As Daily Kos has contextualized while covering anti-queer legislation proposed and implemented by Republicans, LGBTQ+ people report disproportionate rates of mental health issues like anxiety and depression and harassment, abuse, and even homelessness. An important aspect of that context is looking at the situation with an intersectional lens: understanding, for example, that trans women of color experience disproportionate rates of violence in a different way than a white, cisgender gay male might.

According to a study released in October by the Williams Institute, LGBTQ+ American Indian and Alaskan Native adults (AIAN) report higher levels of mental health struggles, as well as economic instability and abuse, than their non-queer peers. The report stresses that it is “critical” for interventions and policies to actually address and consider gender identity, sexual orientation, and race and ethnic background, as reported by LGBTQ Nation. 

This report offers subsets of data for AIAN people who identify as only AIAN (more than 160,000 LGBTQ+ adults in the U.S.) as well as those who identify as multiracial (124,000). In total, the data suggests at least 285,000 LGBTQ+ AIAN adults live in the U.S.

The report found that about 60% of LGBTQ+ AIAN adults live in the West and South and that more than half identify themselves as religious. Most queer, cisgender AIAN respondents said they felt connected to the LGBTQ+ community, though just over one-third of trans AIAN adults said the same. About one-third of AIAN LGBTQ+ respondents said they felt connected to AIAN communities, with about three-quarters of respondents saying they felt support via some kind of social community.

Somáh Haaland, a nonbinary queer person who uses they/them pronouns, spoke to NBC News in an interview about life as an LGBTQ+ AAIN advocate. Haaland serves as the media coordinator for the Pueblo Action Alliance and is also the child of U.S. Interior Secretary Deb Haaland.

“Being queer and being Indigenous are both beautiful identities to carry that are sacred when they intersect,” Haaland told the outlet, stressing that “we often must fight twice as hard just to show that we are worthy of living and thriving.” Haaland explained that they’ve heard from friends about their struggles to feel acceptance both at home and with white LGBTQ+ people, adding, “In white queer spaces they experience racism and disconnection, while at home or on their reservation they may feel like being out could exclude them from cultural activities.”

LGBTQ+ respondents were more likely to drink heavily, along with other behaviors designated as “high-risk,” for example. More than 40% of respondents have been diagnosed with depression. More than 80% said they’d experienced verbal abuse in their lifetime, while more than 50% said they’d been physically or sexually assaulted. LGBTQ+ AIAN respondents were more likely than non-queer respondents to say they felt unsafe and insecure. 

75% said they didn’t have enough money to cover all of their necessities in the year before the survey. Almost 50% said they’d experienced a significant financial crisis. 19% said they’d been fired or laid off in the previous year. Among AIAN-only adults, unemployment and food insecurity rates are similar across LGBT status. More than 40% of AIAN-multiracial LGBTQ+ adults said they experienced food insecurity. 

LGBTQ+ AIAN respondents were more likely to be uninsured. Fewer LGBTQ+ AIAN respondents said they had a personal physician than non-LGBTQ+ respondents. LGBTQ+ AIAN respondents reported a higher prevalence of some health conditions, like diabetes, cancer, high blood pressure, high cholesterol, and asthma. 

Here are five free mental health resources if you or a loved one are in need.