Why Affirming Care Matters: Co-occurring Disorders in the LGBTQIA2+ Community

A co-occurring disorder is when an individual has a mental health and substance use disorder simultaneously. Due to constant minority stress research shows that individuals who are part of the queer community do not typically have a substance use disorder without a mental health condition that got them there.

This community experiences co-occurring disorders at a rate of 2 times higher than their heterosexual counterparts. The higher rates aren’t inherent to being a queer individual but a product of chronic stress and systemic barriers. The minority stress occurs through trauma exposure, discrimination, identity suppression, oppression of their community, and inadequate  access to appropriate gender affirming care.

The queer community has higher rates of  depression, anxiety, PTSD, substance use disorders, and suicidality. To effectively treat these individuals, we must treat both disorders simultaneously and provide that care through an affirming care model. 

Minority Stress Model 

This model acknowledges the chronic and pervasive stress that the queer community experiences  in their lifetime. It acknowledges distal stress like prejudice, discrimination, violence as well  as the proximal stress such as negative self-talk, chronic worry, health concerns etc. It takes the blame off the individual and asks what happened to you, and not what is wrong with you. This model focuses on the structural and systemic reasons a queer person would rely on substances or behaviors to cope through day-to-day life and validates their lived experience.  

Treating the Whole Person: Affirming Care Practices 

Affirming care is a range of models that create a safe and judgment free environment that is  grounded in the belief that queer identities are normal and an expected part of the human experience. To have treatment engagement, we must create an environment that values safety, cultivates trust, and prioritizes identity validation. As well as affirming practices, we must  practice cultural humility. Below is a short list of ways to begin implementing this into your daily practice. 

LGBTQIA2+ Affirming Practices: 

• Respect the client's identity, like their chosen name and pronouns 

•  Open ended questions 

•  Nonjudgemental language 

•  Inclusive intakes, ie: having a blank space to write in gender identity 

•  Quick repair after a mistake – correct mistake, I'm sorry, and move on

•  Avoid Microaggressions- don't assume normatively, invasive curiosity, pathologizing their identity, invalidation of their identity

Consider Support from LGBTQIA2+ Affirming Therapists in Michigan

Ready for support in identity and/or intentional allyship? Connect with Being Human Group in Plymouth & Grosse Ile, Michigan, and speak with affirming therapists dedicated to creating a safer and more inclusive world for all.

About Our Michigan Therapists

The expertly trained and compassionate therapists at Being Human Group are licensed mental health professionals offering affirming, trauma-informed care to clients across Michigan through in-person sessions in Plymouth and Grosse Ile and convenient online therapy statewide. Our team brings advanced training and lived awareness in areas like trauma recovery, anxiety, depression, LGBTQIA+ mental health, relationship concerns, and life transitions, all grounded in a Health at Every Size and anti-oppressive, queer-affirming lens.  ​

When you reach out for a consultation about therapy, you are matched with a therapist whose background, specialties, and style align with your goals so you can access both practical tools for right now and deeper healing for long-term change. When you're ready, reach out and take the next step toward a more grounded, authentic life.