This document discusses providing culturally competent services to GLBTTIQQ (gay, lesbian, bisexual, transgender, transsexual, intersex, queer, and questioning) clients. It covers topics like understanding key terms, developing cultural competency, assessing for risks and needs of GLBTTIQQ clients, counseling approaches, working with families, making appropriate referrals, and advocating for GLBTTIQQ clients and employees. The goal is for organizations and professionals to be respectful, knowledgeable, and able to meet the needs of GLBTTIQQ individuals.

1. Dr. Gay E. Phillips
barton.phillips & associates, inc.
Tulsa, Oklahoma

2. GLBTTIQQ
What is this
alphabet soup?

3. PREMISES OF WEBINAR
1) GLBTTIQQ persons exist and are your clients.
2) Homophobia/Heterosexism exists in society and
within our organizations.
3) GLBTTIQQ clients have a right to access services
from respectful, competent staff and volunteers.
4) GLBTTIQQ employees and their families have a right
to be treated with dignity and respect.

4. Cultural Competency Definition
Gaining cultural competence is a long term process of
expanding horizons, thinking critically about issues of
power and oppression, and acting appropriately.
Culturally competent individuals have a mixture of
beliefs, attitudes, knowledge, and skills that help them
establish trust and communicate with others.
University of Oklahoma, National Resource Center for Youth Services, Tulsa, OK

5. 5 Steps Toward Competency
1. General Awareness & Acceptance of Differences
How accepting am I of others?
2. Self-Awareness Regarding Population
What are my issues w/this population? (Pro & Con)
3. Dynamics of Differences/Inter-Cultural Work
Historical Distrust for Minority Pop. w/Majority & Authority/Not Easy
4. Knowledge of an Individual’s Culture
Within Group Variations
5. Adaptation of Skills
What skills do I have/need to develop? (Communication/Practice?)
Terry Cross, Portland State University, OR

6. Four Areas of Competency-Based
Services to GLBTTIQQ
1. Creating Intentional Invitations
Conversation, attitude, and environment.
2. Triage, Assessments, Counseling
Best practices.
3. Advocacy
Giving voice & support!
4. Referrals
When I’m not the one to help, who is?

7. Agency Readiness
 Leadership
 Policies & Procedures
 Human Resources
 Knowledge & Development
 Climate & Environment
 Practices
 Community Relations

8. GLBTTIQQ Statistics
 Prevalence
 5-20% + of your clients are gay, lesbian, bi, or two-spirit
 1-10% of clients are transgender
 1 in 2,000 newborns have ambiguous genitalia (inter-sex)
 100-200 surgical reassignments annually; no surgeries prior to 1950
 Prejudice and Discrimination (one national study reported)
 Rejection by family – Average of 34%
 Lesbians – 50%; Gay Men – 32%; Bi – 26%
 75% of GLBTTIQQ report prejudice or discrimination
 32% have been targets of physical violence to person/property
 Youth on the streets report higher rates

9. Challenges
 Physical/Psychological Threats &/or Harm (Bullying)
 Isolation/Ostrasized
 Rejection by Family, Friends, School, Religious Affil.
 Name-calling
 Self-Hatred

10. Challenges, Cont.
 These issues can put these youth at higher risk for:
 Homelessness
 Self-Harm, including suicide
 Substance Abuse
 Promiscuity, including human trafficking
 Etc.

11. GLBTTIQQ Racial/Ethnic Minorities
Ethnic Community LBGTQQ Community Mainstream Society
Acceptance/validation
Acceptance/validation National identity
of ethnic identity
of LBGTQQ identity Access to multiple
Family & community
social & cultural
support
Access to community groups
Positive Buffer for racism &
support Access to resources
discrimination
(e.g. education,
experienced in
Access to information employment, health &
mainstream society &
& LBGTQQ resources mental health services)
LBGTQQ community
Denial of Racism & Racism &
homosexuality discrimination discrimination
Homo/Trans phobia Homo/Trans phobia
Negative Rejection based on Rejection based on Rejection based on
sexual orientation or ethnic/racial identity ethnic identity & sexual
gender identity orientation/gender
Invisibility Invisibility Invisibility

12. Religious/Faith Issues
 Explore own issues
 Expect faith issues
 Find out/explore concerns
 Acknowledge this isn’t your expertise (if isn’t)
 Provide alternative views within their own faith
 Ask families & friends to
 resist “reacting”
 discuss consequences of any actions
 Be an alternative voice
GLBTTIQQ PEOPLE OF FAITH HAVE NOT ABANDONED THEIR FAITH

13. Resources for Dealing with Religious
Issues
Is the Homosexual My Neighbor
by Scanzoni & Mollenkott
PFLAG (Parents, Family, and Friends of Lesbians and
Gays) – religious materials: www.pflag.org

15. Language
 Words/Labels are powerful (Positive & Negative).
 Some youth self-identify, use their words.
 Language changes often, go with the flow/Get comfortable
with the words.
 Ask when you don’t know what something means.
 ALWAYS CONFRONT NAME-CALLING/BULLYING!!!

