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Each of us is a unique individual with his or her own experiences. There are common clinical concerns for lesbians, gay men, bisexual, and transgendered clients, but you may also realize that there are important differences that further delineate these concerns. The tendency to generalize about each of the groups dealt with in this course (lesbians, gay men, bisexuals, and the transgendered) should not neglect the fact that there is diversity within each of these groups. This section defines some of those differences. Review the following as they pertain to you.
- Clinical Concerns for Lesbians in Treatment
Some common areas for assessment with lesbian clients include:
- Coping with sexism in addition to homophobia
- Reliance on bars for socializing and support
- Coming Out Issues / "Passing as Straight"
- Fear of losing custody of their children.
- Trauma history
- Clinical Concerns for Gay Men
Some common areas for assessment with gay male clients include:
- Reliance on bars for socializing and support
- Coming Out Issues/ Managing cultural expectations to be a man
- Gay men tend to have an early awareness of being "different" and may come out younger.
- HIV-particularly grief and loss issues, as well as unsafe sexual behavior.
- Clinical Concerns for Bisexuals
Some common areas for assessment with bisexual clients include:
- Invisibility
- Identity may be continuous, sequential or concurrent
- Coming Out Issues/ Explaining or understanding bisexual identity
- Assumptions about promiscuity
- Self-Acceptance/ Self-Esteem
- Clinical Concerns for Transgendered Clients
Some common areas for assessment with transgendered clients include:
- Secrecy, being closeted, and the stress of "passing."
- Coming Out Issues/ Disclosing to spouse, other clients in treatment (Note: some post-transition transsexuals have lived "stealth" for many years, and should not be encouraged to disclosure their physical birth sex; this should be treated as private information, unless the client wants to reveal it.)
- Use of hormones: Support clients in continuing their hormone use while in treatment (if they desire to do so), and help them distinguish between "street drugs" and medically approved hormonal treatments. (Note: some clients are using black market hormones, and these should be stopped, and the client referred for an appropriate evaluation.)
- Due to discrimination and stigmatization, screen for transphobia and how it may have impacted client's daily experiences, including housing, employment problems and economic stress.
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The information provided by Rainbow Access Initiative, Inc. is for educational purposes only and is not intended to render medical advice or professional services. The information should not be used for diagnosing or treating a health problem or a disease and is not a substitute for professional care. If you have or suspect you may have a health problem, consult your healthcare provider.
Rainbow Access Initiative is a 501(c)3 tax-exempt organization.
These materials were produced through a grant from the New York State Department of Health.
You may not use them without the written permission of Rainbow Access Initiative, Inc.
Permission may be obtained by contacting the Director.
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