Mental health tougher for queer youth in Hamilton

Getting help for mental health issues is even harder when some therapists think your sexuality is part of the problem, experts say.

Not all therapists are gay friendly

Sam Russell is happily queer, but seeks help for depression and anxiety. Experts say some therapists try to fix all three. (Larry Strung)

Sam Russell thinks of herself as gender fluid — neither male nor female, but somewhere outside society's usual binary. And she's fine with that. It doesn't need to be fixed.

The McMaster University student also has depression, anxiety and obsessive compulsive disorder (OCD).

  • The risk of suicide in LGB youth is estimated to be 14 times higher than their heterosexual peers.
  • LGB individuals are one and a half times more likely to have depression and anxiety.
  • A Canadian study suggests that the experience of stigma and discrimination increases internalized homophobia and stress-related cortisol production, both of which are associated with increased depression, anxiety and suicidal thoughts.
  • 77 per cent of the trans people in Ontario have seriously considered suicide, and 45 per cent have attempted it. Trans youth were at the greatest risk.

Source: Rainbow Health Ontario

Like many LGBTQ youth, the 21-year-old faces a specific set of fears when approaching the mental health system.

How do you find a therapist who doesn't consider your gender identity to be part of the problem? How can you be sure, when sharing your deepest thoughts, that the person listening isn't judging your gender or sexuality?

It's a problem Russell anticipates facing one day. While Russell's therapist at McMaster is liberal and understanding, the fear was there, and will be in the future.

"Having to go to new people triggers my anxiety," Russell said. "I had seven billion trains of thought about not fitting where I thought I should be fitting."

The communications major grew up in a "pretty normal" family full of rough-and-tumble brothers. Russell's mother was a fan of traditional gender notions such as dresses and dolls and playing house.

"It was always 'Sam can play with Barbies and the boys can go out and play in the mud,' but I always wanted to play in the mud," Russell said.

When puberty hit, Russell's self loathing increased. It continued through high school, when Russell created a character of sorts — a pretty girl who wore dresses and dated boys. A girl who fit the so-called norm.

McMaster psychiatrist Albina Veltman has co-authored a new queer-friendly policy for the Canadian Psychiatric Association. (Larry Strung)

It wasn't until Russell's third year at McMaster that the mental health issues became too great to ignore.

"I started skipping a lot of classes. I stayed in bed for four months," Russell recalled. "That's when my friends stepped in and said, 'We're going to get you to go to the doctor. We're going to figure this out.'"

'Corrective therapy'

Russell was diagnosed with depression and anxiety last year and OCD this year. Now there are answers and medication, and the pieces are slowly fitting into place.

Russell's anxiety about seeking help is not uncommon, or even unfounded, said Dr. Albina Veltman, a McMaster psychiatrist. Veltman sees patients in a small, dark basement office at The Well — Hamilton's LGBTQ resource centre — once a week.

Many psychiatrists and social workers in Canada are undertrained and uninformed about LGBTQ issues, particularly as they pertain to gender, Veltman said.

One of Veltman's transgender clients needed foot surgery but approached a surgeon only to be told "I don't do trans surgery," Veltman said.

Some therapists even attempt "reparative or corrective therapy" with patients.

Living in two closets

"That is something that although pretty much every single professional association has come out and said shouldn't be happening, we do know of people who have had that experience," she said.

Mental Health 101: Youth and the Hidden Crisis in Our Community

Where: McIntyre Performing Arts Centre, Mohawk College

When: Oct. 24, doors open at 7 p.m., town hall session from 7:30 to 8:30 p.m.

Cost: Free

The event will also be streamed live at cbc.ca/mentalhealth101

As a result, a population already more likely to attempt suicide has difficulty getting help. That same population is more likely to have family problems and social ostracism, Veltman said.

The closet itself can also be a stressor, said Deirdre Pike, a social planner and co-chair of the Hamilton Positive Space collaborative. And queer youth with mental health issues are living in two of them.

"The first closet is your sexual orientation, which you might not have disclosed," Pike said. "The second closet is identifying yourself as someone with mental health issues."

The Canadian Psychiatric Association does not have a policy around dealing with the LGBTQ community, Veltman said. But she and Dr. Gary Chaimowitz from McMaster just wrote one that is now being reviewed.

New rules for psychiatrists

It needs to be implemented, she said.

"Without that policy statement in place, at this point in time, if a trans identified patient comes to a psychiatrist and says they want care for depression or bipolar, that psychiatrist can still deny care if that's what they chose to do."

Queer issues also need to be addressed at the post-secondary level when nurses, social workers and medical students are trained, she said.

"If you haven't encountered it in the curriculum, the implication is it's not important, and we know that's not true."

Right now, Russell is getting good help at Mac. But finding help may be more challenging later on. In the meantime, she is learning to feel better about herself.

"People seem to approach that your gender is a mental health issue, and that's not what it is to me," Russell said. Rather than sitting on a static point on the gender spectrum, "I'm flowing through it all."