When Identities Collide:
Mental Health at the Intersection of Military and LGBTQIA

While I never served in the military, I’ve always been surrounded by it. My father, uncles, great uncles, my grandfather, and some of my childhood best friends all served. I grew up hearing stories of World War II, the Korean War, Vietnam, and the Gulf War.

I also grew up in the era of Don’t Ask, Don’t Tell (DADT), a policy in place between 1993 and 2011 that forced LGBTQIA+ service members to hide their identities. Friends and partners were forced to hide parts of their identity, living in fear of being found out and losing their careers.

It was impossible to ignore that suicide rates among military personnel and veterans were at crisis levels, especially after seeing what serving in the Afghanistan and Iraq wars did to my family and friends who served. Witnessing the post-traumatic stress disorder (PTSD) I saw in my loved ones throughout my life led me to pursue a career in therapy and counseling focused on supporting active service military and veterans.

It was a stark realization when I learned that mental health and suicide rates of LGBTQIA+ service members and veterans were devastatingly high. I saw how DADT turned a person’s queerness — an inherent part of them — into a weapon of judgment and fear that inflicted further trauma.

Now, as I work with queer service members and vets, I see the positive impacts of access to a judgement-free, queer-inclusive space. When they’re supported and give themselves permission to practice authenticity and embrace their queerness, they experience a new, more resilient sense of self.

I’m only one person; broader progress depends on a collective understanding by anyone who cares for or works with LGBTQIA+ veterans or service members to understand their unique risk factors, the barriers they face, and how we can help them thrive.

Addressing the LGBTQIA+ Service Member and Veteran Mental Health Crisis

The systemic stresses of military service inherently elevates suicide risk for veterans and active duty military personnel compared to the general population. This is further exacerbated for LGBTQIA+ individuals who face compounded vulnerabilities — both within military and civilian contexts — because of their sexual orientation and gender identity.

The military environment, often described as traditional, hierarchical, and heteronormative, can create a particularly hostile or isolating space for LGBTQIA+ individuals. For those who served under DADT, their challenges were exacerbated by pervasive experiences of discrimination and harassment.

I encountered so many queer people in the military during DADT, living “undercover,” “stealth,” or “down low.” While my own story of queerness was one of general acceptance, it was still at a time when queer identities were acknowledged, but rarely discussed openly.

Serving under a formalized policy like DADT bred pervasive fear: exposure, scrutiny, expulsion, dehumanization. Knowing loved ones who served, I wondered: if they were in this situation, how would they react? How would they treat their queer comrades? That fear didn't vanish with DADT’s repeal; the trauma persists. Today's LGBTQIA+ troops still face battles, evident in ongoing attempts to ban transgender service and care.

LGBTQIA+ identity is not synonymous with mental health issues; however, the compounded stressors of military service and societal discrimination create significant risk factors. This leaves the community in dire need of enhanced support.

Research shows that LGBTQIA+ military personnel are more likely to experience depression, anxiety, PTSD, and suicidal ideation compared to their heterosexual peers. A 2014 study by the American Journal of Public Health found that 50% of LGBTQIA+ veterans experience PTSD versus 30% of non-LGBTQIA+ veterans. Moreover, LGBTQIA+ veterans are 1.5 times more likely to die by suicide than their non-LGBTQIA+ counterparts.

Why LGBTQIA+ Veterans and Service Members Face Increased Suicide Risk

Before we can solve a problem, we must understand the root causes. Understanding the range of factors that can contribute to the elevated suicide risk among LGBTQIA+ veterans and service members is essential for effective intervention. Some root causes are:

1. Discrimination and Harassment

LGBTQIA+ service members may face discrimination and harassment from their peers and superiors. This can manifest as verbal abuse, social ostracism, or even physical violence.

The National LGBTQ Task Force’s 2018 report highlights that nearly one in five LGBTQIA+ veterans report experiencing military-based discrimination. This trauma can lead to long-lasting psychological damage, including an increased risk of suicide. Further, a 2017 study in The Journal of Military Medicine found LGBTQIA+ service members report higher rates of emotional distress, but only a small percentage are willing to seek mental health services due to a fear of further discrimination or retaliation.

2. Isolation and Lack of Social Support

Many LGBTQIA+ veterans and service members feel isolated due to their sexual orientation or gender identity. The fear of rejection by family, peers, or military colleagues can lead to a lack of social support, which is a crucial buffer against suicidal ideation.

Social isolation is one of the strongest predictors of suicide among LGBTQIA+ veterans according to 2015 research published in Psychiatric Services. This isolation is particularly concerning during deployments or when stationed in locations with limited access to LGBTQIA+ communities or resources.

3. Internalized Stigma

Internalized homophobia or transphobia can exacerbate mental health issues among LGBTQIA+ veterans and service members. Growing up in environments that may devalue LGBTQIA+ identities can lead individuals to internalize negative stereotypes about themselves.

