;;;;;;;;;;;;;;;;;;;;;; Psychology 604 Ethics Paper heterosexist statement; one is rhetorically assuming that a particular male client has a girlfriend and that The Challenges he is heterosexual. A question like the one mentioned above can inhibit the culture-speciÞc experiences of and Approaches to LGBT clients (Garnets & Kimmel, 1993). Working with Lesbian, LGBT Challenges Adolescence is a time of crisis for LGBT youths Gay, Bisexual, and trying to develop his or her identity. Like a typical adolescent, LGBT youth strive for Þtting in with Transgender Youth their peers but feel ÔdifferentÕ due to their sexual Edward M. Johns orientation (Morrow, 1993) in a society that may not have acceptance. Abstract This ÒdifferenceÓ, according to Vare (1998), comes Psychologists working with adolescents are between the age of 13 and 26 when both males and bound to encounter many unique challenges females discover his or her same-sex attraction. regarding those of Lesbian, Gay, Bisexual and This age can be rather difÞcult because LGBT youth Transgendered (LGBT) youth that must be dealt not only have to deal with the same pressures that with careful considerations. As an ethical duty to the typical adolescent period pervades, but they understand and support LGBT youth, it is the purpose also have signiÞcantly higher stress levels living of this paper to explore (1) the different types of in a heterosexist society that harbors homophobia challenges that are encountered by LGBT youth such (Coleman, 1996; DÕAugelli, 2002). as stigmatization in a heterosexual society, and (2) the Homophobia, according to Lips (1988) is the techniques that can help mental health practitioners Òwidespread irrational fear and intolerance towards provide a safe and supportive environment, working homosexuality.Ó This intolerance is often displayed against stigmatization and oppression of the LGBT with verbal and physical homophobic gestures such population. as gay-bashing jokes, name calling, physical threats, and violence which can cause a hostile environment The LGBT population is an oppressed group with for LGBT youths. Subsequently, this can lead to a special needs that should be delineated with careful copious amount of problems in the LGBT youth consideration. According to APA (2002) ethics codes, which can escalate into numerous health difÞculties, psychologists are not supposed to engage in unfair deteriorating school performance, truancy, running discrimination based upon sexual orientation; such as away from home, substance abuse, consultation with denying people of their basic human rights. However, mental health professionals, juvenile prostitution, most discrimination that does occur to LGBT clients psychiatric hospitalization, coming out and are actions that therapist may be unaware of and is an disclosure, mental health, substance abuse, sexuality effect of heterosexism. and sexually transmitted diseases, harassment, According to Herek (1995), heterosexism is violence and even suicide (Crisp & McCave, 2007; deÞned as, Òthe ideological system that denies, Little, 2001; Vare, 1998). Because of the copious risks, denigrates, and stigmatizes any non-heterosexual it is important for practitioners to be aware of certain form of behavior, identity, relations or communityÓ. stigmatization, and to work towards allevating The discipline of psychology, in its most general sense, the stigmatization by providing a safe, unbiased is pervaded by this idea and by those in the practice, environment for LGBT youth in order to possibly whether by conscious or subconscious realization. decrease their potential health disparities. Psychologists who take a Òsexual-orientation- blindÓ perspective often do not see that his or her "Coming Out" and Disclosure heterosexist ideologies affect their therapeutic ÒComing outÓ is a term that is used when processes. If a practitioner were to ask one of their an LGBT individual acknowledges and accepts their male clients if he had a girlfriend, although it may sexual orientation. This Òcoming out,Óaccording to seem harmless, it can be viewed as an unintentional Mallon (2001), has a Þve-step development in which 27 LGBT youths explore their sexual orientation while LGBT youthÕs experiences of disclosing oneself, the weighing out the pros and cons. individual is a part his or her own dynamic social Stage one is the period of acknowledgement; network. As explained in steps two, three, and four, when the youth asks the question, ÒCould I be the teen explores the pros and cons of being LGBT: homosexual?