Unit 8

Readings and Resources

eBook:

Zastrow, C., Kirst-Ashman, K.K. &Hessenauer, S.L. (2019). Empowerment series: Understanding human behavior and the social environment (11th Ed.). Cengage Learning.

• Chapter 13: Sexual Orientation and Gender Identity

Articles, Websites, and Videos:

The highly politicized topic of sex, gender and sexual orientation from the view of a health care provider will be discussed in this video. It provides information on how we utilize terms to describe others, yet these terms eventually become labels which do not consider the uniqueness of the individual and therefore, turn into stereotypes and assumptions.

https://youtu.be/2yM_P6WdRJU

Unit 8: Chapter 13: Sexual Orientation and Gender Identity

 

Sexual Orientation and Gender Identity

Chapter Introduction

CREATISTA/ Shutterstock.com

Learning Objectives

This chapter will help prepare students to

 

EP 2a

EP 2b

EP 2c

EP 3a

EP 3b

EP 6a

EP 7b

EP 8b

• LO 1Explain sexual orientation and gender identity (including concepts such as homosexuality, bisexuality, and transgender people)
• LO 2Review stereotypes about lesbian and gay people
• LO 3Discuss conceptual frameworks concerning sexual orientation
• LO 4Address discrimination and the impacts of homophobia
• LO 5Describe lesbian and gay lifestyles (including lesbian and gay relationships, sexual interaction, gay pride, and empowerment and a sense of community)
• LO 6Explore significant issues and life events for lesbian and gay people (including legal empowerment, violence against them, coming out, ethnicity, adolescence, parenting, aging, and HIV/AIDS)
• LO 7Recognize gay and lesbian pride, empowerment, and a sense of community

John had been attending the state university for more than a year. He didn’t have a chance to visit his parents in their small Midwestern town very often. When he did get home, his visits were usually limited to holidays. So when Thanksgiving rolled around, he found himself hopping on the Greyhound bus headed for Slab City, Wisconsin, his home.

This trip home was a problem for him. No matter how often or how deeply he mulled it over in his mind, he couldn’t find an answer. He had something to tell his parents that he didn’t think they would like very much. Over the past year, John had come to realize something about himself. He had come out; he was gay.

As he watched the countryside roll by, he thought about his childhood, about his high school friends, and even about the girl, Millie, he had dated for two and a half years during high school. What would they think if they found out?

He had never really been interested in girls. Sure, he pretended to be. Once a guy got labeled a “fag,” he might as well run off to a monastery. He had always been pretty bright. He had learned really fast how men were supposed to act. As all-conference fullback on the high school football team, he became quite adept at telling the appropriate locker room jokes and at exaggerating the previous weekend’s conquests with women. He often wondered why he had to pretend so hard. The others seemed to really get into it. They seemed genuinely enthralled with the ideas of big-breasted women and sex. He never dared mention the fact that he’d rather spend time with Dan or Chuck. He certainly never came close to mentioning any of his secret fantasies.

Dating Millie was “safe” for him. She was a nice girl, in addition to being cute and extremely popular. With her, he didn’t feel the pressure of constantly having to push for sex. Typically, every Saturday night they’d go to a movie or a basketball game or something like that. Then afterward they’d fool around in his car in the driveway for just a bit. That couldn’t last too long because Millie’s parents were pretty strict and imposed a midnight curfew. She was in by midnight, or else. John always had to put a little bit of a move on her and try to get to second base. At that point, she always stopped him, told him she loved him, and firmly stated she was waiting for marriage. What a relief.

At college, things were different. John had chosen the state university for a variety of reasons. He found that a person could do a lot of hiding among 40,000 other students. He also found that there were other men who felt just like he did. There was an exceptionally active gay rights group that sponsored a spectrum of social and recreational activities for gay men. Through one of these activities, he had met Hank. Lately they had been spending a lot of time together. He had never felt so comfortable in a relationship before. He found he could talk to Hank about his most intimate thoughts. He also discovered how much he enjoyed expressing his affection for Hank both verbally and physically.

John was jolted from his reverie as the bus pulled up to the local bus stop. He could see his parents waiting to pick him up. There was his father with a big smile on his face, waving at the son he was so proud of. John smiled, waved back, and thought, “Oh, boy. Well, here goes.” He stepped off the bus.

Although most people have a sexual orientation toward the opposite gender, many do not. Many are attracted to members of the same gender and some to both genders.

 

EP 1

For whatever reasons, the idea of a same-sex intimate relationship, which involves having a sexual orientation for members of the same gender, frequently elicits a strong negative emotional response. As future professional social workers, you need to identify and address this negative response. The National Association of Social Workers’ (NASW) Code of Ethics specifies that “social workers [should] respect and promote the right of clients to self-determination and assist clients in their efforts to identify and clarify their goals” (NASW, 2008). Additionally, it specifies that “social workers should obtain education about and seek to understand the nature of social diversity and oppression with respect to race, ethnicity, national origin, color, sex, sexual orientation, age, marital status, political belief, religion, and mental or physical disability” (NASW, 2008). The NASW Policy Statement on “Lesbian, Gay, and Bisexual Issues” states that “NASW is committed to advancing policies and practices that will improve the status and well-being of all lesbian, gay, and bisexual people” (NASW, 2012, p. 221). Clearly, determination of one’s sexual orientation is a person’s right.

A Perspective

This chapter will provide information about various aspects of sexual orientation and gender identity. The intent is to encourage readers to examine their own feelings and reactions. Understanding the effects of diverse sexual orientations on human behavior is necessary for objective, professional social work practice. Assessing one’s own values toward people’s diverse sexual orientations is a major step in developing professional social work values.

13-1Explain Sexual Orientation and Gender Identity

13-1aDimensions of Sexuality

It is a mistake to view sexuality as static and binary (that is, male-female, gay-heterosexual). In actuality, sexuality is a fluid concept that is experienced differently by different individuals. To illustrate this perspective, we will look at three major dimensions of sexuality: biological, sexual orientation, and gender.

13-1bBiological Dimension

This dimension refers to an individual’s chromosomal and genital structure. Typical males have penises with accompanied male organs and XY chromosomes. Typical females have vaginas and accompanying female organs and XX chromosomes. However, there are also some individuals who have ambiguous genitalia with chromosomal structures that are different from the typical corresponding ones. These biological conditions are termed “intersex,” as these individuals have sexual characteristics between a typical male and typical female.

13-1cSexual Orientation Dimension

This dimension refers to romantic and sexual attraction. Most individuals are heterosexual, as they are attracted to the opposite sex. However, there are gay and lesbian individuals who are attracted to the same sex, and there are bisexuals who are attracted to both sexes.

Transgender individuals can feel attraction to people of the same sex, opposite sex, or both sexes. There are also asexual individuals who do not feel a sexual attraction to either sex.

There also “questioning” individuals who question whether they are heterosexual, gay/lesbian, bisexual, or transgender. There are also individuals who struggle with determining what sexual attraction is “right” for them; these individuals may “try on” different forms of sexual attraction to arrive at the one that feels most congruent with their internal experience.

13-1dGender Dimension

As indicated in Chapter 9, gender relates to the feeling of being “male or “female.” Typically, persons with male biology feel “male,” and those with female biology feel “female.” However, there are persons with female biology who feel “male,” and persons with male biology who feel “female.” The general term “transgender” may apply to these individuals. There are also individuals who may feel both female and male (“bigender”): and persons who may feel neither male nor female (“agender”).

13-1eThe Fluidity of Sexuality

A man is committed to prison and has sexual relations with other men. Is he gay? A shy, lonely woman who has never dated any men is approached by a lesbian friend. The lonely woman decides to have an affair with her friend. Is she a lesbian? Two 14-year-old male adolescents experiment with each other by hand-stimulating each other to orgasm. Are they gay? While having sexual intercourse with his wife, a man frequently fantasizes about having sexual relations with other men. He has never had any actual sexual contact with a man in his adult life. Is he gay?

The answers to these questions are not so easy. Placing people in definite, distinct categories is difficult. It is not always easy to draw a clear distinction between a heterosexual and a person who is gay/lesbian. It may make us feel more secure and in control to cordon off the world into neat and predictable little boxes of black or white. However, in reality, the world is an endless series of shades of gray. People frequently like to polarize others as being either heterosexual or gay/lesbian. Perhaps such labeling makes situations appear to be predictable. If a person is labeled a heterosexual, then many assume that they know a lot of things about that person. For example, if a woman is labeled a heterosexual, then she is probably unassertive, sweet, demure, and emotional. She will date men and probably marry and become a mother and homemaker. If a man is gay, then he will probably frequently flick his wrists and become a hairdresser. In reality, things are not so predictable and clear. Chapter 9 discussed the construction and complexity of gender.

The problem with these neat categories is that they foster stereotypes. As we know, a stereotype is a fixed mental image of a group that is frequently applied to all its members. Often the characteristics involved in the mental picture are unflattering. Stereotypes refuse to take into account individual differences. They negate the value and integrity of the individual. Highlight 13.1 identifies some of the stereotypes characterizing lesbian and gay people.

Highlight 13.1

Review Stereotypes about Lesbian and Gay People

LO 2

Lesbian and gay people are not only the victims of homophobia, but also the targets of derogatory, inaccurate stereotypes. Some of the more common ones are that gay and lesbian people like to assume either a male or female role, and that they are potential child molesters. These stereotypes are false.

Overview of Stereotypes

A prevalent stereotype about gay and lesbian people is that gay men typically look extremely feminine and that lesbians appear very masculine. In truth, these stereotypes are not accurate in most instances (Johnson, 2014; Nugent, 2014; Rathus, Nevid, &Fichner-Rathus, 2014; Tully, 2001). People are individuals with individual traits. With the breakdown of traditional gender roles, identifying lesbians and gay men by appearance is difficult.

The stereotypes about how gay and lesbian people look is the result of confusion between two central concepts—gender identity and sexual orientation. Gender identity refers to a person’s internal psychological self-concept of being either male, female or another gender. We have indicated that sexual orientation refers to “one’s erotic, romantic, and affectional attraction to the same gender, to the opposite gender, or to both” (Greenberg et al., 2014, p. 370).

Playing Male and Female Roles

Another common stereotype about gay and lesbian people is that in any particular pair, one will choose a “masculine,” dominant role and the other a “feminine,” submissive role. As with most heterosexual couples, this is usually not the case (Johnson, 2014; Morrow, 2006c; Rathus et al., 2014). Any individual, gay/lesbian or heterosexual, may play a more dominant or more submissive role depending on his or her particular mood, activity, or the interaction involved. People are rarely totally submissive or totally dominant.

The Myth of Child Molesting

Another derogatory stereotype targeting gay and lesbian people is that they are inclined to molest children (Greenberg et al., 2014; Rathus et al., 2014; Tully, 2001). This stereotype is especially damaging for gay/lesbian teachers in that it can cause them to lose their jobs. In reality, the majority of all child molesting is done to young girls by heterosexual men, usually people trusted and close to them (e.g., a father, stepfather, or brother) (McAnulty & Burnette, 2003). Heterosexual men are 11 times more likely to be child molesters than are gay men (McCammon & Knox, 2007; Moser, 1992).

Ethical Question 13.1

 

EP 1

1. Do you harbor any stereotypes about lesbian or gay people? If so, what are they? What, if anything, do you plan to do about them?

13-1fWhat Does Being Gay/Lesbian Mean?

Many theories in the past have focused on how people develop their same-gender sexual orientation by passing through a number of stages. Numerous models have been proposed, all of which “tend to have several things in common. There is almost always a predictable progression from some sort of first awareness of same-gender attractions and feelings; to a stage of self-labeling as being gay, lesbian, or bisexual; through stages of becoming more accepting of the new identity and sharing it with others; to a final stage of incorporating the identity into the total sense of self” (Crooks & Baur, 2014; Kelly, 2008, p. 375; Rathus et al., 2014).

However, such a perspective may be overly simplistic and ethnocentrically biased (taking account of only one’s own cultural values and considering them superior over others) to North American and European groups (Martin, 2008; Messinger& Brooks, 2008; Miller, 2008). The concept of having a same-gender sexual orientation might be an ever-emerging social construction of reality that changes as social conditions and expectations change (Martin, 2008). There may be different perspectives depending on one’s racial, ethnic, and cultural background. “For example, Latino immigrant men who have sex with other men may not consider themselves to be gay as long as they take a dominant role in sexual intercourse (Zea, Reisen, & Diaz, 2003)” (Martin, 2008, pp. 247–248). The important thing may be each person’s self-identification of his or her own sexual orientation (Kelly, 2008; Martin, 2008).

An important aspect of any definition of “gay/lesbian” is that above all else, a gay/lesbian is a person. In the eyes of some heterosexuals, the sexuality of a lesbian or gay person often takes precedence over all other aspects of his or her personality, and the person becomes lost or invisible (see Figure 13.1).

Figure 13.1The Personality Pie

The same-sex sexual orientation is seen as prominent, at the expense of all other aspects of the lesbian or gay person’s personality. A more realistic view is one in which the same-sex sexual orientation is seen in context. The fact that a person is lesbian or gay is only one slice of a person’s personality pie. A realistic perspective allows the many various aspects of the person’s personality to be acknowledged and appreciated.

