Sexual minority and transgender women experience increased rates of societal discrimination, harassment, and violence. Minority stress theory links these experiences to increased rates of mental illness and substance use disorders in those groups.
For many mental health conditions and substance use disorders, bisexual women are at even higher risk than are lesbians. This is partly attributable to stigmatization of bisexual women in both heterosexual and gay communities.
Family acceptance, social support, and community connectedness have been shown to contribute to resilience in sexual minority and transgender women. Sexual minority and transgender women often avoid mental health and substance abuse treatment because of past or feared negative experiences with clinicians or treatment programs.
Clinicians should not rely on their sexual minority and transgender clients to educate them. Instead, they should seek out education from other sources in order to develop cultural competence in working with such clients.