A Journey Toward Liberation: Confronting Heterosexism and the Oppression of Lesbian, Gay, Bisexual, and Transgendered People
Gary W. Harper
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In this chapter I address the issue of heterosexism and the continued oppression of lesbian, gay, bisexual, and transgendered (LGBT) people and communities. In addition, I present ways in which community members and community psychologists have promoted liberation and well-being through intervention and activism at multiple levels. In order to understand the issues that confront LGBT people, it is first important to understand the historical and current variations that exist in self-definition and in societal definition when it comes to different forms of sexual orientation and gender identification. It is difficult to find consensus on how to define the sexual lives and identities of people since sexuality is a very personal and often private aspect of our existence, and is strongly influenced by societal and cultural factors (Diaz, 1998; Harper, 2001). I will use the acronym LGBT throughout this chapter to indicate the collective community of lesbian, gay, bisexual, and transgendered people, and LGB in instances where transgendered individuals have not been a part of the discourse.
DEFINING VARIATIONS IN SEXUAL ORIENTATION AND GENDER IDENTITY: THE POWER OF WORDS
As was presented in Chapter Two, Julian Rappaport (1998; 2000) has talked about dominant cultural narratives as being shared stories that are communicated through media and popular symbols, words, and phrases to describe a particular group of people in a stereotyped fashion. These narratives are often used by members of dominant groups to continue the oppression of people who lack social power. It is important, then, to be aware of the meaning that society may attach to the words we use so that we are not participants in the continued oppression of disadvantaged people. Words can be powerful—they can both oppress and liberate. In this section of the chapter I will review relevant terms that will help you to understand the complexity of individuals and groups that are often classified under the umbrella phrase “LGBT” and describe the historical roots of terms such as “homosexual” that have been used to pathologize and marginalize LGBT people. In addition, I will discuss the importance of attending to diversity considerations when addressing LGBT issues in community psychology, with an emphasis on the role of culture in defining sexual orientation and gender identity.
Lesbian, Gay, Bisexual, Transgender: What’s The Difference?
Individuals in Western societies who experience varying degrees of same-gender desire and attraction, and engage in same-gender sexual behavior are typically referred to by the terms “lesbians,” “gay men,” and/or “bisexual women or men.” The focus here is on the individual’s sexual orientation, which is defined by the identity of the person to whom an individual is physically and emotionally attracted. The term “transgender,” on the other hand, is focused on issues of gender identity and represents a range of individuals who do not conform to traditional societal expectations and roles for each gender such as transvestites, transsexuals, transgenderists, androgynists, and intersex people (Gainor, 2000). A transgendered individual’s sexual orientation is not defined by her/his gender nonconformity, thus transgendered people may experience sexual attraction to females, males, or both.
Therefore, group membership for lesbians, gay men, and bisexual women and men is defined by their sexual orientation, whereas transgendered individuals’ group membership is defined by their gender identity and gender nonconformity. Although the life experiences of these groups of people can vary tremendously, psychologists and other professionals from related disciplines often group them together under the acronym LGBT to represent a group of people who experience oppression and marginalization based on their sexual orientation or gender identity, and who do not share the same basic civil rights as other citizens in many societies. In addition, members from these various groups may join together in their activism efforts in order to create social support, form a sense of community, and increase solidarity.
The term “homosexual” was first coined in the 1800s to categorize those who engaged in same-gender sexual behavior as sick or deviant (Bullough, 1994; Donovan, 1992). Over the years the term “homosexuality” has been associated with sin, criminal behavior, uncleanliness, and mental illness (Donovan, 1992; Hunter, Shannon, Knox, & Martin, 1998; Pierce, 2001) - all of which serve to place LGBT people in the subordinate role of being categorized as “deviant” individuals who are marginalized by mainstream society. One example of the relatively recent negative use of this term by larger societal institutions is the inclusion of “homosexuality” in the Diagnostic and Statistical Manual (DSM) of Mental Disorders by the American Psychiatric Association. Although “homosexuality” was removed from the DSM in 1973 as a specific mental illness, it was not until 1987 that all references to LGB sexual orientation were removed.
Dean Pierce (2001) has suggested that using the term “homosexual” is one way that perpetuates the power of the majority group by creating what he calls “the rule of symbolic opposites.” He suggests that the term “heterosexual” is used to describe the more powerful majority group and that the term “homosexual” is then the more negative hierarchical opposite, and is even seen by some as the “enemy” of “heterosexuality.” This type of hierarchical and opposing term serves to perpetuate a negative discourse about LGBT people. In 1991 the American Psychological Association’s Committee on Lesbian and Gay Concerns published a set of guidelines for avoiding heterosexual bias in language, and discouraged psychologists from using the term “homosexual” because of its negative connotations with pychopathology and its primary focus on the sexual aspect of a person’s identity.
Diversity and Culture
When we talk about LGBT communities, it is important to keep in mind that this category includes both a range of different types of individuals that share some aspect of oppression related to their sexual orientation and/or gender nonconformity, and that within each of these categories there are a diverse array of individuals who are also members of other oppressed or marginalized groups with varying levels of social power (e.g., women, people of color, people with disabilities). Even when people share membership in some of these multiple identity groups, each individual has his/her own unique set of reactions and experiences (Greene, 2000). As community psychologists, we should be cognizant of the importance of recognizing this diversity within the larger LGBT community, and strive to promote the inclusion of these various voices in our research and liberation efforts. Beverly Greene (2000) cautions against the silencing of LGBT people who are not members of the dominant group, and suggests that “The very act of defining the experiences of all lesbians and gay men by the characteristics of the most privileged and powerful members of that group is an oppressive act.” (Greene, 2000, p. 39).
