There is no delicate way to put this (WARNING! Sensitive Subject Ahead)

[BunnyBunnyBSNRN, ASN, BSN]

Here at the Jr High level, I've run across students who either 1) believe themselves to be homosexual or 2) appear to be, but deny it. Either way, I don't allow my beliefs to cloud my care of these students when they present to my office - or at least I haven't in the past. Now, however, I've run into a student that has me at the end of my chain and I'm not sure how much longer I can go.

This male student came to us in Feb from another school in the city. He was living with Mom but she sent him to live with Dad, idk why. When he first entered the district, he was assigned to our Alternative campus d/t a discipline issue at his previous school. By all reports, at the Alt Campus, he was low key. Now that he is here on my campus, he is VERY attention seeking. He's also become a frequent flyer (part of the attention seeking behaviour). Typically, he c/o of the ever elusive HA/SA kind of thing, but recently, he showed up for eye irritation. The first time, he presented with bilat eye irritation - redness, itch, no other s/sx of pink eye. I rinsed his eyes with sterile water, he complained because I made his mascara run, I did some pt education about tossing old eye makeup and buying fresh q 6 months/if infection is present. Two weeks later (day before yesterday) he returned for same issue, but this time c/o pain, itch, eye "hard to open in the morning" - looks like pink eye, but I'm not convinced, but he says the pain is too much and he thinks he should go home. I go to call Dad, and he FREAKS OUT - do I have to tell Dad about the makeup? Please don't! etc... We finally agree that if Dad directly asks me why I think his eyes are irritated, I'll tell him, but otherwise, I'll stick to basic info. Dad doesn't anwser, so I leave a voice mail, while we are waiting for Dad to call back, the student pulls out his compact (yes, a typical, pressed powder compact) and makes a huge show of looking at his eyes and putting on lip gloss. The whole time he's doing this, he keeps looking up to see if I'm watching - I can see him out of the corner of my eye, but continue to chart on the computer and do other work. After talking with Dad, student goes back to class. Before his return to class, we talk about the eye makeup again, and ILeft remind him he needs to buy new stuff to avoid continued re-infection. Dad calls later in the day to check on him. Yesterday, student comes in, and now I'm convinced it's pink eye. I call Dad, tell him about my assessment, and Dad says he'll come to pick him up and take him to be seen. Kid goes for his things, and comes back to use my bathroom to take off his makeup so Dad won't see it.

This morning, kid comes in to show me his doctor's note and I can smell his perfume (not colonge) from the door. This is also something I've talked to this student about before - d/t asthma students, he needs to scale back his perfume usage.

I don't know if this is a vent or an advise seeking post. What I do know, is I'm not sure how much longer, I can continue to not give this kiddo a reaction to his show.

Sigh...10 more weeks...WOW! I'm gonna miss this place.

[Flare, ASN, BSN]

Oh, I know the story. I've had male students come in and claim they are female. Can't recall many females identifying as male.

I think you handled it the right way. That if dad specifically asks where the infection comes from, let him know. I am with you. I will not lie to a parent.

Stay the course. Don't give into the attention seeking /shock value behavior. I am not saying it will go away, but it may certainly take it down a notch. Continue to be frank with him about how he needs to be responsible when it comes to use of makeup and perfumes. There should also probably be a dialogue about the risky types of behavior that are often associated with an alternative lifestyle if the opportunity lends itself. Not saying it has to come from you, but you can certainly encourage him to seek advisement from another trusted source.

[intheweeds]

Sounds like he is seeking attention to help work through his identity. I'd refer to the school counselor to help him talk things out, find a support group, etc. I think you handled the father appropriately, but if the student continues coming in all the time, I might want to have the "frequent flier" chat with the parents.

[caliotter3]

Don't encourage him. Continue to address the problem at hand while ignoring the attention seeking behavior. I'll bet he doesn't do his makeup in the male bathroom in the presence of other males.

[heartflutter, ADN, BSN]

The student may be transgender or just happens to like wearing make up. I don't think either of those things imply homosexuality.

