Work is usually a place of id and belonging, however it may also be a supply of stress that undermines psychological well being, particularly when the office tradition is unsupportive or hostile.
For LGBTQ+ staff, there are further threat elements, together with experiences of exclusion, stigma, and discrimination that proceed to form each day working lives. Nationwide surveys present that almost 40% of LGBTQ+ staff within the UK nonetheless disguise their id at work for concern of detrimental penalties (Stonewall, 2025), whereas 4 in ten report experiencing office battle reminiscent of humiliation, verbal abuse, or discrimination (CIPD, 2021).
Trans staff are notably deprived, with over half reporting harassment and fewer than half describing their office as inclusive (LGBT Well being & Wellbeing, 2021). Current UK experiences spotlight persistent limitations to LGBTQ+ profession development, from bias in hiring and promotion to a scarcity of seen function fashions (The Satisfaction and Management Report, 2025).
Whereas these nationwide surveys present worthwhile insights into office experiences, educational analysis affords one other perspective by inspecting psychological well being outcomes in a extra systematic manner. Tomic et al. (2025) got down to assessment the out there quantitative proof on LGBTQ+ staff’ psychological well being, mapping what’s presently recognized and figuring out the place additional analysis is required.
Nationwide surveys spotlight ongoing limitations for LGBTQ+ staff, however what does worldwide analysis proof present about their psychological well being?
Strategies
The authors consulted with a bunch of LGBTQ+ people on the conceptualisation stage after which carried out a preregistered PRISMA-compliant systematic assessment. They searched 5 main databases from 2000–2024 for quantitative or mixed-methods research that reported psychological well being outcomes amongst LGBTQ+ staff.
The inclusion standards have been pretty strict: research needed to deal with staff and report ICD-10 psychological well being situations reminiscent of despair, anxiousness, PTSD, or suicidality and needed to be revealed within the English language. Research that included college students or army personnel, in addition to qualitative research, commentaries, or measures of office wellbeing that didn’t map onto psychiatric diagnoses (e.g. burnout, job stress) have been excluded. The standard of included research was assessed utilizing the Joanna Briggs Institute (JBI) essential appraisal instruments.
The authors systematically searched the literature between 2000-2024 to determine English-language research of psychological well being outcomes amongst LGBTQ+ staff.
Outcomes
Who was studied?
The assessment included 32 research from 33 papers with a complete of 8,369 LGBTQ+ staff. Nearly all have been cross-sectional, and over a 3rd targeted on intercourse employees. The remaining have been unfold thinly throughout occupations reminiscent of healthcare, instructing, farming, emergency providers, and veterinary follow.
What psychological well being issues have been studied?
Despair and anxiousness have been probably the most generally measured outcomes, with prevalence estimates various extensively relying on the research (24–87% for despair; 0–80% for anxiousness). Suicidality was one other constant concern, with particularly excessive charges amongst emergency service staff and veterinary professionals. Different situations, together with alcohol and substance use, PTSD, and consuming problems, have been reported much less usually.
What elements have been linked to threat?
The assessment highlighted office heterosexism, job stress, internalised stigma, and low supervisor assist as contributors to poor psychological well being. Few research explored protecting elements, however those who did recommended that stronger assist networks might buffer threat.
What comparisons the place made?
Out of the 32 research included within the assessment, solely 16 really in contrast LGBTQ+ staff with heterosexual or cisgender colleagues, or with different subgroups. The place comparisons have been made, the sample was usually constant: LGBTQ+ staff tended to report worse outcomes. For instance, a big US survey discovered that LGBTQ+ staff have been virtually twice extra probably than heterosexual staff to report despair and anxiousness.
In Australia, LGBQ+ emergency service personnel have been practically six instances extra prone to try suicide than their heterosexual colleagues. Within the UK, junior docs who recognized as LGB have been additionally at higher threat of suicidality than their heterosexual colleagues. In contrast, some subgroup comparisons inside LGBTQ+ staff, reminiscent of variations between lesbian and homosexual {couples}, or between intercourse staff and non–intercourse staff produced extra blended outcomes that can’t result in particular conclusions.
Worrying outcomes emerged, with LGBTQ+ despair starting from 24–87%. The place comparisons have been made, LGBTQ+ staff reported poorer psychological well being.
Conclusions
The assessment recognized a restricted variety of research that confirmed worrying outcomes on the subject of the self-reported psychological well being of LGBTQ+ staff, suggesting elevated threat of despair, anxiousness, alcohol use and suicidality amongst LGBTQ+staff, in comparison with non-LGBTQ+ staff.
Strengths and limitations
The authors spotlight a number of strengths of their assessment. The work was prospectively registered on PROSPERO and carried out in keeping with PRISMA tips, which helps to make sure methodological transparency and minimise bias.
Importantly, the staff made an try to seek the advice of with LGBTQ+ people on the conceptualisation stage, which is a optimistic step in the direction of grounding the assessment in neighborhood views and making certain that terminology and scope have been acceptable; although extra element may have been offered on how this public involvement helped share the design of the research. Whereas session with LGBTQ+ stakeholders was restricted to the early levels, the willingness to embed co-design components in any respect continues to be notable in a discipline the place such practices are not often tried.
