Queer communities are more vulnerable to mental health challenges and suicide risks than cis het people, various studies globally and in India show. These risks are heightened because of structural inequities such as social stigma, discrimination, violence, and the lack of affirmative support.
It is against this backdrop that World Suicide Prevention Day—observed the world over on 10 September—takes on a particular significance for queer people. Established in 2003 by the International Association of Suicide Prevention and the World Health Organisation, this day seeks to bring global attention to suicides as a public health issue and emphasise that suicides can be prevented.
To understand the various psychosocial factors that increase mental health challenges and suicide risks among queer folks, queerbeat spoke with Arjun Kapoor, a psychologist and lawyer who serves as co-director and senior research fellow at the Centre for Mental Health Law and Policy (CMHLP) in Pune.
Arjun co-leads several suicide prevention initiatives. These include the Keshav Desiraju India Mental Health Observatory, an open-access database; Outlive, a youth suicide prevention programme; and ENGAGE, which trains secondary and high school teachers to identify and support at-risk adolescents.
Arjun’s work has also focussed on suicide prevention within queer communities in particular. In June 2026, his colleagues and he conducted a training workshop with Sappho For Equality—a Kolkata-based queer feminist organisation—to help participants identify and support queer individuals with suicidal ideation. Earlier this year, he helped organise a national consultation on suicide-related support for LGBTQI+ communities at the Tata Institute of Social Sciences.
In this interview, Arjun spoke about the compounded mental health challenges that marginalised queer folks experience; how changes in law and policies can adversely impact queer communities; and what a multi-pronged approach to suicide prevention could look like.
Could you tell us about mental health and suicide risks within LGBTQI+ communities? How do the intersections of caste, class, or other marginalisations add to this risk?
It is a fact that folks from LGBTQI+ communities are vulnerable to mental health conditions and suicide. It is not inherent to their identities. It is because of the stigma, discrimination, abuse, and lack of acceptance that queer folks experience in their families, social circles, and broader societal context.
In India’s context, a few studies have been conducted with specific groups—for instance, men who have sex with men, lesbians, transgender, and bisexual folks. This content review from 2020 provides a summary of research studies conducted between 2009 to 2019 on the prevalence of mental health conditions among LGBTQIA+ individuals. All these studies have fairly small sample sizes. But they indicate high rates of mental health conditions, suicidal ideation, and suicide attempts in LGBTQ communities. So, that is a consistent finding. A study published in 2021 found that 42 percent of the 282 hijras and kothis interviewed in Karnataka reported suicidal ideation or attempt.
We need more research, more data to understand the extent of the situation and also to understand what the intra-group differences are. For instance, what is the vulnerability for, say, transgender folks as compared to bisexual folks, as compared to lesbian or gay or non-binary folks, and also when it comes to other intersecting identities.
There is some research in the West, specifically in the United States of America. The Trevor Project has done large-scale national surveys, which indicate the impact of intersectionality. They talk about how LGBTQ folks from Black communities, from other ethnic minorities, and from indigenous communities tend to have higher rates of mental health conditions and suicidal ideation and attempts compared to their cis heterosexual peers or LGBTQ peers from the white community.
What psychosocial factors—apart from the ones you have mentioned—contribute to increased risks of suicide among LGBTQ folks?
A lot of this could be understood through the Minority Stress Model, which talks of proximate and distal factors. [The Minority Stress Model is a mental-health framework that explains why marginalised groups face higher incidences of mental health distress].
The distal factors are largely found in your environment—prejudice, discriminatory events, and abuse. The proximate factors are more individualised, but also influenced by external stressors. These could be internalised homophobia, or hypervigilance about the threat of being outed or being disclosed. There’s also this idea of concealment, where you have to constantly hide [your true self].
Proximate and distal factors impact an individual’s general psychological processes, their coping skills, and social connection. This leads to other forms of concern such as hopelessness and helplessness, which can further impact their mental-health conditions, and lead to suicidal ideation, attempts, or self-harm.