It is also important to keep in mind that the majority of the conceptualizations and definitions of LGBT people described in this chapter and other writings are those from modernized Western civilizations, and that some authors such as Mary Fukuyama and Angela Ferguson suggest that sexual orientation is a “Western psychological construct not always found in or stigmatized across other cultures” (Fukuyama & Ferguson, 2000, p. 88). They point out that anthropologists such as Gilbert Herdt (1990) have demonstrated that same-gender sexual behavior is quite common in other cultures, and that those who participate in such activities are not stigmatized. American Indian culture offers another departure from traditional Westernized conceptualizations of LGBT identification, and allows for a range of sexual identity categories, as is characterized by the term “two spirited” which serves to describe an individual whose identity is determined by social roles and spiritual powers rather than physical sex (Jacobs, Thomas, & Lang, 1997). Contemporary use of the term “two spirited” has been expanded to signify “a fluidity of gender roles and sexuality beyond the dualistic Western notions of male/female and homosexual/heterosexual” (Walters, Simoni, & Horwath, 2001, p. 135).
Box 19.2 illustrates the importance of considering the role of culture in defining sexual orientation and gender by discussing the cultural conceptualization of same-gender sexual behavior in Mexico, Brazil, and Peru. As was discussed in Chapter Two, this also emphasizes the need for community psychologists to listen to the stories and narratives of the people with which we work as we strive to respect the unique social identities of people and communities. We also must engage in continual self-examination and reflexivity to assure that when working with LGBT people and communities we are not imposing our own cultural conceptualizations of sexuality, gender, and sexual orientation onto another group, especially when we come from a relative position of power and privilege. In doing this we should examine our own biases related to sex and gender related topics, and acknowledge that discourse about sexual expression and desire may cause discomfort because of the often private and personal nature of sexuality, and that discussions of gender identity may challenge our very notions of what it means to be a “man” or a “woman”- issues that we often take for granted.
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HETEROSEXISM AND OPPRESSION
In this next section of the chapter, I review the meaning of the terms homophobia and heterosexism, and discuss the implications of using these terms. I then discuss how multiple forms of heterosexism serve to oppress LGBT people and interfere with attempts at liberation and well-being, and differentiate between cultural heterosexism and psychological heterosexism. After discussing various forms of these types of heterosexism, I explore ways in which LGBT people who belong to other marginalized groups may experience multiple layers of oppression. In the last part of this section, I use the conceptual framework for community psychology presented in Chapter Two as a basis for exploring the range of issues and problems that are experienced by some LGBT people as a result of heterosexism and oppression.
Is it Homophobia or Heterosexism?
The term “homophobia” was first coined in the late 1960s by George Weinberg, a heterosexual psychoanalyst who used the term to describe heterosexual people’s fear, contempt, and hatred of LGB people. “Heterosexism” is a term that emerged after “homophobia,” and shares more in common with other terms like racism and sexism that focus on multiple levels of prejudice and oppression experienced by a group of people. Gregory Herek, a psychologist who has conducted a great deal of research on negativity and stigma directed toward LGBT people, has defined heterosexism as “the ideological system that denies, denigrates, and stigmatizes any nonheterosexual form of behavior, identity, relationships, or community” (Herek, 1995, p. 321). Joseph Niesen (1990) stresses that heterosexism emphasizes the power that major social institutions possess, and the way this power is used to subordinate any non-heterosexual lifestyle. The term “heterosexism” also differs from homophobia in that it was created by activists within the Women’s and Gay Liberation Movement to have political meaning and to offer a common language to discuss the systemic oppression of LGBT people (Kitzinger, 1996).
Some researchers and activists caution against the use of the term “homophobia” since it focuses on invididual-level thoughts, actions and behaviors of the homophobic person and does not recognize the societal level oppression that LGB people face (Blumenfeld, 1992; Hunter, Shannon, Knox, & Martin, 1998). This micro-level analysis makes it easier for people to isolate the negative experiences of LGBT people into discrete events and to lose site of the macro-level changes that are needed to help liberate LGB people. This may be a more comfortable position for some people to accept since they can then divorce themselves from the actions of an “individual” who engages in homophobic behavior, and do not have to take responsibility for being part of the larger social system that perpetuates the oppression of LGB people.
Homophobia also suggests that the person who engages in homophobic thought or actions is experiencing some type of individual-level psychopathology and may even engender compassion for the homophobic person since s/he is “suffering” from a “fear” (Hunter, Shannon, Knox, & Martin, 1998; Blumenfeld, 1992; Herek et al., 1991). In addition, Celia Kitzinger (1996) cautions that the use of terms such as “internalized homophobia” denote negative psychological states experienced by LGB people, since it describes a negative reaction to oppression. She points out that even though LGB people typically do not seek psychological services to change their “homosexuality” any more, they now seek the assistance of therapists in overcoming their “internalized homophobia” - shifting the focus from the powerful oppressor to the less powerful individual who experiences the impact of oppression (Kitzinger, 1996).
