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Letters | Hong Kong must see how systemic exclusion hurts LGBTQ mental health

Readers discuss structural factors impacting the LGBTQ community, marriage equality, and road safety

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Disparities in LGBTQ+ mental health stem partially from minority stress. Photo: Antony Dickson
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In our clinic rooms, people often tell us they feel alone or that they can’t be themselves. For many in Hong Kong’s LGBTQ+ community, this is an unfortunate everyday reality. Discrimination and marginalisation remain woven into daily life, sometimes in the form of isolation or microaggressions, sometimes through systems and structures, and often simply as the quiet fear of being authentic. All these experiences – overt or subtle – are consequential.
According to a 2024 survey by the Chinese University of Hong Kong and the Society of True Light, 30 per cent of the LGBTQ+ community report moderate to severe depression, and a quarter live with anxiety. These rates have shown little improvement in recent years and are higher than those of the general population. Among transgender people, the figures are especially alarming: according to another survey, 67 per cent of respondents have considered suicide, and about one in five have tried it.
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Disparities in LGBTQ+ mental health stem partially from minority stress: stress experienced due to the stigma, discrimination and exclusion felt deeply by minority communities. When social stigma related to identity converges with mental health stigma, double stigma emerges, making it even more difficult for individuals to seek and receive timely support. Othering – the experience of being treated as fundamentally different – further isolates people from their communities. Together, these interconnected phenomena dovetail to create an environment where exclusion is felt at every turn, taking a measurable toll on mental health.

While recent advances in mental healthcare locally are commendable, no amount of treatment can fully compensate for structural factors harming mental health. Places that have fostered inclusion by enacting systemic changes supporting same-sex partnerships have seen mental health outcomes improve, often closing much of the health gap.

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If we are to support the mental health of Hong Kong’s LGBTQ+ community, we must look beyond individual symptoms and address the social environment. The mental health of LGBTQ+ individuals is shaped by systemic factors – social exclusion, discrimination and institutional barriers – that impose persistent and disproportionate challenges.

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