Couples Therapy with Gay and Lesbian Clients: An Analysis of Important Clinical Issues

Abstract

This article reviews and critiques couples therapy research that has focused on gay and lesbian relationships. In conducting our examination, we felt that it was imperative to address the sociopolitical climate that affects same-sex couples and that historically impeded this area of research. Upon addressing the therapist's role and comparing heterosexual relationships to same-sex relationships, this article presents the theoretical formulations and empirical findings that have informed gay and lesbian couples therapy research. We also present limitations of the current literature and suggestions for future research.

The authors would like to extend their deepest gratitude to Maureen Davey and Julie Askew for their feedback and support during the writing of this article. For the purposes of this article, the term gay refers only to men who engage in sexual behavior with other men or who self-identify homosexual. In turn, the term lesbian refers to women who engage in sexual behavior with other women or who self-identify as homosexual.

Notes

1 Nine negative practices were included, such as “your therapist indicated that he or she believed that a gay or lesbian identity is bad, sick, or inferior,” “your therapist pressured or advised you to come out to someone in spite of the fact that you believed it was too risky,” and “your therapist apparently did not understand the problems of societal prejudice against gay men and lesbians and/or internalized homophobia.” Four supportive practices were also included, such as “your therapist never made an issue of your sexual orientation when it was not relevant” and “your therapist helped you feel good about yourself as a gay man or lesbian.”

2 In empirical studies investigating frequency, quantity, and satisfaction of sexual behavior, sexual behavior typically assumes genital contact (i.e., vaginal penetration, oral sex, genital fondling). Defining sexual behavior with these behaviors may not represent the most valid model of sexual behavior. The need for a more-accurate model of sexual functioning for lesbians will be addressed later in this article.