SINGAPORE, July 22 ― Four years after reading about a teenager who allegedly hung himself in 2015, the tragedy continues to weigh heavily on the mind of a 48-year-old gay man.

Online users have said that the teenager in Singapore experienced homophobic bullying on social media before his death, though that has not been verified.  

Talvin (not his real name), who works in the music industry, told TODAY: “I don’t even know this boy personally, but I was (and am still) very affected by his death.”

Talvin does not want to be identified because he is afraid there may be repercussions for his work. He is well-acquainted with discrimination against lesbian, gay, bisexual, transgender and queer (LGBTQ) people and the emotional toll it can take on individuals and their families.

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Over the last 30 years, he has experienced intense periods of rage and bouts of depression due to work and relationship issues. He also had suicidal thoughts.

“I’ve always felt like I’m a one-man army," he said.

Last year, for the first time in his life, he sought help from a professional counsellor. An acquaintance in his workplace suggested counselling after pointing out his increasingly destructive behaviour — he was drinking too much and got overly emotional while interacting with others.

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Increased awareness

Talvin is among the increasing number of LGBTQ individuals in Singapore seeking mental health support in recent years.

Experts attributed it to an increased awareness of mental health and LGBTQ-related issues, along with greater access to support services.

At Oogachaga, a non-profit community-based organisation that works with LGBTQ individuals, demand for counselling services has doubled in the past five years.

Last year, Oogachaga’s counsellors handled a total of 2,012 counselling sessions, up from 974 sessions in 2013.

They included professional face-to-face counselling as well as counselling sessions conducted via phone, WhatsApp and email.

Sexuality, gender identity, relationship and mental health issues make up the bulk of the cases seen by its counsellors.

Think Psychological Services, which offers counselling services for LGBTQ-related issues among its other psychological services, has seen an estimated 50 per cent increase in the number of LGBTQ clients in the last three years. It now sees around 10 to 12 cases every month.

Think’s clinical psychologist Vyda S. Chai said that many seek help to work through the coming-out process, and relationship and infidelity issues.

“There have also been numerous cases grappling with oppression, discrimination and social issues related to their LGBTQ identity,” she said.

Mental health problems

Research has shown that LGBTQ people face a higher risk of having mental health issues such as depression, anxiety, substance abuse, suicide and self-harm than heterosexuals.

For instance, gay and bisexual youth are four times more likely to have attempted suicide in the past year than their straight classmates, based on a 2015 report by the United States’ Centers for Disease Control and Prevention.

While not all LGBTQ individuals have the same struggles, experts told TODAY that stress from discriminatory experiences are a recurring theme among those seeking mental health support.

A 2012 study here done by Oogachaga found that three in five LGBTQ respondents surveyed reported some form of discrimination as a result of their sexual orientation and/or gender identity.

Dr Adrian Wang, consultant psychiatrist at Gleneagles Medical Centre, said the patients he sees from the LGBTQ group generally have similar mental health issues, such as anxiety attacks, depression and work stress, as the straight population. However, discrimination, the lack of acceptance and support network can compound mental health issues. Dr Wang sees three to four LGBTQ patients every month.

“Being gay does not make one biologically predisposed to mental health disorders. Rather, it is because some of them face discrimination and acceptance issues at their workplace or at home,” Dr Wang said.

“One of the most depressing things LGBTQ people face is when they are not accepted by their own family members,” he added.

Oogachaga’s executive director Leow Yangfa, a registered social worker, said that discriminatory experiences can occur at various life stages, and can affect LGBTQ people from all walks of life.

They may include homophobic slurs in school or religious community, family members disapproving same-sex relationships, social isolation of an elderly or disabled LGBTQ person or racism faced by LGBTQ people from ethnic minority backgrounds, Leow said.

They could also be in a workplace environment where people are transphobic, meaning there are negative attitudes, dislike or prejudice against transgender or transsexual people.

Transgender individuals, in particular, tend to experience even higher levels of stress and poorer mental health.

June Chua, who founded transgender shelter The T Project in 2014 with her late sister, said: “If you are gay or lesbian, you can choose to ‘come out’ to selected groups of people, and not others. But for transgender people, the physical aspect and changes of transitioning makes it impossible for them to choose, which can be very stressful.”

Battling stigma and isolation

Ironically, some of the most hurtful and discriminatory slurs targeted at Talvin came from the gay community.

“One time, someone invited me to ‘gay night’ at a club. When his friend saw me, he whispered loudly, ‘Eh, why you bring Indian here?’

“I’ve also been accused of ‘straight-acting’ by gay men. It’s really depressing,” he said.

Straight-acting is a term used to describe a person who does not look like or behave in a way that is considered typical of gay individuals.

“My straight friends and bosses from my previous companies don’t seem bothered by (my sexual orientation). My experience is the reverse — the LGBT people I’ve met have been quite nasty to me,” Talvin disclosed.

At home, Talvin continues to experience stigma and isolation. His 70-year-old mother is unable to accept his sexual orientation.

Once, she insisted that he read a news article of a man who was allegedly beaten to death at Orchard Towers for offering oral sex to his attackers.

“I don’t understand why my mum did that. Did she really think I was the type to do that?” he said.

“My mum has also grumbled to people about never being able to have a daughter-in-law or grandchildren. She doesn’t realise that her words have hurt me a lot and definitely played a part in me being a darker, colder person.

More avenues of supports

Even as LGBTQ individuals battle stigma and discrimination, more support services are opening up to cater to the LGBTQ group.

Chua said that mental health and social support services for LGBTQ individuals are now more readily available than before, although there is room for improvement.

The T Project started offering counselling services by professional counsellors, at a fee, at its Alicia Community Centre in Kovan earlier this year. It is supporting 12 people at the moment.

“Back then, if you were a transgender person, there was no support service, but now, there are services like The T Project and an increasing number of other online support platforms,” Chua said, adding that the online platforms are usually informal support groups.

Chai from Think Psychological Services encourages LGBTQ individuals grappling with mental health issues to reach out and get support.

Her advice: When seeking support from professionals, it is important to ensure that they are qualified and hold a current professional registration. If they feel that the professional is not well-equipped to support them, they should seek a second opinion.

On the other end, more social workers, counsellors, psychologists and other social service professionals have signed up for Oogachaga’s professional training workshops, which impart appropriate skills and information to help professionals better connect with LGBTQ clients.

From an average of 50 to 80 participants a year when it first started in 2008, Oogachaga’s professional workshops has seen around 100 to 120 participants yearly in the last five years.

However, there may be still some way to go in equipping mental health and social service professionals with skills to support people from sexual minorities here.

Leow said: “In our experience working with LGBTQ individuals, couples and families for over 20 years, some of them reported that they feel uncomfortable or are not adequately supported by these professionals.”

In a study here published in the International Social Work journal in 2015, three-quarters of the 89 registered social workers surveyed said that they did not have adequate skills to attend to LGBT issues. Nine in 10 felt they did not have enough training.

Dr Wang said that, technically speaking, no special training is required for mental healthcare professionals to support LGBTQ individuals.

“We are all humans. You just need to be a non-bigoted, non-discriminatory person to treat anyone with mental health issues,” he said.

Although Talvin does not think his issues can be easily resolved, he intends to continue with his counselling sessions. “Talking to a counsellor has been very helpful. I think I got lucky — my counsellor is not judgmental at all despite me sharing with her my darkest thoughts,” he said. ― TODAY