Despite some important step forward, lesbian, gay, bisexual, trans and intersex (LGBT+) people still experience discrimination, harassment and hostility in many parts of the world. Many LGBT+ experience poorer mental health outcomes that are directly related to experiences of stigma, prejudice, discrimination and abuse on the basis of being LGBT+.

The Universal Declaration of Human rights states in Article 2: “Everyone is entitled to all the rights and freedoms set forth in this Declaration, without distinction of any kind, such as race, colour, sex, language, religion, political or other opinion, national or social origin, property, birth or other status” This article is an important reminder of the absolute right not to be discriminated on the basis of sexual orientation or gender identity.

To follow up on the human rights perspective in relation to this, we have added this thematic page on LGBT+ rights where we have collected publications on UN resolutions and documents, articles regarding LGBT+ and mental health and organizations that are working with LGBT+ issues. We would very much appreciate feedback, comments and suggestions on relevant publications to add to this page.

Lesbians, gays, bisexuals and transgender + (LGBT+) persons are vulnerable to a range of human rights violations, including homophobic violence, killings, rape, arbitrary detention and widespread discrimination in the workplace and in access to basic services like housing and healthcare. In more than 70 countries, laws make it a crime to be homosexual, exposing millions to the risk of arrest, imprisonment and, in some cases, execution. The UN Secretary-General, the High Commissioner for Human Rights and heads of various UN agencies have all spoken out—calling for the worldwide decriminalization of homosexuality and further measures to protect people from violence and discrimination on the basis of their sexual orientation or gender identity.

International Human Rights Law & Sexual Orientation & Gender Identity 
Free and equal – UN for LGBTI Equality 2018
Human rights are rights inherent to all human beings. We are all equally entitled to our human rights without discrimination, whatever our nationality, place of residence, sex, national or ethnic origin, color, religion, language, or any other status, such as age, disability, health status, sexual orientation or gender identity.

United Nations Resolutions – Sexual orientation and gender identity
Human Rights Council, UNHCR
Expressing grave concern at acts of violence and discrimination, in all regions of the world, committed against individuals because of their sexual orientation and gender identity. Conducting a study, documenting discriminatory laws and practices and acts of violence against individuals based on their sexual orientation and gender identity, in all regions of the world, and how international human rights law can be used to end violence and related human rights violations based on sexual orientation and gender identity.

Gender, Equity & Human Rights: FAQ on Health and Sexual Diversity
World Health Organization, 2016
The 2030 Sustainable Development Agenda is working towards a world that reflects equity with universal respect for human dignity, pledging to leave no one behind. Lesbian, gay, bisexual, transgender, queer, and intersex (LGBTQI) individuals face high rates of physical and mental health issues and reduced access to medical and social services. In order to combat the dramatic health disparities faced by LGBTQI populations, we must first understand the key concepts surrounding the intersection of health with gender and sexual diversity. The attached FAQ on sexual diversity and health defines terms, highlights key issues and underscores the UN’s commitment to gender identity and sexual diversity.

Learn More 
Free and equal – UN for LGBTI Equality 2018
Learn more about the human rights challenges facing lesbian, gay, bi, trans and intersex (LGBTI) people everywhere and the actions that can be taken to tackle violence and discrimination and protect the rights of LGBT people everywhere. These United Nations factsheets break down the problems and the solutions.

Making Room for Sexual Orientation and Gender Identity in International Human Rights Law: An Introduction to the Yogyakarta Principles.
Michigan Journal of International Law, Brown 2010
In November of 2006 a group of international human rights law experts met in Yogyakarta, Indonesia, to draft the Yogyakarta Principles on the Application of International Human Rights Law in Relation to Sexual Orientation and Gender Identity (Yogyakarta Principles).’ In twenty-nine principles, the document purports to “reflect the existing state of international human rights law in relation to issues of sexual orientation and gender identity.’

