Dr. Ahuja is a Board-Certified Psychiatrist and Fellow of the American Psychiatric Association. He is a leading voice for the LGBTQ+ community. As the Director of Psychiatry at the LA LGBT Center, the largest of its kind in the world, he oversees a team that serves over 2,000 patients. In addition, he is the Past President of AGLP: The Association of LGBTQ Psychiatrists, the nation's leading organization for LGBTQ+ healthcare providers and their patients and is the current Associate Editor of the Journal of Gay and Lesbian Mental Health. He is a former board member of GLMA: Health Professionals Advancing Equality.

Dr. Ahuja has been in private practice for years in Beverly Hills, Calif., and New Jersey. His academic interests include health disparities and health equity, conversion therapy, intersectionality, and addictions. His latest book just came out and is a guide for practitioners on assessing and treating LGBTQ+ intimate partner violence available at the following: Amazon, Blackwells, VitalSource, AbeBooks, and Thriftbooks. His next book will be about connections and how they can create and maintain better mental health.

The reason I was drawn to psychiatry was an early exposure to how adverse experiences as children and adults can affect one’s mental health. My grandmother and mother are refugees from Africa and had experienced trauma and depression. Seeing them struggle helped me realize how powerful mental health could be. I gravitated towards an LGBTQ+ focus from a place of organizing and wanting to be in the equity space. LGBTQ+ people face a lot of disparities. Being part of the community, I can see the lack of family structure, lack of social support, and discrimination, that lead to poor mental health outcomes. So, it was a natural fit and an opportunity for me to champion this. It also comes from wanting my own therapist or primary care doctor to speak the same language as me in terms of cultural competence and feeling that I can provide that for someone else.

For the LGBTQ+ community it has changed significantly. It has opened up in a way that did not exist when I was growing up. There is more acceptance of LGBTQ+ identity, of coming out, and of mental health disparities. The landscape has particularly changed for young LGBTQ+ people as they come out and into their own, whether they are trans, gay, lesbian, bisexual etc.

To get into that identity is formative work and to see the support and fostering of this has been nice because it is a different landscape. There is also less anti-LGBTQ legislation, which helps because we know that these types of policies can have a negative impact on people’s mental health. That changing throughout my lifetime has been big. Also, we have all been lucky to witness more public examples of LGBTQ individuals being successful and open about their mental health and overcoming it. That is part of how I got to this book that I wrote Intimate Partner Violence: A Guide for Mental Health Practitioners. For our forward we interviewed Greg Louganis, the diver, and he talked to us about his experience. He is one of the few people open about being LGQBT+ and experiencing IPV. These examples are helpful for people to see that others have struggled like they are and have gotten past those struggles and succeeded despite hardship.

I was in the role for four years. We just changed over in May, and Pratik Bahekar, M.B.B.S. is the new president. During my time we worked on creating a membership pipeline for medical students and residents, increasing our membership by 200 people. This brought in more diversity, increasing transgender-identifying, women-identifying, and racial minority members. We have found some best practices in attracting more diverse members and getting more people involved. For example, not counting anyone out such as medical students and starting as early as high school. Whether you go into psychiatry or not, we will give you some experience that could make you more mental healthcare minded. It is helpful to foster those passions. We also started a mentorship program and offer scholarships. We think about encouraging a lifelong commitment, offering support at every step such as the stage where you are growing your practice all the way to staying involved in retirement. We also improved our social media presence and focused efforts on the AGLP journal. We are getting more submissions and working on getting Medline status. I am one of the associate editors now and my role is transitioning into academia and helping the journal become cited more and become the premier journal for LGBTQ+ mental health.

We are seeing more rigorous data. In the past we received a lot of qualitative data, as there was a lack of funds for randomized controlled trials. There is a lot more attention being paid to specific groups under the umbrella of queer health. There is more data needed, but there is for sure more quality data emerging, especially focusing on youth of color.

The LGBT center was a natural fit as a non-profit in terms of mission. There was not a consistent psychiatry department at the center so we created this role and the department, so our patients could have consistency versus a revolving door of people. It is hard to build trust and rapport, especially with patients who are mistrustful of institutions. We grew from 500 to 2,000 patients and have six permanent providers. We are expanding to different sites throughout the city and are engaging in different communities where they are. For example, we have a Spanish-speaking clinic in East LA. There is also a transgender wellness center and we hope to bring Psychiatry there soon.

There are benefits to non-profits in terms of not having a mill of patients. Being a provider, it is refreshing to have more control over what we can do for patients, and not have money be the primary focus of treatment. Although resources are limited I wouldn’t want to work anywhere else. We provide care for a wide variety of people, though caring for the less fortunate who would not be able to get care otherwise is particularly satisfying.

Bullying was interesting because I was both heartened and saddened by the fact that around the world, the statistics are pretty similar. If you look at England, Australia, and France, they have similar statistics to the United States. We know bullying has a negative impact on mental health, increasing substance use and suicidality. The good news from the research in the symposium is that it does not take a lot to intervene. It takes one supportive teacher, having a gay/straight alliance in your school, or welcoming LGBTQ+ signage, to have a positive effect. Small moves can make a big difference. We know that Gen Z and Gen Alpha are more LGBTQ+ friendly, so as these new generations of educators come in I would hope that we will be able to see and measure progress.

Cultural competence is really important. Small things really help, such as learning statistics and getting to know transgender and nonbinary people who can convey their experience firsthand. I want there to be a more robust educational shadowing program at the LGBT center, since a wonderful way to increase cultural competence would be doing rotations at our center, Howard Brown, Fenway, or other LGBTQ+ centers around the country. You get to see many LGBTQ+ patients in a short amount of time which gives you exposure to a lot of different experiences of trans and queer people. Educating yourself is also important, and you can read books such as Transgender Mental Health by Eric Yarborough M.D., or you can subscribe to LGBTQ+ mental health journals. Both of these are valuable ways to become informed and stay informed as the research gets updated.

The biggest change for me was the first APA conference I attended with AGLP. It taught me that there was a community out there, and I was not alone in being an LGBTQ psychiatrist and also in having a motivation to want to change things for our patients and for us. The feeling that you're in this together is huge. Connection and community are the core of what we are talking about as a solution, so we need to do better for ourselves first and then for others. Psychiatry can be an isolating job, and these experiences help you learn a lot and have people relate to what you are going through. I was also on the board for GLMA, which further showed me there is a world out there of equity-minded healthcare providers and kept me motivated out there to keep doing this.

Currently, the topic of intimate partner violence is a passion of mine. With this book, we are making an appeal to people about how important this is. It isn’t talked about enough, so I am very passionate about that. The next thing I want to write about is connection. The LGBT center grew out of an HIV clinic in the 1980s. It was largely males of a certain age who were diagnosed in the 80s and 90s. So, a lot of them are in their 60s and single, having lost their friends and partners in the epidemic. They aren’t close with their families and are dealing with mental health problems. They are isolated and I think about how to help these people find a community. My sense of the research now is that while we are online more than ever but this does not replace real connection. There is no replacement for in-person communication. People don’t make the effort to do this enough and we need to take inventory of our connections. We need to ask ourselves, are we doing a good job? Having a goal and a plan like a personal trainer would with our physical health and evaluating how well we are doing. Part of what I want to know is beyond people, what other connections help mental health, like spirituality and nature?

Continue to be engaged as much as you can. To the extent that you don’t like what is happening in psychiatry or the world, you can sit back and complain, or you can do something about it. You won’t always win every fight, but in the end you can say you did what you could. If you don’t achieve it, you can also pass the baton to the next person. I encourage everyone to make what they are envisioning in the world happen.