Sex, Drugs & Science

Ryan Watson: Sexual & Gender Diverse Youth

January 27, 2021 Valerie Earnshaw & Carly Hill Season 1 Episode 14
Sex, Drugs & Science
Ryan Watson: Sexual & Gender Diverse Youth
Show Notes Transcript

Dr. Ryan Watson is an Assistant Professor of Human Development and Family Sciences at the University of Connecticut. Ryan’s research focuses on reducing health disparities among sexual and gender minority (SGM) youth and young adults. Ryan talks with Valerie and Carly about how terminology used by sexual and gender minority individuals changes over time (especially among youth), the role of minority stress in health, and how parents can buffer or protect youth from minority stressors. Ryan and Valerie nerd out about their interests in disclosure and time.

Read more about Dr. Watson’s work here:

Follow Dr. Watson on Twitter: @DrRyanJWatson

I’m Valerie Earnshaw 

 I’m Carly Hill 


And this is Sex, Drugs and Science. Today is episode three of three of our short winter season. 




Yeah, so happy news that there was a winter season, sad news that this is the last one. But happy news again! Because today we’re going to share a conversation with Dr. Ryan Watson who is an assistant professor of Human Development and Family Sciences at the University of Connecticut. And Ryan is focused on reducing health disparities among sexual and gender minority youths and young adults. So please, enjoy. 


Valerie (00:00:04):

Dr. Ryan Watson, welcome to sex drugs in science for so thrilled to see your smiling face this morning. Yeah.

Ryan (00:00:13):

I'm very happy to be here.

Valerie (00:00:14):

Yeah. Usually we're in a writing group, I think with Lisa Eaton who was in season one. And I think we had did that writing group for like a year and a half or two years. And then Lisa moved the time to purposefully cut me out of the right writing group. I finally figured it out. I think you guys all got together and you were like, okay, what time can Valerie not make it? Let's put it on time.

Carly (00:00:40):

Val can't sit with us anymore.

Ryan (00:00:44):

You're getting too famous with this podcast. So we had a branch off and find out

Valerie (00:00:49):

It was really a jealousy thing.

Carly (00:00:50):

It's intimidating here, to be with an international superstar like Valerie Earnshaw.

Valerie (00:00:56):

Carly's favorite thing is that there's someone in France who listens to this podcast. I mean, there's actually people on pretty much every continent who listens to the podcast, but her favorite person is like this made up persona.

Carly (00:01:10):

This person in France who made us the international sensation that we are today. So again, I'll say thank you, French listener for making us an international sensation.

Valerie (00:01:20):

She's really amused. So Ryan, a lot of your work focuses on sexual and gender minority youth. And I thought that we could take a beat to just talk terminology. So I'm a little bit curious as to, you know, there's a lot of, there's a lot of choices here when it comes to terminology. So, um, why do you use the term sexual and gender minority and sexual gender minority youth when you're, um, doing your work and describing your work?

Ryan (00:01:47):

Yeah, that's a great question. I was just talking to a reporter about this and I think reporting a lot about this because they talk about the population and it's important to be accurate and, um, it's changing. And so it's a good question. When I started doing the research, we, the term I knew was LGBT, um, and this was 10 years ago and, and people started saying LGBTQ at the time and I quickly was aware and doing my initial research, that the T in LGBT is actually very different than the LGB and the Q. So lesbian, gay, bisexual, and transgender. And so most people may know that LGB lesbian, gay, bisexual is sexual orientation. And so those are the, those who we have romantic attractions to, or have sex with. Um, and T is gender identity. And so how we identify our gender, usually it aligns with our sex assigned at birth, sometimes it doesn't.

Ryan (00:02:41):

Um, and so what I learned quickly was that T was grouped with LGB and Q and we hear other acronyms, like I a, um, you know, there's a lot of different versions and, and they do that, uh, because this is a group that has faced various similar discriminations, um, health problems, um, victimization experiences. And so they, uh, that these groups of people, uh, are, it's very different. These concepts are very different, but you can have someone who's LGB and T um, you could be a gay transgender person. And so that's when I first learned about the term and quickly became aware that it's really not a homogenous group. There's a lot of difference in this, um, and this, in these terms that we use. And so what I found out as I started studying this is that, uh, scholars, it's mostly like a researcher term, I think, um, use SGM, sexual, gender minority, and even the national institutes of health.

Ryan (00:03:42):

Uh, one of our largest government funded, um, agencies or taxpayer funded agencies also has adopted this term and uses this to describe LGBTQIA plus individuals. And so sometimes I'll say, I mean, to, for ease of things, I can say I'm studying populations who are not heterosexual. And so anyone who has not heterosexual, so they could be gay, they could be, um, queer, they can be pansexual. Those are the folks I study. Um, there are other terms people are using now. I was just on a national Academy of sciences webinar, where they released a new report about the health and wellbeing of LGBT people. And so they reviewed all the literature and they, as some of the leaders in the field got together and did this, and they were using the term sexual and gender diverse instead of minority.

Valerie (00:04:32):

Ah, okay

Ryan (00:04:32):

So minority, a lot of people think now it may not be the best term because nobody wants to be labeled a minority. Like you don't want to be thrown in your face that you're not the majority. And so there's a lot of terms. Uh, I think the most widely used term now is sexual gender minority. And so I use them interchangeably sometimes. Um, but I just SGM really does encompass the sex, the sexual and gender aspects of the diversity in identities. And so, yeah,

Valerie (00:05:00):

And it's nice, cause it's like, it's a broad catch. All right. Because some of your work has, um, suggested that there's so much diverse identities within that. And so, I mean, Carly was saying earlier that what was it pride two years ago?

New Speaker (00:05:16):


Valerie (00:05:16):

So it was like 2019, right?

New Speaker (00:05:18):

Yeah. So it was like pride two years ago was the first time that I heard like the LGBTQIA plus. And then that sort of like, didn't catch on, you know, I dunno if that's like the way I want to phrase it, but it's not really the term that you hear most often. And then I was also telling Valerie that, like I identified as, someone, I think even you might even have been at pride as . And they were like, no, you're a lesbian. And I was like, well, okay, like sounds like cooler. We decided, it sounds like punkier, you know, and I mean, I was like...

Valerie (00:05:49):

Yeah like punk rock

New Speaker (00:05:49):

Oh, okay. And then it, you know, becomes like, uh, you know, anyway, I landed on lesbian, but it was just like, even like that journey of just like kind of sifting through the terminology to see like, what feels good for you is, you know, one thing, let alone trying to find a term that encompasses like the entire community as a whole, you know, but I think SGM is that, that balance.

Ryan (00:06:15):

You're right. So it's really attuned to one of the papers. I think Val just mentioned was, um, one where we found a large diversity of sexual identity labels among a contemporary sample of young people. And so, um, if you, you know, of course, LGBTQIA, even, which is progressive (as it just came out two years ago) as you say, the first time you heard it, um, it does not capture P pansexual or other identities D demisexual, um, you know, other, uh, labels that are catching on, if you will, not necessarily identities that are new, like these, they're not really new concepts. It's just, we have words now that we can, uh, describe them with and people can understand that they are legitimate identities. And so I do like this umbrella term that can be respectful of acknowledging there are many identities, but at the same time, not erasing, uh, identities that many people hold while trying to describe a population.

New Speaker (00:07:13):


Valerie (00:07:15):

I was impressed. I think it was like 26% of your sample. And it was a huge sample. Just fell into identities that were, I think you called them like emergent identities. Like they're not ones that are maybe out there in the literature. They're certainly not the like LGBTQ identities. And it reminded me of some work suggesting like young people are language innovators, and they're also, they just like kind of push the envelope. And so this really struck me as that as this kind of like language innovation, identity innovation. And I was like, I was like, once again, young people are saving, (laughs) saving everybody.

