Thursday 10/27/2011
Mentally Preparing for Lower Surgery
Preparing for any surgery can be mentally challenging. Over the past six years I have had four surgeries to prepare for both mentally and physically. For me, mentally preparing for the lower surgery was a little more intense then the chest surgery or complete hysterectomy.
There were several reasons for that, the first being that I was flying over to another country so I was experiencing a lot of anxiety surrounding traveling, airplanes, and then being in a country where I didn’t speak the language. The second, and biggest, was thinking about the surgery, the risks/complications and the effects it would have on my sexual self and physical ability to urinate the way I wanted to.
So for anyone out there preparing for lower surgery, either the metoidioplasty or the phalloplasty, the first thing I’d recommend doing is taking a deep breath and not thinking about everything that could go wrong. When I say this, I don’t mean that you should be in denial of the potential risks and complications, but as you are first getting used to the fact that the surgery is actually going to happen you need to be calm. I believe bodies heal better when you keep calm.
After you have found this peace in knowing the surgery is going to happen, then it is time to think about the risks and complications. For me, I was mentally preparing for the worse case scenarios, meaning, if my urethral lengthening didn’t work, then I told myself that I’d just say, “Well at least I tried. I’ll just go to plan b for now.” Plan b for me, if I had experienced a failed urethral lengthening, was to have it reopened behind my balls. I found peace in knowing that my surgeons had a pretty high success rate and for those urethral problems that were reported, they were able to fix them or the patient had someone in the U.S. help them.
Since I was going to be overseas for the surgery and then returning home, I had my general practitioner contact my city’s local urology office to see if any of them would be willing to work with me if I had problems. Their response was, “We’ve never seen this type of surgery before, but if he has problems we’d be happy to help him.”
This helped me relax a little, just knowing that I wouldn’t be walking in somewhere unexpected. But again, I was lucky and only had infections that were cured by using antibiotics, so I didn’t need to visit the local urologist.
After you have found peace with the surgery, reviewed the pros/cons and risks/complications and developed your game plan for after care, then you should again sit back and take deep breaths.
I can confidently say that the lower surgery was the most painful and most physically and emotionally challenging for me, especially when I returned home and started the recovery process alone.
As you are healing from the surgery the key is to HAVE PATIENCE. The first two months are the hardest and the healing is slow, but after two months have passed you’ll start feeling better and have more energy. If you have the urethral lengthening completed it will take you six months before it is healed. (This timeline is following my one-stage procedure, I know there are other things to take into account if you have a multiple-stage procedure completed).
Even though the surgery was extremely painful and tedious to recover from, I’d do it again if I had to. I love the results of my metoidioplasty, adored my surgical team, and am happy, very happy, with the choice I made. The most exciting thing for me is I only have 1,200.00 dollars left on medical bills….six years and over 38,000.00 out-of-pocket, I’m ready to move forward with my life ;)
For more information about my metoidioplasty experience visit my website at http://www.ryansallans.com
Good luck,
Ryan
There were several reasons for that, the first being that I was flying over to another country so I was experiencing a lot of anxiety surrounding traveling, airplanes, and then being in a country where I didn’t speak the language. The second, and biggest, was thinking about the surgery, the risks/complications and the effects it would have on my sexual self and physical ability to urinate the way I wanted to.
So for anyone out there preparing for lower surgery, either the metoidioplasty or the phalloplasty, the first thing I’d recommend doing is taking a deep breath and not thinking about everything that could go wrong. When I say this, I don’t mean that you should be in denial of the potential risks and complications, but as you are first getting used to the fact that the surgery is actually going to happen you need to be calm. I believe bodies heal better when you keep calm.
After you have found this peace in knowing the surgery is going to happen, then it is time to think about the risks and complications. For me, I was mentally preparing for the worse case scenarios, meaning, if my urethral lengthening didn’t work, then I told myself that I’d just say, “Well at least I tried. I’ll just go to plan b for now.” Plan b for me, if I had experienced a failed urethral lengthening, was to have it reopened behind my balls. I found peace in knowing that my surgeons had a pretty high success rate and for those urethral problems that were reported, they were able to fix them or the patient had someone in the U.S. help them.
