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Kristina De Los Santos

on 13 December 2014

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Transcript of LGBTQ

Sheri Bath & Kristina De Los Santos

The best way to understand how sexual or gender minority clients want to be referred as is to ask. Persons who are sexual or gender minorities may identify in one of many different ways, including, but not limited to, lesbian, gay, bisexual, transgender, transsexual, or queer.
Difficult to estimate with accuracy due to pervasive institutionalized, social, religious, and governmental discrimination against sexual and gender minorities.
New data according to the CDC: Among all U.S. adults aged 18 and over:
96.6% identified as straight, 1.6% identified as gay or lesbian, and 0.7% identified as bisexual
a higher percentage of women (0.9%) than men (0.4%) identified as bisexual
the percentage of adults who identified as gay or lesbian was similar for adults aged 18–44 (1.9%) and adults aged 45–64 (1.8%)
What is Stigma?
According to Goffman, Stigma is an "attribute that links a person to an undesirable stereotype, leading other people to reduce the bearer from a whole and usual person to a tainted, discounted one"
Stigma can come from peers/family, media, laws, culture, and history

"As gay men, we are bombarded from an early age with negative messages that there is something wrong with us. This disconnects our internal feelings from our external presentation, and leads inevitably to the challenge of discovering our authentic self. Such a deep well of shame creates a fertile breeding ground for felt stigma, where the very real danger of discrimination fuses with one’s internal negative beliefs, resulting in a destructive, self-sustaining pattern." - David Fawcett (psychotherapist and advocate)
Historical Perspectives
Within psychology, the failure to both recognize the implications of race privilege, and question the legitimacy of white forms of knowledge is evident in the desire of white psychologist to measure, describe, and “know” the “other”
Barbaric practices as measuring skull differences between races, incarcerating, medicating or silencing those who do not conform to the white, heterosexual subject of psychological knowledge

Religious Perspectives
Double Indemnity

"Coming Out"
Relationship & Marital Concerns
Career Concerns

Parenting Concerns
Spirituality Concerns
Hate Crimes
Suicide in the LGBT Community

Drug and Alcohol Abuse
LGBTQ Treatment Facilities
Coping with HIV Stigma
Military: "Don't Ask, Don't Tell"
Social Change &Community Outreach
National LGBT Organizations
Social Media
LGBTQ Psychology
New Jersey
Garden State Equality (http://www.gardenstateequality.org/)
150,000 members, the largest civil rights organization in NJ
Since 2004 has enacted over 200 pro-LGBT laws at the state, county and municipal levels.
Current issues : Bullying, Transgender community, hate crimes, adoption/foster care
Q-Spot (http://qspot.org/)
LGBT community center
Jersey Pride (http://www.jerseypride.org/)
Organizes NJ's annual pride parade
Pathways (http://pathwaystg.org/)
transgender support group in Bergen county
welcomes crossdressers, transsexuals, or anyone else seeking the support and community of their peers
has a changing room available for those who need to transform on site
Church programs/faith sharing groups
make church a welcoming place for LGBTQ indivudals

The Trevor Project (http://www.thetrevorproject.org/)
crisis intervention and suicide prevention services to lesbian, gay, bisexual, transgender and questioning (LGBTQ) young people ages 13-24.
chat rooms, hotlines, and texting available for crises intervention around the clock
workshops and trainings are offered for both professionals and LGBTQ youth
Human Rights Campaign (http://www.hrc.org/)
largest civil rights organization working to achieve equality for lesbian, gay, bisexual and transgender Americans
1.5 million members!
equality magazine
programs for LGBT children youth and families (adoptive, foster families)
programs for LGBT senior citizens
Workplace equality programs
LGBT college students
Social Movements
LGBTQ activism
Community Organizations
Online Communities
Advocacy and Political Change

