Lesbian Clients Research Articles

Lesbian and Homosexual Clients in Our Daily Work

Lesbian and Homosexual Clients in Our Daily Work

Learning to Hear Each Others' Voice: A Response to Melendez and LaSala

It is a pleasure to respond to Melendez and LaSala's (2006) critique of my article Epistemological Frameworks, Homosexuality, and Religion: How People of Faith Understand the Intersection between Homosexuality and Religion (Hodge, 2005a). Over the course of our profession's history, we have expanded our understanding of diversity to include characteristics such as race, gender, and sexual orientation Both writers have contributed to this evolving understanding. Melendez has added to the andragogy knowledge base (Garcia & Melendez, 1997), and LaSala (2001, 2004) has enhanced our ability to provide culturally competent services to gay and lesbian clients. The evolutionary process, however, has not always been smooth (Guzzetta, 1996; Sue & Sue, 2003). With each iteration of diversity, misunderstandings occurred as existing groups struggled to deal with previously unheard voices. Given the often problematic task of interpreting text (Derrida, 1976), misunderstandings occurred when existing definitions and tools were applied in new ways. At present, the profession is beginning to grapple with the issue of spiritual diversity. Consequently, it is perhaps unsurprising that Melendez and LaSala seem to have misunderstood some of the content of my article, including its primary point. CENTRAL POINT OF THE ARTICLE AND OTHER MISUNDERSTANDINGS As Melendez and LaSala underscore, social work has an ethical mandate to serve all with respect and dignity (p. 376). As a result of changing immigration patterns--stemming in part from the passage of the Immigration and Nationality Act (P.L. 89-236) in 1965--spiritual diversity in the United States has increased dramatically (Smith, 2002; Smith & Seokho, 2005). The nation's existing spiritual diversity has been supplemented by growing numbers of Korean Presbyterians, Soviet Jews, Indian Hindus Latino Pentecostals, Punjabi Sikhs, Asian Muslims, and Hispanic Catholics. Many of these individuals affirm the historic, mainstream tenets of their respective faith traditions. Called orthodox by some, they often self-identify as of faith. The creation of this rich, colorful, spiritual mosaic has resulted in the United States becoming perhaps the most spiritually diverse nation on the planet (Eck, 2001). In addition to providing services to all, the National Association of Social Workers' Code of Ethics (NASW, 2000) calls on us to pay particular attention to the needs of people who are vulnerable, oppressed, and living in poverty. As implied earlier, individuals have multiple identities (Wambach & Van Soest, 1997). Although spiritual identity plays a predominant role for many people of faith, other identities also shape their status in society. Orthodox believers are disproportionately likely to be African American, Latino, Native American, female, working class, or poor (Davis & Robinson, 1997; Hodge, 2002b; McAdams, 1987;Wilcox, 2004). To fulfill our ethical mandates with people of faith (or any other group), we must understand how they tend to construct reality (Sue, Arredondo, & McDavis, 1992; Wambach & Van Soest, 1997). It is here, perhaps, that Melendez and LaSala's central misunderstanding occurred. The key point of my article was to expand our understanding of diverse reality constructions. Toward this end, I attempted to set aside my own beliefs, enter the worldview of people of faith using traditional Christians as a proxy, and tell a story that reflects how members of the group tend to view the world. As I argued (for example, p. 213), it is not a one-way street. Social workers also need to understand common reality constructions among gay and lesbian clients. As the NASW Standards for Cultural Competence in Social Work Practice (NASW, 2001) states, we do not have to agree with the values of the groups that make up society. We do, however, need to understand how members of these groups tend to construct reality so that we can provide culturally competent services. …

Long-Term Planning and Decision-Making Among Midlife and Older Gay Men and Lesbians

This article examines the issues of long-term planning and decision-making among midlife and older gay men and lesbian caregivers. Using a qualitative methodology, in-depth interviews were conducted with 19 gay men and lesbians over 50. Participants reported on their long-term planning and decision-making processes. All but four persons reported that their partners had advance directives, but the majority of caregivers did not have advance directives for themselves. Concerns about informal family dynamics and interactions with formal systems were expressed, along with financial and ownership issues. It is important for social workers to intervene across individual, organizational, and community levels in advocacy for the needs of older gay men and lesbian clients.

