MY NAME IS MARILYN POWELL,
CLINICAL DIRECTOR AND DEPUTY
SCIENTIFIC DIRECTOR FOR THE
NATIONAL INSTITUTE OF MENTAL
HEALTH.
I'M SO PLEASED TO WELCOME YOU TO
THIS NIMH SYMPOSIUM TITLED
SUICIDE PREVENTION FOR LGBTQ+
YOUTH IN RECOGNITION OF PRIDE
MONTH.
THIS SYMPOSIUM IS GOING TO
HIGHLIGHT THE MENTAL HEALTH
NEEDS OF LGBTQ+ YOUTH, INCLUDING
INTERVENTIONS TO ADDRESS
INCREASING SUICIDE RISK.
THIS IS A TIMELY AND IMPORTANT
TOPIC.
IN FEBRUARY, THE CENTERS FOR
DISEASE CONTROL AND PREVENTION
RELEASED THE 2021 YOUTH RISK
BEHAVIOR SURVEY RESULTS, WHICH
IS A NATIONAL SNAPSHOT OF HIGH
SCHOOL YOUTH'S SELF-REPORTED
RISK BEHAVIORS.
AMONG LESBIAN, GAY, BISEXUAL,
QUESTIONING AND OTHER
NON-HETEROSEXUAL IDENTITY OR LGQ
PLUS GROUPS, 22% OF THE STUDENTS
AND LGBTQ STUDENTS AND 33% OF
THE STUDENTS WHO HAD SAME-SEX
PARTNERS REPORTED MAKING AT
LEAST ONE SUICIDE ATTEMPT IN THE
PAST YEAR COMPARED TO 6% OF
HETEROSEXUAL STUDENTS.
THANKS TO THE ANALYSES OF THE
NIH ADOLESCENT BRAIN
DEVELOPMENT -- BRAIN COGNITIVE
DEVELOPMENT STUDY KNOWN AS THE
ABCD STUDY, WE ALSO KNOW THAT
SUICIDE THOUGHTS AND BEHAVIORS
OF SEXUAL MINORITY YOUTH BEGIN
BEFORE ADOLESCENCE.
BLASHILL AND COLLEAGUES IN 2021
EXAMINED 9 TO 10-YEAR-OLDS'
BASELINE DATA AND FOUND OUT OF
THE 11,777 TOTAL SAMPLE, 150 OF
THE YOUTH WERE SEXUAL MINORITY
OR 1.3%, AND COMPARED TO
HETEROSEXUAL CHILDREN, SEXUAL
MINORITY CHILDREN WERE SIX TIMES
MORE LIKELY TO REPORT A LIFETIME
SUICIDE ATTEMPT, AND FIVE TIMES
MORE LIKELY TO REPORT LIFETIME
SUICIDE THOUGHTS.
AND IN OUR OWN UNPUBLISHED
SECONDARY ANALYSIS OF THE NIMH
FUNDED EMERGENCY DEPARTMENT
SCREEN FOR TEENS AT RISK OF
SUICIDE OR THE ED STARS STUDY,
THAT IMPLEMENTED SUICIDE RISK
SCREENING IN A PEDIATRIC
EMERGENCY DEPARTMENT, WE FOUND
OVER 40% OF SEXUALLY DIVERSE AND
OVER 60% OF TRANS YOUTH SCREENED
POSITIVE FOR SUICIDE RISK.
COMPARED TO ONLY 11% OF CIS
HETEROSEXUAL YOUTH.
SO NIH AND NIMH HAS BEEN --
THROUGH A NUMBER OF FUNDING
ANNOUNCEMENTS ON THE SUICIDE
RISK AMONG LGBTQ+ YOUTH.
TO HELP GUIDE OUR EFFORTS, WE
RELEASED A STRATEGIC FRAMEWORK
FOR ADDRESSING YOUTH MENTAL
HEALTH DISPARITIES.
IT PROVIDES A CONCEPTUAL
APPROACH TO HELP GUIDE NIMH
ACTIVITY, INCLUDING RESEARCH
FUNDING, STAKEHOLDER ENGAGEMENT,
WORKFORCE DEVELOPMENT, AND
RELATED RESEARCH ON THE MENTAL
HEALTH NEEDS OF YOUTH IMPACTED
BY RACIAL, ETHNIC, AND SEXUAL
AND GENDER HEALTH DISPARITIES.
I'M REALLY HONORED TO CONVENE
THIS SYMPOSIUM TO HEAR ABOUT THE
LIVED EXPERIENCE OF SOMEONE WHO
FACED SUICIDE AS AN LGBTQ+
YOUTH, AND TO HIGHLIGHT
PROMISING RESEARCH AS WELL AS
IDENTIFY RESEARCH GAPS THAT MUST
BE ADDRESSED IN ORDER TO REDUCE
SUICIDE AMONG THIS YOUTH.
I'M NOW PLEASED TO INTRODUCE MSE
PROGRAM DIRECTOR OF THE WOMEN'S
MENTAL HEALTH RESEARCH PROGRAM,
AND THE PROGRAM LEAD FOR THE
NON-HIV SEXUAL GENDER MINORITY
RESEARCH PROGRAM AT THE NATIONAL
INSTITUTE OF MENTAL HEALTH.
AND SHE WILL BE OUR MODERATOR
FOR TODAY'S SYMPOSIUM.
SO LET'S WELCOME TAM.
[APPLAUSE]
>> THANK YOU, DR. POWELL, AND
WELCOME.
I'M JUST GOING TO START WITH AN
INTRODUCTION OF ADMIRAL LEVINE.
AND NOW THE INTRODUCTION OF ADMIRAL LEVINE.
ADMIRAL RACHEL LEVINE SERVES AS
THE 17TH ASSISTANT SECRETARY FOR
HEALTH FOR THE U.S. DEPARTMENT
OF HEALTH AND HUMAN SERVICES
AFTER BEING NOMINATED BY
PRESIDENT JOE BIDEN AND
CONFIRMED BY THE U.S. SENATE IN
2021.
AS ASSISTANT SECRETARY FOR
HEALTH, ADMIRAL RACHEL LEVINE
FIGHTS EVERY DAY TO IMPROVE THE
HEALTH AND WELL-BEING OF ALL
AMERICANS.
SHE'S WORKING TO HELP OUR NATION
OVERCOME THE COVID-19 PANDEMIC
AND BUILD A STRONGER FOUNDATION
FOR A HEALTHIER FUTURE.
ONE IN WHICH EVERY AMERICAN CAN
ATTAIN THEIR FULL HEALTH
POTENTIAL.
ADMIRAL LEVINE ALSO IS THE HEAD
OF THE U.S. PUBLIC HEALTH
SERVICE COMMISSION CORPS, ONE OF
THE EIGHT UNIFORMED SERVICES.
ADMIRAL LEVINE IS A MEMBER OF
THE NATIONAL ACADEMY OF MEDICINE
AND A FELLOW OF THE AMERICAN
ACADEMY OF PEDIATRICS, THE
SOCIETY OF ADOLESCENT HEALTH IN
MEDICINE, AND THE ACADEMY FOR
EATING DISORDERS.
SHE WAS ALSO THE PRESIDENT OF
THE ASSOCIATION OF STATE AND
TERRITORIAL HEALTH OFFICIALS.
IN ADDITION TO HER RECENT POST
IN MEDICINE IN GOVERNMENT,
ADMIRAL LEVINE IS AN
ACCOMPLISHED SPEAKER AND AN
AUTHOR OF NUMEROUS PUBLICATIONS
ON THE OPIOID CRISIS, ADOLESCENT
MEDICINE, EATING DISORDERS, AND
LGBTQ+ MEDICINE.
>> HELLO.
I AM ADMIRAL RACHEL LEVINE,
SHE/HER PRONOUNS.
AND I'M HONORED TO BE THE
ASSISTANT
>> HELLO.
I AM ADMIRAL RACHEL LEVINE,
SHE/HER PRONOUNS.
AND I'M HONORED TO BE THE
ASSISTANT SECRETARY FOR HEALTH
AT THE UNITED STATES DEPARTMENT
OF HEALTH AND HUMAN SERVICES AND
TO SERVE AS A FOUR STAR ADMIRAL
FOR THE UNITED STATES COMMISSION
CORPS.
I'M ALSO THE FIRST OPENLY
TRANSGENDER PERSON WHO IS A
SENATE-CONFIRMED FEDERAL
OFFICIAL.
I KNOW MY APPOINTMENT PAVES THE
WAY TO NATIONAL LEADERSHIP THAT
IS MORE REFLECTIVE OF THE PEOPLE
THAT WE SERVE.
BUT MY APPOINTMENT ALONE IS NOT
ENOUGH.
WHICH IS WHY I WANT TO THANK
EVERY SPEAKER WHO HAS JOINED
TODAY'S EVENT TO PROMOTE SUICIDE
PREVENTION INITIATIVES FOR
LGBTQ+ YOUTH.
THIS EVENT COMES AT A CRITICAL
TIME, AS OUR NATION'S LGBTQ I
PLUS YOUTH ARE REPORTING
NEGATIVE MENTAL HEALTH IN
RESPONSE TO UNPRECEDENTED LEVELS
OF ANTILGBTQ I PLUS POLICIES AND
LEGISLATION.
HEALTHY PEOPLE 2030 DEFINES
HEALTH EQUITY AS THE ATTAINMENT
OF THE HIGHEST LEVELS OF HEALTH
FOR ALL PEOPLE.
I FIRMLY BELIEVE THAT WE HAVE
NOT MADE PROGRESS UNLESS WE HAVE
ALL MADE PROGRESS.
ACHIEVING HEALTH EQUITY REQUIRES
VALUING EVERYONE.
THAT MEANS MAKING FOCUS AND
ONGOING EFFORTS TO END
INEQUALITIES, ELIMINATE THE
IMPACTS OF INJUSTICE, AND
IMPROVE THE HEALTH FOR EVERYONE.
WE HAVE TO TAKE A STAND ON
BEHALF OF THOSE WHO ARE BEING
HURT BY THESE ATTACKS.
TODAY, MANY YOUNG PEOPLE LIVING
IN THIS COUNTRY NEED EMPATHY,
COMPASSION AND UNDERSTANDING
BECAUSE OF THESE HATEFUL ACTIONS
AND THEY SEE FEW PLACES TO TURN.
IN APRIL OF 2023, THE CDC
RELEASED THE YOUTH RISK BEHAVIOR
SURVEY, WHICH PROVIDES DATA ON
KEY BEHAVIORS AND EXPERIENCES
AMONG ADOLESCENTS RELATED TO
SEXUAL BEHAVIOR, SUBSTANCE USE,
EXPERIENCE OF VIOLENCE, MENTAL
HEALTH AND SUICIDALITY.
AND THESE DATA SHOW A
DISTRESSING PICTURE.
THIS NATIONALLY REPRESENTATIVE
SURVEY OF U.S. HIGH SCHOOL
STUDENTS REVEALS THE CHANGING
HEALTH RISKS THAT OUR YOUNG
PEOPLE ARE FACING.
THE FINDINGS FROM 2021 ARE THE
FIRST NATIONAL YRBS DATA THAT
HAVE BEEN PRESENTED SINCE THE
START OF THE COVID-19 PANDEMIC.
WHILE MUCH ATTENTION HAS BEEN
GIVEN TO THE YOUTH MENTAL HEALTH
CRISIS DURING THE COVID-19
PANDEMIC, THE YRBS DATA HAVE
SHOWN THAT MANY MEASURES WERE
MOVING IN THE WRONG DIRECTION
EVEN BEFORE THE PANDEMIC.
LESBIAN, GAY, BISEXUAL,
TRANSGENDER AND QUEER STUDENTS
CONTINUE TO BE AT HIGH RISK.
IN 2021, LGBTQ+ TEENS WERE MORE
LIKELY TO HAVE EXPERIENCED ALL
FORMS OF VIOLENCE, AND THEY HAVE
WORSE MENTAL HEALTH OUTCOMES
THAN HETEROSEXUAL YOUTH.
ALMOST A THIRD OF LGBTQ+
STUDENTS WERE BULLIED ONLINE.
ALMOST A QUARTER WERE BULLIED AT
SCHOOL.
AND MORE THAN 1 IN 10 ACTUALLY
DID NOT GO TO SCHOOL BECAUSE OF
SAFETY CONCERNS.
TRAGICALLY, ALMOST HALF
SERIOUSLY CONSIDERED SUICIDE.
AND NEARLY 1 IN 4 HAD ATTEMPTED
SUICIDE.
THEY ATTEMPTED SUICIDE.
1 IN 4.
LGBTQ YOUTH REPORT SIGNIFICANTLY
LOWER RATES OF SUICIDE ATTEMPTS
IF THEY HAVE JUST ONE SUPPORTIVE
ADULT IN THEIR LIVES.
THAT'S ALL IT MAY TAKE TO SAVE A
LIFE.
ONE SUPPORTIVE ADULT.
I WANT TO POINT OUT HERE, IT IS
CRITICALLY IMPORTANT THAT
EVERYONE, EVERYONE BECOME
FAMILIAR WITH SAMHSA'S
988 PROGRAM.
SIMPLY DIALING OR TEXTING
988 WILL CONNECT A PERSON IN
NEED WITH A SUICIDE AND CRISIS
LIFELINE.
SUICIDE PREVENTION FOR LGBTQI+
YOUTH IS A NATIONAL PRIORITY.
THE LIFELINE PROVIDES A CLICK
3 PROGRAM THAT ALLOWS PEOPLE TO
CLICK 3 TO BE DIRECTED
SPECIFICALLY TO LGBTQI+-TRAINED
COUNSELORS.
988 IS AN INCREDIBLE TOOL THAT
WILL PREVENT SUICIDES.
I AM ENCOURAGING YOU TO SHARE
INFORMATION ABOUT 988 WITH YOUR
WORK AND HOME COMMUNITIES AND
HAVE INFORMATION ABOUT
988 AVAILABLE IN YOUR
COMMUNITY'S SPACES OR RESTROOMS.
IF YOU KNOW SOMEONE WHO IS
STRUGGLING, YOU CAN HAVE THEM
CALL, TEXT OR CHAT WITH THE
LIFELINE.
THEY ARE AVAILABLE 24/7, AND
THEY ARE CONFIDENTIAL.
THERE ARE CRISIS COUNSELORS
AVAILABLE TO LISTEN AND SUPPORT
YOU WITHOUT JUDGMENT.
I WANT TO SPEAK FOR A MOMENT
ABOUT THE HATEFUL ACTIONS
AGAINST TRANSGENDER YOUTH, THEIR
FAMILIES AND THEIR PROVIDERS,
THAT WE ARE SEEING IN MANY
STATES ACROSS THE COUNTRY.
AS ASSISTANT SECRETARY FOR
HEALTH, I AM URGING US TO BASE
MEDICAL CARE ON FACTS, NOT
FEARS.
