In 2008, Teresa Sheehan, a woman with a long history of mental health issues, was shot multiple times by two San Francisco police officers. The incident occurred after a social worker called police to the group home where Sheehan lived. Sheehan was experiencing mental health difficulties, and allegedly threatened group home members. When police arrived and entered the home without a warrant, they claim she threatened them with a knife.

Sheehan sued the city, claiming that her status as a person with mental health issues should have been considered when police evaluated how to deal with her. The Americans With Disabilities Act, a federal law, requires that people with disabilities—including mental health disabilities—not face discrimination. It also mandates that employers and schools give “reasonable accommodations” to those with such disabilities.

The Supreme Court’s opinion has been widely cited as determining that the ADA does not apply to Sheehan’s case. In fact, the Court opted not to rule on the issue, citing the fact that the City changed its arguments halfway through the proceedings. This change means that lower courts were not fully able to address the ADA issue, making it inappropriate for the Supreme Court to do so. Justice Scalia wrote in his opinion, “We were thus deprived of the opportunity to consider, and settle, a controverted question of law that has divided the Circuits, and were invited instead to decide an ADA question that has relevance only if we assume the Ninth Circuit correctly resolved the antecedent, unargued question on which we granted certiorari.” Thus the law on whether the ADA applies in police shootings remains unclear for now.

Oregon Outlaws Gay Conversion Therapy, Joining Two Other States

Conversion therapy, which attempts to change a person’s sexual orientation or gender identity, is increasingly the subject of controversy. It’s also been roundly condemned by most major mental health organizations. Now, Oregon has joined California, New Jersey, and Washington, D.C. in outlawing conversion therapy for minors. While adults can still seek conversion therapy, it’s often minors who are subjected to it, frequently against their will. Many other states are considering similar legislation. [fat_widget_right]

Ted Lieu Introduces First Federal Ban on Gay Conversion Therapy

Congressman Ted Lieu (D-Los Angeles) played a key role in California’s ban on conversion therapy three years ago. Now, as a member of the U.S. House of Representatives, he hopes to replicate these results. Arguing that conversion therapy is a kind of fraud, he introduced the Therapeutic Fraud Prevention Act this week. If the bill passes, it will ban conversion therapy at the federal level.

The Army’s New Plan to Help Soldiers with PTSD

Veterans and active-duty soldiers continue to struggle with posttraumatic stress (PTSD), anxiety, depression, and other effects of war. An overhaul of the military mental health system endeavors to reverse this trend. As part of this overhaul, the Army wants to make mental health care more accessible by putting mental health specialists within walking distance of soldiers’ barracks. The idea here is that soldiers will be more likely to seek care when it’s convenient and accessible.

Texting at the Playground: New Study Shows How Much Time Parents Spend Buried in Their Smartphones

Though a new University of Washington study suggests 44% of parents think smartphones have no place at the playground, the temptation of the phone can be tough to resist. To assess whether smartphones are a playground distraction, researchers observed caregivers at several playgrounds, collecting a total of 33 hours of data. It turns out that many parents spend little time on their phones when watching their children at playgrounds. They found that two-thirds of participants spent less than five minutes on their phones. Forty-one percent didn’t use their phones at all.

Groundbreaking Study on Shifting Attitudes Toward Gays Used Fake Data

Late last year, a study was published in Science claiming that a 20-minute conversation might be sufficient to undermine homophobia. Now, the authors of the paper have retracted it, admitting that they faked their data. The research was so convincing that it fooled even statisticians. It took two graduate students intending to extend the study to uncover the problem. The news comes on the heels of a study in which researchers were only able to duplicate 39% of recently published psychology studies.

Bullied as a Kid, Obese as a Grown-up?

According to a study of more than 7,000 adults, there may be yet another consequence of bullying: obesity. Researchers gathered data about participants’ childhood experiences, including whether they were bullied. By the age of 45, more than 25% of women who were bullied were obese, compared to just 19% of women who weren’t bullied. Men were also more likely to become obese if they had been bullied, and both men and women who were bullied were more likely to have high blood inflammation, a risk factor for heart disease, diabetes, and similar health problems.

Last December, 17-year-old Leelah Alcorn jumped in front of a tractor-trailer and died. Her online suicide note indicated that pressure to conform to the male gender assigned to her at birth played a role. Alcorn’s parents took her to a conversion therapist to “cure” her of being transgender. She also stated in her suicide note, “My death needs to mean something.” LGBT advocates responded with an outpouring of grief and a petition to enact “Leelah’s Law,” a law that would ban all attempts to change the sexual orientation or identity of LGBT people.

In response to the petition, the White House issued a public statement calling for an end to conversion therapies. “The overwhelming scientific evidence demonstrates that conversion therapy, especially when it is practiced on young people, is neither medically nor ethically appropriate and can cause substantial harm,” the statement read, adding that, “As part of our dedication to protecting America’s youth, this Administration supports efforts to ban the use of conversion therapy for minors.”

Mental Health Care: NAMI Report Finds Insurance Discrimination, Lack of Transparency Under Parity Laws

The Mental Health Parity and Addiction Act of 2008 requires some employer-backed insurers to provide equal coverage for mental and physical health care. According to a NAMI report, many insurers continue to ignore the law by routinely denying mental health benefits, charging high co-pays for mental health medications, and establishing extensive out-of-pocket costs for those in need of mental health services. 