Human Rights Council panel on ending violence and discrimination against individuals based on their sexual orientation and gender identity, summary. 
The High Commissioner’s study had documented disturbing abuses in all regions – including widespread bias in workplaces, schools and hospitals, imprisonment, torture, physical assaults and killings. It was called upon the Human Rights Council to respond effectively and on States to tackle homophobic violence, decriminalize consensual same-sex relationships, ban discrimination, and educate the public. Regular reporting was also needed to verify that violations are genuinely being addressed.

Discriminatory laws and practices and acts of violence against individuals based on their sexual orientation and gender identity, full report
UN 2011
The present report is submitted to the Human Rights Council pursuant to its resolution 17/19, in which the Council requested the United Nations High Commissioner for uman rights to commission a study documenting discriminatory laws and practices and acts of violence against individuals based on their sexual orientation and gender identity, and how international human rights law can be used to end violence and related human rights violations based on sexual orientation and gender identity.

Tackling discrimination on grounds of sexual orientation and gender identity 
The UN human rights treaty bodies, whose role it is to monitor compliance by States parties with their obligations under international human rights treaties, have consistently held that States have an obligation under existing treaty provisions to protect people from violence and discrimination on the basis of their sexual orientation.

Not an illness nor a crime’ lesbian, gay, bisexual and transgender people in Turkey demand equality 
Amnesty International 2011
On 25 June 2010 thousands of people – among them lesbian, gay, bisexual and transgender (LGBT) men and women, members of their families, activists and other supporters marched through the centre of Istanbul in the greatest show of solidarity for the rights of lesbian, gay, bisexual and transgender people ever seen in Turkey to date. The show of support in 2010 and a similar event planned for 2011 take place against the background of continuing violence and systematic harassment and discrimination by the state authorities against members of the LGBT community in Turkey.

Are LGBT rights human rights? Recent developments at the United Nations
American Psychological Association
With the increased global media attention on violent acts of persecution inflicted on Lesbian, Gay, Bisexual & Transgender (LGBT) persons, a crucial question before the world community today is whether gay rights are included under our basic human rights. At the United Nations, this question is slowly taking center stage, but it is not at all clear what the U.N. deliberations will yield from the linkage between gay rights and human rights. Foundational U.N. documents appear to provide guidance.

Gender-based violence against the transgender community is underreported 
The Transgender Day of Remembrance on Nov. 20, 2011
is important opportunity to address the serious but often-ignored issue of gender-based violence (GBV) against transgender persons. The status of the transgender population has important implications for the progress toward gender equality and other human rights.

Reflections and thoughts on the Passing of the follow up Resolution on Sexual Orientation and Gender Identity [SOGI] at the UNHCR
CAL Director, Dawn Cavanagh, shared some thoughts with AWID [Association for Women’s Rights in Development] FRIDAY FILE about the process, and substance behind the recent passing of the follow up Resolution on Sexual Orientation and Gender Identity at 27th Session of the United Nation’s Human Right Council

Best Practices for Mental Health Facilities Working With LGBT Clients
American Psychological Association
Because LGBT people are members of a minority group that is the target of social stigma, mental health facilities and their personnel who serve people with serious mental illness face important challenges in addressing the needs of LGBT clients. The following list of resources below is provided to assist people who work with LGBT clients in addressing these issues.

Guidelines for Psychological Practice With Lesbian, Gay, and Bisexual Clients
American Psychological Association, 2012
The Guidelines for Psychological Practice with Lesbian, Gay and Bisexual Clients were adopted by the APA Council of Representatives, Feb. 18-20, 2011, and replace the original Guidelines for Psychotherapy with Lesbian, Gay and Bisexual Clients adopted by the Council, Feb. 26, 2000, and which expired at the end of 2010. Each of the 21 new guidelines provide an update of the psychological literature supporting them, include a section on “Rationale” and “Application,” and expand upon the original guidelines to provide assistance to psychologists in areas such as religion and spirituality, the differentiation of gender identity and sexual orientation, socioeconomic and workplace issues, and the use and dissemination of research on LGB issues. The guidelines are intended to inform the practice of psychologists and to provide information for the education and training of psychologists regarding LGB issues.
Also available in Arabic, Chinese, Czech, and Spanish. An overview of the guidelines can be accessed here.

