Gay Lesbian Bisexual & Transgender

1. GayLesbian Bisexual & Transgender Issues for Substance Abuse Treatment

2. Agenda • Review Objectives • Introductions • Review of terms • Homophobia • Myths/Facts • Alcohol & Substance Abuse • “Coming Out Process • What we CAN do! • Wrap-up: Take aways, evaluations, certificates Created by Amy Shanahan, MS CASAC

3. Objectives • Sensitize participants to the biases that interfere with the treatment process • Offer tools/interventions for working with gay, lesbian, bisexual and transgender people in treatment • Raise awareness of personal biases Created by Amy Shanahan, MS CASAC

4. Introduction • Name • Identify yourself as being gay, lesbian. • Why did you choose this training? • What do you hope to get out of the training?

5. Terminology Sexual orientation – includes sexual attraction; sexual behavior; sexual fantasies; emotional, social and lifestyle preferences; and self-identification Heterosexual – “straight”, sexual and romantic feelings that are mostly for the opposite gender Homosexual – “gay” sexual and romantic feelings that are mostly for the same gender Lesbian – A woman who is homosexual.

6. Terminology Bisexual – “bi”, sexual and romantic feelings are for both genders. Transgender – umbrella term including drag queens and kings, bi-genders, cross dressers, transgenderists and transsexuals. Transvestites – people who like to dress like members of the opposite sex. Transsexuals – people who feel that their anatomical sex does not match the gender with which they identify.

7. Terminology Bi-gender – people who define themselves as having the behavioral, cultural or psychological characteristics associated with both the male and female genders Transgenderist – someone who is gender variant or transgresses gender norms as part of their lifestyle or identity. Heterosexism – a prejudice denying, ignoring, denigrating or stigmatizing any form of homosexual expression. Homophobia – fear or loathing of gay men and lesbians. (Antigay bias is another phrase meaning the same).

8. Acculturated Socialization Family Schools Religious institutions Youth groups Television portrayal Internalized Accepting acculturated messages Believing these messages to be true Internalizing them Homophobia

9. Find a partner. Take a few minutes to discuss things that come to mind when you think of gay, lesbian, bisexual or transgender. Write down the first things that come to mind.

10. Myths • Feminine vs. Masculine • Acting out husband and wife roles • GLBT are bad influence on children. • GLBT shouldn’t be parents. • GLBT don’t want long-term relationships.

11. Facts • 3-11% of the total population is homosexual • Gay people come out at various points in life. • 80% of GLBT have experienced verbal bashing, 40% have been threatened with violence and 17% have been attacked.

12. Alcohol & Substance Abuse • 30 % GLBT abuse drugs and alcohol. • Discrimination, homophobia & violence contribute to substance use & abuse. • Bars – are safe places to socialize. • Social attitudes contribute to lower self esteem, increased anxiety, depression and isolation.

13. “Coming Out” Process • This process is unique for each person. • Several stages have been identified by Cass (1979). • Providers should consider which stage the client is in when developing treatment plans.

14. Stages of “Coming Out” Process • Identity Confusion – recognized thought/behaviors as homosexual and usually finds this unacceptable. • Identity Comparison – feels positive about being different, accepts behavior but rejects identity. • Identity Tolerance – seeks out meeting other GLBT through groups, bars, etc. Building sense of community (positive and negative).

15. Stages of “Coming Out” Process • Identity Acceptance – increased anger toward anti-gay society, greater self-acceptance. • Identity Pride – immersed in GLBT subculture, less interaction with heterosexuals. Views world as divided as “gay” or “not gay.” • Identity Synthesis – recognizes supportive heterosexual others. Sexual identity is still important but not a primary factor.

16. Treatment Consideration • GLBT struggle with self acceptance (internalized homophobia). • GLBT live in genuine fear. • GLBT sometimes “identify with the aggressor” and cast out fringes within their own sub group.

17. Treatment Issues • GLBT may not attend gay support groups due to repeated victimization. • Because of the small community, clients in treatment may know each other. • Grief and loss issues. • Bisexuals are often pressured to “choose”.

18. What Organizations can Do! • Communicate to all employees that no forms of discrimination will be tolerated. • Make GLBT employees visible in newsletter and communications. • Encourage formulation of GLBT support groups. • Educate employees to refrain from making homophobic jokes and statements.

19. What Organizations can Do! • Reward employees who support an all-inclusive workplace. • Inquire about partners of GLBT co-workers. • Encourage employees to bring harassment complaints to the attention of management. • Do not assume all employees (or customers) are heterosexual. • Select openly GLBT employees to represent the organization at events.

20. What we CAN do! • Get informed! • Own up to and identify your own biases and prejudices. • Recognize that being GLBT does not constitute being competent in dealing with the issues. • Understand, if you don’t identify as GLBT, that you can’t really fully understand what it is like.

21. What we CAN do! • Deal with feeling inadequate. • Role model accepting behaviors for all clients at all times. • Have zero tolerance for prejudice at all times. • Offer GLBT groups.

22. What we CAN do! • Don’t tell gay jokes and let others know you are offended when they do. • Fully teach GLBT about internalized homophobia. • Don’t push the “coming out” process. • Involve partners (and made families) to treatment.

23. What we CAN do! • Be aware that sex, drugs and alcohol help deal with shame. • Affirm homosexuality as a healthy lifestyle. • Address transgender individuals as they request. • Offer resources.

24. Final Thoughts . . . • Take Aways…Key Learnings • Final thoughts • Evaluations • Certificates • Handouts

25. “Oh the comfort, the inexpressible comfort, of feeling safe with a person; having neither to weigh thought nor measure words, but to pour them all out just as they are, chaff and grain together, knowing that a faithful hand will take and sift them, keep what is worth keeping, and then, with the breath of kindness, blow the rest away.” -George Eliot

26. Resources www.health.org/features/lgbt/whoisgay.aspx www.samhsa.gov A Provider’s Introduction to Substance Abuse Treatment for Lesbian, Gay, Bisexual, and Transgender Individuals (DHHS Publication No. (SMA) 01-3498)

27. Websites www.metrokc.gov/health/glbt www.gayhealth.com www.gaycenter.org/index.html www.nalgap.org www.glma.org