Stories

How can counseling psychologists better serve LGBTQ people in the South? Assistant Professor Sherry Wang says it starts with asking better questions. 

Holding hands with your partner in public seems like a small thing, and for many people, it is. But in gauging the identity development of LGBTQ people, holding hands can be a big step. And depending on where you live, it may be too big, says Assistant Professor Sherry Wang.

Identity development is an assessment performed by counseling psychologists to determine how evolved one’s sense of identity is—culturally, professionally, ethnically, religiously, and in terms of sexual orientation or gender identity.

One of the ways commonly used by counseling psychologists to determine someone’s “outness” includes taking stock of a person’s public displays of affection, such as hand holding with a partner. If an LGBTQ person feels comfortable holding the hand of their same-sex partner in public, their identity is supposedly more evolved. If they don’t, they’re assumed to be less comfortable with being “out” and their identity less developed.

Wang rejects this conclusion.

“If you’re living in an area where you can be lynched or fired or ostracized in these ways, then why would you be out?” Wang asks, explaining that the problem lies not with the individual, but the heterosexism in their community. “There’s nothing wrong with your identity development; it’s accounting for contextual pieces like physical safety or danger.”

Another example is healthcare. For many LGBTQ people in the South, Wang says, the biggest hurdle to adequate medical care can be lack of transportation. Needing transportation means asking for a ride, which often leads to questions of where you’re going, and if it’s to a medical appointment, if you’re sick, and why. For a person living with HIV, for example, that line of inquiry might inadvertently pressure someone to come out in an unsafe environment.

Should having a car impact the assessment of someone’s identity development? Wang doesn’t think so.

Context is important to the experiences of LGBTQ people and it’s especially important in Wang’s research. What might be true for an LGBTQ person in Santa Clara, California isn’t necessarily true for someone living in Birmingham, Alabama, Wang says. And that’s an important distinction. LGBTQ people live varied and nuanced lives. To properly assess their identity development, she believes that counseling psychologists need better questions.

In 2016, Wang collaborated on a project with Auburn University in Alabama to chronicle the experiences and needs of LGBTQ people living in the surrounding region. Wang traveled to the state where she and her colleagues interviewed dozens of LGBTQ people in focus groups to learn about their experiences, including their reactions to the questions used in assessment tools nationally: Did this question pertain to your experience? How did you react to it?

In many instances, Wang says that not only did the questions traditionally used by national psychological researchers miss the mark, but participants found them offensive. Questions were often hyperfocused on sexual needs or desires—fetishizing homosexuality or treating it as a perversion. Rather than exploring the full, complex lives of LGBTQ people, the questions started from the perspective that there was something wrong with the person or focusing on how they deviated from standard norms.

One commonly used prompt, Wang recalls, said, “My understanding of my sexual needs coincides with my overall sense of self.”

“People didn't even understand this. What is this question asking?” Wang says. “If you asked a heterosexual person what their needs or preferences are, they don’t think about them. So why is it that we keep asking LGBTQ people about it?”

The answer to this lies within the field of psychiatry itself. Until 1973, the American Psychiatric Association categorized homosexuality as a disorder. Before the second edition, you could open up the Diagnostic and Statistical Manual of Mental Disorders (DSM)—used by clinicians and psychiatrists to diagnose psychiatric illnesses—and find homosexuality listed that way.

“So when you think of the medical model that serves as the foundation for the field of psychology, [homosexuality] really has been seen as a sexual perversion,” Wang says. “Our current instruments still have that flaw.”

Through her research, Wang hopes to extract that bias and help the field of counseling psychology move beyond such assumptions. She wants to develop a tool or survey that provides hard data, while taking into account intersectionality and the complexity of LGBTQ people.

This isn’t just about picking on the South or rural areas, Wang says. It’s about reframing the discussion concerning LGBTQ people—not victimizing or shaming, but highlighting strengths and capturing meaningful data in diverse regions nationwide.

That starts with inviting people from these groups to the table to speak for themselves, something she has done in her focus groups. Rather than assuming what’s important or defining them by their sexual experiences, she wants to ask individuals to describe the fullness of their lives and identify questions that are meaningful to their experience. Focus on all the things they are, rather than how they differ from a stereotypical heteronormative existence.

“We want to know where people find resilience in their process and what they would like people to know about them,” Wang says. “What are the stories they want to tell?”