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Section 16
Therapy and Sexuality

Question 16 | Test | Table of Contents


Counselor Self-Preparation
The first step for counselors who want to work with gay and lesbian clients is to take a personal inventory of the ways that often subtle or unconscious biases may influence the counseling process (Bieschke & Matthews, 1996; Buhrke & Douce, 1991; Celberg & Chojnacki, 1995; Prince, 1997a). Previous research studies have documented the mental health profession's poor treatment of all sexual minorities (Barret & Logan, 2001). Bias toward this oppressed minority will have an impact on interventions that the individual career counselor chooses to use (Belz, 1993; Brown, 1975; Chung & Harmon, 1994; Hetherington, Hillerbrand, & Etringer, 1989; Hetherington 8c Orzek, 1989; Morgan & Brown, 1991; Pope, 1992). For example. Pope (1992) used the example of how heterosexually oriented counselors may have the idea that if they can help a young man become more masculine in his behaviors, he can change his sexual orientation and
will not have to deal with all ofthe problems that being gay brings for him. Such counselors are simply trying to help, but these interventions are not research based, and although they may seem intuitively appropriate to some counselors, there is no research literature suggesting that (a) training in gender-appropriate behavior is a determinant of sexual orientation or (b) that a same-sex sexual orientation is subject to change anymore than an opposite-sex orientation (LeVay, 1996).

Living in communities that routinely discriminate against gay men and lesbian women makes it difficult if not virtually impossible to avoid internalizing negative stereotypes or attitudes about this sexual minority culture. Because misinformation or misunderstanding will quickly be evident to sexual minority clients, and may cause them to seek help
elsewhere or not to get help at all, counselors must be familiar with gay and lesbian culture so they are credible and congruent in their attitudes (Pope, 1992,1995c). Attending workshops, reading the literature, and participating in lesbian and gay culture are effective ways to acquire knowledge about gay men and lesbian women and their culture. Former
clients and friends who are gay men or lesbian women are also invaluable sources of information.

In particular, career counselors who work with gay men and lesbian women must understand the process of developing a gay or lesbian cultural identity (Adams, 1997; Boatwright, Gilbert, Forrest, & Ketzenberger, 1996; Cass, 1979; Chung & Katayama, 1998; Croghan, 2001; Driscoll, Kelley, & Fassinger, 1996; Dunkle, 1996; Fassinger, 1991,1996; Pope, 1995c, 1996). Morgan and Brown (1991) identified the process of cultural identity development as critical in the lives of lesbian women. These authors had reanalyzed data from two previously gathered large lesbian samples and concluded that the lesbian career development process seemed both similar to and different from previously published minority group models of career development. Because age cannot be a predictor of lesbian or gay identity development because individuals discover their sexual orientation at a variety of ages, career counselors need to be aware oftheir clients' stage of gay/lesbian identity development as well as their other development issues in order to provide effective career counseling. Further, issues of multiple identity and discrimination are complex and challenging. Martinez and Sullivan
(1998) examined the complexity of gay identity development in African American gay men and lesbian women. They identified three specific issues as adding the most complexity and as differentiating their identity development from most gay or lesbian identity development models: racial prejudice, limited acceptance by the African American community, and a lack of integration into the larger White gay community. Van Puymbroeck (2002) found that the effects on career development of ethnic or sexual minority status are not simply additive but interactive and that gender plays a defining role.

Further, counselors who cannot be gay and lesbian affirmative in their attitudes are ethically required to refer the client to a career counselor who has experience with sexual minorities (Pope, 1995a; Pope et al., 2000; Pope & Tarvydas, 2002). The National Career Development Association (1994), American Counseling Association (1995), and American Psychological Association (2002) have well-defined ethical codes that offer guidance for individuals who work with sexual orientation issues as well as career issues.

Client-Focused Interventions
From the earliest (Brown, 1975) to the most recent articles in this domain (Pope & Barret, 2002), the issue of coming out has been central for gay men and lesbian women who are seeking career counseling. Even if unstated, it is important for the counselor to recommend this topic for discussion as part ofthe career counseling process.

