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Mental Health

Study: Transgender Youth at High Risk for Negative Mental Health Outcomes



A new study released by The Fenway Institute based on data from the Sidney Borum Jr. Health Center in Boston, Massachusetts shows what a handful of local and regional studies on transgender youth have long suggested: Transgender youth have disparately negative mental health outcomes compared to non-transgender youth.

The study examined data from the electronic health records of 180 transgender patients age 12-29 years matched with non-transgender patients who were seen for healthcare at the Sidney Borum Jr. Health Center. Compared with non-transgender youth, transgender youth had an elevated probability of being diagnosed with depression (50.6% vs. 20.6%); suffering from anxiety (26.7% vs. 10%); attempting suicide (17.2% vs. 6.1%); and engaging in self-harming activities without lethal intent (16.7% vs. 4.4%).

Among transgender patients, there were 106 female-to-male youth and 74 male-to-female youth, and there were no statistically significant differences in negative mental health outcomes between female-to-male and male-to-female youth.

The findings are detailed in Mental health of transgender youth in care at an adolescent urban community health center: A matched retrospective cohort study, which was published January 6, 2015 in the Journal of Adolescent Health.

“To date, there are limited comparative mental health data available in transgender adolescents and young adults to document health inequities by gender minority status. This research points to the need for gender-affirming mental health services and interventions to support transgender youth,” said Sari Reisner, ScD, Research Scientist at The Fenway Institute and Postdoctoral Research Fellow in the Department of Epidemiology at Harvard School of Public Health, and the lead author of the report. “It is clear that clinicians serving transgender youth should routinely screen for mental health concerns.”

Findings from the study also point to the need to integrate gender-inclusive measures into electronic health records, including assigned sex at birth and current gender identity at patient registration. Including these questions facilitates clinic-based epidemiological research as well as quality improvement efforts to ensure high-quality, gender-affirming care.

Although the Sidney Borum, Jr. Health Center devotes a good part of its resources to the care of transgender youth, it is still a primary care clinic for adolescents and emerging adults. Therefore, this study shows that expanded care for transgender youth can be provided in the context of overall pediatric care: integration of behavioral health, psychiatry, and pediatric primary care – a medical home approach – can more than adequately support the medical and behavioral health needs of transgender youth and provide a locus of care for reduction of psychiatric outcomes described by the study.

The full report is available online.

Chase is the Founder and Creative Director of, Host and Executive Producer of OutCast Austin, an award-winning LGBT weekly radio program on KOOP 91.7 FM in Austin. In 2011, he was named the Critics Pick for 'Most Gaybiquitous' in the Austin Chronicle's Best of Austin. In 2012, CultureMap Austin named him one of Austin's Top LGBT bloggers and he received the AGLCC's Chamber Award for Social Media Diva.

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Mental Health

Sex Addiction Or A Good Time: A Conversation With Sexpert Robert Weiss On Gay Male Sexuality



Recently I attended the second annual Contemporary Relationships Conference held here in Austin.  The conference focused on topics specific to LGBTQ+ relationships and families; and this year the keynote speaker was Robert Weiss, LCSW, CSAT-Supervisor.  Weiss is an expert on addictions (he is the Senior Vice President of Clinical Development with Elements Behavioral Health) and technology.  His book, “Cruise Control: Understanding Sex Addiction in Gay Men” is already in its second edition.  Being a straight-friendly therapist, who works with clients around sexual functioning, I was ecstatic that Weiss agreed to sit down with me and speak about his work after his presentation.

When we sat down to talk about sex addiction and gay men, the first thing we acknowledged was how challenging it can be to talk about this topic because of stigma.  Many gay men have experiences of the world trying to make them feel shame for simply loving other men.  Laws, religion and families are only some of the sources of judgment.  Once a man develops pride and overcomes the irrationality of internalized shame, it can be difficult to have any discussions about healthy sexuality because those conversations echo of past judgement.

As a sex-positive person, I believe that sex can be healthy, good and fun in its many forms.  From monogamous to open, alone or in groups, vanilla to kink; do your own thing.  As long as it is consensual (animals and minors are unable to consent), non-coercive, and connecting (you to yourself or your partners).  So the first question Weiss and I explored is:

What is sexual addiction and what is a good time?

