1. Barden, Connie MSN, CCRN, CCNS

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In May 2003, about to deliver a speech as president of the American Association of Critical Care Nurses to more than 6,000 colleagues, I stood listening while president-elect Dorrie Fontaine introduced me and briefly chronicled my life, including my relationship with my partner of 11 years, Martha Fugate. In the days that followed, many people thanked me for having the courage to be open about being gay. Some asked how I had made the decision to be "out." As I reflected, I realized I'd never made a decision to be out; I'd simply made the decision to be truthful, always, about who I am.


I grew up white, middle class, college educated-in short, privileged. Only in my 30s, when I discovered I was gay, did I feel the sting of discrimination. There were awkward moments with family and friends and hateful slurs and accusations. My best friend rejected me when I told her that I was gay; and I've been told that I'm a sinner unworthy of God's love. I will never forget the day that a physician colleague and I were chatting about his four children. "I'll be happy with anything my kids do with their lives," he said, "just as long as they don't turn out gay. If I found out one was gay, I think I'd shoot myself." Stunned, I remained silent. This colleague, who has known and respected me for years, assumed his comment was innocuous. I was hurt but not devastated. But how do such comments affect young people?


For gay teens, the risk of parental rejection is real. I learned that gay kids ejected from home by their parents (and thus called "throwaways," not runaways) constitute a large percentage of homeless kids; many quickly resort to drugs or prostitution to survive. An article published in School Administrator in February 2000 reported that gay-related name-calling (for example, "faggot" or "dyke") occurs an average of 26 times daily on middle and high school campuses-and that many students harassed in this way identify themselves as heterosexual. Children who are perceived to be gay are at increased risk for abuse at home, assault, substance abuse, and attempted suicide, according to state-level reports by the Massachusetts Governor's Commission on Gay and Lesbian Youth and the Safe Schools Coalition of Washington State. A young person who is questioning his or her sexual orientation or gender identity often finds no one to talk to; isolation, depression, and desperation often result.


In 1996 I decided to take action. My partner and I founded Project YES (the acronym stands for Youth Empowerment and Support) (, a nonprofit organization that provides education to school personnel, clergy, parents, and other community providers. I've learned that we can make a huge difference by providing a safe environment for dialogue, so that people can express their fears, gain the knowledge needed to dissolve them, and cultivate mutual understanding.

FIGURE. Ask yourself... - Click to enlarge in new windowFIGURE. Ask yourself, 'Are we really including everyone?'

The world often isn't safe for gay and lesbian people, and young people are especially vulnerable. For this to change, each of us has to be more open-and open-minded-about sexual orientation and gender identification. The next time you consider how well you and your colleagues, unit, and institution address diversity, ask yourself, "Are we really including everyone?" Have you created work and home environments in which others feel safe enough to reveal themselves? Have you educated yourself and your staff on homophobia and how it affects the health of young people? Have you requested that diversity training at your institution specifically include sexual orientation and gender identification? If you are gay or lesbian, do you live your life openly, serving as a role model for others-especially kids?


Regardless of how one feels about gays and lesbians, no one wants neglected, abused, or suicidal children. As nurses, we owe it to our young people to make our communities and workplaces safe for them-no matter whom they love.