Sexual Fluidity
Once upon a time, there was a certain clarity in the world of sexuality. Regardless of whether one believed a homosexual orientation was innate or a matter of choice, the sexual orientations were easily and clearly defined -- those who were attracted to, and had sex with, people of the opposite gender were heterosexual (straight), while homosexuals (gays and lesbians) were attracted to, and had sex with,, people of the same gender. You knew who was who by the gender of the sexual partner.
As time went on, the waters became muddied a bit by acknowledgment of bisexuals and their ability to be attracted to, and have sex with, people of either gender. Initially, they were seen as immature or confused, either closeted gay people or curious straight people. But eventually we got our heads around bisexuality and, for the most part, accepted that it was a real sexual orientation, just like gay/lesbian and straight.
Still later, we made a place for love in all of this. What is still called “sexual” orientation was acknowledged to be not only about sex, but about emotional attachment as well. Having a homosexual orientation, then, came to mean being sexually and emotionally attracted to those of the same gender, although the emotional aspect of sexual orientation is commonly underplayed.
But then things became very confusing. In studying HIV transmission in the Black community, men “on the down low” came to light. These are men who identify as straight but secretly have sex with other men; when the sex was unsafe, this resulted in some Black women becoming infected with HIV. Men who have sex with men (MSM) aren’t limited to the Black community, and they violate the core underlying assumption of our model of sexuality: that sexual orientation is defined by sexual behavior. Since men having sex with men is incongruent with heterosexuality (unless the men are imprisoned), these men are commonly assumed to be gay (or bisexual) but either in denial or in the closet, or have compartmentalized sex completely in order to live with the dissonance of having same-gender sex but being straight. But MSM are not the only confusing phenomenon.
Once upon a time, the sexualities—heterosexual, homosexual, even bisexual—were considered categorical and mutually exclusive. Further, sexual attraction/desire, sexual behavior and sexual identity were assumed to be congruent: same-gender sexual attraction/behavior presupposed a gay or lesbian or bisexual identity, and other-gender sexual attraction/behavior assumed heterosexuality. But results of sexuality research over the last 20 years have turned our paradigm of sexuality on its head. What we’ve learned is that while these assumptions may be true for some, they are not true for all.
The truth is, Kinsey was right: sexuality not only exists on a continuum, some people may (and do) move on that continuum across the lifespan. The truth is, sexuality can be fluid, varying across time and situation. The truth is, sexual orientation appears to be comprised of many variables, not just sexual behavior. And the truth is, desire/behavior and orientation/identity do not always line up neatly. Some completely straight individuals have unexpectedly found themselves falling in love with, and being sexual with, those of the same gender, and some happily gay people have unexpectedly become partnered with those of the other gender. How could this happen? What does it mean?
Note that the research does not prove that sexuality is fluid, only that it can be. Studies have shown that sexual fluidity is not uncommon and is found more frequently in women than men, though it clearly exists in both. This does not mean that we all experience a degree of fluidity, nor that we are all really bisexual. Nor does it mean that coming out as gay or lesbian is reversible or a phase, that sexual orientations are a choice, or that non-heterosexual people can be guided to embrace heterosexuality. It simply means that while the majority of people experience a stable sexual orientation congruent with their sexual and romantic attractions and behavior, some of us do not.
The Tragic Impact of Family Rejection
on Gay, Lesbian and Bisexual Young People:
New Study Results
When a young non-heterosexual person shares his or her sexual orientation with a parent, the parent is thrust into a critical moment. While this moment is crucial for the quality of the parent-child relationship, it has much broader implications. A new groundbreaking study* shows that parents’ rejecting behaviors towards their gay, lesbian and bisexual (GLB) adolescents promote serious negative health outcomes in early adulthood. Let’s take a closer look at this study and what it means, beginning with clarifying what is meant by “rejecting behaviors” and “negative health outcomes.”
Parents’ reactions to their child “coming out” -- what parents actually say and do-- range from acceptance to disowning and everywhere in-between. Sometimes parents take a “tough-love” approach, laying down a “oh no you aren’t/won’t be gay” law. They verbally (and non-verbally) provide negative feedback such as shaming and blaming, restrict who their child associates with or dates, send their child away to a different school or home, or kick their child out of the house. These behaviors may be motivated out of love and concern for the child, longstanding beliefs and values, and/or by a conviction that if the parents clearly let their child know how inappropriate or unacceptable the child’s gayness is to the family, the child will set it aside, much like a career idea that goes against the family’s wishes. Well-intended or not, such rejection has proven to be extremely harmful.
