In spite of the fear - 2. Thirty two years ago (1983)

The truth is that I really do not remember our first meeting very well, and I am being helped by some of the information Luis has given me to help me refresh my memory.

“You were sitting behind your desk, which was gray, not very big, and just efficient enough,” he recalled. “I remember that you had what seemed like a custom-made white coat – not exactly the hospital required outfit. You didn't look over forty and looked slim but not skinny. Your hair was dark, though not black. You looked impressive,” he added.

The only thing that I do remember was that my next patient at the outpatient services came through the door donning a challenging stance. This I found amusing, as he seemed very young. In fact, the policy was not to accept any client under eighteen years old. Nevertheless, in my particular case this was waived as the program was the only one that offered any sort of psychological assistance to people with sexual orientation issues in the country. To top the situation, the young man was wearing his high school uniform, which I imagine made him stand out even more while he waited his turn in the waiting room.

I remember a chap a quite over the average height of Panamanian males – 5’11” – and he was slim, had shining black hair, and almost slanted matching eyes. He was fifteen years old. On hindsight, I feel that I recalled one of my wife’s comments: “To pretty for a guy. Men should be handsome, not pretty.”

“I’m gay,” he said right off bat.

“Is that a problem? “ I asked.

“Not really. But I want to make sure it never becomes one,” he answered. There was a pause where I perhaps was trying to understand the real motive for the kid’s visit. Usually, minors were brought in by their parents or some concerned family member when they became too uncomfortable with the child’s not-so-masculine behavior. This was the first time that a youngster had come in on his own accord.

Though homosexuality had been taken out of the list of mental diseases in the DSM -- Diagnostic and Statistic Manual of Diseases-- in the United States of America in 1976, it took at least a decade for it to be modified in the International Classification of Diseases of the World Health Organization. Therefore, in Panama we worked under the assumption of homosexuality as a mental disease. Moreover, I was having many qualms with the concept because I was not convinced that any of my patients were sick, per se. Of course, there were many adjustment issues due to fear of rejection by our society, which led mainly to depression and, in some cases, to psychotic reactions. Some suicides had been reported, but they were not officially related to problems with homosexuality.

“What I do remember,” Luis told me years later, “was that you were listening to me as if nothing was really wrong with me. I was taken to a psychologist when I was around twelve, and he bawled me out for not playing sports and gesticulating too much while I talked.”

I really don’t recall much of that first meeting except for one scene. After the initial clinical history was complete and I was ready to schedule the next appointment, the kid looked at me very seriously and asked, “Do you know so much about all this because you’re gay, too?”

I was taken aback and didn't give him an answer. None of my patients had ever asked me such a question, though I think that I would have had the same doubts if the roles were reversed. Following the psycho therapeutic procedure, I’m quite sure I answered, “This is about you and not me.” Nowadays, I ask myself why I started to work with gay issues, especially at a time when in my small country there seemed to be enough tolerance but much gossip.

During my initial clinical practice, when I had become very familiar with behavior modification techniques, and considering the illness label, most homosexual patients consulted and almost demanded a cure for their condition. I must admit that it was rather easy to deal with a change of behavior, which would make the person less vulnerable to social rejection. Nevertheless, in one of my clinical research papers I mentioned that I was not convinced that sexual orientation was modifiable. This led me to detain my practice in “unwanted homosexual behavior.”

By the time I met Luis I was starting a group therapy program. The goal was to learn to adjust to Panamanian society while gaining self-respect and social tolerance – hoping for future acceptance. Most of the participants were under twenty years old. In spite of his age, the boy fit right in. The meetings were held once a week for two hours, and they continued without even a break until I retired in 2006.

Luis left the group after fifteen years, but continued a work relationship when the HIV epidemic hit Panama and a small group of collaborators joined me in founding a non-profit organization called APACSIDA – Panamanian Association against AIDS. The interaction progressed from professional to social.