from Clinical/Therapeutic Issues

Pachankis and Goldfried, in "Clinical Issues In Working With Lesbian, Gay, And Bisexual Clients," suggest that the mental health professions have "historically demonstrated heterocentric and homophobic beliefs, prejudices, and practices against LGB individuals, placing the burden of distress on the client and his or her possession of an illness (Goldfried, 2001). Indeed, some professionals continue to promote cures for homosexuality (Nicolosi & Nicolosi, 2002)."

The authors caution against heterocentric or homophobic bias in therapists as a hindrance to effective counseling for LGB individuals. "Countering such bias is central to establishing ethical practices with LGB clients," note the authors.

Therapists who display these biases have often been poorly trained, have lack of contact with LGB individuals, or have a fear or denial of LGB sexual orientations. Pachankis and Goldfried believe that heterocentric assumptions must be challenged in the universities to overcome these biased beliefs.

Couple Relationships And Parenting
Professors Pachankis and Goldfried suggest that LGB couples are much like their heterosexual counterparts, but that because of widespread homophobia in the culture, the experiences of LGB couples may differ from heterosexuals.

While admitting that male homosexuals are less monogamous than heterosexual males, the authors say that "...we need to understand the meaning and implications that sex often has for gay men. Like heterosexual men, many gay men in relationships do not seem to attach emotional meaning to the sex that they have with others outside of their primary relationship."

And, LGB couples "might have to work extra hard in negotiating the meaning, significance, and function of their relationship. This is likely due to the heterocentric institutions in society that typically deny lesbian and gay relationships the legal, familial, and social recognition that their heterosexual counterparts receive."

The authors say that research shows that children with one or more lesbian or gay parents are similar to their peers raised by two heterosexual parents in terms of psychological, behavioral, emotional, and intellectual functioning. To help LGB parents develop a healthy identity, they suggest that therapists encourage them to establish social connections with other same-sex parents.

Pachankis and Goldfried suggest that LGB individuals who consider themselves religious but have inner conflicts about their sexual orientation because of their religious heritage may deal with this conflict by identifying themselves as spiritual rather than religious. In addition, they may choose to reinterpret religious teachings, change affiliations, remain religious but not attend services; abandon religion altogether; or seek sexual reorientation therapy.

In discussing bisexuality, Professors Pachankis and Goldfried observe that bisexuals are frequently made to feel invisible because gay and lesbian communities are often biphobic and unaccepting of this identity. In many gay/lesbian circles, bisexuality is considered only a transitional identity from heterosexuality to homosexuality and is a denial of true homosexual feelings. "These stereotypes may hamper bisexual individuals' efforts at accepting their bisexuality as a valid identity," say the authors.

They conclude by noting that LGB clients present unique challenges for therapists but as therapists affirm these identities, "we increase the likelihood that our work will lighten the impact that societal homophobia and discrimination has had on these individuals. LGB issues also have the potential to inform our work with heterosexual individuals.... [and] has the potential to increase our comprehensive understanding of human behavior."

Updated: 8 February 2008

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