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Articulating Identities: Language and Practice with Multiethnic Sexual Minority Youth

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Clinicians working with sexual minority youth (SMY) should be knowledgeable about the contemporary language around sexuality and gender used by adolescent clients. Such knowledge contributes to the clinical environment and aids clinicians in developing therapeutic relationships. However, individuals working with SMY should also be aware of the potential impact of social environment and individual context on SMYs language and terminology. This paper discusses the role that socio-demographic and contextual factors may play in access to discourses of sexuality and sexual identity taxonomies for a population of multiethnic sexual minority youth (MSMY) (n = 500) from Miami-Dade County, Florida. The study population is comprised of primarily Black, non-Hispanic (31.4%), and Hispanic (65.4%) SMY; 94.2% identify using traditional sexual identity terminology, including lesbian (38.1%), gay (25.7%), and bisexual (28.1%). The impact on clinical practice and counseling with SMY is discussed throughout.
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Counselling Psychology Quarterly
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Articulating identities: Language
and practice with multiethnic sexual
minority youth
Lauren McInroy a & Shelley L. Craig a
a Factor-Inwentash Faculty of Social Work, University of Toronto,
Toronto, Ontario M5S 1A1, Canada
Available online: 27 Apr 2012
To cite this article: Lauren McInroy & Shelley L. Craig (2012): Articulating identities: Language and
practice with multiethnic sexual minority youth, Counselling Psychology Quarterly, 25:2, 137-149
To link to this article: http://dx.doi.org/10.1080/09515070.2012.674685
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Counselling Psychology Quarterly
Vol. 25, No. 2, June 2012, 137–149
Articulating identities: Language and practice with multiethnic
sexual minority youth
Lauren McInroy and Shelley L. Craig*
Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto,
Ontario M5S 1A1, Canada
(Received 30 November 2011; final version received 5 March 2012)
Clinicians working with sexual minority youth (SMY) should be knowl-
edgeable about the contemporary language around sexuality and gender
used by adolescent clients. Such knowledge contributes to the clinical
environment and aids clinicians in developing therapeutic relationships.
However, individuals working with SMY should also be aware of the
potential impact of social environment and individual context on SMYs
language and terminology. This paper discusses the role that socio-
demographic and contextual factors may play in access to discourses of
sexuality and sexual identity taxonomies for a population of multiethnic
sexual minority youth (MSMY) (n¼500) from Miami-Dade County,
Florida. The study population is comprised of primarily Black, non-
Hispanic (31.4%), and Hispanic (65.4%) SMY; 94.2% identify using
traditional sexual identity terminology, including lesbian (38.1%), gay
(25.7%), and bisexual (28.1%). The impact on clinical practice and
counseling with SMY is discussed throughout.
Keywords: sexual minority youth; LGBTQ (lesbian, gay, bisexual, trans,
queer/questioning); adolescence; clinical; practice; language; terminology
Introduction
The development of an adolescent’s sexual identity is influenced by a combination
‘‘of biological, psychological, social, and cultural factors’’ (Dube
´, Savin-Williams, &
Diamond, 2001, p. 130); thus, the labels contained within any taxonomy of sexual
identity exist within a socio-cultural system of meaning (Hammack, Thompson, &
Pilecki, 2009). Clinicians working with sexual minority youth (SMY) should be
knowledgeable about the contemporary language used by clients to identify their
sexual and gender identities to facilitate a positive clinical environment (Garofalo &
Bush, 2008), as well as to aid in building productive therapeutic relationships
(Greenfield, 2008). SMY negotiate and reconcile their individual sexual attractions
and experiences within taxonomies of identity which are meaningful in the systems
they inhabit (Hammack et al., 2009). However, many models of sexual identity
development for SMY have been criticized for being overly linear, failing to account
for social context, and minimizing the role of other socio-demographic character-
istics (i.e. gender, race/ethnicity, socioeconomic status, etc.) (Cox, Vanden Berghe,
Dewaele, & Vincke, 2010), making them less appropriate for multiethnic sexual
*Corresponding author. Email: shelley.craig@utoronto.ca
ISSN 0951–5070 print/ISSN 1469–3674 online
ß2012 Taylor & Francis
http://dx.doi.org/10.1080/09515070.2012.674685
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minority youth (MSMY). There is a lack of attention to the complex ways in which
various sub-populations of SMY, including MSMY, negotiate their multiple
identities, as well as how the identification of diverse SMY populations may
impact practice with them.
