When A Loved One Comes Out: Family Dynamics & Mental Health I mplications

1. When A Loved One Comes Out: Family Dynamics & Mental HealthImplications Wesley C. Davidson, author of When Your Child Is Gay: What You Need To Know Nicole Avallone, LCSW, Psychotherapist MHA Conference, Washington, D.C. June 15, 2017

2. Welcome Who We AreWhy We’re here

3. What do we mean by“Coming Out”? • Assumed straight and cis-gender until proven otherwise (heterosexism, cis-normativity) • Come out tooneself first, before coming out to others • May be individual’s choice to disclose and come out, or may be “outed” (e.g. unexpected discovery) • Family members are also in a position of deciding: When, where, and why might I share my family member’s identity? • Not something that happens just once – rather hundreds, maybe thousands of times, in a lifetime

4. Goals for Today • Understand how homophobia and transphobia continue to place LGBT people at elevated risk of mental health challenges • Increase knowledge about family experience when a member comes out • Lessons learned – what works, what doesn’t when supporting a loved one coming out • Best strategies to support families in transition [If asking a question or sharing something throughout this workshop, please also share your name and PGP – personal gender pronoun.]

5. Real Biggest Goal for Today Decrease Anxiety Increase Action

6. Quick Agreements • Trust best intentions – we are all here to learn together. • No stupid questions – if you’re thinking it, you’re likely not alone!

7. Sexual Orientation: The LGB+ Refers to whom we are attracted to emotionally, physically, spiritually Some identities people may use include… • Lesbian – woman attracted to woman • Gay – man attracted to man • Bisexual – attraction to both men & women • Queer – a more flexible term, may include people attracted to people of multiple genders, affirmed as an activist position, etc. • Questioning – someone exploring their attraction • Asexual – no attraction • “No labels,” sapiosexual, pansexual….the list goes on! • Any others we’ve heard…?

8. What about the T? Refers to how we self-identify our gender. Whom we know ourselves to be. We all have a gender identity! • Cisgender (e.g. Cis-man, Cis-woman) • Someone who’s gender identity aligns with their sex assigned at birth • Transgender – an umbrella term • Someone who’s gender identity doesn’t align with their sex assigned at birth

9. Gender Identity Examples include… • Man • Woman • Cisgender Woman/Cisgender Man • Trans-man/Man of transgender experience • Trans-woman/Woman of transgender experience • Gender fluid, Gender expansive, Gender exploring, Gender unicorn! • The list goes on...

12. How many LGBT+ people are there, really? • At least 10 million Americans, or about 4% of the population self-identify as LGBT (Williams Institute, 2011) • 3.5% of adults self-identify as LGB, and 0.3% as transgender • % rises as age declines, with over 7% of Millennials (born 1980 – 1998) identifying as LGBT (Public Religion Research Institute, 2015) • Limitation of statistics • LGBT not counted in U.S. Census • Term “sex” not defined for those answering questionnaires • May be wary of admitting identity – when survey is anonymous, or identity asked in a “round-about” way, response increases up to 50% • “If you build LGBT inclusion, they will come out!”

13. Staggering LGBT Youth Stats • Over 30% missed school in past month due to feeling unsafe • Up to 40% of homeless youth population • LGB youth 4x more likely to attempt suicide than non-LGB GLSEN School Climate Survey 2015 • 56% of LGBT students have heard homophobic remarks • 64% from SCHOOL STAFF.  • 85% experience verbal harassment. • 1/3 (33%) avoid bathroom, 38% avoid locker rooms *GLSEN Nat’l School Climate Survey, 2015. http://www.glsen.org/article/2015-national-school-climate-survey and Trevor Project http://www.thetrevorproject.org/pages/facts-about-suicide **Just the Facts: LGBT Data Overview, 2015. William’s Institute. http://williamsinstitute.law.ucla.edu/datablog/just-the-facts-data-overview_2015/

