What Does "Couple" Mean in Couple Therapy Outcome Research? A Systematic Review of the Implicit and Explicit, Inclusion and Exclusion of Gender and Sexual Minority Individuals and Identities.

Abstract

This study systematically reviewed extant couple therapy outcome studies (k=111) through December 2018 to evaluate for implicit or explicit, inclusion or exclusion of gender and/or sexual minority individuals and identities. We evaluated sampling, participant demographic reporting, and language used in each manuscript for any reference or consideration given to participants' sexual and/or gender identity. Results indicate that couples have been historically presumed to be heterosexual and cisgender male or female without reported assessment. More recent inclusion and consideration of sexual minority individuals is limited and absent for nonmonosexual and gender minority individuals. These findings are contextualized in supplementary analyses of other sociocultural characteristics (e.g., race, age, length together). Suggestions are provided for affirmative consideration of the plurality of individuals' sexual and gender identities. Implications are discussed for research, training and practice of couple therapy with sexual and/or gender minority couples.