Navigating as Black and gay in College

By Antoine Craigwell

Twelve years ago, a young man, now 32, left his home in the Bronx, NY to attend college in a sub-urban community. There he said, because he could not find acceptance, he kept himself shut away and only ventured out to attend choir practice, as it was the one activity that interested him. While in college, he contracted HIV and he eventually dropped out and today, is struggling to make life on his own.

For while it is likely that this young man may have known that he was depressed, what was he to do, where was he to go for help? And, if indeed anyone were to know or suspect that he was depressed, without proper training to recognize the signs and characteristics, how could that person help?

Many people feel powerless to render assistance when faced with someone who is experiencing some type of mental crisis, especially if that person is about to or indicates that he or she would commit suicide. While most people think that a suicide attempt is a cry for help, as indeed it is, without proper training and knowledge most people don’t know what to do.  Most often, too, when someone attempts suicide, if they fail at that attempt and are coherent enough after, he or she would say that they just wanted to end it all; for everything to stop; that pain, that is deep and bothersome.

The issue of depression and it’s ultimate conclusion has been brought into the public consciousness with the death of performers such as Phyllis Hyman, of whom it was known, was battling depression for years. Many know, also of the popular books and scholarly articles that have been written about the issue of depression, especially in the Black community. But, very little, outside of academic literature, is known about depression in the Black gay community. As an illness, depression is seen by a majority of the Black community as an embarrassment to the family, a sickness that speaks of weakness and ineffectualness.

“The thing is depression is an organic disease, a disorder just like diabetes. It is about the lack of a neurotransmitter or several different essential connecting neurotransmitters that could have a number of environmental or genetic causes,” said David Goode-Cross, Ph.D. “We don’t tend to look at depression as a medical condition in the same way we would look at diabetes or high blood pressure or anything like that. So one thing that needs to happen is that we as a community need more discussions about positive mental health, about well being, about what depression looks like, about what it really is. As a professor of Counseling Psychology at West Virginia University who also supervises psychologists, and who has published “African-American Men Who Have Sex With Men: Creating Safe Spaces Through Relationships,” and “Managing Multiple-Minority Identities: African-America Men Who Have Sex With Men at Predominantly White Universities” Goode-Cross said that depression is not a function of not having prayed, it is not a function of not having faith. Depression is a function of not having enough serotonin in your life.

In an article  “Depression is Associated with Sexual Risk Among Men Who Have Sex with Men, but is Mediated by Cognitive Escape and Self-Efficacy,” which was published in March 2010, Lisa Alvy and David McKirnan of the Department of Psychology at the University of Illinois at Chicago and the Howard Brown Health Center of Chicago; and Gordon Mansergh and Stephen Flores of the Division of HIV/AIDS Prevention, U.S. Centers for Diseases Control and Prevention, in Atlanta, GA; and others focused directly on the specific issue of the underlying cause or factor responsible for risky sexual behavior among men who have sex with men. The authors stated that they examined and conducted an investigation of a national sample of 1,540 HIV-positive and HIV-negative men who have sex with men, and who reported unprotected sex and drug use with sex partners and declared that, “more broadly, university students who report depressive symptoms are more likely to engage in everyday unhealthy behaviors including a lack of physical activity, not eating breakfast, and keeping irregular sleep hours.”

Confirming these findings, Goode-Cross said, “in general, environmentally, if you are talking about people around the ages of 18 to say, 24, one of the major tasks is to develop an identity, something that is separate from one’s parents, something that is determining who a person is and college is a way that a lot of young people do that. For more than half of the young men in this country, this is a developmental challenge in itself and for all students it can cause some wrinkles as they separate from their parents’ ideologies and learn other things about other people and question their own previously held values and  beliefs. Where it gets more complicated is sometimes at this age it is the first time that students are experiencing themselves as sexual beings, although increasingly young people are having sex much earlier than perhaps in generations past even from my generation. So overlaying the idea of developing one’s identity from just being away from home or whatever is identifying another marginalized identity and if you’re talking about students who are at a predominantly white institution, they are already marginalized as being Black in a place that is largely white.

“While it can get a lot more complex, there are a lot of loses that come with “coming out,” not even coming out, but discovering or declaring one’s self to be gay or bisexual or non-heterosexual and feelings of sadness are pretty common, therefore, in the best of scenarios, even with the best adjusted student, with no other factors, those issues in themselves, this period of identity development can be really challenging.

