Dec 10

When you call a girl a slut

By Dr. Micaela Wexler
When I say “girl,” I am talking about females who have not yet reached adulthood. Girls start being subjected to this abuse starting at the age of 10, if not earlier. By “slut,” I am not just referring to the actual word, but also to any language that shames a girl for expressing her sexuality. And, when I say “you,” I am limiting myself to the adults in girls’ lives who do this who are supposed to be supporting and nurturing these girls: parents, step parents, parents’ girlfriends, aunts, older sisters, teachers, neighbors.

This behavior is so wide spread that a word defining this behavior is now part of our lexicon: slut-shaming. Slut-shaming is defined as “publicly or privately insulting a woman because she expressed her sexuality in a way that does not conform with patriarchal expectations for women.” As a child psychiatrist, I hear slut-shaming several times a day. And, sadly, it is usually women who engage in this behavior. Examples I have heard include:

- a teacher I spoke to about a bullying incident said, of the 12 year old in question, “excuse my language, but if she didn’t dress like a slut . . . ”
- a woman, speaking about her stepdaughter: “she is 15, and she’s already a slut”
- another stepmother, speaking of her husband’s 14 year old daughter, “she goes prancing out the door with skirts up to here, make up that makes her look cheap, to hang out with a bunch of kids to do who-knows-what. I don’t like that sort of behavior around my 12 year old son. You should see how he looks at her. I wish she would just go away.”
- a woman whose boyfriend has a 16 year old: “instead of making her babysit (their one year old), he let her go out with her friends. All she does is go out and screw everyone she sees.”

The implications behind this slut-shaming behavior is that these girls are unworthy of our love, support and protection. In each of these examples, the girls’ behavior was being used as a rationale for not considering her needs. In the first example, the teacher is absolving herself of any responsibility for protecting a 12 year old girl because of how she DRESSES. The other examples all involve stepchildren. So, not only do the girls in question have to suffer the calamity of their parents’ divorce, but they now have a new slut-shaming person in their lives.

In every single example, the needs of the girls are completely ignored. The 14 year old girl mentioned above is entitled to safety in her own home regardless of how she dresses. The 12 year old son would benefit from being taught to respect females rather than watching the behavior that is undoubtedly being demonstrated. If it really is true that the 16 year old is “screwing everyone she sees,” that is a tragedy, not an opportunity for derision.

As a child psychiatrist, I have to think that the women in these slut-shaming examples, and others like them, do not truly wish these girls harm. The teacher chose a helping profession and has dedicated several years to serving middle school children. All the mothers in these examples are incredibly nurturing to their own children.

So, why do you do this? One reason, in my opinion, is that you are truly overwhelmed by the daunting task of shepherding girls through these turbulent years. Raising teenagers, both boys and girls, has become very complicated. Families face constant intrusion from the world at large, through the media, social media, as well as from economic pressures that expose families to risky situations. Many of you are the products of a society that gave you negative images and limited opportunities. You live in a world that offers your family very little support.

I have to believe, also, that you are unaware of the damage this behavior causes. Slut-shaming causes deep, long lasting damage to a girl’s self perception. When girls are slut-shamed by the adults in their lives, they are shunned, isolated, left to navigate the dangerous waters of the teenage world alone, without protection, information and support. This places boys at risk, as well. Slut shaming leaves boys without any meaningful tools they can use in communicating with girls. They are being asked to view potential friends and romantic partners in a negative, one dimensional fashion which ignores who they are as people.

When we make negative comments about how a girl dresses, we are are objectifying that girl, and teaching her, and her male peers, that her value is based on how she looks. Whenever we slut-shame, we make it harder for these girls to defend themselves against rape, child molestation and relationship abuse. We also make it difficult for these girls to develop a healthy sexual identity. Some girls react by exaggerating this behavior. Other girls react by shutting down their sexual side, acquiring negative attitudes about their sexual feelings.
By slut-shaming, you are adding to the turbulence all teenagers face. Since I know that this is not at all your intention, I ask, for the sake of all teenagers, that you examine this behavior and why you engage in it. Next time you get the urge to do this, instead find out what the girl’s behavior means about how she feels as a person. Reach out to her and help her navigate the treacherous waters she and all teenagers find themselves in.

