Sexual Education & Disability: Why it Should Matter to Social Workers

What do you get when you mix the taboo nature of discussing sexual intimacy with the social stigma surrounding intellectual and developmental disabilities? The answer: a heck of a lot more problems than you might think. Sexual education in the school setting is already a hot-button issue for non-disabled students. But when students with intellectual and developmental disabilities are introduced into the mix, so too are the ableist stigmas we all hold.

Taboo-Nature

I would like to start this piece with a brief exercise one of the health teachers at my high school conducted at the beginning of sex ed. Repeat after me: Penis. Vagina. Penis. Vagina. Why do you think she would make a room of teenagers yell these words in school? Isn’t that inappropriate? If you think it is, you proved my point from earlier. Sexual intimacy and anything loosely related to sex are currently incredibly taboo topics. To help break down the air of discomfort surrounding such topics, that health teacher did something many are afraid to do: she spoke openly and encouraged others to follow suit.

One could argue these topics are not to be spoken about simply because we are taught to not speak about them. A child can ask why their anatomy is different from their siblings, but they will often be met with shushes or roundabout answers. In many cases, there is no reason for this reaction other than traditional values. Those same values are often times what causes conflict in regard to sexual education in public schools.

My sex ed experience at a public school was mediocre at best. Genitalia, STIs, and contraceptive methods were discussed. Consent was not taught nor were the proper ways to actually engage in sex, just that if we did it we should do it safely. This was not the most educational experience. And if this is what I received, what is the experience of children and adolescents with intellectual and developmental disabilities?

The Institutional Deficit

Working in a behavioral school for boys with emotional, developmental, and intellectual disabilities yields an interesting perspective. These students are taught the same subjects most other students in the country are taught just with more academic and therapeutic support. However, they are not always provided with a health class.

I worry greatly about this institutional deficit, partly due to my own ableism. These students are receiving very little, if any, sexual education during the school year from our faculty and who knows what they see on the Internet and what their families and friends are telling them. As they get older and begin to develop their curiosity, I am worried that they might not always have a reliable source of sexual education. With that, the concept of consent is often discussed but not in the context of intimacy. I don’t know if the connection between consent and sexual activities has been made or if it ever will be in this school setting. I don’t know if some of these students would understand the magnitude of these topics. I’d like to think these kids can do anything, but from what I’ve seen I don’t know if I would feel confident in their understanding. I wish I could feel otherwise.

Deeper Issues

Individuals with an intellectual or developmental disability are seven times more likely to experience sexual assault than non-disabled people. In many cases, the perpetrator is another individual with an intellectual or developmental disability. Ableism likely prevents people from thinking this to be possible. Common stereotypes around this population convince the non-disabled community that these individuals can do no wrong and are by default sweet and innocent. Of course, this is not realistic. Another ableist stereotype, as seen above, is the incapability of this population to understand topics related to sexual education and sexual intimacy. Like the non-disabled community, however, individuals with an intellectual or developmental disability prove that idea wrong.

Why This Matters to Social Workers

So, if people with intellectual and developmental disabilities are able to learn about sexual education, and learning about sexual education dramatically decreases instances of sexual assault, then what is the reason for this population to not receive sexual education? The signs point towards ableism held by those in helping professions, with social workers being a perfect example. While the social work community prides itself on how educated and accepting they are of different identities, very rarely do social workers take the time to reflect upon identities they may not be as familiar with. Race and sexual orientation are examples of identities social workers study extensively, but disability as an identity and the depths of disability culture are rarely examined. To combat this, social workers need to begin the process of confronting personal ableism.

Confronting personal ableism is difficult, but doing so will only benefit social workers and others who choose to do so. It is important and necessary to challenge internal biases. Critically examining personal ableist ideas pushes social workers to gain a different perspective. Through this difficult process, one gains clarity in the issues they may not even know they wrestle with. Understanding how ableism impacts perceptions allows social workers to get a firm grasp on the disability community. They may begin to feel empowered to advocate for a change they never once considered, such as a stronger sexual education program for people with an intellectual or developmental disability. The importance of critically examining personal biases should be emphasized throughout the entirety of the social work community and by every social worker.

The Causes, Risks, and Solutions for LGBTQ+ Youth Homelessness

In 2020, the population of homeless people grew for the fourth year in a row, and a single night count in January of that year revealed 580,000 people were experiencing homelessness. But while the homelessness crisis is widely acknowledged, a problem that is less recognized is how (and why) LGBTQ+ youth are disproportionately represented among the homeless. Moreover, the problem is not only the overly high representation of LGBTQ+ youth without homes but the increased risks and challenges they face while they are living homeless. And if they are also Black, Indigenous and People of Color (BIPOC), then there are even further risks yet. Mitigating the problem will therefore require a broad, multifaceted, and holistic approach that addresses the multiplicity and intersectionality of these challenges, some of which have been exacerbated by the pandemic.

Causes, Risks, and Minority Stress

At the deepest level, generalized homophobia and transphobia are foundational causes of the high percentage of homeless LGBTQ+ youth. Both homophobia and transphobia underlie family rejection, which is a primary cause of the higher rates of LGBTQ+ youth homelessness. Among LGBTQ+ youth without housing, around 46 percent run away due to family rejection and 43 percent are forced to leave home by their parents.

Once homeless, LGBTQ+ youth also face higher risks of mental health challenges, substance use, sex trafficking, sexual assault, and becoming victims of hate crimes compared to their cisgender, heterosexual counterparts. And when we probe deeper into any one of these risks, we find them inevitably linked with numerous forms of discrimination. For example, one of the reasons unstably housed LGBTQ+ youth are at higher risk of sex trafficking is that many of them are pressured into alternative forms of making money to survive due to discrimination against sexual and gender minorities in the job market.

In addition to the job market, there is discrimination against the LGBTQ+ community when it comes to housing and accessing homeless services as well. Minority stress theory is used to describe this kind of intertwining of discrimination in multiple, overlapping dimensions in a way that compounds stress and increases risk factors for minority groups.

Racism is also a major factor. While LGBTQ+ youth in general are disproportionately represented among the homeless, so too are Black people. Because of this, there are even more risks for Black LGBTQ+ youth experiencing homelessness since they lie at the intersections of sexual, gender, and racial identities and are thus exposed to all of the discriminations these minority groups face.

Tragically, many of these preexisting disadvantages faced by homeless LGBTQ+ and Black LGBTQ+ youth were exacerbated by the pandemic, which caused numerous programs and services designed specifically for these communities to reduce hours or shut down entirely.

Minority Strengths, Resilience, and Action

A newer framework that can be seen as complementary to minority stress is minority strengths.  That is, even as racial and sexual minority statuses come with increased stresses and risks, they can also be sources of strength when members of these minority groups can identify with, and experience camaraderie with, other members of their respective minority group(s). Here as well, however, there are complexities since not every minority may have equal access to social support. Even within the LGBTQ+ community, for example, there can be transphobia and/or racism. A Black trans youth may therefore experience multiple forms of discrimination from within the very community they look to for strength. Still, it is useful to consider the minority strengths model alongside minority stress so that neither the positive nor negative aspects are overemphasized.

Speaking of overemphasizing, the tendency to focus on resilience in the context of LGBTQ+ youth homelessness has become a double-edged sword. While, on one hand, resilience should certainly be acknowledged, its role as a solution should not be exaggerated. The fact of the matter is that there are many ways to reduce LGBTQ+ youth homelessness and the risks associated with it.

We can work to address homophobia, transphobia, and racism in the culture at large, for instance, and to reduce discrimination in the job and housing markets which would help reduce the rate of homelessness among LGBTQ+ youth in the first place. We can also work to implement protections for the LGBTQ+ community more widely within homeless services so that those who do end up homeless can safely access these services. Social workers and providers of social services can also be trained to better recognize and address the unique challenges that unstably housed LGBTQ+ youth face. Relying too much on resilience creates a danger of neglecting concrete actions such as these which can and should be taken as preventative measures.

Finally, a word needs to be said about research which, like resilience, is sometimes overemphasized. As a researcher myself, I know that research can certainly help play a mitigating role, but we need to be mindful of the tendency to put the onus on more research when we already know enough to get to work and make a sizable difference. Research and advocacy can complement each other. There will always be more to learn, but if we wait until we know everything we will never act. With rates of homelessness increasing, and the pandemic having amplified the causes and risks of LGBTQ+ youth homelessness, the time to act is now.

Why U.S. Government Agencies Need Comprehensive Policies For Employees With Various Gender Identities

Sex and gender identities are becoming increasingly complex in America, creating new challenges for public administrative agencies. So far, the vast majority of U.S. federal agencies lack comprehensive transgender employee policies – which are currently in place for only nine of approximately 235 federal agencies (including sub-agencies).

Yet as the workforce evolves, federal employment policy must accommodate the needs of employees who do not fit traditional sex and gender categories – and particular attention needs to be paid to formulating policies specifying the responsibilities of employers when their employees undergo transitions meant to shift their anatomy or appearance to align with their gender identity.

What Should a Transgender Policy Include?