Social media, particularly Twitter, have given a greater voice to Lesbian, Gay, Bisexual and Transgender (LGBT) communities around the world
Individuals and groups have used social media to gather, physically and virtually, to promote and support LGBT issues and rights
Recent Facebook Controversy.....
Locked dozens of drag queens out of Facebook because it was required these individuals use their legal names
Facebook said: this policy would help with impersonation, trolling, and bullying. "It’s a matter of principle, Facebook’s Chief Product Officer Chris Cox said. Facebook doesn’t want to be like the icky anonymous Web. Facebook wants to be “a force for good.”
LGBT community said: the real-name policy jeopardized their safety and their rights. Pseudonyms were often used by authors, bloggers, and celebrities
What's happening: accounts are slowly getting reactivated. LGBT community is demanding Facebook remove the option where users can report unauthentic accounts, this power is being abused by users who dislike the LGBT lifestyle

Don't ask Don't Tell:
Timeline:20th Century
1941 – The U. S. Selective Service System includes "homosexual proclivities" as a disqualifying condition for inclusion in the military draft.

1942 - Military psychiatrists warn that "psychopathic personality disorders" make homosexual individuals unfit to fight.
If identified as "homosexual" denied VA benefits

1953 –
homosexuals posed a threat to national security

1970s to 1990s- Many cases against armed forces, most were losses for the LGBT community

1993- President Clinton Signs Don't Ask Don't Tell Law
the policy defined homosexuality as "an unacceptable risk to the high standards of morale, good order and discipline, and unit cohesion that are the essence of military capability."
13,000 members of the armed services have been discharged under "Don’t Ask, Don’t Tell."
2007 – Senator Barack Obama, campaigning for the presidency, pledges that if elected he will repeal the "Don’t Ask, Don’t Tell"

September 9, 2010 – U.S. District Judge Virginia Phillips rules that the "Don't Ask, Don't Tell" policy is unconstitutional because it violates the First and Fifth Amendment rights of homosexuals.

December 2010 – The House of Representatives and Senate votes to repeal "Don't Ask, Don't Tell"

December 22, 2010 – President Barack Obama signs the repeal into law. The formal repeal will not begin until 60 days after the President, Secretary of State and Chairman of the Joint Chiefs of Staff certify in writing that the military is sufficiently prepared for the change.

June 26, 2013 – U.S. Supreme Court strikes down a portion of the 1996 Defense of Marriage Act (DOMA)
military families CAN now receive federal benefits
"Don't Ask Don't Tell"
Timeline: 21st Century
Source: http://www.usni.org/news-and-features/dont-ask-dont-tell/timeline
The act prohibited any homosexual or bisexual person from disclosing his or her sexual orientation or from speaking about any homosexual relationships, including marriages or other familial attributes, while serving in the United States armed forces. The act specified that service members who disclose that they are homosexual or engage in homosexual conduct should be separated (discharged)
Geography of Hate
Humboldt State University Project that mapped how many homophobic tweets occured in the US.
From 2012-2013
Only shows a small portion, because only individuals who had "geotagging" enabled on their smart phone could be traced
Homophobic tweets
Tweets using the word "Dyke"
Tweets using the word "fag"
Tweets using the word "queer"
Source: http://users.humboldt.edu/mstephens/hate/hate_map.html#
Ways Bullying can occur:
Verbal, Physical, Cyberbullying, Indirect Bullying
Students who also fall into the gay, bisexual, lesbian or transgendered identity groups report being
five times as more likely
to miss school because they feel unsafe after being bullied due to their sexual orientation.
In fact, about
9 out of 10
LGBT teens have reported being bullied at school within the past year because of their sexual orientation
A national survey of 760 students, ages twelve to seventeen, indicates that the most likely group to be bullied are "
kids who are gay or thought to be gay
Students who had experienced anti-gay harassment are
four times more
likely than non-harassed youth to be
threatened with or injured by a weapon.
LGBTQ students are
two to three times
as likely to commit suicide as heterosexual students and may account for a startling
30 percent
of all completed youth suicides
Source: http://www.violencepreventionworks.org/public/bullying_sexual_orientation.page
For Further information..
Counseling Implications
When working with LGBTQ clients, counselors should:
be knowledgeable about the importance of LGBTQ relationships
understand the particular challenges faced by LGBTQ parents
understand that a client’s sexual orientation may have an impact on relationships within the family
recognize challenges of being LGBTQ and a member of a racial or ethnic minority
understand the special problems and risks that exist for LGBTQ youth and older adults as well as those with physical, sensory, and/or cognitive/emotional disabilities
review the literature on appropriate treatment with LGBTQ clients