Nov 27

Genital warts: what to tell your teenager

By Dr. Micaela Wexler
One wouldn’t expect a child psychiatrist to be writing about this, but it turns out a common source of severe anxiety for teenagers is discovery of a sexually transmitted infection. Genital warts is one such infection, which is poorly understood by teenagers. Once they have it, they hear just two things: 1) it’s forever; 2) it’s transmittable. In most cases, no one has ever sat down and had an in depth discussion with them about genital warts.

First, parents always want to know: HOW do you talk to your teenager about GENITAL WARTS?

Here’s a way I know of that has worked for parents. This is the phrase that you can use for just about anything:
“This may not ever happen to you, but I was reading an article about it, and I want you to be prepared if it does happen to you, or if it happens to anyone you know.”

Practice saying that to yourself, and then practice saying that phrase to your teenager. Start by using it for a topic that isn’t so sensitive, like, how to avoid being pick-pocketed. You can then segue to topics about health, like, how to treat a urinary tract infection, how to avoid constipation, all the way to talking about sex.

Once you’ve used it a few times on these less sensitive subjects, don’t waste your currency. Dive in and use it before it “expires.” You can say, “now that we’re on the topic of things I’ve read about, what do you know about genital warts?”

Here’s the skinny on genital warts.

Genital warts are warts that are located near or in the genital areas. In a female, that means on or near the vulva (the outside genital area), vagina, cervix, or anus. In a male, that means near or on the penis, scrotum, or anus. They look like bumps or growths. They can be flat or raised, single or many, small or large. They tend to be whitish or flesh colored. They do not cause pain. They do not drain or ooze.

Genital warts are caused by a type of virus, the Human Papilloma Virus (HPV). There are 100’s of types of HPV warts, and they infect multiple parts of the body. Some types of HPV cause plantar warts, which appear on the bottom of one’s foot. Other types infect the genital area, and a smaller subset of those can cause cancer.

Typically, a wart will show up between three weeks to six months after exposure. Sometimes warts can take even longer, up to years, to appear; the virus can live in the body for a very long time without causing any symptoms. This makes it difficult to know who gave you HPV.

Because warts are caused by a virus, they need to INCUBATE in order to cause a visual wart. In simple terms, what this means is that the virus needs to take over the cell’s genetic machinery, and then change those cells to become cells that look like warts. This takes time; it doesn’t happen in just a few days. And, while the virus is going through all the steps of creating a wart, our body’s immune system is fighting the virus at each step. So, if a person is healthy with a good immune system and living a stress free life, the body could potentially fight off HPV enough to keep a wart from appearing.
To better understand this, think about chicken pox, which is also caused by a virus which causes skin eruptions. The chicken pox virus is much stronger than the HPV virus: no matter how healthy and stress free you are, you’re going to get skin eruptions after being exposed (unless you have been vaccinated). Chicken pox requires at least 10 days to incubate and cause skin eruptions, ie, it takes at least that long after exposure to get the chicken pox rash.

How contagious are warts?

HPV transmission can be complicated. If you have a wart, or a lesion, then you are very contagious. For women, this can be a problem, because they could potentially have an eruption on a part of the body they can not see, like the vaginal canal, and not even know they have HPV. The male sexual partner could then get the virus on his penis, and then give that virus to another female, and SHE could get HPV. All of this could happen without anyone knowing anyone has HPV. This complicated transmission is a strong case for using condoms. However, condoms are not 100 per cent protective, because a male could have a virus on his scrotum and transmit it to a woman’s vulva.

How dangerous are genital warts?

Some types of HPV can cause cancer. In women, they can cause anal or cervical cancer. In men, they can cause penile cancer. For this reason, they should not be ignored. Because of the complicated transmission described above, ALL women are advised to get annual pap smears. (Pap is short for papilloma.) Men should examine their genital area on a regular basis, including the penis, the scrotum and the anal regions. If they see or feel a lesion, they should have it looked at by a doctor. Some physicians provide “anal pap smears” for people who have engaged in receptive anal sex.

How can genital warts be prevented?

The only 100 per cent way to prevent genital warts is to abstain from all sexual activity. For many people, especially married people, this is highly impractical. There are ways to reduce the risk of genital warts: 1) use condoms; 2) get the Gardisil vaccine; 3) know your sexual partner well enough to examine the genital area; 4) get annual pap smears; 4) let your partner know you have “tested positive in the past for HPV.”

