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By Nia Williams REVELSTOKE, British Columbia Canada is sending armed forces to tackle fast-spreading wildfires in British Columbia,

Coming out can be hard at any age, but by the time you’re well into adulthood it may feel terrifying, and be completely life-changing. Many people who come out in their thirties and onwards may have wanted to for a long time but not felt safe enough to do so. As October 11 marks National Coming Out Day, it’s important to reflect on how, if and when people can share their authentic selves. “I wasn’t raised in a time when it felt safe to express attraction to women,” says author and creative mentor Fiona Fletcher Reid, who came out last year at the age of 35. “I wasn’t sure about my sexuality until I had psychosexual therapy and was able to explore all the layers of internalised homophobia and repression that I had accumulated over my 35 years,” she says. So, how you can support someone who is going through it? Don’t assume everyone is the same Not every person’s coming out looks the same, and some LGBTQ+ experiences are not universal. “Coming out is a personal experience and because it is often physically and emotionally dangerous to be openly queer, lots of people never feel able to be open,” says Fletcher Reid, now 36. “Some people might feel free to come out once they have ended a particular relationship, or after meeting people who they feel safe around. “For others, like me, it’s that we don’t consciously acknowledge our sexuality until we are a lot older and have the confidence to work through the emotional implications and real-life consequences that come with that,” The writer, from Glasgow, was going through a divorce at the time with a man she’d been with since the age of 17. “During therapy, I talked a lot about the pain I was experiencing during intercourse as well as my general anxiety around sex. It wasn’t until I’d built up a trusting relationship with my therapist that I felt able to discuss the fact that I thought I might be gay and I did not expect that to come up, so I was just as surprised as everyone else when I came out.” Don’t question their authenticity Validate what the person who has come out is saying. “Don’t say, ‘Are you sure?’ because you can rest assured that the person coming out to you has thought long and hard about this,” says Fletcher Reid. “Casting self-doubt on someone when they have opened up a vulnerable part of themselves to you is hurtful.” Don’t question them about their sex life It’s no one else’s business. “Please don’t ask about whether they have been intimate with anyone, or any other sort of suggestion that they need to ‘prove’ their sexuality to you,” she stresses. Consider what they feel and accept that it is a big deal They are probably feeling “a mix of emotions, including excited, happy, empowered and scared for their safety”, says Fletcher Reid. “Sadly coming out can still cause huge ruptures in relationships so be aware that this is a huge moment for them and comes with real consequences. “Dismissing their experience as ‘not a big deal’ because you think it’s ‘normal to be gay’ now is a dangerous and false narrative.” It may sound simple, but just listening and supporting them is vital. “Be there to listen and try to celebrate all the new things that they are exploring as they come out, whether that’s dating, meeting new people or finding ways to experiment with their identity through fashion,” says Fletcher Reid. “Repeat often that you love and care for them and that you accept this evolution of them, that you are happy to see them happy.” Suggest they find community “Encourage them to talk to other people who have been through similar experiences if you can,” she says. “As much as friends and family want to understand what they are going through, it is far more validating to talk to someone else who has come out later in life and understands the emotional intricacies of the experience. “They can also hopefully show them that there are good times ahead.” Thank them for sharing with you “It is a privilege that someone trusts you with coming out, especially later in life. Tell them that you are honoured to have been trusted with this information, and reassure them that you will keep it private until they are ready to tell other people,” Fletcher Reid suggests. “The best reactions that I had from people were seeing their joy that I had discovered this important part of myself, and that had a huge impact on my ability to feel hopeful amidst the pain caused by my divorce. “Allowing them to feel conflicted and guilty and offering reassurance that they have the right to be themselves will make them feel so much happier.” Read More Israel-Hamas conflict: How to talk to teenagers about distressing news stories Autumn décor ideas for a seasonal refresh Why you shouldn’t tidy your garden too much in autumn World Mental Health Day: 5 ways to beat anxiety and change your life Alternative veg to grow for next season How to spot if your child is struggling with their mental health – and what to do next

