Please Note: If you need any support for any of the issues raised within the article, please look at the information on the MIND website here about LGBTIQ+ and mental health.
The paper Queer in Africa LGBTQI Identities, Citizenship, and Activism is a collection of debates about sexuality in the region. These debates show that African sexualities are dynamic, multifaceted, and resilient. However, people with non-heterosexual sexualities and gender-variant identities are often involved in struggles for survival and self-definition which can have adverse effects on their mental health.
Furthermore, the 2018 paper on mental health among lesbian, gay, bisexual, transgender and intersex people in East and Southern Africa expands on this further. Müller and Daskilewicz demonstrated that mental health issues are higher in the LGBTQIA+ community in Kenya and South Africa than among the general population in these countries.
The research, based on studies in Southern and East Africa, disclosed that sexual orientation, gender identity and expression (SOGIE) can lead to structural stigma, prejudice and discrimination which, in turn, can lead to health disparities among LGBTQIA+ populations.
It showed that in Kenya, where laws criminalise same-sex activity, 46% of respondents showed signs of depression, and 55% displayed signs of anxiety. 12% had signs of alcohol dependence, with 7% showing signs of dependence on other drugs. The research also revealed that 22% of the respondents had attempted suicide.
Meanwhile in South Africa, where the constitution offers protection from SOGIE-related discrimination, 57% showed signs of depression, and 66% of partcipants demonstrated signs of anxiety. 12% had signs of alcohol dependence, and a further 5% showed signs of dependence on other drugs. The paper also indicated 27% had attempted suicide in the past year.
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AMAKA spoke to two Black queer therapists working hard in their communities in Zambia and Kenya to create safe spaces where LGBTQIA+ individuals can receive the support and help they need navigating mental health issues.
*Elizabeth Mulenga, who has been working in the mental health sector for four years in Zambia, describes herself as someone who is consumed by the mental health implications in all areas of life and that her passion is what drove her to psychology and thereafter therapy.
She explains that having Black queer therapists to represent the community is integral: “Representation matters. Queer folk generally have so many things on their plate (a big portion of which is often acceptance), that the last thing that anyone should have to consider is whether being completely yourself with your therapist is actually safe.
Queer Black therapists are important because of queer Black people existing and there are certain nuanced aspects that only a queer therapist would get which in turn builds the connection between client and therapist and thus starts the journey towards healing.”
Mulenga tells AMAKA that she sees roughly 20 clients a week (ages 7-45) with up to four of those clients being queer individuals. Her clients discuss various challenges related to family, friends, romantic relationships, grief, domestic violence, community discrimination, and challenges in the workplace.
“Discrimination or homophobia are the most recurring themes amongst my queer clients. It’s usually subtle such as a comment about their clothes at tea break or a comment passed when walking down the street. There are also some coming out stories that are less than kind, where people are less than supportive.”
She explains that homophobia has led to silence amongst LGBTQIA+ community members especially with regards to challenges in certain situations that heterosexual people would not even have to think twice about.
“For example, the optics of spending the night at your lover's [hospital] bedside if they’re ill. Most people don’t have to worry about whether it’s ok or how much they’re safe to emote. Whilst these seem like almost harmless problems, when they come up in sessions you find that people aren’t able to express these concerns or worries because they don’t have the same amount of counsel (as a queer Black person) that other people have and are forced to bottle things up. That has led to cases of depression, anxiety, and even suicidal ideation.”
Mulenga concludes adding that her goal is to always provide safe spaces for the queer community to heal and speak out about their experiences.
“Most people want coping skills. They want to be less depressed and have something to live for. I have seen an improvement in most of my clients. There’s a healing that comes from speaking your mind and feelings in a safe space. Also, the knowledge that the person they’re speaking to is also queer helps with opening up. It speaks a lot to safety.”
"Discrimination or homophobia are the most recurring themes amongst my queer clients"
Relatedly, Lowry Achieng' (a.k.a Jahera) is a licensed psychotherapist, who has been practising for six years, details that it is important to have Black queer therapists who can understand the lived experiences of both Black people and queer people.
“In most cases you find that when a queer person goes to a heterosexual therapist who hasn’t educated themselves about issues which affect queer people, most of the time it turns into an education session where the queer person has to educate the therapist on what they’re going through and they end up not getting the support that they were looking for.
As a Black and queer therapist I have dedicated myself to making sure that all the needs of the queer people who come to me are provided for in therapy. The support, the understanding and unconditional positive regard. I make it my job to make sure that I am constantly educating myself, as much as I may be queer and Black, there are some things that I haven’t experienced so it is my responsibility to ensure that I am informed and can be honest about the kind of care that I can and can’t provide.”
Achieng’ is also an art therapist, certified yoga teacher, and visual artist committed to creating collective care spaces. She has also founded two mental health community projects known as Mental Wellness Initiative Kenya and Self-Care in the Park Festival. The festival was launched in December 2019, and utilises music therapy, art therapy, dance therapy and yoga for trauma and stress relief.
In the past year she has partnered with a number of local organisations in Kenya such as the Queerhive to provide psychotherapy and arts therapy to disadvantaged groups including LQBTQIA+ individuals, Christians, recipients of HIV/AIDS care, and cancer patients.
“What drives me as a therapist is to provide quality and accessible healthcare especially to marginalised groups. When I started my therapy work in 2016, I was providing pro bono services mostly to children. Then in 2018/2019 I partnered with organisations that gave pro bono psychotherapy services to sexual and gender-based violence survivors and cancer patients.”
Achieng’ reveals that her clientele has increased fourfold since she started working as a paid psychotherapist in 2020 with the majority of her clients coming through referrals.
She tells AMAKA that the major issues she handles are trauma and trauma recovery. Achieng’ also works with several clients who need personal development support (including mental health diagnoses and treatment, anger management, loss and grief). In addition, her therapy work includes child therapy, couples therapy, and family therapy.
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“I have worked with a lot of people facing trauma and severe mental illnesses so to be able to watch that recovery process is an assurance for me that I’m doing a good job and that is where I find my satisfaction.”
Achieng’ explains that providing mental health services can sometimes take a toll on therapists and it is integral for workers to have a good support system.“
Initially when I was starting out as a therapist my work really used to affect my mental health and luckily I had a supervisor who I would see once a week and I’d talk about the issues I was experiencing. Honestly most of my issues were that I had really poor emotional boundaries with my clients. So, I would end up sympathising with my clients and my supervisor supported me through it, and taught me how to have healthy boundaries with clients and I have grown so much and matured in the last six years.”
Although Achieng’ and Mulenga are providing support to queer individuals on the continent, there is still a need to create many more safe spaces that enable the LGBTQIA+ community to seek mental health services and support without discrimination or fear.
*name has been altered for safety precautions