Ethical Issues in the Mental Health Treatment of Gender Dysphoric Adolescents

SUMMARY

This paper will focus on ethical dilemmas that arise in the treatment of adolescents with gender dysphoria. We will begin with a discussion of ethical and legal issues pertinent to the treatment of any adolescent, and then proceed to the gender dysphoric adolescent, since there is a great deal of overlap between the two areas. The authors re-view legal decisions, the existing data on adolescent decision-making, and ethical principles that may help the clinician in resolving some very complex situations. Utilizing case vignettes of three gender dysphoric adolescents, the authors provide a pragmatic illustration of the ethical dilemmas involved in evaluation and treatment of these youth. It is the authors' belief that treatment interventions should be based on respect for the adolescent's autonomy and confidentiality where he or she is deemed competent to make decisions.     

An Ethical Assessment of Structured Intervention with Chemically Dependent Clients

ABSTRACT

Structured intervention is a widely accepted approach to helping the chemically dependent client get treatment. Because this method departs from the tradition of the client directly seeking help, it raises unique ethical diletnmas-for both client and practitioner-including issues of self-determination, secrecy, coercion, environmental manipulation, and “fair exchange.” Analysis of these issues using a model for ethical decision-making is followed by discussion of four ethical options for the practitioner. The authors identify a preferred emical position based on theoretical and practice knowledge plus professional and personal values.     

Enhancing Critical Thinking and Professionalism Through Use of the Discussion Forum in Social Work Practice Courses

SUMMARY

Development of critical thinking skills, application of theory, ethical decision-making, and achieving a professional identity are among the goals of social work education. This paper describes a three-year experience integrating discussion forums into graduate and undergraduate practice courses. Forums were designed to promote students' ability to use theory, analyze controversial issues, analyze and address ethical issues, professionally critique the work of peers, and conceptualize practice problems and issues for discussion in the forum. Evaluations indicated that discussion forums enhanced the depth of thinking about practice and practice issues and increased the sense of collegiality among students.     

Between the market and the hard place: neoliberalization and the Polish LGBT movement

ABSTRACT

Whilst the fall of state socialism in 1989 opened up a space for the Polish LGBT movement to emerge and develop, over the last three decades the process has taken place against the backdrop of material and ideological constraints of neoliberalization, a point that has been largely overlooked in the scholarship on the Polish LGBT movement. Informed by interviews with Polish LGBT activists this article explores the contradictory ways in which processes of neoliberalization and market logic influence and often constrain the Polish LGBT movement. The argument is that neoliberalization and its logic profusely affect what is possible and desirable for the Polish LGBT movement on a personal, local as well as a national level. The contradictory effects of the processes of neoliberalization combined with the political climate, with minimal or no state support for LGBT organizing, result in a movement that is at the mercy of the market-like environment, under-resourced, dependent almost entirely on voluntary labor and spatially scarce.     

Morals,Ethics and practice — in search of social justice

Abstract

This paper reports a study of sources of influence on moral and ethical decision-making in social work practice. Practitioners from ten government and five non government agencies kept journals about the main moral issues they faced over a one-month period and were then interviewed about the nature of those issues, their resolution and the influences that shaped those resolutions. Practitioners' personal moral perspectives were found to be the main sources of influence on resolutions to a wide range of dilemmas and most of those resolutions did not conform to accepted social wok ethical practice principles. Even though the results of this study are drawn from a small sample, some implications are suggested for practitioner development, professional ethics and social work education.     

Queer Domicide

ABSTRACT

This article examines lesbian, gay, bisexual, and trans (LGBT) experiences of displacement, home loss, and rebuilding in the face of natural disasters. LGBT vulnerability and resilience are little studied in disaster research; this article begins to fill this gap, focusing on LGBT domicide—how LGBT homes are “unmade” in disasters. To do this, we critically read a range of non-government, scholarly, and media commentaries on LGBT experiences of natural disasters in various settings over 2004–12, including South Asia, the USA, Haiti, and Japan. Additionally, we utilize preliminary data from pilot work on LGBT experiences of 2011 disasters in Brisbane, Australia, and Christchurch, New Zealand. we find that disaster impacts are the first stage of ongoing problems for sexual and gender minorities. Disaster impacts destroy LGBT residences and neighborhoods, but response and recovery strategies favor assistance for heterosexual nuclear families and elide the concerns and needs of LGBT survivors. Disaster impact, response, and recovery “unmakes” LGBT home and belonging, or inhibits homemaking, at multiple scales, from the residence to the neighborhood. we focus on three scales or sites: first, destruction of individual residences, and problems with displacement and rebuilding; second, concerns about privacy and discrimination for individuals and families in temporary shelters; and third, loss and rebuilding of LGBT neighborhoods and community infrastructure (e.g. leisure venues and organizational facilities).     