This discussion of the term “homophobia” is an excellent example of how terminology that is used to describe the negative experiences of an oppressed group of people can be used (intentionally or unintentionally) to limit efforts at liberation and well-being by concentrating the focus on a micro-level analysis of a social issue as opposed to a macro-level analysis. In addition, it can work against the community psychology principle of ecology and promote the dominant culture’s focus on individualism and promote victim-blaming, as in the use of the term internalized homophobia. In community psychologists’ efforts to be accountable to oppressed groups of people, we must be cognizant of the ways in which we conceptualize and discuss the actions of oppressive forces in society and the role that terminology plays in these efforts.
Heterosexism as a Form of Oppression
Given that heterosexism serves to subordinate and stigmatize LGBT people, it can be viewed as a major oppressive force in the lives of LGBT people. Celia Kitzinger (1997) suggests that because of the pervasiveness of heterosexism, “Lesbians and gay men are oppressed in almost every aspect of our lives” (p. 204). This oppression is experienced at multiple levels of analysis (as described in Chapter One), including the personal, interpersonal or relational, and social or community. Although LGBT people may experience heterosexism and oppression in multiple forms within these various ecological systems, Gregory Herek (1992) and Ski Hunter and her colleagues (1998) assert that heterosexism is manifested in two primary ways: through societal customs and institutions (cultural heterosexism) and through individual attitudes and behaviors (psychological heterosexism).
Some forms of heterosexism within these categories are blatant and vengeful, whereas others may be more subtle (regardless of whether or not they are intentional), and may be perpetuated without the oppressor’s conscious recognition that she or he is being heterosexist. Many non-LGBT people are not aware of the heterosexist nature of most societies since heterosexist language, icons, images, and messages are so pervasive within various realms of our existence. For example, LGBT people are traditionally non-existent in mainstream advertising. How many television commercials or magazines ads have you seen that include a same gender couple purchasing a car, or having a meal with their children, or sharing a tender kiss?
Most heterosexual women and men have never been forced to question their sexual attraction to, or love for, members of the opposite gender, since they assume that their affectional feelings and emotions are just a “natural” or “normal” part of being a woman or man. For many LGBT people, on the other hand, these feelings of sexual desire and love for a person are often questioned on a daily basis, as they are constantly bombarded with messages regarding the deviance of the feelings and emotions that to them are “natural” and “normal.”
Cruikshank (1992) has suggested that one method that heterosexuals have used to maintain power over LGBT people is to “erase” their lives and accomplishments from history. Ski Hunter and her colleagues (1998) point out that this has occurred in several instances such as the alteration of Greek poetry that described love between men and the alteration of Emily Dickinson’s love letters to women. In addition, history books rarely reveal that several historical figures, such as Florence Nightingale, Billie Holliday, Virginia Woolf, Michelangelo, Alexander the Great, and Oscar Wilde, were gay men or lesbians. In some instances the “invisibility” of LGBT people is self imposed, as individuals may chose to conceal their sexual orientation for fear that talking about their partner, love interests, and general lifestyle will result in negative consequences such as harassment or victimization.
This protective desire to hide one’s sexual orientation can lead to the living of a “double life,” whereby a person only talks about LGBT-related experiences with those friends, family, and co-workers who are aware of the person’s LGBT identity. LGBT people who are only “out” to some individuals in their social and family networks may become quite facile at “pronoun switching” when talking about same-gender dating partners or love interests - using opposite gender pronouns around those who are not aware of their orientation and same-gender pronouns around those who are aware. Some individuals even adopt a different set of behaviors and language that are enacted around those to whom they are not “out” in order to remain “invisible.”
Discrimination is the other form of cultural heterosexism. In many instances LGBT individuals are not legally protected from abusive and discriminatory actions, as many oppressive legal ordinances and laws restrict LGBT-identified individuals from sharing the same basic human rights and privileges as those who do not identify as LGBT (Swan, 1997; Wetzel, 2001). For example, in the United States this includes actions such as prohibiting same-sex marriages, restricting same-gender sexual activity, giving employers the right to terminate LGBT employees, allowing landlords the right to prohibit same-gender couples from cohabiting, prohibiting LGBT people from serving in the military, terminating parental rights of LGBT individuals, and using sexual orientation as a factor in making restrictive custody decisions. Unfortunately many of these laws are not based on objective decisions regarding basic human rights for all people, but instead are strongly influenced by court justices’ and lawmakers’ views regarding the morality of same-gender sexual conduct (Feldblum, 2000; 2001).
Psychological heterosexism represents individual-level heterosexism that may be manifested through both feelings/attitudes and behaviors, and is usually discussed in terms of how it promotes and perpetuates violence against LGBT people (Herek, 1992; 1995). Ski Hunter and her colleagues (1998) outline three levels of psychological heterosexism: prejudice and stereotypes, harassment, and violence. The negative attitudes that some people have toward LGBT people result from prejudice and stereotypes regarding LGBT people, which often are created and promoted by people who have had either no contact or limited interactions with LGBT people. These negative attitudes can then lead an individual to engage in harassment or violence as they “act out” their perceived hatred of LGBT people. The perpetuation of negative stereotypes and myths represents one way in which people in the majority can use their position of power to influence others who have never come into contact with LGBT people, and also rationalize their role in oppressing LGBT people (Rappaport, 2000).
