In June, the Bay Area came alive with vibrant examples of the diversity and visibility of the Gay, Lesbian, Bisexual, Transgendered, and Queer (GLBTQ) community. June, Gay Pride Month, which has also been offi cially declared “Gay Mental Health Awareness Month” by the San Francisco County Board of Supervisors, gives therapists an opportunity to learn more about the GLBTQ community, and thus be of more help to our clients. Whether you have clients who are exploring their sexuality, who already identify as gay (or whatever word they choose), or are friends or family members of someone who is GLBTQ, this is a good time to look at the clinical and community issues which affect many of our clients.

In working with GLBTQ clients, the inherent homophobia, gender bias and rigidity of the culture at large must be addressed. Many clients may feel an intense pressure to conform to models of life that intrinsically do not fit them. Their attempts to shape themselves to cultural norms can greatly disturb their self-esteem and relationships, both intimate and extended, as with family and friends. The client’s sexuality probably is not the issue, but their various coping mechanisms and adaptations to society may be. It is important to be sensitive to how easily differences can be seen as inferior or negative, by both ourselves and the individuals with whom we work. This awareness helps to maintain rapport and a positive therapeutic relationship.

GLBTQ clients present with the same issues in therapy as anyone else. Their issues may be accentuated by real or perceived homophobia. The developmental tasks over the life span are often negatively infl uenced by minority status. Low self-esteem, shame, guilt, anxiety or depression may mask sexual identity coping issues, so thoughtful questioning by the therapist may reveal the source of the client’s struggle. If you work with teenagers and young adults, you already know that identity issues are key. GLBTQ or questioning youth have higher rates of suicidality because of the potentially lethal mixture of teen angst and homophobia. Alcoholism and drug use must also be looked at in a homophobic context. Fortunately, the gay community has worked hard to support non-addictive behavior.

Coming out is a lifetime process as new people and situations arise. It can lead to family alienation and/or social isolation, although this is becoming less common. Creating families which are outside the “norm” brings up confl icting feelings around parenting and integrating into the community. Job stress may be heightened and career development may be affected. Health care access or discrimination can be problematic. Seniors may have an especially diffi cult time fi nding a place to feel accepted. Assessing for domestic violence is confounded by our notions of gender role conformity and compounded for our clients by even more guilt, shame and confusion.

Many issues that come up with any client are more challenging for a GLBTQ individual. Confl icting cultural norms, values and beliefs, race, ethnicity, class and disabilities have an additional element when layered over homophobia. Although the gay community still struggles with its own racism, there are numerous GLBTQ groups that identify primarily with minority groups that are a source of support. Many clients may have been brought up in oppressive religious environments and strive as adults to fi nd a more welcoming spiritual practice. Gays are embraced in various religious communities and have created their own institutions and traditions. Therapists should be mindful of all these issues to help clients heal and reintegrate their culture and/or spirituality into their sense of self.

You may work with family members or friends of GLBTQ individuals who face their own “coming out”. You can help clients struggling with their feelings about a GLBTQ loved one by normalizing the situation and reassuring them that their loved one is not sick or bad. Misconceptions about bisexuality and transgender issues abound, and fi nding appropriate, accurate information is crucial. Support and educational groups (see PFLAG, below) are immensely helpful, as research has shown that homophobia decreases when a person actually knows someone who is gay.

For your own professional development, you may want to seek out a gay colleague for consultation, or attend any number of public events or drop-in groups. Consider going to a LGBTQ event or fi nding a gay-focused newspaper such as Bay Area Reporter to increase your comfort level and to stay current on important community issues. Psychologists may want to refer to the December 2000 issue of American Psychologist for the Guidelines for Psychotherapy with Lesbian, Gay, and Bisexual clients http://www.apa. org/pi/lgbc/guidelines.html.

Gaylesta.org provides direct web links to a comprehensive directory of GLBTQ community resources.

Other resources/events for GLBTQ people or their families:
• The Pacific Center, E.B. GLBT Therapy Services, 510.548.8283 www.pacificcenter.org
• The Castro Street Fair, October 7, 2007, 11am-6pm, San Francisco
• The Lighthouse Community Center, Hayward,CA, www.lgbtlighthouse.com PRIDE Picnic, Aug.18, 2007
• Rainbow Center, Concord,CA, rainbowcc.org
• Our Family Coalition, a clearinghouse of information for families 415/981-1960, Ourfamily.org,
• LYRIC (Lavender Youth Recreation and Information Center) Youth Talk Line is 800/246-PRIDE;
• PFLAG (Parents, Family, Friends of Lesbians and Gays) meetings at 510/562-7692 (Oakland/East Bay), http://www.pflag.org

Gaylesta, the Gay, Lesbian, Bisexual, Transgender Psychotherapists Association of the Bay Area has 200 members and 150 participants in the Referral Service. We will be celebrating our 20th Anniversary next year as a professional, non-profi t group to address the diverse needs of our multidisciplinary members, who represent at least seven counties. Gaylesta, Inc. activities include educational programs, peer consultation groups, social events, a newsletter, a pre-licensed committee, and more. The Referral Service provides confi dential referrals and a widely-distributed directory. To obtain more information about Gaylesta, contact our business offi ce at 5245 College Ave. #713, Oakland, CA 94618, 510/433-9939, or www.gaylesta.org. Referral service inquiries: toll-free 888/869-4993.

• Gaylesta Open House Picnic for Psychotherapists, Sept. 23, 2007, 12 PM Sunday, in Tilden Park, at the Big Leaf Picnic site across from the old Pony Rides. EBCAMFT members you are welcome to come and bring partners, kids, and friends. This is a free event we provide the vittles, fi eld games, and volleyball. Bring a folding chair if you want, and think about participating in our auction/raffl e fundraiser with great therapist’s prizes for a worthy LGBTQ organization.