Proud to be Anti-Oppression and Pro LGBTQIA+
As therapists, we offer greater safety to LGBTQIA+ clients when we understand the impact of our own biases
I had already been married and divorced with one child when my then therapist told me I was “in a phase” after sharing how I thought I was more attracted to women than men.
Her recommendation was to consider this sense of myself as part of the emotional turmoil of ending a marriage. She was sure it was nothing more than that. My therapist had known me for a couple of years prior to marriage and throughout my adjustment to becoming a new parent. I regrettably changed therapists soon after.
This was 27 years ago. I’ve been legally married to my wife for almost 9 years and together with her for 21.
As a member of the LGBTQIA+ community and an EMDR trained therapist, I have heard a variation of this story from many others. Yes, times have changed in the last 27 years. We can legally marry now in the US. Some employers allow for domestic partner benefits. Unfortunately, as we all know, bias prevails regardless of any fragile advances.
A competent therapist explores their own beliefs about sexual orientation and the global binary gender system, whether working with the LGBTQIA+ community directly or not. Despite advances, the LGBTQIA+ community continues to endure relentless discrimination.
To put it in perspective, more than 1 in 3 LGBTQIA+ adults report facing some type of discrimination in the past year – in health care, employment, housing and in public spaces (American Progress Organization).
In addition, we hear others minimizing pronoun usage rather than embracing and celebrating another’s (or your own) individuality. Transgender discrimination is on the rise globally, with 30% who physically present as a gender different than their assigned sex at birth, reporting being attacked.(Washington Post/KFF report).
It is widely understood that therapists have a greater positive impact on the outcome of a client’s therapy if they have worked on their own biases in therapy and/or case consultation. Most of us have elements of bias regardless how open-minded we may know ourselves to be. How can we not when our global culture and perhaps our families judge and/or reject differences? In addition, if a clinician has had unfortunate experiences that are linked to bias, that requires direct attention as well.
Being an anti-oppressive therapist
Being an anti-oppressive therapist means that we strive to understand and put into practice a critical consciousness of how we, directly or indirectly, can be complicit in reacting or reinforcing inequality among clients who are different. Reflecting on how we may inadvertently maintain a position of privilege can unconsciously inform how we view another as “other.” Looking back, when my therapist suggested that my desires were nothing more than a reaction and a phase, it was as if I had told her I found a lump and dismissed it as hysterical. The message beneath the words discouraged exploration and curiosity, which is what I needed. Instead, I felt dismissed. I no longer felt safe enough to continue my journey with her.
Being different from one another is the norm. Variety is, as they say, the spice of life. However, acceptance for living or looking differently isn’t what most minorities experience. In Joan Roughgarden’s book, “Evolution’s Rainbow”, she states, “all species have genetic diversity, their biological rainbow. No exceptions.” From a biological perspective, adapting to change has been the hallmark of evolution. No person is the same as another. DNA contributes to this claim. Even identical twins who come from identical genetic material develop independently. Replication is manufactured. The rainbow affirms organic diversity.
Sexual fluidity, meaning having a pliable expression of oneself in orientation, identity or behavior, is important to name as well. Sexual identity can be on a continuum for some. A client may leave a heterosexual marriage and pursue a same sex relationship and eventually identity as asexual. Sexual identity can change throughout a person’s life, although constancy is more common or, with some, more compliant. In her book, “Sexual Fluidity” Lisa Diamond recommends moving beyond traditional labels for sexual desires which can be limiting and inadequate.
In 1948 and 1953, the Kinsey Scale (Sexual Behavior of the Human Male and Sexual Behavior of the Human Female) measured sexual orientation in three categories – heterosexual, bisexual and homosexual, with 7 different descriptions starting from exclusively heterosexual to no socio-sexual contacts or reactions (kinseyinstitute.org). Even in 1948, Kinsey stated, “The living world is a continuum in each and every one of its aspects.” Fritz Klein developed the Kline Sexual Orientation Grid (1978, The Bisexual Option) which is a multidimensional grid for describing sexual orientation that expanded the Kinsey Scale and is often used as a research tool today.
History is filled with examples of sexual fluidity as far back as ancient Egypt. Native American cultures recognized that many individuals harbored “two spirits,” a concept we now understand as gender nonbinary. (Psychology Today)
Managing aggressions and oppressions
As EMDR therapists, there are an unfortunate amount of targets any minority client has in his, her or their memory networks of life experiences. These aggressions and oppressions are not because someone is LGBTQIA+ but rather because they are seen by others as unequal. Straight or sis privilege can be identified in both subtle and obvious ways. Consider hand holding. A straight couple can walk together holding hands without considering safety issues. Holding hands with a same sex partner or spouse may be lethal in some areas and in more accepting communities, there may be lingering ambivalence. Oppressions are explicit to any minority member. Perhaps not so much to those fitting into a majority.
