Sexual Orientation and Gender Identity

Sexual Orientation and Gender Identity
Student’s Name
Institutional Affiliation
An individual’s gender identity or romantic or sexual orientation may not necessarily be their source of distress. However, persons identifying as transgender, lesbian, gay, queer, bisexual, asexual, questioning, or any other form of gender identity or orientation find their status or standing as a major cause of distress. This distress and anxiety particularly occur where the social stigma of being a minority is high. Many debates and controversies have occurred all through the history of psychopathology including its major categorization systems concerning gender identity and sexual orientation. These disagreements are still evident on the current redesigns of gender dysphoria in different data, statistics, and studies which reveal different aggressions gay, lesbians, transgender, and bisexual patients undergo while in mental health care institutions. This work discovers the history and present debates revealing that this profoundly complex sector contributes the focus on the individual-centered experience of psychopathology and manifestation of the very theory of mental sickness. Additionally, this paper shows that this field contributes to the identification of discrimination and stigma as considerable superseding variables. The work argues that the historical perception of gender identity and sexual orientation in the discipline of psychopathology lies between gender variance and gender transgression.

Lastly, the paper describes impacts of bias against homosexual persons.
Definitions and Theories
It is usually imperative for individuals in search for therapy in such problems as those linked to their gender identity, or romantic, or sexual course, or for issues concerning mental health, identify qualified mental health professional. In particular, persons with these needs require professionals with familiarity and experience with the problems members of lesbian, gay, bisexual, queer, questioning, and other gender and sexual orientations populations regularly encounter for successful results. Theories and descriptions referring to gender identity and sexual orientation continue to evolve as evidenced by continued definition changes witnessed throughout the years. More particularly, it is apparent that numerous terms employed in the past when defining LGBT persons especially in the mental health department are now deemed as insulting and outdated. According to the American Psychological Association (n.d), sexual orientation refers to a long-term pattern of romantic, emotional or sexual attractions to females, males, or both sexes. Sexual orientation also describes an individual’s sense of identity on the basis of those attractions, associated behaviors, and being a member of a society of other persons sharing similar attractions (American Psychological Association n.d).
The past few decades have seen research reveal that sexual orientation varies based on a continuum from restricted attraction to the same sex to sole attraction to the other sex. Nevertheless, it is important noting that sexual orientation is usually argued around several categories including gay whereby one has sexual, romantic, or emotional attractions towards members of their sex (American Psychological Association n.d). The other category involves heterosexual in which an individual has romantic, sexual or emotional attractions to members of other sex and bisexual whereby one has these attractions to both males and females (American Psychological Association n.d). The different attractions and behaviors are defined in various countries and cultures across the globe with several cultures employing identity labels to illustrate populations that express such attractions. The most frequently used labels in the United States include gay men, a term used to describe men attracted to men, lesbians which describes women attracted to women and bisexual people, a term commonly used when labeling people attracted to both sexes.
And while a considerable number of members in different communities utilize these labels, some use none at all. The American Psychological Association (n.d) indicates that sexual orientation is different from other elements of gender and sex such as biological sex which involve the physiological, genetic and anatomical features linked to being female or male. Another component involves social gender role which includes the cultural standards that describe masculine or feminine behavior and lastly, gender identity, which entails the psychological sense of being a woman or man (American Psychological Association n.d). In a universal description, sexual orientation is the sex of those to whom a person is romantically or sexually attracted. Following these explanations, it is worth noting that sexual orientation does not constantly occur in such definable groupings but, rather appear on a range in which the LGBT people may identify in different forms.