Coming out in camouflage: A queer theory perspective on the strength,resilience, and resistance of lesbian,gay, bisexual,and transgender service members and veterans

ABSTRACT

Lesbian, gay, bisexual, and transgender (LGBT) service members have made profound contributions to the U.S. military despite serving under anti-LGBT military policies. Little is known about their everyday acts of strength and resistance, which is vital information for developing strengths-based services. This article utilizes a queer theory framework to (a) discuss LGBT military contributions and anti-LGBT military policies, (b) explore three LGBT-specific military minority stressors, and (c) identify four strategies of strength and resistance used to manage an anti-LGBT military environment. Clinical suggestions are proposed for integrating military and LGBT identities and designing interventions that blend military and LGBT cultures.     

Sexual orientation and the European Convention on Human Rights: What of the “L” in LGBT?

Abstract

The European Court of Human Rights (ECtHR) has long been celebrated for its role in advancing LGBT rights. This article adopts an intersectional feminist approach in order to critically examine the trajectory of the Court’s LGBT case-law from a gendered perspective. In doing so, it foregrounds the portrayal, experience and, indeed, invisibility of lesbian applicants. Adopting an intersectional approach that considers the gender dimension of sexual orientation claims provides a somewhat different perspective on the struggle for LGBT rights before the ECtHR and suggests that lesbian voices and experiences have been marginalized and excluded in the struggle for LGBT rights.     

Seeing the Same Thing Differently: Program Director,Faculty, and Student Perceptions of MSW LGBT Competence

ABSTRACT

This exploratory study examined MSW education’s organizational-level lesbian, gay, bisexual, and transgender (LGBT) competence. Data were gathered from a sample of MSW program directors, faculty members, and students (N=1385) from 34 MSW programs in the United States. Hierarchical linear modeling analyzed differences in perceptions of organizational LGBT competence between MSW programs and among participants in the same program. Results showed organizational LGBT competence varied significantly among MSW programs and indicated program directors, faculty members, and students had different perceptions of the competence of their shared program. Specifically, directors rated the LGBT competence of their program higher than faculty, and faculty rated their program higher than students did. Implications for research and suggestions for social work education are discussed.     

Cultural and ethical considerations in late-life polyvictimization

ABSTRACT

This article examines the cultural and ethical considerations for professionals working with older adults who experience polyvictimization. Drawing from the Department of Justice training program, Polyvictimization in Later Life (OVC/TTAC, 2017), topics include cultural competencies, ethical standards, personal and professional ethics, and ethical considerations when working in teams. Also described are specific suggestions and recommendations to ensure sensitive and ethical responses when working with cases involving polyvictimization.     

LGBT Faculty,Research, and Researchers: Risks and Rewards

ABSTRACT

Self-identified lesbian, gay, bisexual, and transgender (LGBT) faculty along with heterosexuals with scholarly interests in these populations can face heterosexism, heterocentrism, homophobia, and hostility within and outside of social work programs. This article describes the risks and rewards of being an LGBT faculty based on the experiences of the authors. Myths and realities relating to coming out, promotion, and funding are discussed, along with the pitfalls of tokenism and the stress of being an LGBT faculty of color. Ways to endure and even thrive in spite of these potentially formidable burdens are also described.     

“Family” Support for Family Violence: Exploring Community Support Systems for Lesbian and Bisexual Women Who Have Experienced Abuse

ABSTRACT

“Family” is a euphemistic term that lesbian, gay, bisexual, and transgender (LGBT) people use among ourselves to designate membership in lesbian, gay, bisexual, and transgender communities. Ironically, this “family” may be the most sought, yet least successful, support for dealing with the intimate partner violence that occurs within LGBT families. This study of 11 lesbian and bisexual women's experiences seeking support revealed several tiers of unmet needs within the LGBT community. They rarely used services in the general community, although these services are often the focus of both criticism and efforts to build support systems for LGBT victim/survivors. A model presents the different stages and potential sources of support.     

