Insights into the Swiss LGBTIQ+ Panel: key findings

Of central importance is the fact that the longitudinal nature of this study makes it possible to see how changes in the legal and social climate affect LGBTIQ+ people over time. Significant effort was also put into including the various subgroups of the LGBTIQ+ community, as well as participants from all regions of Switzerland. The findings are used by researchers, LGBTIQ+ organizations and institutional stakeholders, providing insights into coming out, discrimination, social inclusion and health through annual surveys. This paper presents the key findings from the 2023 annual survey – the fifth wave of the Swiss LGBTIQ+ Panel (for the whole report, see Eisner & Hässler, 2024). The topics covered include coming out, conversion therapy, discrimination, hate crimes and health.

The 2023 annual report included data collected from January 2023 to August 2023. In order to address the specific challenges faced by different subgroups within the LGBTIQ+ community, tailored versions of the questionnaire were designed for sexual minorities (e.g. gay, lesbian, bisexual, pansexual or asexual individuals) and gender minorities (e.g. trans, non-binary or intersex individuals). Interested cisgender endosex heterosexual (hereafter cis-heterosexual) individuals were also invited to participate. It is important to note that individuals can belong to both sexual and gender minority groups. To minimize the time required to finish the survey, participants completed only one version of the questionnaire. All versions were available in German, French, Italian and English. Former participants were recontacted via email, and new participants were informed through posts, articles, newsletters, and chats from LGBTIQ+ and other organizations. Importantly, the sample represents a wide range of sexual orientations, gender identities, sex characteristics, age groups, educational levels, and regions of Switzerland. Although the aim was to encompass diverse subpopulations within the LGBTIQ+ community across Switzerland and to be sensitive to intersecting identities, the data are not representative. Younger individuals, people with higher levels of education and residents of urban areas were over-represented. This report presents descriptive statistics derived from the 2023 survey. Please note that the central aim of this paper is to make the data accessible to the general audience. For this reason, statistics that are available in our published peer-reviewed journal articles are not provided here.

A total of 2,812 people were included in the 2023 annual report: 1,825 filled out the sexual minority version of the questionnaire, 648 the gender mi­nority version, and 339 the cis­heterosexual ver­sion. People from all Swiss Cantons participated in the survey, although respondents from Zurich were over­represented. Table 1 below shows a summary of the participants’ sexual orientation, gender iden­tity, intersex status, age group, geographical area, education and religion.

The following sections of this paper present the findings on people’s coming out, their exposure to conversion therapies, experienced discrimination, hate crimes and interactions with the police, and re­spondents’ self­reported health.

Context of coming out

First of all, survey respondents were asked in which contexts they were open about their sexual or gender identity and to how many people they had come out. Importantly, one’s sexual orientation and/or gender identity might not always be relevant and people might not feel the need to come out. How­ever, this measure still provides a valid estimate of how openly people are able to talk about their iden­tity and current relationships/activities. The answers were grouped into three categories, depending on the amount of people respondents had come out to: (1) None or a few people, (2) Approximately half of the people, and (3) Most/all people. The results are shown separately for sexual minority (see Fig­ure 1) and gender minority members (see Figure 2).

It is important to bear in mind that respondents could also choose that a context was not applicable to them (e.g. if they were not attending a school). Therefore, the valid number of responses varies between contexts. The number in the brackets represents the total number of participants answering the question.

As in previous years, participants were most open about their sexual orientation towards their friends and families (see Figure 1 below). Less than half of the respondents to whom the categories acquaint­ances, university and workplace were applicable had come out to most/all people. Furthermore, most participants did not (or only very selectively) reveal their sexual orientation in the school context (52.0%) and to their neighbours (55.1%). Finally, two thirds (68.0%) of the respondents to whom the category church/religious organization was applicable had not come out in this context.

Members of gender minorities (see Figure 2 below) were on average less likely to reveal their gender identity than sexual minority members were to re­veal their sexual orientation. Approximately two thirds (66.5%) of respondents had come out to most/all their friends. About half (45.1%) of the gender minority respondents had come out to most/all family members. In workplace, university, school and church contexts as well as towards their neighbours, gender minorities were particularly guarded: between half and two thirds of respondents re­vealed their gender identity to (almost) no one.

