by Maria Companioni, APRN
A few days ago, I was interviewed with a group of collages to promote mental health and help break the stigma in the Latin community. Particularly, I was asked to speak about the effects of mental health in the Latin LGBTQI+ community. When a set of questions arrived at my email with the purpose of preparing the material for the interview. The first image that came to mind was that of two asteroids collapsing in the middle of the universe and creating a black hole. How to resume the creation of a universe in 10 televised minutes? How to fit two parallel worlds and controversial topics in a conversation that might reach hundreds of people?
I began by researching literature that could help me understand the systematic inequality that the Latin LGBTQI+ community experienced and without surprise my first obstacle was to understand the terminology. Commonly speaking, “I came out of the closet so many years ago,” that now the abbreviation has a few extra letters, I quiet did not understand. Definitions completely new to my knowledge. Consequently, I began by breaking down the definitions of each of letters to get some enlighten; L for lesbians, G for gays, B for bisexuals, T for transgender, Q for queer, I for intrasexual and + for non-binaries. Now, if I want to dig deep in the subject, I need to clarify some of the newly added letter’s definitions to really understand the topic and provide accurate information.
First came the definition of transgender, who are those individuals that were born with reproductive organs that do not match their identity. For example, born males that live like females, they feel attracted to feminine clothing, they dress and act as per society definition of femininity. Then came the term queer, which is used for all those who do not define as homosexual or heterosexual, but rather have an open terminology where no social norms apply to their sexuality. Proceeded with identifying intersexual who are those individuals born with genitalia opposite to their external appearance, for example born with a female reproductive organ but have physical male appearance. Finally, the most foreign terminology to me came into play, non-binaries. Which is represented with the + and their identity is nor male or female but inclusive of all genders.
As Latins we are a constantly part of the systematic inequalities of social factors, gender, or ethnicity. As we are immigrants out of our country of birth, we experience inequality from the moment with set foot in a foreign territory. The Latin LGBTQI+ community experiences these inequalities even more, as we add to the immigrant component the sexual identity. As Latins we already come with the taboo of sexuality within our own culture adding the discriminations suffer by being immigrants. We find individuals at higher risk for mental health illnesses. Our own culture, previous generations and society have created a horror story based on sexuality.
Therefore, mental health in the Latin LGBTQI+ community is greatly affected not only because of the sexual preference but because the alienated feelings of immigration. As immigrants we are exposed to severe changes like new language, culture, socioeconomics, and labor principles. In addition to our internal sexuality battle. The combination of all these stressors makes the Latin LGBTQI+ community at a 15% higher rate of mental illness in comparison to Caucasians of the LGBTQI+ community, according to recent statistics from the Center for American Progress.
As Latins of the LGBTQI+ community we find unique challenges like limited access to medical and mental health care, poor economic security, and lack of benefits assistance. We encounter barriers with stability on labor, education, and economy. It is fair to mention as the Spaniards commonly say “we come in a bunch” meaning we are forced to fear as we work together. Therefore, we can re-invent ourselves mentally and emotionally in any ecosystem. We have the innate resilience of fighters that comes from our roots. We are ready to fight for a better future, not just for us but for our families and those who come after us.
To end the stigmas, in my opinion, we should start by eliminating stereotypes. Fair to clarify stereotypes are those preconceived images or ideas and simplified of a social group conformed by a series of socially learned behaviors. Common stereotypes that affect the Latin LGBTQI+ community are sexual inversion, promiscuity, hiding, rejection, and devalue. Inferior valorization is considered a norm of our community. Most of our patients come in with a poor understanding of their own process and experimenting with their mental health.
The best way to support our patients is to listen, offer an impartial space where the patient can express themselves, where there are no stereotypes and as I always say, “a safe space”. Once the person feels heard, respected, and not judged, we create an alliance where education plays the next step. To give our patients the ability to speak the thoughts that are stuck on their brain helps create a proper treatment plan. Reassuring the alliance and getting to an agreement regarding therapy and medication is the whole purpose of the patient clinician interaction. To see palliative improvement of the patient’s mental health is our main goal.
The Latin LGBTQI+ primary mental health problems are depression, anxiety, negative thoughts about life and risk for suicide. The most prominent diagnosis that we see are depression and anxiety. Most of our patients seek help once symptoms are advancing and interfering with their functionality due to lack of access to health benefits and poor understanding of mental health. As providers our first step as mentioned above is to listen and modify the patient treatment plan to the specifics needs of each patient. Based on literature the most effective treatment for one’s mental health is a combination of therapy and medication management.
My constant battle with my patients and the mental health stigma is medication management and therapy compliance. I find myself every new encounter repeating “If you can set aside one hour of your week and thirty minutes a month to take care of your mental health and be fully functional, have a better quality of life. Why not?” A session with a therapist does not take more than one hour a week and has clinically proven results of improvement in functionality. Taking an antidepressant, a day can improve someone’s quality of life by 100%. “Then if you wake up every morning and take a pill that makes you completely functional, connected to reality and present for your family. Why not?”. All these labels created socially around mental health, sexuality and culture without a significant based cost the life of thousands of humans every year.
The integration of family is equally important as therapy and medication management in one’s mental health. Our culture is extremely family oriented, and family integration is primordial for the improvement of our patient’s mental health. The most important thing I have to say about it is “education.” Constant reinforcement of the importance of the family involvement. When we talk about family participation in our treatment plan, we refer to a multidisciplinary approach for all those involved in the day-to-day dynamics of the individual. With the plan to establish objectives to help communication and create a healthy atmosphere.
My Psychiatrist in the Latin LGBTQI+ community has a lot to offer. We are committed to offering multidisciplinary care to our patients. All our locations offer License Therapists, TMS and mental health providers with extensive experience. We offer medication management for all psychiatric diagnosis; our practice works hand to hand with the Latin and LGBTQI+ community to promote mental health. Our leaders are involved with local entities that protect and promote mental health. We provide care to hundreds of patients of both communities. We strive to continue our advocacy and work on the integration of the community to improve mental health.
I believe the most important thing to take out of this text is that mental health does not have a gender, it does not look at skin color, profession, race, or culture. The norms created by society in reference to Heteronormativity, are just labels established by society without a rational base. At the end of day, we are all human beings, unique and individual.