Veterans Mental Health Bill Introduced in the Senate

The Prioritizing Veterans Access to Mental Health Care Act of 2015 promises to expand the Veterans Access, Choice and Accountability Act of 2014. The earlier law attempted to expand access to mental health care by allowing veterans who live more than 40 miles from a VA clinic to seek care outside the VA system. The new law attempts to fill holes in the old one by loosening the 40-mile rule incentivizing mental health care providers within the VA system. [fat_widget_left]

Impact of Domestic Violence on Women’s Mental Health

According to a study of 1,052 mothers, domestic violence endangers women’s mental health, not just their physical well-being. Women were only recruited for the study if they had no prior history of depression. During the study, a third reported suffering domestic violence. These women were also more likely to report a history of childhood abuse, early pregnancy, and poverty. Even when controlling for these factors, women exposed to domestic violence were twice as likely as other women to experience depression. They were three times as likely to develop symptoms of psychosis.

Texting Too Tempting for College Students Even When Inappropriate

Stories about young adults who constantly text frequently frame the behavior as a new communication style. According to a study from Pennsylvania State University, though, college students may text not because they want to, but because they can’t resist. Researchers surveyed college students about their views on and use of texting. While most agreed that texting while showering is socially unacceptable, 34% reported that they’d still do it. Students also agreed that texting while having sex or attending religious services was problematic. But 22% reported texting during religious services, and 7.4% admitted to texting during sex.

Ivy League School’s ‘Withdrawal Policy’ for Extremely Depressed Students Is Under Fire

Mental health issues can require time-consuming treatment, and psychological pain can make it difficult to complete even basic daily tasks. Yet Yale University places a significant burden on students who withdraw for mental health reasons. To re-enroll at Yale, students must complete two courses at another school, receiving a “B” average in the courses. They must also prove that they are “constructively occupied.” The second requirement, which was also the title of a Yale Daily News piece, has come under scrutiny for being needlessly vague. The piece also says that some students have been forced to withdraw for mental health reasons, with no guarantee they can later return.

New Treatment for Dementia Discovered: Deep Brain Stimulation

Deep brain stimulation, which has proven effective at treating neurological conditions such as Parkinson’s, may also effectively treat dementia. Researchers successfully used the process to generate new brain cells in middle-aged rats.

Lonely Seniors Visit Doctors More Often

According to a survey of 3,500 seniors, those who are chronically lonely are more likely to visit the doctor. The survey, conducted in 2008 and 2012, labeled any senior who reported high degrees of loneliness in both surveys as “chronically lonely.” Those seniors went to the doctor more, but were not more likely to be hospitalized, suggesting that loneliness—and not serious health problems—might explain the increase in medical visits.

1 in 10 Americans Has Anger Issues and Access to Guns: Survey

A national survey of 5,600 adults has found that many people with anger problems also have access to guns. Nearly 9% of survey respondents reported being “short-fused” and having access to firearms. And 1.5% of respondents with anger problems admitted to carrying guns outside their homes.

Conversion therapy—sometimes called reparative therapy and other names—is a widely discredited form of therapy that attempts to change people’s sexual orientation or gender identity. In recent years, a number of states have moved to ban the practice for minors, and dozens of mental health advocacy and professional organizations have produced statements against it. In spite of research showing that conversion therapy can be harmful, an Oklahoma state House committee in February 2015 approved legislation designed to protect the practice.

Concerns with Conversion Therapy

Mainstream mental health organizations and the American Psychiatric Association’s Diagnostic and Statistical Manual have long accepted that homosexuality is not a mental health diagnosis, yet conversion therapy typically focuses on changing one’s sexual orientation to heterosexual. According to the American Academy of Pediatrics, “therapy directed specifically at changing sexual orientation is contraindicated, since it can provoke guilt and anxiety while having little or no potential for achieving changes in orientation.”

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Though there are many ways to approach therapy, ethical therapy works to increase self-awareness and self-acceptance while offering judgment-free treatment in the context of a safe therapeutic relationship. Conversion therapy can include a range of approaches such as talk therapy, prayer, re-education, or aversion therapy. In some cases, techniques used in conversion therapy may be abusive and/or dangerous. For instance, a therapist might electrically shock the person every time he or she expresses interest in a person of the same sex. A group of people who experienced abusive conversion therapy recently sued their therapist, claiming he forced them to strip naked in front of him and engage in other questionable practices.

For some people, conversion therapy is an involuntary form of treatment. Parents of gay children (or children who display behavior culturally associated with the opposite sex) sometimes force their children to undergo conversion therapy, though conversion therapists may decline to work with children who do not want the treatment. Leelah Alcorn, a 17-year-old transgender girl, sparked national outrage in late 2014 when she committed suicide after being exposed to conversion therapy.

Legal Issues Regarding Conversion Therapy

California, New Jersey, and Washington, D.C. have banned conversion therapy for minors, and states such as Arizona, Colorado, Florida, Iowa, Ohio, Oregon, Washington, and West Virginia have taken preliminary legislative measures to eliminate the practice or methods associated with it. In 1997, the American Psychological Association passed a resolution disavowing conversion therapy, and since then, many leading mental health governing bodies have come out against the practice.

Nevertheless, Oklahoma legislators are diligently working to protect conversion therapy. Republican Rep. Sally Kern introduced the bill to “protect” parents’ ability to pursue such treatment for their children; the bill was later amended to prohibit “physical pain, such as electroshock or electroconvulsive therapy, touch therapy, pornography exposure, or vomit-induction therapy,” controversial tactics which not all therapists who practice conversion therapy use. Kern argues that the freedom to pursue conversion therapy for minors is a parents’ rights issue.

A host of professional organizations in the field of mental health and social work have spoken out against the bill. On March 4, 2015, GoodTherapy.org affirmed its opposition to conversion therapy, and declines to list in its therapist directory mental health professionals who advertise conversion therapy as a service they offer.

