Kate Fordham

June 1998

Life, Love, and AIDS

Special Feature: an Interview with Dr. Laura Herst

Laura Joan Herst, Ph.D., is an internationally-renowned psychologist who specializes in adolescent psychology, with her main area of interest being the developmental and social problems faced by minority adolescents, including gay youth. Dr. Herst has recently published several ground-breaking research studies in the academic literature concerning her counseling work with gay adolescents. I was fortunate enough to arrange an interview with Dr. Herst while we were both attending a conference in Dallas a few weeks ago. Although I previously only knew Dr. Herst by her stellar reputation, I found her to be a caring and engaging person, as well as a superb clinician and researcher.

Kate Fordham: How did you become interested in gay youth and the issues affecting them?

Laura Herst: I encountered several adolescents who had attempted suicide and who self-identified as gay or questioning of their sexuality as far back as my clinical training -- when I was finishing my doctorate -- in the late sixties. I was interested in pediatric psychology at that time, and as I learned the ropes, I found that gay youth certainly did exist and they made up a disproportionate segment of the kids we saw in the clinical setting, that is, kids who were hospitalized for psychological or behavioral problems.

Kate Fordham: Did your own sexuality -- being lesbian -- affect your attitude towards these patients? Do you think that prompted your concern for them?

Laura Herst: No doubt that it played a role; I knew what they were experiencing because I had been through much of the same myself. But I would have -- I hope I would have -- wanted to help gay youth as a population of young people even if I happened to have been heterosexual. Maybe I wouldn't have understood it as well, though; I don't know if I can speculate on that, really.

Kate Fordham: Many health professionals and educators -- or at least many of those scant few who study gay youth in depth -- have pointed to the level of suicide and attempted suicide among gay teens, which is certainly higher than it appears to be for straight adolescents. How do you feel about this issue and the approach or lack thereof of the mainstream medical community to gay youth and suicidality?

Laura Herst: Well, not enough is being done to intervene, that's for sure; not enough is being done in intervention and little is being done for preventative efforts. I have yet to see any public school-based program that even involves homosexuality as a factor in the risk for suicide, anything that acknowledges this risk and that communicates to gay youth that they are not alone in their problems, anything which encourages them, which provides them with somewhere to go to get help. Most public schools have presentations and other teaching about suicide as a risk of adolescence, so where is the specific inclusion of gay youth as a group at added risk? As you said, many researchers have shown substantial evidence of gay youth being at greater risk for suicidal behavior than their heterosexual peers. Gary Remafedi's work in Minnesota would indicate that gay youth are perhaps -- proportionately, speaking -- at highest risk of all youth minority groups. It's difficult to determine exact figures given that many times we don't know if a person who has taken her own life is homosexual or not, and other matters do complicate all this, too. But there's enough evidence to say that gay youth need our help, that we need to reach out to these kids before they attempt suicide or become involved in other unhealthy behavior.

Kate Fordham: Though the data is still pretty scarce, all the research I've seen to date indicates that gay youth are at a high risk level for drug abuse, smoking, alcoholism, and certainly unsafe sexual practices. Yet we don't tend to even look at gay youth as a discreet population within the larger society of adolescence.

Laura Herst: You are so right to say that, and to consider adolescence as a "society" as well as a period of development. Successful interventions for adolescents at risk for anything -- whether they are gay youth or not -- must take into account the social aspects of adolescence. It's probably the most socially stressful and difficult stage of the human life; a very rough period of development for many people. Gay youth are made to feel ostracized by their own peers if they are openly gay and the shame and stigma that comes with being gay, with having homosexual feelings, that weighs heavily on many of these kids. Add to that the frustrations of dating and lack of opportunities to date, often to even admit attraction to another person, and the issues of family acceptance, religion, and the list continues. The bottom line is that gay youth really have their cards stacked against them by our so-called modern and caring American society, our supposedly advanced and sophisticated educational and health care systems. All the various risk-taking behaviors you mentioned are just classical indicators of the stress these kids experience and how they combat that stress.

Kate Fordham: Is the changing image of homosexuals in the media having any positive affect on gay youth, do you think?