Research indicates the benefits when LGBTIQ+ people feel they do not need to conceal their iden­tity, but instead can live their lives authentically. Yet, the decision to disclose their identity is significantly affected by the societal climate, proximal climate, and the reactions of those surrounding them (Hässler et al., in preparation). Moreover, LGBTIQ+ people might not always feel safe to disclose and may even be pushed to change or suppress their sexual orientation and/or gender identity.

The term “conversion therapy” describes any at­tempt to change a person’s sexual orientation, gender identity or expression, or any component of these. Importantly, these “conversion therapy” practices are not “therapies” and can do serious long­term damage. They are often conducted by laypersons (such as religious leaders) without any medical or psychological training. The scientific evi­dence relating to these so­called “conversion thera­pies” and their harm is clear: attraction to the same gender or multiple genders, gender nonconformity, and identification as a sexual and/or gender minority are not illnesses and do not need treatment (see fact­sheet on “Conversion Therapies”, Hässler & Eisner,  2023a). Many psychological and medical societies, including the Swiss Psychological Association, have therefore clearly distanced themselves from “con­version therapies” and are in favour of a ban. While “conversion therapies” are illegal in Germany, their prohibition in Switzerland at both the regional (part­ly already done, partly rejected, partly ongoing) and the national level is currently under discussion.

Due to the limited amount of in­depth data on this issue, questions about “conversion therapies” were included in the 2023 survey. Participants were asked if they had experienced any attempts to alter or conceal their sexual orientation or gender identity. The findings from the survey show that 9.5% of the sex­ual minority members and 15.5% of gender minor­ity members reported having participated in efforts to change or suppress their sexual orientation and/or gender identity. Figure 3 illustrates the ages at which individuals reported the experience of being offered suggestions aimed at changing or suppress­ing their sexual orientation and/or gender identity, or when they participated in such efforts. The results indicate that most of these attempts occurred be­fore the age of 20, a time when LGBTIQ+ individuals are particularly vulnerable because they have often not yet come out publicly or have only come out in a very limited way. Indeed, a large European study found that on average people realize that they are members of a sexual minority at the age of 14.8 years. On average, they first come out 3.9 years later, at 18.5 years (Layland et al., 2023). As a result, they lack a support network from the LGBTIQ+ commu­nity and other allies.

Participants who reported efforts to change or sup­press their sexual orientation and/or gender identity were asked in a follow­up question to specify when this occurred. They were also given the option of pro­viding additional context about the circumstances.  Details of these responses are provided below. The contexts mentioned (see example quotes  below) included various religious institutions (such  as evangelical churches, the Catholic church, free churches and Scientology), educational settings (including sex education and religious teaching), therapy settings (psychiatrists), medical settings (involving doctors and osteopaths), and family set­tings (parents, siblings and grandparents). Below are some of the answers provided by the survey participants:

“Several times! But the traumatic moments were in the fall of 2017 when I participated in a ‘Torrents of Life’ [Evangelical group based in Geneva] style course… but under another name that I don’t remember! And a discussion with my pastor in fall 2020 where he suggested I ‘keep praying’ for my sexual orientation to change!”

“In sex education class we had a very Christian, orthodox teacher who introduced us to a woman who claimed to have been a lesbian previously and told us how she managed to no longer be a lesbian.  (approx. 2013)”

“Two phases: 1.) My efforts: a special year of prayer between 15 and 16. It didn’t bring the desired result, but a much better one: the realization that I’m gay and want to make the best of it. 2.) When I was around 18, my parents wanted clarity and sent me to a psychiatrist. He tried – gently – to get me on the heterosexual path. He was loyal to the Pope, which I didn’t know during the treatment.”

“2008. My mother wanted me to see an osteopath who wanted to get me to listen to music to 'calm me down’ and get out of homosexuality.”

