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Lesbian clients face multiple challenges

August 12, 2014
by Lauren Costine, PhD
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Lauren Costine, PhD

It is extremely important that the lesbian, gay, bisexual and transgender (LGBT) community continue to band together on both behavioral health and political levels so that we can help one another maintain the fight for equal rights, acceptance by the heterosexual community, and effective treatment in addiction and mental health. On the other hand, it is also important that appropriate attention be given to the different psychologies of each orientation and gender identity within this united group. This will ensure that generalized healing practices are not directed to each subgroup when it would not be helpful to do so.

This article focuses on the lesbian population’s unique psychological and cultural concerns from a lesbian-affirmative perspective. It highlights how addiction and mental health professionals can better understand the specific issues lesbians face as they grow up in a heterosexist, homophobic and sexist world. At the same time, it will not only look at the similarities lesbians share with one another, but also pay attention to the many differences that exist within each lesbian’s life experiences and psychological makeup.

Important concepts affecting lesbians

Heterosexism. Herek defined this idea best when he referred to heterosexism as “an ideological system that denies, denigrates, and stigmatizes any non-heterosexual form of behavior, identity, relationship, or community.”1

Heteronormativity. This is similar to heterosexism, but needs its own explanation because it is a belief system that teaches, overtly and covertly, that heterosexuality and traditional family systems (man, woman, children) are the most valued lifestyle and the only lifestyle that is considered normal, given attention and celebrated by society as a whole.

Lesbianphobia. This is a concept I developed years ago to distinguish between male-focused homophobia and the kind of discrimination lesbians face in being both same-sex oriented and women. This is the irrational fear and/or hatred of same-sex emotional, romantic and erotic love between women—combined with the varying degrees of misogyny that exist in a patriarchal and heteronormative culture.2

Sexism/misogyny. Still alive and well in our current culture, this ideology continues to have a negative impact on all women. Developing authentic feelings of self–love is difficult when the world keeps saying that men are more valuable than women.

Genderphobia. This is the irrational fear and/or hatred of anyone whose gender expression is different from the prescribed gender roles placed upon people by the heteronormative society (e.g., women should be feminine in nature and men should be masculine). Lesbians whose natural style of personal and gender expression falls into the more “masculine” expression and roles can face greater discrimination than lesbians who fit more “acceptable” gender expressive roles. On the other hand, lesbians who are more feminine in their expression may be able to “pass” as heterosexual (which can give them certain types of privilege), putting them in the position of having to “come out” frequently because everyone assumes they are heterosexual. Both of these situations carry varying degrees of emotional distress and life stressors.

Internalized lesbianphobia. This occurs when societal lesbianphobia is internalized into the psyche and stored in the unconscious. This can cause chronic and misunderstood feelings of self-hatred, low self-esteem, and low self-worth as a lesbian, a woman, and a human being. These core issues, because they reside outside of conscious awareness, can disrupt and/or hinder the development of a stable sense of self, thus creating symptoms such as depression, anxiety, the inability to self-regulate intense or distressing emotions, substance abuse, eating disorders, sex and love addictions, and so on.2 Because these institutionalized oppressions are internalized into the psyche, a greater threat of addictive and mental health disorders surfaces.

Multiple oppressions. These are experienced by LGBT people who have more than one minority status. People of color and women fall into this category. For example, an African-American lesbian experiences triple oppressions, being that she is black, lesbian, and a woman. She has to deal with racism and lesbianphobia. These oppressions are then internalized, and again addiction and psychological issues can occur.

Lesbian visibility and invisibility. Although media visibility for lesbians is increasing in the U.S. in breathtaking ways through television programs such as “Orange Is the New Black,” “The Real L Word” series, “The Fosters,” “The L Word,” and the breakthrough show “Ellen,” lesbians still experience an invisibility in pop culture that affects self-esteem and self-efficacy. Though not as obvious as overt lesbianphobia, areas such as marketing campaigns (TV commercials, billboards, magazine ads), and mainstream articles that are chronically heteronormative represent ways in which lesbians experience invisibility on a daily basis. These examples affect a lesbian’s self-esteem because of their lifelong pervasiveness and subtle nature. Because lesbians rarely see themselves represented in everyday life, feeling important and valuable can be a struggle. It is difficult for a lesbian to develop authentic feelings of self-love when she knows in her heart of hearts that her family, community, and culture either hates her or at the very least does not find her existence valuable.

Coming out as a lesbian

Coming out, for all LGBT people, is a big deal. For some lesbians, it can be a wonderful experience. Unfortunately for others, it can be traumatizing, depending on how the news is received by family members, peers and community.




Love this article!! It's very educating.

I don't know how to comment upon an issue of this magnitude.

Thanks Lauren Costine for this article
all the things you shared related to this article is right as well as political and behavioral health both part is more important for LGBT community and i also have read more article and feedback about the LGBT clients faces changes.