Ryan (00:07:54):

So I did my post-doc, um, in, in, uh, Vancouver, Canada at the university of British Columbia. And we, when I was there collected data from young people in schools, um, they're in high school. And the first thing I think of is those youth were being critical of our questions. And so we were like the researchers and they were like this question, and we, you know, we were sexual gender minority researchers and they were like, this question is not inclusive. Like, I don't identify with any of these, why don't you have this listed? And so you're right. That youth are really pushing forward and are on the cutting edge on know the ones moving forward the movement. Whereas sometimes we think of, I mean, of course we should acknowledge the amazing work that many people never do of like, of Stonewall and pre Stonewall, all that work that people did for visibility for this population.

Ryan (00:08:40):

Um, but almost I think like youth are like, thanks for doing all that. But like, I don't identify as lesbian or gay. Like now I'm, you know, we have new terms. And so I sometimes think of that. That's like a, there's these amazing things youth are doing, um, on the backs of all the amazing things people have done in the last few decades. Um, but you're right, you guys are really pushing us these identities forward. So the data set, you mentioned, um, this paper that I, that we published was the first out of a data project that my team partnered with the human rights campaign, which is, uh, an organization you may, people have heard of it. They have like a bumper sticker that has an equal sign on it. You see those all over the country. Um, they really were, they're a nonprofit and they were instrumental in passing, uh, same-sex marriage.

Ryan (00:09:23):

They have a lot of lawyers and they get tons of money and donations. They do really good work and they haven't traditionally been a research organization, but they have done research their own research, um, for the last, you know, for, for awhile. And so we partnered with them to kind of add like a rigorous scientific approach to studying LGBTQ kids and, um, like using scales, using validated instruments to be able to, um, really be sure that what we were measuring was, you know, we were doing best practices and measuring some of these constructs that you think of. Whereas the previous work they had done didn't necessarily use like the Beck depression scale, you know, or things that we had used. And so we, I think at least, and I think they would agree that by partnering with us, we were able to access large amounts of youth and also add scientific rigor to the way we measured these constructs.

Ryan (00:10:15):

And so they, um, were able to connect us to tons and tons of 17,000 actually young LGBTQ kids, age 13 to 17. Um, and in that, the, one of the first findings we reported from this dataset were that there was just such a, it was such a heterogeneous group of youth. Um, there were, as you said, uh, 26% of what we called emerging identities or emergent identities, and we called the other's traditional.

Valerie (00:10:42):

Hmm, okay

Ryan (00:10:42):

What we mean by traditional is lesbian, gay, bisexual. We've heard these terms for decades and decades. Um, I think almost everyone knows what that means, but, but even what I find interesting is like some of my colleagues, some of the smartest people, I work with professors who have been in the Academy for, for decades. Um, or again, some the smart people I know, but are, or like, what does that term, I've never heard it yet...

Ryan (00:11:04):

Thousands of kids said that they identified with this term. So it shows you that things are moving quick. Not everybody is an expert in all of the terms that are out there. Um, and so this, so this paper helped us document that, that there are, uh, um, shifts in language and youth are using these new terms. And if we continue to measure health for LGBTQ people, and we aren't aware of these changes, we're going to not be able to capture nuances that we might see across these various important identities. One of the biggest, one of the most, one of the ones I was most surprised about, not that it existed, but that it exists in such great numbers, was the identity of pansexual. And I think we'll probably talk about what some of these terms mean, um, in a bed, but that was, I was just like, wow, there were, there was more than 20% of the sample identified as pansexual, which I was very surprised at that, you know, that, that many kids endorsed that identity

Valerie (00:12:01):

So, so what is pansexual or what does that identity mean to the, to the young people who are identifying with it?

Ryan (00:12:08):

That's a really good question. So I'll give you a, an anecdote, like a, actually an ex, uh, a story that I was at the human rights campaign, time to thrive conference. Um, and so they have a youth conference that's youth focused, and I was presenting this data to a group of parents, uh, very active parents who wanted, who wants to change the world and who have kids who are queer. And I just used a term. I used the term queer right now to mean sexual gender minority. Um, so there, of course, again, like the terminology is all over the place, but they all them have, have kids who are sexual or gender sexual and, or gender minorities. Um, and they asked what does demisexual mean? And I was caught off guard because a lot of kids identify differently and there are, you know, definitions that, that HRC or the Trevor project or other organizations that help LGBTQ people have.

Ryan (00:12:56):

And there are like some consensus around these things. And so what I define right now may not be for every kid and what they, what they think of pansexual. When I hear pansexual, I think of kids who don't think of the binary, who aren't saying, like, I only like gay men or boys, or I only like, um, one gender, a pansexual person might just like people. They like people of all genders, whether they're male, female, non-binary trans, um, it's someone who's looking beyond our socially constructed definition and views of sex and gender and love. And they're just saying, look, I'm not only gonna say I like boys. I'm not, if, if I'm a man and I only like, why I just, not that only like, I'm, it's not the only like boys. So I'm gay. It's that? I just like people. And if I ever romantic attraction to you, uh, who knows what gender you might be.

Ryan (00:13:48):

I think of that more as pansexual people sometimes confuse it or conflate this pansexual identity with bisexual identity and bisexual to me implies historically more of a binary that not for all people, bisexual people can identify as bisexual and not recognize a binary, but, but historically people have thought about you're bisexual. You like both males and females, which does erase, you know, that bisexual people can like non-binary people or people who are not male or female. Um, but historically I think people have thought, um, laymen had thought that that bisexual was like, Oh, you like both, but pansexual the word pan. I think I like all, you know, not just males or females, but everyone.

Valerie (00:14:34):

So this, so it's, it seems like as a researcher, it might be challenging to, to measure people's sexual and gender identities overall. But then when you add on the extra, like layer of youth and this like language innovation and this, like, I don't to maybe be put into a box, but it might become like extra challenging one could argue. So how have you thought about measuring these constructs, these identities within your research and sort of what kind of, um, is it different for youth versus adults? Do you take the same sort of tactic or what do you, what do you do? What do you recommend?

Ryan (00:15:13):

Yeah, that's a great question. So I've mostly worked with youth, um, my most recent research doesn't, um, so I mostly can speak to a youth measurement of sexual orientation and gender identity. And so I think of, I think of a few things. One is that for decades, the only way that surveys asked about sexual orientation, quote unquote, is, uh, was it through attraction? So in this, in one of the, the best datasets we have to, to look at youth over time, it's called the national longitudinal study of adolescent health. And it's referred to as ad-health. Um, this started in 1994. And so quite a while ago now, and at the time it was too taboo and too contentious to ask on a survey for children, are you lesbian or gay or bisexual?

Valerie (00:16:02):


Ryan (00:16:02):

And so they didn't. Yeah, they didn't ask us.

Valerie (00:16:04):

I realize I didn't realize that that was the reason it wasn't in there. It just was like, it freaked people out in the nineties to ask that, wow,

Ryan (00:16:12):

Okay. That's what I've heard from my mentors. And

Valerie (00:16:14):

No, I think that's, yeah, no, that really checks out because like, if you look at, um, you know, we been working on a paper together and one of the things that we're thinking about is how quickly does stigma change over time and some of these attitudes change over time. And so if you look at like some people's attitudes surrounding sexual and gender minorities in the nineties versus the late 2010s, like it's, it's a wild, it's, it's really changing quickly. So, um, I mean that's well within my lifetime and I'm not surprised. I mean, to hear that there might be some change,

Ryan (00:16:49):

I I'm too. Yeah. I mean, the nineties, I was growing up in middle school and high school or middle school and like, I don't even remember it. Yeah. I mean, I wasn't in research and I wasn't even thinking that, that like we were alive at that time and we were, I was going through that. And so it's interesting even to think about that, to see where we are today, I tell my class that, um, uh, that like same-sex rights and marriage and equality has moved quicker than really any kind of social movement we've seen. And it's so, uh, it's amazing in a lot of ways. And so at that time, when ad-health was around, folks did not. And, and on government surveys on government run surveys, which are we also utilize still today, um, they didn't ask identity questions. So there's two other ways you might be able to get at someone's sexual orientation.

