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There is an assumed innocence that accompanies childhood. We follow our desires, wear whatever we fancy, laugh, cry, shout and sing. White children play with black, brown and Asian children because they share a love of sand, trucks, dolls or books. Queer children share toys and games with other children because they enjoy the same things. And then something changes.

In this article, I use the term ‘queer’ to describe my identity and position within the lesbian, gay, bisexual, transgender and queer (LGBTQ+) community. The term can have different meanings to different people, and for some it has negative associations. I identify as gay and think of myself as a gay man. I use the term ‘queer’ to refer to my position in and experience of the world as different from the dominant majority.

On being gay

My earliest memory of being gay was of a primary school lunchtime in the early noughties. As I was about to take on the monkey-bars for probably the 10th time that day, I thought to myself that all boys must like other boys and all girls must like other girls, because that is how I felt and therefore it must be true of everyone. I’m not sure why that thought popped into my head that day, but it did.

Sex education at primary school was heteronormative, with a pervasive assumption of prominence, prestige and power ascribed to heterosexuality. The boys went into one classroom, and the girls into another. We were taught about the dangers of getting someone pregnant, the risk of sexually transmitted infections, and, of course, how to put a condom on a banana. The word ‘girlfriend’ was used consistently, and while I do not remember taking issue with this at the time, I do remember boys asking me if I had a girlfriend, or if there was a girl that I fancied. Without explicitly realising why, I said yes, there was, which there wasn’t, because I was gay.Ìý

So why did I say that I did? Children and young people are very impressionable. In my book, The Queer Mental Health Workbook,¹ I talk about the influences of three major factors on our mental health and wellbeing. These are 1. people and groups, 2. institutions, laws and policies and 3. social stories. Looking back, I could see that people around me were behaving in a certain way, according to gendered stereotypes, boys playing football and liking girls, girls playing netball and liking boys, and so I probably thought that I should conform too. I think that the implicit and explicit influence of Section 28 of the Local Government Act,² that prohibited local education authorities from ‘promoting homosexuality’ and teaching ‘the acceptability of homosexuality as a pretended family relationship’ silenced my teachers and made it impossible to see myself represented in the educational material. The social story that existed (and still exists) about boys fancying girls and girls fancying boys, and anything deviating from that being abnormal, probably influenced me too. Much in the same way that political and social influences lead to a gendered sense of fashion and behaviour, they elevate masculinity and heterosexuality and oppress femininity and homosexuality.

On being queer

The fallout from growing up queer can be pervasive and have serious mental health consequences. I am white, cisgender, had support from family and friends and was afforded social privileges that are not afforded to many. This included a roof over my head and food on my table. The consequences of growing up queer in a world that explicitly and implicitly tells you that your very core is wrong or disordered can be traumatic and overwhelming.

The felt sense of shame, disillusion and disconnection is very real for those who are LGBTQ+. There are disproportionate rates of anxiety, depression, substance misuse, eating difficulties, self-harm and suicide among the LGBTQ+ community,^3–7 which are the mental health consequences of living in, coping with and navigating a world not designed for you.

Of course, the development of mental health challenges is complex, and there are likely to be many contributing factors, other than queerness. However, being queer can make identity formation difficult. Being queer can reduce opportunity for meaningful connection with friends, family and loved ones. Being queer can lead to an internalised sense of ‘wrongness’, because you are the odd one out and so you must change. It is no wonder that these enduring erosions of positivity and protection can confer risk for the development of mental health challenges. You cannot drill thousands of tiny holes into a boat, cast it out to sea, and then blame the boat when it ultimately sinks. Growing up queer can be like being that sinking boat.

For me, there are innumerable positives connected with a queer identity, including a sense of solidarity with and empathy for other marginalised and minoritised groups. Some people experience gender freedom, breaking free from the shackles of a binary social story that have kept women and gender-variant people oppressed by patriarchal structures for millennia. My hesitation about centring the positives is that they can only be fully appreciated when they are contained within structures and systems that allow them to flourish. It is vital that we challenge the oppressive structures and social stories that exist, to allow these positives to shine through.

On how to help

So, as professionals, what can we do to support young LGBTQ+ people? The first thing that I would emphasise is the need to help your client understand the context in which they are living, including individuals, groups, institutions, policies, laws and social stories. Some clients will not want to think about these things, and that is OK. As professionals, however, we can hold them in mind and hypothesise about the potential relationship between external factors and what we see presented in the counselling room. I recognise, for example, that sometimes it can feel too confronting for clients to hear that the relationship they have with unhelpful (or abusive) others in their life is part of their difficulties. As therapists, we can guide and allow clients to talk about this if and when they feel ready.

Linked to this, I would encourage professionals to consider culturally appropriate resources and therapy for their LGBTQ+ clients. Traditional or routine therapeutic techniques may need tweaking to fully account for the experiences that are relevant to your queer client. For example, in The Queer Mental Health Workbook, I have created a thought diary that includes columns titled, ‘Is this related to my queer identity?’ and ‘If so, in what way?’. Specific and tailored resources can help clients feel like the therapy we are offering is appropriate to them, and the act of doing this sends a powerful message: ‘I see you and I see your experience of the world’.

Finally, I would ask professionals to think about their own position of influence and power in the world. How can you lobby for change in your professional organisations? How can you have positive influence in the systems and institutions in which you work? How can you elevate the voices of those who need it most (or recognise which voices are missing)? ‘Power’ is a word which therapists are taught to think carefully about, and I leave you with the latter part of a quote from Desmond Tutu, ‘If an elephant has its foot on the tail of a mouse and you say that you are neutral, the mouse will not appreciate your neutrality.’ If you are neutral, you side with the oppressor, and that is not what allyship is about.Ìý