Many people are taught homophobia , the extreme and irrational fear and hatred of gay and lesbian people. These feelings warp their perception of gays and lesbians. Some people feel that being of the same-gender orientation is “pathological” (Bieschke, McClanahan, Tozer, Grzegorek, & Park, 2000, p. 311; Greenberg et al., 2014). Highlight 13.2 describes conversion therapy that attempts to change people to heterosexuals.

Highlight 13.2

The Ethical Problems of Conversion Therapy

 

EP 1

Some people harbor the belief that “same-sex attraction represents a deviation from normal sexual and gender development” (Bieschke et al., 2000, p. 311). They support the idea of conversion therapy (also referred to as reparative or reorientation therapy) to convert people who are gay or lesbian to heterosexuals (Bieschke et al., 2000; Johnson, 2011b; Morrow, 2006b). The idea is that having a same-gender sexual orientation is simply wrong and should be changed. The implication is that external values (specifically, heterosexism , the intolerant attitude and discriminatory behavior against gay and lesbian people by heterosexuals) should be forcibly imposed upon people, thus denying their right to self-determination in this area.

In the past, such treatment included “techniques such as prayer, exorcism, religious-based guilt inducement, and punishment-oriented forms of behavior modification (Tozer & McClanahan, 1999; White, 1995)” (Morrow, 2006b, p. 185). Today’s approaches tend to focus on “cognitive-behavioral techniques in an attempt to suppress an individual’s attraction to others of the same sex” (Bieschke et al., 2000, p. 312). Cognitive-behavioral therapy “involves the modification of thoughts and actions by influencing an individual’s conscious patterns of thought” (Boyle, Hull, Mather, Smith, & Farley, 2009, p. 363).

The American Psychological Association (APA) rejected the effectiveness of and ethics involved in conversion therapy after an APA panel reviewed “83 studies on sexual orientation change conducted since 1960” (Associated Press, 2009). The APA determined that no concrete support existed on the behalf of conversion therapy. If anything, it determined such “therapy” could be damaging by causing depression and suicidal inclinations.

Thirteen professional organizations of helping professionals and educators have published a pamphlet entitled “Just the Facts About Sexual Orientation and Youth” that is available online without charge (APA, 2008; Just the Facts Coalition, 200S). It concludes,

Because of the aggressive promotion of efforts to change sexual orientation through therapy, a number of medical, health, and mental health professional organizations have issued public statements about the dangers of this approach The American Academy of Pediatrics, the American Counseling Association, the American Psychiatric Association, the American Psychological Association, the American School Counselor Association, the National Association of School Psychologists, and the National Association of Social Workers, together representing more than 480,000 mental health professionals, have all taken the position that homosexuality is not a mental disorder and thus is not something that needs to or can be “cured” (Dively et al., 2008, p. 9)

Morrow (2006b) comments on conversion therapy for youth:

Parents who are uncomfortable with having a gay or lesbian child may seek out conversion therapy practitioners under the mistaken assumption that their child’s sexual orientation can be changed through such therapy. There is no credible empirical support for the success of conversion therapy in actually changing sexual orientation … Conversion therapy practice can cause psychological harm, to LGBT [gay, lesbian, bisexual, and transgender] youth by reinforcing negative stereotypes and misinformation and inducing, internalized homophobia. (pp. 185–186)

The National Association of Social Workers Policy Statements (NASW, 2012) state that conversion therapy is unethical. Specifically,

• NASW supports the right of the individual to self-disclose, or to not disclose, sexual orientation and encourages the development of supportive practice environments for lesbian, gay, and bisexual clients and colleagues.
• NASW reaffirms its stance against reparative therapies and treatments designed to change sexual orientation or to refer to practitioners or programs that claim to do so. (p. 222)

Morrow and Tyson (2006) suggest how social workers can help people who are seeking conversion therapy to better understand themselves and their sexual orientation:

An initial response would be to assess the nature of the personal thoughts, feelings, and experiences that could have led the client to the point of seeking sexual orientation change. Affirmative practice would include helping the client understand the powerful forces of homophobia, internalized homophobia, and heterosexism—at the micro and macro levels of social power and influence—and the ways in which these forces create and perpetuate the internationalization of GLB-negative messages. Thus, initial intervention in such cases lies in helping clients understand the power of heterosexism in how they view sexual orientation in their own lives. Also, it would be appropriate to inform clients that conversion therapy is scientifically unproven and that its practice is considered unethical. (p. 396)

Another aspect of the definition of having a same-sex sexual orientation is that the gay/lesbian person is attracted primarily to people of the same gender to satisfy sexual and affectional needs. A gay male is attracted to and would choose to have an intimate sexual and affectional relationship with another male rather than a female. A lesbian would opt to have such an intimate involvement with another female instead of a male. This part of the definition excludes people who under certain circumstances engage in same-sex sexual activities. For instance, prisoners and other institutionalized persons might establish same-sex sexual relationships with others simply because persons of the opposite gender are unavailable. These people will typically return to heterosexuality when the opportunity arises.

The word homosexual is derived from the Greek root homo, meaning “same.” The word homosexual itself, however, was not used until the late 1800s (Karlen, 1971). Terms used to refer to lesbian and gay people can be confusing. Both women and men with same-gender orientations have been labeled homosexuals. Gay men prefer the term gay instead of homosexual because it has neither the direct sexual connotations nor the demeaning implications frequently associated with the word homosexual.

The word lesbian refers to female homosexuals. Around the year 600 BCE, a woman named Sappho lived on the Greek island of Lesbos in the Aegean Sea (from which the term lesbian is derived). Although Sappho was married, she remains famous for the love poems she wrote to other women.

Many people who are not lesbian or gay have traditionally used the term gay to refer both to lesbians and gay men. However, many lesbians have expressed concern that men are given precedence over women when this term is used by itself to refer to both genders. There is some indication that the media now often use the phrase “gay men and lesbians” (American Association of Sex Educators, Counselors, and Therapists [AASECT], 2006, p. 17). Although we have established specific definitions of lesbian, gay, and homosexual, many who use these terms do not have a clear picture of what they mean. All three words may refer to a person with slight, moderate, or substantial interest in or sexual experience with persons of the same gender. Heterosexual people are often referred to as straight .

Note that sometimes the concepts of sexual orientation and gender identity are confused, although they are distinctly separate concepts. We have defined gender identity as a person’s internal psychological self-concept of being either male or female, or possibly some combination of both. Some people assume that gay men really want to be women and that lesbians desire to be men. This is false. Gay men and lesbians are simply romantically attracted to (i.e., have a sexual orientation toward) their same gender instead of the opposite gender.

Some people, however, regardless of whether they are gay or heterosexual, feel that their biological gender identity is wrong. In a discussion about the complexity of gender, Chapter 9 introduced transgender and transsexual people. Spotlight 13.1 discusses this group further.

13-1gBisexual People

A bisexual person is romantically and sexually attracted to members of either gender. We have already initiated the idea that same-sex sexual orientation is not a clear-cut concept. Bisexuality is even less clearly defined. In the first major study of sexuality in our era, Kinsey, Pomeroy, and Martin (1948) found that it was very difficult to categorize people as homosexual, bisexual, or heterosexual. They found that many people who considered themselves heterosexual had had same-sex sexual experiences at some time during their lives. For example, 37 percent of the men in his sample of 5,300 had had at least one sexual experience with another male, to the point of orgasm, after reaching age 16. In a study of 5,940 women, Kinsey and his associates (1953) found that between 8 and 20 percent had had some type of same-sex intimate contact between ages 20 and 35. A significantly smaller percentage of each group had exclusively same-sex sexual experiences throughout their lifetimes.

Because Kinsey and his associates found it so difficult to place people into distinct categories of gay/lesbian or heterosexual, they developed a six-point scale that placed people on a continuum concerning their sexual experiences (see Figure 13.2). A rating of zero on the scale meant that the individual was exclusively heterosexual—the person had never had any type of same-sex sexual experience. Conversely, a score of 6 on the scale indicated exclusive homosexuality—this individual had never experienced any form of heterosexual behavior. Those persons scoring 3 would have equal same-sex sexual orientation and heterosexual interest and experience.

Figure 13.2Conceptualizations of Homosexuality and Heterosexuality

Source: A. C. Kinsey, W. B. Pomeroy, and C. E. Martin (eds.) (1948). Sexual Behavior in the Human Male. Adapted by permission of the Kinsey Institute for Research in Sex, Gender & Reproduction, Inc., Bloomington, IN; Adapted from M. D. Storms, 1980, “Theories of Sexual Orientation,” Journal of Personality and Social Psychology, 38, 783–792.

More recent researchers have discovered similar difficulties in clearly categorizing people in terms of their sexual orientation. Storms (1980, 1981) suggests that the Kinsey scale still failed to provide an accurate description. He developed a two-dimensional scheme to reflect sexual orientation (see Figure 13.2). The two dimensions are homoeroticism (sexual interest in and/or experience with those of the same gender) and heteroeroticism (sexual interest in and/or experience with those of the opposite gender).

Additionally, Storms’s scheme portrays level of sexual interest. Those individuals who express high interest in both sexes are placed in the upper right-hand corner. They are considered bisexuals. Those persons who have a very low sexual interest in either gender are placed in the lower left-hand corner. They are considered asexual. Persons with primary sexual interest in the same gender, homosexuals, are placed in the upper left-hand corner. Similarly, people with primary sexual interest in the opposite gender, heterosexuals, are placed in the lower right-hand corner.

We’ve established that gender expression is complex. Terms used to refer to various groups depend on the issues involved. Lesbian, gay, bisexual, and transgender (LGBT) people may experience some of the same issues, such as homophobia and discrimination. In these contexts, the terms LGBT or GLBT (gay, lesbian, bisexual, and transgender) might be used. However, each group also has its own special circumstances and issues, so sometimes only one or some of these groups (such as transgender people, or lesbians and gay men) will be the focus of reference.

Ethical Question 13.2

 

EP 1

1. What ethical issues do you think are involved in conversion therapy? Explain your reasons.

Note that a newer acronym sometimes being employed to refer to people whose sexual orientation is not strictly toward the opposite gender is LGBTQ. Here “Q” stands for “queer” or “questioning” (Carroll, 2013b, p. 270; Rosenthal, 2013, p. 234). Another tern used is LGBTI (lesbian, gay, bisexual, transgender, and intersex) (Alderson, 2013). Chapter 9 discussed intersex people, individuals who have some mixture of male and female predisposition and configuration of reproductive structures.

However, Alderson (2013) cautions:

Terminology is often challenging when writing or talking about groups who have been historically oppressed and disenfranchised. Postmodern writers have become very sensitive to the labels used to describe individuals….

Identities [labels used to refer to some group of people] describe one aspect of a person. A lesbian woman, for example, is more than just her nonheterosexual identity—she is also someone’s daughter, someone’s neighbor, and someone’s friend. She is a lover, a worker, and an inhabitor of earth. Similarly, referring to a transsexual individual as a “transsexual” diminishes this person’s existence to this one aspect of self …

Identity labels—when chosen at all—are picked by individuals themselves to describe some aspect that defines their sense of self. Consequently, they can be transient labels, inaccurate labels, or over-simplified labels. Such is also the case with some LGBTI individuals—our sexuality and gender is so much more than the label we give it. (pp. 2–4)

13-1hNumbers of Lesbian and Gay People

It’s difficult, if not impossible, to state exactly how many people are lesbian or gay. However, it may be useful to consider the numbers of people who have adopted a primarily lesbian or gay orientation over an extended period of time.

Based on Kinsey’s work, “many authors have used 10 percent as the proportion of men who are gay” (Berger & Kelly, 1995, p. 1066; Mallon, 2008). Kinsey found that although more than one-third of American men had had homosexual experiences leading to orgasm during their adolescent or adult lives, only 10 percent of men were exclusively gay/lesbian for a three-year period between ages 16 and 55, and only about 4 percent were gay/lesbian throughout their lives.

Supposedly, two to three times as many men as women have a same-sex sexual orientation. Although Kinsey found that 19 percent of American women had had same-sex sexual experiences by the age of 40, only 2 to 3 percent of these remained lesbian throughout their lives.

The Kinsey research posed some methodological problems that make it difficult to compare it with more recent research. For example, Kinsey and his colleagues included a large number of prisoners and volunteers from gay organizations (Masters, Johnson, &Kolodny, 1995). They also “included feelings and fantasies in their definition of homosexuality, whereas some recent surveys focused exclusively on sexual behavior” (Berger & Kelly, 1995).

Many lesbian and gay organizations maintain that lesbians and gays make up 10 percent of the population; one such organization is called “The Ten Percent Society.” However, the controversy regarding the actual number of lesbian and gay people continues (About.com, 2014; Berger & Kelly, 1995; Rogers, 1993; Tully, 1995), with various studies and polls producing different results. Somewhere between 2 and 10 percent of the population appears to be gay or lesbian (Johnson, 2011c; Kelly, 2008; Mallon, 2008). Other indications are that more than 5 percent of the total population over age 18 is probably gay or lesbian (Mallon, 2008). Yet other data indicate that about 2 percent of men and 1 percent of women have “a gay/lesbian identity,” which is quite different than having varying degrees of same gender sexual experiences (Hyde &DeLamater, 2014, p. 339). Regardless of whether lesbian and gay people make up 1 or 10 percent of the population, they are a sizable minority group.