References:

1. APA resolution on “reparative therapy” (1997). Retrieved from http://psychology.ucdavis.edu/faculty_sites/rainbow/html/resolution97.html
2. Fox, F. (2015, January 8). Leelah Alcorn’s suicide: Conversion therapy is child abuse. Retrieved from http://time.com/3655718/leelah-alcorn-suicide-transgender-therapy/
3. Gay conversion therapy bill clears Oklahoma House committee. (2015, February 24). Retrieved from http://newsok.com/gay-conversion-therapy-bill-clears-oklahoma-house-committee/article/5396127
4. Homosexuality and adolescence. (1993). Retrieved from http://pediatrics.aappublications.org/content/92/4/631.full.pdf
5. Iowa senate panel approves ban on conversion therapy. (2015, February 17). Retrieved from http://stlouis.cbslocal.com/2015/02/17/iowa-senate-panel-approves-ban-on-conversion-therapy/
6. Michael Ferguson, et al. v. Jonah, et al. (n.d.). Retrieved from http://www.splcenter.org/get-informed/case-docket/michael-ferguson-et-al-v-jonah-et-al
7. Steinmetz, Katy. (2014, June 30). California Ban on Gay Conversion Therapy Stands. Time. Retrieved from http://time.com/2940790/california-ban-on-gay-conversion-therapy-stands/

It should go without saying: conversion therapy is an outdated mode of treatment for an issue that is not, and has not been, a mental health diagnosis for quite some time. GoodTherapy.org does not endorse conversion therapy —also known as reparative therapy or sexual orientation change efforts (SOCE)—for homosexuality, nor does it permit mental health professionals to advertise those services to website visitors.

On March 3, 2015, The Huffington Post published an article in which Human Rights Campaign, a leading LGBT rights group, condemned Psychology Today, an online therapist directory, for allowing its therapist members to advertise conversion therapy on its profile pages. A representative of Psychology Today told The Huffington Post that the company did not intend to begin removing or refusing membership to therapists who offer conversion therapy. The backlash and criticism from health professionals, human rights advocates, and others was immediate.

Within 24 hours, Psychology Today had changed its position. In a statement issued March 4, the company asserted that it does not condone conversion therapy, and has notified therapist members that they would be de-listed if their profiles advertised this practice. Their updated stance is in line with what the majority of the mental health community has come to believe: conversion therapy has no place in mainstream mental health care.

Flaws in the Conversion Concept

Conversion therapy, also known as reparative therapy, is a controversial type of treatment aimed at changing a homosexual person’s sexual orientation on the assumption that homosexuality is an inherent flaw or disorder that must be altered. While homosexuality was once listed in the Diagnostic and Statistical Manual (DSM) as a mental health diagnosis, it was removed from the DSM by the time the third edition was published in 1980 with support from the professional mental health community.

In addition to rejecting conversion therapy as a useful treatment, GoodTherapy.org does not acknowledge homosexuality as a mental health disorder. The American Psychiatric Association (APA) agrees; a statement issued by the board of the APA in 1998 states: “The American Psychiatric Association opposes any psychiatric treatment, such as ‘reparative’ or ‘conversion’ therapy, which is based upon the assumption that homosexuality per se is a mental disorder, or based upon a prior assumption that the patient should change his/ her homosexual orientation.”

The APA isn’t the only organization to reject conversion therapy, as research over the course of years has affirmed concerns over conversion therapy as a treatment modality. The American Association for Marriage and Family Therapy, the National Association of Social Workers, the American Psychological Association, and the American Medical Association, among others, have issued statements against reparative therapy. Many cite research that suggests conversion therapy is likely to lead to harmful outcomes, such as contributing to anxiety, depression, relationship problems, self-loathing, and other issues. According to the Pan-American Health Organization (PAHO), “Services that purport to ‘cure’ people with non-heterosexual sexual orientation lack medical justification and represent a serious threat to the health and well-being of affected people.”

Several states consider conversion therapy detrimental enough that they have enforced or are considering bans on it. California, New Jersey, and Washington, D.C. have banned the use of conversion therapy on minors. Other states that have pending legislation to ban reparative therapy include New York, Massachusetts, Illinois, Iowa, Minnesota, Michigan, Ohio, Vermont, Pennsylvania, Colorado, and Hawaii.

Given a lack of research that supports the effectiveness or safety of conversion therapy, the American Psychiatric Association “recommends that ethical practitioners refrain from attempts to change individuals’ sexual orientation, keeping in mind the medical dictum to ‘First, do no harm.’ ”

GoodTherapy.org Philosophy of Membership

GoodTherapy.org is founded on a mission and vision to reduce harm in therapy by educating consumers so they can be equipped with resources and services that will help them achieve their mental and emotional health goals.

When mental health professionals sign up to be listed in the GoodTherapy.org therapist directory, applicants are required to certify that the services they provide accord in orientation and attitude to its Elements of Healthy Therapy Statement. A peer-review team verifies each clinician’s credentials and screens his or her profile content to ensure the person’s practice is in line with elements of good therapy. Profiles are reviewed for questionable content, such as homophobic, sexist, racist, or other discriminatory or harmful practices or beliefs. GoodTherapy.org does not list conversion therapy or reparative therapy as a type of therapy that members can select.

[fat_widget_left]Because the review process for inclusion in GoodTherapy.org’s therapist directory is done on a case-by-case basis by human beings, and because members are able to update their listings at any time, it is possible that an inappropriate listing could appear for a period of time in its directory. However, GoodTherapy.org addresses any such listing as soon as it becomes aware of it and takes action to remove the individual from its directory. Since GoodTherapy.org was founded in 2007, situations like this have been extremely rare.

