Tag Archives: gay suicides

Listening to HIV

Tap tap tap. 

One of my students peeked her head through my office door. “Can I talk to you for a minute?” she asked.

It wasn’t my regular office hour, but I always keep my office door open if I’m in there, in case a student needs to talk to me (and lately, that’s been a LOT). Usually they want to talk about their grades (the real-life version of the YouTube video “I Am Worried about My Grade” gets played out a lot). Not infrequently, probably because I’m a psychologist, they come to see me because they need help with some mental health issue. And it’s never just a little end-of-semester anxiety, or something easy like that – it’s always something heavy-duty. I had a feeling that this was one of those times.

“So I have a friend,” she said. That’s what they all say, I think to myself. But as she continued, it was clear that she was talking about a friend – and that she was very concerned about him. He’s HIV-positive. He’s in denial. He’s African-American, and has sex with men. He’s partying, doing drugs, not taking care of himself. She suspected he was having unprotected sex, although she didn’t know for sure. And she was very, very worried about him.

“How old is he?” I asked.

“Twenty-four,” she said.

Sadly, this friend is a textbook example of the highest risk demographic for HIV. According to a recent report from the CDC, although AIDS diagnoses and deaths continue to decline because of the effectiveness of antiretrovirals, HIV infections continue to rise. Every year, according to the CDC, more than 50,000 people in the United States become infected with HIV. More than half are men who have sex with men, and about half are Black or African-American. What’s particularly scary is that about one-third of those who are diagnosed with HIV will develop AIDS within one year of that diagnosis – suggesting that they could have been HIV positive for as long as 10 years before they were tested and diagnosed. This young man, I thought to myself as my student was talking, may have been infected a long time ago – and just didn’t know it.

AIDS diagnoses and deaths may have gone down significantly since the mid-1990s, but HIV infection is another story. Hundreds and hundreds of studies have been done, looking at everything from identifying at-risk populations, teaching safer sex practices, working to increase access to health services, improving sex education curriculum in schools, decreasing behaviors that are associated with risky sexual practices. And over the last twenty years or so, the research paints a depressing picture. Because none of this seems to be working.

Many people aren’t practicing safer sex. Many people don’t have access to health services. Many people don’t get great sex education in school (my students have told me many horror stories about what they’ve learned – or what they didn’t learn).  And what’s the common thread behind all this?

Oppression.

If you want a concrete example of how oppression increases the risk of HIV infection, take a look at Sacramento County, where I live. According to a recent article in the Sacramento Bee, Sacramento County has the highest rates in California of STD infection, including HIV as well as chlamydia, gonorrhea, and syphilis – all three of which commonly co-exist with HIV infection, according to the CDC. The highest rates of infection tend to be in the poorest and the most racially and ethnically diverse areas – South Sacramento, Oak Park, Del Paso Heights, and Florin. If we extrapolate from CDC data, it’s likely that many of those infected are gay or bisexual males, living in areas where there are few, if any, resources for LGBTQ people. Moreover, most clinics in Sacramento where people can get STD and/or HIV testing and treatment are located in the downtown or midtown areas – not in the neighborhoods where the highest percentage of cases are clustered. And young people between the ages of 14 and 29 are overwhelmingly overrepresented in these statistics. These are people who are poor, nonwhite, and lack access to health care, and, if they’re gay or bisexual, may also lack a direct connection to LGBTQ resources.

What’s interesting to me – and I don’t think this is a coincidence – is that this is the exact same demographic that’s at higher risk for depression and suicidality. In fact, when I asked my student if she thought her friend might be depressed, she didn’t hesitate.

“Definitely.”

Then she paused. “But I’m not sure if he’ll do anything . . . you know . . . .”

I knew.

“He’s already doing something,” I said. People who are HIV positive are thought to be seven times at higher risk for suicide than the general population – and it’s common for these suicidal feelings to be expressed indirectly through risky, self-destructive behaviors.

HIV and depression seem to go hand-in-hand. And that brings us back to our common denominator.

Oppression. It doesn’t just increase the risk of HIV infection – it increases the risk of depression as well. No wonder they coexist so frequently.

You know what’s ironic? The same day this student came to see me (November 25th), David Huebner of the University of Utah published a research article in Health Psychology that, in a nutshell, told this young man’s story. The title of the article? “Social Oppression, Psychological Vulnerability, and Unprotected Intercourse with Young Black Men Who Have Sex with Men.” With a title like that, you almost don’t even need to read any further. What this article does, in my mind, is connect the dots. Among the 1,2o0-plus participants in the study, those who experienced higher degrees of racism, homophobia, and socioeconomic distress were more likely to engage in a range of risky behaviors – unprotected anal sex, multiple partners, sex in public places, etc. What’s interesting, though, is that depression appeared to be the missing link. If racism, homophobia, and socioeconomic distress were all on board, then depression was likely to be part of the picture as well – which in turn was associated with risky sexual behaviors.

