Cross-Cultural Counseling: LGBT, Latinas, and Disabilities

Introduction to Cross-Cultural Counseling Competence

This paper examines cross-cultural values and mores through the lens of counselor interactions with gay, lesbian, and transgendered individuals, Latinas, and individuals with disabilities. It integrates case study analyses drawn from Case Studies in Multicultural Counseling and Therapy and relevant social justice counseling issues to support its discussions. For each of these three populations, the paper considers what factors should be kept in mind during interactions so that all parties are honored — whether the relationship is that of therapist, colleague, social acquaintance, partner, or neighbor. The paper concludes with a reflection on what was especially accessible and what proved challenging to understand about these cultures, given the author's unique worldview, followed by a summary of key research findings.

Gay, Lesbian, and Transgendered Individuals

With a growing number of states legalizing same-sex marriages and acceptance of gay, lesbian, and transgendered communities increasing across the country, it is reasonable to suggest that counselors in all fields will likely encounter individuals from these communities during their careers. In order to become proficient in cross-cultural counseling, it is essential to learn as much as possible about people from other cultures, particularly those with whom counselors frequently come into contact. The definition provided by Krentzman and Townsend (2008) indicates that cultural competence means "having the beliefs, knowledge, and skills necessary to work effectively with individuals different from one's self; that cultural competence includes all forms of difference; and that issues of social justice cannot be overlooked" (p. 7). For heterosexual counselors, understanding the world of gay, bisexual, and transgendered individuals can represent a challenging enterprise.

The definitions of gay, bisexual, and lesbian are common knowledge, but the concept of transgendered may be novel to some counselors. Chung (2003) defines transgendered individuals as: (a) people whose gender identity or behavior deviates significantly from what traditional culture deems appropriate for their biological sex at birth; or (b) people with ambiguous or multisex genitalia. According to Chung, "This definition includes transvestites and transgenderists (part-time and full-time cross-dressers), transsexuals (both before and after sex-reassignment operations), and androgynous and intersex (ambiguous or multisex) persons" (2003, p. 78).

Research to date has been largely unsuccessful in precisely determining the prevalence of transgendered individuals in the United States, because the majority of studies have included only people placed on waiting lists for surgery who were classified as transsexuals for analytical purposes, without any follow-up to determine actual clinical outcomes (Carroll & Gilroy, 2010). Current estimates place the percentage of transgendered individuals in the U.S. at between 3% and 10% of the general population, making it highly probable that counselors will encounter individuals from the lesbian, gay, bisexual, and transgendered communities at some point in their professional careers (Carroll & Gilroy, 2010).

An interesting point raised by Chung (2003) concerns the status of transgendered individuals within mainstream American society and within the lesbian, gay, and bisexual (LGB) communities in particular. In contrast to the growing public acceptance of LGB cultures, transgendered individuals continue to be stigmatized and face discrimination even from within the LGB community. As Chung emphasizes, "Opponents to inclusion argue that LGB is about sexual orientation — a person's affective and sexual desires for people of the two sexes — whereas transgenderism is about gender identity, a person's self-identification as male or female in self-concept or behavior" (p. 78).

Opponents of inclusion also maintain that LGB and transgendered cultures are sufficiently distinct that they should not be grouped together (Chung, 2003). Chung notes that "transgendered people are not widely accepted, or may be discriminated against, in the LGB community" (2003, p. 78). These perceptions are slowly changing, however, both within mainstream American society and the LGB communities. As Chung adds, "In recent years an increasing number of LGB organizations have moved toward the direction of inclusiveness. Proponents of inclusion argue that transgendered people are an integral part of the LGB community" (2003, p. 78).

Despite these advances, many members of the LGBT community remain marginalized throughout American society and even within the LGBT community itself. McCabe and Rubinson (2008) report that harassment of LGBT young people in the nation's schools continues to threaten the physical safety and emotional stability of LGBT youth. Young LGBT persons are at three times the risk of experiencing a violent attack compared to their heterosexual peers (McCabe & Rubinson, 2008). An overwhelming majority — 90% — of LGBT young people have experienced physical harassment or assault based on their perceived sexual orientation, gender expression, appearance, race/ethnicity, disability, or religion, compared to 62% of heterosexual teenagers (McCabe & Rubinson, 2008). Not surprisingly, LGBT young people are also three times more likely to feel unsafe at school compared to their heterosexual counterparts (McCabe & Rubinson, 2008).

In spite of the growing need, many counselors remain woefully unprepared to work with members of the LGBT community, especially transgendered or transsexual persons. Bess and Stabb (2009) point out that "working with transgender and transsexual clients calls for specialized knowledge. Because of the lack of formal specialized training, therapists wishing for specialized training often have to educate themselves about working with transgendered persons" (p. 264). Unfortunately, there remains a dearth of relevant and timely curricular offerings concerning the provision of counseling services to members of the transgendered community (Bess & Stabb, 2009).

Conclusion

Interfacing with others effectively always involves a complex blend of verbal and nonverbal communications, and the quality of these interactions is enhanced when the parties understand each other's cultural worldviews and perspectives. The quality of these interactions is further improved when clinicians make an effort to better understand the salient contextual issues that are adversely affecting their clientele. When it comes to interactions with people from the LGBT community, Latinas, and individuals with disabilities, the research consistently shows that understanding these contextual factors requires counselors to move out of their comfort zone and invest in deeper understanding of these communities through individual research and empirical observation.

Although there is no one-size-fits-all approach to counseling members from these disparate cultures, it is possible to develop a better understanding of their worldviews and perspectives in ways that contribute to the formulation of effective clinical outcomes — outcomes that would not be achievable without this effort and understanding. Achieving successful clinical outcomes with clients from other cultures demands that counselors apply different counseling methods from those with which they are most familiar. Despite these challenges, the research also demonstrates that counselors can succeed in achieving optimal clinical outcomes when they take the necessary steps to see the world through their clients' eyes. In the final analysis, not only can counselors do a better job by genuinely striving to understand the unique worldviews and perspectives of their clients — they have a fundamental professional and ethical obligation to do so.