Stages in "Coming Out" Process for GLBTQ Persons

Sexual Identity: The Cass Model

Identity Confusion: "Could I be gay?" Person is beginning to wonder if "homosexuality" is personally relevant. Denial and confusion is experienced.
Task: Who am I? - Accept, Deny, Reject.
Possible Responses: Will avoid information about lesbians and gays; inhibit behavior; deny homosexuality ("experimenting," "an accident," "just drunk"). Males: May keep emotional involvement separate from sexual contact; Females: May have deep relationships that are non-sexual, though strongly emotional.
Possible Needs: May explore internal positive and negative judgments. Will be permitted to be uncertain regarding sexual identity. May find support in knowing that sexual behavior occurs along a spectrum. May receive permission and encouragement to explore sexual identity as a normal experience (like career identity, and social identity).

Identity Comparison: "Maybe this does apply to me." Will accept the possibility that she or he may be gay. Self-alienation becomes isolation.
Task: Deal with social alienation.
Possible Responses: May begin to grieve for losses and the things she or he will give up by embracing their sexual orientation. May compartmentalize their own sexuality. Accepts lesbian, gay definition of behavior but maintains "heterosexual" identity of self. Tells oneself, "It's only temporary"; I'm just in love with this particular woman/man," etc.
Possible Needs: Will be very important that the person develops own definitions. Will need information about sexual identity, lesbian, gay community resources, and encouragement to talk about loss of heterosexual life expectations. May be permitted to keep some "heterosexual" identity (it is not an all or none issue).

Identity Tolerance: "I'm not the only one. " Accepts the probability of being homosexual and recognizes sexual, social, emotional needs that go with being lesbian and gay. Increased commitment to being lesbian or gay.
Task: Decrease social alienation by seeking out lesbians and gays.
Possible Responses: Beginning to have language to talk and think about the issue. Recognition that being lesbian or gay does not preclude other options. Accentuates difference between self and heterosexuals. Seeks out lesbian and gay culture (positive contact leads to more positive sense of self, negative contact leads to devaluation of the culture, stops growth). May try out variety of stereotypical roles.
Possible Needs: Be supported in exploring own shame feelings derived from heterosexism, as well as external heterosexism. Receive support in finding positive lesbian, gay community connections. It is particularly important for the person to know community resources.

Identity Acceptance: "I will be okay." Accepts, rather than tolerates, gay or lesbian self-image. There is continuing and increased contact with the gay and lesbian culture.
Task: Deal with inner tension of no longer subscribing to society's norm, attempt to bring congruence between private and public view of self.
Possible Responses: Accepts gay or lesbian self-identification. May compartmentalize "gay life." Maintains less and less contact with heterosexual community. Attempts to "fit in" and "not make waves" within the gay and lesbian community. Begins some selective disclosures of sexual identity. More social coming out; more comfortable being seen with groups of men or women that are identified as "gay." More realistic evaluation of situation.
Possible Needs: Continue exploring grief and loss of heterosexual life expectations. Continue exploring internalized "homophobia" (learned shame for heterosexist society). Find support in making decisions about where, when, and to whom he or she self discloses.

Identity Pride: "I've got to let people know who I am!" Immerses self in gay and lesbian culture. Less and less involvement with heterosexual community. Us-them quality to political/social viewpoint.
Task: Deal with incongruent views of heterosexuals.
Possible Responses: Splits world into "gay" (good) and "straight" (bad). Experiences disclosure crises with heterosexuals, as he or she is less willing to "blend in." Identifies gay culture as sole source of support; all gay friends, business connections, social connections.
Possible Needs: Receive support for exploring anger issues. Find support for exploring issues of heterosexism. Develop skills for coping with reactions and responses to disclosure of sexual identity. Resist being defensive!

Identity Synthesis: Develops holistic view of self. Defines self in a more complete fashion, not just in terms of sexual orientation.
Task: Integrate gay and lesbian identity so that instead of being the identity, it is on aspect of self.
Possible Responses: Continues to be angry at heterosexism, but with decreased intensity. Allows trust of others to increase and build. Gay and lesbian identity is integrated with all aspects of "self." Feels all right to move out into the community and not simply define space according to sexual orientation.

According to the UNC Safe Zone (2001)

I believe that when working with GLBT persons it is important to understand where someone is developmentally and provide nonjudgmental interventions. I hope this is helpful and have a great Pride month!

