• I believe strongly that a cornerstone of my responsibility as a mental health professional is to remember that the history of my profession was really bad in the ways that we added to the stigma and suffering of lesbian, gay, bisexual, trans, questioning, and the remaining tapestry of sexual orientations and identities.  Until 1973 “Homosexuality” was a diagnoses, and “Ego-dystonic Homosexuality” remained in the American Psychiatric Association’s diagnostic manual until 1987. Worse, we haven’t recovered all the way yet from our wrong-headedness - even today. The current version of the World Health Organization’s diagnostic manual still contains this “diagnosis” today (ICD-10).  Even slower to change is the diagnosis of trans individuals with “gender dysphoria.” This is shameful and destructive [full stop].  

    Simply, the coming out process can certainly be challenging, and so this process may be an important aspect of the work a person does in therapy.  However, these challenges are almost completely due to a sickness at the cultural level – prejudice and the marginalization that comes with it – not with any sort of disorder in the person.  Everyone’s gender and sexuality are important parts of who they are, and so can be important aspects of psychotherapy, across the spectrums.  For individuals who fall within a sexual minority, the coming out process can provide a major benefit to one’s life, and can lead to even greater resources to use within the psychotherapy process.  Coming out always involves significant growth in self-awareness, openness, and sensitivity to one’s self and to others. During my training as a psychotherapist, I was fortunate enough to be able to fully explore my own gender identity and sexual orientation, which is critical if you are going to be able to separate your own biases and misconceptions from other people’s genuine experiences with their own sexuality.  It is also a critical part of training to continue to be open to my own sexuality so that I can comfortably discuss the sexualities of the people I am working to help.