Ryan (00:17:37):

Uh, you could the first way you usually think of a sexual identity. So you ask them, are you lesbian, gay, bisexual , pangender, or sorry, pansexual or straight, um, or, or something else. Um, and that's what we, most of us think when we think of sexual orientation, but like I said, they weren't asking that in the nineties and definitely not before that. And so instead they would ask about sexual attraction, um, and this is another component of sexual orientation. And so they would ask, you know, early on in the survey, they would ask the kids, are you a boy or a girl? Um, and then later in the survey they would ask, are you attract, are you romantically attracted to boys or girls or both, or neither? I don't, I'm not sure if they had an either option in that survey. Um, and that was a way that for, for over 10 years and still today, people use that data that we would call those kids who had attractions to the opposite.

Ryan (00:18:27):

We would say at that time, cause they only asked about boys and girls. Now we would say maybe the other, because we know that there are more than just boys and girls. Um, we would, uh, we would say, if someone's interested, if someone's attractive to the opposite sex, they are sexual minorities or sexual, you know, say, yeah, that's term we've been using are they're LGB, T Q. Um, and so that was one way that we've said it, um, or that we measured it at one time. And the other way is to, is to ask about sexual practices. Um, and so do you have sex with, uh, people of the same or other, uh, gender and they didn't ask kids that, I mean, that's, that's usually more contentious as kids. Of course we usually get, um, you know, we were careful around the questions we ask as we, we asked adults that all the time, um, and in the surveys I do.

Ryan (00:19:14):

And so in my, in this HRC human rights campaign survey, uh, we asked all three components, which I think is a very, a very good way to do it. Oftentimes when people are doing research, they don't have that much, uh, space to ask, you know, tons of questions about all different kinds of identities. And so it's not possible for people to always ask these three components, but so one of my personal interests is to see the, um, what's the right word. I, don't not continuity, but the, um, like, just to see if the, if there are, if there are, if you're the same across the board for all three components. And so might there be kids who are attracted to this, the same gender, but have never had sex with the same gender, but actually call themselves straight. Um, or th this is reminds me of some of the hookup research I do.

Ryan (00:20:09):

And someone wrote a very influential, a sociologist wrote a book called, uh, Dude Sex Among Adults.

Valerie (00:20:16):

Dude Sex?

Ryan (00:20:16):

but it was guys who have sex with guys and consider some, consider themselves straight. They are straight. They believe themselves to be straight, but they are sexually fluid. There are having sex with the same gender. And so that, that, I mean, we've probably talked about that for the whole podcast. So what are they like are who are we as a society to put labels on, people will ask, are they in the closet? Are they actually gay? And is it even our role that you question those things or say those things? And so you're able to get at that with these three components. And there are people who are discordant, that's the word I was looking for concordance or discordant on these three, uh, identity, uh, orientation questions. Uh, and so I think a lot about that and that's right.

Valerie (00:21:02):

Interesting. And the three, what, just so that I'm getting them all. It's it's how do I identify? So how I might, I label myself it's who am I attracted to? And then it's who, who do I have sex with? Or who do I have these interactions with? Okay.

Ryan (00:21:16):

Three components I would say of measuring operationalizing sexual orientation.

Valerie (00:21:21):

Yeah. Three questions is not a lot. I mean, if you're, you know,

Carly (00:21:25):


Valerie (00:21:25):

I can understand when you're at a premium, but three questions is not a lot given the complexity of, of, of this, you know, the complexity of sexual and gender identities and everything.

Carly (00:21:40):

And it's also interesting to me that we're still, um, I don't know if either one of you, I think this is like the third time I've brought up this show, but the show, ER, from like the nineties into the two thousands, that was like my jam. And also the first exposure I had to like anyone remotely queer in the media. But I remember, uh, even before Carrie was the main character that ended up being a lesbian. But before all that, there was this episode where they had, uh, patients come in and they made, um, I think the issue was that one of them was HIV positive.

Carly (00:22:08):

And the question of like, where did they, you know, contract that came up and it ended up being, um, you know, exactly what you're saying is that it was, um, you know, men who have sex with men who identify as straight and it was like, the doctors were all trying to wrap their heads around like, well, no, you know, like that's not real. And like, it was like the whole thing for this whole episode is just so funny. Cause I think the episode probably aired in like 1996 and here we are still, you know, trying to get to like the root of, you know, not maybe not the root of that, but like still trying to like measure that and, and understand it and like, you know, wrap our heads around it. But,

Ryan (00:22:44):

And I think there's two things I was thinking as both of you spoke. And the first is that I think what's hard sometimes for people too, to get their head around or it's, it's sometimes you're like, am I going to ask three questions about sexual identity? Which, I mean, this is what I do for a living. So I find it very important. When the majority, the vast majority of Americans or, you know, people living in the world are not SGMs, LGBTQ. And so sometimes people think like, well, why would I ask those questions? And so I usually respond with, well, w when we learn, I think we'll get into this some of the worst or some of the broadest health disparities and problems in health are found among this population. And so if we could just ask two additional questions or three additional questions to understand somebody's identity, that is well-documented, it's real documented that these identities are what explain or not, not necessarily explained, but are associated with, or we might see, um, when we're looking at problem and probably, you know, uh, problematic health outcomes, then maybe we should, I mean, it is, um, incumbent upon us to really accurately measure these identities.

Ryan (00:23:50):

And you might also think like, well, you know, we don't have great estimates. People say one in 10, uh, folks in the country are our SGM-- sexual gender minorities. Um, some people think fewer studies shows fewer, but other studies say more, but there, when we do the best data we have about, uh, sexual behavior and sexual attraction, is that more perhaps than this 1 in 10, uh, especially among women are interested in, or do have sex with the same gender. And this goes back even to Kinsey. I mean, this was groundbreaking when they didn't want Kinsey to release his research, um, that like more people than you would ever imagine are interested in or having sex with the same, uh, gender, uh, and are not telling people because it's taboo because it's emasculating because it's, you know, against religion and, uh, religious values. And so to me, if you know, the gold standard would be to have a nationally representative data set, you could generalize to everybody. I would bet money that we would see, uh, probably substantially or significantly more, uh, people say that they have had sex with the same gender, or want to have sex with the same gender then are actually identifying as not heterosexual. And that in itself, I think is, is note-worthy to study and think about

Valerie (00:25:07):

Absolutely. And, you know, just given what we were just talking about with social change, I mean, more and more people will admit to having engaged in sex with people at the same gender or they'll, they'll respond, you know, more accurately with time as the stigma decreases as the extent to which this field tab, this feels taboo decreases it's even like some of those estimates, like, Oh, 10%, like, well, if that was taken in that early two thousands, like who knows if that's accurate, like there was a big barrier to people answering those surveys. So yeah, we need that nationally or, you know, worldwide representative representative study, and we need it today.

