Coming Around: Parenting Lesbian, Gay, Bisexual, and Transgender Kids (18 page)

Other factors that can increase the likelihood of suicidal behavior include environmental stressors such as victimization or a recent suicide attempt by a family member or peer.
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Homelessness, with all its inherent difficulties and its association with parental rejection, is a critical mediating factor. In one study, 53 percent of gay homeless youths had attempted suicide.
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Suicide risk is highest during youth and adolescence, but it is unclear if this elevation is directly related to age or if it reflects an in-creased risk during the early stages of coming out. Among LGB adolescents, African American males appear to be at greatest risk of attempting suicide. Among LGB adults, the highest rates of suicide are among men with lower socioeconomic status and among Latinos and Asian Americans. Overall, gay and bisexual men are more likely to attempt suicide than lesbian and bisexual women.
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Jamie’s Story

Jamie, a sixteen-year-old high school student, recently came out as a lesbian and entered a relationship with Jennifer. After Jennifer broke up with her,
Jamie found several partially used bottles of pills in her parents’ medicine cabinet and took them with a large amount of wine. Her parents returned home from work a half an hour later and found Jamie passed out on the living room floor. They took her to the hospital where doctors pumped out her stomach.

There is nothing more frightening for a parent than a child’s suicide attempt. Jamie’s attempt, though spontaneous, was serious. Parents should not assume that, because their child could anticipate being discovered and rescued, the attempt was not serious.

Psychologists consider degree of planning, method used, access to method and potential lethality of method when assessing a person’s suicidal thinking. They also consider factors that have been associated with an increased risk of suicide, such as having a family history of suicide, recent exposure to a peer’s suicide, previous suicide attempts, substance abuse or drug dependence, mood disorder, head injury with disinhibition, chronic pain and chronic illness. Being gay, young and in the early stages of coming out are also risk factors, as is a recent breakup. Adolescents lack the coping skills to deal with intense grief and they lack the experience to know that the pain they feel will eventually pass.

In most cases, such an attempt would result in admission to a hospital’s psychiatric unit after medical stabilization. After Jamie was discharged from the hospital, I advised Jamie’s parents to insist that she attend sessions with a qualified, gay-friendly therapist for counseling until that provider, in this case me, felt comfortable that Jamie’s thoughts and feelings had stabilized. As Jamie’s psychologist, I screened her for mental health disorders, including substance dependence. It is important that parents not take any attempt at self-harm lightly.

TRANSGENDER HEALTH CONCERNS

The National Gay and Lesbian Task Force and the National Center for Transgender Equality released the results of the National Transgender Discrimination Survey in 2011. This survey explored the health and well-being of 6,450 transgender and gender-nonconforming people across the United States. The results are deeply disturbing. Of the respondents, 51 percent reported being harassed or bullied in school,
61 percent were victims of physical assault and 55 percent reported losing a job due to bias. Respondents were almost four times more likely to live in extreme poverty when compared to the general population. Of those surveyed, 41 percent reported attempting suicide.

Those who reported gender nonconformity during kindergarten through high school reported being harassed (78 percent), physically assaulted (35 percent) and sexually assaulted (12 percent). A total of 15 percent of respondents said they dropped out of school due to harassment at some point in their lives. Respondents who identified as non-white, especially those who identified as African American, fared worse on most measures when compared to their Caucasian counterparts. The desire for hormonal reassignment was strong and constant. Even though access to health care was a barrier, 76 percent of transgender people surveyed received hormone therapy; 78 percent felt more comfortable at work and felt their performance improved after transitioning, despite the fact that harassment continued.
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According to a meta-analysis of twenty-nine studies, 27.7 percent of male-to-female transgender persons were infected with HIV.
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Higher rates were found among African Americans. (The prevalence of HIV infection in female-to-male transgender persons was low.) Those transgender people infected with HIV often had mental health concerns, histories of physical abuse and unmet transgender-specific healthcare needs. They also experienced economic problems and social isolation.