13-1iTransgender Persons

A transgender person is someone who identifies with or expresses a gender identity that differs from the one which corresponds to the person’s sex at birth. Laverne Cox, for example, was the first African American transgender person to appear on television and was nominated for an Emmy Award for her work in Orange Is the New Black.

Another well-known transgender person is Caitlyn Jenner. She was formerly known as Bruce Jenner, who is an American television personality and was an Olympic gold medal winner in the decathlon event in 1974. Bruce Jenner was formerly married to Kris Jenner. Bruce appeared on the reality television series Keeping Up with the Kardashians with his wife (Kris), their daughters Kylie and Kendall Jenner, and stepchildren Kimberly, Kourtney, Khloé, and Rob Kardashian. Jenner revealed her identity as a trans woman in April 2015, publicly announcing her name change from Bruce to Caitlyn. She has been called the most famous openly transgender woman in the world. In July 2015, she began starring in the reality television series, “I Am Cait,” which focuses on her gender transition.

Caitlyn Jenner’s public transition has helped bring awareness to the transgender community and their battle for equality

Helga Esteb/ Shutterstock.com

There are a variety of terms used to define people who identify as a gender other than the gender the individual normally expresses or were identified as birth. These people include the following:

• Crossdresser: One who wears clothing intended for the “opposite” gender for relaxation or personal comfort.
• Transvestite: One who wears clothing of the “opposite” gender for sexual satisfaction. (It should be noted the term transvestite is often considered an offensive term.)
• Drag King/Drag Queen: One who wears clothing intended for the “opposite” gender for entertaining other people.
• Bigender: One whose gender identity is both female and male at the same time; the person may exhibit aspects of both.
• Agender: One who has no gender identity at all.
• Cisgender: One whose gender identity matches the sex assigned at birth.
• Androgyne: One whose gender identity is somewhere in between female and male; the person may exhibit some aspects of one gender and some of the other.
• Genderqueer: One whose gender identity is completely different from female or male.
• Gender fluid: One whose gender identity can change. (For most transgendered persons, gender identity does not change.)
• Transsexual: One whose sex at birth is “opposite” to their gender identity.

A transsexual is a person who has a persistent desire to transition to living as, and being perceived as, the sex that is consistent with his or her gender identity. Typically, this desire is driven by an extreme discomfort with his or her current sex. Transsexuals transitioning from male to female are often referred to as “MTFs.” Similarly, female-to-male transsexuals are frequently referred to as “FTMs.”

Transsexual transitions are complex processes and look different for every person. A person may change their name, clothing or pronouns. They may also change their identification documents to better reflect their gender. Others may complete undergo hormone or other medical procedures. A medical transition may involve the following four processes. First, they enter counseling to make certain that they are aware of their true feelings and that they understand the potential ramifications of changing genders. Second, they undergo a “real-life test” where they actually live and undertake their daily activities as a person of the opposite gender however, there is no research to support this method. Third, they receive extensive hormone treatments to align their bodies with the opposite gender as much as possible—a process that they must continue for the rest of their lives. For example, female-to-male transgender people would take male hormones to encourage facial and body hair growth, while male-to-female transgender people would take female hormones to encourage the softening of body tissue and the redistribution of body fat. The fourth step involves undergoing surgery where genitals and other areas of the body are surgically altered to more closely resemble the opposite gender.

In the past, male-to-female operations were more common, but today female-to-male operations are catching up in frequency. Female-to-male surgery is generally more complex. In view of the physical pain and discomfort, in addition to the high cost, many transgender people choose not to pursue surgery.

Transgender persons are often subjected to extensive discrimination. If they “come out” during adolescence, they are likely to be shunned, victimized, and discriminated against by their peers. Family may present another challenge: some of these youth experience acceptance from family, while others have great struggles. Rates of suicidal ideation and life-threatening interactions with others among transgender youth are high (Dooley, 2017). These stressors also leave transgender youth vulnerable to substance abuse and accompanying risky sexual behaviors that may result in acquiring a sexually transmitted disease (Dooley, 2017). Transgender youth are also at a higher risk of becoming homeless. Homelessness can lead these youths to offering sex to survive, which increases the risks of sexual and physical abuse.

Transgender individuals face many other challenges. For example, which bathroom should they use—the men’s room or the women’s room? The medical community and a number of schools and employers now recognize that it is essential to the health and well-being of transgender people that they use the bathroom the corresponds to their gender identity. Yet this opens them up to the potential of adverse reactions from others; for example, parents of daughters may violently object to a biological male who views herself as female using the women’s bathroom. If transgender persons are arrested, the question arises as to which jail unit should they be placed in—the one that is consistent with their sex, or the one that is consistent with their gender? When transgender persons go to a physician for a medical exam, they may experience embarrassment in trying to explain why their gender identity is different from their biological sexual structure.

Highlight 13.3

What’s in a Name?

Olympic athlete Bruce Jenner made national headlines when she reported she was transgender. In 2015, she made the decision to transition to a female after reporting spending her life feeling like a woman living in a man’s body. With this transition, she changed her name from Bruce to Caitlyn. Jazz Jennings has also become widely known after her parents supported her decision to transition from a boy to a girl at a young age. Born Jaron Bloshinsky, she changed her name to Jazz. Now in high school, Jazz has started the transition process, documenting her journey in her television show, I am Jazz. In working with individuals, it is important to ask them their preferred name and then refer to them by that name. Although this is of course true for everyone you meet, it is especially true for transgender individuals or other individuals who do not identify with their assigned name or assigned gender at birth. It is also recommended that you speak in the present tense (referring to their current identity and present-day language), that you do not put quotation marks around the person’s name, and that you use the correct term to identify the person (such as transgender, transsexual, asexual) (GLAAD, 2016).

It is also important to ask what pronoun the individual goes by so that you do not offend this person (University of Wisconsin-Milwaukee, 2016). More people are getting rid of the binary pronouns of he and she, instead opting for gender-inclusive pronouns (University of Wisconsin-Milwaukee, 2016). Some of the more gender-neutral pronouns include e, ve, they, their, ze, sie, and ve. It is important, however, to recognize that mistakes do happen. The best thing to do if you make a blunder is apologize and try to use the name and pronouns the person prefers from that point on (University of Wisconsin-Milwaukee, 2016).

Some transgender individuals wait until midlife to “come out.” Others keep transgender inclinations a secret and never “come out.” Coming out in midlife can be quite complicated in many ways. Some of these individuals may be married (as was Bruce Jenner), and the reactions of their spouse and their children can be quite emotional, ranging from utter rejection to gradual acceptance. Dooley (2017, p. 241) notes,

Likewise, coming out can jeopardize a transgender person’s employment. There are few states which protect transgender persons from being fired because of their transgender status. This, of course, can be quite devastating psychologically and also economically. Although it is difficult to assess the socioeconomic levels of transgender persons, a survey of transgender individuals in the Washington, DC, area found that 42% of the participants were unemployed, 29% had no income, and 31% had an income less than $10,000….

One must think about the motivation of persons to come out as transgender. To assume this status is to place one’s self in an extremely marginalized position in society. Transgender persons experience very high rates of violence and discrimination. So it would take a good deal of strength to come out as transgender, and the need to do so must be very strong….

It is also important to realize that transgender people do survive these difficulties and feel much happier living as their proper gender.

There is scant literature on the experiences of older transgender persons. It appears older transgender persons also experience considerable prejudice and discrimination in such areas as health care, housing, and employment (Dooley, 2017).

The NASW (2012) Policy Statement on “Transgender and Gender Identity Issues” reads as follows:

• NASW reaffirms a commitment to human rights and freedom and opposes all public and private discrimination on the basis of gender identity and of gender expression, whether actual or perceived, and regardless of assigned sex at birth, including denial of access to employment, housing, education, appropriate treatment in gender segregated facilities, appropriate medical care and health care coverage, appropriate identity documents, and civil marriage and all its attendant benefits, rights, and privileges.
• NASW encourages the repeal of discriminatory legislation and the passage of legislation protecting the rights, legal benefits, and privileges of people of all gender identities and expressions. (p. 341)

Ethical Question 13.3

 

EP 1

1. According to the NASW Code of Ethics, why is it important for social workers to advocate for transgender individuals? What are some specific steps social workers can do to advocate for the transgender population?

13-2Discuss Conceptual Frameworks concerning Sexual Orientation

LO 3

Why are some people lesbian or gay? Although various theories have been proposed to explain why people are lesbian or gay, none has been proven. (A similar question that could be asked is, “Why are some people heterosexual?”) No one can give a definitive answer concerning why some people are gay/lesbian and others heterosexual. Some of the principal hypotheses will be reviewed here. They fall under the umbrellas of biological and psychosocial theories. Evaluation of theory, interactionist theory, ethical issues related to theory, and other research will also be discussed.

13-2aBiological Theories

The biological theories attempting to explain same-sex sexual orientation can be clustered under three headings: genetic, anatomical (brain), and hormonal. They are based on the idea that same-sex sexual orientation is caused by physiological factors over which individuals have no control.

Genetic Factors

The genetic explanation for same-sex sexual orientation supports the idea that people’s sexuality is programmed through their genes. Bailey and Pillard compared groups of identical twins, fraternal twins, and brothers who were adopted (1991). Identical twins develop from the splitting of a single fertilized egg. They are therefore genetically identical. Fraternal twins, on the other hand, develop concurrently from two separate eggs that were fertilized by two separate sperm. They are only as genetically similar as any brothers might be. Brothers who are adopted, unless they are family members, have no genetic commonality. The researchers found that when one identical twin was gay, 52 percent of the time, their twin brother was also gay. But in the case of fraternal twin brothers, only 22 percent of the pairs were both gay, and when the brothers were adopted, both brothers were gay only 11 percent of the time. The researchers concluded that this provides evidence for a genetic link. They indicated that the degree of genetic contribution to same-sex sexual orientation could vary from 30 to 70 percent.

Another study looked at 108 lesbians who had either identical or fraternal twin sisters and another 32 lesbians who had adopted sisters (Bailey et al., 1993). They found that among almost half of the identical twins, both were lesbians. However, only 16 percent of fraternal twins and 6 percent of the unrelated sisters were both lesbians. These results further support the idea of a genetic component to same-sex sexual orientation. Subsequent research using more refined methodology had similar findings that helped substantiate the results of this study (Kendler, Thornton, Gilman, & Kessler, 2000; Kirk et al., 2000).

“Gay men have more gay brothers than lesbian sisters, while lesbians have more lesbian sisters than gay brothers”; Carroll (2010, pp. 283–284) also “found evidence of a ‘gay’ gene on the X chromosome but did not find a ‘lesbian’ gene.”

Some research in Australia studied 1,538 pairs of twins (Bailey, Dunne, & Martin, 2000). The researchers used “a strict criterion for determining sexual orientation” and “found a concordance rate (the percentage of pairs in which both twins are gay) of 20% among identical male twins and 0% among pairs of male same-sex fraternal twins. The corresponding concordance rates for female identical and same-sex fraternal pairs were 24% and 10.5%, respectively” (Crooks & Baur, 2011, p. 255).

“There is a great deal of evidence that gay and lesbian sexual orientations run in families” (Bailey et al., 2000; Carroll, 2013b; Dawood, Pillard, Horvath, Revelle, & Bailey, 2000; Greenberg et al., 2014, p. 377; Kendler et al., 2000). However, “[s]exuality experts do caution that a specific gene linked to homosexuality has not been identified. Also, because of the complexity of sexual orientation, it is likely that a possible genetic link is only part of the picture” (Greenberg et al., 2014, p. 377).

Brain (Anatomical) Factors

LeVay (1991, 1996) studied the brains of 41 cadavers: 19 of gay men, 16 of supposedly heterosexual men, and 6 of supposedly heterosexual women. He found that the anterior hypothalamus (a marble-sized cluster of cells that regulates sexual activity in addition to appetite and body temperature) in gay men was only half the size of that in heterosexual men.

“More recent studies have also found brain differences—specifically in the cerebral hemispheres—of heterosexual and homosexual men and women” (Carroll, 2013b, p. 274). Yet, it is unknown whether such variations were present at birth or arose at some time after that; additionally, no evidence exists to confirm that such differences were directly related to sexual orientation (Carroll, 2013a; Kinnunen, Moltz, Metz, & Cooper, 2004; Swaab, 2004). Therefore, at present, there are no clearly established brain differences related to sexual orientation (Carroll, 2013a; Gooren, 2006).

Hormonal Factors

Hormonal theories of heterosexuality suggest that hormonal type and level cause homosexuality. One subset of hormonal theories concerns differences in hormonal levels during adulthood. Another subset of the hormonal theories indicates that abnormal hormonal levels during the prenatal period may result in same-sex sexual orientation (Berger & Kelly, 1995).

Research has established no relationship between hormonal levels and sexual orientation either during the prenatal period or in adulthood (Carroll, 2013b; Hyde &DeLamater, 2017). Hormone levels are related to sexual interest and activity in adulthood. However, as Hyde and DeLamater (2014) comment, “As a clinician friend of ours replied to an undergraduate male who was seeking testosterone therapy for his homosexual behavior, ‘It won’t make you heterosexual; it will only make you horny’” (p. 343).

13-2bPsychosocial Theories

Psychosocial or behavioral theories suggest that same-sex sexual behavior is learned, just as any other type of behavior is learned. Early in life, same-sex sexual behavior may be positively reinforced by pleasurable experiences and thereby strengthened. Or such behavior may be punished by negative, punitive experiences and, as a result, be weakened.

