Rainbow flags and Stars of David

I have attended two Passover seders in my lifetime. When I was in college, a friend of mine (actually, a sorority sister, for you regular readers of “The Active Voice”) invited me to her grandparents’ seder in Charleston, South Carolina. I’m told it was very watered-down and a far cry from what a “real” seder should be. Frankly, this here Gentile didn’t know the difference. I thought it was fun – and, even in its watered-down state, the experience taught me a lot about the meaning of Passover.

About five years later, I attended my second seder, this time in Berkeley, California. Only two people at the table were actually Jewish. But everyone at the table was queer. We used the “Queer Pride Seder” that had been developed by the Berkeley Queer Minyan (of which one of the two Jewish attendees was a member). I was tasked with bringing three bottles of wine – and, knowing that my meager graduate student budget couldn’t absorb the shock of the $25 kosher wine option, I took my chances with Manischewitz. How bad could it be, anyway? I thought to myself. Apparently this transgression was worse than bringing a loaf of crusty artisanal bread.

There are obvious intersections throughout history between queer identity and Judaism. For one thing, both groups were targeted by the Nazis during the Holocaust (yellow Stars of David for Jews, pink triangles for gay men, black triangles for lesbian women). During the 1950s, both Jews and homosexuals were linked to Communism, and ultimately targeted and persecuted in the age of McCarthyism. Throughout history, Jews have been major forces in a range of activist efforts – Emma Goldman, Betty Friedan, Gloria Steinem, Naomi Wolf, and Eve Ensler are just a few examples – and that social justice ethos has at times spilled over into the LGBTQ rights movement. Harvey Milk, the slain San Francisco City Supervisor, was Jewish. Barney Frank, who was the 1st openly gay member of the U.S. House of Representatives, is Jewish. The overlap between the two communities is strong.

Even with those strong overlapping commonalities, there is still a tension that exists between Judaism and homosexuality, which has caused some division among the various Jewish denominations. At the most conservative end of the spectrum, Orthodox Judaism explicitly prohibits same-sex sexual conduct – in fact, certain homosexual acts are considered to be in the category of “die rather than transgress.” Over time, some Orthodox leaders have become more sympathetic, stating that although homosexual acts violate Judaic law, people with same-sex attractions should be treated with compassion and respect. Yet many Orthodox Jews who are gay have incredible difficulty reconciling their sexuality with their religious and cultural beliefs. To use a term coined by Tova Hartman Halbertal, many gay Orthodox Jews experience “identity pluralism,” meaning that their gay identity is maintained completely separately from their Orthodox Jewish identity (the film Trembling before G-d depicts this tension in a very poignant way). On the far end of the spectrum, it’s not uncommon for gay Orthodox Jews to try to change their sexual orientation – the best-known organization in the Orthodox Jewish community is JONAH, which stands for Jews Offering New Alternatives to Homosexuality. (As an aside, one of JONAH’s founders is Arthur Goldberg, who is the former secretary/treasurer for the National Association for Research and Therapy of Homosexuality (NARTH), the nation’s largest secular reparative therapy organization.)

On the more progressive side, the Reform and Reconstructionist movements do not prohibit homosexual sex, and they allow people who are lesbian, gay, or bisexual to be ordained as rabbis and cantors. The Central Conference of American Rabbis (CCAR) has endorsed same-sex marriage, and in 2003 the Union for Reform Judaism issued a resolution that calls for the inclusion and acceptance of bisexual and transgender communities. The Reform movement is the largest branch of Judaism in the United States.

And then we have this middle ground, in the form of Conservative Judaism, which has taken the most complicated stance on the issue of homosexuality. In 2006, drawing upon the Jewish tradition of pluralism, the Committee on Jewish Law and Standards (CJLS) issued three different opinions, the most progressive of which lifted most prohibitions on homosexual conduct and allowed for same-sex marriage and the ordination of gay rabbis. By adopting multiple opinions, the CJLS essentially gave permission for individual rabbis, congregations, and rabbinical schools to choose the option that suited them best. Shortly after the CJLS issued this statement, the Jewish Theological Seminary and the Ziegler School of Rabbinic Studies started acccepting openly gay students into their rabbinical and cantorial programs.

