Clinical Issues With Lesbians

Perhaps the most important thing a counselor needs to bear in mind when working with lesbian clients is that there is no one lesbian client—that there is tremendous diversity among lesbians. As women, lesbians share the diversity inherent in womanhood; they also share the experience of dealing with sexism. The range of their experiences, perspectives, life situations, and statuses can hardly be overstated. Lesbians are from all races and ethnic groups, all socioeconomic levels and ages, all areas of the country and indeed of the world. Some lesbians are sexual with men at times, yet see and identify themselves as lesbians. Some women have same-sex relationships, but do not see themselves as lesbians. There are also women who choose to self-identify as lesbians on the basis of their emotional attraction to other women and in spite of being sexually attracted to men.

While some lesbians have children or want to have them, others do not. Some women have known they were lesbians since the age of 5 or 6 years (but were without the vocabulary to describe it at the time). Others become aware of their attractions to other women only in later life, often after having been in a heterosexual marriage for a number of years. Some lesbians are very comfortable with and public about their lesbian identity. Others have great difficulty taking on a lesbian identity and may keep it secret and hidden, whether from shame (internalized homophobia) or from a need to protect their jobs or maintain relationships. Some lesbians may look and act “masculine,” whereas others may look and act “feminine.” Many lesbians are not at all distinguishable from the general population of women.

Lesbians exhibit great diversity in their drinking or drug-taking behavior as well. There is no single pattern of such behavior among lesbians who are substance abusers. In this sense, again, they also may be indistinguishable from the general population of women.