LGBTQ psychology

LGBTQ+ psychology is a field of psychology surrounding the lives of LGBTQ+ individuals, in particular the diverse range of psychological perspectives and experiences of these individuals. It covers different aspects such as identity development including the 'coming out' process, parenting and family practices and supports for LGBTQ+ individuals, as well as issues of prejudice and discrimination involving the LGBTQ+ community.[1][2][3]

Definition

LGBTQ+ psychology stands for Lesbian, Gay, Bisexual, Trans and Queer psychology. This list is not inclusive to all people within the community and the plus represents other identities not covered within the acronym. In the past this field was known as Lesbian and Gay psychology.[4] Now it also includes Bisexual and Transgender identities and behaviours. In addition, the "Q" stands for Queer which includes sexual identities and behaviours that go beyond traditional sex and gender labels, roles, and expectations.[5]

It is important to note that the word "queer" was historically a slur used towards people within the community. Those who identify as queer today have reclaimed this label as self-identification. However, due to the traditional use of the word, many people in the LGBTQ+ community continue to reject this label.[6]

The names for this field are different in different parts of the world. In the UK and USA, the acronym LGBTQ+ is widely used. The terms 'lesbian', 'gay', 'bisexual', 'trans' and 'queer' are not used all around the world and definitions vary.

Apart from the terms above, there are other words and phrases that are used to define sexuality and gender identity. These words and phrases typically come from western cultures. In contrast, in non-western cultures, the range of sexual and gender identities and practices are labelled and categorized using different languages, which naturally also involve different concepts compared to Western ones.

It is concerned with the study of LGBTQ+ individuals' sexuality – sexual identities and behaviours – thereby validating their unique identities and experiences. This research focus is affirmative for LGBTQ+ individuals, as it challenges prejudiced beliefs, attitudes, and discriminatory policies and practices towards the LGBTQ+ community.[3][7][8]

It also includes the study of heterosexuality – other-sex romantic attraction, preferences and behaviours, as well as heteronormativity – the traditional view of heterosexuality being the universal norm.[3][9] This line of research aims to understand heterosexuality from a psychological perspective, with the additional goal of challenging heterosexuality as the norm in the field of psychology and in society as a whole.[4][3]

The overall goal of LGBTQ+ psychology is to raise awareness of LGBTQ+ issues in scholarly work and psychological research. In raising this awareness, LGBTQ+ psychology aims to be one of the fields in which inclusive, non-heterosexist, non-genderist approaches are applied in psychological research and practice.[3] These approaches reject the notion that heterosexuality is the 'default' and acknowledge a spectrum of genders outside of the traditional binary, allowing for more inclusive and accurate research. In line with LGBTQ+ psychology being an inclusive field of study and practice, it welcomes scholars or professionals from any branch of psychology with an interest in LGBTQ+ research.

History
Alfred Kinsey.

Sexology

Sexology is a part of the historical foundation upon which LGBTQ+ psychology was built.[5] The work of early sexologists, in particular those who contributed to the establishment of sexology as a scientific field of sexuality and gender ambiguity, is highly relevant and seminal to the field of LGBTQ+ psychology.

As previously mentioned, sexology is a scientific field of study focusing on sexuality and gender identity. In the field of sexology, a broad classification spectrum known as inversion, is used to define homosexuality. On this spectrum, early sexologists included both 'same-sex sexuality' and 'cross-gender identification' as belonging to this all-inclusive category. More contemporary sexology researchers conceptualize and categorize sexuality and gender diversity separately. In terms of LGB sexualities, this would fall under sexual diversity. As for transsexuality, this would be placed under gender diversity.[3] Important figures in this field include Magnus Hirschfeld and Karl-Heinrich Ulrichs.

The historical emergence of 'gay affirmative' psychology

Gay affirmative psychology was first established in the 1970s. It was founded with the mission of 1) challenging the idea and view of homosexuality as a mental illness and 2) affirming the normal and healthy psychological functioning of homosexual individuals by dispelling beliefs and attitudes of homosexuality being associated with mental illness.[10]

Following this field's mission, most of the research conducted in this area has naturally looked at the pathologization of homosexuality. In relation to this, much attention has also been placed on heterosexual and cis-gender (i.e. non-trans) individuals' lived experiences.