GENDER-AFFIRMING CARE IS MEDICAL
CARE.
GENDER-AFFIRMING CARE IS MENTAL
HEALTH CARE.
GENDER-AFFIRMING CARE IS
LITERALLY SUICIDE PREVENTION
CARE.
IT IMPROVES QUALITY OF LIFE AND
IT SAVES LIVES.
IT IS BASED UPON DECADES OF
STUDY, AND IT IS A
WELL-ESTABLISHED MEDICAL
PRACTICE.
BASED UPON DECADES OF RESEARCH
AND MEDICAL EVIDENCE, AND THE
ANALYSIS OF RESPECTED MEDICAL
ORGANIZATIONS FROM MANY DIVERSE
FIELDS OF MEDICINE, EXPERTS
AGREE THAT GENDER-AFFIRMING CARE
IS MEDICALLY NECESSARY, SAFE AND
EFFECTIVE FOR TRANSGENDER AND
NON-BINARY YOUTH AND
ADOLESCENTS.
THOSE WHO ATTACK OUR LGBTQI+
COMMUNITY ARE DRIVEN BY AN
AGENDA THAT HAS NOTHING TO DO
WITH SCIENCE AND NOTHING TO DO
WITH MEDICINE.
THESE POLITICAL AND IDEOLOGICAL
ATTACKS ON TRANS YOUTH AND THEIR
FAMILIES ARE CONTRARY TO THE
OVERWHELMING SCIENCE AND
EVIDENCE THAT SUPPORTS THE
WELL-ESTABLISHED STANDARDS OF
CARE.
WE ALL HAVE TO CONTINUE TO STAND
UP AND TAKE A STAND ON BEHALF OF
THOSE WHO ARE BEING HURT.
I HAVE BEEN AT MANY PRIDE
CELEBRATIONS AND OUR COMMUNITY
IS BEAUTIFUL, PASSIONATE,
STRONG, AND RESILIENT.
AND I AM A POSITIVE AND
OPTIMISTIC PERSON, AND I BELIEVE
THAT WORKING TOGETHER, WE CAN
CREATE A BETTER FUTURE FOR ALL
THOSE LIVING IN THE UNITED
STATES.
I AM HOPEFUL FOR A MORE
INCLUSIVE FUTURE BECAUSE OF THE
WORK THAT MANY OF YOU ARE DOING
EVERY DAY.
THE TRUTH IS THAT WE HAVE NOT
MADE PROGRESS UNLESS WE HAVE ALL
MADE PROGRESS.
AND WE ALL HAVE A ROLE TO PLAY
IN MAKING THAT HAPPEN.
WE MUST STRONGLY ADVOCATE FOR
THE MOST UNDERSERVED AND
MARGINALIZED IN OUR COMMUNITIES,
INCLUDING OUR TRANS YOUTH, TRANS
SENIORS, AND PARTICULARLY TRANS
WOMEN OF COLOR.
YOU SHOULD BE ABLE TO LIVE YOUR
LIFE FULLY AND SAFELY IN ANY
PART OF THIS COUNTRY, NO MATTER
WHO YOU ARE, OR WHO YOU LOVE.
AND I'D LIKE TO LEAVE YOU WITH A
MESSAGE OF HOPE.
THERE IS A PLACE FOR YOU IN THIS
GREAT COUNTRY.
HIS MOST RECENT PUBLICATION, "WE
BURN OUT, WE BREAK, WE DIE", WAS
AWARDED THE JOHN A. BENSON
PROFESSIONALISM ARTICLE PRIZE
FOR BEST ARTICLE OF 2021 BY THE
AMERICAN BOARD OF INTERNAL
MEDICINE.
HE HAS WORKED CLOSELY WITH THE
AMERICAN ACADEMY ACADEMY OF PED,
IN DEVELOPING A REVISED
BLUEPRINT FOR YOUTH SUICIDE
PREVENTION IN THE UNITED STATES.
UPON THE COMPLETION OF HIS
RESIDENCY TRAINING IN 2024,
DR. VEAL WILL BE JOINING HOWARD
BROWN HEALTH IN CHICAGO,
ILLINOIS AS A PRIMARY CARE
PHYSICIAN, FOCUSING ON
TRAUMA-INFORMED CARE, ADVERSE
CHILDHOOD EXPERIENCES,
GENDER-AFFIRMING CARE, AND
LGBTQ+ HEALTH.
DR. VEAL.
[APPLAUSE]
I REALLY APPRECIATE IT.
HOPEFULLY EVERYONE CAN HEAR ME.
SO BEFORE I GET STARTED, I WOULD
JUST LIKE TO TAKE THIS MOMENT TO
THANK THE NATIONAL INSTITUTES OF
HEALTH AND MENTAL HEALTH FOR THE
OPPORTUNITY TO BE PART OF THIS
INCREDIBLE SYMPOSIUM.
THOUGH I'LL ADMIT AS A RESIDENT
JUST ENTERING HIS FINAL YEAR OF
MEDICAL TRAINING, I WOULDN'T
CONSIDER MYSELF A EXPERT, PER
SE, ON SUICIDE PREVENTION FOR
LGBTQ YOUTH, FIRST REASON BEING
THAT ALTHOUGH I'D LIKE TO
BELIEVE I EXUDE THE YOUTHFUL
ENERGY AND CHARACTERISTICS OF A
TWINK, I'M REMINDED BY MY LGBTQ
FRIENDS AND PATIENTS THAT MY
HABIT OF GOING HOME AND WATCHING
THE GOLDEN GIRLS PLACES ME IN
THAT CATEGORY OF THE ELDERLY
TWUNK.
WITH ALL KIDDING ASIDE, I REALLY
WAS SURPRISED WHEN I RECEIVED
THIS INVITATION.
I MEAN, I'M JUST STARTING MY
CAREER.
WHAT COULD I BRING TO THE STAGE
THAT ANY ONE OF YOU COULDN'T
BRING WITH TWICE THE AMOUNT OF
DATA AND RESEARCH?
BUT THAT'S WHEN IT DAWNED ON ME
THAT I DO HAVE SOMETHING TO
BRING TO THE STAGE.
THAT NO ONE ELSE CAN.
AND IN FACT, WE ALL HAVE
SOMETHING TO BRING TO THE STAGE
BASED ON OUR LIVED EXPERIENCES
THAT DEFINE WHO WE ARE, AND
GRANTS US THE POWER TO CHANGE
LIVES.
IT'S THE POWER OF THE LIVED
EXPERIENCE THAT I WANTED TO
FOCUS ON TODAY, THROUGH SHARING
MY OWN STORY.
FOR YOUR INFORMATION, I HAVE NO
FINANCIAL DISCLOSURES.
I AM STILL VERY POOR FOR AT
LEAST ONE MORE YEAR.
OKAY.
SO BACK IN LATE SUMMER, 2016, AS
YOU CAN SEE, THIS IS WHERE I HAD
HAIR -- I DIDN'T HAVE HARRIET.
GREW IT LATER ON.
I ALWAYS TELL PEOPLE THAT DURING
THIS TIME IN MY LIFE, I ALWAYS
FELT LIKE I HAD A DARK CLOUD
HANGING OVER MY HEAD.
WHETHER I WANTED TO BELIEVE IT
OR NOT, I WAS STRUGGLING.
SIX MONTHS BEFORE STARTING
MEDICAL SCHOOL, MY BEST FRIEND
ALEX HAD TRAGICALLY DIED BY
SUICIDE.
SHORTLY AFTER HIS DEATH, I
DECIDED TO COME OUT OF THE
CLOSET TO MY FAMILY WHICH
ULTIMATELY RESULTED IN A GREAT
PART OF MY FAMILY DISOWNING ME.
MY RELATIONSHIP WITH MY FATHER
ALSO BASICALLY ENDED.
AT THE SAME TIME, I HAD NO
MONEY, AND I WAS AN EMOTIONAL
MESS.
WHAT BETTER TIME TO START
MEDICAL SCHOOL, RIGHT?
I WAS HOPING THAT BY THAT TIME,
WHEN I STARTED CLASSES, THAT YOU
KNOW, THE DISTRACTION OF MEDICAL
SCHOOL WOULD BE ENOUGH TO HIDE
THE DEPRESSION THAT I HAD BEEN
STRUGGLING WITH FOR SEVEN YEARS.
BUT SOMETHING DIFFERENT
HAPPENED.
THAT DEPRESSION DIDN'T GO AWAY.
IN FACT, IT STARTED TO MORPH
FROM A FEELING OF SADNESS TO
THIS UNSHAKEABLE FEELING OF
ISOLATION, INCOMPETENCE, AND
IMPOSTER SYNDROME.
THAT BEGAN TO HAUNT ME WITH EACH
PASSING DAY.
CONTRIBUTING TO THAT FEELING WAS
THE UNMISTAKABLE RECOGNITION
THAT I WAS THE ONLY BLACK MALE
IN MY CLASS OF 120.
WHICH TO THE CREDIT OF THE
UNIVERSITY OF VERMONT WAS THE
MOST DIVERSE MEDICAL SCHOOL
CLASS OF ITS 194-YEAR HISTORY.
ALONG WITH THAT, I BEGAN TO FEEL
LIKE THERE WAS A TARGET ON MY
BACK.
AFTER I BEGAN TO NOTICE SEVERAL
OF MY CLASSMATES, THE OVERWH
OVERWHELMING MAJORITY PEOPLE OF
COLOR HADN'T RETURNED FOR
CLASSES AFTER THE FIRST SEMES
SEMESTER.
-- TOLD ME THEY WERE ASKED A
QUESTION BY THE DEAN THAT
ENCOURAGED THEM TO LEAVE AND
THAT QUESTION WAS, "ARE YOU SURE
YOU WANT TO BE A DOCTOR?"
THAT CHILLING QUESTION WOULD
KEEP ME UP AT NIGHT.
WITH THAT QUESTION, I WOULD HEAR
THE ECHO OF MY MOTHER'S CONSTANT
REFRAIN FROM MY CHILDHOOD:
FAILURE IS NOT AN OPTION.
THESE WORDS ECHOED THROUGH MY
MIND AS I DESPERATELY FOUGHT TO
SUPPRESS MY GROWING DEPRESSION.
GROWING UP, FAILURE MEANT WE
WERE ON THE STREET.
FAILURE MEANT THAT WE WOULDN'T
HAVE FOOD.
AND FAILURE MEANT THAT THE
POVERTY THAT MY GRANDMOTHER, THE
GRANDDAUGHTER OF A SLAVE IN
ALABAMA, THE POVERTY THAT SHE
WORKED SO HARD TO ESCAPE WAS A
WASTE.
YES, FOR ME, FAILURE SIMPLY WAS
NOT AN OPTION AND DEET PRETION
DEPRESSION WASNOT AN EXCUSE.
DURING THAT TIME I REACHED OUT
TO MY GRANDMOTHER, AT ONE OF MY
LOWEST POINTS, AND I SAID NANNA,
I AM SO DEPRESSED, I CAN BARELY
GET OUT OF BED IN THE MORNING.
TO WHICH SHE RESPONDED, KRI
WHAT'S WRONG WITH YOU?
BLACK FOLKS DON'T HAVE
DEPRESSION.
LEAVING SLAVELY IS A FUN JOB,
NO, DEPRESSION IS JUST OUR
BASELINE.
WHAT MAKES YOU FEEL SPECIAL?
BUT THE THING IS, I DIDN'T FEEL
LIKE I WAS SPECIAL.
I FELT LIKE A FAILURE.
AND THIS FEELING GREW STRONGER
AS I ENDED MY FIRST YEAR
MARGINALLY PASSING MY REMAINING
COURSES.
ULTIMATELY BY MY SECOND YEAR,
THE OPTION THAT MY MOTHER
FOREBAID ME FROM CONSIDERING IT
FINALLY HAPPENED.
I FAILED A COURSE BY A SINGLE
POINT.
FAILURE HAD BECOME AN UNDENIABLE
OPTION.
I FELT MYSELF BEFORE MY SCHOOL'S
ADVANCEMENT COMMITTEE ALONE AND
FEELING MORE ISOLATED THAN EVER
BEFORE.
HERE I PLED MY CASE FOR ONE MORE
CHANCE AND I MADE A PROMISE THAT
I'D DO BETTER AND RETAKE THE
TEST AFTER WINTER BREAK.
NOW THERE WAS NO PLAN ON HOW I
WAS GOING TO DO BETTER OR WHAT
THEY EVEN ENTAILED, BUT AS FAR
AS I WAS CONCERNED, I WAS
WILLING TO SAY ANYTHING TO
PREVENT THEM FROM ASKING ME THAT
OMINOUS QUESTION ASKED OF MY
LAST CLASSMATES.
THE COMMITTEE DID GIVE ME THAT
SECOND CHANCE.
BUT IT WAS ONLY AFTER A NEW
SOLUTION TO MY SUFFOCATING
DEPRESSION BEGAN TO MANIFEST
ITSELF IN MY MIND.
AND THAT WAS SUICIDE.
WHILE THIS NEW OPPORTUNITY TO
CHANGE COURSE TO PRESS THAT
THOUGHT FOR THE MOMENTS LEADING
TO MY REMEDIATION, THE THOUGHT
CAME BACK WITH EVEN MORE
STRENGTH AND CLARITY DURING
THE -- DURING MY MEETING WITH
ONE OF MY DEANS AFTER ULTIMATELY
FAILING THAT REMEDIATION.
AS I SAT ACROSS THE DESK FROM
THAT DEERNTION I STRUGGLED TO
KEEP MY HANDS FROM SHAKING.
THE NEWS THAT I'D FAILED THIS
TEST AGAIN WAS GROUND SHAKING
ENOUGH, BUT IT WAS WHEN THAT
DEAN UTTERED THOSE WORDS, THAT I
FEARED THE MOST: ARE YOU SURE
YOU WANT TO BECOME A DOCTOR,
WHEN EVERYTHING CHANGED.
MY HANDS STOPPED SHAKING, A
RINGING NOISE BEGAN TO GROW
LOUDER AND LOUDER IN MY EARS AND
I JUST FELT ABSOLUTELY
BREATHLESS.
I COULDN'T HEAR OR RESPOND TO
ANYTHING THE DEAN SAID AFTER
THIS.
THAT.
BUT I KNEW I NEEDED TO GET OUT
OF THERE.
MOMENTS LATER, I WOULD FIND
MYSELF CROUCHED DOWN ON THE
FLOOR OF AN ENCLOSED STAIRWELL,
CRYING UNCONTROLLABLY.
WHILE TRYING AND FAILING TO
SUPPRESS A GUT WRENCHING PAIN
THAT PARALYZED MY BODY AND
SPIRIT.
THE ONLY WAY I COULD IMAGINE
ALLEVIATING THIS PAIN WAS
THROUGH SUICIDE.
