Coming Out Kinky: An Introduction for Clinicians

From a therapeutic standpoint, there are a number issues involved with coming out as a participant of any of these lifestyles. As previously discussed, Carol Clark (2011) theorizes that the number one motivator of all human behavior is a sense of belonging to a group and it is important in the formulation of one’s identity and sense of meaning. Additionally, from studies examining the ramifications of hiding one’s sexual orientation or gender dysphoria, we know that there are negative effects on self-esteem along with an increase in anxiety and depression. We can then extrapolate that repressing a Kinky identity may also have these negative side effects.

There are times where the negatives far outweigh the benefits of coming out. As a therapist, it is important to examine both short-term and long-term consequences prior to helping a client come out. Consequences of coming out may include the loss of family and friends, complications with work, custody issues, housing, and relationships issues.

Why Would a Patient Want to Come Out?

Oftentimes when I have a Kinky patient coming in to process a plan towards coming out, I first try to understand the need they are trying to fulfill. This is essential in formulating a plan and addressing the realistic expectations of the consequences. There are a number of reasons why patients will feel the importance of coming out. Some individuals feel it is important to come out prior to any suspicion of physical abuse, in the case of BDSM, or infidelity, in the case of non-monogamy. Others want to stop feeling like they are lying to people that they love about who they are. Still others feel it is unfair to their partners to exclude them from family and work functions that encourage family participation. No matter the reason it is our job to support, educate, and help them to weigh the costs and benefits of doing so.

Coming Out to Family or Friends

The shunning from friends and family is one of greatest fears I hear among polyamorists and GLBTQ+ patients about the idea of coming out. Also, if they have children, they often fear someone may attempt to take their children away from them. Fears of schools and other professionals calling CPS are very legitimate, and we have had incidents in many states to prove that this can occur. Loss of their children during a particularly high conflict custody battle is also a consideration for many patients. When making the decision about coming out, I find it important to have contingency plans for these situations so that the patient can feel more comfortable with their choice.

When coming out to family or friends, it is important to note that less is more. Neither of the people in these roles generally have an interest in knowing the ins and outs of one’s sex or home life. Additionally, we cannot control the reaction or behaviors of others. It is important to note that one’s friends and family have an absolute right not to accept this information, and that if they choose not to accept it, there may be unpleasant consequences. It is important to pick and choose disclosure recipients wisely.

coming out

How an individual comes out can be as important as to whom. Some people choose face- to-face individual meetings, group conversations, or talking on the phone, whereas others choose email so that the other party can digest the information prior to responding with what could be an immediately emotional response. It is important to be honest and thoughtful. Remember to remind the patients to empathize with whom they are disclosing to. The loved ones and friends to whom they are opening up have their own schemas and must have time to process and adapt this new information. Remind the client to be patient and open with questions, and to have minimal expectations of the recipient.

Coming out to children is not important until they start asking questions. Children could not care less about adult bedroom behaviors but rather want to know that they are safe and loved. Normalize the lifestyle and answer questions in an age-appropriate way. For the most part, coming out to children is primarily an issue with polyamorous and GLBTQ+ individuals as opposed to those involved in BDSM.

Coming Out to Healthcare Providers

Coming out to healthcare providers can be a very stressful experience, but it is essential that one do so in order to allow medical providers to make the best decisions regarding the patient’s healthcare. As medical providers, it is our responsibility to help clients feel at ease when discussing their sexuality. If the patient is dancing around the topic, let them know that you are a safe person to disclose to. Remind them that they are in a safe place and that their family does not have access to their medical records. As a therapist, coach your clients to interview healthcare providers and inquire about their feelings about sexual diversity and sexuality. This is a great lead in for clients to determine if a given medical provider is a good match for their needs.

Coming Out To Employers

This is a particularly touchy subject that I often see in my practice. As with coming out to friends and family, I first feel the need to explore their need for it. Most workplace scenarios will not require that a patient’s home life be relevant for their employment, but in the professions that require a morality clause, this can be highly detrimental to the patient’s career. This is an especially important topic for my clients in the military, with security clearances, and in primary education. Also, I have had a number of celebrities, politicians, clergy, and healthcare administrators for whom coming out publicly or in the workplace has generally been an unrealistic expectation. So why would one need to come out at the workplace? I have had clients who wanted to advocate for their group, as in the case of many of my transgender clients in the military and some celebrities. Otherwise, my clients have mostly wanted to disclose so that they no longer feel like they are lying or have to put on an act in order to fit into their workplace. In the end, as a therapist, it is important to support the client’s choices but again, educate them on the consequences and help the client strategize a plan that works for them.

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