“If It Ain't Broke, Don't Fix It”: Ethical Considerations Regarding Conversion Therapies

Despite the unanimous adoption of a position statement by the American Psychiatric Association objecting to reparative therapy in December 1998, the decision was not without its critics. The current work examines the ethical considerations regarding conversion or reparative therapies in light of the extensive psychological literature documenting the societal stigma (homophobia and heterosexism) suffered by lesbian and gay individuals. Overall, there are two major concerns regarding conversion therapy, namely its ethical inappropriateness, and lack of empirical evidence supporting its efficacy. The author argues that no professional health associations support reparative therapy, homosexuality per se is not an illness and does not require treatment, and, the mental health profession must acknowledge its own role in the oppression of homosexual individuals.     

Boundary Issues in Gay and Lesbian Psychotherapy Relationships

Abstract

Gay and lesbian psychotherapists face unique challenges when working with clients who also identify as gay or lesbian. Of particular importance are the roles professional boundaries play in working with sexual minorities. For example, clinicians must decide whether it is in the client's best interests to know the therapist is gay. Issues of contact outside of the therapy hour also become important, particularly when the therapist lives in a small community, or otherwise risks the possibility of seeing the client in the community. This chapter addresses some of these issues, and poses options for therapists on how to minimize professional boundary or ethical violations.     

The intersections of lesbian studies and postcolonial studies: one possible future for class

This position piece addresses the decline of class as a mode of inquiry in Lesbian Studies and Postcolonial Studies. It argues that in spite of this decline, class continues to forcibly pervade all areas of our lives and, therefore, should be fundamental to the research praxis of these fields of study. It goes on to suggest that the intersections of these two disciplines are able to open up a space where questions regarding class and its global dimension in the twenty-first century can be addressed. It concludes by reflecting on the possibility of an ethical methodological approach to research.     

Association for Lesbian,Gay, Bisexual,and Transgender Issues in Counseling’s Best Practices in Addressing Conscience Clause Legislation in Counselor Education and Supervision

The amount of various, state-level legislation allowing the denial of counseling services to individuals with values that conflict with those of the professional counselor continues to increase. Such laws are in direct conflict with the values, principles, and ethical standards of the counseling profession. These “conscience clause” legislations are of concern due to the ability of the counseling profession to safeguard and protect the welfare of clients seeking counseling services. Potently, however, much of the focus of conscience clause legislation centers around the legal sanctioning of bias and refusal to provide services to affectional and gender minority clients, and the intersection of sexual/affectional orientation to spiritual and religious values. Provided is a review of these laws and the way they clash with the counseling profession. To assist profession counselors in navigating appropriate ethical behavior, specific counseling-appropriate and lesbian, gay, bisexual, trans, and queer affirming recommendations are provided. Each layer of professional counseling, direct work with clients, supervision, and counselor education, is addressed.     

Lesbians and Gay Men Embrace Their Sexual Orientation After Conversion Therapy and Ex-Gay Ministries

Abstract

This article examines narratives of gay men and lesbians who participated in conversion therapies and/or ex-gay ministries in order to change their sexual orientation to that of heterosexual. Data for this study were gathered through an analysis of the stories of 14 people, published in a document titled Finally Free, who describe their negative experiences with conversion therapy through ex-gay ministries. Analysis of the data revealed seven common psychosocial issues faced by gay men and lesbians who turned to conversion therapy in an attempt to become heterosexual. These issues provide knowledge for social workers' intervention with gay men and lesbians seeking healing and personal growth after participating in conversion therapy and ex-gay ministries.     

Out of the Darkness: Three Waves of Family Research and the Emergence of Family Therapy for Lesbian and Gay People

Like family relationships themselves, the history and treatment of lesbian and gay people and their families is complicated. For this paper, three waves of research on the families of gay and lesbian individuals are described. During the first wave, gay and lesbian sexual orientation was seen as a disease and family dynamics were blamed for its genesis. Subsequently in the second wave it was believed that, fearing rejection many gay and lesbian people either distanced or were rejected from their own families and established friendship networks that have been described as families of choice. More recently, in the third wave, the family has been identified as a resource for lesbian and gay youth whereby open relationships with parents can help protect them from mental illness, substance abuse, and HIV risk. Furthermore, an increasing number of same-sex couples are choosing to become parents, overcoming biological and social obstacles. In this article these shifting views of the role of family in the lives of lesbian and gay people will be described along with case material that illustrates the historic influences, current developments and future directions of family treatment for this population. To be maximally effective with gay and lesbian people and their families, clinical social workers and other mental health professionals must understand how family therapy has been influenced by a progression of ideas that continue to evolve. In this paper, research examining the role of the family in the lives of lesbian and gay people will be described in three waves; as a source of blame, to an impediment to gay and lesbian happiness and ultimately a resource that can enhance lesbian and gay well-being. The influences of research on family therapy with this population will be described and case examples will demonstrate how to harness the strengths of family relationships identified in the most recent wave.     

