LGBTQIA/MENTAL HEALTH/RELATIONSHIPS

The most significant challenges are often telling the people we love the most

Loren A Olson MD Oct 26, 2020·8 min read published for the first time in Medium

Afew years ago, I gave a talk about men who come out gay later in life to a group of about sixty mostly grey-haired gay men at an LGBTQ community center.

A man I’ll call “David” sat near the back of the room. David appeared to be in his mid-fifties. Nothing about him gave any inkling that he was a gay man. He was large and powerful, a very masculine man with the calloused hands of a tradesman. His jeans, t-shirt, and work boots lent further support to that impression. His hair was thick, and his attempt to control it was only partially successful. His shadow beard seemed more a statement of rebellion than of style. He had a reserved and notably shy manner. He scrutinized every word I said and clutched on to it.

My remarks engaged the group and led to an active discussion. As the comments wound down, David hesitated and then raised his hand. When I acknowledged him, he stood to speak.

His voice quivered as he began. “I want to tell you guys something that I’ve never talked about before. Even my friends here don’t know about this.” He looked around the room as if to get their support. “I was married once, and I had a young daughter.”

His voice broke as he continued, “My wife and daughter were both killed in a car accident.” He paused as if to gather strength, and then he said, “I know what I should have felt, but what I felt was a relief.” Then he sat back down.

The room fell silent, and it took me a while before I could think of anything to say. At first hearing, the story is horrifying. How could he have felt relief in the face of such a tragic loss? But the more I reflected on it, I thought I know exactly how you felt.

Like many of us in the room who loved our wives and children, we understood that David wasn’t relieved because he lost them. His relief came when the accident lanced an abscess of his soul that had festered deep inside him. The accident had punctured the painful decision of leaving the family he loved to come out as gay.

The problem was not that he didn’t love them. The predicament for him was how much he would hurt the people he loved.

Many of the men I’ve met or corresponded with delay a decision to come out because they don’t want to hurt their wives, kids, parents, and even their in-laws. They had made their “for better or worse” vows in good faith. They had never considered any other life than the one they had. They expected to live to old age with their wives, surrounded by their children and grandchildren.

They wanted nothing more than what almost everyone wants.

Still, they’d spent years feeling lonely. With whom can you speak when you consider walking away from your dream for a life of uncertainty and social disapproval. Loneliness comes from trying to be someone you’re not. Fitting in is not belonging.

You can’t tell someone, “I think I might be gay,” and the next day say, “I take it all back.” Even admitting it to yourself means you’re acknowledging you’re a flawed man. When you say, “I think I might be gay,” the person to whom you’re speaking thinks He’s gay. Otherwise, why would he say that! Once you confess it, you’ve lost control over how that information is shared.

The Internet has offered isolated men — many from rural areas or cultures with strong prohibitions against homosexuality — an opportunity to have anonymous conversations with others like them. If they are lucky, they will cross paths with someone who offers hope. But the fears and sense of isolation persist. Even if they find someone, that person has no useful advice on how to solve their predicament.

Empathy spread through that room like a pine-scented car air freshener. Although everyone had a different story, we all knew what David felt. Some knew they were gay early on but thought marriage might fix them. Others knew but struggled with varying degrees of success to contain their same-sex attractions. Others buried underground a more robust secret sexual life.

Of course, some were jerks about it and betrayed their wives from the beginning. But those guys don’t often come to my talks, and if they do, they aren’t eager to share their stories.

You don’t need to precisely experience what another person has experienced to feel empathy for them. Although my story is different from David’s, the sense of loneliness and hopelessness he felt resonated with me. I once had a thought If only my wife would become an alcoholic. I could leave and take the kids with me, and everyone would understand. It mortifies me to admit those thoughts, but I felt a sense of desperation to escape the torment I felt.

Itbegan for me when I was thirty-two years old. I thought I had it all.

I was married with two kids living on a small farm on the coast of Maine. I had completed medical school, residency in psychiatry, and passed all my board examinations. I had been a Flight Surgeon in the U. S. Navy, and I was discharged as a Lieutenant Commander. I had paid off all my education debts. I had a successful psychiatric practice with an office in our 1800s-era sea captain’s house.

My wife and I had accomplished our shared goals, everything for which we’d worked and sacrificed. We’d made our families proud. Why was it neither of us was happy? I not only felt alone; I thought I would never not feel alone.

Life wasn’t as good as I expected it would be, but I didn’t know why. Maybe what I have is what everyone has. Was I expecting too much? Did the intense focus on my career exclude the possibility of taking a look at my sexuality? Or could it be that I fixated on work to avoid taking a more in-depth look at it? Being busy is a respectable excuse for not doing almost anything.

