Across the region, there's a big disparity in how long people live. Nearly 90 years, on average, in Indian Hill and Mason, but barely over 60 in Arlington Heights and Adams County. That's nearly 30 years of life, love, children, grandchildren, and memories that are lost. Why? Community health experts are looking at the larger forces that shape health and wellness. The places where we grow up, live, work, and age shape our lives and our opportunities to thrive. This is the seventh story in the series, Health Justice in Action, a year-long deep dive into the factors that people and neighborhoods need for long, healthful lives.You can read other stories in the series here.
It was as a budding adolescent that Brandon Long first became aware that he was different from the other boys. When they talked about girls, he didn’t really share the same thoughts and feelings. But he was afraid to talk about it with anyone.
His fear came into horrible focus in October 1998 when he and the rest of the world learned about the killing of Matthew Shepard, the 21-year-old college student who was beaten and left to die tied to a fence in rural Wyoming. His killers hated gay people, their friends testified.
For 12-year-old Brandon struggling with his own sexual feelings at the time, it was a warning to keep it all inside. “It just communicated to me that this world isn't safe, and I can't really share this with anyone,” he says.
As a teen a few years later, in what he perceived to be a safe space -- his church -- he summoned the courage to speak up about what he was going through physically and emotionally. But rather than meeting him with acceptance and support, congregation members directed him into therapy to “fix” his problem. Now 38, the Fort Thomas resident spent 20 years in various therapies and programs, many of them now discredited, in an effort to be what he felt society wanted him to be.
“Everything that was communicated to me was that I don't belong in this world,” he says. “Something is wrong with me and I need to get it fixed.”
It wasn’t until a few years ago that he accepted his sexuality, came out publicly, and is now active in support of LGBTQ rights. But that only came after years of enduring bouts of depression and thoughts of suicide.
His story is an example of the mental health challenges often faced by those who identify as gay, lesbian, bisexual or transgender. Collectively, LGBTQ people are
far more likely to suffer from poor mental health and limited access to appropriate mental health care. Societal attitudes, discrimination, bullying, and family dynamics all play roles in the disparity that this population experiences when it comes to emotional mental wellness.
High rates of suicide, depression
“That population is much more vulnerable,” says Nancy Eigel-Miller, the founder and executive director of
1N5, the Cincinnati-based not-for-profit that promotes awareness and education about mental health in teens and adults. The organization’s name comes from the fact that 1 in 5 teens and adults (20%) suffer from a mental illness. But that incidence is significantly higher for lesbian, gay, bi, and transgender people.
Thirty-nine percent of LGBTQ young people seriously considered suicide in the previous year, found
a 2024 national survey by the Trevor Project, a not-for-profit focused on suicide prevention for LGBTQ youth. The group surveyed more than 18,000 people aged 13 to 24 in its sixth national survey.
“There is a significant association between anti-LGBTQ+ victimization and disproportionately high rates of suicide risk,” the organization says.
In Greater Cincinnati, 57% of LGBTQ adults have experienced depression and anxiety, more than twice the rate of non-LGBTQ, found Interact for Health’s
2022 Community Health Status survey. The same survey found that 42% of LGBTQ adults experience overall poor mental health, nearly three times the rate of the rest of the population.
The wide disparity largely stems from feelings of isolation, disapproval, and stigmatization. “Over and over, what we have heard is they don't feel like they have safe spaces or safe adults,” Eigel-Miller says. “They don't feel supported, they don't feel heard, they don't feel like people understand the issues they're having.”
Doubling down
Aggravating what is already a precarious mental state is the recent surge in anti-LGBTQ laws and rhetoric in Ohio, Kentucky and across the country. Some government leaders have doubled down on efforts to pass laws that many believe would further stigmatize and isolate the LGBTQ population. In 2024, the American Civil Liberties Union
tracked 533 anti-LGBTQ bills moving through state legislatures. That was up from 510 in the 2023 legislative sessions.
The state legislatures in Ohio, Kentucky, and Indiana, all controlled by Republicans, were among the most active. In those states, the number of anti-LGBTQ bills filed nearly tripled just from 2020 to 2023.
Politics and power lie behind the trend, says Chris Hartman, executive director of the
Fairness Campaign, a Louisville-based advocacy group. Attacking the gay community “has long been a convenient political wedge issue to score cheap political points for conservatives during election time,” he says.
But people end up paying the price for political gain.