Transgender Equality Network Ireland (n.d) describes gender identity as an individual’s inner feeling of being female, male, or any other gender, or a mix of genders, also known as transgender. While some population identifies as not belonging to any gender at all, others consider their gender identity does not match with the traditional female/male gender binary. Communities understand and construe gender through gender expressions including how one appears to other persons including the way they walk, dress, talk and their mannerisms as well as the way they live their lives. Transgender and Equality Network Ireland (n.d) explains that gender identity can never be changed through counseling or treatment and is entirely different from one’s sexual orientation. The word “transsexual” was traditionally limited to describing people who had undertaken medical procedures involving genital reassignment surgeries. The term has, however, evolved in the present years to connote people with a gender identity that is dissimilar to the sex assigned at birth. In this regard, these persons choose and work towards living as members of the sex different from the one given at birth irrespective of the medical processes they may have undertaken or may choose to undertake in the future (Coleman et al 2012). Transgender is a term used in the past few decades universally to define persons who challenge societal assumptions and expectations concerning gender. The term includes individuals who are intersex and transsexual as well as those identifying outside the male/female binary and those whose gender behavior and appearance vary from what is socially expected. Similarly to the case of sexual orientation, individuals described or viewed as transgender by communities involving transsexual women and men may also identify in different ways.
LGBT Bias and its Influence on Mental Health
Lesbian bisexual, gay, and transgender persons tend to suffer from different kinds of social exclusion, prejudice, and stigma including psychological and physical bullying, abuse, economic alienation and persecution (Bostwick, Boyd, Hughes & West 2014). Furthermore, encounters of bias among this population sometimes transpire in several fields such as education, jobs, and healthcare and also in the context of important interpersonal relations such as family. It is, therefore, that based on the various forms of prejudices undergoing through this stigmatization and bias among LGBT people increase their risk of developing mental illnesses. Some of the mental diseases that LGBT members may be vulnerable to compared to their socially accepted counterparts include being suicidal, traumatic stress reactions, or substance abuse. Other mental disorders may involve significant depression disorders or generalized anxiety disorders.
Transgender persons are also commonly noted as being at a higher risk of developing depression, anxiety disorders, substance abuse, adjustment disorders and social phobia, and eating disorders. Bauer, Travers, Travers A., Scanlon, & Kaay (2011) study reveals that transgender communities including male-to-female and female-to-male experience a high prevalence of depression. Bauer et al. (2011) found out from Ontario transgender participants that although a majority is highly educated, many were jobless and accounted for the lowest income-to-needs quotient group n which they earned less than $15,000 per person. Additionally, both female-to-male and male-to-female groups experienced high frequencies of childhood physical or sexual abuse as well as chronic physical health statuses (Bauer et al. 2011). Correspondingly, a majority of male-to-female and female-to-male persons experienced prejudice in the form of transphobia (Bauer et al. 2011). Bauer et al. (2011) also found out that nearly two-thirds of male-to-females experienced symptoms associated with clinical depression which is seemingly obvious percentage considering the challenges these groups encounter throughout their lives. Notably, the prevalence is nearly certainly more than one would anticipate on the basis of populace approximations given that in 2005 the Ontario and national occurrences of depressions were less than 6.0 percent (Bauer et al. 2011). Bauer et al. (2011) add that the figure should have been even lower if the study had used limited time as that utilized by CES-D which evaluates symptoms lasting no more than a week.
Bauer et al. (2011) also noted that the frequency of depressive symptoms among male-to-female transgender matched the prevalence recorded among female-to-male Ontario participants. Additionally, the findings were equal to or higher than approximates from other male-to-female studies that employed similar depression gauge. However, Bauer et al. (2011) suggest that different frequencies can be expected due to the differences between transgender communities and the psychosocial background of transphobic encounters and dissimilarities in the study and sampling design. In sum, studies unambiguously acknowledge the function of discrimination and stigma as important overriding variables in psychopathology among the LGBT groups. However, the connection between gender identity and sexual orientation and stress r mental illnesses may be arbitrated by different variables such as religiosity, family, and social support, or interaction with other LGBT populations. Other variables involve expectations of acceptance versus rejection and low internalized homophobia. It is, hence, imperative focusing on subjective distress and also an individual-centered familiarity to psychopathology.