Guidelines for Psychological Practice with Transgender and Gender Nonconforming People
American Psychological Association, 2015
The purpose of the Guidelines for Psychological Practice with Transgender and Gender Nonconforming People (hereafter Guidelines) is to assist psychologists in the provision of culturally competent, developmentally appropriate, and trans-affirmative psychological practice with TGNC people.
Also available in Arabic, Italian, Portuguese, and Spanish.

Mental Health in the LGBT Community
MentalHealth.net
According to the National Alliance on Mental Illness, the risk of a mental health condition, like depression, anxiety disorders, or post-traumatic stress disorder, is almost three times as high for youth and adults who identify as lesbian, gay, bisexual, or transgender (LGBT) – or those with a sexuality that doesn’t apply to any existing category. With high rates of suicide and mental health conditions, it’s vitally important that the LGBT community is understood and supported. We analyzed over 160,000 records from the CDC’s annual Behavioral Risk Factor Surveillance System and spoke personally with members of the LGBT community to get an in-depth sense of the struggles they face and how their experiences in society have come to bear on their mental health. Read on to find out how LGBT people are navigating the difficult issues of mental health, addiction, and more.

LGBTQ
National Alliance on Mental Illness, NAMI
If you live with a mental health condition and identify as lesbian, gay, bisexual, transgender, queer and/or questioning (LGBTQ), it’s important to prioritize your mental health. Not all members of the LGBTQ community will have the same experiences. However, discrimination, prejudice, denial of civil and human rights, harassment and family rejection are still tragically common for people with these identities.

Sexual orientation and symptoms of common mental disorder or low wellbeing: combined meta-analysis of 12 UK population health surveys
Semlyen, J., King, M., & Hagger-Johnson, G., BMC Psychiatry, 2016
Conclusion study: In the UK, LGB adults have higher prevalence of poor mental health and low wellbeing when compared to heterosexuals, particularly younger and older LGB adults. Sexual orientation identity should be measured routinely in all health studies and in administrative data in the UK in order to influence national and local policy development and service delivery. These results reiterate the need for local government, NHS providers and public health policy makers to consider how to address inequalities in mental health among these minority groups.

Mental Health in Lesbian, Gay, Bisexual, and Transgender (LGBT) Youth
Russell, S. T. & Fish, J. N., Annual review of clinical psychology, 2016
Today’s lesbian, gay, bisexual, and transgender (LGBT) youth come out at younger ages, and public support for LGBT issues has dramatically increased, so why do LGBT youth continue to be at high risk for compromised mental health? We provide an overview of the contemporary context for LGBT youth, followed by a review of current science on LGBT youth mental health. Research in the past decade has identified risk and protective factors for mental health, which point to promising directions for prevention, intervention, and treatment. Legal and policy successes have set the stage for advances in programs and practices that may foster LGBT youth mental health.

A systematic review of mental disorder, suicide, and deliberate self harm in lesbian, gay and bisexual people
BMC Psychiatry, 2008
Conclusion study: LGB people are at higher risk of mental disorder, suicidal ideation, substance misuse, and deliberate self harm than heterosexual people.

Prejudice, Social Stress, and Mental Health in Lesbian, Gay, and Bisexual Populations: Conceptual Issues and Research Evidence
Meyer, I. H. Psychological Bulletin, 2003
In this article the author reviews research evidence on the prevalence of mental disorders in lesbians, gay men, and bisexuals (LGBs) and shows, using meta-analyses, that LGBs have a higher prevalence of mental disorders than heterosexuals. The author offers a conceptual framework for understanding this excess in prevalence of disorder in terms of minority stress—explaining that stigma, prejudice, and discrimination create a hostile and stressful social environment that causes mental health problems. In this article the author reviews research evidence on the prevalence of mental disorders in lesbians, gay men, and bisexuals (LGBs) and shows, using meta-analyses, that LGBs have a higher prevalence of mental disorders than heterosexuals. The author offers a conceptual framework for understanding this excess in prevalence of disorder in terms of minority stress—explaining that stigma, prejudice, and discrimination create a hostile and stressful social environment that causes mental health problems.

