Alyssa Bernadette Cahoy and Taylor Philips
The Montrose Center
The Montrose Center serves as the health hub of the Houston LGBTQ+ community, providing comprehensive counseling and treatment services to help individuals reach their fullest potential.
LGBTQ+, mental health, sexuality, sexual orientation, gender identity, social determinants of health, health advocacy, Houston, Rice University
About Montrose Center
Healthcare systems have historically privileged heterosexual, cisgender white men, leading to poorer health outcomes for everyone, including LGBTQ+ individuals, who already face numerous other social and economic challenges (Drescher 2015). For example, when the first cases of AIDS were reported in 1981, many physicians refused to provide care for LGBTQ+ patients due to prevalent homophobia that pathologized non-heterosexual orientations. These dangerous biases, exacerbated under the Reagan Administration (1981-1984), caused unnecessary death and suffering, estimated to be around 89,000 deaths during Reagan’s presidency (Francis, 2012). LGBTQ+ individuals are also particularly vulnerable to mental health challenges such as depression, anxiety, self-harm, and suicidal thoughts, ideations, and actions, exacerbated by the lack of infrastructural support at the organizational, community, and policy level. Compared to heterosexual adults, LGBTQ+ individuals are 3-6 times more at risk of having suicidal thoughts, plans, and attempts within similar age and racial groups (Ramchand et al., 2022).
Community health care in Houston began to mobilize before the unprecedented HIV/AIDS crisis surge. In 1977, members of Houston’s LGBTQ+ community protested against Anita Bryant, a singer and anti-gay rights campaigner. She came to perform in the city as a part of her Save Our Children campaign. Protestors, led by Houston gay rights activist Ray Hill (1940 - 2018), numbered about 10,000 and marched past the Hyatt Hotel where Bryant was performing (Houston LGBT History, 2017). A year later, in 1978, Ray Hill and the Texas Gay Political Caucus organized a town hall (Town Meeting I), which became the city’s first official celebration of Gay Pride Week. Town Meeting I resulted in creating the Montrose Activity Center, the Montrose Sports Association, the Gay and Lesbian Switchboard, and a behavioral health center specifically for LGBTQ+ individuals (Houston LGBT History, 2017). Later, in 1978, a group of social workers, community members, and psychiatrists opened the Montrose Counseling Center to provide behavioral counseling to Houston’s queer community.
In 2013, the Montrose Counseling Center was rebranded as the Montrose Center as its services had expanded beyond just behavioral health to try to meet the complex array of health challenges facing LGBTQ+ people. And now, more than 40 years later, the Montrose Center, located on Branard Street, has grown into a community advocacy organization that leverages an integrated health model to provide behavioral and mental health support, adult primary care, psychiatric care, and free wellness programs. Montrose is also now staffed with state-licensed clinicians, therapists, and social workers (Robinson, 2021). In addition to addressing physical and mental health, the Montrose Center aims to address social and economic disparities faced by the LGBTQ+ community through training and educating mainstream providers, police academies, and educators about how to address bias and provide care for the LGBTQ+ community. Within the center, they focus on substance addiction and abuse recovery, domestic violence, and HIV/AIDS for seniors, adolescents, and veterans, among many other programs. Additionally, the Montrose Center conducts community outreach, organizes educational programming, and arranges support groups. Volunteers can contribute to the efforts of Montrose Center by facilitating peer-led support groups, working special events, or signing up with one of the numerous LGBTQ-affirming social and civic groups housed within the Montrose Center, such as HATCH Youth or SPRY Diner for LGBTQ+ older adults.
