Overview
The terms 'LGBTIQ+' and 'LGBTIQA+' refer to people who identify as lesbian, gay, bisexual, trans/transgender, intersex, queer, and other sexuality (including asexual), gender, and bodily diverse people. LGBTIQ+ communities are diverse but are often grouped together because of a shared history of challenges and discrimination. Sexuality or sex or gender identity are aspects of a person’s total identity and different people may use different language to describe their sexual orientation, gender identity and innate sex characteristics. LGBTIQ+ Australians may face discrimination and unique challenges to their health and wellbeing, as well as barriers to accessing health and support services. These challenges may differ depending on a person's other attributes, such as their age and cultural background.
Some reasons to prioritise data about the LGBTIQ+ community
This topic page uses the acronym LGBTIQ+ to refer to a diverse population of people who identify as lesbian, gay, bisexual, trans/transgender, intersex, queer, and other sexuality (including asexual), gender, and bodily diverse. There is no single LGBTIQ+ community, rather a range of identities and experiences which may change over time. Other variations of this acronym exist. Acronym choice can vary depending on the groups or issues being discussed and the available evidence. The acronyms used in this resource reflect the research conducted but may not accurately reflect the populations described in the source reports. In many of the reports and other projects cited in this topic page, people with innate variations of sex characteristics may have been excluded due to small sample sizes, but if they also identified as being LGBTIQ+, people with innate variations of sex characteristics were included in analysis according to the sexual orientation and gender they identified with.
AIHW reports and other products include information about the LGBTIQ+ communities in Australia when data are of sufficient quality and completeness. Some reports focus on a subset of LGBTIQ+ communities and use terms such as 'LGB' or 'LGBT' as well as broader terms such as LGBTIQA+.
Protective factors
Stable and positive support networks have emerged as protective factors for both the physical and emotional well-being of LGBTIQ+ individuals (Life in Mind 2023). In addition, access to healthcare and mental health services is another protective factor against anxiety and depression in LGB people (Lysenko et al. 2015), particularly services delivered by LGBTIQ+ community-controlled peer-led organisations. Peer-led organisations play a critical role in addressing the barriers experienced by people in this diverse population group when seeking healthcare and support. Peer-led services provide LGBTQ+ communities with access to safe, inclusive, and knowledgeable healthcare and support, which is essential for improving health and wellbeing outcomes (Meridian 2023).
It is important to acknowledge the diverse lived experiences of LGBTIQ+ people. Compared with the general population, LGBTIQ+ people have historically faced discriminatory laws and policies and continue to encounter discrimination, social isolation and social stigma in various settings and at different times across their lives. Improved consistency in reporting on the health and wellbeing of LGBTIQ+ communities will support further research into sub-population groups and the development of tailored policies and services that aim to reduce the impact of various risk factors.
Young people
Young people in this population group may experience discrimination such as bullying and harassment at school, lack of support from family and friends, barriers to healthcare and support services, and are more likely to experience homelessness (Hill et al. 2020; Hill et al. 2021; McNair et al. 2017). Young trans people use music and art, peers and friends, activism, social media and pets to make themselves feel better and take care of their mental wellbeing (Strauss et al. 2017). It is important to recognise and support the health and welfare of LGBTIQ+ young people while promoting acceptance and providing safe and inclusive spaces.
Australia's youth: Contributions from young people
Older people
Older LGBTIQ+ Australians often face unique challenges as they age. They may have experienced discrimination throughout their lives and may not have the same social support networks as their non-LGBTIQ+ counterparts. This can lead to increased isolation and poorer mental and physical health. Additionally, many aged care facilities and services may not be equipped to meet the needs of LGBTIQ+ older people (AIHW 2023c).
However, recent improvements to the allocation of resources towards community programs and interventions have resulted in LGBTIQ+ communities becoming a priority group in aged care research and the provision of services in the aged care sector.
Older Australians who identify as lesbian, gay, bisexual, transgender or intersex
Dementia in the LGBTIQ+ community
Illicit drug use
LGBTQ+ people have higher rates of alcohol and other drug use compared with the general population. Discrimination, social stigma and lack of access to support services may increase the risk of LGBTQ+ people using illicit drugs and/or alcohol to self-medicate to help manage these experiences. It is important for healthcare providers to be aware of these potential risk factors for illicit drug and/or alcohol use and to provide inclusive care for LGBTQ+ people seeking help (AIHW 2023b).
