Counseling Sexual and Gender Minority Youth

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Sexual and gender minority youth seldom seek therapy of their own accord. Most are referred for therapy by their parents, teachers, school practitioners, and other adults because of issues unrelated to their sexual orientation and gender expressions. Youth often present themselves for counseling with symptoms such as depression, anxiety, substance abuse, academic failure, and family conflicts (Holman & Goldberg, 2006). For that reason, it is recommended that practitioners routinely screen for their sexual orientation/gender identity concerns (Holman & Goldberg, 2006). Holman and Goldberg recommended the use of a simple statement and a probe: “Many people struggle with gender [sexual orientation]. Is this an issue for you?”

The exploration of sexual feelings and behaviors is considered a developmentally appropriate task of adolescents. Sexual and gender minority youth are particularly interested in exploring their sexual and/or gender feelings and expressions. For this reason, it is imperative that practitioners who work with youth understand the fluidity and diversity of sexual and gender expressions and identifications that characterize this population. Many practitioners are already familiar with Klein’s Sexual Orientation Grid (Klein, Sepekoff, & Wolf, 1985; Klein, 1990), which conceptualizes sexual orientation in terms of arousal, fantasy, sexual behaviors, and social and emotional preferences over time. The grid requires persons to rate themselves on each dimension, using a seven-point heterosexual-bisexual-homosexual scale for each dimension.

Another tool that helps youth and family members think beyond a dichotomous view of gender is Eyler and Wright’s (1997) nine-point gender continuum. This psychoeducational tool helps increase awareness and appreciation of the complexities of gender identities and expressions. With the support of helping professionals, youth evaluate each point to determine those that seem most relevant:

1. Female-- I have always considered myself to be a woman (or girl).
2. Female-maleness--I currently consider myself to be a woman, but at times I have thought of myself as really more of a man (or boy).
3. Genderblended-female predominant--I consider myself gender-blended because I consider myself female predominantly (in some significant way to be both a woman and a man, but somehow more of a women).
4. Othergendered--I am neither a woman nor a man, but a member of some other gender.
5. Ungendered--I am not a woman, a man, or a member of any other gender.
6. Bigendered--I consider myself bigendered because sometimes I feel (or act) more like a woman and other times more like a man, or sometimes like both a woman and a man.
7. Genderblended-male predominantly--I consider myself gender-blended because I consider myself male predominantly (in some significant way to be both a man and a woman, but somehow more of a man).
8. Male-femaleness--I currently consider myself to be a man, but at times I have thought of myself as really more of a woman (or girl).
9. Male--I have always considered myself to be a man (or boy) (Eyler & Wright, 1997).

This tool is meant to serve as a catalyst for further dialogue and as a way of normalizing the concept of gender diversity.