotherapy
While therapeutic interventions exist, the path is often hindered by numerous challenges.
Barriers to accessing mental health care
Accessing mental health care that meets the unique needs of LGBTQ individuals can be challenging due to multiple barriers.
Here are three significant ones:
- There is a shortage of culturally competent providers who have the necessary knowledge and understanding of LGBTQ identities and experiences. This limits the availability of professionals who can provide affirming and inclusive care.
- Financial constraints and lack of insurance coverage can make mental health services unaffordable or inaccessible.
- The fear of experiencing discrimination or bias from healthcare providers or staff can deter LGBTQ individuals from seeking help. Past negative experiences or the anticipation of encountering stigma can create a reluctance to engage with mental health services.
These obstacles can lead to a large gap in care for those who need it.
Ketamine-Assisted Therapy for LGBTQ Mental Health
As mentioned at the start of this article, KAT could be an effective tool for addressing mental health concerns within the LGBTQ community.
But how can KAT help LGBTQ individuals? And what are the theoretical underpinnings?
Let’s take a closer look.
The theoretical underpinnings: How can KAT help the LGBTQIA+ community?
According to Belser, psychedelics offer a powerful avenue to explore and even reconstruct gender and sexual identities.
Far from the harmful LSD-conversion therapies used in the 60s, KAT doesn’t aim to undo LGTBQ people of their identity but rather help them embrace who they really are.
To quote Belser: “If a person has been fighting their sexual identity, the neuroplastic window of opportunity is a critical period for them to shift to a new way of understanding themselves and relating to other people in their lives. That can be incredibly relieving and quite liberating.”
Integration of KAT within a holistic treatment approach for LGBTQ mental health
To maximize the benefits of KAT, integration within a holistic treatment approach is key.
This involves combining KAT with other evidence-based therapies, support networks, and community resources. Creating comprehensive treatment plans that address the multifaceted needs of LGBTQ individuals leads to more effective and inclusive care.
In addition, we need advocacy for policy changes and improved mental health resources.
This includes raising awareness about the unique mental health challenges faced by LGBTQ individuals and advocating for increased funding and support for LGBTQ-affirming mental health services.
Mental health concerns within the LGBTQ community require special attention due to the unique challenges and experiences faced by these individuals.
For this, inclusive and affirming therapeutic approaches are needed.
Due to its antidepressant qualities and neuroplasticity-enhancing nature, Ketamine-Assisted Therapy (KAT) holds promise as a potential solution to address mental health concerns within the LGBTQ community. To maximize the benefits, integration within a holistic treatment approach as well as further advocacy for policy changes are key.
Join Psychedelica Collective’s LGBTQ+ Ketamine Therapeutic Group in Los Angeles today! It’s an inclusive and confidential space where you can safely explore your mental health concerns while building connections with like-minded individuals. Let ketamine-assisted therapy help you dive deeper into self-discovery, empathy, and holistic well-being. Contact us today and start your journey toward healing.
- Why does the LGBTQIA+ community suffer from poor mental health at higher rates? (https://healthcare.utah.edu/healthfeed/2021/07/why-does-lgbtqia-community-suffer-poor-mental-health-higher-rates)
- Russell, S. T., & Fish, J. N. (2016). Mental health in lesbian, gay, bisexual, and transgender (LGBT) youth. Annual review of clinical psychology, 12, 465-487. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4887282/)
- Psychedelics are for queer folks, too (https://www.vice.com/en/article/8xwz95/lgbtq-psychedelic-therapy-trauma-depression-anxiety)
- Meyer, I. H. (1995). Minority stress and mental health in gay men. Journal of health and social behavior, 38-56. (https://pubmed.ncbi.nlm.nih.gov/7738327/)
- National Academies of Sciences, Engineering, and Medicine. 2022. Reducing Inequalities Between Lesbian, Gay, Bisexual, Transgender, and Queer Adolescents and Cisgender, Heterosexual Adolescents: Proceedings of a Workshop. Washington, DC: The National Academies Press. https://doi.org/10.17226/26383. (https://nap.nationalacademies.org/read/26383/chapter/6#51)
- Meyer, I. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence. Psychological bulletin, 129(5), 674. (https://pubmed.ncbi.nlm.nih.gov/12956539/)
- Pachankis, J. E., Harkness, A., Jackson, S., & Safren, S. A. (2022). Transdiagnostic LGBTQ-affirmative cognitive-behavioral therapy: Therapist guide. Oxford University Press. (https://doi.org/10.1093/med-psych/9780197643303.003.0001)
- Project EQuIP: Empowering Queer Identities in Psychotherapy (EQuIP) (https://classic.clinicaltrials.gov/ct2/show/NCT03721276)
- Project Youth AFFIRM (https://www.projectyouthaffirm.org)
- Drozdz, S. J., Goel, A., McGarr, M. W., Katz, J., Ritvo, P., Mattina, G. F., … & Ladha, K. S. (2022). Ketamine assisted psychotherapy: a systematic narrative review of the literature. Journal of Pain Research, 1691-1706. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9207256/)