Affirmative Counseling with LGBTQI+ People E-Book
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- Herausgeber: John Wiley & Sons
- Kategorie: Fachliteratur
- Sprache: Englisch
This current and comprehensive handbook will guide educators, students, and clinicians in developing the awareness, knowledge, and skills necessary to work effectively with LGBTQI+ populations. Twenty-five chapters written by experts in the field provide direction for working with clients in an authentic, ethical, and affirmative manner that is tailored to their individual strengths, needs, and identity.
The book is divided into four sections, which explore the science behind gender and affectional orientation; developmental issues across the life span and treatment issues; the specialized needs of nine distinct populations; and the intersectionality of ethnicity and overlapping identities, the role of religion, and counselor advocacy. To further a deeper understanding of the content, each chapter contains an "Awareness of Attitudes and Beliefs Self-Check," a case narrative relating to the material covered, questions for discussion, and a list of online resources. The book concludes with an extensive glossary of terms, both preferred and problematic, which counselors working with these communities should understand and use appropriately.
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Contents
Cover
Title Page
Copyright
Dedication
Preface
About the Editors
About the Contributors
Acknowledgments
Section I: Foundations
Chapter 1: Developing Competence in Working With LGBTQI+ Communities: Awareness, Knowledge, Skills, and Action
Chapter 2: The Science of Gender and Affectional Orientation
Section II: Counseling Considerations and Counseling Strategies
Chapter 3: Growing Up LGBTQI+: The Importance of Developmental Conceptualizations
Chapter 4: LGBTQI+ Youth Development
Chapter 5: LGBTQI+ Persons in Adulthood
Chapter 6: Identity Development, Coming Out, and Family Adjustment
Chapter 7: Physical and Mental Health Challenges Found in the LGBTQI+ Population
Chapter 8: Disaffirming Therapy: The Ascent and Descent of Sexual Orientation Change Efforts
Chapter 9: Evidence-Based Practice for Counseling the LGBTQI+ Population
Chapter 10: Affirmative, Strengths-Based Counseling With LGBTQI+ People
Section III: Specialized Populations
Chapter 11: Counseling Lesbian Clients
Chapter 12: Counseling Gay Male Clients
Chapter 13: Counseling Bisexual/Pansexual/Polysexual Clients
Chapter 14: Counseling Transgender Clients
Chapter 15: Counseling Queer and Genderqueer Clients
Chapter 16: Counseling Clients Questioning Their Affectional Orientation
Chapter 17: Counseling Intersex Clients
Chapter 18: Counseling Asexual Clients
Chapter 19: Counseling Two-Spirit Clients
Section IV: Emerging Issues
Chapter 20: Counseling an LGBTQI+ Person of Color
Chapter 21: Counseling LGBTQI+ Immigrants
Chapter 22: The Role of Religion and Spirituality in Counseling the LGBTQI+ Client
Chapter 23: The GRACE Model of Counseling: Navigating Intersections of Affectional Orientation and Christian Spirituality
Chapter 24: Working With LGBTQI+ Clients Who Have Experienced Religious and Spiritual Abuse Using a Trauma-Informed Approach
Chapter 25: Becoming an Ally: Personal, Clinical, and School-Based Social Justice Interventions
Glossary of Terms
Index
Technical Support
End User License Agreement
List of Illustrations
Figure 1.1
Figure 1.2
Figure 22.1
Figure 25.1
Guide
Cover
Table of Contents
Begin Reading
Part 1
Chapter 1
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Affirmative Counseling with LGBTQI+ People
edited by
Misty M. Ginicola • Cheri Smith • Joel M. Filmore
AMERICAN COUNSELINGASSOCIATION6101 Stevenson Avenue • Suite 600Alexandria, VA 22304www.counseling.org
Copyright © 2017 by the American Counseling Association. All rights reserved. Printed in the United States of America. Except as permitted under the United States Copyright Act of 1976, no part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval system, without the written permission of the publisher.
American Counseling Association6101 Stevenson Avenue • Suite 600Alexandria, VA 22304
Associate Publisher Carolyn C. Baker
Digital and Print Development Editor Nancy Driver
Senior Production Manager Bonny E. Gaston
Production Coordinator Karen Thompson
Copy Editor Beth Ciha
Cover and text design by Bonny E. Gaston
Library of Congress Cataloging-in-Publication Data
Names: Ginicola, Misty M., author. | Smith, Cheri, author. | Filmore, Joel M., author.
Title: Affirmative counseling with LGBTQI+ people / Misty M. Ginicola, Cheri Smith, Joel M. Filmore.
Description: Alexandria, VA : American Counseling Association, 2017. | Includes bibliographical references and index.
Identifiers: LCCN 2016048753 | ISBN 9781556203558 (pbk. : alk. paper)
Subjects: LCSH: Sexual minorities—Counseling of. | Sexual minorities—Psychology.
Classification: LCC RC451.4.G39 G56 2017 | DDC 616.890086/64—dc23 LC record available at https://lccn.loc.gov/2016048753
With ignorance comes fear—from fear comes bigotry. Education is the key to acceptance.
—Kathleen Patel
We would like to dedicate this book to all of those who are brave enough to live and love authentically as well as those who are looking for hope that it does indeed get better. We would also like to honor those counselors and helping professionals who commit their lives to learning about and helping lesbian, gay, bisexual, transgender, queer, questioning, intersex, asexual, ally, pansexual/polysexual, and two-spirited people find their way, their joy, and their value.
Preface
We should indeed keep calm in the face of difference and live our lives in a state of inclusion and wonder at the diversity of humanity.
—George Takei
Possessing counseling competence in serving the lesbian, gay, bisexual, transgender, queer, questioning, intersex, asexual, ally, pansexual/polysexual, and two-spirited (LGBTQQIAAP-2S, henceforth referred to as LGBTQI+) communities is important, particularly because previous research has shown that large numbers of this population seek therapy (Garnets, Hancock, Cochran, Goodchilds, & Peplau, 1991). If counselors are unprepared for work with this population, they could potentially do harm to these clients. Many counselors have not received adequate training to work with affectional orientation and gender minority clients; LGBTQI+ clients are aware of this deficit in the field and prescreen therapists for safety and competence in issues of affectional orientation and gender orientation (Kaufman et al., 1997; Liddle, 1997). Although many standard counseling interventions will be appropriate for work with the LGBTQI+ population, counselors need an awareness and knowledge of this population and its cultures and subcultures that extend beyond typical client concerns (Bieschke, Perez, & DeBord, 2007; Dworkin & Pope, 2012).