For instance, a child who has several positive sexual contacts with members of the same gender might be positively reinforced or encouraged to seek out more such contacts. Similarly, a child who has a negative experience with a member of the same gender might be discouraged from having more such encounters.

13-2cThe Evaluation of Theory: What Is the Answer?

The answer to why people are gay is a multifaceted one. Genetic rationales have major shortcomings. For example, we discussed the research finding concerning identical twins. If, as some researchers postulate, genetic rationales explain some component or percentage of why people are gay, then what explains the remaining components or percentages? If people are gay or lesbian because of some hormonal impact (perhaps prenatally), why aren’t all people lesbian, or gay who experienced similar hormonal impacts?

At least two major shortcomings can be cited with respect to psychosocial theories of same-sex sexual orientation that emphasize the learning process. First, there is a tremendous amount of negative feedback about same-sex sexual orientation. Children learn early that being called a “fag” is not a compliment. How same-sex sexual behavior would be reinforced and would increase in frequency, in view of such punitive circumstances, might be questioned.

Second, learning theory implies that a person must first have a same-sex sexual experience. Then, if the experience was positively reinforcing or personally rewarding, the person would seek out more such experiences. However, might it not be the case that individuals who have same-sex sexual desires seek out sexual experiences with the same gender in the first place? In other words, might not the desire for sexual contact with the same gender be there even before any actions ever occur?

13-2dInteractionist Theory

Storms (1981) has proposed a theory that focuses on the interaction of biological predisposition and the effects of the environment. He poses that the development of a same-sex sexual orientation is related to the rate at which people mature during preadolescence. Children tend to play and interact with people of the same gender during preadolescence. This same-sex interaction reaches its peak at about age 12, after which heterosexual interactions begin to develop. Heterosexual dating may start around age 15. Storms suggests that the sex drive for some people emerges earlier than for others. If children who mature earlier are still in same-sex groupings, they may have positive sexual experiences with persons of the same gender during this time. They may develop a pattern whereby they remain oriented toward the same gender. They never become interested sexually in the opposite gender. This is where the environment plays a part. If these children happen to have positive sexual same-sex experiences, they may continue with that same sexual orientation. If early maturers do not have these experiences, they continue later to develop a heterosexual orientation as they begin interacting with people of the opposite gender.

Many experts agree that gay/lesbian orientation probably results from some mixture of both biological and psychosocial variables. As yet we don’t know what that mixture is. There is still no clearly established reason why people are lesbians or gays.

13-2eEthical Issues Related to Theory

 

EP 1

Some lesbian and gay people have expressed ethical concerns regarding proving any theory about same-sex sexual orientation involving a biological component. On the one hand, many express relief at the thought that others might consider their same-sex sexual orientation not to be their “own fault.” If there’s a medical basis, the general public might become more accepting of lesbians and gay men. Gelman and his colleagues (Gelman, Foote, Barrett, & Talbot, 1992) found that people were generally more accepting of lesbian and gay people if they felt such people were “born that way” instead of choosing or learning that lifestyle.

On the other hand, if specific genetic or hormonal “ingredients” are found for same-sex sexual orientation, lesbian and gay people might be considered defective by society at large. Taking this one step farther, society at large might decide to make biological “corrections” prenatally. Might this mean changing what a person was meant to be into something else? Might potential parents be more likely to abort a fetus determined to be lesbian or gay if they learn about the same-sex sexual orientation early in the gestational process? There are no easy answers to these questions in our technological age.

13-2fOther Research on the Origins of Same-Sex Sexual Orientation

Bell and his colleagues (Bell, Weinberg, Martin, & Hammersmith, 1981) undertook a massive investigation through the Alfred C. Kinsey Institute for Sex Research concerning the causes of same-sex sexual orientation. They studied 979 lesbians and gay men, and compared them to 477 heterosexual women and men. Study participants were asked extensive questions about many aspects of their lives. A statistical method called path analysis allowed the researchers to explore possible causal relationships between a number of variables, such as prenatal characteristics and family relationships, and the development of sexual orientation.

Although the research offers some of the most extensive and methodologically sound findings available, none of the aforementioned theories to explain same-sex sexual orientation was supported. If anything, several of the variables proposed by these other theories were found not to be related to same-sex sexual orientation. For instance, no relationship was found between being gay and having been seduced by a person of the same gender when young. The researchers found no ultimate answers, but they did identify some interesting aspects of being lesbian or gay. Three findings are of special significance.

First, sexual orientation appears to emerge by the time both males and females reach adolescence. This is the case even when people have little or no sexual experience. Sometimes people begin grasping that they’re not heterosexual because of different feelings during childhood. “Many realize during adolescence that something is missing in their heterosexual involvements and that they find same-sex peers sexually attractive” (Crooks & Baur, 2014, p. 269).

Second, lesbian and gay people have similar amounts of heterosexual experience during childhood and adolescence when compared to heterosexual people. There is one basic difference, however. Although lesbian and gay people participate in heterosexual activity, they do not enjoy it very much.

The third major finding of the study involves the concept of gender nonconformity, which appears to begin in childhood for gay males and lesbians (Bailey & Zucker, 1995; Lippa, 2008; Rathus et al., 2014; Singh, Vidaurri, Zambarano, & Dabbs, 1999). Gender nonconformity refers to a child’s preference for play and activities that our society generally considers appropriate for children of the opposite gender. For example, little girls usually choose to play with Barbie dolls and play dishes, whereas little boys generally prefer GI Joes and toy bulldozers. A little girl who only plays with tanks and footballs or a little boy who only plays with Barbie dolls would be examples of gender nonconformity. Gender nonconformity was a much stronger causal factor for gay men than for lesbians. Other factors such as family relationships have a stronger causal relationship with lesbianism.

This research indicates that sexual orientation develops very early in life. It also suggests that whether a person is gay or lesbian or heterosexual is not a matter of choice. Just as a heterosexual person may be sexually attracted to another heterosexual person, so is a lesbian or gay person sexually attracted to another of the same gender. It appears that it would be just as impossible for a lesbian or gay person to turn heterosexual as it would be for a heterosexual person to begin choosing sexual partners of the same gender.

The fact that many lesbian and gay people externally assume heterosexual roles for the sake of appearance is also logical. Numerous homophobic stigmas are placed on gay or lesbian people. They are often subjected to serious discrimination. In evaluating the consequences of the various alternatives open to them, some lesbian and gay people may decide that it is too difficult to survive openly as a gay or lesbian person (e.g., hold a job, relate to family members, participate in community activities). A lesbian or gay person with a heterosexual facade is burdened with pretending to be someone she or he is not. Such pretense can violate individual dignity and freedom. Spotlight 13.1 discusses discrimination and the impact of homophobia on gay and lesbian people.

Spotlight on Diversity 13.1

Address Discrimination and the Impacts of Homophobia

LO 4

“Did you ever hear the one about the dyke who … ”

“Harry sure has a ‘swishy’ way about him. You’d never catch me in the locker room alone with that guy.”

“They’re nothing but a bunch of lousy faggots.”

Our common language is filled with, derogatory terms referring to lesbian and gay people. Just as other diverse groups are subject to arbitrary stereotypes and to discrimination, so are gay and lesbian people. Because of negative attitudes and the resulting discriminatory behavior, alternatives for lesbian and gay people are often different and limited. There are often other negative consequences. Other, nonsexually related aspects of their lives are affected because of their sexual orientation.

For example, a male third-grade teacher may live in fear that the parents of his students will discover he’s living with another man. He loves his job, which he’s had for nine years. If parents put pressure on the school administration about his same-sex sexual orientation, he may get fired. He may never get another teaching job again.

Another example is provided by a female college student who expends massive amounts of energy to disguise that she’s a lesbian. She attends a state university in a small, Midwestern, rural town. She is terribly lonely. She keeps hoping that that special someone will walk into her life. However, she doesn’t dare let her friends know she’s lesbian or she really will be isolated. There wouldn’t be anyone to talk to or to go to dinner with. They would just never understand. People have committed suicide for less.

Lesbian and gay people are frequently the victims of homophobia. We have defined homophobia as the extreme and irrational fear and hatred of gay and lesbian people. People with same-gender sexual orientation have historically been discriminated against by the U.S. military, religious, mental health, medical, and various other institutions and systems.

Some feel that the term homophobia is too strong because the word phobia means “an intense and persistent fear of an object or situation” (Barker, 2014, p. 322). Antihomosexual or antigay stance, prejudice, or discrimination might be alternate terms. In reality, homophobia is likely a continuum. People probably vary markedly in the depth of their negative feelings about lesbian and gay people. Regardless of what it’s called, many people harbor seriously negative perceptions and prejudice against lesbian and gay people (Carroll, 2013b; Kelly, 2008; LeVay& Valente, 2006; Messinger& Brooks, 2008).

It is not clear how homophobia originated. It may involve people’s attempts to deny same-sex sexual feelings in themselves (Maier, 1984). Perhaps the more strongly homophobic people are, the more they are working to deny such feelings in themselves. Regardless of the cause, the manifestations of homophobia are all around us. In the past, same-sex sexual orientation was considered an illness. Not until 1974 did the American Psychiatric Association remove it from the list of mental illnesses.

Crooks and Baur (2011) potently describe how venomous homophobia can be:

Unfortunately, homophobia is still common and often plays a big role in the lives of many gay men, lesbians, and bisexuals (Symanski, 2009)…. The homophobosphere, antigay postings on Internet blogs, both expresses and creates hate (Doig, 2008). Such expressions contribute to the ongoing daily harassment of and discrimination against anyone outside ‘acceptable’ heterosexual parameters, and they legitimize the mind-set of people who commit hate crimes directed at gays. Hate crimes include assault, robbery, and murder, and they are committed because the victim belongs to a certain race, religion, or ethnic group or has a certain sexual orientation. (pp. 261–262)

Rathus and his colleagues (2014) relate that homophobia may assume “many forms, including the following:

• use of derogatory names (such as queer, faggot, and dyke)
• telling disparaging ‘queer jokes’
• barring gay people from housing, employment, or social opportunities
• taunting (verbal abuse)
• gay bashing (physical, sometimes lethal, abuse).” (p. 283)

A potentially negative side effect would be to internalize such negative attitudes. In other words, a gay or lesbian person might think, “If being gay or lesbian is bad, and I am gay or lesbian, then that means that I am bad, too.”

It is vitally important that social workers confront their own homophobia and learn more about the special issues of lesbian and gay clients. Social workers must explore and confront their own homophobia in order to understand and meet the needs of lesbian and gay clients and their families; not doing so raises grave questions about their ability to undertake ethical social work practice (Alderson, 2013; Morales, 1995; Morrow, 2006c).

Social workers must do the following:

1. Develop LGBT content knowledge base [including the recognition of current LGBT issues and an understanding of the LGBT lesbian and gay communities] …
2. Challenge personal biases about sexual minority people and practice in accordance with social work values and ethics….
3. [N]ot presume the sexual orientation or gender identity of clients….
4. Use accurate and respectful language in all communication to and about clients….
5. Avoid assuming that the characteristics and needs of all sexual minority groups—gay, lesbian, bisexual, transgender—are the same….
6. Approach cases from an ecological systems perspective [It is important to appreciate the significance of the social environment and its effects on lesbian and gay people’s lives. Practitioners should confront oppressive policies, laws, and treatment and advocate for change. Social workers should be aware of available resources and potential social supports.] …
7. Honor diversity among LGBT people [Each lesbian or gay person is a distinct and unique individual, just as each heterosexual person is.]
8. Honor client self-determination regarding disclosure …
9. Honor clients’ rights to privacy regarding their sexual orientation and gender identity….
10. Advocate for LGBT-affirmative work environments and LGBT-affirmation agency services. [Social workers should advocate for fair and equal treatment and for services designed to meet the needs of LGBT clients.] (Morrow, 2006c, pp. 13–15)

Ethical Questions 13.4

 

EP 1

1. Why do you think people are lesbian, gay, or bisexual? To what extent does a person’s sexual orientation matter to you, and why?

13-3Describe Lesbian and Gay Lifestyles

LO 5

What is it like to be a lesbian or gay person? How would life be different or similar if you awoke tomorrow morning and discovered that you were homosexual? What would happen to your relationships with family, friends, and colleagues?

No one typical lifestyle is practiced by all lesbians and gay people. Lesbians and gay men have lives that are just as varied as those of heterosexuals. Being a gay man in Dickeyville, Wisconsin, is different from being a gay man in a San Francisco suburb. Being a white lesbian mother receiving public assistance in Utah is different from being an African American upper-class lesbian mother in Boston. However, some common patterns emerge in the lives of lesbian and gay people. Several issues reflected by these patterns are addressed here.

13-3aLesbian and Gay Relationships

Individual relationships and lifestyles vary among lesbian and gay people just as they do among heterosexuals (Longres&Fredriksen, 2000; Mallon, 2008; Tully, 2001). As with heterosexuals, many lesbian and gay people live with a significant other as a couple. Others live by themselves or with a heterosexual partner, friends, children, or family. Additionally, many have children (Mallon, 2008; Messinger& Brooks, 2008). Same-sex couples face many of the same issues and hold many of the same values as their heterosexual counterparts (Crooks & Baur, 2014; Holmberg & Blair, 2009). The diversity characterizing heterosexual couples (e.g., socioeconomic status, educational level, racial and ethnic background, communication style) is also reflected in same-sex couples.