New data on lesbian, gay and bisexual mental health APA 
Tori deAngelis 2002
In a study that examines possible root causes of mental disorders in LGB people, Cochran and psychologist Vickie M. Mays, PhD, of the University of California, Los Angeles, explored whether ongoing discrimination fuels anxiety, depression and other stress-related mental health problems among LGB people. The authors found strong evidence of a relationship between the two.

Using the Minority Stress Model to Understand Depression in Lesbian, Gay, Bisexual, and Transgender Individuals in Nebraska 
McCarthy et al. 
Previous studies demonstrated the utility of the minority stress model in understanding health disparities for lesbian, gay, bisexual, and transgender (LGBT) populations. Since most research has considered large metropolitan areas, predominantly in coastal regions of the United States, this research focuses on a midwestern state, Nebraska. This study sought to assess the relationships between depressive symptoms experienced by participants (N = 770) and minority stress variables, including experiences with violence, perceptions of discrimination, and respondents’ degree of self-acceptance of their LGBT identity. Regression analysis revealed that after controlling for demographic variables, self-acceptance, and perceived discrimination were correlated with depressive symptoms. These findings have implications for policy makers, public health planners, and health care providers. Journal of Gay & Lesbian Mental Health 2014.

Gay and Bisexual Men’s Health 
CDC
Homosexuality is not a mental disorder, but homophobia, stigma, and discrimination have negative effects on the health of MSM, lesbians, and other sexual minorities. The negative effects of social marginalization can be found in adolescent and adult MSM, for example, research has shown that MSM and other members of the LGBT community are at increased risk for a number of mental health problems.

Higher Risk of Mental Health Problems for Homosexuals 
Collingwood
Higher risk of mental health problems due to discrimination – This “lends support to the idea that people who feel discriminated against experience social stressors, which in turn increases their risk of experiencing mental health problems.”

Lesbian, Gay, Bisexual, and Transgender Health
CDC

Some LGBTQ youth are more likely than their heterosexual peers to experience difficulties in their lives and school environments, such as violence.

In this chapter we try to collect some articles which are highlighting some aspects LGBT+ rights violations.

Armed conflict, homonegativity, and forced internal displacement: Implications for HIV among Colombian gay, bisexual, and transgender individuals. 
Zea et al. 2013
Colombia has endured six decades of civil unrest, population displacement, and violence. We examined the relationships of contextual conditions, displacement, and HIV among gay, bisexual, and transgender individuals in Bogotá, Colombia. Nineteen key informants provided information about internal displacement of sexual minorities

LGBT+ Rights
Human Rights Watch

In June 2013 President Putin signed a law allowing police officers to arrest tourists and foreign nationals they suspect of being homosexual, lesbian or “pro-gay” and detain them for up to 14 days. The law could mean that any Olympic athlete, trainer, reporter, family member or fan who is gay — or suspected of being gay, or just accused of being gay — can go to jail.

Russia’s Anti-Gay Crackdown 
Fierstein 2013
In June 2013 President Putin signed a law allowing police officers to arrest tourists and foreign nationals they suspect of being homosexual, lesbian or “pro-gay” and detain them for up to 14 days. The law could mean that any Olympic athlete, trainer, reporter, family member or fan who is gay — or suspected of being gay, or just accused of being gay — can go to jail.

Advancing Effective Communication, Cultural Competence, and Patient- and Family-Centered Care for the Lesbian, Gay, Bisexual, and Transgender (LGBT) Community a Field Guide 
Joint Commission Contributors & The California endowment 2011
The role of effective communication and patient-centeredness in providing safe and high-quality health care to diverse patient populations is well accepted. Effective patient–provider communication has been linked to an increase in patient satisfaction, better adherence to treatment recommendations, and improved health outcomes. Patient-centered care “encompasses qualities of compassion, empathy, and responsiveness to the needs, values, and expressed preferences of the individual patient.”2 (p.48) Combining the elements of effective communication and patient-centeredness into care delivery has been shown to improve patients’ health and health care.