Issues to address in such a discussion include the how-tos (Croteau & Hedstrom, 1993; Pope & Schecter, 1992) and the whys associated with deciding to come out (Brown, 1975; Hetherington et al., 1989; Pope, 1995c). Professional counselors can help their clients consider the advantages and disadvantages of coming out in the workplace or school
(Adams, 1997; Belz, 1993; Brown, 1975; Croteau & Hedstrom, 1993; Elliott, 1993; Hetherington et al., 1989; Morgan & Brown, 1991; Morrow, 1997; Pope, Rodriguez, & Chang, 1992; Pope & Schecter, 1992; Savin-Williams, 1993). They can provide clients with opportunities for behavioral rehearsals that are directed toward developing and training strategies for informing others.

Furthermore, it is important for professional counselors to recognize that there are two different types of coming out (Pope, 1995a). On the one hand, coming out has been discussed as a developmental task for gay and lesbian individuals to complete successfully. This coming out involves a self-acceptance of the individual's own sexual orientation and might be better termed coming out to self. On the other hand, coming out has also been discussed as disclosing to others. Such disclosure might be accomplished by verbal or written, private or public statements to other individuals.
By this action, individuals inform other persons of their sexual orientation. This might be better termed coming out to others. For many, the final step in this process is coming out in the workplace.

Anderson, Croteau, Chung, and DiStefano (2001) reported on the initial development of the Workplace Sexual Identity Management Measure (WSIMM). Psychometric properties of the WSIMM were examined for a sample of 172 student affairs professionals. The authors reported that the WSIMM successfully assessed a continuum of strategies for coming out in the workplace. Such measures as this are important to aid lesbian and gay workers in assessing their work environment and exploring appropriate strategies for sexual orientation disclosure.

For many sexual minorities, coming out is the most important event in their lives at that point in time and may be fraught with peril. Croghan (2001) discussed the special issues in coming out as a gay man and forming a strong cultural identity. Croghan found that the special characteristics in the development of a cultural identity as a gay man included being more aware of the acquisition of gay identify than male identity; having feelings leading to secrecy, withdrawal, self-loathing, and creation of false selves; and separating gay and nongay aspects of life in attempts to hide sexual orientation from others. These were precursors to the internal resolution and development of a healthy cultural identity as a gay man. Pope (1995a) and Gonsiorek (1993) identified some inherent problems in delayed mastery of the developmental task of accepting one's sexual orientation (coming out to self) along with the concomitant development of appropriate dating and relationship strategies with same-sex partners. This may cause a "developmental domino effect," whereby the inadequate completion of a particular task causes the next important developmental task to be delayed, missed, or inadequately completed. These delayed or skipped developmental tasks may have long-term and pervasive effects for individuals who come out in their 30s, 40s, 50s, or even later.

Adams (1997) discussed how gay men's selection of jobs as flight attendants was a choice to integrate their cultural identity with their work identity. The participants in this study saw their movement into an occupation composed of a large group of gay men as extremely positive. They reported that three factors were most important for them: their hope of companionship with a large group of other gay men; an escape from family, a community, or a job that stifled being gay; and being safe. Adams found a positive relationship between working as a flight attendant and acculturation into the gay community, an increase in openness with others, and heightened self-esteem.

Special attention must also be paid to the issue of coming out in families from cultures that do not readily accept same-sex sexual orientations. "There is not much qualitative difference between Asian and United States cultures in terms of traditional attitudes toward homosexuality, but the intensity of heterosexism and homophobia is much stronger in Asian cultures than in U.S. culture" (Chung & Katayama, 1998, p. 22). The strategies that are used in more coUectivist cultures (such as Asian) are different from those used in more individualist cultures (such as U.S.; Han, 2001; Pope, 1999; Pope, Cheng, & Leong, 1998; Pope & Chung, 2000; Pope et al., 1992). Newman and Muzzonigro (1993) studied differences between gay males in general who were raised in more traditional families and those raised in less traditional families. They reported that gay males from more traditional families felt more disapproval of their sexual orientation than gay males from less traditional families. Wooden, Kawasaki, and Mayeda (1983) addressed the issue of sexual identity development (coming out to self) in a sample of Japanese men and found that, although almost all often sample had come out to their friends, only about half had disclosed their sexual orientation to their families. These issues must be addressed when providing career counseling to lesbian women or gay men from such cultures, and strategies must be revised accordingly. Other authors have similarly addressed these issues for African Americans (Maguen, Floyd, Bakeman, & Armistead, 2002; Martinez & Sullivan, 1998; McLean, Marini, & Pope, 2003), Hispanic Americans (Fimbres, 2001; Merighi & Grimes, 2000), and Native Americans (Morris & Rothblum, 1999; Piedmont, 1996).