Laura Herst: Our increased openness about homosexuality in the media and in entertainment can only be a step in the right direction, but for every step forward it seems like we have two or three back in the old direction. I cite the cancellation of "Ellen" as a perfect example. When gay adults become brazen enough to acknowledge their sexuality in a public forum, they are silenced, and that has to be a horrible thing for our young people to witness. And not just our gay youth, but I mean all of our young people. The welfare of gay youth is dependent to degree on the amount of understanding and lack of prejudice we can foster in straight youth.

Kate Fordham: But the overall situation for gay youth is better than it's been before.

Laura Herst: I'm not so sure; certainly, it is better and more open than it has been over the past twenty years or so. In the sixties, however, we really had the sort of complete situation that was more conducive to coming out and to promoting a greater understanding and tolerance for all people. At that time, I think most youth would be willing to accept their gay peers because they would be open-minded enough to see the person beyond the stigma. Now, a lot of straight young people who are accepting tend to still see a difference between their sexuality and the sexuality of their gay friends. This is a whole topic by itself; I could continue about this at length because I think the overall approach that today's youth take towards sexuality and related issues is crucial to our understanding --to their understanding and acceptance-- of gay young people.

Kate Fordham: Today's youth are not as idealistic in the sense that they are not setting --as a majority-- high ideals and collectively striving towards these goals.

Laura Herst: Right, they are --and I'm generalizing here-- more concerned about their lives --their own being, their own existence-- than a collective future, than issues affecting everyone. They are --and by no fault of their own-- much more cynical, which goes the distance to isolating them from considering larger problems as just as important as their own personal problems.

Kate Fordham: Safer sex is about the only aspect of the health of gay youth as a group that has received even a slight level of attention from public health authorities and educators. How can we move the other issues affecting gay youth into the spotlight alongside the sexually-related issues?

Laura Herst: And we must do that, move those issues into that "spotlight" and see that they become part of the school health curricula. It has to happen in the schools; that's the only environment that reaches enough kids to have a decided impact. But how? First, I think the national-level health agencies --namely, the Division of School and Adolescent Health (DASH) within the Centers for Disease Control and Prevention (CDC)-- must focus on these issues, draw up recommended practice-type guidelines and let state boards of education know how essential these topics are as part of school health. The CDC is the only place where it can happen; only DASH as part of the CDC can reach all these diverse and scattered health department and school boards that act at the state level. As you know, DASH has not been all the effective even in ensuring quality safer sex education --particularly including gay-specific material-- so the cards are stacked against them, too. I hate to sound so pessimistic, but there's so much to be done and really not that much is being done. We can't forget the importance of individual teachers, school nurses, and students in this. These people can act at their local level and get at least some of this information into their schools.

Kate Fordham: Do you think gay-straight alliances can play a crucial role in the development of the gay adolescent?

Laura Herst: They can, and where they exist, they most often do. I've looked at high school-based gay-straight alliances and other gay-oriented or gay-inclusive clubs across the country to see what they are doing and see how they're fairing, what obstacles they face. These groups are wonderful as concepts, but they suffer from several types of problems. One, in many schools, they are simply not welcome. Schools either say this explicitly and turn them down, deny them official club status, or they mount roadblocks to their progress. A single high school teacher who dislikes the idea of such a club can do a great deal to make life difficult for the club as a student organization. That's one person; and much of the time many people --teachers, parents, other students-- object. To make these clubs effective, they have to be safe places where young gay, lesbian, bisexual, or questioning students can seek refuge from the rest of the school, particularly when the school environment as a whole is less than hospitable to the openly gay student. So to be that sort of haven the club has to be safe from attack, from persecution by school officials, parents, or anyone else. Achieving that status is the most difficult step for many of these clubs.

Kate Fordham: What about coming out, how do you find most gay adolescents --at least of those you have encountered-- come out? To whom do they come out and at what age, if there is even a mean age for coming out?