It is important to note that there are people who seek therapy as part of an effort to change their sexual orientation. GoodTherapy.org’s position is in no way an invalidation of these individuals’ desires to work toward their chosen goals in therapy. GoodTherapy.org respects individuals’ rights to identify their treatment goals and choose treatment modalities that appeal to them for any reason.

It is perfectly acceptable for individuals to discuss, explore, and evaluate their sexual orientation in the context of a therapeutic relationship. Trained therapists should be equipped to support people in these efforts without prejudice or discrimination. GoodTherapy.org works to ensure that it offers people seeking treatment quality choices so they can find a therapist who meets their unique needs.

GoodTherapy.org was founded in 2007 with the mission of:

• Reducing harm in therapy
• Advocating healthy and ethical psychotherapy practices
• Encouraging therapists to work collaboratively and nonpathologically
• Depathologizing diagnostic-based language and therapy practices
• Educating consumers about the differences between healthy and unhealthy therapy practices

Toward this end, GoodTherapy.org makes every effort to avoid and remove from its site any content—including blog material and therapist listings—that contains a homophobic, sexist, racist, ableist, or otherwise discriminatory message. Dan Fajans, director of member services at GoodTherapy.org, explains, “Everything we do, from our therapist directory, to our Continuing Education Program, to The Good Therapy Blog, to our GoodCause program and beyond, is first and foremost an effort to put this mission into action. Providing an advertising platform for conversion therapy would be directly at odds with our mission.” GoodTherapy.org takes this stand based on mounting evidence that conversion therapy causes harm; leading mental health organizations do not view it as ethical; and it requires the therapist to operate from a fundamentally pathology-based understanding of the person who is seeking therapy.

Noah Rubinstein, GoodTherapy.org’s founder and CEO, stands behind GoodTherapy.org’s position on conversion therapy both professionally and personally. As a licensed marriage and family therapist who has worked in the mental health field for over 25 years, Rubinstein elaborates:

“In general, any psychotherapy that focuses on trying to depreciate, banish, or exile a psychological aspect of a person at the expense of curiosity, appreciation, and compassion is not in the best interest of the individual. Even with issues such as depression, anxiety, addiction, anger, self-criticism, and nearly every other symptom which motivates a person to seek help, the only agenda ever set by the therapist, in my opinion, should be to help the individual understand the purpose, function, and existence of such an aspect. The decision to help a person change some aspect of themselves should be made by the person in therapy only when he or she is in a psychological state of calm and self-compassion.

“I can only imagine how difficult it is in this culture for some individuals to recognize, accept, and explore their sexuality when it differs from the majority. I assume that those who want to change their sexual orientation are under enormous pressure internally and/or externally to assimilate and that any desire to alter their sexuality does not originate from self-compassion, unless their sexual practices are harmful to self and others—which homosexuality in and of itself is not. The only way to tell, I imagine, would be to first work with an individual to access the internal resources to transcend any internal or external pressures. At that point, one could reach a place of understanding, acceptance, and self-compassion for his or her own sexuality.”

As an organization, GoodTherapy.org reiterates its support for individuals experiencing any type of mental health challenge, in any stage of their mental health journeys. No person should be made to feel inadequate or broken because of a psychological concern, and all people are worthy of healing and love—especially self-love. If you feel discouraged or troubled, or if you feel you have been treated unfairly in therapy, there is hope and help available.

We invite you to share your thoughts or comments in the “Leave a Reply” section below.

References:

1. APA Board of Trustees. Position Statement on Issues Related to Homosexuality. March 2000. Retrieved from http://www.aglp.org/pages/LGBTPositionStatements.php#Anchor-55000
2. Herek, Gregory M. Facts about Homosexuality and Mental Health. Retrieved from http://psychology.ucdavis.edu/faculty_sites/rainbow/html/facts_mental_health.html
3. Millar, Katharine S. The Myth Buster. February 2011. Retrieved from http://www.apa.org/monitor/2011/02/myth-buster.aspx

As a therapist who specializes in working with LGBTQ (lesbian, gay, bisexual, transgender, queer) teens and their families during the coming-out process, I am often witness to the reactions parents have to a teen revealing his or her sexual identity. These reactions range from “We suspected for quite a while” to “We had no idea!”

As I work with these families, the expectation is that therapy needs to focus on the issues surrounding the teen coming out. While this support for the LGBTQ teen is vital, in my experience, parents may need just as much support. Parents are often in territory that is new to them and they may not have developed the language to speak effectively and sensitively with their teen, or the awareness to sort through their own changing perspectives.

One of the most basic things that I have parents focus on is that the child they have lived with and known for years is still the same person. One of the most supportive things any parent can offer at the moment of coming out is simply a hug and reassurance that there is still a relationship based on love. Remember that when a teen comes out to his or her family, he or she has probably been thinking about and building anxiety around how that coming-out experience will play out and be received. Simply connecting with the teen will help to relieve some of the anxiety and reassure the teen that there is still space for him or her in the family story.

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It is also important at the beginning to simply listen and support. Even with parents who suspect that a teen may be gay, it is important that they take time to process some of their own feelings before opening up a litany of questions and concerns. When parents are caught completely off guard when a teen comes out, it is vital to offer loving support to the teen and at the same time recognize that there are questions and concerns that there may not be answers to immediately. Parents may need time to adjust to this new information and to process it.

