The connections between mental and sexual health

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There are many ways in which our mental and sexual health are connected. Talking about sexual or mental health is taboo for many people, so it’s even harder to talk about all of the ways in which they are connected. Getting to know how they are related can help us make important connections, start crucial conversations, and when it makes sense, seek the support we need and deserve.

What do you mean sexual and mental health are connected?

Sexual and mental health are linked in a number of ways – and the following are just some examples of how they are connected. We all have different bodies, minds, and contexts in which we are navigating sex, relationships, and our health and wellness. Starting to see those connections can help us take better care of ourselves.

Taking care of our health means taking care of our whole selves. Everyone, including our health care providers, should know that it is important to pay attention to how sexual and mental health can be connected.

Important things to think about

The following sections highlight the negative impacts of challenges faced specifically by gender and sexual minorities, people who experience sexual violence, those who are diagnosed with mental illnesses, and those who face racism and the impacts of colonialism. The content is meant to show the connection between mental health and wellness with issues touching on gender and sexuality. The goal is to validate these important links. People deserve care and support and to see their rights to health and non-discrimination respected.

This is only one aspect of people’s stories and showcase public health considerations. Individuals facing such challenges have complex lives that can’t be reduced to research data. It is also important to mention the resilience, courage, community mindedness, and resourcefulness of people impacted by one or many of the following things. Many become advocates in their own rights to speak to their experiences of discrimination and change the world.

Gender, sexuality, and mental health

Lesbian, gay, bisexual, and queer people are much more likely to experience mental health concerns because of the stigma, prejudice, and discrimination they experience.

In a similar way, discrimination and violence experienced by trans folks can result in being excluded from social spaces, higher likelihood of unemployment, avoidance of health care, and poor mental health outcomes.

At the same time, many LGBTQI2S+ folks often go without treatment or care for their physical and mental health concerns due to not having access to a health care provider, because of concerns, or because they cannot find a provider who can understand and speak to their needs and realities as an LGBTQI2S+ individual.

Experiences of homophobia or transphobia, whether on the daily or when growing up, the loss of community and family support that often come from disclosing (or not disclosing) sexual orientation and gender identity, and having to deal with that reality and history are things that can impact our health and wellness in big ways.

Having support and community results in better health outcomes across the board – loneliness and isolation harm our wellbeing.

The stigma, prejudice, and discrimination the LGBTQI2S+ people experience both in their daily lives and when they go to the doctor result in higher rates of depression, anxiety, obsessive compulsive and phobic disorders, suicidal thoughts and acts, self-harm, alcohol and drug dependence. These impacts can be worse if people also face discrimination because of their race, class, ethnicity, or disability.

It is important that we know about these impacts because it can help us understand our needs better, become better advocates for ourselves and others, and build stronger communities. If this is your experience, you deserve support and care.

Sexual trauma and mental health

Sexual violence is any unwanted act of a sexual nature that is imposed on another person. People who experience sexual violence can feel like they lost their sense of safety and their bodily autonomy. That can take a toll on mental wellness. Following sexual trauma, some may be at higher risk of experiencing depression, anxiety, post-traumatic stress disorder, personality disruption, attachment disruption, or addiction.

Survivors of sexual violence are more likely than the average person to attempt suicide. This is in part because in addition to the violence itself, survivors have to deal with rape culture and myths about sexual assault that can make it difficult to be believed and get support, protection, and justice.

It is important that we know about these impacts because it can help us understand our needs better, become better advocates for ourselves and others, and build stronger communities. If this is your experience, you deserve support and care.

The stigma of getting diagnosed with a mental illness

Getting diagnosed with a mental illness comes with its own baggage of stigma. Some of the fears and misunderstanding around some mental illnesses have to do with sexuality. Many people with mental illnesses are seen as either hypersexualized, asexual, or undeserving/unfit to engage in sexual or romantic relationships.

This can impact how people with mental health conditions are treated in health care settings. In an interesting twist, the negative feelings that can come from being stereotyped can impact how people decide whether or not to take certain risks relating to our sexual health.

At the same time, the sexual and reproductive health needs of people with mental illnesses are often neglected because of these stereotypes. In many cases, people do not have the sexual symptoms of their illness (for example, bipolar disorder can cause hypersexuality) or the side effects of their medication (for example, antidepressant can make it more difficult to experience orgasms) on their sexual health taken seriously. Or they are not seen as fit to have sex and so, receive little to no support and information to have healthy sexual lives.

It is important that we know about these impacts because it can help us understand our needs better, become better advocates for ourselves and others, and build stronger communities. If this is your experience, you deserve support and care.

Health impacts of colonialism and racism

Canada has a long and ongoing history of controlling the reproductive lives of Indigenous peoples. As recently as 2017, a report in Saskatoon exposed the experience of Indigenous women being forced to get their tubes tied, a method of permanent birth control.

Canada’s sterilization policies have had disastrous effects on Indigenous peoples and communities. One example of the intersection of mental health and sexual health is how, historically, large numbers of Indigenous men and women were sterilized for being “mentally unfit.” This was determined by the government under a number of reasons, including not conforming to colonial notions of sexual customs, ways of living, and behaviours. This designation of Indigenous men and women as “mentally unfit” was also used as a tool for the government to steal land and property from Indigenous peoples and transfer it to the federal government and/or the provinces.

The fact is, the forced sterilization of Indigenous women and the removal of Indigenous children from their families continue today.

Health care in Canada and North America at large has also been marked by historical and contemporary racism and discrimination, including the testing of contraceptives of non-consenting people of colour across North America, the conducting of experiments on enslaved Black women in the United States, and the early history of the family planning movement as attempting to limit “deviant” populations through population control.

Because of these historical and contemporary realities, as well as ongoing racial discrimination in health care and a lack of culturally competent health care, many Black, Indigenous, and racialized people don’t trust the health care system and delay going to the doctor.

Another clear example of how racism impacts both the mental and sexual wellness of Black people and people of color is the poor maternal health outcomes of Black women in North America, including disproportionately high rates of death related to pregnancy or childbirth.

Both societal and health system factors contribute to high rates of poor health outcomes and maternal mortality for Black women, who are more likely to experience barriers to obtaining quality care and often face racial discrimination throughout their lives. This includes the experience of physical “weathering,” meaning their bodies age faster than white women’s due to chronic stress linked with socioeconomic disadvantage and discrimination, thus making pregnancy riskier at an earlier age.

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