The Impact of Internalized Homophobia on Outness for Lesbian, Gay, and Bisexual Individuals

Sep 6, 2014 | Article, Volume 1 - Issue 3

Genevieve Weber-Gilmore, Sage Rose, Rebecca Rubinstein

Internalized homophobia, or the acceptance of society’s homophobic and antigay attitudes, has been shown to impact the coming out process for LGB individuals. The current study examined the relationship between levels of outness to family, friends and colleagues and internalized homophobia for 291 lesbian, gay, and bisexual individuals. Results suggest internalized homophobia is a predictor of outness to friends, colleagues, and extended family, but not nuclear family. A discussion of these findings as well as implications for counselors are provided.

Keywords: internalized homophobia, “coming out,” lesbian, gay, bisexual

Lesbian, gay and bisexual individuals (LGB) have been shown to be one of the most stressed population groups in society (Iwasaki & Ristock, 2007). Beyond dealing with daily stressors common with their heterosexual counterparts, LGB individuals experience unique stressors such as homophobia, societal discrimination and limited social and institutional supports due to their same-gender sexual orientations. Homophobia is defined as the anxiety, aversion, and discomfort that some individuals experience in response to being around, or thinking about LGB behavior or people (Davies, 1996; Spencer, & Patrick, 2009).

Homophobia is endorsed through the perpetuation of negative stereotypes about LGB behavior and people on both societal and individual levels, and the discrimination and prejudice of LGB people across the lifespan (Bobbe, 2002; Davies, 1996; Spencer & Patrick, 2009). Subtle forms of homophobia and discrimination such as the exclusion of LGB couples in the media and blatant acts of alienation experienced when individuals refuse to rent to LGB people are far too common in the lives of LGB individuals (Neisen, 1990; Smiley, 1997). Other examples of homophobia include unfair treatment by family, friends, and peers; loss of employment or lack of promotions; and observing/hearing people making anti-gay jokes (King, Reilly, & Hebl, 2008; Rankin, Weber, Blumenfeld, & Frazer, 2010). These homophobic events greatly affect the lives of LGB individuals such that many LGB individuals hide their sexual orientation from others and feel shame and other negative feelings towards themselves (Center for Substance Abuse Treatment [CSAT], 2001).

Higher levels of stress are common among LGB individuals who feel they have to hide their sexual orientation from others (Iwasaki & Ristock, 2007) or have negative feelings towards themselves based on their same-gender sexual attractions (Weber, 2008). The acceptance of society’s homophobic and anti-gay attitudes about LGB sexual orientations is known as internalized homophobia. Low self-esteem and low self-acceptance; shame; guilt; depression and anxiety; feelings of inadequacy and rejection; verbal and physical abuse by family, partners, and/or peers; homelessness; prostitution; substance use and abuse; and suicide are some of the common feelings or behaviors that are associated with internalized homophobia (CSAT, 2001; Diamond & Wilsnack, 1978; Grossman, 1996; Lewis, Saghir, & Robins, 1982; Ross & Rosser, 1996; Saghir & Robins, 1973; Spencer, & Patrick, 2009; Stall & Wiley, 1988; Stein & Cabaj, 1996). According to Bobbe (2002), the negative feelings and behaviors associated with internalized homophobia can have a more painful and disruptive influence on the health of LGB individuals than external, overt forms of oppression such as prejudice and discrimination.

Homophobia and internalized homophobia have been shown to impact the coming out process for LGB individuals. “Coming out” is a shortened term for “coming out of the closet” (Hunter, 2007, p. 41). As LGB individuals begin to disclose their sexual orientation to others, or “come out,” they often experience a series of stages that include but are not limited to an initial awareness of being different, grieving, feelings of inner conflict, and an established sexual minority identity with long-term relationships. This is a developmental process that involves a person’s awareness and acknowledgement of same-gender oriented thoughts and feelings while accepting being LGB as a positive stage of being (Browning, Reynolds, & Dworkin, 1991; Kus, 1990; McGregor et al., 2001; Ridge, Plummer, & Peasley, 2006). The process of forming an LGB identity or “coming out” is a challenging process as it involves adopting a non-traditional sexual identity, restructuring one’s self-concept, and changing one’s relationship with society (Reynolds & Hanjorgiris, 2000; Ridge, Plummer, & Peasley, 2006).

Coming out for bisexual individuals is a “more ambiguous status” (Hunter, 2007, p. 53) as it is complicated by marginalization from both the straight and gay communities. This marginalization usually includes same-gender oriented friends urging bisexual individuals to adopt a gay lifestyle and heterosexually-oriented friends pressuring them to conform to heterosexual standards (Smiley, 1997). Although it is common for research on bisexual individuals to be lumped with lesbians and gay men (Hoang, Holloway, & Mendoza, 2011), Knous (2005) proposed a series of steps that individuals who identify as bisexual might take in disclosing and ultimately embracing their sexual identity. The first step is to be attracted or to participate in sexual activity with someone of either gender. The second step is to become labeled as bisexual either by themselves or by society. The third step is to be participatory in the bisexual community through personal or group pride. Bisexual individuals still experience stigma similar to their lesbian, gay, or heterosexual counterparts (Knous, 2005), and respond in similar ways: they might “pass” as either gay or straight, an act intended to hide one’s same-gender attractions (Herek, 1996); disclose their bisexual identity; or join support groups to fight the stigma (Knous, 2005).