Lack of access to healthcare is also a huge issue. I want to make a special mention of those who are transitioning, or those who want to transition and access gender affirming treatments and surgeries. Navigating that space can be costly. Adding to that, access to the right kinds of doctors and health professionals is a huge factor.
In India’s context and across the world, families play a huge role. We know from research that family support and acceptance as well as social support from your immediate peers and communities work as protective factors. When you don’t have family support, you are looking for other forms of emotional support, and often that happens in the form of a romantic relationship. So, relationship issues also tend to cause a lot of pain and distress.
For trans and gender non-conforming folks, navigating public spaces could contribute to stressors. The pressures that come with using a washroom or going through the scanner at the airport are micro-instances that act as distal factors. Over a period of time, these accumulate. It reaches a point for the individual where it begins to take the form of an adverse outcome.
Vulnerability to suicide doesn’t arise because of any one factor. There are always multiple factors at play because suicide is a multifactorial phenomenon.
Have you come across any particular intersecting identities that are more vulnerable to risks of adverse mental health and suicides within India?
I haven’t come across any published evidence or studies with good sample sizes on the impact of how intersectional identities cumulatively impact LGBTQI+ folks and their suicide risk [in India]. There is a lot of anecdotal evidence, lived experience accounts, and narratives among LGBTQ persons belonging to a Dalit, Bahujan, or Adivasi background, or somebody living with HIV/AIDS, or somebody having substance use and addiction problems. Class definitely plays a role.
If you’re coming from a socioeconomically underprivileged class or community, there are other stressors. This could mean discrimination based on any of these identities. It could mean lack of access to basic socio-economic services. There is a lot of discrimination, especially in higher educational institutions. It’s a double kind of discrimination.
For a lot of privileged upper-caste, upper-class folks, your socio-economic standing can actually help you navigate and negotiate the stresses you experience in a far easier manner, as opposed to somebody who doesn’t have access to those privileges.
Trans communities face structural factors that impact their [mental health]. A lot more stigma, lack of access to livelihoods, and large amounts of violence—both from the state, in terms of the police, and from the immediate social context.
The case of HIV becomes more tricky…like a double stigma. First, you belong to the LGBTQI+ community. Second, living with HIV is extremely stigmatised in our communities even now.
The impact of intersectionality is not additive. It’s not like one plus one equals two. It is cumulative. The discrimination tends to be compounded. What happens, say, when an LGBTQI+ person comes from the Northeast to mainland India? We know of the discrimination or racism that they experience. How does that come together when somebody is also navigating their sexual and gender identity?
There are instances of physical and emotional violence within the community too. We also have instances of caste-based discrimination. Across queer groups, we see an implicit bias and discrimination towards people from oppressed castes and communities, like in the choice of partners. There are a lot of biases among cis males against gender non-conforming folks or feminine folks or those who identify as trans feminine. Those complexities have to be looked at in the context of intersectionality and studied, quantitatively and qualitatively.
How do laws and public policies shape the mental health and well-being of queer folks?
Ever since 377 was struck down, there is some palpable shift we’ve seen, at least in urban contexts. There’s now a lot more discussion in popular culture, in films, and in shows. [Section 377 of India’s erstwhile criminal code criminalised same-sex relationships, and was struck down in 2018.]
That’s what law and policy do. It builds the appetite for acceptance. Anti-stigma work can never achieve that by itself . Addressing stigma directly just focuses on an individual’s perceptions and attitudes. It can take years of deconditioning to change that. It will still not change, given how some of these broader ideologies of patriarchy or Brahmanism are embedded in our culture.
It’s only when you build structural solutions that everybody in society slowly begins to orient themselves. What structural changes can do is help regulate behaviour. This is what we’ve learned from the mental health space.