Employee policies specifically fashioned by agencies to deal with transgender issues should, at a minimum, cover matters that arise when employees undergo transition processes; restrooms and locker rooms; dress codes; and the use of proper names and pronouns. Many benefits come from transgender-specific employee policies. Such measures can educate supervisors and coworkers about what to expect when someone transitions in the workplace and, by providing protocols to follow, help supervisors and coworkers become more comfortable with and supportive of workplace transitions.

Transgender employees also benefit and gain a sense of security when specific policies are in place. Each federal agency should create its own internal set of transgender-relevant policies, to educate all employees and help transgender employees understand their rights and know where to go for assistance. More can be said about each of the major issues a good policy needs to address.

When Employees Go through Transitions

In the absence of a comprehensive transgender policy, most agencies are left unprepared when employees change their anatomy or appearance to align with their felt gender identity. An effective way to prepare for such processes is to spell out the agency’s workplace transition protocol. Without such an explicit plan, transgender employees who want to transition do not know where to go to begin the process or where they can find answers about what a transition might entail for an agency employee. Additionally, without a standard set of practices, agencies do not know what is required to change all applicable records. Confusion can leave transgender employees scrambling to deal with many different record changes. Submitting requests and medical records to many places can be unnecessarily cumbersome and intrusive.

Plans for Restrooms and Locker Rooms

One aspect of transgender employee policy that has garnered significant attention – and sometimes controversy – is the issue of who uses which restrooms and locker-rooms. A key example comes from North Carolina’s “House Bill 2” that banned individuals from using public restrooms that do not correspond to their biological sex assigned at birth. The United States Department of Justice declared this law in violation of Title VII and Title IX of the Civil Rights Act as well as the Violence Against Women Reauthorization Act of 2013.

Openly transgender employees have, at times, been discouraged or outright or prohibited from using the restroom or locker room that correspond to their gender identities. Many federal employees use a locker room to change into their uniforms or when they enter the agency gym. Additionally, some jobs, like those in the Forest Service, necessitate the use of showers in the locker room. Existing open-shower floor plans in many facilities may not afford transgender individuals a sense of privacy and safety that everyone should have in their workplace. Inside particular workplaces, conflicts and awkward situations can often be headed off by spelling out clear guidelines for appropriate restroom and locker-room use by all employees, including transgender individuals.

Flexible Dress Codes

A comprehensive transgender policy could also resolve problems related to dress codes. Overall, transgender individuals should be allowed to wear clothing consistent with their gender identity; failure to do so could cause harm to their mental health. Obviously, this applies to employees who have gone through transitions. In addition, although dress code policies often assume that all individuals fall into a female-male binary; many individuals identify in non-binary ways.  Someone who identifies as gender neutral, for example, may not fit into sex-specific dress codes.

Because it is discriminatory for employers to force transgender people to conform to gender norms, an agency-specific transgender policy should articulate dress and grooming standards that allow employees to dress and groom in ways that are consistent with varied gender identities. The policy should state that no employee will be required to dress and groom in conformance with a particular sex or gender stereotype.

Respectful Use of Proper Names and Pronouns

Another concern to be addressed is the proper use of the name and pronoun corresponding to a transgender individual’s gender identity. After a person transitions, managers and coworkers often use the wrong name and pronoun. The Equal Employment Opportunity Commission found in 2013 that the intentional and repeated misuse of a transgender employee’s new name and pronoun could harm the employee and thus substantiate a claim of sex-based discrimination and harassment. A further issue is that agencies often have no policy about pronoun use for individuals who request designations other than the traditional “he,” “she,” “him,” or “her.”

When coworkers refuse to use the correct pronoun for a transgender colleague it is disrespectful. The Office of Personnel Management should expand the definition of “transgender” to include gender non-binary employees and clearly communicate this definition to agencies. Transgender policies for each agency should include clear guidelines indicating that all employees – including transgender, non-binary, and other gender non-conforming employees – are entitled, both verbally and in writing, to be called by their preferred name and pronouns.

Read more in Nicole M. Elias, “Constructing and Implementing Transgender Policy for Public Administration” Administration and Society 49 no. 1, (2017): 20-47.

Applying the Cass Identity Model to Social Work

Individuals who identify as lesbian, gay, bisexual, transgender (LGBT+) or other gender and sexual minorities can have significant mental health issues – not just as a result of their sexuality or gender identity but also because of discrimination and isolation. These individuals may find themselves seeking case management, counselling, or other social work support services and it can be helpful to have a framework for understanding their coming out process.

Coming out is the process a lesbian, gay or bisexual (LGB+) individual follows in order to disclose their sexual orientation or gender identity to those around them. It can be an intensely personal and challenging process.

Cass Identity Model

The Cass Identity Model was created by Vivian Cass in 1979 in order to better understand the coming out process for LGB+ individuals. It consists of 6 stages or phases that a person will proceed through. The six stages are:

Identity Confusion

Identity confusion is the very first stage of the model. In this stage, an individual is confused by their sexual identity and begins to become aware that sexual identities are a concept. They are possibly in early puberty and noticing individuals expressing their sexuality.

At some point though, the individual will experience thoughts or feelings regarding an individual of the same-sex that will make them wonder if they are actually LGB+. This might lead to a denial that the individual is LGB (repressing these feelings.)

Identity Comparison

In the Identity Comparison phase, the individual will ask themselves more openly if they are homosexual. They will confront the idea that they might be alone in their LGB+ experiences compared to those around them and the resulting social alienation or need to keep their LGB+ identity hidden. This is especially challenging for people living in repressive societies or communities where LGB+ identities are not tolerated.

Identity Tolerance

Once the individual has reached Identity Tolerance, they have understood that they are firmly LGB. To those around them, they may be perceived one-dimensionally – as only homosexual. This can cause these individuals to seek out other LGB+ individuals and begin to build a support network.

Some individuals may continue to deny their identity and thus experience self-hatred, which may delay their coming out process and cause much distress.

Identity Acceptance

Identity Acceptance is exactly what it sounds like. The individual has accepted themselves as an LGB+ individual. They make begin to make the LGBT+ subculture a larger part of their life. This can lead to an insulation of one’s support network as a differentiation is made between those people who are openly supportive of the individual’s LGB+ identity and those who tolerate their sexuality as long as it is not displayed openly. Limiting the role these other individuals play in the LGB+ person’s life serves to reduce distress and alienation.

Identity Pride

The Identity Pride stage is the one most associated with LGBT Pride events. The person’s sexuality continues the pendulum swing from lack of awareness to tolerance to complete pride, overtaking the other aspects of their identity. The person may even dichotomize the world into an LGB area and a second, less important heterosexual category.

The understanding of heteronormativity may appear here as well, with the individual reminding others around them that the assumption they are heterosexual is a false one.

Identity Synthesis

Finally, in Identity Synthesis the individual has come to the realization that their LGB+ identity is merely one part of them and does not dominate their life. It is one part, like their career, hobbies, ethnicity and other aspects are simply other pieces of the puzzle that makes them up. At this stage, they fully accept themselves and experience little or no distress as a result of their LGB identity.

Applying the Model

A Social Worker may apply the Cass Identity Model by noting where in the six stages their client seems to be and reading the primary literature to better understand the conflicts that may occur at each stage. This can help ensure interventions are targeted to the unique distress the client is experiencing and continue to deepen the therapeutic relationship by demonstrating a strong understanding of the client’s inner-pain.

Conclusion

The Cass Identity Model is a six-stage model that demonstrates a lot of value in understanding the coming out process as it relates to LGB individuals.

Certain Moral Values May Lead to More Prejudice, Discrimination

People who value following purity rules over caring for others are more likely to view gay and transgender people as less human, which leads to more prejudice and support for discriminatory public policies, according to a new study published by the American Psychological Association.

“After the Supreme Court decision affirming marriage equality and the debate over bathroom rights for transgender people, we realized that the arguments were often not about facts but about opposing moral beliefs,” said Andrew E. Monroe, PhD, of Appalachian State University and lead author of the study, published in the Journal of Experimental Psychology: General.

“Thus, we wanted to understand if moral values were an underlying cause of prejudice toward gay and transgender people.”

Monroe and his co-author, Ashby Plant, PhD, of Florida State University, focused on two specific moral values –what they called sanctity, or a strict adherence to purity rules and disgust over any acts that are considered morally contaminating, and care, which centers on disapproval of others who cause suffering without just cause – because they predicted those values might be behind the often-heated debates over LGBTQ rights.

The researchers conducted five experiments with nearly 1,100 participants. Overall, they found that people who prioritized sanctity over care were more likely to believe that gay and transgender people, people with AIDS and prostitutes were more impulsive, less rational and, therefore, something less than human. These attitudes increased prejudice and acceptance of discriminatory public policies, according to Monroe.

Conversely, people who endorsed care over sanctity were more likely to show compassion for those populations, as well as support public policies that would help them.

“The belief that a person is no better than an animal can become a justification for tolerating and causing harm,” said Plant. “When we believe that someone lacks self-control and discipline, we may make moral judgments about their life choices and behaviors, which can lead down a dark path of discrimination and hate.”

