GLEN BeLonG To TENI GLEN is a national policy and strategy BeLonG To is the national youth Transgender Equality Network Ireland focused NGO which aims to deliver service for lesbian, gay, bisexual and is a non-profit organisation supporting ambitious and positive change for transgender young people aged between the trans community in Ireland. TENI lesbian, gay, bisexual and transgender 14 and 23. BeLonG To’s vision is for an seeks to improve the situation and people in Ireland, ensuring full equality, Ireland where Lesbian Gay bisexual advance the rights and equality of trans inclusion and protection from all forms and transgender (LGBT) young people people and their families. Our Vision of discrimination and harm. We have a are empowered to embrace their is an Ireland where trans people are range of work programmes including development and growth confidently understood, accepted and respected, mental health, education, workplace, and to participate as agents of positive and can participate fully in all aspects of sexual health, families and older people. social change. Irish society. T: +353 1 672 8650 T: +353 1 670 6223 T: +353 1 873 3575 [email protected] [email protected] [email protected] www.glen.ie www.belongto.org www.teni.ie For information on LGBTI services visit www.lgbt.ie For LGBT support call 1890 929 539 LGBTIreland The LGBTIreland Report: national study of the mental health and wellbeing of lesbian, gay, bisexual, transgender and intersex people in Ireland Cover_artwork.indd 1 18/03/2016 10:30 Copyright © Agnes Higgins, Louise Doyle, Carmel Downes, Rebecca Murphy, Danika Sharek, Jan DeVries, Thelma Begley, Edward McCann, Fintan Sheerin, Siobháin Smyth; 2016. Published by GLEN and BeLonG To, Dublin. ISBN: 978-0-9561023-8-6 Cover_artwork.indd 2 18/03/2016 10:30 FOREWORD Ireland’s national suicide prevention strategy Connecting for Life 2015-2020 has two in- tended outcomes: reduced suicide rate in the whole population and amongst specified priority groups; and reduced rate of presentations of self-harm in the whole population and amongst specified priority groups. Members of the lesbian, gay, bisexual, trans- gender and intersex (LGBTI) community have been shown by national and internation- al research to have increased risk of suicidal behaviour, and have been identified as a priority group within Connecting for Life. The LGBTIreland Report details the findings of a national study of the mental health and wellbeing of LGBTI people in Ireland, with a special emphasis on young people. It is considered to be the largest study of LGBTI people in Ireland to date, as well as the largest study of transgender people, and the first study with a sample of intersex peo- ple. It facilitates comparison with the 2009 Supporting LGBT Lives study, which was the first major research on the mental health and well-being of LGBT people in Ireland, to help assess and identify a way forward. It also makes comparison with the 2013 My World Study, which is the national study of youth mental health in Ireland. Against this background, The LGBTIreland study was funded by the HSE’s National Office for Suicide Prevention in order to add to our understanding of the link between society’s negative treatment of LGBTI people and the increased risk of poor mental health, self-harm and suicidal thoughts. This information is vital in order to better design effective responses. The findings of this study suggest that similar to the general population a large propor- tion of LGBTI people (approximately 70%) are experiencing positive wellbeing. Howev- er, the study also highlights particular vulnerability among young LGBTI people, and reports rates of self-harm as two times higher, and attempted suicide as three times higher, compared to their non-LGBTI peers. While this study reports improvements in the lives of LGBTI people, it also highlights that minority stress continues to have a very real negative impact on the mental health and wellbeing of LGBTI people. I would like to acknowledge the crucial role our LGBTI partner organisations have and continue to play in leading and coordinating initiatives to improve the lives of LGBTI people in Ireland. I believe this study and its recommen- dations capture progress made, as well as provide a platform for collaborative efforts to help ensure that the appropriate supports and services are available for LGBTI people. I would like to thank GLEN (Gay and Lesbian Equality Network) and BeLonG To Youth Services for commissioning this study. I also wish to thank the research team led by Professor Agnes Higgins from the School of Nursing & Midwifery, Trinity College Dublin. The LGBTIreland Study 1 Connecting for Life sets out a vision of an Ireland where fewer lives are lost through su- icide, and where communities and individuals are empowered to improve their mental health and wellbeing. We recognise that we cannot do this alone, no single agency, no single Government Department, no single