Psychedelic experiences linked to identity shifts and improved mental health among LGBTQIA+ individuals

A new study published in the Journal of Psychoactive Drugs suggests that psychedelic experiences may be associated with positive changes in gender and sexual identity and improvements in mental health among LGBTQIA+ individuals. Intense psychedelic experiences were linked to greater self-acceptance, reduced symptoms of trauma and anxiety, and increased psychological flexibility. Many participants reported that psychedelics helped them explore their identities more deeply, with some indicating shifts in how they understood or felt about their gender or sexual orientation.

The research was conducted by a collaborative team of scientists and clinicians from institutions such as The Ohio State University, Columbia University, Johns Hopkins University, Naropa University, and the Child Mind Institute. Their goal was to address a gap in psychedelic research by exploring how these substances are experienced by LGBTQIA+ individuals outside of clinical settings, especially in relation to identity and mental health. (LGBTQIA+ is an inclusive term that stands for lesbian, gay, bisexual, transgender, queer or questioning, intersex, asexual or aromantic or agender, with the plus sign representing other diverse sexual orientations and gender identities.)

This study was motivated by the high rates of psychological distress among sexual and gender minority populations. Despite growing acceptance in some regions, LGBTQIA+ people continue to face systemic discrimination, rejection, and violence, all of which contribute to elevated rates of depression, post-traumatic stress, anxiety, and other mental health challenges.

Traditional therapeutic approaches are often inadequate, particularly when providers lack cultural competence or fail to address the identity-specific aspects of psychological distress. The researchers proposed that psychedelics might offer a unique avenue for healing by facilitating self-exploration, emotional breakthroughs, and shifts in perspective that are difficult to achieve through conventional talk therapy.

“I’m a trans person whose own psychedelic experiences have been deeply affirming and healing in relation to gender and sexual identity,” explained study author Rafaelle Lancelotta, a licensed professional clinical counselor and PhD candidate at The Ohio State University who is affiliated with the Center for Psychedelic Drug Research and Education.

“That lived experience, combined with my passion for tailoring psychedelic therapy to vulnerable populations, motivated this research. I was invited to lead this project by Dr. Alan Davis, who provided a lot of mentorship and guidance to help make this project a success. The timing of this project felt like a truly aligned opportunity to contribute something meaningful to the field.

“There’s a major gap in the literature when it comes to the experiences of gender and sexual minorities, as well as BIPOC communities, in psychedelic contexts. Too often, the field has focused on the experiences of white, cisgender, middle-class men—so it’s urgent that we broaden our understanding to include those historically excluded.”

The researchers conducted a cross-sectional survey that collected detailed self-report data from LGBTQIA+ adults who had previously used psychedelics or MDMA. Recruitment was conducted through psychedelic advocacy websites, social media, and community networks.

The survey asked participants to reflect on a particularly meaningful psychedelic experience that occurred at least 30 days prior to participation. Participants were assessed using a wide range of validated instruments, including measures of mental health symptoms, emotional breakthroughs, mystical experiences, ego dissolution, self-acceptance, and identity-related rumination. Measures also captured the frequency and intensity of psychedelic use, as well as attitudes about the potential therapeutic value of these substances.

After stringent quality control checks and data validation steps, the final sample consisted of 346 individuals. Most participants were White, with a mean age of 31.7. Just over half were assigned female at birth. Participants identified across a broad spectrum of gender identities, including women, genderqueer individuals, nonbinary people, and men.

Many participants reported prior psychiatric diagnoses, with high rates of anxiety, depression, post-traumatic stress, and attention difficulties. On average, respondents reported having experienced four types of adverse childhood events, which are known to increase vulnerability to mental health problems later in life.

In terms of substance use, participants had used classical psychedelics about 23 times on average, and MDMA about 11 times. The most commonly used psychedelics were LSD and psilocybin. Nearly half of respondents described their most memorable psychedelic experience as involving a moderately high dose, and a smaller portion reported a high dose. Most participants believed that psychedelics could be helpful in addressing issues related to gender dysphoria, and two-thirds reported that their psychedelic experiences had affected their attitudes toward their own gender identity.