As parents begin the process of unraveling their feelings about their teen’s sexual orientation, it is also a good time to gather information and learn more about what it means to be a member of the LGBTQ community beyond stereotypes and popular conceptions. Parents can join organizations such as PFLAG and gather the latest info regarding LGBTQ teens on the GLSEN website. As parents become more educated, they can release some of their fears and build a foundation for conversation with their teen.

As the process continues, another question that may arise is, “Who gets to know?” The coming-out process is just that, a process, and how the information is disseminated is worth discussing. Often, a teen will come out to one parent first and then ask for that information to be held in confidence for a time. There is no need to force the conversation, and it can help the process a lot if the teen feels like he or she is in charge of who gets to know. It is also common for a sibling, friend, relative, or teacher to know first, so I encourage parents to be OK with the fact they may not be the first to know.

Finally, don’t forget that while it should be a priority to be open and available to converse with your teen about his or her sexual identity, it is not all that he/she is. He or she is still facing all of the same battles and angst that other teens go through as they develop their identity. Be sure to support LGBTQ teens in all their efforts in life, including school, hobbies, sports, friendships, and spirituality. Though it may seem like the coming-out story is the most important thing on the list at the moment, teens are complex, vital, intriguing, and amazing people who are open to guidance, acceptance, and love in all forms and areas.

I hear your struggle and pain, and you are not alone. It is so hard to know just what the right thing to do for your kids may be when you see them potentially heading down a road that could make their lives more difficult and quite possibly more dangerous.

The best thing you can do for your son is offer him unconditional love and support by letting him know that you love him as he is, for who he is, and that nothing can change that. Whether he eventually realizes himself to be a member of the LGBTQIA community or is simply just drawn to more traditionally feminine toys and activities, he is likely to hear about these things from his peers. By trying to protect him from the hate and mockery of others, you may unintentionally give him the message that you don’t think his choices are OK and that he needs to hide who he is. He needs to have a safe place to be himself, and that should be with you. (It should be everywhere, really, but with you is a must.)

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That said, you can also equip him for living in your community. You can give him the tools he needs to combat bullying and hate. At 7, he is probably at least somewhat aware of how others may respond to him. You can talk with him about possible reactions to him choosing an Elsa costume over a Spider-Man costume. Empower him to make choices and prepare him for the ramifications. Let him know that the problem is NOT in his choice, but in the ignorance and bigotry that exist in the world. Help him find allies in the community—friends, teachers, other parents—who support him. Bullying and hate are terrible things, but they can be managed with support. Kids who internalize feelings that who they are is not OK suffer terribly, often feeling shame, isolation, and loneliness. These are the kinds of feelings that lead to hopelessness, depression, and even suicide.

Your question resonates deeply with me. My 4-year-old son is also drawn to dresses and make-up. He loves trucks and dinosaurs, but he chose to be Elsa for Halloween this year (it’s a popular costume!). When he wanted to wear a dress to school last week, I hesitated. When he was 2 or 3 it was no big deal, but lately I’ve seen that his peers respond in less accepting ways to cross-gender preferences. He wore the dress, but we practiced what he might say to friends if they laughed, made fun of him, or called him a girl. The moment we walked into the classroom, a group of boys did exactly that. He responded with, “Nope, I’m a boy. I just wanted to wear this.” And that was the end of it. Granted, at 4 and 5, kids are generally more accepting than at 7, but I hear your fears and your concerns, and all you can do is equip him to handle what he may face—and the best way to do that is by making sure he knows there is nothing wrong with him.

If I can also offer a little clarification as well: There is a difference between gender preferences, gender expression, gender identity, and sexual orientation. Preferring toys and objects that are traditionally associated with a different gender does not necessarily have anything to do with gender identity or sexual orientation. Your son may be more sensitive and nurturing than his male peers. There are girls his age who prefer some of the more traditionally male toys. That does not necessarily mean they are gay or straight or bisexual. Nor does it mean that those girls identify more as masculine or the boys identify more as feminine. Kids like what they like. We are the ones who make meaning of it and attach labels.

If you need support for yourself or your son in figuring out how to navigate through these issues, find a therapist who works with gender fluidity. Whether or not your son is gay, a therapist trained in LGBTQ+ issues would have a lot of resources and strategies for navigating how to be different in an intolerant community.

Best of luck,
Erika

You are single, feeling good about yourself, looking your best, and decide to go out for a night on the town. In the back of your mind, there is a small nugget of hope that perhaps tonight you will finally meet the person of your dreams and begin the relationship you have been fantasizing about.

As you arrive at the party, bar, or dance club, you settle in to the festive atmosphere and begin to enjoy yourself when you spot that potential mate across the room. Their physical appearance fulfills all your requirements and they appear to be witty, vivacious, and fun as you observe them interacting with their friends.

Suddenly, you find yourself unable to move, your feet stuck to the ground, and all of your desire to connect stymied by a sudden loss of will and resolution. As much as you may wish to follow through and walk the 20 feet across the floor, you find yourself unable to gather up the courage to make what now feels like a million-mile march.

This sudden shift is driven by a common fear among people both LGBT (lesbian, gay, bisexual, transgender) and straight: the fear of rejection. Rejection is a concern that many people carry in the dating world, as it can influence one’s ability to make a connection to someone who could potentially be a great friend, a fun fling, or even a partner.

The fear of rejection is often rooted in the misguided belief that we are not good enough for a person. We fear giving that person the power to make us feel foolish or less than in comparison to them. We build a construct around the person we are hoping to meet that makes them better than us, even though this is often not the truth.

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Here is the kicker to the fear of rejection: It is very possible that someone at that same party, bar, or club finds you to be the object of their attraction and is fearful of approaching you because they imagine you will reject them. It might even be that person you were attracted to, the one standing 20 feet away.