The last one is important. Many teenagers will neglect to tell their partners out of fear that they will be ostracized, or accused of intentionally spreading STDs. However, saying “I have tested positive for HPV” is clinically no different than saying “I have genital warts,” but much easier to get out of your month. If teenagers are informed with the knowledge in this article, they can at least have the proper “ammo” to disclose this important information.

Click here for more information on genital warts.

Nov 14

Is your depression keeping you from losing weight?

By Dr. Micaela Wexler
If you are having trouble losing weight, it could be due to depression. As a family psychiatrist, this link is very obvious to me, but not to my patients. Studies show that depression and obesity are linked to each other. A meta analysis study published in JAMA in March 2010 shows a that depression can lead to obesity and obesity can lead to depression. (1) A study of Dutch teenagers, published in Obesity in March 2010, showed a clear association between weight status and suicidal behavior in obese adolescents. (2) The same link was found in a later study done on Korean teenagers. (3)
Depression causes physical changes which affect interest, sleep, appetite, sexual drive, and thought processes. Some types of depression cause people to eat and sleep more than normal. If you are having trouble finding the willpower to exercise it might be due to decreased motivation, which might be due to depression.

Are you finding it hard to lose weight even though you are exercising and sticking to your diet? This could also be due to depression because depression makes the body’s metabolism change. When a person is depressed chemical changes take place that make it harder to lose weight. Some of these changes can cause weight gain and fatigue.

Depression can also cause a change in eating patterns. The chemical imbalances caused by depression make it harder for people to connect hunger with food intake, which is why some depressed people eat even when they are not hungry. Or, they are hungry even after eating.

It is easy to blame your weight on lack of willpower. But, if you are having trouble losing weight, it is important to make sure you are not depressed. Besides causing weight gain, untreated depression can cause more serious problems like diabetes, heart disease, and suicide. And, studies show that treating depression leads to weight loss.

Do you feel sad or hopeless? Are you having trouble sleeping? Have you lost interest in things like hobbies or TV shows or fun activities? Do you have trouble motivating yourself to do things? Are you short-tempered? Do you have negative thoughts about yourself? All of these are signs that you might be depressed.

If you’re having any of these signs, go see a therapist or a doctor or call your local mental health center. Start treating your depression so it doesn’t keep you from losing weight.

1) Overweight, Obesity, and Depression
A Systematic Review and Meta-analysis of Longitudinal Studies FREE
Floriana S. Luppino, MD; Leonore M. de Wit, MS; Paul F. Bouvy, MD, PhD; Theo Stijnen, PhD; Pim Cuijpers, PhD; Brenda W. J. H. Penninx, PhD; Frans G. Zitman, MD, PhD

2) Weight status, psychological health, suicidal thoughts, and suicide attempts in Dutch adolescents: results from the 2003 E-MOVO project.
van Wijnen LG, Boluijt PR, Hoeven-Mulder HB, Bemelmans WJ, Wendel-Vos GC.

3) The relationship of weight-related attitudes with suicidal behaviors in Korean adolescents. Kim JS, Lee K. Department of Family Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea.

4) Pagoto S, Schneider KL, Whited MC, et al. Randomized controlled trial of behavioral treatment for comorbid obesity and depression in women: the Be Active Trial. Int J Obes (Lond). 2013 Mar 5. [Epub ahead of print]

Sep 10

“Suicide prevention starts with you.”

By Dr. Micaela Wexler
Whenever I say this to people, they think I mean for them to help prevent suicide in other people. They immediately think about their families, friends, co-workers, children, spouses. In most cases, they are eager for tips on how to join in the fight to stop suicide.

“I mean YOU, specifically. Suicide prevention starts with YOU.”

Suicide is something that can happen to anyone. While we all need to help each other in preventing this tragedy, you can’t prevent someone else from committing suicide unless you prevent yourself from committing suicide.

“Well, that’s easy,” people tell me, “I don’t believe in suicide. Suicide is a selfish act; I would never do that to my loved ones.”

It turns out that people who commit suicide were once just like you: they didn’t believe in suicide. Like you, they had children, parents and friends. They loved them very much and did not want to hurt them. Just like you, they had religious beliefs that once gave them strength and comfort. They had goals and dreams and plans. They had crushes. They had love affairs. They had marriages.