Since I was going to be overseas for the surgery and then returning home, I had my general practitioner contact my city’s local urology office to see if any of them would be willing to work with me if I had problems. Their response was, “We’ve never seen this type of surgery before, but if he has problems we’d be happy to help him.”
This helped me relax a little, just knowing that I wouldn’t be walking in somewhere unexpected. But again, I was lucky and only had infections that were cured by using antibiotics, so I didn’t need to visit the local urologist.
After you have found peace with the surgery, reviewed the pros/cons and risks/complications and developed your game plan for after care, then you should again sit back and take deep breaths.
I can confidently say that the lower surgery was the most painful and most physically and emotionally challenging for me, especially when I returned home and started the recovery process alone.
As you are healing from the surgery the key is to HAVE PATIENCE. The first two months are the hardest and the healing is slow, but after two months have passed you’ll start feeling better and have more energy. If you have the urethral lengthening completed it will take you six months before it is healed. (This timeline is following my one-stage procedure, I know there are other things to take into account if you have a multiple-stage procedure completed).
Even though the surgery was extremely painful and tedious to recover from, I’d do it again if I had to. I love the results of my metoidioplasty, adored my surgical team, and am happy, very happy, with the choice I made. The most exciting thing for me is I only have 1,200.00 dollars left on medical bills….six years and over 38,000.00 out-of-pocket, I’m ready to move forward with my life ;)
For more information about my metoidioplasty experience visit my website at http://www.ryansallans.com
Good luck,
Ryan
Sunday 10/23/2011
Transitioning Teens
Many times, teens fear that they won’t be able to start hormones until they hit the age that their state deems them as an adult. While for some this may be true, it isn’t the case for everyone. The difference between starting hormones as a teenager, is that your informed consent is not enough to allow you to begin, you’ll also need parental consent.
I have worked with plenty of teens and their parents where they we’ve found a provider and they’ve begun hormones and transitioned in high school. Most teens I have worked with have been able to begin hormones by age 16, however I have heard of other providers (at least in the Midwest) who’ve prescribed to 14 and above.
Those under the age of 14 can be prescribed puberty blockers like Lupron, however it is hard to find providers who will do this (at least in the Midwest) AND Lupron is very, very expensive (around 1,300.00 a month – and not covered by insurance). So some providers will prescribe a small dosage of hormones and forgo the blockers all together. (All of these treatment plans are covered in the Standards of Care).
I recognize there are a lot of challenges for teenagers who are ready to transition. Coming out and gaining parents’ trust and acceptance can be difficult. Dealing with kids in the school, the school system and teachers can also seem impossible, but if you set your mind on this, and tell yourself that you will continue to pursue your dreams and medical needs then it give you hope and a goal.
For those teenagers who are fearful or feel their parents won’t understand, I don’t want the above statements to make you feel pressured. Coming out, talking with parents and school systems, etc takes time and has to happen only when you feel like it is time (you may still be scared at this point but you know it is time to take the next step). When you come out, expect parents to going through their own process. To help you understand their process, think about how you felt, questioned, explored and grew during your own identity recognition. Parents have to go through this too.
It is important to not take hurtful or questioning statements from your parents to heart. They may say things that you don’t like, but that is their own process, not yours. If you continue to approach them in a non-defensive manner (even if they get defensive) and continue to affirm your identity they will eventually recognize that their bargaining and/or
rationalizing to get you to change, won’t change you.
To help them explore/understand trans issues more, have them watch documentaries, look at pictures online, read books, or even attend a special speaker (if I’m speaking in your area, please come!) or event related to trans issues.
Sometimes you may find one parent is more accepting than the other (if you live in a two-parent household). This can be helpful for you because then they can also help you, nudge the other parent along.
So, again, although some may wait until they are considered an adult in their state to begin hormones, that doesn’t have to be the case depending on your readiness, parental support, and an affirming provider.
