
Reflections and Refractions
Magnifying the Spectrum of Care for QTAPIs in Southern California
In December of 2022, Moonbow launched a community survey to better understand the mental health needs of queer and trans Asians and Pacific Islanders (QTAPIs) in Southern California. As experts of our own lived experiences, we wanted a survey that reflected our identities and centered our values of care, collectivity, and autonomy.
Our Findings
In sharing the findings of this survey, we hope to deconstruct the monolithic view of our identities while building a shared understanding of the different challenges we face. We’ll highlight the disparities that exist within our diverse and expansive community but also showcase our resilience and the ways we care for ourselves and each other.
A third of our community’s mental health needs are unmet and we desire a multitude of supports with specific qualities that aid us in accessing care and feeling connected.
Along every point in accessing care, QTAPIs are impacted by service gaps, insufficient care, and dehumanization.
We need financial resources to cover our care, meet basic needs, and create stability.
We heavily rely on community to receive and provide care, and desire spaces that provide safety and belonging.
Of the 221 QTAPIs who took our survey…
70%
were unable to find culturally competent care
69%
experienced a lack of financial resources
57%
experienced a lack of a support network
When disaggregating data, we found key disparities impacting specific groups within the QTAPI community who were:
91%
of 18-24 year old QTAPIs with unmet mental health needs named financial coverage of care as a desired support.
54%
of low income respondents experienced barriers to accessing therapy/counseling.
55%
of South Asians
46%
of Southeast Asians
did not have their mental health needs met compared to 61% of East Asians.

Recommendations
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Deconstruct broad identity labels and center the most vulnerable within API and LGBTQ+ communities.
Asians and Pacific Islanders: Be curious about the various identities and experiences within our community. Challenge East Asian centrism and Pacific Islander erasure. Redistribute wealth to more vulnerable groups. Work with us to cultivate spaces that are attuned to queer and trans community members needs and desires. Recognize queer and trans needs as API needs - don’t let our voices be overshadowed in coalition spaces where we are one of the few LGBTQ+ organizations present.
LGBTQ+ Community: Resist white supremacist tactics and culture in queer and trans organizing. Center the needs of queer and trans Black, Indigenous, People of Color as core to LGBTQ+ liberation.
Frame and approach QTAPI mental health challenges as a systemic issue, not a personal or individual one. Though self-confidence and self-image were the most cited factors in negatively impacting one’s mental health, this cannot be addressed by simply making QTAPI’s love themselves more. Negative self-confidence and self-image often reflect systemic issues and existing in a society that is actively violent to our identities and selves.
Respect our autonomy and knowledge when we share our needs and how we wish to receive support. We are experts of our own lived experiences and what would best support us.This is especially true for trans folks in all aspects of their lives.
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Be intentional when creating an event or space on who that space is for, and be transparent when promoting that space. For example, if a space is intended for the inclusion of trans folks, be explicit in your communications. Do not assume that all QTAPIs will identify with or feel safe in a broader QT, API, or QTAPI gathering. Be clear with its purpose, who is facilitating/leading/participating, what accessibility accommodations are available, and what people can expect from this space.
Expand our community’s capacity to care and support one another by building more support networks and strengthening existing ones. This can be done by investing in resource sharing, caregiving, and interpersonal skills development (e.g., boundary-setting, communication, conflict transformation). Community care is critical to our well-being as we continue to face barriers when relying on institutions for care.
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Ensure quality of care for QTAPIs by offering inclusive, trauma-informed, and client-centered programs and services. This includes:
Affordability: sliding scale, low cost, or free of cost
Accessibility: accommodations for the disabled, autistic, and neurodivergent; COVID-19 safety practices; scheduling flexibility; virtual and in-person options
Culturally Competent: informed and inclusive of various mental health conditions, ethnicities, intergenerational trauma, and social justice; decenters Western and colonialist perspectives
LGBTQ+ Affirming: informed and inclusive of various sexual orientations and gender identities
Care providers need to have awareness and honesty in their limitations around QTAPI experiences and identity, and have a responsibility to communicate these limitations to clients and patients.
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Ensure QTAPIs are represented in research focused on the API or LGBTQ+ community. Targeted outreach and inclusion of QTAPI staff or consultants in research efforts are key.
Disaggregate research data by ethnicity, age, gender orientation, and sexual identity. Apply multi-level disaggregation whenever possible to allow for more detailed and nuanced analysis.
Conduct research on underrepresented QTAPI subpopulations, including TGNCs, Pacific Islanders, Southeast Asians, South Asians, people above 45 years of age, low income individuals, disabled people, those without U.S. citizenship, and those who have not received an education beyond high school, monolingual API language speakers, etc.
Address language and digital accessibility gaps by providing translated survey materials in multiple API languages as well as digital and print survey forms.
Conduct QTAPI focus groups and individual interviews to capture in-depth data on their experiences with services, financial situations, and mental health. This approach would be particularly effective when looking at how sexual orientation intersects with mental health, due to the fluidity and expansiveness of this identity.
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Resource our community to meet basic needs. Supporting mental health needs also means addressing disparities in housing, labor, immigration, reproductive, food access, and healthcare. Resourcing can be using your money, time, and labor to support mutual aid networks, direct aid, and collectives. This can also be providing multi-year unrestricted funding to organizations. We recognize these are temporary measures in the face of capitalism and other unjust systems, yet we are committed to meeting the basic needs of QTAPIs as a critical survival strategy.
Advocate for and invest in legislation, policies, and programs that emphasize non-carceral, holistic care that includes prevention, early intervention, and community-defined evidence based practices. We reject any forms of non-consensual care and involuntary institutionalization as they create more harm for QTBIPOC communities, especially those who are disabled, neurodivergent, mad, experience altered states, are unhoused, and/or experiencing poverty.

Acknowledgements
Our survey builds upon the work of the former API Equality-LA team who conducted a community needs assessment in 2018. We are also deeply indebted to the two surveys created by Lavender Phoenix (formerly API Equality - Northern California) and the LYRIC Center for LGBTQ+ Youth in partnership with the TransCanWork, El/La Para TransLatinas, and Parivar Bay Area.
Funders
Asian Americans Advancing Justice Southern California
Asian Pacific Community Fund
David Bohnett Foundation
The California Endowment
The Weingart Foundation
Community Mental Health Survey Team
Jess Baker Michelle Galán
Ronnie Dinh Priscilla Hsu
Shanahan Europa Sonya Tianang
Zachary Frial
Staff
Christine Hipolito
Nora Fujita-Yuhas
Graphic Designer
Emma Mei Li (Tiger Stepmom)