Counseling issues with gay and lesbian adolescents

Adolescence,  Winter, 1996  by Janet H. Fontaine,  Nancy L. Hammond

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In a culture already uncomfortable about adult sex and worried about adolescent sexual behavior, the idea of homosexual sex generates hostile and almost reflexive contempt. Society's abhorrence, and hence avoidance, of homosexuality is reflected in the dearth of articles in the professional literature of counseling and psychology. From 1978-1989, only 43 of 6,661 articles published in six major psychological journals addressed gay and lesbian issues (Buhrke, Ben-Ezra, Hurley, & Ruprecht, 1992). This omission is even more striking when reviewing literature on adolescent homosexuality. For example, from 1977 to 1993, only three articles on gay and lesbian adolescents were published in The School Counselor, the primary professional journal for a counseling group which has access to the entire population of adolescents. This neglect coupled with lack of coverage in counselor preparation programs (Buhrke, 1989; Bodnar & Fontaine, 1993; Graham, Rawlings, Halpern, & Hermes, 1984) essentially precludes professionals from receiving adequate preparation for ethical and competent counseling of gay, lesbian, and bisexual adolescents.

That the need for this training exists is well documented. Although the American Psychiatric Association depathologized homosexuality in 1973 by removing it from the Diagnostic and Statistical Manual list of psychological disorders, and the American Psychological Association acted similarly in 1975, psychologists have maintained resistance to this new perspective. A recent survey of psychologists found that nearly 30% of responding clinicians felt that treating homosexuality per se as pathological constituted ethical practice (Pope, Tabachnick, & Keith-Spiegel, 1987). A study of heterosexual bias in counselor trainees determined that 83% of participants assumed client heterosexuality when given ambiguous conditions (Glenn & Russell, 1986).

What do counselors need to know in order to work effectively with sexual minority adolescents? Pederson (1988) identifies a tripartite approach to diversity training which begins with awareness of the counselor's own attitudes and beliefs, moves into the acquisition of knowledge, and then toward the final stage of skill acquisition. Effective counseling with homosexually oriented youth or those questioning their sexual identity cannot happen if the provider has not first come to terms with his or her own feelings and attitudes about homosexuality. While not addressed in this article, we believe it is incumbent upon the professional to address this issue.

This articles goes beyond Zera's (1992) efforts to outline the developmental struggles of gay and lesbian adolescents. Stages of identity development are presented along with suggested intervention strategies. Also included is a perspective on the components of sexual orientation in order to guide the practitioner in assisting adolescents to more completely address the struggle of exploring and clarifying their sexual orientation.

Identity Development for Lesbian and Gay Adolescents

Like their heterosexual counterparts, gay and lesbian adolescents share the same physical, cognitive, psychological, and social tasks of development, many of which are unaffected by issues of sexual orientation. However, since one of the major psychological tasks of adolescence is that of identity formulation and consolidation, the gay, lesbian or bisexual adolescent faces myriad challenges that the heterosexual adolescent does not.

The various components of any individual's identity include the sense of who one is as a sexual being, i.e., a sexual identity. Several processes by which an adolescent clarifies and consolidates this particular sense of self are cohort comparisons, societal confirmation, and peer affirmation. Environmental systems such as school, family, neighborhood, and work setting assist in this process. For the adolescent struggling with a sense of undefined "differentness" regarding the focus of his or her sexual attractions, these typical avenues and resources for sexual identity clarification and healthy formation are frequently unavailable at best. More likely, however, they present a negative and stigmatizing backdrop against which the adolescent must explore feelings and thoughts about this highly personal and integral aspect of personal identity. In schools, it is commonplace for students to routinely apply the words "faggot," "gay," "dyke," or "queer" to anyone they dislike for any reason, highlighting the devaluing of anything associated with being gay. Nor can support be expected from family and friends since it is likely that they have expressed antagonistic attitudes toward homosexuality at some point in the past.

The cost of this stigmatization becomes all too apparent in statistics which reflect disproportionate frequencies of psychological disturbance among gay and lesbian teens. Runaways, substance abuse, depression, anxiety, suicide attempts, and prostitution have been evidenced by this group in higher proportions than by nonhomosexual youth (Jay & Young, 1979; Bell & Weinberg, 1978; Hetrick & Martin, 1987; Remafedi, 1987a). Gibson (1989), in a project funded by the U.S. Department of Health and Human Services, found that 30% of completed teen suicides were committed by youth dealing with sexual identity issues.