The effects of antidepressants on the LGBTQ community
by Nathan Makela; illustration by Britta Lam
Maybe it was being called “fag” every morning during first period gym class of my ninth-grade year. Or maybe it was later, when I came out to my best friend and he told me I was “mislabeling” myself. Or the nickname that caught on that same year—Gaythan Fagela.
The hallways of my high school were filled with people who seemed to know something about me that I hadn’t quite figured out.
The next semester, when I had finally escaped gym class, but was still just as gay, my depression started to catch up with me. My parents sent me to a therapist, and I was first diagnosed with ADD. I was sent to a psychiatrist, who prescribed me Adderall, which only made my depression and anxiety worse.
A few months later, I found a new therapist, who quickly diagnosed me with depression. Over the next year, I was prescribed five different antidepressants, all Selective Serotonin Reuptake Inhibitors (SSRIs).
SSRIs are the most commonly prescribed antidepressant in the country, and are most often prescribed by personal care providers, not actual mental health professionals. One of the most commonly reported side effects of SSRIs are sexual complications, including reduced sex drive, inability to achieve orgasm and erectile dysfunction. And for individuals struggling with their sexuality, SSRIs can work to solve one problem, while making another even more difficult.
So when personal care providers quickly prescribe antidepressants to LGBTQ individuals, without discussing sexuality, the root of the problem can be ignored, and sexual confusion can often ensue.
I first started grappling with this idea when I went off my own antidepressants a few months ago. After steadily taking SSRIs for six years, I was still struggling with side effects and, after consulting my psychiatrist, made the decision to wean off. A few weeks after I stopped my medication, I realized that it was completely changing how I was experiencing my sexuality.
My relationship between my depression and my sexuality has been both inextricable and inevitable, particularly in the way my depression has been treated and how that treatment has affected my sexuality. And for me, SSRIs only made the struggle with my sexuality even more confusing. I spent months of my high school career grappling with confusing and frightening sexual side effects from medication, all while keeping my sexuality a secret.
Depression for LBGTQ individuals can often be a response to their situational environment (e.g. a town, city, state or country where there is still prevalent homophobia). There is both biological and situational depression, but with such high rates of depression in the LGBTQ community (LGBTQ individuals are almost three times more likely than the average population to experience depression or generalized anxiety disorder), the environment these individuals grow up in must hold a large portion of the blame.
When the solution to situational depression in these circumstances is medication, it’s almost like the queer individual is being blamed for the situation. Situational depression by LGBTQ individuals is often caused by questioning sexuality. So if antidepressants are preventing an individual from finding their sexual identity, the situation is unlikely to improve.
How is prescribing medication that subdues libido and sexual ability—sexual expression and their sexual identity—going to remedy the problem for LGBTQ individuals? If the depression stems often from sexual confusion, medication that further complicates sexuality can be working against the end goal of stronger mental health. Personally, medication ledme to a kind of purgatory, in which my antidepressants led me to further repress and ignore my sexuality, while my stifled sexuality was really the biggest factor affecting my mental health in the first place. Medication in the environment I was in led to what I felt was an inescapable situation, and my mental health deteriorated at an alarming rate.
I entered a three-month inpatient wilderness therapy program halfway through my sophomore year of high school, when I was 16 years old. While in the program, I came out to my parents. I consider myself supremely fortunate for those three months, particularly because, for the first time in my life, I was living in an environment in which I could talk about my sexuality without fear. Even the therapists I had back home, while caring, never provided a space where I felt comfortable talking about my sexuality.
Once I returned from the program still continued to take SSRIs every day, and I continued to hide my sexuality from my peers. It took a long time for me to finally come out of the closet and figure out my sexuality.
Now, five years later, I can’t help but wonder to what extent my years of taking antidepressants affected how long it took for me to come out. Though my high school was a painfully homophobic environment, making it hard to come out in general, I spent an inordinate amount of time just struggling with the sexual complications and side effects from my antidepressants. Thinking I couldn’t be the only one who experienced such a frustrating relationship with antidepressants, I asked around.
I talked to one Colorado College junior who only recently began to identify as bisexual. She has experienced depression since the end of elementary school, and has been on and off antidepressants for a number of years.
“So I was attracted to pretty much everyone all the time, and yeah, it’s shitty to be queer, but [once I went on antidepressants] I lost sex drive, and I have to think, what does that mean?”
Her responses were surprisingly honest, and it was clear the topic was something she had thought about before. “I’m still attracted to people, but it’s like I don’t want to be intimate. It just totally makes me doubt or consider if I’m asexual. It’s very displacing and makes me feel fucked up.”
For some LGBTQ individuals, it can take a lifetime to understand their sexuality. When you put antidepressants into the mix, the whole situation becomes a whole lot murkier.
“I was hooking up with a girl last year and I did want to hookup with her, but then my sex drive was so low, I just didn’t know if it was ‘you’re not queer enough to do this,’” she said. “And then when I hookup with men, I still feel like I’m forcing it, so I just doubt my whole attraction to people. . . I’m trying to get back to sex being positive, but I just could never feel that because of the meds that I was on. And it definitely causes you to be way more lost if you can’t even feel okay in your identity, because you don’t even want to have sex with anybody.”
Another Colorado College junior agreed to share her story with me. She identifies as queer or bisexual, and her journey with mental health has been a long one. She said that early on she felt her therapists didn’t create a space in which it was possible to talk about her sexuality.
“[With] my first two therapists, I never even mentioned I was queer,” she said. “And it wasn’t a fault of theirs, an oppressive fault of theirs, rather [that] they kind of just went into it assuming. And I don’t think I was comfortable yet standing against the norm.”
And for LGBTQ youth questioning their sexuality, the burden of challenging the norm shouldn’t be on the person attending the therapy appointment. When she was later prescribed antidepressants, her sexuality became an even more confusing concept.
“Once I start taking higher doses of medication, I can start losing my sex drive, and I don’t know what it is, but it really fucks with my head. It really freaks me out. It makes me scared that I’ll never be intimate with someone. I remember the first time it happened, I was on Prozac, and it happened with Zoloft too, I had to go off them because I couldn’t have orgasms. It was just so scary and unsettling.”
Unfortunately, there isn’t a lot of research about this topic. From my own personal experience and the testimonials I have heard, I see a problem that isn’t being addressed.
For individuals dealing with the often inescapable connection between queerness and depression, antidepressants offer an easy potential solution to a complex problem. With such high rates of depression within the LGBTQ community, the answer here isn’t immediately prescribing medication to treat situational depression, but to offer alternative services to help LGBTQ youth deal with the exhausting process of coming to terms with their sexuality. However, there is no precedent for asking minors about their sexuality unless there is a female minor at risk of pregnancy once she begins menstruating. Personal care providers and mental health professionals simply don’t ask these questions unless suspicions are raided that said symptoms are related to sex or sexual expression.
For queer individuals experiencing situational depression, growing up in homophobic environments, medication can be counterproductive to actually reaching a place of sexual confidence and mental wellbeing.
Over two months have passed since I went off my antidepressants, and I’m continuing to realize that many of my problems with sex and intimacy were perpetuated by the medication I was taking. For me, depression is something I am going to have to live with for the rest of my life. But I’m learning I can live with the symptoms of my depression without medication, and for the first time in six years, truly experience my sexuality uninhibited by side effects.
Part of the Toxic issue