Spirituality, Coping, and LGBTQ+ Pride

“If God is perfect, why am I in the wrong body?” a transgender patient recently asked a hospital chaplain I know. It was late one Saturday night, and the chaplain was unsure how to respond. The patient had been raised Catholic and still had strong religious beliefs but now felt anguish.

The patient’s statement reflected several major questions, including why someone is transgender, why, ultimately, any of us are the way we are, and what role, if any, God might have in all this.

The chaplain stammered out that God created this patient's soul, which was perfect in God’s eyes, but that in creating a body, “billions of little things happen as cells divide,” and “for some reason, some people’s bodies don’t match what they feel to be their soul, but that luckily, treatment today can help them match.” The patient felt better, though the chaplain remained troubled, feeling that her answer was inadequate and that larger tensions underlay the question.

This chaplain told me about their interaction when I conducted research for my new book, Doctor, Will You Pray for Me?: Medicine Chaplains and Healing the Whole Person, and this LGBTQ+ Pride Month, I have been thinking a lot about their conversation.

Much recent media discussion of LGBTQ+ issues has focused to a considerable extent on laws against LGBTQ+ and especially transgender individuals. In 2023 alone, state legislators introduced over 220 bills undermining transgender and non-binary individuals’ rights and well-being, with more than 70 bills enacted, including restrictions on gender-affirming care, deeming such treatment “child abuse.” Thus far this year, 10 more states have passed such bills, and though the number of new such laws is less than last year, about half of all states now have such legislation.

But this population faces a far broader array of other challenges as well. These laws cause many problems, fueling stigma and discrimination that foster psychological, spiritual, existential, and religious challenges that also require attention.

Discrimination and stigma contribute to mental health problems. The LGBTQ+ population is two to three times more likely to have depression than the general population, and transgender individuals have even higher rates (almost half), with youth in this group committing suicide at three times the rate of their heterosexual counterparts.

We all confront fundamental human quandaries about our lives and seek and need sources of meaning, hope, purpose, and connection. Failure to find these may also contribute to anxiety and despair.

For millennia, spirituality and religion have helped billions of people find answers and cope, partly by providing social and psychological support. Yet while numerous religious institutions increasingly welcome LGBTQ+ individuals, others remain wary, and many members of the LGBTQ+ community have felt rejected or unwelcome by various religious and other institutions.

Nevertheless, spirituality is important to most LGBTQ+ individuals. In 2014, 55% of LGBTQ+ adults, as well as 56% of heterosexuals, thought about the meaning and purpose of life at least once a week, and 54% of gays, lesbians, and bisexuals “felt a deep sense of spiritual peace and well-being.” The majority of LGBTQ+ individuals (77%) believe in God, and 38% pray daily.

This LGBTQ+ Pride Month offers an important opportunity to recognize how these individuals have important religious, spiritual, existential, and other psychological needs, with which we can often assist. Many of us are members of religious, spiritual, and other institutions that could potentially be more accepting and that we can help influence and shape. Currently, millions of heterosexuals do not fully recognize or appreciate these challenges, and thus could potentially encourage changes in attitudes, reaching out, as individuals as well as organizations, to make LGBTQ+ individuals feel as welcome into various organizations and communities as possible.

This transgender patient’s seemingly simple question highlights how LGBTQ+ individuals can struggle in particular ways with fundamental human quandaries that we all confront and that many of us can help address.