14. U.S. Transgender Survey 2015(Transgender Equality, 27,715 respondents) • 29% living in poverty, with unemployment rate 3x the national average • 30% lost a job, were denied promotion, or face other workplace discrimination based on gender identity • 40% made a suicide attempt, 9x the national average • 46% verbally harassed, 9% physically assaulted • Trans people of color consistently reported significantly higher negative economic, safety, and health outcomes compared to white peers. http://www.ustranssurvey.org/report

15. Mental Health Impact of Family Rejection

17. Family Support MATTERS • All feelings are VALID, but how we respond to feelings, has real IMPACT. • If parents are high rejecting, particularly evict child, outcomes compared to non-LGBT child: • 8 x more likely to kill self. • 6 x more likely to report high-level depression. • 3 x more likely to use illegal drugs. • 3 x more likely to have risky sex. Ryan, Family Acceptance Project, 2009.

18. Impact of Family Acceptance

19. What’s The Difference between Tolerance and Acceptance? • Acceptance means acknowledging the reality of a particular situation and not trying to change it. • Treating your LGBT child as an equal to heterosexual child. • If a parent doesn’t want to march on behalf of his LGBT child or write letters to Congress, does this mean they are not accepting?

20. Family Dynamic when a Child Comes Out Mental Health Complications Due to Stigma, Prejudice, Causing Stress on LGBT Population

21. Family Dynamic When Child Comes Out • Role Reversal – child perceived as “in charge” when they come out. • Child often educating straight/cisgenderparents, siblings, others. • Parent may go “in the closet” after discovery/disclosure. • Family (perhaps) no longer “mainstream” or a “new minority” experience. • One parent often more accepting than the other; may tell one parent first, often mother, and asked not to tell other parent until it’s time.

22. Parental Reactions • Shock, denial - calling orientation/identity a “phase,” refusal to accept child’s self-knowledge • Holding out hope – e.g. if bisexuality, maybe my child will change mind, or still have privilege of appearing “straight” if they fall in love with the opposite set • Anger, confusion- may blurt out inappropriate, hostile remarks. • Guilt, responsibility? – did they passed on “gay gene” or encouraged “gendered” pursuits (e.g. artistic, athletic, etc). • Worry, fear - for safety due to homophobia, violence, prejudice in workplace, communities. • Mourning loss of image of “traditional” life: heterosexual marriage, biological grandchildren (?), and easier life for heterosexuals.

23. It’s not all bad!Positive Reactions • Relieved • That child felt comfortable enough with themselves to share. • Child no longer harboring a secret may result in better outlook, improved mental health. • Glad to know that suspicions were accurate, thereby not wondering/worrying. • Proud of child for being so open, trusting, and sharing with parent. • Admiration for child’s self-knowledge, confidence to come out. • Flattered that child shared such an important part of self,trusted the parent. • Many others…

24. Straight/Cis Sibling Reactions • Protectiveof LGBT sibling: hears derogatory remarks at home, in school, etc. • Fearful of also facing bias/harassment due to association with LGBT sibling • Guilty about keeping sibling’s secret from parents. • Pressureto look “feminine” or “masculine” to compensate for sibling’s same-sex attraction, to be the “normal” one • Worry they may also be LGBT. • Many others…

25. LGBT Child’s Reactions • Fearful of anticipated, potential, or actual rejection. • Relieved at telling parents – burden lifted. • Guilt, sorrow - feeling they have disappointed parents, made family’s life harder. • Happier - may feel greater self-esteem not harboring secrets, good about educating parents. • Healthier - physical health may improve: sleeping & eating habits, positive outlook, etc. • Many others….

26. What to do? • What is seen and felt as rejection may be misguided attempt at protection. • Help with resolving conflict between loving family member and faith-based rejection. • Family member who believes identity is a choice may try to change orientation/identity. e.g. conversion therapy. • Create safer space for family members to acknowledge ALL of the feelings that may come up.

27. Mental Health Support for Families With LGBT Children

28. See ALL families at potential sources of support • Even moving from HIGH REJECTING to LOW REJECTING can have a positive impact! • Who in the family has already demonstrated desire for support? Consider extended and chosen family. • Who in the family may show desire and potential to increase level of support? • How can we reduce the harm of a high rejecting family member?

