When now 54-year-old San Francisco resident Fay Zenoff thinks back on being a teenager and young adult, the memories are tough. Not only did she suffer a series of terrible blows — the death of her brother, her parents’ divorce, and her father’s move to Europe — but she also found herself unable to cope with her feelings of attraction to other women.

“Drinking was how I dealt with internalized homophobia, as well as the implosion of my family,” she recalls. “I had no idea where to look for help, or who to ask. It felt like something was the matter with me, that I had this soul-crushing problem, and the only relief was alcohol.”

Zenoff was far from alone in being uncertain about where to turn for help, and this can be particularly true for people with addiction and trauma, says Sarah Church, PhD, a clinical psychologist and the founder of Wholeview Wellness, a New York City–based outpatient addiction treatment center that serves many LGBTQ+ clients.

“For many people in the LGBTQ+ community, there can be emotional health issues that are more complicated than they might be for those outside the community,” Dr. Church says.

Church has counseled many people in the LGBTQ+ community who have faced hostility from family members when trying to come out, which may cause increased anxiety, shame, and depression, and in turn, lead to the use of alcohol and drugs to soothe that pain.

The pandemic, with its high level of isolation, may have deepened existing mental health challenges for those in the LGBTQ+ community, Church adds.

A study published on June 17, 2020, in the Journal of General Internal Medicine looked at survey data from 2,288 people who identify as nonheterosexual, transgender, or gender-expansive and found that depression and anxiety have increased significantly, especially for those who haven’t struggled with these mental health conditions previously.

According to a Kaiser Family Foundation report published in March 11, 2021, 74 percent of people who identify as lesbian, gay, bisexual, or transgender said that worry and stress from the pandemic has had a negative impact on their mental health, compared with just 49 percent of people who were not lesbian, gay, bisexual, or transgender. (The analysis is based on telephone interviews with a nationally representative sample of 3,239 adults, including 174 who identified as lesbian, gay, bisexual, or transgender.)

Even when addiction is not part of the equation, emotions are multilayered and can be challenging to cope with, says Alex Greenwald, a mental health counselor at Empower Your Mind Therapy in New York City, who specializes in working with people from the LGBTQ+ community.

There’s still a stigma about coming out and feeling rejected, but there’s also bullying, homophobia, transphobia, BIPOC trauma, and discrimination, which can put LGBTQ+ people of any age at higher risk of self-harm and eating disorders, Greenwald says. That may be exacerbated by the fact that these people often aren’t treated as individuals, she adds.

“Sadly, some professionals may lump together anyone in the LGBTQ+ community, and not see the person for their unique story,” she says. “The community encompasses a wide range of individuals with separate challenges regarding their mental health.”

LGBTQ+-Friendly Emotional Health Resources to Turn To

Deciding to ask for support and knowing where to turn can be the hardest part of getting help when you’re struggling.

For Zenoff, exploring recovery options with the right therapist made an enormous difference. She has since become a recovery coach and advocate who now consults with companies about increasing the well-being of employees in the workplace. Before she launched her own consultancy business, Zenoff served as the executive director at Open Recovery, a San Francisco nonprofit focused on ending the stigma of addiction.

“There are so many paths to recovery, no matter what you’re facing,” she says. “For me, it was comforting to find out there were many people who were eager to help, and that asking for help wasn’t a weakness, it was a strength.”

Greenwald and Church recommend these organizations that provide support for members of the LGBTQ+ community who are struggling.

The Trevor Project

The Trevor Project is a mental health organization for LGBTQ+ youth founded in 1998 to provide crisis intervention for those under age 25. Since then, it’s funded research, driven advocacy, and been a major force for suicide prevention.

If you need immediate support, call the TrevorLifeline at 866-488-7386. The organization also provides resources, events, and education on its website, and you can go online to sign up for email updates and find local volunteer groups.

The It Gets Better Project

For young people with challenges around coming out, the nonprofit It Gets Better Project provides education, stories, and referrals to mental health professionals.

The organization holds events and also has materials for educators available through its website.

National Queer and Trans Therapists of Color Network (NQTTCN)

Working at the intersection of social justice and mental health, NQTTCN maintains a directory of therapy practitioners, as well as a number of community resources. Its Trans Lifeline is a hotline for trans people staffed by trans people: 877-565-8860.

True Colors United

LGBTQ+ youth have a 120 percent higher risk of homelessness, often as a result of family rejection or discrimination, according a 2018 University of Chicago report. Risk is particularly high among Black LGBTQ+ young adults.

True Colors United focuses specifically on this issue through advocacy and education, as well as assistance programs to help young people. You can donate to their program, and young people have the opportunity to apply for fellowships to gain professional development and advocacy skills.

Human Rights Campaign

The Human Rights Campaign is an organization committed to ensuring every LGBTQ+ person can live openly, with equal rights and support. Turn to it to find resources specific to topics like elections, hate crimes, workplace issues, coming out, and legislation. Via the website, find ways to donate, attend events, and volunteer.

National Alliance on Mental Illness (NAMI)

NAMI has resources specific to the LGBTQ+ community, with information on coming out, trauma, substance use, suicide, and homelessness. The organization offers tips on how to find the right mental health professional, including what type of questions to ask providers.

Trans Lifeline

This nonprofit organization offers direct emotional and financial support to transgender people in crisis. The organization runs a hotline (a peer support phone service run by trans people for trans and questioning individuals) that is confidential, anonymous, and will not refer a caller to another emergency service (such as 911, emergency services, or law enforcement) without the caller’s consent. The hotline number is 877-565-8860 in the United States and 877-330-6366 in Canada. The organization also runs a microgrant program to provide trans and nonbinary people with low-barrier funds and support to correct names and gender markers on identifying legal documents, as well as to supply necessities to incarcerated trans people.