Gender identity in the Black community presents unique matters of consideration. As both a personal and clinical perspective,* this article addresses the ways anti-LGBTQ+ bias creates barriers to the spectrum of Black identity, as well as intra-cultural divide, which furthers the system of capitalist white supremacy. The author gives special attention to the impact on our youth – who represent the highest risk – and poses a path forward.

The Simple Complexity of Humanity and Its Flawed Framework

Around the 18th century, “political and intellectual leaders began publicly to assert that Africans were naturally inferior and that they were indeed best suited for slavery.”1 The US Constitution extended this premise by valuing enslaved Africans at three-fifths of a person, an assertion that has never been corrected. Even post-emancipation, this determination continues as the bedrock of how Black people are viewed, compensated, and related to in American society. Black people continue to live under a narrow frame – that of a white, cis-gendered heterosexual male – too small to fit the many. This frame reinforces the narrative that Black people are not only inferior, but not human, and therefore due to that identity alone, not entitled to the basic needs of other human beings.

This revocation of a Black person’s full humanity has not only limited the ways that their experiences can be seen but also impacted their internal view of self. For Black people, knowing that society views us this way, and has maintained systems that reinforce that view, weighs on our psyche. This inescapable atmosphere can lead to low self-esteem, feelings of worthlessness, and pervasive fatigue from fighting to be seen as whole. Intersectionality, a framework first defined and expounded upon by Kimberle Crenshaw, recognizes and considers a person’s overlapping identities, including their race, gender, and sexuality, allowing others to see their position in society and resultant needs.2 It invites viewing of others as complex beings, instead of seeing them the same.

How society constructs race and gender are similar. Across the African Diaspora, Black people have witnessed hundreds of years of the impact of racism and stringent gender norms. According to Majied, Black people have been assigned sexual distortions dating back to the colonial era, where Black men were viewed as rapists and sexually aggressive, while Black women were viewed as promiscuous, and lacking in morals, cattle for sexual exploitation.3 In sum, Black people were viewed as dangerous and inhuman, and therefore are less likely to be helped and regarded, and most often punished.

Today, we can see the ways the construct of gender mirrors the construct of race, as both serve as a social contract to create a linear hierarchy of superior and less than. Both create a category of inhuman humans. Both are part of the lens of the ways Black people are viewed and treated, and all too often, how Black people view themselves.4

Beyond Binary Gender Constructs

Gender is one of humanity’s earliest social constructs. Children have awareness of gender norms along the binary between 18 and 24 months and recognize their own gender by about 3 years of age.5 While there is a tendency to conflate one’s gender identity – especially one’s gender expression – with sexual orientation when speaking about gender identity, we are speaking to an internal sense of one’s gender, which falls on a spectrum beyond the binary of male and female. This spectrum differs from sex, defined by the genitalia with which one is born. Gender expression, meanwhile, is typically aligned with societal gender roles – mannerisms, behaviors, interests of a person – typically aligning along the spectrum of “male” or “female.”

Rigid Gender Rules, Toxic Masculinity, and the Black Community

Our society is built on gender discrimination, centering and giving the most power and influence to cisgender males, which perpetuates inequities by forcing rigid gender roles. Although one’s gender does not impact a person’s personality or beliefs, it does impact how others see them and what is expected of them. In utero, the anticipation of placing a gender label along the binary is one of the first constructs imposed on children. Again, this can be limiting to the psyche and create barriers of being as well as barriers in being seen fully.

Rigid gender rules generate toxic masculinity, increasing the risk to other gender identities of facing “violence, stigma and discrimination as a result, including in healthcare settings. Consequently, they [LGBTQ+] are at higher risk of HIV and mental health problems, including suicide.”6 According to the WHO, this discrimination also makes women more susceptible to gender-based violence, and historically, there has not been protection for Black women victims of sexual assault or rape. With added divergent identity comes increased risk for being a victim of police brutality and murder (especially for Black transgender women), inequities in the criminal justice system, homelessness, economic insecurity, and underrepresentation in all fields.

While these risks impact Black transgender women significantly, they have impact on all genders. For example, stringent norms narrow the emotional range of expression for those with masculine identity by inhibiting willingness to seek care and encouraging behaviors that perpetuate violence and self-harm.

The Gender Spectrum is Black

How quickly we forget that many Black cultures have their roots in different gender expressions, identity, and attraction! Many different cultures have long documented same-sex interactions and gender-expansive traditions. For example, in Nigeria, the Yan Daudu were individuals assigned male at birth who dressed in traditionally feminine garb and were accepted in northern Muslim regions. In 1640, the Dutch military met Ana Nzinga in what is present-day Angola, who had succeeded her brother as the ngola, or “King,” and dressed in king’s garments and was referred to as King. In Southern Ethiopia, the Maale people documented a small group of men protected by the king who carried out traditionally feminine roles and tasks and who had sexual relationships with men.