Rathus and his colleagues (2014) reflect on lesbian and gay relationships:

Most gay males and lesbians who share close relationships with their partners are satisfied with the overall quality of their relationships. Researchers find that heterosexual and gay couples report similar levels of satisfaction with their relationships (Henderson et al. 2009; Kurdek, 2005). Moreover, gay males and lesbians in enduring relationships generally report high levels of love, attachment, closeness, caring, and intimacy.

As with heterosexual people, not all the relationships of gay people are satisfying. Among both groups, satisfaction is higher when both partners feel that the benefits they receive from the relationship outweigh the costs (Henderson et al., 2009). Like heterosexual people, gay men and lesbians are happier in relationships in which they share power and make joint decisions. (pp. 282–283)

Ossana (2000) elaborates:

The correlates of relationship quality are similar for all couples: appraisals that the relationship includes many rewards and few costs; personality characteristics such as high expressiveness; partner’s placing higher value on security, permanence, shared activities, and togetherness; less belief that disagreement is destructive; higher mutual trust; better problem-solving and conflict resolution skills; more frequent shared or egalitarian decision making; and greater satisfaction with perceived social support. (p. 277)

Gay people in a committed relationship differ little from their heterosexual counterparts.

Paul Gapper/Alamy Stock Photo

Major social and legal obstacles do exist that prevent lesbian and gay people from establishing long-term relationships. For example, gay and lesbian marriages are a hotly debated issue (ProCon.org, 2014). Even if gays and lesbians are very much in love with each other and want to spend their lives together, social obstacles might exist, such as pressure from family and heterosexual friends to form heterosexual relationships, marry, and have children.

13-3bSexual Interaction

Many people find it hard to imagine what lesbian and gay people do sexually. After all, they don’t have the “necessary” ingredients of both penis and vagina. The fact is that lesbian and gay people engage in the same types of activities that heterosexuals also enjoy. These include hugging, kissing, touching, fondling of the genitals, and oral sex.

The physiological responses of gay and lesbian people are exactly the same as those of heterosexuals. They become aroused or excited, enter a plateau stage of high arousal, have an orgasm, and go through a period of resolution during which the body returns to its normal, unaroused state. The process is the same for all people, male or female, gay or heterosexual.

13-4Explore Significant Issues and Life Events for Lesbian and Gay People

LO 6

As members of a diverse group, lesbian and gay people are victims of stereotypes and homophobia. Discrimination may frequently limit the alternatives available to them. Social workers and other human service professionals need to be aware of the special issues and life events confronting lesbian and gay people so that they might provide leadership in improving service delivery. In order to help clients define and evaluate the alternatives available to them, social workers must understand the effects of certain life events. Significant issues and life events of gay and lesbian people are examined here. Additionally, social work with gay and lesbian people is addressed.

13-4aThe Impacts of Social and Economic Forces: Legal Empowerment and Social Justice

For hundreds of years, laws have existed to suppress homosexuality and ban sodomy, defined as anal or oral sex between same-gender or heterosexual people. Harper-Dorton and Lantz (2007) discuss the historical legal perspective:

Laws against homosexual behavior date back at least as far as Roman law. Colonists in early American history punished sodomists with floggings, hangings, and periods of confinement (Robinson, 2003). This history may seem ancient; however, as recently as 2002, sodomy laws continued to be enforceable in fourteen states in addition to Puerto Rico (Robinson, 2005). Legislation against, homosexual acts in the United States and the prevailing homophobia in American culture have caused many gay and lesbian persons to fear revealing their sexual orientation. Perhaps for personal safety, many gay men and lesbian women remain covert about their sexual practices. Personal decisions about coming out and openness about sexual orientation are influenced by factors such as fear of hate crimes, discriminatory experiences in the workplace, and exclusion from institutional settings such as the military (Reicherzer, 2005; Tully &Nibao, 1979). (p. 162)

In 2003, the U.S. Supreme Court in Lawrence et al v. Texas struck down a “Texas sodomy law that made private sexual contact between homosexuals illegal” (Crooks & Baur, 2014, p. 265). The Court found that such laws violated people’s constitutional right to privacy. As a result, laws in several other states banning sex between same-sex individuals and prohibiting sodomy were also overturned (Crooks & Baur, 2014).

Four issues will be addressed in which lesbian and gay people are treated differently than heterosexual people under the law: employment, the military, personal relationships and finances, and child custody and visitation. In light of all these challenges, Spotlight 13.2 discusses the importance of a sense of community among gay and lesbian people.

Spotlight on Diversity 13.2

Recognize Gay and Lesbian Pride, Empowerment, and a Sense of Community

LO 7

All people, gay, lesbian, and heterosexual, need places to socialize, to feel free to be themselves, and to feel that they belong. Gay and lesbian pride and the sense of community are important concepts (Greenberg et al., 2014; LeVay& Valente, 2006; van Wormer, Wells, &Boes, 2000). One young man summarized these concepts well by joyously stating:

As someone who has recently “come out,” I have acquired a sense of pride in my homosexuality: a part of me I have run and hidden from for twenty of my twenty-five years. I owe much gratitude to many people in the gay community who have given me the courage to stand up for who I am. I am proud to call these people my gay brothers, the first real friends I have ever had. I’m not ashamed—I’m proud to be gay. My sense of gay pride has made me realize that I’m as good as any other person on this earth and deserving of the same basic human dignity and respect all human beings are entitled to. (“What Does Gay/Lesbian Pride Mean to You?” 1985, p. 2)

Heterosexual innuendos, expectations, values, and ideas saturate our society. One gay man said he always felt he had to be watchful and cautious in heterosexual groups. He carefully censored what he said to protect himself from homophobic attacks on himself and his lifestyle.

Within the lesbian and gay communities, lesbians and gay men can be themselves. They can let down their protective facades. They can be with other people who understand what it’s like to be gay in a heterosexually oriented world. This is not to say that many lesbians and gay men have not openly and proudly proclaimed their sexual orientation. This is so even though it means they expose themselves to homophobic criticism, prejudice, and discrimination. In a way, by doing this, they are advocating for individual freedom and the end of discrimination.

In this homophobic world, there are a multitude of lesbian and gay activities and organizations. These range far beyond crisis lines and support groups. There are sports teams and organizations, choral groups, churches, bookstores, newspapers, magazines, advocacy groups, and computer dating services all oriented toward lesbians and gay men. The sense of community has developed and grown far beyond that of the gay bar.

People march in a gay pride parade. The rainbow flag is a common gay pride symbol.

iStock.com/andipantz

Employment

LGBT people “suffer pervasive discrimination in employment, housing, public accommodation, education, medical care,” and a host of other avenues in their everyday lives because they are not legally protected (American Civil Liberties Union [ACLU], 2014a; National Gay and Lesbian Task Force, 2008d). Not until 1976 was the federal government’s personnel manual changed to forbid discrimination against lesbian and gay people in hiring or terminations unless the public agency involved could prove that same-sex sexual behavior affected work completion (Dale, 1993). This means that most federal government agencies cannot discriminate against lesbian and gay people purely on the basis of their sexual orientation. However, these rules don’t apply to state and local jobs. For example, police departments and public schools have often succeeded in driving out lesbian and gay employees (Dale, 1993). Discrimination occurs in a wide range of settings. One gay married man was recently offered a job as food services director at a Catholic girls’ school; the school rescinded the offer two days later when an administrator noted that the man indicated on a form that his husband should be the emergency contact person (Valencia, 2014). The man allegedly was told that he couldn’t be hired because the church did not recognize gay marriage.

Other than for federal government jobs, there are no federal statutes that prohibit employers from discriminating against lesbian and gay people in the private sector (Human Rights Campaign, 2014; NOLO, 2014b). They are not considered to be one of the groups, such as racial minorities, included under the equal protection clause of the U.S. Constitution. As of this writing the U.S. Congress is considering the Employment Non-Discrimination Act (ENDA), already passed by the U.S. Senate. The law would impart fundamental safeguards against discrimination in employment that is based on sexual orientation or gender identity. Prior attempts to pass similar legislation have failed, although such efforts solicit increasing support from members of Congress each year.

Major progress has been made in implementing antidiscrimination policies in corporate America, although this progress is not reflected in many small businesses and organizations. Most Fortune 500 companies have nondiscrimination policies that include sexual orientation; and a majority of these companies have policies that incorporate nondiscrimination involving gender identity.

Ethical Question 13.5

 

EP 1

1. What, if anything, should be done to protect lesbian, gay, and bisexual people from discrimination in employment?

The Military

Since gay and lesbian people historically have been prohibited from joining the CIA, the FBI, and the armed forces, it’s important to view the current picture within a historical context (McCrary & Gutierrez, 1979/80; Tully, 1995). The following content discusses both the history of the treatment of lesbians and gay men in the military, and the current, much different scenario.

Leonard Matlovich provides one of the most publicized examples of discrimination against gay and lesbian people by the military. As the son of an air force sergeant, Matlovich was raised on air force bases. Upon his high school graduation, he immediately joined the air force. He received numerous decorations for his service, which included fighting in Vietnam. He was also labeled superior in his evaluations.

Years later, at age 30, Matlovich acknowledged that he was gay and became involved in gay activities. When he told this to his superiors, he was discharged with a general discharge, a type of discharge considered less than honorable. He eventually took his case to court. He “later collected $160,000 in back pay when the air force could not rebut his claim to an exemption from the no-gays policy.”

In January 1993, President Clinton announced a plan to revoke the 50-year-old ban on gay and lesbian people in the military. However, Congress so eroded the plan that the final version entailed an uncomfortable “Don’t ask, don’t tell, don’t pursue” guideline (Gelman, 1993, p. 28). This meant that military personnel were supposed to pretend, with an “out of sight, out of mind” approach, that same-sex sexual behavior doesn’t exist. Many questions were raised regarding this policy. Consider the following facts.

Under the so-called “Don’t ask, don’t tell” policy, 13,000 service members were fired or discharged (O’Keefe, 2011), many of them specialists who were critical to military operations. These included health-care specialists, sonar and radar specialists, combat engineers, law enforcement agents, security guards, and biological and chemical warfare specialists (Servicemembers Legal Defense Network [SLDN], 2005a). Many gay and military personal serving in Iraq and other places in the Middle East experienced serious difficulties because of their sexual orientation. Because they “couldn’t tell” that they were gay or lesbian, they couldn’t cite their partners as next of kin if something happened to them. And their partners were not beneficiaries of supportive services provided to heterosexual partners and families. At times, many partners were left hanging regarding whether their loved one was alive, hurt, or dead.

In December 2010, President Barack Obama repealed the “Don’t Ask, Don’t Tell” policy. The repeal finally went into effect on September 20, 2011; by that time almost “2 million service members had been trained in preparation” for the disclosure of sexual orientation by lesbian and gay military personnel in anticipation of potential issues (Bumiller, 2011).

Some estimate that at least 2 percent of service members (including active and reserve) are lesbian, gay, or bisexual (Bumiller, 2012). One survey found that 32 percent have divulged their nonheterosexual orientation; however, this estimate may be high due to a sample that may have used participants who are less guarded about their sexual orientation (Bumiller, 2012).

Bumiller (2012) makes several points concerning the new policy of military personnel being open about their gay or lesbian sexual orientation. The policy generally appears to be successful. Troops have not protested by quitting in droves, as some adversaries to the change had feared. Many gay and lesbian service members express relief that they may be open about their relationships without being discharged. However, many others remain fearful of negative repercussions if they come out to others in a military context. They feel that many heterosexual peers still think a nonheterosexual orientation is unacceptable. “[H]arassment and discrimination against gays in the military has not disappeared.” There are derogatory comments and jokes. There have been incidents. For example, one female officer was dancing with her partner at a military ball. A senior officer commanded the women to stop dancing. When the women refused, the senior officer “shoved” them off the floor. The female officer filed a complaint, the Pentagon investigated it, and the senior officer was removed from his position and compelled to retire.

A major positive aspect of the policy concerning openness is the fact that spouses of gays and lesbians in the military may now receive spousal benefits such as Social Security survivor benefits and family leave (Williams &McClam, 2013). Federal benefits for same-sex couples after new U.S. Supreme Court determinations will be discussed in Personal Relationships, Finances, and Same-Sex Marriage.

Personal Relationships, Finances, and Same-Sex Marriage

The right of lesbian and gay people to marry legally in the United States has been a hotly debated issue. A major change occurred in June 2013 when the U.S. Supreme Court struck down major aspects of the federal 1996 Defense of Marriage Act (DOMA). DOMA had defined marriage as being between a man and a woman (Gacik, 2014). In 2013 the Court ruled that same-sex marriage must be accepted by the federal government and that such couples should receive all the federal benefits available to heterosexual couples. These benefits include “Social Security survivor benefits, immigration rights and family leave” (Williams &McClam, 2013). They also include federal tax benefits such as filing joint federal tax returns. Note, however, that federal agencies may determine which same-sex marriages are eligible for benefits; for example, some agencies such as the IRS will recognize all same-sex marriages, whereas the Social Security Administration takes into consideration the couple’s state residence and whether that state recognizes same-sex marriage (NOLO, 2014a).