16. Attitude/Willingness is Everything
 Heterosexist Assumption
 Historical Distrust/Impact of “Ism’s”
 Know your Values & Biases
 Readiness/Timing on their part
 Be Comfortable w/being Uncomfortable!
 Transference/Counter Transference – ours/theirs

17. Physical Environment
Is your….
 Lobby
 Van
 Waiting room
=
 Office
 Common staff area
…open & affirming?

19. Sexual Orientation and/or
Gender Identity may/may not
complicate current issues,
trauma, or mental health
concerns

20. Triage/Assessment
Assess for Safety & Risk Behaviors
Assess Support Network
Stabilize & Support

21. Coming Out Process/Identity:
CASS Model
Confusion
Comparison
Tolerance
Acceptance
Pride
Synthesis

22. Protecting Confidentiality
 Avoid pathologizing/DSMR…
 Strategize with Client (or your co-worker)
 Understand Insurance Impact
 HIPPA/Privacy vs. Inclusion/Documenting

23. Adjustment Counseling
 Validate the “Coming Out” Process
 Developmental Delays
 Dealing with Stigma/Rejection
 Internalized Homo/Trans Phobia
 Risky Behaviors/Healthy Decision-Making
 Redefining/Adjusting Expectations
 Issues in Relationships with Family, Partner,
Friends, Employer

24. No data demonstrates that reparative or
conversion therapies are effective and in
fact, they may be harmful. NASW and
most other professional associations do
not support these programs.

25. “Reparative” Programs/Therapy
 If a client decides to try one of these programs, stay in
contact and monitor their feelings, behaviors – overall
mental health. Most individuals fail in these programs
and can become more at risk of self-harm. A few
people use these programs to improve their overall
functioning, but do not claim that their “gayness” ---
sexual orientation is changed, it’s just not lived out.
*Be ready to step back in to assess and/or
provide services.

26. Trauma Issues
 Abuse Victimology: Child, Sex, Substance
 Dysfunctional Families
 Domestic Violence
 Impact of Risk Behaviors
 Dealing with a History of Rejection

27. Coming Out/Counseling
with Families
 34% of GLBTTIQQ persons are rejected by their
families
 Explore each members individual/personal issues:
grief, “loss of dreams,” fears, etc.
 Help them adjust/redefine their expectations &
use coping skills to deal w/anxieties, fears, beliefs,
“hiding”
 Explore consequences of any actions
 Work for acceptance/Find common ground
 Your goal is to keep family talking/connected.

28. Transgender Issues – FTM/MTF
 Sexual Orientation Vs. Gender Identity
 Housing
 Developmental Delays
 Transphobia & Internalized Transphobia
 Relationship Issues – who will love me?
 Personnel Practices/Harry Benjamin Standards
 Stages of Transition
 Life After Surgery

29. Inter-sexed Issues
 We are beginning to see/become aware of youth
dealing with issues of gender identity, sexual
orientation, sexuality, etc. who were born with non-
descript or multiple genitilia. Perhaps they were
surgically changed at birth, perhaps not.
 And there is a growing network of these individuals
who are advocating for non-surgical approaches until
the child can make their own decisions.

30. INTERSEXED ISSUES
 Identity at Birth
 Surgery at Birth
 Prepare for Possible Stigmatization
 Later in Life Identity/Surgery?
 Work with this group in the same ways: assess, triage,
counsel, support, advocate, network, etc.

32. Effective Advocacy
 Arm Yourself – Policies/Procedures w/in
Agency/Professional Org., & Laws
 Be Willing to Advocate/Speak Up
 Look for “Blind Spots”/In Competencies
 Educate Those Around You
 Advocate for your GLBTIQQ Colleagues

33. Advocacy- What can you do?
Agency/Company Readiness Checklist
How ready is our agency/state Professional organizations?
Educate colleagues, friends and family.
How often do Professional Asso. host trainings on these topics?
Does our local Association have training?
Check your local library
Donate books related to GLBTIQ issues.
Does our college campus library have any books or
journals on GLBTIQ issues?
“52 things you can do for transgender equality.”
Advocate for local, state and national legislation for equality.

35. Timely & Appropriate Referrals:
Who, When, Where
 Build Your Professional Network
 Contact GLBTTIQ Community Centers
 If you don’t know, don’t refer. Check out a therapist or
program yourself first.
 Asso. policies state that as a licensed therapist it is
unethical to refer clients to therapists who participate
in “reparative therapies or conversion programs.”

36. Additional Resources
 Kaiser Permanente – Health Protocols
 PFLAG (national and local chapters)
 Child Welfare League of America
 National Association of Social Workers
 Gay and Lesbian Student Alliance Network (safe zone
stickers)
 COLLAGE (for youth whose parents are GLB)

37. Thank You For
Participating!!
)))))))

38. Questions?
Comments?

39. TRANSGENDER PROTOCOLS
Sample Policies
Hayworth House Emergency Shelter
Boston
1. Allows individuals to self-identify and staff strive
to not make assumptions based on appearances.
2. If staff members are unsure of what pronoun
(he, she) to use with a resident they will ask that
person how they identify.

40. Hayworth House model policy
3. Trans residents will not have any additional
clothing requirements imposed upon them
different than other residents (e.g. wearing
makeup or particular clothing.)
4. If a person does not have identification,
staff will not refuse the person.
5. If the person uses a different name than on
their identification, both names will be noted,
and the preferred name will be used.

41. Hayworth House model policy
6. If the person identifies as particular sex or
gender and presents or lives as that sex or
gender, they will have access to the dorms of
that sex/gender, or the dorm the individual feels
most safe in.
7. If there are concerns about the safety of a
resident (such as a transgender person) those
who are threatening the safety of the resident
(through intimidation, threats, violence, or other
forms of unacceptable behavior) will be
approached.

42. Hayworth House model policy
8. Hayworth House addresses behavior issues,
not identification issues. If someone breaks the
rules of the shelter that behavior will be
addressed.
9. Residents who harass, abuse, assault, or
discriminate against other residents will be dealt
with based upon the suspicion of guideline
violation. Heyworth House recognizes that
harassment based upon sex or gender identity is
discriminatory behavior and will be treated as
such.

43. Hayworth House model policy
Training:
All staff working at Heyworth House are
required to go through training regarding trans
issues within 6 months of commencing work at
the shelter.
There will be regular training for residents
regarding trans issues (at least three times a
year.)