A Review of Research on Violence in Same-Gender Couples

This paper reviews current research that has primarily focused on domestic violence among same-gender couples. Several key issues pertaining to the identification, assessment, and treatment of domestic violence among same-gender couples are examined and outlined to assist clinicians in effectively working with gay and lesbian clients who may be experiencing domestic violence. Resource information is included to help mental health clinicians recognize specific stressors of marginalized individuals as well as assessment and treatment recommendations are made.

How Heterosexism Plagues Practitioners in Services for Lesbians and Their Families

SUMMARY Barriers to services for lesbians and their families have been well documented in the literature (DeCrescenzo, 1984; Harris, Schatz, & O'Hanlan, 1994; Nightengale, & Owen, 1995; Mallon, 1998), especially among medical professionals and social service providers. This study seeks to explore the prevalence of heterosexism and homophobia among mental health practitioners who identify as qualified providers for lesbians and the recipients' perspectives regarding the services they have received. Of the twenty-five practitioners who responded, 48% of them “knew personally of incidences of professional bias against lesbian clients.” Interestingly, only 26% of the 98 families reported heterosexual bias from their providers.

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.

Counselors as Social Advocates

ABSTRACT The authors discuss the importance of social advocacy and empowerment models in working with lesbian clients. They also explore the multiple contexts that impact lesbian clients and their families. A case illustration involving a lesbian client facing issues of internalized homophobia, heterosexism, sexism, and legal issues is presented. Suggestions for applying a feminist and social advocacy approach are offered.

America's Changing Attitudes toward Homosexuality, Civil Unions, and Same-Gender Marriage: 1977-2004

On May 17, 2004, Massachusetts became the first state to legalize same-gender marriage. From California to Missouri, nearly all states now face legislative challenges to the once firmly entrenched notion that marriage can only exist between a man and a woman. Public opinion polls conducted from 1977 to 2004 found that Americans' attitudes toward gay men and lesbians and marriages or civil unions for same-gender couples have evolved. Opposition persists, however. The most recent data indicate support for some legal recognition of gay and lesbian couples, but most Americans favor civil unions over same-gender marriages. Although the future of civil unions and same-gender marriages remains uncertain, social workers can serve gay and lesbian clients and their families best by staying informed of the attendant legal, social, and policy issues.

Legal and Ethical Implications of Refusing to Counsel Homosexual Clients

In 2001, a federal appeals court upheld the job termination of a counselor who requested being excused from counseling a lesbian client on relationship issues because homosexuality conflicted with the counselor's religious beliefs (Bruff v. North Mississippi Health Services, Inc., 2001). This article provides the facts of the case and the legal reasoning of the court. The authors also explore the legal and ethical issues related to this case.

Lipstick or Timberlands? Meanings of Gender Presentation in Black Lesbian Communities

Mignon R. Moore Lipstick or Timberlands? Meanings of Gender Presentation in Black Lesbian Communities C onsider the ways in which the following women explain gender pre- sentation in one black lesbian community: Asa Bambir (age 34, executive assistant): 1 In New York I saw more of this butch-femme thing and I was a little floored by it, a little shocked, like why do people have to play these roles? . . . But at the same time I looked at it in awe because there was a part of my childhood when I really liked wearing boyish clothes, but I never did. . . . So, I was very intrigued by it, and I think over the years I’ve just been allowing that to surface. I really do like wearing boyish clothes. Were you drawn to women who were more feminine looking or less feminine looking? I was definitely drawn to women who were feminine looking, very feminine looking. Lynn Witherspoon (age 33, corporate attorney): When I first started to come out . . . it was interesting because I had this type that I was attracted to, and yet when I was going out I was always attracting the more butch looking women. And I was like, “Oh, I’m carrying this purse,” and all of these other things, you know, all these things you do in the straight community. So I had to change the way I dressed, and I stopped carrying a purse, and I was able to find women who I was more attracted to, to go out with. When I first came out I was wearing makeup; I stopped wearing makeup. Data collection was supported by the Woodrow Wilson Junior Faculty Career Enhance- ment Fellowship, the Andrew W. Mellon Foundation, the Institute for Social and Economic Research and Policy, and the Institute for Research in African-American Studies at Columbia University. The Russell Sage Foundation generously supported the writing of this manuscript. I thank Karolyn Tyson, Elaine Harley, Laurie Essig, two anonymous reviewers, and the current and former editors of Signs for their helpful comments. Pseudonyms are used to protect respondents’ anonymity. Following Kath Weston’s (2004) model, I assign surnames to this study’s participants to convey a sense of respect and adult status not always afforded sexual or racial minority group members. [Signs: Journal of Women in Culture and Society 2006, vol. 32, no. 1] ᭧ 2006 by The University of Chicago. All rights reserved. 0097-9740/2006/3201-0009$10.00

