Our society defines heterosexuality as the normal form of sexuality. Yet in real life, each one of us has at least a friend, a relative, a schoolmate and/or a colleague who is clearly non-heterosexual whether we want to acknowledge their specific sexual identity or not.
The variation of sexual identity is obviously a common phenomenon that our society has been ignoring until recently. In most societies, children were also taught from a young age by parents, schools, communities and religious institutions that heterosexuality is the only social norm and that homosexuality is inferior, sinful and subordinated. Gays and lesbians as a result often suffer from psychological problems of shame, guilt, low self esteem and post-traumatic stress disorders.
With decades of hard work by researchers, sociologists, educators and rights activists, we are becoming more aware of the common and natural phenomenon of gender variants, which include gays, lesbians, bisexuals, transgenders and gender queers whose privileges and rights including those of basic legal, marriage, reproduction, display of affection etc. continue to be challenged although certain countries are beginning to make some progress.
Bisexuality and transgenders as well as gender queers while receiving similar discriminations to gays and lesbians, may be even more isolated in society since they may also be rejected within the gay and lesbian community. There is also additional minority stress if these individuals happen to be in minority racial or religious groups.
There is still debate on whether sexual orientation is genetically determined or not but it is becoming more accepted that sexual identity is a discovery by the individual rather than his or her choice or preference. Research has shown that individual men and women has capacity for fluidity in sexual desire, attraction, expression as well as identity at a given point in time as well as over time. Awareness of sexual identity requires specific connection between physical and psychological components which are also powerfully shaped by social, cultural and interpersonal contexts.
Although mental health practitioners have been moving away from trying to convert non-heterosexuals to heterosexuals and recognised their previous reparative or conversion therapy as either ineffective and/or unethical, there are still individuals and societies who believe homosexuality can be converted by lifestyle changes such as by marrying a heterosexual or even be prevented by “proper” parenting and therefore exerts homophobic pressures on non-heterosexual individuals often from childhood or adolescence.
Resulting homophobic behaviour through chronic verbal, emotional, psychological and sometimes sexual assaults against the individual’s gender expression, sex feelings and behaviour, via the violation of trust, power and influence are common. These homophobic behaviour are based on fear, prejudice and shame. Occasionally, in certain countries, homophobic behaviour may even be exhibited through violence or death through jurisdiction towards the individuals. The homophobic behaviour in turn may be internalised by the gay or lesbian individuals themselves, in order to avoid stigma or simply to survive.
Internalised homophobia is particularly relevant to sex educators, counsellors and therapists as this may be exhibited through practices of denying their sexual identity such as looking for straight acting friends and partners; being critical of stereotypical gays and lesbians; restricting attractions to unavailable people; believing they were gay because they were sexually abused; disbelief that relationships can last, denigrating gay ghettos, trying to convince the therapist of negativity about gays and lesbians or telling the therapist that they could never tell their family as it would kill their parents.
These internalised homophobics are particularly at risk of isolation, depression, substance abuse and suicide attempts and their risks are escalated if they are teens and lack of parental support with additional bullying in their community or with additional minority stress. Sex therapists, counsellors and educators should be aware that by helping these individuals to come out of their LGBTQ identity will reduce these risks. The dangers of not coming out are addictions, depressions, phobias, hypochondriasis, low self-esteem, personality disorder and death attempts which may be the first presenting symptom of the individuals.
The sex counsellor or therapist may need to utilise gay affirmative therapy: telling the individual there is nothing wrong with their sexual identification, what is wrong is what is done to them. The individual can then be helped to function affectationally , psychologically, emotionally, spiritually, romantically and sexually.
On the other hand, although coming out of their LGBTQ identity may reduce the risks to their mental and physical health, both the therapist and the individual need to be aware of the stages of coming out once they become aware of their sexual identity. These stages may include confusion, comparison, tolerance, acceptance, pride and synthesis into the community. These stages may take a variable amount of time and may even occur during their marriage to a heterosexual. Assessment of the risks of coming out must be balanced of the risks of closeting particularly when marriage with a heterosexual or custody of children are involved. It is sad but worth noting that in the current statistics, coming out of being gay during marriage with a heterosexual person, only one-sixth would stay married after two years.
The LGBTQ sexual identity development and recognition is a complex process. The LGBTQ community has also suffered for a long time due to ignorance and prejudice of society members. Professional sex educators, counsellors and therapists aim to help these individuals and their communities to live well and enhance their well-being.