In the past twenty years there has been positive sociological shift toward a greater public understanding and acceptance of LGBTQ identities. Yet the reality for many LGBTQ youths is not all rainbows. Research suggests LGBTQ youth are more prone to compromised mental health and self-destructive behaviors than their cisgender, straight peers.

A colleague and I, both queer women, recently embarked on a journalistic narrative podcast to find out why queer people, particularly those with intersecting marginalized identities, are disproportionately affected by mental illness. We found that stigma-related stress, which encompasses fear of rejection, hostile social environments, and internalized homophobia puts LGBTQ folks at a higher risk for mental illness. Furthermore, many health care providers—players in a $3 trillion dollar industry—often fail to provide adequate and informed care for LGBTQ individuals.

We’ve spoken to individuals on both sides of the table—researchers at the National LGBT Health Education Center who specialize in the subject, and LGBTQ individuals who have lived these experiences. What we found from both groups was an overwhelming desire to simply be heard on a subject that is often overlooked and stigmatized. LGBTQ individuals who participated in our podcast recounted numerous experiences of dismissal and erasure by the health care providers from whom they sought counsel. And the experts at the National LGBT Health Education Center, many of whom devote their lives to LGBTQ health, expressed a desire to change the way LGBTQ health is discussed in the medical field.

In a temporal context where LGBTQ Pride is increasingly prominent, stigma-related stress is still profoundly impacting individuals in the queer community. The solution to these issues is extremely hard to pin down, but should begin with increased social and institutional acceptance of LGBTQ identities.

The first step in this process may be to identify and change the way stigma-related stress impacts the queer community. We must delve into the structure of social institutions that impact the development of queer youth—our public education system, religious institutions, and health care providers to name a few—and demand inclusivity and acceptance.