The needs of LGBTQI+ individuals are different from those of clients who identify as heterosexual because of variant affectional and developmental experiences that occur as well as the increased stigma and oppression that they may face in their current cultural context. A theme throughout this book is the high level of minority stress that LGBTQI+ persons experience. Without a doubt, common issues of oppression, abuse and neglect, and discrimination are threaded throughout the subgroups of the LGBTQI+ communities; however, it is both the common struggles and the unique ones that are addressed in this text.
Members of the LGBTQI+ population have frequently been lumped together as if their individual needs were exactly the same and they formed one singular community. However, there is a rich history of development, strengths, and needs in this population, both as a collective group and also in its singular subgroups (Bérubé, 1990; Faderman, 1991) that bears acknowledgment and understanding. For example, issues specific to the development of lesbian identity and culture are different from those of other subgroups (Chapman & Brannock, 1987; McCarn & Fassinger, 1996); the same can be said for identity development for gay men, bisexuals, and transgender individuals.
Another theme that is addressed in this book and is crucial for counselors to understand is that of intersectionality; stressors and difficulties are compounded for LGBTQI+ individuals when other minority statuses, such as race and ethnicity, are also present (Chung & Katayama, 1998). Racial identity development and affectional orientation identity development are complex processes, with research suggesting that they occur concurrently (Jamil, Harper, & Fernandez, 2009). Although some assume that in LGBTQI+ communities there is more acceptance of differences, including race, there is not; in fact, there is just as much racism and prejudice in the queer community as the heterosexual community (Goode-Cross & Tager, 2011). Queer people of color (QPOC) often feel as if they are unable to identify with the predominantly White gay culture (Balsam, Molina, Beadnell, Simoni, & Walters, 2011). They also have difficulty identifying with their racial/ethnic culture, from which they risk rejection and the loss of their only social support and cultural ties because of their affectional orientation (Diamond & Savin-Williams, 2003). The research that has focused on the intersection of race/ethnicity and affectional orientation has suggested that individuals who have to negotiate multiple identities, such as QPOC, are at an increased risk for psychosocial distress because of heterosexism and racism, which is beyond what White LGBTQI+ individuals experience (Smith, Foley, & Chaney, 2008). The discrimination suffered by QPOC is also unique based on various cultural/religious traditions and can contribute to isolation among QPOC, exacerbating psychosocial distress (Lewis, 2009). Along with these factors, one must also consider socioeconomic variables and geography, as well as other -isms that can impact a client's development, such as sexism, ageism, ableism, and the like (Smith et al., 2008).
Given these complex and specialized needs, it is imperative that counselors and other helping professionals obtain specific training on working with members of the LGBTQI+ communities; a brief class session in a multicultural course will not prepare practitioners for understanding the needs and interventions that the entirety of this population requires. As use of the LGBT acronym has increased, so too has the need to understand these complex, varied, and sometimes overlapping identities. A competent counselor needs to have an awareness of the LGBTQI+ experience and knowledge of this population and its specialized needs, as well as the skills required to work with various subcultures in the LGBTQI+ population.
This book seeks to aid in filling the gap in counselor training by providing a current and inclusive reference for developing the awareness, knowledge, and skills needed to work with the LGBTQI+ population. The intended audience is counselor educators, all counselors-in-training, and practicing counselors. This book is also appropriate for other helping professionals, such as psychologists and social workers.
By seeking out the most recent literature and including chapters by authors who serve as experts on LGBTQI+ populations in the counseling field, we have focused on making this book current and of practical importance for the clinician, student, and educator. The book is divided into four main sections: (a) Foundations, (b) Counseling Considerations and Counseling Strategies, (c) Specialized Populations, and (d) Emerging Issues.
Section I: Foundations
In Chapter 1, “Developing Competence in Working With LGBTQI+ Communities: Awareness, Knowledge, Skills, and Action,” the authors review the multicultural counseling framework and multiple American Counseling Association–based competencies as well as aspects of basic competencies, including terminology and a history of oppression among the LGBTQI+ population. In Chapter 2, the author reviews the science of gender and affectional orientation.
Section II: Counseling Considerations and Counseling Strategies
In this section developmental issues for LGBTQI+ people are explored. The authors of Chapter 3 provide a conceptualization of growing up LGBTQI+ and how being an affectional orientation and gender minority may result in additional challenges to development. In Chapter 4, the authors review what is known about LGBTQI+ youth development. Chapter 5 discusses LGBTQI+ persons in adulthood. In Chapter 6, issues surrounding identity development, coming out, and family adjustment are reviewed. It is crucial to understand the process of coming to terms with having a minority gender and/or affectional orientation as well as how the coming out process impacts both individuals and their families. Finally, in Chapter 7, the authors review issues that, because of excessive minority stress, may bring those in the LGBTQI+ population in for medical care and mental health counseling. This chapter, “Physical and Mental Health Challenges Found in the LGBTQI+ Population,” provides counselors with an understanding of normative symptoms in the population due to the oppression, marginalization, and trauma surrounding being a minority. Special attention is paid to how stress may be expressed differently in the subgroups of the queer community.
In addition, counseling treatment issues with LGBTQI+ clients are explored. In Chapter 8, the empirical basis of treatment strategies for these clients is reviewed in “Disaffirming Therapy: The Ascent and Descent of Sexual Orientation Change Efforts,” in which the authors explore the traumatizing role that past mental health professionals and faith-based leaders played in treating affectional orientation as a curable disease. Chapter 9, “Evidence-Based Practice for Counseling the LGBTQI+ Population,” provides a review of the literature as well as an introduction to the importance of using an affirmative approach with clients who are gender and affectional orientation minorities. Finally, in Chapter 10, the authors focus specifically on the affirmative approach in “Affirmative, Strengths-Based Counseling With LGBTQI+ People.” The elements of an affirmative approach, as well as specific methods that can be utilized, are discussed.
Section III: Specialized Populations
In this section, the individual populations that make up the LGBTQI+ community are reviewed in order to provide the crucial counseling competence required to meet each population's specialized needs. In each chapter, authors address (a) an awareness of differences in the population, (b) knowledge of issues and problems faced by the specific population, and (c) the counseling skills and techniques appropriate for use with each specialized population.
Chapters 11 through 19 discuss issues relevant to counseling lesbian clients, gay male clients, bisexual/pansexual/polysexual clients (individuals whose relationships and bonding are not based on gender), transgender clients (individuals whose designated sex at birth and gender identity do not match), queer and genderqueer clients (individuals whose gender and affectional orientation do not fit into distinct categories), clients questioning their affectional orientation, intersex clients (those born with ambiguous or both male and female genitalia), asexual clients (those who have little or no sexual attraction to others), and two-spirit clients (individuals who are both indigenous peoples to the Americas and LGBTQI+ persons).