Source: http://www.dshs.wa.gov/pdf/dbhr/mh/resourceguide/gaybestpract.pdf
Cochran, Stewart, Ginzler and Cauce (2002)
Lesbian, gay, bisexual and transgender youth that are victimized in their family of origin are more likely to runaway from home
are victims of physical violence from family members (particularly for males)
this may result in higher incidence of homelessness, substance abuse, symptoms of psychopathology, more sexual partners than heterosexual homeless youth

LGBTQ youth have fewer opportunities to explore social roles and socialize with their peers. Their "rehearsal for adulthood" becomes more difficult
By age three, most children can recognize gender and by age 5-6, children have a strong understanding of gender-appropriate behavior
Between the ages of 12 and 14, many gay adolescents begin to realize that their attraction to members of their own sex could mean they are part of stigmatized minority group (same-sex attraction could occur younger than puberty). Some suggest that LGBT youth suffer more than non-LGBT youth from issues related to family, violence, substance use, suicide, and sexually transmitted infections.
Fear of rejection
If they disclose their sexual thoughts to their parents, the feelings often are denied as just being a part of a phase the teen is going through or parents will express shock or anger. Similar to a grief process of denial, anger, bargaining, and acknowledgment.
If do not disclose, could lead to mutual isolation due to awkward and inauthentic communication
Source: http://www.advocatesforyouth.org/publications/424?task=view
Source: http://www.cdc.gov/nchs/data/nhsr/nhsr077.pdf
Movement Advancement Project Results: Populations
See the map and more details at : http://www.lgbtmap.org/equality-maps/lgbt_populations
New Jersey Statistics
Total Adult Population: 6,838,206
LGBT Population: 253,014
LGBT % of State Population:3.7%
Same-Sex Couples Raising Children: - 20%
New York Statistics:
Total Adult Population: 15,307,107
LGBT Population: 581,670
LGBT % of State Population:3.8%
Same-Sex Couples Raising Children:16%
Total Adult Population: 2,796,789
LGBT Population: 95,091 LGBT
% of State Population:3.4%
Same-Sex Couples Raising Children: - 17%

Tri-State Area Statistics
Source: Movement Advancement Project
Some LGBT individuals may be LGBT and also be substance abusers, HIV-positive, or disabled. Some are sex workers, some have a diagnosed mental illness such as depression, and others may be homeless.

Stigma (Continued)...
HIV/AIDS & Stigma
Stigma about being LGBTQ impacts access to:
prevention, testing, and care for HIV/AIDS

One’s willingness (or not) to be tested for HIV is driven by stigma
Stigma accounts for at least a portion of the estimated 20% of people living with the virus who don’t know their status
Fears of walking into a testing site
Fears of disclosing risky sexual behaviors with health care providers

There are even stigmas within racial groups
Research shows that members of the African American community sometimes feel that having unprotected sex with a masculine man is less risky, because "such a strong man wouldn't be infected"
The notion that HIV positive people "look unhealthy" is a stigma

Another study showed that some health care providers deny that they treat HIV infected individuals when asked in group settings
Sources: http://www.positivelyaware.com/2012/12_07/spoiled-identity.shtml
Lectures by HIV positive speakers
Support Groups
Help others
Educate others
Source: http://www.positivelyaware.com/2012/12_07/spoiled-identity.shtml
Recent Hot Topic
Stigma of being a LGBT Athlete
"Sports" is the stronghold of masculinity in North America and athletes thrive off of it ... and there is nothing less masculine in our culture - or the perception anyways in our culture - than being gay."-Cyd Ziegler, co-founder of outsports.com