While cultural attitudes toward the LGBTQ+ population in the U.S. have improved, structural forms of discrimination and casual heterosexism continue to affect the psychological wellbeing of many LGBTQ+ individuals and contribute to persistent mental health disparities. Lesbian, gay, and bisexual adults are twice as likely compared to heterosexual, cisgender adults to experience a mental health condition, and transgender adults are four times more likely (National Alliance on Mental Illness, 2017 & Wanta et al., 2019). The LGBTQ+ community is one of the most targeted by perpetrators of hate crimes, with almost one-quarter of hate crimes in 2020 being motivated by bias against sexual orientation and gender identity (Federal Bureau of Investigation, 2020). Last year was reportedly the deadliest year for transgender people globally, with most victims being transwomen of color (Human Rights Council, 2021). Social rejection, harassment, and abuse have contributed to a higher risk for LGBTQ+ individuals to develop post-traumatic stress disorder or a substance use disorder. LGBTQ+ individuals also experience higher rates of homelessness and suicidal ideation (National Alliance on Mental Health, 2022). LGBTQ+ adults are more than twice as likely to have experienced homelessness in their lifetime than the general population (UCLA Williams Institute, 2020). Moreover, should members of the LGBTQ+ community seek mental health treatment, they may be denied care outright due to homophobia, face a lack of cultural competency, or encounter implicit bias from providers (Mental Health America, 2022). The Montrose Center continues to address these barriers to healthcare.
With the onset of the COVID-19 pandemic in early 2020, the Montrose Center shifted to telehealth services. It implemented several measures to continue supporting its patients, including financial assistance for housing and professional development programs for individuals seeking a career change. Patients can access COVID-19 Recovery Funds through the Montrose Center to obtain help with rent, utilities, and groceries (The Montrose Center, 2020). The Montrose Center further established private technology stations with new laptops for clients to use in-office when they needed a computer or access to the internet. The Montrose Center also adjusted its congregate meal activities to a meal delivery service.
The Montrose Center is one of five LGBTQ+ community centers in Texas that work together under the guidance of CenterLink, a non-profit that helps strengthen and support its member organizations. Today, the Montrose Center is still working to navigate COVID-related changes while adapting to meet the needs of LGBTQ+ clients in Houston and surrounding areas. Potential clients hear about the Montrose Center through social media or recommendations from former and current clients. Their work is part of a nationwide move towards justice-based health promotion and education that combats the “othering” of LGBTQ+ identities to close the social, economic, and health disparities within America’s queer communities. Every year, the Montrose Center serves over 100,000 people across southern Texas and Louisiana (Robinson, 2021). In 2020, over 3,000 people received individual counseling, HIV case management, substance abuse recovery, and domestic violence support and shelter (The Montrose Center Annual Report, 2020). Today, the Montrose Center continues to engage with Houston’s LGBTQ+ community and introduce new services based on their needs, and is a global leader in providing holistic wellbeing support to queer youth, adults, and seniors.
Altman, D. (1998). HIV, Homophobia, and Human Rights. Health and Human Rights, 2(4), 15. https://doi.org/10.2307/4065184
Ann Robinson, interview by Taylor Phillips, March 10, 2021, interview, transcript, and recording, Medicine, Race, and Democracy Lab Collection
Bayer, R., & Oppenheimer, G. M. (2006). Pioneers in AIDS Care—Reflections on the Epidemic’s Early Years. New England Journal of Medicine, 355(22), 2273–2275. https://doi.org/10.1056/NEJMp068202
Francis, D. P. (2012). Deadly AIDS policy failure by the highest levels of the US government: A personal look back 30 years later for lessons to respond better to future epidemics. Journal of Public Health Policy, 33(3), 290–300.
Hindus, L. A. (2006). Transparency in the age of AIDS: The reality and mythology of a disease. The Journal of Management Development, 25(10), 996–1003. http://dx.doi.org/10.1108/02621710610708612
Wanta, J. W., Niforatos, J. D., Durbak, E., Viguera, A., & Altinay, M. (2019). Mental Health Diagnoses Among Transgender Patients in the Clinical Setting: An All-Payer Electronic Health Record Study. Transgender Health, 4(1), 313–315. https://doi.org/10.1089/trgh.2019.0029