American Indian Lesbians and Gays

Abstract

This article is a study of American Indian lesbians and gays. Using interview content, this study helps practitioners understand these virtually unstudied individuals. Interview data are compared to reports in the literature in an effort to understand how American Indian lesbians and gays are similar to and different from other lesbians and gays. Implications about future research and social work practice with American Indian lesbians and gays are discussed.     

From Fragmentation to Integration

Abstract

Within the mental health field, there is an increased attention to issues of diversity. However, this awareness has not yet been applied to racially and culturally diverse gays and lesbians who are chronically mentally ill. Some of the reasons for this include the long history of homogeneity of American institutions; the underutilization of mental health services by minority groups; the stigmatization of the mentally ill; and homophobia, within both the psychiatric community and society at large. As a result, there is a need for mental health professionals to acknowledge minority gays and lesbians with chronic mental illness, and begin to provide programs that affirm their sexual orientation, race, and cultural identities.     

The Privatization of Social Services from Public to Sectarian

ABSTRACT

This article explores the privatization of social services from public to sectarian points of view while examining the implications of the Charitable Choice movement on the gay and lesbian community. The history of this movement is explored from a developmental perspective outlining the socioeconomic makeup of gays and lesbians, the societal perceptions and mythology of the economic status of homosexuals, and actual figures related to the number of gays and lesbians who rely on publicly supported social service providers. The article explores the history as well as the positive and negative aspects this type of privatization movement involves. Finally, a comprehensive assessment of the effects of this movement on the gay and lesbian community is presented and future recommendations will be made.     

Lesbians Leaping Out of the Intergenerational Contract:

Changing demographics and economic models in modern industrial countries have led to changes in the nature of the intergenerational contract, repositioning of the family as the site for care, and increasing privatization of welfare, housing and health services for the aged. These shifts have important implications for access to services for lesbians and gays as they age and enter their third age, often in the absence of traditional family support. The needs and desires of some older lesbians in Australia in relation to housing and health care were explored via focus group interviews. The results are discussed in relation to the intergenerational contract, policy shifts and the social organization of aged care in Australia.     

Care Coordination of Services for People Living with HIV: A Case Study of a Rural Clinic

Abstract

The healthcare landscape is changing with the development of integrated health care models across the country. Counseling is uniquely positioned to add to the continuum of services of integrated health by providing counseling and case management services through advocacy for clients. One particular chronic illness that remains highly stigmatized is HIV, which is slowly becoming more integrated into the larger healthcare system. This pilot study documents the process and experience of a hospital-based midwestern AIDS service organization in the development of innovative and unique services to address the needs of the HIV population in a rural midwestern state.     

Older Gays and Lesbians

Summary

This article discusses the impact that coming of age in the Pre-Stonewall era has had on older gays and lesbians. Anti-gay hate and violence, within a historical context of homophobia and heterosex-ism, are examined. Risk factors, as well as coping capacities, for older lesbians and gays are explored. Research on the psychological adjustment and well-being of older gays and lesbians is reviewed, and suggestions for intervention with this population are proposed.     

Health and Well-Being for Late Middle-Aged and Old Lesbians in a Rural Area

Abstract

Previous research on lesbian health care has drawn primarily from samples of young lesbians living in metropolitan areas. Through face-to-face interviews with twenty-one lesbians aged 54 or older and living in rural communities, this exploratory, naturalistic inquiry begins to fill a gap in the literature by examining the health care experiences of older, rural lesbians. Five themes emerged from the narrative data: issues of access; good health/good care; open to her own diversity; family and community; and visions-ideals and fears. We present these themes through informant quotes and discuss implications for policy and practice.     

Lesbian Health

ABSTRACT

Health care research suggests that lesbians may face unique physical and mental health risks, yet few studies make use of gender and sexuality theories to explain lesbian health. In this study, a social constructionist view of sexuality is used to examine the impact of lesbian identity on well-being. Drawing from nineteen intensive interviews with women who self-identify as lesbians, the results show that individuals' sexual identities change over time and are affected by their social environments. The data also demonstrate that sexual identity and social context have implications for well-being. Specifically, hostile environments, which are characterized by animosity toward gay men, lesbians, and others who do not conform to heteronormative gender expectations, are associated with distress over lesbian identity and with physical and mental health problems. By contrast, supportive environments, which many women report finding through feminism, facilitate the construction of a positive lesbian identity and enhance well-being.     

Rural Lesbian Mothers and Their Families

Abstract

Lesbian mothers face unique challenges to parenting based on their status as lesbians. They face not only the challenges of discrimination based on sexism and homophobia, but the challenges of parenting. This article explores these challenges and offers practice recommendations to be supportive of good parenting and resources for parenting enrichment.

