April 17, 2019
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The Gatekeepers' Role in Supporting High-Risk Populations
- Carolyn V. Coarsey, Ph.D
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Evidence now indicates that lesbian, gay, bisexual, and transgender (LGBT) populations are indeed, at elevated risk for suicides.
-Paul Quinnett, Ph.D.
Founder & CEO, QPR Institute
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For the third year in a row life expectancy in the US has dropped and there is no indication that the trend will reverse. According to Dr. Robert Redfield, director of the Centers for Disease Control (CDC), this trend is likely due to deaths by suicide and drug overdoses. The global picture according to the World Health Organization (WHO) unfortunately is not more encouraging. The WHO predicts that by 2020, the number of deaths by suicide will increase.
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The Family Assistance Foundation endorses the Gatekeeper program offered by the QPR Institute because the intervention shows co-workers, peers, supervisors, friends, and family members how they can help prevent suicide. The approach involves teaching the risk factors and warning signs for recognizing when someone we work with, or a family member may need our help. In addition to identifying indications of distress a co-worker, friend, or family member may be experiencing— becoming aware of high-risk groups is also an essential part of becoming a gatekeeper.
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The next few articles are intended to increase our understanding of groups who are at greater risk for death by suicide. One high-risk group includes those who face challenges related to their sexual orientation (LGBT), as well as transgender people. According to a publication by the American Academy of Pediatrics, being transgender is not a sexual orientation: it describes someone’s gender, not that person’s attraction to other people.
[1]
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Groups who use the acronym LGBT are identified as a high-risk group, mainly due to depression and other mental health problems, alcohol and drug use, stress from discrimination, and feelings of social isolation. This acronym is often used to group those individuals who identify as lesbian, gay, bi-sexual, transgender, and queer (LGBTQ).In addition to knowing the risk factors, it is important to understand what protects at-risk individuals from depression, harming themselves, and/or their desire to die by their own hand. The protective factors have been identified as family acceptance, connections to friends and those who care about them, and a sense of safety. Protective factors are part of an individual’s narrative which are shown to help keep them alive, despite the stressors in their lives. While the "t" refers to "transgender" in the acronym, experts point out the difference, as this is often misunderstood and causes additional distress.
A Corporate Man’s Success Story
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Ian and Sarah
[2]
were proud parents of an 8-year-old son and a 9-year-old daughter when Ian decided he could not go on living the life of a heterosexual man. Since he was a young boy, Ian knew that while he liked girls as friends, his romantic feelings were for boys. Ian kept this truth about himself quiet, as he could not imagine a life where his true feelings would be acceptable. When he was only thirteen, he overheard his parents talking about the son of a couple who attended the same church —and how his parents understood why their church-friends would no longer see their son. Because of his love for his parents, Ian made a silent promise, that whatever his secret longings, he would never do anything to cause his parents to reject him.
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When Ian was in high school, he dated girls to keep up the “normal image” of a boy his age. Immediately after Ian graduated from college, he married a good friend and tried his best to live the life he felt obligated to live. Within the first year, their daughter was born, followed shortly after by their son. Ian was proud to be a father, and while he tried to be a good husband, within a few short years, he knew that he was not living up to his end of the marriage. He cared deeply for his wife, but he longed for a truly loving, romantic relationship with someone of his gender. He found himself noticing men who seemed to look at him as if they knew somehow that his glances were more than just “friendly.”
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Ian started drinking as a way to mask his desires and numb his pain. The drinking became a daily habit and his depression grew to the point that he could no longer engage with his family—including his children. Ashamed of his drinking and even more ashamed of the source of his growing addiction, Ian also knew that his performance as a middle-manager in a large corporation was starting to decline.
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His behavior and withdrawal from the family did not go unnoticed by Sarah. Finding Ian at home one evening after work, drinking alone—she finally forced the issue. Slightly drunk, unable to hide his true feelings, Ian confessed that while he loved her as a friend, he longed for a different life where he could have a man for a partner. He admitted that he wanted to live an authentic life—but he was instead, living a lie.
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Sarah shared that for some time she suspected that something was wrong in their marriage but had no suspicion that her husband was gay. For several months, Sarah worried that Ian had met someone else and might be withdrawing from her because he no longer wanted to be married to her. As a devoted mother, she had already begun to think about how they might share their children’s lives, even if they were no longer married. While she had no idea about why Ian had pulled away from her, this worry had already caused her to prepare on some level for their inevitable separation.
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Hurt as she was—and she told friends that she was devastated over the news, Sarah realized her children deserved more than for her to make this about her pain and disappointment. To Ian’s relief, Sarah suggested they see a marriage counselor—someone they had seen before. While their problems at a previous visit to the therapist may have related to Ian’s sexuality at the time, nothing along those lines had been discussed.
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If there is a textbook case where children and parents can make a major life change with the least amount of added suffering, it was Ian and Sarah's story. The marriage counselor helped the young parents find separate counselors suited for the individual transitions that were taking place in their lives. And when the time was right, Ian and Sarah went together with their children to see a family therapist who supported the group and individual processes that were taking place.
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The next positive surprise for Ian took place at work. He and Sarah had decided to keep their lives outwardly the same until they filed for divorce and the living arrangements for co-parenting were complete. When that time came, Ian made an appointment with his supervisor at work. Having practiced with his counselor how best to tell his supervisor about his new life, Ian laid his cards on the table as unemotionally as possible. His supervisor listened to his story intently. To Ian’s surprise, his boss complimented him for the way he and Sarah had handled the challenging and painful process. While Ian tried to give Sarah credit, because had her reaction been less understanding, it might have put them on a different course; his supervisor gave him credit too. He told Ian that his honesty and handling of the situation in such a forthright way validated his impression of Ian. Ian continued to thrive in his corporate career after he “came out.”
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As Ian feared, his parents did not accept his divorce and moving out of his family home as well as his supervisor had. However, their affection for their grandchildren influenced their long-term response. They expressed respect over the way Ian and Sarah had handled the situation with their children. They approved of how the couple had worked out the custody process and other details of their new “family” life.
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By the time Ian told me his story, he was involved in a committed relationship with a man. Sarah had married someone she met shortly after the divorce. The two had a good friendship and were co-parenting their children, who by all accounts had adjusted well to the changes in the family. Once Ian had begun living life authentically, he helped other gay men who struggled with issues that he once faced.
Protective factors which have been identified include family acceptance, connections to friends and those who care about them, and a sense of safety.
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One can only wonder if Ian's wife and others had not been accepting of him in his drive to take control of his life. As gatekeepers, when we become aware of any individual struggling with life’s challenges, we support them. Like in Ian’s case, we help them connect with professionals and others who will assist them as they transition into the life that awaits them on the other side of their suffering.
[1]
Supporting & Caring for Transgender Children
, American Academy of Pediatrics.
[2]
These are not the actual names of the two people in the case study.