So, to prevent suicide, you have to start by examining yourself.

Do you find yourself doing things you never did before like yelling at the grocery checkout person? Are you snapping at your husband? Does your best friend suddenly make you fly into a rage? Are you drinking more than you ever did? Are you in a financial crisis you feel you have no way out of?

Do you find yourself being careless about your safety: being less careful about locking doors at night; not slowing down for yellow lights; driving recklessly on the freeway?

Many people have these thoughts. That doesn’t mean you should ignore their seriousness. Letting thoughts like these pile up can put you on the road to developing a serious depressive episode. That is the most common reason for suicide.

If you are having these thoughts, then you are not taking care of yourself. You are not taking time to enjoy life. You are losing sight of your dreams and goals. Maybe you are not spending enough time with friends who appreciate you. Maybe you are working too much, at the expense of socializing and exercising.

You can do things immediately if any of these situations pertain to you. Right now, take a deep breath and think of something positive you will do for yourself TODAY. It can be something simple like taking a walk, calling a good friend, making plans to go watch a movie, buying yourself a new song, playing a computer game.

Look at your schedule and see what items are on it that make you feel good. How can you add more? You may not be able to get out of your financial crisis, but you can probably find someone to talk to, either about your problem, or something completely unrelated, to take your mind off your crisis.

If you are having the thoughts I’ve mentioned, this is a sign you need to find time to reflect on what is good about you and your life; you need to make it a DAILY practice; you need to refocus on your hopes and dreams. You need to reach out to loved ones, clergy, maybe a therapist, or the employee assistance program.

There are some thoughts that will require much more than than what you can do alone. There are thoughts that are a sign of something serious that needs immediate professional attention.

Do you feel you have no purpose in life? Do you feel completely hopeless? Do you ever find yourself having thoughts about what it would be like to be dead? Do you find yourself thinking that people would be better off without you in their lives? Do you find yourself going beyond simply not slowing down for yellow lights, and actually running red lights? Do find yourself wondering what it would be like to go toppling off the overpass? Do you notice you are preoccupied with the after life?

These are all thoughts that are a sign of serious suicide risk. Do not ignore this. There are several options for immediate help, from calling 911 and talking to the police, to calling 1-800-273-TALK or 1-800-SUICIDE (1-800-273-8255, 1-800-784-3433) or going to the emergency room. Either one of these options will lead to a trained professional who can help determine the type of help you need immediately.

Nine out of ten people who commit suicide had a diagnosable mental disorder. But, only THREE out of 10 people who die by suicide received mental health care in the year prior to their suicide.

So, start preventing suicide by taking a look at yourself. Because, trust me, we need you around.

Aug 18

Talk to your kids about sex (love)

By Dr. Micaela Wexler
Whenever I perform a psychiatric evuation on a new teenage patient, I always take a sexual history. In ideal situations, I am able to do this outside of the parents’ presence, and then bring it up again when the parents have re-entered the room. Sadly, the ideal situation is rare, as I tend to encounter a great deal of resistance from parents and teenagers alike.

Too often I find that my adolescent patients have never had an in depth discussion about sexuality with their parents. In the best case scenarios, they have been told about pregnancy and STDs, but usually sex has been presented as a a forbidden activity, with the emphasis on religious prohibitions, and it is obvious that the topic has been presented in an atmosphere of discomfort and embarrassment. There is rarely any discussion about relationships, intimacy, sexual expression, body image, masturbation and acceptable behavior. Parents seem to be oblivious to the fact that according to the Guttmacher Institute, 46% of teenagers age 14-19 report having had sex at least once.

Failing to talk to your teenager about sexuality puts him or her at grave risk for a variety of dangers ranging from the obvious – pregnancy – to others that are less obvious but potentially more life threatening, like depression and relationship abuse. Depression is the greatest risk factor for teenage suicide. Romantic break ups are a common trigger for depression in teenagers. Teenagers most at risk for depression following a relationship break up are those who have limited support and poor coping skills. Parental support is a potent protection against teen dating violence.

It is never too early to talk to your child about sex. Ideally, the “sex” talk should begin at birth. Use correct words for genitalia when changing diapers or giving your child a bath. Make positive statements about their body (and yours) throughout their childhood. Early childhood is when boundaries should be taught, that their private parts are their own and no one else should touch them. The same is true about other people’s private parts. Introduce the physiological aspects of sexuality in the elementary school years, with anatomy lessons, including the different processes that occur, such as hormonal and physical changes, pregnancy and orgasms.