Be well,
Ryan
http://www.ryansallans.com
I have worked with plenty of teens and their parents where they we’ve found a provider and they’ve begun hormones and transitioned in high school. Most teens I have worked with have been able to begin hormones by age 16, however I have heard of other providers (at least in the Midwest) who’ve prescribed to 14 and above.
Those under the age of 14 can be prescribed puberty blockers like Lupron, however it is hard to find providers who will do this (at least in the Midwest) AND Lupron is very, very expensive (around 1,300.00 a month – and not covered by insurance). So some providers will prescribe a small dosage of hormones and forgo the blockers all together. (All of these treatment plans are covered in the Standards of Care).
I recognize there are a lot of challenges for teenagers who are ready to transition. Coming out and gaining parents’ trust and acceptance can be difficult. Dealing with kids in the school, the school system and teachers can also seem impossible, but if you set your mind on this, and tell yourself that you will continue to pursue your dreams and medical needs then it give you hope and a goal.
For those teenagers who are fearful or feel their parents won’t understand, I don’t want the above statements to make you feel pressured. Coming out, talking with parents and school systems, etc takes time and has to happen only when you feel like it is time (you may still be scared at this point but you know it is time to take the next step). When you come out, expect parents to going through their own process. To help you understand their process, think about how you felt, questioned, explored and grew during your own identity recognition. Parents have to go through this too.
It is important to not take hurtful or questioning statements from your parents to heart. They may say things that you don’t like, but that is their own process, not yours. If you continue to approach them in a non-defensive manner (even if they get defensive) and continue to affirm your identity they will eventually recognize that their bargaining and/or
rationalizing to get you to change, won’t change you.
To help them explore/understand trans issues more, have them watch documentaries, look at pictures online, read books, or even attend a special speaker (if I’m speaking in your area, please come!) or event related to trans issues.
Sometimes you may find one parent is more accepting than the other (if you live in a two-parent household). This can be helpful for you because then they can also help you, nudge the other parent along.
So, again, although some may wait until they are considered an adult in their state to begin hormones, that doesn’t have to be the case depending on your readiness, parental support, and an affirming provider.
Be well,
Ryan
http://www.ryansallans.com
Thursday 10/20/2011
Trans Folk and the Standards of Care
While writing healthcare modules for providers, I began to review the new Standards of Care, SOC 7, put out by WPATH. These standards are used by mental health, hormonal, and surgical providers as guidelines when working with transgender clients. The changes that the WPATH committee have made to the SOC are huge for the transgender community. If you are interested in healthcare and trans clients or are trans yourself, then continue on!
Below I am going to go over the new and improved standards but before doing so, I want to list what the old standards had as a contrast/comparison of the changes.
THE OLD STANDARDS
SOC 6 (published in 2001)
Recommended that a person seeking hormones or medical treatments follow the following standards in regard to their medical care. Again, it was recommended not REQUIRED (even though providers often assumed it was).
1. See a Mental Health Practitioner who is certified in Gender Issues for at least 3 months or 12 consecutive sessions.
2. Undergo a “Real Life Test” or “Real Life Experience” where they live as the gender they desire to transition to.
3. Begin Hormone Therapy (recommended to be on hormones for a year before seeking surgery - typically top surgery for FTM…suggested two years on hormones for MTFs prior to breast augmentation due to the effects of estrogen).
4. If seeking chest surgery, provide 1 letter from a mental health therapist to your surgeon (what the letter needed was listed in the SOC).
5. Wait two years after being on hormones before having lower surgery. When seeking lower surgery, provide surgeon with 2 letters from mental health therapists.
The NEW Standards
The new standards are not listed in a chronological order, which shows the SOC’s recognition that one’s identity, choices, and medical treatment needs are very individualized!
So instead of listing a 1, 2, 3 order, I’ll list treatment options and recommendations.
If you are seeking hormones and/or surgeries the following is taken verbatim from the SOC, page 28.
