I was standing at a bar on Mackinac Island, waiting to order a drink for Tonda and me. The room was full of afternoon sun. It was a truly gorgeous day. A woman was sitting there with her husband, and we struck up the kind of easy conversation people have on vacation, and she asked me what I do for a living.
I told her the truth. I work with people who come out to the LGBTQ community later in life. It is my field.
She told me she did not understand that. How could a person not know? They must be confused. Or it is a phase. She had noticed that a lot of people her age and mine seemed to be coming out now, and she believed it was because they were following the crowd. A fad.
Coming Out Later in Life Is About Visibility, Not a Fad
I said that it is about visibility. Queer folks have become more visible over the last twenty years. Gen Z is the most LGBTQ identifying generation yet. I believe that older generations are seeing this and asking questions. Plus, in recent decades, there are many visible creators who are talking about midlife sexuality exploration. It is literally not in the closet anymore. So folks can finally see a life they did not know was possible, and so they can finally name what was always there. I said it was much more complicated than she understood, and that she should look at my website.
Then she told me she is a psychiatrist. She runs an eating disorders clinic.
Eating disorders are not my field and I will not pretend otherwise. I have no expertise in her clinical work and I am not going to talk about treatment I do not understand. What I can tell you is what I know from my own side of things, which is that many of the women I have worked with have had eating disorders, or have one now. I do believe that sexuality and gender exploration is still believed to be shameful by many people. Shame can also live in the body. A woman who has spent decades at war with who she is often carries that war somewhere physical.
What Happens When a Clinician Has a Blind Spot
So I stood there holding two drinks, doing the math. If a woman in her care is quietly wondering whether she is straight, what happens to that? Where does it go? My guess is that it gets dismissed, or downplayed, or treated as a distraction from the real work, or handed back to her as confusion. I do not believe this psychiatrist is cruel, but I do believe she has a genuine blind spot. After all, she told me, without hesitation, that people like me are following a crowd.
I got angrier as we talked. Not visibly. I stayed friendly, and I have thought a great deal since about why I did that, and I am not sure I have a good answer. Some of it was that we were on vacation and I did not want a scene. Some of it, if I am honest, is the old habit of being agreeable when a professional says something wrong to my face.
But the anger was real, and it was not about her personally. She is a physician. Human sexuality is not a niche interest, it is part of being a person, and it belongs in the room when we are caring for someone’s mind. She has patients. She has a clinic. And she said what she said easily, in public, to a stranger, which tells me it is not a thought she has ever had reason to examine.
Why So Many of Us Never Say It Out Loud in a Therapist’s Office
I told Tonda about the conversation and my lovely wife, in her full lesbian humanity, wished she was there. She had a few choice words for the doctor. I stayed angry for a while after; I couldn’t seem to let it go. I know why. Many of us who come out in midlife have spent years in and out of care. We have sat across from good, credentialed, well-meaning professionals. And many of us never said the true thing out loud in those rooms, because we could feel, in a hundred small ways, that it would not be welcome there. Or we have said them out loud and were quickly dismissed in similar ways to what the psychiatrist said to me.
If this is the kind of care we are getting, I understand completely why it takes us so long.
I am writing about this because I think her cluelessness is widespread and typical, and that is the problem. Most clinicians were never taught this. It was not in the training or maybe it was an elective. There is a cost to this incomprehension. It is borne by us, the people seeking support and help to navigate a very challenging time in our life.
A Free Guide for Therapists Working with Questioning Clients
Barbara Rowlandson and I put together a free guide for therapists and clinicians called 8 Things to Consider When Working with Clients Questioning Their Sexuality. It is short and it covers the things that get missed. It is important for the clinician to have unconditional positive regard. Our clients do not have to prove their sexuality to anyone to know themselves. Minority stress and religious history are very important parts of this discussion. It gives directions on how to set up a safe, supportive LGBTQ practice and space. Finally, it talks about the importance of community.
If you are a professional reading this, please take it. It is free and there is nothing to sign up for beyond your email. If you are one of the women I write for, and you have a therapist or a doctor you trust, send it to them. Or send it to one you are not sure about.
And if you have ever sat in one of those offices and not spoken your truth out loud, I want you to know that this was not a failure of nerve on your part. You read the room and the room needs to change.
With love,
A-M
