Ethil Issu Psychotherapy wh Lbian, Gay, Bisexual, and Transgenr Clients (Chapter 20) - The Cambridge Handbook of Applied Psychologil Ethics

Contents:

• ISSU ARISG PSYCHOTHERAPY WH LBIAN, GAY, BISEXUAL, AND TRANSGENR PATIENTS
• 20 - ETHIL ISSU PSYCHOTHERAPY WH LBIAN, GAY, BISEXUAL, AND TRANSGENR CLIENTS
• APA’S GUIL FOR PSYCHOTHERAPY WH LBIAN, GAY AND BISEXUAL CLIENTS: THE FUNDAMENTALS FOR PRACTICE
• LBIAN, GAY, BISEXUAL, TRANSGENR, QUEER, AND INTERSEX (LGBTQI+)
• MENTAL HEALTH CHALLENG OF LBIAN, GAY, BISEXUAL AND TRANSGENR PEOPLE: AN TEGRATED LERATURE REVIEW
• HANDBOOK OF COUNSELG AND PSYCHOTHERAPY WH LBIAN, GAY, BISEXUAL, AND TRANSGENR CLIENTS, SEND EDN

ISSU ARISG PSYCHOTHERAPY WH LBIAN, GAY, BISEXUAL, AND TRANSGENR PATIENTS

In many ways, psychotherapy wh lbian, gay, bisexual, and transgenr (LGBT) patients do not differ om psychotherapy for heterosexual, genr nformg, and cisgenr patients. In many ways, the practice of psychotherapy wh lbian, gay, bisexual, and transgenr (LGBT) patients do not differ om treatments ed wh heterosexual, genr nformg, and cisgenr patients. In this article, the abbreviatn LGBT is ed as shorthand for a wi range of inti, sometim wrten as LGBTQQI+, meang lbian, gay, bisexual, transgenr, queer, qutng, and tersex, wh the + ditg that the list do not leate all possible sexual and genr inti.

20 - ETHIL ISSU PSYCHOTHERAPY WH LBIAN, GAY, BISEXUAL, AND TRANSGENR CLIENTS

A lbian, gay, bisexual, or transgenr inty is evably lked to multiple inti: child, parent, spoe and/or partner, siblg, profsnal, employer, employee, ngregant, patient, or if a patient’s LGBT inty is not the primary foc of treatment, s impact on the urse of treatment should not be unrtimated or overlooked. However, this attu may overlook the fact that growg up lbian, gay, bisexual, or transgenr is a different cultural experience than growg up heterosexual and cisgenr.

Lendg support to that observatn is the fact that 30% of homels youths are LGBT, most often rultg om beg forced out of their home or feelg a need to n away om home bee their sexual orientatn, genr inty, and/or genr exprsn are not accepted (15) the nsequenc of wispread negative attus toward LGBT dividuals, is not surprisg that they may be unable to acknowledge to themselv, or reveal to others, any homoerotic feelgs, attractns, or fantasi. Clil prentatns related to beg the closet n vary severy, om the ls tense se of a young adult man nsirg the possibily that he might be gay to more severe maniftatns, which any ht of same-sex feelgs ris totally out of nsc awarens. Stayg the closet is sometim done for relig reasons; at other tim is due to personal choice, such as an dividual’s efforts to mata a stable, heterosexual, cisgenr Out of the ClosetGay people the pre-war years, then, did not speak of g out of what we ll the “gay closet” but rather of g out to what they lled “homosexual society” or the “gay world, ” a world neher so small, nor so isolated, nor, often so hidn as “closet” impli.

APA’S GUIL FOR PSYCHOTHERAPY WH LBIAN, GAY AND BISEXUAL CLIENTS: THE FUNDAMENTALS FOR PRACTICE

—Gee Chncey (18)In ntemporary age, “g out of the closet” means tellg another person that one is lbian, gay, bisexual, or transgenr. Herdt and Boxer (20) have scribed g out as a rual procs of passage requirg a lbian, gay, or bisexual person to unlearn prcipl of sentialist heterosexualy, unlearn stereotyp of homosexualy, and learn the ways of LGBT culture.