Prior research on sexual minority youth
Some recent research has indicated an ongoing shift in the social and cultural
landscape of North America, which is positively impacting SMY. These studies
indicate social changes, such as an increase in sexual minorities in media, a decrease
in homophobia, an increase in access to sexuality-related information, and an
increase in civil rights for sexual minorities has led to an environment in which SMY
identities are more accepted within society, and in which contemporary SMY have
increased access to social and cultural support, such as online resources and
communities, as well as school-based LGBTQ (lesbian, gay, bisexual, trans, queer/
questioning) groups (i.e. gay-straight alliances), than previous generations of
adolescents (Hammack et al., 2009). However, scholarly debate remains over this
supposed shift in North American culture, as well as the problems confronting SMY
(Cohler & Hammack, 2007). Research continues to demonstrate that, in addition to
homophobia and heterosexism, SMY experience increased the risk of victimization,
stigmatization, rejection, and isolation. Additionally, SMY are at increased risk for
an array of maladaptive social and behavioural issues compared to heterosexual
youth, including substance use, homelessness, risky sexual behaviour, truancy, and
delinquency (Fisher et al., 2008; Garofalo & Bush, 2008; Garofalo, Wolf, Kessel,
Palfrey, & DuRant, 1998; Morrison & L’Heureux, 2001; Thompson & Johnston,
2004). SMY are also more likely to experience emotional and mental health
problems, including loneliness, worthlessness, depression, and suicidality (Fisher
et al., 2008; Garofalo et al., 1998).
Although there is a lack of knowledge about the unique risks of MSMY, SMY
who experience multiple minority statuses, such as being a racial/ethnic minority as
well as a sexual minority, may experience an increase in risk factors including
discrimination, harassment, or marginalization (Fisher et al., 2008). Further, MSMY
may struggle to negotiate the expectations of multiple communities. Literature
suggests that racial/ethnic minority LGB people may experience homophobia in their
communities of origin as well as racism or alienation in the LGBTQ community
(Fisher et al., 2008; Meyer, 2003). Some research has also shown that particular
resources for SMY, such as gay-straight alliances, may not provide the same benefits
to MSMY due to the structure, format, and environment of the school and group
(Griffin, Lee, Waugh, & Beyer, 2004; McCready, 2004). Further, despite these
challenges, racial/ethnic minority LGBTQ populations are underserved in the mental
health system (Wynn & West-Olatunji, 2009).
Shifting sexual identity taxonomies
There is also debate over the identity labels being used by SMY. Recent research
suggests that SMY may increasingly use more fluid terminology, multiple terms, or
terms which are less recognizable to label their sexuality. Such labels include queer,
pansexual, bicurious, same-gender-loving, and polyamorous (Boykin, 2005; Garofalo
138 L. McInroy and S.L. Craig
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& Bush, 2008; Potter, Goldhammer, & Makadon, 2008; Savin-Williams, 2005b;
Thompson & Morgan, 2008). Savin-Williams (2005a, 2005b) suggests that SMY may
be increasingly unlikely to label their sexuality at all. However, these claims assume
that SMY are exposed to such taxonomies of identity, as well as the cultural discourses
underlying them. This may not be the case for all SMY. Cohler and Hammack (2007)
acknowledge that the discourses and narratives associated with this shift in culture
may be most relevant to youth in communities which are more prosperous,
sophisticated, and urbanized.
Identity and multiethnic sexual minority youth
The lack of research on MSMY makes the impact of this cultural shift on their sexual
identities unclear. However, scholarship does indicate that as a result of contextual,
environmental, historic, soci-cultural, socio-economic, political, and geographical
differences, SMY in North America are diverse and may experience the cultural
landscape differently (Cohler & Hammack, 2007; Davis, 2009; Fisher et al., 2008;
Frankowski, 2004; Savin-Williams, 2005b; Smith, 2010). These differences, as well as
other factors including age and ethnicity, may result in variations in the process by
which an individual identifies as a sexual minority (Fisher et al., 2008; Savin-
Williams & Diamond, 2000). Thus, sexual identification may vary with social
environment, and may be dependent upon various socio-demographic categories
(Garofalo & Bush, 2008; Potter et al., 2008; Smith, 2010).