“Psychotherapy is not an absolute requirement for hormone therapy and surgery. A mental health screening and/or assessment… is needed for referral to hormonal and surgical treatments for gender dysphoria. In contrast, psychotherapy – although highly recommended – is not a requirement”
The criteria for hormone therapy are as follows:
1. Persistent, well-documented gender dysphoria;
2. Capacity to make a fully informed decision and to consent for treatment;
3. Age of majority in a given country;
4. If significant medical or mental health concerns are present, they must be reasonably well controlled.
In selected circumstances, it can be acceptable practice to provide hormones to patients who have not fulfilled these criteria.”
The SOC stated on page 59 that one DOES NOT need to be on hormones in order to be a candidate for chest surgery for FTMs or GenderQueer female-bodied individuals. The SOC still recommends, although not an explicit criterion, that MtF patients undergo feminizing hormone therapy (minimum 12 months) prior to breast augmentation surgery. The purpose is to maximize breast growth in order to obtain better surgical (aesthetic) results.
“Criteria for mastectomy and creation of a male chest in FtM patients:
1. Persistent, well-documented gender dysphoria;
2. Capacity to make a fully informed decision and to consent for treatment;
3. Age of majority in a given country (if younger, follow the SOC for children and adolescents);
4. If significant medical or mental health concerns are present, they must be reasonably well controlled.
Criteria for breast augmentation (implants/lipofilling) in MtF patients:
1. Persistent, well-documented gender dysphoria;
2. Capacity to make a fully informed decision and to consent for treatment;
3. Age of majority in a given country (if younger, follow the SOC for children and adolescents);
4. If significant medical or mental health concerns are present, they must be reasonably well controlled.
Criteria for metoidioplasty or phalloplasty in FtM patients and for vaginoplasty in MtF patients:
1. Persistent, well documented gender dysphoria;
2. Capacity to make a fully informed decision and to consent for treatment;
3. Age of majority in a given country;
4. If significant medical or mental health concerns are present, they must be well controlled;
5. 12 continuous months of hormone therapy as appropriate to the patient’s gender goals (unless the patient has a medical contraindication or is otherwise unable or unwilling to take hormones).
6. 12 continuous months of living in a gender role that is congruent with their gender identity;”
It still appears that prior to lower surgery they recommend “two referrals.” Page 56...”Consultation is readily accomplished when a surgeon practices as part of an interdisciplinary health care team. In the absence of this, a surgeon must be confident that the referring mental health professional(s), and if applicable the physician who prescribes hormones, are competent in the assessment and treatment of gender dysphoria, because the surgeon is relying heavily on their expertise.”
If what I have written hasn’t answered your concerns or questions, contact me and I’ll go into deeper detail!
http://www.ryansallans.com
Below I am going to go over the new and improved standards but before doing so, I want to list what the old standards had as a contrast/comparison of the changes.
THE OLD STANDARDS
SOC 6 (published in 2001)
Recommended that a person seeking hormones or medical treatments follow the following standards in regard to their medical care. Again, it was recommended not REQUIRED (even though providers often assumed it was).
1. See a Mental Health Practitioner who is certified in Gender Issues for at least 3 months or 12 consecutive sessions.
2. Undergo a “Real Life Test” or “Real Life Experience” where they live as the gender they desire to transition to.
3. Begin Hormone Therapy (recommended to be on hormones for a year before seeking surgery - typically top surgery for FTM…suggested two years on hormones for MTFs prior to breast augmentation due to the effects of estrogen).
4. If seeking chest surgery, provide 1 letter from a mental health therapist to your surgeon (what the letter needed was listed in the SOC).
5. Wait two years after being on hormones before having lower surgery. When seeking lower surgery, provide surgeon with 2 letters from mental health therapists.
The NEW Standards
The new standards are not listed in a chronological order, which shows the SOC’s recognition that one’s identity, choices, and medical treatment needs are very individualized!
So instead of listing a 1, 2, 3 order, I’ll list treatment options and recommendations.
If you are seeking hormones and/or surgeries the following is taken verbatim from the SOC, page 28.