I recommend that birth control and STD protection issues be brought up during elementary school years, even if you are a strong believer in abstinence before marriage. Hearing about both birth control and abstinence at the same time does not lead to children engaging in sexual activity earlier. Parents should remember that children hear alternative, even conflicting views about many topics in their lives. Presenting children with choices teaches them decision making skills.

Children are being exposed to sexual topics outside of the home at an earlier age, and they will be safer if they have heard about them from you. In addition, talking about birth control and STDs helps children open up about other sexuality related topics; they are less shy about sharing what they have been exposed to at school and in the media. Don’t be afraid of letting them know the meanings of words they hear, ie blow jobs, fuck, cunt, etc. These are valuable opportunities for parents to express their views on acceptable sexual behavior.

Explore your own thoughts and feelings about sexuality. If you are uncomfortable discussing the topic of sexuality, try to figure out why. Are you unhappy with your own sex life? Are you disappointed with the level of satisfaction you are achieving? Maybe you have a history of domestic abuse or childhood sexual abuse. Were you taught negative views about sexual expression during your own childhood? Or, perhaps you are mourning the loss of a relationship. Getting in touch with your own emotional feelings regarding your sexuality will help you address the emotional impact sexual expression has on your teenager.

Studies show that most parents do not discuss the emotional aspects of sexuality with their teenagers. They do not discuss intimacy, relationship conflicts and violence in relationships. Teenagers are left to navigate the confusing world of dating, relationship building, sexual expression without any skills and with no one to turn to when problems occur. Whether they are engaging in sexual activity or not, teenagers experience very strong emotions when it comes to relationships. Due to their raging hormones, every aspect of the relationship is magnified. This is a dangerous time to withdraw parental support.

Once you have talked to your child about all the concrete aspects of sexuality, you have set the groundwork to talk about the complex emotional issues surrounding sexual expression. It is important to approach the topic in a non- judgmental and non-threatening manner. Open the discussion by asking if their friends are in relationships. Rather than focusing on sex, focus on issues like trust, mutual respect, friendship and honesty. Guide your teenager through a relationship conflict. Be on the lookout for signs of teenage violence. Do not trivialize their feelings. Teach your teenagers that their sexuality is a gift that should be treasured, and that it should never be used to hurt them.

Jul 14

How do I help my mom get over my brother’s suicide?

By Dr. Micaela Wexler
Sadly, as a rural psychiatrist, I have heard several versions of this question. Each time I have heard it, it has been a painful reminder that there really is not much support for families who have lost a loved one to suicide, especially in the rural setting.

When a family loses a loved one to suicide, each member experiences the trauma in their own way. The father might be numb, and in denial. The mother can be incapacitated by her guilt and loss, fearful of losing her remaining children. And, the siblings may be angry; I have heard more than one sibling express a common, and untrue myth about suicide: that the person was motivated by selfishness, and did it to intentionally hurt those left behind.

My patients who have lost a child to suicide are the most bewildered people I have encountered as a psychiatrist. I have tried to put myself in their shoes, and have found those attempts nothing short of overwhelming. I feel I would be pulverized if such an event happened in my life; I would not be able to keep from blaming myself. I don’t feel I would be able to continue living. These are the very thoughts that these parents have shared with me, in the immediate aftermath of a child’s suicide.

However, as a psychiatrist, I know that with the proper support, these thoughts will pass as the parents heal. I have watched parents survive this most horrible of events; I have been a witness as they have made the journey through their grief and learned to live again; I have watched as the healing allows them to eventually continue to advocate for their child by increasing society’s understanding of this monumental problem.

“Where did I go wrong?”
Parents feel a deep sense of guilt, both their own guilt and the guilt which society puts on parents. The guilt is incapacitating in those early days. Mothers will spend hours upon hours day after day trying to go over every single decision they have ever made regarding their child. They will reach far into their history, examining even the most trivial events. Their surviving children will have little patience for this, most likely because it is painful for them to see their parents punishing themselves. Or, they will feel resentful that so much attention is being given to the one child. Hearing their parents express this guilt makes surviving children even angrier at their siblings for doing something so “selfish.”