The identity development process for SMY has been addressed in many models.
Generally, these models ‘‘describe a process of identity formation and integration as
individuals strive for congruence among their sexual orientation... sexual behavior,
and sexual identity’’ (Rosario, Schrimshaw, Hunter, & Braun, 2006, p. 46). However,
identity models for racial/ethnic or sexual minorities do not account for the unique
experiences or challenges experienced by multiple-minority individuals (Jamil,
Harper, & Fernandez, 2009). Literature suggests that racialized sexual minority
individuals may experience particular challenges in their development and integra-
tion of sexual minority identities as a result of various cultural factors (e.g.
homophobia, gender role expectations, religiosity, etc.) (Rosario, Schrimshaw, &
Hunter, 2004). One study found that among African Latino and African American
male SMY the development of sexual orientation and ethnic identity occurred
simultaneously but independently. Ethnic identity involved increasing awareness of
cultural background, while sexual identity development involved locating and
articulating a ‘‘personally relevant sexual orientation label’’ (Jamil et al., 2009,
p. 203) and making connections to the LGBTQ community. Similarly, research by
Rosario et al. (2004) on the coming-out process of a racially and ethnically diverse
SMY population suggests that cultural factors do not significantly impact sexual
identity development for MSMY. Yet, their findings also indicate that MSMY,
specifically Hispanics and Blacks, are less likely to disclose their sexual minority
status, perhaps due to cultural expectations. Further, literature suggests that MSMY
may be particularly likely to experience fluidity in their identification, renegotiating
their identities based upon various contextual factors (Savin-Williams, 2005b;
Smith, 2010).
The minimal literature available on identity articulation debates the particular
terminology used by MSMY, indicating that MSMY may be less likely to label their
Counselling Psychology Quarterly 139
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sexuality, and more likely to identify as straight despite same-sex attraction
(Boykin, 2005; Potter et al., 2008; Savin-Williams, 2005b). When identifying as
sexual minorities, MSMY may also be more likely to use non-traditional terms, such
as queer or down-low, in order to reject sexual identity discourses which they
perceive to be irrelevant to their social experience (Cohler & Hammack, 2007; Potter
et al., 2008).
Identity and practice with multiethnic sexual minority youth
As discussed, SMY experience unique risks, stressors, and sexuality-related stigma.
Further, their sexual identity or gender expression may limit their access to sources
of social and emotional support. Thus, it is the responsibility of counselors working
with adolescents to provide positive, ‘‘welcoming clinical environments’’ (Garofalo &
Bush, 2008, p. 76) for SMY, whether or not they identify as LGBTQ. This
development of an affirmative clinical climate is crucial; as these locations may be the
only situations in which SMY feel comfortable asking for support or guidance
(Garofalo & Bush, 2008).
Cultural competence necessitates the development of a base of knowledge,
attitudes, and skills relevant to a particular population. Sometimes termed ‘‘gay
affirmative practice’’ (Crisp & McCave, 2007, p. 403), culturally competent practice
with sexual minorities requires SMY to be considered in their multiple social and
cultural environments and contexts (Crisp & McCave, 2007), thus using an
ecological approach. This framework emphasizes interaction within multiple
domains of an individual’s life, encompassing an SMY’s context of growth in all
settings simultaneously (Bronfenbrenner, 1989, 1994; Morrison & L’Heureux, 2001).
A culture-centered approach may be particularly crucial with racialized LGBTQ
populations, as a result of the intersection of race and sexuality presenting unique
challenges (Wynn & West-Olatunji, 2009) in clinical practice.
