Level of Openness about Sexual Orientation

It cannot be repeated enough that not all patients who engage in same-sex behaviors identify themselves as LGB. Often this is based on multicultural differences within this population (Trujillo, 1997). Therefore, a therapist should not assume that a patient's lack of identification with an LGB community or self-reference as such means that he/she is "in the closet" or harboring negative beliefs about the self. On the other hand, literature suggests that those individuals who self-identify as LGB fare better when they are connected to an LGB community (DiPlacido, 1998). "Coming out," the public acknowledgment of one's sexual orientation, can be an ongoing process for LGB many people. Furthermore, people may be "out" in certain settings and not others. It is common to encounter individuals who are very open about their sexual orientation among close friends and family. They include partners in family holidays and are comfortable attending some community events for LGB people. Yet these same individuals may remain closeted at work for fear of losing their job or being overlooked for promotions. LGB employees who perceive greater discrimination based on sexual orientation report fewer promotions than their heterosexual coworkers or LGB employees who do not perceive such discrimination (Ragins & Cornwell, 2001). Remaining closeted at work is adaptive for many patients (Badgett, 1996). However, it is not without cost. Partners cannot be invited to company picnics or holiday gatherings. Men and women may frequently be asked why they are not "hitched" in a heterosexual relationship, which forces them either to lie about the gender of their partner or to remain silent about the issue. Such complications can exacerbate a patient's depression if he/she feels like a fraud on the job or that employment necessitates being untrue to him/herself and loved one.

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