Carly (00:25:47):

We need it like with today, yesterday,

Ryan (00:25:51):

And this is a big fight of, uh, people who, I mean, I remember Laverne Cox was really advocating recently to get sexual orientation questions or same-sex marriage questions on the census and their shifts with administrations. And like, do we want that data? Is there enough room people argue? And of course I think, and I think people might feel, think it's imperative. We need to have accurate counts of, um, you know, who's represented in our country for all identities, for, for race, ethnicity, for immigration purposes, for, you know, whatever it might be. Um, and it's just as important here. And the other thing I thought about, you're asking about how we measure this among youth. So there's the three components are important, but as Val you kind of touched at, and what folks have studied to some degree is the, um, transients. I don't know if that's the right word, but the change of identity.

Valerie (00:26:40):

The change mhmm

Ryan (00:26:42):

And we know some, some folks have looked at that study. I told you about ad-health. It's a longitudinal study. So they've followed kids since they were teenagers in 1994, even younger than teenagers all the way. They're still following them today. So they've been following for 20 or more years.

Valerie (00:26:58):


Ryan (00:26:58):

And later in later surveys, they finally asked, how do you identify? And so you can actually go back and match that up, right? To those, to the same people. And what some scholars have done is tried to trace their sexual orientations over time. And they find that it is not very stable for many people. Um, if you, of course can imagine that someone might've said that they're straight or that they are only attracted to the offered, you know, to the other opposite gender when they were a kid. And then they came out. I mean, that, that makes sense to me is that kid people are coming out so they change.

Ryan (00:27:32):

But we do see, there is a fair share of kids who said they were attracted to both genders, uh, the way the question was asked and now they're straight. And so there are, you know, and which can happen. I mean, people say this also among transgender people, um, and they it's---called desistence. And so it's like, uh, kids or, or anybody, uh, people who have made this transition who have started living as the, um, as usually the other gender or another gender, and then, um, want to go back to their sex assigned at birth. Once we go back to the original, um, and live as a person of the original of the first gender. And so this is a hot topic. Like, you know, this is a hot topic, especially among conservatives where like you're letting kids, um, you know, uh, live in the gender they want to, and it's irresponsible.

Ryan (00:28:22):

So usually the conversation around this is as a conservative one.

Valerie (00:28:25):

ah okay

Ryan (00:28:25):

but you can also think though that it's possible. We all, you know,

Valerie (00:28:29):


Ryan (00:28:29):

it's (not) necessarily a bad thing. I, you know, sometimes we are, it's okay for us to change our mind and go and change it back to what it was or whatever it might be. And so we see this in sexual orientation, we see this in gender identity, um, and that, and so that is what makes it very difficult. And that's like, I, the survey I'm telling you about the HRC survey is cross-sectional, so it's just one snapshot in time. So on that day in 2017, when that person and the kid answered my survey that day, they identified as pansexual or, or as gay. And I know for a fact, well, I mean, I, I can't verify it, but I'm, I would bet money that in any year or even today, or in 10 years, that, that, that those same, that all those kids will not identify the exact same way.

Ryan (00:29:13):

And that's what is challenging and doing this kind of research is that it's hard to track over time, and it's hard to, uh, watch the progression or the changes in these identities. And that's important if you want to understand health over time, but in the studies we publish, we're explaining somebody has experiences in health at that same time when they identified at a certain way. And so it makes it a little less complicated because, you know, there may be changes and we're just not able to document that and the kind of research that most psychologists conduct,

Valerie (00:29:45):

Right. Well, circling back to this idea of health and, you know, one of the reasons to really measure this well and, um, characterize it well is, um, as you pointed out, is that there are differences in health between folks who identify as sexual and gender minorities, um, and folks who don't identify that way. So what are some of these big health differences, or as we call it in the field health disparities that you see in your research and across the field.

Ryan (00:30:15):

Yeah, that's a great question as well. And unfortunately, the answer is almost every health outcome.

Valerie (00:30:21):

Oh okay (laughs) You can think of whether it be sleep, how much you sleep, whether it be depression, whether it be how much alcohol you drink. Uh, we see disparities in, um, many and most, I would say health outcomes for sexual and gender minority people when compared to cisgender, which is, um, someone we haven't defined that term yet, but it's for someone whose sex assigned at birth matches their gender identity. So if you, if the doctor said you were a boy and your parents celebrated you as a boy, and you still identify as a boy or a man you're cisgender, the majority of people are cisgender. And so this is when compared when sexual gender minorities are compared to their cisgender and heterosexual counterparts. Typically not all, but typically many sexual gender minorities have the worst health outcomes.

Ryan (00:31:07):

So a lot of my work has used big data. Um, government run data, the centers for disease control has one of the most popular data sets that scholars use is called a youth risk health behavior survey. And so this is a survey administered to thousands and thousands of kids in schools. And the government has worked with, um, data scientists to make sure their sampling is representative of all kids. And so if I say that, you know, the YRBS, the survey I'm talking about found that gay boys drink more alcohol than straight boys, you can be pretty confident that that is representative of many or all or most boys in the United States. Um, that's the kind of gold standard of research and survey research we want to see, um, and this kind of data and the work I've done consistently shows that, um, LGB most, mostly focuses on lesbian gay and bisexual identities.

Ryan (00:32:00):

So these big data sets as I've previewed, don't ask about pansexuality. Don't ask about some of these emergent terms that we've talked about, but they do ask about lesbian gay, bisexual identities. And among those three identities, we see these disparities, um, mostly in substance use. And so bisexual girls, lesbian girls, um, are smoking, are drinking, are doing illicit drugs at much higher rates than their counterparts who are not, uh, um, LGBT who are heterosexual. Um, one thing I, when I was doing my postdoc, which I talked about in Vancouver, we created this new site, this new statistical method, and I published a lot of papers with it. I didn't create it, my team created it, but I was able to use it. Um, and it's something where we, you could look at, uh, trends into end disparities over time. So this, this YRBS data from the centers for disease control that I'm talking about, they actually ask these questions every two years to use all over the United States.

Ryan (00:32:59):

And it's the same questions. And so you could look in 2000, 20% of gay boys smoke cigarettes in 2002, it was 23% in 2004, it was 18%, right. You can just imagine looking at that line, that chart of lines, where you could see going up and down like the stock market, for example, right. Um, and typically we see, uh, meaningful trends. You know, there's been a lot of smoking cessation work in the past decades. And so we've seen smoking has decreased for all youth over the last several years, but what this method does is it says it helps us compare the disparities over time. So if you can imagine that line graph, you can imagine there's a line for gay boys, and it shows you their smoking rates. And then there's another line for, for straight boys, and it shows you their smoking rates. And you can imagine there's a gap between them.

Ryan (00:33:48):

I just told you that there's disparities, right? There's a gap between how much gay boys smoke and how much straight boys smoke. And the question we asked was, is that gap, is that gap in disparity actually widening over time? Is it getting worse or is it narrowing over time? Is it getting better? And this kind of gets at like that, you know, most people have heard of the, it gets better campaign, like just way it'll get better or things are getting better. Um, and so we want, we wanted to investigate that, like, are some of these disparities that are still very, very much out there, um, are they getting better? And the findings are actually mixed for oftentimes, uh, smoke, substance use is actually getting worse for girls. Um, and we have all kinds of theories of why that might be maybe there's social pressure, um, you know, bisexual kids, uh, sometimes face biphobia, you know, stigma from both, uh, straight and people. Um, and so I, to me, this kind of work helps us identify where the biggest issues, where might we have, where's the biggest bang for our buck, if you will, because there's of course limited money to go around to help, uh, uh, improve these disparities. And so I, and I could probably talk for an hour about the differences in these, but I think what most people should know is that there are still large disparities in health, um, across the board for lesbian gay, bisexual. Uh, that's how we study it in youth.

