A little discussion on sexual orientation

Sexual Orientation

            Over 1,500 animal species participate in homosexual behavior (http://www.news-medical.net/news/2006/10/23/20718.aspx), yet humans seem to be the only species who seems to have an issue with sexual practices that stray from the “norm” of heterosexuality. The idea of sex for purely procreation reasons is an outdated one, yet it still seems to infiltrate many social media outlets and even politicians debate the morality of same-sex relationships.

            The sexual continuum, as suggested by Kinsey, Pomeroy, and Martin (1948) suggests that sexuality is even more complex than many realize. The Heterosexual-Homosexual Rating Scale consists of a range from 0 (exclusively heterosexual), to 6 (exclusively homosexual), with a myriad of degrees of sexual preferences located along the scale. The scale portrays just how intricate individual sexuality can be, and just like humans, varies greatly.

            Another, and a bit more complicated way of measuring sexuality is the Klein Sexual Orientation Grid. While it does share the varying degrees of sexuality like in the Kinsey Scale, the Klein takes into account several different variables of interest. These include sexual attraction, sexual behavior, sexual fantasies, emotional preference, social preference, heterosexual/homosexual lifestyle, and self identification (Klein, 1993). Additionally, the Grid takes into consideration the past, present, and ideal sexual identity categories of the individual, thus indicating that in some, sexuality is fluid.

Legal and Ethical Considerations of Homosexual Clients

            In theory, mental health workers should treat every client like a human being, allowing full access to the quality care they deserve. However, this has not always been the case, which has led to legal implications for those who refuse to offer services to homosexual clients. A student in the counseling program at Eastern Michigan Universtiy was expelled from her program due to her refusal to counsel a gay client in 2009 (http://abovethelaw.com/tag/julea-ward/). However, a recently proposed bill in Tennessee (HB 1185) would prohibit universities from taking disciplinary actions against students in counseling programs who refuse to see LGBT clients, citing religious objections (http://openstates.org/tn/bills/108/HB1185/documents/TND00022457/). So, it appears that counselors can in some cases legally refuse to offer services to clients who identify as LGBT, but it still remains unethical, as the refusal to treat can in some cases, inflict more harm (Hermann & Herlihy, 2006).

Multicultural Competency and Sexual Orientation

            Multicultural competency addresses all aspects of who a person is, which encompasses their heritage, racial background, religious affiliation, and their sexuality. While there may be some counselors who object to same-sex relationships based on their own beliefs, there are steps that they can take to better prepare them to offer assistance to a wider variety of clients. Such steps include class activities, discussions, and continual learning in a safe environment (Charles, Thomas, & Thornton, 2005). Neglecting to include sexual orientation in multicultural training is a disgrace, especially within the marriage and family therapy (MFT), as not all couples that seek counseling are heterosexual.

References

1,500 animal species practice homosexuality. (2006, October 23). Retrieved from http://www.news-medical.net/news/2006/10/23/20718.aspx

Charlés, L. L., Thomas, D., & Thornton, M. L. (2005). Overcoming bias toward same-sex couples: A case study from inside an MFT ethics classroom. Journal of Marital and Family Therapy, 31(3), 239-249. doi:10.1111/j.1752-0606.2005.tb01566.x

Hermann, M. A., & Herlihy, B. R. (2006). Legal and ethical implications of refusing to counsel homosexual clients. Journal of Counseling and Development, 84(4), 414-418.

Kinsey, A. C., Pomeroy, W. B., & Martin, C. E. (1948). Sexual behavior in the human male. Philadelphia: W.B. Saunders Co.

Klein, F. (1993). The bisexual option. New York: Harrington Park Press.

Lat, D. (2012, February 6). Julea Ward « Above the law: A legal web site – News, commentary, and opinions on law firms, lawyers, law schools, law suits, judges and courts + career resources. Retrieved from http://abovethelaw.com/tag/julea-ward

Open States (n.d.). Bill Text - HB 1185 - Tennessee 108th Regular Session (2013-2014). Retrieved from http://openstates.org/tn/bills/108/HB1185/documents/TND00022457/

Sexual issues and multicultural implications: A personal reflection

Abstract

The realm of sexuality is quite vast, with many individuals having different concepts of what “normal” looks like with respect to human sexuality. Some are influenced by their own experiences, family beliefs passed down over generations, from religious definitions, and even by what culture deems as acceptable. Counselors often work with clients who have a different background, which includes sexuality. Multicultural competency spans more than where someone comes from, their ethnic makeup, and their socioeconomic status; sexuality also plays a key role in establishing who a person is, just as much as the aforementioned aspects. This paper will identify some key sexuality topics, as well as how counselors can help their clients when working with diverse clients. Additionally, legal considerations for counselors will be addressed in regards to sexuality issues.