A central aspect of creating a supportive counseling environment for SMY is
facilitating communication by creating a dialogue which is honest, open, and safe for
clients (Garofalo & Bush, 2008), but which is also relevant to lived experience and
social context. The language/terminology of clinicians working with some SMY
populations may be different from that used by the clients with which they are
working (Davis, 2009). The use of dated, incorrect, or irrelevant language may
indicate to clients a lack of understanding or respect (Kaufman, 2008). Literature
recognizes that SMY’s progressively multi-faceted identities, and the taxonomies tied
to them, may be challenging for counselors (Frankowski, 2004; Garofalo & Bush,
2008). Increased knowledge of the language used by SMY populations aids clinicians
in their awareness and comfort with these populations (Crisp & McCave, 2007;
Davis, 2009), as well as in providing culturally appropriate care.
This study contributes to this effort by elucidating the sexual identification of
MSMY experiencing multiple social and demographic risk factors. This is crucial, as
the literature on sexual identity taxonomies and discourses of sexual identity used by
MSMY remains limited and could inform counseling practice with this population.
Methods
This study is a secondary analysis of data drawn from a pilot research project carried
out in Miami-Dade County, Florida in collaboration with a community organization
140 L. McInroy and S.L. Craig
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providing clinical services to a predominantly MSMY population. The study is
covered under a University of Toronto Research Ethics Board protocol (no. 25074).
Description of study setting
Based on an ecological approach (Bronfenbrenner, 1989), the context of the
population is examined as context may frame identity negotiation and labeling. This
population experiences marginalization as a result of their sexual, gender, and racial
identities and individual circumstances, but also as a result of their socio-cultural
environment. Participants resided in low-income communities (by zip code), in a
county with a family poverty level well above the United States average (American
Community Survey, 2012). Additionally, most participants attended schools in a
large, urban school system, in a state struggling with educational attainment (Miami-
Dade County Public Schools, 2012; United Way of Miami-Dade, 2011).
Participant recruitment and inclusion/exclusion criteria
Participants were recruited from a community organization serving SMY in Miami-
Dade Country. The youth were participating in either individual care coordination
or group counseling programs, or a combination of the two, at various locations
throughout the county. Inclusion criteria for the study comprised: (1) completion of
an intake form; (2) identification as a sexual/gender minority; and (3) identification
as a racial/ethnic minority. In contrast, exclusion criteria included: (1) not providing
a sexual orientation/gender identity; (2) identification as straight/cisgendered;
and (3) identification as White, non-Hispanic.
Data collection
Data collection took place from June 2008 to September 2010. Two measures were
used: (1) intake forms and (2) psychosocial assessments. The measures were collected
from youth at the start of their participation in the care coordination or group
counseling programs, during their first appointment/meeting. The intake collected
primarily demographic data (i.e. age, race, gender, sexual orientation, disabilities,
education, etc.). The psychosocial assessment gathered data in an array of socio-
demographic areas; including home and family, education and school, health and
mental health, and community and neighborhood. Additional questions addressed
youth concerns in various individual and family areas (i.e. violence, substance use,
discrimination, suicidality, etc.). With regard to questions about sexual identity and
gender expression, options included both traditional and non-traditional terms, as
well as open-ended alternatives (Figure 1).
Data analysis
All analyses were completed using SPSS 19.0. On demographic variables (n¼500)
the missing data ranges from 0% to 1.8%.
Straight, gay, lesbian, and bisexual are considered by the literature to be
conventional or traditional identity labels. These terms, along with questioning,
considered a normal stage of adolescent identity development, were selected as
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‘‘traditional’’ terminology (Cohler & Hammack, 2007; Garofalo & Bush, 2008;
Savin-Williams, 2005b). All other terms were considered ‘‘non-traditional.’’ Several
variables were altered during the analysis. For gender identity, transgender and other
were merged due to lack of use, while queer and intersex were redacted as they
remained unused. For sexual orientation, queer and pansexual were amalgamated
due to lack of use, while the other category was divided into questioning and other to
examine sexual identity as closely as possible.
Results
Participants
Demographic characteristics included age (median 17.0; range 13–22); gender
identity (male, 30.8%; female, 67.2%; trans and other, 2.0%); sexual orientation
(traditional terminology, 94.2%; non-traditional terminology, 5.8%); and race and
ethnicity (Black, Hispanic, 5.2%; Black, non-Hispanic, 31.4%; White, Hispanic,
37.6%; Hispanic, No/Other Race, 22.6%; Other, 3.2%) (see Table 1).