Valerie (00:35:09):

I was particularly interested in some of these findings, you know, exactly what you're saying, where you're seeing kind of improvements in health and heterosexual or cisgender youth over time, especially like some of these substance use findings. It makes me think a lot about exactly as you brought up smoking. So I was at a conference recently where someone basically said, you know, we've, we're done with smoking. Like we have like checked that box on smoking cessation and, you know, and they were basically, I mean, the underlying argument here was, was we used stigma against smoking and people stopped smoking, which is like an over simplification, but they were like, should we do the same thing with opioids? Should we ramp up stigma towards people who use opioids to try to prevent people from using opioids, which is like flaw...It's a flawed argument in a lot of ways. So we can put that to the side. But one of the things that really struck, stuck with me about that was this idea that, well, we only have solved smoking if we like don't count these like health disparity populations, including like a lot of sexual and gender minority youth and adults who smoke at much higher rates than others. So like we only, when smoking, if we don't care about that, or if we don't care about this population's health. And I just, I always think, I always think about that with a smoking argument,

Ryan (00:36:31):

Right. I mean, and that's been the trope or like the argument for researchers is like, your people are not caring about these, about a substantial segment of young people and all people. Um, and I think especially among young people who have the most to lose who could get kicked out of their houses, who can't support themselves. Um, and so it's almost like, well, I guess we have to give up on them then. And so a lot of this is like, um, indicative of the overall shift in the field of developmental science, around LGBT people for, for the night in the nineties and the early two thousands, almost everyone focused on this deficit, negative, risky aspect of health. And, you know, most people would say, LGBTQ people are at risk. They are, they have bad health, they need help. And we've really shipped in the last decade to looking at asset driven, protective factor work.

Ryan (00:37:22):

And so, um, what can we do? You know, instead of just documenting all these negative trends and all these negative disparities, um, what is it that we can leverage, maybe parents, maybe laws, maybe, um, environments that have more gay flag or pride flags, um, more gay, straight alliances or gender sexuality alliances. That's what a lot of scholars now we're looking at, which is what, how I've shifted my own work and is, uh, I think the key to, I mean, we can't overnight just eliminate all the disparities. And even if we keep measuring how many disparities there are, it's good to know, but the next step of course is to do something about it. Um, and, and a lot of folks are trying to focus on where, again, my, the most bang for my buck be who should we focus on? And the spoiler alert is that the number one place to look is parents. Um, a lot of, uh, an all my work above and beyond everything else for kids, the way your parents support you. And especially if they accept you for being a queer person, that is what shows the big difference between youth who are thriving and youth who are not

Valerie (00:38:26):

Okay. That's Hey, I love that we cut to the biggest bang for our buck here. So that's so great. So, um, not to be taking a deficits too much of a deficits approach, but you, you know, that I'm a stigma researcher, so busted, but so, so can you take one quick moment to talk about why do these, why do some of these disparities exist, especially for youth, and then use that maybe to understand why our pare--, why are parents helpful for some of these like maybe additional stressors or things that are going on in youth lives, um, to protect them from these disparities that they might face.

Ryan (00:39:03):

This is I think one of the most important questions. And it's an, and so as your listeners probably know, we publish a lot of papers as academics. It's, it's one of the most important things of our job. And oftentimes people will say, well, why are you answering this question? What's the theory, or what's the framework by which this question is important. And so your question is what's driving these disparities and what almost all researchers that study SGM populations would focus on is it's called the minority stress model. And so Ilan Meyer and, uh, the late nineties, and it has a similar paper in 2003 where he builds on, uh, uh, stigma work and, um, uh, things and, and, uh, puts forward a minority stress theory and framework. And so what this says is that, um, it acknowledges that all young people, all people, but I'm going to talk about young people here.

Ryan (00:39:55):

We've been talking about youth a lot. All young people have stressors and, um, uh, you know, stressors in their lives. And so you can think of a math test coming up, or you got to ask someone to prom, or, you know, you have to, you have to function with four hours of sleep because you're a teenager. Um, all kids, whether they're straight or gay, uh, or any other identity faced these general stressors, but Ilan's theory is that, uh, sexual and gender minority people, um, face specific stressors that are only unique to these populations. Any age, put these in two camps, one are distal stressors and the other is proximal stressors. And so proximal stressors are things I think approximate close to me. Um, these are things happening internally. Like, um, I don't want anyone to know I'm gay. I have internalized homophobia. I think I'm a bad person because I'm not straight.

Ryan (00:40:47):

Um, it could be concealing your identity, you know, the stressors that, uh, for many kids every day, they have to walk around and pretend to be someone who they're not, or they have to hide their identity from someone they think will reject them. Um, I, when I think of distal, I think a far away these are things other people might be doing to you because they think you are, or because you are, you know, you've said you are a sexual agenda minority person. So these are things like you're being beat up at school, or you're being called names, or you're being excluded from, uh, you know, the playground or a group assignment, because someone's calling you a queer person and they don't like you because of that. And so Ilan Meyer says that these, uh, these compounds and they are, uh, you know, the more are the worst, the, the, the, the worst for your health and many people experienced multiple, uh, microaggressions or, uh, stressors.

Ryan (00:41:41):

And so these in part are what explain these health disparities we talk about. So you can imagine a queer person who is, um, everyday thinking about, I wish I could be who I really am, you know, public and who is being called names. Uh, you would imagine that this person might turn to drugs and alcohol, or might, uh, be more depressed or might not get enough sleep at night. And so this is in part, we know that this is what's driving many of these disparities for, for many youth, but this gets into what you're talking about. This, uh, protective lens. And in the same model, Ilan Meyer says, um, there is room for, or we acknowledged that there might be a buffer, and this is a scientific term. We might use a buffer or a moderator or there's room for, um, something to modify this relationship.

Ryan (00:42:32):

And so, even though I am, you know, being called names because I'm a gay young person, um, even though that's happening, maybe, um, something can happen that can reduce my stress, my stress, and thus make me not as depressed as I could be. And so we call this a protective factor. Um, maybe if you have two kids, one has a mother who's saying, look, look, Ryan, I love you because you're gay. Like you, you're amazing. I'm so proud of you. But the other kid, Brian has a mother that says, you know, if you're gay, I'm going to kick you to the house. And I don't want that to happen. Uh, you can imagine that the protective parent might be able to protect against right. That kid may be protected against some of that depression that Brian would instead actually face, um, and, and have to deal with because they know they could turn to their parents. They know they're not going to get kicked out of the house. Um, and so that's where we look at parents as most important. We think of them as a protective factor, someone who can intervene in that relationship between stress and negative outcomes. And so Ilan Meyer, he doesn't, this model is not specific to smoking cigarettes or to depression. Uh, you can really think of any compromised health outcome as, uh, the outcome of this model. Um, does that make sense? Does that answer it?

Valerie (00:43:51):

I mean, it's, parents are such a great place to focus for so many reasons. I mean, for one thing, parents can teach us how to cope with stressors, right? They can, they can teach us like how to respond to bullies on the playground or just, you know, what should I do when I come home? And I've had like a really, really bad day? Like what, what does that look like? Do I, do I go outside? Do I go for a run with my parents? Or like go throw a ball around or do I sit there and like, cry. I mean, crying is a good thing. I just had this chat earlier with Carly. I'm like crying is completing the stress response cycles. So please do cry, but, you know, do I cope with it by like eating pints of ice cream or by using substances?

Valerie (00:44:31):

Do I watch my parents use substances to cope with stressors or do they encourage me to like, you know, cope with my stressors, but with external, you know, things. Um, and then also one of the things that I think people have really been focusing on recently is the, in the stigma world is the extent to what experiences of discrimination impact our health, because they simply cut us off to resources. Right? So like, if I am, um, someone who's experiencing discrimination at work, I'm going to make less money. That's actually, you know, real story as a lady side. So like I make less money. And so then I, maybe I don't have enough money to like go to like afford a gym membership in a safe neighborhood, or like maybe I don't have as much access to healthy foods or all sorts of things. So parents for kids hold like the resources, right?

