Homophobia and Heterosexism

Having a general understanding of heterosexism, homophobia, and antigay bias is important for substance abuse treatment providers working with LGBT individuals. Alport (1952) defined prejudice as a negative attitude based on error and overgeneralization and identified the three interdependent states of acting out prejudice as verbal attacks, discrimination, and violence. Verbal attacks can range from denigratory language to pseudoscientific theories and findings, which serve as a foundation for discrimination and violence. Following this theory, prejudice and discrimination against LGBT individuals is formed, in part, by misinformation such as the following:

• All gay men are effeminate, and all lesbians are masculine.

• LGBT persons are child molesters.

• LGBT individuals are unsuitable for professional responsibilities and positions.

• LGBT persons cannot have fulfillingrelationships.

• LGBT persons are mentally ill.

Once negative generalizations are formed about a group of people, some members of the majority group feel that they can treat the other group differently. As the acceptance of negative stereotypes spreads, discrimination and violence can result.

Heterosexism and homophobia are used to describe the prejudice against LGBT people. Heterosexism is a prejudice similar to racism and sexism. It denies, ignores, denigrates, or stigmatizes any non-heterosexual form of emotional and affectional expression, sexual activity, behavior, relationship, or socially identified community. Heterosexism exists in everyone—LGBT individuals as well as heterosexuals—because almost everyone is brought up in a predominately heterosexual society that has little or no positive recognition of homosexuality or bisexuality. Heterosexism supports the mistaken belief that gay men because they are attracted to men—are in some way like women, and lesbians, in turn, are in some way like men.

Homophobia, although a popular term, lacks precise meaning. Coined in 1972 to describe fear and loathing of gay men and lesbians, it also has been used by gay men, lesbians, and bisexuals to describe self-loathing, fear, or resistance to accepting and expressing sexual orientation (Weinberg, 1983). Antigay bias is another phrase to describe the first concept, and nternalized homophobia is another phrase for the latter. Internalized homophobia is a key concept in understanding issues facing gay men, lesbians, and bisexuals in substance abuse treatment.

Examples of heterosexism in the United States include the following:

• The widespread lack of legal protection for individuals in employment and housing

• The continuing ban on lesbian and gay military personnel

• The hostility and lack of support for lesbian and gay committed relationships (except in Vermont) as seen in the passage of Federal and State laws against same-gender marriages

• The enforcement of outdated sodomy laws that are applied to LGBT individuals but not applied to heterosexual individuals.

Examples of heterosexism in the substance abuse treatment setting are as follows:

• Gay-bashing conversations

• Cynical remarks and jokes regarding gay sexual behaviors

• Jokes about openly LGBT staff members

• Lack of openly LGBT personnel

• Lack of inclusion of LGBT individuals’ family members or significant others in treatment processes.

Substance abuse treatment providers should remember that LGBT clients do not know the reaction they will receive when mentioning their sexual orientation. For example, public opinion measures indicate that homosexuality is not widely accepted. In 1996, Gallup Poll data showed 50 percent of respondents reported that homosexuality was unacceptable and only 45 percent found homosexuality an acceptable lifestyle. In addition, Herek (1989) found that as many as 92 percent of lesbians and gay men reported that they have been the target of threats, and as many as 24 percent reported physical attacks because of their sexual orientation.

It is likely that all substance abuse treatment programs have LGBT clients, but staff members may not be aware that they are treating LGBT clients. Most treatment programs do not ask about sexual orientation, and many LGBT people are afraid to speak openly about their sexual orientation or identity. Treatment programs also may not realize that they have LGBT staff members, who can be a great resource for treating LGBT clients.