Experienced Discrimination

A large body of research indicates that in addi­tion to the daily upsets experienced by everyone,  LGBTIQ+ people face discrimination and structu­ral inequalities due to their sexual orientation, gen­der identity, and/or sex characteristics (i.e. minority stressors; Meyer, 2003). To assess the prevalence of LGBTIQ+­specific discrimination, both sexual and gender minority members were asked to indicate how often they had experienced different types of discrimination due to their LGBTIQ+ identity in the past 12 months (see Figure 4). The answers were grouped into two categories: (1) Yes, experienced discrimination, and (2) No, experienced no discrim­ination. Most members of both sexual and gender minorities reported having been exposed to jokes and being stared at in public spaces. Furthermore, more than one­third of sexual minority (37.3%) and gender minority (42.6%) members reported hav­ing experienced sexual harassment by men. Addi­tionally, a large majority of gender minority mem­bers reported structural discrimination (86.6%), that their gender identity was not taken seriously (81.8%), and that they were socially excluded be­cause of their identity (61.0%). Significantly, 16.0% of gender minority members and 7.4% of sexual minority members reported being targets of phys­ical violence within the last year. As was the case in previous years, gender minority members are very often the target of discrimination, which stands in stark contrast to the lack of protection against acts of discrimination on the grounds of a person’s gen­der identity.

Another central theme of the 2023 annual survey was the experiences of hate crimes among sexual and gender minority members. There is currently no sys­tematic assessment of hate crimes against LGBTIQ+  people in Switzerland. For this reason, participants were asked to indicate whether they had ever ex­perienced a hate crime based on their sexual ori­entation, gender identity, and/or intersex status. For sexual minority members, 10.7% indicated that they had personally been the target of a hate crime, with an additional 11.8% being unsure and 77.6% reporting having not faced such incidents. Among those who had experienced a hate crime only 26.4% reported the crime to the police. The results were even more pronounced when it came to gender minority members. 17.7% reported having experi­ enced a hate crime, 21.8% were unsure, and 60.5% had not faced such a situation. Similarly, among those who had encountered hate crimes only 22.1% reported it to the police. The reasons behind the decision not to report the crime were multifaceted.

A prevalent theme was the lack of trust in law en­forcement and the pervasive fear of facing further discrimination. For example, one participant stated that they weren’t “treated well by the police,” while another said, “Threats to my life and physical vio­lence were dismissed when I was younger; I don’t trust them [the police] with the discrimination I face on top today.” Similarly, someone else stated, “I don’t think the police take threats of sexual assault against women and trans people seriously.” Other participants expressed skepticism about the effec­tiveness of reporting the crime, citing the absence of pertinent statistics or legal protections against discrimination based on gender identity. “There is no distinction in law around hate crimes for trans people. It wasn’t worth going through the trouble of reporting [it] if all they could face was a fine.” Finally, some participants revealed that they had not even considered reporting the hate crime because they were in a state of panic: “I was in a panic; it didn’t occur to me. I had to quickly seek shelter with my partner.” Others considered the crime not serious enough: “It was insults, mockery, and twice intimi­dation (by two men). I did not dare. It wasn’t ‘serious enough.’” These narratives shed light on the com­plex dynamics surrounding the (non­)reporting of hate crimes, underscoring the need for enhanced trust­building, increased sensitization among po­lice forces, and a more supportive environment for those who have faced such traumatic experiences. One of the aims of the survey was to investigate participants’ perceptions of the police in more de­tail and thus shed light on the complex relation­ship between the law enforcement system and the  LGBTIQ+ community.

For example, participants were asked how likely it was that they “would…hide their sexual orientation or gender identity in interactions with the police due to fear of discrimination?” on a scale of 1 (does not apply at all) to 7 (fully applies). The responses revealed that sexual minority members were rela­ tively neutral on this matter (M = 3.6), while gender minority members (M = 5.1) were more hesitant to be open about their gender identity during inter­actions with the police, fearing potential discrim­ination. Participants were also asked whether they perceived that the police treat LGBTIQ+ individuals with less respect than cis­heterosexual people on a scale of 1 (strongly disagree) to 7 (strongly agree). The findings suggest that both cis­heterosexual (M = 4.2) and sexual minority participants (M = 4.0) were neutral in their perceptions, indicating that sexual minority members perceive the Swiss police as relatively trustworthy. On the other hand, gender minority members (M = 5.0) felt that, to some extent, the police treat LGBTQ+ community members with less respect than cis­heterosexual individuals.