This ultimately leads to a room full of people, many attracted to others, and yet all equally fearful to step across the room and introduce themselves. Thus, the room is frozen in a static energy of missed connections.

There is a powerful means to counteract the fear of rejection—and that is by recognizing that almost everyone is being influenced by it. With this knowledge, you can choose to empower yourself and be the person who breaks the shackles of the rejection construct and risks crossing the room to say hello.

By taking this risk, you reveal yourself as someone who is not constrained by social encumbrance, someone who will take the time and energy to reach out for connection. This presentation of self-assurance and risk taking can be quite sexy to the person you are approaching. Confidence is a proven aphrodisiac.

It also helps to make the approach with a deep sense of curiosity about the person rather than being overwhelmed by your preconceived ideas of who this person is based on how they represent themselves in the moment. They may be projecting a little bit of attitude that is founded in their fear of rejection protecting them from harm. If you assume everyone is holding a tiny bit of fear of rejection, it can help you to be kind and gentle in your approach.

As you begin to release your fear of rejection, you will notice that other people begin to find you more approachable, and the potential for deeper connections will begin to blossom.

In 1982, sociologists Pepper Schwartz and Philip Blumstein published American Couples: Money, Work, Sex, the first major study of its kind to compare gay male, lesbian, and heterosexual couples on basic issues such as sex, communication, and money. Among many other findings, their research showed that lesbian couples had less frequent sex than anyone else. And thus was born the trope of “lesbian bed death.” A majority of comparative studies in the past 30 years have replicated these results, although a few have found no differences between lesbian and heterosexual couples.

Over the decades, though, those of us who first publicized the American Couples findings have come to doubt them. More specifically, we have questioned whether “sexual frequency” is the most valuable measure of the sexual health of a relationship, whether our views and definitions of sex may be inherently heterocentric, even phallocentric. However, until recently we had nothing but our theories—and the incontrovertible data showing that female couples have less sex. The stereotype of “lesbian sex” became … cuddling, even the stereotypes that lesbians have of themselves. Never mind that the frontiers of BDSM, polyamory, and erotic gender bending were explored by lesbian and bisexual women long before most heterosexual women had a clue. Let’s forget the gay and bisexual female sex radicals, from Virginia Masters to Betty Dodson to Tristan Taormino. Lesbian sex, when not thought of as entertainment for men, has come to be seen as tepid and a little bit boring.

But now, finally, someone has done the research that explores the questions raised by feminist sexologists. At the annual conference of the Society for the Scientific Study of Sex (SSSS), which I attended for the first time in many years, I discovered that an abundance of the smartest young researchers in sexology are women, many of them queer women. One of them, Dr. Karen Blair, presented research that tested several measures of “sexual well-being,” not just frequency. She compared more than 800 men and women in relationships, about equal numbers of lesbians, gay men, heterosexual men, and heterosexual women, and asked questions about sexual frequency, duration of each sexual encounter, types of sexual acts, and orgasms.

Sure enough, as measured by frequency lesbians fell behind the others. Only about 15% of the lesbians had sex more than twice a week, compared to 50% or more of the others, and about 40% said there were weeks when they had no sex at all, compared to less than 20% of the rest of the sample. But if you looked at how long each sexual encounter lasted, women in same-sex relationships were champs. Gay men and especially male and female heterosexuals reported typical sexual encounters of a half hour or less, often much less. Lesbians, on the other hand, described sexual sessions lasting upward of 30 minutes, and nearly 10% reported encounters of two hours or more. This is our first hint that the measure of “sexual frequency” is inadequate. Perhaps lesbians have lower frequency because if each sexual encounter involves extended periods of sensual and sexual activity, it is harder to find time for sex. And if sex is that intense, maybe you don’t need or desire it as frequently. Maybe some of the other needs that genital sex fills—such as the need for intimacy and closeness—CAN be fulfilled by cuddling.

Blair’s other results are also food for thought. Not surprisingly, the most frequent sexual activity engaged in by heterosexual men and women was penile-vaginal intercourse, with the most common among gay men and lesbians being giving and receiving oral sex. More surprising was the finding that heterosexual women were most likely to say they did not always have an orgasm during partner sex—and lesbians, of all four groups, most frequently reported not only orgasms but multiple orgasms most frequently. Perhaps lesbians have sex less frequently because—due to those extended sessions and an abundance of oral sex—they tend to not only climax, but climax repeatedly on a regular basis. Looked at from this perspective, the “lesbian bed death” trope is clearly inappropriate and grossly misleading.

All participants in Blair’s study reported similar levels of sexual satisfaction, regardless of their orientation, and other comparison studies have shown a similar result. This is an interesting finding, considering that heterosexual women report fewer orgasms than lesbians, and that a common complaint of heterosexual women is that their partners do not spend enough time on foreplay. Do heterosexual women trade consistent orgasm for frequency? Do they care? The neuroscientist Sari van Anders, who rocked a plenary at SSSS with her research on hormones and neurotransmitters, provided a clue to the last question. Van Anders included both lesbians and heterosexual women in her research on the relationship of hormones to sexual behavior, and she found that heterosexual women did not expect orgasm during sex, while lesbians took having an orgasm in partnered sex for granted. Perhaps our expectations are shaped by our experiences, and “satisfaction” may have more to do with what we think is realistic than what is ideal.

So what does this mean about “lesbian bed death”? Sexual frequency declines in all long-term relationships, just a bit more drastically for women with women. Is frequency the only measure we should be looking at? Blair’s research suggests not. For lesbians, it seems just as satisfying to have fewer sexual encounters, to spend more time on each one, and to know that both partners will have at least one orgasm when they do choose to have sex. For many women, exchanging quantity for quality may seem an exchange worth making. What’s so bad about that?