Within the military, these risks are intensified by the constant fear of exposure, career sabotage, and the broader societal pressure to conform to heteronormative standards. Research shows internalized stigma significantly correlates with depression and suicidal thoughts among veterans.

4. Post-Traumatic Stress Disorder

PTSD is a major risk factor for suicide in all military personnel, but LGBTQIA+ service members may face additional challenges due to the intersection of trauma from military service and discrimination. A JAMA Psychiatry 2016 study notes that LGBTQIA+ individuals with PTSD are at a higher risk of suicide, particularly if they do not feel supported in their efforts to seek care.

Addressing Barriers and Fostering Resilience

Beyond recognizing the unique mental health struggles faced by LGBTQIA+ veterans and service members, we must confront the barriers preventing them from accessing vital mental health services and suicide prevention resources. Common barriers include:

1. Lingering Stigma and Fear of Seeking Help

Despite policy changes like the repeal of DADT, a residual stigma lingers in many military and cultural settings. LGBTQIA+ individuals often fear disclosure will result in discrimination, harassment, or career-ending consequences. As a result, many do not seek mental health support, find it difficult to engage in open conversations about their struggles, or are reluctant to seek help.

Military culture may discourage any service member to seek mental health care through official channels, since having it on their medical records can greatly impact their career. Many lack access to affordable civilian alternatives.

2. Cultural and Institutional Barriers

The military's traditional, hyper-masculine culture often equates mental health needs with weakness, further isolating LGBTQIA+ personnel. As a RAND Corporation report notes, this culture discourages emotional vulnerability, compounding the reluctance to seek help.

3. Systemic Inequities

LGBTQIA+ specific mental health resources remain scarce, particularly those for service members. General suicide prevention programs exist, but most fail to address the complexities of gender identity and the need for culturally competent care. This gap is exacerbated by a lack of LGBTQIA+ inclusive training for mental health professionals within the military and veteran space.

Cultivating Resilience and Preventing Suicide

To combat the suicide crisis among LGBTQIA+ veterans and active duty service members, it’s essential we offer targeted strategies that acknowledge the unique challenges this population faces, while fostering a culture of support and hope. We can accomplish this together by embracing these strategies:

1. Empowering and Training Mental Health Professionals

Mental health professionals within the military require specialized training to address the needs of LGBTQIA+ service members. This includes developing an understanding of gender identity, sexual orientation, and the intersectionality of military trauma, while providing LGBTQIA-affirmative care to reduce stigma and build trust and safety.

2. Creating LGBTQIA+ Inclusive Support Systems

The military must prioritize and promote LGBTQIA+ inclusive policies, including access to tailored mental health services and peer support networks. Programs like Veterans Affairs LGBTQ+ Health Care Program demonstrates the efficacy of specialized care.

3. Fostering Community and Peer Support

Peer support networks are crucial in combating isolation. Creating LGBTQIA+ support groups within military installations provides safe spaces for discussion, allyship, learning coping strategies, and stigma reduction.

As a therapist, I see firsthand how empowering LGBTQIA+ service members to embrace their queerness and immerse themselves into the community benefits their mental health and wellbeing.

4. Driving Public Awareness

The military must launch robust public awareness and educational campaigns promoting suicide prevention, offering resources, and destigmatizing mental healthcare, especially within the LGBTQIA+ community.

Our Duty to Protect Lives

LGBTQIA+ veterans and active duty service members face distinct mental health challenges and risks, amplified by today’s political climate, which has created renewed pressure and scrutiny.

Discrimination, isolation, internalized stigma, and military pressures exacerbate their vulnerability. While progress exists, much more is needed to create a safe and inclusive environment that encourages help-seeking behavior.

Tailored suicide prevention efforts offer hope. Investing in cultural competency, inclusive support systems, and peer support networks reduces mental health struggles and saves lives.

I’ve witnessed the transformative power of empowering queer individuals. When properly supported, LGBTQIA+ people are better able to build confidence, find community, achieve fulfillment, cultivate resilience, and gain coping skills to weather life’s storms. Those of us who work with the community, especially with individuals whose identities intersect with military service, have a duty to ensure they are able to thrive.

About the author

Roland Scheppske

Roland Scheppske was born and raised in Baltimore and has spent his life in the DMV area. After originally attending school for Art and Design, Roland found that his original passion for helping others and love for psychology beat out his interest in the arts. He changed paths and earned his Bachelor's of Science from University of Maryland in Psychology.

He then completed his Master's degree in Clinical Mental Health Counseling at Marymount University and became a Licensed Professional Counselor. He currently practices out of the LGBT+ Counseling Collaborative in the DC area.

Professionally, Roland enjoys working with the greater rainbow of the queer community, but has a special love and interest in working with young adults, the asexual and aromantic communities, queer veterans/service members and their families.

In his free time, Roland loves to traveling, listening to mid-2000’s emo music (it was never a phase, Mom), spending time with his two cats, practicing herbalism (he has training), getting more tattoos (he’s at 24), and co-hosting his therapy podcast “You Seem Fine.”

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