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3 Things to Know When Working With LGBT Clients

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On June 26, 2015 the Supreme Court ruled that all couples, regardless of gender, have a constitutional right to marry the person they love. After the ruling was announced, states across the nation were forced to drop their bans on same-sex marriage allowing loving gay, lesbian, bisexual and transgender couples the right to marry.

The ruling marks a significant advancement for the rights of LGBT individuals, who have faced a long history of discrimination and oppression. While the ruling is a monumental victory for the rights of LGBT Americans, our LGBT brothers and sisters face challenges that extend far beyond the right to marriage.

lgbtqhomeless1_400_393_90When working with individuals in the LGBT community, we must acknowledge the ways in which societal and social influence, oppression, and discrimination impact these clients as well as the communities we serve. As social workers, we have an obligation to be culturally competent and sensitive to the unique needs of our clients.

To do so effectively, we must first understand some of the significant psychosocial stressors that may impact members of the LGBT community.

Discriminatory Policy

While LGBT individuals now have the right to marry the person they love, only 22 states in the nation protect the LGBT community from employment discrimination. This means that in over half of our nation’s states, a person could be denied employment or fired from their job for identifying as LGBT. For LGBT individuals working in these states, such policies can prevent individuals from feeling comfortable in the workplace for fear of being fired. Uncertain job stability coupled with the stress of hiding one’s identity in the workplace can lead to a variety of negative effects, such as low job satisfaction or even depression and anxiety.

Knowing the policies of your state and how these policies impact the LGBT community can help you better assess the role discrimination may be playing in the lives of your LGBT client(s). Having a good understanding of these policies also allows you to engage in meaningful conversation with clients, the community and other stakeholders about how to best facilitate change to such policies.

Violence

Individuals within the LGBT community are at a significantly higher risk for violence. Though individuals identifying as LGBT account for only 3.8% of the U.S. population, they are the victims in 21% of reported hate crimes. Sexual violence is also a very real threat for those in the LGBT community. According to a startling report by the Centers for Disease Control and Prevention (CDC), 46.4% of lesbian women, 74.9% of bisexual women, 40.2% of gay men and 47.4% of bisexual men report being victims of sexual violence.

As social workers, it’s not uncommon for clients to seek our help in working through issues related to sexual or physical violence and intimate partner violence. Because of the high rates of these occurrences within the LGBT community, assessing clients for a history of sexual and physical violence as well as domestic violence are critical components of a thorough assessment. Using treatment approaches that take into account the experiences of the LGBT community will enhance the therapeutic milieu for your clients and help foster healing.

Mental Health

Individuals identifying with the LGBT community have significantly higher rates of mental health conditions, substance use disorders, and suicide attempts. According to the National Alliance on Mental Illness (NAMI) , LGBT men and women have a 2.5 times higher rate of mental illness or substance abuse than the heterosexual population. The types of mental health conditions impacting this population also differ. Gay and bisexual men are more likely to experience major depression and panic disorder than heterosexual men. Lesbian and bisexual women are more than 3 times as likely to experience generalized anxiety disorder.

In addition, the CDC reports that LGBT youth are more than twice as likely to attempt suicide than their heterosexual peers, with as many as 25% of transgendered youth attempting suicide. This is often due, in part, to the higher rates of bullying, physical and sexual violence, and social isolation experienced within this population.

Social workers need to be aware of the disparities in mental health and substance use disorders among the LGBT population so that proper assessment and intervention can take place. Ongoing screening for suicidal ideation or behavior is also of significance, especially for LGBT youth.

As the largest providers of mental health services in the nation, social workers frequently work with individuals across the various spectrums of diversity. This requires us to be skilled in understanding how discrimination, oppression, and public policy all play roles in the lives our clients. While this may not always be easy, by tapping into your inherent skills as a social worker you can be a champion for your LGBT clients. If you feel overwhelmed by these complexities or find it difficult to understand issues surrounding the LGBT population, start by being a genuine, accepting presence for all your clients. After all, it’s all about love, isn’t it?

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Paul C. Milford, MSW is a social worker specializing in the assessment and treatment of children, adolescents, and families. Milford has a passion for helping others find the keys to their own success and draws from a variety of therapeutic modalities to help them do so. Milford received his Master of Social Work degree from the University of South Florida. Milford's clinical areas of interest include behavior management, depression, chronic disease management, relationship issues, school performance, and anxiety within the individual and family systems.

          
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