The International Day Against Homophobia, Biphobia and Transphobia was this week.

Karl Lötter works for the Department of Work and Pensions. He writes about his own mental health and his experience of getting mental healthcare as an LGBT person.


The International Day Against Homophobia, Biphobia and Transphobia, is an opportunity to raise an awareness of the rights and issues faced by LGBT* people.

It is an opportunity to develop the knowledge, education, values and skills in others. This is not only to manage conflict, but to achieve acceptance through understanding, irrespective of one’s sex, gender (identity, expression or reassignment), race (or ethnicity), age, sexual orientation (or identity), disability, or other personal characteristic or status.

The theme of this year’s IDAHOT is mental health and wellbeing, so I thought I might share something personal about me as an example of what many can and do face in accessing suitable mental health care. If we are unable to bring our whole selves to diagnosis or treatment, then how effective is either likely to be?

As a survivor of childhood trauma, I have since lived with Posttraumatic Stress Disorder (PTSD) and Borderline Personality Disorder (BPD) – these are mental health disabilities. The effects of which are negative, substantial and long-term, influencing every aspect of how I interact with the world and people around me.

I have had considerable contact with those in the mental health profession, in two different countries, and often as a result of debilitating depression and anxiety, nervous breakdowns or failed suicide attempts. These were often triggered by perceived danger, personal circumstances, my interactions with others, and importantly, suppressing my sexuality in every sphere of my life.

I was not able to articulate my sexuality in an informed way. Although desperate for support, attempts to disclose or discuss my sexuality (or gender identity) as part of initial diagnosis or treatment were disregarded and prevented. Disclosure clearly caused discomfort in those undertaking assessment and support, and clearly damaged trust and openness.

When I started to question my gender identity, I sought the support of a workplace psychologist whose response was to ‘stop being ridiculous’. Later, while attending an outpatient programme, I was told that my sexuality and gender identity were irrelevant to both diagnosis and treatment.

Contact with the profession had instead fuelled the belief to suppress rather than express myself, to cover and conceal, ignoring what I was experiencing, and fail to seek out or demand the right support. Those I came into contact with were incapable of seeing the relevance of sexuality and gender identity on mental health, or the risks associated with these not being taken into account.

After all of these years I have still not had the chance to explore issues of my sexuality or gender with a mental health professional, or to factually determine how these have or could affect my disorders. I no longer feel I need to. My sexuality and gender are neither a cause nor result of my disorders, but they are a factor in how I experience them.

Now, when coming into contact with any profession, I clarify this experience to ensure that, where relevant, my sexuality and gender are included in the conversation, and focused on as needed. I aim to provide context, educate and highlight the importance of these personal characteristics in every aspect of my life.

Phobia is an extreme or irrational fear of or aversion to something. It underpins prejudice and discrimination, and leads to bullying and harassment. It can result in denying the existence of other sexualities and genders, making people who identify in different ways invisible, excluding, marginalising and stereotyping them. It impacts upon mental health and inhibits access to care.

Although great progress has been made in recent years in embracing diversity, including within the Civil Service, there is still more that needs to be done.

We all need to set aside our fears and prejudices. We all need to look at the whole person, and the circumstances in which they find themselves. Mental health and wellbeing is not just of the mind, but of the whole person, their circumstances and their experience.


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