Lesbians who are parenting either alone or as part of a couple face numerous barriers. And women living in rural communities present unique issues to mental health practitioners. Mental health practitioners working with rural lesbian mothers and their families need an awareness of those issues which are unique to this population as well as those issues which are exacerbated by the combination of minority statuses and social and geographic isolation.

Lesbian mothers in any geographic location find themselves belonging to several populations: lesbians, women, and mothers, to name a few (Friedman, 1990). Each of these populations has its accompanying pressures which, when combined, exacerbate some of the sub-group issues. Rural social service practitioners will encounter lesbian mothers and their families. A clear understanding of their issues will enhance the therapeutic process. The issues and themes of each of the sub-groups will be explored and then examined in the context of rural life.     

Older Lesbians and Gays Accessing Health and Aged-Care Services

Abstract

The present paper examines older lesbian and gay people's experiences of and expectations for the delivery of health and aged-care services. In-depth narrative interviews were conducted with older gays and lesbians in the Blue Mountains, west of Sydney (NSW, Australia). Data were analysed by identifying evaluative statements within specific narratives and grouping these statements into themes. Participants reflected on the meaning of their sexual identity and how they would like it to be acknowledged when in contact with health and aged-care service providers. In addition to direct discrimination, participants reported a more indirect form of discrimination in providers’ assumption of heterosexuality among clients and their failure to provide lesbian- or gay friendly services. The findings highlight the need for health and aged-care services to better understand and acknowledge older gay and lesbian people's sexual identities to enable improved access to services in the future.     

Correlates of Homophobia and Use of Gay Affirmative Practice Among Social Workers

ABSTRACT

Research on social work practice with gay and lesbian clients has historically focused on examining social workers' attitudes towards gay and lesbian individuals, however, no studies have examined the relationship between attitudes and practice using validated measures to assess practice. The focus of this study was therefore to examine the relationship between attitudes and practice with gays and lesbians using the recently developed and validated Gay Affirmative Practice Scale (GAP). Significant relationships were found with the GAP and two measures of homophobia as well as with measures that assessed feelings about lesbians and gay men, contact with gays and lesbians, attendance at workshops that focused on gay and lesbian issues, relationship status, sexual orientation, political party, and primary area of practice. Relationships with measures of attitudes were also examined. Implications for social work practice, education, and research are discussed.     

Listening to the Voices of Lesbians Diagnosed with Cancer

Abstract

This paper focuses on the operations of heterosexism and strategies to counter it in a particular service context: the context of psychosocial support services for women with cancer. The paper draws on findings from a participatory, qualitative study set in Ontario, Canada in which 26 lesbians were interviewed about their experiences of cancer diagnosis, treatment, health care and social support, and their feelings and perceptions about shifts in identity, body, sexuality and relationships. This paper focuses on findings related to the changes research participants perceived as necessary in the provision and organization of cancer support services, in order to increase access and ensure equity for lesbians with cancer and their families.     

Life Course Diversity Among Older Lesbians and Gay Men: A Study in Chicago

How much can we assume about the shared life experiences of older lesbians and gays? This article is broadly concerned with rethinking the significance of this question as it pertains to cultural images and stereotypes of “older gay and lesbian” identities in a large and diverse American city. In 1996, the authors completed a 10-month needs assessment study regarding the lives and needs (social and psychological), which must be addressed for older lesbians and gays in the city of Chicago. The authors take the approach that simply being of the same or similar age is insufficient to understand the meaning of people's sexual identities. They entered into this study aware of some stereotypes about older lesbians and gays, but like previous investigators, they were surprised at the range of diversity that they uncovered. They discovered not only the common denominators in their participants' experiences and their lives, but as some commentators have already suggested, they also discovered a great deal of variation. To address the issues, the authors describe conceptual problems that emerged in a recent needs assessment of older lesbians and gay men in Chicago.     

“We Have to Create Family”: Aging Support Issues and Needs Among Older Lesbians

Gay and lesbian seniors are more likely to be single, live alone, and be childless. The current evidence base suggests that limited social supports are associated with a variety of health disparities among all older adults. Research regarding the aging issues of lesbian seniors is scarce. This instrumental collective case study of 4 older lesbians (ages 59 and older) illustrates unique aging support concerns, issues, and needs. The purpose of the case study is to increase provider sensitivity and provide supportive evidence of the need for more research. Findings suggest that limited biological family support, childlessness, and “families of choice” may be important factors in support service and health care decisions for older lesbians. Implications for care providers in working with the older lesbian population include exploring existing supports and assisting with the formation of culturally acceptable support systems and services. Given the current evidence base regarding the impact of social support on elder health, it is critical for providers to have a better understanding of elder lesbians’ unique concerns and needs relating to support and health care services in order to prevent health disparities among this vulnerable population.     