The first experiment involved people who were generally moderate politically and religiously. They rated their agreement with five moral values (care, fairness, sanctity, loyalty and authority) and then read short descriptions of five different men: a gay man, a man with AIDS, an African-American man, an obese man and a white man. Afterward, the participants filled out questionnaires about their thoughts on each man’s state of mind (e.g., “John is rational and logical”) and emotions (e.g., “John is rigid and cold”) and their attitudes and feelings of warmth toward each man.

“We found that people who placed more value on sanctity were more likely to believe that the gay man and man with AIDS had less rational minds than the obese, African-American or white men,” said Monroe.

Experiment two focused on how political affiliation might affect responses. The researchers recruited an equal number of self-identified liberal and conservative participants and used the same morality survey as in the first experiment, but this time, participants rated their thoughts on the state of mind for only four men: a gay man, a man with AIDS, an African-American man and a white man.  The liberals and conservatives then assessed their feelings of prejudice for each man (e.g., “I would rather not have a black person/gay person/person with AIDS in the same apartment building I live in”), their attitudes about public policies that would help or harm gay people (e.g., conversion therapy) and people with AIDS and their willingness to help them by being involved with pro-gay/AIDS awareness activities.

Liberals tended to value care and fairness more while conservatives were more focused on loyalty, authority and sanctity. And the people who valued sanctity were more likely to discriminate against the gay man and man with AIDS but not the African-American or white men, according to the study.

Experiment three focused on perceptions of transgender people and found that participants who endorsed sanctity were more likely to hold prejudiced attitudes about transgender people and to support discriminatory public policies.

The fourth experiment tested whether temporarily increasing sanctity values, relative to care, increased dehumanization and prejudice. Experimenters collected survey responses on a college campus on two separate days –Ash Wednesday—a day associated with sanctity and spiritual cleansing in the Christian faith—and a non-religious day. Participants filled out a survey intended to assess their moral beliefs and attitudes toward a woman described as a prostitute.

Participants surveyed on Ash Wednesday reported much higher concerns about sanctity compared to care and this caused participants to become more likely to dehumanize and express negative feelings towards the prostitute, according to the study.

The final study explored whether heightening concern about care was an effective method of reducing prejudice about gay and transgender people. To prime care values, participants listened to a radio news clip about the importance of safe spaces for people of color, while in the control condition participants listened to a clip about Brexit. Afterward, the participants rated their moral values, made judgments of a transgender woman, a gay man and a white man and indicated their support or disapproval of three public policies that would either help or harm gay and transgender people (e.g., national legislation for marriage equality, banning transgender people from the military).

Participants who listened to the clip about safe spaces emphasized caring as an important moral value over those who listened to the clip about Brexit. Caring individuals showed less prejudice toward gay and transgender people and less acceptance of discriminatory policies against them.

“Our study suggests that a person’s moral values can be altered, at least temporarily, and that highlighting certain values, like caring, can be an effective way to combat prejudice,” said Monroe. “We hope that by showing the moral roots of bias and discrimination against sexual and gender minorities we encourage others to conduct further research to increase equity and inclusion.”

The Power of Language and Labels

A while ago I posted a meme which said, “Better to have lost in love than to live with a psycho for the rest of your life.”

I liked it, of course, otherwise, I wouldn’t have posted it. Eleven others did too, some commenting on Facebook, “Amen to that,” and “Definitely!!”

Then this: “Hate it. It’s beat up on people with mental illness time again. Ever had the amazing person you love tell you that they just can’t deal with your mental illness anymore? Our society is totally phobic about people with mental illness having intimate relationships.”

Woah, that came a bit out of the blue. I hadn’t made the link between “person with a mental illness” and “psycho”, otherwise I wouldn’t have posted it. It didn’t say, “Better to have lost in love than to live with a person with a mental illness for the rest of your life.” I had linked “psycho” with the often weird, unspoken assumptions people make when in relationships, which have kept me out of long-term relationships all my life.

It made me think, though. Suppose it had read, “Better to have lost in love than to live with an idiot for the rest of your life.” Would that have been a slight against people experiencing unique learning function?

Probably a more accurate meme would have been, “Better to have lost in love than to live with an arsehole for the rest of your life.” But that’s not what the image said.

For the record, I have had someone I loved tell me he couldn’t cope with my unique physical function anymore. It was hard to hear, but ultimately he was the one who lost out. And I know intuitively many would-be lovers haven’t even gone there — again, their loss and my gain, because why would I want to be with anyone so closed-minded?

The power we let labels have over us can be overwhelming. If I had a dollar for every time a person called someone a “spaz” in my presence, I’d be wealthy. If I got offended because “spaz” is a shortened version of “spastic”, which is one of my diagnoses, and I got another dollar for that, well — I’d be angrily living in the Bahamas.

I think the evolution of language — and the generalization of words like, “gay,” “spaz,” “idiot” and “psycho” — creates the opportunity for them to lose their charge and liberate us from their stigma. By allowing them to continue having power over us, though, we re-traumatize ourselves every time we hear them. Words are symbols and they change meaning over time and in different contexts.

I celebrate that “gay” means “not for me” rather than “fag”; that “spaz” means “over-reacting”, not “crippled”; that “idiot” means “unthinking”, not “retarded”; and that “psycho” means “someone with weird, unspoken assumptions”, not “a crazy person”.

By letting words change meaning for us, we are redefining diversity and creating social change. It’s not a case of, “Sticks and stones will break my bones but words will never hurt me.” It’s recognizing that, unless someone is looking directly at us menacingly, calling us gay, spaz, idiot or psycho, we’re not in their minds — they’ve moved on.

Maybe it’s useful for us to move on with them?

Right from the Start: Investing in Parents and Babies – Alan Sinclair

It is widely accepted the earliest months and years of a child’s existence have the most profound impact on the rest of the lives. Attachment theorists believe the early bonds and relationships a child forms with his/her carer(s) or parent(s), informs that child’s ability or inability to form successful and healthy relationships in the future.

Alan Sinclair’s ‘Right from the Start’ is the latest in the Postcards from Scotland series of short books, which aim to stimulate new and fresh thinking about why us Scots are the way we are.

In my previous book review in the Scottish Journal of Residential Child Care, I commended the author of ‘Hiding in Plain Sight’ (another book in the same series) Carol Craig for her ability to write succinctly and accessibly about a complex subject matter. I feel the same way about Alan Sinclair’s writing in this book.

The premise of this book, put simply, is laying out the bare truths of how good and bad us Scots are at parenting as well as having the appropriate supporting systems in place for parents and carers of our most vulnerable children.

A consistent thread throughout the book is the author arguing that by investing in parents and babies ‘from the start’, governments and the surrounding systems who support children and families can relieve the heartache of tomorrow in the form of poorer outcomes in education, employment and in health.
The book begins by acknowledging the UK’s position on the UNICEF global league table of child well-being, ranking 29 of the world’s richest countries against each other. The UK is placed 16th, our particular challenge being a high proportion of young people not in work, training or education. Although the league table did not single out the devolved nation of Scotland, the author describes the UK as a ‘decent proxy for Scotland’.

The first 1,000 days

The author goes on to explore the theory of the first 1,000 days of a child’s life. This theory suggests this is the most significant indicator of what the future holds for them. He touches on child poverty, which we know from well-cited research can lead to adversities in life, but he also mentions too much money can be an issue as well.

This point is explored more deeply later in the book’s in a chapter titled: ‘Is social class a factor?’. The author is effective at challenging the popular rhetoric that it’s the least educated and most poverty-stricken parents in society who are most likely to neglect their children. He talks about the longitudinal study, Growing Up in Scotland, which tracks the lives of thousands of children and families from birth to teens. Amongst many other findings, the survey shows 20% of children from the top income bracket have below average vocabulary; it also finds problem-solving capabilities are below average for 29% of this group. This proposes child poverty is only a small indicator of the child’s developmental prospects.

Where the Dutch Get it Right

The most intriguing part of the book from my point of view is the comparison the author makes between raising a child in Scotland versus the Netherlands (which ranked first in the UNICEF league table). In Holland, pregnant women have visits from a Kraamzorg, an omnipresent healthcare professional who identifies the type of support required. Post-birth the Kraamzorg plays a very active role and can typically spend up to eight hours a day supporting the new mother in her first week of childcare. The Kraamzorg also becomes involved in household chores including shopping and cooking. And it doesn’t stop there. The Dutch system includes Mother and Baby Wellbeing Clinics, which support families from birth to school age and have been doing so effectively for the last century.

On reading how the Dutch system operates, it’s hard to not make comparisons to the system here in Scotland (and the wider UK) within our NHS where mothers are wheeled in to give birth and very quickly wheeled out again to free up bed space. I exaggerate slightly here and I do not want to discredit the incredible job hard-working NHS staff do, but I’m sure I’m not alone in feeling envious of the Dutch system and thinking they’ve got something right, in comparison with Scotland. This was neatly summarised at the start of the book in a quote from a Dutch woman who had spent time living in both Holland and Scotland when she said: ‘In Holland we love children. In Scotland you tolerate children.’

But it’s not all bad. As the author remarks himself: ‘Scottish parenting is not universally awful: if we were we would not be almost halfway up the global table of child well-being’ (p. 12).

