Season of pride

By S. Bryn Austin, ScD, director of Fellowship Research Training in the Division of Adolescent and Young Adult Medicine at Boston Children’s Hospital

This past Saturday was Boston’s 42nd annual lesbian, gay, bisexual and transgender (LGBT) Pride parade. As I stood among the jubilant throngs, cheering on the joyfully endless stream of colorful marchers, cyclists, roller skaters and floats, I was struck by how much we have to be proud of here in Massachusetts. And I mean all of us, not just the LGBT community.

Boston Children's Hospital's presence at this year's LGBT Pride parade

In 2004, Massachusetts was the first state to legally recognize the right of same-sex couples to marry. Twenty years ago, we were the first state to establish—by executive order from then-Governor William Weld—Gay-Straight Alliances (GSA), which are vital school-based support groups for teens. Across the state, we have many outstanding community-based organizations providing valuable resources for LGBT youth. And right here at Boston Children’s Hospital, we’re a national leader in health care and research for LGBT youth.

Every milestone achieved on the path toward equality and inclusion is a direct result of the compassion and dedication of our whole community working together, gay and straight, transgender and nontransgender. We can all share in the season of pride.

But my enjoyment of the parade was clouded this year because of a research study my team and I were about to publish in the American Journal of Public Health. We surveyed over 9,000 young adults of all sexual orientations from across the country. We asked them a lot about their lives growing up, from when they were young children and through their teen years. We asked some hard questions too, like how they were treated by their parents and siblings and also about their mental health now, as young adults.

S. Bryn Austin, ScD

Our results turned up a heart-breaking picture, a reality far from the prideful embracing of diversity I witnessed at the parade. During childhood, young people who are LGB or who express their gender in nonconforming ways (girls who are less feminine than other girls or boys who are less masculine than other boys) are two to four times more likely to be targeted for mistreatment and abuse by family members and others outside the home when compared to their straight or gender-conforming peers. This abuse takes a terrible toll on some of these young people. By their mid 20s, roughly 20 percent of lesbian and bisexual young women and 12 percent of gay and bisexual young men have post-traumatic stress disorder (PTSD), compared to 7 percent and 4 percent of heterosexual young women and men. Unfortunately we found in our study that much of the PTSD occurred as a result of abuse inflicted by family members.

Why are LGB and gender-nonconforming children singled out for abuse? We don’t know all the reasons, but we suspect it may have something to do with what I might call the abject absence of pride. For some parents, having a child who is gender nonconforming or different in some way that may be related to their future sexual orientation is confusing and frightening. Far from feeling pride in their child’s uniqueness, they feel ashamed, fearing it means they are bad parents, especially if what they have learned is only prejudice and misinformation about LGBT people. Many may feel that as good parents, they must “correct” their child’s differentness, either for their own sake or in the name of protecting the child from the hostility they think awaits them in school, in their faith community and in society at large.

GLBT youth are two to four times more likely to be targeted for mistreatment and abuse by family members

But this “correction” can become abuse and is especially harmful if the child sees it as rejection of his or her worth. From their parents’ shame, these children learn at a young age to be ashamed of who they are. All of this can occur early—in childhood and early adolescence—well before a young person has a chance to come out as LGBT and seek out a Gay Straight Alliance or a supportive community-based organization or health care provider.

On showcase this past weekend at Boston’s LGBT Pride parade was our model of community building and advocacy that clearly works. In 2012 we have increasing legal protections, a president who is willing to speak out in support of same-sex marriage and an abundance of organizations and resources to connect LGBT people, foster community and instill a healthy pride and dignity in being who we are.

At the same time, we are missing the most vulnerable among us: young children and their families during the time of life many years before they will know they will be LGBT.

From their parents’ shame, these children learn at a young age to be ashamed of who they are.

Can we bring the season of pride even to these young children and their families? Our research suggests it’s going to take a new approach to do that. One that includes everyone who works with expectant and new parents and parents of young children. That means pediatricians and pediatric nurses, psychologists, social workers, parenting mentors, early childhood educators, child-welfare agencies and faith-community leaders. Graduate training programs for all these professions also need to be part of the solution.

Just like the successes we’ve celebrated over the past many years, our success with this new approach will take the combined efforts of our whole community, good people of all sexual orientations and genders, working together to support young children and their families. And when we do, that will be something we can all be proud of.