Alcohol, tobacco & other drugs in Australia
Suicide and self-harm
LGBTIQ+ communities have been identified as priority populations under The National Mental Health and Suicide Prevention Agreement (Cth of Australia 2022) and for data development as part of the National Suicide and Self-harm Monitoring System. The Australian Research Centre in Sex, Health and Society (ARCSHS) at La Trobe University runs two large targeted surveys of LGBTIQ adults and LGBTQA+ young people, the Private Lives 3 (PL3) and Writing Themselves In 4 surveys, respectively (Hill et al. 2020; Hill et al., 2021). The findings of PL3 are consistent with evidence from Australia and overseas, which indicate that LGBTQ+ communities experience higher levels of mental ill health, suicidality and self-harm, compared with the general population (Hill et al. 2020; Hill et al. 2021; Marchi et al. 2022; Swannell et al. 2016; Zwickl et al. 2021).
LGBTIQ+ Australians: suicidal thoughts and behaviours and self-harm
Impact of the COVID-19 pandemic
While the COVID-19 pandemic has had a significant impact on the wider Australian community, it has also adversely affected the LGBTQ community. Social isolation measures, such as lockdowns and travel restrictions, restricted access to support networks, such as family and friends, negatively affecting emotional well-being (Amos et al. 2022). Additionally, the economic downturn caused by the pandemic has disproportionately affected LGBTQ+ individuals, who are more likely to work in industries that have been hit hard by the pandemic, such as the service industries (Rainbow Health Australia 2022). The pandemic has also highlighted and exacerbated existing inequalities and discrimination faced by the LGBTQ community including access to healthcare.
First Nations people
The high rates of suicide-related behaviour among First Nations people, combined with similar evidence relating to LGBTIQ+ people, suggest that there is a need to investigate the compound risk of suicide-related behaviour among people who are both Aboriginal and Torres Strait Islander and LGBTQIASB+. ‘SB’ represent ‘Sistergirl’ and ‘Brotherboy’. These are two terms used by some Aboriginal and Torres Strait Islander people, and refer to Aboriginal and Torres Strait Islander women and men who are transgender. The ‘Aboriginal & Torres Strait Islander LGBTQIASB+ people and mental health and wellbeing’ report highlights gaps in existing data collection and research literature regarding the experiences of this group. It explores the risks to social, cultural and emotional wellbeing, as well as protective factors for suicide, for this group.
Family, domestic and sexual violence: LGBTIQA+ people
LGBTIQA+ people may be at increased risk of experiencing family, domestic and sexual violence (FDSV) when compared with other population groups. The Australian Institute of Criminology has found dating app-facilitated sexual violence is disproportionately experienced by non-heterosexual people, and eSafety has identified LGBTIQ+ people as an at-risk group for serious online abuse. Findings from the Personal Safety Survey (ABS 2023) and Australian Longitudinal Study of Women's Health found LGB+ women experience sexual and intimate partner violence at higher levels compared with women who identified as heterosexual.
LGBTIQA+ people may also experience distinct forms of violence that may be referred to as identity-based abuse. Identity-based abuse may include behaviours such as:
- pressuring a person to conform to gender norms or stopping them from accessing gender-affirming care
- corrective rape (a hate crime in which the victim is raped because of their perceived sexual orientation)
- threatening to 'out' the person's gender, sexuality, or intersex status
- exiling a person from their family due to their sexuality or gender
- forcing a family member into conversion therapy (DSS 2022).
Intersex people may also experience body shaming, along with forced and coercive medical interventions and body modifications in childhood and adulthood, because of stigma and misconceptions about intersex variations (DSS 2022).
Additionally, a lack of understanding of these issues by support services may present unique barriers to accessing support for LGBTIQA+ people (Cullen et al. 2022; DSS 2022).
Family, domestic and sexual violence: LGBTIQA+ people
References
ABS (2023) Sexual violence, 2021–22, ABS website, Australian Government, accessed 23 August 2023.
AIHW (Australian Institute of Health and Welfare) (2023a) Alcohol, tobacco & other drugs in Australia, AIHW, Australian Government, accessed 30 January 2024.
AIHW (Australian Institute of Health and Welfare) (2023b) Older Australians, AIHW, Australian Government, accessed 30 January 2024.