To me, looking at the equation from that perspective paints a different picture. For decades, public health researchers have been trying to stem the tide of HIV infection by focusing on risky sexual practices. But if you think about it, they’re not just “risky sexual practices” – they’re indirect suicidal behaviors. Whether they’re consciously aware of it or not, many people with HIV walk the line and flirt with danger, putting themselves and others in harm’s way. It’s a cry for help.

My student wants her friend to go to an HIV support group, although he was lukewarm about the idea when she brought it up to him. I hope he changes his mind.

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Filed under HIV/AIDS, homophobia, intersectionality, LGBTQ youth, mental health, psychological research, racism, transphobia

Is “neutrality” really neutral?

Yesterday, in a New York Times article titled, “In Suburb, Battle Goes Public on Bullying of Gay Students,” Erik Eckholm reports that, in the Anoka-Hennepin School District in Minnesota, eight student suicides have taken place within the last two years. Four of those students who committed suicide had been struggling with their sexual identity. While suicide rates among LGBTQ youth have always been high (studies cite between a 30-42% suicide rate among gay kids), the fact that so many suicides have occurred within such a short period of time is disturbing. What’s particularly important to note is that the Anoka-Hennepin school district lies within Michelle Bachmann’s Congressional district. And therein lies the backdrop to the suicide contagion we’re seeing within this school district.

Michelle Bachmann and her husband, Marcus Bachmann, run a Christian counseling center that has been accused of providing “conversion therapy” to clients. While those allegations haven’t been clearly substantiated, Michelle Bachmann’s attitudes towards homosexuality leak out in her words. For example, in 2004 Bachmann was quoted as saying, “We need to have profound compassion for people who are dealing with the very real issue of sexual dysfunction in their life and sexual identity disorders” (emphasis mine). That homosexuality-as-pathology belief system has infiltrated the public school system, contributing to a heated debate resulting in a “gag order” on any discussion involving sexual orientation. More specifically, the Anoka-Hennepin school district has adopted a policy of “neutrality” regarding sexual orientation, stipulating that sexual orientation should not be taught in the schools in any way, and that school personnel shall remain neutral on issues involving sexual diversity. Although this seems on the surface to be the best “agree-t0-disagree” solution, I think it’s important to question whether a “neutrality” stance is truly neutral.

Anti-gay bullying is not a new phenomenon. High schools have been something of a battleground for gay teens (or teens who are perceived to be gay, regardless of their true sexual orientation). Teens repeatedly say things like, “That’s so gay!” They bully gay kids by using anti-gay epithets against them. LGBT teens get verbally harassed and physically assaulted, and they are routinely subjected to intimidation tactics. According to one study, 80% of gay youth are subjected to verbal harassment, 45% are threatened with physical violence, and 20% are physically assaulted. And sadly, many of these incidents – particularly those incidents involving anti-gay comments and name-calling, and incidents involving intimidation – result in no intervention whatsoever by school personnel. It’s not just the Anoka-Hennepin School District that practices a code of silence around LGBT bullying – it’s almost every school district in the country. And yet, when we stay silent about bullying, discrimination, and oppression, we are ultimately engaging in complicity. Sadly, the LGBT students end up being collateral damage.

What the “neutrality” policy does, in essence, is that it contributes to a hostile campus climate. It also straitjackets teachers who want to intervene on behalf of LGBT students. And it shuts down any potential for conversation.

I’m reminded of a distinction made by Gregory Herek, professor of psychology at UC Davis, who has conducted scores of research studies on sexual prejudice. In his arguments in support of overturning the U.S. military’s “don’t ask, don’t tell” policy, Herek underscores the difference between social cohesion and task cohesion. Social cohesion involves liking each other and forming close personal and emotional bonds. Task cohesion, on the other hand, refers to the shared commitment among group members to work towards a common goal. It seems to me that public schools need to step up to the plate and engage in task cohesion regarding ensuring the personal safety and respect of all students. And ensuring that personal safety requires that school personnel be able to exercise the right to intervene when an anti-gay bullying incident is occuring (or, for that matter, any bullying incident). A policy of neutrality does nothing to achieve that goal.

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Filed under anti-gay bullying, gay suicides, hate crimes, homophobia, LGBTQ youth, reparative therapy, Uncategorized