SO AFTER I MUSTERED ENOUGH
STRENGTH TO LEAVE THE STAIRWELL,
I LEFT THE BUILDING ONLY TO FIND
MYSELF IN A MASSIVE SNOWSTORM.
IRENEED WITH THE WEATHER, IF I
WERE TO RUN MY CAR INTO A
TRAFFIC POLE, MY MOTHER AND
GRANDMOTHER WOULD ASSUME THAT MY
DEATH WAS AN ACCIDENT AND FIND A
WAY TO MOVE ON WITHOUT THINKING
THEIR SON WAS A FAILURE.
AS I SAT IN MY CAR WITH THE SNOW
BUILDING UP ON MY WINDSHIELD, I
BEGAN TO THINK ABOUT MY LATE
BEST FRIEND.
WHILE THE THOUGHT OF ALEX' LIFE
AND DEATH HAD NEVER LEFT ME, I
DEEP DOWN -- I BELIEVED DEEP
DOWN THAT ALEX' SPIRIT MOVED ME
TO REACH OUT TO HIS MOTHER IN
THOSE FINAL MOMENTS.
IN THE WAKE OF HIS DEATH, I
BECAME VERY CLOSE TO HIS MOTHER,
AND HIS STEPFATHER, JIM, CARLA,
WHO I STARTED TO REFER TO AS MY
OWN GOD PARENTS, PRIMARILY
BECAUSE THEY GAVE ME THE LOVE
AND SUPPORT THAT I LOST FROM MY
OWN FAMILY.
AFTER I CAME OUT OF
THE CLOSET.
SO I PULLED OUT MY PHONE AND I
CALLED CARLA.
AND THE MOMENT SHE HEARD MY
VOICE, SHE INSTANTLY KNEW
SOMETHING WAS WRONG.
WE WENT BACK AND FORTH WITH ME
DENYING HER ACCUSATION AND
INSISTING -- AND HER INSISTING
ON KNOWING BEFORE I FINALLY
BROKE DOWN AND TOLD HER WHAT
HAPPENED.
WHILE I NEVER TOLD HER ABOUT MY
INITIAL PLAN PRIOR TO THAT CALL,
SHE REFUSED TO GET OFF THE PHONE
UNTIL I GOT HOME.
ALWAYS HAVE A PLAN IN PLACE FOR
MY EVENTUAL LEAVE OF ABSENCE,
TIME I WOULD USE TO ADDRESS MY
MENTAL HEALTH UNDER THE LOVE AND
PROTECTION OF HER AND HER
HUSBAND IN SAN DIEGO.
SO TWO WEEKS LATER, I WAS ON THE
ROAD FROM VERMONT TO SAN DIEGO.
THOSE FIRST TWO DAYS ON THE ROAD
WERE AS THERAPEUTIC AS THEY WERE
TERRIFYING, MAINLY BECAUSE I
DIDN'T KNOW WHAT WAS GOING TO
HAPPEN NEXT.
ALL I WANTED TO DO WAS CURL UP
IN A BALL AND SHUT THE WORLD
OUT.
I CONVINCED MYSELF THAT I WAS --
THAT I WAS NOT GOING TO COME
BACK TO VERMONT AND I WAS GOING
TO LEAVE MEDICAL SCHOOL ALL
TOGETHER AND START A NEW CHAPTER
OUT WESTMENT WHEN I ARRIVED AT
THEIR HOME, SOMETHING HAD
CHANGED.
SURE, THE TREMENDOUS IMPROVEMENT
FROM THE COLD AND DARK WINTER IN
VERMONT TO WARM AND SUNNY
SAN DIEGO WAS A GREAT
TRANSITION, BUT IT WAS THE
UNMISTAKABLE AND UNWAVERING LOVE
OF CARLA AND JIM THAT HAD THE
GREATEST IMPACT.
THEY SAW MY PAIN.
AND DESPITE THE DARK CLOUD OF
DEPRESSION THAT CONSTANTLY
OBSCURED MY VISION, I COULD SEE
THEIR PAIN TOO.
IT HAD ONLY BEEN TWO YEARS SINCE
ALEX HAD DIED AND ALTHOUGH IT
CAME IN WAVES, IT WAS CLEAR THAT
CARLA WAS STILL GRIEVING.
WITH THAT KIND OF LOSS, A MOTHER
NEVER REALLY STOPS GRIEVING.
BUT OVER THOSE TWO YEARS, I'D
ESTABLISHED A RELATIONSHIP WITH
HER AND HER HUSBAND THAT FELT
SAFE.
FOR ME, THEY BECAME SURROGATE
PARENTS, AND IN A WAY, I BECAME
A SURROGATE SON.
SO YOU COULD IMAGINE THE PAIN
THAT I FELT WHEN I SAT ACROSS
THE KITCHEN TABLE FROM CARLA AND
SAW HER WEEPING.
IN THAT MOMENT, SHE LOOKED UP AT
ME AND PAINFULLY SAID, I CAN'T
LOSE ANOTHER SON.
I WILL NEVER FORGET THAT MOMENT.
EMOTIONALLY, THEN AND TO THIS
DAY, IT SHOOK ME TO MY CORE.
I MADE A PROMISE THAT NIGHT TO
HER THAT SHE WOULD NEVER LOSE
ME.
SO NEXT DAY I OPENED MY BAC PAC
AND I STARTED STUDYING FOR STEP
ONE.
I MADE A DECISION THAT I WAS
GOING TO YOUR HONOR TO RETURN F
NOT FOR ME, FOR MY GOD PARENTS,
BUT I STILL WAS TERRIFIED.
I STILL DIDN'T KNOW HOW TO
TAMPER OR CONTROL THE
DEPRESSION.
AND ALTHOUGH I DIDN'T WANT TO
ADMIT IT, I DIDN'T REALLY KNOW
HOW TO STUDY FOR A BOARD EXAM.
I WAS AFRAID OF JUDGMENT.
I WAS AFRAID OF FAILURE.
BUT THAT FEAR DIDN'T STOP MY GOD
PARENTS FROM GETTING ME SET UP
WITH A THERAPIST.
SPECIFICALLY, ONE THAT WAS
TRAINED IN COGNITIVE BEHAVIORAL
THERAPY.
NOW I'LL ADMIT, INITIALLY I WAS
PRETTY SKEPTICAL.
BUT I KEPT AN OPEN MIND, AND
HONESTLY, IT CHANGED MY LIFE.
THE GREATEST LESSON I GOT FROM
THOSE SESSIONS WAS LEARNING THAT
FAILURE CAN BE AN OPTION, AND IT
CAN BE USED FOR CONSTRUCTIVE
CHANGE.
THERAPY HELPED ME ATTAIN A NEW
PERSPECTIVE.
IT TAUGHT ME HOW TO BE
RESILIENT.
BUT BECAUSE OF THE SHAME I
CONTINUED TO FEEL WHEN IT CAME
TO ASKING FOR HELP, I CONTINUED
TO STRUGGLE ACADEMICALLY WHILE
PREPARING TO TAKE STEP ONE.
SO AS YOU PROBABLY PREDICTED,
WHEN I TOOK THE EXAM THREE
MONTHS LATER, I FAILED.
BUT THE DIFFERENCE BETWEEN THAT
FAILURE AND THE FAILURE THAT LED
ME TO CONTEMPLATING SUICIDE WAS
THAT I FINALLY UNDERSTOOD WHAT I
WAS DOING WRONG.
I NEEDED HELP.
AND I NEEDED TO BE COMFORTABLE
ASKING FOR THAT HELP.
FAILURE IS INDEED AN OPTION.
THAT'S HOW YOU GROW FROM THAT
FAILURE THAT DETERMINES YOUR
SUCCESS.
I LEARNED THAT THROUGH THERAPY,
AND FROM MY GOD PARENTS.
SO WHEN I RETURNED TO VERMONT, I
GOT TO WORK.
FIRST THING I DID WAS FIND A
PERSONAL TUTOR TO HELP ME LEARN
IN A WAY THAT WAS BEST FOR ME.
SECOND THING I DID WAS FIND A
NEW THERAPIST WHO COULD PICK UP
WHERE MY OLD THERAPIST LEFT OFF.
I WAS COMMITTED TO ENSURING THE
PERSON I WAS WAS NO LONGER THE
PERSON I AM NOW.
I BEGAN THE WORK ACADEMICALLY,
EMOTIONALLY AND PHYSICALLY AND
IT WORKED.
I RE-TOOK STEP ONE, I PASSED.
I WAS SO EXCITED WHEN I FOUND
OUT.
AND WITH THAT, I HAD STARTED A
NEW CHAPTER IN MY LIFE.
I DIDN'T JUST WANT TO LIVE
ANYMORE, I WANTED TO THRIVE.
BUT I WANTED TO DO IT WITHOUT
SHARING HOW DARK MY LIFE HAD
BEEN.
OR RE-OPENING UP MYSELF TO THE
PAIN AND SHAME THAT I HAD FELT
FOR SO LONG.
THEN THE SPRING OF 2020 CAME.
WHILE 2020 SEVERED AS A SHARED
TRAUMA AMONG EVERYONE LIVING
THROUGH THIS NEW PANDEMIC, THE
PEOPLE IN THIS ROOM NO
WITHSTANDING, FOR ME THIS TIME
PERIOD BETWEEN MARCH AND JUNE OF
2020 WAS ABSOLUTELY SO
QUESTIONING.
WITHIN THE FIRST THREE MONTHS OF
THE PANDEMIC, I LOST THREE
FAMILY MEMBERS TO COVID-19.
A COUSIN TO POLICE BRUTALITY
WHOSE DEATH WAS CAPTURED ON FILM
AND BROADCAST ALONG GEORGE FLOYD
AND DOZENS OF OTHER VICTIMS OF
POLICE BRUTALITY IN 2020, AND
FINALLY, MY FRIEND AND
CLASSMATE, ONE OF ONLY FIVE
BLACK MEN IN THE ENTIRE MEDICAL
SCHOOL, HAD DIED BY SUICIDE.
WHILE I WILL NEVER KNOW WHAT IT
WAS EXACTLY THAT LED TO HIS
DEATH, I COULD NOT DENY THE
PARALLEL EXPERIENCES THAT BOTH
OF US WENT THROUGH, LEADING UP
TO OUR MOMENTS OF CRISIS.
I FELT AND STILL FEEL A
TREMENDOUS GUILT.
HE WAS ONE CLASS BEHIND ME.
HE HAD SOME REAL STRUGGLE, HE
HAD SIMILAR WAYS OF COPING,
SIMILAR FEARS, BUT I DID
NOTHING.
I NEVER TOLD HIM ABOUT THE
WARNING SIGNS, I NEVER WARNED
HIM ABOUT HOW BAD THINGS COULD
GET, HOW DARKER THOUGHTS COULD
BE OR HOW ISOLATED YOU COULD
FEEL, BUT THE POINT THAT HAUNTED
ME THE MOST WAS THAT I DIDN'T
TELL HIM IT WORKED.
I WAS INCREDIBLY BLESSED TO HAVE
CARLA AND JIM, BOTH GREATLY
WOUNDED BY THE LOSS OF THEIR SON
AND MY BEST FRIEND, COME IN AND
SAVE ME FROM MYSELF.
BEFORE I REACHED THE POINT OF NO
RETURN.
THE LESSONS I LEARNED WERE LOVE,
EMPATHY AND EXPERIENCES, TOOK ME
TO A PLACE WHERE I COULD FINALLY
BE HEALED.
BUT MY CLASSMATE DIDN'T HAVE
THAT.
AND WHILE BEFORE HIS DEATH, I
THOUGHT THE PROBLEM WAS ME, THAT
I WAS UNIQUE I AND MY EXPERIENCE
WAS EXTRAORDINARY, I BEGAN TO
RECOGNIZE THAT I WAS NOT UNIQUE.
AND IN FACT, I WAS PART OF A
TREND.
AFTER MY FRIEND'S DEATH, I BEGAN
TO DO SOME RESEARCH.
AND WHAT I DISCOVERED ABSOLUTELY
HORRIFIED ME.
THE FIRST THING I LEARNED WAS
THAT MEDICAL STUDENTS DIE THREE
TIMES -- OR EXCUSE ME -- FIRST
THING I LEARNED WAS THAT MEDICAL
STUDENTS ARE THREE TIMES MORE
LIKELY TO DIE BY SUICIDE THAN
THE REST OF THE GENERAL
POPULATION.
AND IF THAT WASN'T BAD ENOUGH, I
LEARNED THAT SUICIDE WAS THE
LEADING CAUSE OF DEATH IN MALE
RESIDENTS.
AND AS RESIDENTS ADVANCED
BECOMING TO ATTENDINGS,
PHYSICIANS CONTINUED TO DIE BY
SUICIDES AT HIGHER RATES THAN
THE GENERAL POPULATION.
CLEARLY THIS WAS A SYSTEMIC
PROBLEM BUT IT'S HARDLY NEW.
GOING BACK JAMA PUBLISHED AN
ARTICLE TRYING TO BRING
ATTENTION TO THIS ISSUE OF
SUICIDE AMONG PHYSICIANS BU.
RECOGNIZING THE POWER OF HOW THE
LIVED EXPERIENCE OF ALEX, CARLA
AND JIM HAD SHAPED MY LIFE FOR
THE BETTER, I DECIDED IT WAS
TIME TO SHARE MY STORY AND HELP
OTHERS DO THE SAME.
START WITH THE VIDEO SERIES
WHICH SHINED A LIGHT ON THE
PEOPLE AT MY MEDICAL SCHOOL,
THAT FACED GREAT CHALLENGES AS
THEY WENT THROUGH THEIR
TRAINING.
BUT NONETHELESS, OVERCAME THESE
CHALLENGES OR BECAME STRONGER
BECAUSE OF THEM.
THEN I BEGAN TO WRITE ABOUT THE
TWO ISSUES I KNEW THE MOST
ABOUT.
THE EXPERIENCE OF BEING A BLACK
MALE MEDICAL STUDENT IN 2020, IN
THE MIDST OF BOTH COVID-19 AND A
NATIONAL RACIAL RECKONING, AND
THE CRITICAL NEED FOR A CULTURE
CHANGE.
TO ADDRESS THE EPIDEMIC OF
SUICIDE AND MENTAL HEALTH IN OUR
TRAINING AND PROFESSION.
TO MY SINCERE SURPRISE, THE
PUBLICATION OF THESE H ESSAYS WE
CRITICALLY ACCLAIMED.
THE RECOMMENDATIONS I OUTLINED
IN MY ESSAY, "WE BURN OUT, WE
BREAK, WE DIE," REGARDING
SUICIDE PREVENTION WITHIN
MEDICAL EDUCATION LED TO
CURRICULUM CHANGES AROUND THE
WORLD.
FROM MEDICAL SCHOOLS IN THE U.K.
TO HARVARD MEDICAL SCHOOL.
