ALGBTIC

LGBTQ People and the holiday season

The holiday season is here, and many LGBTQIQA people will be making plans for how they will navigate the various holidays that they choose to celebrate. This time of year can be one filled with warmth, connection, joy, and a little relaxation, or it can be a stressful time, filled with loneliness, regret, hurt feelings, anger, or sadness. For LGBTQIQA people, the holiday season is often dictated by the lived experience of being LGBTQIQA. Now is a more important time than ever for our Allies and community to support the LGBTQIQA people in their lives, whether to join in celebrations or to reach out with a supportive gesture.

I wanted to take a moment to remind you of some of the issues that many LGBTQIQA people will face this holiday season. The ongoing process of coming out is of particular focus for the lives of LGBTQIQA individuals. Some individuals have come out to their families and/or loved ones and have been rejected, disowned, or had their relationships damaged as a result. For those who have experienced this, the holidays can be particularly painful and lonely. For those who have come out and received some level of acceptance from their families/loved ones, they may face issues such as bringing a partner home for the holidays for the first time, having family respond to physical changes of a transition, or navigating fragile relationships with different family members/loved ones present. Some LGBTQIQA individuals may be out to a few supportive family members and not to others, making it difficult to be oneself in the presence of these different kinds of relationships. Others have come out only to have this information subsequently ignored (and thus they may have to go through the process a second time). Some who are out to their families and loved ones may have partners who are not out, and these differences in outness can create conflict or just make the holidays more difficult to navigate. For those who have not come out, the strain of hiding their identities through the holiday season (where families often try to catch up on what is going on in each other's lives) can lead to additional stress and feelings of being misunderstood and alone.

A common theme for the holidays for a lot of people is loss. When we have lost family members or friends, the holidays can be a particularly challenging. If those losses are obscured by issues related to our LGBTQ identity (loss of a partner that our family or friends are not aware of or if we were never able to come out to someone before we lose them), suffering in silence alongside others who do not understand our experiences can make the holidays even more difficult. If we have lost members in our community (particularly from suicide or murder), the holidays may remind us of the hardships we experience as LGBTQ individuals. Whether losses occurred on/near the holiday or if the loss was someone we used to spend time with during this season, the holidays can be a time of particularly painful grieving.

Additionally, if homophobic, biphobic, or transphobic remarks are used through the holidays in the presence of LGBTQ individuals, it can cause further hurt and strain relationships. It can also remind us of the ways we have been rejected in our lives. If someone already experiences seasonal depression or other mental health concerns, any of these additional stressors over the holidays can really add up.

These issues are just some of the more common themes that come up for LGBTQ people at this time of year. As with anything, having supportive members of our community and our chosen families to provide that extra bit of support this time of year can be particularly important. It is also a season that reminds us to give thanks for the good that has been a part of our journeys as well. As ALGBTIC President, I want to take a moment to thank the members of our communities, and especially our Allies, for all that they do. Your support is imperative to our lives, and we will never be able to express this appreciation enough. This is a good time of year for giving as well, so I urge you to consider supporting your favorite local or national/international organizations that promote the rights and dignity of LGBTQ individuals around the globe.

No matter what holiday you and yours celebrate, I wish you the love and acceptance you deserve. A student who works at a local community agency recently talked about a concept used at her internship site called "creating a new normal", from the work of Sylvia Coleman. It describes the process we go through when we let go of things in our lives that are not working for us and take on new behaviors. These new behaviors constitute the "new normal". While what was "normal" to us before may have been unhealthy or harmful to us, this idea reminds us that we can start over, make new traditions, be different in the world, and that we can reclaim these new beginnings as our center any time we like. So my wish for everyone for this holiday season is that if you have struggled through the holidays in the past, that you are able to create a new center for yourself, that you are able to heal from past hurts, and that your new normal can be marked by acceptance, cheer, goodwill, peace, and love. For our communities, my wish is that we are able to create a "new normal" in our world that includes LGBTQIQA lived experiences and identities and celebrate each for the important differences we hold.

Amney Harper, Ph.D.
President, Association of LGBT Issues in Counseling

Transgender Committee Response to DSM V proposed Gender Dysphoria diagnosis

Upon reviewing the proposed DSM V Gender Dysphoria diagnosis, the Transgender Committee for the Association of LGBT Issues in Counseling (a division of the American Counseling Association) has determined our position. We will be focusing on diagnosis in adults as the Committee has less experience regarding issues affecting transgender youth.

We realize that some progress has been made. To illustrate, the Committee appreciates that the diagnosis is no longer listed with Sexual Disorders, as we believe that this will support practitioner clarity in the diagnostic process, and prevent confusion with the etymology of gender dysphoria. The removal of the term "disorder" is similarly a positive direction, and we commend this decision. Additionally, the removal of the Sexuality specifier lends greater clarity to the relatedness of sex and gender without conflating either. We also appreciate the Dimensional Assessments for assessing severity.

In addition to the strengths we noted, we have identified some opportunities that we believe bear consideration for improving the diagnostic process, as well as the diagnosis itself. The assessment questions need to be clearer for a non-mental health professional audience, as it is likely that practitioners will choose to use this as an instrument in diagnostic assistance. The terms "primary and secondary sex characteristics" could be clarified by identifying examples of bodily features to which these refer. Transgender persons often do extensive research in self-exploration, and it would be helpful for them, as well, to be able to clearly understand all of the questions in this very valuable section. It is important for transpeople to be empowered consumers of mental health services given that the particular type of treatment depends on diagnosis. For example, gender queer individuals who may not wish to change secondary sex characteristics may not receive the diagnosis of Gender Dysphoria.

