LGBTQ+ Latinxs Share Their Experiences with Mental Health Services in South Texas

Background and Purpose: Mental health disparities are disproportionately experienced by lesbian, gay, bisexual, trans, queer, and other sexual and gender diverse individuals (LGBTQ+) who are Latinxs. Conservative states like Texas have a prevalence of anti-immigrant and anti-LGBTQ+ legislations that foster hostile social environments and reduce trust in help-seeking. Hence, LGBTQ+ Latinxs living in conservative states like Texas face unique harmful experiences due to homophobia, xenophobia, and other forms of oppression. However, there is a lack of qualitative research that examines the experiences of LGBTQ+ Latinxs with mental health services in this area. Our study heard directly from the LGBTQ+ Latinx community in South Texas about their experiences with mental health services in the region.

Methods: The participants were adults who (1) self-identified as LGBTQ+; (2) self-identified as Latina/x/e, Hispanic, Chicana/x/e; (3) lived in one of the 19 counties in the Rio Grande Valley (RGV)/Lower South Texas region; and, (4) had sought and/or accessed mental health services for themselves in the last 5 years (e.g., mental health case management, outpatient and/or inpatient therapy, psychiatric medication). We utilized purposeful sampling, with information about the study being shared with local community leaders and organizations. Qualitative data collection was done through semi-structured in-depth interviews in English, Spanish, or a combination of both, depending on the participants’ preference. Our research questions were: (1) What are the experiences of LGBTQ+ Latinx individuals with mental health services in South Texas? And (2) What do LGBTQ+ Latinx individuals recommend mental health service systems and providers do to enhance the reach and delivery of mental health services in South Texas? To examine the participants’ experiences, we used the six steps of thematic analysis as delineated by Braun and Clarke (2006) to analyze the interviews in their original language.

Results: In-depth interviews were conducted with 15 participants. The age of the participants ranged from early 20s to early 60s. Their sexual orientation and gender identity varied, including queer and trans participants. Most participants were US-born and carried out interviews in English. Themes constructed from participant interviews included: (1) Telehealth has been helpful for facilitating mental health services during the COVID-19 pandemic but there were barriers with technology, (2) There is a lack of access to mental health information and services in South Texas, (3) The gender and standing of the therapist in the community are important for LGBTQ+ individuals in their process of identifying potential providers, (4) Mental health providers can and have caused harm (e.g., not using correct pronouns), (5) Mental health providers must obtain knowledge about LGBTQ+ communities in South Texas, and (6) Therapy was helpful when the provider was empathic, client-centered, nonjudgmental, and considered the whole personhood of clients.

Conclusions and Implications: LGBTQ+ Latinx individuals’ mental health in the South Texas region is already impacted by structural racism, cultural values, gender identity and expression stigma, and religious discourses. Our study shows that mental health clinicians in South Texas must learn about and engage in affirming services that do not further harm LGBTQ+ Latinx individuals in the region.