Treating the bisexual client

Accessing Counseling Services Where the Rainbow Doesn't Shine: A Heterosexism Audit Study

Through a field experiment set among licensed therapists (N = 425), we found nuanced evidence of heterosexist discrimination at the entry point of mental health services for a fictitious White, presumably gay man seeking counseling. We called therapists in LGB-affirming and LGB-hostile states and left voicemails requesting services. To manipulate perceived sexual orientation, a confederate using the name "Jon" recorded one of three conditions (a) heterosexual-presenting Jon, (b) gay-presenting Jon, and (c) gay-sounding Jon. Analyzes comparing the rate of returned calls for each condition within LGB-affirming versus LGB-hostile states against our referent group, gay-presenting Jon calling mental health professionals in an LGB-affirming region, revealed a number of significant effects. Notably, being perceived as gay in LGB-hostile states significantly decreased the rate of returned calls, with the reverse being true in an LGB-affirming state. The use of "gay-sounding" voice, however, did not appreciably affect these relationships.

Sexual Orientation Beliefs and Identity Development: A Person-Centered Analysis among Sexual Minorities

We conducted person-centered analysis of sexual orientation beliefs among sexual minorities to explore potential relationships between these beliefs and sexual orientation, developmental milestones, race and ethnicity, and attitudes about sexual orientation. We recruited participants (N = 416) via Amazon Mechanical Turk who completed measures of beliefs about sexual orientation and attitudes about their own sexuality, as well as assessments of mental health and age of sexual identity development milestones. We conducted a latent profile analysis and found three distinct sexual orientation belief profiles, similar to those previously observed in predominantly straight samples. We found that sexual orientation and race-ethnicity predicted belief profile membership, with the latter exhibiting the most substantial effect. Of the four identity developmental milestones tested, only the age of first same-sex attraction predicted belief profile membership. Across profiles, members differed significantly in their mean endorsement of both positive and negative attitudes regarding sexual orientation and psychological distress. Thus, the current research suggests that sexual orientation beliefs are powerful constructs in the lives of sexual minorities, with relationships to sexual orientation, other social identities, and mental health.

Heterosexual College Students Who Hookup with Same-Sex Partners

Individuals who identify as heterosexual but engage in same-sex sexual behavior fascinate both researchers and the media. We analyzed the Online College Social Life Survey dataset of over 24,000 undergraduate students to examine students whose last hookup was with a same-sex partner (N = 383 men and 312 women). The characteristics of a significant minority of these students (12% of men and 25% of women) who labelled their sexual orientation "heterosexual" differed from those who self-identified as "homosexual," "bisexual," or "uncertain." Differences among those who identified as heterosexual included more conservative attitudes, less prior homosexual and more prior heterosexual sexual experience, features of the hookups, and sentiments about the encounter after the fact. Latent class analysis revealed six distinctive "types" of heterosexually identified students whose last hookup was with a same-sex partner. Three types, comprising 60% of students, could be classified as mostly private sexual experimentation among those with little prior same-sex experience, including some who did not enjoy the encounter; the other two types in this group enjoyed the encounter, but differed on drunkenness and desire for a future relationship with their partner. Roughly, 12% could be classified as conforming to a "performative bisexuality" script of women publicly engaging in same-sex hookups at college parties, and the remaining 28% had strong religious practices and/or beliefs that may preclude a non-heterosexual identity, including 7% who exhibited "internalized heterosexism." Results indicate several distinctive motivations for a heterosexual identity among those who hooked up with same-sex partners; previous research focusing on selective "types" excludes many exhibiting this discordance.

Negative Attitudes Toward Same-Sex Behavior Inventory: An Internalized Homonegativity Measure for Research with Bisexual, Gay, and other Non-Gay Identified Men who have Sex with Men

Substantial evidence exists about the negative role of internalized homonegativity on the health and well-being of lesbian women and gay men. However, existing measures of internalized homonegativity assume a gay or lesbian sexual identity ("I wish I wasn't gay") and therefore may be inappropriate for non-gay identified individuals, including bisexual people. Therefore, we developed and tested the psychometric properties of the Negative Attitudes Towards Same-Sex Behavior Inventory (NATSBI) which was designed to assess one's negative attitudes towards their same-sex behavior, regardless of their self-identification. Using data from an ethnically-diverse sample of 203 non-gay identified behaviorally-bisexual men, we examined the factor structure, construct validity, and reliability of the NATSBI. A factor analysis of the NATSBI yielded three subscales: (1) personal homonegativity, (2) disclosure discomfort, and (3) privacy preference, with very good internal consistency reliability estimates for both subscales (α = .90, α = .89, and α = .84, respectively). The reliability was also strong within each of various demographic subgroups within the sample (e.g., race/ethnicity, age, sexual identity). The correlations of the NATSBI with various constructs (e.g., self-esteem, depression, emotional support) provided evidence of the concurrent (i.e., construct) validity of the NATSBI. These findings on the reliability and validity of the NATSBI suggest that it is possible to assess internalized homonegativity based on sexual behavior rather than assuming specific sexual identity labels. As such, we propose the NATSBI for use in studies that focus on bisexual and other non-gay-identified MSM, as well as studies that anticipate including non-gay-identified MSM.

