365 GAY VIDEO: Culture & Ideas

Dr. Caitlin Ryan began her career as a clinical social worker, trained to care for children and adolescents. By the mid-1970’s, she was involved as an organizer in the emerging movement of lesbian and gay health that was focused on developing services that treated sexual orientation as innate, not deviant.

In the early 1980s, when AIDS was first identified, Ryan was doing her clinical internships in Atlanta. At the request of a public health worker, she helped start AID Atlanta, the first AIDS organization in the Southeast, and became the organization’s first director.

Caitlin Ryan

By 1985, she had lost 100 clients to AIDS, many of them young gay people who had left their homes and families.

“I met their families when their son was in intensive care and the parents found out within the first few minutes that their son was gay and was dying of AIDS,” she recalled. “The parents were devastated. Their world was falling apart. They realized that they were about to lose their child and there was often no time to reconcile; no time to tell their son that they loved him.

“Those experiences stayed with me and I think especially motivated me to develop the family interventions, based on our research, to help families decrease rejection and increase support for their LGBT children,” she said.

When she first began looking for resources to help LGBT youth, however, almost all of the professional literature discussing “homosexual” patients was about risk for suicide and the isolation and pain of being gay, with little focus on the positive.

“Gay youth were really seen just as walking risk factors,” she said.

“No one was looking then at what it took to be part of a very stigmatized social minority, to survive living in the closet and come out of that, to be able to be a successful adult and have a good life and a family and career. . . . As an adolescent, people were told, ‘You can’t be like that because those people live on the fringes of society.’ The concept of resiliency and inner strength and coping capacities were never attributed to young gay people who had to struggle with all of these issues, and yet largely as a community, did very well as adults.”

In the early 1990’s, therefore, Ryan joined forces with Donna Futterman, a lesbian pediatrician in New York, and other experts across the country to develop the first appropriate, supportive clinical care guidelines for working with lesbian and gay adolescents.

Ryan and Futterman then wrote the first book on health and mental health care for this population, Lesbian and Gay Youth, in 1998.

She noted that at the time, “People weren’t quite sure what bisexual identity meant during adolescence, and there were very few transgender youth.” After days of searching at the Library of Congress and the National Institutes of Health, she said, “I couldn’t find anything written about transgender youth that wasn’t pejorative, that was in any way seeing that as a normative adolescent identity.”

She and Futterman nonetheless included a chapter in the book on transgender adolescents, taking a more supportive approach.

Ryan came to realize, though, that still, “there was a critical gap in our understanding of how LGBT young people were evolving and developing. . . . We didn’t know how their families were adjusting and adapting.”

Although the general healthcare literature talked about families as “a very important protective factor against major health and mental health risks,” providers knew nothing about families’ role in contributing to well being and increasing or decreasing risk for LGBT young people.

Even though children were coming out at younger and younger ages, there were no resources to help families understand their LGBT children’s developmental needs, to find appropriate health care providers, or to address peer victimization and school-related problems.

She therefore decided to develop a family-based project that would include research, education, intervention, and public policy in culturally and socioeconomically diverse ways.

“The research,” she said, “would be a basis for developing interventions that would change the way that we were working with LGBT young people.” In 2001, she received a grant from the California Endowment to begin the work.

Publishing the first paper to come out of the FAP and getting ready to release the first of the resources they have developed is “incredibly exciting,” she said.

“We’re able now to write about promoting positive coping among LGBT young people to foster well being in adulthood . . . all of the kinds of positive things that are absent from the literature. We also can write about the health benefits of coming out during adolescence as well as the impact of reparative therapy on health and mental health outcomes, the long-term impact of anti-LGBT school victimization, and how do we use school environments to promote well being for these young people in adulthood?

“There are many, many research papers as well as a lot of tools. There are all kinds of things I want to do.”

Dana Rudolph is the founder and publisher of Mombian, a blog and resource directory for LGBT parents.