Out Loud Pride Summit Recap: Highlighting LGBTQ+ Mental Health
Our team at Eating Recovery Center and Pathlight Mood & Anxiety Center (ERC Pathlight) recently hosted the third annual Out Loud Pride Summit, created by mental health advocate Eric Dorsa (they/them) in 2021 to address the need for more informed, affirming care for LGBTQ+ individuals.
This virtual event served as a day of educating, elevating, and advocating for LGBTQ+ voices with clinical experts, speakers with lived experience, and national influencers and advocates. Dorsa’s own personal experience as a nonbinary queer person was woven throughout all presentations, including their unique challenges when seeking treatment and the need for affirming mental health resources.
Fostering alignment with caregivers around gender-affirming care
Elizabeth Easton, PsyD, CEDS (she/her), director of psychotherapy at ERC Pathlight, and Kaila Peak-Rishel, LCSW, LMFT, CEDS-S (she/her), clinical director of virtual child and adolescent services at ERC, helped define gender-affirming care as that which supports and affirms an individual’s gender identity. They then identified and addressed emotional blocks that impact both caregivers and clinicians.
Shay Ayres (she/her), alum and Recovery Ambassador Council member at ERC, and Kyle Woodson, MA, LPC (he/him), clinical manager at ERC Pathlight, answered questions on how to best provide gender-affirming care for clients.
Woodson remarked, “Sometimes the name we get on a sheet of paper doesn’t match the name our client prefers… I ask myself, can I address this as soon as possible to ensure the person feels comfortable in the space?” He emphasized how some clients feel comfortable in one space but are hesitant to use that identity in other spaces. He explains:
“We want to create a space where they can feel safe. Feel comfortable. We can acknowledge that it doesn’t always feel safe to be who we are.”
Both participants and presenters referenced the recent slew of bills and laws across the country that put gender-affirming care at risk, stating that their clients’ fear comes from a very real place. Dr. Easton replied, “Helping people feel that they have someone they can vent to, express fear to, put it into words, discuss how it affects them personally is key. I’ve even disclosed to some clients how I am emotionally affected by it.”
Part of the session’s exploration focused on emotion expression and emotion processing -- the opposite of emotion avoidance. Clinicians noted that it is possible to sit in discomfort and fear with clients. Dorsa additionally referenced the critical importance of community:
“Letting people know they are not alone in this storm goes a long way in building community, which builds resiliency.”
Expanding understanding of eating disorders and body image in LGBTQ+ masculine communities
Benjamin Shepherd, MED, MS (he/him), a doctoral student in clinical psychology, and Tyler Wooten, MD (he/him), medical director and psychiatrist at ERC, explored how to increase understanding of sexuality and gender-based differences in the development and presentation of body image concerns and eating disorders, with a focus on people who identify as masculine in LGBTQ+ communities.
In addition to a description of the etiology of body image concerns and eating disorders – including general and unique risk factors affecting LGBTQ+ masculine communities – presenters identified gaps, considerations and potential solutions in the clinical assessment and treatment of eating disorders within these communities.
Body image is influenced not only by historical causes such as cultural socialization, interpersonal experiences and personality characteristics but by current causes including activating events, self-defensive actions and body image emotions. Shepherd first identified how minorities who experience stress due to stigmatization may develop negative mental and physical health outcomes. A social safety framework includes reliable social connection, inclusion and protection, “but our brains and bodies are still wired to see any social threat as an actual threat.”
Shepherd went on to identify how gay men have historically had more challenges with body image and what is perceived as the “ideal” body. There is a specific stress that emerges among men who rely on and compete with other men to satisfy social and sexual needs – in a community where wealth, masculinity and attractiveness are common status elements. Presenters referenced how LGBTQ+ masculine persons may feel socially and physically safer by appearing stronger and more stereotypically masculine.
Dr. Wooten delved into his own decades-long experience of working with males with eating disorders, referring to when and why his interest was initially sparked in these communities. Gay males are thought to only represent 5% of the total male population, but among males who have eating disorders about 42% identify as gay.
“What is the experience that the male population is having with eating disorders and the experience within the LGBTQ+ community?” asks Dr. Wooten. “The number of kids we work with daily that are in that minority field is pretty substantial, with an offshoot within the cisgender male population. What is society teaching that is having an observable effect on males with eating disorders?”
This session also included insights from Christopher Patterson-Rosso (they/them), a Black queer nonprofit and community advocate.
Grief in the LGBTQ+ community
Devon Stephenson, MSW, LSW (he/him) explored the unique impacts and history of grief in the LGBTQ+ community, and how to redefine grief and apply it through a community lens to reframe it as a concept related to hope and action.
Stephenson identified the six guiding principles of grief, citing Elisabeth Kubler-Ross’s five stages of grief. In addition to describing how support groups can impact the processing of grief, he outlined how the pandemic changed service delivery and directly influenced grief, including a loss of social kinship connection, a loss of LGBTQ+ community connection, and a loss of LGBTQ+ identity authenticity, affirmation and visibility.
Stephenson identified and discussed clinical presentations of grief before defining grief through an LGBTQ+ lens, concluding with the application of strategies for embracing grief in practice. His description of “disenfranchised grief” – a term that describes grief not acknowledged as legitimate by society and, as a result, not typically socially accepted or publicly mourned – segued to how providers can hold space for stories, consider how grief impacts social determinants of health and practice active listening.
Additional speakers included Rebecca Eyre (she/her), CEO of Project HEAL, the only national eating disorder nonprofit focused on equitable access to care; Vik Chopra (he/him), co-founder and director of Unincarcerated Productions; and Bonnie Violet (she/her), a trans femme genderqueer spiritual drag artist and digital chaplain.
Dorsa says it best:
“Eating disorder treatment must evolve to meet the needs of the diverse LGBTQ+ community…. By prioritizing ongoing education, diverse representation and the implementation of LGBTQ+ inclusive policies, providers can help bridge the gap between the needs of the LGBTQ+ community and the care available to us. Together we can work toward a future where all individuals…receive the compassionate and effective support they deserve in their journey toward full recovery from eating disorders.”