THE BLOG

Are You 'Coming Out' as You Are?

07/05/2013 16:08 BST | Updated 07/07/2013 10:12 BST

In what seems like another life, I was a medical student in the mid-80s. The New Romantic movement had only just begun its steep decline, along with my spiked-up straw-dyed hair. Around then, one of my clinical tutors died from Aids. Fellow students whispered that he was gay and "promiscuous". So then, otherwise caring people were implying that he deserved to die from HIV. "These are future doctors, God help us", I thought. They were dark days. Not only were we a decade away from learning to survive this plague, but the epidemic of stigma and fear was also triggering all kinds of unhelpful responses, such as calls for sexual abstinence.

One thing that really shocked me back then was how little the community seemed to care about gay school students killing themselves. The homophobia and related bullying (e.g. for gender non-conformity) that they were experiencing was intense, pushing - as it did - huge number of teenagers to the edge. One well cited US study showed that nearly three out of 10 gay teenage boys (average age 15) had attempted suicide according to a 1987 survey, although this figure could go as high as four in 10 in other studies. I clearly remember thinking "How is this different to child abuse?"

Community attitudes to gay youngsters are now changing out of all recognition. Survey after survey shows steep declines in levels of homophobia in communities, to the extent that thoughtful people are shocked about homophobic bullying in schools. For instance, hundreds of people have posted YouTube videos trying to reach out to sexual minority teenagers before they attempt suicide, with the message 'It gets better". Obama, Google employees and even the actor behind the killing machine, Sylar, out of the Heroes series, have all posted messages. This 180 degree turn around in community attitudes is astonishing. What made the difference? A new story was told. In fact, one of the most successful stories to emerge out of the 20th Century: The "coming out" story.

Now, firstly, if you worry whether this story is true or not, you've missed the point. As one famous writer said: "There is no longer any such thing as fiction or nonfiction, there's only narrative". Who knows if the riots at the Stonewall Inn Bar in New York in 1969 - sparked by a police raid - really were the dawn of gay liberation. Of course, there had been other gay riots before then, but this one at Stonewall was at the right time, in the right place. It created a flashpoint for public sentiment, sparking off events that would eventually shame (at least) the secular Western public for its strange fixation on homosexuality. By 1973 psychiatrists were politically forced to drop homosexuality as a disease category from their diagnostic manual, lest they draw unwanted attention to themselves.

It became possible for the first time to imagine that a class of people made illegal and pathological by a label could fight back. The hope was that coming out would promote pride and acceptance. And the trickle eventually became a flood. Now, every reality TV show has to have a resident gay. And straight school boys sit on each other's laps referring to each other as "lover" and "boyfriend". Suddenly, it is hard for people to fathom why marriage is not equally available. The coming out story could not have been more successful.

In research I have conducted at the University of Westminster in collaboration with the University of Oxford on contemporary patient experiences of depression, we have been taken aback by how closely the coming out story resonates with the language and experiences of modern day people with depression. As with sexual minorities, people with depression frequently talk about feeling vaguely "different" to others from childhood, "I would sit with other people, other children, and it was as if I was on the edge", said one woman. And like the internalised homophobia faced by sexual minorities, the inner stigma associated with mental illness has to be faced too: "I had very little sympathy for myself, I think the stigma started with myself," said another woman. There is even a depression "closet" where the true self is hidden away, and "it's like having a secret", as many people we interviewed pointed out.

In line with the coming out story, people talked about coming to better accept themselves in time. As one person put it "By the time I came out [of hospital], I thought, you know what, I've got nothing to be ashamed of." Mirroring the sexual coming out story, people talked about how the stigma of depression was in decline, or as a young women said:, "Prozac is quite a fashionable antidepressant". Furthermore, people talked about their struggle to not only ditch the shame, but to feel pride in themselves "[Depression] can make you extremely strong and something perhaps to be proud of, if you can make that transition." One woman echoed the more militant arm of gay liberation, saying "I'm very out" and "...explode it [stigma] whenever you can I say".

In conclusion, I am not advocating that people with depression or other mental health problems "come out". This is already happening. I just want to note that the possibilities of people better accepting themselves and defying community stigma to cherish who they are, as they are, is one hell of a story. May it be as triumphant as the story that began that defiant night at the Stonewall Inn.