Weiss explained that he is also sex positive and that there are a number of indicators that distinguish sexual addiction from a healthy sexual appetite.  One factor is a person’s functioning.  Is the person able to have the life he wishes to have or is sex a hindrance to his goals?  For example, if a career-driven individual is consistently unable to accomplish duties at work because he is compulsively cruising Grindr then his functioning may be a concern.  Weiss went on to note that sexual addiction usually includes: shame, secrecy, hiding, self-hatred and denial.  Elements that are not typically a part of a healthy sexuality.  A man who struggles to keep commitments with friends because he gets caught up edging himself to porn in his free time will likely hide his behavior when talking to his friends about the reason for his absence.  Where healthy sexuality is about connecting to ourselves or our partners, sexual addiction is about escaping difficult feelings through obsessing about sex and acting on that obsession.  Successful treatment of sexual addiction is not about stopping sex or becoming a eunuch; according to Weiss the goal is sexual integrity.  That means feeling good about the sex we have with our partners and ourself with limited impediment of our professional and personal pursuits.

In his book, “Cruise Control: Understanding Sex Addiction in Gay Men” Weiss noted technology’s role in increasing the number of sex addicts. Prior to the internet there where a number of steps and risks involved in obtaining pornography.  A person would have to drive to sex shops where he would risk being seen and need to have money to purchase or rent materials.  Over time, pornography and dating sites (including apps) became more easily accessible (thank you smartphones) at little to no cost, while offering users anonymity.  This has increased number of people struggling with sexual addiction.  Weiss told me during our interview that we’d see an increase in cocaine addiction if one day every medicine cabinet in America magically had free cocaine in it.  Since technology has lead to more sexual addiction, I wondered:

How technology might help those in recovery from sex addiction?

Weiss noted how technology has made it easier for people to connect with each other, as well as resources to manage sexual addiction.  Folks in recovery from sexual addiction are able to maintain a consistent core support group via technology (such as Skype) no matter where their lives might take them. Recovery in rural areas is easy when a person doesn’t have to drive two hours to a larger city to attend a Sex Addicts Anonymous meeting.

As we finished up our chat I was interested in any new work that might be interesting.  Weiss recommended keeping an eye out for a book from his colleague, Lauren Costine, PhD called “Urge To Merge.”  He also noted that folks should check out the Global Pride Summit which is free online.

My hope is that people are able to have fulfilling sex, in any of its many wonderful forms.  If you think that you might be struggling with developing a healthy sex life consider talking with a therapist.  When guilt, shame and judgement are removed from exploration, you might just find the kind of sex for which you’ve been searching.

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Mental Health

Tips For Finding A Therapist



Choosing a therapist can be a challenging task. Austin therapist, Adam Maurer, LMFT-Associate, LPC-Intern, offers some insights into the process of finding a therapist that meets your needs.

I have a confession to make. Even as I consider typing the words my body cringes at the thought of admitting this. It sounds like career suicide, but the truth of the matter is that for some people, I would be a rotten therapist.

I mean, I would just stink it up: and it’s not that I’m inept or anything like that. My university made sure to give me a certificate commemorating my 4.0 GPA so that I might prove to others that I know about therapy. This overachieving student cannot be a sensational therapist for everyone who wants help because I, and every other mental health professional, am limited by my scope of competency and my therapeutic modality.

Therapy is similar to medicine in this way. There are doctors who focus on specific diseases, demographics or parts of the human body. All doctors can check a patient’s vital signs, no problem. But, a pediatric surgeon may not be the first choice to perform heart surgery on a 65-year old woman because the surgeon lacks expertise in geriatric medicine.

Graduate schools train therapists how to develop empathy, listen without judgement and work with issues that are common to the human experience. Therapists develop their scope of competency through: practicums, workshops, reading, supervision, training, lectures, and work experiences. For a person seeking therapy, it can be difficult to figure out which therapists may be best suited to help for a particular issue. So, here are some tips for finding a therapist.