MSMY identification
Nearly 92% of participants identified as lesbian, gay, or bisexual, with 1.0% of
participants identifying as straight with a trans identity, and 1.4% identifying as
questioning. In contrast, 2.8% identified as queer or pansexual, with 3.0%
identifying as other (or using other terms). Thus, only 5.8% were using non-
traditional terms.
Risk factors
MSMY reported many individual risk factors: suicide concerns (16.9%); personal
substance use concerns (22.8%); personal violence concerns (20.3%); and health
concerns (44.3%). Similarly, family and living situation risk factors were also
reported: family/home concerns (79.2%); family substance use concerns (26.5%);
family violence concerns (25.2%); homeless/thrown out/run away (34.7%); out
about sexuality at home (54.3%); and of those out about sexuality, family conflicts
over sexuality (33.5%). Finally, MSMY reported environmental risk factors:
discrimination concerns (20.7%); school concerns (60.1%); felt unsafe at school
(28.3%); and out about sexuality at school (65.8%).
SEXUAL ORIENTATION:
LESBIAN
GAY
BISEXUAL
QUEER
PANSEXUAL
STRAIGHT
OTHER:__________
GENDER IDENTITY:
FEMALE
MALE
TRANSGENDER
(circle) FEMALE / MALE
INTERSEX
QUEER
OTHER:__________
Figure 1. Sample questions: sexual orientation and gender identity.
142 L. McInroy and S.L. Craig
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Discussion
This study found that more than 94% of participants continued to use traditional
identity labels; in contrast, less than 6% used non-traditional terminology, which
contrasts with previous research findings on both SMY and MSMY. According to
some recent research, SMY are increasingly identifying using less traditional identity
labels, while MSMY are more likely to use fluid or flexible terms, or identify as
straight (Boykin, 2005; Cohler & Hammack, 2007; Potter et al., 2008; Savin-
Williams, 2005a, 2005b). In comparison, our findings indicate that the study
population is persistent in its use of traditional identifiers.
MSMY may face unique challenges in the ways which their sexual orientation
and racial identity intersect. Daley, Solomon, Newman, and Mishna (2007) describe
how youth may be unclear regarding whether the bullying they experience is due to
their race or their sexual orientation. Many youth also found that they did not fit in
any identified category and had to juggle multiple identities in discriminatory
situations. Further, Dı
´az, Ayala, Bein, Henne, and Marin (2001) as well as Adams,
Cahill, and Ackerlind (2005) found that gay male Latino experiences with
discrimination are unique; therefore it is critical that research efforts avoid
presumptions of similarity among various minority groups. Research indicates that
diversity, and thus socio-demographic context, is significant in the development of
sexual minority identities (Cohler & Hammack, 2007; Frankowski, 2004; Garofalo &
Bush, 2008; Hammack et al., 2009; Smith, 2010). However, a more in-depth
understanding of identity, and the labels used to articulate them, would allow for
more responsive practice with all SMY populations.
Table 1. Demographic characteristics of participants
(n¼500).
Characteristic N%
Gender (n¼497)
Female 334 67.2
Male 153 30.8
Trans & Other 10 2.0
Sexual orientation (n¼499)
Traditional terminology 470 94.2
Lesbian 190 38.1
Gay 128 25.7
Bisexual 140 28.1
Straight 5 1.0
Other, Questioning 7 1.4
Non-traditional terminology 29 5.8
Queer/Pansexual 14 2.8
Other, Other 15 3.0
Race and ethnicity(n¼500)
Black, Hispanic 26 5.2
Black, non-Hispanic 157 31.4
White, Hispanic 188 37.6
Hispanic, no/other race 113 22.6
Other 16 3.2
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Potential links between risk and identity
The results of this study suggest that the presence of numerous risk factors in
multiple domains of participants’ lives may be contributing to their use of traditional
taxonomies of sexual identity. Existing theory on identity is consistent with this
proposition. MacKinnon and Heise (2010) identify sexuality as a socially experienced
identity, which shifts in meaning and significance. They argue that the language used
by individuals to articulate their social world is impacted by cultural context, and
that contemporary cultural knowledge is experienced differently by various
individuals or groups. Additionally, labels and terms may change in meaning and
salience over time, or may be created or disappear as a result of social change.
