The role of psychology in working with the LGBT population

This text seeks to briefly present the role of psychology and psychotherapy with the LGBT population, a generalist acronym for lesbian, gay, bisexual (ie non-heterosexual) and trans or transgender (designated persons). with one sex at birth and identify with another). Psychological science has produced a vast literature on the effects of chronic stress to which LGBT people are subjected daily to living in invalidating, hostile, and violent social contexts (American Psychological Association [APA], 2009; Meyer, 1995; 2003). One of the pillars for the production of this type of studies is the understanding of the phenomenon of prejudice.

Prejudice is an inclination to act, think and feel about certain groups and individuals. Simplifying, grouping and generalizing are processes inherent in the human brain, based on a principle of cognitive economics. The difference between simple generalization and prejudice is that the latter is based on hierarchies that establish that certain people are superior and others inferior, feeding stereotypes, that is, distorted and generalist views about people only because they belong to a group or group. specific segment. This generates individual valuations based on negative characteristics assigned to this group / segment. These hierarchies are fostered and tend to grow and reproduce in contexts where human plurality is not guaranteed and encouraged, and this becomes especially alarming when considering gender and sexual diversity (Costa, 2015).

The LGBT population is subject to alarming prejudice scores, with direct physiological consequences and negative psychological outcomes (Herek & Garnets, 2007). There is a significant relationship between experiences of discrimination, expectations of rejection and internalized homophobia / transphobia (Meyer, 2003). Impacts are not just symbolic, subjective; they are material, concrete. People feel the wound of stigma, hatred, misunderstanding, apathy on their skin. Research has shown that LGBT life expectancy is reduced in environments explicitly contrary to sexual and gender diversity, putting this population at risk for suicide, homicide and cardiovascular disease deaths (Bockting et al., 2013; Lick, Durso , & Johnson, 2013).

There are findings that point out that LGBT youth who experience family prejudice and rejection and other support networks may be four to eight times more likely to attempt suicide (Costa et al., 2017; Haas et al., 2011; Ryan, Huebner, Diaz, & Sanchez, 2009). Lesbian women are subject to persistent objectification and self-monitoring, which may lead to risk for eating disorders (Feldman & Meyer, 2007). Also, levels of depression, anxiety, substance abuse, suicide attempts, and consummate suicides among non-heterosexual and transgender people are higher than in the heterosexual and non-transgender population (King et al., 2008).

The barriers of access of the trans population to health are diverse and need a closer look by public policy makers and researchers themselves in the Brazilian context. By anticipating prejudice, transvestites and transgender people stop attending health services; when they attend, they are mistreated and rejected. Most transgender people resort to prostitution as their only means of survival, as they do not have access to formal education, resulting in closed doors in the labor market (Costa, 2015).

From 2008 to 2013, 539 murders of transvestites and transgender people were reported in Brazil; these numbers are probably higher as underreporting appears to be large (Transgender Europe, 2013). In the school environment, sexual orientation bullying is a common experience among young gay, lesbian and bisexual people; reports of harassment, physical aggression, harassment, and other abusive situations are more common than we would like to imagine (APA, 2009; Herek & Garnets, 2007).

The foregoing situations are merely illustrations of the harms to which the LGBT population in all its segments is exposed in various places around the world. And Brazil has been considered one of the most dangerous places to be LGBT. A life of fear, abandonment, vulnerability and aggression can lead to deep psychological scars. The deleterious repercussions of prejudice and discrimination are not talk of advocates of “gender ideology”, but evidence based on a series of robust studies and on the daily and systematic experience of the victims of this process of death production. This is what, in the end, stigma, prejudice and discrimination produce: subjective, social and physical death.

Given this scenario, the role of psychology professionals is to provide quality care for the LGBT population, having a proper understanding of how the experience of exposure to violence, prejudice and rejection can impact mental health and bring a host of of losses. As directed by the American Psychological Association (2009), psychologists and psychologists must receive specific training and training in prejudice and mental health psychology of the LGBT population in order to develop affirmative, evidence-informed and culturally appropriate psychological practices to recognize and validate specificities. of LGBT people's experiences. Affirmative psychotherapeutic tools can help reduce the deleterious effects of stigma, minimize suffering, enhance resilience, strengthen support networks, increase assertiveness, and optimize psychological functioning.