By involving LGBTQ+ individuals, mainstream psychological research could be more inclusive. With this in mind, LGBTQ+ psychologists hold the firm belief that psychology can truly be called the 'psychology of people' if it includes an open-minded, accepting attitude towards examining individuals from all backgrounds and their diverse lived experiences.[3]

In the 1980s, the name gay affirmative psychology changed to Lesbian and Gay psychology to denote that this branch of psychology spanned both the lives and experiences of gay men and lesbian women.[11][3] Later on, additional terms were included in the name of this field. Variations of LGB, LGBT, LGBTQ+ or LGBTQIA+ are used to refer to the field of LGBTQ+ psychology.

Due to the variation in the terminology to define this field, it has led to significant discussion and debate regarding which term is the most inclusive of all individuals. Though there continues to be ongoing debate surrounding the terminology used to define the field of LGBTQ+ psychology, this in fact highlights the field's concern over the diversity in human sexuality and gender orientation. Further, the various letters within the LGBTQ+ acronym indicates the diversity and variation in the scope of research that is conducted within the field – namely the types of research questions and the types of methodological approaches used to address these questions.

Traditionally, LGBTQ+ psychology has largely focused on researching the experiences of gay men and lesbian women meeting the following criteria:[12]

  1. Young
  2. Caucasian
  3. Middle-class
  4. Healthy
  5. Residing in urban areas

The scope of research within the field of LGBTQ+ psychology has been somewhat lacking in breadth and diversity, neglecting the experiences of those who do not fit the stated criteria but rightly belong to the LGBTQ+ community.

Overall, LGBTQ+ psychology is a sub-discipline of psychology that incorporates multiple perspectives and approaches regarding the populations of study, topics of research, as well as the theories and methodologies that inform the ways in which this research is carried out.

The historical emergence of critical psychology

The emergence of the field of critical psychology has led to the establishment of LGBTQ+ divisions within several key professional psychological associations.

Firstly, within the American Psychological Association (APA), Division 44 is known as the Society for the Psychological Study of Lesbian, Gay, and Bisexual Issues. Secondly, within the Australian Psychological Society, there is a Gay and Lesbian Issues and Psychology Interest Group. Thirdly, within the British Psychological Society, there is a Psychology of Sexualities Section. Lastly, within the Canadian Psychological Association, there is a Section on Sexual Orientation.[4]

All the above divisions specializing in LGBTQ+ psychology research and research-related issues demonstrate the increasing recognition and status of LGBTQ+ psychology in major psychological organizations covering the English speaking world.

Mental health
See also: Mental health inequality

LGBTQ+ individuals experience a significant amount of stigma and discrimination at various stages of their lives. Often this stigmatization and discrimination persists throughout their lifetime. Specific acts of stigmatization and discrimination against LGBTQ+ individuals include physical and sexual harassment. Hate crimes are also included.[13] These negative experiences put LGBTQ+ individuals' physical and emotional well-being at risk. As a result of these experiences, LGBTQ+ individuals typically experience a higher frequency of mental health issues compared to those who do not belong to the LGBTQ+ population.[14][1]

The following list shows the different mental health issues that LGBTQ+ individuals may experience:

The list above is by no means complete or exhaustive, rather it shows the range and severity of the issues that LGBTQ+ individuals often experience. These issues usually result from a combination of negative experiences and a perpetual difficulty accepting their LGBTQ+ identity in an anti-LGBTQ+ society.[15]

Suicidal tendencies and suicide are serious issues for LGBTQ+ youth. Compared to their non-LGBTQ+ peers, LGBTQ+ youth typically engage in a higher rate (around 3 to 4 times higher) of attempted suicides. In school, LGBTQ+ youth have a higher likelihood of experiencing verbal and physical abuse due to their sexual orientation, gender identity and expression. LGBTQ+ youth quickly learn from these negative social experiences that they are more likely to receive negative judgment and treatment, and often rejection, from those around them. This becomes a vicious cycle in which LGBTQ+ youths' self-beliefs and self-perceptions are negatively reinforced by society. Evidently, the high rates of mental health issues among LGBTQ+ communities has been perpetuated, and continues to be so, by systemic prejudice and discrimination against LGBTQ+ individuals.[16]

Nevertheless, LGBTQ+ individuals do not necessarily experience the same types of prejudice or discrimination, nor do they respond in the same ways to prejudice or discrimination. What is common are the reasons leading to prejudice and discrimination. In the context of LGBTQ+-targeted prejudice and discrimination, it broadly relates to sexual orientation issues (e.g. LGB) or gender identity issues (e.g. transgender). Systemic prejudice and discrimination leads to LGBTQ individuals experiencing substantial amounts of stress on a long term basis. It also influences LGBTQ+ individuals to internally assimilate all the negativity they receive, emphasizing the differences they have with others. This, in turn, causes LGBTQ+ individuals to experience guilt and shame regarding their identity, feelings and actions.[17]

