American history is filled with experiences and narratives from minorities who suffered prejudices as they fought to gain acceptance and, ultimately, freedom. And although we’ve come leaps and bounds in our inclusion of gender minorities—like the Supreme Court’s decision to recognize same-sex marriage in 2015—we have a way to go.

Homophobia, whether internalized or expressed culturally, is still very much present. And with those stigmas comes stress. Of course, feeling frazzled is part of being human—like hitting traffic when you’re late for work, or finding your finances strained one month. But when you suffer from additional stress, it can have long-lasting effects and cause a host of problems. 

“Sexual minority women are nearly three times more likely to be overweight or obese as their heterosexual counterparts,” says Dr. Emily Panza, Ph.D., an assistant professor at the Weight Control and Diabetes Research Center in the Department of Psychiatry and Human Behavior at Brown University.

In addition to the stigma that comes from having excess weight, gender minority obesity carries a deeper bias and can cause more shame. This type of stress, specifically, only began being studied about 15 years ago, but here’s what we know so far.

We all grow up wanting to be accepted—there’s most likely some memory that pops into your head, even if it’s vague, when you think of your first day of school, or the friend group you had or wanted to be a part of. As you get older, that need to fit in grows.

You don’t want to feel like an outcast, or being the person who isn’t cool. On top of that, kids learn hetero-social norms, like being gay is “just a phase” or they see mainly heterosexual characters portrayed in movies and TV. And often the gender minorities kids we do see portrayed are downplayed or exaggerated characters on the latest Netflix series.

On top of that, co-workers, acquaintances, or even family members may disapprove or have negative feelings. Feeling invisible, not accepted by those closest to you, and singled out can cause shame—leading to even more pressure to try to fit in. “Minority stress includes discrimination, expectations of rejection due to minority status, and concealment of sexual identity,” according to a 2015 study that involved 737 people who self-identified as lesbians. Going through day-to-day life having to constantly hide or be fearful can, understandably, cause a lot of anxiety. 

In fact, stress that comes from exclusivity and alienation has been shown to lead to suicide among some—a fact that's actually been studied since 1951, when trail-blazing French social-scientist Émile Durkheim suggested that not following social norms could cause people to take their own life. Meaning, if you don’t conform or appear to be “normal” your risk of suicide is substantially higher. 

Going to the doctor for a health issue can seem daunting to anyone. But for gender minority adults, seeking medical care can feel even harder because of fear of discrimination.

Those who are a part of the LGBTQIA+ community, especially transgender people, may struggle with lower rates of insurance coverage, and fewer healthcare providers that understand their needs. In fact, not being able to openly discuss issues can cause challenges to become even worse. Here are a few.

It’s easy to feel swallowed up when experiencing life as a gender-minority and having excess weight. If this is something you’re feeling, the most important thing to do is reach out—find camaraderie with a support group in your area or join the Found Facebook Group for more help. You’re not alone, and there are resources to help you not only survive, but to thrive.