Other career counseling recommendations that appear in the published literature include having the career counselor

1. Give information on how to go about coming out (Croteau & Hedstrom, 1993; Elliott, 1993; Pope & Schecter, 1992)

2. Train clients in asking and responding to informational interview and job interview questions like "Are you married?" and "How many children do you have.>" (Hetherington & Orzek, 1989)

3. Offer special programming to meet the career development needs of lesbians and gays (D'Augelli, 1993; Evans & D'Augelli, 1996), including special programming on (a) resume writing, such as directly addressing issues of how far out to be on the resume or how many times the word lesbian is mentioned on a resume page (research on lesbian issues, teaching lesbian topics; Elliott, 1993; Hetherington et al., 1989), and (b) job interviewing (Hetherington et aL, 1989)

What about the client who has not completed the coming out tasks and keeps his or her sexual orientation private.^ There is no guaranteed way that professional career counselors can elicit this information. There are, however, specifics that will help create a supportive atmosphere. Having gay and lesbian books, along with other professional literature, that address career development on the bookshelf will help some clients realize that counselors are prepared to work with sexual minorities. Placing gay and lesbian literature in the office waiting room will send a very overt signal that the counselor is gay and lesbian affirmative. Popular magazines such as The Advocate, Curve, Genre, DIVA, and Out send obvious signals to all clients and may help clients in general gain more information about gay and lesbian coworkers.

Discrimination against individuals on the basis of their race, ethnic origin, gender, disability, religion, political affiliation, or sexual orientation is a fact of life in U.S. society. Professional career counselors who fail to recognize this and do not assist their clients in coping with this reality do a disservice to their clients. Issues of dual and multiple discrimination must also be addressed when providing career counseling services. For example, lesbian women face at least two virulent forms of discrimination in U.S. society: sexism and heterosexism. If they are also a member of an ethnic or racial minority, older, or physically challenged, they may face daunting barriers to achieving their career goals. Openly addressing these issues and preparing clients to cope with the more overt manifestations of racism, sexism, heterosexism, ableism, and ageism are important and primary roles often career counselor. As simple as it may seem, talking openly with clients about issues of employment discrimination is very important. Even if clients are not the first to broach the subject, the issues ought to be discussed so that the client is aware of the career counselor's sensitivity and knowledge in this area (Adams, 1997; Anastas, 1998; Brown, 1975; Croteau & Hedstrom, 1993; Elliott, 1993; Hetherington et al., 1989; Keeton, 2002; Pope, 1991; Pope et al., 1992; Terndrup, 1998; Van Puymbroeck, 2002).

When these issues are openly and fully discussed, such discussions lead to improved decision making. Ford (1996) found that young lesbians in her sample sought jobs, communities, and employers in which they were less likely to experience discrimination and chose occupations in which they could disclose their sexual orientation. Terndrup (1998), in a study of gay male teachers, found that most of the participating teachers revealed their primary reliance on "implicitly out" identity management strategies to alleviate fears of discrimination, public accusation, job loss, and impaired credibility.
- Pope, Mark, Culturally Appropriate Counseling With Gay and Lesbian Clients, Career Development Quarterly, December 2004, Vol. 53.

Personal Reflection Exercise #2
The preceding section contained information about culturally appropriate counseling with gay and lesbian clients. Write three case study examples regarding how you might use the content of this section in your practice.
Reviewed 2023

Update
Interrogating Gender-Exploratory Therapy

Ashley F. (2023). Interrogating Gender-Exploratory Therapy. Perspectives on psychological science : a journal of the Association for Psychological Science, 18(2), 472–481. https://doi.org/10.1177/17456916221102325


Peer-Reviewed Journal Article References:
Bettergarcia, J. N., & Israel, T. (2018). Therapist reactions to transgender identity exploration: Effects on the therapeutic relationship in an analogue study. Psychology of Sexual Orientation and Gender Diversity, 5(4), 423–431.

Goodman, J. A. (2021). Parent support for same-sex relationships: Considerations for clinical work and intervention research. Couple and Family Psychology: Research and Practice. Advance online publication.

Weinstein, D. (2018). Sexuality, therapeutic culture, and family ties in the United States after 1973. History of Psychology, 21(3), 273–289.

QUESTION 16
What is the positive relationship found between working as a flight attendant and acculturation into the gay community? To select and enter your answer go to Test.

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