Homosexuality History and Psychiatric Diagnoses
It is evident that the notion and overall understanding of LGBT populations and their diversity have evolved. In particular, people currently understand that the increased rates of psychological disorders among these groups link to bias against them as well as their minority social status. In contrast, however, psychiatrists and communities in the past century perceived homosexuality as pathological and in the latter half of the 20th century, professionals including psychologists, psychiatrists, and physicians sort to treat and change homosexuality. Drescher (2015) indicates that homosexuality was in the early 20th century classified as a sociopathic personality disturbance based on previous theories by renowned psychiatrists including Sandor Rado. Rado claimed that homosexuality was pathological that resulted from insufficient parenting and was only a phobic avoidance of other sex (Drescher 2015). The 1968 publication of DMS-II by the American Psychiatrist Association reclassified homosexuality as no longer a sociopathic personality disorder but instead a sexual deviation. And later in 1973, it was completely cut off from the Diagnostic and Statistical Manual of Mental Disorders (DSM) (Drescher 2015).
Gay and lesbian activism acted as the main catalyst to the ultimate declassification of homosexuality as a mental disease as well as its promotion attempts within the American Psychiatrist Association Drescher 2015). Removing homosexuality from mental ailment category necessitated an adequate understanding of what constitutes mental disorder agreeing that psychological disorders result in subjective distress or links to the overall harm of social efficiency of operation. And although this declassification was a major achievement by the LGBT population, it, however, did not end the recognized identification of some homosexuality presentation as pathology as soon as anticipated. The removal of homosexuality diagnosis, it was replaced with sexual orientation disturbance and later ego-dystonic homosexuality (Drescher 2015). It is, hence, noteworthy the influence these diagnoses had in which they served the purpose legalizing the practice among psychopathology professionals of sexual conversion therapies. The therapies mostly focused on people with same-sex attractions who hoped to change their sexual orientation and those with distress disorders.
Continued challenging and activism against the labeling of homosexuality as a mental disorder led to the removal of ego-dystonic homosexuality from the DSM-III-R (Dresche 2015). In particular, activists argued racial minorities are not classified as mentally ill, LGBTs should not either (Drescher 2015). These changes during this period are what led to improvements in the wider cultural understanding and perceptions of LGBT community where psychiatric diagnoses of sexual orientation were now illegal. This achievement also marked the end of modern civil rights pursuits to equality. Drescher (2015), nonetheless, notes that the removal of homosexuality from the International Classification of Diseases by the World Health Organization did not happen until 1992 whose diagnosis matched with that of ego-dystonic homosexuality and meant to change in the 2017 publication. Evidently, these persons have had significant milestones towards the liberation of their rights and recognition as different but eligible irrespective of their minority status. But still, there s more that needs doing especially in successfully eliminating discrimination among communities as well as equal opportunities in healthcare and employment among other social settings.
Debates Surrounding Mental Health Care among LGBTs
Compared to non-LGBT persons, LGBT communities record higher tendencies to seeking psychotherapy services which leave them susceptible to the increased threat of ineffective or harmful therapy. This circumstance is not only due to the fact that these groups are vulnerable to being a minority but also since they are frequent uses of these services. Recent years have seen increased worries in the mental health department focused on the encouragement of the welfare of transgender and non-heterosexual populations which has leveled with the diagnostic improvements. The figures are set by the amount of literature on lesbian and gay affirmative psychotherapy gathered in the past few decades. Additionally, it is obvious that key global accrediting bodies in psychotherapy and counseling have realized the importance for clinicians to work efficiently with clients identified as minorities, usually termed as LGBT persons. The American Psychological Association promotes psychotherapy with the gay, bisexual, and lesbian client by providing moral guidelines in which clinicians must utilize in their operations and dealings with patients.