Ó This is the step where the youth starts how their social groups will play into to them being to explore his or her feelings about being homosexual homosexual, the reaction from family, school, and whether or not they are consciously attracted to friends. If an individualÕs family is not accepting of members of the same sex. homosexuality it may cause the individual added Stage two of this Òcoming outÓ is when stress and guilt (Beaty, 1999), and the LGBT youth the individual thinks critically about his or her could potentially be kicked out of his or her house sexuality while considering the possibility of being because of the disclosure of their sexual orientation homosexual. This sexual orientation seeking is usually (Shelby, 1998). All of these scenarios are what youth accompanied with questions such as Òam I?Ó and must consider before deciding if they are going to ÒWhat happens if I am?Ó Òcome out.Ó It is a life changing growth that has In this stage of acknowledgement, there is also the potential of affecting their physical and mental denial. Some people, when questioning their sexuality, wellbeing, setting the precedence for the rest of their retract and choose to deny his or her feelings because life. of the homosexual social stigma. They themselves have often seen and compared themselves to people Mental Health who have Òcome outÓ, have been harassed, or have During the discovery of oneÕs sexual heard anti-gay slurs, which can make it a difÞcult orientation, LGBT youth are likely have an increased period for adolescents who are still uncomfortable. risk of mental health disparities, one of the most The third stage of Òcoming outÓ is when an prominent mental health problems being depression individual believes they are probably homosexual and suicidal ideation (Crisp & McCave, 2007; and at this point, have usually come to terms with DÕAugelli, 2002; Shelby, 1998; Vare, 1998). Other the social stigma of homosexuality, pushing through issues, such as being victimized at school, and being negative societal impressions of LGBT, such as the threatened physically and verbally, relates to the stereotype of being promiscuous, as well as their own. development of posttraumatic stress symptoms. At this stage, the youth is likely to engage in activities ItÕs estimated that over a third of all LGBT students such as dating people of the same sex and possibly that have had health problems have attempted to engaging in sexual intercourse. Because these teens as commit suicide, which, according to DÕAugelli et al still so vulnerable, these actions can be harmful. (2001), is signiÞcantly higher than that of the general Stage four is when an adolescent fully accepts his population; there are likely to be many more suicides or her sexual orientation and chooses this to be an and suicidal attempts that have not been recorded identifying factor in his or her life. During this time, (DÕAugelli, 2002). adolescents usually choose to disclose their sexual Substance Abuse orientation to others but it is also a stressful time for Research has shown that LGBT adolescents, adolescents because of the potential for rejection in addition to mental health problems, encounter from family and friends. During this time, teens increased risks of developing heavy substance abuse have generally gauged whether or not it would be problems due to the different harassments that they appropriate for them to disclose their information are subjected to (Crisp & McCave, 2007; Little, 2001; or not. For people who grew up in families where Vare, 1998). According to Shelby (1998), LGBT youths homosexuality is not accepted, they may not choose are 1.6 times more likely to report heavy substance to declare their sexual orientation. If not dealt with abuse to escape the emotional and physical pain that in an adaptive manner, this choice can result in they encounter and potentially develop substance psychological harm such as low self-esteem and problems later in life which include withdrawal and suicide. isolation from family, school, and friends (Little, 2001). The Þfth stage, a stage that generally is not accomplished until young adulthood is over, is fully Sexuality and Sexually Transmitted Diseases coming to terms with being LGBT. ÒIdentity crisisÓ no As many LGBT adolescences begin to explore longer becomes an issue and the person is now able, their sexuality, most are ill-informed about safe sexual if they choose, to focus on other important aspects of practices, many are disowned from their families and their life such as education, or on work. forced into sexual exploitation (Durby, 1994), risking Although the Þve stages listed above describe an contracting STDs including syphilis, gonorrhea, HIV, ���� chlamydia, and hepatitis B (Crisp & McCave, 2007). Knowledge In other cases, some LGBT, especially gay males, will Knowledge is a key element in providing try to Þt in by engaging in sexual intercourse with a culturally competent services to LGBT youths (Crisp female as