Section IV: Emerging Issues
The last section includes emerging issues in the field: ethnicity, religion, and advocacy needs.
The Role of Ethnicity
In Chapter 20, “Counseling an LGBTQI+ Person of Color,” the intersectional issues of ethnicity and LGBTQI+ identity are discussed. In Chapter 21, “Counseling LGBTQI+ Immigrants,” intersectional issues surrounding immigration and naturalization as a member of the queer community are delineated.
The Role of Religion
In Chapter 22, “The Role of Religion and Spirituality in Counseling the LGBTQI+ Client,” the impact of religion on clients' identity development, numerous affirmative religions, and issues involving counselors' religious beliefs are discussed. In Chapter 23, “The GRACE Model of Counseling: Navigating Intersections of Affectional Orientation and Christian Spirituality,” an established counseling model for working with religious LGBTQI+ clients is delineated. In Chapter 24, “Working With LGBTQI+ Clients Who Have Experienced Religious and Spiritual Abuse Using a Trauma-Informed Approach,” the authors discuss the impact of religious trauma.
Counselor Advocacy
In Chapter 25, “Becoming an Ally: Personal, Clinical, and School-Based Social Justice Interventions,” the authors discuss why it is important for counselors to identify as allies as well as how counselors can do so in their specific setting.
Glossary of Terms
The book concludes with an extensive glossary of terms that counselors working with this community should know. Problematic terms to avoid are also covered in the glossary.
Conclusion
Each chapter in this book focuses not only on the knowledge base important for practice but also on specific counseling strategies important for treatment planning. The goal of this book is to provide information that is widely needed in practice as well as in counselor training programs. Each chapter additionally has several elements to help counselors understand how to apply this knowledge as well as how to gain resources in the field. First, the “Awareness of Attitudes and Beliefs Self-Check” has three questions designed to increase counselors' cultural competence, particularly their self-awareness of marginalization and privilege. Second, each chapter contains a brief narrative and case study of a client who represents the content covered. These narratives provide a context that personalizes the information and helps the reader envision a potential client. This context is important, as it helps in the development of a practical framework of counseling strategies for a client who could present in a counselor's practice or agency. It also provides a transition into each chapter, where authors provide the essential information for counseling practice via theoretical knowledge and established research. At the end of each chapter is a list of five questions related to the original case that represents content for further discussion, which is especially useful for practicing counselors and counselor educators. Finally, online resources are provided to guide readers to more information on each topic.
When counselors have the awareness, knowledge, and skills required to work with the LGBTQI+ population, they will be much more competent providers. The key to being an effective counselor for members of these communities is truly being able to work with each client using an authentic, ethical, and affirmative approach tailored to that client's individual needs and identity. This book provides a deeper understanding of the theory and process behind counseling LGBTQI+ clients, what these clients' lives and cultures may entail, and trends in serving this population. We believe that with this information, counselors will enhance their aptitude for serving the needs of this population, which often faces misunderstanding and rejection from others in their lives. Counselors who work with this population can then provide the understanding, acceptance, affirmation, and healing that LGBTQI+ clients so very often seek in counseling.
References
Balsam, K. F., Molina, Y., Beadnell, B., Simoni, J., & Walters, K. (2011). Measuring multiple minority stress: The LGBT People of Color Microaggressions Scale.
Cultural Diversity and Ethnic Minority Psychology, 17
(2), 163–174.
Bérubé, A. (1990).
Coming out under fire: The history of gay men and women in WWII.
New York, NY: Free Press.
Bieschke, K. J., Perez, R. M., & DeBord, K. A. (Eds.). (2007).
Handbook of counseling and psychotherapy with lesbian, gay, bisexual and transgender clients
(2nd ed.). Washington, DC: American Psychological Association.
Chapman, B. E., & Brannock, J. C. (1987). Proposed model of lesbian identity development.
Journal of Homosexuality, 14
(3–4), 69–80.
Chung, Y. B., & Katayama, M. (1998). Ethnic and sexual identity development of Asian American lesbian and gay adolescents.
Professional School Counseling, 1,
21–25.
Diamond, L. D., & Savin-Williams, R. C. (2003). Gender and sexual identity. In R. M. Lerner, F. Jacobs, & D. Wertlieb (Eds.),
Handbook of applied developmental science: Promoting positive child, adolescent, and family development through research, policies, and programs: Applying developmental science for youth and families
(Vol. 1, pp. 101–121). Thousand Oaks, CA: Sage.
Dworkin, S. H., & Pope, M. (2012).
Casebook for counseling lesbian, gay, bisexual and transgender persons and their families.
Alexandria, VA: American Counseling Association.
Faderman, L. (1991).
Odd girls and twilight lovers: A history of lesbian life in twentieth-century America.
New York, NY: Columbia University Press.
Garnets, L., Hancock, K. A., Cochran, S. D., Goodchilds, J., & Peplau, L. (1991). Issues in psychotherapy with lesbians and gay men: A survey of psychologists.
American Psychologist, 46,
964–972. doi:10.1037/0003-066X.46.9.964
Goode-Cross, D. T., & Tager, D. (2011). Negotiating multiple identities: How African American gay and bisexual men persist at a predominantly White institution.
Journal of Homosexuality, 58,
1235–1254.
Jamil, O. B., Harper, G. W., & Fernandez, M. I. (2009). Sexual and ethnic identity development among gay/bisexual/questioning (GBQ) male ethnic minority adolescents.
Cultural Diversity & Ethnic Minority Psychology, 15
(3), 203–214.
Kaufman, J. S., Carlozzi, A. F., Boswell, D. L., Barnes, L. B., Wheeler-Scruggs, K., & Levy, P. A. (1997). Factors influencing therapist selection among gays, lesbians and bisexuals.
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Lewis, N. M. (2009). Mental health in sexual minorities: Recent indicators, trends, and their relationships to place in North America and Europe.
Health & Place, 15,
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Liddle, B. J. (1997). Gay and lesbian clients' selection of therapists and utilization of therapy.
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(1), 11–18. doi:10.1037/h0087742
McCarn, S. R., & Fassinger, R. E. (1996). Revisioning sexual minority identity formation: A new model of lesbian identity and its implications for counseling and research.
The Counseling Psychologist, 24,
508–534.
Smith, L., Foley, P. F., & Chaney, M. P. (2008). Addressing classism, ableism, and heterosexism in counselor education.