The authors acknowledge a number of limitations. First the findings have been summarised narratively, which limits the power of the conclusions. Additionally they notice that the vast majority of research have been cross-sectional, offering solely a snapshot of the prevalence or comparisons, limiting our capacity to attract doubtlessly causal inferences.
One other limitation is the uneven deal with occupational teams, with a big proportion of research inspecting intercourse staff and solely a small quantity on different professions reminiscent of healthcare, training, or emergency providers. Lastly, the authors spotlight that excluding army populations, whereas methodologically justified, leaves out an vital occupational group the place psychological well being dangers are recognized to be excessive.
You will need to spotlight that the assessment additionally displays the truth that analysis on this space continues to be at a really early stage. Solely half of the included research supplied any comparability with heterosexual or cisgender staff, which makes it arduous to quantify the dimensions of the disparity. Even amongst these with comparators, the proof is unfold thinly throughout nations and occupations.
We can not but say whether or not the upper dangers noticed in, for instance, US healthcare staff or Australian emergency providers workers would look the identical in different settings. The restriction to English-language research provides one other layer of uncertainty, particularly since most of the nations the place same-sex relationships are criminalised – and the place dangers to LGBTQ+ staff could also be even higher – are absent from the proof base.
Taken collectively, these limitations remind us that that is an rising proof base: the findings are vital and regarding, however they’re greatest understood as the beginning of a analysis agenda.
The assessment was nicely carried out and designed with some LGBTQ+ neighborhood enter, however there have been important gaps within the distribution of occupational populations and geographic areas studied, suggesting the proof base stays underdeveloped.
Implications for analysis and follow
Solely half of the included research in contrast LGBTQ+ staff with heterosexual or cisgender colleagues, and most have been small, cross-sectional, and concentrated in sure teams reminiscent of intercourse staff. With out constant comparisons, prevalence figures lack context so future analysis ought to intention to ascertain the dimensions of disparities extra systematically.
As captured by Talen Wright within the 2021 Psychological Elf Weblog, microaggressions amongst trans individuals can critically hurt psychological well being. Future office research ought to seize these day-to-day stressors alongside medical diagnoses and self-reported psychological well being outcomes.
Early session with LGBTQ+ stakeholders must grow to be the norm, however stays skinny on the bottom, with latest criticisms being levelled at UK analysis and experiences that ostensibly have an effect on LGBTQ+ communities themselves, e.g. the Cass Report (Noone et al, 2025). Meaningfully co-designed analysis will assist be sure that analysis questions and outcomes mirror actual office considerations, not simply medical classes.
Though the proof base is uneven, the proof up to now signifies a transparent want for motion at work: strengthening anti-discrimination insurance policies and offering seen managerial assist and focused psychological well being sources for high-risk teams.
Within the UK, whereas there’s a authorized framework in place, together with the Equality Act and enhanced harassment legal guidelines, insurance policies usually fall brief in follow. Many workplaces nonetheless lack express protections or inclusive initiatives. The place structured steerage exists, like from Thoughts, ACAS, or NHS management, it affords robust fashions, however uptake varies extensively.
Coverage doesn’t at all times translate into tradition, follow, or authorized security for LGBTQ+ staff; highlighting actual gaps between what ought to and what actually occurs at work day-to-day. One-off range workshops threat being performative and significant change comes when management accountability, structural insurance policies, and intersectional consciousness are embedded into office tradition.
From the Equality Act to NHS inclusion frameworks, the UK has constructions to assist LGBTQ+ staff, however we have to transfer from coverage on paper to supporting individuals in office follow, particularly when rollbacks of rights are evident.
Assertion of pursuits
I’ve no competing pursuits to declare.
Hyperlinks
Major paper
Tomic, S., Carlucci, M., Baiocco, R., & Fiorillo, A. (2025). Psychological well being of LGBTQ+ staff: A scientific assessment. BMC Psychiatry, 25, 129. https://doi.org/10.1186/s12888-025-06556-2
Different references
Chartered Institute of Personnel and Improvement. (2021). Inclusion at work: Views on LGBT+ working lives. CIPD.
LGBT Well being and Wellbeing. (2021). Trans individuals and work: Survey report (PDF).
Noone C, Southgate A, Ashman A, Quinn É, Comer D, Shrewsbury D, Ashley F, Hartland J, Paschedag J, Gilmore J, Kennedy N, Woolley TE, Heath R, Biskupovic Goulding R, Simpson V, Kiely E, Coll S, White M, Grijseels DM, Ouafik M, McLamore Q. Critically appraising the Cass Report: methodological flaws and unsupported claims. BMC Med Res Methodol. 2025 Could 10;25(1):128. doi: 10.1186/s12874-025-02581-7. PMID: 40348955; PMCID: PMC12065279.
Stonewall. (2025, January). New analysis reveals virtually 40% of LGBTQ+ staff nonetheless disguise their id at work.
The Satisfaction and Management Report. (2025). LGBTQ+ profession limitations within the UK.