To go a little deeper, if we throw out ‘frequency’ as the sole or even most important measure of sexual health, we see differences in sexual style that vary by sexual orientation but also by gender, and contrasting these dimensions gives us new insights. Lesbian sexuality could be thought of as what women do when they construct sexual scripts without male influence, while the sexual styles of women who have sex with men reflect how sex is constructed when there is a need to balance both male and female sexual styles. Lesbians construct sex as less frequent but more prolonged, intense, and orgasmic. Heterosexual women are content with fewer orgasms and more frequent genital encounters. Many heterosexual women dream of what in heterosexual terms is called “foreplay” but for lesbians is a routine part of sex—a lot of touching and oral genital contact. Do lesbians dream of quickies and sexual encounters where you go straight for the crotch?

There is tremendous variety, of course, in women’s sexual preferences, and the stereotypes I’ve created based on Blair’s study are grossly reductionistic. But there is something to be looked at here, something involving gender, the purposes served by genital sexual contact, clues that will help us learn more about human sexuality in gender.

But we will only learn it when we stop using terms such as “lesbian bed death” and start to look at all sexual styles as equal but different, instead of privileging certain types of sex over others. Sex is not a competition; it’s a rich and diverse activity whose mystery we have only begun to comprehend.

For people who are dating or dealing with the starting and ending of intimate relationships, a certain question tends to arise… can ex-partners maintain healthy roles in each others’ lives? And if so, when, where, how, and (most obviously) why? Sometimes an ex’s role is clear; for example, a couple who has children together will most likely continue as co-parents in the event of a separation. Other post-breakup scenarios have less obvious answers. Exes can, often unintentionally, fall into dysfunctional roles in each other’s lives, such as a baggage-laden “friend”, convenient sexual outlet, or receptacle of lingering animosity. Deciding how to continue forward, together or separately, after a relationship dissolves can be tricky for anyone. However, for several reasons, this quandary appears to be particularly challenging for lesbians.

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First of all, gay women’s friends and lovers are typically the same gender, making boundaries around friendships and romantic relationships more flexible. This is a challenge unique to lesbian relationships, simply because women—of any sexuality—tend to forge their closest bonds with other women. The potential for any gay-leaning friend or acquaintance to become a lover adds a level of challenge and confusion to many lesbian social circles. It is very common for lesbian friendships to morph into a more intimate configuration for a period of time, changing the interpersonal patterns within their friendship group. If the romantic relationship ends, it is often natural for the former couple to try to return to being “just friends”. It may sound simple in theory, but the physical and emotional intimacy shared and corresponding bonds established are not easily severed. And it’s not always the most comfortable of arrangements for the exes or for the new partners involved, to say the least.

This leads to another issue contributing to lesbian post-breakup complications… both partners in the couple are guided by the emotional physiology of the human female. In heterosexual relationships, a hormonal balance is generally struck so that reactions may be tempered through differing intensities of experience and response to emotional stimulation. Meaning men are often less emotionally reactive whereas women tend to be more highly sensitive. When both partners in a couple are sensitive women, the resulting emotional intensity can create significant difficulty for the ex-couple.

An anecdotal social review suggests it is uncommon for lesbians to neatly pronounce the death of a relationship and simply move forward separately without looking back. This may be related to the neurochemistry involved; women experience much stronger effects than men of oxytocin, the “bonding hormone”, which promotes nesting, monogamy, pair bonding, and emotional extremes. This hormone is activated very easily; a single touch starts it flowing and further intimacy-creating activities (including sex) break the dam. So, two neurochemically typical women will naturally create very tight bonds which only break with great difficulty and emotional pain. Many women avoid completely detaching from an ex in an attempt to minimize the pain involved with a breakup.

An additional piece of scientific information helps explain the difficulty of intimate breakups between women. Brain researchers have discovered that emotional and sexual intimacy between individuals creates a physical connection in the brain which cements that relationship neurologically as a meaningful attachment. The evolutionary purpose of sexual contact and its related hormonal processes is to bond people together— and these hormonal and neurological operations are especially effective in women. So when a breakup occurs, the critical healing task is to break that physical bond of intimacy in the brain in order to move forward with emotional freedom and strength. While the bond remains in tact, so do the feelings associated with the loss of the bonded object: sadness, fear, anger, shame, and love. Again, women experience and process this connection more intensely than men do, so an intimacy bond between two women can be even more difficult to break. This phenomenon is evidenced by the number of lesbians who choose to keep their exes in their lives as friends or some permutation of such. Full severing of the intimacy bond requires physical and emotional distance, negative associations with the ex-partner, and forgiveness.These goals cannot be achieved with continued contact immediately after the breakup. Any true friendship or healthy continuation of contact is possible between exes only after the bond of intimacy is completely broken.

The conclusion to be drawn from this information is that after a period of separation and deep emotional healing, ex-partners may be able to occupy space in each others’ lives. Offered below are some healthy scenarios for continuing contact with an ex, with cautions to consider.

Exes as friends. Intimate relationships are typically based on a combination of shared interests and sexual chemistry. After the chemistry dies and the emotional intimacy vanishes, the shared interests will likely remain. Rather than avoiding the places, groups, and activities they both enjoy, exes may find it more convenient to develop a civil and friendly relationship with one another in order to be at peace when their paths cross. When an intimate relationship is lost, it can be additionally painful if a cherished social circle or activity is also affected. It may, in fact, be possible for exes to resume a functional friendship after each has thoroughly healed from the loss and resolved any lingering feelings related to the relationship or breakup.

