Psychological professionals in this day and age need to be an ally in one way or another to the LGBT+ community. As you grow in your skills, it is likely that you have learned that one of the key tenets of being a good psychological professional or therapist is your ability to listen and address your client with unconditional positive regard. Even if you don’t fully agree with the LGBT+ lifestyle, it is still important that you listen to your client with an open mind [10].  Many people have felt rejected their entire life, and if they feel rejection when seeking counseling, it could be extremely detrimental to their mental health [10].

As June draws to a close, it is important to reflect on what this month represents. Aside from being effective communication month [1], June is also LGBT+ pride month [2]. To best understand why Pride Month is so important in our field, it is important to look at the historical context of the month in general.

Pride month began as a response to the socially stigmatized position historically taken toward people who identify as LGBT+ [3]. LGBT+ Pride is the positive outlook on the discrimination faced by people who are LGBT+ to promote their own self-affirmation and equality rights [3]. Pride is the dominant response that members and allies of the LBGT+ community will take to boost their visibility and maintain their rights [3].

LGBT+ History in Psychology

Homosexuality was considered a psychological disorder until the third iteration of the Diagnostic and Statistical Manual of Mental Disorders (DSM) in 1973 [4]. In that edition, the American Psychological Association partially removed homosexuality from the DSM [4]. Rather than removing it entirely, they kept “sexual orientation disturbance”, which was left in to describe individuals who were feeling conflict about their sexual orientation [4]. In the following edition, sexual orientation issues were entirely removed from the DSM [4].

The World Health Organization (WHO) removed the classification of homosexuality as a diagnosable condition from their tenth edition of disorder classifications (ICD-10), which came out in 1992 [4]. This edition, however, still carries the condition “ego-dystonic sexual orientation” [4]. For this diagnosis, the individual is not considered diagnosable simply because of their orientation, but instead because of their own wish to change their sexual orientation because of associated disorders [4].

Changes in Treatments for LGBT+ Individuals

As recent as the 1950s – 1960s, treatments were conducted in an attempt to “cure” individuals of homosexuality or other “sexual disturbances” [4]. Psychological professionals at the time saw homosexuality as a behavior that needed to be corrected [5]. Much like the film A Clockwork Orange [7] showcased, aversion therapy was the norm [4]. Aversion therapy was a technique that was employed by showing homosexual individuals images of naked men and simultaneously administering something that would elicit an unconditioned negative response, such as an electric shock [6]. This was seen as “curing” homosexual individuals by pairing any homosexual desires with aversive stimuli [6].

Although the film creates a dramatized depiction of true aversion therapy [7], it is a good reminder of our history. It can be a grim thing to remember, but as aspiring psychological professionals, it is important to be particularly wary of these historical issues so that active steps can be taken to avoid similar mistakes in the future.

Gay Affirmative Therapy

The American Psychological Association’s (APA) current position on homosexuality is a positive stance [8]. The Public Interest Directorate of the APA states that they are attempting to preserve the progress that LGBT+ individuals have made. They have also come out as stating that they are acting in this interest in public forums and in the legislative ring.

The APA has also released guidelines on how psychological professionals should address clients who identify as LGBT+ [9]. At this point in time, the standard of care is to affirm persons who identify as LGBT+ in their sexual identity, rather than try to convert them [9]. This standard has shown that it is more effective than historical treatment modalities which would tend to negate any sexual orientation issues that were brought up in the session [9]. By the late 1970s, literature in general seemed to begin to favor this practice, known as gay affirmative therapy (GAT) [9].

Our Role as Psychologists

Overall, psychotherapy seems to be most effective for persons who identify as LGBT+ when their presenting issues are treated independent of their sexuality, and that their sexuality is left out of the therapeutic setting unless it is necessary [9]. When topics of sexuality are addressed, a crucial step to take as an aspiring psychological professional is to believe their narrative [10]. In order to stand properly in unconditional positive regard, believing their own story is extremely important. There are several different stereotypes that have circulated about the LGBT+ community and inserting personal assumptions about a person can damage the therapeutic relationship [10]. Similarly, using preferred pronouns or names that a client asks of you is important [10]. It helps to convey a level of respect for your client and include them into your professional demonstration of unconditional positive regard.

You can also help LGBT+ clients by encouraging them to reach out to specific resources and public advocates [10]. Although public opinion is mostly positive toward the LGBT+ community, support of the lifestyle is not all-inclusive [10]. It is likely that if you work with a client who identifies as LGBT+, that person will experience some sort of discrimination based on their sexual orientation [10]. Your role as a psychological professional is to act in the best interest of your clients. By acting in your own clinical realm, you can have an impressive impact on your society at large.

 

References

  1. Communications, V. (2014). June is Effective Communications Month. Retrieved fromhttps://news.vanderbilt.edu/2014/06/05/june-effective-communicationsmonth/
  2. About Lgbt-Pride-Month. (2018). Retrieved from https://www.loc.gov/lgbt-pride-month/about/
  3. Nappo, M. K. (2010). Not a Quiet Riot: Stonewall, and the Creation of Lesbian, Bisexual, Gay, and Transgender Community and Identity Through Public History Techniques (Doctoral dissertation, University of North Carolina Wilmington).
  4. Burton, N. (2015). When Homosexuality Stopped Being a Mental Disorder. Retrieved fromhttps://www.psychologytoday.com/us/blog/hide-and-seek/201509/when-homosexuality-stopped-being-mental-disorder
  5. Drescher, J. (2015). Out of DSM: depathologizing homosexuality. Behavioral Sciences, 5(4), 565-575.
  6. Feldman, M. P. (1966). Aversion therapy for sexual deviations: A critical review. Psychological Bulletin, 65(2), 65.
  7. Kubrick, S. (Producer & Director). (1971). A Clockwork Orange [Motion picture]. United States: Warner Brothers.
  8. LGBT Pride: Preserving Progress. (2018). Retrieved fromhttp://www.apa.org/pi/lgbt/resources/lgbt-pride.aspx
  9. AS, P. C. (2011). Appropriate Therapeutic Responses to Sexual Orientation. Lesbian, Gay, Bisexual, & Transgender Concerns, 10.
  10. O’Brien, J. (2017). 5 Tips for Being a Good Ally. Retrieved from https://www.psychologytoday.com/us/blog/all-things-lgbtq/201711/5-tips-being-good-ally