Community psychologists have documented the shocking frequency of LGBT harassment and violence that occurs in North America, and the negative impact it has on people who experience it (e.g., D’Augelli, 1989; D’Augelli & Hershberger, 1993; Garnets, Herek, & Levy, 1990; Rosario, Rotheram-Borus, & Reid, 1996; Schneider, 1991; Waldo, 1998). The threat of violence is part of the everyday lives of many LGBT people, especially youth. Rivers and D’Augelli (2001) documented the astounding proportion of LGBT youth who are subject to bullying, harassment and physical abuse in multiple settings including their neighborhood, home, and school; and from various individuals such as peers, parents and teachers.
Examination of current events detailed in the media offer further evidence for the continued acts of violence perpetuated against young LGBT people. In 1998, 21-year-old Matthew Shepard, a gay University of Wyoming student, was a victim of a fatal anti-gay attack. He was brutally beaten, burned, and then tied to a fence in a remote area where he remained for over 18 hours in nearly freezing weather and eventually died. In 1993 Brandon Teena, who was born Teena Brandon and raised as a girl, was living as a man in Falls City, Nebraska. When two of Brandon’s male acquaintances learned that that he was biologically a female, they brutally raped him. Brandon reported the rape to the county sheriff who, instead of protecting him, told the two rapists that Brandon had reported the rape. These two men then shot and killed Brandon.
These atrocious acts of violence against LGBT people are not restricted to the United States. In 1999 in New Zealand, two young men viciously assaulted and murdered Jeff Whittington, a 14 year old male who was assumed gay because of his effeminate behavior. After brutally beating his head, face and body, the two men jumped up and down on his head and left him in the middle of the street to die (Public Education Regarding Sexual Orientation Nationally, 1999). In other countries the number of documented cases of anti-LGBT murders each year is astounding. For example, a recent report revealed that in 2000, 130 gay men, lesbians, and transgendered people were murdered throughout Brazil (Mott & Cerqueira, 2001). In the past decade there have been more than 1200 anti-gay murders in Brazil (Mott, 1997).
Multiple Membership and Layers of Oppression
LGBT people who are members of one or more other marginalized communities may experience multiple layers of oppression. Oftentimes LGBT people of color, for example, must not only contend with the negative societal reactions to their sexual orientation and/or gender nonconformity, but also may experience racial prejudice, limited economic resources, and limited acceptance within their own cultural community (Diaz, 1998; Martinez & Sullivan, 1998). Some LGBT people of color even feel that they must chose between being LGBT and being a member of their own ethnic/racial group. This is perpetuated by a belief that the gay liberation movement and LGBT identification are White middle-class phenomena, and that those people of color who join this movement are rejecting their culture of origin, and joining the White oppressor (D’Emilo, 1983; Fukuyama & Ferguson, 2000). Pat Washington (2001) has referred to the perpetuation of multiple layers of oppression against LGBT people of color by non-LGBT people of color as “one subordinating group subordinating another” (p. 123). People of color also may experience racial prejudice and marginalization within the predominately White mainstream LGBT community. This may be manifested in an objectification and eroticisation of LGBT people of color by White LGBT men and women who are seeking to fulfill an exotic or passionate fantasy (Diaz, 1998; Han, 2001; Martinez & Sullivan, 1998).
This differential treatment in both the community of culture and mainstream White LGBT community, may lead some LGBT people of color to experience varying degrees of visibility and invisibility within these communities, and their identity as a LGBT person may change depending on the cultural context (Fukuyama & Ferguson, 2000; Morales, 1989). Maria Cecilia Zea, Carol Reisen, & Raphael Diaz (in press) have illustrated this by their finding that some Latino men identify as “gay” when they are in the context of a gay bar, but not when they are with their families. Other LGBT people may make themselves “invisible” within their cultural group, as was demonstrated by Tremble, Schnedier, and Appathurai’s (1989) study of lesbian and gay youth of color in Toronto, which revealed that these young people would often exclude themselves from cultural activities in order to avoid bringing shame to their families.
Issues of power may further complicate the picture, as switching or concealing LGBT and other identities may result in varying levels of social power and opportunities for one’s voice to be heard. Mariana Romo-Carmona (1995) suggests that for some LGBT people who experience multiple layers of marginalization, such as lesbians of color, the act of being visible as a LGBT person can be empowering. She posits that “‘Coming out’ by the least powerful, most oppressed members of a society challenges the foundation of power, by individuals whom the power structure considers to be the least threatening” (Romo-Carmona, 1995, p. 90). She cautions that although this act can be empowering, it may also spark retaliation from those in positions of privilege who do not want to surrender power and social control.
Although the vast majority of research and writing about multiple identity concerns and layers of oppression for LGBT people have been related to people of color, similar issues of invisibility, lack of acceptance, and negativity have been reported by other groups of LGBT people as well. Tom Shakespeare (1999) conducted interviews with disabled LGB people in Britain and found that one of their most distressing concerns was the hostility that they faced in either or both the LGB and disability communities. This lack of acceptance and need for a cohesive community that unites multiple forms of identity has been echoed by those working with LGB people with developmental disabilities as well (Thompson, Byrson, & Castell, 2001). Within the deaf community, William Rudner and Rochelle Butowsky (1981) found that some LGBT individuals have maintained their invisibility by creating a set of signs in American Sign Language that are known only to lesbian women and gay men and serve to conceal certain aspects of their LGBT-related communication from straight deaf men and women.
