SEXUAL ORIENTATION MICROAGGRESSIONS: THE EXPERIENCE OF LESBIAN, GAY, BISEXUAL AND QUEER CLIENTS IN PSYCHOTHERAPY by KIMBER LEIGH SHELTON (Under the Direction of Edward Delgado-Romero) ABSTRACT Existing literature repeatedly illuminates the detrimental effects homophobia and heterosexism have on lesbian, gay, and bisexual (LGB) clients and the psychotherapeutic relationship. There is a growing body of literature that discusses the negative effects microaggressions, subtle, often innocuous messages that communicate a denigrating message to an attended target (Constantine, 2007; Pierce, et al., 1978; Sue, et al., 2007b), have on the therapeutic environment. However, research literature fails to discuss the effects subtle forms of discrimination, specifically sexual orientation microaggressions, have on LGB and queer (Q) clients and the therapeutic relationship; nor is there an established typology of microaggressions directed towards LGBQ psychotherapy clients. The dearth of empirical research on sexual orientation microaggressions is problematic given the LGB community’s high utilization of mental health services, and the high probability that sexual minority clients are seen by heterosexual clinicians who most likely, consciously or unconsciously, hold some disparaging views for sexual minorities. The purpose of this study was to utilize a qualitative methodology to explore the phenomenon of sexual orientation microaggressions with 16 self-identified LGBQ psychotherapy clients. It was hypothesized that: (a) themes or a typology would emerge to represent sexual orientation microaggressions, (b) the presence of sexual orientation microaggressions within the individual therapeutic environment would have a negative impact on the therapeutic process, and (c) LGBQ individuals experience sexual orientation microaggressions in a variety of formats within the individual therapeutic environment. Results of this study validated the existence of sexual orientation microaggressions within the therapeutic environment and a typology of eight sexual orientation microaggression themes was constructed. Sexual orientation microaggressions had negative emotive, cognitive, and behavioral consequences for LGBQ clients, and detrimentally impacted the overall therapeutic process. Sexual orientation microaggressions also manifested in a variety of formats, including verbal, nonverbal and environmental transmission. This study extended the empirical research on microaggressions, and implications from this study can be used to advance clinical training and improve the quality of services provided to LGBQ clients. INDEX WORDS: Microaggressions, sexual orientation, psychotherapy, counseling, gay, lesbian, bisexual, queer SEXUAL ORIENTATION MICROAGGRESSIONS: THE EXPERIENCE OF LESBIAN, GAY, BISEXUAL AND QUEER CLIENTS IN PSYCHOTHERAPY by KIMBER LEIGH SHELTON B.A., Roberts Wesleyan College, 2002 M.S., Niagara University, 2005 A Dissertation Submitted to the Graduate Faculty of The University of Georgia in Partial Fulfillment of the Requirements for the Degree DOCTOR OF PHILOSOPHY ATHENS, GEORGIA 2009 © 2009 Kimber Leigh Shelton All Rights Reserved SEXUAL ORIENTATION MICROAGGRESSIONS: THE EXPERIENCE OF LESBIAN, GAY, BISEXUAL AND QUEER CLIENTS IN PSYCHOTHERAPY by KIMBER LEIGH SHELTON Major Professor: Edward Delgado-Romero Committee: Linda Campbell Yvette Getch Rosemary Phelps Electronic Version Approved: Maureen Grasso Dean of the Graduate School The University of Georgia August 2009 iv DEDICATION I dedicate this dissertation to my family. Completing this dissertation and graduate school have not been solitary efforts. I would not be where I am today without the love and support you have all given me. My hope is that each one of you knows that this work is as much of a reflection of you as it is of me. As well as being supportive, I am grateful that you also made it so easy for me to forget about schoolwork. Thank you! v ACKNOWLEDGEMENTS I would like to express my gratitude to Dr. Edward Delgado-Romero who has been a wonderful mentor, supervisor, professor and friend. Looking back over the last four years, I cannot imagine what my doctoral experience would have been like without his involvement. He has been a better advisor than I could have ever wished for. Thank you for encouraging my research, pushing my growth in multiculturalism, and for helping me define who I am as a psychologist. In the future, I hope to provide leadership and support to African American women as Dr. Rosemary Phelps has provided to me. Not only did she provide me with opportunities to lead diversity-focused groups and classes, she provided me with guidance along the way. I am thankful for developing a relationship with her that both challenged me to grow and validated who I am as a woman and as a psychologist. Of course, our West Virginia connection immediately drew me to Dr. Linda Campbell, but my respect for the many hats she wears kept me invested in staying close to her. Somehow she balances supervising, teaching, CCPE, assessments and professional activities, yet always remains cool, calm, and collected. As my life becomes more hectic, I hope that some of her composed demeanor rubbed off on me. I would like to thank Dr. Yvette Getch for helping me improve my teaching skills and for her guidance in this dissertation. I am inspired by her dedication and expertise in disability issues and I hope that I demonstrate the same dedication to multiculturalism and diversity. vi I would like to send a special thank you to Dr. Anneliese Singh for her guidance in qualitative methodologies and for sharing some of her expertise in LGBT issues with me. Thank you to Dr. Corey Johnson who allowed me to work under the Safer Spaces grant, which began my structured research on LGBT issues. I must acknowledge my clinical supervisors at the Georgia State University Counseling and Testing Center who have showed an interest in my dissertation and my clinical development. Thank you Drs. Michelle Lyn, Yared Alemu and Alaycia Reid. I am also grateful that I can continue my commitment working with LGBQ individuals co-facilitating Sexual and Gender Diversity group with Dr. Rachel Kieran. I have been extremely fortunate to receive financial support for my dissertation from the University of Georgia’s Center for Research and Engagement in Diversity (RED) seed grant, and Graduate School and Alumni Association’s Diversity Research Scholarship Award. This dissertation would not have been possible without the support of the UGA LGBT Resource Center. Thank you to Dr. Michael Shutt for allowing me to co-facilitate the Rainbow Chat Gender group and to Jennifer Miracle for advertising my focus groups and for providing space for the focus groups. Finally, I must thank the group members of Gender Chat, the young man I met at the Augusta Youth Development Campus, and the individuals who participated in this research study. Being a well-intentioned and multiculturally-focused individual, it came as a shock (and horror) to discover the covert biases and heteronormative beliefs I unknowingly held for LGBQ individuals. I entered into my experiences working with LGBQ individuals thinking that I would somehow help LGBQ individuals be LGBQ, but I quickly realized that it was I who would be doing much of the learning. My overall goal from this work is to help seemingly well-informed clinicians, similar to myself, provide the best quality services possible to LGBQ individuals. vii TABLE OF CONTENTS Page ACKNOWLEDGEMENTS .............................................................................................................v LIST OF TABLES ......................................................................................................................... ix CHAPTER 1 INTRODUCTION .........................................................................................................1 Background and Context ...........................................................................................1 Purpose ......................................................................................................................7 Statement of the Problem ..........................................................................................8 General Hypotheses ...................................................................................................9 Delimitations ...........................................................................................................10 The Researcher ........................................................................................................11 Definitions and Operational Terms .........................................................................13 2 REVIEW OF RELATED RESEARCH .......................................................................19 Microaggressions .....................................................................................................19 Heterosexism and Homophobia within the Mental Health Professions ..................26 Current Study ..........................................................................................................53 3 Methods and Procedures ..............................................................................................59 Research Design ......................................................................................................59 Description of the Sample .......................................................................................62 Data Collection ........................................................................................................64