Barry Aneda, MS, NCC, LAC

Ask an Expert - Visit my Virtual Office at Kasamba

Sleep and the Bear Gay Community

Sleep is a dynamic process that our brain and body needs for physical restoration and proper mental processing. According to Fadia (2002), the amount of sleep that is necessary depends on a number of factors (age, weight, etc.) Infants require about 16 hours of sleep while teenagers require around 9. For most adults, about 7 or 8 hours of sleep tends to be the average. However, there are some adults that require as less as 5 hours a night and as much as 10 hours of sleep per night. In addition the amount of sleep a person needs will also increase if that person has been deprived of sleep or experiencing sleep deprivation. This causes sleep debt. This means that when a person is deprived of sleep that sleep must then be made up (2002). Many people are able to notice the difference between a good night sleep and waking up feeling sleep deprived. However, those who have constantly had to deal with sleep deprivation developed a conditioning that overtime became normalized. They were unable to determine that sleep deprivation had caused and continues to cause impairments in their judgment, reaction time and/or in their overall functioning. They simply have come to believe that this is the way it is for them. This process has been noted in larger heavier individuals that have been heavy most of their lives. Thus, this article will focus on sleep disorders and gay men in the bear community in order to increase awareness regarding the health risks posed by sleep disorders in the GLBTQ community.

Sleep Apnea: A Common Sleep Disorder Affecting the Bear Community

What is Sleep apnea? Sleep apnea is a sleep breathing disorder that causes severe sleep deprivation by interrupting sleep and collapsing the windpipe. This occurs because of a build up of extra tissue in the neck area from weight gain. Men tend to gain weight in their neck and have thicker, heavier necks. When we fall asleep our muscles relax throughout our body. When our throat muscles relax the weight of the neck, along with attempting to inhale causes the windpipe to collapse and become blocked. When this occurs the individual must wake up to regain his muscle tone in order to open the windpipe and breathe. This occurs for just about three seconds before returning to sleep and usually the individual is unaware of waking. However, some individuals may have awareness that their sleep is very restless. They may even wake up coughing from a dry throat. The number one sign that one may have sleep apnea is snoring. Everyone that has sleep apnea snores. However, everyone that snores may not have sleep apnea. Additionally, if one’s neck is greater than 17 inches then there is a greater risk of having or developing sleep apnea.

Sleep apnea can be very dangerous as it deprives the body of oxygen and results in chronic sleep deprivation and disease if not treated. Symptoms such as morning headaches, loss of sex drive and a decline in mental overall functioning (loss of concentration, memory deficits, etc.) could be signs that you have sleep apnea. Sleep deprivation clearly also has an effect on our mood and can lead to experiencing symptoms of depression and irritability. This can affect your performance at work and/or your personal relationships with your partner(s) and family. Additionally, sleep apnea can put one in a higher risk category for stroke, hypertension, and heart attack. It also can suppress the immune system influencing how efficiently the body fights infection. Thus, sleep apnea can lead to an increase in one’s viral load and decrease T-cells if HIV positive.

Diagnosing in the Sleep Lab and Treatment

In order to find out for sure if you have sleep apnea, you need to be evaluated by a physician. Your primary care physician can refer you to a sleep specialist that can order an overnight sleep study. A sleep technologist will then apply sensors to measure your sleep stages, eye movements, heart rate, breathing, muscle tone and leg movements and oxygen levels and then fit you with a mask for the CPAP. CPAP (Continuous Positive Airway Pressure) is a device that blows air in your airway to create pressure that lifts the soft throat tissue off of the airway allowing it to stay open. You should get a chance to practice with the mask before going to bed. So talk to your technologist about the proper fit of the mask. There are a number of choices to choose from. It is important that no air is able to escape through the sides of the mask when wearing it. If there is, then tell your technologist. After going to bed, the technologist will monitor your sleep for the first half of the night in order to get a baseline of your sleep. If the technologist assesses you as meeting the criteria for sleep apnea, he or she will put on your CPAP mask and turn on the CPAP machine. It is important to note that this treatment is non invasive and is part of the overnight study. After the study, your results will be ready in about two weeks or so. At that point, schedule an appointment with your doctor to discuss your test results as well as treatment options besides CPAP.

Conclusion

Sleep apnea is a very common sleep disorder and has been known to cause accidents in the workplace resulting in lawsuits and personal injury. So if you believe you are at risk for this sleep disorder, talk to your doctor or health care professional. Relief could be just around the corner. We value our Bears. You deserve it and you are worth it!

References

Fadia, V. (2002). Insomnia, Sleep Apnea, Narcolepsy. Homestead Schools, Inc.: Torrence: CA.

Barry Aneda, MS, NCC, LAC is a counselor that works with clients with HIV/AIDS and substance abuse/addiction struggles. I also have an online virtual office, just click the link below.

Ask an Expert - Visit my Virtual Office at Kasamba

My webpage is www.myspace.com/barryaneda