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303–309.
About the Editors
Misty M. Ginicola, PhD, is a professor in the clinical mental health counseling program in the Counseling and School Psychology Department at Southern Connecticut State University.
Dr. Ginicola earned a bachelor's degree in psychology from State University of New York at Cortland. She earned a master's in psychology from State University of New York at New Paltz, where she received training in counseling psychology. She received two additional master's degrees (MS, MPh) from Yale University and graduated with a Doctor of Philosophy from Yale in 2006, where she completed her postdoctoral fellowship focusing on school-based mental health programming and social-emotional skills in youth.
Dr. Ginicola is of Cherokee and Celtic descent and identifies as two-spirited. Her personal experiences and professional interests have developed into specific research areas: working with diverse clients, including the lesbian, gay, bisexual, transgender, queer, questioning, intersex, asexual, ally, pansexual/polysexual, and two-spirited (LGBTQI+) population; teaching multicultural competence; and teaching creative counseling strategies. Her previous and ongoing research studies address the broad definition of multicultural issues, including ethnicity, disability, women's issues, affectional orientation and gender orientation, and religion and spirituality, among others.
She additionally serves as her department's liaison for the Council for Accreditation of Counseling and Related Educational Programs and chair of the Diversity Committee. She also is currently the chair of the President's Commission of Campus Climate and Inclusion LGBTQI+ Subcommittee. In the Connecticut Counseling Association, Dr. Ginicola is a past-president of the Connecticut Association for Counseling Education and Supervision; chair of the Special Interest Group Connecticut-Association for Lesbian, Gay, Bisexual, and Transgender Issues in Counseling (CT-ALGBTIC); and chair of the Multicultural Counseling and Development Committee. Dr. Ginicola has served on national task forces for the American Counseling Association's ALGBTIC and is currently an editorial review board member for the Journal of LGBT Issues in Counseling.
In addition, she is a licensed professional counselor in the state of Connecticut and operates a private counseling practice called Walk in Balance Counseling. The name has a specific meaning attached to her cultural identity of Cherokee. Reflecting the Native saying “Walk in balance and beauty,” she works with clients on a holistic level to ensure that physically, emotionally, psychologically, cognitively, and spiritually (if desired) they are caring for themselves. She also uses a person-centered existential approach to therapy, thereby helping individuals see and maintain the beauty in their lives, even in times of trauma and stress.
Her most challenging and fulfilling role has been as a mother to two sons, Wilson and Waylon. Raising her children has taught her more about teaching and modeling compassion and acceptance than she has ever learned in any textbook.
Cheri Smith, PhD, is a professor at Southern Connecticut State University. She earned her bachelor's degree at the University of West Florida and her master's in education in school counseling and Doctor of Philosophy in educational psychology/counseling at Mississippi State University. She worked in student affairs at Mississippi State University and Florida Atlantic University. Her teaching career began at the University of Montevallo. She has also taught at St. John's University, the University of West Georgia, the New York Institute of Technology, and Troy University. In 1995, while serving as president of the Association for Spiritual, Ethical, and Religious Values in Counseling (ASERVIC), she participated in the first Summit on Spirituality, where the initial ASERVIC competencies were developed. In the late 1980s and 1990s, her research also included HIV/AIDS education. This connection led her to combine her research in the area of spirituality with the LGBTQ+ community.
Dr. Smith is a member of the American Counseling Association, the Connecticut and Alabama Counseling Associations, ASERVIC, ALGBTIC, the Association for Specialists in Group Work, the Association for Counselor Education and Supervision, and Chi Sigma Iota. She has served on the editorial review board for the Alabama Counseling Association Journal. Also, she has served as president of the Montevallo chapter of the American Association of University Women and president of the Alabama Counseling Association. In addition, for 5 years she served on the Alabama Board of Examiners in Counseling. She has served on the editorial review board for the journal Counseling and Values, and currently she is a site visitor for the Council for Accreditation of Counseling and Related Educational Programs.
She is a licensed professional counselor and supervising counselor in Alabama as well as a National Board Certified Counselor. Her proudest role has been as a parent. Along with her husband, she is raising two daughters with open hearts and open minds.
Joel M. Filmore, EdD, is the founder, co-owner, and director of clinical services for the Lighthouse Professional Counseling Center; he is also lead faculty and program coordinator for Springfield College in Milwaukee. Dr. Filmore earned his bachelor's degree in psychology from the University of Illinois at Chicago. He earned his master's in clinical psychology from Roosevelt University in Chicago. He earned his Doctor of Education in counselor education and supervision from Northern Illinois University in DeKalb, Illinois, where he also earned a graduate certificate in quantitative research methods.
Prior to becoming a counselor educator, Dr. Filmore worked as an academic advisor in the university setting as well as a counselor in the community college setting. He also worked for more than 8 years in social services, predominantly with homeless, HIV-positive, drug-addicted, chronically mentally ill, lesbian, gay, bisexual, transgender, and other disenfranchised populations. Dr. Filmore is a biracial (African American and German/Norwegian) gay man. His personal and professional interests are in the areas of LGBTQI+ populations, multicultural issues, substance abuse/addiction, sex offender issues, sex trafficking, and trauma, as well as counselor competency.
Dr. Filmore currently serves as President-Elect for the national ALGBTIC. He also served as the cochair of the LGBTQQIA Affirmative Counseling and Social Justice Committee 2 years running for ALGBTIC. He is past-president of the South Dakota Association for Counselor Education and Supervision as well as the cofounder and past-president of the Illinois ALGBTIC.