The penultimate chapter explores some real-life examples of parents who are struggling and striving to succeed in bringing up children with some success despite the odds stacked against them. I found the author’s injection of such human stories among the explanation of evidence useful as it allowed a chance for the reader to reflect on how all this is applicable in everyday life in Scotland.

To me, there was, however, a glaring omission in these stories: a voice from the LGBT community. Gay adoption in Scotland was legalised almost 10 years ago in 2009, and at the same time the Looked After Children (Scotland) Regulation 2009 came into force allowing same-sex couples to be considered as foster parents. It would have been interesting to hear from this historically marginalised part of our society what the experience has been like and how different, or similar, this was from the other stories included in this chapter. Are they arguably better equipped as carers of Scotland’s most vulnerable children given their own life experiences of being marginalised?

The book ends with the author setting out his vision for a better future for Scotland’s children where they have better life chances and are fully nurtured. It’s clear we have some way to go but reading this book makes you feel a glimmer of hope that could, one day, become a reality.

National AIDS Awareness Month

Even though the overall number of people with HIV and AIDS has fallen, it is still a disease which predominately affects gay males. An estimated 67% of new HIV cases are transmitted via male-to-male sexual contact, with heterosexual contact accounting for 24%, and 6% due to drug use. Young people are also more likely to be infected. Young people ages 13-24 account for 21% of new AIDS cases. The most at risk individuals are young gay and bisexual men which “accounted for 81% of all new HIV diagnoses in people aged 13 to 24 in 2016, and young African American gay and bisexual men are even more severely affected,” according to the CDC.

Since 1987, the first year Human Immunodeficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS) was listed on death certificates, over 500,000 people have died in the United States from HIV/AIDS. That’s more than the number of people who have died in the Syrian War. Currently, in the United States, AIDS is the 9th leading cause of death in people 25-44 years old.

The AIDS epidemic reached its peak in 1992, with an estimated 78,000 cases diagnosed annually. Since then, AIDS diagnosis began to steadily decline until stabilizing in the late 1990s at approximately 40,000 cases diagnosed annually. The latest statistics from the Center for Disease Control and Prevention (CDC) show between 2010 and 2015 the estimated number of annual infections declined 8% from 41,800 to 38,500.

Victims of intimate partner violence (IPV) are also at a greater risk for contracting HIV. People who report a history of being a victim of IPV are more likely to engage in risky behaviors – intravenous drug use, prostitution, unprotected anal sex – increasing their risk of contracting HIV. HIV-positive women also report higher rates of IPV than the general population.

The opioid epidemic is responsible for the first uptick of HIV diagnosis attributed to intravenous drug use in two decades. In 2015, opioid use led to 181 individuals being diagnosed with HIV in Scott County, Indiana. Lowell, Massachusetts has also seen a recent spike in HIV cases attributed to opioid use.

One of the biggest obstacles faced by HIV/AIDS patients is a healthcare system which is less than perfect. A recent Times article stated, “no class of medicines is more scandalously expensive than for H.I.V.” In the U.S., HIV medication can cost $39,000 a year, while countries in Africa the same medication costs $75 a year.

The U.S. healthcare system may not be perfect, but HIV treatments are getting better. Experts think it’s possible HIV transmission can be stopped in the United States within 3-7 years. The most current and powerful antiretroviral drugs on the market can lower the amount HIV in a person’s system to a level so low it cannot be transmitted.

Let’s Have Some New Gender Stories–Please

When I was a kid, there were girls and boys, men and women. My sister was a bit of a tomboy which was hardly surprising perhaps given she had two older brothers. Truth be known, I was a bit of a sissy – not as acceptable as my sister’s gender-non-stereotypical behavior. However, apart from ‘big boys don’t cry’, I was never particularly shamed on account of it.

Those were the early 70s and 80s. Cut to the mid-80s, as puberty and adolescence coursed through my body and threw open my mind, one afternoon I was watching Ready to Roll and a new song appeared on the charts: “Do You Really Want To Hurt Me” by Culture Club. The group was fronted by this person over whom, for the next couple of weeks (there was no Google back then), I obsessed. Whether they were female or male, I really couldn’t tell.

Finally, listening to the UK Top 40, it was confirmed: Boy George was a guy and he preferred a cup of tea to sex.

Then followed others in the new romantic music scene of the 80s: Dead or Alive’s Pete Burn, Marilyn, Annie Lennox, and others. All challenged gender appearance norms in what seemed to be a sea-change of gender ambiguity. Even before my burgeoning awareness of my own sexual orientation, I remember having this growing excitement that gender, as we knew it, had changed for the better and, I was sure, or at least hopeful, it would never be the same.

Alas, the 90s intervened. The Spice Girls and Backstreet Boys fought back, re-entrenching the normative ideology that boys were boys and girls were girls. Even Blur’s “Girls Who Like Boys Who Like Boys Who Like Girls” couldn’t cut through the hysterical backlash.

Hyper-gender-role-normalcy had to be restored because, well, it had to be. In my late teens and early 20s, as I came out and became immersed in the social and political worlds of the gay scene, the only genderf*cking to be seen was the caricatured gender stereotyping of drag queens and, less commonly, drag kings.

The intriguing, creative, uncertain and unknowing story of androgyny, it seemed, had just been a phase.

Over the following couple of decades, a new phenomenon emerged: the transgender or now more openly termed trans* movement moved to the fore. Beginning, in my circle anyway, mainly with men who decided to live as women and then women who would realize that they identified as men.

Unlike androgyny, trans* people wanted to be recognized, for all intents and purposes, as the opposite gender. Most would want their birth gender to go unnoticed; a few activists would tell their story to raise awareness and lessen the stigma.

This new phenomenon medically termed gender dysphoria but politically dubbed genderqueer speaks a different story: gender isn’t what you’re born with — it’s what you think and how you feel. Sometimes they match, sometimes they don’t. If it’s the latter, it’s okay to change.

I felt compelled to write this blog is when I read a news article entitled Born in the Wrong Body, which I think signals the beginning of another new story:

  • “The parents of a seven-year-old girl are backing a decision for her to live as a boy and to medically stop puberty.
  • “If he reaches 11, 12 or 13 and decides it’s not what he wants, then he stops blockers and he’ll go through puberty as a woman,’ said the child’s mother.”

Here’s why I think it’s a new story, one which I’m excited about. Boy George and his peers told a story of growing up cis-gendered (meaning the gender they were born), but refusing to conform to gender stereotypes, particularly in appearance.

Trans* people tell the same first half of the story:

I grew up cis-gendered. (Then it changes.) It didn’t feel right. When I was old enough to be autonomous I changed my gender. I had to take hormones and have surgery to undo what puberty and adolescence did, which was to make me an adult of the gender I didn’t identify with.

This boy, the subject of the article, and Jason mentioned later, will tell a new story:

I was born a physical gender that didn’t match my identity. I was aware and my parents were open enough to understand, so took steps to allow me to grow up and go through puberty and adolescence that gave me an adult body that better matched my gender identity.

I was surprised at Georgina Beyer’s response:

“I don’t think a seven-year-old has enough life experience to understand precisely what they’re doing. I think it’s better a person gets to puberty and through puberty and then if this is continuing to develop . . . then yes, there is more of a case to be fought.”

I disagree with that stance because, all through life, we do things about which we may feel different later. If this boy gets to 15 and wants to be female, the woman he will then become will simply have another part to her story:

And then I changed my mind.

The stories we tell as humans are what sets us apart from every other species on the planet. Yet we fear to change our stories. We mindlessly ignore the influence of nurture on our social and intellectual development. We conservatively defer to nature as being statically right, rather than embracing the wonder of human nature: that we can change what nature creates for us because we have the awareness, understanding, technology and will to do so.

Changing our stories is what allows us to evolve. Our gender stories are the most basic and fundamental of all. Until we can change those, how on earth will we change the more complex stories of our diversity?

What Schools Can Do To Reduce Risky Behaviors and Suicides Among Lesbian, Gay, and Bisexual Youth

A high school English teacher in New Mexico told me about one of his students who had difficulty focusing in class. When the teacher showed concern, the student confided in him that her parents had kicked her sister out of the house after they found out she was dating a girl. The teacher tried his best to console the student and referred her to the school counselors for help.

The next year, the same girl sought his support when her parents took similar punitive measures against her because she, too, came out as a lesbian. This time he spoke openly with her, explaining that she had to keep her spirits up; that no matter what happened, she had to be true to herself. In concluding the story for me, the teacher explained that he knows the school needs to be a safe place in a community that may not accept his student. But even though he strives to create a safe environment, he does not think all staff people or students at the school are equally accepting.

At another high school, I heard something quite different. When asked about the experience of lesbian, gay, and bisexual students, an administrator responded – simply and implausibly – “We don’t have any of those kids at this school.”

Such accounts from teachers, administrators, nurses, and counselors illustrate the importance of schools and school staff for students struggling with their sexual orientation in a world that does not always support or even acknowledge their existence. Paradoxically, schools are often the only places lesbian, gay, and bisexual youth may find marginally more accepting than the surrounding community – and of course schools may not be more accepting. The everyday traumas experienced by these youth, especially when they find themselves in schools that ignore their needs, can put lesbian, gay, and bisexual students at increased risk for depression, substance misuse, and suicide.