Particular subcultures may also have their own specialized identity taxonomies.
Interestingly, they posit that ‘‘[l]ay persons with their vernacular language do not
have anywhere near... [the] level of discrimination in the realm of sexualities’’
(MacKinnon & Heise, 2010, p. 62) assumed by those specializing in the field. Finally,
MacKinnon and Heise (2010) argue that while changes in taxonomies or lexicons
may appear to result from epic cultural shifts when they receive particular attention,
in reality shifts in language tend to be incremental.
The individual and familial risks experienced by the study population were
notable. For example: 22.8% had personal substance use concerns; 20.3% were
concerned about violence (physical, domestic, and/or sexual violence) against them;
79.2% expressed family or home-related concerns; and 34.7% reported past or
present homeless, or having been thrown out or run away. Yet, participants also
demonstrated significant strength and resilience. In addition to continuing to access
LGBTQ-specific services despite experiencing these risk factors, 54.3% were open
about their sexuality with their family. This indicates substantial courage, as MSMY
are less likely to disclose their sexuality, as well as be out with family and peers
(Rosario et al., 2004; Savin-Williams, 2005b). However, 33.5% of those who were
out reported identity-based problems with family which could contribute to clinical
concerns. The school and community settings were also concerning; 60.1% expressed
issues or concerns with school, while 28.3% felt unsafe at school.
These factors, comprising multiple ecological domains, may have framed the
sexual and gender identification of the population, which may not be the case for all
adolescents. Cohler and Hammack (2007) acknowledge that the discourses and
narratives associated with this shift in culture may be most relevant to youth in
communities which are more prosperous, sophisticated, and urbanized, who may not
have to contend with many of the significant risks experienced by our population.
Thus, socio-demographic categories such as gender, race/ethnicity, and socio-
economic status may constrain or direct identity development. Clinicians working
with LGBTQ people should recognize that taxonomies of sexual identity, as well as
the meaning of particular identity categories, are embedded in culture, history,
context, and circumstances (Hostetler & Herdt, 1998).
Suggested guidelines for counseling practice
These findings indicate that particular populations of MSMY may continue to
identify in traditional ways, which has implications for clinicians working with SMY.
Several strategies for counseling are indicated from this study: (1) Counselors should
strive for enhanced competence by being flexible, aware, and responsive regarding
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the language of sexuality and gender used by clients as this will increase the
likelihood of developing positive therapeutic relationships (Crisp & McCave, 2007;
Davis, 2009; Greenfield, 2008). (2) Counselors should understand the relationship
between identity and other factors in client lives to ensure cultural competency and
mutual understanding. (3) Counselors should be positive, supportive, and encourage
a client who is questioning or unsure ‘‘to express or explore who they are from within
rather than be constrained by [the] stereotypes... of others’’ (Greenfield, 2008, p. 50).
(4) Counselors should initially use language which may be easily understood by
adolescent clientele; particularly with younger SMY (Garofalo & Bush, 2008), who
may not understand, or have access to, certain terminology (Davis, 2009). (5)
Counselors should demonstrate non-judgmental respect and ask a client how they
elect to self-identify, using their preferred language in subsequent interactions
(Kaufman, 2008). (6) Counselors should take a careful, concise history of an
adolescent experiencing same-sex attraction or engaging in same-sex sexual
behaviour, regardless of their sexual identification or identity labeling (Garofalo &
Bush, 2008; McGarry, Hebert, Kelleher, & Potter, 2008). Ultimately, these strategies
will allow clinicians to provide support appropriate to clients’ needs.
Regarding MSMY specifically, clinicians should work toward understanding the
interactions between the multiple, simultaneous cultural contexts of MSMY;
mainstream culture, their racial/ethnic community, and the LGBTQ community
(Crisp & McCave, 2007; Davis, 2009); interactions which may impact the selection of
identity labels (Boykin, 2005; Cohler & Hammack, 2007; Garofalo & Bush, 2008;
Potter et al., 2008; Savin-Williams, 2005b). Counselors should consider the impact of
these multiple contexts and identities on access to discourses of sexuality and use of
sexual identity taxonomies. For example, MSMY may elect to identify as straight or
decline to disclose their sexuality, regardless of their sexual attraction or experiences
(Boykin, 2005; Potter et al., 2008; Savin-Williams, 2005b). While the sexual minority
status of MSMY should not immediately be considered problematic, sexual identity
represents an important area for clinical consideration with all SMY; particularly
due to their increased risk of social, behavioral, and mental and emotional health
issues (Fisher et al., 2008; Garofalo & Bush, 2008; Garofalo et al., 1998; Thompson
& Johnston, 2004).