The label "gender dysphoria" is one that we find problematic in that the term itself suggests that that the person's gender is a source of disturbance. We have seen significant blocks to transgender social mobility created by intolerant and transphobic cultures, and would wish to see these elements used in naming the diagnosis, itself. Many cultures revere or at least do not pathologize transgender experiences: the Hijira of India and Pakistan, the Kathoeys (or "ladyboys") of Thailand, Two-Spirit individuals (Winkte of Lakota), Mashoga of Swahili-speaking areas of the Kenyan coast, and the Waria of Indonesia are examples. The fact that United States cultures, rooted as we are in Eurocentric medical norms, do not recognize gender in more flexible and non-pathologizing terms does not legitimize the APA's collusion with transphobia in naming transgender persons as "dysphoric."

Moreover, the new criteria includes, "a significantly increased risk of suffering death, pain, disability, or an important loss of freedom" (Diagnostic and Statistical Manual of Mental Disorders Proposed Revision (5th ed., DSM-5, in process.) Firstly, the overall body of literature regarding mental health problems is inconclusive. As well, we believe that transgender people should not be pathologized for distress caused by actions of others such as bullying and more severe forms of transphobia. We believe that for most transpeople, transphobia itself is linked to mental health conditions, not their gender identity. The research provides supporting evidence as documented by the National Transgender Discrimination Survey (NCTE & NGLTF, 2009). The minority stress literature (e.g., Meyer, 2003, Waldo 1999) has shown that prejudice and stigma has been linked to increased levels of mental health problems in sexual minorities. A more recent study (Kelleher, 2009) revealed similar findings among LGBT youth.

Though there has been some societal progress regarding acceptance of transgender people and increased visibility through the media, transgender people continue to experience severe discrimination and prejudice. As documented by the National Transgender Discrimination Survey (NCTE & NGLTF, 2009), fifty-three percent (53%) of respondents reported being verbally harassed or disrespected in a place of public accommodation, half were discriminated at work, and just over 25 percent lost a job because of their transgender identity.

Lastly, the Committee does not believe that the post-transition specifier be included. According to the DSM revision proposal itself, people do not have gender dysphoria following transition and therefore should not be diagnosed with this condition.

Sean Moundas, Psy.D.

ALGBTIC Competencies Update

An Update on the ALGBTIC Competencies for Counseling with Lesbian, Gay, Bisexual, Queer, Questioning, Intersex and Ally Individuals

Authors of the Competencies for Counseling LGBQQIA Individuals/ALGBTIC LGBQQIA Competencies Taskforce Members: Amney Harper (co-chair), Pete Finnerty (co-chair), Margarita Martinez, Amanda Brace, Hugh Crethar, Bob Loos, Brandon Harper, Stephanie Graham, Anneliese Singh, Michael Kocet, Linda Travis, and Serena Lambert

The LGBQIQA (Lesbian, Gay, Bisexual, Queer, Intersex, Questioning and Ally) Competencies Taskforce of the Association for LGBT issues in Counseling (ALGBTIC) has been developing an updated set of competencies to use in professional counseling practice, research and training with LGBQIQA clients.  This taskforce has been working diligently on these competencies for the past two years.  The taskforce was originally convened under the direction of Michael Kocet, previous ALGBTIC President, and continued during Past-President Mike Chaney’s term in the last year.  We are excited to report that our work is coming to completion, and we hope to see the competencies in front of the ALGBTIC Board for approval in the next few months.

The goal of this set of competencies was to develop a series of best practice standards and aspirational goals to use in professional counseling practice, research and training with LGBQIQA clients. Using the eight domains of the Council for Accreditation of Counseling and Related Educational programs, current theoretical and empirical literature on counseling with LGBQQ individuals, members of the team constructed core areas for competencies in the various domains, received feedback from the team as a whole, and then used that feedback to construct competencies that addressed various facets of these core areas. The entire team processed each domain individually and feedback was processed by all members of the team. For two new areas added to this set of competencies, Intersex and Ally, the team sought to create separate sections to address the differing needs of these populations. Each area was similarly reviewed by all members of the taskforce.

Currently, the competencies are undergoing outside review by professionals in the field who have expertise with issues pertaining to LGBQIQA individuals.  Once this is complete, the taskforce will integrate the feedback received into the competencies, and it will then go to the ALGBTIC board for approval.  Once approved, this set of competencies will replace the Competencies for Counseling Gay, Lesbian, Bisexual and Transgendered (LGBT) Clients that is currently available on the ALGBTIC Website.  The taskforce has utilized the Competencies for Counseling Transgender Clients as a model for our work, and we are excited to add the level of depth found in those competencies in the set we are developing.  It is our belief that this work is ever-evolving, and it is important to continue to review and update these competencies periodically in order to maintain best practices in working with this population.  We are excited to see how these competencies will aid practitioners in evolving their work and understanding of working with LGBQIQA Clients.

Amney Harper, Ph.D.
Association of LGBT Issues in Counseling President