National Coming Out Day: Stigma Against Gay People Can Be Deadly

With my husband in the Windsor Suite of the Greenbrier Resort. 

Today is National Coming Out Day which operates on the concept that one of the most basic forms of activism is to "come out" to family, friends and colleagues and live an authentic life as an openly lesbian or gay person. Stated another way, homophobia thrives in an atmosphere of silence and ignorance, and that once people know that they have loved ones who are lesbian or gay, they are far less likely to maintain homophobic or oppressive views.  I came out roughly 17 years ago and lived through periods when Virginia's sodomy law was still binding law and when same sex couples could not marry. (For the record, I am also the survivor of two serious suicide attempts driven by the adverse consequences of "coming out.")

Obviously, ending homophobia runs directly counter to the efforts of the Trump/Pence regime and the Republican Party to continue to demonize gays and lesbians and to role back LGBT rights.  These efforts are aimed in part to endear the GOP and Trump/Pence to Christofascists who continue to use the bogeyman of LGBT rights as their number one fundraising scare tactic.   Nowhere in the calculus of this vicious agenda is the very real harm done to real people.  A piece in the New York Times by a licensed physician looks at the documented harm such homophobic efforts cause.  I maintain that these "godly Christian" folk care little about "religious freedom" and instead are focused on inflicting cruelty on those who are different, even if such cruelty drives individuals to suicide.  Here are article highlights which look at the harm being done to individuals and often their families:

I’ve never been sure what to expect when meeting someone who’s just tried to take his own life. But I’ve learned to stop expecting anything.

Yesterday, my patient, a 20-something graduate student, swallowed a jumble of unmarked pills, hoping to die, after his father told him never to come home again. Today, he greeted me with a soft smile, his delirium starting to clear, his heart beating normally again.

“Whoops,” he said.   He’d been a happy kid who aimed to please. He once felt so bad for lying about having done his homework before playing video games, he told me, that he’d grounded himself. Sociable but square, he didn’t drink until he was 21, even though he’d gone to a college with a reputation for partying. Deeply religious, he was gay but desperately wanted not to be.

Now his father’s disavowal pushed him over the edge, capping a string of stigmatizing experiences at home, at school and at church. He’d had enough.

For decades, we’ve known that lesbian, gay, bisexual and transgender individuals experience a range of social, economic and health disparities — often the result of a culture and of laws and policies that treat them as lesser human beings. They’re more likely to struggle with poverty and social isolation. . . . . L.G.B.T. youth are three times as likely to contemplate suicide, and nearly five times as likely to attempt suicide.

Some of these disparities have interpersonal roots: social exclusion, harassment, internalized homophobia. But often they stem from an explicit denial of rights: same-sex marriage bans, employment discrimination, denial of federal benefits.

Sexual minorities living in communities with high levels of prejudice die more than a decade earlier than those in less prejudiced communities.

But civil rights advances and growing public acceptance of L.G.B.T. individuals in recent years are among the more transformative social changes in modern American history. And evidence increasingly suggests this shift has measurably improved health care access and health outcomes for L.G.B.T. populations.

The halting, patchwork nature of L.G.B.T. rights expansions across the country has allowed researchers to study the effects on health and well-being by comparing states that expanded rights to those that failed to introduce protections, or actively curtailed them.

After Massachusetts legalized same-sex marriage in 2003, mental health visits dropped significantly for gay men across the state. Other states that followed suit saw a 7 percent reduction in suicide attempts among L.G.B.T. adolescents. Nationwide, legalization of same-sex marriage is linked to increases in the likelihood that gay men have health insurance and a regular doctor to see.

By contrast, in states that passed same-sex marriage bans in 2004 and 2006, L.G.B.T. individuals experienced a marked rise in mental health problems, including anxiety, alcohol use and mood disorders. (No such increase was found in neighboring states that did not pass bans.)

But it’s more than just marriage. L.G.B.T. individuals who live in states where it’s legal for businesses to deny people service based on their sexual orientation have a higher risk for mental health problems. One study found a 46 percent increase in the proportion of sexual minorities reporting depression, anxiety and other emotional problems in states that passed denial-of-service laws. Again, no increase was observed in states without these laws.

But there’s reason to believe progress in L.G.B.T. health may be imperiled by a political and social environment that is growing less friendly toward sexual minorities. More states are trying to pass “religious liberty” laws that allow for discrimination based on gender and sexual identity. Several federal health surveys will no longer include questions about sexual orientation, making it more difficult for researchers to study disparities. And the Trump administration recently established a new division in the Department of Health and Human Services to defend health professionals who refuse to provide care to people or in situations that conflict with their personal beliefs, which could include the right to treat L.G.B.T. individuals. (L.G.B.T. patients already face discrimination at concerning rates.

I think of my young patient in the hospital bed who had attempted to kill himself. I remember the pain that remained even as the toxins he ingested left his body. And I worry that a new wave of anti-L.G.B.T. rhetoric and policy will mean that he — and people who love like him — will end up feeling more stigmatized, in poorer health, or no longer with us at all.