Multiple researchers have described average chronological ages at which experiences related to coming out occur, which were summarized by Hunter (2007). Lesbians and bisexual women first experience awareness of same-gender attraction between the ages of ten and eleven years; gay and bisexual males between the ages of nine and thirteen years. Gay male youths on average experience their first sexual experiences a few years later between the ages of thirteen and sixteen years, while lesbian youths experiment around twenty years of age. First disclosures of sexual orientation happen between the ages of sixteen and nineteen for lesbian youths, and sixteen and twenty for gay male youths. Regardless of the age of disclosure, negative responses to being lesbian, gay, or bisexual still occur, and this “tempers the motivation of persons…in terms of making disclosures” (Hunter, 2007, p. 84). This may explain the three main patterns of sexual identity in individuals who are moving towards identifying as gay, lesbian, or bisexual (Rosario, Schrimshaw, Hunter, & Braun, 2006). These patterns include consistently identifying as gay or lesbian, transitioning from bisexual to gay or lesbian, and consistently identifying as bisexual. Youths who were engaged in transitional identities continued to change their behavior and orientation to match their new identity. The process of acceptance of one’s sexual identity, committing to that identity, and integrating that identity into one’s life is something that does not end after adolescence, but continues into adulthood (Rosario, Schrimshaw, Hunter, & Braun, 2006).

The process of coming out could be a major source of stress for LGB individuals (Iwasaki & Ristock, 2007). Some disclosures could cause harm in the lives of LGB individuals such as family crisis, dismissal from the household, loss of custody of children, loss of friends, or mistreatment in the workplace (Hunter, 2007; Rotheram-Borus & Langabeer, 2001; Savin-Williams & Ream, 2003). Yet, not coming out to others means LGB individuals must maintain personal, emotional, and social distance from those to whom they remain closeted in order to “protect the secrecy” of their “core identity” (Brown, 1988, p. 67).

A number of studies have explored the unique challenges associated with the coming out process for LGB individuals. A study by Flowers and Buston (2001) investigated “passing” as heterosexual, or assuming the identity of a heterosexual individual while hiding behaviors associated with an LGBT identity. In their study, Flowers and Buston examined the retrospective accounts of gay identity development for 20 gay men. Living a lie was identified as a common theme in their interviews such that many men continued to assume a heterosexual identity as a response to a non-accepting homophobic society. This lie was not something that was simply stated; rather, it had to be created and maintained “all the time” (p. 58, Flowers & Buston), and only temporarily eased the participants’ feelings of isolation and identity confusion (Flowers & Buston). Shapiro, Rios, & Stewart (2010) support the findings of Flowers and Buston. In this study that explored narrative accounts of sexual minority identity development among lesbians, cultural norms that failed to acknowledge the existence of non-normative sexual identities were identified and discussed. Such neglect of LGB identities required personal silence on the part of the respondents, which helped them avoid the negative consequences of coming out such as feelings of danger and discomfort as well as punishment.

Paul and Frieden (2008) examined the process of integration of gay identity and self-acceptance among gay men. Participants described societal homophobia and heterosexism as “powerful barriers” to self-acceptance, and validation and acceptance from others as helpful supports in the acceptance of themselves. Respondents indicated that they felt emotional pain or crisis when they began to develop a same-gender sexual identity and received negative messages about that identity. They feared that loved ones would not be accepting, and often denied that they were gay, both to themselves and to others.

A study by Rowen and Malcolm (2002) examined internalized homophobia and its relationship to sexual minority identity formation, self-esteem, and self-concept among 86 gay men. Results indicated that higher levels of internalized homophobia were associated in less developed gay male identities. In addition, gay men who felt more uncomfortable with their sexual orientations were more likely to experience guilt over their same-gender sexual behavior. Internalized homophobia also was found to be related to lower levels of self-esteem and self-concept in terms of physical appearance and emotional stability.

There are a diverse range of personal variables such as “personality characteristics, overall psychological health, religious beliefs, and negative or traumatic experiences regarding one’s sexual orientation” (Hunter, 2007, p. 94) that impact to whom LGB individuals disclose their same-gender sexual orientation. Some same-gender oriented individuals are closeted entirely and hide their sexual orientations from others for fear of their reactions (Iwasaki & Ristock, 2007). Others will only come out to selected people (e.g., friends, family, colleagues, teachers, medical providers) rather than everyone at once. Several will come out completely and become very involved in the LGB community by attending LGB events and venues.

In general, disclosures are most often first made to friends of LGB people who are considered to be somewhat affirming of one’s same-gender sexual orientation (Hunter, 2007). According to Cain (1991), coming out to friends can bring two friends closer together, confirm an already close relationship, or cause a strain between previously close friends. Results from a study by D’Augelli and Hershberger (2002) revealed that 73% of lesbian and gay youths first told a friend about their same-gender sexual attractions. Other research suggested that bisexual men and women are also more likely to disclose to their friends than to family members and work colleagues (Hunter, 2007). These friends are usually across sexual identities and often with individuals who are heterosexual, and less with other bisexuals (Galupo, 2006).

Regardless of the outcome, the notion that disclosure to friends differs from disclosure to family members allows for LGB individuals to “select friends who are supportive or drop those unlikely to accept the revelation, something they cannot do in their parental or sibling relationships” (Cain, 1991, p. 349). LGB individuals do not always disclose their LGB sexual orientations to family members for fear of consequences such as “…anything from a dismissal of their feelings to an actual dismissal from the household” (Rotheram-Borus & Langabeer, 2001, p. 104). Disclosures to parents elicit much anxiety for LGB individuals as there are limited ways to predict how parents will respond (Hunter, 2007). Many LGB individuals fear losing familial support after disclosing to family members (Carpineto et. al, 2008; D’Augelli, Grossman, & Starks, 2005). According to Shapiro, Rios, & Stewart (2010), when LGB individuals have identified the family as a source of conflict, these individuals considered their parental figures to be unsupportive of their sexual identity. This conflict leads to an increase in tension within the family. According to Savin-Williams and Ream (2003), 90% of college men reported that coming out to their parents was a “somewhat” to “extremely” challenging event for them (p. 429).