Hartman has led the Fairness Campaign for 16 years and says that the gay community has always faced hostility from some quarters, but it’s become worse in recent years. “The level of vitriol, the hyperfocus of hate coming from so many different sources, the deployment of really demeaning hateful tactics that keep particularly trans kids in the crosshairs every election season and now every legislative cycle … is having a really dramatic and lasting impact on our community's mental health,” he says.
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Cincinnati's annual Pride Parade. Cincinnati City Council has updated its fairness ordinance to include sexual orientation.The Trump Administration announced in early July that it was ending a suicide hotline service that was staffed by crisis counselors trained in LGBTQ issues. The hotline has received more than 1.2 million contacts since 2022.
"Anti-LGBTQ+ attacks from all levels of government have left LGBTQ+ youth facing a mental health crisis unlike anything we’ve seen before," the Trevor Project said after the hotline plan was made public.
In Ohio, the state legislature passed a wave of anti-LGBTQ legislation in its 2024 session. One requires educators to disclose a students’ sexuality to their parents. It also passed a law that put the state in the bathroom-policing business, requiring people at Ohio schools and universities to use restrooms that align with their birth gender.
Transgender youth have come in for particular attention from state lawmakers. The Ohio legislature previously passed a ban on gender-affirming care for transgender youth and some mental health services, as well as a law preventing transgender athletes from playing women’s sports.
'Something is wrong with me'
In Kentucky, Gov. Andy Beshear signed an executive order in 2024 banning conversion therapy for minors in the state. A few months later, the state legislature voted to override the order, undoing the governor’s protections against what is a widely discredited practice.
The American Academy of Child and Adolescent Psychiatry, a 72-year-old professional medical organization, states that conversion therapies “lack scientific credibility and clinical utility.” Their practice can also be damaging, it says. “There is evidence that such interventions are harmful,” the group said in a
policy statement.
Brandon Long survived 20 years of various forms of conversion therapy. “It would produce, about once a year or every other year, an emotional and mental breakdown,” he says. “Then I would turn around and I would try again to find the fix.”
His experience showed him that such efforts, rather than being therapeutic, are actually injurious.
“It just produces a distrust of your own self, your thoughts, your feelings, your emotions, your attractions,” he says. “The heart of conversion therapy is the belief that something is wrong with me and every effort needs to be taken to find what causes this.”
In contrast, organizations such as 1N5 work to provide safe space where youth and adults struggling with mental health can express their thoughts. The organization works with about 330 schools in 14 counties educating students, staff and parents on strategies for protecting their mental health and preventing suicide. It’s recently begun working with employers too. Its staff works with the LGBTQ population, particularly youth who are among the most vulnerable to mental health stress, Eigel-Miller says.
“These are our kids,” she says. “This is the future. We need to support everybody in this space, especially the more vulnerable population. And it shouldn't be a political conversation.”
Small cities promote fairness
Amidst the wave of anti-LGBTQ legislation on the state and federal levels, some local communities have taken a more accepting approach. In Kentucky, 24 communities, most of them small towns, have enacted fairness ordinances outlawing LGBTQ discrimination in employment, housing, and public accommodations.
Twelve communities in Northern Kentucky have passed fairness ordinances, beginning with Covington in 2003. Newport, Bellevue, Elsmere, and Dayton are among the towns in the region that have passed anti-discrimination laws that specifically include sexual orientation.
The city of Cincinnati passed a law several years ago outlawing discriminatory practices and city council has updated it to include sexual orientation and gender identity.
Hartman of the Fairness Campaign sees a disconnect between the attitudes of local government leaders, who need people to move into and stay in their communities, and state and federal elected leaders, who may prioritize politics over people.
“At the grassroots level, people see, by and large, acceptance and support from those around them,” he says. “But that is in no way reflected in the sort of division and attitudes in the state capitols.”
Kentucky is one of more than two dozen states that lack a statewide fairness law that specifically includes sexual orientation and gender identity.
Ohio also lacks a statewide law, despite a version being introduced in every state legislative session for more than 20 years. "This legislation is the most basic attempt we can make in ensuring that all people can call Ohio home,” said Rep. Tristan Rader, a Cleveland-area Democrat, upon introducing the Ohio Fairness Act for the 12th time in February 2025.
With the wellness and mental health of youth, young adults and others at risk, cities, states, and the country would be better served by adopting the welcoming attitude expressed by Dayton, Kentucky Mayor Ben Baker when that city of 5,800 people passed its fairness ordinance: “In Kentucky, y'all means all," he said.
This series, Health Justice in Action, is made possible with support from Interact for Health. To learn more about Interact for Health's commitment to working with communities to advance health justice, please visit here.