LGBT in Therapy

LGBT in Therapy

Ash Wickell, LMFT-T

Sex, Gender, Orientation

Identity Models

LGBT Experience

Trauma & Attachment

Core Assumptions:

Gay, Lesbian, Bi, Trans...

How do we COPE?

Best Practices...?

Clinical Experiences

Online Resources:

Local Resources

AAMFT says...

Spectrum Models

Developmental Models

LGBTQ Identities are Real

To Do:

Developmental

...or maybe...

Violence

To Avoid:

Oppression? Also real.

...then again...

Relational

Relational Impacts

A Basic Taxonomy of Identity:

SEX: What's in your pants?

(or what do you wish were?)

GENDER: What kind of pants do you

(or would you like to) wear?

ORIENTATION: Whose pants do you want to get into?

2011-Present: Clinician at First MCC

2011-Present: Founding Director at Wichita Trans Rise Above

2009-Present: Teaching Team Member at Campus Pride

2006-2010: That Gay Group Executive

2003-2006: Center for Jewish Studies

CONTACT: ash.wickell@gmail.com

*Reality: Most of us use WORDS to communicate about who we are!

*Identity signifiers may be: limiting, emotionally fraught, contextual, and complicated, however...

*Identity signifiers may also be clarifying, liberating, routes to relationship and community, hard-won

*Spectrum models manage complexity by placing identity on a continuum.

*This can be an effective way to group identities, for example, for research purposes.

*Not all identities fit on a spectrum.

*The "range" may become outdated.

*How many do we need?!

*Developmental models often seem to hold more promise, given their goal-oriented, growth-focused structure!

*Developmental models tend to reify specific cultural, contextual, and identity-based goals

*Multiple identities, roles, and contexts are seldom accounted for.

*Family Acceptance Project

*National Center for Transgender Equality

*The Task Force

*World Professional Association for Transgender Health

*Coming Out/Family of Origin

*Coming Out Later In Life

*Intimate Partners: Commitment; Violence; Separation; Child Custody

*Parenting: Custodial Rights after Divorce

*Aging: Relational Access in Supportive Care

Gay, Lesbian, Bisexual, Transsexual, Transgender, Homoflexible, Heteroflexible, Pansexual, Sexually Fluid, Queer,

Genderqueer, Third-Gender, FtM, MtF,

Two-Spirit, Stud, Butch, Aggressive,

Femme, Stone, Drag King, Drag Queen, Androgynous, Same-Gender-Loving, Trans*

*NAMI: 20% of gay and bi women, and 25% of gay and bi men experienced physical violence related to their sexual orientation.

*National Center for Transgender Equality: 26% of trans individuals experienced physical violence; 10%, sexual assault.

*Do your own research!

*Acknowledge client expertise.

*Be inclusive in language and clinical documentation (relationship and identity labels; genograms; intake documents).

*Make therapy about the client.

*Be willing to change.

*Childhood: seeing/naming representative bodies, genders, relationships; affirmation for behavior congruent with sense of self.

*Adolescence: first relationships/sexuality; cultural and religious rites of passage.

*Adulthood: sexuality; commitment; children; adult children; aging

*LGBTQ people, identities, experiences, and histories are the targets of physical and emotional violence, silencing, exclusion, erasure, and other forms of marginalization.

*These oppressive gestures significantly impact the physical, psychological, and relational realities of LGBTQ people.

Top, Bottom, Vers, Monogamous, Nonmonogamous, Monogamish, Open, Closed, Kinky, Vanilla, Polyamorous, Monoamorous, Transitioning, Non-Transitioning, Pre-Op, Post-Op, Non-Op,

No-Hormones, Stealth, Out, Closeted, Positive, Negative, Sero-Sort, Bare-Back

*Family of Origin Considerations: Coming out vs. staying in; implications for relationships

*Committed Relationships: Marriage, civil union, partnership; child custody; adoption

*Chosen Family: Unique paths to mentoring, support, and safe interdependence

*Use clients as encyclopedias.

*Devalue or negate client experience and knowledge, especially of self.

*Language and documents that erase clients

*Make therapy about the clinician.

*Insist that clients should change.

Refuse to do so, yourself.

*LGBTQ people and identities exist!

*LGBTQ people have a right to define ourselves and our lives on our terms.

*LGBTQ people are present in clinical populations that we serve.

*LGBTQ identities and experiences are relevant to clinical experience and Tx.

*The Center of Wichita

*First Metropolitan Community Church

*Parents and Friends of Lesbians and Gays, Wichita Chapter

*That Gay Group

*Trans Rise Above

*Conversion therapy, including forced hospitalization in childhood/adolescence

*Identity negated, aggressively challenged, or made sole focus of Tx by clinician

*Developmentally appropriate care, per WPATH standards of care, denied by clinician

*Client forced to lie about ID to access care

Marriage and family therapists provide professional assistance to persons without discrimination on the basis of race, age, ethnicity, socioeconomic status, disability, gender, health status, religion, national origin, sexual orientation, gender identity, or relationship status.