So we have progress, and we have tensions. And, within both the Jewish and the LGBTQ communities, we have our own forms of intersecting oppressions. Homophobia exists in Judaic circles, and anti-Semitism exists in the LGBTQ community (and others). And various forms of oppression exist in both communities – racism, class oppression, and sexism, to name a few. While Jewish people have been persecuted for centuries, the Israeli-Palestinian conflict rages on. While lesbians and gay men continue to experience oppression, there is tension within the community regarding whether to be fully trans*-inclusive. Anna Freud (Sigmund’s daughter), in her 1936 book The Ego and the Mechanisms of Defense, referred to this as “identification with the aggressor,” where the victim of oppression takes on the role of the oppressor by victimizing others. We end up coming full circle.

Politics is complicated. Overlapping oppressions is complicated. But I come back to the celebration of Passover, which is a festival of liberation, commemorating the Jews’ release from slavery in ancient Egypt. The foods that are eaten during Passover and served during the seder are reminders of that oppression. At the Passover seder, the youngest child asks “the four questions,” starting with, “Why is this night different from all other nights?”  What an opportunity to reflect upon the devastating impact of oppression, however complicated it might be. And what an opportunity to invite everyone to the table (literally and proverbially) to celebrate the release from the bonds of oppression. Even those of us who can only afford Manischewitz.

The sickening truth about trans* health

I spend way too much time on Facebook. In my case, the line between “guilty pleasure” and “mind-numbing addiction” is embarrassingly fuzzy.  We’re talking DSM-style addiction here. (Okay, so the word “addiction” doesn’t appear anywhere in the DSM – so, to be diagnostically accurate, let’s call it “dependence” instead.) Over time, my Facebook usage has gradually increased. When I’ve gone for a while without checking my Facebook page, I get the mental shakes. If it’s nighttime, and I tell myself, “Oh, I’ll just check Facebook really quick,” that’s a guaranteed hour down the drain. And hey, I could quit anytime I want to. Right?

Facebook Anonymous, here I come.

Now, in defense of my excessive Facebook usage, let me say this: every once in a while, something important gets posted on Facebook that doesn’t show up anywhere else.  Like this:

HELP KATE BORNSTEIN STAY ALIVE!

Help Kate Bornstein stay alive? I think to myself. Whoa.

Kate Bornstein was the first person to really get me thinking about gender. Years ago, when a friend of mine was undergoing a gender transition, I read Gender Outlaw. Then I read My Gender Workbook. Both of those books took my previous understanding of gender and blew them to bits. As a humble admission, her work also gets credit for saving my relationship with my gender-transitioning friend (a relationship that was cracking at the seams due to my ignorance, transphobia, and unwillingness to explore discomfort). After reading her books, the seed-concept of “men, women, and the rest of us” was planted, and, like any hardy perennial, it has grown, flourished, and matured.

But even the hardiest of perennials don’t last forever. Kate Bornstein has two forms of cancer. For the last 15 years, she’s lived with chronic lymphocytic leukemia, a very slow-progressing cancer that often doesn’t require immediate treatment. This past year, she was diagnosed with lung cancer – and that has been a game-changer. She underwent surgery last August, but the cancer is back – and her treatment needs to go into high gear. “High-gear” means chemotherapy, radiation, tons of supplements – and a high insurance deductible, high co-pays, and a hiatus from work (which, in her case, is self-employment – writing, performances, and speaking engagements). Lots of money going out, no money coming in.

When I saw this announcement on Facebook, my thought process went in two different directions. One was just sheer disbelief – a normal reaction when you’re confronted with the mortality of an icon. But the other thought-direction was this: Being trans can’t make this easy.

In some ways, Kate Bornstein is one of the lucky ones. She has health insurance (albeit a high-deductible policy). She’s well-known in the LGBTQ community, and she has a lot of fans, supporters, and followers. In three days, her GoFundMe campaign has raised over $82,000 (with a goal of $100,000). Most people in the trans* community are not so fortunate.

Here’s the reality. According to a study conducted by the San Francisco Department of Public Health, 41% of transmen and 52% of transwomen lacked health insurance. Half had experienced employment discrimination because of their trans* status (and, for many people, unemployment and underemployment means no health insurance). For most of the participants in this study, purchasing an individual health insurance policy was out of the question – the reported median income was $744 for transwomen and $1100 for transmen. And according to several studies, trans* youth and young adults are significantly more likely than their lesbian, gay, and bisexual counterparts to experience family violence, parental rejection, eviction, and loss of financial support. When confronted with a life-threatening illness, it’s common to turn to family members for emotional and financial support – but, for many transpeople, that just might not be an option. (The film Gen Silent shows this very powerfully through the story of KrysAnne, who also, ironically, was battling lung cancer.)

