Mental health in the LGBTQI+ community cries out for help

It is not "only" about sexual violence and prejudice. The cis-heteronormative tradition imposes itself in supposedly progressive environments such as universities and even in psychology offices.

Jaqueline Gomes de Jesus*, a psychology professor at Federal Institute of Rio de Janeiro, a doctorate in social psychology from UnB, the first manager of the quota system for blacks in the institution, post-doctorate in social sciences from FGV, participates in an interesting study on the mental health of the LGBTQI+ community, which investigates anxiety, depression, post-traumatic stress disorders and suicidality in several countries, including ours.

In the Brazilian case, there are many setbacks and points of attention but also advances.

"I am Jaqueline Gomes de Jesus, I am a carioca born in Brasília or a candanga living in Rio de Janeiro. I come from a black family of immigrants who built Brasilia. I am a psychologist, a black trans woman who grew up in the periphery of Brazil in Ceilândia, I was a child who was seen as a transgressor. I faced many challenges to get where I am as an academic, and today I recognize the achievements I had.

"There is a problem of reducing people - this complex human being - to certain markings of their identity. For example, when we talk about "how to serve an LGBT+ person in an office," we have already made a mistake if we think that the person is only LGBT+ because the person is not only LGBT+. It doesn't matter if he is a straight cisgender white man, he is also diverse and I have to consider him, even in these dimensions of privilege. And I have to understand this LGBT+ person in his plurality: is he a white person? Is she a black person? Is she an indigenous person? Is she a woman? A man? A non-binary person? Where does she live? What is her historical context? There is no escape, we must always understand the human being in his complexity. Otherwise, we will reduce him to the stereotypes that culture attributes to the subject. So we have a necessary marking of knowledge, and knowledge not only of the categories but also of the individual in-depth. It is necessary to understand him in his complexity, not disregarding his diversity.

"Diverse every human being is. What happens historically in mental health practices, scientific practices, in psychology, in the different psi areas, is a disregard of this diversity, as if the idealization of a universal subject worked, and we know that it doesn't work. They are falsely universal perspectives that talk about the human being but, in fact, have as their model the supposedly heterosexual cisgender white man.

In this field of discrimination in general, the [mental health] professional himself has this difficulty in seeing a subject as a subject. And this professional, as he has difficulty understanding these dimensions, ends up having a discourse that we pejoratively call "psychologizing" - which disregards the context of the patient.

"People usually don't come to the doctor's office to question why they are cis, or why they identify with the gender they have been assigned. Because the culture itself doesn't question that. The culture already expects you to stay with your [biological] gender."

"What has been addressed within the academy in Brazil unfortunately still brings this Eurocentric cut, which obviously by historical logics, is a cis-heteronormative logic. Cis-gender because it excludes the trans population and heteronormative in the sense that there is no perspective of other sexual orientations and forms of expression that are not within the stereotype of compulsory heterosexuality.

We have been working to change this. Because the very institutional structure of psychology in Brazil, in spite of having advanced a lot through counselling, even in the field of education, is still very strongly linked to this tradition. This tradition, which besides being cis-heteronormative, is racist, sexist, and classist.

"The last HIV-AIDS epidemic marked very much the LGBT+ population, it brought this stereotype of reducing the identity of people who are LGBT+ to sexuality, to sexual rights and sexually transmitted diseases, as if they had no origin, racial-ethnic identity, disabilities and so on."

"There is still a scarcity of studies on the mental health of the LGBT+ population. (...) We have investigated anxiety, depression, post-traumatic stress disorders and suicidality in several countries.

Brazil, particularly, is a country where people are extremely anxious, more than in other places. Here in Brazil, there is a lot of ideation, suicide planning among transvestites, trans women, and many trans men. Trans men have a level of post-traumatic stress also linked to 'corrective rape' experiences, which is an experience of some lesbian women."

"With regard to the bisexual population, Brazil was the country where we identified the most biphobia. My thesis in relation to this has to do with the culture that we live in Brazil, which in terms of sexual diversity is extremely monosexual. It is difficult to understand sexual diversity outside the parameters of heterosexuality or even homosexuality. And bisexuality that is outside of these spectrums of monosexuality ends up being the target of many violations and difficulties to assert itself."

"Here in Brazil, it is very naturalized, particularly for the trans population, the right to access any social space, any field. This is a struggle, it is not questioned whether the population can or cannot, it is whether they are having access. It is already an advance in relation to other countries, like Kenya, for example.

"Freud himself, who was so referenced to justify LGBTphobia in therapeutic practice, had extremely inclusive positions. He received the mother of a homosexual girl and wrote a very beautiful letter. These are paradoxes that exist and that are part of this education process of psychoanalysis."

"In fact, this education for diversity should come from kindergarten, since early childhood education, that would be ideal. But particularly with regard to professionals in higher education, every course should have training in the curriculum about gender, about diversity in general, that is the big challenge."

"In the pandemic, it is already known that many had to stay at home with relatives in sometimes very closed spaces. People who were already suffering discrimination there gained this context of having to stay permanently at home with that other person who already had LGBTphobic discourses. For example, I had to attend to a patient and he had to talk about her life issues alongside the person who was a rapist."

"His [Bolsonaro's] election was a giant sorrow for the LGBT+ population. It was really a thud for the LGBT+ population to recognize, above all, that the Brazilian population elected a person who was explicitly LGBTphobic. In the period after the [2018] election, I had already received many suicide attempts. The degree of depression increased a lot."

"In the federal government there is a Ministry of Women, and the question is: which woman? Which womanhood is being defended? In the Palmares Foundation, which maintains our Afro-Brazilian culture, what is the perspective of the black person who is directing Palmares? There is even an LGBT secretary in this government, but when there was a Mercosul meeting last year, this LGBT secretary went there adopting the Brazilian government's position of not formally accepting the documents to use the terms "hate crime" for LGBTphobia, nor the terms "sexual orientation" and "gender identity" in the official documentation.

"I think unfortunately not everyone will survive - I talk about this a lot with my husband. We have to think about how we are going to take care of people. First, we have to take care of ourselves, how we are going to survive, how we are going to take care of ourselves in this context, not only of the pandemic but of everything that we have lived through. What gives me particularly hope is to remember our ancestors, our ancestry, how many black, indigenous, LGBT women in other times resisted."

* Jaqueline Gomes de Jesus is Director of SEMEAR's Psychosocial Support Council

This article was published on 06/30/2021 in the ESTADO DE SÃO PAULO and is available at: https://brasil.estadao.com.br/blogs/inconsciente-coletivo/a-saude-mental-na-comunidade-lgbtqi-pede-socorro/