THE ESSAY WOULD GO ON TO WIN THE
JOHN A. BENSON AWARD FROM THE
AMERICAN BAMERICAN BOARD OF INTD
SON FOR BEST ARTICLE OF 2021.
THIS WAS THE POWER OF THE
WOUNDED HEALER.
SO AFTER A WHIRLWIND YEAR AND
COUNTLESS MOMENTS OF GRIEF, JOY,
PAIN AND HEALING, I'D FINALLY
REACHED MY GRADUATION DAY.
AND WHILE THE PANDEMIC HAD HAD A
DEVASTATING IMPACT ON MY FAMILY,
IT ALSO MADE US STRONGER.
THE TENSIONS I'D HAD BETWEEN MY
FATHER AND FAMILY DIDN'T MATTER
ANYMORE.
THE WOUNDS THAT BOUND US
TOGETHER HELPED HELPED FACILITAA
UNITED HEEL HALING THAT I WILL
BE FOREVER GRATEFUL FOR.
SO WHAT IS THE POINT OF THIS
STORY?
MY ULTIMATE GOAL IS TO HELP YOU
RECOGNIZE THE POWER THAT YOU
HAVE.
AND WE ARE ALL WOUNDED HEALERS.
IN OUR OWN UNIQUE WAY.
AND COLLECTIVELY, OUR
EXPERIENCES, BOTH LIVED AND
WITNESSED, GIVE US A POWER THAT
CAN INSPIRE CHANGE.
BRIDGE DIVIDES THOUGHT TO BE
INSURMOUNTABLE AND SAVE LIVES.
THIS IS ESPECIALLY TRUE WHEN WE
TALK ABOUT MENTAL ILLNESS.
WHETHER YOU'RE BLACK, WHITE,
STRAIGHT, GAY, REPUBLICAN OR
DEMOCRAT.
OVER THE COURSE OF THIS ENTIRE
TALK, I'VE SPOKEN RATHER
CANDIDLY ABOUT MY STRUGGLE WITH
DEPRESSION AND SUICIDE.
AND OF COURSE I DIDN'T HAVE TO.
IN FACT, WHEN I WAS APPLYING FOR
RESIDENCY, I WAS STRONGLY
ENCOURAGED NOT TO.
BUT WHAT GOOD WOULD THAT HAVE
DONE?
WHAT MESSAGE WOULD THAT HAVE
SENT?
AS WOUNDED HEALERS, WE HAVE THE
POWER TO CHANGE PERCEPTION.
WE ARE IN POSITIONS THAT WE HOLD
TODAY AS A REFLECTION OF THE
EXPERIENCES THAT BROUGHT US
HERE.
GOOD OR BAD.
FOR ME, MY JOURNEY LED ME INTO A
INCREDIBLY FULFILLING CAREER
DEVOTED TOWARD THE MENTAL AND
PHYSICIAN WELL-BEING OF THE
FOLKS FROM MARGINALIZED
COMMUNITIES LIKE MY OWN.
THIS IS PARTICULARLY TRUE WHEN
IT COMES TO MY -- I AM A PROUD
PROVIDER OF GENDER-AFFIRMING
CARE BECAUSE I UNDERSTAND THAT
ACCESS TO THIS CRITICAL RESOURCE
IS ONE OF THE MOST EFFECTIVE
TOOLS WE HAVE FOR SUICIDE
PREVENTION IN THE TRANSGENDER
COMMUNITY.
AND WHILE I MAY IDENTIFY AS A
BLACK CISGENDER GAY MALE, THE
POWERFUL CONNECTION THAT I'M
ABLE TO CREATE AS A WOWBD WOUNDD
HEALER FOR MY PATIENTS CREATES
AN INVALUABLE TRUST THAT SAVES
LIVES.
UNFORTUNATELY, WE ARE LIVING IN
A TIME WHERE THE HEALTH AND
WELL-BEING OF THE LGBTQ
COMMUNITY IS UNDER ATTACK.
AND NUMEROUS COMMUNITIES ACROSS
THIS COUNTRY.
THIS IS NOT -- THIS NOT ONLY --
TO DO MOI JOB EFFECTIVELY LU
MOREOVER IT AIIVETS THE LIVES OF
THOSE I LOVE.
SO I'M TAPPING INTO THIS POWER
OF THE WOUNDED HEALER MORE THAN
EVER.
SO AS I WRAP UP THIS TALK, I
PROMISE YOU I'M ALMOST DONE, I
WANT TO ENCOURAGE ALL OF YOU AS
LEADERS IN OUR PROFESSION AND
FELLOW WOUNDED HEALERS TO SHARE
YOUR LIVED EXPERIENCE.
ESPECIALLY IF IT INCLUDING
STRUGGLING WITH MENTAL ILLNESS.
BECAUSE THE ONLY WAY WE CAN
REDUCE OR ELIMINATE STIGMA IS
THANK YOU EMPATHY.
A WISE WOMAN TOLD ME RECENTLY
THAT EVERYTHING THAT HAS
HAPPENED TO YOU WAS ALSO
HAPPENING FOR YOU.
AND IN THOSE MOMENTS YOU WERE
BUILDING STRENGTH.
I WOULD ADD TO THAT IN THOSE
MOMENTS YOU WERE BUILDING POWER,
YOU WERE BUILDING POWER.
EXCUSE ME.
MY MOUTH IS SUPER DRY RIGHT NOW.
USE THIS POWER, YOUR GIFTS AND
WISDOM TO LEND GUIDANCE TO
SOMEONE WHO MIGHT BE A LITTLE
LOST.
YOU CAN START BY SIMPLY ASKING
THE RIGHT QUESTIONS.
OR JUST THE QUESTIONS IN
GENERAL.
YOU ASK SOMEONE HOW THEY'RE
DOING, REALLY MEAN IT, RIGHT?
ASK WITH INTENTION.
THEN FOLLOW UP BY BEING PRESENT,
ACTUALLY LISTENING AND BEING
WILLING TO HELP.
OR OFFER SUPPORT IN WHATEVER WAY
YOU CAN.
THIS CAN COME IN THE FORM OF
MENTORSHIP, SCHOLARSHIP, A WARM
MEAL, EVEN A HUG.
WHATEVER ASSET YOU HAVE TO
OFFER, PAY IT FORWARD.
BECAUSE YOU NEVER KNOW WHAT
INCREDIBLE AND LIFE CHANGING
MOMENTS THAT WILL CREATE.
I AM A LIVING EXAMPLE OF THAT.
THANK YOU INVESTM VERY MUCH.
[APPLAUSE]
>>THANK YOU SO MUCH, DR. VEAL.
NOW I WILL INTRODUCE OUR
SPEAKERS FOR OUR PANEL.
IF YOU WOULD JUST BEAR WITH ME.
I'LL INTRODUCE EVERYONE AS THEY
WILL BE PRESENTING.
OUR FIRST PRESENTER IS DR. JOSE
BAUERMOSSTER, CHAIR OF THE
DEPARTMENT OF FAMILY AND
COMMUNITY HEALTH AT THE
UNIVERSITY OF PENNSYLVANIA
SCHOOL OF NURSING.
HIS RESEARCH FOCUSES ON
TRANSLATING THEORETICALLY
INFORMED RESEARCH TO DEVELOP AND
TEST INTERVENTIONS FOR RACIAL
AND ETHNICALLY DIVERSE SEXUAL
AND GENDER MINORITIES.
HE HAS AN ACTIVE PORTFOLIO OF E
INTERVENTIONS FOCUSED ON
CREATING PERSONALIZED CONTENT
FOR SEXUAL MINORITY ADOLESCENTS
AND YOUNG ADULTS.
HIS DEDICATION TO
MULTIDISCIPLINARY WORK IS
REFLECTED IN HIS FUNDING
PORTFOLIO.
HE'S CURRENTLY THE PRINCIPAL
INVESTIGATOR AND CO-INVESTIGATOR
OF SEVERAL MIXED METHODS R AND U
PROJECTS IN THIS AREA.
INCLUDING A LIFE SKILLS
INTERVENTION FOR ADOLESCENT MEN
WHO HAVE SEX WITH MEN, AND HIV,
STI, TESTING INTERVENTION
EMBEDDED WITH THE NIH ADOLESCENT
TRIALS NETWORK, AND AN
INTERSECTIONAL STIGMA
INTERVENTION FOR BLACK AND
LATINX MSM AND TRANS WOMEN.
NEXT IS DR. JILL FRIEDMAN,
SENIOR VICE PRESIDENT OF
RESEARCH AND LEADS THE AMERICAN
FOUNDATION FOR SUICIDE
PREVENTIONS RESEARCH PROGRAM,
WHICH FUNDS RESEARCH GRANTS,
OFFERS WORKSHOPS AND TRAINING TO
RESEARCHERS AND DISSEMINATES
RESEARCH FINDINGS TO INCREASE
PUBLIC AWARENESS AND SUPPORT
ADVOCACY.
DURING HER 35 YEARS AS A
CLINICIAN AND RESEARCHER, SHE
HAS PUBLISHED OVER 100 PEER
REVIEWED ARTICLES AND TRAINED
CLINICIANS NATIONWIDE.
SHE EARNED HER B.A. IN
PSYCHOLOGY AT THE UNIVERSITY OF
PENNSYLVANIA, AND HER PH.D. IN
CLINICAL PSYCHOLOGY AT THE
UNIVERSITY OF FLORIDA.
AND COMPLETED HER INTERNSHIP AT
YALE NEW HAVEN HOSPITAL.
AFTER SHE JOINED ALBERT EINSTEIN
COLLEGE OF MEDICINE,
ESTABLISHING THE ADOLESCENT
DEPRESSION AND SUICIDE PROGRAM.
IN 1989, SHE MOVED TO COLUMBIA,
NEW YORK STATE PSYCHIATRIC
INSTITUTE, WHERE SHE IS THE
ASSOCIATE PROFESSOR IN THE
DEPARTMENT OF PSYCHIATRY.
SHE JOINED AMERICAN FOUNDATION
FOR SUICIDE PREVENTION IN 2011,
AND MAINTAINS A CLINICAL
PRACTICE IN MANHATTAN.
SHE WILL BE FOLLOWED BY
DR. CATHERINE FOX.
THE PRIMARY GOAL OF DR. FOX'
RESEARCH IS TO IMPROVE THE
UNDERSTANDING AND TREATMENT TO
SELF INJURIOUS THOUGHTS AND
BEHAVIORS AND TO REDUCE THESE
BEHAVIORS ON A LARGE SCALE.
HER RESEARCH TAKES MULTIPLE
APPROACHES TOWARDS THE SAME,
INCLUDING SUMMARIZING EXISTING
RESEARCH ON THIS TOPIC,
CONDUCTING EXPERIMENTAL AND
LONGITUDINAL STUDIES OF RISK AND
DESIGNING AND TESTING NOVEL AND
SCALABLE TREATMENTS FOR THESE
OUTCOMES.
HER RESEARCH INCREASINGLY SEEKS
TO UNDERSTAND RISK AMONG
ADOLESCENTS AND PEOPLE
IDENTIFYING AS LESBIAN, GAY,
BISEXUAL, TRANS, QUEER AND
QUESTIONING, BECAUSE THESE
SELF-INJURIOUS THOUGHTS AND
BEHAVIORS TEND TO BE
PARTICULARLY PREVALENT AM THESE
POPULATIONS.
AND DR. JACK TURBIN IS DIRECTOR
OF THE GENDER PSYCHIATRY PROGRAM
AND ASSISTANT PROFESSOR AT THE
UNIVERSITY OF CALIFORNIA IN
SAN FRANCISCO, AND AFFILIATE
FACULTY AT THE PHILIP R. LEE
INSTITUTE FOR HEALTH POLICY
STUDIES, WHERE HE RESEARCHES THE
MENTAL HEALTH OF TRANSGENDER
YOUTH WITH A FOCUS ON TOPICS
RELEVANT TO PUBLIC POLICY.
HE'S A FREQUENT OP-ED
CONTRIBUTOR WITH WORK FEATURED
IN THE "NEW YORK TIMES," "THE
WASHINGTON POST," CNN, THE
"LOS ANGELES TIMES," SCIENTIFIC
AMERICA AND VOX.
HE'S ALSO A REGULAR COMMENTATOR
ON MENTAL HEALTH, PARTICULARLY
ON ISSUES ROW LATE RELATED TO GD
SEXUALITY.
NOW WE'LL BEGIN THE
PRESENTATIONS BY OUR SPEAKERS.
>>HAPPY PRIDE.
I'M REALLY THRILLED TO GET TO
SPEND SOME TIME WITH YOU TODAY.
I JUST WANT TO THANK THE KEYNOTE
SPEAKER FOR SUCH AN AMAZING
KEYNOTE TALK, AND HIGHLIGHTING
THAT IMPORTANT QUESTION, RIGHT,
OF WHY SHOULD WE BE THINKING
ABOUT WOUNDED WARRIORS?
I'LL TELL YOU A LOT OF THE WORK
THAT I DO AND I'M HOPING TO
SHARE WITH YOU VERY BRIEFLY
TODAY REALLY THINKS ABOUT NOT
JUST THE WAY BY WHICH WE GET
WOUNDED AS AN LGBTQ+ COMMUNITY
AND HOW IT AFFECTS OUR HEALTH,
BUT MORE IMPORTANTLY, HOW WE CAN
INNOVATE AND HELP FROM THOATIONE
LESSONS OTHER SECTORS OF OUR
SOCIETY.
SO I'M GOING TO BE TALKING ABOUT
ONE PROGRAM OF RESEARCH THAT'S
FUNDED BY IMPLEMENTATION
SCIENCE, SUICIDE PREVENTION
CENTER HERE AT PENN FUNDED BY
NIMH, TO REALLY THINK ABOUT HOW
TECHNOLOGY CAN HELP US IMPROVE
THE WELL-BEING OF LGBTQ+ YOUTH,
AND REDUCE SUICIDE ATTEMPTS.
SO AS HAS BEEN ALLUDED, LGBTQ+
YOUTH HAVE A HIGHER SUICIDE RISK
AND YET THERE ARE FEW TREATMENTS
TAILORED TO THEIR UNIQUE NEEDS.
SOME OF THE PLACES WHERE WE HAVE
HAD A CALL TO ACTION TO ADDRESS
INTERVENTIONS TO ADDRESS SUICIDE
PREVENTION INCLUDE ATTENTION TO
REPEATED MICRO AGGRESSIONS,
DISCRIMINATION EVENTS AND LIFE
STRESSORS, A GREATER
UNDERSTANDING OF THE ADOLESCENT
DEVELOPMENT OF LGBTQ+ YOUTH, AND
EVERYTHING THAT IS HAPPENING IN
THEIR ECOSYSTEM.