Siblings have been described as more accepting of their LGB sibling’s disclosure, and if there is rejection it is usually less stressful than rejection by the parents (Cain, 1991). Lesbian wives do not often disclose to their husbands for fear of consequences (i.e., violence, custody battles), but men who come out as bisexual following their marriage to a woman tell her soon after he accepts his bisexual identity (Hunter, 2007). No data on gay men and their disclosure to their wives could be located. It also is not uncommon for LGB parents to keep their same-gender sexual orientations from their children for fear of losing custody or inflicting harm on their children (Hunter, 2007).

There are positives and negatives to coming out at work and to work colleagues (Hunter, 2007), and therefore there are varying levels of disclosure among LGB individuals. Research suggests that LGB individuals who are more open at work experience higher levels of job satisfaction and commitment to the workplace (Day & Shoenrade, 1997; Griffith & Hebl, 2002; King, Reilly, & Hebl, 2008). Some LGB individuals may feel “honest, empowered and connected” after disclosure at work, and able to speak more freely about their personal lives and romantic relationships (Hunter, 2007, p. 127). Organizations that have written non-discrimination policies, are actively affirmative, and offer trainings that incorporate LGB issues usually impact whether lesbian and gay individuals come out in the workplace (Griffith & Hebl, 2002). It is unfortunate, however, that there is little legal protection for LGB individuals based on sexual orientation in most workplaces (Hunter, 2007). The possible harm (i.e., ridicule, ostracism, job loss) of disclosing at work without legal protection, and in some cases even with legal protection, causes many LGB individuals to stay closeted at work. Although keeping one’s LGB sexual orientation a secret might create fewer problems with regard to stigma, discrimination, and discreditability, living “a double life” can be personally and professionally “costly” (Hunter, 2007, p. 126). Hunter further summarized the limited professional literature on outness in the workplace and reported that more than two-thirds of lesbian and gay individuals think coming out in the workplace would create problems and challenges for them, while one-third believed disclosure would hurt their career progression (i.e., not being hired, not being promoted, not receiving personal or professional support). Fears of and personal experiences with harassment and heterosexism in the workplace also could negatively impact one’s psychological and physical well-being and thus one’s decision to disclose to work colleagues.

A major study based on the utilization of The National Lesbian Health Care Survey (NLHCS; Bradford, Ryan, & Rothblum, 1993) examined the degrees of outness and to whom disclosures were made for a national sample of 1,925 lesbians. The results of this study support the aforementioned identification of whom LGB individuals come out to more often as they move through the process of forming a sexual minority identity. Researchers found that although the majority of lesbians (88%) were out to all gay and lesbian individuals who they knew, much smaller numbers were out to all family members (27%), heterosexual friends (28%), and co-workers (17%). Furthermore, many participants reported not coming out to any family members (19%) or co-workers (29%). Correlations between degree of outness and fears as a lesbian were also analyzed and results showed a negative relationship such that lesbians who were less out to family, heterosexual friends, and co-workers had more fear of exposure as a lesbian. Correlations were strongest among outness to heterosexual friends and co-workers. No other studies that specifically examined the relationship between level of outness and internalized homophobia could be located. Therefore, this important relationship remains underexplored.

In summary, LGB individuals have been described as an at-risk group based on the high level of homophobia on both societal and individual levels. Such experiences with homophobia impact the way LGB individuals view themselves, particularly how they define their sexual minority identities which have been historically marginalized and stigmatized. Consequently, negative views of self result from the internalization of society’s negative attitudes towards LGB individuals. Internalized homophobia has been documented as a potential disruption to the coming out process as it impacts an LGB individual’s decision to be closeted completely, come out to selected individuals, or come out to all (Cabaj, 1997). Disclosure or non-disclosure to family, friends, and colleagues and how it is impacted by internalized homophobia warrants attention from researchers as it has significant implications in the lives of LGB individuals.

Purpose of the Study

The purpose of the present study was to gain a better understanding of the relationship between levels of outness to family, friends and colleagues and internalized homophobia. Conducting research on risk factors that negatively impact the coming out process, such as internalized homophobia, will generate knowledge that will help reduce the stress unique to LGB individuals. Such research also will increase the provision of quality and effective support to cope with stress for this historically underserved population group (Iwasaki & Ristock, 2007).

We hypothesized that internalized homophobia would predict whether one comes out to all family (nuclear and extended family), friends, and colleagues. Internalized homophobia and concerns about coming out contributes to an LGB individual’s reluctance to enter the ‘scene’ or culture which is related to their sexual identity (Ridge, Plummer, & Peasley, 2006). In fact, internalized homophobia has prevented some LGB individuals from never finding their true selves, creating a further disconnection from their true identities. Based on this finding as well as others, we propose that LGB individuals with high levels of internalized homophobia would be less likely to come out as LGB to all family (nuclear and extended family), friends and colleagues. If issues related to internalized homophobia, a well-documented risk factor for stress among LGB individuals, are addressed, improvement in the mental health and overall quality of life for LGB individuals can occur (Wagner et al., 1996).