Surviving siblings are in need of support themselves, and will naturally turn to the people, their parents, they have always turned to first in times of great need, only to find these people completely unable to help them. In those early weeks, it would be ideal for siblings to turn to someone other than their parents for support, and for parents to find someone besides their surviving children with whom to share their grief. However, suicide carries such an immense stigma that it is rarely possible for families to do what is ideal. What happens instead is the surviving family members turn to the only people available, which can result in them further injuring themselves and each other.

“Why?!”
This is one of the most common questions a psychiatrist will hear. Parents will look for any clue possible to explain why their child did this. Their deep need to answer this question will cause them to overburden their surviving children, convinced they hold the key to this secret. This pushes the surviving children, who have not had time to process the loss themselves, to come up with an answer: selfishness. And, so one of the more destructive myths about suicide is given more life.

These families need to learn as much as possible about suicide, so they can understand the true causes, and stop blaming themselves. What I have learned as a child psychiatrist about suicide is that the “why” has nothing to do with selfishness, and everything to do with deep, emotional pain. Research on suicide has shown us that the person has to become sufficiently accustomed to pain to be able to consider something most of us would find too agonizing to carry out. This pain has many sources.

With time, parents will come to understand that they were not, could not, have been the source of so much pain. As a psychiatrist who provides emergency psychiatric care, I treat suicidal patients on a regular basis. What I often hear is that the parents are one of the few sources of comfort in their child’s life.

“What did I miss?”
Parents are convinced they should have seen the signs. Even parents who sought psychiatric help for their children for many years believe they should have been able to prevent their child’s suicide. This causes them to become frightened of “missing something again” with their other children.

Suicide is partly the result of irrational thinking, and this thinking leads children to believe they are causing too much suffering to their parents by being alive. Mental illness carries such a stigma that some people feel their parents are over burdened from having a mentally ill child, and will feel relieved when that child is gone. In their efforts to spare their parents more pain, these children will do everything they can to hide their plans, and their pain, from their parents. I have had suicidal patients in great emotional turmoil tell me they feel good only when they are with their parents, and will genuinely show no signs around them for this reason.

Another sentiment my suicidal patients express is a feeling they are a burden to their parents. This is especially true of gay teenagers who are not out to their parents: they feel they are too great a source of future pain to their parents, which contributes to their suicidal feelings.

With time, as they go through the grieving process, many parents come to understand that they truly were their child’s best, and many times only, advocate. Parents need the space and support, as well as knowledge about suicide, to make this important realization.

“They gave him everything they had.”
The financial toll on parents is a topic I have seen seldom mentioned among my psychiatric colleagues. The costs come from many sources. Chances are the family member lost to suicide was already receiving psychiatric care, placing a financial burden on the parents. The rescue attempt itself can result in astronomical medical costs, especially if the suicide is a teenager or young adult, since every effort will be made to save the patient.

In the case of one family I was familiar with, the suicide (which occurred years ago) took place by gunshot, in the home. That family faced costs in the clean up. The home lost value due to a suicide taking place there. This was compounded by the family’s inability to properly maintain the home during the grieving process. Most people who commit suicide have a compromised financial situation: they generally do not leave assets, many leave behind significant amounts of debt, and surprisingly few have insurance, including burial insurance. The parents are also left with one less child to share in the costs of their care in their later years.

If the surviving family members are able to heal and stay together, ie, adult children moving back in with parents, this has the potential to soften the financial blow. This is one of the advantages families in the rural setting do seem to have. The loss of value to the home will not be as relevant if they are all able to continue living in it for an extended amount of time. With time, they will form new memories in their home, and it will stop being a house where someone shot themselves and become, once again, a home where a family lived, and loved together.

Support in the form of therapy, education and medications, if needed, will go a long way in helping a family properly heal. This, unfortunately, is often in short supply in the rural setting. This is unfortunate because family members who have been given proper support and treatment are society’s greatest hope in helping to prevent future tragedies.

If you have lost a child to suicide, regardless of your child’s age, I highly recommend the following web site: childsuicide.org It is the best resource I have found online for parents dealing with this tragedy.

Jul 06

“My kid isn’t gay! Why should I care about gay rights?!”

By Dr. Micaela Wexler
EVERY parent should care about gay rights because the way gay teenagers are treated, and the way they react to this mistreatment affects ALL teenagers. Let’s start with the most grim of those reactions: suicide.

