Just in 2024, there have been 530 anti-LGBTQ+ bills introduced in the United States (ACLU.org). In 2024 in Alabama, there were four. Two attempted to limit the definition of sex in a way that is harmful to transgender and nonbinary people, and one attempted to censor education on sexual orientation and gender diversity in public K-12 schools. One devastating bill was passed this year (SB129), which prevents state agencies, boards of education, and institutions of higher education from sponsoring DEI programs or offices. This bill seriously limits resources for marginalized students and censors free speech around topics of identity and diversity. This bill will also impact the education Alabama's future health professionals will receive on diversity, health equity, and culturally competent care, having downstream effects on the future healthcare transgender individuals receive.
Additionally, the overturning of Roe vs. Wade in June 2022 has limited the reproductive freedom of women and trans and nonbinary folks. Since then, at least 14 states have enacted near or total bans of abortion, forcing individuals to continue pregnancies that were compromising their fertility and/or life-threatening. A majority of OB-GYNs surveyed fear this will increase maternal mortality and decrease their ability to practice within the standard of care (Frederiksen et al., 2023). Following the overturning of Roe, Alabama enforced its abortion ban, with exception to save the pregnant person's life, to prevent serious injury, or if the infant is not expected to survive. Advocates have rightly noted that physicians fear being criminalized or having their licenses removed and therefore are more hesitant to enact abortions when medically necessary.
In February of 2024 in Alabama, the Alabama Supreme Court ruled that frozen embryos were considered "unborn children," which caused a statewide pause in IVF procedures for months. Although many clinics have begun treatments again, these political actions have continued to cause significant worry and tension among those with frozen embryos in the state.
When the news is endlessly flooded with headlines of politicians and citizens alike arguing for legislation that restricts bodily autonomy...feeling tense, anxious, or hopeless is an understandable reaction. In fact, data show that these legislative actions have greatly impacted the well-being of LGBTQ+ folks and women.
Anti-trans laws have increased visibility but in a negative light. Trans individuals have reported increased anxiety, depression, and hopelessness due to societal rejection, fear of violence, and threat of limits to their access to medical care (Budge et al., 2013, Horne et al., 2022, Tebbe et al., 2022). Past suicide attempts among trans teens increased up to 72% in states that enacted anti-transgender laws (Lee et al., 2024).
A similar trend has been observed related to abortion restrictions. A 2017 longitudinal study found that women who were denied an abortion experienced greater anxiety compared to women who were granted an abortion (Biggs et al., 2017). A nationwide study following the overturning of Roe revealed an increase in mental distress, especially among individuals with less economic resources and education (Anderson et al., 2024).
When the IVF clinics paused treatments across the state in February 2024, I witnessed firsthand the surge in understandable panic and rage among those affected. When I offered a support group, I received dozens of inquiries, some even coming from over state lines. When I consider the amount of money, time, physical effort, mental effort, and love that people put into the IVF process, all for the future of their family planning to hang in the balance of a political battlefield, I feel nothing short of rage. As someone who is not affected personally, I can only imagine what I feel is a fraction of what those affected feel. That rage has to go somewhere, and a lot of times, it goes inward. While I have not seen studies on this (yet), I can assume that depression, anxiety, and other mental health symptoms have surged among those affected by the AL Supreme Court's ruling.
Finally, public discourse around LGBTQ+ and women's rights can lead individuals to "hide" more. For example, some individuals may not reveal their sexual orientation or gender due to increased fear of stigma or violence. Some may not discuss difficulties with fertility or undergoing an abortion for fear of judgment. LGBTQ+ couples may not discuss their reproductive plans due to increased scrutiny over these procedures and uncertainty about whether they will be supported or rejected and marginalized. Hiding and social isolation lead to shame, and shame is incredibly damaging to one's mental health.
You might be wondering, is it even possible to cope with this? (short answer: yes)
While there is no magic pill to cure systemic oppression that these legislative actions represent or to completely remove the distress...there are some things you can do to promote your individual well-being in the face of these stressors. Now, I know what you might be thinking...maybe something like "Seriously? please don't ask me to deep breathe may way through this hellhole." And if you are thinking that...that is a totally fair thought. It is natural to wonder: what can coping skills really do?
Please humor me in a grim analogy.
Think of it this way: The house is on fire and all you have is a bucket. The house is our political system that has real impacts on you and your life. And that house is on fire. Coping skills are not going to put out the fire. So don't think of coping skills as the bucket, or even as putting out the fire. Think of coping skills as you getting as much physical distance from the fire as you can. Just enough distance for you to be able to breathe and survive! You can't entirely leave the property, as long as you are still in this country and under its political system. But coping skills get you enough distance where you are enough feet away that you see the house burning down, you smell the smoke, and you are affected. There is no realistic way to not be affected. But with just enough physical distance, you are able to do what is within your control to stay alive, see clearly, and pursue what matters to you (within your control). You can plan for your future and engage with your life (with what's within in your control). This is more difficult than it sounds, and I imagine there might be a lot of "buts" or "what about this." Again, that is understandable! Of course, I am biased, but this is where therapy can really help you figure out how to make sense of this and implement this. But here are some ideas (again, these are not the bucket putting out the fire, but getting you some emotional distance to help you engage with your life amidst the pain).