The harm, or "negative health outcomes” found in the study, is dramatic and affects both physical and mental health. GLB young adults who experienced higher levels of family rejection during adolescence, compared to those that reported little or no family rejection, were
over 8 times more likely to report having attempted suicide
nearly 6 times more likely to report high levels of depression
over 3 times more likely to use illegal drugs
over 3 times more likely to report having engaged in unsafe sex**
Parents, once they learn these facts, are often appalled at the effects of their actions. The good news is that a little less rejection goes a long way: ongoing research suggests that parents who take minor steps to respond without rejection can dramatically improve a gay young person's mental health outlook. This means that parents who do not feel wholly accepting of their child’s sexual orientation have an alternative to doing considerable harm to their child, simply by reacting with equanimity rather than rejection. As a parent, if your attitudes, translated into behaviors, directly put your kid at risk of suicide or other harm, isn’t it worth it to moderate your behavior a little?
* Researcher Caitlin Ryan, Ph.D. and team at San Francisco State University publish results from study of 224 youth ages 21-24 in the January issue of Pediatrics (the journal of the American Academy of Pediatrics). For more information about the study, see http://familyproject.sfsu.edu.
** from Lisa Leff, Associated Press article on the study, December 29, 2008.
What About Medication?
People often wonder whether or when they should start or stop taking medications for their psychological problems. The question of medication is a serious one, since medications may have side effects or even unexpected effects. Given that I am not a medical doctor, I cannot advise anyone about the appropriateness of a medication. However, here is my perspective on the issue of medication.
First, I am neither categorically “pro” or “anti” medication. Whether medication might be useful depends on the condition a person is struggling with and its severity. The fact is, medication can be incredibly helpful for many people. It can quiet racing and obsessive thoughts, moderate panic, alleviate crippling depression, improve inattention. It can save and improve lives.
That said, few psychological conditions are resolved merely by medication. There are certainly some conditions for which medication is the first treatment choice, such as schizophrenia, bipolar disorder, attention deficit disorders. There are others for which no medication has yet been found to be particularly useful. And there are some conditions for which the combination of medication and talk therapy has been shown to be more effective than either one alone.
Additionally, often issues “co-exist”—for example, a person suffering from anorexia may also be depressed. So a person suffering from both may take an anti-depressant, which will help the depression, and perhaps secondarily benefit the struggle against anorexia.
If your distress is so profound that it is interfering with your day-to-day functioning, medication may well be necessary to bring you back to functioning adequately. Consult a medication provider (primary care physician/nurse or psychiatrist). Once you are more stable, you will be better able to utilize the other healing tool: therapy.
If you are considerably distressed but still able to function, consulting a medication provider may be something you want to consider. The decision of whether or not to take medication is always up to you. There may also be non-medication options to consider. I regularly talk with my clients about this decision and their feelings about taking medication, so they can make the best choice possible for themselves.
Couples Counseling: Can It Really Help?
Whether married or not, couples of all kinds can face problems in their relationships. These problems span the gamut of concerns, including conflicts over extended family and/or friends, sex, parenting, money, infidelity, and so on. Issues can be raised, fought over, but never resolved.
One of the most frequent complaints I hear from couples concerns “lack of communication.” Sometimes this complaint is about “lack”—that is, the quantity of communication-- but more often it’s about the quality of a couple’s communication. Not feeling heard or understood can lead to feeling that one’s partner lacks respect or caring.
Another issue couples may struggle with is decreased intimacy. Balancing needs for work, daily life tasks, personal time, and/or children can negatively impact a couple's relationship. Some couples unhappily find themselves evolving into roommates, but don't know how to change their situation.
Style differences affect couples as well. Although we’re often drawn to those of opposite styles, the differences that were once so appealing can drive us nuts! Differences in planning, organizing, prioritizing, and approaching tasks like home projects or child-rearing; personality differences such as introversion and extroversion; differences in expectations of what it means to be partners; and a host of other differences can cause conflict in couples.
The good news is, recent research has provided sound information about the nature of longer-term relationships, as well as behaviors that either help or hinder satisfying and lasting relationships. Couples therapists can help translate this knowledge into practical skills.
Learning conflict resolution skills, learning to talk and listen, experimenting with different approaches, accepting “acceptable” differences, and learning to show love in ways our partners value, can all be gained through relationship counseling. Working with a third party gives the couple a safe place to discuss their concerns and to learn, practice, and receive guidance and feedback about their relationship skills.
Choosing a Therapist: Who’s Right for Me?