The final theme of the 2023 survey was that of par­ticipants’ health. The participants were asked about various health conditions diagnosed by a health­care provider. The results, displayed in Figure 5, re­veal the proportion of participants reporting each condition, categorized by sexual minority, gender minority, and cis­heterosexual groups. LGBTIQ+ participants, particularly those who identify as trans, non­binary, or intersex (i.e. gender minority members), are more likely to have been diagnosed with various conditions. This trend is especially pro­nounced for conditions like depression, anxiety disorders and social phobia. For example, gender minority participants were five times as likely and sexual minority participants were twice as likely to report depression compared with cis­heterosexual  participants. Importantly, the data also suggests differences amongst sexual minority members: bi­sexual and pansexual individuals experience poorer health compared with lesbian women and gay men.

Participants were asked to rate their health over the past 12 months. The answers were grouped into three categories: (1) Bad or poor health, (2) Neither bad nor good health, and (3) Good or excellent health. As in past years, the results displayed in Figure 6  reveal a health gap – one in three gender minority members (34.0%), one in six sexual minority mem­bers (19.6%), and one in seven cis­heterosexual participants (13.9%) reported “poor health”. These results thus reveal significant health disparities be­tween LGBTIQ+ and cis­heterosexual individuals. However, it is interesting to note that these gaps are significantly wider among gender minority mem­bers, while sexual minority members and cis­hetero­sexual individuals only showed minor differences. This raises the question as to which factors contrib­ute to these health gaps.

In conclusion, the data, gathered from a large sam­ple of LGBTIQ+ and cis­heterosexual individuals across all Cantons in Switzerland, underscore that LGBTIQ+ individuals do not fully disclose their iden­tities in all contexts. Furthermore, some LGBTIQ+ people are still exposed to suggestions to change or to suppress their identities, including efforts to conform to heterosexual and/or cisgender norms, especially in religious, medical and educational settings. There is robust scientific evidence that so­called “conversion therapies” cannot alter individ­uals’ sexual orientation and/or gender identity but rather have harmful effects on LGBTIQ+ individuals (for more detailed information see our fact sheet on “conversion therapies” available in English, German, French and Italian, Hässler & Eisner, 2023a). Leading psychological associations – such as the Swiss Pro­fessional Association for Applied Psychology and the German Society of Psychology – emphasize that these practices violate ethical guidelines and advo­cate for their prohibition. While Germany has already implemented such bans, Switzerland is still debating whether to impose a nationwide prohibition of con­version therapies. It is important to note that gender minority members are especially vulnerable.

Many LGBTIQ+ participants have encountered dis­crimination based on their sexual orientation and/or gender identity in the past year. These experiences ranged from subtle instances like jokes to more overt forms such as harassment and physical vio­lence. Again, it is important to note that gender mi­nority members are especially vulnerable. This high­lights the critical need for legislative action, seeing that existing anti­discrimination laws in Switzerland only safeguard against discrimination based on sexual orientation and do not include protections for gender identity. Consequently, our data reveal that gender minority members exhibit lower levels of trust in the police and are less inclined to dis­close their gender minority identity to law enforce­ment agencies compared with sexual minority and cis­heterosexual participants. This reluctance may stem from the belief that the police cannot (due to the legal situation) help or will not help, coupled with the fear of encountering further discrimination.

Finally, the data (Eisner & Hässler, 2024) and the results of an LGBT study on behalf of the Federal Office of Public Health in Switzerland (Krüger et al., 2022) reveal health disparities between cis­hetero ­ sexual and LGBTIQ+ individuals. Within the LGBTIQ+ community disparities also emerge, with our and other research showing that bisexual and pansex­ual individuals are more vulnerable compared with lesbian women and gay men. Furthermore, health disparities are particularly pronounced among gen­der minority members, such as trans, non­binary, and intersex people. Additionally, early surgeries on intersex children continue to be performed in Switzerland, even when they are medically unnec­essary and irreversible. Despite warnings from vari­ous medical associations and international bodies – including the American Academy of Family Physi­cians, Human Rights Watch, Physicians for Human Rights, the United Nations, and the World Health Organization – against non­consensual medical in­terventions and recommendations for deferring un­necessary surgeries until the child can participate in decision­making, Switzerland has not banned med­ically unnecessary interventions on intersex children (for more details see our fact sheet on prohibition of non­consensual medical treatment of intersex chil­dren available in English, German, French, and Italian,  Hässler & Eisner, 2023b). This practice violates their autonomy and physical integrity and has been banned in Germany.

