Sure, it's 2012 we live in Canada, one of the most gay-friendly nations in the world where same-sex marriage is legal and gay rights are recognized. So is coming out becoming a thing of the past?
Far from it.
Vancouver Coastal Health's David Devine, who was part of a panel at the B.C. Gay Men's Health Summit on November 7, still sees the need to help people struggling to come out of the closet.
"A week doesn't go by that I don't have a client come in my door saying, 'David, I need to talk to you'," he said. "And I know that look in their eye. It's 'I'm gay. I haven't told anyone. Can we have a session?' "
In spite of great strides in gay equality in Canada, Devine observed that we somehow still haven't progressed beyond the "heteronormative pressure put on men…to act and be straight and sublimate your true feelings".
What's more, he has also seen that the connection between mental health problems and identity issues tends to get overlooked.
"How much are we seeing in the mental health world and the addiction world because people are not being true to themselves and truly who they are? I've seen that people who are later in recovery, I say 'Go be yourself' and they say 'I have no idea who that is', and that's straight, gay, bi, whatever."
He gave the example of one client in his 30s who had both a mood disorder and drug addiction. Although married to a woman, he had been experiencing same-sex attractions he had difficulty talking about.
Although this client grew up with liberal, progressive, queer-positive family and friends, he was still contending with deeply rooted internalized homophobia.
"He always felt that if he came out today, he would be accepted," Devine said. "But…he got a lot of…[his internalized homophobia] from the external world, not necessarily the family."
Even after being diagnosed with mental illness and receiving treatment, and even after being caught viewing gay porn by his wife, he still did not disclose his same-sex attractions until he met Devine, who was openly gay.
The client said he wouldn't have told Devine about his same-sex attractions if he didn't know Devine was gay.
"When the healthcare provider is out and there's a queer-positive vibe…in the healthcare setting," Devine said, "that makes it a lot easier and a lot safer for the clients or patients who are struggling to feel safe to say 'I'm in the closet. I'm gay.' "
Devine pointed out the importance of looking at both mental health and sexual orientation issues as potentially related rather than independent of each other.
"We tend to separate mental health and addiction, and sexual orientation from addiction and mental health. When we address something as powerful as your identity as a sexual being—in this case a sexual man—and who and what you really are…he was able to handle his urges and cravings and they were not as big because he was no longer hiding this secret. He was no longer having this shame and guilt. And he was able to learn how to act on his attraction to other men in a healthier way."
After therapy with Devine and pursuing some recommendations, such as taking 12-step programs and making friends with gay men, the client became able to tell his friends about his same-sex attractions, to enjoy gay porn without the use of drugs, and to even go on to have his first relationship with another man.
Devine underscored the benefits of helping clients out of the closet by citing results from the Sex Now study that indicate that people who remain closeted may face health consequences.
"We find that people who are not out of the closet fare worse in their health outcomes than those of us who are out of the closet, in work and personal lives and families."