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BUENOS AIRES, Argentina. January 13th is World Depression Day. Its objective is to raise awareness, provide guidance, and promote prevention of a disease that is growing exponentially worldwide.

We probably all know someone who has suffered from depression or have experienced it ourselves. Depression is one of the most common mental health conditions worldwide ( WHO, 2022 ). It is a state characterized by great suffering, both for the person experiencing it and often for their support network. When not addressed properly, it often becomes a serious problem that leads to a decline in various areas of a person's life. In some cases, it can lead to suicide.

There's a classic approach to mental health that feels outdated but remains prevalent and is reinforced from many quarters. This approach views mental health problems as the result of individual responsibility. "Come on, just try harder and you'll get better," "If you raise your spirits, your depression will go away." Discourses like these are dangerous not only because they blame us for our own distress if we're experiencing mental health problems, but also because they depoliticize health. They deny that any health-illness process we go through is also a result of our interaction with our environment.

A binary mental health

What happens, for example, to the mental health of LGBTQIA+ people in a context of violence and structural discrimination? What are the relationships between depression and LGBTQIA+ people?

To begin, we could point out that almost all the research and statistics that offer data on depression and its relationship to gender and diversity variables are constructed in a binary way. That is, they analyze its prevalence in terms of women and men (cisgender, of course, although that clarification remains implicit as a mark of cissexism) and/or with significant gender bias. They also tend to pay little attention to other intersectional factors such as race or social class. Even so, we have known for some time that there is a high frequency of mental health problems in the LGBTQIA+ population.

Does being trans, non-binary, queer, dyke, gay, asexual, lesbian, or aromantic inherently make you more prone to depression? No, fortunately, the reality is more complex than that. If we re-evaluate our lived experiences, and also if we revisit minority stress theory ( Meyer, 2003 ), we've known for some time that belonging to a socially oppressed group means living with higher levels of stress, which in turn leads to a decline in quality of life. And it predisposes individuals to the emergence of certain mental health problems, although not in a causal or linear fashion.

Having to correct one's own pronouns, being exposed to hate attacks in public, being expelled from our homes, being assumed to be heterosexual in a health consultation, having difficulty finding accessible representations in the culture that narrate and validate our ways of life, are just some examples of specific, socially rooted and chronic stressors.

Specific, because these are not stressors that cisgender heterosexual allosexual people experience. At least not due to gender identity or sexual orientation, although they may experience other stressors resulting from other forms of oppression. Socially ingrained, because they are the product of situations where cissexism, heteronormativity, allonormativity, amatonormativity, and other systems of oppression (such as racism, classism, ableism, etc.) are combined. And chronic, because these stressors go beyond the coping mechanisms that individuals can develop on a personal level to deal with these situations.

For an urgent approach

Of course, learning individual coping tools is essential for LGBTQIA+ individuals to live a more fulfilling life in a context of structural violence. This can take place in various settings, each with its own specificities, potential, and limitations (from building support networks and community spaces to psychotherapy, etc.). But the focus should never be solely on the premise that "you should learn how to ignore all of this .

We need to dismantle the normative ways in which we have learned to understand and address mental health , as well as to interpret normality. It is essential to understand life trajectories that deviate from the norm, their relationship to mental suffering, and how experiences of hatred and discrimination, as well as validation and accommodation, color our processes of health, illness, care, and treatment.

Only in this way can we continue to build community, clinical, and educational approaches that are effective and of high quality when it comes to promoting mental health and addressing the ailments that afflict us.

Sources cited:

World Health Organization (2022). World report on mental health. Transforming mental health for all (Available online).

Meyer, I. H. (2003). Prejudice, Social Stress, and Mental Health in Lesbian, Gay, and Bisexual Populations: Conceptual Issues and Research Evidence . Psychological Bulletin , 129 , 674–697