individual can reduce suicide on their own. Therefore, we must ensure that we work together, to achieve our shared and attainable goal for all people of our nation. Gerry Raleigh Director HSE National Office for Suicide Prevention 2 PREFACE The LGBTIreland Report is a groundbreaking study of the mental health of lesbian, gay, bisexual, transgender and intersex (LGBTI) people in Ireland. It is the result of a very productive partnership between GLEN, BeLonG To, the National Office for Suicide Prevention and Trinity College Dublin. This report includes the findings from a national study with two distinct components. Module 1 aimed to gain a better understanding of the lives of LGBTI people with a special emphasis on young people. It looked at the factors that may impede or facilitate their mental health and wellbeing. Module 2 assessed public attitudes towards LGBT people to gain a better understanding of how the social environment can shape the lives and wellbeing of LGBTI people. Due to the extraordinary response rate received, this study is the largest study of LGBTI people in Ireland to date, the largest study of transgender people, and the first study with a sample of intersex people. In the last two decades, Ireland has slowly but steadily made significant advancement in achieving equality for its LGBTI citizens. As a direct consequence of these developments, Ireland has evolved from a society noted for being LGBTI oppressive to being considered internationally as a forerunner in progress on equal civil rights of LGBTI people. It is heartening to see in the findings of this study that a majority of participants aged 26 and over were doing well and reported good self-esteem, happiness and life satisfaction as well as being proud of their LGBTI identity. It was also very encouraging to find that the majority of the Irish residents polled were largely positive about LGBT people, although some misunderstandings remain about sexual orientation and gender identity which need to be addressed. However, despite recent positive social changes the study found that a very significant number of those aged under 25 did not experience the same levels of positive mental health and wellness as those older than them. Some of the findings are harrowing, especially the very elevated levels of suicidal behaviour and self-harm among LGBTI teenagers as well as the worrying levels of severe and extremely severe stress, anxiety and depression. The study confirms that 12 is the most common age for people to know they are LGBTI and that they negotiate coming out against the backdrop of a very challenging school environment where there has not been a significant reduction in anti-LGBTI bullying in recent years. The data reveals that anti-LGBTI bullying in schools can have a devastating impact on LGBTI teenagers’ mental health, increasing the likelihood of reporting stress, depression, anxiety, self-harm and attempted suicide. The LGBTIreland Study 3 The LGBTIreland Report also reveals that there is a hierarchy of risk among LGBTI people, with intersex, transgender and bisexual people reporting poorer mental health outcomes compared to gay men and lesbian women. This hierarchy of risk reflects the fact that more progress has been made on reducing homophobia in Ireland than biphobia and transphobia. This hierarchy of progress highlights the need for increased advocacy and support for bisexual, transgender and intersex people and to address the diverse needs within the LGBTI community. The exciting progress achieved for Irish LGBTI people in 2015 gives us solid ground from which we can work to achieve the recommendations in this report. Marriage equality and gender recognition were momentous milestones, but much work still needs to be done to ensure that all LGBTI people are equal, safe, included and valued across Irish society. The past continues to exert its negative legacy on many LGBTI lives. The harmful effects of stigmatisation of LGBTI identities and the associated experiences of rejection and discrimination still continue to be a reality. These can be compounded by a continuing level of misunderstanding of LGBTI sexual orientations and gender identities among the general public. The participants who were aged 16 at the time of this study were born in 1998. This was 5 years post-decriminalisation of homosexuality, 2 years before the Equal Status Act, 12 years before the Civil Partnership Act, and 17 years before the Marriage Equality Referendum and the Gender Recognition Act. While they have seen Ireland change incrementally in the direction of being a more LGBTI-friendly country, with laws and social attitudes steadily moving in the right direction, they have also encountered a range of LGBTI-specific stresses which pose enormous challenges to their mental health. The many manifestations of homophobia, biphobia and transphobia the teenagers in this study experienced are at the core of what needs to change in Ireland henceforth.