“Many students navigate these challenges by selectively disclosing or not necessarily being “out.” “Out” is a culturally laden term, but they may be less forthright about their sexual orientation; there certainly is a perception among Black people that African Americans tend to be less accepting of homosexuality and bi-sexuality in the community.”

However, said Goode-Cross, “I don’t know that the research bears that to be exactly true. I think that most Americans are heterosexual and homophobic, I think that, but the experience and because of the high degrees of religiosity in Black communities, and the experience of their peers, they see their peers as being pretty discriminatory, so it becomes a really scary time and without lots of support and depending on where that person is, whether they are visibly gay or whether they “clockable” or whether they are masculine or not; things get tricky really quickly. The way that most young men manage that is to be selective about who they disclose their sexual orientation to, which comes with its own set of costs as one could imagine, the cost of being secretive and the pressure of keeping quiet about it, and that often that raises a lot of anxiety. I have seen a lot of students who can’t tell anyone about their sexual orientation and that can cause its own consequences, including a lot of self medication with marijuana or alcohol and lots of sex. There are lots of ways people mask the discomfort that comes with being in between or being in a marginalized group, which of itself complicates issues. This is not talking about people with more severe difficulties, students with trauma history or who don’t come from supportive or stable families. If you’re entering in those dynamics and you keep in mind that human beings have a finite amount of resilience, then what can happen very quickly is that any kind of problem already present or developing is made worse by the stress and the fear associated with being a member of a double mind or any group. Also, because of the specifics, depending on where the campus is located, if it is in a rural or non urban environments, one is generally talking about a pretty small number of people. If one was thinking about age range where developing a sense of self and exploring adult sexual and emotional relationships as part of the developmental path, that gets tricky. If a person is one of, and there are only five other gay Black men that he knows about, he certainly has fewer opportunities to date and to explore and so what does he do with that? This could present a number of issues, such as dating people who are developing pseudo-relationships online or engaging in anonymous hook-ups. A good picture about exactly how this looks in this calculation, for everyone, is that there are lots of different ways that the stressors can interact with student environments and could cause some pressure that often leads to mood disorders including depression and anxiety.”

Of the students involved in study, Goode-Cross’s said, he found that two years later, two of those students or a full fifty percent of the students had left school and they specifically highlighted that they had difficulties with depression; they both reported having suicidal ideations. One of them was so depressed that his grades dropped and he lost his scholarship and so he ended up having to leave school because of financial reasons.

Goode-Cross said that while he too was in college twelve years ago, the story of the young man could easily have been his, “I certainly had my own bout of major depression. I had grown up in a very fundamentalist Baptist household. My mother used to say, “if you grow up to be a sissy I’ll kill you,” and so it was very difficult for me to understand myself as gay and in the midst of that I certainly tried to find comfort.”

“I weep for the man I was back then but I certainly made some terrible sexual choices. Thankfully I was in a position or in a setting, I wasn’t in an urban environment where I could have been taken advantage of or my own ignorance about disease or my own need for psychological acceptance or love put me in harms way but that could have happened very easily and it happens all the time for these young men, when you don’t have enough, when you’re struggling to get a sense of who you are, when you’re not comfortable in your skin and when you’re afraid, you don’t have your full ability to reason, you don’t have all the resources to make smart, self loving decisions; in those kinds of settings a lot of people have unprotected sex, a lot of people are using a lot of substances and having sex,” he said.

Goode-Cross said that people get into horribly dysfunctional relationships, horribly abusive, emotionally abusive relationships all the time or they conceptualize themselves in this kind of stereotypical role of, “so I’m gay, I must be a woman,” and so they behave in ways that they think women should behave in terms of not asserting one’s self, not advocating for his own needs, putting up with substandard treatment, putting up with infidelity. All those types of things can happen very easily when talking about students or not even students but young men who are vulnerable at this age.

“That gentleman’s story is similar to my story,” said Goode-Cross, “ and it is similar to the stories of some of the men I talked to, similar to the many, many, many men who have been to college and not who have looked for acceptance and found something else.”

Nevertheless, he added, there are things that people can do and a lot of it is based on the individual. There is a huge stigma in the community about mental health services. If one thinks about the Black community, the idea is that if a Black person is depressed, the immediate suggestion is that the person is not working hard enough or not praying right or some such explanation, he said.