Amos, A, Macioti, PG, Hill, AO, Bourne, A (2022). Pride and Pandemic: Mental health experiences and coping strategies among LGBTQ+ adults during the COVID-19 pandemic in Australia. National report. Melbourne, Australia: Australian Research Centre in Sex, Health and Society, La Trobe University.
The Commonwealth of Australia (Cth of Australia) (2022) National Mental Health and Suicide Prevention Agreement, The Federal Financial Relations website, accessed 15 June 2023.
Cullen P, Walker N, Koleth M and Coates D (2022) ‘Voices from the frontline: Qualitative perspectives of the workforce on transforming responses to domestic, family and sexual violence’ ANROWS (Australia’s National Research Organisation for Women’s Safety) Research report, 21/2022, accessed 9 June 2023.
Day M, Carlson B, Bonson D and Farrelly T (2022) Aboriginal & Torres Strait Islander LGBTQIASB+ people and mental health and wellbeing, AIHW Indigenous Mental Health and Suicide Prevention Clearinghouse, accessed 2 February 2024.
DSS (Department of Social Services) (2022) The National plan to end violence against women and children 2022-2032, DSS, Australian Government, accessed 9 June 2023.
Hill AO, Bourne A, McNair R, Carman M & Lyons A (2020) Private Lives 3: The health and wellbeing of LGBTIQ people in Australia, ARCSHS Monograph Series No. 122. Melbourne, Australia: Australian Research Centre in Sex, Health and Society, La Trobe University.
Hill AO, Lyons A, Jones J, McGowan I, Carman M, Parsons M, Power J, Bourne A (2021) Writing Themselves In 4: The health and wellbeing of LGBTQA+ young people in Australia. National report, ARCSHS monograph series number 124. Melbourne: Australian Research Centre in Sex, Health and Society, La Trobe University.
Kang M, Robards F, Sanci L, Steinbeck K, Jan S, Hawke C et al. 2018. Access 3: young people and the healthcare system in the digital age – final research report, 2018, accessed 24 January 2024. Sydney: Department of General Practice Westmead, the University of Sydney and the Australian Centre for Public and Population Health Research, University of Technology.
Life in Mind (2023) LGBTIQ+ communities, Life in Mind website, accessed 3 July 2023.
Lysenko N, Pryor R, Leung R, Field K and Toumbourou J (2015) Building the evidence base of risk and protective factors for depression and anxiety within the LGBQ community, drummond street services, accessed 8 Nov 2022.
Marchi M, Arcolin E, Fiore G, Travascio A, Uberti D, Amaddeo F, Converti M, Fiorillo A, Mirandola M, Pinna F, Ventriglio A, Galeazzi, GM & Italian Working Group on LGBTIQ Mental Health (2022) Self-harm and suicidality among LGBTIQ people: a systematic review and meta-analysis, International Review of Psychiatry, 34:3-4, 240-256, doi.org/10.1080/09540261.2022.2053070.
McNair R, Andrews C, Parkinson S and Dempsey D (2017). LGBTQ Homelessness: Risks, Resilience, and Access to Services in Victoria – Final Report. Melbourne.
Meridian (2023) The role of LGBTIQA+ peer-led services in meeting the health needs of LGBTIQA+ people in Australia, Meridian, accessed 29 June 2023.
Rainbow Health Australia (2022) What have we learnt about COVID-19 and LGBTIQ communities?, Rainbow Health Australia website, accessed 24 July 2023.
Strauss P, Cook A, Winter S, Watson V, Wright Toussaint D, Lin A (2017) Trans Pathways: the mental health and experiences and care pathways of trans young people, Telethon Kids Institute, accessed 14 December 2022.
Swannell S, Martin G, Page A (2016) Suicidal ideation, suicide attempts and non-suicidal self-injury among lesbian, gay, bisexual and heterosexual adults: Findings from an Australian national study, Australian & New Zealand Journal of Psychiatry, 50(2):145-53,.doi.org/10.1177/0004867415615949
Zwickl S, Wong AFQ, Dowers E, Leemaqz YN, Bretherton I, Cook T, Zajac JD, Yip PSF & Cheung AS (2021) Factors associated with suicide attempts among Australian transgender adults, BMC Psychiatry 21:81 doi.org/10.1186/s12888-021-03084-7