Consequences of Heterosexism and Oppression for LGBT People
The multiple acts of oppression experienced by all LGBT people, regardless of their membership in other communities, can lead to a range of threats to their well-being and liberation. As discussed in Chapter Two, it is important to differentiate between the surface manifestations that may be experienced by marginalized people, such as mental health problems, and the root causes of these manifestations, which include a complex web of oppressive forces and power inequalities. The issues and problems experienced by LGBT people are multi-dimensional and are typically a result of society’s negative reaction to LGBT people and the perpetuation of heterosexist actions and forces, not because of anything inherent in being LGBT. Gregory Herek’s (1991) review of research on the mental health of lesbian women and gay men demonstrated that overall these individuals do not experience higher rates of negative mental health outcomes, with the exception of higher rates of suicide among LGB youth and higher rates of substance use among lesbian women and gay men. Both of these psychosocial problems (i. e., suicide and substance use) are strongly influenced by the root cause of oppression.
Reactions to Immediate and Chronic Oppressive Actions
Several of the “Issues and Problems” listed in the first column of Table 2.2 in Chapter Two are experienced, to varying degrees, by some LGBT people as a result of society’s reaction to LGBT people, including internalized oppression, fragmented identity and living a double life, poor mental health, psychosocial problems, social isolation and rejection, powerlessness, and discrimination, harassment, and violence. These issues are typically inter-related and not mutually exclusive, often impacting the individual in multiple interactive ways. The most frequently studied areas have been negative physical, psychological, and psychosocial outcomes (e. g., depression, anxiety, suicide, substance use) experienced by some LGBT adolescents and adults due to their experiences of discrimination, harassment, and violence (e. g., D’Augelli, 1993; D’Augelli & Hershberger, 1993; Garnets et al., 1992; Meyer, 1995; Rosario et al., 1996; Ryan & Futterman, 1998; Waldo, Hesson-McInnis, & D’Augelli, 1998). These outcomes may be a response to more immediate or direct acts of harassment and violence, or to more chronic exposure to oppression.
One clear example of the direct impact of anti-LGBT violence can be found in a study conducted by Gregory Herek, Roy Gillis and Jeanine Cogan (1999). They examined lesbian women and gay men who were survivors of hate crimes over a five-year period and found that they demonstrated more signs of psychological distress such as depression, anger, anxiety, and post-traumatic stress, than lesbian women and gay men who had experienced non-prejudice-based crimes during the same time period. In addition, these negative health effects appeared to be maintained over a longer period of time than those resulting from random crimes.
Chronic and pervasive exposure to oppressive actions and systems may lead to internalized oppression, a broad term that has been used to describe the experience of an individual from an oppressed group accepting the negative societal views of the oppressor and experiencing self-blame and shame. For LGBT people, it has been suggested that internalized oppression may be expressed in both overt and covert ways (Consiorek, 1993). Overt expressions may take the form of self-deprecating comments and failure to access needed social supports due to internalizations of messages that they are not deserving of such assistance; whereas covert expressions may be more difficult to detect since the individual may appear to exhibit a healthy self acceptance, yet places herself/himself in situations that are destined to lead to distress.
Ilan Meyer (1995) has suggested that the chronic negative societal stressors and oppression experienced by LGBT people as members of a stigmatized numerical minority group leads to the experience of “minority stress.” He has demonstrated, in a sample of gay men, that the minority stressors of “internalized homophobia” (i. e., directing negative societal attitudes toward the self), stigma (i. e., expectations of rejection and discrimination), and actual experiences of antigay violence and discrimination are each independently related to psychological distress (e. g., demoralization, guilt, suicide, sexual problems; Meyer, 1995). Rafael Diaz and his colleagues (2001) also demonstrated the impact of oppression on psychological distress with their sample of gay and bisexual Latino men living in the United States. They assert that the psychological symptoms that were exhibited by their participants (i. e., social isolation/loneliness and low self-esteem) could not be attributed to individual pathology, and instead were “deeply connected to a lifelong history and current experiences of social discrimination owing to sexual orientation and racial/ethnic diversity, as well as to high levels of financial hardship due to severe unemployment and poverty” (Diaz, Ayala, Bein, Henne, & Marin, 2001, p. 93).
Although the most commonly studied psychosocial reactions to oppression for LGBT people have been suicide and substance use, the more recent and persistent threat of HIV and AIDS among gay and bisexual men in most industrialized countries has lead researchers to examine the potential role of oppression in increasing gay and bisexual men’s risk for HIV infection. Caitlin Ryan and Donna Futterman (1998) have discussed the need to attend to the increased risk for HIV infection among LGBT youth, since the societal stigmatization and invisibility they face compound the existing high risk of infection with sexually transmitted diseases that all adolescents traditionally experience. Rafael Diaz and George Ayala (2001) have demonstrated a relationship between increased HIV sexual risk and experiences of homophobia, racism, and financial hardship among Latino gay and bisexual men in the United States. On a more individual level, Margaret Rosario and her colleagues (2001) have examined the impact of internalized homophobia/oppression within a sample of LGB youth in New York, where they found that more negative attitudes toward same-gender sexual expression (including attitudes related to their own sexual orientation) were related to increases in unprotected sexual activity.