THE WAY BY WHICH POLICIES AND
ABSENCE OF SUPPORTIVE
ENVIRONMENTS MAY REQUIRE ONLINE
APPROACHES TO DELIVER CARE,
PARTICULARLY WHEN COMING OUT MAY
INCREASE THE RISK OF SUICIDE AND
OTHER FORMS OF VIOLENCE AGAINST
OUR YOUTH, AND IMPORTANTLY, THE
INCLUSION OF A HEALTH EQUITY
FRAMEWORK IN EVERYTHING WE DO.
I THINK IT'S REALLY IMPORTANT TO
JUST SET THE STAGE BY
RECOGNIZING THAT POLICY AND
HEALTH EQUITY GO HAND IN HAND,
AND THIS IS A CURRENT TA TALLY
ACROSS THE DIFFERENT STATES IN
OUR COUNTRY AND U.S.
TERRITORIES, AND YOU CAN SEE
THAT DEPENDING ON WHERE YOU
LIVE, THE OVERALL SUPPORT
TOWARDS LGBTQ+ PEOPLE CAN BE
QUITE DIFFERENT.
SO AS WE THINK ABOUT DELIVERING
CARE, WE REALLY HAVE TO TAKE
INTO ACCOUNT HOW POLICIES, LAWS
AND REGULATIONS MAY BE AFFECTING
THE DELIVERY OF SAID CARE,
INCLUDING GENDER-AFFIRMING CARE
AS HAS BEEN ALLUDED TO, BUT ALSO
HOW WE ARE GOING TO BE ABLE TO
PUSH SOLUTIONS THAT ARE
EVIDENCE-BASED THROUGH RESEARCH.
SO TECHNOLOGY IS ONE OF THE WAYS
BY WHICH WE CAN DO THIS.
WE OFTEN TALK ABOUT THE FIVE
As.
IN DEVELOPING THE INTERVENTIONS.
TECHNOLOGIES ALLOWS US
PARTICULARLY FOR YOUTH TO BE
MORE ACCESSIBLE TO CARE, FOR
AVAILABILITY OF SERVICES AT
TIMES THAT ARE CONVENIENT FOR
YOUNG PEOPLE.
THEY TEND TO BE MORE AFFORDABLE
THAT IN-PERSON SETTINGS.
IT ALLOWS US TO USE DIFFERENT
MODALITIES TO ADDRESS DIFFERENT
ABILITY STATUSES AND MORE AGENCY
TO NAVIGATE HOW AND WHEN TO USE
SERVICES.
I WANT TO TALK STARS REALLY
QUICKLY IN THE TIME I HAVE LEFT.
STARS IS A SUPPORTING TRANSITION
NOOSE ADULTHOOD AND REDUCING
SUICIDE.
THIS IS THE P50 PROJECT THAT I
WAS TELLING YOU ABOUT.
AND ATITY CORE, WE KNOW THAT
EVIDENCE-BASED INTERVENTIONS
LIKE THE DEVELOPMENT AND
IMPLEMENTATION OF A SAFETY PLAN
PROGRAM WITH A CLINICIAN IS VERY
IMPORTANT AND ACTUALLY CAN
REDUCE THE LIKELIHOOD OF
SUICIDAL IDEATION AND SUICIDE
BEHAVIOR ATTEMPTS, BUT
OFTENTIMES, ONCE THAT PLAN IS
BUILT, IT TAKES A LOT OF YOUNG
PEOPLE AND OTHERS SUFFERING FROM
DEPRESSION BE PROBABLY THE NEXT
CLINICAL VISIT TO SAY WHETHER OR
NOT THEY USED THE PLAN, WHAT
CHANGES TO MAKE TO THE PLAN AND
WE WANTED TO CREATE AN APP THAT
WOULD GO ALONGSIDE THE SAFETY
PLAN INTERVENTION SO THAT THERE
WOULD BE A DAY-TO-DAY CHECK-IN
AS WELL AS A WEEKLY OPPORTUNITY
TO ACTUALLY THINK ABOUT THE
CONTEXT IN WHICH YOUNG PEOPLE
ARE LIVING.
SO ARE THERE WAYS WE CAN HELP
THEM THINK ABOUT LIFE SKILLS
TRAINING, HELP THEM ELICIT
SUPPORT IN THEIR COMMUNITIES AND
ALSO LEARN HOW TO COPE.
WE HAVE EMBEDDED INTO STARS.
IN ORDER TO DO THAT, WE ACTUALLY
HAD AN EXISTING LIFE SKILLS
INTERVENTION BUILT FOR
ADOLESCENT LGBTQ+ YOUTH, BUT WE
BROUGHT TOGETHER BOTH CLINICIANS
AND YOUNG PEOPLE TO HELP US
THINK ABOUT HOW TO ADAPT IT IN A
WAY THAT WAS BOTH RIGOROUS BUT
ALSO INCLUSIVE OF THE EXPERIENCE
WITH FOLKS WHO ARE LIVING WITH
DEPRESSION AND/OR EXPERIENCING
SUICIDAL IDEATION.
AND THROUGH THIS 8-MONTH
PROCESS, WE WERE ABLE TO CREATE
THE NEW APP.
SO WE'RE DOING AN IMPLEMENTATION
SCIENCE PROJECT AND THAT IS BOTH
TO BE ABLE TO THEN FIGURE OUT
WHETHER OR NOT WE HAVE
SUFFICIENT EVIDENCE OF
PRELIMINARY EFFECTIVENESS OF THE
INTERVENTION AS WELL AS STARTING
TO THINK ABOUT WHAT ARE SOME OF
THE BARRIERS OR FACILITATORS WE
WANTED TO SCALE THIS AS QUICKLY
AS POSSIBLE, WE'RE DOING THAT BY
RECRUITING 60 -- OR THE SAFETY
PLANNING INTERVENTION WITH THE
APP.
AND WE FOLLOW PARTICIPANTS OVER
SIX MONTHS.
WE ARE ALMOST DONE WITH
RECRUITMENT.
ASK ME IN TWO MONTHS WHAT WE'VE
FOUND BUT SO FAR WE'VE ACTUALLY
NOT HAD A SINGLE MISSED WEEKLY
CHECK-IN WITH A PEER MENTOR TO
TALK ABOUT HOW THE SAFETY PLAN
INTERVENTION IS BEING USED AMONG
THOSE RANDOMIZED WITH THE STARS
GROUP, BUT THERE'S SOME OTHER
THINGS WE'RE LEARNING ALONG THE
WAY, AND JUST VERY QUICKLY, I'LL
SAY THAT YOU'LL SEE IN THE
ELIGIBLE SLIDE, THE MAJORITY OF
FOLKS WE ARE LOSING ARE IN THE
PSYCHOSIS SCREENER, SO 96 FOLKS
HAD TO BE EXCLUDED DUE TO
PSYCHOSIS, AND I THINK THERE'S
SOME MEASUREMENT ISSUE HERE THAT
FROM A HEALTH EQUITY STANDPOINT
WE HAVE TO WRESTLE WITH AS
CLINICIANS AND RESEARCHSEARCHER.
ONE OF THE QUESTIONS ASKED FOR
PSYCHOSIS IS WHETHER OR NOT YOU
BELIEVE SOMEONE IS TALKING ABOUT
YOU.
AND IF YOU ARE A RACIAL GENDER
MINORITY -- CHANCES ARE THAT'S
IS NOT AN INDICATOR OF PSYCHOSUS
BUT RATHER THE STRESS AND
DEPRESSION YOU FACE DAY TO DAY.
SO WE'RE WORKING TO BE ABLE TO
ROLL OUT THIS INTERVENTION AS
QUICKLY AS POSSIBLE.
AND AGAIN AS I MENTIONED FROM AN
IMPLEMENTATION SCIENCE
FRAMEWORK, OUR HOPE IS TO BE
ABLE TO BE LOOKING BOTH AT --
NEXT SLIDE, PLEASE.
AGAIN.
THANK YOU.
IS TO BE LOOKING BOTH AT REGION
EFFICACY BUT ALSO WHAT ARE THE
IMPLEMENTATION CONSIDERATIONS
FOR ITS ADOPTION, ITS
MAINTENANCE, AND SO REALLY
LOOKING FORWARD TO BEING ABLE TO
SHARE MORE AS THE DATA BECOMES
AVAILABLE.
BUT I HOPE THIS IS BUT A FIRST
PART OF THE CONVERSATION AND
KIND OF A CALL TO ACTION FOR ALL
OF US TO BE THINKING ABOUT
EFFECTIVE AND CULTURALLY
RESPONSIVE INTERVENTIONS FOR OUR
POPULATION, AND RECOGNIZING THAT
IT WILL HAVE TO -- TECHNOLOGY
CAN REALLY HELP US OVERCOME SOME
OF THE GEOSPATIAL VARIATION
WHERE OUR YOUNG PEOPLE LIVE.
I THINK THAT'S MY LAST SLIDE.
THANK YOU SO MUCH.
>>HELLO, EVERYONE.
I'M HAPPY TO BE HERE WITH YOU
TODAY.
I WANT TO THANK DR. VEAL FOR
SHARING YOUR LIFE EXPERIENCE TO
MAKE OTHER PEOPLE'S LIVES
BETTER.
I ALSO WANT TO THANK DR. MATT
FOR HIS RESEARCH.
I AM THE SVP OF RESEARCH AT THE
AMERICAN FOUNDATION FOR SUICIDE
PREVENTION, AND I THOUGHT WHAT
I'D DO TODAY IS SHARE SOME OF
THE THINGS THAT WE DO AT THE
AMERICAN FOUNDATION FOR SUICIDE
PREVENTION, ALSO KNOWN AS AFSP,
IN RELATION TO THE LGBTQIA
COMMUNITY.
I WANT TO START OFF WITH OUR
MISSION, BECAUSE OUR MISSION IS
TO SAVE LIVES AND BRING HOPE TO
THOSE AFFECTED BY SUICIDE.
AND WE KNOW THAT THIS IS A
PARTICULARLY IMPORTANT MISSION
FOR THE LGBTQIA COMMUNITY.
THE WAY WE WORK IS THAT WE ARE
IN ESSENCE A GRASSROOTS
ORGANIZATION.
WE HAVE CHAPTERS IN ALL 50
STATES.
WE HAVE 74 CHAPTERS.
AND WE ARE DEVOTED TO RESEARCH,
EDUCATION, ADVOCACY AND SUPPORT
FOR THOSE WHO ARE AFFECTED BY
SUICIDE.
WHEN IT COMES TO THE LGBTQIA
COMMUNITY, ALL THESE PARTS OF
THE PROCESS ARE IMPORTANT, AND
AS WE SEE IT, RESEARCH INFORMS
EDUCATION AND ADVOCACY AS WELL
AS SUPPORT FOR THOSE AFFECTED BY
SUICIDE, AT EACH STEP ALONG THAT
WAY INFORMS RESEARCH.
SO IT'S KIND OF LIKE A CIRCLE.
SO WHAT I'M GOING TO TALK ABOUT
TODAY ARE THE PREVENTION EFFORTS
FOR LGBTQIA YOUTH, AND I'M GOING
TO REVIEW OUR RESEARCH
PRIORITIES, WHICH HIGHLIGHT THIS
POPULATION AND OTHER
UNDERREPRESENTED POPULATIONS,
INFORMATION THAT CAN BE FOUND ON
OUR WEBSITE, THE PROGRAMS THAT
ARE SPECIFICALLY GEARED TOWARDS
LGBTQIA YOUTH, AND ALSO OUR
STANCE ON ADVOCACY AND SUPPORT
FOR THOSE AFFECTED BY SUICIDE.
AND PART OF THE REASON I'M DOING
THIS IS TO SHOW YOU THAT THERE
ARE MANY WAYS IN WHICH WE CAN
SUPPORT PEOPLE IN THE LGBTQIA
COMMUNITY AND BY BUILDING A
COMMUNITY FOCUSED ON SUICIDE
PREVENTION, WE CAN MAKE A HUGE
DIFFERENCE AND WE ALREADY HAVE
THROUGH THE YEARS.
SO LET'S TALK ABOUT RESEARCH
FIRST.
SO WHEN I FIRST CAME TO AFSP,
ONE OF THE FIRST THINGS WE DID
IS RECOMMEND TO PEOPLE WHO ARE
DOING RESEARCH THAT IT'S NO
LONGER -- TO GO BEYOND BINARY
MALE HR/FEMALE SEX, AND TO THINK
ABOUT ADDING A MORE
REPRESENTATIVE MEASURE OF SEXUAL
ORIENTATION AND GENDER IDENTITY.
AND THEN THE NEXT YEAR, WE
REQUIRED IT.
SO ALL APPLICANTS ARE ASKED TO
HAVE A MEASURE IN THEIR STUDY
WHEN THEY'RE MEASURING
DEMOGRAPHICS OF GENDER IDENTITY
AND SEXUAL ORIENTATION THAT IS
MORE FITTING TO THE FULL
SPECTRUM OF THE NORMAL
VARIATIONS OF IDENTITY.
AND ALSO, IF THEY CAN'T DO IT,
THEN THEY NEED TO TELL US THE
REASON THEY CAN'T.
AND SOMETIMES THAT HAPPENS
BECAUSE THEY HAVE -- THEY'RE
WORKING ON OLD DATASETS THAT
DON'T HAVE THAT INFORMATION FOR
THEM.
WE ALSO HAVE ESTABLISHED
RESEARCH PRIORITIES, AND THE
GOAL OF RESEARCH PRIORITIES
ISN'T THAT THIS IS WHAT WE WANT
TO FUND.
THE GOAL IS TO TAKE UNDERSTUDIED
AREAS AND BRING THEM TO THE
FOREFRONT SO THAT WE CAN BUILD
BOTH A DATA UNDERSTANDING AND A
RESEARCHER COMMUNITY TO ADDRESS
THAT AREA, AND SO ONE OF OUR
PRIORITIES IS SUICIDE PREVENTION
RESEARCH RELATED TO
UNDERREPRESENTED COMMUNITIES, OR
BY PEOPLE FROM UNDERREPRESENTED
COMMUNITIES.
AND WE KEEP TRACK OF THIS, AND
WE START TODAY ASK PEOPLE THEIR
OWN DEMOGRAPHICS SO WE COULD SEE
IF WE'RE MEETING THAT CHALLENGE.
AND MOST PEOPLE, ABOUT 70%
ACTUALLY PROVIDE THEIR OWN
PERSONAL DEMOGRAPHICS.
SO IN THIS PAST YEAR, WE ARE NOW
FUNDING -- WE HAVE 27 NEW GRANTS
THAT ARE COMING IN, FROM 156
APPLICATIONS.
WITH RESPECT TO SOGI, WE GOT 29
APPLICATIONS.
THEY WERE ALMOST 20% OF THE
APPLICATIONS WE RECEIVED IN
TERMS OF INVESTIGATORS.
AND WE DID RECOMMEND SIX FOR
FUNDING.
KEEP IN MIND, THIS IS ONE YEAR.
WE HAD BEEN GROWING RESEARCH IN
THIS AREA OVER YEARS, SO WE HAVE
MANY OTHER APPLICATIONS AND
STUDIES IN THIS AREA.