Research Links Suicide to Sexuality

According to the Youth Risk and Resiliency Survey conducted by the U.S. Centers for Disease Control and Prevention, more than two-fifths of lesbian, gay, and bisexual youth have seriously contemplated suicide. These young people are three times more likely to think about taking their own lives than their straight peers and four times more likely to actually plan and attempt suicide.

In addition to risk of suicide, lesbian, gay, and bisexual youth are twice as likely to be bullied or threatened with a weapon on campus and three times more likely to miss school because they feel unsafe. Risk behaviors that could result in negative health outcomes are also prevalent at a higher rate among lesbian, gay, and bisexual youth. For example, such young people have higher rates of smoking cigarettes, drinking alcohol, misusing prescription medicines, and using dangerous drugs including cocaine and heroin.

These statistics underline serious threats to many American young people. What can be done? The Center for Disease Control has identified several evidence-based ways to reduce the risk of suicide and risk behaviors among lesbian, gay, and bisexual youth – by creating safer and more supportive school environments. So far, however, these strategies have not been fully or consistently implemented, and they are only rarely combined to create an optimum response.

How Schools Can Help

Schools are a critical point of intervention because they are the places where students spend most of their waking hours. When it comes to reducing risky or suicidal behaviors, schools are second in importance only to families. School nurses and counselors also often provide the first line of response to student medical or behavioral health issues. In rural settings where resources can be scarce, the school or school-based health center may be the main place students can find support or help. Based on available evidence, the Center for Disease Control has defined several strategies that can be adopted and combined to ensure that all American young people are supported and protected, regardless of their sexual orientation. According to these recommendations, schools can take the following steps – and, to date, only eight percent of schools do all.

  • Create “safe spaces” like a designated classroom, office, or student organization where students can receive support from school staff or other students. Only about 60% of schools currently have such spaces available.
  • Prohibit bullying and harassment based on sexual orientation or gender expression. Most schools report having such policies in place, but a fraction of them do not.
  • Facilitate access to medical health and behavioral health providers with experience serving lesbian, gay, and bisexual youth. Fewer than half of US. high schools facilitate such access.
  • Promote professional lessons on how staff can create safe and supportive school environments. Less than 60% of high schools provide this type of support to their faculty.
  • Deliver health education that includes information relevant to lesbian, gay, and bisexual youth. Only one-fourth of U.S. schools do this.

These strategies are an important way to address the needs of not only lesbian, gay, and bisexual youth, but may also help transgender and gender non-conforming students as well. Unfortunately, research on these subgroups and programs to help them remains to be done. An important recent development is the inclusion a gender identity question in the 2017 Youth Risk and Resiliency Survey.

Recognizing the existence of sexual and gender minorities in America’s schools and gathering large-scale data about their experiences can provide a clearer picture of the challenges various groups of students face – and, in turn, allow improved responses to their needs. By creating safer and more supportive school environments, we can reduce dangerous behaviors, eliminate many suicides, and improve academic and health outcomes, not only for sexual and gender minority youth, but also for all other students in our schools. Problems and tragedies that affect some students reverberate among many – and undermine America’s future.

On Stacking Books in the Library, and Undoing My Own Ableism

My first job right out of high school was working in a public library. I was one of three library pages who would put books away in order to maintain the bookshelves. A majority of the library staff watched me grow up in that building, and I was given my first opportunity at an internship the year before. I was very bonded to the staff and to the building itself. Working there reminded me a great deal of my childhood.

“Violet” was one of the book pages I worked alongside. For as long as I can remember, she had always worked at the library, it was almost as if she came with the building. Violet retired the year the building was given a grant to be rebuilt, which I always found to be appropriate timing. As a child, I could always count on Violet to be in the fiction section of the library.

Walking in, I knew I would find her pursing her lips and mumbling to herself while she put the cart of books away. Typically, she would stop me, and let me know I looked just like my mother and would then ask after her, right before complimenting me for the season I reminded her of, Autumn. By the time I began to work at the library, Violet was an elderly woman. She would come into the library every morning at 8:45 a.m. with fifteen minutes to spare, so she could sit on the ratty old orange couch in the staff lounge for ten minutes and then spend the last five minutes greeting staff as they came in before getting to her book cart.

Violet was meticulous at keeping time and budgeted herself to shelving two carts for the three hours she would work every day. Some days she was overly ambitious and was able to complete two and a half carts, but that was rare. Once she finished her shift she would grab her things from the staff lounge and go home. Later I learned Violet had a schedule she followed daily, consisting of breakfast at the Tea Cup Café, a walk to work, completion of her shift and then a return to the Tea Cup Café before going home. She lived alone and had a visiting nurse who would come to her home twice a day, once in the morning and once in the afternoon.

Once I had gotten really efficient at keeping my shelves well maintained, I would go down and help Violet with her books. At this point, I was shelving three to four carts an hour. Many times, I would put Violet’s books in alphabetical order for her on the cart so all she had to do was shelve while I walked around after her and fixed her shelves to make them look as “fronted and faced” as mine.

After several weeks of doing this, I was taken aside by my supervisor and asked that I not help Violet because Violet was capable of doing her own work and she took the time she did because she had schizophrenia. I was not aware of this, and always felt I was doing what was “right” because Violet was elderly and honestly, seemed to me to present as not very aware of her surroundings. It wasn’t until I was told of Violet having a diagnosis of schizophrenia that I realized why she presented the way she did.

I learned later on that she had been institutionalized for many years as a young woman until her brother and sister were old enough to discharge her from the facility she was in. Violet came from a time where health practitioners believed it was best to lock away persons with disabilities and forget them. This process is consistent with the manifestation of oppression through what is referred to by disability advocates as ‘containment.’ Society would rather hide Violet away than have her become a productive member of society or teach her skills because her life was less valuable than that of a person without a disability.

Violet and I never discussed her past or her diagnoses for the four years she and I worked together. After learning of Violet’s diagnosis, I realized I had been practicing ableism by doing her work for her and immediately stopped. I was not allowing Violet to do the work she was capable of because I assumed she couldn’t do it. Following this incident, I learned to ask before assisting her because I wanted to ensure I was respecting her ability to work at her own pace and do what she had been doing for thirty plus years.

The irony of it all is my brother has schizophrenia and it wasn’t until I met Violet. that I realized the importance and effectiveness of a routine but also, knowing Violate gave me hope that my brother might someday find himself in a similar position where he could function independently from my parent’s care.

The last year I worked at the library, Violet could no longer live independently due to needing around the clock assistance and eventually moved to a nursing home where she passed away some years ago. Every so often I visit the library and think of the woman who taught me about resiliency but also gave me a perspective that I keep with me always.

Deadpool, Gaymers and Girlfriends at London ComicCon

10 Video Games for Gay Gamers

Being gay and being a geek are, you might think, quite different things. But sometimes these two aspects of identity collide, creating a wonderful spectrum of possibilities. London ComicCon 2018 raised the rainbow flag and became a sparkling example of one such space for the  LGBT (Lesbian, Gay, Bisexual, and Transgender) community.

Glittery linguistic stereotypes aside, London Gaymers presented a funny, intimate and hopeful panel about LGBT gamers and the video gaming community at large.

They started with startling offline statistics from the LGBT charity Stonewall which found over 60% of university graduates return to the ‘closet’ and over a quarter are not ‘out’ at work. Conversely, the panel was comprised of Charley Hodson, Ashely Spindler, Izzy Jagan, and Nathan Costello all work in the gaming industry and all are ‘out’ in their workplaces.

So, how can we continue the good practice, and ensure that more geek workplaces are queer-friendly?  “We need people leading organisations to be supportive, to be open, to be kind most of all – from the top to the very bottom”.

Working in small firms, where one is known and appreciated as a person, was seen as a Good Thing with regard to sexuality representation. At some points, the positive storytelling had an almost bashful edge – perhaps a tacit acknowledgment that this is counter to the dominant narrative of hardships.

That is: It is much more effective if someone from a dominant (or privileged) position espouses the values and principles of equality. In addition to the usual impact of management/leadership positions, a privileged individual is not subject to a fallacy of vested interest when they promote equality. Allies have “access to cultural capital, and cultural power to change the world” (well said, Ashley!).

Doesn’t that sound just like a superhero power?

Of course, some gamers in online communities may need help to adjust their belief in the ‘post-homophobic era’. That era, sadly, is currently as much of a fantasy as a crocodile shooting out bananas from its Kart in order to trip up a pink-clad princess (ten points for getting the reference). It may seem as though LGBT persons have ‘enough rights’, but the sobering statistics say otherwise.

Whilst the London Gaymers panel was in agreement that true equality is on its way, it is still in its infancy. It needs nurturing, and time, and effort… and, yes, the occasional time-out. Ashley was candid regarding the online abuse aimed at her, purely for being trans, leading to necessary banning. Likewise for times that people need to shut their comments sections or step away from the gaming community’s occasional toxicity.

A soft hug of an idea to address this comes from Overwatch. The popular first-person shooter game translates unsavoury phrases into, for example, “It’s past bedtime. Please don’t tell my Mommy” and “I feel very, very small… Please hold me”.  A nudge into nonviolent communication – with humour.

