Disclaimer: The usage of the word “sick” in this article is to reflect the problematic, social stigma around mental illness, and not as a moral or social indictment of people with mental illnesses or disorders.

The first woman I ever loved told me that when you’re queer and Black, illness is a shadow that always follows you but that no one ever acknowledges. She sang the words “I’m fine” every day, and sometimes I wasn’t sure if it was the world or herself that she was trying to convince. You know, she wanted to convince herself that if she simply followed the advice of well-intentioned friends and strangers to smile a little more and to “cheer up,” that she truly would be fine.

I find my loved ones in the gossamer pages of dictionaries. I find myself when I read between the lines. We are a series of bullet points and over-simplified definitions. The New Oxford American Dictionary defines “sick” as:

1. Affected by physical or mental illness

2. of or relating to those who are ill

3. (of an organization, system, or society) suffering from serious problems, esp. of a financial nature

4. pining or longing for someone or something

One.

It took 19 years for me to see a therapist. I squirmed on an ugly love-seat that looked more comfortable than it felt, surrounded by posters that championed ways to feel happy. I didn’t know where to start when the doctor asked me what was wrong, so I blurted out my laundry list of despair all at once, just put it all out there. When I told the doctor that sometimes life feels too heavy, when I told the doctor that death looked more inviting, she replied, “Nothing’s wrong with you. I think you’ll be okay.” A box of tissues and a plastic smile prescribed to yet another queer Black kid.

To be queer and Black and unwell is to live in silences.

Like the doctor’s silence in a room too sanitized to hold my pain.

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Silence.

Like my mother who cried wordlessly when she found the suicide notes I wrote in case I needed them.

Silence.

After that first appointment with the therapist, I was too ashamed to tell my family that I tried to get help.

Silence.

Two.

My chosen family consists of many Black queers the world deems “sick.” I was privileged enough to get better. No unpronounceable names were issued to define the way my mind works (or doesn’t work), or the way my body moves (or doesn’t move). In time, I found myself on the upside of a downward spiral. I was finally… okay. I didn’t understand that not everyone is fortunate enough to “get better,” especially as easily as I did. I held other people to unreasonable standards. I held and sometimes still hold my family to unreasonable standards. I held the woman I loved to unreasonable standards.

In a given year, one in every four US Americans experience a mental illness, according to the National Alliance on Mental Illness (NAMI). NAMI also confirms that LGB populations are two-and-a-half times more likely to have a mental disorder than heterosexual populations, while a survey conducted in 2010 reported that 41% of trans* individuals have attempted suicide.

One study explains, “In mainstream mental health settings, [LGBT folks] often feel compelled to hide their sexual orientation or gender identity; conversely, in the LGBT community, mention of their mental health status is often unwelcome.”

We tell each other to “come as you are” into a big, rainbow-decorated family, but we, who are neuro-typical, do not always make proper accommodations for our neuro-diverse siblings, or don’t always check our privileges. We may even roll our eyes when one of our queer siblings “forgets” to leave their depression, anxiety, PTSD, OCD, bipolarity, or other illness at home. I too have rolled my eyes before, reducing another person’s struggle to “extreme sensitivity” or “unnecessary drama”.

To be Black means to be 20% more likely to report having psychological distress than white US Americans. The disparity is compounded when socioeconomic class factors into the reports. Narrowing the categories complicates the results because the number and types of illnesses and/or disorders increase in proportion to the number of marginalized identities a person has. A study done from February of 2004 to January of 2005 details that 60% of Black LGBTQ people have some type of mental disorder.

Three.

My family used to joke that only white people need therapy. Black people go to church instead, find remedies on their knees in prayer, sing their sorrows away. Meanwhile, white academics told me that African-Americans merely fabricated ungrounded stigma around psychiatric help. As absurd as these two viewpoints may sound, these myths actually point to a greater phenomenon.

As of 2012, 15% of the US American population without health insurance was African-American. Considering the role economic status plays in healthcare sheds light on the racial discrepancy with respect to treating mental illness. Many people with health insurance find that their companies don’t cover the cost of mental illness treatment, and those without any health insurance find themselves facing incredibly high prices to pay for medical care, or opting not to pursue treatment at all. These obstacles often lead Black folks in the states to “rely on family, religious and social communities for emotional support rather than turning to health care professionals, even though this may at times be necessary,” states NAMI’s fact sheet on African American Community Mental Health.

Even if able to pay for treatment, many Black folks encounter prejudices and biases from medical caregivers. Black people, especially Black men, are frequently misdiagnosed when it comes to mental illness. For example, most prominently in the 1960s, white doctors institutionalized Black men involved in civil rights protests (particularly in Detroit) on the grounds that the behaviors these men defended as political activism was really schizophrenic rage and volatility. Also, medical practitioners’ prescriptions sometimes reflect discriminatory and generally racial assumptions that Black people do not need as much medicine as white people. Studies conducted by the University of Michigan’s School of Public Health discovered that Black US Americans are 1.5 times as likely to be denied antidepressant treatment. No one wants tell you that the system is sick. No one wants to tell you that the healthcare system intentionally keeps historically marginalized groups like queer folks, and Black folks, and people who happen to find themselves at the intersection of queerness and Blackness sick.

Four.

The first woman I ever loved was always just out of reach, every inch of her slipping through my careless hands, every word she spoke barely intelligible. I held her as if she were simultaneously fragile and lethal to convince myself that I wasn’t the one falling apart. Loving her meant learning to love the parts of me that sometimes cannot get out of bed, that sometimes feel broken for no apparent reason, that make me unwell. She said, “I’m not a fucking statistic,” but I could only see her through percentage signs and medical dictionary definitions. The first woman I ever loved told me that when you’re queer and Black, illness is a shadow that always follows you, but that no one ever acknowledges. I walked away because I didn’t know how to see it.