Why is LGBTQIA+ Affirmative Therapy so Important?
When you are questioning or coming out with your sexual orientation or gender identity, it is so important to have a safe person in your corner- helping you make decisions about your own process and the thoughts and feelings that come up around it. Family members, however well intentioned, don't always know how to help or what to say.
As a clinical supervisor for a community mental health center that serves LGBTQIA+ clients as well as a therapist in private practice, so much of my work has been in empowering, accepting, and giving people a place to be who they are.
I often get asked questions about LGBTQIA-what do the letters mean? What does it all mean?
Here is just some of the definitions that may be a helpful starting place-language is so important and using the correct language when supporting a member of the LGBTQIA+community is a way to show someone you get it or are open to trying to understand them.
Some basic concepts:
Internalized homorphobia/biphobia/transphobia-etc.-this is the shame and guilt a person that identifies with being non-heterosexual. In our society, we are generally conditioned to be straight and taught anything else is different, not ok, or just weird. There is often self-hatred that comes with aspects of being LGBTQIA+ that needs to be looked at in therapy.
Gender Identity: One’s internal sense of being male, female, neither of these, both, or other gender(s). Everyone has a gender identity, including you. For transgender people, their sex assigned at birth and their gender identity are not necessarily the same
Sexual Orientation: A person’s physical, romantic, emotional, aesthetic, and/or other form of attraction to others. In Western cultures, gender identity and sexual orientation are not the same. Trans people can be straight, bisexual, lesbian, gay, asexual, pansexual, queer, etc. just like anyone else. For example, a trans woman who is exclusively attracted to other women would often identify as lesbian
Some definitions:
L-Lesbian-a woman who has sexual attraction to other women.
G-Gay-a man who has sexual attraction to other men.
B-Bisexual-a person who has sexual attraction to more than one gender.
T-Transgender-a person who feels their gender identity is not congruent with the assigned sex of which they were given at birth. Ex. a born male grows up feeling he is really a girl and is in the wrong body. Transexual-A deprecated term that is often considered pejorative similar to transgender in that it indicates a difference between one’s gender identity and sex assigned at birth. Transsexual often – though not always – implicates hormonal/surgical transition from one binary gender (male or female) to the other. Unlike transgender/trans, transsexual is not an umbrella term, as many transgender people do not identify as transsexual. When speaking/writing about trans people, please avoid the word transsexual unless asked to use it by a transsexual person. Transition: A person’s process of developing and assuming a gender expression to match their gender identity. Transition can include: coming out to one’s family, friends, and/or co-workers; changing one’s name and/or sex on legal documents; hormone therapy; and possibly (though not always) some form of surgery. It’s best not to assume how one transitions as it is different for everyoneYou can be cisgender or someone who exclusively identifies as the sex they were assigned at birth.
Q-Queer-General term for gender and sexual minorities who are not cisgender and/or heterosexual. There is a lot of overlap between queer and trans identities, but not all queer people are trans and not all trans people are queer. The word queer is still sometimes used as a hateful slur, so although it has mostly been reclaimed, be careful with its use.
I-Intersex-Describing a person with a less common combination of hormones, chromosomes, and anatomy that are used to assign sex at birth.
A-Asexual or Ally-not sure why they are both here but these are two different things. An Asexual person is someone who has some or no sexual attraction to another person-this doesn't mean he or she cannot be in a relationship. An Ally is someone who advocates and supports a community other than their own. Allies are not part of the communities they help. A person should not self-identify as an ally but show that they are one through action.
What is the +? The + stands for the variety of others not listed here. That can be Pansexual, Aromantic, Genderfluid, or Androgynous.
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Another big piece of this is understanding the Stages of Sexual Identity Formation- I like the Cass Identity Model developed in 1979 by Vivienne Cass.
1. Identity Confusion-"Could I be gay?" The task is to allow for uncertainty about sexual identity.
2. Identity Comparison-"Maybe this does apply to me." The task is to help a person develop their own definitions about their sexuality. A person can talk about the loss of heterosexual life expectations and may be permitted to keep some of their "heterosexual" identity.
3. Identity Tolerance-"I'm not the only one." The task is to decrease social alienation and seek out other LGBTQIA+social support. This is usually where one explores their own internalized homophobia.
4. Identity Acceptance-"I will be okay." The task is to no longer subscribe to the norm and bring congruence between private and public self.
5.Idenity Pride-"I've got to let people know who I am." The task is to receive support for anger issues related to heterosexism and develop coping skills and responses to disclosure of sexual identity -to resist being defensive.
6. Identity Synthesis-"This is me." The task is to integrate the identity to it is an aspect of the self.
In therapy, I listen carefully to see where a client is in their stage of LGBTQIA+identity formation and seek to help them by witnessing and honoring their journey and helping them move through their stages. Sometimes the stages are not in order and can go back and forth. This process is personal and unique to each person and I honor one's timeline and need to move through it with acceptance and affirmation.
If you are questioning or coming out and need support, I provide individual, couples, and child/adolescent therapy around all issues LGBTQIA+.
More to come in future blogs about this and the spectrums and types of sexuality and gender identity.
Here is an extensive list of terminology-it is constantly changing.
https://lgbtqia.ucdavis.edu/educated/glossary