In its 2013 decision the Supreme Court did not force states to accept gay marriage, but rather left them to make their own determinations (Williams &McClam, 2013). (For many decades prior to 2015, a majority of the 50 states had banned same-sex marriages.)

Whether gays and lesbians have the right to marry has been a hotly debated issue for the past few decades in the United States. In June 2015, the United States Supreme Court in a landmark ruling said that same-sex couples have a constitutional right to marriage. The 5–4 U.S. Supreme Court decision means all 50 states must perform and recognize gay marriage.

Internationally, the following countries now allow same-sex marriage, in addition to the United States: Netherlands, Belgium, Canada, Spain, South Africa, Norway, Sweden, Argentina, Iceland, Portugal, Denmark, Uruguay, New Zealand, Brazil, and France, England, and Wales.

The right of lesbian and gay people to legally marry was a hotly debated issue in the United States.

Jim West/Alamy Stock Photo

Ethical Question 13.6

 

EP 1

1. Should lesbian and gay people have given the right to marry?

Child Custody and Visitation Rights

In the past, lesbian and gay parents have experienced major difficulties in custody debates over their children because of their sexual orientation. Numerous courts have denied parents custody simply because they were lesbian or gay (ACLU, 2014b; Barusch, 2012; Carroll, 2013b; Hunter &Hickerson, 2003; Parks & Humphreys, 2006). For example, a Florida lesbian mother lost “custody of her 11-year-old daughter to the child’s father, who was convicted of killing his first wife” (CNN, 1996). Further complicating the matter, the man’s daughter with his first wife accused him of sexually abusing her when she was a teenager. In another case, an Alabama court refused custody to a lesbian mother; the chief justice condemned homosexuality as an “inherent evil and an act so heinous that it defies one’s ability to describe it” (Kendell, 2003). Still another instance involves a grandmother who was awarded custody of her grandson because his mother was a lesbian living with a female partner; the Virginia judge ruled that the mother’s “conduct is immoral” and that her behavior “renders her an unfit parent” (Kendell, 2003). On the other hand, some state courts have ruled that child custody could not be denied purely on the basis of parental homosexuality unless it was proven that such sexual orientation would hurt the child (Berger & Kelly, 1995).

Judges presiding over custody disputes can make arbitrary judgments concerning what is in the child’s best interests (Hyde &DeLamater, 2014; Kendell, 2003). Some judges may have homophobic ideas, which have the potential of influencing their decisions.

There are several myths about lesbian and gay parenthood that might influence people against lesbian and gay parents. First, there is the misconception that lesbian or gay parents will influence their children to become gays or lesbians. No verification exists for this myth or for the worry that children growing up in families with lesbian or gay parents are more likely to be lesbian or gay (Barusch, 2012; Carroll, 2013b; Hyde &DeLamater, 2014; Morales, 1995). Second, there is the idea that children will be damaged by growing up in lesbian or gay homes. All indications are that children growing up in such households flourish as well as those raised in heterosexual homes (Carroll, 2013b; Hyde &DeLamater, 2014). Third, some people mistakenly believe that gay and lesbian people’s parenting skills are inadequate. No evidence bears this out (Barusch, 2012; Moses & Hawkins, 1982). Finally, research indicates that fears about children with lesbian or gay parents experiencing difficulties in peer relationships, having inadequate social skills, or enjoying less popularity than their peers with heterosexual parents are also unsupported (Hyde &DeLamater, 2014).

It’s interesting that the American Association of Pediatrics “endorsed its support of gay and lesbian parents to adopt a partner’s children” (AASECT, March 2002, p. 10). It maintained that it is in the best interest of children, and their security, that they live with legal parents.

Highlight 13.4

Arguments for and against Same-Sex Marriage

Pros		Cons
1.	Same-sex couples should be allowed to publicly celebrate their commitment in the same way as heterosexual couples.	1.	The institution of marriage has traditionally been defined as between a man and a woman.
2.	Same-sex couples should have access to the same benefits enjoyed by heterosexual married couples.	2.	Allowing gay couples to wed will further weaken the institution of marriage.
3.	Marriage is redefined as society’s attitudes evolve, and the majority of Americans now support gay marriage.	3.	It potentially leads down a “slippery slope” giving people in polygamous, incestuous, bestial, and other nontraditional relationships the right to marry.
3.	Gay marriage is protected by the Constitution’s commitments to liberty and equality.	3.	Gay marriage may lead to more children being raised in same-sex households, which are not an optimum environment because children need both a mother and father.
5.	Legalizing gay marriage will not harm heterosexual marriages or “family values,” and society will continue to function successfully.	5.	Marriage should not be extended to same-sex couples because they cannot produce children together.
6.	If the reason for marriage is strictly reproduction, infertile couples would not be allowed to marry.	6.	Marriage is a religious rite between one man and one woman.
7.	Same-sex marriage is a civil right.	7.	Gay marriage is incompatible with the beliefs, sacred texts, and traditions of many religious groups.

SOURCE: Gay Marriage: Pros and Cons, ProCon.org (2014).

Without the sanction of marriage, same-sex couples experienced a number of disadvantages. Greenberg and his colleagues (2014) cited five of these:

1. Any potential income tax benefitsapplied to married partners did not apply to unmarried lesbian or gay partners.
2. Lesbian and gay couples had more difficulty adopting children. Sometimes, states forbid the practice.
3. “Married couples do not have to pay any federal estate taxes(and usually only a limited amount of state estate tax) on the death of a first spouse (Emphasis added). State law provides (for people without wills) that property moves directly to the spouse (or spouse and children, depending on the state)” (Greenberg et al., 2014, p. 393). In same-sex couples who lived without the sanction of marriage, after a partner’s death, his or her relatives could demand all of the deceased partner’s assets.
4. Partners in same-sex couples were often denied employment benefitssuch as health or life insurance. Although many large companies provided benefits, many small companies did not.
5. Unmarried partners did not automatically have decision making rightswhen partners were seriously ill and unable to make decisions for themselves. Gay and lesbian partners had no legal rights under these circumstances because they did not fall under the legal definition of family.

The Future of Lesbian and Gay Rights

Although lesbian and gay people are sometimes not treated equally under the law, the great progress that has been made should be emphasized. Same-sex couples in the United States, and in many other countries, now have the legal right to marry. Some states and localities are adopting equal housing and employment legislation for lesbian and gay people. Homosexuality is no longer considered a psychiatric illness. Federal government agencies should no longer be able to discriminate against gay and lesbian people. Lesbian and gay people, through their advocacy and hard work, have achieved a great deal.

Gays and lesbians’ struggles for equality is sometimes characterized by the expression “Remember Stonewall!” Stonewall was a gay bar in New York City’s Greenwich Village. On June 28, 1969, police stormed and raided the bar, an incident not unusual in those times. How the gay men at the bar responded, though, was indeed unusual. They fought back. The struggle continued in the street for hours.

People involved in gay and lesbian liberation have provided much impetus to progress made in gay and lesbian legal rights. Such groups exist in many communities, especially in urban settings. Group meetings often provide opportunities to discuss issues, plan political interventions, and get help and support concerning personal difficulties such as employment discrimination. Additionally, they provide a means of becoming acquainted with other lesbian and gay people and with the gay and lesbian community in general.

Social workers need to attend to LGBT rights issues. Not only is an objective, open-minded attitude and belief in individual self-determination necessary, but an advocacy stance is also critical. Unfair, discriminatory rules in public and private agencies can be confronted. Attention can be called to any discrimination that does occur. Political candidates who encourage LGBT rights can be supported. Finally, others, including friends, family, and professional colleagues, can be educated about LGBT rights and encouraged to support them.

13-4bCommunity Responses: Violence against LGBT People

On June 12, 2016, homophobic Omar Mateen shot and killed 49 people in an Orlando, FL gay nightclub. An additional 53 people were injured. Mateen used an AR-15 semi-automatic assault weapon. This incident was the deadliest mass shooting in American history. Mateen was killed in a gun battle with SWAT team members.

“In October [1998] Matthew Shepard, a gay college student, was pistol whipped, beaten and left tied to a fence near Laramie, Wyoming, for 18 hours. Shepard died of his injuries four days later. Sources close to Russell Henderson, 21, and Aaron McKinney, 21, claimed that originally the two men had only intended to rob Shepard, but that awareness of his sexual orientation drove them to violence” (AASECT, 1998, p. 1).

Consider the following homophobic hate incidents against lesbian and gay people of color. In May, 2013, Mark Carson, 32, was walking with a friend in Greenwich Village in New York City, when another man taunted him with insults and then shot him with one bullet directly in the face (Slattery, Badia, & Kemp, 2013). The gunman along with two companions had called Carson and his friend “f——s” and “gay wrestlers” prior to the shooting. RaShawnBrazell, 19, was allegedly on his way to meet a lover; he was found mutilated, chopped into pieces, and dumped in a Brooklyn, New York, subway tunnel (Burke & Lemire, 2005). Sakia Gunn, 15, an African American who was a lesbian, “was stabbed to death in Newark, NJ” by a man “after she and a friend refused his advances by declaring that they were lesbians” (LGBT Hate Crimes Project, 2010). Jose Sucuzhanay, 31, a Latino, died of injuries from being beaten over the head with a beer bottle, struck numerous times with a baseball bat, and kicked repeatedly (McFadden, 2008). He had been walking home with his brother after attending a church function and later stopping at a bar. “They may have been a bit tipsy as they walked home in the dead of night, arm-in arm, leaning close to each other, a common [practice] … of men in Latino cultures, but one easily misinterpreted by the biased mind” (McFadden, 2008). A car suddenly pulled up and three men jumped out shouting antigay and anti-Latino vulgar remarks. The beating ensued. Jose’s brother managed to escape.

Carroll (2013b) describes the current context of violence against LGBT people:

Hate crimes are those motivated by hatred of someone’s religion, sex, race, sexual orientation, disability, or ethnic group. They are known as “message crimes” in that they send a message to the victim’s affiliated group. (American Psychiatric Association, 1998). Typically, hate crimes involve strong feelings of anger (Parrott & Peterson, 2008). (p. 288)

Swigonski (2006) cites the following statistics, based on Mason’s (2002) summary of surveys conducted in several English-speaking countries:

• 70 to 80 percent of lesbians and gay men reported experiencing verbal abuse in public because of their sexuality.
• 30 to 40 percent reported threats of violence.
• 20 percent of gay men reported physical violence.
• 10 to 12 percent of lesbians reported physical violence.

Swigonski concludes, “For people whose sexual orientation or gender expression is outside narrowly defined societal norms, violence is a normative part of life. That is a fact, but it is not a tolerable fact” (p. 366).

Seven types of victimization have been noted (Wertheimer, 1988): verbal harassment, which occurs most frequently; threatening behavior, such as being followed by harassers or being warned that attacks are forthcoming; physical attacks by groups of men, which can result in emotional and physical injury; assaults associated with AIDS and the resentment toward gay and lesbian people related to it; sexual assaults of women and men; assaults and discrimination by police; and even murder. Homophobia seems to form the foundation for these attacks.

What can be done to halt such victimization of LGBT people? Wertheimer (1988) proposes four potential solutions. First, LGBT civil rights legislation must be passed. Discrimination on the basis of sexual orientation must be clearly illegal. People must get the message that such behavior will not be tolerated. Victims need to feel safe in reporting abusive incidents.

Wertheimer’s second suggestion involves the passage of laws that specifically address crimes committed because of hatred and prejudice toward specific groups. Such legislation would protect not only LGBT people but also others subjected to prejudice because of their gender, race, ethnic status, religion, or beliefs.

The third proposal involves educating the police, and people working in the criminal justice system, about homophobia, LGBT victimization, and the needs and rights of gay people. Education could include training employees to have greater empathy for LGBT people, and to be more sensitive to their situations. This would encourage LGBT victims to report crimes instead of fearing harassment and retribution from authorities.

Finally, Wertheimer’s fourth suggestion for combating LGBT victimization is to establish crisis centers for victims. Such resources would resemble the centers that have already been developed to help heterosexual victims of sexual assault and domestic violence.

Ethical Question 13.7

 

EP 1

1. How can violence against lesbian, gay, bisexual, and transgender people be stopped?

13-4cComing Out

“Coming out of the closet,” or “coming out,” refers to the process of a person’s acknowledging publicly that she or he is lesbian or gay. It is frequently a long and difficult process in view of the homophobia and stereotypes enveloping us (Crooks & Baur, 2014; Morrow, 2006a; Swigonski, 1995).

Lesbian and gay people today usually become aware that they are different from most others in terms of sexual orientation before the age of 20 (Martin, 2008; Moses & Hawkins, 1982). The process of coming out itself frequently takes one to two years. It should be noted, however, that there is great variation regarding how any specific individual comes out. For some people, it may take much longer, and they may come out much later in life. For many people, especially adolescents who do not have much independence and are subject to severe peer pressure, the coming-out period may be very difficult.

One way to describe coming out is to identify the four stages involved (Boston Women’s Health Book Collective, 1984; Crooks & Baur, 2014). These stages are

• (1)

coming out to oneself;

• (2)

getting to know other people within the gay and lesbian community;

• (3)

sharing with family and friends that one is lesbian or gay; and

• (4)

coming out of the closet—that is, openly and publicly acknowledging one’s sexual orientation.