TOWARD LIBERATION AND WELL-BEING
The concepts of health promotion and prevention reflect the community psychology value of health, and can be applied at multiple ecological levels through person-centered prevention, community-wide prevention, and public health policy. Over the past several years, there has been an increasing recognition that LGBT people experience unique societal circumstances that may differentially impact their health and well-being. In the United States, these changes have come about through the united efforts of LGBT activists, community members, researchers, the American Psychological Association and clinicians from various disciplines who have provided federal public health officials with documentation regarding the need for an increased focus on the health-related needs of these populations. Due to these united voices, the National Institutes of Health (NIH) released a program announcement calling for research on LGBT health on May 21, 2001. Three institutes within NIH invited submissions of grant applications for behavioral, social, mental health, and substance abuse research with LGBT and related populations. This is the first time that NIH has released a program announcement specifically focused on LGBT health issues. This action provides overt legitimization of LGBT research by virtue of the commitment of the federal government to secure funds specifically for these populations, and represent a shift in LGBT public health policy.
Another major milestone in the national recognition of the health issues of LGBT people is the relatively recent publication of the Healthy People 2010 Companion Document for LGBT people. Every 10 years a new Healthy People report is published by the U. S. federal government in order to set guidelines and objectives for federal public health issues in the preceding ten years. This is the first time that the U. S. Healthy People public health agenda has ever included a separate document that includes a comprehensive look at the unique needs of LGBT people. The document includes approximately 120 objectives and 12 focus areas that cover a range of public health issues, as well as specific recommendations regarding areas that have been neglected including improved access to care for LGBT people, LGBT-specific preventive medicine initiatives, and cultural competency for health care providers.
Major advances also have been made in the specific areas of lesbian health and gay men’s health. In 1999, the Institute of Medicine released the first national report on lesbian health issues, Lesbian Health: Current Assessment and Directions for the Future. This effort began in 1997 and was funded by NIH and the Centers for Disease Control and Prevention to assess the available scientific data on the physical and mental health of lesbian women and to review the challenges of conducting research on the health issues specific to lesbian women (Institute of Medicine, 1999). In addition, in June 2001 the first National Lesbian Health Conference was held in San Francisco with support from the National Institute of Health. In 1999 the first Gay Men's Health Summit was held in Boulder, Colorado and addressed diverse issues specific to gay men through interactive workshops and seminars focused on topics such as rural gay men’s health, hepatitis, anti-gay violence, domestic violence, and gay men of color.
Several specific groups of people within the larger LGBT community who share a common identity or membership in another group (e. g., ethnicity, age), as well as the families and friends of LGBT people, have engaged in community organizing and mobilizing efforts in order to increase their social support and improve collective well being. Self-help groups and community-based organizations that are formed by individuals who share a common concern are examples of meso-level interventions that can combat the impact of social isolation experienced by oppressed people. The formation of community organizations and collective networks, and participation in community development initiatives can also create change for LGBT people and their allies at a macro-level by increasing community capacity and social capital.
Self help groups have been quite helpful for parents who need assistance in understanding and coping with their child’s sexual orientation (Savin-Williams, 1996). The most recognized and extensive of self help groups is Parents, Families, and Friends of Lesbians and Gays (P-FLAG), which is a non-profit organization that provides support group meetings, community education, and advocacy for LGBT civil rights in more than 460 communities in the United States through its local chapters and national office. P-FLAG began with a simple act of activism by a mother who witnessed her son being attacked at a gay rights demonstration in New York. In reaction to this event, Jeanne Manford marched with her son in the 1972 New York Pride Day parade and later, at the urging of many lesbian and gay people who asked her to talk with their parents, held a support group for parents in a local church (http://www.pflag.org).
Although Latina lesbians were involved in many of the social activist activities of the gay rights liberation movement in the 1960’s, they began organizing in autonomous groups in the early 1980’s in major cities in the United States as a way to show solidarity and to provide support and assistance to each other (Romo-Carmona, 1995). Many of these women organized themselves as networks, as opposed to formal organizations that were often viewed as hierarchical, and groups such as Las Buenas Amigas were formed to create a safe space for Latina lesbians to build connections with other Latina lesbians in other parts of the world. In 1987 the first Encuentro de Lesbianas de Latino America y El Caribe was held in Mexico to create a space for Latina lesbians to unite and to show solidarity (Romo-Carmona, 1995). Groups such as Las Buenas Amigas were critical to organizing this event and also have been involved in major lesbian and gay political movements and actions.
Nancy Nystrom and Teresa Jones (in press) describe the community organizing efforts of a small group of older lesbian women in the Pacific Northwest region of the U. S. who met in 1996 to discuss the lack of support and resources for aging and older lesbian women in their community. These women formed the Elder Initiative1 in attempt to ensure the involvement of aging lesbians in community planning efforts in their community, and to increase social support through building connections among lesbian women over the age of 45. Within three years membership in the group grew from 45 to 550 women, and over time the women organized a range of efforts such as monthly workshops on health, grief and loss, and social support; a newsletter and website to inform members about relevant community events and issues; and the Skills Bank which was a clearinghouse for home repair projects, fundraising, networking, and maintaining contact with the housebound (Nystrom & Jones, in press).