What can change is when you regulate behaviour through anti-discriminatory measures, or you facilitate greater contact between, say, people who have mental health conditions and those who don’t, and then you normalise and naturalise it. The other doesn’t seem like the other anymore.
If you [want] to restructure the collective social consciousness of a society, it is important to put in place measures that can structurally change how we think, perceive, and respond. This often happens through mainstreaming. So, you ensure that people have an equal space in public spaces, workplaces, schools and institutions. At the same time that there is a prevention of any form of discriminatory or prejudicial behaviour.
How do policy rollbacks—such as the Transgender Persons (Protection of Rights) Amendment Act, 2026—and unequal legal or social recognition impact queer mental health and suicide risk?
Fundamentally, what law and policy do is that they give you recognition. Recognition is extremely important for a sense of internal dignity. It is extremely important for one to exercise their sense of autonomy and agency.
Until you are recognised as a legally valid individual in the eyes of the law or society, you will always move around with this sense of internal rupture—that I’m not person enough, or that I’m not equal enough. Often, at the core of that lie feelings of helplessness, hopelessness, and worthlessness. It is a rupture in one’s perceived sense of dignity. This can have profound consequences on one’s emotional and mental health.
Legal recognition has a psychological, material, and legal dimension—and they’re all connected to each other. [With legal recognition] I get a sense that I have been accepted. And then, based on that, I’m able to access entitlements and resources for my sustenance, my survival, to be able to flourish and thrive.
After this amendment happened, we heard from a lot of folks in the community who are working in the mental-health space. The number of calls went up on helplines. We’ve seen distress, uncertainty, and anxiety: Am I going to be persecuted further? What does this mean for my future? Am I going to be subjected to more violence? Are people around me going to not accept me? There’s generally a lot of concern and distress and a sense of insecurity—physical and psychological—about what’s going to happen.
What can help reduce suicide risks among queer folks?
If the factors are multiple for suicide risks among queer folks, then the solutions and the protective factors are also multiple.
We have to look at it at an individual level. The whole thing around resilience as a way of improving the ability of an individual to deal with mental stressors tends to focus on improving a person’s coping skills. But how much can you improve an individual’s coping skills when they’re consistently being bombarded by distal factors in their environment? That’s where the issue of resilience becomes problematic; because the problem is external. Yet, the solution for mental distress is always located within the individual.
So, when we do talk of individual coping skills, one tries to work in the direction of externalisation. If someone is experiencing distress because of their gender or sexual orientation and how people are responding to it, or if they have internalised homophobia, or a sense of worthlessness or hopelessness, then it is about helping them realise that these feelings are being created due to things outside their control. This happens through peer support or from a queer-affirmative mental health professional.
The other bit in terms of solutions is interpersonal. What do we need to do to strengthen peer groups? How do we work with families? We need to work with community leaders who can help mediate between families and LGBTQ folks. There’s a lot of misinformation and they need to be educated. There needs to be more dialogue, but of course not negotiation with abusive families.
Community spaces are also extremely important. But there are individuals with issues around confidentiality and anonymity. So, we need to think of those who find it difficult to come out openly and create spaces of interpersonal support for them; where one doesn’t feel the pressure of having to come out openly and become a part of a group because that can come with its own share of worries. One has to think and design for such differences because the community is extremely heterogeneous.
At a legal-policy level, we need to push for legal recognition of relationships within the LGBTQ community. Not just romantic relationships or marriage—different kinds of relationships. We need to have a legal framework that can also create entitlements, whether financial, housing, succession, or for end-of-life care and other healthcare decisions.
We need to work with health professionals to ensure that healthcare is more LGBTQI+ affirmative. It is often a cause of immense distress for people. We need to work more on this business of doctors who force [queer] people to change their gender orientation or sexual orientation through so-called conversion ‘treatments’.