Indeed, the voice actors who play Genji, Mercy, and Zarya noted in their panels that the popularity of the game it partly its inclusivity and diversity – not just within the game but within its community – “There is something for everybody”.

London Gaymers suggested the Overwatch model “holds people accountable” without necessarily stepping into the shaming, combative dance which can so often play out. Banning users from chats can ‘work’ in the short term – in order to remove hate or bigotry from online spaces – however, in the longer term, change will be created by supportive re-education.

Well, that, and visibility: the old adage we’re here, we’re queer still has its place. The fact of the matter is that gay people are game. “We support the industry, and the industry needs to support us too…. We deserve this respect – if we’re not getting it, demand it.”

There are, of course, different kinds of representation. It is not all about mere presence. There is the bells-and-whistles flounce of a queer archetype, whose one discerning feature is their sexuality. However, there is also the happens-to-be-gay character, whose queerness is part of ordinary – or extraordinary! – human richness.

We have seen this in television with shows such as The Wire, The Walking Dead, and Brooklyn Nine Nine. There are already games which allow same-sex romantic interactions, such Dragon Age, The Sims and more recently The Last of Us and (author favourite) Life is Strange.

The number of Gaymers who explored their gender and sexuality through The Sims (Nathan helpfully chimed in, “I’m gay, so I could make lesbians!” compared to actual lesbian Izzy, who unfortunately couldn’t) was cute to the extent of heart-warming. True sandbox play.

In short, as Nathan stated: “You can put gay characters in the game, and if the game is good, people will want it”. If an audience is interested in the story, the game will be popular.

However we must be careful about how we cater to online spaces: “It’s not a bonus if someone isn’t homophobic, transphobic, racist”. We must expect better from our online communities. Most importantly, “Sharing the positivity, enthusiasm, passion, and love we have, speaking up against injustice and misrepresentation, pulling people up to our level rather than going down to theirs” are all ways that the Gaymers think we can make a difference.

Brianna Hildebrand (Negasonic Teenage Warhead, from Deadpool) (R)

Indeed, it isn’t just video games that are changing to represent audiences. Brianna Hildebrand (Negasonic Teenage Warhead, from Deadpool and the more recent Deadpool 2) noted that she was respectfully asked by bigwigs (or biggish wigs) in the industry whether she wanted to keep quiet about her own sexuality, given the presumed response from audiences.

Brianna did not want to ‘keep quiet’ although she didn’t want to shout either. Her sexuality emerged in the public eye quite casually in a tweet which has been covered extensively elsewhere (not to be sensationalised as a ‘reveal’, mind). Responses have been supportive, and Brianna said that ComicCon 2018 had provided a platform for queer kids to talk to her about the importance of herself and her character in representing queerness in geek pop culture.

And it didn’t stop there. Not only is Brianna officially gay, but so is her character Negasonic, who was ‘outed’ in the same lowkey style. Ryan Reynolds – the characteristically ‘sweet guy’, the eponymous anti-hero, and co-writer of Deadpool 2–asked Brianna, “Hey, would you mind if we gave Negasonic a girlfriend?”.

(It is important, of course, to ask first).

Brianna claimed, with a wry smile, that she responded, “Mind?! I’m ecstatic!”.

And so, love of a feminine and lilac-becostumed variety struck the teenage warhead. Brianna discussed how they thought it would be more impactful if Negasonic’s love interest was mentioned, but ‘not a thing’. (This, by the way, has been considered by some theorists as the mark of ‘true diversity’; a celebration that neither erases nor exotifies difference).

When asked how Deadpool 2 covers such tender and sensitive issues amidst its swearing, sexuality and gratuitous violence, Brianna and Stefan Kapičić (who plays the well-mannered, gentle giant Colossus) said it’s because of the “Magic of Deadpool”. It’s the use of humour, the fact that these issues are treated as if they’re “Not a big deal”.

And it is magic. It’s the magic of fun, and fantasy, and play. It’s the fun about engaging in media that represents you – or gives you empathy to understand someone who is different to yourself.

It’s putting equality as a casual thread, not as a snazzy sideshow, the same way that the many queer vendors at ComicCon’s Comic Village market were just.. there. Not in a special LGBT section, but integrated with all the other talented artists. (Pride comics, and Joe Glass in particular, I have to give you a mention because you expertly encompassed the superhero realm with the adage, I didn’t see anything like me, so I created it. Allow me to share your creation.)

In short, pop culture is evolving, and much like an Eevee (ugh, too dated?) it comes with a range of elements. It is okay in the modern era to get your geek on. It is becoming steadily (or sporadically) more acceptable to get your gay on. And of course, at ComicCon, you can even get your gay geek on.

Call for the change you want to see – and if you can’t see it, be it. Rainbows for the win.

Delaware Legislature Sends Anti-“Conversion Therapy” Bill to Gov. Carney’s Desk

Today, the Human Rights Campaign (HRC), the nation’s largest lesbian, gay, bisexual, transgender and queer (LGBTQ) civil rights organization, hailed the Delaware General Assembly’s passage of Senate Bill (SB) 65, legislation protecting LGBTQ youth in the state from the dangerous and discredited practice known as “conversion therapy.”

The legislation was sponsored by State Senator Harris McDowell and State Representative Debra Heffernan, and Governor John Carney is expected to sign it into law. Once signed, Delaware will join 13 other states and Washington, D.C. with laws or regulations protecting LGBTQ youth from the harmful practice.

“For young people across Delaware, this legislation provides vital and potentially lifesaving protections from the damaging, dangerous and discredited practice known as ‘conversion therapy,’” said HRC National Press Secretary Sarah McBride, a Delawarean. “While Delaware has made historic progress on LGBTQ equality, we can and must do more to protect LGBTQ youth from rejection, stigma, and harm. SB 65 is a critical and significant step in that direction. We thank the Delaware General Assembly for their support of this vital legislation and we look forward to Governor Carney signing it into law.”

“We thank those members of the General Assembly who voted to protect LGBTQ children against the dangerous and harmful practice of conversion therapy, and especially prime sponsors Senator Harris McDowell and Representative Debra Heffernan and their legislative aides for their leadership,” said Equality Delaware’s Mark Purpura. “We look forward to Governor Carney signing the bill into law promptly.  We are also thankful to have had the opportunity to work together again with the HumanRights Campaign on this important issue. We need to keep the momentum going across the country to end this despicable practice once and for all.”

There is no credible evidence that conversion therapy can change a person’s sexual orientation or gender identity or expression. To the contrary, research has clearly shown that these practices pose devastating health risks for LGBTQ young people such as depression, decreased self-esteem, substance abuse, homelessness, and even suicidal behavior. The harmful practice is condemned by every major medical and mental health organization, including the American Psychiatric Association, American Psychological Association, and American Medical Association.

Connecticut, California, Nevada, New Jersey, the District of Columbia, Oregon, Illinois, Vermont, New York, New Mexico, Rhode Island, Washington, Maryland, and Hawaii all have laws or regulations protecting youth from this abusive practice. A growing number of municipalities have also enacted similar protections, including cities and counties in Ohio, Pennsylvania, Washington, Florida, New York, Arizona, and Wisconsin. In addition, lawmakers in New Hampshire recently passed similar legislation which currently awaits the governor’s signature.

According to a recent report by the Williams Institute at UCLA School of Law, an estimated 20,000 LGBTQ minors in states without protections will be subjected to conversion therapy by a licensed healthcare professional if state lawmakers fail to act.

HRC has partnered with the National Center for Lesbian Rights (NCLR) and state equality groups across the nation to pass state legislation ending conversion therapy. More information on the lies and dangers of efforts to change sexual orientation or gender identity can be found here.

Gay, Bisexual, Sexually Abused Male Inmates More Fearful of Prison Rape, More Open to Therapy

There is nowhere to escape in what often is referred to as a “sexual jungle,” especially for the most vulnerable. However, “Zero tolerance” toward prison rape is now national policy thanks to the Prison Rape Elimination Act passed by the United States Congress in 2003. Although this law changed how Americans think about prison rape, few studies have examined how inmates perceive rape and if they feel safe in prison. Even less is known about how their perceptions influence whether or not they ask for mental health treatment while incarcerated.

The most recent National Inmate Survey of 2011-12 of 92,449 inmates age 18 or older shows that among non-heterosexual prison inmates, more than 12 percent reported sexual victimization by another inmate and almost 5.5 percent were victimized by a prison staff member within the past 12 months. In comparison, 1.2 percent of heterosexual prisoners were sexually victimized by an inmate and 2.1 percent were victimized by a prison staff member. These rates are even higher for those with mental illness. About one in 12 inmates with a mental disorder report at least one incident of sexual victimization by another inmate over a six-month period, compared to one in 33 male inmates without a mental disorder.

Using data from more than 400 male inmates housed in 23 maximum-security prisons across the U.S., researchers from Florida Atlantic University conducted a novel study to examine the factors related to fear of rape in prison and the likelihood of male inmates requesting mental health treatment while incarcerated. They focused specifically on prisoners at risk of being sexually victimized in prison: gay or bisexual inmates and those with a history of childhood sexual abuse.