The first stage of the process—namely, coming out to oneself—involves thinking about oneself as a person who is lesbian or gay instead of as one who is heterosexual (Crooks & Baur, 2014; Moses & Hawkins, 1982; Rathus, 2014b). This may involve a period of identity shifting, during which individuals experiment with the label. They may begin conceptualizing themselves as lesbian or gay and begin thinking about what such a label will mean concerning their own lifestyle.

Part of the signification process involves accepting a label about which society has had so many negative things to say. Some people feel much better about themselves after applying a label of lesbian or gay. It seems that such a label helps in the process of establishing a self-identity. It also seems to give people permission to think and feel honestly about themselves. They then feel that they can pursue new thoughts and experiences they feared and avoided before.

Human service professionals can use several intervention strategies when helping lesbian and gay clients during their coming-out period. To begin with, it is important to provide the client with information about what being lesbian or gay is really like (Morrow, 2006a). Chances are that the client thinks in terms of some of the same stereotypes and has some of the same homophobic responses that many others in society do. A gay man who is coming out may need to be educated about the difference between gender identity and choice of sexual partner. He also needs to understand that same sex sexual behavior is not an illness.

The issue of self-concept may need to be addressed in counseling. Often, it is initially difficult for lesbian and gay people to distinguish between society’s somewhat negative view of gay and lesbian people and their own views of themselves. They need to understand that they will not suddenly become different people with odd habits. Rather, they can be helped to see that different options are available to them, which may provide them with greater freedom to be themselves.

Another suggestion is the realistic identification and evaluation of the alternatives open to a lesbian or gay person (Chernin& Johnson, 2003). Signification may have advantages and disadvantages. Advantages might include the decreased fear and anxiety that result from pretending to be someone you’re not. Another advantage might be the blossoming of new possibilities for social activities and support systems with other lesbian and gay people. Referrals to local organizations would be helpful here.

Disadvantages also need to be confronted. These might include the discrimination in employment and social settings sometimes suffered by lesbian and gay people. Another disadvantage might be the potential loss of some friends and family members. Any anxiety about potential risks in telling people needs to be explored.

The second phase of the coming-out process involves meeting and getting to know other lesbian and gay people. This involves searching for a sense of community where people can develop a feeling of belonging. The best way to curb fears and rid oneself of stereotypes is to meet other lesbian and gay people and find out that the horrible things one has heard simply are not true. It’s important to establish a social support system made up of people who understand what it is like to come out and who can talk about it easily.

The third phase of coming out involves telling friends and family (Crooks & Baur, 2014; Morrow, 2006a). Most people come out to friends first, because it seems to be more difficult to tell family members (Boston Women’s Health Book Collective, 1984). However, it’s also difficult not to tell family members.

There are a number of specific suggestions for coming out to friends and family (Crooks & Baur, 2014; Morrow, 2006a; Moses & Hawkins, 1982). First, the potential consequences need to be realistically examined. It may not be necessary to tell all close friends, relatives, and colleagues if the consequences for the lesbian or gay person are likely to be negative.

For example, a young man, a junior in college, has recently come out. His relationship with his father has always been marginal in that they have never communicated well and do not feel close to each other. However, they do attend family functions together and participate in the family system with other family members. The father has often made derogatory statements about gay people for as long as the son can remember. In this case, it may serve no purpose to come out to the father, because the relationship will probably not be improved. On the contrary, coming out may cause the son much painful criticism and potential ostracism from the family unit.

The fourth phase of coming out involves publicly acknowledging that one is a lesbian or a gay man. As with friends and family, it’s important to evaluate the potential positive and negative consequences of each alternative. That is, one must carefully consider if letting it be known that one is a lesbian or a gay man will be to one’s advantage or disadvantage in any particular setting.

Many people choose not to come out of the closet. We’ve already discussed the criticism, rejection, and discrimination lesbian and gay people experience. Perhaps each individual needs to consider what’s best personally. Those on one side of the issue emphasize that discrimination victimizes people unfairly and that each individual must decide for herself or himself what is best. Some believe that this is a conservative approach. Those on the other side of the issue believe that one cannot be free to be oneself without honesty and openness to everyone. Spotlight 13.3 discusses some issues involving ethnicity and sexual orientation.

Spotlight on Diversity 13.3

Ethnicity and Sexual Orientation

It is critically important for social workers to assess “the impact of differences in class, ethnicity, health status, rural or urban background, and stage of gay identity formation, in addition to the individual’s psychodynamics, ego strengths, and social supports” in order to help clients most effectively (Shernoff, 1995, p. 1077). Appreciation of people’s individual strengths and differences is the key. For example, a 45-year-old Hispanic gay man living in a sparsely populated rural environment in Texas will experience very different life circumstances and issues than will an 18-year-old African American gay man living in a bustling urban Los Angeles neighborhood. Likewise, a 24-year-old Asian American lesbian living in uptown Manhattan will experience life very differently from a 78-year-old Native American lesbian living in northern Montana.

African American and Hispanic gay men may have difficulty experiencing a comfortable level of acceptance both in their ethnic communities and in the primarily white gay community (Alderson, 2013; Tully, 2000; van Wormer et al., 2000). This is also true for gay men who are Asian American and Native American (Alderson, 2013; Shernoff, 1995). On the one hand, white gay organizations may be racist or unresponsive to the needs of other ethnic groups despite reflecting the same sexual orientation. On the other hand, various ethnic and racial communities may be homophobic, resulting from a range of cultural traditions (Alderson, 2013; van Wormer et al., 2000).

Nonwhite gay men may see their racial and ethnic communities as safe havens from the oppressive white majority culture. Therefore, they may be less likely to divulge openly their sexual orientation for fear of losing that support (Morales, 1995). It can be very helpful for them to seek linkage and support from other gay men of similar racial and ethnic heritage who better understand the problems resulting from membership in two “minority” groups (Shernoff, 1995).

A special issue for gay Hispanic men involves their traditional religion and folk beliefs (Shernoff, 1995). Many Hispanic people are strongly influenced by “the impact of conservative Catholicism and its emphasis on traditional values (which strongly reject gay love or sexual expression)” (p. 1077). Additionally, many gay Hispanics place serious significance on the concept of espiritismo, or spiritualism (Shernoff, 1995). Social workers must be aware of such issues and explore the significance they have for clients.

Asian American gay men may see their sexual orientation as being incompatible with traditional values espoused by their culture. As a result, many may be pressured to adopt dual identities, one concerning their racial heritage and one their sexual orientation (Shernoff, 1995). Social workers may help them to think through their situations and make effective decisions regarding what choices and plans are best for them.

Tafoya and Rowell (1988) indicate that “Native American gay and lesbian clients often combine elements of common gay experiences with the uniqueness of their own ethnicity. To treat them only as gay and to ignore important cultural issues may bring … [counseling] sessions to a quick end with little accomplished” (p. 63).

Lesbians of diverse ethnic and racial backgrounds experience pressures similar to those suffered by gay men of diverse ethnic and racial heritage; this is due to their membership in more than one diverse group (Alderson, 2013; Almquist, 1995; Hunter College Women’s Studies Collective, 1995; Smith, 1995). Lesbians of nonwhite racial backgrounds confront a type of “triple jeopardy”; they suffer not only from racism and sexism but also from heterosexism (Greene, 1994). “Just as the experience of sexism is ‘colored’ by the lens of race and ethnicity for women of color, so is the experience of heterosexism similarly filtered for lesbian women of color” (p. 395). Furthermore, “for racially oppressed groups, lesbianism may seem like a betrayal of … [their] ethnic community. Among African Americans and Native Americans, for example, reproductive sexuality may be viewed as contributing to the survival of a group subject to racist genocide attempts” (Hunter College Women’s Studies Collective, 1995, p. 151). In other words, lesbianism may be viewed as a betrayal of one’s racial heritage, because lesbians don’t form traditional heterosexual pairs oriented toward reproduction and increasing racial numbers.

A reality-oriented approach entails looking at all available alternatives. The positive and negative consequences for each alternative must be evaluated. The idea is to assist clients in making decisions that are in their best interest. Highlight 13.4 addresses one woman’s exploration of her self-identity and sexual orientation.

Coming out can be a difficult process. Support from others is very important.

KayteDeioma/PhotoEdit

Highlight 13.4

Cheryl’s Exploration of Her Self-Identity and Sexual Orientation

Cheryl, age 19, worked as a sales clerk at Shopko, the local discount store. Although she still lived with her parents primarily for financial reasons, she was starting to make her own decisions. She debated moving into an apartment with several female friends, and whether she should attend the local technical school or college part-time. These were not the issues she addressed, however, as she came in for counseling.

Cheryl hesitantly explained that she was very anxious about the sexual feelings she was having. Although she was steadily dating her high school sweetheart, he did not interest her sexually. She was thinking more and more about her sexual attraction toward other women. She had had these feelings for as long as she could remember. Lately she was becoming obsessed about them. She was very worried that she might be a lesbian.

On further discussion, she expressed fears about what being a lesbian would be like. She was concerned about starting to look too masculine and about becoming sex-starved for other women. Cheryl’s counselor provided some information about what being lesbian or gay is really like. They discussed and discarded some of Cheryl’s negative stereotypes. The counselor referred Cheryl to some written material on lesbianism and to some local organizations so Cheryl could get more information.

As counseling progressed, Cheryl began to nurture her weakened self-image. Her years of anxiety and her efforts to hide her feelings had taken an emotional toll. Her counselor helped her to work through her confusion about all the negative things she’d heard about gays and her perception of herself. Cheryl began to look at herself more realistically. She began to focus on her personal strengths. These included her sense of humor, her pleasant disposition, and her desire to become more independent and establish a career for herself. She found that these attributes and her personal identity had nothing to do with the negative stereotypes she had previously heard about same-sex sexual behavior.

Finally, her, counselor helped net to define and evaluate the various alternatives open to her. For the first time, she explored the possibility of breaking up with her boyfriend. She considered the possibility of pursuing a sexual relationship with one of the women she had recently met at a gay and lesbian rights organization meeting. She was already beginning to develop friendships with other women she’d met in a lesbian support group.

After several months of counseling, Cheryl had made some decisions. She had gone through the signification process. She had moved out of her parents’ home and into an apartment with several female friends, none of whom were lesbians. After much fear and trepidation, she had come out to them. To her relief, they indicated that although they were surprised, it made no difference concerning their friendship. She had broken off with her boyfriend and had started a sexual relationship with another woman. Not only did she have no regrets about her new romantic situation, but she felt extreme relief, satisfaction, and a new sense of freedom.

Cheryl still had not decided whether to come out to her parents. She was still working on that. Nor had she yet decided what career route would be best for her. However, her new sense of self-identity provided her with new confidence and strength. The future looked hopeful and exciting instead of dull and restrictive.

13-4dLesbian and Gay Adolescents

Lesbian and gay adolescents have to deal with not only their identity development in general but also their identities as lesbians or gay males in a heterosexual world. This frequently occurs during adolescence when their sexual selves start to awaken. Social workers should pay particular attention to lesbian and gay adolescents during this time in their lives. (Chapter 7 addressed some of the issues facing adolescents concerning the special circumstances of their identity development.) Boes and van Wormer (2002), noting that adolescents “are sometimes treated as if they were less than human,” go on to explain:

Struggling to survive in environments (school, home, church) that are more often than not hostile to their very being, gay and lesbian youth have many intense personal issues to resolve. Among the most pressing issues … are [the following]:

• The turmoil involved in coming out to yourself discovering who you are and who you are not.
• Deciding who to tell, when, and how to tell it.
• Rebuilding relationships and grieving rejections when the truth is known.
• Developing new and caring support systems.
• Protecting oneself from a constant onslaught of attacks of one who is openly out or from the guilt feelings accompanying the secrecy and deception of being in the closet.

Lesbian and gay adolescents are up to four times more likely to attempt suicide than their heterosexual counterparts (Johnson, 2011a). A major suggestion for working with lesbian and gay youth is to avoid minimizing or denying the young person’s developing identity and sexual orientation. Rather, help to empower them by taking their thoughts and feelings seriously and providing them with the information and support they need.

Three principles should guide social workers when trying to help lesbian and gay youth (Woodman, 1995). First, acknowledge that some adolescents, perhaps many with whom you work and come into contact, are lesbian or gay. Second, increase your own awareness and that of your agency regarding how to provide accessible services to lesbian and gay youth. Third, do not allow antigay, homophobic sentiment to get in the way of providing lesbian and gay youth with the services they need. Such services may include “special advocacy efforts, peer support groups, recreational programs, and other resources to counter the isolation and despair that are all too common among gay and lesbian adolescents” (Alderson, 2013; Laird, 1995, p. 1611).

13-4eEmpowering Lesbian and Gay Parents

Many lesbian and gay people have children (Carroll, 2013b; Mallon, 2008; Messinger& Brooks, 2008; Rosenthal, 2013). It’s impossible to give an exact number because no accurate numbers exist of how many people are gay/lesbian. Many have them from prior marriages. Others choose new fertility methods such as sperm insemination or surrogacy. Still others seek to adopt children.

Even when a lesbian or gay parent gains custody of a child, there still may be problems to overcome. For instance, lesbian and gay parents must deal with the ongoing discrimination and social censure they face because of their sexual orientation. Losing a job or an apartment might have a much greater impact on lesbians with children than on lesbians who aren’t parents. Much more may be at stake when the welfare, support, and living conditions of children must also be taken into consideration.