Are we there yet? Faculty Members’ Beliefs and Teaching Practices Related to the Ethical Treatment of Lesbian,Gay, and Bisexual Clients

The purpose of this study was to explore (a) faculty members' beliefs about the ethics of reparative therapy and referring lesbian, gay, and bisexual (LGB) clients, (b) course content related to reparative therapy and referral of LGB clients, and (c) positions taken by programs associated with reparative therapy and referral of LGB clients. A total of 117 faculty members from accredited family therapy programs completed an online survey for this study. While the vast majority of faculty members reported that reparative therapy is unethical, there was less agreement related to the ethics of referring LGB clients, which may highlight the need for clearer ethical guidelines to regulate this potentially harmful practice. Implications for clinical training and future research are discussed.     

Sexual identity development among gay, lesbian, and bisexual youths: consistency and change over time

A longitudinal report of 156 gay, lesbian, and bisexual youths examined changes in sexual identity over time. Fifty-seven percent of the youths remained consistently self-identified as gay/lesbian, 18% transited from bisexual to gay/lesbian, and 15% consistently identified as bisexual over time. Although youths who consistently identified as gay/lesbian did not differ from other youths on time since experiencing sexual developmental milestones, they reported current sexual orientation and sexual behaviors that were more same-sex centered and they scored higher on aspects of the identity integration process (e.g., more certain, comfortable, and accepting of their same-sex sexuality, more involved in gay-related social activities, more possessing of positive attitudes toward homosexuality, and more comfortable with others knowing about their sexuality) than youths who transited to a gay/lesbian identity and youths who consistently identified as bisexual. Contrary to the hypothesis that females are more sexually fluid than males, female youths were less likely to change identities than male youths. The finding that youths who transited to a gay/lesbian identity differed from consistently gay/lesbian youths suggests that identity integration continues after the adoption of a gay/lesbian sexual identity.     

Essential components of curricula for preparing therapists to work effectively with lesbian, gay, and bisexual clients: a Delphi study

The purpose of this study was to determine the knowledge, experiences, and values that therapists should possess to provide quality therapy services to lesbian, gay, and bisexual (LGB) persons and their families. Using the Delphi method, consensus from a panel of experts on LGB topics was obtained on the components that training curricula should ideally include to prepare therapists adequately to work with this population. Panelists provide suggestions for important therapist values and qualities, key theoretical orientations, common issues of LGB clients and their support persons, key components of assessment and interventions, ethical and legal issues, and recommended materials. The panelists stress self-of-the-therapist work and development of a systemic perspective as critical aspects of training. The role of sexuality was deemphasized. Recommendations to training programs based on these findings are provided.     

Methodological standards for randomised controlled trials of interventions for preventing recurrence of child physical abuse and neglect

Despite the significant financial and human resources invested in child protection services (CPS), it is unknown whether these services are effective in preventing recurrence of child physical abuse and neglect. This paper reviews available studies evaluating the effectiveness of these interventions and identifies methodological limitations and factors that may contribute to these limitations. We searched databases to identify randomised controlled trials published in peer‐reviewed journals in the past five decades that evaluated interventions to reduce recurrence of physical abuse and neglect. We outlined ten methodological standards that are important for rigorous testing of psychosocial interventions and applied them in critically appraising identified studies. Thirteen randomised controlled trials were reviewed. This review identified methodological limitations (e.g. small sample size, lack of standardisations, contamination) that made it difficult to draw reliable conclusions as to the effectiveness of interventions. Field‐specific factors that contributed to methodological limitations (e.g. heterogeneity of sample, multiple family problems, psychosocial nature of interventions) were identified and recommendations were provided for improvement. It was concluded that it is possible to implement high‐quality trials that are ethical and feasible in the child welfare field. Copyright © 2009 John Wiley & Sons, Ltd.     

Gay and lesbian couples in therapy: perspectives for the contemporary family therapist

This paper outlines the major concerns of gay and lesbian couples who seek therapy. Presenting problems are classified as either internal to the relationship or as external (contextual) ones that reflect the influence of oppressive cultural and gender biases. Throughout the article, distinctive therapy methods are described that address the unique concerns of lesbian and gay couples, with special sensitivity to heterosexist and homophobic bias.     

It All Starts Now! Gay Men and Fatherhood in Sweden

ABSTRACT

This article investigates how Swedish gay men pursue and understand fatherhood, using a qualitative, semi-structured methodological approach. We are interested in how practical issues and different fatherhood arrangements are understood and handled by the fathers; how the construction of “rainbow families” is understood in relation to legal issues; parental responsibilities; and thoughts regarding gender-equal and gender-neutral relationships within Swedish society and culture. The results show that the trajectory of gay men toward fatherhood is shaped by a variety of mediating factors such as interactions with agencies, clinics, attorneys, and the state. There are some significant legal, social, financial, and cultural obstacles to realizing gay parenthood. There are also cases where study participants talked about a sense of intolerance expressed toward gay parents within a gay community. Although there are still strong normative dimensions involved in the construction of modern parenthood, the grip of heteronormative views on family life and sexuality is changing; the narratives presented also represent a questioning of the hegemonic image of fatherhood in Sweden. Consequently, it is possible to discern different attempts at transgressing and changing the cultural landscape of fatherhood and the ways people build families today.     