A substantial body of research indicates that the health gap among LGBTIQ+ people can be attrib­uted to exposure to structural inequalities and dis­crimination based on sexual orientation, gender identity, and/or sex characteristics. Despite legal advancements such as marriage equality and eas­ier gender changes in official documents, structur­al inequalities, marginalization, and discrimination against gender and sexual minorities – known as minority stressors – persist in Switzerland as high­lighted by our data. Furthermore, there is a lack of legislation prohibiting non­consensual medical in­terventions on intersex people and conversion ther­apies. Gender minority members are also not pro­tected by anti­discrimination laws. These minority stressors are widely recognized as the primary fac­tors contributing to the health gap among LGBTIQ+  individuals (Frost & Meyer, 2023; Hinton et al., 2022). Research increasingly shows that individuals who experience discrimination based on their LGBTIQ+ identity are more likely to suffer from depression and anxiety, conditions that were notably prevalent among our LGBTIQ+ participants, alongside vari­ous other physical health issues. Furthermore, not only minority stress but also the lack of social safety can contribute to health inequalities among sexual and gender minorities. Social safety encompass­es “social connection, social inclusion, social pro­tection, social recognition, and social acceptance”  (Diamond & Alley, 2022).

Importantly, individual and institutional support and safety cues can help mitigate the detrimental effects of discrimination and thus potentially nar­row the health gap. Therefore, healthcare providers and institutions need to provide tailored support to LGBTIQ+ individuals. However, data indicate that many health practitioners have little to no training in the specific needs of LGBTIQ+ people (Dullius et al., 2019). Furthermore, many forms still adhere to binary gender classifications, reflecting a limited awareness of gender minority individuals. Similarly, women are often asked about their male partners and men about their female partners, disregarding the reality that not everyone is in a heterosexual relationship or that bi­ and pansexual people may have partners of different genders. Unsurprisingly, our previous survey indicated that 20.0% of the sex­ ual minority participants and 57.1% of the gender minority participants had experienced discrimina­tion in hospitals within the last 12 months (Eisner & Hässler, 2021). This creates an environment in which LGBTIQ+ people may not feel safe disclosing their identity to medical staff or may even refrain from visiting a doctor. Implementing simple steps could demonstrate LGBTIQ+ awareness and foster a wel­coming atmosphere, such as asking how individuals prefer to be addressed (e.g., Mr., Mrs., or using neu­tral terms with their first and last name), inquiring about relationship status without assuming the gen­der of their partner, and providing brochures spe­cifically tailored for LGBTIQ+ people, all of which would signal awareness. It is also of utmost import­ance to train healthcare professionals in LGBTIQ+ issues during their vocational education, and to en­sure that unconscious bias is also addressed. This would ensure that health services are accessible to all individuals, regardless of their sexual orientation, gender identity, and sex characteristics. 

A central goal of the Swiss LGBTIQ+ Panel is not only to enhance academic understanding of LGBTIQ+  issues but also to empower policymakers, organi­zations and the general population to make in­formed decisions that foster a more inclusive and eq­uitable society in Switzerland and beyond. Moving  forward, we intend to prioritize health­related be­haviours and outcomes, specifically addressing the unique needs of LGBTIQ+ individuals and their families in end­of­life and palliative care, as well as the needs of LGBTIQ+ adolescents. To achieve this we have gathered both survey and biological data, including cortisol and cortisone values (see Eisner et al., 2024). Our collaboration with healthcare pro­fessionals from the Psychiatric University Hospital  Zurich, the palliative care unit at CHUV in Lausanne, and international researchers aims to integrate our expertise in LGBTIQ+ issues with medi cal know­ledge. We anticipate that this collaboration will provide valuable insights for scientists, healthcare practitioners, LGBTIQ+ associations and the general  public.

 If readers want to know more about our research work, we invite them to visit our website (www. swiss­lgbtiq­panel.ch) or check out our social media accounts. Here you can learn more about our fact sheets (e.g., on medical interventions on intersex people or so­called “conversion therapies”), our published and ongoing research, interviews, work­shops, and the talks we have given to the media, companies, institutions, universities, and at interna­tional conferences, and much more.