29. Family Tips for Being An Ally • Employ the 3 Ls: Listen, Learn, and Love. • Keep the dialogue going. It’s never too late to move toward increased support. • Believe that your child/family member knows who they are. • Acknowledge and apologize for initial struggles (e.g. if blurted out inappropriate remarks about family member being LGBT). • Watch for signs of harassment, bullying, and discrimination and advocate where appropriate. • Ask child/family member whom he/she/they wants you to tell, and ask permission to share if you need support too. • Welcome LGBT child’s friends into your home. • Require that family members respect your LGBT child’s identity. • Show interest in LGBT child’s dating life, just as with non-LGBT child. • Support LGBT child’s identity, even if you are still working to understand or be comfortable with it. • Seek out LGBT-specific community resources and supports for yourself.

30. For Parents • Seek out positive role models: PFLAG (Parents of Lesbians & Gays, and now, transgenders) with nationwide chapters. https://www.pflag.org • LGBT-friendly therapist to resolve issues preventing acceptance of LGBT child.  Find one at https://www.aglp.com. • Obtain information about LGBT-specific safer sex from https://www.cdc.gov/sexual health/

31. For Straight/Cis Siblings • Acknowledge and accept if sibling’s own struggles, while requiring respect and offering support. • Encourage sibling to attend family/group therapy, if needed. • Help sibling come up with strategies for addressing homophobic/transphobic remarks. • Require they respect LGBT child’s privacy, as with any other family member.

32. For LGBT Child • Identify and engage LGBT adult mentors: teacher, relative, work friend. Get to know others in LGBT community. • If needed, seek out LGBT-affirming therapist. • If harassed at school, tell teacher, principal, even Superintendent of Schools.  Keep records of conversations and written requests. • Safety Planning: Find “safe spaces” at school and en route to home.   • Join or form a GSA (Gender & Sexuality Alliance) at school. • Seek out LGBT-affirming health care providers you can trust. • Advocate for inclusive sex education in school. • For more suggestions, see GLSEN (Gay, Lesbian, Straight, Education Network) https://glsen.org

33. Religion/Spirituality • “Conversion Therapy” does not work, and can be incredibly harmful – increases risk of suicide and self- harm. Many states outlaw this type of therapy. • Direct parents to Matthew Vines’s video.  He is author of “God and the Gay Christian: The Biblical Case in Support of Same-Sex Relationships.” • There is an organization for every religion. To reconcile faith with having LGBT children, parents can seek out affirming spiritual communities and group supports (e.g. Metropolitan Community Church in major cities, Dignity for Catholics https://dignityusa.org, etc).

34. Some Simple Steps For Providers • Family members may fear rejection in “coming out” about their child/sibling/family member. • May minimize own difficulty/discomfort with family member’s identity. • Affirm all feelings, while sharing information about potential negative impact of rejecting behaviors. • Help clients (youth and families) see you as a potential resource • Evaluate and explore your own “implicit” bias • Address homophobia &transphobia when you see it • Advocate for inclusive forms at your agency (search “LGBT-inclusive forms” for suggested language) • Display LGBT-affirming literature and materials • Use gender-neutral language • Educate yourself

35. Recommended Reading/Viewing • Family Acceptance Project - https://familyproject.sfsu.edu/ • Gender Revolution: A Journey with Katie Couric • Educators and organizations can sign up for a free DVD and discussion guideNatGeoTV.com/GenderRevolution • Always, My Children by Kevin Jennings, PhD & Pat Shapiro, MSW • Stuck in the Middle with You by Jennifer Finney Boylan • The Transgender Child and The Transgender Teen by Rachel Pepper and Stephanie Brill • The New Gay Teenager by Mitch Savin-Williams, PhD • Transgender Children & Youth: Culitivating Pride and Joy with Families in Transition by Elijah Nealey, PhD • Gender Spectrum – www.genderspectrum.org

36. Questions?

37. Thanks! Wesley C. Davidson Co-author with Jonathan L. Tobkes, M.D. of When Your Child Is Gay (Sterling, 2016) wcdwrite@aol.com www.whenyourchildisgay.com Nicole Avallone, LCSW navallonelscw@gmail.com www.nicoleavallone.com