He added, that it’s quite difficult to say how someone manages that or what are the ways that people even deal with a particular stress or what is known to be the many number of factors that can test someone’s psychological resilience, well being and breaking point. There isn’t a formula and so certainly there are risk factors that students have to face. Taking an example of someone who is an African immigrant, who finds himself in a state university and now has to deal with a whole lot of white people, or an example of someone from the Bronx who is experiencing some culture shock; we do know that both of those are in environments that maybe not be risk factors but there are certainly contextual variables that can add a wrinkle to the underlying psychological processes and make them more or less likely to emerge. So for someone from the Bronx, they may or may not experience problems with adjustment. The fact that they are from an urban environment, they actually may be well suited to manage in the face of pretty adverse situations, because New York City life is not always easy and while there may be an adjustment, they may have fear that may have developed over time to approach orientation, which provides two ways to react in the face of a problem: to face the situation head on and try to figure out what resources to help him manage, and the avoidance situation, which is to retreat. What is known, is that the approach orientation has been more beneficial in this context; students who choose that, regardless of the demographic factors, are more likely to have a positive outcome. But then again, that is not a guarantee because A does not necessarily equal C.

Institutions can do some key things that beyond workshops, such as, Black students are more comfortable in Black spaces, because prior to coming to college, they tended to be more comfortable in Black spaces. Universities do a good job, as other institutions in society, with rare exceptions, about giving this spiel about being tolerant and being diverse, and many institutions have domestic partner laws which are targeted to the student body as a whole. What is left out is the assumption that Blacks, as minorities, and gays, as minorities, are culturally competent; that because a person knows what it’s like to be oppressed that he is much better off at dealing with others who are oppressed and he is not likely to oppress. That’s not the truth and this assertion has not been supported by data. What happens is that in ignoring populations, for instance when talking about anti-racism programs on campus, those that are usually addressed, are to the university as a whole. What would happen if institutions target those to the LGBT resource center on the campus and for example letting people who feel oppressed already recognize that they have their own way of oppressing others and make them look more critically at themselves? How might that provide students with another layer of safety or conversely, the safe zone that a lot of schools have about diversely tolerant and diverse sexual orientations? If discrimination was targeted at the African-American or Latino populations, what would that look like in a culturally sensitive way? Would that raise consciousness, would that make places safer for the LGBT student?

On a systemic level, on a broader level, things can change, said Goode-Cross. A person also needs culturally competent clinicians and therapists who understand the issues. Generally, if someone was doing research on gay people, the ideal psychological state historically is meant to be “out” in every context and every circumstance, which would be the picture of mental health. That‘s not necessarily true. That’s a very culturally biased perspective, “I may be gay, my mother may know I am gay but my employer may not and I can be perfectly fine and healthy.” Clinicians don’t always now that, they don’t always know the nuances of what normal development look like and that these developmental processes are really culturally based. It’s not a prescriptive one size fits all that institutions can do differently, he said.

Addressing a taboo subject in the Black gay community

(Material in this article was presented at the Barbershop Discussion Series of the Black Men’s Initiative of York College, City University of New York, on Monday, May 17, 2010)

By Antoine Craigwell

On Friday, Apr 30, according to a New York daily, New York Daily News, a 20-year-old man posing as a subway track worker caused a terror scare. At about 5:30am, track maintenance workers picking up garbage, noticed someone they did not recognize as being a worker like them in the subway tunnel connecting the Borough Hall in Brooklyn and Bowling Green in Manhattan stations, under the East River, along the Number 4 and 5 lines. The police was summoned and the young man, a Pace University student, was taken into custody on suspicion of attempting to commit a terrorist act, but when his backpack was searched, it was discovered to contain a bottle of sodium cyanide pills – when heated is used for cleaning jewelery, a large bottle of water and some flares. On questioning, Aaron Fetto, declared to the authorities that he was not a terrorist and that all he wanted to do was to find a corner where he could mix the pills with the water and drink it, to commit suicide.

“He did not want to be found,” said Deputy Commissioner Paul Browne, the New York Police Department spokesman. “He had no ID on him. He was looking for some isolated place in the system.”

Fetto, who is from New Hampshire and ran track and field in high school, and who was in the fall of 2008 on the Dean’s list at the University, admitted to investigators that he was depressed and wanted to end his own life – not that of anyone else. According to the police, even though a source said that he was on medication, it was not immediately clear what was troubling him.