Valerie (00:45:28):

So like a parent can help to decide, well, my kid's having trouble at school. I'm going to invest in therapy for this kid. Or like, this school is bananas. I'm going to take them out of this school. I'm going to put them in a different school where there is a GSA or, um, something like that. Like parents just, they can, they can help to provide some of these resources that can be helpful for, you know, empowering kids to either like leave situations or figure out better how to cope with those or things like that. I mean, there's just so much that parents parents can do.

Ryan (00:46:06):

I think you're right. I think these resources as well. So if I'm a, if I'm a kid who knows myself to be gay, but I know that my family all the time makes fun of, or belittles or demeans gay people, then I likely will not tell them. And I'll likely have that stress that goes along with me all the time. So I would be afraid of losing those resources. I also don't think that I'm all, I always think I've never studied this. I want to, but I always think about this idea that when there are parallels in scholars who study ethnic and racial minority kids and people, and so thinking about the resources, um, or the lack of resources or the disproportional resources that, uh, people of color have in this country. Um, and when you think of parents of color who are parenting kids of color, um, I think that I would say the majority of those, and I'm not an expert in this field, but I think that the majority of those parents are capable of being able to prepare their child for racism, for the racism that we, that many people experience in this country.

Ryan (00:47:11):

And they can say, "Hey, watch out for this", where this might happen and prepare them. And when you think about that, compared to most parents are straight a and most parents of gay or lesbian or bisexual kids are straight. Some of them are also, but not all of them and not, not many of them. And so it's harder. I mean, we, we can read books and we can educate yourself. And that's what I think parents should do. Um, but it's harder for a parent automatically to just know how to prepare their queer child, to face a homophobic world and to be prepared for these stressors that we were talking about. And I think that's where, uh, I don't know the answers yet of how to get around that, you know, with our interventions we could do or just with time, if that will get better. But I see that as a large difference between where this field diverges in a way, um, the role of parents and how we can prepare them to prepare their kids for society. That's still not welcoming completely of a sexual gender minority of people.

Valerie (00:48:12):

Yeah. And I think that the very brilliant Sabra Kats-Wise and such some other new England folks, um, close to where you're at are doing, you know, some research on families and looking at like, well, what kind of interventions can we do with families? Or what kind of programs can we offer at families? Especially, I think Saber's work is with, um, families who might have a transgender kid. Um, but you know, and I'm not sure how she's addressed this in our work or how other people have addressed this within their work. I mean, we would definitely expect that the families to sign up for those programs are going to be the ones who are most supportive and enthusiastic. So, you know, that's great. Like please, those families sign up for these programs and kind of like grow these skills and learn how to best support their kids.

Valerie (00:49:00):

But then, you know, we've got this whole other group of kids who have families who are not going to sign up for those programs and those, uh, I mean, part of what I hear you saying is, you know, some of those kids are just going to decide not to disclose which, you know, you and I both take a very like nuanced approach to thinking about disclosure or sharing this kind of information with others, which is that like, it can be, it can be a great thing and it can be a really bad thing. So it's not like disclosure is always good or disclosure is always bad. But, um, so yeah, some of those young people are just not going to disclose to their parents. Um, but then for the other ones that do like, I mean, research has shown that those kids are that that can be a really bad situation leading to homelessness instead of other, other outcomes. Yeah. It's just,

Ryan (00:49:49):

Yeah. I'm glad you mentioned Saber's work, Saber's my next door neighbor, which is right by, she is at Harvard.

Valerie (00:49:56):

No she's not! Is she?

Ryan (00:49:56):

and she lives in Providence and I live in Providence and I worked at university of Connecticut. And so this is kind of like our middle ground

Valerie (00:50:02):

I know lots of people just, I know lots of people who live in Providence and then commute, like, you know, these are all like academics, like to like universities throughout that sort of tri-state Connecticut, Massachusetts. And, uh, yeah, I guess just Connecticut, Massachusetts, and then maybe they also work in Rhode Island.

Ryan (00:50:20):

Well, the thing about new England is, I mean, I grew up in California and you have to drive eight hours to get across the state, but here in Connecticut, we have five minutes we have across the state. Um, so she's close and she, and I talked about this stuff a lot and she studies, uh, gender expansive. There's another term you could use talk about transgender or non binary kids, um, and parent and parenting.

Valerie (00:50:40):

Yeah there you go

Ryan (00:50:40):

And the one thing I want to say about that, and I, I want to talk a little bit about disclosure because I find it so interesting. You just talked about that, but before I do, I wanted to just say, um, that there's one nuance. I, my research is really interested in exploring, and that's the difference between parent acceptance and rejection of identity and parents support. So ad-health does dataset that, um, you know, was from 1994 and still going, they looked at parent, uh, like warmth.

Ryan (00:51:06):

So they asked, do you have fun with your family? Does your, does your family, um, do you feel like, uh, they give you warm feelings, things like this. And we think of that as just general family support, and you could have a parent that is so warm and loving and caring, but is anti-gay, you know, that does not believe that, you know, it was very religious maybe or something else that does not believe that a gay, a gay identity is valid. And so now we're trying to study those nuances and we ask questions, like, does your family tell you, does your parents, your parents, does your mother... Does your caregiver tell you that they're proud of you because you are LGBTQ? Do they tell you that you're a rolemodel? And we know that those what we're starting to know that those kinds of questions really get at the heart of the relationship with the parent around sexuality. And there's big differences between how we usually measure family support or care or connectedness versus family acceptance and rejection specific to your identity. And so, I mean, I think parents can think about how the various behaviors and attitudes they have, um, whether it be just, you know, general support, like you are just, you know, supportive of your kid, um, in general and you, and you show them affection versus like, how do you really talk about, uh, people, LGBTQ identities, and that we're finding is what's most important.

Valerie (00:52:29):

That's so interesting. I mean, the thing that I'm thinking about while I'm talking with you is that how, like, how totally is important. It is like as a scientist or a researcher to like talk to the Ryan when you're designing your study. Right? (laughs) Because like, in this case, like I think sometimes with social and behavioral sciences, especially like some of this type of research, which, which feels rather intuitive, and it's the same for stigma. Like people tend to think that they know what stigma is, and then they'll go out and they'll measure discrimination, and then they'll find that their measure doesn't predict the thing that they think it predicts because they missed some nuance. Like they didn't actually measure internalized stigma and internalized stigma is like maybe the big predictor or the big thing that's related to the type of health outcome that they're related to. And the thing that I'm thinking about as you're describing this as like, you know, a very smart person with a PhD could just be like, yeah, let's measure warmth. And then they miss this like nuance and they totally, they like they miss it. They just, they don't capture the important thing in their research. So anyway, I'm just thinking,

Ryan (00:53:33):

Well, that's a good, that's a good segue to outness. And so I think what, this is how I came about being interested in outness, um, ad-health when I was in grad school, I used ad-health to one of my first papers published was about how family warmth was more important for school belonging for people compared to heterosexual people. So if you had, um, a stronger family and more connected, warm family, you were even more likely, and it was more strongly related to how you, how you belonged at school. But I, but questions I had follow-up questions I had to that finding was, well, we know that there are some unique relationship between family support and in school for queer people, but the question was, do these parents even know or suspect that their kid is queer? We don't know. And that is clearly a really important piece of this puzzle of, you know, maybe they're just bad parents, maybe they're just not warm.

