Thinking about trauma, suicide and health inequalities on LGBT History Month

by David Barbour, SCSN Communications Officer

February is LGBT History Month. It’s a month where LGBT people reflect on our past, present and future. We remember and celebrate those who came before us and the struggles they faced to progress legal equality and shift social attitudes, we take stock of where we are now, and we look forward to what we’d like to see change in the future.

Scotland is one of the most progressive countries in the world for LGBT rights and equality. The recent vote in the Scottish Parliament to enshrine LGBT education into the school curriculum is just the latest forward step which should help at least marginally improve the lives of future generations of LGBT people, just as adopting equal marriage and civil partnerships did before.

But all is not rosy in the garden. Far from it.

A few years ago I was in a gay bar in Glasgow. I had got talking to a young guy who was a mutual acquaintance of a friend of mine. He was quite drunk. I wasn’t yet but I’m sure I was on my way there (LGBT people are more likely to drink and to drink excessively than their heterosexual peers – I know, I’m a recovering alcoholic). I went outside for a cigarette (LGBT people are more likely to smoke than their heterosexual peers) and he came out and began talking to me further. Without being invited, he opened up to me about abuse he had suffered as a child, how his family had taken his coming out badly and various other struggles he had had in his life and how he felt suicidal sometimes. I listened intently and with compassion. He obviously read this as my showing a romantic interest in him because he asked if I’d go home with him. I politely turned him down and he took it pretty rough. I continued to talk to him and told him about a charity in Glasgow that offered counselling for gay men and asked him to promise me he’d contact them about the issues he’d discussed with me. He went home after a little while. A few weeks later I heard that his body had been pulled from the River Clyde.

This weekend just passed, I heard that a gay friend of mine (I can’t say we were close friends, but we knew each other for about nine years, we liked each other very much and he helped me out with a couple of pieces of work as well as always being very nice to me) who I knew had been suffering with or had suffered with poor mental health for a long time, had killed himself. He was in his early 50s. I don’t know enough about it to be able to causally link his suicide to his sexuality, but nonetheless he was one of many LGBT people who suffered with mental ill health and who died by their own hand. Ostensibly he was comfortable with his sexuality, had many friends, was well loved, had had relationships and was supported. He was a warm, flamboyant and jovial character whenever I saw him and always happy to help you out. Yet still he’s gone now.

These two examples represent only the tip of an iceberg of gay people, many of them close friends, who I know who have thought about or attempted suicide – myself included. Or if not actually killing themselves, then as Stephen Fry so eloquently and sadly phrased it in his autobiographies, having a feeling of ‘just not wanting to be anymore’. Fry is just another of a long list of LGBT celebrities who have thought about, attempted or actually carried out suicide – including Elton John, Kenneth Williams, Alan Turing and Justin Fashanu to name a few.

A lot of us in Glasgow are talking about how this situation just can’t go on. We’re not just sad, we’re angry. And some of us are scared – because we know it could all too easily be us one day. Many of us know all too well the feelings of loneliness, anxiety, depression, stress or hopelessness that can feel overwhelming at times. And when we see people who seem well supported and relatively speaking happy enough take their lives, then how can we be sure it won’t happen to us even if we have good support mechanisms and even good awareness of the issues?

In discussing this on Facebook with some friends, one friend, who lectures on anthropology in Seattle, sent me a fantastically interesting article to read titled ‘The Epidemic of Gay Loneliness’. I recommend that any LGBT person read it and I recommend those with an interest in addressing the health inequalities suffered by LGBT people read it.

Trauma

The article tells of a social worker and epidemiologist who wanted an answer to why gay men in particular kept killing themselves in so much higher numbers than their heterosexual counterparts. Before homosexuality had been removed from the DSM (psychiatric diagnostic manual) as a mental illness, it was simply assumed that the disparity was a symptom of homosexuality itself, a ‘sexual inversion’. The explanation then shifted to trauma – with gay men being kicked out of their families and their love lives illegal. It stood to reason they had alarming rates of suicide and depression and young gay people might be most vulnerable.

The article continues:

But when he looked at the data, it wasn’t just suicide, it wasn’t just teenagers and wasn’t just occurring in areas stained by homophobia. He found that gay men everywhere, at every age, have higher rates of cardiovascular disease, cancer, incontinence, erectile dysfunction, allergies and asthma. In Canada, more gay men were dying from suicide than from AIDS, and had been for years.

“We see gay men who have never been sexually or physically assaulted with similar post-traumatic stress symptoms to people who have been in combat situations or who have been raped,” says Alex Keuroghlian, a psychiatrist at the Fenway Institute’s Center for Population Research in LGBT Health.”

I encourage you to read the article in full as it covers a wide array of nuanced areas and topics.

The main thing I took from it was that being LGBT and living in a heterosexist, heterocentric world would appear to be bad for your health – regardless of whether you experience direct homophobia. Internalised homophobia and a hyper active anxiety response triggered by years of constant stress of being in the closet in youth (and for some into adulthood) seems to be carried into adulthood and finds expression in every part of many of our lives.

This thought had already occurred to me some months ago when SCSN organised a screening of the documentary, ‘Resilience: the biology of stress and the science of hope.In the context of a discussion on childhood trauma, the documentary defined toxic stress as being the experiencing of sustained stress in childhood without a supportive adult relationship. It struck me that being in the closet and not being or feeling able to discuss it with anyone for many years fit the bill of toxic stress.

It’s little wonder then that we see higher rates of alcohol consumption and excessive consumption, higher rates of smoking, higher rates of drug use and higher rates of sexually transmitted infections compared with our heterosexual peers. (Apropos of which, the Resilience documentary further highlighted that childhood trauma actually changed the brain and affected the development of the part of the brain responsible for impulse control).

Pleasingly, the issue of suicide in the LGBT community in Scotland has been specifically addressed in the Scottish Government’s new Suicide Prevention Strategy – with LGBT people listed as one of the groups who require targeted interventions.

Right now, in my other role as a Community Alcohol Brief Intervention at the Glasgow Council on Alcohol, I am currently leading a review of the organisations’ LGBT inclusivity. This is in response to Scottish research which has described the health inequalities around alcohol use for LGBT people in Scotland and other peer led research carried out by the Scottish Transgender Alliance, which has recommended that drug and alcohol services work to be explicitly welcoming and inclusive of LGBT service users – also covering the reasons why many of them are not currently. This has already seen us incorporate the Rainbow flag into our website and social media banners for LGBT History Month, the display of a Pride Flag in our office reception, a new webpage with links to LGBT services, and will see internal staff training delivered by myself in the coming weeks. More work is planned.

These issues are important to me. And not necessarily because I care about other LGBT people and their health, though I do. It’s because I care about me and my health. I’m part of that community and I’m an individual within it. I’ve suffered with depressive anxiety and had severe problems with alcohol as well as being a smoker. None of these things are great for your life expectancy. But I don’t want to die by suicide. Nor do I want anymore of my friends or acquaintances to die by suicide.

I reckon there’s a discussion to be had about whether growing up as an LGBT person ought to be officially recognised as an Adverse Childhood Experience.

I also reckon that as LGBT people, maybe we can help ourselves at least a little where we’re struggling by recognising that we’ve been victims of trauma. And if we need support to appreciate it, come to terms with it, and survive it – then to help each other and ourselves to get that help.

If you’d like to know more about the work I’m involved in with the Glasgow Council on Alcohol, email david.barbour@glasgowcouncilonalcohol.org.uk

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