SOCIAL WORK

PRACTICE WITH GAY

MEN, LESBIAN
WOMEN, AND
BISEXUAL
INDIVIDUALS
 Sexual orientation is defined as “whom we are
sexually attracted to and also have the potential for
loving.”
 In Western society, any sexual preference other than
heterosexuality, attraction toward someone of the
opposite sex, is typically frowned upon as a socially
unacceptable sexual orientation.
 The belief that all people are heterosexual is common
and this myth is often reinforced by the media, laws,
advertising, sex education and by health and mental
health professionals
 In American society, heterosexual behavior is
considered to be the norm against which all other
sexual orientations are compared.
 Bisexuality, having sexual preferences toward both
sexes, and homosexuality, having sexual preferences
toward members of the same sex, are considered by
many Americans to be unacceptable forms of
affectionate attraction
 Homosexuals, particularly males, are often referred to
as gays.
 Female homosexuals are generally referred to as
lesbians.
 The word lesbian is derived by the Greek poet,
Sappho who lived on the island of Lesbos. Although
Sappho was married and had a child, she often wrote
love poetry about other women, and her lesbian
feelings were the focus of her life.
 The terms gay males and lesbians are the
preferred way to address male and female
homosexuals. Gay activists prefer these terms
because they believe that the term homosexual
emphasizes the sexual aspects of the life-style,
and homosexuality has often been used as a
derogatory label, negatively ingrained into
society
 Although heterosexuality is considered the norm, the
incidence of homosexuality has occurred across all
times and cultures and involves a significant percent
of the total population.
 Most researchers agree that the incidence of
homosexuality is higher among males than females
 Research has shown also that bisexuality is almost as
common as exclusive homosexuality.
 Homosexuality is found universally and is practiced
by some individual in all societies at all times.
 Cross-Cultural Perspectives
 In the United States, homophobia is prominent;
however, this is not the case in other societies.
 In Melanesia, an area of the southwest Pacific,
homosexual behavior is a necessary part of the
entrance into male adulthood. They believe that if a
carefully selected older male gives semen to a
younger male, either orally or anally, it will
strengthen the younger male. It is also believed that
this period of homosexual intercourse serves to
increase the preparedness of the young male for
upcoming heterosexual relationships.
 Throughout history some societies have accepted and
documented homosexuality, but only for the rich.
 In ancient Chinese literature, homosexuality was viewed as
acceptable for royalty.
 During the feudal period in Japan, male homosexual love was
considered more “manly” than heterosexual love. Men visited
teahouses which employed male geishas. These facilities
decreased by the end of WWII because of the influence of
Western culture and the occupational invasion of American
forces into the country.
 Oppression and Homosexuality
 Gay males and lesbians have often been the
targets of overt and covert prejudice and
discrimination.
 In Medieval and early modern history, gay
men and lesbians were declared heretics and
burned at the stake. The word faggot, which
means a bundle of kindling, became another
term for gay males because they were used as
human stakes in the burning of witches.
 In Nazi camps, all minority prisoners were labeled
with patches which corresponded to their “crime”
(e.g. Jews wore a yellow star, Jehovah’s Witnesses
wore a purple triangle, and gay men wore a pink
triangle).
 Gay men were used in dress rehearsals for the mass
executions of the Jews. They were viewed as
detriments to the supremacy of the German race and,
therefore they had to be eliminated.
 Lesbians did not wear the pink triangle, as their
existence was not recognized by the state.
 Myths and Stereotypes
There are many myths and stereotypes about gay
men and lesbians which continue to create
prejudice and discrimination toward these
individuals. Some of the most common and the
most destructive include the following:
 1. All gay men are effeminate and all
lesbians are masculine or “butch.”

Apart from a small number of cases, it is

impossible to determine a person’s sexual
orientation from their appearance, mannerism,
interest, or job.
 2. Homosexual couples play heterosexual roles in
their relationships, sexual or otherwise.

This refers to the belief that one of the partners always

assumes the dominant or male role in the relationship,
while the other partner assumes the passive or female
role. This type of role playing is more common among
older couples.

Research does not support that such role playing is

typical.
 3. Most male homosexuals are child
molesters, and gay men and lesbians are
constantly trying to recruit others into their
life-style, especially children.

Most child molesters are heterosexuals and are

usually male heterosexuals molesting young
girls. Adolescents who are initiated into
homosexual activity are more often persuaded by
another teenager, not by an adult.
 4. Homosexuals dislike members of the
opposite sex, and all a lesbian really needs is
a “good man who can show her a good time.”

Most gay males are not woman-haters and most

lesbians are not man-haters. Many
predominately gay males and lesbians engage
in heterosexual activities.
 5. All gay men have AIDS.

While disproportionately higher numbers of gay

men are represented among those with AIDS, the
fastest growing group with HIV are heterosexuals
( largely African-Americans and Latinos).
The reported cases of AIDS among lesbians remain
rare.
 6. Homosexuals choose this lifestyle and orientation and
they could change if they wanted to.