Sources of sexual information

            A challenge faced by many of the current generation stems from the plethora of sources available in which they can gain information about society, sexuality, and culture. In the past, people were more apt to share the outlooks and beliefs of their family and those in their social circle. However, advances in technology have afforded individuals to expand their horizon when it comes to sexuality, thus broadening the definition of what is considered “normal” in society.

            Many still receive their guidance on appropriate sexual behavior from their religious affiliations. While turning to faith may comfort some, it also can make others feel excluded. According to the literature, a shift in acceptable sexual standards has swayed away from that of which is associated with Biblical tradition (Williams, 2013). Within the Christian faith, especially those who observe strict interpretation of the Bible, sexuality that strays from heterosexual or sex for procreation reasons is shunned. Sadly, such an outlook excludes many people, leading to an increase in depression, guilt, anxiety and suicidal risk (Subhi & Geelan, 2012).

            An additional influence into the definition of sexual identity is geographic location, which is also a part of one’s culture. One study found that sexual practices could be categorized by either “good/normal” or “bad/abnormal,” based on Western cultural standards (Morrison, Ryan, Fox, McDermott, & Morrison, 2008). The same study revealed that in addition to the acceptable practices, there were differences between what was deemed “normal” when it comes to gender, with male sexual practices that include homosexual fantasy and submission to fall under the category of “abnormal,” whereas the same was not found among female sexuality practices.

Geographic location comes into play when analyzing the level of acceptance of practices that are deemed “abnormal,” with the United States, Ireland, and Poland being associated with conservative sexual practices. Canada, Norway and the Czech Republic were reported as being more liberal when it comes to “abnormal” sexual practices (Morrison, Ryan, Fox, McDermott, & Morrison, 2008). The most sexual liberal, when compared to the United States, is Sweden, which reports a more accepting stance on nudity, masturbation, and expressing a desire for sex, including those that were deemed as “abnormal.”

Education and exposure: Combating biases

            Within the United States, many receive their sexual education from uncomfortable school presentations, which focus largely on either abstinence-only or abstinence-plus programs that stress abstinence as the primary choice, but also provide information on condoms and contraceptives (Haglund & Fehring, 2010). While the programs do provide some information about sexual health, they often come up short when it comes to the broad definition of sexuality. Many focus on safe sex, including condoms, contraceptives, pregnancy, and sexually transmitted diseases (Kirby, Laris, & Rolleri, 2007), leaving a large percentage of sexuality unaddressed.

            The educational shortcoming is not limited to those in the K-12 grades, as medical residents have also reported a lack of formal education when it comes to sexual health practices. A lack of education was found among the topics of non-Western cultures and homosexual relationships, with less than 50% of medical schools in the United States and Canada spending more than two hours on sexual health (Morreale, Arfken, & Balon, 2010).

            While many physicians and mental health care workers have come to the consensus that sexuality plays a large role in the lives of their patients (Morreale, Arfken, & Balon, 2010), the educational system does not appear to mirror their sentiments. Individuals who identify as gay often report feeling left out of the sexual education present in the educational system, and are more prone to being the target of harassment (Sherblom & Bahr, 2008).

            Just as sexual orientation seems to be missing from the curriculum, so do many other aspects of sexuality, including sexual dysfunctions. The lack of education regarding sexual dysfunction is not limited to the K-12 area of knowledge, but it is also present at the physician level. Formal education among physicians in the realm of sexual health is often just a bare bones version, which ignores an aspect of life that has the ability to affect the lives of their patients. Many physicians have reported being uncomfortable discussing the topic of sexual issues with their patients (Foley, Wittmann, & Balon, 2010). However, data suggest that physicians, who are involved in continuing education and possess effective communication skills, are more apt to speak to their patients about sexual health related topics (Foley, Wittmann, & Balon, 2010).

Ethical considerations and sexual issues

            Personal beliefs are an important part of one’s identity, but it is important for physicians and those in the mental health profession to separate their personal beliefs from that of their client. Counselors are bound to encounter clients who have a different cultural background, which makes multicultural education, including sexual identity, an important part of continuing education.

            The American Counseling Association has set forth a code of ethics for those in the counseling field to abide by, which includes several references to cultural sensitivity. Specifically, Section A.4.b. addresses the idea that counselors are to be aware of their own values, and being cognizant of not imposing their own values onto their clients (ACA, 2005). Additionally, if counselors find that they are unable to treat clients, they are to cease treatment and offer referrals to other counselors that may be more adept within the scope of practice, as noted in section A.11.b. (ACA, 2005).

Conclusion

            The vast array of sexual issues that counselors may encounter during their practice makes personal reflection and continued education essential in providing quality services for clients. Cultural influence regarding what is deemed “normal” can vary due to religion, geographic region, and personal experiences, all of which contribute to an individual’s identity, including their sexual identity. Being aware that people vary within a culture is important for both those working in the mental health field, and society as a whole.

**References Available Upon Request**