“Psychotherapy is not an absolute requirement for hormone therapy and surgery. A mental health screening and/or assessment… is needed for referral to hormonal and surgical treatments for gender dysphoria. In contrast, psychotherapy – although highly recommended – is not a requirement”
The criteria for hormone therapy are as follows:
1. Persistent, well-documented gender dysphoria;
2. Capacity to make a fully informed decision and to consent for treatment;
3. Age of majority in a given country;
4. If significant medical or mental health concerns are present, they must be reasonably well controlled.
In selected circumstances, it can be acceptable practice to provide hormones to patients who have not fulfilled these criteria.”
The SOC stated on page 59 that one DOES NOT need to be on hormones in order to be a candidate for chest surgery for FTMs or GenderQueer female-bodied individuals. The SOC still recommends, although not an explicit criterion, that MtF patients undergo feminizing hormone therapy (minimum 12 months) prior to breast augmentation surgery. The purpose is to maximize breast growth in order to obtain better surgical (aesthetic) results.
“Criteria for mastectomy and creation of a male chest in FtM patients:
1. Persistent, well-documented gender dysphoria;
2. Capacity to make a fully informed decision and to consent for treatment;
3. Age of majority in a given country (if younger, follow the SOC for children and adolescents);
4. If significant medical or mental health concerns are present, they must be reasonably well controlled.
Criteria for breast augmentation (implants/lipofilling) in MtF patients:
1. Persistent, well-documented gender dysphoria;
2. Capacity to make a fully informed decision and to consent for treatment;
3. Age of majority in a given country (if younger, follow the SOC for children and adolescents);
4. If significant medical or mental health concerns are present, they must be reasonably well controlled.
Criteria for metoidioplasty or phalloplasty in FtM patients and for vaginoplasty in MtF patients:
1. Persistent, well documented gender dysphoria;
2. Capacity to make a fully informed decision and to consent for treatment;
3. Age of majority in a given country;
4. If significant medical or mental health concerns are present, they must be well controlled;
5. 12 continuous months of hormone therapy as appropriate to the patient’s gender goals (unless the patient has a medical contraindication or is otherwise unable or unwilling to take hormones).
6. 12 continuous months of living in a gender role that is congruent with their gender identity;”
It still appears that prior to lower surgery they recommend “two referrals.” Page 56...”Consultation is readily accomplished when a surgeon practices as part of an interdisciplinary health care team. In the absence of this, a surgeon must be confident that the referring mental health professional(s), and if applicable the physician who prescribes hormones, are competent in the assessment and treatment of gender dysphoria, because the surgeon is relying heavily on their expertise.”
If what I have written hasn’t answered your concerns or questions, contact me and I’ll go into deeper detail!
http://www.ryansallans.com
Tuesday 10/11/2011
Happy National Coming Out Day
Happy National Coming Out Day, or as my girlfriend likes to joke..."Why does everyone have to 'come out' of a closet? What would happen if you'd would just invite people in?"
What I am about to say may be controversial, or it may bring up a question or two, hang in here with me for a second and then share your thoughts.
Okay, I admit, I sometimes struggle with the phrase, "coming out."
I had to sit back today and ask myself, why am I struggling with this? After pondering on the visual I received with the phrase, I came to the conclusion that my slight discomfort comes from the fact that only people in the LGBT community have to "come out." And the undertone around it is that coming out now makes you "different" from the rest of the world. The only other aspect of a person's identity where I could see them have to come out with fear of acceptance or possible retribution is when a child tells their parents they switched from their parents' political or religious stance to the opposite or something different.
So, yeah, I struggle because coming out shows that having an LGBTQ identity is still put out there as an "other."
On a positive note, it is pretty amazing to see the pride that individuals take, either who identify as LGBTQ or who are Allies to the community on this day. For some reason, today has been one of those days where I just wanted to escape, drive away, and not be seen. In order to try and work through these emotions I found myself driving over to Memorial Park in Omaha, NE and just sitting there, on the ledge of a cement wall looking out toward the treeline and listening to the birds (and traffic).
I noticed after awhile that a lot of the cars were honking...I looked around to see what was going on and in the distance, held within the middle of a bridge that crosses over the road was a flapping rainbow flag. Along with the flag I could make out the shape of four bodies. I then realized all the honking came from cars celebrating and voicing their support of NCOD and the LGBTQ community.