At this point in time, no single factor has emerged from the

research as to what causes a homosexual orientation or any
other sexual orientation. No support has been found for
explanations of homosexuality which emphasize parental
relationships (e.g. absent father or domineering mother),
early unpleasant heterosexual experiences, or a child’s
seduction by a same-sex adult.
Perhaps the only element of choice is whether or not to act on
these preferences
 Homosexuality and Religion
 Often, religion has been a block for many non-
heterosexual individuals. In the Bible several
texts have been quoted as condemnations of
homosexuality. The texts that are usually
referred to are: Leviticus 18:12, Genesis 9,
Corinthians 6:9, and Timothy 1:10.
 I Corinthians 6:9

Do you not know that the unrighteous will not

inherit the kingdom of God? Do not be
deceived. Neither fornicators, nor idolaters,
nor adulterers, nor homosexuals, nor
sodomites…
Timothy 1:10
…for fornicators, for sodomites, for kidnappers,
for liar, for perjurers, and if there is any other
thing that is contrary to sound doctrine…
 The Medical Model
 In the 20th century, the idea that homosexuality was a sin was
replaced with the medical model and the notion that it was an
illness or sickness that needed to the treated.
 For years the inclusion of homosexuality in the American
Psychiatric Association’s (APA) Diagnostic and Statistical
Manuel (DSM) was used to support treatment of homosexuality as
a disease and mental illness.
 On December 15, 1973, a landmark treatment event occurred
when the APA’s board of trustees voted to remove homosexuality
as a psychiatric disorder from the DSM.
 The rationale for excluding homosexuality as a mental illness was
that the definition of a mental disorder had not been met; no
evidence of social impairment or emotional distress was found.
 Legal Implications
 Although homosexuality and bisexuality are not directly
outlawed per se, some of the behaviors and processes held in
common, such as sexual behaviors other than heterosexual
intercourse, including oral or anal sex, are illegal in many
states.
 These laws, known as sodomy laws, also apply to
heterosexual couples; however, in regard to heterosexuals,
these laws are less likely to be enforced. Cases of acts of
sodomy involving two male adults have been brought to court
 Changes in the laws have occurred over the years, and as of
1990, 26 states and the District of Columbia had
decriminalized consensual homosexual activity.
 According to the Associated Press, sodomy laws
remained on the books in 13 states as of the middle of
2003. "Sodomy" is illegal for everyone -- gay and
straight -- in Alabama, Florida, Idaho, Louisiana,
Mississippi, North Carolina, South Carolina, Utah
and Virginia. In addition, four connecting states,
Kansas, Missouri, Oklahoma and Texas, criminalized
certain forms of private, consensual sexual behavior
between persons of the same gender, but permitted
them if performed by a man and woman.
 Coming out in America
 At the start of 1960, homosexuality was referred to as primarily a private
affair. This decade was marked by numerous political movements,
reflecting support for non-establishment themes. In this atmosphere, the
“sexual liberation movement” became a popular cause.
 As part of the nation’s desire for sexual political liberation, gay
liberation became visible.
 A critical incident occurred in Greenwich Village, New York in June,
1969. A gay bar called the Stone Wall Inn was invaded by police. The
gay consumers of the club became angered by what they believed was
unprovoked harassment. The consumers fought police for several night,
refusing to close the bar. This incident, generally referred to as
Stonewall, has been noted as the beginning of the awakening of gays
into personal and sexual liberation.
 After this rebellion, homosexual individuals began to openly express
their non-heterosexual preference or “closet existence” and the term
“coming out” was coined.
 Practice Issues
 Because a person has a non-heterosexual
orientation doesn’t necessarily mean that the
difficulties for which they are seeking help are
related to sexual orientation (not a gay
problem)
 Nonjudgmental assessments can assist in
targeting the exact nature of the client’s
concerns
 One practice concern that may be unique to
gay male and lesbian clients is the personal
and social acceptance involved in admitting to
oneself and/or others that a sexual attraction
toward the same sex exists.
 Although this identity confusion often occurs
in adolescence or early adulthood, it can occur
at any age.
 Anti-homosexual messages denouncing this type of behavior
almost always come from parents, peers, and the community.
The choice to accept this stigmatized role can be a difficult one.
 Just as homophobia may be manifest in those who surround the
non –heterosexual, it can also be internalized by the individual.
In internalized homophobia, gay males or lesbians can begin to
hate or resent themselves, feeling inferior to their heterosexual
friend. They may become frightened of what they feel and
become unsure of how they can fit. These feelings can cause
confusion and may result in their denying, hiding, or justifying
their non-heterosexual preferences.
 In extreme cases, some of these conflicted individuals commit
suicide.
 For therapy to be effective with these individuals, a
task-centered approach should be used. In this
approach, the individual must accomplish certain tasks
such as learning how to manage information about self
and deriving support from peers, all to gain self-
acceptance.
 In discovering and accepting the self, many individuals
pass through a militant phase characterized by a need
to assert their homosexuality. This phase is considered
normal and should not be viewed as pathological.
 The second practice issue concerns family structure
and patterns. The factors that keep heterosexual
couples together do not always apply to non-
heterosexual couples. For example, non-heterosexual
couples tend to be less monogamous.
 Also, non-heterosexuals tend to be financially
independent, removing the need to remain in
relationships for financial reasons.
 Maintaining a relationship for the sake of the children
is rarely an issue.
 The third practice issue deals with the sexual practice of
non-heterosexual couples. Gay males or lesbian couples
may be aware of more sexual variations than the
therapist treating them. Practitioners must examine their
own feelings in regard to these practices and educate
themselves regarding the various forms of sexual
expression prominent in the non-heterosexual repertoire.
 The role of the therapist is to aid these couples in
choosing and deciding what practices are best for them,
in a well-informed, nonjudgmental, supportive
atmosphere.