Eon Scott, a 22-year-old man from the rural town of New Amsterdam, Berbice, in the Caribbean country of Guyana, committed suicide on May 7. The cause and nature of the agent Scott used, as discovered through an autopsy report, was that he drank a quantity of Gramatzone, a powerful pesticide. In a published report in a local daily, Kaiteur News, although Scott’s family claimed someone else had given him food and poisoned him, the pathologist determined that there was no food in his stomach, and it was quite likely that the pesticide was self-administered. According to the report, investigators were told that Scott drank the poison because of a broken relationship. Scott was a customer service representative for a local telecommunications company and was described as a cross-dresser.

The U.S. National Institutes of Mental Health designated May as Mental Health Month. As a mental illness, the universality of depression has several different characteristics and manifestations, and when acknowledged, is either treated through medication, talk therapy, or a combination of medication and talk therapy. A new U.S. Centers for Disease and Control and Prevention report — Surveillance for Violent Deaths — National Violent Death Reporting System, 16 States, 2007 — summarizes data on 15,882 fatal incidents involving 16,319 deaths in 16 states. The majority of deaths were suicides, 56 percent, followed by homicides and deaths involving legal intervention at 28 percent, deaths of undetermined intent at 14.7 percent, and unintentional firearm deaths at 0.7 percent.

For many Black men, especially those struggling with their identity and more importantly, their sexual identity, the stress of adjusting to demands of family, friends, co-workers, culture and the society as a whole has created a pressure-cooker type of situation, where many men suppress their feelings, and as they do, the bottling up of their emotions finds unlikely but often socially accepted, and sometimes misunderstood outlets. These outlets include alcohol and drug use and abuse, persistent feelings of sadness, prolific sexual promiscuity with unsafe sexual practices, violence – against a spouse or partner, inabilities to maintain stable relationships and jobs, and a desire to withdraw or be alone and away from everyone. From a biological perspective, even though men and women experience depression differently, for someone who is Black and gay, there is a particular difference.

But, for men who are Black and gay or same-gender loving, there are additional stressors on top of those experienced by their counterparts in the heterosexual community, including the influence of stigma and discrimination from within culture, the role religion plays – which tells them that being gay is an abomination, their ethnicity, and gender identity reconciliation from society – that being gay is a weakness to be eradicated; all of which contribute significantly to the level and intensity of depression, and which combines to inhibit their ability to lead productive and wholesome lives.

In the Black community, it is taboo to speak about depression. Because of expectations from family and society, most of which are based in history, the unspoken rule is that if someone is suffering from any of the symptoms of depression and can identify it as such, he is not encouraged to speak about it; rather, he is strongly persuaded to “man up” and “be strong”.

A commentator to a Facebook page said, “It isn’t just the Black gay community. Mental illness still carries a stigma in this country that prevents most people from openly discussing their personal struggles.”

But, Ocean Morrisset, another commentator on Facebook, on the issue of depression in the Black gay community said, “because it’s not a party or about sex, although those may be the very root causes of depression, the topic in and of itself in the Black community is one of those taboo topics that most would rather avoid.”

Generally individuals are reluctant to acknowledge that depression is present, let alone when it involves a specific group,  Rose  October-Edun said in a comment on FaceBook, “You’d be surprised how many people are experiencing depression and sometimes do not even know it. I am not saying this is so across the board, but the bottom line is, if I don’t know I have it, I cannot and will not talk about it. Sometimes individuals categorize depression as something else like, “I feel (or have been feeling) a little down, but I always bounce back”. Remember if one recognizes something as a problem, in this case depression, and look for professional intervention, they often wonder what others would say if they were to find out, thus some stigma might be attached. Now when we throw in someone’s sexual orientation (homo, bi, or transsexual), this creates different scenarios for that particular person involved. Depression is very alive in the real world and the sooner we acknowledge and address it, the better we will be as a person, group, nation, or country.”

Depression and sexual risk

In March 2010, a group of academics and researchers published a paper, “Depression is Associated with Sexual Risk Among Men Who Have Sex with Men, but is Mediated by Cognitive Escape and Self-Efficacy,” and in it the authors focused directly on the specific issue of the underlying cause or factor responsible for risky sexual behavior among men who have sex with men. In the paper, the authors, Lisa Alvy and David McKirnan of the Department of Psychology at the University of Illinois at Chicago and the Howard Brown Health Center of Chicago; and Gordon Mansergh and Stephen Flores of the Division of HIV/AIDS Prevention, U.S. Centers for Diseases Control and Prevention, in Atlanta, GA; and others, stated that they examined and conducted an investigation of a national sample of 1,540 HIV-positive and HIV-negative men who have sex with men, and who reported unprotected sex and drug use with sex partners, “we found evidence that depression is related to HIV transmission risk. Qualitative research with MSM in community settings suggests that depression and negative affect are strongly associated with risky sex”.

