A report on the mental health and well-being of LGBTI (lesbian, gay, bisexual, transgender and intersex) people in Ireland was published on 22 March 2016.1 The largest study of LGBTI people in Ireland to date and the first to incorporate intersex people, the research was commissioned by the Gay and Lesbian Equality Network (GLEN) and BeLonG To, funded by the National Office for Suicide Prevention and undertaken by a team at Trinity College Dublin.

In the past 25 years Ireland has made great legislative strides in achieving equality for its LGBTI citizens. Despite this progress, there is little evidence of similar progress regarding general attitudes to LGBTI people among the wider Irish population. The aim of this study, undertaken just before the same-sex marriage referendum in May 2015, was to fill this knowledge gap. The study comprised two modules: (1) to gain insight into the lives of LGBTI people, in particular young people, by examining factors which affect their mental health and well-being; and (2) assess public attitudes towards LGBTI people and how these can impact on LGBTI people.

The selection criteria for inclusion in the first study module were any persons who lived in Ireland, identified as LGBTI, and over the age of 14. Participants were recruited mainly through social media, posters or by invitation through LGBT organisations. The vast majority completed the questionnaire online.

Module 1 findings

In total, 2,264 people met the inclusion criteria and had provided sufficient information to be included in the study. Of these, 3.6% identified as gay males, 26.5% as lesbian/gay females, 14.4% as bisexual, 12.3% as transgender, 6.3% other identity2 and 2.0% as intersex.

Nearly three-quarters (72%) of participants were aged between 14 and 35 years, with a mean age of 29.6 years (range 14‒71 years). Younger people were overrepresented in the study perhaps due to the nature of the recruitment of participants mostly through social media. The study included participants from all counties of the Republic with almost half (49.6%) of participants living in Dublin. Over 80% of participants were in paid employment or education.

Self-esteem was gauged using the Rosenberg Self-Esteem Scale. Intersex, transgender and bisexual people had statistically significant lower self-esteem compared with gay males and lesbian/gay females. Younger age groups also had significantly lower self-esteem compared with their older counterparts. The life satisfaction and happiness of participants were also assessed, revealing that both improved with age. The mean scores for both satisfaction and happiness were lowest for transgender and intersex participants and highest for gay males.

The majority of participants reported incidents of verbal abuse, while 20% reported physical attacks. Participants recommended stronger legal protection and increased visibility of LGBTI identities as a means of reducing exposure to these risks. The results also showed that many LGBTI people experienced mental health issues, mainly depression, anxiety and substance misuse. Almost 60% of the sample seriously considered suicide, and one in five had attempted suicide. The mean age of those who had attempted suicide was as 18.5 years (range 6‒55 years). Two-thirds of these people reported their suicide attempt(s) related to being LGBTI.

The Alcohol Use Disorders Identification Test (AUDIT) was used to measure alcohol use, where depending on the score the participant fell into one of four categories. These are: no alcohol problems (≤7); medium level alcohol problems (8‒15); high level alcohol problems (16‒19); and very high level alcohol problems (>20). The mean score in this study was 8.1 (range 1‒33). Table 2 shows the mean audit scores by LGBTI group and age.

Almost half (43.8%) of the AUDIT scores in the sample indicated some level of alcohol problem or dependence. This is however approximately 10% less than previously indicated in a study involving the general population. Long and Mongan (2014) found that more than half (54%) of the general population of 18‒75-year-olds are classified as harmful drinkers.3

Over half (55.9%) of the participants had taken recreational drugs. This is higher than the rate of 27% found in the general population.4 Almost 30% (29.8%) of 14‒18-year-olds had taken recreational drugs, while almost two-thirds (62.5%) of 19‒25-year-olds had used recreational drugs. Cannabis, codeine-based drugs and MDMA/ecstasy were the three most commonly used drug types.

Module 2 findings

In order to gauge societal attitudes to LGBTI people in module 2, some 1,008 telephone interviews with the general public were conducted. This part of the study found mixed views among the general population. For example, 75% of participants believed that LGB people’s sexual orientation was normal, 11% believed it was a phase that people would grow out of, while 17% believed that someone could be convinced to become LGB. A smaller proportion (56%) were uncomfortable with people who were transgender, perhaps due a lack of understanding their identity. The general public were less comfortable with public displays of same-sex affection, for example 39% were uncomfortable with a male couple kissing in public compared to 17% for a heterosexual couple kissing in public.

While the vast majority of participants did not believe it was acceptable to discriminate against LGBTI people, 15% still believed using LGBTI slang words was not a major concern. This suggests that a section of society is unaware of the negative effects such slang can generate.

The public perception of what constitutes equal rights does not appear to match the views of the LGBTI community. One of the strongest findings from module 1 was the desire for normalisation and visibility of LGBTI relationships. However, the general population had noticeable levels of discomfort towards public displays of affection.

Recommendations

The report recommends seven strategies for achieving positive change for LGBTI:

• Reduce mental health risks and build resilience among LGBTI people.
• Support the LGBTI community to flourish.
• Protect and support LGBTI children and young people in schools.
• Increase public understanding and change attitudes and behaviours.
• Recognise the diverse needs within the LGBTI community.
• Build the knowledge and skills of professionals and service providers.
• Conduct further research and assess progress.

1 Higgins A, Doyle L, Downes C, Murphy R, Sharek D, DeVries J, Begley T, McCann E, Sheerin F and Smyth S (2016) The LGBTIreland Report: national study of the mental health and wellbeing of lesbian, gay, bisexual, transgender and intersex people in Ireland. Dublin: Gay and Lesbian Equality Network (GLEN) and BeLonG To. https://www.drugsandalcohol.ie/25323/

2 Other identity: comprised participants who subscribed to another gender identity or sexual orientation outside of the LGBTI categories see page 39 of report.

3 Long J and Mongan D (2014) Alcohol Consumption in Ireland 2013: Analysis of a National Alcohol Diary Survey. Dublin: Health Research Board. https://www.drugsandalcohol.ie/22138/

4 National Advisory Committee on Drugs (2011) Drug use in Ireland and Northern Ireland: first results from the 2010/2011 drug prevalence survey. Bulletin 1. Dublin: National Advisory Committee on Drugs & Public Health Information and Research Branch. https://www.drugsandalcohol.ie/16353/