Lessons on social and health disparities from older lesbians with alcoholism and the role of interventions to promote culturally competent services

ABSTRACT

Older adults who are lesbian, gay, bisexual, or transgender (LGBT) face greater health risks and possibly more costly care because of their reluctance to seek out health and long-term care services because of limited cultural sensitivity of service providers. This is particularly evident in older lesbians who face substantial risk of health problems associated with alcoholism and are less likely to be open with health care providers because of stigma combined with feelings of alienation, stress, and depression. An estimated 4.4 million older adults are predicted to have problems with alcohol by 2020, and the rates of alcohol-related hospitalizations are similar to those for heart attacks, creating exorbitant medical costs. More culturally competent health and long-term care may reduce health care costs by effectively addressing the dynamics of alcoholism, aging, and lesbian culture. Training initiatives such as those developed by the National Resource Center on LGBT Aging have begun to address the need of a more culturally competent aging services network. This article provides exemplars from empirical data on older lesbians with alcoholism to highlight some of the health, economic, and social disparities experienced in the aging LGBT community. Current interventions in the form of cultural competence training for service providers are presented as a potential step toward addressing health disparities among LGBT older adults.     

Disrupting Cultural Selves: Constructing Gay and Lesbian Identities in Rural Locales

Research points to the increasing geographical diversity of gays and lesbians, in contrast to cultural narratives that link gay and lesbian sexualities to urban spaces. Examining the sexual identity constructions of rural gays and lesbians thus provides an opportunity to analyze the connection between cultural and personal levels of narrative identity. Drawing on data from thirty interviews with rural gays and lesbians, I address how this group negotiates cultural narratives about queerness and constructs sexual identities in rural locales. I find that their interpretations of geography make clear distinctions between urban/rural and draw on elements in rural culture. These interpretations provide resources to modify cultural understandings that narrate gay/lesbian identities in rural areas as closeted, hidden, and oppressed.     

COLLEGE STUDENTS' ATTITUDES TOWARD GAYS AND LESBIANS

A variety of pedagogical techniques have shown promising results in promoting acceptance and affirmation of gays and lesbians among students in social work, allied health, and education professions. In this article we examine whether 211 students enrolled in a human sexuality course in a southeastern university changed their attitudes toward gays and lesbians and identify differences in attitudes by demographic groups. At pretest the sample scored moderately negative on the Index of Attitudes Toward Homosexuality. Scores were significantly lower at posttest. Males scored significantly higher than females at pretest, but their scores changed more at posttest. Human sexuality courses that incorporate an exposure component are one way social work educators can change negative attitudes toward gays and lesbians.     

Invisibility,Illegibility, and Stigma: The Citizenship Experiences of Divorced Gays and Lesbians

The campaign for marriage equality emphasized that without access to legal marriage, gays and lesbians were relegated to “second-class citizenship.” Following the U.S. Supreme Court’s decision in Obergefell v. Hodges (2015), gays and lesbians find that marrying can lead to greater acceptance and support from family, friends, and colleagues, suggesting that marriage helps gays and lesbians achieve citizenship, defined in terms of belonging and inclusion. However, it remains unclear whether such acceptance and support then disappears or diminishes after divorce. In this article, the informal social consequences associated with same-sex divorce were explored by drawing on in-depth interviews with a small convenience sample of recently divorced gays and lesbians. Results indicate that same-sex divorce is largely invisible, which leads divorced gays and lesbians to worry that their life circumstances will make them illegible to others. In turn, some also withdraw from social interaction, and others report experiencing stigma.     

The Needs of Older Lesbians and Gay Men in Chicago

Abstract

The authors report results from a study assessing the social service needs of gay menand lesbians over 45 years of age in Chicago. Results suggest that this population is diverse and presents a wide range of needs. The authors advocate the use of a community organizing approach that involves older gay men and lesbians in the provision of services. The authors also highlight the need to consider the social context in which services will be provided.     

A Gay and Lesbian Congregation Seeks Social Justice for Other Marginalized Communities

SUMMARY

The Cathedral of Hope in Dallas, Texas, is the world's largest gay and lesbian congregation. As an unabashedly liberal church, the Cathedral of Hope views social justice as the foundation of theological beliefs and the heart of community building activities with other marginalized and oppressed people. These actions of social justice and community building have produced an unexpected outcome. Social justice has been returned to this congregation in the form of community affirmation, acceptance, recognition, and advocacy. Thus, one significant way for gays and lesbians to achieve social justice is to work for the same with other oppressed people, devoid of strings or hidden agendas.