AS THE world marks World Mental Health Day, Identity Kenya’s Editor Denis Nzioka sat down with Susan Gitau a noted psychologist, addiction counselor and nurse to talk about the mental health state of LGBT Kenyans. Here is what she had to say.
Q: You have dealt with a lot of LGBT persons in your practice and in personal life. What, in your opinion makes people gay or lesbian?
There are different theories that attempt to explain homosexuality. They include biological, psychoanalytic, learning, interactional and sociological theories. None seems to be adequate and supported by empirical data. However, According to a research by Alan Bell, Martin Weinberg and Sue Hommer Smith of the Kinsey Institute (198, cited in Hyde & Delamater, 2000) sexual orientation seems to be determined before adolescence. It is also likely that there is a biological basis for homosexuality but this has not been adequately proved.
Generally most people believe that all people are heterosexual, that heterosexuality is the norm. There are therefore stereotypes about homosexuality and bisexuality. This stereotypes and negative attitudes lead to discrimination and hate crimes against gays and lesbians.
Q: Apart from stereotypes, what challenges do LGBT persons face generally?
There is a lot of Homophobia or antigay prejudices that influence people’s attitude towards LGBT persons. Homophobia often results in hate crimes against the LGBT. Gays and lesbians are a minority group. They thus suffer discrimination and may be denied certain job positions for which they are suitably qualified; they are also susceptible to being blackmailed. LGBT can hide their statuses, this way they are able to get along in the heterosexual world – to ‘pass’. However, this has the disadvantage of encouraging the person to live a lie and deny her or his true identity. This may be psychologically stressful. Some of the homosexuals may be heterosexually married, have children and be respected professionals in the community, spending only a few hours a month engaging in secret same gender sexual behaviour. This renders a person psychologically vulnerable.
Q: As a therapist, what his your course of action when dealing or treating someone with a non-heterosexual orientation or has a different gender identity?
Before beginning any treatment with a homosexual client, a therapist has the responsibility of making sure he or she is well versed on issues related to sexuality, has the skills necessary to create a positive and nonjudgmental environment, and will not feel uncomfortable discussing issues related to homosexuality. If a therapist believes homosexuality is wrong, sinful, immoral, or a mental illness, he or she should NOT work with gay clients. Refer this client to someone who is able to provide the necessary components of a therapeutic relationship.
If a therapist believes that a person can change his or her sexual orientation (often referred to as conversion, reparative, or reorientation therapy), it is only ethical to do adequate research on the topic before beginning such treatment. Understand that the American Psychiatric Association, The American Psychological Association, The American Academy of Paediatrics, and others have denounced this type of treatment due to the high incidences of negative outcomes and very low and even questionable success rates.
Also understand that while you can help a client change his or her behaviour, it is much more difficult, if not impossible, to change who they are. Think about convincing a straight male attracted to blonds that he must now be attracted only to red heads. He would likely respond, “But I like blonds, I can’t change that, it’s a part of who I am.”
Q: Are there any difficulties a therapist may have with dealing with an LGBT client? What about the client themselves; do they have an understanding of what they want or who they are?
When working with gays and lesbians, it is often important to know where your client is in terms of acceptance. If sexuality is a presenting issue, understanding the stages is even more important. Cass (1979) lists six stages that many homosexuals go through when dealing with their own sexual orientation. These stages have been widely accepted by professionals and gay men and women alike. They include:
(1) Identity Awareness. The point when the child or adolescent begins to realize he or she has feelings that are different from others and different from what they have been taught.
(2) Identity Comparison. The individual begins to explore his or her feelings alone and to compare them to the beliefs of society, parents, and peers.
(3) Identity Tolerance. During this stage, the individual will often rebel against his or her feelings and attempt to deny them. After all, nobody wants to be gay in a straight world.
(4) Identity Acceptance. After realizing that sexuality is a part of who they are, they begin to embrace it, explore their feelings and desires, and start to find a place in the world where they are accepted and belong.
(5) Identity Pride. Often involves anger toward parents, society, religion, or other aspects of the world that tells them that they are bad, wrong, immoral, or mentally ill merely because their feelings are directed toward the same sex. They embrace the ‘homosexual lifestyle’ and explore their newfound sexuality. It is during this stage that the gay or lesbian may start fighting against what society has taught them.
(6) Identity Synthesis. The final stage in which homosexuality becomes a part of who they are rather than the defining factor. Instead of being a gay man or lesbian, they begin to see themselves as parents, employees, leaders, teachers, supervisors, coaches, and volunteers who just happen to be gay. In the final stage, they are able to accept themselves more wholly rather than seeing their sexuality as separate from the rest of who they are.
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