Michael Sam, a defensive end, who was the SEC defensive player of the year in 2013, was the
openly gay drafted NFL player
Drafted by St. Louis Rams, where he kissed his boyfriend on LIVE TV
He played for both St. Louis Rams and the Dallas Cowboys, but was released. He is currently a free agent
Any gay player contemplating coming out will need to answer this question -- if Michael Sam had not publicly come out as gay, would he still be in the NFL?
Source: http://www.outsports.com/2014/10/22/7037797/michael-sam-cut-dallas-cowboys-gay-players-nfl-future
Increasing numbers of young people have “come out”, at even younger ages as lesbian, gay, bisexual, transgender, or queer.
homophobic nature of our society.
risk the loss of interpersonal relationships
economic hardship
physical danger due to prejudice and discrimination
Periodic regression to previous stages of identity development is a natural part of the coming out process when homophobia is confronted.
Positively correlated with mental health and with relationship satisfaction.
Counselors working with a client who is dealing with coming out:
role play to practice disclosure
participation in a support group with other gay people
Branch of psychology concerned with the lives & experiences of LGBTQ people.
Examines aspects including sexuality, prejudice/discrimination, parenting & family concerns, identity development and “coming out”.
Challenges the view that homosexuality is a mental illness

“If psychology is to be a true ‘psychology of people’, then it must examine the experiences of all people and be open to the ways in which people’s lives differ.” -By Charlotte J. Patterson
1930s: Aversion therapies aimed at changing sexual behaviors of homosexuals, sexual dysfunctions, and paraphilias.
1935: Dr. Louis W. Max (NYU) published a paper discussing the use of an apparatus designed to administer powerful electric shocks (80 to 100 volts) to clients when they were experiencing an "inappropriate" erotic stimulus.
ex. viewing a photograph of someone of the same gender who the client finds sexually attractive
Marriage Equality
Typically denied of most legal, religious, economic and social benefits bestowed on heterosexual couples.
Denial of marriage rights may negatively contribute to their mental health
Counselors can help gay couples anticipate and perhaps plan rituals or celebrations around changes in their relationship
Find alternative legal signs of commitment: buying a house, making a will, filing a power of attorney
When two men build a relationship together, there is a double influence of male sex role socialization in terms of low interpersonal skills, aggression, independence, achievement, competition, and object-oriented sexuality may become problematic
when relationship difficulties arise, gay men may be more prone to seek isolation, a coping mechanism from childhood used to deal with gay feelings
When two women build a relationship, about 95% have dated men and between one-fourth and one-third of them have been married to a man
couple issues: difficulty with differentiation and maintaining a sense of self, identity fusion
Counselor could help discover ways to promote individual autonomy: encourage statements of individuality, teach about boundaries, triangulation and fusion, and reframe undifferentiated care taking as disrespectful
The denial of civil marriage rights is a specific example of minority stress that can negatively affect the psychosocial well-being of self-identified lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals in same-sex partnerships, their families, and their allies.
Counseling psychologists have an important role in addressing the minority stress that same-sex couples experience as a result of the lack of marriage equality.
In the service of social justice, counseling psychologists can use their training as practitioners, advocates, and researchers to effectively intervene at multiple levels of the ecological system to support same-sex couples & their families.
individuals who self-identify as female gender and express either self-identities as lesbians, sexual or romantic fantasies involving other women, or sexual or romantic behavior with other women
gay men:
individuals who self-identify as male gender and express either self-identities as gay, sexual, or romantic fantasies involving other men, or sexual or romantic behavior with other men
individuals who self-identify as one gender (male or female) and express either self-identities as bisexual, sexual or romantic fantasies involving same and other-gender persons, or sexual or romantic behavior with same and other gender persons
a person born with the culturally sanctioned characteristics of one gender (male or female) and whose psychological experience is that of the other gender. Transsexuals, like non-transsexuals, may identify as gay, lesbian, bisexual, straight, queer, or none of the above
a person who strongly identifies with the opposite sex and may seek to live as a member of this sex by attempting to look, dress, and act like a member of the opposite sex; undergoing surgery and hormone therapy to obtain physical appearance
a person who self-identifies as not belonging to the dominant cultural view of sex or gender
Verbal and physical assaults motivated by the perception that the victim is gay, lesbian, or bisexual. Include verbal insults, taunts, threats, spitting, kicking, punching, throwing objects, vandalism, arson, attacks with weapons, rape and murder
at least 92% of gay men and lesbians have experienced anti-gay verbal abuse and as many as 24% have experienced physical violence
only 7 states provide legislation protecting citizens independent of gender identity or expression
Hate crimes can lead to internalized homophobia
Succumb to anti-gay prejudices of our society. Associated with depression, low self-esteem, defensiveness, and impaired intimacy