I began to wonder, Am I in the right place in my life? Have I been living my own life or a life to please others? Have I taken a good look at what I value? I imagined that David had asked himself some of those same questions.

AnAustralian psychiatrist, Dr. Saxby Pridmore, described what he called “predicament suicide.” A predicament suicide, according to Pridmore, is when an individual without a mental disorder completes suicide to escape intolerable circumstances.

Predicaments are problems that have no right solutions. There are only bad choices and worse choices; no good options are available. When a married family man considers coming out, he faces a predicament. He cannot find an honorable escape. He begins to feel hopeless that a respectable resolution exists.

Whether you’re young or old, one common theme underlies almost all successful suicides: a sense of hopelessness.

Wetend to believe that coming out is more accessible as more young people come out at younger ages. On the level of society at large, that may be true; on an individual basis, not so much.

After one of my book readings, an older woman tried not to cry as she told how her grandson had recently visited her to tell her he was gay. She reassured him that it didn’t matter; she would always love him.

He then went home and told his father. His father responded, “I will not have a gay son!” Her grandson then went out and shot himself.

Many people contemplate suicide when they first begin to have serious questions about their sexual orientation. For some, they can think of no other way to resolve the conflict.

At whatever age a person first begins to question their sexual orientation seriously, that conflict has been implicated in the lead up to the suicide attempts. When coming out milestones are reached later in life, the first suicide attempt for gay, bisexual, and questioning men occurs at an older age.

Most gay and bisexual men maintain good mental health, but compared to other men, gay, bisexual, and questioning men are at a higher risk for mental health problems and suicide. Gay and bisexual men seek mental health care more frequently than heterosexual men, but they are three times more likely to have attempted suicide and succeeded. About half have made multiple attempts.

Several things account for the more common mental health issues for older gay men:

• Homophobia, stigma, and discrimination

• Social isolation

• Lack of trust in healthcare providers

• Lower-income

• Alcoholism and illegal drug use

Most research on suicide has been done on youth with an increasing emphasis in recent years on bullying. Gay boys know the code of masculinity even better than straight boys. The code is enforced by self-appointed gender police who threaten them if they transgress the norm. They remind non-conforming boys to Take it like a man!

If you’re having difficulty finding hope, here, I’ll lend you some of mine.

For those struggling with conflicts about sexual orientation, reaching out to someone can offer hope. Many older gay, bisexual, and men who have sex with men do not seek care from a mental health provider because they fear discrimination and homophobia.

Therapists who are knowledgeable and affirming provide helpful therapeutic experiences. It is essential to find a provider that is trustworthy and compatible. Patients have a right to interview a prospective therapist about their attitudes and training before committing to therapy.

A good therapist will not impose their values on their clients. Counseling from therapists who focus on changing sexual orientation or encouraging hiding is not helpful and can worsen things. People who see religious counselors who consider homosexuality sinful have a higher risk of suicide than those who counsel with affirming religious groups. For some, medications may help.

Most gay and bisexual men can cope with coming out successfully if they have access to the right resources.

With almost all of the older men I have worked with or interviewed, they magnified the potential negative consequences of coming out. It is also difficult for them to understand the peace that comes with living authentically.

Here is a fairly typical response I receive: “I had a two-hour conversation with my parents tonight and everything went a lot better than expected. They told me they would love me no matter what. I think my mom was still in shock about me having an affair with a man. But it feels like a big weight has been lifted off my shoulders!”

Suicide looks like a rational choice when faced with a seemingly impossible predicament, but many of the challenges that lead gay, bisexual, and questioning men to consider suicide are not enduring.

Coming out is not an event but a process, but the most significant challenges are often telling the people we love the most. Not everyone has to come out to every person in every circumstance. A supportive group of family and friends is essential. But when families are not accepting, some will need to develop a “family of choice.”

The “It Gets Better” campaign provides an encouraging message of hope for young people faced with conflict about their identity. But that message of hope, the hope that it gets better, must also be shared with older men who feel a sense of loneliness and despair. For those struggling with conflicts about sexual orientation, reach out to someone who can offer hope.

If you’re having difficulty finding hope, here, I’ll lend you some of mine.Loren A Olson MD – MediumEvery story has a back story. In doing research for a previous book about my coming out when I was forty, I was often…lorenaolsonmd.medium.com

Read an excerpt from Dr. Olson’s award-winning book, Finally Out, here. Sign up for my newsletter here.