Sexuality,Boundaries, Professional Ethics,and Clinical Practice

Abstract

Gay male therapists often practice in milieus where it is virtually impossible not to have contacts with clients outside of the therapy room. The necessity of maintaining appropriate boundaries can be strained when client-therapist contacts occur in situations that are overtly or even potentially sexual. This Practice Note addresses professional challenges and various approaches to these situations while maintaining necessary therapeutic appropriateness.     

Association between sexually explicit messages and sleep health among French sexual minority men

It has been demonstrated that sexual minority men (SMM) participate in sexting. While research has shown that engagement in the exchange of sexually explicit media is associated with poor health outcomes, no previous research has investigated its association with sleep health outcomes. This study sought to examine the association between sexually explicit media and sleep health among SMM, a population that suffers from poor sleep health. A popular geosocial networking application was used to recruit SMM individuals (N?=?580) in the Paris, France, metropolitan area. Multivariate analyses, adjusting for sociodemographics, were used to test the association between the frequency of sexually explicit messaging and three dimensions of sleep health: (1) sleep quality, (2) sleep duration, and (3) two aspects of sleep problems. In multivariate analyses, those who reported engaging in sexually explicit messaging more were more likely to report getting less than seven?hours of sleep (aRR = 1.24; 95% CI = 1.08, 1.43) compared with those who reported engaging in sexually explicit messaging less. No significant associations were found between sexting and sleep quality or reporting sleep problems. Sexually explicit messaging was associated with shorter sleep duration. Intervention targeted at individuals who sext could potentially improve sleep health outcomes.     

Staying put in the Closet: Examining Clinical Practice and Countertransference Issues in Work with Gay Men Married to Heterosexual Women

Gay men married to heterosexual women seek psychotherapy for numerous reasons, not only to find a way out of their marriages. Therapists must identify their countertransference reactions to avoid pushing the patient either to commit to his marriage or leave it. The patient’s underlying problems should be addressed before the patient can explore the fate of his marriage. Therapists also need to be understanding of the patient’s attachment to his wife. In addition, therapists must be aware of the societal implications of homophobia on gay patients. This article discusses motivations for heterosexual marriage among gay men, examines two clinical cases, and addresses practice and countertransference issues. A version of this article was presented at the tenth national conference of the National Membership Committee on Psychoanalysis in Clinical Social Work on March 10, 2007.     

Sexual Dysfunction,Paraphilias and their Relationship to Childhood Abuse in Men who have Sex with Men

ABSTRACT

This study aimed to examine 1) the occurrence of sexual dysfunctions and paraphilias and 2) the relationship between childhood abuse and current sexual disorders in a MSM sample. Participants were MSM in the Midwest who completed baseline surveys prior to attending a sexual health seminar. Most men reported a sexual dysfunction or paraphilia. Thirty-nine percent of the sample reported childhood abuse. Results indicated childhood abuse was associated with a significant increased risk of male erectile disorder (OR = 1.83) and secondary sexual dysfunction (OR = 2.01). The intent of the study was to generate hypotheses to guide future research efforts.     

Psychological Distress in Older Portuguese Gay and Bisexual Men: The Mediating Role of LGBT Community Connectedness

Abstract

Objectives: Examining Psychological Distress (PD) among older Portuguese gay and bisexual men (GBM), and the mediator role of LGBT community connectedness (LGBTCC) of minority stress variables on PD. Methods: We performed a mediation analysis with LGBTCC as mediator between minority stress variables and PD with a sample of 110 elderly GBM. Results: We found moderate PD levels; LGBTCC was a significant mediator between concealment of sexual orientation and PD, but not between internalized stigma and expectations of rejection and PD. Conclusions: More attention is needed to Older Portuguese GBM’s mental health. LGBTCC is an important ameliorating factor for older GBM.     

Psychological Flexibility and Self-Compassion in Gay and Heterosexual Men: How They Relate to Childhood Memories,Shame, and Depressive Symptoms

This study explores differences between men who are gay (n = 53) and men who are heterosexual (n = 52) regarding memories of shame events and of warmth and safeness experiences with parents during childhood and adolescence, self-compassion, psychological flexibility, internal shame, and depression. Also, it aims to explore whether psychological flexibility and self-compassion play a role in the association between these memories and internal shame and depressive symptoms. Results confirmed the mediating role of psychological flexibility and self-compassion. These findings suggest the appropriateness of promoting acceptance and self-compassion towards difficult memories in a therapeutic setting with men who are gay experiencing shame and depressive symptoms.     

Predicting Attitudes Toward Lesbian and Gay Parent Families Among Portuguese Students from Helping Professions

The authors' goal was to characterize predictors of attitudes toward lesbian and gay parent families (LGPF), held by students enrolled in psychology, social work, medicine, nursing, elementary, and preschool education programs in Portugal. The authors examined the predictive value of students' (n = 600) sociodemographic characteristics when assessing their attitudes toward LGPF. Participant's gender, interpersonal contact with lesbians and gay men, gender role attitudes had indirect effects on attitudes toward LGPF, through attitudes toward lesbians and gay men. Understanding characteristics associated with attitudes toward LGPF may inform decisions in terms of the education and training of helping professionals.