Sexual or gender minority people of color ethnic gay people face “double indemnity” of race and sexual orientation
must find a way to exist in three communities simultaneously: interacting with gay people, people of their ethnic group, and with predominantly White heterosexual majority

6 to 14 million children in the U.S. have a parent who is gay/lesbian and 8 to 10 million children are being raised in households identified as lesbian or gay through adoption, alternative insemination by donor, heterosexual intercourse during marriage, heterosexual intercourse for the purpose of procreation, and foster parenting
Research indicates that there are no major differences between lesbians and heterosexual women in terms of child rearing
children of gay parents are no different from children of heterosexual parents in terms of gender identity development, sexual orientation, toy preferences, activities, interests, occupations, personal adjustments, or social relationships
one issue may be over-parenting or competition for the primary parent and maternal role
Whether to come out to children in consideration of psychological or physical harm to the child by peers, the child’s rejection of the parent, or the child telling other people which might lead to employment, social or custody issues
most difficult time to come out is during early adolescence due to generally high homophobic attitudes (children who are told of parental gay, lesbian, or bisexual identity in either childhood or late adolescence may find the information easier to handle)
Legal issues
concerns with losing physical custody of their children, visitation restrictions and prohibitions against adoption
Sexual orientation may affect the work life of many gay people in several potential areas such as career choice, workplace benefits, workplace stresses, and career advancement.
often not able to integrate their personal lives into the workplace as freely as their heterosexual colleagues do, in simple actions such as displaying a photo of their partner
Corporate nondiscrimination policies, including those concerning sexual orientation are becoming normative in many parts of the countries, especially for large corporations.
most now grant full domestic partner benefits
Counselors working with a gay client in career planning
identify the client’s level of sexual identity formation and accept the client’s sexual orientation as viewed from within the client’s own frame of reference

Conservative religious organizations tend to base beliefs on self-defined “tradition” leading to more rigidity, exclusiveness, and condemnatory attitudes towards LGBT communities

Counselors should engage in a process of self-reflection of their own sexual orientation and gender identity
increase self-awareness and identify heterosexual privileges
20-30% of LGBTQ adolescents attempt suicide (2-3 times higher than other adolescents). Also at higher risk for drug use, truancy, academic problems, dropping out of school, and running away from home.
typically 1 out of 5 lesbian adolescents and half of gay male adolescents experience verbal harassment or physical assault at school due to their sexual orientation.
22% of LGBT students report not feeling “safe” at school compared to 7% of non-LGBT students