Ryan (00:54:34):

And this kid in the study happens to have really bad parents, you know, just not warm and not caring. And is it because they're LGBTQ? We just don't know because we didn't ask that question. Um, maybe they're not even out, or maybe they act very straight if you will. Right. Maybe it's a boy and the parents would never guess in a million years that this kid is gay. And so we don't know if the finding we found, um, is really because they're and that's an important question to ask. And so, um, so some of the work I started doing was looking at whether or not kids were out, you know, who and who they're out to because, you know, when you hear anecdotes from kids, you hear, you know, they came out to their friends first, or they came out to their mother and they didn't come out to the father for years after.

Ryan (00:55:18):

Um, and so these are things that I started studying, um, uh, you know, different contexts of outness. And so whether the kid was out to, uh, their mother and, or their father, and of course we acknowledged all kids don't have mothers or fathers. Um, then so are you out to your caregiver, um, or you out to your siblings and what we found in our preliminary research and we still Val you and I, and others, we're still thinking about combinations and, uh, different, uh, contexts of outness of disclosure. And my early work found that there is, there's some, there's something about these kids who are mixed disclosing, who are out to some, but not out to others. Um, and you can see sometimes I think of those kids as they're progressing through the natural phases of coming out, right? You, don't not all kids just come out to everyone at the same time, you kind of test the waters or you tell people, youth or safe who you think will support you.

Ryan (00:56:16):

Um, and this was me when I came out, like I told some people first and not others. Um, but for many kids this time of their life is, um, complicated. It's tough, you know, like they're, they're probably thinking what if my dad finds out. That's what I was thinking. What if my dad finds out before I tell him, or what if my mom tells my dad, you know, something, you know, these are thoughts. I probably went through kids' heads and unsurprisingly kids who are managing or are mixed disclosure in their identities are not doing very well. They have, in one study, we published, they had, there was more school bullying that they reported. They had reported lower grades, like a lower GPA. Um, and maybe we couldn't answer this question with the data we had, but maybe our hypothesis was that maybe that's because these kids, um, are constantly stressed out thinking who knows, who can I tell?

Ryan (00:57:12):

Um, what if my parents find out what if I get kicked out of my house? Um, and so it seems like they're on a, on a, on a journey to coming out for many of these people, they're not completely closeted. Um, but, uh, I found it to be important to understand those nuances and to, to understand who knows about sexual identity, because that is a place to start. You know, if the parents don't even know, is it appropriate? Is it time to start intervening and helping those parents? Maybe, maybe it's time. Maybe that's the perfect time to start having parents, uh, become more supportive. Um, is it too late in other cases, you know, I mean, I, I would argue it's never too late to for education, but, um, these are kind of the conversations we can have once we know who a kid is out to.

Valerie (00:57:54):

We've done some work, um, on disclosure and substance use disorders and substance use disorder recovery. And one of the things just because you've been talking a little bit about development and longitudinal research, which is research that happens over time. One of the things that I was really surprised at is people don't, you know, at least in our studies that people who are in recovery, they don't get particularly comfortable with disclosure over time. Like, I would think that, I mean, a 40 years into recovery I've like figured this out, but, you know, from the data that we've seen, like people, you know, they'll flip into recovery and then they'll get more comfortable for like, you know, two or three years. And then they sort of plateau at like medium comfort levels. Um, so, you know, recovery from substance use disorders is very different from sexual and gender minority in terms of like, you know, disclosure and things like that.

Valerie (00:58:47):

Especially, you know, given what we just talked about in terms of like, there's a lot of social changes happening with stigma around patrol and gender minorities, and there's arguably less so. Although maybe a little bit with substance use disorders, but, um, I was just like, I was really surprised by how many people can continue to struggle with it. I mean, it's really, it's really complex…

Valerie (00:59:34):

Like, Carly and I have been working on this disclosure intervention. So trying to help people figure out if they want to disclose, but then when we dug into it, we were like, there's a million decisions to be made with disclosure. So not only do I have to disclose to decide like, am I going to disclose or not? Um, and again, here, we're talking about like, am I going to tell someone or not that I'm in recovery from the substance use disorder, but then also like, well, how much information am I going to share with them? Like, um, and then also, how am I going to tell them, am I going to write them a letter? Am I going to send up, am I going to just like blast Facebook or tic-tac, or like, whatever kids are on my current approach to social media is non adoption.

Valerie (01:00:19):

So I'm just leveling out of Instagram forever, but, you know, like, am I going to go that direction? Um, and then when am I going to do it? So like, there's just so many decisions. Like, it's, it's a really complex thing. So I can only imagine like for young people also that navigating that, figuring out how you're going to do it is, is challenging. So, so, so no wonder that it's like, it's a long process that takes time, you know, because like it's just super complex.

Carly (01:00:50):

And that was one of the first things that, um, my therapist, who is a gay man, like told me to, he was, I said something, you know, like when will it be easier? Cause I came out like really late in life, actually just like a couple of years ago. And, uh, he was like, unfortunately, dear, like you never stopped coming out.

Carly (01:01:07):

Like this is your whole life. It just gets like you just eventually either, you know, care less about the possibility of a negative reaction or, you know, you kind of create your own way to do it. That feels comfortable for you. And like wherever the cards fall, you know, is where they go. And that was like the goal of it. But that always stuck with me of just the, like you're never done coming out. Like you, it's something that you have to do all the time. And I think that that's like similar for people with substance use disorders. Like, you know, you're, that's something that like with, with each new person you meet or someone that doesn't know about like that phase of your life, you know, I think it's a little bit different cause you, you know, anyway, it's a little bit different for obvious reasons, but I think overall, like it is something that like, I think it kind of develops as you develop. And I think, you know, you get more comfortable with it to some degree we find, but it's just like, that's one of the things that always stuck with me. It was like, you're just never done coming out.

Ryan (01:01:58):

Well, that's what I wanted to say too. I mean, you stole the words out of my mouth. I think that that's the big thing with sexual identity disclosure is that, um, you're always shifting in life, going to a new job, you're meeting new people, um, and that job has never done or that task has never done. Um, this really made me think of, if you, if anyone, if you're the listeners are really interested in psychology, or developmental psychology, this is what, um, I think a lot about. And it gets complicated when you think of coming out over the different like life phases or, you know, transitions in life. And that'll actually, Val and I are working it's Val's project and I've contributed some to her project and thinking about, um, time and thinking about, you know, the role of time, which is understudied or as, you know, not necessarily looked at in all fields, maybe even special like public health, but when you think of developmental psychology, you're really always thinking about the role of time in generations.

Ryan (01:02:52):

Um, and it really makes me think of, um, my PhD advisor. His name is Dr. Steven Russell. He has been thinking a long time about this theory. He's called the developmental collisions theory, I think is what he calls it. And I probably will not. I hope I don't butcher it and I don't want to probably get it wrong. Of course you can go read about it. Um, his idea is that he shows this data where we know we've talked about this already, that kids are coming out as LGBTQ earlier and earlier in their lives. It used to be like 18 would be an average time or even older. And now kids are coming out at 13 and 14. And Steven Russell's idea is that this is colliding with processes like puberty of like time of like times when kids are learning new things about themselves, not just their sexual identity, but everything.

Ryan (01:03:41):

How do you navigate the world? How do you, you know, uh, how are you, how do you get popular? I mean, he doesn't use this word, but how do you like try it? Cool. Um, and at the same time, he mentions where we are being forced many kids in this country being forced to move schools. And so you're moving from middle school to a high school, usually a new school with new people, which almost all the research shows is not good. Like what, like why would you be putting, does kids in one room, um, with one teacher who are acting out, you know, this is just like the model we have done is not supported by science. So all that's happening when now kids are coming out, this is the average age of the kids are coming out. And so to have to think about that, you know, what's happening in someone's life when they're coming out and how to eat..