Brief Reports: Unequal Treatment: Mental Health Care for Sexual and Gender Minority Groups in a Rural State

Brief Reports: Unequal Treatment: Mental Health Care for Sexual and Gender Minority Groups in a Rural State

Improving Services for Lesbian Clients: What Do Domestic Violence Agencies Need to Do?

In her 2004 master's thesis Simpson identified that lesbian victims of domestic violence who are seeking services face systemic, institutional, and individual barriers. For this qualitative study, building on that work, we used in-depth interviews with six staff members who represented both a traditional domestic violence agency and a lesbian social service agency providing domestic violence services. The interviews revealed policy changes that might be made: institutional inclusion, assessment of language and literature, training and supervision, and institutional evaluation and quality assurance. These changes may improve the experiences of lesbian victims who are seeking services from domestic violence agencies. Each change, with specific examples provided, is discussed.

The Gay Affirmative Practice Scale (GAP): A New Measure for Assessing Cultural Competence with Gay and Lesbian Clients

Gay affirmative practice models provide guidelines for behaviors and beliefs in social work practice with gay and lesbian individuals. The aim of this study was to develop a valid rapid assessment instrument to assess the extent to which social work practitioners engage in principles consistent with gay affirmative practice. The Gay Affirmative Practice Scale is a 30-item scale designed to assess practitioners' beliefs and behaviors in practice with gay and lesbian individuals. Information about the rationale for development of the instrument, reliability and validity of the measure, potential uses of the scale, and implications for social work practice, education, and research are presented.

A Qualitative Analysis of theLesbian Connection's Discussion Forum

Letters submitted to the discussion forum of the Lesbian Connection between 2000 and 2002 were analyzed to identify issues of importance to lesbians. The analysis revealed 5 discussion categories: (a) isolation, safety, and aging; (b) children; (c) lesbian relationships and sexuality; (d) physical and mental health; and (e) political issues. The author presents an overview of those discussions along with the implications of the findings for counselors working with lesbian clients.

The booking visit: A difficult encounter for lesbian clients?

The objective of this study was to explore the experience of the maternity booking visit and blood sampling for lesbian clients.The design of the project was based on a review of relevant literature together with personal reflection on the care offered to one lesbian client. Among the findings the author notes that at the booking visit, midwives often make presumptions that the client is heterosexual. This can make it difficult for lesbian clients to discuss their needs. When midwives are aware of clients' sexuality, personal beliefs and attitudes may affect the care offered. The author makes a number of key conclusions and recommendations for practice which include: midwives must be aware of the diversity of the pregnant population; avoid making presumptions about sexuality; midwives prejudices need to be set aside; and appropriate care should be offered to all women.

Speaking vulnerable issues into existence: Their consequences for psychotherapy

Healthcare has traditionally been dominated by norms making the sexual orientation of clients invisible. To explore processes counteracting or promoting invisibility. A single case study based on notes from psychotherapy and a research interview. The client's story can be understood in terms of pathology but also in terms of finding her lesbian lifestyle. A special focus is required for transcending heterosexuality and for realizing the meaning of being a lesbian in everyday life. In conducting inquiries, practitioners need to be aware of how their own norms take heteronormativity for granted. This aids recognition of the important need for gay and lesbian clients to tell their personal stories.