Several suggestions can be made to social workers and other human service professionals in their efforts to help lesbian and gay people cope with parenthood (Moses & Hawkins, 1982). First, social workers can help the lesbian or gay parent identify and appreciate the joys of parenthood. It may be all too easy to get lost in the additional problems of being lesbian or gay and miss all of the normal pleasures of raising children.

Many lesbian and gay people have children.

AP Images/Eric Risberg

Second, social workers can help lesbian and gay parents address the issue of coming out to children. Practitioners can help parents identify the various alternative ways of sharing information about their sexual orientation with children and evaluate the potential positive and negative consequences of each. Probably no perfect single approach exists for how parents should come out to their children (Morales, 1995). Lesbian and gay parents may use any of a number of tactics. Some hide their sexual orientation from their children because they fear custody battles or the effects such knowledge will have on children. Others encourage secrecy on the child’s part, although such concealment can create quite a strain for the child (van Wormer et al., 2000).

Still other lesbian and gay parents feel it is important to come out to their children as soon as possible. Hunter and Hickerson (2003) recommend that parents adopt such an open attitude. There are some advantages to this approach. First, it may avoid family stresses and problems in communication that could result from the parents’ hiding such an important aspect of their lives. Daily living is much more comfortable when the lesbian or gay parent can openly interact with and express affection toward a partner, without excluding the children. Finally, sharing the truth with children prevents them from finding out about it from someone else—which might cause them surprise and shock. Children would wonder why their parents hadn’t told them, and this secrecy might convey a negative perspective about being lesbian or gay.

However, it should be remembered that every lesbian or gay family situation is unique. A social worker’s role can be to help parents determine the best way to come out to children in their particular family system.

A third way social workers can assist lesbian or gay parents involves dealing with new partners. When a lesbian or gay parent finds a partner and decides to live with her or him, a social worker can help that parent address many of the same issues that need to be dealt with when a new heterosexual partner joins a household. Issues about child management need to be discussed. Expectations regarding how money will be shared or spent, how daily routines will be organized, and how the adults will act in front of the children need to be clarified openly.

Fourth, many lesbian and gay parents worry about the prejudice and discrimination their children might experience because of the parents’ sexual orientation. Social workers can help such parents identify and evaluate ways to help children with these issues. Parents can learn to help their children think through situations and determine when to talk about their parents’ sexual orientation and when not to (Laird, 1995).

One suggestion is to teach children situational ethics (Wolf, 1979). The idea here is for lesbian and gay parents to be open about their sexual orientation. Children then can learn about being lesbian or gay in a positive sense. However, at the same time, a lesbian or gay parent can teach a child that it is more appropriate to refer to and talk about sexual orientation in some situations than in others. For example, it is appropriate to be open about mother’s female partner at home with the family. However, more discretion might be necessary when the child is giving a report before his or her class at school.

That children learn when certain behavior is appropriate or inappropriate is a normal part of growing up. One means of teaching the concept of appropriateness is to teach about individual differences (Moses & Hawkins, 1982). Children understand that each person is different. Every individual has his or her own ideas and beliefs. Each lives a distinctly unique life. Differences in sexual orientation are simply another type of human difference. Because people have divergent ideas about sexual orientation, they might be prejudiced. Therefore, it is not always wise to raise the issue.

Cohen, Padilla, and Aravena (2006) review how social workers can provide psychosocial support for families of LGBT people:

In sum, psychosocial intervention may include providing families with accurate information about gender identity and sexual orientation, helping families to deconstruct negative stereotypes about sexual orientation and gender identity, and assisting families of various cultural backgrounds in negotiating their values and beliefs regarding sexual and gender identity vis-a-vis the well-being of their LGBT [gay, lesbian, bisexual, and transgender] family member [or members]. Finally, intervention may also involve providing resources to family members, including information on how to access local agencies and other support organizations that offer services for families [that have LGBT members]. (p. 169)

13-4fAs Lesbians and Gay Men Age

“The adage ‘Nobody loves you when you’re old and gray’ has been modified by lesbian women and gay men to read, ‘Nobody loves you when you’re old and gay’” (Baron & Cramer, 2000, p. 207). Stereotypes further suggest that when older lesbians and gay men lose their youthful appearance, they are rejected by other lesbian and gay people as well as by homophobic heterosexuals. They become lonely, isolated, saddened human beings.

Contrary to this stereotype, some research indicates that what often happens is just the opposite. There are two basic summary statements about older lesbian and gay people based on their strengths (Alderson, 2013). First, most are relatively well adjusted (Lee, 1991; Longres&Fredriksen, 2000; Tully, 1992; van Wormer et al., 2000). Many have numerous gay and lesbian friends and a few heterosexual ones, have some ties with the gay and lesbian community and its support network, and have an age-appropriate sexual and emotional relationship with a longtime partner. The second major summary statement is that both the adjustment levels and the psychosocial needs of older lesbian and gay people are more similar to those of heterosexuals than dissimilar.

If anything, lesbian and gay people may adjust better to aging than do heterosexual people based on two principles: competence in being independent and experience in coping with stigma (Alderson, 2013; Berger, 1985; Fullmer, 2006; Moses & Hawkins, 1982). Establishing competence in independence means that being self-sufficient is nothing new to lesbian and gay people. Heterosexuals tend to be more involved with their traditional family systems and often have difficulties coping with the death of a spouse and other peers. In a sense, heterosexual people have been sheltered during their lives. Lesbian and gay people, however, often have had to fend for themselves and experience a lifetime of independence. Because their lifestyle did not fit with the traditional heterosexual one, they always had to reach out to others and forge new paths and relationships. Coping with the “aloneness” of old age theoretically might not be as great a shock to lesbian and gay people as it can be to heterosexuals.

The second concept that involves coping with stigma, suggests that lesbian and gay people are probably better at dealing with the stigma of old age because they already have experience dealing with stigma and rejection (Longres&Fredriksen, 2000). Coping with one stigma—namely, homosexuality—may help prepare them to cope with another, namely, aging. Note, however, that LGBT people continue to experience the effects of stigma and homophobia as they age, which is true even as they enter nursing homes (Carroll, 2013b; Rosenthal, 2013).

Both heterosexuals and lesbian and gay people face similar concerns as they grow older, including health and financial security concerns. Consider, however, that because women generally earn less than men over the life span, older lesbians “are particularly vulnerable to financial woes … Gay and lesbian seniors are also less likely to have a live-in partner or adult children to help care for them” (Rosenthal, 2013, p. 248). Additionally, lesbian and gay people have issues with institutional regulations, legal concerns, and emotional needs that heterosexual people don’t necessarily face.

Institutional regulations often involve access to benefits and resources (National Gay and Lesbian Task Force, 2011). Until the recent Supreme Court ruling concerning federal benefits (discussed earlier), Social Security did not pay spousal benefits to same-sex partners. For example, it would pay survivor benefits to surviving heterosexual spouses, but not to the survivor in a same-sex relationship.

Other institutional problems involve being placed in a nursing home or having to be hospitalized. A person’s lover and closest friends may not be allowed input into whether and where the person is placed, nor even allowed admission to see the person. As was discussed under legal issues, the traditionally defined family can often take over and deny access to the lesbian or gay person’s companion.

We have also already established that the legal system frequently ignores gay and lesbian relationships. If a will is not clearly written, well established, updated, and well documented, a lesbian or gay unmarried partner may lose much of what the couple has worked for. The biological, legal “family” may claim it all.

One of this chapter’s themes is how important it is for social workers to advocate for improved rights, policies, and services for their LGBT clients. This is just as true for LGBT older adults as social workers address their special institutional and legal issues. Such advocacy is part of the social work role.

The emotional needs of older gay and lesbian people are much like the emotional needs of older heterosexuals. They need social contacts, human warmth, and self-respect. However, lesbian and gay people have the additional pressure of battling the biased assumptions of a heterosexual world. For instance, consider a social worker who can’t understand why a client would want to take a leave from work and apply for public assistance in order to care for a very close “friend.” Lesbians and gays must wage constant battle either to explain or defend themselves and their behavior.

McInnis-Dittrich (2014) reflects on the importance of social workers stressing and turning to an older person’s support system, whomever that may include:

Effectively mobilizing support systems requires the practitioner to “think family.” … Thinking family means seeing the older adult as part of a complex system of multigenerational relationships that have had a profound influence on his or her life and serve as the primary source of interaction and support. Family roles—such as spouse or partner, parent, grandparent, aunt, or uncle [or close friend]—are important parts of older adult’s self-concepts, influencing older adults’ thinking even when the specific functions associated with those roles [e.g., as a parent, raising children] have ceased. Human beings are born into various family constellations, create their own versions of family in adulthood, and turn to whatever they perceive to be family as they grow older. (p. 315)

Thus, it’s important to view the lesbian or gay person’s family configuration and support system however that individual defines it. Life partners and other significant people should be identified and be integrally involved in case planning and decision making for the older adult.

13-4gGay and Lesbian People and AIDS

AIDS was discussed in depth in Chapter 10. Although initially many people labeled it a gay disease, it is now spreading among heterosexuals at a greater rate than among gays. Therefore, in Chapter 10, AIDS was discussed as a condition that could affect anyone, heterosexual or gay or lesbian. Because gay men were among the first to contract the disease in the United States, a few comments will be made here about its impact on them. (AIDS is virtually unknown among lesbians, except those who are intravenous drug users, a separate high-risk group.)

Before the existence of AIDS was acknowledged in the United States, many people had already been exposed to and had contracted it. Most of them were gay men. As a result, many gay people have seen dozens of their friends die of AIDS. The emotional impact on the gay community has been immense.

Little attention was initially given to AIDS. Many people saw it as something that happened to homosexuals, drug addicts, and other “bad” people. Homophobic responses by heterosexual people and the idea that AIDS is a punishment for bad behavior may have contributed to the relative inaction on the part of the government. Meanwhile, many gay men, along with their friends, families, and lovers, were suffering desperately from the disease.

Gay people can be thanked for much of the publicity about AIDS, the new resources directed to research for a cure, and the strong emphasis on prevention. Gay people were infuriated that the crisis was ignored by the government. The implication was that those contracting the disease weren’t that important anyway and that they deserved it. As a result, people in the gay and lesbian community banded together, wrote letters to legislators, marched, advocated for people with the disease, and demanded that it be given some attention.

Gay people also took major steps to initiate a massive campaign aimed at prevention. They provided people with information in any way they could think of. For instance, brochures emphasizing the need for safer sex practices were distributed at gay bars. Gay people slowed the spread of the disease within their own communities.

Any social worker who works with a gay or lesbian client needs to be aware of the ramifications and emotional impacts AIDS has had. Those close to the client have likely dealt with many of the economic and social issues involved with AIDS. These include not only serious illness, but poverty when personal resources have been depleted, social isolation, insurance and public assistance problems, and problems getting medication.

Sensitivity to these issues can help social workers better serve their clients’ needs. Spotlight 13.4 addresses the promotion of optimal well-being for all LGBT people, not just those who are HIV-positive.

Spotlight on Diversity 13.4

Social Work with LGBT People: Promoting Optimal Well-Being

Social work has at least two important thrusts in working with LGBT people. One involves the individual practitioner’s attitudes and skills. The other concerns agencies’ provision of services to LGBT people.

Counseling

Josephine Stewart, who chaired the NASW National Committee on Lesbian and Gay Issues, has made several suggestions for social work practitioners working with LGBT clients (NASW, 1984). For one thing, we have established that it is very important to confront one’s own homophobia. One of the worst things a practitioner can do is negatively label an LGBT client and criticize that client for her or his sexual orientation. This contradicts the basic social work value of the client’s right to self-determination. A negatively biased practitioner can unknowingly work against a client’s development and maintenance of a positive self-image. Alternatives involving an LGBT lifestyle and resources available in the LGBT communities might be ignored or even rejected.

Another suggestion for working with LGBT people is to become familiar both with the LGBT lifestyles and with the LGBT communities. This knowledge is necessary in order to help clients identify and evaluate the various alternatives available to them. Such learning is a career-long process. It’s also helpful to know people within the LGBT community who can update a practitioner on new events and resources.

Agency Provision of Services

The other issue concerning social work with LGBT people involves agencies’ provision of services. Social workers should provide leadership to improve and develop agency policies on the behalf of LGBT people and help initiate programs to serve them. LGBT people need various services that address specific aspects of lesbian and gay life. These might include lesbian support groups, groups for gay men who are in the process of coming out, legal advice for lesbian or gay parents seeking child custody, or couple counseling for same-sex partners. Such services can be provided by agencies focusing on and serving only LGBT people, or the services can be main-streamed into traditional agencies.

Regardless of where services are provided for LGBT people, the fact is that they are needed. Social workers need to apply social work values to LGBT clients. They need to learn about resources available for LGBT people and make appropriate referrals. They also need to educate others about the special issues confronting LGBT people. Finally, social workers frequently need to act as advocates for the rights of LGBT people. Sexual orientation needs to be addressed as simply another aspect of human diversity. Sexual orientation should be respected instead of denied. Political candidates in favor of LGBT rights need to be supported. Agencies that discriminate against LGBT people need to be confronted, educated, and pressured to provide needed services in a fair and unbiased manner.