A key finding from the study, published in the Journal of Interpersonal Violence, is that sexual orientation and a history of childhood sexual abuse are significant predictors of male inmates fearing rape as a big threat in prison and voluntarily requesting mental health treatment. Findings from the study reveal that nearly 38 percent of gay and bisexual inmates and 37 percent of inmates with childhood sexual abuse fear rape as a big threat.

Compared with straight inmates, gay and bisexual inmates are approximately two times more likely to perceive rape as a threat and three times more likely to voluntarily request mental health treatment in prison. Inmates with a history of childhood sexual abuse are more than twice as likely to perceive rape as a threat and almost four times more likely to request mental health treatment than inmates who did not report a history of childhood sexual abuse. Notably, this finding is inconsistent with previous research that has shown that there is no significant relationship between childhood sexual abuse and feelings of safety among male inmates.

“The consequences of perceiving rape to be a threat in prison are vast and could contribute to violence among inmates as well as negative mental health ramifications such as increased fear, psychological distress, chronic anxiety, depression and thoughts of suicide,” said Cassandra A. Atkin-Plunk, Ph.D., co-author and an assistant professor in the School of Criminology and Criminal Justice within FAU’s College for Design and Social Inquiry.

Inmates incarcerated for two to five years are nearly three times more likely to perceive that rape is a big threat compared with inmates incarcerated for less than two years. Inmates in prison longer than 18 years are nearly four times more likely to voluntarily request mental health treatment in prison. The researchers also found that Black inmates are twice as likely to seek mental health treatment in prison compared to White inmates.

“Knowing that gay and bisexual inmates and inmates with a history of childhood sexual abuse are more likely to fear rape and seek mental health treatment, prison staff can target outreach and treatment efforts for this vulnerable sub-population,” said Mina Ratkalkar, LCSW, MS, lead author and a licensed clinical social worker pursuing a Ph.D. who conducted the study while she was a graduate student at FAU. “Our study shows that these sub-groups of inmates are receptive to treatment, and our findings have implications for both practice and policy in the United States.”

The sample consisted of a nearly equal number of men in their 20s, 30s and 40s. Black inmates made up about half of the sample, with White inmates comprising about one-third of the sample. Nearly one-third of the sample had previously been in juvenile detention and about one-quarter were incarcerated for the first time in the adult criminal justice system at age 18 or younger.

About 16.4 percent of the sample identified as gay or bisexual. About one-fifth of the men (73) reported a history of childhood sexual abuse, and about one-third of the men reported having received mental health treatment outside of prison.

It’s National Coming Out Day

Today is National Coming Out Day which is a day of raising awareness and destigmatization for the LGBTQ community.

Texting is the preferred method of communication for young people.

https://twitter.com/LukeGrayyy/status/917998300338454529

Proof you have great friends who also will throw you a party.

Great Advice, don’t feel pressured to do anything or be afraid to show your true self…Write your own story!

https://twitter.com/BeaIe_/status/918028843889373189

https://twitter.com/themackenzilee/status/918213499255427073

Happy Coming Out Day!

Military Service Boosts Resilience, Well-Being Among Transgender Veterans

Transgender people make up a small percentage of active-duty U.S. military personnel, but their experience in the service may yield long-term, positive effects on their mental health and quality of life.

A study from the University of Washington finds that among transgender older adults, those who had served in the military reported fewer symptoms of depression and greater mental health-related quality of life. The findings were published in a February special supplement of The Gerontologist.

The paper is part of a national, groundbreaking longitudinal study of LGBT older adults, known as “Aging with Pride: National Health, Aging, Sexuality/Gender Study,” which focuses on how a range of demographic factors, life events and medical conditions are associated with health and quality of life.

Estimated numbers of U.S. military personnel who are transgender vary widely, but range between one-tenth and three-quarters of 1 percent of the roughly 2 million active-duty and reserve forces. A study from UCLA estimates about 134,000 transgender veterans in the United States.

The new paper, by researchers from the UW School of Social Work, explores how military service affects transgender people because previous data indicated that, among LGBT people over age 50, those who identified as transgender were more likely to be veterans than lesbians, gay men or bisexuals.

Reports have indicated that transgender individuals serve in the military at higher rates than people in the general population. In the 2015 U.S. Transgender Survey of 28,000 individuals, 15 percent said they had served, compared to about 9 percent of the U.S. population overall. And yet, little is known about how military service influences the well-being of transgender veterans later in life.

Other studies have shown that transgender veterans suffer higher rates of depression than other veterans. UW researchers were somewhat surprised, then, to learn that the transgender veterans they surveyed tended to have better mental health than transgender people who hadn’t served, said lead author Charles Hoy-Ellis, a former UW doctoral student who is now an assistant professor at the University of Utah College of Social Work.

The traditionally masculine culture of the U.S. military would seem to be a potentially difficult environment for someone who doesn’t identify with the gender they were assigned at birth, he said.

But military service creates its own kind of identity, the authors said, because it presents often dangerous and traumatic challenges; overcoming those challenges builds resilience. And that’s where the identity as a transgender person enters the picture.

“Many people develop an identity as a military person — that it’s not just something they did but something that they are,” said Hoy-Ellis. “If transgender people, who are among the most marginalized, can successfully navigate a military career, with so many of the dynamics around gender in the general population and in the military, then that experience can contribute to a type of identity cohesiveness.”

The internalizing of negative stereotypes, such as those around sexual orientation, is considered a risk factor for poor mental health, added co-author Hyun-Jun Kim, a UW research scientist in the School of Social Work. Military service could be the opposite — a protective factor.

“Often when people think of the transgender population, they focus on the risk factors, but it’s equally important to focus on the protective factors and nourish those resources. In this case, what aspects of military service contribute to being a protective factor?” Kim said.

Researchers said they were somewhat limited by the size of their study sample: Out of the 2,450 people ages 50 to 100 who were surveyed for Aging with Pride, 183 identified as transgender. Of those nearly one-fourth, or 43, had served in the military. Of those who had served, 57 percent identified as female. People of color made up 29 percent of the transgender veterans in the study.

But as awareness grows about gender-identity issues, there is an opportunity to address support services for transgender veterans at the federal level and in the community, Hoy-Ellis said.

“This is a population that has served the country very proudly, and it’s important that we recognize that service,” he said. “Learning what we can about transgender older adults with military service may help us develop and implement policies and programs for people who are serving today.”

Other co-authors were Chengshi Shiu, Kathleen Sullivan, Allison Sturges and Karen Fredriksen-Goldsen, all in the UW School of Social Work. Funding was provided by the National Institutes of Health’s National Institute on Aging.

Exploring the Traumatic Impact of Criminalizing Policies on Black Women and Girls

Black Youth Project 100 with Freedom Side in New York City August 2014. (Photo: Caleb-Michael Files)

The truth is, “black girls and women are still some of the most vulnerable members of society, thereby putting us more at risk for adverse childhood experiences (ACEs). Black teen girls, in a given year, are more likely to attempt suicide and become trafficked at younger ages than their racial counterparts. Additionally, black girls are at a significantly higher risk for sexual abuse, physical abuse, and child neglect.

Stressors that occur during black and brown children girlhood, such as loss, grief, substance abuse, mental illness, exposure to violence and parental incarceration are identified as adverse childhood experiences (ACEs). A tool to “assess the cumulative effect of trauma on a person’s life”, ACEs identifies household dysfunction by exploring childhood experiences through a series of questions. At the conclusion, the response totals are utilized to assess the likelihood of risk factors for negative physical, mental and behavioral health outcomes (i.e. – asthma, early experimentation with drugs, suicidal ideation).

The National Survey of Children’s Exposure to Violence indicates that more than 60 percent of children from birth to 17 years experience victimization and 38 percent witness violence sometime during childhood. While our recent focus has centered on the black and brown #missingDCgirls, who are disproportionately pushed out of the educational system, the community needs the conversation expanded in order to continue to coalition build and support efforts for black and brown girls affected by many of the issues that girls face, within their families, schools, and communities.

Faced with significant trauma and limited coping skills, many girls engage in behaviors that impede healthy socio-emotional development and positive overall well being. Cutting, drug experimentation, poor diet, violent outbursts, social isolation and displays of depressive emotions are just some of the behaviors that precede unaddressed stress and hopelessness, particularly in black and brown girls’ lives.

Restricted by geographic location, lack of resources, lack of knowledge of supportive services, healthcare access barriers due to age and parental rights and adolescents are left with no options. It is the foundation for a perfect storm hopeless feelings and stress.

Exploring the Impact of Criminalizing Policies on African American Women and Girls

In September 2015, scholars, community members, activist, and advocates gathered for a roundtable to discuss the impact of incarceration and mandatory minimums on survivors. With goals that focus on black women and girls, survivors of domestic violence and sexual assault highlighted criminalizing policies, mandatory minimums, and challenges in reform initiatives.

The summary report highlighting the US Department of Justice Office on Violence Against Women key points and recommendations from the roundtable was issued in January 2017. The report captures these critical issues at “the intersection of multiple aspects of a person’s identity (i.e., gender, race).” When examining the “impacts of increasing incarceration and criminalization,” public health issues faced by black women and girls, such as domestic violence, sexual assault, mental illness, disability and chronic health ailments are often an afterthought. While acknowledging, the roundtable did not further discuss the impacts due to expression or exploration of sexual orientation.