It is essential for clinicians to discover the relevance of their knowledge and attitudes concerning experiences sexual minorities undergo to ensure successful therapeutic procedures with the patients. This objective can only be realized through studying of various literature concerning the same, acquire proper training, as well as supervision to oversee the accurate and effective provision of psychotherapy to all clients without any form of discrimination. It is, nonetheless, apparent that some therapists still practice clinical operations that are less suitable for LGBT populations. In fact, despite the broad recognition that being homosexual or bisexual is not an illness, some therapists still engage in practices where they seek to help gay, bisexual, and lesbian clients become heterosexual, a session known as conversion therapy. This less appropriate practice is despite methodical evaluation of various peer-reviewed journal literature concerning attempts to change sexual orientation concluded such efforts are highly unlikely to succeed. The change efforts also may involve or result in some form of harm such as reinforcing stenotypes and creates a negative climate for such persons (American Psychological Association n.d). Other forms of inappropriate clinical operations with the lesbian, bisexual, gay, and transgender exist.
It is also obvious that even among mental health practitioners that claim to be supportive and affirmative of the LGBT group often tend to show some little heterosexual discrimination while working with these clients. Common micro-aggressions therapist exhibit towards LGBT such as automatically presuming the patient is heterosexual. Other forms of antagonisms include centering on one’s sexual orientation or gender identity among LGBT patients even when such factors are not the areas where the patient needs help. Clinicians also attempt to elaborate the etiology of one’s gay or lesbian status which is a form of violence against LGBT societies. Sexual orientation blindness or ignorance can be a major contributor to heterosexual discrimination in psychotherapy and counseling which may entail striving for assumed nonaligned status. Additionally, it may involve ignoring specifications concerning the marginal condition of a homosexual person. Evidently, the idea of a person’s experience especially non-homosexual terms available in therapeutic field lack complete independence from psychotherapist’s fundamental training as well as the historical heterosexist in psychology and medicine training. And concerning involvement directed to transgender persons, the metal health professional’s work has for decades been sorting out and identifying “true” transsexuals from other persons identifying as transgender.
While persons considered to be “true “once identified get access to physical transformation, those not categorized under this segment do not receive any medical help or other forms of psychotherapy. This form of behavior depicts these professionals as gatekeepers who upon acting intentionally or unintentionally work towards ensuring that a majority of those who successfully transform does not remain unclear about their gender anymore. Bauer et al. (2011) point out that transgender people in the modern world still experience stern issues when accessing healthcare such as ones linked to improper gatekeeping by professionals. Moreover, various health workers continually focus on the evaluations of characteristics associated with gender expressions and gender identity instead of the distress LGBT individuals tend to struggle. Therefore, transgender persons tend to feel the need to articulate personal stories that match with the expectations they perceive the clinicians to have when analyzing surgical or hormonal treatments. This occurrence, therefore, explains the use of diagnoses in the current world despite the modifications in the DSM concerning transgender diagnoses which match with those of transsexualism. These diagnoses occur in medics attempts to find true transsexual persons. It is, therefore, apparent that cultural and social prejudices continue to impact significantly the diagnostic methods for gender identity and sexual orientation. Culture and society also affect the surgical and hormonal treatment for transgender persons.
Psychological Impact of Discrimination and Prejudice against LGBT
International human rights agencies prohibit prejudice based on gender identity and sexual orientation was approved by a majority of states throughout the world. However, individuals with gender identity or sexual orientation that fail to conform what is commonly viewed as majority standards experience unequal marginalization, bias, and violence. And while types and circumstances of bias differ in various contexts, human rights violations continue in all parts of the world. Given its continued presence in human existence, discrimination and prejudice always have personal and social effects. Prejudice on the social level against LGBT groups usually manifests in daily stereotypes of members of these sects. These labels thrive even when not supported by proof and tend to be used as an excuse for unfair treatment of LGBT (American Psychological Association n.d). For instance, parenting, employment opportunities, and relationship identification often tend to be justified by stereotypic presumptions regarding LGBT populace. Discrimination on the individual level has negative repercussions particularly if persons identifying as LGBT try to cover up or deny their identity or sexual orientation.
