The LGBTQI+ community encounters many stigmas every day that the heterosexual community does not. Harassment, discrimination, violence, and other stressors have a profound effect on the health and wellness of LGBTQI+ individuals. As a result, they tend to have higher rates of substance use disorders (SUDs) and mental health issues. For this reason it’s important we examine two policy initiatives that will increase the risk of developing SUDs and mental illness in the LGBTQI+ community: a national memorandum on the classification of a person’s sex, and Massachusetts ballot question 3.

Recently the New York Times reported on a memo by the federal Department of Health and Human Services which stated a proposal to define a person’s gender as either male or female “based on immutable biological traits identifiable by or before birth… The sex listed on a person’s birth certificate, as originally issued, shall constitute definitive proof of a person’s sex unless rebutted by reliable genetic evidence.”

This system of labeling based on anatomy is flawed and dangerous. Not only does it go against widespread medical understanding of biology and gender identity, failing to take into account people born with sexual anatomy variations, it marks civil rights breach for a population who, under the Obama administration, enjoyed recognition in public spaces like schools or hospitals. Indeed, part of the Affordable Care Act (aka Obamacare) protects trans people from discrimination by health programs or organizations that receive federal funding.

Which brings us to Massachusetts.

On November’s ballot, the residents will vote on three ballot questions. Question 3 considers the 2016 state law granting LGBTQI+ individuals the right to use public restrooms and locker rooms based on their gender identity, not, as the Trump administration is now attempting, on their anatomy. A yes vote would keep the law in place, prohibiting discrimination based on gender identity. A no vote would repeal it.

Fears have been stoked by messaging surrounding question 3. Those in support of no vote cite the possibility of someone using the law as a means of gaining entry into bathrooms and locker rooms of the opposite sex for malicious purposes. But the Association for Behavioral Healthcare (ABH) came out in support of a yes vote on question 3, saying there’s no statistical data to support this baseless reasoning.

“The reality is that there is no credible evidence that there is any threat to public safety by protecting transgender persons from discrimination in places of public accommodation, resort, or amusement,” said the ABH. “ABH urges our members to reject bigotry and discrimination by voting Yes on 3.”

Related: Transgender Governor Candidate Helps Focus Attention on LGBTQI+ Substance Use & Mental Health

Both policies, federal and state, have major implications for the LGBTQI+ population. According to the National Alliance on Mental Illness (NAMI), stigma and fear of discrimination can lead to depression, posttraumatic stress disorder, SUDs, and thoughts of suicide; LGBTQI+ are nearly 3-times more likely to experience a mental illness.

To cope, many turn to substances and ultimately develop a disorder. Between 20% and 30% of LGBTQI+ people misuse substances, compared to approximately 9% of the general population.

The Substance Abuse and Mental Health Services Administration (SAMHSA) notes that sexual minorities—the LGBTQI+ population—are “more likely to use illicit drugs in the past year, to be current cigarette smokers, and to be current alcohol drinkers compared with their sexual majority counterparts… more likely than sexual majority adults to have substance use disorders in the past year, including disorders related to their use of alcohol, illicit drugs, marijuana, or misuse of pain relievers… more likely than their sexual majority counterparts to need substance use treatment.”

SUDs and mental health issues are so rampant in this community that the American Psychological Association developed guidelines to specifically assist “transgender and gender nonconforming” people with treatment services.

It’s important for everyone, regardless of sexual orientation and gender identity, to understand the consequences of the Department of Health and Human Services’ policy attempts, and the misrepresentations of question 3 on the Massachusetts ballot. Concerns of the opposition are incited by fear and a lack of understanding. If we as a society truly want to combat the opioid crisis, overall substance use, and mental health stigmas, we need to fully acknowledge that the LGBTQI+ community is severely at risk and in need of support.

The Gándara Center fully recognizes the rights and needs of the LGBTQI+ community. Our youth residential programs have the capacity to, and are operated by staff trained to, engage and support this population.

We are dedicated to fighting stigma and supporting the LGBTQI+ population mentally, physically, and emotionally. We hope you are too.

Featured image via Creative Commons/ Ted Eytan (CC BY-SA 2.0)