When I think of meeting new people for the first time, whether they are clients, colleagues or at a party there are basic questions that help us break the ice and get to know one another.  For example, what do you do for living; are you married; do you have children, where do you live, what did you do this weekend, have you seen any good movies; read any good books; what gym to you go to?  These seemingly innocent questions pose a real threat to the lesbian, gay bi-sexual, transgender and queer (LGBTQ) community.  The answers could imply they are gay thereby putting them in real danger.  In 2014, the National Coalition of Anti-Violence Programs received 1,359 incidents of hate violence from LGBTQ and HIV-affected survivors; and at least 20 LGBTQ individuals were murdered. Being known as a member of this community could be dangerous.    Each time they answer a question such as one of those, they will assess the situation for safety.  Can I trust this person?   If they don’t feel safe, they may lie to protect themselves; this could derail the therapeutic relationship.

When I talk with clinicians, they will share how challenging a client might be.  Or that it is taking longer than usual to get them to open up.   Much of this has roots in fear.  Working with the LBGTQ community could mean real danger that they could be outed and hurt?  My suggestion to my colleagues is do some professional self exploration to become aware of our own prejudices and stereotypes.  Be comfortable with one’s own background and an understanding of how that background, as well as one’s own life experiences, affect one’s worldview and perceptions of other groups.

Setting up a group or session that demonstrates how each person’s story will be respected and kept in confidence is essential for creating a safe space.  Asking in the initial meeting, what name would they like to be called, what pronoun would you prefer. Honoring the client and recognizing that you are looked upon to keep this person safe while in your office and everything you do and say should convey this. Empathy is shown not through trying to identify with the person’s experience but to hear and feel the pain in their story.  Comfort with modeling “not-knowing,” coupled with a commitment to continuous learning.  I will share two things I learned from my LGBTQ clients by humbling myself and encouraging them to teach me.  The first was I didn’t understand if a person was “out” why they are still guarded about being LGBTQ.  I learned they often have to come out several times a day.  Each time they walk out the door; at the grocery store, a new job, getting gas, etc.…..  It isn’t the same as coming out to family and friends but there is definitely vulnerability about being seen and known as LGBTQ to strangers just by the way they look.  The second crucial bit of information I learned from an LGBTQ family member; it was the difference between sexual orientation and gender.   I knew someone who was having sex reassignment surgery; going from her birth assignment, a woman to man (F to M).  It was explained that this was a gender issue, not a sexual orientation issue.  The person did not feel she was born in the right body and needed to live out her life as a man.  As a man, he was attracted to men.  So his sexual orientation is considered gay.  The question many heterosexuals ask, is why didn’t they just stay a woman if they like men?   Understanding the difference between gender and sexual preference clearly defines this.  Gender is the way we see and feel in our own bodies.  Sex is about what bodies we are attracted to.  One has nothing to do with the other.  Let me say that again, one has nothing to do with the other.

Vicki Dyar, MA, PCC Intern
The Cafferty Clinic
Under Supervision of Kansas Cafferty, LMFT

For an appointment with Vicki for individual, couples, or family psychotherapy please call True North Recovery Services at 760-517-6544