However, there’s another health care-related issue that marginalizes transpeople even more powerfully than the lack of health insurance. It’s called the “transgender exclusion,” which can take several forms. First, transpeople can be denied health insurance solely on the basis of gender identity – despite the fact that the American Medical Association issued a policy statement opposing this practice. Second, insurance companies can deny coverage for claims related to gender transition. This is probably the most common form of the “transgender exclusion,” and it’s the trans* health care issue that’s probably gotten the most air time in the media. (Ironically, while hormones are often not covered for transpeople, in the general population they’re among the most commonly prescribed drugs. When I was preparing to go through donor insemination, the doctors were handing out hormones like candy – and I was considered to be a “noncompliant patient” for refusing to taken them.)

But there are more subtle, insidious, and dangerous forms of the “transgender exclusion” to those of us who have never walked in a transperson’s shoes. For one thing, insurance companies routinely deny coverage for gender-specific health issues. If a transman is registered with his insurance company as male, and he needs a Pap smear, chances are he isn’t going to get it. If a transwoman has prostate cancer, it’s highly likely that her insurance company won’t cover her treatment.

The worst-case scenario? In some cases, an insurance company may fail to cover any treatments, arguing that their medical concern is the direct or indirect result of hormone therapy, surgery, or other transgender-related treatment.  Jamison Green, author of Becoming a Visible Man and president-elect of WPATH (World Professional Association for Transgender Health), told me this story when I interviewed him for my upcoming book:

[I know a woman who] was riding a bicycle, skidded and fell, and broke her arm. She was taken to the emergency room and treated, but a few months later she got this humongous bill. She called and said, “What’s this about?”

They said, “You’re transsexual, and our policy prohibits treating transsexuals.”

She said, “My broken arm has nothing to do with being transsexual.”

They said, “You’ve taken those hormones, and they affect every part of your body. As far as we’re concerned, any part of your body that has been affected by your sex change is ineligible for treatment.” 

Ineligible for treatment. That’s about as dehumanizing as it gets.

Please consider supporting Kate Bornstein in her fight against cancer. More importantly, please take the time to learn more about transgender health care discrimination. If you’re in Northern California, the Center of Excellence for Transgender Health, in conjunction with WPATH, is hosting the 2013 Transgender Health Summit on May 17th and 18th. Check it out.

Do you hear what I hear?

It was a bright, sunny, beautiful spring day. Hundreds of people were milling about. There was a band playing on the outdoor stage. It was a typical Thursday “college hour” at Sacramento City College – the name we’ve given to the noon hour, which is, for most students, a free hour between classes. On those days, when the weather’s nice, I like to take a walk up to the local coffeehouse, grab a cup of coffee, and walk back to campus through the quad, savoring the energy and the music. I have to say, it’s one of the nice perks of working on a college campus.

A few months ago, on one of those walks, I ran into an acquaintance, A.J., whom I hadn’t seen in quite some time. He had never been my student, but we’d crossed paths numerous times through my interactions with the LGBTQ community on campus. He’s a fun, smart, and energetic guy, and I was thrilled to see him.

“It’s so great to see you!” I smiled. “How are you?”

He gave me a big hug, stepped back, and said, “I’m doing great!” A typical greeting, except for the fact that he also signed his response to me in American Sign Language.

“Are you taking American Sign Language?” I asked.

“Yes,” he said. “And I’m losing my hearing. I’m going deaf.”

Going deaf. 

That led to a long conversation that I got so engrossed in that I was almost late to class. More recently, I got to have a more extensive conversation with A.J. about being queer, hard-of-hearing, and the intersections between the two – which will become part of the narrative of my upcoming book, Fringe: On the Edges of the Mainstream Gay Community.

I want to make abundantly clear that I’m no expert on Deaf culture, or on the range of Deaf experiences. I know American Sign Language (with an East Coast dialect) reasonably well, although I’m very much out of practice. However, ever since my coming-out days in the early 1990s, I’ve noted again and again and again how strikingly similar the Deaf community is to the queer community.

Think about it. Deaf people, like LGBTQ people, have been treated like second-class citizens throughout history. Deaf people may not get support or understanding from their hearing family members, just as LGBTQ people may experience rejection from their straight biological kin. Both LGBTQ people and Deaf people have been subjected to efforts to protect children from them (Deaf people through forced sterilization, gay people through “Save Our Children”-type campaigns). Deaf people have been forced to “act hearing” by learning to speak and lip-read, while gay people historically have tried to “act straight” by dating someone of the opposite sex and getting married. Deaf children have been operated on without their consent in order to make them “normal” – and so have intersex babies. And both have formed communities of pride, with activism, resistance, and social justice at the heart of those communities.

