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Abstract
Queer theory is often maligned as being inadequate for advancing social justice. So, how might queer theory guide research and practice in public mental health services (PMHS)? Within the research on mental health issues for lesbians, gays and bisexuals (LGB) there are calls for making mental health services more LGB affirmative. Mostly this scholarship is from the field of ‘lesbian and gay psychology’. This tends to have an individualistic, positivist and essentialising focus. As such, it is limited in exploring how heteronormative cultural discourses impact on research, mental health systems and clinical practice. For example, common recommendations include separate LGB services and matching clients and clinicians along sexual orientation lines. Utilising a queer perspective on the homo/hetero binary, this article argues that such strategies are minoritising, in that they make homosexuality relevant to only a minority of clients and staff. When applied to mental health practice, minoritising strategies have limited scope to effect change for the wide group of same-sex attracted clients within PMHS. Based on research with same-sex attracted clients and staff of PHMS in Aotearoa/New Zealand, this article explores how a queer theoretical perspective can usefully inform research and clinical practice in ways that affirm queerness by questioning heteronormativity.
Acknowledgement
This is a research conducted at the Psychology Department, University of Auckland, New Zealand.
Notes
1. Here I am using ‘queer’ to denote same-sex attracted people in the broadest sense and to signify that many do not identify with the common terms of lesbian, gay or bisexual. For a discussion of various limitations and strategic possibilities of ‘queer’ as a term, see Halperin (Citation1995) and Hegarty (Citation2005).
2. My own research focussed on men who have sex with men (MSM), but it is possible that the queer theoretical considerations outlined in this article may be relevant to research and practice with other same-sex attracted sexualities.
3. In exploring universalising strategies, I agree with Sedgwick (Citation1990), and others (Chambers, Citation2002; Nairn & Smith, Citation2003), who argue that the marginalising/universalising dichotomy is a useful analytical tool, but need not represent mutually exclusive approaches. Rather, I contend that it is important to use both approaches strategically and ethically to support queer-affirmative goals.
4. When designing the research I chose to focus on MSM as it seemed likely that being a man would significantly impair my ability to access women clients within PMHS.
5. As with the universalising/minoritising dichotomy discussed earlier I am not implying a good/bad dichotomy between constructionist and positivist research in LGB psychology. Both have their strengths and limitations and positivist LGB psychology has achieved much for the cause of LGB rights (Bohan & Russell, Citation1999; Kitzinger, Citation1995, 1997). ‘The oppression of lesbians and gay men can be effected by both essentialism and social constructionism alike: and equally, the struggle against that oppression can make use of both (albeit logically incompatible) perspectives’ (Kitzinger & Coyle, Citation2002, p. 21). Thus, I agree with Clarke and Peel (Citation2007) who argue that critical psychology can add to rather than ‘replace other approaches to this area of psychology’ (p. 5).
6. For further examples, see Meyer (Citation2001) who poses various heteronormative restraints to researching LGBT public health issues.
7. It is relevant to note here that throughout the literature, the terms ‘sexual orientation’, ‘sexual identity’ and ‘sexuality’ are used interchangeably. There seems to be little pattern to how they are used and I follow this multiple usage.
8. This observation does not negate the significant research done within the field of LGB psychology on the effects of marginalisation and homonegative experiences on the lives of LGB people (see Balsam & D'Augelli, Citation2006; D'Augelli & Grossman, Citation2001; D'Augelli & Hershberger, Citation1993; D'Augelli, Grossman, & Starks, Citation2006; Espelage, Aragon, Birkett, & Koenig, Citation2008; Meyer, Citation1995, Citation2003a, Citation2003b; Rivers, Citation2001; Rivers & D'Augelli, Citation2001; Ryan & Rivers, Citation2003; Wright & Perry, Citation2006).
9. For more examples of this style of questioning, see ‘Appendix 2 – Interview Guidelines Clients’ in Semp (Citation2006, pp. 329–331).
10. The ‘Gender and Critical Psychology Group’ is in the Psychology Department, University of Auckland. Key staff involved are Associate Professor Nicola Gavey and Senior Lecturer Dr. Virginia Braun.
11. Furthermore, I did not want to exclude men who experienced same-sex attraction but had not acted upon it. So in the recruitment brochures I additionally stated that ‘the study also includes men who are sexually attracted to men but who have not had or do not have sex with men’ (Semp, Citation2006, p. 335).
12. In an article on issues regarding lesbians and gay men doing research with lesbian and gay communities, LaSala (Citation2003, p. 23) discusses the notions of lesbian and gay researchers being ‘both insiders and outsiders’ in relation to the communities and participants they study. However, I include this comment to acknowledge that LaSala does not use a social constructionist perspective to theorise this. Nevertheless, his article is useful for considering some of the advantages and disadvantages of a partial ‘insider’ status as a researcher.
13. Consistent with a queer perspective on identity, my use of a ‘gay’ identity for the purposes of the research does not presuppose that I use this identity consistently across contexts or time.
14. These discourses are explicated in Semp (Citation2006).
15. Semp (Citation2006) critiques the research on ‘gaydar’ as being limited by which lesbian and gay people get represented by it. ‘Gaydar’ research tends to focus on ‘out’ ‘lesbian’ and ‘gay’-identified people who are involved in lesbian and gay communities. There is also little attention paid to ethnicity in such research.
16. Māori are the indigenous people of Aotearoa/New Zealand.
17. At this point I use the term LGBT (lesbian, gay, bisexual and transgender) as it is the terminology most commonly used in the literature regarding separate services for sexual minority groups. This term (while still contested) represents a broader shift towards increasing inclusivity within what was previously called ‘Lesbian and Gay Psychology’ (Clarke & Peel, Citation2007).
18. CMHC stands for Community Mental Health Centre. This is the term commonly used to describe adult outpatient public mental health services in the United States, the United Kingdom and New Zealand.
19. This study focussed on LGB, and did not use the terminology of LGBT.
20. I asked eight of the men about this issue. Of those eight, all said that they would prefer it if mainstream services were able to meet the needs of MSM clients. One said he thought both should be available.