Laura Herst: Coming out can take so many forms, the only thing many of these forms have in common is that the coming out process is an affirmation of the person's sense of sexuality as well as an acceptance of their sexuality as a truth in their lives. Some kids come out first to friends, or to parents, perhaps siblings, or even a teacher or other adult whom they trust. I don't know of a mean or common age for coming out and would not trust any statistics on this, really. I think it's true that kids are coming out at earlier and earlier ages than ever before, but there's no way of gauging exactly when the majority of them are coming out. Besides, coming out to many gay youth means telling someone, anyone, that you are gay; it is not the same idea as declaring your sexuality to everyone in your life. I have met teens who identify themselves as being "out" when in fact, only a small number of people out of everyone they know is aware that they are "out". There's nothing wrong with this at all, but I think the term "coming out" has been so overused that kids feel almost an obligation to come out in some form; this is seen as a right of passage for the gay adolescent and it is not always the most healthy or safest option for someone, given his or her specific circumstances. If we can learn to encourage people to accept their sexuality and then share that acceptance with others as they see fit, then we will be presenting the reality of the situation more truthfully. Teens cannot always come out and expect this action to be the best choice for them while still at a relatively young age --I wish this was not so, but it is-- however, they can always learn to come to terms with who they are, embrace their sexuality as just an extension of everything else that makes them who they are, and deal with the issue of being gay in that context.

Kate Fordham: How do you think the overall ordeal of AIDS --as a social problem as well as a personal and medical problem-- has affected gay youth?

Laura Herst: AIDS has been associated with gay men for so long that many young gay males still feel the hatred and fear stemming from that association, especially in rural areas where there have not been that many cases of AIDS and not a lot of community activism or even communal knowledge. The gay community is beginning to suffer from compassion fatigue for those who have been afflicted by AIDS, and young people are aware of this, I think. There is no longer such an overall feeling of dread with AIDS but then among youth there's not that much thought given to the matter on an everyday basis as there might have been around seven years ago. People get tired of crisis conditions, unfortunately, and young people often don't want to examine the unpleasant reality of a situation if they don't feel it affects them directly.

Kate Fordham: You have conducted several important research studies on the psychologies of gay youth; what has been the main focus of this research and what have you found, if you can give us a general synopsis?

Laura Herst: My research has centered around the psycho-social status of gay youth in a predominantly heterosexual environment, looking at what allows some such youth to adapt to that environment while others encounter considerable difficulty. The actual methodology of our research might be a bit too extensive never mind boring for your readers, but suffice it to say that we mainly work through interviews and other, common psychological survey methods to gather our data. What we have found to date is that most gay youth can avoid the perils classic to a troubled adolescence when they are provided with some means of communicating with like-minded peers and supportive adults. In other words, aside from a supportive family environment, a supportive and non-threatening school environment is the best defense against losing these kids to suicide, or drugs, or something else. Certainly, in major cities we have interventional programs outside of the schools that have proven largely effective in intervening where teens --whether gay or otherwise-- have displayed risky behavior, mainly in the case of drugs, yet I ask why not incorporate preventional efforts to match these interventions, to stop the damage before it starts? Again, I don't see many high schools even acknowledging that gay youth are a risk group for unhealthy behavior, I don't see them taking on this problem from a preventative perspective.

Kate Fordham: In those gay youth who have taken part in your research studies, do you find that they are hopeful about their future, that they feel the future is going to be better for them than the past and perhaps the present?

Laura Herst: I find that many of these kids are not overly optimistic, yet they do want to see a better future and would like to work towards that goal, although in many cases, there is no direct mechanism for them to work towards improving their own circumstance. They are looking for some sort of empowerment, which is another thing that gay-straight alliances and the like can accomplish.

Kate Fordham: What one singular thing needs to be done --if you can name one thing-- to improve the status of gay youth in our society?

Laura Herst: Permit them some empowerment, provide them with resources where they know they can talk to someone who will understand them, who can provide accurate information on safer sex and who will help them however they need help. This is not only what we need for gay youth; we need it now for all our youth. We need our schools and our teachers and school counselors to do their utmost to prevent self-destructive behavior in teens. Maybe they think they are doing it already, but everything I see on a daily basis tells me otherwise.

Kate Fordham: I want to thank you for talking to me and to Oasis Magazine.

Laura Herst: It's been a real pleasure, Kate.

Please send all questions for the "Life, Love, and AIDS" column to Dr. Fordham at: KFordham@hotmail.com

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