How to "cope" (i.e., live as fully as you can) in the face of harmful legislation
There are many "coping strategies" in psychotherapy that we could review (e.g., deep breathing, grounding, etc). I won't be reviewing those here today. Check out reels on my instagram page if you are curious about those. In this post, I am going to focus on three steps that don't get as much airtime on the great world wide web, but that I focus on significantly in therapy. These strategies intend to help you to "turn down the volume" on negative thoughts associated with oppression and engage in meaningful action.
Name the story these political attacks activate for you and put it in the backseat.
Some of us internalize negative messages. Are these bills activating a negative story about yourself? For example, one might think "I am nothing more than an object or political pawn. My life is not worth anything" or "I'm never going to be able to have the life I want. I'm powerless."
Ask yourself "is this story mine or the result of systemic oppression?" Visualize putting it in the backseat. You are the driver of your car. The "I'm not worth anything" or "I'm powerless" story is in the backseat, trying to tell you where to go. You'd rather it not be there, but it's there anyway, trying to tell you what to do. Naming the story can get you distance from it, so that it does not dictate what you do (e.g., cause you to isolate, give up, consider escaping through substance use, self-injury, or suicide). Naming the story takes practice. Any time you notice an increase in anger, anxiety, or sadness...ask yourself "what is my mind telling me right now?" Name the story.
Thank your mind
I know, that sounds weird right? Why would I thank my mind for telling me bad things about myself? Here's why: Your mind is trying to protect you (funny way of showing it right?). Our brains have evolved to look for threats. Your mind is likely telling you this story to try to protect you in some way...maybe it's asking you to hide out from the world and be safe or to conserve efforts due to the constant fatigue of fighting oppression. But those options aren't always feasible and are often in conflict with other needs. For example, you might be tempted to isolate but that doesn't work for you because...well, you want to live your life! You want to see your loved ones. You need to work to pay the bills. You have things you want out of life. These stories can be holding you back from those things. But you don't want to judge yourself for having those thoughts. Judgment is counterproductive. Judgment only pushes you farther down into a hole of negative thoughts about yourself. Instead of judging yourself for having the thoughts/stories, thank your mind for trying to keep you safe and redirect it. For example: "Thank you mind for the 'I'm not worthy' story. I know you're trying to protect me, but I value (insert value here, e.g., seeing my friends) more over that right now." After you thank your mind, don't expect the story to go away. It will very well linger there, but it's not pulling you in or hooking you like it would if you judged yourself for it or let it take the driver's seat.
Move towards What Matters to You
Pain usually directs us to move away from things. When you touch a hot stove, you pull your hand away to try to protect yourself. You naturally are not thinking about an alternative to move towards that is positive. The pain takes up all the mental space. Additionally, oppression is a source of pain that ultimately seeks to restrict meaning and purpose from a person. These political attacks try to reduce people down to their bodies and remove their choices, their freedom.
Even as these attacks are in motion, retaining the meaning and will that you have is critical to your mental wellbeing. The goal in this step is to move towards something that matters to you, even though you are experiencing pain associated with oppression. Imagine several years from now and you are looking back on the present moment, what will you say mattered to you? What will you say was most important? This can vary from person to person. Some may say "social connection"; some may say "creativity." Others may say "advocacy." You can have more than one. Then break those values down into actions. If you were creative, connected, or advocating...what does that look like on a daily basis? Get as concrete as you can and come up with the smallest steps possible. For example: calling a friend once week, writing letters to lawmakers, creating for 10 minutes a day. Then build on it. Now remember, as you are doing these things, the fire is still in the background. You can smell the smoke. It's painful and even limiting. But you are doing what is in your control and power to engage in your life, despite efforts of others to control it.
Also central to this step is identifying behaviors you are engaging in that are not connected to your values. Usually these are activities that we engage in to try to control or avoid pain. An example of attempting to control pain is over-engagement with news media to the point that it is consuming significant time and mental energy. While an understandable behavior, it gives the illusion of control but takes away from time spent on other activities that are meaningful to you. Avoiding/attempting to escape pain would look like social isolation, frequent substance use, or suicidal thinking/behavior.
Identifying these behaviors can help you reduce them and instead, move towards what is meaningful. For example, one might decide to limit exposure to negative media. One could engage with trusted media sources that do not frame their existence in a negative light. Allow yourself only a few minutes to "read comments" or engage with media that brings you down. Ask yourself before reading the news what you are seeking to gain first (e.g., education on what's going on) and end the reading session when you have gotten it. Engage with social supports that provide you with a sense of safety and belonging, and do not reinforce these negative stories.
I hope this helps you consider some new ways to cope with these political stressors. If you are curious about doing more work on this, I recommend the following workbook (not sponsored, click image to read more). I welcome you to contact the practice for more information, to join my waitlist, or request for referrals to my colleagues.
Best,
Dr. C
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