Addressing coping and escape, the authors said that, “there is consistent finding that those who experience negative affect are more likely to engage in avoidant coping or affect-based regulation, as opposed to instrumental problem-solving. Avoidant coping has also been found to be associated with unprotected sex. In one sample of HIV-positive men, avoidant coping was the best psychosocial predictor of unprotected anal intercourse with an HIV-negative or unknown status partner. From a cognitive escape perspective, individuals may cope with negative mood states by attempting to escape cognitive awareness of behavioral norms, narrowing their attention to more immediate, pleasurable outcomes. The concept of cognitive escape is similar to theories involving alcohol or drug expectancies, but frames substance use as a specific form of avoidant coping. Studying a high-risk MSM sample, McKirnan, and others found that men who combine drugs with sex to cognitively escape awareness of HIV risk were more likely to engage in sexually risky activities. Although researchers have not explored a relationship between depression and cognitive escape, conceptual similarities between escape and avoidant coping suggest that escape tendencies may be higher in depressed MSM.”

In the paper, the Alvy, McKirnan, and others said that while conducting group interventions sessions of MSM sexual behavior interventions, there emerged from the participants reports of feelings of sadness and loneliness as consistent themes related to sexual risk. Similarly, interview data collected by other researchers, Bancroft and others, revealed that some gay men described engaging in unsafe sex when depressed because they were less concerned about the consequences.

The authors, Alvy, McKirnan stated that their sampling of 1,540 MSM contained a near equal representation of HIV-positive and HIV-negative MSM, with strong representations of African-American, Caucasian, and Latino men, and that the depression severity yielded 611 participants or 40 percent with low depression; 594 participants or 39 percent with moderate depression; and 335 participants or 22 percent with high depression. According to the sample, 493 or 32 percent were African-American men, 583 or 38 percent Caucasian, and 294 or 19 percent Latino. While the report details the age groups and other demographic information such as income ranges, location by major cities, and education, it did not specifically identify or focus in to provide clearer details of the 493 African-American men who participated in the study. Needed are specific studies of the issue of depression in Black gay men and the correlation between depression and sexual risk and HIV infection rates, and with a larger and more representative sample size.

Henri’s Story

To protect his identity the name Henri is used: With one younger sibling, Henri had experienced lots of self-hate and low self esteem. Henri who’s originally from Haiti, still lives at home with his parents in a family house that sits on the border between Queens, NY and Long Island. Born in Haiti, he came to the U.S. with his parents when he was 2-years old.

As a 19-year old Black young man, Henri said he knew that even though he was attracted to other boys, he never knew how to express his feelings or what they meant. Now, on the verge of leaving his teens and entering his 20s, he is still in the process of accepting himself as gay. This acceptance, he says, was fraught with internal and external struggles, “I haven’t arrived completely at acceptance.”

He recalled that when he was about 8-years old, he was sexually abused by a relative, one of his older cousins, but it wasn’t until he was abused again when he was 14-years old, by someone he said was a stranger, that together with the realization that he was attracted to someone of the same sex, that he began to feel guilt, shame and sadness.

While he wanted to and struggled to accept himself, he was torn between obligations to his family – the love he knew they had for him, but reasoned that if they knew he liked guys, he was unsure of their reaction –and confusion, and saw himself falling into a category of stigma with bias attached, to experiencing rejection by family and friends, and with thoughts of suicide and contracting diseases, including HIV all swirling in his head.

“I was taught that I if could have sex with 20 girls and if I get a disease, that’s okay, but if it’s with a guy, then that’s not okay,” Henri said.

He said he spoke with a psychologist who asked him why he was depressed and he responded that he was fighting to put his feet in a “straight man’s” shoes, “I don’t know how I lived this long. I stopped going to church,” he said.

Henri and his mother had a close relationship but when he told her that he is gay, she cried and said some hurtful things. She had said, “How did I give birth to this? What did I do wrong? People at my job ask how my son is doing and I don’t talk about him; he stays by himself. They have somehow figured out that my son is gay. I never thought it’d be in my house, but in other people’s houses. What did I do wrong?”

He declared that he would not let his sexuality stop him from achieving happiness in his life, “I want to become an artist and entertainer,” he said.

But, Henri is concerned about rejection from his culture, “It would affect me a lot; in life no one wants to be alone, everyone wants to be accepted, but I know I’m not mentally strong.”