Oakland University Counseling ConferencePresentation Transcript
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”
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
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.
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.
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
Feminine / Femme
Masculine / Butch
Gender identity refers to ones own sense of gender
Gender identity is distinct from sexual orientation.
Gender Identity (cont.)
Gender expression incongruent with expectations of biological/assigned sex.
MTF (male to female) / FTM (female to male)
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.
Common language: Summary (cont.)
Preferred vs. Other Terms
Lesbian, Gay, Bisexual Homosexual
Sexual orientation Sexual preference
WHEN IN DOUBT… ASK!
Words/Phrases Often Used “Within” the Community
Dyke, Queer, Family, In the Life
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
NOT A RESULT OF ONES SEXUALITY!
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)
Treatment Providers need to consider an LGBT client’s partner, children, family of origin and family of choice when providing care!
LGBT Clients May Be Coping With:
Homophobic family members, employers, and work colleagues
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
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.
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.
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
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.
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?
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.