Caution: Sharing interests with an ex may be possible, but emotional sharing or activities which may rekindle the bond of intimacy (read: substance use and/or amorous exchanges) are strictly to be avoided to keep things healthily platonic.

Exes as support. If a relationship ends constructively and sufficient time has passed for the emotional fallout to settle, continued contact with an ex may serve a purpose of support in times of need. This scenario can be tricky because, again, the support being offered cannot be emotional in nature. Sharing feelings is something to be done with intimates only, if healthy boundaries are desired. If, after recovering from a breakup, an ex-partner maintains residual concern for someone with whom she spent a significant time of her life, she may be psychologically prepared to help out during a time of need. It can be nice to have a connection with a caring individual in life, as the coming and going of hard times is a fact of human existence.

Caution: It is important for exes to monitor their feelings around their supportive interactions and regain personal space as needed to resolve any lingering emotions that might threaten their peace of mind or current relationship.

Exes as history. Intimates who have experienced important eras of their lives together are irreplaceable emblems in one another’s lives. Although they move forward on their life paths, retaining a connection with the past is something that can offer comfort and a sense of continuity along life’s long and winding road. Googling someone from long ago or occasionally checking in via email can be a perfectly reasonable way to enjoy a bit of nostalgia, reflect on the past, and gain perspective on the present.

Caution: When relationships begin to sour, human nature instinctively nudges people to reflect on the past with rose-colored glasses. It is helpful to be honest with oneself about the reasons for seeking re-connection with an ex to ensure one is not escaping from a problem in their current relationship or resurrecting emotions formerly associated with their ex.

Many people believe that negotiating intimate relationships is the crux of life’s purpose. The bonds of love and intimacy formed with others bear witness to the value of human interconnectedness. The memory of loved ones cannot easily be forgotten and, as mentioned above, new roles can sometimes be assumed once the intimate nature of a relationship has changed. These are tricky waters which require emotional strength and stamina to navigate successfully. Observing a new partner’s decisions around her relationships with exes can provide valuable information regarding her emotional needs, boundaries, and strengths. And noticing one’s own tendencies in this area can highlight areas of mental and emotional health and areas in need of attention. If personal growth and deep healing are desired, discarding exes as emotional crutches and severing outdated intimacy bonds will strongly support the goal of moving forward in a healthy, happy way.

It’s a pretty well known fact that ‘happily ever after’ is a concept that is often easier said than done. People still cling to and admire the ideals of a long-term commitment and marriage and with a little effort and cooperation many find that it is actually doable when they have both feet in the relationship, whilst others are finding that finding a new partner is sometimes just easier, and divorcing themselves from their partner and situation makes more sense. But with so much exposure to new and alternative ways of embracing marriage, more and more couples are ‘coming out’ so to speak, to embrace their sexuality by exploring alternative lifestyles within the marriage. Alternative lifestyles, also known as open relationships, are giving couples a third option, so to speak, when relationships need a little extra push to get up that hill.

So, what exactly are these alternative lifestyles and how do you know they are for you?

When I speak about alternative lifestyles I am talking about anything that deviates from the expected and usual monogamous, heterosexual marriage. Some lifestyles include the swinger lifestyle which is when a couple may choose to swap partners with another couple, threesomes/foursomes which may be in the form of polygamy or polyandry (marriage with more than one wife or husband, respectively) or just introducing a new member/s occasionally or on short term basis. LGBTQ lifestyles are another style where although married, one partner, or perhaps both parties have another partner of the same sex, or may be involved in a lifestyle as another gender, with another gender, etc..outside the marriage. The variations, labels and titles are endless.

These lifestyles differ from the norm because in general they introduce more people into an intimate space, either physical or emotional, and beyond what is generally viewed as the space of the dyad or couple, and hence referred to as ‘alternative.’ Sometimes these happen naturally. Sometimes the couple makes a decision to do this together based on other circumstances. They are not always the easiest of lifestyles and couples need to communicate openly and honestly to both get their needs met. Communication and cooperation are key here. Note: To me, cheating and infidelity do not qualify as an alternative lifestyle, although technically other people are involved. A healthy alternative lifestyle with your partner includes consent, honesty, and communication.

I’d like to refresh your memory a little on a little old study Dr. Helen Fisher, PhD did. She found that there were 3 stages of love. Basically they were Lust, Romance and Commitment. In the lust and romance phase things are exciting, passionate and the sex is great. In the commitment phase all the excitement and unrest leads to stability, security, things which are perfect for family raising, and often times also lack luster sex, especially when couples are comparing it to before. I call it the 2-year lull. Couples often start freaking out at this point and wonder what is wrong with them. Couples in the know recognize this is normal and find a way to flow through this time with continued efforts and this is also a time when many couples decide they may want to do something different or alternative to spice up the relationship.

How do you know if this lifestyle is for you? You have to be honest with yourself and your partner. If something doesn’t feel right or comfortable discuss it openly. If there is something that does interest you, discuss it with your partner and try to set as many ground rules as you can before proceeding as it can get a little complex out there. Getting more people involved means more emotions, personalities, time spent, so on and so on. Jealousy and insecurity happen too. So be realistic and don’t be afraid to speak up to your partner.

Setting ground rules is key. Things will come up while you are out there ‘mixing it up’ so having as many key words, and advance communication to help ease the situation will make it all the better.

One last thing to remember is that this lifestyle isn’t for everyone, and it’s okay if you’re not feeling it. A must read on the subject matter is “Ethical Slut,” by Dossie Easton, Catherine A. Liszt, if you are truly thinking about embarking on something new and adventurous with your partner.