Invisible Wounds: The Hidden Stress LGBTQ Workers Carry
By Deirdre Arato, M.Ed, LPC, NCC
As a therapist who has spent years working with LGBTQ clients, I’ve seen firsthand how employment discrimination quietly affects mental health. Often, the stress isn't obvious to outsiders. There's no dramatic confrontation, no formal report filed. Instead, it's a slow, corrosive process—being overlooked for promotions, excluded from projects, or subtly disrespected in meetings. These moments may not always be recognized as discrimination, but they accumulate and do real damage over time. This is what we refer to as “minority stress”—the emotional toll of navigating a world that isn’t always safe or accepting.
Many LGBTQ clients describe a constant internal dialogue at work: “Can I talk about my weekend?” “Will someone judge my voice, my clothes, my pronouns?” It’s a form of hypervigilance that creates chronic anxiety. For transgender individuals especially, the stakes are even higher. Studies show that nearly half of trans people have experienced employment discrimination. The psychological burden of constantly navigating unsafe or invalidating workplaces can lead to depression, burnout, and even trauma.
And yet, many don’t seek help. That’s one of the most heartbreaking patterns I’ve observed. The reasons are layered. First, there are real structural barriers—many people can’t afford therapy or lack insurance. Even when they can, they often can’t find providers who understand LGBTQ experiences. I’ve heard clients say things like, “I tried therapy once, but they didn’t get it,” or worse, “They made me feel ashamed.” This is especially true for trans and nonbinary clients, who report being misgendered or dismissed in healthcare settings.
Another reason people don’t seek help is internalized stigma. After years of feeling “less than,” many believe they should just push through, or that their stress isn’t “bad enough” to justify support. Others fear they’ll be retraumatized in therapy. Past negative experiences—whether with teachers, doctors, or even family—make it hard to trust new professionals. There’s also the simple exhaustion of having to educate someone about your identity just to get basic care.
So, how do people cope? Many find strength in peer support—trusted friends or chosen family who offer validation and community. Some engage in activism or self-care rituals like meditation and journaling. These practices help, but they don’t always replace professional mental health care. Without access to affirming therapy, people may turn to less healthy coping strategies, like substance use or emotional withdrawal.
From my perspective as a therapist, healing begins when someone finally says, “This is hurting me.” That moment is powerful. But for it to happen, we need systems that welcome them in. That means more LGBTQ-affirming providers, more affordable services, and healthcare spaces that actively show they are safe. Intake forms should include pronouns. Offices should display visible signs of inclusion. Most of all, therapists must be trained in cultural humility and LGBTQ mental health—not just tolerance, but deep understanding.
In the meantime, I often recommend what I call “spa-style self-care” to clients who can’t access therapy yet. These are small, soothing rituals that help reset the nervous system: five minutes of deep breathing, a short guided meditation after a stressful meeting, or simply journaling one thing you love about your identity each day. These aren’t substitutes for therapy, but they are meaningful ways to affirm your worth.
Employment discrimination against LGBTQ people might not always leave visible scars, but the emotional impact is real. If you’re carrying that weight, know that your feelings are valid. You deserve support that honors your identity and your humanity. Seeking help isn’t a weakness—it’s a courageous act of self-preservation. My hope is that more LGBTQ people will find safe paths to healing, not just when the damage is overwhelming, but as soon as they begin to feel those invisible wounds.