LGBTQ+ Needs Assessment: Stresses mount in Ohio as youth bullying, hateful legislation increase

by Tyler Stimpert

Living openly and authentically as an LGBTQ+ person inevitably means navigating a landscape filled with both progress and persistent struggle. This year alone, more than 500 anti-LGBTQ+ bills have been introduced across the U.S., including seven in Ohio, according to the American Civil Liberties Union. These bills create a reality in which LGBTQ+ identities are often challenged, invalidated or directly threatened. Add to that the lasting effects of pandemic loneliness, and it becomes pretty obvious why LGBTQ+ people are stressed and unsurprisingly, their coping mechanisms kick in.

Addiction, for our community, is bound up with societal expectations and the pressures of growing up in a world built for cisgender, heterosexual people, with little to no consideration for the queer vantage point. Substance use often begins during early teen years for LGBTQ+ youth: around the same time as when many are first exploring their identities. 

According to the Greater Cleveland LGBTQ+ Community Needs Assessment – a Kent State University-sponsored study that collects information through surveys, interviews and focus groups for future decision making – an alarming 100% of 59 LGBTQ+ youth surveyed reported bullying because of their identity. The relentless impulse to “fit in” often forces LGBTQ+ individuals into a double life—masking parts of themselves to avoid judgment and rejection. As Alan Downs explains in one of my favorite and most recommended books, The Velvet Rage, LGBTQ+ people often carry a deep sense of shame, “instilled by a society that, consciously or not, values [heteronormativity].” This results in many queer people feeling like they don’t quite belong.

The physical toll of this manifests as pervasive stress. As Dr. Arline Geronimus explained during Cleveland Clinic Cancer Institute’s recent Health Equity Symposium, prolonged exposure to discrimination leads to a process she calls “weathering”—a kind of accelerated aging brought on by constant stress. This isn’t just emotional exhaustion; it’s the biological wearing-down from years of enduring prejudice, isolation and rejection. For LGBTQ+ individuals, this stress is piled on top of the recent wave of anti-LGBTQ+ legislation and the lingering effects of pandemic-induced isolation. When you’re carrying this weight day after day, it’s no surprise that many turn to substances in search of relief from a reality that feels unrelenting.

The Community Needs Assessment reveals some hard truths around substance abuse within our community, and also some hard truths about our trust in healthcare. Among 234 individuals surveyed with a history of substance use, almost 80% have been diagnosed with or experienced depression, and 64% have been diagnosed with anxiety disorders. Over 60% of these individuals rate their overall mental or behavioral health as fair or poor. Alarmingly, one-third report needing to educate their own medical or mental-health providers about their unique healthcare needs, and more than 25% admit to sometimes delaying care because of concerns related to their LGBTQ+ identity.

Self-esteem emerged as the leading challenge, with 64% of 167 respondents who have faced substance abuse or addiction identifying it as a top issue. This was followed by difficulties with planning for the future and setting goals, reported by 52%. Additionally, experiences of discrimination remain widespread: of 180 respondents, 78% have faced discrimination in public spaces, while 58% have encountered it in the workplace.

For LGBTQ+ individuals, substance abuse is often about survival. With few safe spaces to explore identity and community, no one to trust with the fears they carry, and often no relief from the physical manifestations of chronic stress, substances become an escape route, even if temporary. When addiction treatment programs are rigid and generalized, they fail to meet the lived realities of LGBTQ+ individuals. Culturally competent, LGBTQ+-tailored addiction recovery services are absolutely necessary to provide affirming care that addresses the root causes of addiction instead of simply treating its symptoms.

Comprehensive, wrap-around care that addresses the whole person, including basic needs, is crucial in this space. The report reveals that 18% of LGBTQ+ individuals struggling with substance abuse are currently experiencing housing instability, and 37% have faced it in the past. Housing insecurity is a destabilizing factor that often perpetuates reliance on substances like drugs and alcohol. Imagine trying to focus on recovery without a stable place to sleep, eat or recharge. This instability makes any self-care and recovery feel out of reach for so many.

Substance use and addiction within our community is a deep-rooted social justice issue, exposing significant gaps in care, social isolation and persistent stigma that have endured for decades. The findings of the Greater Cleveland LGBTQ+ Community Needs Assessment remind us that addiction is often a reflection of the structural challenges LGBTQ+ individuals face in environments not built for their lived realities. 

Our community has long shown resilience in the face of adversity, but we must ensure that our support systems genuinely address our unique experiences. At the heart of this issue is the urgent need for systemic change—not only in addiction treatment but throughout healthcare and community support systems. We need to prioritize funding for LGBTQ+-specific addiction and recovery services, creating affirming spaces where individuals can seek help without fear of rejection or hostility. Building networks of belonging—from affirming care to stable housing—demands our collective attention. Only by prioritizing inclusive, competent care can we break the cycle of isolation and provide the recovery pathways that LGBTQ+ individuals deserve. Discover more about these findings and data outcomes by checking out the full report at www.lgbtqohio.org. 🔥

Tyler (Ty) Stimpert is a public health professional and LGBTQ+ advocate based in Cleveland, focused on advancing health equity and cancer prevention. He serves as Community Outreach Program Manager at Cleveland Clinic’s Taussig Cancer Institute and is Board President of B. Riley House. Ty is also a dedicated researcher with the Greater Cleveland LGBTQ+ Community Needs Assessment. His work is grounded in a commitment to dismantling health disparities and building a more inclusive future.

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