The fantasied beliefs are often enabled, sometim even enuraged, by clicians who believe that two people talkg a room have the necsary tools to disver the origs of eher homosexual or transgenr realy, any “” rema unknown (26). In the se of lbian, gay, and bisexual people, the etlogil narrativ take three forms: theori of normal variatn, theori of pathology, and theori of immatury (14, 30). Theori of pathology fe a homosexual or bisexual orientatn or a transgenr inty as psychopathologil, a disease or abnormal ndn that viat om blogilly pretermed heterosexual, cisgenr velopment.

Theori of normal variatn regard homosexualy and transgenr prentatns as phenomena that occur naturally and that are not signs of illns or psychopathology. (32, 33) played a signifint role the eventual dissematn, among both health profsnals and the general public, of theori of homosexualy as a normal variatn.

LBIAN, GAY, BISEXUAL, TRANSGENR, QUEER, AND INTERSEX (LGBTQI+)

Whereas pathologizg theori treat homosexualy as viant and abnormal, immatury theori regard homosexualy as a normal step, ially a passg phase, to be outgrown on the road to adult heterosexualy.

Harry Stack Sullivan hypothized that children who ultimately beme homosexual as adults were members of the “out-group, if only wh rpect to so-lled mutual masturbatn and other prumably homosexual activy which went on this group of boys as preadolcent pals” (34).

In matag that homosexualy uld be a normal part of the heterosexual experience, theori of immatury were more clive and passnate than theori of pathology. They allowed for the possibily of a lbian, gay, or bisexual person beg sufficiently mature to bee heterosexual, if they are motivated enough and have aquate adult (meang heterosexual) etlogil theori are not formulated an objective vacuum.

MENTAL HEALTH CHALLENG OF LBIAN, GAY, BISEXUAL AND TRANSGENR PEOPLE: AN TEGRATED LERATURE REVIEW

A therapist who thoratively claims knowledge of the five etlogy of beg lbian, gay, bisexual, or transgenr would have difficulty appreciatg how etlogil narrativ serve as vehicl for other issu. Richard Isay (36) reported that the gay male patients he treated often sought him out as an openly gay psychoanalyst bee they had ncerns that heterosexual therapists would not treat them wh appropriate empathy, rpect, and should not assume that therapists who intify as LGBT themselv will herently have greater sight to the issu that brg LGBT patients to treatment.

This practice began to change toward the end of the 20th century, which saw a growg lerature by openly gay and lbian therapists (38, 40–43). Transferenc will velop whether or not a patient knows a therapist is LGBT—or whether the patient knows anythg else about a therapist for that matter (47) (36) noted that gay therapists livg closeted, profsnal liv may have a untertransferential need to hi, particularly if or when they experience their own homosexualy as somethg secretive and shameful. An unwillgns to self-disclose n lead to gaslightg patients, as the example of the gay male therapist makg naive quiri about his gay patient’s social i, which he knows very well.

However, he may also not want the patient—or anyone else for that matter—to know that he, the therapist, has gone to the same gay club. Referenc1 Meyer IH: Prejudice, social strs, and mental health lbian, gay, and bisexual populatns: nceptual issu and rearch evince. J Adolc Health 2018; 62:14–21Crossref, Google Scholar5 Instute of Medice: The Health of Lbian, Gay, Bisexual and Transgenr People: Buildg a Foundatn for Better Unrstandg.

HANDBOOK OF COUNSELG AND PSYCHOTHERAPY WH LBIAN, GAY, BISEXUAL, AND TRANSGENR CLIENTS, SEND EDN

Med Care 2016; 54:1010–1016Crossref, Google Scholar9 Sab JA, Riskd RG, Nosek BA: Health re provirs’ implic and explic attus toward lbian women and gay men. E1Crossref, Google Scholar11 Drcher J: Queer diagnos: parallels and ntrasts the history of homosexualy, genr variance, and the Diagnostic and Statistil Manual.

Psychoanal Dialogu 1994; 4:517–547Crossref, Google Scholar17 Drcher J, Byne W: Homosexualy, gay and lbian inti, and homosexual behavr; Kaplan and Sadock’s Comprehensive Textbook of Psychiatry, 10th ed.

Philalphia, Wolters Kluwer, 2017Google Scholar18 Chncey G: Gay New York: Genr, Urban Culture and the Makg of the Gay Male World, 1890–1940.