Just seeing these kids standing on the bridge, holding their signs and waving a rainbow flag made me feel better. While watching and listening, I heard one person yell out the window, but all the other noises I heard were in support of the community. This reminded me why "coming out" is still an important phrase to use and day to celebrate. With each brave soul who is willing to be true to themselves and share with others a part of their identity that may challenge their beliefs comes another accepting individual.
The world is changing. I am amazed at the changes I've seen in the past ten years related to the LGBTQ community. The reason these changes happen is because of people who are open, approachable, and living their life to the fullest.
So even though "coming out" is sometimes bothersome to me, Happy National Coming Out Day everyone.
What I am about to say may be controversial, or it may bring up a question or two, hang in here with me for a second and then share your thoughts.
Okay, I admit, I sometimes struggle with the phrase, "coming out."
I had to sit back today and ask myself, why am I struggling with this? After pondering on the visual I received with the phrase, I came to the conclusion that my slight discomfort comes from the fact that only people in the LGBT community have to "come out." And the undertone around it is that coming out now makes you "different" from the rest of the world. The only other aspect of a person's identity where I could see them have to come out with fear of acceptance or possible retribution is when a child tells their parents they switched from their parents' political or religious stance to the opposite or something different.
So, yeah, I struggle because coming out shows that having an LGBTQ identity is still put out there as an "other."
On a positive note, it is pretty amazing to see the pride that individuals take, either who identify as LGBTQ or who are Allies to the community on this day. For some reason, today has been one of those days where I just wanted to escape, drive away, and not be seen. In order to try and work through these emotions I found myself driving over to Memorial Park in Omaha, NE and just sitting there, on the ledge of a cement wall looking out toward the treeline and listening to the birds (and traffic).
I noticed after awhile that a lot of the cars were honking...I looked around to see what was going on and in the distance, held within the middle of a bridge that crosses over the road was a flapping rainbow flag. Along with the flag I could make out the shape of four bodies. I then realized all the honking came from cars celebrating and voicing their support of NCOD and the LGBTQ community.
Just seeing these kids standing on the bridge, holding their signs and waving a rainbow flag made me feel better. While watching and listening, I heard one person yell out the window, but all the other noises I heard were in support of the community. This reminded me why "coming out" is still an important phrase to use and day to celebrate. With each brave soul who is willing to be true to themselves and share with others a part of their identity that may challenge their beliefs comes another accepting individual.
The world is changing. I am amazed at the changes I've seen in the past ten years related to the LGBTQ community. The reason these changes happen is because of people who are open, approachable, and living their life to the fullest.
So even though "coming out" is sometimes bothersome to me, Happy National Coming Out Day everyone.
Monday 9/19/2011
Supporting Your Identity First
Last week I conducted a three-hour training in front of a room full of counselors who specialize in substance abuse. The topic I was asked to cover was Addictions and the LGBT Community.
I felt dismayed as I completed research and looked at the numbers of people who identify as LGBT that are affected either by alcoholism, tobacco use or drugs.
Being a health behaviorist, I then asked the question, why are so many people in the community struggling? Just like there isn't a gay gene, I'm pretty sure there also isn't an alcoholic gay gene just hanging out in our bodies.
What I believe DOES cause so many people to struggle is how society treats us because of an aspect of our identity. It isn't fair that after all the struggles of figuring out who we are, we risk losing friends, family, employment and legal rights when we want to come out or simply just live our lives openly and honestly, no longer in hiding.
One person in my talk sounded a bit annoyed when I was covered the current data related to our teens and the effects of bullying in our public school systems. She believed things are better now and it just isn't a big deal. Her beliefs were partly right, things are getting better for some people, but even if one group accepts you, there is still the risk of others not.
So what can we do besides turning toward substances to help us cope when we feel alone or unsupported?