But there are other ways in which Deaf communities overlap and intersect with queer communities – and not always in a pretty, nice-and-neat way. For one thing, both communities have disproportionately high rates of HIV infection. Deaf people are more likely to be HIV-positive compared to their hearing counterparts, just like some queer communities have been considered to be high-risk (most notably, gay men and transwomen). And when you look at the interaction, the statistical risks are compounded: According to one study, the gay Deaf community, compared to the hearing community, has a 40% higher rate of substance use – a significant risk factor for HIV infection. HIV infection tends to be more common in marginalized communities, and clearly the Deaf community hasn’t been immune to that.

A second observation is this: Being a member of a marginalized group doesn’t mean that you can’t oppress other marginalized people – and that’s true for the queer community as well as for the Deaf community. For example, while there are certainly safe and welcoming spaces for Deaf people within the LGBTQ community, there are online dating websites for people who fetishize deafness (or blindness, or being in a wheelchair, among others). On the other side of the coin, a 2006 dissertation study indicated that, out of 174 Deaf and hard-of-hearing people, most had at least moderately positive attitudes towards lesbians and gay men – but there were people who held onto homophobic attitudes, and they tended to be very religious. “You get people on one extreme or the other,” confirmed A.J. in his conversation with me. “Either Deaf people are very left and progressive, or they’re very right-wing conservative and religious. There’s no middle ground.”

And those extreme polarities (and intersecting identities) can make for very messy politics. Case in point: The educational epicenter of Deaf culture, Gallaudet University, found itself embroiled in controversy when Angela McCaskill, chief diversity officer for the university, signed a petition against same-sex marriage. Then, when the university placed McCaskill (who is African-American) on administrative leave, the Black student community called out the university on its unresolved racism. Oh, a tangled web of diversity and oppression we weave.

Here’s a third observation. People who are members of marginalized groups often get judged for how they choose to express themselves and deal with oppression. If a gay man decides not to come out at work, he might be judged for acting straight, for pretending to be something he’s not, for “passing” in order to gain heterosexual privilege. If a transperson decides not to have surgery, that individual might be judged within the LGBTQ community for not being “trans enough.” If a deaf person decides to get a cochlear implant (which is a HUGE political issue in the Deaf community), that person might be shunned for assimilating and “playing for the other team,” so to speak.

The similarities between the two communities are striking. But you know what is most surprising to me? Almost NO psychological research exists that focuses on people who are LGBTQ and Deaf. Literally, there is a small handful of studies out there – and some of those studies date back to the early 1980s. Which is a shame. Because what I’m learning more and more as I work on my book-in-progress is this: If you truly want to understand and eliminate oppression, look for where our oppressions intersect. Therein lies a golden opportunity.

Sisterhood is powerful

In 1990, when I was a sophomore at Tufts University, I made the very difficult decision to take a year-long break from school. My college experience had gotten off to a rocky start, and my first three semesters were pretty tumultuous, to say the least. When I returned that following spring, I was, in many ways, a very different person from the young woman who had begun college two and a half years earlier. I was just starting to question my sexuality. I was getting turned on to feminism, and I was toying with the idea of majoring in Women’s Studies (much to the initial chagrin of my parents). And, ironically, I realized that I had almost no close female friends. That, I decided, needed to change – and, upon my return, I started seeking out women’s spaces on campus.

What were my options? There was the Women’s Collective (which sounded kind of hippie to me, to be honest). There was one women’s only dormitory (which was actually one of the nicest housing options on campus). There was a pretty active lesbian and gay group. And there were various Division III women’s athletic teams (Division III being code for “if you have ANY athletic ability, you’ll probably get on the team”). None of those options appealed to me. I wasn’t really a “women’s collective” kind of gal (at least, not initially when I returned to school). I wanted to meet other women, but I didn’t necessarily want to live 24/7 with other women exclusively. I wasn’t even close to the point of clarifying my sexual identity and coming out, so the lesbian and gay group got nixed. And women’s athletics – well, let’s just say that I. Am. Not. Athletic.

So what did I do? I pledged a sorority.

There. I said it.