1The name of the group was changed during the development process but was not revealed in the article to protect the confidentiality of the members.
Collective Power: Gay Rights Liberation Movement and Community Partnerships
Dalton, Elias, and Wandersmann (2001) suggest that movements for social change and liberation that occurred among various oppressed groups in the U. S. during the 1960s had a strong influence on the development of the field of community psychology, and they cite the gay rights liberation movement as one of those motivating forces. The gay rights liberation movement is an example of a macro-level social change movement that occurred as a result of oppressed people joining together in an attempt to promote collective well-being.
Lesbian women and gay men actually began participating in a variety of community organizing and mobilizing efforts on social, organizational, and political fronts many years before the New York Stonewall riot in 1969, which is often recognized as the event which marked the beginning of the modern gay rights liberation movement (Poindexter, 1997). In fact, formal gay and lesbian organizations such as the Mattachine Society, Daughters of Bilitis and ONE existed early in the 20th century, and the first formally organized gay civil rights group in the U. S., the Society for Human Rights, was formed in 1924 in Chicago (Nardi, Sanders, & Marmor, 1994; Poindexter, 1997). These early organizations served as venues for affiliation and community organizing around issues of harassment, politics, and discrimination.
Community psychologists Linda Garnets and Anthony D’Augelli (1994) provide an excellent historical trajectory of empowerment efforts in lesbian and gay communities within the United States beginning in the 1950s. In tracing this history they demonstrate how lesbians and gay men have enacted Swift and Levin’s (1987) four steps for translating empowerment into action. They demonstrate how lesbian and gay communities have identified empowerment deficits by documenting discrimination and prejudice based on sexual orientation; promoted empowerment awareness by analyzing gay/lesbian history, and providing public education regarding anti-lesbian/gay violence; mobilized economic, social and political power by forming social networks and political coalitions directed at confronting prejudice and discrimination; and attempted to change levels of equity in society by developing and implementing interventions that attempt to change social norms related to prejudice and violence and to create formal legal and institutional protections against such harm (Garnets & D’Augelli, 1994).
An example of addressing collective power at the relational or meso-level of analysis is the formation of partnerships between community psychologists and LGBT people. For the past five years, some of my graduate students and I have been working collaboratively with a community-based organization that provides sexual health promotion services to gay and bisexual Latino and African-American male adolescents. We have worked together to reveal the various oppressive narratives that impact young gay and bisexual men of color, and then have used this information to help youth in the community modify existing narratives and create new narratives through the agency’s health promotion program. In order to maintain a collaborative partnership and to work in solidarity with the agency and the youth, my graduate students and I actively participate in agency rituals and meetings, attend program activities (i. e., street/ community outreach and intervention sessions), participate in cultural events and fundraisers, and generally “hang out” at the agency and in the community (Harper, Bangi, Contreras, Pedraza, Tolliver, & Vess, in press).
LGBT Legal Issues and Public Policy: Toward Inclusion and Equity
Laws and public policies that restrict the human rights of LGBT people, or fail to offer LGBT people the same legal protections as non-LGBT people, serve as major oppressive forces. The community psychology value of respect for diversity and cultural relativity can be enacted at the macro-level through policies that are designed to provide a greater degree of equity for marginalized groups and to create a society that is more inclusive of all people. Within the past 20 years, several countries have made advances in laws and public policies that are beginning to provide LGBT people with the same basic human rights as non-LGBT people.
The U. S. is one country that has evidenced recent victories in the fight for LGBT rights. As of January 2002, thirteen of the 50 U. S. states have anti-discrimination laws, all of which protect lesbian and gay employees, and some include additional discrimination protection (Lambda Legal Defense and Education Fund, 2002). Although the U. S. Supreme Court has only heard three cases related to LGBT rights in the past 13 years the weight of their decisions has had a tremendous impact on the way LGBT rights are viewed (Feldblum, 2001). One significant case was the Supreme Court's 1996 ruling in Romer v. Evans which struck down Colorado’s Amendment 2, which would have removed the possibility that LGBT people could be protected against discrimination in Colorado (Feldblum, 2001; Russell & Richards, in press). Supporters of Amendment 2 claimed that LGBT individuals receive “special rights” because they received discrimination protection under the law, not realizing that these laws merely allowed for the provision of “equal treatment,” not “special treatment.”
The Romer v. Evans decision was considered by many to be a legal victory for LGBT individuals, and some LGBT civil rights groups considered it to be the most important Supreme Court ruling in the history of the gay rights movement (Lambda Legal Defense and Education Fund, 1996). State Supreme Court rulings also have been viewed as a measure of advances in the growing recognition of the need to protect the rights of LGBT people. For example, the Nebraska Supreme Court held a County Sheriff accountable for his failure to protect Brandon Teena in the case that was previously discussed, where the sheriff’s failure to protect Brandon based on his transgendered status led to his tragic death. This ruling is seen as strengthening law enforcement’s duty to protect LGBT crime victims (Lambda Legal Defense, 2001).