IN TERMS OF APPLICATIONS, WE HAD
SIX APPLICATIONS ON THE TOPIC,
AND THIS YEAR ONE WAS
RECOMMENDED FOR FUNDING.
LAST YEAR FIVE WERE RECOMMENDED
FOR FUNDING.
AND VERY MUCH IN OUR PROGRAM, WE
ARE LOOKING FOR INNOVATION,
POTENTIAL IMPACT, AND VERY TIGHT
METHODOLOGY.
WE DO OFFER APPLICANTS THE
OPPORTUNITY TO RESUBMIT, WE GIVE
EVERY APPLICANT DETAILED
FEEDBACK ABOUT THEIR GRANTS, AND
WE ALLOW FOR UP TO TWO
RESUBMISSIONS.
BUT WHAT WE FOUND IS THAT THE
LGBTQIA COMMUNITY IS WELL
REPRESENTED IN OUR RESEARCH
GRANTS WITH 26% OF NEW GRANTS,
AND BY THE WAY, WE ONLY FUNDED
17% OF OUR APPLICATIONS.
THE PROBLEM IS, WE NEED MORE
RESEARCH STUDYING THE COMMUNITY
AND THE POPULATION.
SO WE'RE GOING TO KEEP PUSHING
ON FOR THAT.
WE ALSO HAVE A FULL AREA OF OUR
WEBSITE DEVOTED TO THE LGBTQIA
COMMUNITY.
WHETHER YOU'RE A PERSON WHO IS
INTERESTED IN PREVENTING
SUICIDE, IF YOU'VE EXPERIENCED
YOUR OWN SO YOU SIGH DAL
IDEATION AND BEHAVIOR, OR IF
YOU'RE INTERESTED IN RESEARCH,
YOU CAN COME TO THIS SECTION OF
THE WEBSITE AND TAKE A DEEPER
DIVE AND YOU WILL SEE IN TERMS
OF RESEARCH, YOU'LL SEE ALL THE
RESEARCH THAT WE'VE FUNDED, THE
PUBLICATIONS FROM THE RESEARCH
THAT WE'VE FUNDED, AND SOME OF
THE RECENT FINDINGS.
I WILL SAY THAT WE NEED SO MUCH
MORE RESEARCH IN THIS AREA TO
HAVE A --
[PLEASE STAND BY]
-- PEOPLE IN THE LGBTQIA
COMMUNITY AS WELL AS THE PEOPLE
WHO CARE FOR THEM AND LOVE THEM,
AS WELL AS FOR THE GENERAL
POPULATION.
YOU KNOW WE DON'T WANT TO JUST
TALK TO OURSELVES, WE WANT TO
REACH AS MANY PEOPLE AS WE CAN.
SO WE HAVE A PROGRAM, IT'S
CALLED "TALK SAVES LIVES," AND
WE HAVE AN ADAPTATION THAT
ENHANCES THE INFORMATION THAT'S
PRESENTED ABOUT SUICIDE IN THE
LGBTQ COMMUNITY.
WE ALSO HAVE A PROGRAM CALLED
"STRONGER COMMUNITIES: LGBTQ
SUICIDE PREVENTION," AND THIS IS
A PROGRAM WHERE RESEARCHERS AND
PEOPLE WITH LIVED EXPERIENCE
COME AND SPEAK WITHIN THE
COMMUNITY, SHARING THEIR
RESEARCH FINDINGS, AND NEXT
STEPS.
IN TERMS OF PUBLIC POLICY, WE
HAVE STATED PUBLIC POLICY GOALS,
WHICH YOU CAN FIND ON OUR
WEBSITE, IN ALL AREAS.
THESE ARE GOALS FOR -- WHAT WE
ALD VO KATE FOR IN THE LGBTQ
COMMUNITY.
WE FIRST OF ALL WANT TO
INTEGRATE LGBTQ POPULATIONS INTO
EXISTING DATA COLLECTION TOOLS
ON SUICIDE MORTALITY AND RISK
BEHAVIOR.
THAT'S BECAUSE IT IS NOT
INDICATED ON THE DEATH
CERTIFICATE, AND THIS IS A
COMPLICATED PROCESS.
WE FEEL THAT IF WE COULD GET
THAT INFORMATION, WE WOULD LEARN
MORE, BUT WE ALSO REALIZE THERE
ARE PEOPLE IN THE LGBTQ
COMMUNITY WHO PREFER NOT TO HAVE
THAT INFORMATION, AND ALSO
BECAUSE OF THE OFTEN STIGMA
AROUND IT, SOME PEOPLE ARE
HIDING THEIR TRUE IDENTITY, SO
THE PEOPLE AROUND THEM MAY NOT
EVEN KNOW.
WE SUPPORT BANS ON CONVERSION
THERAPY AND SEXUAL ORIENTATION
EFFORTS.
WE BELIEVE THAT THE WHOLE
SPECTRUM OF SEXUAL ORIENTATION
AND GENDER IDENTITY ARE NATURAL
VARIANTS, AND WE CAN TALK MORE
ABOUT THAT.
WE OPPOSE RESTRICTIONS ON ACCESS
TO GENDER-AFFIRMING MEDICAL
CARE.
AND WE OPPOSE RESTRICTIONS ON
DISCUSSIONS IN SCHOOLS ON LGBTQ
ISSUES.
WE KNOW THESE THINGS ARE HELPFUL
AND IMPORTANT FOR THE LGBTQ
COMMUNITY AND THE PEOPLE WHO
CARE ABOUT THEM, AND WE OPPOSE
ANY RESTRICTIONS.
WE ALSO PROVIDE SUPPORT FOR
SUICIDE PROVIDERS.
WE HAVE A PROGRAM CALLED HEALING
CONVERSATIONS, WHERE PEOPLE WHO
ARE RECENTLY BEREAVED BY SUICIDE
CAN SPEAK WITH SOMEONE WHO HAS
BEEN BEREAVED SOMETIME BEFORE,
AT LEAST TWO YEARS, AND THEY ARE
ALSO TRAINED TO SPEAK WITH NEWLY
BEREAVED PEOPLE.
WE DO HAVE PEOPLE WHO WILL
SPECIFICALLY SPEAK WITH PEOPLE
IF REQUESTED WHO ARE IN THE
LGBTQIA POPULATION.
WE ALSO HAVE OUR INTERNATIONAL
SURVIVOR LOSS DAY.
WE DON'T JUST HAVE PROGRAMS FOR
PEOPLE IN THE LGBTQIA COMMUNITY.
EVERYBODY IS WELCOME WHEREVER WE
GO, BUT IF YOU WANT TO FOCUS
SPECIFICALLY ON THAT, WE DO HAVE
THOSE PROGRAMS.
WE ALSO HAVE OUR OUT OF THE
DARKNESS COMMUNITY WALKS AND
OVERNIGHT WALKS, AND THESE
ARE -- IN OUR WALKS, THEY SERVE
SEVERAL PURPOSES.
FIRST OF ALL, THEY ALLOW PEOPLE
WHO ARE AFFECTED BY SUICIDE AND
THEIR FRIENDS AND FAMILY TO COME
TOGETHER AND WHAT'S SO
REMARKABLE ABOUT IT IS THAT
SOMETIMES WHEN PEOPLE ARE HIDING
THAT THEY'VE LOST SOMEONE TO
SUICIDE, THEY COME TO THE EVENT
AND THEY ARE SURPRISED THAT IT'S
MOSTLY JOYFUL, THAT THEY'RE NOT
ALONE, AND WE ALSO HAVE
DIFFERENT COLOR BEADS THAT
WALKERS CAN WEAR IF THEY CHOOSE.
RECENTLY WE ADDED HONOR BEADS,
RAINBOW HONOR BEADS FOR THE
LGBTQIA COMMUNITY.
THE BEADS SERVE AS A WAY TO NOT
JUST IDENTIFY WHO YOU ARE AND
HOW YOU'VE BEEN AFFECTED, BUT
ALSO FOR SOMEBODY ELSE TO SEE
THAT THEY ARE NOT ALONE.
AND SOMETIMES PEOPLE COME TO THE
WALKS AND THEY DON'T PUT ON
BEADS IN THE BEGINNING, BUT
THEY'RE ABLE TO LOOK AROUND AND
SEE THAT THEY'RE NOT ALONE.
WE ALSO HAVE MANY SHAREABLES AND
A GROWING SET OF SHAREABLES THAT
YOU COULD SHARE ON SOCIAL MEDIA,
AND WE ALSO HAVE -- WE HAVE
CAROUSELS ON INSTAGRAM, YOU'RE
WELCOME TO LOOK AND SHARE
ANYTHING RELATED TO LGBTQIA
POPULATION.
I FIND THE MORE WE SHARE, THE
MORE PEOPLE ASK QUESTIONS, THE
MORE THEY OPEN UP ABOUT THEIR
OWN EXPERIENCE.
SO SOMETIMES I LOOK LIKE AN AFSP
GROUPIE BECAUSE I'M WEARING MY
AFSP GEAR.
I HAVE TO SAY IN FLORIDA, I WENT
TO PUT MY LGBTQ -- ON MY CHAIR
THE DAY THAT THEY BANNED PEOPLE
BEING ABLE TO TALK ABOUT IT IN
SCHOOLS, BUT THE MORE WE SHARE,
THE MORE WE OPEN UP, THE MORE WE
MAKE IT CLEAR THAT WE ARE ALL
TOGETHER AND WE OWE TO EACH
OTHER TO SUPPORT AND ENCOURAGE
EACH OTHER, THE BETTER IT'S
GOING TO BE FOR EVERYBODY,
ESPECIALLY FOR THE LGBTQIA
COMMUNITY.
SO WITH THAT, I JUST WANT TO
MAKE IT CLEAR THAT SUICIDE
PREVENTION FOR LGBTQIA YOUTH IS
A PRIORITY FOR AFSP, AND YOU'RE
WELCOME TO COME TO OUR WEBSITE,
AAND LEARN MORE ABOUT WHAT WE DO
ABOUT SUICIDE PREVENTION AND HOW
YOU CAN HELP.
THANK YOU.
>>I'M JACK TURBAN, I DIRECT
THE GENDER PSYCHIATRY PROGRAM AT
THE UNIVERSITY OF CALIFORNIA
SAN FRANCISCO.
I'M GOING TO TALK REALLY FAST TO
KEEP TO FIVE MINUTES.
I WAS TALKING TO HOPE A BIT
ABOUT EXPANDING THE MINORITY
STRESS MODEL TO CONSIDER POLICY
DETERMINANTS OF MENTAL HEALTH.
FOR DISCLOSURES, [INAUDIBLE] TO
SUPPORT ADOLESCENT MENTAL HEA
HEALTH -- FROM THE ACLU AND
VARIOUS OTHER -- ORGANIZATIONS,
I HAVE RECEIVED RESEARCH GRANTS
FROM AACAP AND PHARMACEUTICAL
PARTNERS INCLUDING ARBOR AND
PFIZER AND THE ZOR SORENSEN
FOUNDATION.
A LOT OF PEOPLE HERE ARE
PROBABLY FAMILIAR WITH THE
MINORITY STRESS MODEL, THE
PRENO, MA'AM NANT MODEL THAT WE
THINK OF FOR EXPLAINING MENTAL
HEALTH DISPARITIES AMONG SEXUAL
AND GENDER MINORITY PEOPLE.
FIRST ARE THESE DISTAL STRESS
FACTORS ON THE FAR LEFT.
THESE ARE THE ONES THAT TEND TO
BE INTUITIVE, THE WAYS IN WHICH
SESOCIETAL STIGMA IMPACT SEXUALY
JORT MENTAL HEALTH -- THINGS
LIKE EXPERIENCING
DISCRIMINATION, REJECTION,
VICTIMIZATION, UNDERSTANDABLY
LEAD TO ANXIETY, DEPRESSION,
SHAME, OTHER INTERNALIZING --
THAT CAN DRIVE SUICIDALITY
ULTIMATELY.
BUT LESS INTUITIVE ARE THESE
PROXIMAL STRESS FACTORS THERE IN
THAT SECOND COLUMN.
THESE ARE THINGS THAT START TO
LIVE IN ONE'S OWN PSYCHE AS A
RESULT OF BEING EXPOSED TO THE
EXTERNAL FACTORS OR DISTAL
STRESS FACTORS.
SO I CLINICALLY TAKE CARE OF
MOSTLY TRANSGENDER YOUTH AND
WHAT THEY'RE HEARING A LOT IN
THE MEDIA RIGHT NOW ARE THINGS
LIKE YOU CAN'T USE THE BATHROOM
THAT MATCHES YOUR GENDER
IDENTITY BECAUSE YOU ARE A
SEXUAL RISK TO OTHER PEOPLE.
OR YOU CAN'T PLAY ON SPORTS
TEAMS THAT MATCH YOUR GENDER
IDENTITY BECAUSE YOU'RE GOING TO
PHYSICALLY HURT YOUR PEERS.
OR YOUR GENDER IDENTITY IS A
MENTAL ILLNESS SO YOU SHOULDN'T
BE ALLOWED TO ACCESS STANDARD OF
CARE MEDICAL TREATMENTS OR
GENDER-AFFIRMING MEDICAL CARE.
OFTEN THESE KIDS MAY KNOW THAT'S
NOT TRUE ON A CONSCIOUS LEVEL
BUT UNCONSCIOUSLY, A LOT OF IFS
COME UP.
WHAT IF I AM JUST CONFUSED, WHAT
IF I AM DANGEROUS TO MY PEERS?
AND UNDERSTANDABLY, THAT CAN
DRIVE A LOT OF ANXIETY AND
DEPRESSION, AND THEN LEADS TO
THESE OTHER PROXIMAL FACTORS
LIKE NEGATIVE EXPECTATIONS OF
THE FUTURE, NEED TO CONCEAL YOUR
GENDER IDENTITY OR SEXUAL --
HIDE WHO YOU ARE, AND ULTIMATELY
SUICIDALITY.
THE GOOD NEWS IS WE HAVE THESE
RESILIENCE FACTORS LIKE
COMMUNITY CONNECTIVENESS, WHAT
WE'RE DOING RIGHT NOW,
CONNECTING WITH OTHER PEOPLE IN
THE QUEER COMMUNITY, AND -- I
OFTEN TALK TO YOUNG TRANS YOUTH
ABOUT TRANS ROLE MODELS LIKE DRE
WITH US, AS WELL AS OTHER WORLD
LEADERS ACROSS OTHER FIELDS.
BUT I THINK IT'S IMPORTANT
ESPECIALLY RECENTLY TO THINK
ABOUT MAPPING SOMETHING ON TOP
OF THE MINORITY STRESS MODEL.
THIS IS PUBLIC POLICY.
SO IF YOU THINK ABOUT IT, OUR
PUBLIC POLICIES AND LIVES CAN
IMPACT ALL TYPES OF DIFFERENT
DOMAINS OF THE MINORITY STRESS
MODEL.
