Dragowski, Scharron, & Sandigowsky (2011) in their discussion of gender identity development in children, noted in cases  where diagnosis and treatment of “gender non-conforming children” (p. 365) are concerned, it’s important as part of the counseling process, for counselors to rely on having knowledge about the key issues related to gender identity development, so they can be well informed about making well realized decisions. An informed counselor is less likely to assign pathology to children who do not appear to conform to gender norms. In our society, in terms of gender identity, the norm relates to as the researchers clarified, “two biological sexes corresponding to two genders,” (p. 361.). In other words, males and females adhere to their gender identification and enact the corresponding roles. Any deviation from this pattern is considered pathological in nature. But the researchers asserted, female scan also at the same time, adopt a male gender identity and role, and similarly, males can do the same.  Sue & Sue (2013) explained  LGBT persons struggle as they exist and attempt to survive in a “ heterosexual and cisgender” (p. 475.) society which also assigns a label of abnormality to their gender identification and sexual orientation. In relation to transgender individuals one issue they face pertains to gender dysphoria being classified as a mental disorder by The American Psychiatric Association.

With regard to implications as they relate to counseling, mental health counselors who work with LGBT individuals particularly youth, need to be concerned about ensuring they as counselors  can help their clients build their internal structures and develop coping strategies in order to be successful in a world which often can be hostile. The researchers noted an alarming statistic which indicates 40% of LGBT youth have reported having been assaulted  as a result of their sexual orientation or gender identification. Counselors also need to be aware of the high prevalence of suicide among LGBT youth, and work towards helping them have more access to emotionally and physically safe environments.

Sue & Sue (2013) also mentioned another  unique issue that pertains to LGBT youth who are ethnic, racial, and cultural minorities. Disclosure or “coming out” can pose challenges for these individuals. The researchers noted, in comparison to their White counterparts, Black and Latino LGBT youth are less confident in disclosing their sexual orientation or gender identity. Mental health counselors need to be sensitive and supportive regarding the client’s process of disclosure. This process of disclosure  can be difficult for clients who derive from homophobic cultures, so counselors need to emphasize the role prejudice and bias play in society and how it impacts their clients, as well as observe their clients for any signs of self-blame. Cooper (2008) suggested in working with LGBT youth, mental health counselors can adopt the gay affirmative model which clearly identifies the problem afflicting LGBT persons is “homophobia not homosexuality,” (p. 434) (or gender identification).


With regard to bias, Sue & Sue (2013) pointed out studies that demonstrated therapists hold bias toward LGBT clients. One common bias listed related to a belief that “same-sex orientation is sinful or a form of mental illness.” (p. 482.).  In terms of implications connected to counseling, mental health counselors need to carefully examine their personal biases about LGBT persons, to ensure the therapeutic alliance is not compromised. Further, more training is needed especially as it concerns using intake forms that are not discriminatory in nature. Mental health counselors also need to familiarize themselves with The American Psychological Association’s reports in connection with appropriate counselor response to sexual orientation and gender identification.


Concerning any emotional reactions I would have in counseling sexual minorities, this type of issue when it arises should be addressed in supervision, or in therapeutic sessions with my own counselor, if it were necessary. In the counseling profession, maintaining objectivity is paramount, and any departure from it can place the counselor at risk for serious impairment.  Oppenheimer (1954) asserted counselors are open to accepting their client’s attitudes without expressing criticism when often outside the counseling practice similar attitudes from non-clients they may find challenging to even tolerate.  Another strategy would be to pursue further training that illuminates counseling sexual minorities in order to gain further clarity about the kind of emotional reactions, or countertransference that may ensue in counseling sexual minorities.