INVISIBLE WOUNDS: HOW DISCRIMINATION AFFECTS THE MENTAL HEALTH OF THE LGBTQIA+ POPULATION

Abstract

Introduction: The LGBTQIA+ population faces structural discrimination and interpersonal violence in societies marked by cisheteronormativity, with profound impacts on mental health. In Brazil, despite normative advances, institutional and cultural barriers persist that perpetuate inequities in access to basic rights, such as health and safety. Objective: Analyze how the experience of discrimination, at its individual, institutional and structural levels, affects the mental health of the LGBTQIA+ population in the Brazilian context, identifying contextual factors that enhance these problems. Methodology: Systematic review following the PRISMA protocol, with searches in the LILACS, MEDLINE, SciELO and Scopus databases. Of the 353 articles identified, 12 were included after screening using criteria based on the mnemonic PCC (Population: LGBTQIA+; Concept: Discrimination; Context: Brazil). Results: Discrimination was correlated with high rates of depression (24.8%), anxiety (66%), post-traumatic stress disorder (39%), and suicidal ideation, especially among young people and trans people. Black LGBTQIA+ individuals reported discrimination 1.7 times more than white individuals. Institutional violence, such as disrespect for social name in health services and refusal of care, was associated with evasion of medical care and psychological deterioration. During the COVID-19 pandemic, 36% reported weekly episodes of discrimination, intensifying isolation and interruption of specific treatments. Discussion: Minority stress theory explains the accumulation of adversities, such as recurrent discrimination and family exclusion, which generate chronic stress and internalization of LGBTphobia. Intersectionality (race, class, gender) amplified vulnerabilities, with Black and trans individuals facing overlapping oppressions. Conclusion: Discrimination is a critical social determinant for LGBTQIA+ mental health, requiring multi-level actions: professional health training, affirmative public policies and strengthening of community networks.