The first thing I recommend is letting go of self-negativity. "No one cares about me." "What's the point, I won't ever find love anyway." "Nothing I will do, will make a difference." Letting go of these types of thoughts will free you to moving forward and allow you to focus on the positive and self-motivating thoughts instead. I know to some this may sound cheesy, I too have allowed negative thoughts to evade my thinking far more than I care to admit, but recently I hit a turning point and realized I just feel better when I stop negativity within me.
The second thing I recommend is after you let go of the negative thoughts and embrace the positive thoughts, don't apologize to others for who you are.
After you embrace your positive thoughts, don't let others dictate what your identity should be, how you should act or what you should feel. Begin to reach out to people whom you know have a history of being more positive and seek support from them while you push away those that make you feel bad about yourself or others. Now again, in the past, I used to be cautious of positive people because I became annoyed easily by them, but I've learned the reason I was annoyed by them is because they had something I wanted.
If you are having problems finding acceptance from either friends or family, reach out to organizations around you that offer support. PFLAG, LGBT Centers, LGBT bookstores, College LGBT Resource Centers, or support groups that are online.
No matter how daunting it may feel to either tell people about an aspect of you, you aren't alone. The most freeing thing we can do is honor ourselves for who we are and not let the negativity bring us down.
I'm saddened by the health problems I see in our community because it shows that the one's who want to restrict us, are in a way, winning.
We are a community that fights, so we need to begin fighting back and the way to start is just by living our lives openly, honestly and with self-respect. If there is a roadblock either caused by friends, family or employment, we need to turn and find another path toward our destination.
Be well,
http://www.ryansallans.com
http://www.facebook.com/RyanSallansFTM
I felt dismayed as I completed research and looked at the numbers of people who identify as LGBT that are affected either by alcoholism, tobacco use or drugs.
Being a health behaviorist, I then asked the question, why are so many people in the community struggling? Just like there isn't a gay gene, I'm pretty sure there also isn't an alcoholic gay gene just hanging out in our bodies.
What I believe DOES cause so many people to struggle is how society treats us because of an aspect of our identity. It isn't fair that after all the struggles of figuring out who we are, we risk losing friends, family, employment and legal rights when we want to come out or simply just live our lives openly and honestly, no longer in hiding.
One person in my talk sounded a bit annoyed when I was covered the current data related to our teens and the effects of bullying in our public school systems. She believed things are better now and it just isn't a big deal. Her beliefs were partly right, things are getting better for some people, but even if one group accepts you, there is still the risk of others not.
So what can we do besides turning toward substances to help us cope when we feel alone or unsupported?
The first thing I recommend is letting go of self-negativity. "No one cares about me." "What's the point, I won't ever find love anyway." "Nothing I will do, will make a difference." Letting go of these types of thoughts will free you to moving forward and allow you to focus on the positive and self-motivating thoughts instead. I know to some this may sound cheesy, I too have allowed negative thoughts to evade my thinking far more than I care to admit, but recently I hit a turning point and realized I just feel better when I stop negativity within me.
The second thing I recommend is after you let go of the negative thoughts and embrace the positive thoughts, don't apologize to others for who you are.
After you embrace your positive thoughts, don't let others dictate what your identity should be, how you should act or what you should feel. Begin to reach out to people whom you know have a history of being more positive and seek support from them while you push away those that make you feel bad about yourself or others. Now again, in the past, I used to be cautious of positive people because I became annoyed easily by them, but I've learned the reason I was annoyed by them is because they had something I wanted.
If you are having problems finding acceptance from either friends or family, reach out to organizations around you that offer support. PFLAG, LGBT Centers, LGBT bookstores, College LGBT Resource Centers, or support groups that are online.
No matter how daunting it may feel to either tell people about an aspect of you, you aren't alone. The most freeing thing we can do is honor ourselves for who we are and not let the negativity bring us down.
I'm saddened by the health problems I see in our community because it shows that the one's who want to restrict us, are in a way, winning.
We are a community that fights, so we need to begin fighting back and the way to start is just by living our lives openly, honestly and with self-respect. If there is a roadblock either caused by friends, family or employment, we need to turn and find another path toward our destination.
Be well,
http://www.ryansallans.com
http://www.facebook.com/RyanSallansFTM
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