The above list is by no means exhaustive, but it demonstrates a spectrum of behavior and identity. We are so accustomed to the apparent cognitive ease of working along a binary that we do not recognize the ways this view contributes heavily to othering, to planting the seeds of legitimizing violence or exclusion of rights.

Spaces in the Diaspora are working to re-establish the normalcy of the fluidity of identity. In 2018, a judge in Trinidad and Tobago ruled the nation’s colonial-era laws banning sex between two persons of the same gender was unconstitutional. This ruling set a precedent for similar advances in many other Caribbean nations. Barbados Prime Minister Mia Amor Mottley has made supportive statements toward the LGBTQ community. South Africa is leading in legalizing same-sex marriage and adoption. These are truly wins, but they are few and far between when so many in Black diaspora reside in spaces where being LGBTQ is criminalized or punishable by death. Such penalties have been enacted, in large part, by religions imposed during colonization.

Mental Health and the Cost of Being a Black LGBTQ+ Youth

According to the Trevor Project’s National Survey on LGBTQ Youth Mental Health 2020, among Black transgender and nonbinary youth:7

  • 59% reported thoughts of suicide in the last 12 months
  • 70% reported anxiety in the last two weeks
  • 71% reported symptoms of major depressive disorder
  • 61% reported self-harm

The same survey found almost 50% of LGBTQ youth sought care but were unable to access it in the last 12 months.7

The Trevor Project also found 9% of the Black LGBTQ youth surveyed underwent conversion therapy – 82% of them before age 18. Conversion therapy is a practice made by licensed professionals or religious leaders to alter sexual behaviors and attractions, gender identity, or expression. More than 50% of the youth were cajoled into the practice by someone they knew (34% were parents or caregivers) members despite evidence showing it causes a 50% increase in suicide attempts.7 In fact, research has demonstrated that when a Black LGBTQ+ youth has one supportive person in their lives, suicide rates are mitigated.8 There is tremendous power in the presence of one person.

A Way Forward For Black LGBTQ+ Individuals: From Expanding Definitions to Disrupting Demarcations

If we as mental health clinicians can broaden even our definitions wide enough, we can free ourselves from the wretchedness of capitalistic white supremacy, which supports the continued positioning of some over others in our society. We have a tremendous amount of power in fashioning something better, if only we can tolerate the temporary discomfort of understanding and re-establishing our roles and how we might wield power.

First, we need to expand our thoughts beyond the rigidity of the binary, and nature is a great teacher. For example, the tomato plant can be any or multiple sexes. On the chimera butterfly, each wing is different. Perhaps here we can see the spectrums that are natural to our existence. If Nature holds the fullness of being, identification, and interrelation, then why not humans, made of the same elements?

Second, we must recognize that the lives of Black LGBTQ+ persons are not a monolith, and that their many layers of identity need be considered to address barriers to accessing mental health care and recovery. The layer of racial discrimination alone heightens already complicated risk factors.

Third, as providers of care, we need to adjust our lenses to see the unique needs of those we treat. There are many misconceptions, particularly of those who are nonbinary – such as the assumption they are confused about their gender identity, or that all transgender people are nonbinary, or that being nonbinary is the same as being intersex. Using the gift of story is an effective platform to dissolve misconceptions held about those who identify as gender diverse, a means of turning the lens onto ourselves. Education and hearing personal narrative can forge the path of acceptance.

Finally, we must understand that archaic demarcations between mind and body create a rupture in generating acceptance of whole humans in need of health and wellbeing. Disrupting that notion means we must understand all matters impacting an individual’s health. Even in – and especially in – the clinical setting, we must keep in mind that society is normed for cisgender people. In this way, they never have to legitimatize or prove their gender. They do not have to prove their need for care, equity, or justice. However, Black LGBTQ+ people outside these norms must constantly demonstrate multilayered proof, from their gender identity, that supports everything from their choice of clothing to their very humanity. This way of ‘living’ is exhausting and impacts not only mental health but physical and spiritual health. On a wider scale, these narrow views are fragile and unstable – and society as a whole suffers from sustaining them.

*A Word from the Author

This perspective is written by a queer, nonbinary, first-generation, able-bodied, Afro-Caribbean, practicing psychologist who has treated and suffered from mental illness. More specifically, this perspective centers cultural identities of Trinidad and Haiti, my Roman Catholic upbringing, and continued practice in indigenous epistemologies and pedagogies. Understanding and discussing race and gender from every possible perspective would take hundreds of pages. Yet, my position in society as a clinician and teacher encourages me to maintain a beginner’s mindset, one that honors the wisdom and skills gained by practice with a sense of awe, because it offers the opportunity for both flexibility and continued learning.

For, where there is the tension of the unknown, there is the opportunity for change.

Where there is the opportunity for change, there is growth,

and where there is growth, well, there is capacity to hold infinite possibility.

What wonders could happen if we were to allow for it!


More from this collection on vicarious racism, racial targeting in psychiatry, and disability justice in the BIPOC community; plus, a message from our guest editors.

Last Updated: Jul 28, 2021