[gdlr_process min_height=”160px” type=”vertical” ]

[gdlr_tab icon=”icon-question” title=”Identify The Issues” ]Consider what issues are encouraging you to enter therapy and try to prioritize them; then search for therapists who specialize in your top issues.[/gdlr_tab]

[gdlr_tab icon=”icon-search” title=”Do Your Research” ]Most therapists have a website and they offer a free phone consultation or short visit. Before you talk, look over the therapist’s website to gain a sense of who the person is and how the therapist works; then write down any questions you may have.[/gdlr_tab]

[gdlr_tab icon=”icon-comments-alt” title=”Ask Questions” ]Some helpful questions to ask when you call might be about: current trainings they have attended, their therapeutic modality, what a typical client for the therapist is like, books and articles they have been reading or have written, and colleagues they network with currently. This will aid you in developing an idea of how helpful they might be in working with your concerns.[/gdlr_tab]

[gdlr_tab icon=”icon-group” title=”Get A Referral” ]If a potential therapist you like is unable to see you, ask them to refer you to other mental health professionals who may be of service.[/gdlr_tab]


It is also important to understand the difference between an LGBTQ-friendly therapist and a therapist who specializes in LGBTQ issues. An LGBTQ-friendly therapist will not try to pray away your gay. You can talk freely, knowing that you are accepted. An LGBTQ-friendly therapists may not be familiar with the language we use, or they may not understand phenomenons specific to our community. If the main concerns that are prompting you to seek counseling do not appear to be related to your membership in the the LGBTQ community, then a LGBTQ-friendly therapist may be a great fit. Especially if the therapist specializes in an area that is contributing to your distress.

Therapists who specialize in working with the LGBTQ community help their clients consider how heterosexism may be impacting their current issues. In my work I make sure I inquire about family support, levels of outness and other factors that might be contributing to current troubles. There are therapists who identify as allies to the community and specialize in LGBTQ issues. Allies usually have compelling reasons for focusing their work to helping our community. If you are hesitant to work with an ally, consider asking why the therapist chose to work with the LGBTQ community.

A specialization is not about experiencing a certain issue, but about intimate knowledge on the subject. Therapists who specialize in LGBTQ issues tend to be more aware of resources that may be helpful to their LGBTQ clients. Any therapist you decide to work with will be an investment of your time, money and energy. Be wise and make sure you take time to find therapists who are best suited to work with you and your top concerns.

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Mental Health

Gay Men and Eating Disorders



Eating disorders like bulimia and anorexia have long been thought of as problems mainly for women, but recent studies show that men are just as susceptible to develop eating disorders. Austin-area therapist Brad Kennington talks about the how gay culture may drive gay men to extremes for that so-called “perfect” body.

Society is consistently shaming gay men to feel less than. Making it unconstitutional in many of our states for gay couples to marry is just one example of how bigotry is not only accepted but openly encouraged in our culture. And those on the receiving end of this bigotry are real people with real hearts with real feelings. Is there any doubt why so many in the gay community struggle with substance abuse, depression, suicide and eating disorders?

I often wonder what role society’s collective shame plays in the development of body image issues and eating disorders in gay men. All of that shame has to go somewhere, and where it ends up is usually deep in the psyches of those it is intended to hurt. If someone is constantly bombarded with the message from the government, faith communities, corporations, even their own families that they are not good enough, not equal to, then devastating psychological consequences often result.

In a struggle to survive psychologically, gay men may go into overdrive in trying to achieve ideal physical fitness—counting calories, cutting out carbs and going crazy with cardio. This relentless pursuit to be physically fit is but one way to compensate for feeling psychologically unfit.

And to have a fit and so-called “perfect” body in the gay world gives a gay man what a bigoted and rejecting society has stripped from him—his power. Gay men with the toned, chiseled bodies have power, the power to command the acceptance and attention from their gay peers. And this attention and acceptance, albeit based on physical appearance, is still healing nonetheless. Like every other person on the planet, gay men want to feel like they belong, that they are somebody. But in a larger culture that invalidates and shames, gay men turn to their bodies to seek the significance and connection that we all hunger for.

[gdlr_icon type=”icon-external-link” size=”18px” color=”#91d549″]Eating Disorders Blogs

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