Disclosing the Therapist's Sexual Orientation: The Meaning of Disclosure in Working with Gay, Lesbian, and Bisexual Patients

ABSTRACT

When working with patients who are gay, lesbian or bisexual, the sexual orientation, or perceived sexual orientation, of the therapist can never be a neutral issue to the patient and may often have profound impact on the treatment. Like any other personal characteristic, the therapist must carefully consider how the disclosure of sexual orientation will affect the treatment. Of equal importance are lesbian, gay or bisexual patients who never express interest in their therapist's sexual orientation or insist that the therapist not reveal this information. This article describes a clinical case in which the issue of disclosing the therapist's sexual orientation played a significant role. An openly gay patient insisted that the therapist not reveal this information, thus maintaining the therapist as a sexual orientation-neutral object. The decision of whether or not to disclose one's sexual orientation should be determined on a case-by-case basis and several questions should be considered.

KEYWORDS:

• AIDS
• bisexual
• countertransference
• disclosure
• gay
• HIV
• homosexuality
• internalized homophobia
• IV drug use
• neutrality
• sexual orientation
• shame
• transference
• neutrality