LGBT people living with mental illness face double stigma

July is National Minority Mental Health Awareness Month, and in Atlanta, the Health Initiative is teaming up with the DeKalb County chapter of the National Alliance on Mental Illness to bring awareness to LGBT people about resources available.

LGBT people with bipolar disorder, post traumatic stress disorder or chronic depression not only face stigma not only because of their sexual orientation and gender identity, but also because of their mental illness.

“The double stigma of being GLBT and having a mental illness limits our access to resources and support. Not many can provide specialized care I think our community needs and this is a great disservice,” says Alisa Porter, marketing director of NAMI DeKalb.

“We’re not mentally ill because we are gay, but because various factors impact our lives,” she adds.

Arlene Noriega, a psychologist who has studied LGBT and mental health issues, is in private practice and works with adolescents and adults who identify as LGBT as well as gender nonconforming children, and also works with the Latino population.

“When we don’t acknowledge this discrimination there is an increase in negative health and mental health consequences, she says. The discrimination can be overt, such as family rejection as adolescents, sexual and physical abuse, and hate crimes.

“However, the discrimination can also be subtle and these are known as microagressions, which LGBT individuals encounter in their everyday lives, such as someone using heterosexist or transphobic terms, such as fag, dyke or she-male, or when an LGBT person is told ‘not to act so gay,’” Noriega explains.

She says sexual minorities are two and a half times more likely than non-LGBT people to have attempted suicide.

“Studies show that the transgender population risk for suicide attempts is significantly high. Some studies have found that sexual minority women are at a higher risk for substance abuse disorders while sexual minority men are at a higher risk for suicidal attempts,” Noriega says.

Chronic, persistent stress related to stigmatization and marginalization due to sexual orientation and gender identity is known as “minority stress,” she says.

One of the best ways to help people get the help they need is to erase stigma, she says.

“We need to understand that the mental health issues seen in the LGBT population as a result of minority stress are normal ways of responding to abnormal environmental stressors when our coping is depleted,” she says. “We need to address people’s isolation and secrecy around mental health issues through public education.”

buck cooke 1 BUCK COOKE
As executive director of Atlanta Pride, Buck Cooke has the responsibility of planning the city’s largest LGBT party every year. Sometimes, though, he has to plod through his days carrying a burden on his back.

Cooke was diagnosed with depression in 1996. He was having extreme difficulty coming out to himself and his conservative South Carolina family, so he entered therapy.

Antidepressants helped in the beginning, but Cooke says he no longer has to take medications because he’s learned better coping skills. At one time he believed taking medication was a sign of failure.

“If someone has arthritis and they have an especially painful flare-up of their symptoms, they don’t look at themselves and think, ‘My joints really hurt today. I’m a failure.’ It’s the same thing with mental health,” he says.

Cooke finds ongoing talk therapy and lifting weights helpful to stabilize his moods but also several other self-care ideas he’s found useful. These include:

• Being kind to himself and understanding he will have good and bad days.

• Making a conscious choice to listen to positive self-talk that gives him praise and affirms what he’s doing and how he’s doing. “Whether people want to admit it or not, we all have positive and negative self-talk and if you give more weight to the negative perceptions you have about yourself and you have depression, you’re not operating in a healthy way.”

• Music. “From going to concerts to listening to music that I find really uplifting, it’s been an incred- ibly effective tool for me over the years,” he says.

• Laughter is one of the best medicines, he stresses. “Spending time with family with friends, watching old sitcoms and movies that always make me laugh—these are things that always help lighten my mood and remind me that there is good in the world and good in my life.”

Cooke is unafraid to share his story and wants to help eliminate the stigma surrounding mental health.

“I am sure that someone is reading this right now thinking, ‘Buck Cooke is crazy!’ I’m not crazy; I have depression. I also have chronic sinusitis and suffer from allergies, but most people wouldn’t find that shocking to hear in the least,” he says.

People are afraid to deal with their own thoughts, feelings and emotions, much less share them with someone else, Cooke says.

“My allergies are a health condition that has been normalized. I hope that one day, my depression is also [considered] a health condition that can be normalized.”


Denying her gender identity until she was 53 certainly played a role in Jenny Howard’s diagnoses of dysthymia (chronic depression) in 2004 and then major depressive order in 2011.

It was in 2004 when Howard says she hit the “Great Depression”—she and her second wife had been married 11 years, their daughter was four and she was a successful computer systems administrator for a Michigan university.

“My family relationships suffered, my work suffered, and after a couple of uncharacteristic bad performance reviews, I started therapy,” she says. “The depression diagnosis came almost right away. It was only a month or two later that I told my therapist about my cross-gender feelings. Though I’d been acting them out secretly for decades, I’d never talked to anyone about them before. It felt like it would be too frightening, because it was too weird,” Howard, now 63, says.

After finally confronting her feelings of not being a man, Howard says she came to understand she was “a textbook case of transsexualism.”

“And I learned that the only thing that had ever helped a transsexual to relieve the emotional pain was external transition to the internally- sensed gender identity,” she says.

In 2005, Howard came out to her wife and other family members. Her wife demanded a divorce. Howard began her transition and by the end of 2005 had transitioned in her social environments. In 2006, she came out at work “and I’ve been living as Jenny ever since,” she says.

Howard spent 2008-2010 in seminary in Louisville, Kentucky, but that plan didn’t work out. In 2010, she found a computer job, moved to Atlanta and started dating another trans woman. The couple broke up after three years.

Howard still struggles with her gender identity.

“I’m quite clear that I’m not a man, and certainly where society enforces an either/or choice, I live as a woman. Still, I’m a little reluctant to claim the title ‘woman,’ though oddly, I’m quite comfortable with ‘female,’” she says.