Method

Participants
Two hundred ninety individuals between the ages of 18 and 71 responded to our study. Forty-seven percent (n = 131) of respondents identified as lesbian, 42% (n = 117) as gay, and 4% (n = 12) as bisexual. More than half of the respondents identified their gender identity as woman (51%, n = 154), 45% (n=127) as man, 2% (n = 5) as transgender, and 2% (n = 5) as “other.” Seventy-three percent (n = 204) had an associate’s degree or higher, and 69% (n=192) identified as White (see Table 1 for complete demographics). Due to the small number of transgender respondents, we did not examine their experiences by gender identity. We do recognize, however, the unique interaction between gender identity and sexual identity, and encourage future research in this area.

Materials

Levels of Outness. The questions used in this study that assessed level of outness of participants were adapted with permission from a survey developed by Rankin (2003). These questions are part of a larger campus climate survey that is used nationally to assess campus climate for community members. This set of questions showed high internal consistency (α = .80). Using a varimax rotation, items load as one factor and account for 65% of the variance.

Internalized Homophobia Scale (IHP; Martin & Dean, 1987). The Internalized Homophobia Scale is a 9-item measure adapted for self-report. Previous research has indicated that the self-administered version of the IHP scale has acceptable internal consistency and correlated as expected with relevant measures (Herek & Glunt, 1995). Items are administered with a 5-point response scale, ranging from disagree strongly to agree strongly. Reliability coefficients for this scale are typically higher for men (α = .83) then women (α = .71).

Procedure

An online survey was created through PsychData, a Web-based company that conducts Internet-based research in the social sciences. Participants were invited through email advertisements to general and multicultural LGBT list-servs. Personal networks also were utilized. Participants were made aware of the intentions of the survey and the topics they would encounter. Participation was anonymous and all respondents reviewed and gave informed consent before initiating the study. (Appropriate IRB approval was obtained).

Results

A set of regression procedures were conducted to examine how “coming out” to friends, family, and colleagues predicted scores on the Internalized Homophobia Scale (IHP). Table 2 shows the complete regression summaries. Model 1 regressed demographic variables: age, self-identified gender, ethnicity, education level and reported income. This model accounted for 4% of the overall variance with education level contributing most to the prediction of IHP scores (β = -.15, p < .05). This model was used in each of the following hierarchical models as a first step to control for demographics to examine the prediction value of each “coming out” variable.

Model 2 emerged as a significant model. Coming “out to friends” was added as a second step to the model and accounted for an additional 11% of the variance after controlling for demographics. According to the standardized regression coefficients, this variable provided a significant contribution to the prediction of IHP scores (see Table 2). Model 3 did not emerge as a significant model. By including coming “out to nuclear family” only an addition 1% of the total variance was accounted for. Within the third model, coming “out to friends” remained the largest contributor to the prediction of internalized homophobia (β = -.28, p < .05).

Model 4 and Model 5 emerged as significant models. In Model 4, the second step added coming “out to extended family” and contributed 2% to the total variance. Standardized regression coefficients indicated coming “out to friends” and “out to extended family members” were the strongest contributors to the model. By adding “out to colleagues” to the second step of the fifth model, an additional 2% of the variance was accounted for beyond demographics. “Out to colleagues” contributed the most to the predication of internalized homophobia beyond demographic differences, coming out to friends, coming out to nuclear family, and coming out to extended family (β = -.18, p < .05). Model 5 accounted for almost 19% of the total variance.

Discussion

The findings from our study suggest internalized homophobia impacts whether one is out to friends, colleagues, and extended family, but not to nuclear family. These findings are surprising as we hypothesized internalized homophobia would impact whether one is out to all family members (nuclear and extended), friends, and colleagues. Specifically, we hypothesized that higher internalized homophobia would lessen the likelihood that LGB individuals disclose as lesbian, gay, or bisexual to all family (nuclear and extended), friends, and colleagues. This assumption was based on the professional literature that underscored the fact that experiences in an anti-gay society can lead LGB individuals to internalize prejudicial messages and have negative views of self, and the potential consequences of coming out to family (family crisis), friends (disconnection and loss of friends), and work colleagues (dismissal and mistreatment; Hunter, 2007; Rotheram-Borus & Langabeer, 2001; Savin-Williams & Ream, 2003).

Education level also was a strong predictor of internalized homophobia for the sample in this study. Education level may be influential because individuals who are more “in the know” may accept that internalized homophobia is a barrier to self-acceptance and therefore an issue worth addressing and resolving. Further, coming out to friends and colleagues contributed strongly to internalized homophobia which may be a result of the experiences of LGB individuals in an anti-gay society and the possibility that friends and colleagues represent non-affirming members of our society. Therefore, the greater the discomfort with one’s same gender sexual identity, the less likely a LGB individual will come out to friends or co-workers for fear of negative consequences.

Although Hunter (2007) posited that LGB people most often come out to friends first, our study underscores a unique relationship between internalized homophobia and coming out to friends in that respondents with higher internalized homophobia were less out to friends. Findings from the National Lesbian Health Care Survey (NLHCS; Bradford, Ryan, & Rothblum, 1993) support this finding from our study. Correlations from the NLHCS suggest lesbians with higher internalized homophobia feared exposure as a lesbian to heterosexual friends. Furthermore, 88% of lesbians from the NLHCS were out to other LGB individuals, but only 28% were out to heterosexual friends. Perhaps respondents in our study who had higher internalized homophobia had similar fears regarding disclosure to heterosexual friends, particularly those who were non-affirming of LGB sexual identities. Furthermore, based on the results of our study and the professional literature, it is possible to assert that respondents from our study who had lower internalized homophobia were more comfortable coming out to friends who were affirming of LGB sexual identities.