Recent legal and legislative advances have occurred in many other countries besides the U. S., demonstrating a global change in the way that LGBT people’s human rights are being viewed. For example, in 1996 the Republic of South Africa, which was quite oppressive toward LGBT people under apartheid, officially adopted a new constitution that guaranteed protection for lesbian, gay, and bisexual people, making it the first country in the world to include such specific protections for LGB people. In 2000, the Netherlands became the first country in the world to legalize same-gender marriages. The Dutch law gives same-gender couples the right to legally marry, and provides for all of the same privileges and conditions as heterosexual marriages including divorce and adoption rights. On July 12, 2002 the Ontario Superior Court became the first Canadian court to rule in favor of recognizing same-gender marriages when it ruled that prohibiting lesbian and gay couples from marrying violates the Charter of Rights and Freedoms, and thus is unconstitutional. Unfortunately just 17 days later on July 29, 2002 the federal government announced that it will appeal the ruling (Wood, 2002). The final action on this appeal has not been determined as of the writing of this chapter.
National and international human rights groups have addressed other LGBT civil and human rights issues elsewhere in the world. In 1994 the United Nations Human Rights Committee determined that the sodomy laws of the Australian State of Tazmania violated the country’s obligations under the International Covenant on Civil and Political Rights. The International Gay and Lesbian Human Rights Commission (1999) reported that this case was a landmark decision for international LGBT rights. Great Britain was recently charged by the European Court of Human Rights to lift its ban on LGB people in the military, since this exclusion violated the European Convention on Human Rights (Lyall, 1999). In addition, the United Nation’s High Commissioner for Human Rights recently moved to increase their focus on human rights abuse and violations based on sexual orientation and gender identity. This is the first time that a non-LGBT specific group with such international presence and power has stated publicly that they are going to make LGBT issues a significant part of their international agenda (International Gay and Lesbian Human Rights Commission, 2001).
Commitment Through Research: Listening to the Changing Voices of LGBT People
An examination of the progression of LGBT-related research over the past several decades illustrates ways in which the community psychology value of accountability to oppressed groups has slowly been incorporated into scientific inquiry, and how the voices of LGBT people are gradually being heard. Since the end of World War II, scientific interest in sexual orientation has gone through several stages. Early research focused on whether or not “homosexuality” constituted a mental illness, and included a progression of studies that eventually portrayed LGB people in a more positive light. That body of research culminated in the removal of “homosexuality” from the DSM in 1973 (Bayer, 1981).
A second wave of research focused on the lesbian and gay experience, while an awareness of bisexuality emerged even later. This era of research revealed information about the coming-out process, about the effects of discrimination and violence on LGB people, and about the lives of LGB people in their various roles as family members, partners, parents, members of the work force and citizens (Harper & Schneider, in press). This research richly illuminated what it is like to be LGB, but has sometimes been criticized for focusing predominately on the negative aspects of the LGB experience rather than on the strengths and resiliencies of LGB people. The HIV/AIDS epidemic fostered a new wave of research beginning in the 1980’s that ultimately resulted in a greater focus on the strengths of LGB communities and the way in which those strengths could be harnessed for treatment, management, and prevention of HIV/AIDS. For better or for worse, it also focused more attention on the LGB population as underserved and understudied, a point that LGB activists began to emphasize (Harper & Schneider, in press).
Most recently, research related to transgendered individuals is beginning to emerge, and the voice of this oppressed group is slowly being heard. Although some research was conducted on transgenderism in the early 1900s, subsequent early work lacked a solid basis in research, consisting mostly of case studies conducted by psychiatrists with a Freudian orientation (Bullough, 2000; Pfaefflin, 1997). Current work on transgender issues echoes the early wave of gay and lesbian research and is focused on the question of psychopathology. Some authors are challenging the inclusion of transvestic fetishism and gender identity disorder as psychiatric disorders in the current DSM-IV (e. g., Gainor, 2000), but more research that involves the voices and perspectives of transgendered individuals is needed to support the challenge.
As I have illustrated in this chapter, community psychologists are in a prime position to contribute to the social change efforts that are needed in order to liberate LGBT people. Unfortunately, several of the initiatives detailed in this last section of the chapter have not been initiated by community psychologists, but by groups of LGBT people who joined together to fight an oppressive society. Tony D’Augelli was one of the first U. S. community psychologists to write about the need for the field to actively address LGBT issues, and in 1989 noted that despite community psychologists’ level of expertise in empirically describing social phenomena and community change, and in implementing social action initiatives, they have not adequately addressed LGBT communities. More than a decade after this recognition of community psychology’s relative lack of emphasis on LGBT issues in the academic literature, several recent issues of community psychology academic journals have been developed and are offered here as resources for further exploration. They detail recent efforts by community psychologists who are attempting to promote liberation and well being among LGBT people and communities.
1. Adrian Coyle and Sue Wilkinson edited a special issue of the Journal of Community and Applied Social Psychology entitled “Social Psychological Perspectives on Lesbian and Gay Issues in Europe: The State of the Art” which appeared in 2002, Volume 12, Issue 3.
2. Janice Ristock and Danielle Julien edited a special issue of the Canadian Journal of Community Mental Health entitled “Disrupting Normalcy: Gay/Lesbian/Queer Issues in Mental Health” which will be published in Fall 2003.
3. Margaret Schneider and Gary Harper edited a special issue of the American Journal of Community Psychology entitled “Lesbian, Gay, Bisexual, and Transgendered Communities: Linking Theory, Research, and Practice” which will be published in 2003.