Howard prefers to identify as queer—not more attracted to men or to women, but more attracted to LGBTQ people than straight, cisgender people.

Howard says her motivation plummets when she becomes depressed. She is filled with self-loathing and thoughts of suicide can become pervasive.

Therapy and medication help.

“I take my meds faithfully. I’ve tried the trick that so many of us do, telling myself I feel OK, so I don’t have to take them. That doesn’t end well within just a couple of days. So now I take them faithfully,” she says.

Self-care for Howard includes helping others. “Trite but true, I try to reach out to other people who are troubled. Helping others really is part of self-care.”

alejandro lopezALEJANDRO LOPEZ
Alejandro Lopez, 48, was born to migrant farm workers in Laredo, Texas. He also worked on the farms until he graduated from high school and joined the U.S. Army.

In May, just two months ago, he was diagnosed with post traumatic stress disorder. As a navigator for the Health Initiative assisting people sign up for the Affordable Care Act, Lopez says he has listened to many sad stories. Their stories affected him and his mood, causing him to seek professional help. He learned that his suppressed memories of being kicked out of the Army after being investigated for being gay had built up and contributed to his post traumatic stress disorder.

It was in 1987 and 1988 when Lopez was being investigated by the military for being gay. A bitter ex-boyfriend, a civilian, called Lopez’s 1st Sergeant to tell him Lopez was a “faggot who had AIDS.” Lopez was demoted, forced to move back onto base in the bar- racks and was told to not interact much with his fellow soldiers.

“My world became very lonely,” he says.

One night Lopez went to a club, met some people, and was invited back to their place and offered an illegal drug.

“I was so desperate to get rid of this pain I felt that I accepted the offer,” he says.

On the following Monday, his unit had to take a surprise drug test. Lopez failed and he was discharged under Article 13, conduct unbecoming of a soldier, under honorable conditions. The investigation into his sexual orientation was dropped.

“Working as an ACA Navigator and listening to so many sad stories for some reason heightened my memories of this part of my life and I could no longer shake the memories,” he says.

Lopez, who has been HIV-positive for 20 years, lost sleep, quit exercising and found himself unsure what to do. This year he began seeing an AID Atlanta psychotherapist at the Atlanta VA Medical Center and on May 17 was diagnosed with post traumatic stress disorder.

“The shame and embarrassment I had was so intense that it made it difficult at times to even hold a conversation. Therapy is making me feel a better sense of worth and helping me to get a grip on my thoughts. So I now find myself in a better place,” he says.

alisa porterALISA PORTER
In 1996, Alisa Porter was in a high stress job and feeling depressed. Her primary care physician prescribed Prozac.

The popular drug worked well at first, but a couple of months later, Porter emotionally crashed, became suicidal and was hospitalized for two weeks. Her diagnosis? Bipolar disorder.

She went on and fell in love with a woman and the two began a relationship. Porter said she was manic—the extreme high feeling people who have bipolar disorder feel—and she eventually “crashed” again. She was also diagnosed with dissociative identity disorder, once known as multiple personality disorder, and post traumatic stress disorder.

Porter has 15 different personalities, she says, of all races, ages and sexual orientations.

It wasn’t until 2004 when she found a lesbian therapist who helped her through her and her partner’s breakup that she started seriously dealing with her mental illness.

In 2005, Porter gave birth to a girl thanks to artificial insemination. But caring for the infant, changing her diapers, potty training, all of the normal mothering duties, began to wear Porter down. She was projecting the sexual abuse she suffered as a child and young adult onto her daughter.

“I would see myself in her. I felt as though she was being abused. Something in me was being triggered that someone was hurting her,” Porter says. “And I knew as she continued to develop over the years I would continue to be triggered by her.”

Caring for her daughter became increasingly difficult and in 2008 Porter took extreme measures to get her daughter the care she needed. She sent out a message on the MEGA Family Project listserv for gay parents seeking a family to care for her daughter for one year as she worked to get well.

“Six gay families reached out to me. I was overwhelmed with their generosity,” she says.

She interviewed the families and settled on a gay couple (“they were strangers”) to take care of her daughter. The little girl stayed with the family for more than a year while Porter visited when she could.

“The government used to sterilize mentally ill people because it didn’t believe they deserved or were capable of raising children. I plan to do something about that in my lifetime.”

When Porter tried to bring her daughter back into her life, however, her illness again would not al- low her to properly care for her child.

“In 2010 I was not getting any better. I tried to bring my daughter home but the thought put me in deeper crisis. My alter personalities began to act out and began to do dangerous things,” Porter says.

Her daughter was also hurting, acting out in school and at home with her foster family she was living with. Her therapist then gave her an ultimatum—it was time to put her daughter up for adoption.

“That was the most devastating conversation I ever participated in,” Porter says. “I love my daughter more than words can express. I chose to have her and I felt I completely failed her. I really felt I betrayed her.”

Porter was fortunate to find an African-American lesbian couple interested in open adoption and wanting to add a young girl to their family. It was the perfect match under the circumstances, Porter says.

“I could not have chosen a better family or community for her to be raised in,” she says. “It was the hardest thing I’ve ever done but I did not want her to wait to have joy in her life.”

Now Porter is working to help other parents living with mental illness understand the options they have.

“Some people like myself can’t raise their children,” she says. But there is no information available about parenting with a mental illness. Removing a child from a family is traumatic for the parent and child and can be avoidable, Porter says, and not all children should be removed permanently from their parents’ care.

“The government used to sterilize mentally ill people because it didn’t believe they deserved or were capable of raising children. I plan to do something about that in my lifetime,” she says.