Research suggests that LGB individuals who are more open at work experience higher levels of job satisfaction, commitment to the workplace, the fostering of a healthy identity, and the encouragement of employers to promote a diverse workplace (Day & Shoenrade, 1997; Griffith & Hebl, 2002; King, Reilly, & Hebl, 2008). While there are positive aspects of research surrounding coming out at work, research also suggests that more than two-thirds of LGB people think coming out to the workplace would create problems (i.e., not being hired, not being promoted, not receiving support and mentorship necessary for professional development, or loss of job; Hunter, 2007). The context in which an individual comes out at work is much more important than the situational factors which lead them to come out (King, Reilly, & Hebl, 2008). Consequently, many LGB individuals stay closeted at work in anticipation of rejection, which is often based on a lack of legal protection or personal experiences with an anti-gay organizational climate.

Our study uncovered a strong relationship between internalized homophobia and level of outness at work. In fact, outness to colleagues was the largest predictor of internalized homophobia above and beyond all other variables analyzed in this study. Based on this finding, we defend previously cited research that LGB individuals are more likely to be out and experience less internalized homophobia when they have had positive experiences with coming out in the past, or when their organizations are gay-friendly, include written non-discrimination policies and advocate on behalf of LGB people (i.e., offer trainings and workshops that incorporate LGB issues; Griffith & Hebl, 2002). Friskopp and Silverstein (1995) concur with our findings by suggesting those who disclosed at work were not only more comfortable with their sexual identity, but also had many previous disclosures with heterosexual friends and relatives. In the same respect, LGB individuals who enter and remain in a workplace where heterosexism and homophobia are pervasive may never come out to co-workers or may be very selective about to whom they come out (Hunter, 2007). They might decide to pass to divide their work life and personal life, and avoid discrimination at all costs (DeJordy, 2008). Passing, while helpful in the organizational environment, can be harmful to the individual because it reduces an individual’s authenticity of one’s behavior, lowers one’s self-esteem, and denies or suppresses an individual’s LGB identity.

Results from the NLHCS (Bradford, Ryan, & Rothblum, 1993) support Hunter (2007) and our research: lesbians who were less out to co-workers had more fear of exposure as lesbian. For some LGB individuals, “just the thought of disclosure at work typically creates considerable anxiety” (Hunter, 2007, p. 124). This might be true for the participants in our study.

Finally, our hypothesis that internalized homophobia will predict outness to all family members, including nuclear and extended, was partially supported by our results. In particular, internalized homophobia was not a predictor of outness to nuclear family, but was a predictor of outness to extended family.

The fact that internalized homophobia did not predict outness to nuclear family was surprising considering the high degree of difficulty and anxiety associated with coming out to parents, the anticipated rejection by the nuclear family, and the fact that many LGB individuals remain closeted to family members indefinitely or until later in life (Hunter, 2007). Paul and Frieden (2008) contend that negative social messages about LGB sexual identities, particularly those made by family, friends, and religious organizations, increases the challenge of self-acceptance as LGB. With a lack of self-acceptance coupled with “fears related to a potential loss of relationship with specific family members,” LGB individuals might refrain from disclosing their sexual minority identities (Paul & Frieden, 2008, p. 43). It could be assumed that internalized homophobia would affect the act of coming out to family, particularly nuclear family, since “there is no predicting” how parents will react, and disclosure could cause “great turmoil in the home” (Hunter, 2007, p. 95.). Based on the aforementioned assumption, our initial hypothesis would stand. This conception, however, was not supported by the results of our study as internalized homophobia predicted outness to extended family and not nuclear family. It appears that the disclosures or lack of disclosures to nuclear family by participants in our study were not influenced by internalized homophobia. Future research that explores factors that impact disclosure to nuclear family is warranted in order to more fully understand this relationship.

Implications for Counseling

This study presents many implications for counselors. First, experiences with internalized homophobia can impact the lives of LGB individuals, particularly the coming out process.

“If one has a high level of internalized homophobia, the [coming out] process can be fraught with turmoil; however, if the individual is able to connect with supportive people who can help him or her dispel the negative attitudes of society, that state is temporary. This is an area in which counselors can aid in the process” (Matthews, 2005, p. 212).

An affirmative counselor can model a positive reaction to an LGB client’s disclosure, provide a corrective emotional experience for that client, and instill hope that positive consequences can result from coming out. This can help the client externalize his or her experiences with homophobia, and move towards self-acceptance (Matthews, 2007). Ridge, Plummer, and Peasley (2006) found that positive self-talk, writing about problems, and making more positive choices were helpful when an individual is looking to defeat feelings of internalized homophobia. On the other hand, a counselor who perpetuates messages of homophobia or heterosexism can reinforce the negative experiences of the LGB client, and thus cause more distress and heartache.

It is essential that affirmative counselors avoid heterosexism in clinical practice (i.e., review clinical paperwork for heterosexist language; decorate office to be inclusive of diverse sexual identities; advocate for a non-discrimination policy that is inclusive of sexual and gender identity). A counselor also must overcome heterosexism through self-examination and self-education where biases and prejudices are identified and dispelled (Matthews, 2007). Additionally, it is necessary for affirmative counselors to develop the knowledge and skills necessary for working with LGB clients. Continuing education opportunities such as conference workshops and graduate classes that focus on LGB issues are excellent ways to enhance a counselor’s multicultural competency to work with LGB clients. Familiarizing oneself with the LGB community (local and national) by attending LGB venues (i.e., parades, community centers, LGB bookstores), and learning key LGB figures who contributed to LGB rights through movies and literature are all important steps in becoming an affirmative counselor.