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It’s no secret that women are more likely than men to be misdiagnosed by a medical professional. In fact, as many as 57 per cent of women have reported being wrongly diagnosed by a doctor. In 2016, a study found that women have a 50 per cent higher chance than men of receiving a misdiagnosis after a heart attack, while researchers found in 2014 that 33 per cent of women are more likely than men to be misdiagnosed after a stroke. When it comes to women’s health, an explicit gender bias in medicine can lead to serious and sometimes life-threatening results. That’s why Dr Erin Nance, an orthopaedic hand and wrist surgeon located in New York City, has dedicated the month of October to sharing the most commonly misdiagnosed health conditions that affect women. Her series has since gone viral on TikTok, as she discussed how symptoms of rare autoimmune disorders or infertility can present differently in women, leading to a misdiagnosis. For the first video of the series, Dr Nance revealed how postural orthostatic tachycardia syndrome - also known as POTS - affects more than one million people, but is present in mostly women aged 20 to 50. However, Dr Nance explained that POTS is so difficult to diagnose because “we can’t see it”. “This is the group of women that get written off by doctors because they look healthy. There doesn’t seem to be anything wrong with them,” she said. According to the National Institute of Neurological Disorders and Stroke, POTS is a condition in which a reduced volume of blood returns to the heart after someone stands up from a lying down position. As a result, patients with POTS may experience an increased heart rate, dizziness, or fatigue when they stand up after lying down. @littlemissdiagnosed Day 1: It’s me, POTS, I’m the the problem it’s me #littlemissdiagnosed #31for31lmd #pots ♬ original sound - Dr. Erin Nance ?? Dr Nance explained that some other symptoms of POTS include “chronic fatigue, brain fog, total body chronic pain, GI [gastrointestinal] stomach issues, anxiety, headaches, and it can affect any part of your body”. Another difficulty about POTS is that there’s “no specific treatment” to help the condition, Dr Nance said. “We can’t do a biopsy, we can’t do any imaging, there’s no blood test for it,” she added. Instead, doctors may recommend drinking more fluid, exercising regularly, or wearing compression stockings to keep blood flow in the centre of the body. For the 14th day of her video series, Dr Nance received 1.4m views when she spoke about the commonly misdiagnosed symptoms of stroke in women. “Stroke is the third leading cause of death in women,” she began the clip. “Yet, women are over 33 per cent more likely to be misdiagnosed when having an acute stroke.” Dr Nance admitted that most women who experience a stroke are often told by doctors that they simply have anxiety or a migraine. When it comes to the “unique” symptoms of stroke that are present in women, some may experience loss of consciousness or fainting; general weakness; shortness of breath; confusion, unresponsiveness, or disorientation; sudden behavioural change; agitation; hallucination; nausea or vomiting; seizures or even just hiccups. @littlemissdiagnosed Day 14: Stroke is no joke #littlemissdiagnosed #31for31lmd #stroke ♬ original sound - Dr. Erin Nance ?? “These unique symptoms are often the ones that are overlooked,” Dr Nance said, before detailing the individual risk factors that can put women at a greater chance of having a stroke. The first on the list of risk factors was taking birth control pills, followed by pregnancy, hormone replacement therapy, and history of suffering from migraines. “The reason why this is so important for everyone - every normal, everyday person - to know this is because the best outcomes are when women are evaluated and treated within three hours of having this symptom,” Dr Nance added. On day 16, the orthopedic surgeon explained how symptoms of a heart attack can also be wrongfully overlooked by doctors. “More women than men die of heart disease every year, yet women have a 59 per cent increased risk of being misdiagnosed with acid reflux, stress, or anxiety,” Dr Nance said. Besides chest pain, a woman may exhibit signs of a heart attack when she experiences unusual fatigue for several days; sleep disturbances; shortness of breath; lightheadedness; nausea or cold sweats; indigestion or gas-like pain; and pain in the arm, neck, jaw, or back. @littlemissdiagnosed Day 16: It’s not always Big on the Peloton #littlemissdiagnosed #31for31lmd #heartattack #womensheart ♬ original sound - Dr. Erin Nance ?? When it comes to multiple sclerosis (MS), Dr Nance revealed on day 19 of her video series that women are 83 per cent more likely to be misdiagnosed for MS by a doctor. MS is a disease that affects the “myelin” - the protective sheath covering the brain, nerves, and the spinal cord. According to Dr Nance, some of the often-missed signs of MS include extreme fatigue, confusion, forgetfulness, and mood swings. @littlemissdiagnosed Day 19: You’re gonna be okay #littlemissdiagnosed #31for31lmd #ms #multiplesclerosis ♬ original sound - Dr. Erin Nance ?? As for lupus - an autoimmune disease in which the immune system attacks its own tissues, causing inflammation in the body - Dr Nance shared in the 20th video of her series that women between the ages of 15 and 45 are most likely to develop the disorder. “The average time from when you first develop your symptoms to diagnosis is six years,” Dr Nance revealed. @littlemissdiagnosed Day 20: Sneaky little ? #littlemissdiagnosed #31for31lmd #lupus ♬ original sound - Dr. Erin Nance ?? She claimed that 46 per cent of patients report being misdiagnosed with something other than lupus, while “54 per cent of them were told that either nothing was wrong with them or that their symptoms were psychological.” “The main problem with lupus is that the longer you go undiagnosed and untreated, then the greater risk for end organ damages,” she added. The Independent has contacted Dr Nance for comment. 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