Saying it feels like coming out, in some ways – because most people don’t expect queer women to be in sororities. Or for sorority girls to be queer, for that matter. To be fair, it is an unexpected combination – for very good reasons. A 2002 survey of 692 college students revealed that, among other things, attending a college or university that boasts an active Greek system is strongly correlated with a lack of acceptance of lesbian, gay, and bisexual people. And a 2005 study titled “An Exploratory Study of the Experiences of Gay, Lesbian, and Bisexual Fraternity and Sorority Members Revisited” showed that, among the 500+ self-identified LGB fraternity and sorority members who participated, over 70% experienced attitudes and behaviors within their chapter that were considered to be homophobic and/or heterosexist. If you’re looking for a safe space to explore your sexuality, sororities aren’t typically the first option to come to mind.

On top of that, sororities are thought to be rather elitist (considering how much it costs to join many of them) and potentially racist (given the rise of the Black sorority movement). And the icing on the cake? Sororities, according to a 2007 study published in the Psychology of Women Quarterly, tend to be breeding grounds for body hatred and eating disorders. (Pardon the cake expression.)

Given all those strikes against the Greek system, why on earth did I join a sorority? Especially given my budding political awakening and social activism?

It kind of went like this: I met a woman at a social gathering. We struck up a conversation, focusing mostly on feminism and gender issues. She had taken several Women’s Studies courses, and was considering minoring in Women’s Studies (a lofty goal, considering that she was in the highly rigorous electrical engineering program). I told her that I had just returned to Tufts after a year-long hiatus, and was still trying to find my sea legs. “Have you thought about joining a sorority?” she asked. Then she laughed. “I know it might sound weird, because I don’t look like your typical sorority girl. But the sorority I belong to is different.”

The sorority she belonged to, as it turns out, was Phi Sigma Sigma. And it was different. There was a woman in that group who was openly bisexual. There were several women who came from poor, working-class, or otherwise economically challenged backgrounds – possibly because Phi Sigma Sigma was reasonably cheap to join. From the perspective of the other sororities on campus, Phi Sigma Sigma was the black sheep of our campus Greek system. “We’re the anti-sorority sorority,” we’d say, referring to the fact that, under most circumstances, most of us would have never dreamed of joining a sorority.

But we did. And for me, it was perfect. It was a women’s social organization that wasn’t based in politics – and yet, it created a safe space to wrestle with a broad scope of political issues. Very shortly after joining my sorority, I came out as a rampant feminist – and, despite the fact that not everyone agreed with all of my views, I was met with unconditional acceptance. I attended my first march and rally against rape and sexual assault with two of my sorority sisters. I co-taught a freshman seminar with one of my sisters on gender in contemporary film. Shortly before I graduated from college, I told a few of my sisters (as my voice was shaking nervously) that I was bisexual. They responded with – you guessed it – unconditional acceptance. And a few weeks later, a couple of my sisters accompanied me to my first Pride event.

I realize that my experience may well be unique. I’m not naive – I know that many sororities (and, even more so, fraternities) are icy-cold climates for sexual and gender minorities. To some extent, that’s changing. For example, an organization called Lambda 10 – otherwise known as the National Clearinghouse for Gay, Lesbian, Bisexual, Transgender Fraternity & Sorority Issues – was created specifically to heighten visibility of sexual and gender minorities in the Greek system. A few LGBTQ fraternities and sororities have formed (the first being the Delta Lambda Phi fraternity), and, increasingly, more traditional fraternities and sororities are identifying themselves as LGBTQ-friendly.

As oppressed people, we understand the power of finding and creating community. It gives us strength, healing, power, solace, and comfort – and it allows us to see ourselves reflected in others. And, as we all know, many of us find community in creative and unexpected places.

Sexual obsessions – with a twist

Fifteen years ago, when I was a psychology intern at a juvenile hall facility, I met with a 15-year old boy who was a member of gang – a “tagger,” to be more specific. His tagging activities had gotten him into trouble more than once, and this time, the reason he ended up in juvenile hall was because he was caught in the act of tagging a police car. Unless his goal was to end up in juvenile hall (and, after getting to know him, it certainly might have been), this was clearly not a smart move.

I’ll never forget this young man. For one thing, he was an incredibly talented artist. If he could have channeled his creative and artistic ability into something more socially acceptable (or if he could have emulated Jean-Michel Basquiat or Keith Haring), he could have made a successful art career for himself. Which is exactly what I said to him. His response?

“I don’t tag because I’m good at it. I do it because it makes my head shut up.”