About the Contributors
Jahaan Abdullah, MA, Governors State University
Cindy Anderton, PhD, LPC, NCC, University of Wisconsin–Whitewater
Eric R. Baltrinic, PhD, Winona State University
David Barreto, MA, LPC, NCC, Waubonsee Community College
Jamie Bower, PhD, Old Dominion University
R. Lewis Bozard, Jr., PhD, MDiv, NCC, ACS, LPC, Care & Counseling Center of Georgia; Adjunct Faculty, Mercer University–Atlanta
Robyn Brammer, PhD, LMHC, Golden West College
Madeline Clark, PhD, LPC, University of Toledo
Michael DeVoll, MEd, LPC-S, Private practice, Houston, Texas
Diane Estrada, PhD, LMFT, University of Colorado Denver
Peter Finnerty, MS, PCC-S, Ursuline College
Brett H. Furth, PhD, Texas A&M University at Galveston; Houston Community College
Kristopher M. Goodrich, PhD, LPCC, The University of New Mexico
Amney J. Harper, PhD, University of Wisconsin–Oshkosh
Melanie Kautzman-East, PhD, LPC, Carlow University
Michael M. Kocet, PhD, LMHC, Chicago School of Professional Psychology
Ryan Liberati, PhD, LPC, PSC, ACS, Webster University
Melissa Luke, PhD, LMHC, NCC, ACS, Syracuse University
Jeff Lutes, MS, LPC, Private practice, Austin, Texas
Jeffry Moe, PhD, LPC, Old Dominion University
Amy Moore-Ramirez, MAEd, LPC/CR, LSW, The University of Akron
Jared S. Rose, PhD, LPCC, NCC, Bowling Green State University
Angela Ruggiero, MS, Southern Connecticut State University
Samuel Sanabria, PhD, LMHC, Rollins College
The Rev. Cody J. Sanders, PhD, Pastor; Old Cambridge Baptist Church, Adjunct Faculty, Andover Newton Theological School
Anneliese A. Singh, PhD, LPC, University of Georgia
Michael Stokes, MS, LPC, ACS, Stokes Counseling, private practice, Naugatuck, Connecticut
Lindsay Woodbridge, MS, University of Wisconsin–Madison
Chad Yates, PhD, Idaho State University
Acknowledgments
We would like to thank the American Counseling Association for its unwavering support of the lesbian, gay, bisexual, transgender, queer, questioning, intersex, asexual, ally, pansexual/polysexual, and two-spirited (LGBTQI+) community. We are proud to be members of an organization that always advocates for and works toward social justice for the most vulnerable populations among us.
We would also like to thank all of the authors who contributed to this book for their continual work to help those in the LGBTQI+ communities. The impact they make in education, research, and practice truly makes an immeasurable difference in the lives of the clients we serve.
Misty would like to acknowledge her brother, Steve, who taught her that being different was something to be celebrated; growing up with him as a big brother has been an honor and a blessing. She would also like to thank her husband, Mike, who loved and valued her differences from the moment he met her. She would also like to thank her sons, Wilson and Waylon, for opening up a whole new chapter of her life and identity; she works every day to make the world a more accepting place that will value their differences.
Cheri would like to thank Misty, whose hard work and desire to make a difference in the world and in the counseling profession are inspirational. She would also like to thank her fellow coeditor, Joel, and the contributing authors who helped to make this book a reality. She is also thankful to her mentors and colleagues in the Association for Spiritual, Ethical, and Religious Values in Counseling who, for the past 20+ years, have shown her the importance of religion and spirituality in the counseling profession. She would like to acknowledge her parents, who taught her to treat everyone with respect and that social justice is not optional. Cheri would also like to acknowledge Billy R. Cox, an HIV/AIDS activist whose life taught her by example how to fight for a cause with grace and whose death underscored the importance of not waiting for someone else to speak up. Mark Fitzhugh, her favorite Episcopal priest, has supported her with unconditional love and acceptance. Her children, Emma and Ella, both already activists in their own right, give her joy and hope for the future.
Joel would like to thank all of the people who, along the journey of his life, were able to see beyond his brash persona to recognize that underneath was a broken little boy who simply wanted to be loved and accepted. He acknowledges the one woman who helped forge him into the strong, determined firebrand that he is today: his grandmother, Anna Chatfield. He would especially like to thank the one person who can say he truly knows him: his husband and true love, Angel (Chino). Over the past 12 years, Angel has taught him that there really is such a thing as unconditional love.
Foundations
Chapter 1
Developing Competence in Working With LGBTQI+ Communities: Awareness, Knowledge, Skills, and Action
Chapter 2
The Science of Gender and Affectional Orientation
Counselors working with lesbian, gay, bisexual, transgender, queer, questioning, intersex, asexual, ally, pansexual/polysexual, and two-spirited (LGBTQI+) people need a tremendous amount of information in order to serve their clients effectively. Using the framework of American Counseling Association competencies, the authors explore awareness, knowledge, and skills relevant to working with affectional orientation and gender minorities. In this section, the foundation for developing LGBTQI+ competence is addressed through an exploration of American Counseling Association competencies, terminology, history, current civil rights and social struggles, the need for advocacy, and the scientific research surrounding gender and affectional orientation variance.
Chapter 1Developing Competence in Working With LGBTQI+ Communities: Awareness, Knowledge, Skills, and Action
Misty M. Ginicola, Joel M. Filmore, and Cheri Smith
We struggled against apartheid because we were being blamed and made to suffer for something we could do nothing about. It is the same with homosexuality. The orientation is a given, not a matter of choice. It would be crazy for someone to choose to be gay, given the homophobia that is present.
—Desmond Tutu
Awareness of Attitudes and Beliefs Self-Check
When did you first learn what being gay meant? Was it a positive or negative message?
What assumptions do you make about the sexual or affectional orientation of your clients? How might these assumptions emerge in your behavior?
What is your knowledge of the history of oppression for lesbian, gay, bisexual, transgender, queer, questioning, intersex, asexual, ally, pansexual/polysexual, and two-spirited (LGBTQI+) persons?
Case Study
Martin is a 35-year-old Jamaican American gay male who has come to counseling. Martin was born in Jamaica and then moved with his family at age 10 to New York City. One of his first memories from Jamaica was watching a man be beaten to death for being gay. His father died when he was 20, and he has been responsible for caring for his family ever since. He has always known that he is gay but kept it a secret because of the extreme prejudice in his culture and family. Martin has been in a 2-year relationship with Angel, a Puerto Rican man. They have recently talked about moving forward in their relationship and moving in together. However, Martin is afraid because that will mean coming out to his deeply religious mother, who is affiliated with the Church of God.
His family lives with him in his house, so there is no way that he could keep it a secret. He has been depressed and, although not overtly suicidal, has some suicidal ideation.
Multicultural Competence
The main purpose of this book is to assist counselors and other mental health professionals in gaining competence in working with LGBTQI+ clients such as Martin. In Martin's case, there are multiple issues that a counselor without cultural competency may miss. Martin has multiple identities: Jamaican, American, gay, male, caretaker, son, brother, and partner. These roles and identities are conflicting; they may also be something with which a counselor is unable to identify. If a counselor has never had the experience of being an ethnic minority, being an immigrant, being a gay man, growing up in a disaffirming religion and culture, or being the sole provider and caretaker for the family, the way the counselor views the world will be incredibly different from Martin's schema. This is the essential reason why counselors must enhance their cultural competency skills when working with diverse populations.