“…participants noted that efforts to end violence require a deeper analysis of the intersecting factors that shape an individual’s identity. For example, it is important to take into consideration the additional barriers and risks experienced by lesbian, gay, bisexual, transgender and queer (LGBTQ) girls and women. Participants also highlighted the need to take into account the particular challenges and exploitation of transgender women and girls.”

The criminalization black women and girls face due to the inability to cope, runaway status, nonreporting of parental abandonment and all “the ways in which conditions and experiences related to domestic violence and sexual assault intersect with girls’ experiences in the child welfare and social services systems.” This an area of inquiry for further research and development of culturally relevant and trauma informed programming. As evidenced by the short and long term effects of adverse childhood experiences (ACEs), the correlations to pathways involving hyper-regulation and criminalizing trauma are the opposite approach to rehabilitation.

Critical race and black feminist theory are the foundations of my clinical and sociological perspective when presenting bio-psycho-socio-emotional histories. Social workers in clinical roles such as substance abuse and mental health are trained to not only “acknowledge, be supportive and discuss the problem” but also help the client navigate institutions and systems.

As an effective therapist, it’s imperative to not pathologize behaviors but to also understand individuals, communities, and organizations within the context of the social and cultural climate.

Transgender TV Characters Have the Power to Shape Audience Attitudes

transgender teen

Watching transgender characters on fictional TV shows has the power to influence attitudes toward transgender people and policy issues, according to new research from USC Annenberg. Just published in the peer-reviewed journal Sex Roles, the research further highlights the ways political ideology shapes viewer responses to transgender depictions in entertainment.

The researchers surveyed 488 regular viewers of the USA Network series Royal Pains, of whom 391 saw a June 2015 episode featuring a portrayal of a transgender teen, played by transgender activist Nicole Maines. Those who saw this episode had more positive attitudes toward both transgender people and related policies, such as students using bathrooms aligned with their gender identity. The fictional Royal Pains storyline was more influential than news events; exposure to transgender issues in the news and Caitlyn Jenner’s transition (which was unfolding at the time of the research) had no effect on attitudes.

Beyond the impact of the Royal Pains episode, the study is the first to demonstrate the effect of cumulative exposure to transgender portrayals, across multiple shows. The more shows featuring transgender characters (such as Amazon’s Transparent and Netflix’s Orange is the New Black) that viewers saw, the more transgender-supportive their attitudes. Viewing two or more transgender storylines reduced the association between viewers’ political ideology and their attitudes toward transgender people by half.

According to Traci Gillig, a doctoral candidate at the USC Annenberg School for Communication and Journalism and the lead author on the study, “While media visibility of transgender people reached new levels in recent years, little has been known about the effects of that visibility. Our study shows the power of entertainment narratives to influence viewers’ attitudes toward transgender people and policy issues.”

The research was conducted in collaboration with Hollywood, Health & Society (HH&S), a program of the USC Annenberg Norman Lear Center that serves as a free resource to the entertainment industry on TV storylines addressing health, safety and national security issues. HH&S Director Kate Langrall Folb explains: “We worked closely with the Royal Pains writers, connecting them with medical experts and providing information for the storyline.”

The results of this research suggest increased visibility of transgender characters in mainstream entertainment can have far-reaching influence on public perceptions of transgender people and the policies that impact them.

“Watching TV shows with nuanced transgender characters can break down ideological biases in a way that news stories may not. This is especially true when the stories inspire hope or when viewers can relate to the characters,” said HH&S Senior Research Associate Erica Rosenthal.

Read more about the research in an analysis by Gillig and Rosenthal. “Can transgender TV characters help bridge an ideological divide?” was published by The Conversation.

Mental Health Issues Suffered By Gay Men

The mental health issues gay men have to deal with aren’t limited to stigma and discrimination. According to a recent study, gay men are four times more likely to commit suicide than straight men. Moreover, more than half of the men who identify themselves as gay suffer from anxiety or depression. In short, the mental health issues suffered by gay men are a serious problem so finding ways to counter them is crucial.

As mentioned above, the mental health issues suffered by gay men are a serious problem and the best way to counter them is spreading awareness about gay mental health. Spreading awareness about the mental health issues suffered by gay men will help to improve their health and allow them to live a stress free life. So, without further ado, let’s take a look at the common mental health issues suffered by gay men.

Internalized Homophobia

Years of exposure to myths, stereotypes and homophobic rhetoric has forced gay men to internalize this negativity and believe, consciously or subconsciously, that these myths, stereotypes and homophobic rhetoric are true. This mental health problem suffered by gay men is known as internalized homophobia. Internalized homophobia is known to worsen general stress which in turn leads to poorer physical health.

Body image and Femininity issues

If you browse gay dating/hookup sites, you will find many profiles with the statements ‘No Fats, No Fems.’ This statement basically means that the individual isn’t interested in dating men with feminine qualities. This is an indication of larger issues in the gay male community such as overvaluing stereotypical heterosexual qualities and unreasonable body image expectations.

According to a recent study, the pressure of being masculine forces gay men to be less emotional and affectionate. Moreover, body image issues increase their risk of developing an eating disorder. As it contradicts the acceptance, quality, and openness the gay community should provide, the pressure to be masculine causes many gay men to feel frustrated and stressed.

Overworking to prove themselves to the world

Also according to the aforementioned study, on average, gay men have a higher income and are more successful than straight men. This may sound as great news, but it isn’t. Some gay men see their sexuality as a deficiency. So, to compensate for their ‘deficiency’, gay men try to be high-achieving or perfect in other aspects of life. The pressure to be perfect in different aspects of life causes great stress and anxiety in gay men. This is a mental health issue that troubles many gay men today in Australia and abroad.

The fear of bullying, being judged or rejection causes many gay men to isolate themselves or suffer from social anxiety. Also, legislations that limit their right reinforces to gay men that they’re not equal to heterosexuals. All of these things lead to the aforementioned mental health issues suffered by gay men.

Proposed Trump Cuts Imperil Mental Health, Health Care, Education and More

The budget proposed by President Donald J. Trump threatens critical health, scientific research and education programs that contribute to the social safety net for millions of Americans, according to the American Psychological Association.

“This budget, if enacted, would jeopardize our nation’s educational, scientific and health enterprises and limit access to critically needed mental and behavioral health services,” said APA President Antonio E. Puente, PhD. “These cuts would disproportionately affect people living in poverty, people with serious mental illness and other disabilities, women, children, people living with HIV/AIDS, older adults, ethnic and racial minorities, immigrants, and members of the LGBTQ community.”

“While every administration must make difficult budget decisions, any attempts to balance the federal budget should increase, not decrease, the number of Americans who have access to high-quality education, health care and social support,” said APA CEO Arthur C. Evans Jr., PhD. “APA calls on Congress to reject this budget proposal and replace it with one that protects and increases access to services and care for all Americans.”

Among the cuts denounced by APA:

•    $7.2 billion from the National Institutes of Health, approximately a 21 percent decrease from the FY 2017 level, which would result in 1,946 fewer grants. The National Science Foundation would receive a cut of approximately $820 million compared to FY 2017, a decrease of 11 percent.

•    More than $600 billion in reductions over the next decade from the Medicaid program, which could eliminate Medicaid benefits for about 7.5 million people. The proposal also includes the option for states to choose between a per capita cap or a block grant beginning in FY 2020. Medicaid is the single largest payer for behavioral health services in the United States, accounting for over 25 percent of behavioral health spending.

•    Elimination of the Graduate Psychology Education Program, the Behavioral Health Workforce Education and Training Program, and the Geriatric Workforce Enhancement Program, which together would reduce mental health workforce training by nearly $100 million.

•    Almost $400 million from the Substance Abuse and Mental Health Services Administration, including a roughly 22 percent reduction from the Community Mental Health Services Block Grant.

•    14 percent ($9.2 billion) from the U.S. Department of Education, eliminating investments in educational equity and quality, including slashing other key programs that support gifted students, effective teaching and professional development.

•    Elimination of the Public Service Loan Forgiveness program and programmatic changes that would prolong repayment periods for students with graduate school loans.

•    13.2 percent cut from the U.S. Department of Housing and Urban Development, including elimination of the Community Development Block Grant.

•    $200 million reduction for the Special Supplemental Nutrition Program for Women, Infants and Children.

•    Elimination of 75 employees from the Office of Justice Programs, including a cut of over 30 percent, reducing the office’s budget from $1.8 billion to $1.3 billion. The agency administers critical juvenile and criminal justice grants and houses the Bureau of Justice Statistics, Bureau of Justice Assistance and National Institute of Justice.

“A strong educational system is the foundation of a globally competitive workforce that fosters innovation, discovery and research,” Puente said. “As other countries continue to invest in education as part of their economic and workforce development strategies, the need for increased federal investment in American education has never been more important to our nation’s economic stability, national security and public health.”

“APA looks forward to working with Congress to ensure a more balanced approach to addressing our nation’s fiscal 2018 budget priorities, including making progress on increasing access to mental health care and addressing the opioid epidemic, investing in the scientific enterprise and expanding access to higher education for all Americans,” Evans added.

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