“Personal contact is the most consistently influential factor in reducing prejudice” (Hunter, 2007, p. 168). Therefore, it is invaluable for affirmative counselors, particularly heterosexual counselors, to spend time with LGB people. This will help challenge misconceptions and messages that have been learned as members of a society that perpetuates anti-gay attitudes and beliefs in many domains. Counselors must help clients explore and discover how they wish to self-identify, whether it is lesbian, gay, bisexual, queer, or questioning another identity. It is important to use caution in assigning the client an identity before he or she is ready to self-identity. It is beneficial for counselors to utilize sexual minority identity development models (see, for example, Cass, 1979; D’Augelli, 1994; McCarn & Fassinger, 1996; Troiden, 1979). Although these models present stages or phases that are often experienced during the coming out process, it is important to use them as guides as each LGB client is unique and may experience coming out differently.

Coming out can be a risky process, but also an empowering experience for LGB individuals (Matthews, 2007). Consequently, as a counselor, it is important to consider the potential dangers and benefits of disclosing to various individuals in the LGB client’s life. A LGB client might decide not to disclose to a particular individual because the negative consequences outweigh the positives. Counselors should support the decisions made by clients, and always ensure their personal safety (Hunter, 2007). Although there might be consequences as a result of disclosure, there will likely be long-term gains in self-acceptance and overall psychological health for LGB individuals.

It also is very important for an LGB individual to establish a connection to the LGBT community (Matthews, 2007). As a counselor, it is vital to be able to promote exposure to and interaction with positive elements of the LGB community. There are a number of online options such as support groups, chat rooms, and list-servs. Community options include LGBT community centers, support groups at counseling centers, and LGBT-sponsored events. Counselors should be familiar with these resources and prepared ahead of the counseling session to share them with a LGB client. Caution should be used in identifying resources to ensure they are safe and healthy avenues for support.

Limitations and Areas for Future Research

A possible limitation of this research is that it represents a one-time measurement of self-reported data. Such complex perceptions of being closeted and the corresponding feelings of internalized homophobia may be viewed as a dynamic process subject to change over time and experiences. Moradi, Mohr, Worthington, and Fassinger (2009) suggest using experimental, repeated measures designs, and longitudinal designs to best determine causal and or developmental hypotheses regarding sexual minority research areas and would benefit research such as this one. Future research will look toward long-term methods of measuring levels of outness and corresponding feelings of internalized homophobia over time. Additional future research should focus on homophobia and heterosexism in the workplace which, according to a report by the Human Rights Campaign (2001) “occurred in every area of the country, happened in a range of workplaces, and affected employees at all levels” (Smith & Ingram, 2004, p. 59). Although anti-LGB discrimination in the workplace is pervasive in our society, this topic remains under-explored. Finally, best practices to reduce the negative effects of internalized homophobia should be examined. Although internalized homophobia is a strong influential factor to coming out, the exploration of additional risk factors is essential in gaining a stronger understanding of sexual minority identity development.

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Genevieve Weber-Gilmore and Sage Rose are Assistant Professors at Hofstra University. Rebecca Rubinstein is a graduate student in Rehabilitation and Mental Health Counseling at Hofstra University. Correspondence can be addressed to Genevieve Weber-Gilmore, Hofstra University, Department of Counseling and Mental Health Professions, Hempstead, NY, 11549-1000, genevieve.weber@hofstra.edu.

Through a Glass Darkly – Envisioning the Future of the Counseling Profession: A Commentary

Sep 4, 2014 | Article, Volume 1 - Issue 3

Shannon Hodges

The counseling profession has experienced significant growth and diversification to become a viable member of the global mental health profession. Originally founded in the U.S. as the American Personnel and Guidance Association (APGA), the profession has expanded to the flagship American Counseling Association, 19 divisional affiliates, and licensure in all 50 states, Washington D.C., and Puerto Rico, the National Board for Certified Counselors, the International Association of Counselling (IAC) and numerous other global professional organizations. This manuscript will outline the counseling profession’s genesis, growth, enumerate current challenges, speculate on the profession’s future and offer concrete suggestions to ensure the profession’s continued viability in a rapidly evolving global age.

Keywords: counseling profession, professional organizations, global age, professional identity, future development

During its nearly six decades, the counseling profession has experienced significant growth, struggle, and division to emerge as a viable mental health profession. The world’s largest counseling organization, the American Counseling Association (ACA), began as the American Personnel and Guidance Association (APGA). Conceived in 1952 by a loose confederation of organizations, APGA was primarily “concerned with vocational guidance and other personnel activities” (Harold, 1985, p. 4). ACA has evolved from its “guidance” infancy into a multifaceted profession of over 45,000 members (D. Kaplan, personal communication, April 8, 2011) and 19 divisional affiliates (American Counseling Association, [ACA] 2010). In 1976 the State of Virginia passed the first counselor licensure law and 49 other states, the District of Columbia and the territory of Puerto Rico have since followed, making the counseling profession credentialed in all states and major territories. Most states have passed legislation establishing a counselor’s right to bill private health insurance (Remley & Herlihy, 2007) and recently the Veteran’s Administration has approved licensed counselors to work in VA hospitals. Currently, some 635,000 counselors work in schools, addictions, corrections, and public and private agency settings (Bureau of Labor Statistics, 2010–2011). The U.S. Bureau of Labor Statistics (2010) projects “employment for counselors is expected to grow much faster than the average for all occupations through 2016” (p. 209). Relative to its mental health colleagues, the counseling profession has achieved a stakeholder position in a shorter timeframe than the psychology and social work professions (Remley & Herlihy, 2007). The counseling profession also has expanded to Europe, Asia, Africa, Australia and South America. Achievements notwithstanding, the global counseling profession faces numerous pressing challenges. This manuscript will address key issues confronting the counseling profession and offer concrete suggestions to twenty-first century realities. Since the past, present, and future are interconnected, speculation on the counseling profession’s future requires a brief review of its past.