When asked to reflect on that experience, participants scored highly on measures of mystical experience, emotional breakthrough, and psychological insight. These scores suggest that the experiences were deeply meaningful and involved a sense of unity, emotional release, or new understanding. Scores on the ego dissolution measure—reflecting a sense of merging with the environment or temporarily losing a sense of self—were also in the upper middle range. In contrast, scores on measures of challenging or distressing experiences during the trip were low on average, indicating that most participants did not report intense fear, grief, or paranoia.

Lancelotta and her colleagues found statistically significant changes in measures related to sexual identity. Participants reported decreases in uncertainty about their sexual orientation, increases in commitment and exploration, and greater synthesis of their identity. There were also significant improvements in self-acceptance, including a marked decrease in difficulty accepting one’s sexuality. Changes in transgender congruence—how well one’s outward expression matches internal gender identity—were smaller but still significant.

In addition to identity-related outcomes, participants reported substantial improvements in mental health following their psychedelic experience. Large reductions were observed in symptoms of depression, anxiety, and post-traumatic stress. Participants also reported greater psychological flexibility, which refers to the ability to adapt to new situations, accept difficult emotions, and pursue meaningful goals even in the face of internal discomfort. Psychological flexibility is a strong predictor of well-being and is often considered a core mechanism of change in various forms of therapy.

To better understand the relationship between the intensity of the psychedelic experience and these reported changes, the researchers conducted a canonical correlation analysis. This analysis revealed a significant link between higher levels of mystical, emotional, and insightful experiences and greater gains in self-acceptance and identity exploration. In contrast, participants who had more challenging or distressing trips were less likely to report these kinds of benefits.

“Psychedelic experiences might support self-acceptance, identity exploration, and emotional healing in gender and sexual minorities,” Lancelotta told PsyPost. “Our study suggests that these substances may help gender and sexual minorities people reframe their experiences of minority stress, increase psychological flexibility, and reduce shame.”

“But it’s also important to recognize that these experiences don’t happen in a vacuum—they’re shaped by complex interpersonal and social contexts. Destigmatizing psychedelic experiences while also promoting intentional, culturally responsive support is key, and we will need controlled, rigorous clinical studies to better understand how psychedelic experiences may or may not be helpful for this population.”

However, the researchers caution that these findings should be interpreted with care. The data are based on retrospective self-reports, which are subject to memory bias. People who had meaningful or positive experiences may have been more motivated to complete the survey, which could skew the results. The survey focused on participants’ most memorable experience, which may not reflect the full range of their psychedelic use or long-term patterns.

Another limitation is the lack of racial diversity in the sample, which may limit the applicability of the findings to LGBTQIA+ people of color. “Future work should focus on recruiting more BIPOC and transgender participants,” Lancelotta said. “Despite these limitations, we believe this study is an important first step toward filling a gap in the literature.”

The study also raises questions about access and inclusion. Psychedelic-assisted therapy remains expensive and legally restricted in many regions, and marginalized groups are often not included in research trials.

“I’m currently working on a secondary analysis examining how social support may shape mental health improvements following psychedelic experiences,” Lancelotta explained. “Ultimately, I hope to contribute to the development of culturally attuned, trauma-informed psychedelic therapy protocols that center the lived realities of GSM individuals. Dr. Alan Davis is working on a secondary analysis of the data to better understand the role of psychological flexibility in this population and my colleague Skylar Gaughan has done qualitative research with our trans survey respondents to better understand trans psychedelic experiences.”

“My long-term goal is for psychedelic research to be more community-integrated and systems informed. I hope that psychedelics are viewed as potentially helpful, but that we also are considering the importance of the contexts (social, political, cultural) where they are used.”

“This project was shaped by a wonderfully diverse research team that included trans people, people of color, gender and sexual minorities, and neurodiverse individuals,” Lancelotta added. “That diversity brought critical insight into how we framed the study and interpreted the findings. I also love that we trialed our survey with a group of gender and sexual minority individuals to ensure that the survey was culturally attuned for the population we were targeting. I’m proud of that collaborative, community-informed approach.”

The study, “Exploring Self-Reported Effects of Naturalistic Psychedelic Use Among Gender and Sexual Minorities: A Quantitative Survey Study,” was authored by Rafaelle Lancelotta, Meghan DellaCrosse, Diana Quinn, Syre Saniyah, Micah Saniyah, Natalie Gukasyan, Sasha Narayan, Aki Nikolaidis, Jae Sevelius, and Alan K. Davis.