Traversing the Margins: Intersectionalities in the Bullying of Lesbian,Gay, Bisexual and Transgender Youth

SUMMARY

This study explores the perspectives of service providers and youth advocates on bullying of lesbian, gay, bisexual and transgender (LGBT) youth and intersectionalities in LGBT peer victimization. In depth, semi-structured interviews were conducted with nine key informants (4 male, 4 female, 1 transgender male; 4 gay, 3 lesbian, 2 non-identified; 6 white, 1 South Asian, 2 Middle Eastern) recruited using purposive sampling from diverse education and social service settings. Narrative thematic analysis and a constant comparative method were used to identify themes. Five themes emerged from the data: (1) “transgressing gender norm boundaries”; (2) homophobic sexism vs. sexist homophobia; (3) “you choose sexuality or you choose race”; (4) newcomer youth and citizenship; and (5) “multiple wires together … create the cage.” Findings suggest the importance of an intersectional approach to conceptualizing and addressing LGBT bullying and to uncovering the differential experiences of bullying among LGBT youth. Bullying related to sexual orientation should not be assumed to be the only or primary form of violence shaping the lives of LGBT youth.     

Not All Alike

Abstract

Most published research regarding same-sex relationship abuse experienced by lesbian, gay, bisexual, and transgender (LGBT) people notes a need for services. However, the LGBT community is quite heterogeneous, and useful support may vary based on demographic characteristics. This research examined within group differences regarding type of support sought and its usefulness. Eighty nine percent (n = 677) of a diverse sample of LGBT people (N = 760) experienced abuse in a same-sex relationship. Of those who experienced some type of emotional, physical, and /or sexual abuse, differences in help sought and its usefulness were found based on age, income, gender, sexual orientation, and ethnicity.     

Intersections of Identities

ABSTRACT

This paper addresses several key issues related to counseling lesbian, gay, bisexual, and transgender (LGBT) Asian-Americans. An understanding of the intersections of these identities is important, yet can be complex because of the diversity within Asian-American cultural groups (i.e., ethnicity, generation, skin color, religion, levels of minority stress, and acculturation) and within LGBT communities. These factors may influence counselors' selection of developmentally appropriate and culturally sensitive counseling approaches for LGBT Asian-American clients. We propose a framework for understanding the intersection of racial/ethnic and sexual identity development, the Racial Ethnic and Sexual Orientation Identification Chart (RSIC), which is designed to assist therapists in determining relevant counseling issues and strategies. A case study is included along with a discussion of multidimensional assessment and clinical implications.     

Who Is a Jew?

Abstract

When a social worker incurs professional obligations in two different actions, but cannot do both, this is termed “an ethical conflict concerning expectations in concurrently affected arenas” (Levy, 1976, p. 113). This article addresses an ethical dilemma that is centered in one of the most complex and controversial issues within Jewish life today: the question of “who is a Jew.” A case is presented which depicts the complexity of ethical conflicts which may arise from this unanswered question. The values at issue are explored and the process used to clarify, legitimate, and operationalize a plan of action is articulated. Ethical dilemmas invariably arise in social work practice. Resolutions that are clear, easily applied, internally consistent, and that consider the values of all concerned should help in reaching an ethical solution.     

Towards Customized Deliberations

ABSTRACT

The profession of social work has important contributions to make in the rapidly developing dialog about medical care decision making and to the evolution of hospitals as systems that engage with people as patients, for whom illnesses create increased vulnerability (Gruber, 1998). Professional ethics clearly states that the individual professional social worker has a responsibility to influence processes involving vulnerable populations. Articulating social work's responsibility and potential contributions in the area of medical care decision making begins with an application of social work's mission and values, and then continues with consideration of the profession's evolving role in hospitals. Pertinent aspects of the health care industry, including current models for continuum of care and for provider-patient relationships, are discussed in terms of opportunities to modify the models used to guide interactions with patients. Finally, the impact of a growing number of distinct treatment options is also considered. The objective of the article is to offer social workers in health care settings a conceptual framework for considering professional ethical obligations and for participating in the contemporary dialog regarding medical care decision-making.