First-Ever Long Island LGBTQ+ Study Reveals Sobering Numbers on Mental Health Issues

According to The Trevor Project, members of the LGBTQ+ community are not inherently prone to mental and behavioral health concerns because of their sexual orientation or gender identity. But they are at higher risk because of how they are mistreated and stigmatized in society.

A new study from Stony Brook Medicine only proves that further.

The results of the inaugural LGBTQ+ Health Needs Assessment Survey, the first of its kind on Long Island, paints a striking picture, but not a surprising one, according to a panel of experts who presented the findings at a press conference on Friday, October 7.

More than 60 percent of respondents reported symptoms of chronic depression, almost half reported poor mental health and/or anxiety, and more than a third had thoughts of self-harm. Despite this, only slightly more than a third are receiving mental health treatment.

“The conclusion is this population is not a monolith,” said Jennifer Jamilkowski, director of planning at Stony Brook Medicine. “There are very diverse needs, and some of them are profound and really urgently require focus from all of us in the medical community.”

The first-ever health needs survey of lesbian, gay, bisexual, transgender, and queer or questioning adults in Nassau and Suffolk counties was conducted last year by Stony Brook Medicine, in collaboration with more than 30 Long Island-based organizations and community leaders who reach diverse LGBTQ+ populations through advocacy and providing programs and services.

“The idea for the survey grew as we started expanding the Edie Windsor Healthcare Center in Hampton Bays to serve the LGBTQ+ community,” said Robert Chaloner, chief administrative officer at Stony Brook Southampton Hospital. “As Long Island’s first and only LGBTQ+ comprehensive health care center, we were committed to providing a culturally sensitive and safe environment. As we planned programming, we became aware that there was very little LGBTQ+ health-related data.”

Between June and September 2021, Stony Brook Medicine received 1,150 completed surveys from anonymous participants age 18 and older, who varied widely in sexual orientation, gender, race, age, ethnicity and income.

“This is groundbreaking, if you will,” said Gregson Pigott, commissioner of the Suffolk County Department of Health Services. “Everything before this was estimates, guessing, was speculation. But you actually have real, hard data based on the survey, on asking real people these types of questions — these tough questions — and really getting into demographics, and also getting to issues of what makes the experience of someone who is Black and gay different from the experience of someone who is white and gay.”

The behavioral health findings pointed to an urgent need for mental health services across most ages, races and sexual identities. Over 60 percent of respondents have had two or more years of their lives when they felt depressed or sad on most days, although they may have felt okay sometimes — which are symptoms of chronic depression — and almost 44 percent of participants reported “fair/poor” mental health. About 38 percent of respondents were found to have moderate to severe anxiety or depression.

In the past three years, nearly 34 percent of respondents had thought of self-harm and almost 24 percent have seriously considered suicide. Nearly 4 percent attempted suicide.

Reiterating the findings from The Trevor Project, Allison Eliscu, medical director of the Adolescent LGBTQ+ Care Program at Stony Brook Medicine and principal investigator of the study, emphasized that it is the gaps in the health care system that feed mental health issues, not identifying as LGBTQ+.

“It’s the stress and the stigmatism. It’s experiences either they’ve had — over 30 percent of our respondents have had a negative experience in health care. How likely are those individuals to be to reach out for help again?” Eliscu said. “But on top of the LGBTQ stress, there’s also the minority stress that they’re getting from their color, their ethnicity, and I think having the dual pressures from both, it’s exponential and it increases.”

In general, access to health care was revealed as a frequent problem. Thirty-seven percent of respondents reported being treated disrespectfully or in a nonaffirming way by a health care provider or their office staff — and over 60 percent among transgender respondents. More than 16 percent frequently face racial or ethnic discrimination in health care, with nearly 60 percent of multiracial participants, 51 percent of Hispanic and 50 percent of Black respondents who regularly feel discriminated against.

Respondents indicated a strong interest in an LGBTQ+ health center and participating in telehealth visits with a sensitive provider. Among survey participants, cervical cancer screening is low, for example — 65 percent have had a Pap smear test in the past three years — and one survey participant said, “I definitely avoid annual pelvic exams as a trans man.”

“They are very diverse communities amongst themselves, even though there’s this umbrella term,” said Lauren La Magna, public affairs manager at Planned Parenthood Hudson Peconic. “So even amongst the larger population, as we talk about LGBTQ+ communities, there are sub-communities that have different needs and are being left behind, are falling through the cracks, even more so than their queer peers.”

In response to the study, Stony Brook Medicine is rolling out a multi-faceted approach to address the key findings. In clinical and support services, there will be an expansion of LGBTQ+ cultural sensitivity training for health providers, medical trainees, and community-based organizations, as well as behavioral health support group offerings for adolescents and young adults. The data will be used to support funding requests for increased addiction treatment, prevention and mental health services, and private mammography screenings will be offered by Stony Brook Medicine’s mobile unit with staff trained in LGBTQ+ sensitivity. The hospital is also planning a multidisciplinary adolescent gender-affirming care clinic.

“I think something to also be mindful of is not only does the stress and anxiety come from the lived experiences that people have on a day to day, but also the fear of having the lived experience,” La Magna said. “That is a huge factor in this, as well, and could contribute to people not seeking health care at all because they don’t even want to even have the experience that they know that others have had.”

Community engagement and collaboration will continue to play a large role, such as sponsoring events like the inaugural Pride Parade in East Hampton and the Coming Out Day Celebration at the Suffolk County Farm in Yaphank earlier this week.

Sensitivity training will be expanded across the entire health care system, and LGBTQ+ material will be added to medical student and resident curricula. Stony Brook Medicine will provide partners and other organizations access to the data sets, and is creating a plan to publish the community data and share it with other professionals.

“I really want to thank our 1,150 respondents,” Eliscu said. “It was anonymous, but sharing their information, sharing their struggles and their positive experiences they’ve had, as well, they really went above and beyond answering all of the questions … I just really appreciate their honesty, their openness and sharing this information so that we really can make a difference.”