LGBTQIA Support
Sex refers to a person’s biological status and is typically categorized as male, female, or intersex. There are a number of indicators of biological sex, including sex chromosomes, gonads, internal reproductive organs, and external genitalia.
Gender refers to the attitudes, feelings, and behaviors that a given culture associates with a person’s biological sex. Behavior that is compatible with cultural expectations is referred to as gender-normative; behaviors that are viewed as incompatible with these expectations constitute gender non-conformity.
Gender identity refers to “one’s sense of oneself as male, female, or transgender” (American Psychological Association, 2006). When one’s gender identity and biological sex are not congruent, the individual may identify as transsexual.
Gender expression refers to the way in which a person acts to communicate gender within a given culture; for example, in terms of clothing, communication patterns and interests.
Sexual orientation refers to the sex of those to whom one is sexually and romantically attracted. Categories of sexual orientation typically have included attraction to members of one’s own sex (gay men or lesbians), attraction to members of the other sex (heterosexuals), and attraction to members of both sexes (bisexuals). While these categories continue to be widely used, research has suggested that sexual orientation does not always appear in such definable categories and instead occurs on a continuum. In addition, some research indicates that sexual orientation is fluid for some people.
Coming out refers to the process in which one discloses one’s sexual orientation to others. The term closeted refers to a state of secrecy or cautious privacy regarding one’s sexual orientation.
LGBTQIA is a term that collectively represents people who identify as lesbian, gay, bisexual, transgender, queer (those questioning their gender identity or sexual orientation), intersex, and asexual.
An alternate letter order is LGBTIQA. Terms like LGBTQIA are sometimes used in a way in which the A is said to include or stand for Allies—cisgender and heterosexual people who support the people represented by the other letters. For example, an event may be labelled in a way that welcomes such allies.
There are many longer variations of LGBTQIA that include letters representing those who identify in different ways, such as those who identify as pansexual, transsexual, intergender, aromantic, nonbinary, and two–spirit. Common and more limited terms include LGBT and LGBTQ. Sometimes, a plus sign is added after the letters to represent any pertinent groups not represented by a letter.
The stigma and discrimination LGBTQ individuals often face can be a serious impediment to their well-being. LGBTQ affirmative therapy can help empower individuals and help them navigate challenges effectively.
Sexual Orientation Change Efforts (SOCE)
Therapeutic efforts to change sexual orientation have increased and become more visible in recent years. Therapeutic interventions intended to change, modify, or manage unwanted non-heterosexual orientations are referred to as “sexual orientation change efforts” (SOCE) (APA, 2009a). The majority of clients who seek to change their sexual orientation do so through so-called “ex-gay” programs or ministries. Most contexts in which SOCE occur derive from the religion-based “ex-gay” movement, although several psychotherapeutic approaches also exist.
Reviews of the literature, spanning several decades, have consistently found that efforts to change sexual orientation were ineffective. Even the most optimistic advocates of SOCE have concluded that sexual orientation is nearly impossible to change (Spitzer, 2003) and that fewer than a third of subjects in such studies claim successful treatment (Haldeman, 1994). Therefore, in the current climate of evidence-based practice, SOCE cannot be recommended as effective treatment.
The potential for SOCE to cause harm to many clients also has been demonstrated. A majority of subjects reported that they were misled by their therapists about the nature of sexual orientation as well as the normative life experiences of lesbian, gay, and bisexual individuals. Furthermore, they noted that most subjects were not provided with adequate informed consent regarding their conversion therapy procedures as delineated in APA’s policy on Appropriate Therapeutic Responses to Sexual Orientation (APA, 1998). Failed attempts at conversion therapy can cause a spectrum of negative client outcomes including intimacy avoidance, sexual dysfunction, depression, and suicidality is seen. A sense of “de-masculinization” is common in men who have attended such programs, as they are often instructed that “real” men cannot be gay.
Bias and misinformation about homosexuality and bisexuality continue to be widespread in society and are implicated in many client requests to change sexual orientation. Fear of potential losses (e.g., family, friends, career, spiritual community), as well as vulnerability to harassment, discrimination, and violence may contribute to an individual’s fear of self-identification as lesbian, gay, or bisexual. Additionally, some clients report that non-heterosexual orientation is inconsistent with their religious beliefs or values.
What is LGBTQIA Therapy?