THEY CAN IMPACT DISTAL STRESS
FACTORS, PROXIMAL STRESS
FACTORS, RESILIENCE FACTORS, AND
OF COURSE KIND OF DIRECTLY
IMPACT -- BY PROVIDING -- TO
HEALTH SERVICES.
IT A -- WE HAVE RESEARCH AT THE
REALLY BACK THIS UP.
SO TO GIVE ONE EXAMPLE A FEW
YEARS AGO THERE WERE A LOT OF
DEBATES WHERE PEOPLE WERE
ACKNOWLEDGING THAT TRYING TO
CHANGE SOMEONE'S SEXUAL
ORIENTATION WAS DANGEROUS, NOT
POSSIBLE, BUT PEOPLE ARE RAISING
QUESTIONS ABOUT WHETHER OR
NOT -- TO FORCE - -- THE LARGEST
SURVEY IN EXISTENCE OF
TRANSGENDER ADULTS.
OVER 20,000 PARTICIPANTS ONLY
FOUND EXPOSURE TO THOSE
CONVERSION -- ASSOCIATED WITH
ADVERSE MENTAL HEALTH OUTCOMES
INCLUDING SUICIDE ATTEMPTS.
AND THIS IS ANOTHER PAPER WE
PUBLISHED IN THE AMERICAN
JOURNAL OF PUBLIC HEALTH WHERE
WE FOUND EXPOSURE TO THAT
PRACTICE WAS ACTUALLY QUITE
COMMON -- REPORTED THEY WERE
EXPOSED TO CONVERSION EFFORTS AT
SOME POINT IN YOUR LIFE, AND YOU
CAN SEE THERE'S SOME GEOGRAPHIC
DISTRIBUTION WHERE THAT WAS MORE
COMMON.
SO PUT TOGETHER, THIS IS A
COMMON EXPOSURE AND THAT IT'S
EXPOSURE THAT WE FOUND STRONGLY
LIMITED TO SUICIDE ATTEMPTS, YOU
WOULD THINK THIS WOULD BE A HIGH
YIELD AREA TO REDUCE DISPARITIES
FOR TRANS AMERICANS AS WELL AS
SEXUAL MINORITY AMERICANS.
DESPITE THIS, ONLY ABOUT HALF OF
U.S. STATES HAVE PASSED POLICIES
TO OUTLAW CONVERSION EFFORTS.
SO IF YOU LOOK AT THE STATES IN
DARK GREEN, THOSE ARE STATES
WHERE IT'S OUTLAWED.
OTHER STATES IT'S STILL LEGAL,
DESPITE THIS EVIDENCE WE HAVE
THAT IT'S LINKED TO SUICIDE
ATTEMPTS, AND IF WE KIND OF
TOGGLE BETWEEN SLIDES, EXPOSURE
APPEARS TO BE MORE COMMON IN
SOME OF THESE PLACES THAT
HAVEN'T PASSED BANS ON THE
PRACTICE.
SO THAT SHOWS US THAT IT'S
IMPORTANT TO HAVE THE RESEARCH
BUT THAT'S NOT ENOUGH, RIGHT?
WE ALSO NEED TO COMMUNICATE WITH
LAWMAKERS, MAKE SURE THEY'RE
AWARE OF THE DATA, AND IN SOME
INSTANCES, ALSO MAKE SURE THAT
THEIR CON STIT WANTS AND THEIR
BUILDERS ARE WEAR WITH THE DATA
SO THEY CAN COMMUNICATE TO
REPRESENTATIVES AND TH TELL THEM
THIS IS A PRIORITY FOR THEM,
THEY WANT THE PEOPLE IN THEIR
COMMUNITIES TO HAVE THESE MENTAL
HEALTH DISPARITIES COMBATED
BECAUSE WITHOUT HEARING FROM
THEIR CONSTITUENTS -- I THINK
IT'S ALSO WORTH KEEPING IN MIND
THAT THE COURT SYSTEMS HAVE AN
IMPACT ON THESE PUBLIC POLICIES
AND MENTAL HEALTH DISPARITIES AS
WELL.
SO MANY OF THESE BANS ON
CONVERSION EFFORTS HAVE BEEN
CHALLENGED IN THE FEDERAL COURTS
TO APPEALS COURTS IN THE NINTH
AND THE THIRD CIRCUIT RULED
THESE BANS WERE CONSTITUTIONAL.
MORE RECENTLY THE 11TH CIRCLED
RULED THEY WERE
UNCONSTITUTIONAL.
LEADING TO A CIRCUIT SPLIT,
WHICH MEANS THAT IN COMING
YEARS, THE SUPREME COURT MAY
TAKE UP THIS QUESTION WHICH
COULD ULTIMATELY LEAD TO THESE
BANS -- GOING AWAY, WHICH AGAIN
WE WOULD EXPECT WITH MENTAL
HEALTH DISPARITIES.
SO IN ADDITION TO THE RESEARCH
AND EDUCATING LAWMAKERS AND
VOTERS -- THE COURTS, WHETHER
THROUGH AMICUS BRIEFS OR SERVING
AS AN EXPERT WITNESS.
ONE OTHER THING I WANTED TO
HIGHLIGHT WAS THAT THERE'S BEEN
SOME AMAZING WORK RECENTLY
LOOKING AT USING METRIC MODELS,
THESE DIFFERENCE IN DIFFERENCE
MODELS WHERE YOU CAN REALLY DO
CAUSAL INFERENCE TO SEE ARE
THESE POLICIES THEMSELVES, YOU
KNOW, IN A CAUSAL WAY LEADING
TO -- ONE IN JAMA PSYCHIATRY
THAT FOUND THAT LAWS THAT PERMIT
DENIAL OF SERVICES TO SAME-SEX
COUPLES LEADS TO INCREASED
MENTAL DISTRESS AMONG SEXUAL
MINORITY ADULTS.
THIS IS PARTICULARLY RELEVANT
TODAY GIVEN THE DECISION THAT
JUST CAME FROM THE SUPREME COURT
ON THE 303 CREATIVE, WHICH IS
VERY MUCH ON THIS TOPIC.
I KNOW HER WORK WAS CITED
THROUGHOUT THE COURT CASES.
ANOTHER PAPER UP HERE LOOKING AT
A POLICY THAT ACTUALLY IMPROVES
MENTAL HEALTH, SO THIS WAS
LOOKING AT SAME-SEX MARRIAGE
POLICIES AND FOUND THAT THOSE
LED TO A DECREASE IN ADOLESCENT
SUICIDE ATTEMPTS.
THANK YOU FOR DEALING WITH MY
FAST TALKING TO KEEP THIS TO
FIVE MINUTES BUT I JUST WANTED
TO LEAVE YOU WITH REALLY THESE
THREE POINTS, THAT IT'S REALLY
IMPORTANT WE STUDY PUBLIC
POLICIES AS THEY RELATE TO
SEXUAL AND GENDER MINORITY
MENTAL HEALTH, BUT THE RESEARCH
ALONE ISN'T ENOUGH, AND THAT
RESEARCH ALSO NEEDS TO BE
TRANSLATED.
SO NUMBER ONE, I HOPE THAT WE
CONTINUE TO EMPIRICALLY STUDY
BOTH PRACTICES THAT ARE RELEVANT
TO PUBLIC POLICIES, AS WELL AS
THE POLICIES THEMSELVES AND
THEIR IMPACT ON MENTAL HEALTH AT
THE POPULATION LEVEL.
THAT WE INTERFACE WITH POLICY
MAKERS AND VOTERS TO MAKE SURE
THAT IF THERE'S A LAW BEING
INTRODUCED, POLICY MAKERS KNOW
THE RELEVANT DATA.
IF IT'S NOT PRESENTED TO THEM,
IT MAY NEVER MAKE TO THEM.
BUT ALSO TH THAT VOTERS BE
INFORMED.
IF YOU'RE A RESEARCHER AND
PUBLISHED SOMETHING RELEVANT TO
PROPOSED LEGISLATION, WRITE AN
OP-ED IN A BIG PAPER, WHERE
LAWMAKERS AND VOTERS ARE
THINKING ABOUT THIS.
AGAIN VOTERS MAY VOTE ON
SOMETHING DIRECTLY, BUT THEY MAY
ALSO END UP REACHING OUT TO
THEIR REPRESENTATIVES LETTING
THEM KNOW THIS IS IMPORTANT TO
THEM AND THEY WANT THE RESEARCH
HIGHLIGHTED IN SOME OF THESE
DISCUSSIONS.
AND LASTLY KEEPING IN MIND THAT
THE COURTS ALSO PLAY A REALLY
VITAL ROLE IN HOW THESE POLICIES
ULTIMATELY SURVIVOR ARE
IMPLEMENTED AND THAT INTERFACING
WITH THEM EITHER THROUGH AMICUS
BRIEFS THAT YOU MAY DO WITH SOME
OF YOUR MAJOR ORGANIZATIONS,
LIKE THE AMERICAN PSYCHIATRIC
ASSOCIATION, OR THE AMERICAN
ACHAD ME OF CHILD ADOLESCENCE,
BUT ALSO -- TO MAKE SURE THEY'RE
MAKING DESIGS BASED ON THE BEST
DATA, AND -- BUT WE HAVE --
SEXUAL AND GENDER MINORITY
PEOPLE AND SUICIDALITY IN
PARTICULAR.
I THINK THAT WAS MY LAST SLIGHT.
THANK YOU.
>>AS YOU'VE HEARD FROM EVERYONE
TODAY WE KNOW THAT SUICIDE IS A
LEADING CAUSE OF DEATH IN
GENERAL AND THE SECOND LEADING
CAUSE OF DEATH AMONG YOUTH IN
PARTICULAR, THOSE AGED 10 TO 24.
AND PARALLELLING THE ENORMITY OF
THIS PROBLEM, THERE'S BEEN A
HUGE INCREASE IN RESEARCH ON
THIS TOPIC.
BUT UNFORTUNATELY, RESEARCHERS
HAVE FAILED TO INCLUDE SO MANY
PEOPLE THAT ARE AFFECTED BY
SUICIDE AND RELATED OUTCOMES.
INCLUDED THOSE WITH MINORITIZED
IDENTITIES LIKE LGBTQIA YOUTH.
WE HAVE ALSO DONE A TERRIBLE JOB
AT ASSESSING SEXUALITY AND
GENDER ON SUICIDE RESEARCH, FROM
A META-ANALYSIS OF OVER 150
LONGITUDINAL RISK FACTOR
STUDIES, ONLY ABOUT 4% ASSESSED
SEXUALITY AND GENDER IN THE
STUDIES THAT WERE CONDUCTED.
SIMILARLY IN A MORE RECENT
META-ANALYSIS OF INTERVENGS FOR
SUICIDE RELATED BEHAVIORS,
AGAIN, ONLY 4% EVEN ASSESSED
SEXUALITY AND GENDER IN THE
COMPOSITION OF THEIR SAMPLES.
THIS IS A MAJOR PROBLEM BECAUSE
AS YOU'VE HEARD ABOUT TODAY,
SUICIDE AND RELATED OUTCOMES ARE
A PARTICULAR PROBLEM FOR LGBTQIA
YOUTH.
SO THERE'S AN URGENT NEED FOR
MORE RESEARCH ON LGBTQIA YOUTH
SUICIDE AND SUICIDE PREVENTION.
BUT THERE ARE SO MANY BARRIERS
THAT GET IN THE WAY TO DOING
THIS RESEARCH.
WHEN I TRY TO INVITE CLEEX TO
COLLEAGUESTO WORK ON THIS WITH N
HEAR ABOUT MYTHS LIKE ASKING
KIDS ABOUT SUICIDE ISN'T SAFE,
OR KIDS DON'T KNOW THEIR GENDER
AND CAN'T ANSWER QUESTIONS
VALIDLY OR ACCURATELY.
THESE ARE BARRIERS ON TOP OF ALL
THE BARRIERS TO YOUTH RESEARCH
IN GENERAL.
AND SO BEFORE I TALK ABOUT SOME
SPECIFIC DIRECTIONS FOR THIS
AREA OF RESEARCH, I THINK IT'S
REALLY IMPORTANT TO CHAT ABOUT A
FEW STEPS THAT I THINK THAT WE
COULD ALL TAKE TO JUST MAKE IT A
LITTLE BIT EASIER AND MORE
ETHICAL TO DO RESEARCH IN THIS
AREA.
SO FIRST, I WANT TO CHAT ABOUT
DISPELLING MYTHS.
I THINK IT IMPERATIVE THAT WE
MAKE SURE THAT RESEARCHERS AND
IRBs ARE AWARE THAT IT'S NOT
IATROGENIC TO ASK ABOUT SUICIDE
AND RELATED BEHAVIORS.
AND ADDITIONALLY, THAT YOUTH CAN
VALIDLY AND ACCURATELY ANSWER
QUESTIONS ABOUT THEIR SEXUALITY
AND GENDER AND MANY CHILDREN ARE
ALREADY AWARE OF DIVERSE
SEXUALITIES AND GENDERS.
ADDITIONALLY, IT'S IMPORTANT
THAT WE EDUCATE ASSESSMENTS OF
SELF INSURE JUST THOUGHTS AND
BEHAVIORS AS WELL AS LGBTQ
IDENTITIES.
LANGUAGE AND TERMINOLOGY AROUND
SEXUALITY AND GENDER IS
CONSTANTLY EVOLVING AND IT'S
IMPORTANT THAT RESEARCHERS ARE
AWARE OF THE MOST UP TO DATE
MEASURES TO PREVENT DOING
ADDITIONAL PARDON HARM IN THIS .
FINALLY, I WANT TO HIGHLIGHT
THAT WE AS RESEARCHERS AND
CLINICIANS HAVE DONE A LOT OF
HARM TO THE LGBTQIA COMMUNITY,
AND WE HAVE A LOT OF WORK TO DO
IN REBUILDING TRUST.
AND SOME INITIAL STEPS IN THAT
DIRECTION INVOLVE REALLY WANTING
TO MAINTAIN YOUTH
CONFIDENTIALITY.
SO SOMETIMES THIS MEANS ALLOWING
YOUTH TO PARTICIPATE WITHOUT
PARENT AND GUARDIAN CONSENT AND
I'M HAPPY TO ANSWER QUESTIONS
ABOUT THAT TO MAKE SURE THEY
FEEL COMFORTABLE AND SAFE
DISCLOSING THINGS LIKE THEIR
QUEER I' IDENTITIES AND THOUGHTS
ABOUT SUICIDAL BEHAVIORS.