Either way, maybe he just needs to talk to a school counselor or psychologist. And dump the old make up for some new stuff. Yick.

[halkogirl]

If this was a girl, we wouldn't be having this discussion. Girls can dress in boy clothes and have short hair and never wear makeup, but nobody says boo. Many girls put on loads of makeup and perfume and look around to see if anyone is watching them. He may have some attention seeking behaviors, but you need to look past the makeup and the perfume and anything else you consider "feminine behavior" and look at the situation then. I am not denying that he may be an attention seeker, but I think that you may be letting your emotions about his sexuality cloud your judgment. He obviously had some sort of eye irritation or infection; how is that attention seeking? Unless he is sticking his mascara wand into his eye, you shouldn't be considering that attention seeking behavior.

[ddunnrn]

As an RN who also happens to be gay, I would say to you to keep on doing what you're doing in terms of giving appropriate medical information in a non-judgmental way. You'd be surprised how being neutral on the gay thing will help him in the long run. I think he is possibly testing you to see how "society" is going to treat him. Personally, I have had very few negative reactions to people fiinding out I'm gay, but then I live in a big city. One of my most cherished memories is when I was a student, and my class went to a social gathering--my instructor was making small talk with me, and she asked whether I had a girlfriend or a boyfriend in such a matter-of-fact way that I knew it didn't make a difference to her. I have remembered that fondly in the last 30 years.

[LACA, BSN, LPN, RN]

If the student is making a huge show of checking his makeup and putting on lip gloss, then yes it IS attention seeking behavior.

[SolaireSolstice, BSN, RN]

My son wears makeup. He started when he dressed up as Lady Gaga for a Halloween costume contest in 8th grade and liked the way it made his skin look. (He won the contest). He's very vain, in my opinion. Incidently, he has a girlfriend this year in 9th grade. Mostly I just assist him with how to apply makeup so it doesn't look silly and I draw the line at him borrowing mine; he has to buy his own, though I do buy his moisturizers. My son has Karatosis pilaris. http://www.mayoclinic.com/health/keratosis-pilaris/DS00769

This age is all about identity vs role confusion. If the behavior is disruptive, then it must be curbed (especially too much perfume, but so many people do that, even adults), but otherwise, who cares? Who is it hurting? Perhaps, like my son, he is masking something, whether external or internal. Why don't you simply ask him?

[Flare, ASN, BSN]

Solairesolstice, you make some good points. Perhaps just coming out and saying "Jim, what's the reason you are wearing so much eye makeup" is the key. One simple question. No reaction to the answer - especially if it's a shock value type answer or something you don't agree with.

There is a definite difference in a boy wearing make up to cover up a skin condition and a boy theatrically applying lip gloss and eye make up.

[tencat]

It really doesn't matter if he is putting on makeup or lipgloss or perfume. And if you're going to get on his case about toning down perfume, you'll have to make sure you get on all the other kids too, as ALL jr. high kids wear WAY too much perfume and cologne. :) As to sexual behaviors: these days ALL sexual behavior is risky, whether it be heterosexual or homosexual. So I don't think it's appropriate to single him out to 'preach' about the risks of a 'homosexual' lifestyle.

The kid is attention seeking. However, it's not worth making a big deal over. If he's a frequent flier in the nurse's office, then the issue needs to be addressed. I'm willing to bet his peers are less than supportive of his oddness, and he's having issues with the other kids. Maybe he sees you as a safe person and your office as a safe place. The school counselor should also be aware of him, if that person is not already. I think you are bothered by a boy acting like a girl. That's ok, but you need to make sure that feeling doesn't interfere with your care of this kid or any other kid like him.

For the record, I've seen girls who pretend to be boys, as well as boys trying to look like girls. Some of these kids will 'grow' out of their particular way of creating shock value in the adults around them, but a lot of them will not and will struggle for the rest of their lives with their sexual identities. There is a high suicide rate among gay/transgendered kids.

[smily nurse, BSN, RN]

Either way, when I was in a big city high school, I noticed that it was rather "in" to be gay. Just be open and accepting.