Sexual Minority Adolescents

Abstract

Most ethical dilemmas confronting professional school counselors (PSCs) do not involve simple solutions. Therefore, to practice ethically, PSCs need to possess and have the ability to articulate their ethical decision-making process with a clear and defendable professional explanation. Specifically, this article details the ethical decision-making process for PSCs working with lesbian, gay, bisexual, and transgendered (LGBT) adolescents. Additionally, ethical standards and legal statutes relating to counseling LGBT adolescents, ethical decision-making processes, and implications are discussed.     

Memoirs of Gay Militancy: A Methodological Challenge

Biographical and autobiographical material has long been used by sociologists. What are the specific epistemological and methodological challenges of using memoirs of militancy for social movement sociology? This article analyses four memoirs by militants of the gay movement of the late 1960s and 1970s. To understand the validity of memoirs of militancy as sociological sources, it highlights their constructedness as narrative artefacts: as retrospective discourses on an individual's past, memoirs allow for the self-reflexive deployment of their authors' subjectivity. Their narrativeness is a key to understanding how their narrative voice reflects the very agency that animates mobilizations. Memoirs of militancy are thus an invitation for sociologists to turn to literary and rhetorical scholarship for adequate methodological tools.     

Heavenly Monsters: The Politics of the Male Body in the Naked Issue of Attitude Magazine

The male body in contemporary gay culture is subordinated to distinct aesthetic and ethical norms that reflect an all-male idolization of the young, muscular, smooth, and transcendent physique. The queer body is manipulated in different techniques including daily work at the gym, diet, hair supplement/removal, tanning, and dying. Liberating the body from heteronormative oppression does not necessarily guarantee the liberation of the (gay) body from other powerful systems that produce and commercialize body fascism. This article problematizes these body politics and economy of identity focusing on the naked issue of Attitude (October 1999), a six-year-old British life-style glossy magazine. This analysis mainly focuses on the illuminating interview with five gay men who express their intimate feelings and criticize the body worship in the gay media: an over-weight man, a skinny man, a psoriasis sufferer, an old and heavily tattooed and pierced man, and a bodybuilder who works as an escort.     

Patterns of gay and lesbian partnering in the larger metropolitan areas of the United States

This paper had two objectives. First, we developed for each large metropolitan area of the United States with a population of 500,000 or more in 1990 four indexes of gay partnering and four indexes of lesbian partnering. We compared and related these indexes and their variable measurements with one another. Second, using what we argue is the statistically and demographically preferred set of gay and lesbian partnering rates, we proposed and tested an assortment of ecological hypotheses relating characteristics of the metropolitan areas with the gay and lesbian partnering rates. Rates of gay and lesbian partnering, we show, are more influenced by such metropolitan characteristics as physical climate and the crime rate than by a religious characteristic such as the number of Southern Baptist adherents. Among the conclusions of the paper is our claim that there needs to be greater consideration of the methodological issues related to the use of government data for the development of rates of gay and lesbian partnering.     

Use of Assisted Reproductive Technology and Gay and Lesbian Couples

Abstract

There are various reproductive health options for gay and lesbian couples who want to become biological parents. However, there remains controversy regarding the use of assisted reproductive technology for gay and lesbian couples. This article describes assisted reproductive technology options for gay and lesbian couples, socio-cultural and gender issues, ethical and legal considerations that influence access to reproduction options, and implications for counseling.     

Autocastration and autopenectomy in a patient with transsexualism and schizophrenia

Previous research focusing on changes in gay male sexual practices as a result of AIDS often avoids taking into consideration the meanings which sexual practices have within the gay community. As an alternative, the present study used a content‐analysis of personals advertisements within the personals section of The Village Voice to assess changes in the language gay men use to refer to their sexuality between the years 1978, 1982, 1985, and 1988. A significant increase in personals advertisements suggesting a concern with health is noted from 1982 to 1985. This increase continues from 1985 to 1988. Corresponding in time with these changes are increases in the number of personals advertisements which express a rejection of “stereotypical” presentations of self within the gay community. This rejection is seen as an attempt at self‐affirmation of characteristics perceived by gay men themselves as being desirable at particular historical moments. Implications for the basis of future policy interventions in reaction to AIDS are discussed. Finally, the utility of personals advertisement columns as an indicator of the meanings which people of various sexual preferences attach to their sexuality is discussed.     

Relationship Education and Therapy for Same‐Sex Couples

The gay and lesbian community suffers higher rates of discrimination, mental health problems, and relationship break‐up than their heterosexual counterparts. In this paper we analyse the challenges confronting same‐sex couples, and the implications for couple education and therapy with same‐sex couples. We describe some similarities in the challenges confronting heterosexual and same‐sex couples (e.g., negotiation of shared realistic relationship expectations, effective communication). These similarities suggest existing evidence‐based approaches to couple therapy and relationship education are likely to assist same sex couple relationships. We also describe distinctive challenges for same‐sex couples (e.g., homophobic discrimination, internalised homophobia, and low support from many families for same sex relationships). These distinctive challenges suggest some adaptation of existing approaches to couple education and therapy could enhance their relevance and effectiveness to same sex couples.