The National Transgender Discrimination Survey offers evidence that family support can mitigate the negative effects of discrimination experienced by transgender individuals. While most transgender people reported experiencing significant family rejection (57 percent), those who maintained family bonds (43 percent) were less likely to contract HIV, less likely to experience homelessness, less likely to be incarcerated, less likely to engage in sex work or other underground work for income, less likely to smoke, less likely to use drugs or alcohol to cope with mistreatment and less likely to attempt suicide.

WHAT CAN PARENTS DO?

Your adjustment to your child’s gender orientation may be difficult, but be aware your child’s adjustment is greater. Support your child. Be reassured that, in time, whatever awkwardness or foreignness you
may feel will subside. Regardless of his or her gender, your child needs your love.

Too many transgender children kill themselves or sacrifice themselves to the streets because they cannot bear the pain of being transgender or because they cannot bear the abuse they receive because of their gender orientations. If your child is transgender, there are some steps you can take that will improve his or her odds. School personnel and police need to be better trained on issues that affect transgender youths; as a parent, you’re entitled to be the vocal advocate who makes it happen.

You can also help your child connect with other transgender youths through gay alliance groups in your town. Organizations like PFLAG may be able to offer suggestions. You can contact the Gay, Lesbian and Straight Education Network (GLSEN), which works with teachers, parents and students to improve the educational environment for LGBTQs by addressing issues related to harassment. Groups like GLSEN, PFLAG and Straight-Gay Alliance will give your child a chance to work through negative feelings, dissemble stereotypes and build a healthy self-esteem.

Emotional health is, in my opinion, the cornerstone of overall well-being. I treat individuals who suffer from chronic disease but relish life because, though physically in pain or impaired, they are emotionally sound. I also treat clients in good health who, due to emotional problems, suffer anxiety and depression each passing day. While maintenance of all aspects of well-being is the goal, attention to emotional health will likely lead to improved self-care and general well-being.

What is the basis of emotional health? Good self-esteem is a key component. Intrapersonal awareness, the awareness and ability to identify one’s feelings, is another. While important to any child’s emotional health, LGBTQ children need an extra dose of each to help them manage the challenges they are bound to face. Sometimes the challenges life imposes make a person more confident. Involvement in gay-affirmative groups and exposure to important gay-positive role models can transform emotional challenges into emotional triumphs. Many of the people I admire most are those who have struggled against one obstacle or another to survive and live fulfilling lives.

Emotional health also requires identifying and treating a mood or anxiety disorder at the earliest possible stage. The word
depression
implies to de-press, to push down. Depression is often the pushing down and away of feelings that are either too unacceptable or too painful to confront. As discussed earlier, the first stages of sexual identity development for gays are full of angst. Most people recognize that they are gay before believing that being gay is acceptable. As a result, sexual feelings are pushed down and away and self-esteem takes a hit. The tendency for depression subsides as an individual passes through the early stages of conflict and into Identity Pride, which, by its label, announces the return of unfettered self-esteem.

It is important for parents to be vigilant for signs of depression as their child comes out, including: frequent sad mood, loss of interest in pleasurable activities, feelings of low self-worth, excessive guilt, hopelessness or an inability to see a happy future, thoughts of suicide, indecisiveness, inability to concentrate, agitation or restlessness, physical slowing or lethargy, overeating or loss of appetite, oversleeping or trouble sleeping and fatigue. In children and adolescents, depression often presents as increased irritability, increased restlessness and increased acting out. However, quiet, ruminative and isolative behavior can also suggest melancholic depression. Another sign of depression is an increased use or abuse of alcohol, illicit drugs and prescription drugs, such as narcotic pain medications (hydrocodone, oxycodone, codeine, etc.), methylphenidate and anxiolytics (alprazolam, lorazepam and clonazepam). Abuse of prescribed medications is a serious problem in adolescent populations. Adolescents, like adults, will sometimes reach for drugs to escape what they see as unacceptable feelings.

