Jade

Her hair was the first thing that caught my attention. It was a captivating combination of colors; a perfect ombré from cerulean to emerald to lavender. Then I saw her eyes, a calming shade of jade. The juxtaposition of the colorful energy in her hair and the calming tranquility of her eyes was striking, a perfect balance. Behind her eyes and just beneath the shield of her hair, though, I could sense a sea of turmoil years in the making.

Barely entering adulthood, Jade, as we’ll call her, had been living in temporary housing for several years after being forced to leave her childhood home. Her removal from the home was unquestionably due to her sexual orientation and its opposition to her parents’ belief system. Since that time, she had struggled to find stable housing. Subsequently, she had difficulty with job procurement, with her physical and mental health stability, and with maintaining meaningful relationships with other people.

Jade’s story is an amalgamation of portraits painted together from the experiences of young adults I met over the past year during my Albert Schweitzer Fellowship as a physician scholar. I implemented a mental health curriculum and distributed mental health crisis resources at a local resource center for LGBTQ+ young adults experiencing housing insecurity. Unfortunately, this story is not unique to Jade. Housing insecurity disproportionately affects those in the LGBTQ+ community, largely due to overt discrimination. LGBTQ+ young people are also disproportionately affected by mental illness, which may be related to the effects of discrimination and contribute to continued housing insecurity.

The most striking realization to which I came was that knowledge about mental health is rarely the main barrier for these young adults. I underestimated the true resilience and self-awareness that many of them possessed. Most of the clients I encountered were knowledgeable but without true support or sustainable resources. To further complicate this picture, discriminatory policies and legislation across the country are targeting LGBTQ+ people at an alarming rate. This will undoubtedly affect members of this community in a negative way, especially by normalizing the overt discrimination of LGBTQ+ people.

As a pediatrician, one of my main goals is to ensure the safety of my patients. It becomes increasingly difficult to ensure their safety when hate based on sexual orientation and gender identity is both normalized and legalized. Many of the children I see in clinic who identify as LGBTQ+ have loving and supportive parents. Just as many, though, must make an oft deadly choice, a choice between safety and happiness. These young people are facing either the trauma of hiding their true selves and sacrificing the fulfilment of a life lived authentically, or the trauma of being shunned for living authentically. Both options, unfortunately, are often accompanied by severe trauma. The consequences of the current war on LGBTQ+ people, I fear, are yet to be fully realized.

A true public health crisis has only just begun and we, as pediatricians, are of the few with power to influence the narrative. Our voices have power as experts in health. It takes a fraction of the courage that our patients muster daily to speak out and to stand up. Young LGBTQ+ people like Jade are living with courage beyond their years, choosing to live in full color and without inhibition, despite the true despair and uphill battle they face daily. We, as physicians, can also choose to live in color by helping to create a future in which we nurture individuality, we accept and love our differences, and stand fast in the face of hate.