Many homosexual persons learn how to deal with the social stigma of being gay or lesbian. Nevertheless, this form of discrimination can result in serious negative impacts on the individual’s welfare and health. For instance, American Psychological Association (n.d) indicates that the impact of stigma on these groups and people may minimize or deteriorate through other factors such as disability, race, religion, or ethnicity. Additionally, the stigma may vary based on individuals and circumstances in which some LGBT members may encounter less stigma compared to others facing similar situations. For example, sex, race, ethnicity, religion, and disability among other elements may aggravate the negative effect of bias. The prevalent discrimination, violence, and discrimination to which LGBT members often experience are considerable contributors to concerns related to mental health. American Psychological Association (n.d) suggests that sexual orientation, discrimination, sexual prejudice and anti-gay violence are significant contributors to tress among LGBT communities. And while social support is important in handling stress, anti-homosexuality bias and attitudes tend to make it hard for LGBT members to seek and receive such support.
In conclusion, gender identity and sexual orientation are important elements within societies whose understanding and explanation continue to evolve across time. While in the past sexual orientation was considered a mental illness and in some instances, a result of poor parenting, recent progress in the study indicate it as having no relation with psychopathology. In fact, being lesbian, bisexual, transgender and gay or any other form of identity or sexual orientation is a normal way of human bonding (American Psychological Association n.d). These improvements in understanding these sexual concepts, however, do not necessarily mean that communities identifying as LGBT are completely accepted in the general societies which constitute different identities. In fact, LGBT groups are a minority with heterosexuality being a majority. Being a sexual minority has disadvantages including discrimination in different areas such as education, job opportunities, parenting and violence including insults and bullying. All these negativities contribute to sources of mental illnesses experienced by these groups which make LGBT members have higher frequencies of mental distress compare to other groups with a different orientation. And although homosexuality or bisexual is not a medical condition, some medical practitioners still try to cure it and up to now there is no evidence of successful treatment of sexual orientation. It is, hence, imperative for practitioners to have a full understanding of different forms of sexual orientation and gender identity as well as practice neutrality to avoid discrimination or violation against the client. It is also important for all members of communities to learn and understand as well as appreciate sexual diversity and refrain from bias on the basis of gender identity and sexual orientation.
References
American Psychological Association. (n.d). Answers to your Questions: For a Better
Understanding of Sexual Orientation & Homosexuality. The American Psychological Association. 1-6. https://www.apa.org/topics/lgbt/orientation.pdfBauer N., Travers N., Travers A., Scanlon K., & Kaay M. (2011). Depression in Male-to-Female
Transgender Ontarians: Results from the Trans PULSE Project. Canadian Journal of Community Mental Health, 30(2).
Bostwick, W. B., Boyd, C. J., Hughes, T. L., West, B. T., and McCabe, S. E. (2014).
Discrimination and mental health among lesbian, gay, and bisexual adults in the United States. Am. J. Orthopsychiatry (Am. Psychol. Assoc.) 84, 35–45. doi: 10.1037/h0098851
Coleman, E., Bockting, W., Botzer, M., Cohen – Kettenis, P., DeCuypere, G., Feldman, J., et al.
(2012). Standards of care for the health of transsexual, transgender, and gender nonconforming people, 7th version. Int. J. Transgender. 13, 165–232
Drescher, J. (2015). Queer diagnoses revisited: The past and future of homosexuality and gender
diagnoses in DSM and ICD. International Review Of Psychiatry, 27(5), 386-395. doi:10.3109/09540261.2015.1053847
Transgender Equality Network Ireland. (n.d). Transgender and Gender Diversity Information.
Teni. http://www.teni.ie/attachments/e9bfe357-f46d-4f58-b3d6-60fbd2352513.PDF