The American Counseling Association (ACA) Code of Ethics has established several standards that apply to counseling LGBTQI+ people (ACA, 2014). ACA ethical standards require counselors to be developmentally and culturally sensitive in all stages of counseling with all clients as well as in counselor education and supervision (Standards A.2.c., B.1.a., E.5.b., E.8., F.2.b., F.7.c., F.11.c., H.5.d.). The ACA Code of Ethics also requires counselors to be aware of historical prejudices in diagnosis (Standard E.5.c.); this directly applies to work with LGBTQI+ persons, as they were pathologized as mentally ill through much of history. Standard A.4.b. requires counselors to be aware of personal values; counselors working with LGBTQI+ clients must be aware of their own values related to gender and affectional orientation in order not to impose these attitudes in their work with clients. This is very important, as Standard A.11.b. maintains that counselors cannot refer clients based on value conflicts. Standard C.2.a. specifically requires counselors to develop multicultural counseling competence in order to work appropriately with diverse clients; counselors should also receive continuing education to improve their multicultural competence (Standard C.2.f.).
Several sets of specific competencies developed by groups in ACA can be helpful in guiding counselor learning. The Association for Lesbian, Gay, Bisexual, and Transgender Issues in Counseling (ALGBTIC) competencies for counseling with lesbian, gay, bisexual, transgender, queer, questioning, intersex, and ally individuals (Harper et al., 2013) is the quintessential standard for counselors who serve LGBTQI+ clients (see http://www.algbtic.org/competencies.html). Organized along Council for Accreditation of Counseling and Related Educational Programs areas, it provides a framework for understanding all that is needed to be a positive influence in a counseling environment with this minority population. ALGBTIC (2010) also has a set of competencies for working with transgender clients (also available at http://www.algbtic.org/competencies.html).
Beyond the specific ALGBTIC competencies, another important framework to utilize is the Association for Multicultural Counseling and Development competencies. The Multicultural and Social Justice Counseling Competencies (Ratts, Singh, Nassar-McMillan, Butler, & McCullough, 2015) model addresses a variety of cultures through counselor self-awareness, client worldview, counseling relationship, as well as counseling and advocacy interventions (see Figure 1.1). An important focus in achieving multicultural competence is understanding the perspectives of a privileged or marginalized counselor as well as a privileged or marginalized client. The dynamics between marginalization and privilege impact a counselor's perspective and behavior. Each minority status carries marginalization; each majority status carries privilege. However, every person carries a series of complex identities and backgrounds (age, gender, ability status, religion/spirituality, socioeconomic level, race/ethnicity, affectional orientation and gender orientation, immigrant status, indigenous heritage, mental health status, etc.) that form multiple perspectives of both privilege and marginalization, as one person can be a minority in some statuses and in the majority in others. This complex interconnection of social identities is called intersectionality (Harper et al., 2013). For counselors, understanding the impact of discrimination, power, stereotypes, privilege, and oppression is central to serving any population but is particularly important with the LGBTQI+ population.
Figure 1.1 Multicultural and Social Justice Counseling Competencies
Note. From Multicultural and Social Justice Counseling Competencies (p. 4), by M. J. Ratts, A. A. Singh, S. Nassar-McMillan, S. K. Butler, and J. R. McCullough, 2015. Retrieved from https://www.counseling.org/docs/default-source/competencies/multicultural-and-social-justice-counseling-competencies.pdf?sfvrsn=20. Copyright 2015 by M. J. Ratts, A. A. Singh, S. Nassar-McMillan, S. K. Butler, and J. R. McCullough. Reprinted with permission.
In considering their own privilege and marginalization, counselors must consider their intersectional identities, as they will very likely experience privilege in some areas and marginalization in others. Kocet (2008) adapted a checklist from Operation Concern to represent an activity to fully explore power and privilege (see Figure 1.2). In this activity, counselors can identify where they have more power, enjoy less stigma, and have an opportunity to serve as allies for the less privileged or marginalized group. Both privilege and marginalization will shape a counselor's attitudes and beliefs, which can potentially interfere with counseling clients, if one is unaware of them.
Figure 1.2 Kocet's (2008) Adapted Power and Privilege Checklist
Note. Adapted from 'My Personal Privileges Handout,' by M. Kocet, 2008, at http://vc.bridgew.edu/cgi/viewcontent.cgi?filename=2&article=1003&context=change&type=additional. Originally adapted from National Centers of Excellence in Women's Health Cultural Competence Curriculum, originally from Operation Concern, Department of Social Work Education, San Francisco State University, San Francisco, CA. Copyright 1993 by B. G. Gordon and H. B. Hogue. Adapted with permission.
The multicultural competence model also requires counselors to develop an awareness of attitudes and beliefs, requisite knowledge, skills, and actions to take in the areas of counselor self-awareness, client worldview, and the counseling relationship. These areas culminate in establishing competency with counseling and advocacy interventions with and on behalf of clients at multiple levels.
Two other sets of competencies can be valuable for counselors who work with LGBTQI+ clients: the Association for Specialists in Group Work Multicultural and Social Justice Competence Principles for Group Workers (Singh, Merchant, Skudrzyk, & Ingene, 2012) and the Spiritual Competencies of the Association for Spiritual, Ethical, and Religious Values in Counseling (2009). Each of these sets of competencies can help counselors develop skills for working on the wide variety of issues that may present in counseling with clients in LGBTQI+ communities.
Awareness of Attitudes and Beliefs
When working with an LGBTQI+ client, it is crucial that counselors be aware of their own attitudes and beliefs to ensure that they maintain an awareness of their own privilege, marginalization, and potential biases, which could negatively impact the client. These include issues surrounding gender, affectional orientation, and sexuality. Counselors should understand the attitudes and beliefs of their LGBTQI+ clients as well as how these clients' identity development and experiences of oppression, privilege, and marginalization impact their worldviews, attitudes, beliefs, behavior, and physical and mental health. Counselors should be aware of how external cultures, stereotypes, marginalization, power, and privilege will impact the counseling relationship. For example, Martin may be reluctant to seek counseling because of a mistrust of the mental health field resulting from previous experiences of oppression and discrimination. He may be reticent to connect with the counselor for fear that the counselor will be rejecting or might not understand his Jamaican culture. If the counselor is heterosexual and Caucasian, this mistrust may be compounded and Martin may present as resistant. The goal for both heterosexual and LGBTQI+ counselors is to become allies, which are people who are supportive of individuals in the LGBTQI+ communities who may also face discrimination themselves (Harper et al., 2013).
