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Oakland University Counseling Conference


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  • 1. Welcome
    • Providing Culturally Competent Care to Lesbian, Gay, Bisexual, and Transgender Individuals
    • Knoll Larkin MPH
    • Mautner Project-”Removing the Barriers”
    • Funded by the Centers for Disease Control and Prevention
    • Affirmations—”The Community Center for Lesbian, Gay, Bisexual, Transgender People and their Allies”
  • 2. Sexual Orientations
    • Lesbian: A women who is emotionally, romantically, spiritually attracted to women.
    • Gay: A man who is emotionally, romantically, and spiritually attracted to men.
    • Bisexual/bi-attractional: Attraction to members of either sex
  • 3. Sexual Orientations
    • Same Gender Loving: A term used in communities of color to describe women who partner with women or men who partner with men.
    • Queer: a more inclusive term used to describe folks who don’t fit “neatly” into the LGB categories.
  • 4. Identity vs. Behavior
    • Who we say and feel ourselves to be might be different than what we actually do.
      • Identity- the “label” one applies to oneself and one’s community of affiliation
      • Behavior- the specific activities a person engages in.
    T 4:3
  • 5. Levels of Identity
    • Involved in gay, lesbian, bisexual politics or culture
    • “ Closeted and isolated from valuable support resources”
    • Sexual orientation may be only a minor part of personal identity
  • 6. Gender Identity
    • May be:
      • Feminine / Femme
      • Androgynous
      • Masculine / Butch
      • Transgender
    • Gender identity refers to ones own sense of gender
    • Gender identity is distinct from sexual orientation.
  • 7. Gender Identity (cont.)
    • Transgender:
      • Gender expression incongruent with expectations of biological/assigned sex.
      • MTF (male to female) / FTM (female to male)
  • 8. Using Language: Summary
    • One way to demonstrate inclusiveness in a healthcare setting is through use of language.
    • Use terms preferred by your clients. These may be different for each person, regionally or generationally based.
  • 9. Common language: Summary (cont.)
    • Preferred vs. Other Terms
        • Lesbian, Gay, Bisexual Homosexual
        • Partner Lover/Roommate
        • Sexual orientation Sexual preference
        • Crossdresser Transvestite
        • Transgender Transsexual
        • Intersex Hermaphrodite
    • Words/Phrases Often Used “Within” the Community
    • Dyke, Queer, Family, In the Life
  • 10. Negative effects of heterosexism and Transphobia
    • Self-blame for the victimization one has suffered
    • Negative self concept
    • Anger directed inward resulting in destructive patterns
    • A victim mentality or feelings of hopelessness or despair, interfering with leading a fulfilling life
  • 11. Life Cycle Issues For LGBT Individuals
    • LGBT youth face additional stressors
    • (conformity, and coming out)
    • LGBT young adults (social life revolving around bars and substance use settings)
    • Coupling
    • Parenting
    • Treatment Providers need to consider an LGBT client’s partner, children, family of origin and family of choice when providing care!
  • 12. LGBT Clients May Be Coping With:
    • Coming out
    • Societal stigmas
    • HIV/AIDS
    • Discrimination
    • Homophobic family members, employers, and work colleagues
  • 13. Coming Out:
    • Refers to the experiences of some, but not all, LGBT people as they work through and accept a stigmatized identity.
    • Transforming a negative self identity into a positive one
    • Important for those trying to recover: Feeling positive and hopeful about themselves is at the heart of recovering from addition
  • 14. What the coming out process means for counselors?
    • Because many programs and counseling approaches value authenticity, discussing the process of coming out is crucial.
    • Counselors who accept and validate client’s feelings, attractions, experiences, and identities can play an important role in success.
  • 15. Coming Out (cont)
    • There is no correct way to come out
    • Some people may decide they do not want to take on a LGBT identity and may choose not to disclose their feelings and experiences to anyone.
  • 16. Cass Model of Identity Development
    • Stage 1: Identity Confusion
    • Stage 2: Identity Comparison
    • Stage 3: Identity Tolerance
    • Stage 4: Identity Acceptance
    • Stage 5: Identity Pride
    • Stage 6: Identity Synthesis
  • 17. Barriers to receiving care:
    • Marginalization and labeling of sexual orientation or gender identity as deviant or pathological in medical or psychiatric communities.
    • Anticipated, perceived, or actual discrimination
    • Fear of mistreatment
    • Lack of research about use patterns, treatment needs, etc.
    • Provider lack of information
    • Fear of being outed will result in loss of job, custody, housing, or social supports.
    • Exclusion of partner and family of choice from health care settings
    • Lack of insurance coverage under partner’s policy
    • Low self-esteem or belief that sexual orientation or gender identity is wrong.
  • 18. Solutions:
    • Before the patient encounter
      • Marketing materials, brochures, ways services are introduced. Are they representative of the diversity of the populations within the service area? Will LGBT people feel like the advertised facility is a comfortable place for them? How is this communicated? What is the current reputation in LGBT community? Is there a need to address past negative experiences?
  • 19. Creating an Affirming Environment:
    • Display health info, magazines, posters, and other decorations that reflect the faces and interests of clients served. Staff should also be representative of clients served. Consider posting a written non-discrimination policy that includes sexual orientation and gender identity.
  • 20. Inclusive Paperwork
    • Getting beyond “Married, Single, Divorced” Consider “partnered, significant relationship, significant other”
    • -Are you involved in a significant relationship?
    • -Is there someone you would like involved in your care?
    • -With whom do you live?
  • 21. Culturally Competent Approach:
    • Is client centered
    • Uses client’s own language
    • Non-judgmental
    • No assumptions
    • Open ended questions
    • Begins with less threatening questions
    • It’s okay to not know!
  • 22. Culturally Competent Approach:
    • Is client centered
    • Uses client’s own language
    • Non-judgmental
    • No assumptions
    • Open ended questions
    • Begins with less threatening questions
    • It’s okay to not know!
  • 23. Affirmations LGBT Community Center
    • Knoll Larkin
    • [email_address]
    • 248-398-7105