Many lesbian, Gay, Bisexual, Transgender, Queer (or questioning), Intersex & Asexual individuals seek counseling for reasons similar to non-LGBTQ individuals (i.e. – depression, anxiety, grief, couples therapy, work stress, etc). And while some issues have little to do with sexuality, gender, or identity, the LGBTQ community does have their own set of unique challenges as well.
LGBTQ Mental Health Issues and Coping with Stigma
Research suggests that LGBTQIA individuals seek mental health treatment at a higher rate than their non-LGBTQIA counterparts. This may be due to the stigma and discrimination LGBTQIA individuals often face on a regular basis, from society, family members, peers, co-workers, and even classmates. This discrimination contributes to the higher rates of depression, anxiety, and other mental health struggles seen amongst LGBTQIA. Those in the LGBTQIA community are also much more likely to have a substance abuse problem, engage in self-harm behaviors, and/or experience suicidal thoughts. Thus, it is not surprising this population seeks mental health services at higher rates.
In addition to the effects of stigma and discrimination, the LGBTQIA population also often obtains mental health support for:
Gender dysphoria – according to the Diagnostic and Statistical Manual of Mental Disorders (5th ed.), gender dysphoria is a psychological condition experienced by individuals whose gender identity and expression does not match with the gender assigned at birth. Gender dysphoria can cause significant distress and affect a person’s overall mental wellbeing.
Sexual identity issues – sexual identity issues can refer to numerous concerns. Sexual identity (or sexual orientation) refers to the emotions, thoughts, feelings, and fantasies that contribute to a person’s sexual or romantic attraction to another person. LGBTQIA individuals often go through periods of questioning their sexual identity, which can cause confusion and stress. Also pertinent to the LGBTQIA community and sexual identity issues is the “coming out” process, and coping with the reactions of friends and family.
Over the past several years, the general public seems to have become more aware of the issues faced by the LGBTQIA community. With this heightened awareness, mental health services have become more tailored to this population’s specific needs. One way this is being carried out is through LGBTQIA affirmative therapy. This approach to psychotherapy is focused on the empowerment of LGBTQIA individuals in all areas of life and relationships. Therapists working from an affirmative approach seek to honour the unique challenges faced by LGBTQIA individuals and help them navigate the challenges in an effective way.
Historically, many in the LGBTQ community who sought mental health services found counsellors and therapists were uneducated about issues around sexuality, gender, and identity. Unfortunately, this often resulted in LGBTQIA clients ending their treatment prematurely or never actually seeking the treatment and support needed. And, in some cases, the client would end up being the one to educate the therapist on the struggles unique to the LGBTQ population. Thankfully, with the emergence of affirmative therapy (as it is referred to in the mental health community), this gap has started to close, and there has been a significant increase in the effectiveness of mental health treatment for the LGBTQIA population.
Discrimination and stigma, in any form, can seriously impact the well-being of those who experience it. In order to begin to combat some of this (or cope with the stigma if it is directed at you), here are the things you can do:
• Learn more about the LGBTQ community and their struggles. Education is a way to increase understanding and raise awareness about the unique issues this population often faces (socially, economically, financially, etc.)
• Educate yourself on human rights laws and how they pertain to the LGBTQIA population.
• Surround yourself with healthy people, such as supportive and encouraging family members, friends, and peers. Whether or not they are dealing with the same issues as you (or someone you know), it is important to have people with whom you feel safe to express yourself and be open with.
• Speak up if you witness (or are the victim of) discrimination. Although it can be scary to share these kinds of experiences, it is one of the best ways to advocate for yourself, the LGBTQIA community, and fight back at the discrimination.
• Seek professional help. If you are facing a mental illness as a result of the stress from stigma and/or discrimination, getting support from a professional can help you learn ways to better cope, feel less isolated, and establish overall mental health and wellbeing.
• Share your experiences with others. Whether you are part of the LGBTQIA community yourself or have friends or family who identify as LGBTQIA, share what you can with others. The more the stigma surrounding this population is talked about, the more awareness it can gain.
• Join a political or advocacy group to combat unjust policies and/or unfair treatment of the LGBTQIA community.
• Join an online support community to connect with others that can relate: QUEERYTHM (https://www.facebook.com/queerythm)
Given the stressors that LGBTQ groups must confront, such as homophobia, societal discrimination and prejudice, coming out, and negotiating family relationships, finding a therapist who specializes in Lesbian, Gay, Bisexual, Transgender issues can offer some support and healing.