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Working with queer clients: Three Top Tips

by Rachael Peacock
Published on 09 August 2021

Working with queer clients: Three Top Tips

Meg-John Barker

1. Reflect on your own relationship with queerness

Before working with marginalised clients of any kind it’s vital to reflect deeply on our own relationship with the systems of oppression which impact them. With queer clients this particularly means heteronormativity and related gender and relationship norms.

Deep reflection is about more than educating ourselves about these areas academically, or immersing ourselves in relevant popular and social media so that we’re familiar with diverse experiences and current issues. While those things are important, what’s needed is a more embodied, emotional exploration of our own experience with sex, gender, and relationships, including how cultural norms and oppressive systems have impacted - and still impact - us.

Expanding our understanding of queerness is important for this exploration. In what ways have we followed the normative scripts regarding sex, gender, and relationships? In what ways have we resisted these, or found them unavailable to us because of some other aspect of our body, identity, background, or life experience? In what ways do we feel queer, or not queer, or queered by life? When we reflect on our own experience, what are our feelings - such as fear, joy, shame, belonging, loss, alienation, peace, envy, anger, and more - around queerness?

2. Know your limits

Such reflection can help us to greater honesty about which themes and clients we feel able to work with currently, and which present an edge for us. All therapists are going to have some areas within their zone of competence, and some which are on - or over - the edge for them right now.

Again this is not just about lack of knowledge, as - for example - with a client considering medical transition who needs a therapist with expertise and experience around these services. At least as important is knowing our psychological edges. For example, if we have assumptions about monogamy being the best way to conduct relationships, then it would be an edge to work with a couple where one is behaving monogamously and the other non-monogamously. We would likely align with the monogamous client, and we’d be unlikely to think to explore forms of consensual non-monogamy with the couple.

This goes beyond conscious knowledge of our biase. Our deep reflections on our relationship with queerness may reveal, for example, that we have a big fear of ‘getting it wrong’ with non-binary clients, which brings up a sense of being out of touch, and risks collapsing us in shame if we make a mistake. Or we may struggle to allow that a client could be happily asexual, perhaps because of ways in which we have treated ourselves non-consensually around sex, believing it to be essential.

Igi Moon’s research demonstrates that these kinds of feelings easily leak out into the therapy room. Clients are likely to pick up on them when what they desperately need is somebody to mirror and affirm them in a world which generally does not. It’s absolutely fine to refer clients on to people with experience and expertise in such areas until you feel in a place of comfortable competence around them yourself.

3. Don’t assume queer clients’ issues will relate to their queerness, don’t assume straight/cis clients’ issues won’t

While some queer clients will approach a therapist specifically wanting to explore their sexuality, gender, or relationship style, many more will likely be grappling with unrelated issues such as bereavement, depression, or retirement. Indeed queer people are pretty likely to already have engaged in deep reflection around sex, gender, and relationships.

Our professions have a long and deeply problematic history of pathologising queerness and assuming that mental health struggles will relate to a queer person’s sexuality or gender. It’s vital not to reproduce this, for example, by interrogating a queer client’s gender, sex life, or relationship style more than you would a cis or straight client’s, or by assuming that these things will be relevant to their presenting issue.

While queer people do generally have poorer mental health than cis and straight people, this is due to the traumatic experiences that queer people are more likely to have experienced (e.g. family rejection, workplace discrimation, hate crime). It’s also due to the ongoing stress of living in the world knowing that you are considered somehow less normal and valid than others, to the extent that you may well not even be seen as you are unless you explicitly come out with all the risks that entails. Ensuring that you locate client suffering in the unjust culture, rather than individualising it, is a vital part of queer affirmative practice.

At the same time, many people who don’t present as queer will experience some degree of queerness in their lives, which may well be part of their struggle in such a queerphobic world. Statistics suggest that over a third of our clients will experience themselves as to some extent ‘the other gender, both genders, or neither gender’, an even greater proportion will be attracted to more than one gender, and an even greater proportion will be to some extent non-monogamous and/or kinky. Far more than this will - at some point - find themselves falling off the heteronormative standard for a ‘successful life’ (lifelong coupledom, kids, career, property ladder, etc.)

Finally, those who don’t experience themselves in any way queer may well have mental health struggles that are related to sex, gender, and relationship style. We might consider the statistics on suicide among straight cis men, or body image problems among straight cis women, for example, or the majority of straight cis people who report sexual ‘dysfunctions’ and/or relationship dissatisfaction. Exploring gender, sex, and relationships, and affirming queerer options as valid as normative ones, can be particularly helpful for normative clients.

Meg-John Barker is the author of the BACP resource on working across Gender, Sex, and Relationship Diversity as well as a number of popular self-help books and graphic guides on these topics. Website: Twitter: @megjohnbarker. 

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