Damian Bock shoulders in next to his dad, Kurtis, to squeeze into the virtual meeting screen. His hands are constantly touching his thick, nearly shoulder-length blonde hair with a shock of black underneath, tucking it behind his ear and teasing it up along the part. He settles in to tell the story of his transition as a transgender male, and how Child & Adolescent Psychiatry (CAP) at UnityPoint Health–Meriter saved his life.

Everything Piles Together  

As a 15-year-old living through the isolation of the pandemic in 2020, Damian said it was both scary and cool because it gave him a chance to put words to his feelings, choices, and identity. But the anxiety he dealt with his whole life crescendoed as he went through puberty, and he had to begin facing some of these changes. “We’ve always been supportive of the choices Damian makes and how he perceives himself,” Kurtis said. “But he always held feelings in, to where it would boil over.”

Damian describes it as layers that began to pile on top of each other. His anxiety over his gender dysphoria and normal high school stressors led to an eating disorder, and later to self-harm. By the spring of 2021, Damian had suicidal ideations and feelings, and the family made multiple trips to the Meriter ER for intervention. 

He felt buried and hopeless.

Acceptance and Inclusivity Foster Communication  

Dr. Katie Schmitt, Medical Director for CAP at Meriter, a care center that offers inpatient hospitalization and intensive outpatient mental health services for ages 6–18, said Damian’s experience is normal. The 2021 Trevor Project National Survey on LGBTQ+ youth mental health showed that 42% of LGBTQ+ youth seriously considered attempting suicide in the past year, including more than half of transgender and non-binary youth. She adds that when she first started at CAP 12 years ago, it was not common to take care of kids who struggled with gender identity issues or gender dysphoria.

“It is much more common now. There are times in our unit where over 50% of the patients that we have here identify as a different gender or prefer different pronouns or are exploring their sexual preferences,” she said. 

Schmitt points out that while there are many kids who identify as part of the LGBTQ+ community at CAP, they are not always there because of gender or sexuality issues. Many of them are comfortable with their gender and feel supported in their communities and by their families, and they are at CAP because they are teenagers with depression.

“That is the reason we treat all patients the same, by always asking about pronouns, and when talking about dating and relationships, always asking sexual preference,” said Schmitt. “We try to create a safe and inclusive environment so that kids feel comfortable expressing themselves, even if their family is not aware. It gives us the opportunity to open up lines of communication or offer education if the kiddo is ready for that.”

Damian feels grateful that his family is supportive of his choices and they were able to work together for him to start testosterone therapy in August of 2021. His mom, Jennifer, says that this helped relieve some of Damian’s anxiety as he felt he was moving forward on his trans journey. At the time, his depression and anxiety were too much to overcome though, and Damian’s physicians recommended Intensive Outpatient Services at CAP (specialized treatment for adolescents who are struggling with a primary mental health diagnosis but do not require an inpatient hospitalization).

Support Helps You Do the Self Work

“I did not want to go. At all,” said Damian with a sideways glance at his dad. “Especially since I started the program on my 16th birthday.” But he says the dialectical behavior therapy (DBT) and coping skills were easy to understand, and he quickly realized this “work” wasn’t being forced on him to complete for a grade, like at school. He acknowledged that it was on him to use those skills to get better. Only he could do that work. “I also liked that we were able to talk about our feelings and stuff without feeling judged, rather than just talking to, sorry, but old people who wouldn’t understand,” he says as Kurtis chuckles. “And there were other queer youth there which made it nice to connect to people who could understand my situation.”

Schmitt agrees it is critical for programs like CAP to have staff and programming that help kids to feel accepted and supported. She cites the Trevor Project National Survey again, which found that 70% of LGBTQ+ youth stated their mental health was “poor” most of the time or always during COVID-19 and 48% of the youth reported they wanted counseling from a mental health professional but were unable to receive it in the past year. “I think this highlights not only poor access, but also that these kids just want somebody who gets it, and until we have staff who are part of the LGBTQ+ community or are specially trained to support this community, we’re always going to be behind in serving these kids in a way they deserve to be served,” said Schmitt.

She also notes they are seeing an increase in family support for kids dealing with gender identity and sexuality questions. For parents like the Bocks who helped Damian find support groups like Briarpatch’s Teens Like Us and groups at his school, the CAP Intensive Outpatient program was more about understanding how to support Damian through his journey. “It’s impossible for us as parents to understand everything he’s going through because everyone’s journey is experienced through their own prism,” Kurtis said. “But the program really helped me understand the kind of support he needs. Not just meeting his basic needs, but truly understanding what he needs to hear when he’s in his darkest moments. We discovered that sometimes that is just saying that it’s going to be okay.”

A Community Is Better  

Schmitt said, “When this kind of support is not there, kids may feel isolated. It is so much better for kids to have access to medical or mental health professionals, support, and guidance while exploring relationships or beginning this journey. Without this support, kids may struggle more with mental illness, consider self-harm or even suicide.” 

To continue addressing this gap, UnityPoint Health–Meriter Foundation and UW Health are hosting Love is Love on February 3, 2023. The vibrant event will be a celebration of self-expression, hope, and love—all with the purpose of raising funds to support mental wellness and healing for our community’s LGBTQ+ youth. Tickets start at $100 with all proceeds benefiting CAP.

“It’s going to be another fun event! The first Love is Love in 2019 was incredible. Not only is it about raising awareness for LGBTQ+ youth mental health, but also about raising funds to support programming that helps LGBTQ+ youth thrive,” said Schmitt. 

Part of the funding will go toward training CAP staff about optimal ways to engage with and care for LGBTQ+ kids, as well as creating youth and family support groups. There are also plans to assist families with immediate emergency resources and scholarships for therapies proven to help young people heal, like art, music, or animal-assisted therapies.

Almost a year since Damian finished the outpatient program at CAP, he is able to reflect on everything he learned and says that more teens should have regular access to this type of support. 

“It made me realize that a community is better than just one person. When you’re dealing with queer issues or mental health issues, it can feel very self-centered,” he says. “It’s about me. These are my issues. No one else will understand. But when you hear others talking about the same problems, it gives you something to lean on, and you feel less isolated.”

Schmitt and the staff at Child & Adolescent Psychiatry at UnityPoint Health–Meriter are hoping they can continue to expand their programs to create the community that teens like Damian need: one that helps queer teens feel supported and hopeful about their place in the world. 

Emily McCluhan is a Madison-based writer, runner, volunteer, and dog-mom. Her contributions to regional publications in Michigan, Montana, and Wisconsin over the last 20 years provide an outlet for her insatiable curiosity and passion for telling the stories that open our eyes and connect to our everyday lives.