Lastly, attention to language should also be considered in organizational and
institutional practices, including assessment and intake where the full scope of
sexuality and gender expression should be considered; ‘‘forms should explicitly
include questions about gender identity, sexual orientation, and a wide spectrum of
sexual behaviors’’ (McGarry et al., 2008, p. 421) and personal relationships. We
suggest offering a variety of identity labels for sexual orientation (i.e. lesbian, gay,
bisexual, straight, pansexual, polysexual, queer, questioning, two-spirit, asexual, etc.)
and gender (i.e. female, male, transgender, transsexual, intersex, genderqueer,
questioning, two-spirit, etc.), as well as open-ended options for those the offered
labels do not encompass. The option of terms that are gender-neutral, non-binary,
and inclusive on forms and in preliminary interviews is also important in developing
a positive climate, as well as ensuring an accurate client history (Greenfield, 2008;
McGarry et al., 2008). For example, asking about an adolescent’s ‘‘partner’’ or
‘‘relationship,’’ rather than ‘‘boyfriend’’ or ‘‘girlfriend,’’ when discussing dating,
relationships, or sex avoids assumptions of sexuality (Garofalo & Bush, 2008;
McGarry et al., 2008), indicating to adolescent clients that clinicians are ‘‘open to
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discussing same-sex relationships or concerns’’ (Garofalo & Bush, 2008, p. 85) and
facilitating disclosure of sexual identity.
Limitations
There are some limitations to this study. Comparisons between the traditional and
the non-traditional groups were not possible, due to the descriptive nature of the
data as well as the small proportion of participants using non-traditional labels.
Additionally, generalizability of the study is limited by: the geographic focus on
Miami-Dade County; the relatively small sample; the clinical, self-referred nature of
the population; and the exploratory approach of the research. Finally, the cross-
sectional nature of the data prevents conclusively determining if any of the
contextual factors impacted participants’ access to discourses or taxonomies.
Conclusion
Working with SMY necessitates that clinicians be knowledgeable about the language
used by SMY. Appropriate use of language and terminology related to sexual
identity and gender expression is an integral part of building a positive environment
for, and constructive working relationship with, SMY clients (Garofalo & Bush,
2008; Greenfield, 2008). However, as this research demonstrates, clinicians should
also be aware of the role that demographics (e.g. race, ethnicity, gender), context,
and environment play in access to discourses of sexuality and use of language and
terminology. Finally, when working with MSMY, clinicians should be aware of the
potential impact of the intersection of racial identity and sexuality on the sexual
identification of youth.
Acknowledgements
The authors acknowledge the amazing contributions of the youth participants and staff of The
Alliance for GLBTQ Youth. Gratitude is also due to the Children’s Trust of Miami Dade
County for funding the youth programs.
Notes on contributors
Lauren McInroy, MSW, RSW, is a recent graduate of the Factor-Inwentash Faulty of Social
Work. She is a social worker, educator, and researcher. Her research interests include
vulnerable children and adolescents, as well as sexual and gender minority populations.
Dr. Shelley L. Craig, RSW, is an Assistant Professor at the Factor-Inwentash Faculty of
Social Work. Dr. Craig’s research and practice experience focus on the social determinants of
health and mental health and the impact of the service delivery system on vulnerable
populations, particularly urban gay, lesbian, bisexual, and transgender (GLBT) youth.
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Book
This book shows how the individual constructs a self from the thousands of colloquial identities provided by a society's culture, and reveals how the individual actualizes and sustains an integrated and stable self while navigating the sometimes treacherous waters of everyday institutional life. © David R. Heise and Neil J. MacKinnon, 2010. All rights reserved.
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