The 'coming out' process involving LGBTQ+ individuals can also create a lot of added pressure from family, peers and society. This process is about LGBTQ+ individuals openly proclaiming their sexual orientation and/or gender identity to others.[13] In addition, LGBTQ+ individuals also experience other negative outcomes, for example:

Sexual orientation and/or gender transition Internalized oppression of sexual orientation and/or gender identity

The main factors in promoting positive mental health for LGBTQ+ individuals are as follows:[18]

  • Presence of family and peer support[19]
  • Community-based[20] and workplace support
  • Understanding, appropriate and positive feedback provided during the coming out process
  • Defining, assessing and handling the social factors influencing LGBTQ+ individuals' health outcomes

LGBTQ+ identity development in youth

There is an increasing trend of LGBTQ+ youth coming out and openly embracing and establishing their sexual or gender identities to people around them. Since 2000 the average age of coming out was around 14. This age compared to the average age of 16 recorded between 1996 and 1998, and 20 during the 1970s, shows that LGBTQ+ youth are comfortably recognizing their sexual or gender identities at an earlier age. Based on the large aggregate of research on identity development, in particular sexuality and gender identity, it appears that young people have an awareness of their LGBTQ+ identity from an early age. This awareness can be observed starting in childhood, specifically the feeling of being different from their peers and having non-normative appearances, behaviours and interests.

During adolescence, there are gradual shifts in young people's attitudes and behaviours regarding themselves and others. At the beginning of adolescence, young people are more aware of, and concerned about how they and others present against gender and sexuality norms. In the middle of adolescence, young people tend to hold more biased, stereotypical attitudes and show more negative behaviours towards LGBTQ+ individuals and topics. It is clear that the early adolescence years make it easy for LGBTQ+ youth who have come out to have negative or unpleasant social experiences. These experiences could involve peers intentionally excluding them from friendship groups, peers engaging in persistent, harmful acts of bullying, and more.[21]

While there appears to be more and more LGBTQ+ youth coming out about their sexual and gender identities, there are also youth who do not come out and are against the idea of coming out. Thus far, psychological theory surrounding LGBTQ+ identity development suggests that individuals who do not come out, or are against the idea of coming out are either in denial about their identity or wish to come out but are unable to. Aside from the fact that LGBTQ+ youth are more vulnerable to experiencing negative social reactions and treatment as a result of coming out,[13] there may also be other reasons for this. Firstly, the higher visibility of diverse sexualities and gender identities could influence young people in becoming more reluctant towards concretely defining their sexuality and gender identity[22](Savin-Williams, 2005). Young people are turning away from these types of labels in opposition of social identity labels, demonstrating the importance of their sexuality and gender identity within their personal identity.[23] As well, LGBTQ+ individuals from ethnic and cultural minority groups often refrain from using sexual identity labels, which they see as westernized concepts that do not relate to them.[24]

Schools

Current data regarding LGBTQ+ families and their children show an increasing number of such families, as in the United States of America, and suggests that this number is continuously increasing.[25] Children of LGBTQ+ parents are at risk of being the targets of discrimination and violence against LGBTQ+ individuals in the education system.[26] Therefore, this is an important issue that must be addressed to ensure the physical and psychological well-being of children from LGBTQ+ families. Apart from children of LGBTQ+ families having negative school experiences, LGBTQ+ parents also face challenges with regards to anti-LGBTQ+ bias and related negative behaviours that are often a part of the school climate.[26]

Gay-Straight Alliance

LGBTQ+ parents can refer to the following strategies to facilitate a more safe, positive and welcoming experience in interacting with schools and school personnel: school choice, engagement, and advocacy. Many schools are not particularly inclusive of LGBTQ+ individuals, as anti-LGBTQ+ language is often used and cases of harassment and victimization with regards to sexual orientation or gender identity often occur. Therefore, parental choice of the school in which their child enrolls is crucial. As far as parents are able to select a school for their child, selecting a school that is inclusive of LGBTQ+ individuals is one way to ensure a more positive school experience for themselves and for their children. Parental engagement with schools in terms of volunteering and other forms of involvement, such as being on parent-teacher organizations, allows LGBTQ+ parents to be more involved in issues which may concern their child. Parents can access resources that provide information on how parents can facilitate dialogue and collaboration with teachers and schools, enabling them to become proactive advocates of their child's education and school experience.[27]