Gay men are at increased risk for unsafe sex, HIV and other sexually transmitted diseases. While the causes of these risks are likely multifactorial, the effect of oppression cannot be discounted. Shame and poor self-esteem detract from good decision-making, especially when it comes to sexual activity. For one thing, shame contributes to anonymous, fleeting sexual encounters in bathrooms stalls, bars, etc. When an individual believes his sexual desires are unacceptable,
he or she depersonalizes sex and keeps relationships anonymous. When an individual believes his sexual feelings are dirty, he or she gives in to them rather than prepares for them. Lack of preparation and anonymity increase the risk of unsafe sex. Likewise, alcohol and drugs can numb the shame. Feelings of worthlessness add to the risk of unsafe sex. Self-worth is a prime motivator for self-care and self-preservation. Why take precautions if one has no viable future?

When your child comes out, talk to him or her about safe sex, even if s/he is college aged or you think your efforts will be met with mock gagging and rolling eyes. I’m not referring to “the birds and the bees” conversation. If you child has come out to you, s/he is beyond the basics. Have a heart-to-heart discussion about the meaning and power of sex, about intimacy and about relationships. Your conversation should connect sex with love. By putting sex in a relational context, you undo the stereotype that says homosexuality is sex stripped of meaning. You enhance feelings of relational worthiness (self-esteem). You encourage thoughtful, deliberate sexual behavior that takes into account self and other. All of these increase the likelihood of safe sex.

Discrimination and stigmatization are associated with higher levels of stress. Higher levels of stress are associated with suicidal thoughts and drug use. LGBTQ children who view their parents as accepting of their sexual identities are less likely to cope with stress by self-destructing.
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In a study of Latino and Caucasian LGB youths, those who reported high levels of family rejection were far more likely to attempt suicide, to use illegal drugs and to engage in unprotected sex, thus exposing themselves to sexually transmitted diseases.
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The connection between LGBTQ health outcomes and parental reaction to coming out is consistent and indisputable. What about the rest of the family? How does your child’s coming out affect parents and siblings? Families may initially experience a family member’s coming out as a loss. Grief begins with denial and moves to anger, bargaining, sadness and acceptance.
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It might sound like this: Denial: “I don’t believe it. You’re not gay!” Anger: “This is going to be hard on all of us!” Bargaining: “Maybe it’s a phase.” Sadness: “People might hurt you or treat you badly.” Acceptance: “I want to learn more about this. I want to understand.”

The coming out of a child can draw a family closer as they rally in support of the gay family member. By proving loyalty and love, family ties deepen. Conversations occur that might not have otherwise taken place.

On the other hand, trust can also break down in a family when one or more family members respond poorly to a child’s coming out. The worst scenario is parental rejection. Parents hold much power over self-esteem. They can also create a home environment that is so hostile that an adolescent child is compelled to live on the street. As discussed previously, street life usually leads to emotional and physical ruin. Family rejecters can also be siblings, relatives or grandparents. Though not typically as key to a child’s welfare, rejection by any important family member can be a devastating blow to a child who may still be struggling with internalized homophobia. Parents need to assert to all family members that no disrespectful or abusive behavior will be tolerated in their home.

It is very important for parents to resist the natural instinct to compromise. Let’s suppose that a grandparent resides with you and your gay child. Suppose the grandparent feels uncomfortable with your child’s sexual orientation and asks that he not invite his “friend” to dinner. For the sake of keeping the peace, you might be tempted to ask your son if he would yield on this point. Perhaps you offer to go out to dinner, just you, your son and his partner. While this compromise may seem fair, it is not. Asking your son to accommodate prejudice implies that the grandparent’s request is reasonable, thus shaming your son. The request is not reasonable. Your son should be able to bring his partner home for dinner just as he would if he were in a heterosexual relationship.