If your practice is LGBTQIA+ affirming, we must assess for homophobic and transphobic related trauma, as well as internalized homophobia where shame and self loathing prevail. If your practice is not LGBTQIA+ affirming, it is ethical to refer clients to a therapist who is.
My client, aka Barry, is a good example of working with someone who experienced previous oppressions by past therapists, who were not conscious of their impact. Barry was referred by his couple’s therapist who thought he could benefit from EMDR. I met with him for approximately 18 months. His eloquent reprocessing focused on his childhood adaptations that were currently influencing and interfering in his marriage.
During Barry’s first contact with me, he wanted me to know he didn’t need help with his sexual orientation. He mentioned that he was tired of therapists seeing his gay identity as an issue to explore. He wanted to be respected for knowing who he was and that he had other issues to resolve. How he identified himself was not one of them.
Barry was the oldest of four children. His father died when he was a young adolescent. His mother suffered from ongoing clinical depressions, including hospitalizations, throughout his childhood. As the oldest, he felt responsible for his siblings and his mother. His adaptation of over functioning naturally followed him into adulthood. By the time he met with me, Barry was far past his exploring his sexuality and had a healthy self identity as a homosexual man.
Initially, we focused on his oppressive experiences with other therapists who suggested the death of his father or his mother’s emotional unavailability informed his sexual identity. His needing to explain his identity to other therapists only reinforced his adaptation to over function. He continued to educate his therapists not to mention being very frustrated by the suggestion that his sexual identity was even an issue. Undeniably, his father’s death and his mother’s unavailability was traumatic. To imply that his sexual orientation was no more than a byproduct of unfortunate childhood circumstances is never something that would even be considered regarding a straight person's identity. This is a perfect example of oppression. Regardless of how innocent any suggestion may be, therapists offer greater safety to LGBTQIA+ clients when they understand the impact of their own bias.
For the clients who are exploring their sexual desires or identity, the following information can be a starting point for a therapist to open up conversation. How someone responds to these topics does not determine their identity.
Curious exploration is what matters here.
- When did the client first feel different and at what age?
- What made him, her or them feel different from others?
- How did he, she, they feel about being different? Did others comment on the differences?
- Whom had he, she, they talked to about feeling different?
- How did whomever he, she, they spoke to handle their feelings and thoughts?
- What does he, she or them like or not like about their birth gender?
- Does the client feel like his, her, their body matches their internal sense of self?
- When did he, she, they first realize same sex attractions? If they have, when did they first act upon the attractions?
- How was coming out handled? How “out” is the client now?
- What is like to have an LGBTQIA+ or straight therapist?
- What macro-micro aggressions have they encountered? Any with a therapist?
- What is it like for this client to feel fluid in their identity?
In her book, “The Modern Clinician’s Guide to Working with LGBTQ+ Clients,” Margaret Nichols discusses having a gay and gender affirming therapy practice and includes several principles common to the treatment of all LGBTQIA+ people. She states, “Sex and gender diversity is normal. Diversity is a naturally occurring, non-pathological phenomenon.” She reinforces that “LGBTQIA+ people have experienced trauma not because of who they are but because of the institutionalized, attitudinal, prejudicial experiences from family, friends, or the greater community, including the political and religious arenas.” The author mentions how therapists can (unknowingly and knowingly) add to a client’s oppressions. The most common bias is to make an assumption that all LGBTQIA+ clients have a history of sexual abuse. Most LGBTQIA+ clients come to therapy for the same reasons straight people do, however, the traumatic experiences mentioned above are critical to address collaboratively.
We know the alchemy of EMDR training and EMDR therapy relies on a client’s system to move them towards healing. However, therapists are the co-alchemists as we accompany our clients on their journeys. The right brain to right brain communication between client and therapist impacts healing which means any bias, unspoken and unrealized, influences treatment outcome.
We all know it takes presence, courage, confidence and support to live and show up different than normative expectations. The LGBTQIA+ community portrays living examples of these strengths every day, and all day. This is one gigantic and relentless reason to have PRIDE.
If you’re an EMDR therapist seeking clinical consultation, reach out to me at robinrichardson22@gmail.com.
Notes:
https://kinseyinstitute.org/research/publications/kinsey-scale.php
Klein, Fritz, “Figure 2, Klein Sexual Orientation Grid,” The Bisexuality Option, American Institute of Bisexuality, (1993-2012), page 80.
Nichols, Margaret, “Sex and Gender-diverse Affirmative Psychotherapy,” The Modern Clinicians Guide to Working with LGBTQ+ Clients, Routledge (2021), page 5 and 6.
Roughgarden, Joan, “Sex and Diversity” Evolutions Rainbow, Diversity, Gender, and Sexuality in Nature and People, University of California Press, (2013), page 13.