-- WHEN THEY'RE REPORTING
THINGS LIKE SUICIDE RISK AND AT
THE SAME TIME THAT WE DON'T
OVERFUNNEL THESE YOUTH INTO
SYSTEMS WHERE THEY MIGHT BE
HARMED BY PEOPLE THAT DON'T KNOW
HOW TO PROVIDE AFFIRMING CARE
AND WHERE THERE JUST AREN'T NUSS
SYSTEMS IN PLACE TO KEEP PEOPLE
FROM RECEIVING MORE I'D-BASED
HARM THAT THEY ALREADY HAVE IN
THEIR EVERYDAY LIVES.
SO WITH THAT, ONCE THESE INITIAL
STEPS ARE TAKEN, I WANT TO
HIGHLIGHT A FEW ADDITIONAL AREAS
FOR RESEARCH THAT I THINK WOULD
BE REALLY EXCITING AND
IMPORTANT.
SO FIRST AND FOREMOST, IT'S
PRIDE MONTH.
MOST RESEARCH UNFORTUNATELY ON
LGBTQ YOUTH SUICIDE FOCUSES ON
RISK FACTORS AND NEGATIVE
OUTCOMES, AND YET THERE ARE SO
MANY DIFFERENT EXPERIENCES OF
RESILIENCE AND WONDERFUL PRIDE
AND RELATIONSHIPS, ET CETERA,
THAT MAKE UP THE EXPERIENCES OF
OUR QUEER YOUTH, AND RESEARCH IN
THIS AREA REALLY NEEDS TO LOOK
AT THOSE FACTORS IN PARTICULAR
AS POTENTIAL PROMOTIVE FACTORS
THAT HELP REDUCE NEGATIVE
OUTCOMES.
ADDITIONALLY, IT'S IMPORTANT AS
WE WERE JUST HEARING ABOUT NOT
TO JUST FOCUS ON AN INDIVIDUAL
LEVEL BUT ON THESE INTERPERSONAL
AND STRUCTURAL FACTORS THAT WILL
HELP HIGHLIGHT TO LGBTQIA YOUTH
THAT WE KNOW IT'S NOT THEIR
PROBLEM THAT'S LEADING TO HIGH
RATES OF SUICIDE, BUT INSTEAD SO
MANY OF THE DISKR DISCRIMINATORY
POLICIES AND VICTIMIZATION
THEY'RE FACING EVERY -- IN THEIR
EVERYDAY LIVES.
ADDITIONALLY WE KNOW THERE ARE
HUGE DIFFERENCES ACROSS
DIFFERENT SEXUALITIES AND
DIFFERENT GENDERS IN TERMS OF
THE EXPERIENCES OF RISK AND
RESILIENCE THAT THEY FACE IN
EVERYDAY LIFE AND MOREOVER THAT
SEXUALITY AND GENDER ARE NOT THE
ONLY IDENTITIES, THAT THERE ARE
IMPORTANT INTERSECTIONS WITH
RACE AND ETHNICITY AND
DISABILITY AND SOCIOECONOMIC
STATUS, SO A GREAT POSSIBLE WHEN
RESEARCHERS ARE POWERED TO DO
SO, THAT THERE ARE OTHER
MEASURES OF IDENTITIES AND TO
LOOK AT HOW DIFFERENT -- MAY --
FINALLY THERE'S SO MUCH POWER
INVOLVED IN LIVED EXPERIENCE.
SO WHAT I WOULD LOVE TO SEE --
YOUTH -- AND IN PARTICULAR
LGBTQIA YOUTH AND QUEER AND
TRANS YOUTH OF COLOR TO MAKE
SURE THAT OUR RESEARCH IS
ACTUALLY RELEVANT TO THEM, THAT
WE'RE ANSWERING QUESTIONS, WE'RE
INTERESTED AND NOT USING
MEASURES HARMFUL, AND THAT WE'RE
INTERPRETING AND DISSEMINATING
TO THOSE MOST INTERESTED
HELPING, WHICH IS LGBTQIA YOUTH.
I LISTED A WHOLE BUNCH OF THINGS
I DIDN'T HAVE TIME TO TALK
ABOUT.
IT'S AN HONOR TO CHAT WITH YOU
ALL, AND HAPPY PRIDE.
[APPLAUSE]
>>THANK YOU, DR. FOX.
SO IN THE INTEREST OF TIME, I'M
GOING TO ASK THE SPEAKERS WHO
ARE IN THE ROOM TO COME UP TO
THE STAGE HERE.
SO THAT WE CAN HAVE MAYBE A
LITTLE QUESTION AP ANSWER TIME.
AND ANSWER TIME.
MY FIRST QUESTION IS TO
DR. VEAL.
JUST WANT TO AGAIN SAY THANK YOU
TO DR. VEAL AND DR. FOX AND
DR. POWELL AND ALL THE
PRESENTERS THERS THAT VIRTUALLYE
THEIR PRESENTATIONS TO AN
OUTSTANDING SYMPOSIUM THAT WE
HAD THIS AFTERNOON.
AND THE FIRST QUESTION IS FOR
DR. VEAL.
BASED ON YOUR LIVED EXPERIENCES,
WHAT ARE THE COMPONENTS FOR
SUSTAINING AN INSTITUTIONAL
COMMITMENT TO NURTURE A
WELCOMING AND INCLUSIVE
ENVIRONMENT FOR LGBTQ MEDICAL
STUDENTS?
>>YEAH.
ACTUALLY I TOUCHED ON THIS A
LITTLE BIT IN MY PAPER, "WE BURN
OUT, WE BREAK, WE DIE," REALLY
KIND OF EMPHASIZING THE FACT
THAT MEDICAL SCHOOLS SHOULD
AFFIRM THAT THEY ARE WILLING TO
DO WHATEVER IT TAKES TO MAKE
SURE THAT THAT STUDENT
GRADUATES.
YOU KNOW, NOW, IS THAT VERY
SPECIFIC FOR LGBTQ FOLKS IN MED
SCHOOL?
NO.
BUT I THINK THAT ONE OF THE
THINGS I FOUND VERY HELPFUL THAT
THE UNIVERSITY OF VERMONT DID DO
RIGHT WAS ENSURE THAT EVERYONE
OF ALL SEXUAL ORIENTATION AND --
I HAD ONE TRANS PERSON IN MY
CLASS WHICH CHANGED MY OUTLOOK
ON TRANS FOLKS ENTIRELY, MAKING
SURE THAT EVERY ACCOMMODATION IS
MADE THAT IS POSSIBLE, TO MAKE
SURE THAT EVERYONE FEELS SAFE
AND SECURE.
THAT INCLUDES HAVING, YOU KNOW,
NON-GENDER BATHROOMS, THAT
INCLUDES ALLOWING PEOPLE TO HAVE
THEIR PRONOUNCE ON THEIR BADGES.
IT CAN BE SMALL THINGS LIKE THAT
THAT I FEEL IS VERY AFFIRMING
AND VERY HELPFUL FOR ANYONE IN
THE COMMUNITY.
>>THANK YOU SO MUCH.
WE HAVE A QUESTION FROM THE
AUDIENCE.
>>[INAUDIBLE]
>>JUST A SECOND.
>>SO MY QUESTION FOR DR. VEAL
IS, YOU SAID IN A SORT OF
PASSING OFF-HANDED WAY THAT YOU
WERE ENCOURAGED BY YOUR MENTORS
AS YOU WERE APPLYING FOR
RESIDENCIES NOT TO DISCLOSE YOUR
MENTAL HEALTH AND OTHER
CHALLENGES, AND I WANTED TO KNOW
IF YOU COULD MINE THAT A LITTLE
BIT, BECAUSE I THINK FOR, YOU
KNOW, A LOT OF US, THOSE KINDS
OF MOMENTS CAN BE AS INSTRUCTIVE
ABOUT WHERE YOU THINK THEY WERE
COMING FROM, WHETHER OR NOT YOU
THOUGHT THEY WERE LEGITIMATE
RISKS THEY THOUGHT THEY WERE
SAVING YOU FROM.
I KNOW WHEN I WAS APLAYING TO
GRADUATE SCHOOL, I WAS TOLD BY
MY MENTOR AS AN UNDERGRAD NOT TO
DISCLOSE MY GENDER -- MY SEXUAL
ORIENTATION BECAUSE, YOU KNOW,
IT'S A CONSERVATIVE PLACE, THEY
DON'T NEED TO KNOW YOU'RE GAY,
AND YOU KNOW, SHE WAS TRYING TO
HELP ME.
BUT I'M JUST WONDERING IF YOU
CAN SORT OF UNPACK THAT A LITTLE
BIT.
>>YEAH, I LOVE THAT QUESTION.
THANK YOU FOR ANSWERING IT -- OR
ASKING IT.
SO I WILL SAY YES, I WAS
STRONGLY ENCOURAGED NOT TO TALK
ABOUT MY SUICIDE SNAFU IN MED
SCHOOL.
AND I UNDERSTAND WHY, CERTAINLY.
I WILL SAY, I WAS AT A POINT IN
MY LIFE WHERE I WAS JUST SAYING
F IT, HONESTLY.
I'M PROBABLY STILL THERE.
BUT -- WHICH I LOVE.
IT'S LIBERATING.
BUT THE FACT OF THE MATTER IS,
AND UNTIL THE CULTURE CHANGES,
THIS IS GOING TO CONTINUE TO BE
A PROBLEM, THIS IS SOMETHING WE
NEED TO WORK ON AS A MEDICAL
COMMUNITY.
IF YOU SHOW ANY SIGNS OF MINOR
IMPERFECTION, THEY'RE GOING TO
USE THAT AGAINST YOU WHEN IT
COMES TO, YOU KNOW, GETTING A
PLACE OF RESIDENCY.
I DO BELIEVE OUR SCARS MAKE US
BETTER PEOPLE.
I BELIEVE THAT THE STORIES THAT
WE TELL AS THE THEME OF MY TALK
WAS, THE POWER OF THE WOWBDED
HEWOWOF THE WOUNDEDHEALER, I DOS
GREAT POWER IN SHARING OUR
STORIES AND WHAT WE'VE OVERCOME.
UNFORTUNATELY WHEN IT COMES TO
RESIDENCY PROGRAMS, I DID NOT
MATCH WHEN I APPLIED FOR
RESIDENCY.
I SCRAMBLE NEIGHBORHOOD A
PROGRAM AND I LOVE MY PROGRAM,
I'M VERY HAPPY WHERE I AM, BUT
DID MY DISCLOSURE OF THAT HAVE
AN IMPACT ON ME GETTING
RESIDENCY?
IT PROBABLY DID.
AND SO I CAN'T BE ENTIRELY MAD
AT MY ADVISOR THAT, YOU KNOW,
THEY GAVE ME THAT
RECOMMENDATION, BECAUSE THEY MAY
HAVE BEEN RIGHT.
THAT BEING SAID, I DO NOT CARE.
IF AN ORGANIZATION WAS NOT GOING
TO ACCEPT ME FOR WHO I AM, AND
THE STORY THAT I HAD TO TELL,
THEN THEY DON'T DESERVE ME.
THAT'S JUST PLAIN AND SIMPLE.
THE PLACE I WOUND UP AT DID
APPRECIATE ME FOR WHO I WAS AND
THEY ALLOWED ME TO GROW.
AND I'M DOING THINGS I NEVER
IMAGINED DOING, INCLUDING BEING
A PEER REVIEW -- PEOPLE, BASED
ON THE FACT THAT I WAS
SUPPORTED, NO MATTER WHAT.
HOPE THAT ANSWERS SOME QUESTION.
>>THANK YOU FOR THAT QUESTION.
AND I HAVE A QUESTION FOR
DR. FOX.
WHAT ARE THE TWO CRITICAL
FACTORS TO CONSIDER WHEN
DEVELOPING SELF-HARM AND SUICIDE
PREVENTION INTERVENTIONS FOR
LGBTQYOUTH?
WHAT ARE TWO CRITICAL.
NOT JUST -- ONE OR TWO CRITICAL
FACTORS TO CONSIDER.
>>SO I THINK ONE OF THE MOST
CRITICAL FACTORS TO CONSIDER IS
THAT WE KNOW THAT MOST YOUTH ARE
NOT ACCESSING TRADITIONAL FORMS
OF INTERVENTION, AND SO THINKING
ABOUT CREATIVE WAYS TO REACH
YOUTH WHERE THEY ARE WHEN
DISSEMINATING THESE
INTERVENTIONS IS INCREDIBLY
IMPORTANT, AND REDUCING BARRIERS
TO RECEIVING THOSE
INTERVENTIONS.
AND THEN SECOND OF ALL, FOR
LGBTQIA YOUTH IN PARTICULAR, I
MENTIONED THAT ISSUE OF
CONFIDENTIALITY AND RISK
MANAGEMENT.
I THINK THAT IT IS SO IMPORTANT
THAT YES, WE ARE ASSESSING FOR
RISK AND WE ARE TRIAGING FOLKS
TO CARE WHEN IT'S NEEDED, AND
THAT WE'RE INCREDIBLY
TRANSPARENT ABOUT THOSE
PROCESSES TO BEGIN WITH, SO THAT
WE'RE NOT DOING SOMETHING THAT
SOMEBODY DIDN'T NECESSARILY KNOW
WAS GOING TO HAPPEN WHEN THEY
DISCLOSE, AND THAT WE'RE ALSO
BEING CAREFUL IN NOT
OVERTRIAGING WHEN IT'S NOT
NECESSARY TO DO SO, BECAUSE
THOSE KINDS OF EXPERIENCES MAKE
IT REALLY HARD FOR YOUTH TO
TRUST YOU AS PROVIDERS AND TO
CONTINUE TO COME BACK AND
DISCLOSE TO FOLKS WHEN THEY NEED
THAT CARE.
>>THANK YOU SO MUCH, DR. FOX.
I JUST WANT TO -- IN CLOSING, I
WANT TO THANK ALL OF THE PEOPLE
THAT PARTICIPATED IN THE EVENT
VIRTUALLY AND IN PERSON.
AS -- BECAUSE IT TAKES A VILLAGE
TO PUT ON A PRODUCTION LIKE
THIS, AND ONE OTHER THING I
WANTED TO MENTION TO THE
AUDIENCE IS THAT THERE'S AN
UPCOMING OFFICE OF DISPARITIES
RESEARCH AND WORKFORCE DIVERSITY
SEXUAL GENDER MINORITY WEBINAR
THAT'S GOING TO BE HELD ON
WEDNESDAY, AUGUST 2ND FROM 12:3D
"ADVANCING MENTAL HEALTH
RESEARCH FOCUSED ON BISEXUAL
PLUS PEOPLE THROUGH AN
INTERSECTIONAL LENS."
AND THERE'S THE WEBSITE HERE FOR
THOSE OF YOU ON THE SCREEN.
SO I THANK YOU SO MUCH FOR
COMING AND
MAKING YOURSELF AVAILABLE TO THE
AUDIENCE THAT'S IN HOUSE, AS
WELL AS THOSE OF YOU VIRTUALLY,
AND TO OUR SPEAKERS.
JUST A ROUND OF APPLAUSE.
[APPLAUSE]