The Past: From Genesis to the Present

Frank Parsons created the guidance movement by opening an office for vocational counseling in 1909. By creating an approach where the counselor actively attended to what adolescents said about themselves, he countered the prevailing distant, Freudian orthodoxy. Parson’s approach was soon adopted by schools in 35 U.S. cities and collegiate training in counseling began at Harvard University in 1911. University counseling emerged as a specialty in the 1930s when E.G. Williamson published How to Counsel Students: A Manual of Techniques for Clinical Counselors (1939). Williamson’s method was diagnostic in orientation and soon became the prevailing approach in colleges, schools and agencies (Nugent & Jones, 2009).

Carl Rogers (1942) moved the mental health field in a radically different direction with the publication of Counseling and Psychotherapy. Rogers advocated a more process oriented nondirective approach referred to as client-centered therapy (Rogers, 1951). Though schooled in Freudian analysis, Rogers developed an approach focused on a present, humanistic encounter between counselor and client. Additional theoretical approaches emerged in the post-Holocaust era, as many prominent European Neo-Freudian analysts and existentialists such as Alfred Adler, Karen Horney, Eric Fromm, Erik Erikson and Victor Frankl immigrated to the United States, challenging leading humanistic theorists such as Maslow and Rogers (Nugent & Jones, 2009).

The proliferation of diverse philosophical approaches and disparate organizations splintered the field resulting in various organizations representing the “guidance” movement. Finally, in 1952 four independent associations, The National Vocational Guidance Association (NVGA), the National Association of Guidance and Counselor Trainers (NAGCT), the Student Personnel Association for Teacher Education (SPATE), and the American College Personnel Association (ACPA) convened in Los Angeles for the purpose of building a stronger, unified coalition (Sheeley & Stickle, 2008). This meeting gave birth to the American Personnel and Guidance Association (APGA). APGA’s founding is usually referenced as the birth of the counseling profession, though as evidenced by the fact that “counseling” was absent from the title, it was an inauspicious start. APGA was primarily focused on high school academic and vocational counseling and training college student personnel (Aubrey, 1977). The fledging profession faced numerous obstacles: qualifications to become a “guidance” professional were ambiguous; there was no uniform program of study; no written code of ethics; no accreditation standards; and no credential such as licensure. Judging by contemporary standards, the early guidance movement was arguably a semi-profession (Etzoni, 1969).

Despite challenges, the counseling movement demonstrated remarkable resilience during the period from the 1950s through the 1960s. Humanistic approaches spearheaded by Rogers and Fritz Perls became readily accessible to the general public through the group encounter movement (Corey, 2009). The phrase “third force” in psychology was coined to differentiate existential-humanistic approaches from psychoanalytic and behavioral ones (Nugent & Jones, 2009). In the late 1950s notables like Murray Bowen and Virginia Satir, members of related mental health professions, popularized family counseling (Gladding, 2009). The school counseling movement, buoyed by the Soviet’s launch of Sputnik, escalated from around 7,000 counselors to nearly 30,000 (Aubrey, 1977). All these various forces within and outside the counseling profession resulted in popularizing counseling with the general public. By the mid-1970s the counseling profession and counselor education programs had grown exponentially (Nugent & Jones, 2009). Despite counseling’s proliferation however, ethical standards, accreditation, and credentialing still lagged behind related mental health professions (Remley & Herlihy, 2007).

The 1980s to 2000: The Post-Modern Era

In the early 1980s counselor education leaders created the Council for the Accreditation of Counseling and Related Programs (CACREP) to provide standardization and accreditation (Hollis & Dodson, 2001). CACREP, which began as part of the Association of Counselor Educators and Supervisors (ACES), is now an independent agency recognized by the U.S. Council for Higher Education Accreditation (CHEA) to accredit masters’ degrees in six counseling specialties and doctoral programs in counselor education and supervision (CACREP, 2009). Although counselor education programs are not required to be accredited, CACREP’s curricular guidelines form the basis for most states’ licensure laws (Remley & Herlihy, 2007).

During the same time frame as CACREP’s inception, the National Board for Certified Counselors (NBCC) was created. NBCC established a national credential for professional counselors that preceded states seeking licensure. As of November 2009, all 50 states, Washington D.C., Puerto Rico, and Guam have passed counselor licensure laws. Counselor certification, a credential offered by the National Board for Certified Counselors, has consequently transitioned from “licensure substitution” to identifying counseling specialty areas. The advantage of national certification over licensure, however, is that certification is a credential with uniform standards, unlike licensure where requirements vary from state to state. NBCC offers certifications in three professional counseling specialty areas (National Board for Certified Counselors, 2011). Though NBCC’s utility has been debated in the post-licensure era (Emner & Cottone, 1989; Weinrach & Thomas, 1993), Remley (1995) has argued that a license should be for general practice while national certification should identify specialty areas. NBCC also advocates for the counseling profession on a national level (J. S. Hinkle, personal communication, May 12, 2011). The field has moved towards Remley’s specialization model and NBCC credentials have become popular with professional counselors.