There are several constructs to be aware of in understanding attitudes and beliefs surrounding this population. The overarching acronym that represents this community varies depending on the focus (e.g., LGBQQ is typical for work on affectional orientation), organization (e.g., many use LGBT or LGBTQ as their main acronym), or inclusiveness (ALGBTIC uses LGBQQIA in its competencies). However, there are currently 11 recognized identities under the affectional orientation and gender minority umbrella, including allies. The entire population is referred to (in several iterations with different orders) as LGBTQQIAAP-2S (lesbian, gay, bisexual, transgender, queer, questioning, intersex, asexual, ally, pansexual/polysexual, and two-spirited). As the complete acronym is quite unwieldy, two umbrella terms are commonly used to refer to this population without compromising inclusiveness: queer community (which refers to queer theory and includes both affectional orientation and gender minorities) and LGBTQI+ populations or communities. Although queer was once, and sometimes still is, utilized as a pejorative term, many in the LGBTQI+ community have reclaimed the term as an indicator of strength and unity (Harper et al., 2013). It is important to note that in this book, the acronym may be LGBTQ or LGBQQ when discussing research studies of limited populations.
In relation to specific terminology, there are several terms to be aware of in the LGBTQI+ population. One is affectional orientation, which refers to “the direction an individual is predisposed to bond with and share affection emotionally, physically, spiritually, and/or mentally” (Harper et al., 2013, p. 38). It is meant to replace sexual orientation as an outdated term; these constructs are similar, in that they refer to both the nature of an individual's romantic attractions and the identity surrounding those attractions (VandenBos, 2015). However, affectional orientation highlights the full spectrum of relationships rather than just the sexuality aspect (Harper et al., 2013). Although these concepts are similar, shifting to using the term affectional orientation rather than sexual orientation can purposely broaden the focus of discussion of LGBTQI+ people to their relationships rather than just their sexual behavior (Crethar & Vargas, 2007; Klein, 1993). In the realm of affectional identity, there are lesbians, or women who bond romantically with other women, and gay men, or men who bond romantically with other men (Harper et al., 2013). Bisexual, pansexual, and polysexual individuals bond based on a wider range of gender identities, which may include male, female, genderqueer, and transgender. Queer refers to individuals who specifically identify as such because the other categories do not capture the complexity of their identity; this could be because of their identified nonbinary gender identity, relationship status (e.g., polyamory), or political reasons (Harper et al., 2013). Questioning individuals are those who identify with the LGBTQI+ communities but are unsure of the nature of their emotional, physical, mental, and/or spiritual attractions (Harper et al., 2013). Asexual individuals are those who may experience a romantic bonding attraction but not sexual or physical attractions; when present, their romantic attractions can vary from none to heterosexual or gay, lesbian, or bisexual (Bogaert, 2004).
Another characteristic in these communities is gender identity, or the personal identity surrounding masculinity or femininity (Harper et al., 2013; VandenBos, 2015). Gender identity and affectional orientation are not binary, or two separate concepts: male/female, gay/heterosexual. Rather, they both appear to be on a continuum. Gender and affectional orientation are not finite, fixed concepts; they are fluid, meaning that they develop, shift, and evolve throughout the life span. These developmental issues are further delineated in Chapters 3 through 6. In terms of gender identity, persons may identify as genderqueer, or someone who experiences a blending of genders, or as a gender minority. Gender minorities, who may also identify as transgender, experience a mismatch between their physical assigned sex and their gender identity. These individuals present as gender nonconforming, an umbrella term that indicates a child who at a young age does not exhibit gender-stereotyped play or interests. Some gender-conforming individuals may certainly be LGBTQI+; however, heterosexual individuals can also be gender nonconforming. Transgender persons who experience significant distress and/or impairment may be diagnosed as having gender dysphoria according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (American Psychiatric Association, 2013). Another related term in the gender identity category is cisgender, which describes someone whose sex and gender identity align: in other words, non-transgender. Some individuals are also born intersex, with male and female or ambiguous genitalia; such individuals were formerly known as hermaphrodites, but the new term is less pejorative and not associated with the negative aspects with which hermaphrodite was once associated (Harper et al., 2013). Two-spirit individuals are those who have an indigenous heritage and who identify with traditional Native concepts of variant gender and affectional orientation as having spiritual and social value (Jacobs, Thomas, & Lang, 1997).
Some confuse affectional orientation with relationship systems. For example, one might believe that bisexuals have multiple romantic partners at one time. However, this is not the case; relationship systems include monogamy (romantic involvement with one partner) and polyamory (multiple partners). These relationship systems are discussed and are consensual in nature, whether it is to only be involved with each other as romantic partners or to have multiple partners in some constellation or formation (i.e., an open relationship to date anyone, three partners, a partner who bonds with only one individual in a couple, etc.). These relationship systems are present in all affectional orientation identities, most commonly heterosexual partnerships. However, even in a heterosexual context, consensually non-monogamous relationships are severely stigmatized in society and seen as negative or doomed to fail, despite evidence to the contrary (Conley, Moors, Matsick, & Ziegler, 2013).
A key component of being multiculturally aware is understanding how a personal experience may be different from a minority experience in terms of both marginalization and privilege. The majority culture experiences a privilege that those in the LGBTQI+ communities do not, and that is having a gender and affectional orientation that is the norm for and reinforced by society. There are several constructs to be aware of in this regard.
Heteronormativity is the view that people's assigned sex, gender identity, gender roles, and affectional identity are immutable, binary (male vs. female), and heterosexual in nature (VandenBos, 2015). This norm or standard is expressed in human societies, leading those who do not meet this norm to feel abnormal or in violation of society's standards.
Heterosexism is a prejudice against any individuals who do not meet heteronormative expectations, which include binary male versus female gender expression and identity, as well as heterosexual attractions (VandenBos, 2015). These prejudices can lead to homophobia, which is fear associated with same-sex relationships, which can also be internalized into one's own self, or internalized homophobia. Sometimes termed homoprejudice, these prejudices can result in acts of violence and discrimination in employment, housing, and personal relationships.
Knowledge
Having advanced knowledge related to multicultural counseling is important not only to understanding behavior in the counseling process but also to increasing positive outcomes in a multicultural context (LeBeauf, Smaby, & Maddux, 2009). Although counseling programs accredited by the Council for Accreditation of Counseling and Related Educational Programs (2015) are required to infuse multicultural counseling across the eight domains into their curricula, there are no required methods for how to do so. As long as a counseling program discusses multicultural issues and assesses student learning in social and cultural diversity, that can suffice as having met the requirements.
Unfortunately, the truth is that even if counselors were to take a semester-long course on multicultural counseling, they would not necessarily be considered competent or knowledgeable, as such classes are most often introductory. Regardless, the onus is on individual counselors to increase and maintain their knowledge after graduating and engage in a process of learning that continues throughout their professional development.
