Meaningful engagement with LGBTQI+ lived expertise can reduce inequity in mental healthcare

Healthcare must be rebuilt to embed lived experience in design and delivery to tackle the structural homophobia and transphobia that contribute to poorer outcomes among gay and trans people, writes Matthew Jackman Compared with general populations, LGBTQI+ people globally experience increased rates of mental health challenges, including depression, anxiety, post-traumatic stress disorder, self-harm, and suicidal ideation, compounded by inequities in accessing mental healthcare.1 Structural factors such as societal stigma and discrimination produce hostile environments that exacerbate mental health disorders,23 compounded by social exclusion and internalised—that is, self-directed—homophobia and transphobia.1 Recent executive orders from the US president to erase trans and gender diverse communities represent human rights violations.4 Presidential orders to end promotion of diversity, equity, and inclusion have removed protections for LGBTQI+ people, reversing decades of progress.5 Vide

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