"A sickness, and it needs to be treated. Many of those people involved with Adolf Hitler were Satanists, many of them were homosexual. The two seem to go together."
-Pat Robertson, Christian Coalition founder
LGBT’s use alcohol, tobacco and other drugs for the same reasons as others, but their likelihood for doing so is heightened by personal and cultural stresses resulting from anti-gay bias
Some LGBTQ members rely on bars for socialization
Feeling discriminated against or marginalized can increase substance abuse rates
Public health challenges
Lack of research on Transgender and Bisexual Individuals and research with non-white LGBT members
There is evidence to suggest that gay men and lesbians perceive themselves to be at increased risk for alcoholism and substance abuse, that they have an increased need for treatment, and that they face barriers to treatment.
Gay men and lesbians report alcohol problems nearly twice as often as heterosexuals
Substance abuse-specific risk factors for LGBT Youth/Young adults
�Sense of self as worthless or bad.
􀂃 Lack of connectedness to supportive adults and peers.
􀂃 Lack of alternative ways to view “being different”
􀂃 Lack of access to role models.
􀂃 Lack of opportunities to socialize with other gays/lesbians except bars.
􀂃 The risk of contracting HIV.
Source: http://www.nalgap.org/PDF/Resources/LGBT.pdf
Source: https://www.nalgap.org/PDF/Resources/Substance_Abuse.pdf
LGBT treatment facilities for substance dependent individuals are a popular option
Reasons an LGBT client might seek this type of facility
Heterosexism plays a part in the chemically dependent LGBT individual’s inability to access effective treatment services
Substance abuse treatment facilities are often not able to meet the needs of this special population.
Other clients may have negative attitudes toward the LGBT client.
The treatment staff of such facilities may have varying heterosexist assumptions regarding the LGBT clients who access their services.
They may be uninformed about LGBT issues, insensitive to or antagonistic toward LGBT clients or believe that homosexuality causes substance abuse or can be changed by therapy (CSAT, 2003)

Biopsychosocial model for chemical dependency takes into account how society impacts LGBT individuals

Also NA/AA can be very welcoming to LGBT individuals
Believe that "secrets keep us sick"
Source: http://pride-institute.com/about/why-lgbt-treatment/
LGBT Homeless Youth
a few of the photos I took at Pride 2013 in NYC
Counseling LGBT Clients
Handbook of Counseling and Psychotherapy with Lesbian, Gay, Bisexual, and Transgender Clients, Second Edition
ISBN: 1-59147-421-3
Sexual Orientation and Mental Health: Examining Identity and Development in Lesbian, Gay, and Bisexual People
ISBN: 1-59147-232-6
Informative Websites
Homosexual practices were associated with idolatry and heresy
Led to strong aversion and violent reactions against homosexuality by Jewish, Christian, and Zoroastrian religions
Condemned by laws and customs
Sigmund Freud (1905)
Suggested that an exclusive heterosexual orientation is not only a result of biological causes, but influenced by societal prohibitions on homoerotism and early experiences with parents
Oedipus complex
References (cont)
Coming Out "Stars"
1. Each person pick either a
, or
2. Imagine the star represents your world, with you in the center & those things/people most important to you at each point of the star.
write your name in the center of the star
3. Starting on any point of the star, chose a friend who is very close to you and you are about very much & write their name.
4. Chose a community that you belong to (ex. religious, fraternity/sorority, neighborhood) & write it on the next point moving clockwise.
5. Think of a specific family member you always turn to for advice or has had a large impact on your life & write their name on the next point.
6. What job would you most like to have, write it on the next point.
7. What are some of your hopes & dreams (ex. have children, millionaire, etc.); write a few on the last point of the star.
8. Now, imagine that each of you are lesbian/gay. Stand in a circle to begin your coming out process.

Transgender people report experiencing conflict over their gender assignment throughout childhood and adolescence.

Youth of color are significantly less likely to have told their parents they are LGBTQ
pressure to choose between their ethnic and their sexual identities

Risk for STI/Unplanned Pregnancies
lesbians experience pregnancy at higher rates than their heterosexual counterparts and are less likely to use protection during heterosexual intercourse than other women
Source : Fawcett (2012)
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