Effects of Sexuality on Lesbians' Experiences of Depression

1. Lesbians are members of every racial, ethnic, and socioeconomic group. 2. Very little is known about depression in lesbians, and thus far, study findings are conflicting. However, depression in lesbians seems to be underpinned by relationship issues and levels of social support. 3. Caring for lesbian clients requires nurses to think holistically, understand their clients' sexuality within the context of their life experiences, and demonstrate respect and acceptance.

Lesbian, Gay, and Bisexual Clients' Experiences in Treatment for Addiction

SUMMARY This study examined the extent to which lesbian, gay, and bisexual clients perceived their addiction counselors and treatment programs to be sensitive to issues related to sexual orientation. The experiences they considered most successful were reported as more affirmative than experiences they considered least successful; however, in neither situation were counselors or treatment programs consistently affirmative.

Infusing Lesbian, Gay, and Bisexual Issues Into Counselor Education

This article offers suggestions and resources for infusing information about working with gay, lesbian, and bisexual clients into a counselor education curriculum or for use in one's professional development as a counselor. Information is provided for core counseling areas and clinical instruction.

Career Decision Self-Efficacy of Lesbians Throughout the Life Span

This study examined the relationship of lesbian identity development and internalized homophobia and the impact on career decision self-efficacy. One hundred and twenty-four women participated. Although the sample was highly integrated, participants reported different experiences in their career development. Implications for counseling lesbian clients are discussed. ********** Career decision making and occupational choice are viewed as lifelong experiences, occurring in stages and contributing to an individual's values and beliefs. Engels (1994) postulated that the career development process addresses an individual's needs and goals that are associated with different stages of life; the focus and importance of career decision making and occupational choice may change over the years. In addition to environmental influences that affect both heterosexual women and lesbians, lesbians have the additional variable of sexual orientation, which makes it imperative to consider the impact of being lesbian and the prejudice against lesbian and gay individuals when making choices in work and career (Croteau & Hedstrom, 1993; Hetherington & Orzek, 1989; Orzek, 1992). Past research has suggested that sexual orientation does affect career choice and career development; however, little research exists regarding the actual career development process of women who identify as lesbian (Shallenberger, 1998). Boatwright, Gilbert, Forrest, and Kretzenberger (1996) found that lesbians had often (a) reexperienced a second adolescence as they developed their lesbian identity, (b) experienced delays and disruptions in the career development process, and (c) experienced some career benefits from associating with other lesbians. Each of these factors has affected career development and occupational choice for lesbians. Coming out has been discussed as a process with distinct stages of self-acceptance and awareness. It is an ongoing, lifelong process rather than a onetime event (Morrow, 1996), in which the transition to a lesbian identity has depended not only on internal forces (positive self-image and self-efficacy) but also on external forces, such as supportive family and/or friends. For many individuals, developmental tasks must wait to be successfully completed until they are in an environment that is both socially and emotionally safe. As a result, painful experiences have often led to self-hatred, self-devaluation, isolation, and self-destructive behaviors, all having an impact on career development, career self-efficacy, and career choice. To better understand the components of the life span career development process for lesbians, I review lesbian identity development, internalized homophobia, and career decision self-efficacy. LESBIAN IDENTITY DEVELOPMENT Lesbian identity is a unique journey for each individual. It is not linear, nor can it be compartmentalized into succinct steps. The following are two lesbian identity models put forth by researchers who have attempted to capture the complexities of this process. The Cass (1979) Model Cass (1984) emphasized the necessity of offering a clear definition of what identity is, the structural components of identity, how it develops over time, and the external and internal influences on it. Cass's (1979) model considered this process. The Cass (1979) model, which has laid the groundwork for subsequent theories addressing the developmental issues unique to the gay male and lesbian population and is based on the framework of interpersonal congruency theory, has six stages of homosexual identity formation. The stages are differentiated on the basis of the individual's personal perception of self. The six stages of the model are (a) identity confusion, which is characterized by the first conscious awareness of homosexuality within oneself; (b) identity comparison, which is the tentative commitment to homosexual identity; (c) identity tolerance, which signifies a heightened awareness of social alienation; (d) identity acceptance, which is distinguished by increased contact with other sexual minorities; (e) identity pride, which is the near completion of self-acceptance of one's homosexual self; and (f) identity synthesis, which is the complete integration of the person's homosexual self and other important aspects of his or her identity. …