Counselors who work with LGBTQI+ clients should have knowledge of history and cultural events that have shaped their own privileges and marginalized statuses as well as their clients' intersectional backgrounds and identity development. Counselors should also be knowledgeable about international and global affairs. For example, the counselor working with Martin should understand his Jamaican culture, how his experience of trauma in his childhood impacts his own identity development, and what he is risking by coming out to his family and community.
Multicultural counseling has been called the fourth force in the helping professions (Pedersen, 2001) and as such connotes the importance of having a strong knowledge base from which to draw when working with clients who are other than the majority population. Providing counseling services to minority populations has become increasingly commonplace in professional counseling. Although the United States has never been so diverse, when it comes to racial, gender, and affectional orientation differences, the populace struggles with divisiveness brought on by incendiary rhetoric, both political and social.
A History of Oppression and Bias
Throughout ancient history, there were records of same-sex relations, both monogamous and polyamorous bisexual and gay or lesbian relationships, just as there were heterosexual ones (Greenberg, 1988; Hubbard, 2003; Mussi, 2002; Talalay, 2005; Wilhelm, 2008). There is also evidence of transgender and third-gender persons in virtually every civilization across recorded history (Greenberg, 1988). This evidence can be found in Africa, the Americas, Assyria, China, Egypt, Europe, India, Israel, Japan, the Middle East, Persia, and the South Pacific. Although the cultural beliefs and practices differed in each context, the existence of gender and affectional orientation variance was seen as normative, often valued in the civilization (Greenberg, 1988; Hubbard, 2003; Mussi, 2002; Talalay, 2005; Wilhelm, 2008). There is also some evidence that many great leaders, notably Alexander the Great, had same-sex relationships and were highly valued in their time (Green, 2007).
Starting in the fourth century, these previously sanctioned relationships began to be seen as immoral (Fone, 2000). The apparent precedent for the massive change in attitude against acceptance of gender and affectional orientation variance was the advent of Westernized religion, specifically the Roman Catholic Church. Although there is some evidence that the Roman Catholic Church originally accepted same-sex relationships, at some point gender roles associated with natural law (e.g., intercourse for purposes of procreation) became standard teaching, and “homosexuality” and sodomy were condemned in Europe. In 390, sodomy was made illegal by Christian emperors and became punishable by death. From the fifth to the 17th centuries, these laws began to spread to virtually every government around the world where Europeans emigrated and the Catholic Church spread. During the Spanish Inquisition, more than 1,600 individuals were stoned, castrated, and burned at the stake for being sodomites. As the religion spread, so did the negative attitudes regarding sexuality in general as well as affectional orientation and gender variance in particular. During the Renaissance, same-sex acts were punished by assault (e.g., flogging), genital mutilation, and/or death.
In the 18th and 19th centuries, civil rights groups began forming in Europe and countries began to decriminalize “homosexuality” (Fone, 2000). France became the first to decriminalize sodomy between consenting adults, and several other countries followed, including Prussia, The Netherlands, Indonesia, Brazil, and Japan. However, this viewpoint was not accepted globally; during the same period of time, sodomy laws were enacted in the United States, Poland, Guatemala, and Mexico. Subsequently, several countries, including Russia, Panama, Paraguay, Peru, Iceland, Switzerland, Sweden, Portugal, Greece, England, Wales, and Thailand, to name a few, repealed sodomy laws. Although LGBTQI+ individuals were gaining more acceptance, many people around the world were still commonly arrested and detained for same-sex sexual activity; during World War II, gay men, along with other minorities, were persecuted and executed in Nazi concentration camps, with the pink triangle being used to label them in the camps.
The field of psychiatry was partially responsible for the movement to decriminalize same-sex sexual activity; theorists and psychiatrists coined the term homosexual and argued that it was a clinical disorder (Bayer, 1987; Drescher & Merlino, 2007; Krajeski, 1996). The origin of homosexuality as a pathological term is one reason why it is no longer used in the LGBTQI+ community. With the advent of seeing “homosexuality” as a disorder, psychiatrists advocated for the removal of criminal penalties while simultaneously pathologizing those in LGBTQI+ communities. Psychiatric theories regarding the origin of affectional orientation variance at the time ranged from a congenital disorder to degenerative neurological conditions to serious mental illness. Some theorists argued that “homosexuality” was a sexual inversion, which was a variation, not a disease. However, even some of these theorists believed that it could be reversed or cured. One theorist who agreed with the ideas surrounding sexual inversion but disagreed with the idea of a cure was Sigmund Freud. Freud theorized about the role of the oedipal conflict in creating affectional orientation variance but also stipulated that sexual inversion could be completely natural; he particularly believed that bisexuality was universal but sublimated in heterosexuals. Unfortunately, most psychiatrists who practiced after Freud supported the belief that “homosexuality” was pathological and needed to be cured
In America, the history of LGBTQI+ treatment can be split into pre-Stonewall and post-Stonewall, which refers to the revolt in New York City that began the American LGBTQI+ civil rights movement (Edsall, 2003; Fone, 2000; Foster, 2007; Godbeer, 2002). Before Stonewall, Europeans interpreted the Native gender and affectional orientation variance (now known as two-spirit) as sinful and derogatory. Derived from the laws from the English versions of buggery, sodomy remained a taboo and illegal act that would result in genital mutilation and death. Although in the late 1700s states began removing the death penalty for sodomy, it remained an illegal act. The Federal Bureau of Investigation and local police departments kept lists of gay and lesbian persons, the bars and bathhouses they patronized, as well as their friends; sweeps on cities, parks, bars, and beaches were regularly performed to rid cities of LGBTQI+ persons. The mafia, which sometimes blackmailed the wealthier customers, commonly ran the bars that served LGBTQI+ persons in New York City; some historians theorize that local police were receiving kickbacks from this blackmail that kept the bars open. Wearing opposite-gender clothing had been outlawed in some states; educational organizations fired teachers and professors who were suspected of being lesbian, gay, or bisexual. As a result, a multitude of LGBTQI+ persons were exposed, were harassed, lost their jobs, were placed in mental institutions, and/or were jailed. Therefore, it was necessary to be closeted during this time. There had been some LGBTQI+ civil rights organizations and social justice activism in the 1950s and 1960s, but little had changed. A small riot in response to police harassment occurred in Los Angeles in 1959; another occurred in San Francisco in 1966 at Compton's Cafeteria, when police attempted to arrest transgender women and drag queens for dressing in women's clothing.