Psychology professionals who do not feel competent enough for LGBT-affirmative work may seek expert advice. Recently, the Rio Grande do Sul Regional Council of Psychology provided the translation of the “Guidelines for Psychological Practices with Transgender and Non-conforming Persons”, by Ramiro Figueiredo Catelan and Angelo Brandelli Costa, which can be accessed at link: http://bit.ly/2jcF7l8

It is important that the category of psychology can engage in defending other possible trajectories for those who do not fit the socially established gender and sexuality pattern. In this sense, psychoeducation tools are fundamental to ensure access and dissemination of quality information and to combat distortions, stereotypes and untruths circulating about the LGBT population. The contemporary understanding of science understands that homosexuality (and other nonheterosexual orientations) and transsexuality are not characterized as diseases, but rather normal variations of sexual orientation and gender identity. It is not a matter of opinion or personal positioning, but of evidence on which psychologists should support their work.

It is an ethical duty to cross the threshold of indifference toward more empathic postures. The difference is placed in humanity as a complex phenomenon. Life is plural, diverse, multiple, abundant, multifaceted. Human difference and diversity, specifically gender and sexual diversity, needs to be recognized, affirmed, validated and reinforced. What differs from who we are should not threaten, reduce or nullify us, but magnify, qualify and enlarge.

Psychology has been producing theories and tools that can help improve the LGBT population's quality of life and build a society with more respect and empathy, counteracting a history of pathologization and stigma that has unfortunately been stimulated by certain currents of psychology. . The LGBT population can be helped by psychologists and psychologists to restructure cognitively, behaviorally and emotionally; have other visions of yourself, the world and the future; develop assertive coping strategies; and build a life worth living.

Life can be very valuable even in the face of pain, hatred and misunderstanding. Each person is precious and special in their own way. You who feel discriminated, vulnerable, without perspective: you are not alone. Seek help from your support network; above all, seek professional support from affirmative-oriented psychologists and psychologists. It is possible to overcome hopelessness; You can reinvent your story and build a worthy existence. After all, life makes more sense when painted with multiple colors.

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* Text written by Ramiro Figueiredo Catelan, psychologist, psychotherapist, Master student in Social and Institutional Psychology, postgraduate in Cognitive Behavioral Therapy by CEFI, being monitor of his class. She works as a psychotherapist in a private practice and develops training in gender and sexuality. Research mainly on the following topics: LGBT population health, HIV / AIDS-related stigma, prejudice against gender and sexual diversity, and adaptation of psychological interventions for the LGBT population.

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References

American Psychological Association. (2009). Report of the Task Force on Gender Identity and Gender Variance. Washington, DC: Author.

Bockting, W. O., Miner, M.H., Swinburne Romine, R.E., Hamilton, A., & Coleman, E. (2013). Stigma, mental health, and resilience in an online sample of the US transgender population. American Journal of Public Health, 103 (5), 943-951.

Costa, A. B., Pasley, A., Machado, W. de L., Alvarado, E., Dutra-Thomé, L., & Koller, S. H. (2017). The Experience of Sexual Stigma and the Increased Risk of Attempted Suicide in Young Brazilian People from Low Socioeconomic Group. Frontiers in Psychology, 8, 192.

Costa, A. B. (2015). Vulnerability for HIV in Brazilian Trans Women. (PhD Thesis in Psychology) - Federal University of Rio Grande do Sul, Porto Alegre.

Haas et al. (2011). Suicide and suicide risk in lesbian, gay, bisexual, and transgender populations: review and recommendations. Journal of Homosexuality, 58 (1), 10-51.

Feldman, M. B., & Meyer, I. H. (2007). Eating Disorders in Diverse Lesbian, Gay, and Bisexual Populations. The International Journal of Eating Disorders, 40 (3), 218–226. Herek, G.M., & Garnets, L.D. (2007). Sexual orientation and mental health. Annual Review of Clinical Psychology, 3, 353-375.

King, M., Semlyen, J., Tai, S. S., Killaspy, H., Osborn, D., Popelyuk, D., & Nazareth, I. (2008). A systematic review of mental disorder, suicide, and deliberate self harm in lesbian, gay and bisexual people. BMC Psychiatry, 8, 1-17.

Lick, D.J., Durso, L.E., & Johnson, K.L. (2013). Minority stress and physical health among sexual minorities. Perspectives on Psychological Science, 8, 521-548.

Meyer, I. H. (2003). Harm, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin, 129, 674-697.

Meyer, I.H. (1995). Minority stress and mental health in gay men. Journal of Health and Social Behavior, 36, 38-56.

Ryan, C., Huebner, D., Diaz, R.M., & Sanchez, J. (2009). Family Rejection as a Predictor of Negative Health Outcomes in White and Latin Lesbian, Gay, and Bisexual Young Adults. Pediatrics, 123 (1), 346-352.

Transgender Europe. (2013). TDOR Press Release. Nov 13 2013.Transgender Europe. (2013). TDOR Press Release. Nov 13 2013.