School-based interventions are also effective in improving the experiences of children from LGBTQ+ families. Typically, these interventions target school climate, in particular the aspects which pertain to homophobia and transphobia. Enforcing anti-bullying/harassment policies and laws in schools can protect students from LGBTQ+ families from being victims of bullying and harassment. Having these policies in place generally allows students to have fewer negative experiences in school, such as a lower likelihood of mistreatment by teachers and other students. Implementing professional development opportunities for school staff on how to provide appropriate support for students from LGBTQ+ families will not only facilitate a more positive school experience for students, but will in turn, lead to a more positive school climate in general. Using an LGBTQ+-inclusive curriculum where LGBTQ+ individuals, history and events are portrayed in a more positive manner allows students to become more aware and more accepting of LGBTQ+-related issues. Specific ways in which LGBTQ+ matters can be incorporated into the curriculum include: talking about diverse families (e.g. same-sex couples and LGBTQ+ parents), discussing LGBTQ+ history (e.g. talking about significant historical events and movements related to the LGBTQ+ community), using LGBTQ+-inclusive texts in class and celebrating LGBTQ+ events (e.g. LGBTQ+ History Month in October or LGBTQ+ Pride Month in June).

Further, organizing LGBTQ+ student clubs (e.g. Gay-Straight Alliances) are a positive resource and source of support for students from LGBTQ+ families.[28] Studies conducted on Gay-Straight Alliance (GSA) clubs have repeatedly shown a reduction in hopelessness of LGBTQ+ individuals who were victimized for their sexual orientation and helps decrease the risk of suicide attempts or ideation.[29][30][31] With their inclusion of heterosexual youth, GSAs help foster a safe school environment for LGBTQ+ individuals by decreasing victimization and fear for safety.[32] In addition to GSAs, schools that adopt safe school programs such as safe zones, diversity trainings, ally trainings, or implementation of antidiscrimination and antiharassment policies reduce bullying and facilitate a safer school environment.[33]

Types of applications outside the theoretical perspective

Expressive writing

Research has found that writing about traumatic or negative experiences (known as "expressive writing") can be an effective way to reduce psychological stress that stem from such events. When youth engaged in expressive writing on issues related to their LGBTQ+ identity, their mental health well-being improved. This improvement was especially significant in youth who did not have much social support, or who wrote about more serious topics,[34] as well as in individuals who were less open about their sexualities or had not come out.[35] Expressive writing interventions have been shown to produce positive emotional outcomes for a variety of issues, including illness, childhood trauma, and relationship stress.[35] Writing therapy is the use of expressive writing along with other methods in a therapy setting.

Cognitive-behavioural therapy (CBT) – Effective Skills to Empower Effective Men (ESTEEM)

Cognitive-behavioural therapy focuses on changing thoughts and feelings that lead to negative behaviours, into more positive thoughts, feelings and behaviours. This treatment method is effective for a variety of mental health issues, including those related to LGBTQ+ identities.[36] CBT can help reduce depression and anxiety and promote healthy coping mechanisms within LGBTQ+ youth.[37] The ESTEEM program targeted stress-related thoughts and feelings that result from LGBTQ+ discrimination and stigma. Individuals who participated in the ESTEEM program experienced fewer depression-related thoughts and feelings and they also consumed less alcohol.[38][39][37]

Parent and family-based LGBTQ+ treatment and education

Family-based treatment catering to suicidal LGBT adolescents where parents were given significant periods of time to process their feelings about and towards their child was found to be effective. For example, parents had time to think through how they felt about their child's LGBTQ+ orientation, and be made aware of how their responses towards their child could potentially reflect attitudes of devaluation. Adolescents that took part in this treatment had fewer suicidal thoughts and fewer depression-related thoughts and feelings. What is especially noteworthy is that these positive gains were sustained for many youth.[40][41]

Noneffective Treatment methods

Conversion therapy (CT)

Conversion therapy focuses on altering homosexual and/or transgender individuals to heterosexual and cis-gender identities. Conversion therapy consists of a variety of approaches ranging from aversion and hormonal therapy, to religious-based techniques such as threats of eternal damnation or use of prayer. Little empirical evidence exists for CT, as most evidence is anecdotal or lacks acknowledgement of participants potentially faking or experiencing dissonance-induced rationalization. Long-term effects of CT, such as decreased overall sex drive, shame, fear, low self-esteem, and increased depression and anxiety have been observed in individuals that participated in CT programs.[42]

See also

References
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