Perinatal administration of aromatase inhibitors in rodents as animal models of human male homosexuality: similarities and differences

In this chapter we briefly review the evidence supporting the existence of biological influences on sexual orientation. We focus on basic research studies that have affected the estrogen synthesis during the critical periods of brain sexual differentiation in male rat offspring with the use of aromatase inhibitors, such as 1,4,6-androstatriene-3,17 (ATD) and letrozole. The results after prenatal and/or postnatal treatment with ATD reveal that these animals, when adults, show female sexual responses, such as lordosis or proceptive behaviors, but retain their ability to display male sexual activity with a receptive female. Interestingly, the preference and sexual behavior of these rats vary depending upon the circadian rhythm.Recently, we have established that the treatment with low doses of letrozole during the second half of pregnancy produces male rat offspring, that when adults spend more time in the company of a sexually active male than with a receptive female in a preference test. In addition, they display female sexual behavior when forced to interact with a sexually experienced male and some typical male sexual behavior when faced with a sexually receptive female. Interestingly, these males displayed both sexual behavior patterns spontaneously, i.e., in absence of exogenous steroid hormone treatment. Most of these features correspond with those found in human male homosexuals; however, the "bisexual" behavior shown by the letrozole-treated rats may be related to a particular human population. All these data, taken together, permit to propose letrozole prenatal treatment as a suitable animal model to study human male homosexuality and reinforce the hypothesis that human sexual orientation is underlied by changes in the endocrine milieu during early development.

Bisexual women’s understandings of social marginalisation: ‘The heterosexuals don’t understand us but nor do the lesbians’

Drawing on interviews with 20 self-identified bisexual women, this paper contributes to the limited psychological literature on bisexual women by exploring their experiences of social marginalisation. These (mainly white and middle class) British bisexual women reported that they did not feel at home in either lesbian or lesbian, gay, bisexual and transgender communities, nor in the wider (heteronormative) society. They identified a number of understandings – bisexuality as a temporary phase on the path to a fully realised lesbian or heterosexual identity and bisexuals as immature, confused, greedy, untrustworthy, highly sexual and incapable of monogamy – which they reported as arising from lesbian, gay, bisexual and transgender communities and the wider society. The women refuted these accounts which they stated did not reflect their experiences of bisexual identity and which positioned bisexuality as invisible and invalid.

Therapist qualities preferred by sexual-minority individuals

Psychotherapy research concerning lesbian, gay, and bisexual (LGB) individuals has focused on matching clients on gender and sexual orientation, yet has not considered how factors such as therapeutic skill, presenting problem, and cohort membership may influence preference for therapists. This study was designed to identify those therapist qualities that sexual-minority individuals prefer and to determine how the presenting problem influences therapist choice. Forty-two nonheterosexual adults between 18 and 29 years old ranked 63 therapist characteristics from "Extremely Uncharacteristic" to "Extremely Characteristic" when seeking treatment for a problem in which their sexual orientation was salient and one in which it was not. The analyses of both conditions yielded clusters of items reflecting therapist characteristics that participants considered unfavorable, neutral, beneficial, and essential. Participants valued therapists who had LGB-specific knowledge as well as general therapeutic skills, whereas they indicated that they would avoid therapists who held heterocentric views. Application of these findings to clinical practice and future directions are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Are Old Lesbian and Gay People Well Served?

The lesbian and gay population is largely invisible in the gerontological literature and in planning and provision of aging services. A recent survey of providers of aging services in a large midwestern metropolitan area provides insight into providers’ beliefs, preparation, and experience with serving old lesbian and gay people. Few agencies that participated in the study provided services targeted to this population, and some agencies were unwilling to consider their unique needs. Participating agencies generally recognized a need for greater knowledge and specific training in working with aging lesbian and gay people. Providers diverged over whether separate services should be established for the old lesbian and gay population. Providers consistently expressed values of care, inclusiveness, sensitivity, respect, and provision of service to everyone. The study results provide direction for future training and research with providers of aging services.

Motivational, ethical, and epistemological foundations in the treatment of unwanted homoerotic attraction

A recent special section of the Journal of Marital and Family Therapy (October, 2000) focusing on the mental health needs of gay, lesbian, and bisexual individuals neglected to address the clinical needs of homosexual persons who desire to increase their heterosexual potential. This article attempts to correct this omission by outlining common motivations for pursuing change, updating the current state of knowledge regarding the effectiveness of change efforts, and providing some ethical guidelines when therapists encounter clients who present with unwanted homoerotic attraction. Finally, to assist marriage and family therapists (MFTs) in more deeply understanding divergent perspectives about reorientation treatments, an examination of the role of moral epistemology is presented and some examples of its potential influence are described. MFTs are encouraged to recognize and accept, rather than ignore or deny the valid needs of clients who seek to modify their same-sex attraction.