Teenagers who identify as gay, lesbian, bisexual or transgender (GLBT) have the highest suicide rate of any population in our society. According to a study done by the Centers for Disease Control and Prevention (CDC), the numbers of lesbian, gay and bisexual youth who attempt suicide every year may be as high as one out of three. This is regardless of whether they are in or out of the closet.
Those statistics alone should be reason for every parent to care, because as a psychiatrist I can tell you teenage suicide affects all teenagers.
But, there are other important reasons why every parent should support gay rights. One out of every four LGBT youth experiences bullying, which ranges from severe physical attacks to verbal abuse. Bullying, like suicide, affects all kids. It creates an atmosphere of vulnerability for everyone. We should want a world for our children in which people are not attacked simply for who they are, in which people are allowed to love whomever they want, and to have that love celebrated. We should want a world for our children which promotes diversity and acceptance. How does the child with a mental health or physical challenge feel watching gay children being attacked and not defended? How does a teenager who is slow to develop or who is not conventionally attractive, or is overweight, feel hearing the words “faggot” or “dyke” used as slurs? Don’t you think they feel vulnerable on some level?
And, how do you know your own child won’t be bullied for being gay? Children are often bullied for many reasons which are cloaked under the homophobic label. There have been several well publicized cases of children being bullied who never identified as being gay. Carl Walker Hoover, was only 11 years old when he committed suicide in 2009 after being the victim of anti-gay bullying. He was an athlete and a Boy Scout, and there was no evidence he had ever asserted his sexual preference.
That leads me to what I hear as a psychiatrist: parents are often the last people an LGBT child will come out to. Your child may very well be gay, and you may not even know it. Especially if you don’t support gay rights.
So, now that you know you should, as a parent, support gay rights, no matter what, the next natural question is HOW?
First, watch your language. Do you say “that’s so GAY?” Do you use the word “faggot?” “Queer?” “Homo?”
If so, then it will be easy. Just stop. Get the gay slur jar going: a quarter for every time one of your kids catches you using those words. If three kids catch you all at once, then you’re out three quarters. By doing something like this, you are going a long way to supporting gay rights: you are communicating to your children that homophobic behavior is wrong, and maybe, they might think twice about doing it themselves. Children raised in a home where cursing is not allowed tend to have better manners and better language. Why not extend that to homophobic slurs?
If you don’t use those words, you’re not home free. You might still be guilty of homophobic language. What was your reaction to the repeal of DOMA? Was it negative? Do you express to your kids that marriage should only be between a man and a woman? Why? Don’t you think that’s homophobic? If you really believe this, why can’t you keep it to yourself? Why do your kids have to hear it? I’m sure there are all sorts of beliefs, like your thoughts on S&M sex, for example, that you don’t share with your children. Why share your anti gay marriage thoughts with them? It’s not going to affect who they marry, any more than your thoughts about your friend’s husband will affect who they have sex with. But, keeping it to yourself if you don’t agree with it might help stop anti-gay bullying.
Do you lie about friends or relatives who are gay: “They’re just friends.”
Do you even HAVE gay friends? They’re out there: why haven’t you included them in your social circle?
Maybe there is someone at work who is gay, or someone on TV, and you make rude comments. Doing that is anti-gay, and contributes to anti-gay bullying.
Or, maybe you just make comments like, “I don’t care if people are gay, they should just keep it to themselves.” If you don’t CARE, then why does it MATTER if they keep it to themselves? I truly do NOT care if people dye their hair. I truly do not expect my 82 year old neighbor to keep that to herself. (I, however, will be keeping my own hair dye decisions to MYSELF, thank you very much.)
Maybe you are not one of those people who has to change their language. Maybe you have always been open minded and accepting, and your children know this. Wonderful! You are ready to really step it up for gay rights! Did you attend a gay pride event last month? Oops! You didn’t? Why not? You don’t have to be gay to attend a gay pride week event. How did you not know that? Well, there’s always next year. You have a WHOLE YEAR to plan. And, to TALK about it with your kids! They can help you plan. You can all do research on which gay pride event you want to attend. I hear Seattle has a great gay pride celebration with all sorts of family friendly activities. This would be a great vacation option for the family, and great material for that “how I spent my vacation” essay. Great way to set the tone for the new school year.
What about your bookshelf: are there books about gay topics? Go to the gay section of the book store and buy the book with the most prominent title. You don’t even have to read it. (Your kid might, so you should probably look through it. And, I wouldn’t recommend how-to books on gay sex – that might really freak them out.)
And, it doesn’t stop there. Supporting gay rights can actually be really fun, when you consider all the artists, musicians and fashion designers who are gay! Wait! Have you been wanting a Michael Kors watch or a Marc Jacobs bag? Well, now you HAVE to go out and get one. It’s your duty as a parent.