Ryan (01:04:31):

We wouldn't think about disclosure, the importance of it or what it means, uh, in elementary school or high school, the same way we would think about someone who is, uh, transitioning to start a new job in their forties. Um, we'd probably give them different advice. And that's that Steven's whole thing is that this is a new thing that developmental sciences don't know how to really deal with, um, is it could be troublesome is exciting in a lot of ways, but also we don't know a lot about it. Um, and that's kind of where our fields collide, you know, where we think about as developmental people and it's considering the role of transitions and times and how we study sex orientation or stigma or substance use.

Valerie (01:05:12):

Yeah. And this is something, I mean, I think that this is such a big issue because I mean, 14 is like the time when also like young people are going to start experimenting with substances and with sex and all those other things. So you've got that. So you've got like, so if I come out at this early age, if, um, I start to experience maybe some stigma based bullying around my sexual orientation or gender identity, um, you know, I'm just, I'm because of how old I am. I'm like, I'm at greater risk at these things of these other things, but then also because of how old I am, I just like, I haven't built up my armor yet. Like I probably haven't figured out like what my coping, what my healthy, maybe coping systems or my adaptive coping systems are for when I experienced some of these stressors. So I, I think that this is such a big deal and, you know, especially, um, it made me really sad when I was doing some earlier, earlier work at Boston children's hospital with young people, with substance use disorders, because it's like, it's so apparent, like these young kids like are experiencing bullying or other forms of adversity.

Valerie (01:06:24):

They learn early on that they feel better by using substances. And that's like, that becomes a really important way for them to cope. And now they've developed a substance use disorder, which is inviting and like a whole other layer of like stigma into their life and sort of adversities. So, um, I just think that this time period is so important to think about in terms of like, really thinking about resilience and I mean, just circling back, like, you know, set the kids don't have that armor yet. Like what can we do with parents to get them to like protect and shield them while they grow? It is such an important area. It seems.

Ryan (01:07:01):

Right. And, and you know, some of my other, uh, areas of work extend beyond parents, which I've already said are like, we've, we always find is the more or the most important, but you can think that maybe you're not a parent, or maybe you have more influence in other areas. And there are other areas that many people can influence. And so I think of your local policies. I mean, some of them now are looking at, um, we've combined data with this human rights campaign data I collected. Um, and we combine information about, does the state have an, uh, conversion therapy law or an anticonvulsant therapy law? Um, does the state have, what proportion of schools have a gay straight Alliance? Um, what does the school people study? Do schools have enumerated, which means there's a new rate of policy for anti-bullying, which means the policy spells out.

Ryan (01:07:50):

You cannot bully somebody because they are lesbian gay or bisexual or transgender, instead of just saying, Hey, you can't bully people at the school. Um, you know, so you can see, uh, if perhaps you can advocate for your school, your kid's school or the local school, if you don't have kids to, uh, to, um, improve their policies that, um, because we know, you know, if you could just pass a policy that just includes those words, and it means that everyone is safer in school. I mean, I would want to do, of course, I think we all want to do, um, the low hanging fruit things that you can find to make, um, school safer. And by the way, the, the interesting thing is that schools that have GSAs, it's not the gay straight alliances. It's not that it's just that the gay kids feel safer.

Ryan (01:08:31):

All kids feel safer at schools, and sometimes ironically, straight kids feel even safer, uh, than they would have otherwise. And so it's creating an environment that's inclusive. It's not just that, Oh, we have to do this just for the X, you know, the 10% of gay kids or fewer myself, no, it's for everybody. It does show evidence, shows that it makes school safer for all kids. And I don't know who wouldn't want their straight kid to even feel safer. Um, you know, maybe it's not, you know, not all of us think about, uh, you know, uh, all, all minority kids. And so I think this has implications for all cans, um, which I think is helpful for some folks to understand

Valerie (01:09:10):

Ryan, I can't think of like a better science finding to wrap up this episode. I just, the fact that GSAs are good for all kids. So, you know, and it is, you're totally right. Like it's something that everybody can advocate for in our local communities and the science super supports it. So I think that, that, that, that's a really excellent place to land it. Um, Ryan, it's been so lovely to talk with you. I can't thank you enough for your time. And, um, I need to get in contact with Lisa and like force my way back to the lunch table so that I can see your lovely face every week. Um, and we know that you're going up for promotion and tenure this, this year, we assume you're such a rock star that you're rocking out as well, but we...

Carly (01:09:53):
got it in the bag.

Thank you 

Valerie (01:09:55):
Yeah. Celebrate with you and make you a tenure pinata on the other side of that.

Ryan (01:10:00):
I'm sure by that time, we'll be able to gather and hit pinatas.



So, I’ll hold you to it. (laughs) 

Carly, I really really enjoyed this conversation with Ryan. Especially about language and labels. 

I know. That’s-- I feel like it’s such important work. I know—he honestly taught me a few things I didn’t know, and I identify as gay so…I feel like the fact that a lot of that was news to me was like “huh, alright well.” Just got to keep learning and keep rolling with it. 

Yeah! Yeah, I feel like that’s like the tagline, “Just keep learning and just keep rolling with it.” (laughs). For sure. 

One of our RAs, which are our undergraduate research assistants, who listened to this episode really loved the idea of pushing back on the idea of ‘minority’ you know? 


She really resonated with the idea of ‘sexual and gender diverse’ so…

Actually, I’ve been thinking about that too since our conversation with Ryan. I do feel like there is kinda a little stigma associated with the “minority” word just as a term whether it be sexual and gender “minority” or whatever. And, I like that too. I’ve been thinking a lot about sexual and gender “diverse”—it’s just more all-encompassing. It sounds more wholesome and just like…friendlier. You know? 

Sure, yeah. And “minority” has this sorta vibe of smallness you know? 


And “diverse” is so nice because it really speaks to the spectrum. 


I think a lot of what Ryan was talking about is just that, this is a very broad topic…


…thinking about sexuality, and when we’re thinking about gender identity. So, sexual and gender “diverse” really gets at that. 

Right. Completely agreed. 

I also like how Ryan did some role-modeling there. I mean he is a scientist in this area, this is his job. 

(laughs) he’s a professional 

(laughs) he is a professional. So for him to you know, share that he struggles with language sometimes, I think makes me feel better about (also) struggling with language sometimes. 

Yeah, absolutely! 

People feel like, like I think when we correct people’s language or when we invite people to use different terms it feels embarrassing or like they’re doing something wrong. It’s nice to normalize that language is changing all of the time and it’s okay—you’re just going to be wrong. And that’s my approach as a scientist. Every five years or so, I will be using outdated terms and I just need to like stick my head out of the sand and figure it out. 

Right? And just be willing to roll with it, just keep it going, you know? 

Yeah. I actually can’t, it’s hard for me to even read one of my first papers I wrote in 2009 because of the language—like I can’t even…


Yeah! That’s eleven years ago! I don’t even want to talk about it. 

Now I’m instantly going to be digging that up after this, just to look at the language. 

Oh my god, please don’t.  I mean that’s the only time…and I’m a stigma researcher! 


You know? We just, we all get it wrong eventually because language changes. 

We need more Ryans out there having these conversations with more people. I guess we have to be the Ryans now (laughs). That’s how that works. 

We’d like to say a warm thanks to Ryan for having this conversation with us, it was so very much enjoyed. 

Thanks to the Stigma and Health Inequities Lab at the University of Delaware for their help with the podcast, including Saray Lopez and Mollie Marine. Also, thanks to Kristina Holsapple for her editing skills, 
 Thanks to city girl for the music, and as always be sure to check us out on Instagram @Sexdrugsscience, and be sure to stay up to date with new episodes by clicking subscribe 


 And thanks to all of you for listening.