Towards the Effective Protection of LGBTI Persons Deprived of Liberty: A Monitoring Guide
APT 2018
“This guide – prepared by the APT with great attention to the current state of international human rights law, best practices in the field of torture prevention, and the wealth of experience of the extraordinary group of experts that provided its substance – will provide an understanding of the factors of risk and the acts, patterns and extreme manifestations of torture and ill treatment against LGTBI persons, and is an invaluable blueprint for any conceptual understanding of these.”

For many, gender orientation may be related to serious and painful events, for some even traumatic experiences with the consequences known from the trauma field in general In our search for good links we found limited information regarding psychological trauma in persons with LGBT background due to stigma and persecution. But we would nevertheless take the opportunity to refer to our recently published manual about GBV where outline of what is trauma, what are trauma reactions and how to deal with them are outlined and described rather concretely. Our manual is freely available from our website.

United Nations Free and Equal
In July 2013, the Office of the United Nations High Commissioner for Human Rights (OHCHR) launched UN Free & Equal – an unprecedented global UN public information campaign aimed at promoting equal rights and fair treatment of LGBTI people. In 2017, UN Free & Equal reached 2.4 billion social media feeds around the world and generated a stream of widely shared materials.

ILGA – the International Lesbian, Gay, Bisexual, Trans and Intersex Association
The world federation of national and local organisations dedicated to achieving equal rights for lesbian, gay, bisexual, trans and intersex (LGBTI) people across the globe. Established in 1978, ILGA enjoys consultative status at the UN Ecosoc Council. It speaks and lobbies in international fora on behalf of more than 1,200 member organisations from 132 countries.

Transrespect versus Transphobia Worldwide” 
(TvT) is a comparative, ongoing qualitative-quantitative research project conducted by Transgender Europe. The project provides an overview of the human rights situation of trans persons in different parts of the world and develops useful data and advocacy tools for international institutions, human rights organizations, the trans movement and the general public.

The online platform for Taylor & Francis Group content Journal of Gay & Lesbian Mental Health
Official Journal of the Association of Gay & Lesbian Psychiatrists

The Coalition of African Lesbians [CAL] 
A formation of more than 30 organisations in 19 countries in Africa committed to advancing justice for lesbian and bisexual women and transdiverse people.

Association of Gay and Lesbian Psychiatrists (AGLP) 
AGLP traces its roots to the late 1960s when gay and lesbian members of the American Psychiatric Association (APA) met secretly at the annual meetings. In 1973 the APA removed homosexuality from the diagnostic manual (DSM) allowing a more open association of lesbian and gay psychiatrists, who no longer had to fear for their jobs if they were found out to be gay. Even today, the mission of providing support and a safe space for LGBT psychiatrists to meet continues to be important to many of our members.

The Society for the Psychological Study of Lesbian, Gay, Bisexual, and Transgender Issues (SPSLGBTI) 
The pages in this section contain links to documents, websites, and other resources related to LGBT psychology that are consistent with the mission of Div. 44. These links are provided as resources for our members and visitors to this site. Please note that Div. 44 is not responsible for the content or opinions expressed on other websites or within the linked documents.

APA dicvision 44 websites 
With extensive lists of information

Sexual Minorities Uganda (SMUG) 
Is an umbrella non-governmental organization based in Kampala, Uganda. SMUG advocates for the protection and promotion of human rights of lesbian, gay, bisexual and transgender Ugandans.

The World Professional Association for Transgender Health (WPATH) 
A non-profit, interdisciplinary professional and educational organization devoted to transgender health. Our professional, supporting, and student members engage in clinical and academic research to develop evidence-based medicine and strive to promote a high quality of care for transsexual, transgender, and gender-nonconforming individuals internationally.

Immigration Equality 
Since 1994, Immigration Equality has been proud to support and represent lesbian, gay, bisexual, transgender (LGBT), and HIV-positive immigrants seeking safety, fair treatment, and freedom.

LGBT mental health syllabus 
This website was created by the LGBT Issues Committee of the Group for the Advancement of Psychiatry (GAP) to teach psychiatry residents about caring for lesbian, gay, bisexual, transgender, and intersex patients. However, we hope it will also be useful to all health and mental health trainees and practitioners.

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