We have to bring the law down heavily on mental health professionals who are still doing this. We need to have some precedents to ensure that this kind of rubbish is not happening because it is violence and abuse. For instance, we know of Anjana Harish’s case [a queer person from Kerala who died by suicide in 2020, after her family forced her into unscientific and harmful conversion therapy]. This kind of coercive treatment can increase the risk of suicide and self-harm.
What are the challenges that you encounter in intervention work to mitigate the risk of suicide among among queer folks?
It’s so complex with mental health. There’s the family involved. There’s the individual involved. There’s the mental health professional involved. There might be other community folks involved. Sometimes, law enforcement is involved. Each of these stakeholder groups has their own interest. In that whole process, the individual and their autonomy are kind of [forgotten]. Even though the Mental Healthcare Act set out to protect the autonomy and agency of the individual, the realities of how this plays out on an everyday basis are far more complex. When you add the dimension of the LGBTQI+ community to that, it becomes even more complicated.
With suicide prevention, we have to think of interventions that are coordinated and complex because the problem is complex. Say, a person experiencing violence in their natal home leaves the natal home. Their immediate need is shelter, housing, food, basic healthcare, and security. Then, there is a need for social connection. There might be an aspect around legal help. If the police are involved or if families get involved over there, should you go to the courts? There are also the broader issues of rehabilitation and reintegration. A person may require vocational training so that they can then get a job of their choosing.
We have to be able to think of interventions where we’re able to bring all this together in a coordinated way. A person who is experiencing these stressors is dealing with all of these dimensions. We need to think about different models that can work in our context. And again, there might be variations depending on region, language, space, community.
The other thing I also want to highlight is that those who are doing this work, a lot of them are from the [queer] community themselves, and are already experiencing problems in their own lives. There tends to be immense pressure on this caregiver community. I don’t think we’re putting enough focus on their distress. There is an overidentification of one’s own distress with the other person’s, and often, it comes with a huge sense of responsibility. Sometimes it doesn’t work out because people make their decisions despite the care they receive. That can have a huge impact on those who are providing care. That conversation has to be foregrounded when we are talking about suicide prevention in the community.
What can a friend, partner, family member, or community person do to support someone going through suicidal ideation?
The first thing is to be empathetic. Even if you don’t fully understand gender and sexuality, you can still understand that this person is going through an immense amount of distress and needs unconditional, non-judgmental care and support. Be there with the person, listen to them, create a space where they feel comfortable and safe opening up.
In cases of suicide prevention, we do say that it is okay to ask a person if they are thinking about ending their life. This can enable the right kind of support to that person at the right time. It’s a question of creating a space where a person can share this and then of directing them to spaces where they can get further support and care. Knowing helpline numbers or organisations that are supporting LGBTQI+ folks, or maybe even mental health professionals who are queer affirmative is helpful.
Sometimes people might be in a crisis, so you don’t want to leave them alone. You want to ensure that if they might have attempted suicide, they receive medical care immediately. You don’t leave them alone until a trusted adult, natal or chosen family member, or a friend has come there and is supporting them.
There are a lot of tools for safety planning, including this template. It’s an evidence-based tool that a person can use in crisis situations. It has about six steps, things that they can fill in to ensure their safety and security in a crisis.
What can queer community networks and spaces do for effective suicide prevention and to support those at risk?
Queer groups can be first responders. When somebody is in crisis, these groups can be trained in facilitating access to other forms of support, whether it’s healthcare, financial support, shelter, or housing.
Second is to provide space for the person to come and share what they’re going through, so they know they’re not alone, that there are others who’ve gone through and come out of it. We have enough evidence to know that peer support helps build social connection, and that’s a huge protective factor. When you meet somebody who’s gone through what you’ve been through, it gives you an immediate sense of relatability and confidence.
This interview has been edited and condensed for clarity.
Note: If you or someone you know are at risk of suicide, please call a crisis helpline for immediate assistance. Here are some phone numbers and additional resources.
https://outlive.in/get-help-now
http://www.aasra.info/helpline.html