Hmm. After a series of questions (and clarifying that he wasn’t hearing schizophrenia-style voices), it became clear that he was experiencing high levels of anxiety.

“Do you know what it is that makes you so anxious?” I asked him.

“Yeah,” he said. “I’m afraid I’m going to turn gay.”

Hmm.

This was a kid who was in a gang. So was his dad, his brothers, his cousins, and pretty much every male in his family. If he really was gay, his family (and the gang) probably wouldn’t take it well, to say the least. Frankly, I wasn’t convinced that he actually was gay. To me, it seemed like he had some form of obsessive-compulsive disorder, his obsessions focusing on the possibility of turning gay, and his compulsions being, among other things, the tagging behavior. So I shared this case with my supervisor and offered my very novice-level opinion. “What do you think?” I asked.

He shook his head. “He’s gay,” he said definitively. “And the fact that he’s gay is causing him a tremendous amount of anxiety. He’s going to have to come to terms with it at some point.”

Now, if you are a regular reader of this blog, you know that I am all about getting okay with your sexual identity. In fact, therapists who try to convince their clients that they’re not really gay, or that they could be straight (or at least act straight) if they were motivated enough to do so, make me totally sick. “There oughta be a law” was the title of my blog post several months ago about SB 1172, the first piece of state legislation prohibiting mental health practitioners from engaging in sexual orientation change efforts with patients under the age of 18. Personally, I think this is a very good law, because dragging your LGBTQ kid into therapy to try to make them straight will undoubtedly cause them irreparable damage. But what about a (probably straight) teenage boy whose therapist tries to convince him that he’s gay – and that he should be okay with it? That scenario goes way outside the “Psychotherapy 101” training manual.

Fast-forward to 2013. Last week, I had a conversation with someone that, in hindsight, was eerily familiar – kind of like deja-vu. He asked me, “Have you ever heard of HOCD?”

I had never heard of HOCD. So his next question was:

“Well, then, I’m sure you heard of OCD?”

Obsessive-compulsive disorder. Yes, I’m quite familiar with it. I had a feeling I knew where this was going.

“The ‘H’ is for ‘homosexual.’ I have a fear that I might become gay, even though I know I’m straight.” He paused. “I’m not homophobic, and I support gay rights fully. But I have all this anxiety about one day being attracted to men instead of women.”

HOCD is not a scientific term, nor is it a DSM-diagnosable disorder. Rather, it’s a name the OCD community has come up with to identify this phenomenon. A 2010 article in Time magazine addressed the issue of HOCD (also sometimes referred to as SO-OCD, “SO” being short for “sexual orientation”). Monnica Williams, a clinical psychologist and researcher at the University of Louisville, has conducted some research on the prevalence of HOCD and has written an informational article about it, which includes a diagnostic differentiation between HOCD and true homosexuality. But other than that, very little information exists about this disorder. And not having information about it could potentially be dangerous.

Dangerous? How so? Consider the following case example that Monnica Williams provides in her article:

I had a really bad experience. I have been diagnosed with OCD for a while now. The therapist I was seeing told me that I should try to be with a man, and that everybody is bisexual. It really freaked me out, and I was suicidal for five months thanks to what she said. The thoughts grew even stronger. Eventually, I couldn’t be with any person of the same sex alone in the same room, watch TV, read the newspaper, or listen to music with male voices. I’m amazed that I’m still in this world after that experience. Therapists should be aware of what they are telling people like us (Williams, 2008, p. 200).

Of course, reinforcing homophobia and sexual prejudice is not an acceptable therapeutic practice – and Williams makes clear in her writing that people with HOCD are not necessarily, by definition, homophobic. Rather, the point she makes is that trying to convince someone who’s straight that they’re really not, or that they could be gay, is just as damaging as subjecting an LGBTQ person to sexual- or gender-reparative therapy. But I think therapists who work with HOCD clients have to walk a fine line – affirming their clients’ true sexual orientation and help reduce their anxiety, but to do so without reinforcing any internalized homophobia.

I’m actually surprised that more hasn’t been written about this disorder. And in some ways, I understand why – a lot more energy has focused on preventing reparative therapy against LGBTQ individuals. But it seems to me that a ban on “sexual orientation change efforts” should apply across the board – and that any therapy that affirms one’s existing sexual orientation, wherever the person might be on the spectrum, is a healthy thing.

The conversation I had last week ended with me asking the following question: “Have you seen a therapist for this?”

“No,” he said quickly. “I’m afraid they’ll try to convince me I’m gay.”