Jul 04

My Child is Oppositional! What do I do?

By Dr. Micaela Wexler
No one wants to hear this about their child, and when they do, the message parents hear is: I’ve failed! The name has a very negative connotation, with three strong words, one after the other. Oppositional. Defiant. Disorder. It is painful to hear those words said about your child. It doesn’t help that society puts a great deal of pressure on parents to “control” their children, and that the media gives a disproportionate amount of attention to children who are “out of control.” When parents hear this about their child, they experience one or more of the following: anxiety, guilt, fear, anger, helplessness, sadness, or all of these feelings at once. It is easy for them to become overwhelmed with negative feelings about their children, and forget that the American spirit has traditionally celebrated individuality, and that many of our great leaders have been defiant by nature. It is the defiant, non-conformist that changes the world for the better.
As a child psychiatrist, my first advice is to take a deep breath. Remember, you are your child’s number one advocate, but in order to act as one, you have to be calm.
The next thing is to ask yourself, is this really true? Who did you get the diagnoses from? The teacher? A doctor? A therapist? A psychiatrist? What was it based on? How long has the person giving the assessment known your child? What was the assessment based on? If your child responds to limits on his or her behavior with extreme anger, chances are the diagnoses is true. Other more subtle clues include: arguing with adults, constantly getting in trouble at school, being easily annoyed, trouble keeping friends, losing her temper over trivial things, being spiteful or vengeful. If you are in doubt, get a second opinion from a mental health provider with experience treating children. Make sure your child is also evaluated for other disorders, like depression, anxiety, attention deficit hyperactivity disorder and post traumatic stress disorder.
If you feel that the diagnoses is true, it is time to do an inventory. First, start with yourself. Do you have problems with your temper? What were you like as a child? Do you have difficulty keeping friends? Do you have difficulty sleeping, relaxing? Do you feel depressed, anxious? Are you having a conflict with an important person in your life (significant other, best friend, sibling, parent, co-worker, boss)? These are all things that can affect your relationship with your child, as well as contribute to his or her behavior. Children are very sensitive, and react to even the smallest stress in their environment. If you find that you are anxious or depressed, getting treatment for yourself from a psychiatrist will go a long way in helping you cope with and heal your child.
How do you feel about your child? Does your child feel loved and accepted by you? Or, does your child feel you are disappointed in their behavior? It is normal to feel overwhelmed by these children, and to get caught up in the trap of responding to their behavior with negative feedback. Examine your reactions to your child: are they mostly positive or negative? Do you find yourself reacting to the behavior? Do you mostly feel frustrated or angry? If you discover during your inventory that this has happened to you, then know that this will be a good place to start and change things.
Next, take an inventory of the family. Who are the people in the family that your child relates to the best? The worst? Is there someone your child is finding especially challenging to cope with? Have there been many changes in the family structure or living structure? Who does your child feel supported by? Is there someone in his or her life who the child feels acceptance, gratitude, and love from? Is there someone in the family who requires a great deal of attention, or has special needs?
Look at the physical structure of your child’s life. What is the diet they are on? Do they have a diet rich in fruits, vegetables, nuts (for those not allergic)? Is there a routine in the home? Do you have a regular “alone” time with your child, a time when the child can expect NOT to be disciplined? Is there a sleep routine? Does your child have a “safe space” in the house, a place he or she can go to de-escalate? Does the family eat at least one daily meal together?
Taking this inventory will be time-consuming, but it will help you get started on a positive road toward healing your child. More importantly, it will put you in the position to advocate for your child in a positive manner. It is very likely you will need support in taking this inventory. Be sure you turn to people who have a positive attitude toward children, and your child in particular. If you find the need to turn to professional help, find practitioners who have experience treating children. And, remember, your child is a complex, interesting human being who has much to contribute to your family.