RED DOOR counsellor-in-training Ailis Weir discusses LGBTQ+ mental health issues in Hong Kong and resources to cope
By virtue of its sheer size and population density, Hong Kong can offer some LGBTQ+ individuals a sense of freedom—often via anonymity and by being part of a crowd. But even so, LGBTQ+ people have always felt a need to connect with one another, partly through a sense of survival, but also through shared experiences and bonding. Gay bars, hiking groups, choirs and other social clubs can provide a sense of community and connection with others. However, even in safe environments, it can still be difficult to discuss LGBTQ+ mental health issues in Hong Kong. As is still the case in many places, honest discussions around mental health are still seen as taboo in Hong Kong—whether you are straight or not. So for LGBTQ+ individuals, it can be doubly difficult to have these vulnerable conversations in social settings in Hong Kong, for fear of making people uncomfortable or oversharing.
Being queer in Hong Kong
There are a number of challenges facing the LGBTQ+ community in Hong Kong that can exacerbate mental health issues for individuals. Although there have been recent positive developments in equality—like the recognition of the rights of same-sex couples for their children earlier in 2021, and dependent visas being granted for a same-sex expat couple for the first time in 2018—there’s still a lot of work to be done. Same sex marriage, for example, still seems a long way off.
For transgender people in Hong Kong, gender markers on their IDs and passports can be changed. However, to do that they need to undergo full gender confirmation surgery and be sterilized. This falsely equates gender with genitals, but also means that trans people may have to undergo a surgery they might not want, in order to legally be recognized as their gender. There are many reasons trans people might not want to have the surgery, such as the risk of medical complications, uncertain results and long wait times for appointments. Some may also have medical conditions that mean they are unable to have the surgery, or they may want the option of having children at some point.
Regardless of the reason, the decision does not negate their gender. Unfortunately, this reality can cause a huge amount of anxiety and dysphoria in trans individuals and is a barrier to trans people in general. The current law in Hong Kong requires trans people who don’t want to or can’t have the surgery to decide between their body autonomy or having their gender recognized legally. Even putting legal recognition aside, daily invalidation of one’s gender can cause serious mental health issues for trans and non-binary people.
There are also no anti-discrimination laws against LGBTQ+ people in the workplace. This can cause anxiety and fear among LGBTQ+ people who aren’t sure where their bosses or colleagues stand. In a city like Hong Kong, where work often serves as a source of identity, it can lead people to feel as though they are living a double life. If someone does decide to come out at work, the lack of clear protections can result in mocking, abuse or termination. Living as one’s true selves could result in harassment, disownment from their families and job insecurity.
It’s important to also be aware of the differences for LGBTQ+ expats and LGBTQ+ individuals in the local population, due the intersections of privilege around race and wealth. While international companies may have policies in place that protect LGBTQ+ people, local companies may not.
LGBTQ+ mental health issues
Unfortunately, mental health issues are already very common among members of the LGBTQ+ community in Hong Kong. The issues described above—in addition to harassment, experiences of overt or covert discrimination, fear or threat of violence, family and social rejection—can all have a devastating effect on the mental health of LGBTQ+ individuals. According to Stonewall UK in their 2018 report, half of LGBT people surveyed had experienced depression in the last year, and three out of five had suffered from anxiety in that time. 31% of LGB people and 46% of trans people had considered taking their own life in the last year. One in six said they drank alcohol almost every day, and 10% said they had dealt with some form of substance use issue. Depression, anxiety and substance use issues are more common among LGBTQ+ people, not because they are LGBTQ+, but because of the discrimination they face and how they are treated by society.
There are not enough resources to support LGBTQ+ people in Hong Kong when they struggle with mental health issues. The community needs real, sustained support from people who are understanding, empathetic and aware of current issues and are equipped to help. RED DOOR—a counselling center that offers individual, group and couples counselling in Hong Kong—has recently formed a conversational support group for LGBTQ+ adults that is free to join. RED DOOR is led by Angela Watkins, who has experience working with LGBTQ+ youth.
At RED DOOR, Angela and I wanted to create a space where LGBTQ+ adults can talk about their struggles honestly and openly, without fear of rejection or dismissal. Each week we choose a topic to discuss as a group, allowing individuals to share their experiences and learn from each other. The group provides people with a place to share their feelings and discuss the trials, tribulations, and joyful aspects of being part of the LGBTQ+ community in Hong Kong. Even for those who feel relatively equanimous, participating in groups like this can also help protect existing overall good mental health. Through sharing experiences and points of view, people can learn about how to deal with different situations and find techniques and resources to help them if something comes up later in their lives.
Creating a network of support can make people feel more secure and grounded. It can be liberating just to be heard by others who might have a similar experience. The support group at RED DOOR is a place for LGBTQ+ individuals to vent and feel understood and respected, share coping skills with one another and pick up new strategies for dealing with life’s challenges.
If you’re interested in learning more about this group or would like more information about counselling at RED DOOR, please email [email protected].