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The question: I'm gay, and no one in my life knows. Not my family, not my best friend – no one. I'm okay with who I am, but I am terrified to talk about it. I'd like to start with my mom – she's going to be the most difficult, I think – very conservative values (but never outwardly homophobic). Do you have suggestions on how to have this conversation?

The answer: Coming out can be hugely stressful, scary and challenging. Ironically, this process may feel most difficult when it comes to speaking to the people who are closest to you.

I am happy to hear that you feel confident in your sexuality: Self-acceptance is a huge first step. The next steps toward coming out are also key; we are by nature social beings, and both need and thrive off social connections. Having the support and acceptance of those that mean the most to you is integral.

You say that your mom will likely be the most difficult to talk to. My gentle suggestion would be to first come out to other family members or friends who you anticipate may be more approachable. This can help prepare you for how conversations may go, and more importantly put in place a support system for when you do talk to your mom.

When you do speak with her, understand that she may express a range of reactions. In the best-case scenario, she may surprise you, and the conversation may go much easier than you anticipate. However, many parents – despite their best intentions and love for their children – may express sadness, frustration, confusion or anger when their child comes out. Keep in mind that the intensity of any negative emotions she expresses will likely dissipate over time, and may in large part be a knee-jerk reaction to hearing something unexpected.

When you do decide to speak to her, have the conversation when you are both free of distractions and can have dedicated, uninterrupted time. Pick a day in which you are feeling reasonably rested and well from a physical and emotional standpoint. Start by telling her that you need to speak to her about something important and personal, and that you would like her to first listen and try not to interrupt or react. Let her know that you love her and that you realize what you are telling her may be hard for her to hear or accept. And then speak openly and honestly from your heart. Try to describe to her what the journey has been like for you and also express how important her support is to you.

Coming out may be a difficult journey, so do take care of yourself emotionally and physically throughout this time. Engage in good self-care when it comes to sleep and diet. Exercise and minimize use of alcohol. Build a network of support that can be there for you as you start having these conversations.

There are a range of community agencies and professionals that can help support you through this process. PFLAG Canada ( pflagcanada.ca) is a national organization that offers support and referrals, and is available 24/7.

Send psychologist Joti Samra your questions at psychologist@globeandmail.com. She will answer select questions, which could appear in The Globe and Mail and/or on The Globe and Mail web site. Your name will not be published if your question is chosen.

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The content provided in The Globe and Mail's Ask a Health Expert centre is for information purposes only and is neither intended to be relied upon nor to be a substitute for professional medical advice, diagnosis or treatment.

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