Previous to the post-modern era, the counseling profession was based on Eurocentric models and was almost exclusively a U.S. profession (Corey, 2009; D’Andrea & Arrendondo, 2002). Since the late-1980s, however, multicultural considerations have become mainstream, and counseling is becoming an international profession. Often called the fourth force in counseling (D’Andrea & Arredondo, 2002) multiculturalism has had a profound impact on the profession, especially regarding culturally and linguistically diverse populations (Arthur & Pedersen, 2008). Since the late 1980s multicultural task forces have been set up and special editions of various counseling journals have addressed issues such as culture, ethnicity, gay, lesbian and transgender issues. Counseling Today, a monthly magazine published by ACA, also features a regular column on diversity. Multicultural competencies developed by Sue, Arrendondo and McDavis (1992) were adopted in the early 1990s by the Association for Multicultural Counseling and Development (AMCD) and adopted by all 19 ACA division affiliates. CACREP identifies diversity as one of the eight core counseling areas (CACREP, 2009) and coursework in multicultural counseling is a staple in counselor education curricula. Although debate regarding its parameters continues (Dunn, Smith, & Montoya, 2006; Weinrach, 2003), multiculturalism will continue to play a pivotal role in shaping the counseling profession, particularly given the globalization of the field (Arthur & Pedersen, 2008).

The Current Situation: Success and Strife

The counseling profession has achieved numerous goals (e.g., name recognition, licensure, third party billing, emerging international presence, etc.) in nearly 60 years of existence. Nevertheless, concerns loom large over the counseling horizon. One of the most pressing issues is the counseling profession’s attempts to achieve marketplace parity with their mental health colleagues (Gladding, 2009; Remley & Herlihy, 2007). In the U.S., the first significant steps on this long journey towards parity were the profession’s successes in achieving state licensure. Historically, achieving rights coincides with long-term struggle against established forces who seldom abdicate power and privilege willingly (Marx & Engels, 1985). The counseling profession’s experience has been no exception to this maxim, as psychiatrists, psychologists, and social workers have vigorously opposed the counseling profession with regard to licensure, third-party billing, Medicare reimbursement, use of psychological tests and many other areas. Undaunted, the American Counseling Association, American Mental Health Counselors Association (AMHCA), American School Counselors Association (ASCA), and the National Board for Certified Counselors (NBCC) have pressed forward in the aforementioned areas. Such efforts have yielded considerable success (e.g., licensure and third-party billing) while leaving some major privileges unachieved (e.g., Medicare billing rights). Although ACA and its affiliates’ lobbying efforts have witnessed a Medicare reimbursement bill for counselors passing both houses of Congress at separate times, Medicare reimbursement remains unachieved, though well within reach. TRICARE, the U.S. military’s version of Medicare, recognizes licensed counselors as reimbursable providers, and recently has agreed to waive requiring physician referral for soldiers and their dependents desiring to access services of a licensed counselor (Barstow & Holt, 2010). The Veteran’s Administration also has approved licensed counselors to work in VA hospitals, although the VA has been very slow to hire counselors.

Challenges from Within the Counseling Profession: A Commentary

As indicated above, the counseling profession has struggled with many “turf” battles, namely with psychology and social work. But perhaps the counseling profession’s most serious challenge is the splintering of membership and resources among the various counseling organizations. For most of its existence, ACA required members to join one affiliate divisions. For example, applicants desiring membership in, say, the American School Counselor Association (ASCA), also were required to join ACA. For years the requirement to join the flagship organization was the source of controversy, bickering and threats of disaffiliation (B. Collison, personal communication, June 4, 2008). ACA’s membership numbers had already been reduced in the early 1990s when the American College Personnel Association (ACPA) disaffiliated, taking more than 10,000 members from ACA (B. Collison, personal communication, June 4, 2008).

The case of ASCA illustrates an important question for counselors: does the identity and loyalty of a school counselor lie with the flagship organization (i.e., ACA), or with the division/professional organization for school counselors (i.e., ASCA)? This splintering among the professional organizations operating under the counseling umbrella creates the possibility of further reduction, division, and disaffiliation. While ASCA and AMHCA remain divisional affiliates, each collects separate membership dues, holds separate national conventions, retains their own lobbyists and publicizes themselves as primary organizations representing their respective counseling specialties. From an outside perspective, ASCA and AMHCA’s relationship with ACA appears tenuous and one can only speculate whether they will remain divisional affiliates. Since ACPA’s disaffiliation, ACA membership has plunged from a high near 60,000 to the current number of just over 45,000 (D. Kaplan, personal communication, April 8, 2011). It’s also likely that most of the members who left ACA retained their membership in a divisional affiliate. Splintering may partly explain why such a small percentage of the 655,000 U.S. counselors (Bureau of Labor Statistics, 2010–2011) join neither ACA nor their respective divisional affiliate. The high degree of counselor non-affiliation with the profession’s established organizations is alarming and illustrates a disconnect between counseling professionals and the organizations that ostensibly represent them.

Fortunately, there has been recent good news regarding ACA’s membership, which has grown 8% over the past 18 months (D. Kaplan, personal communication, April 8, 2011). Most of this growth in membership has been graduate student members who now receive liability insurance as student members. While any growth in membership is a positive sign, whether graduate students will continue their membership in ACA after graduation is uncertain. The fact also remains that ACA’s membership is composed of a small percentage of counseling professionals cited by the Bureau of Labor Statistics (2010–2011). A more robust sign of growth would be an increase in the numbers of professional counselors currently unaffiliated with ACA.

ACA’s composition has been compared to a “ball of multi-colored yarn with an emphasis on the specialties of counseling as opposed to the overall profession” (Bradley & Cox, 2001, p. 39). This phenomenon of separatism seems likely to continue for the foreseeable future. For example, I regularly receive mailings from national, regional, state, and local counseling organizations, all of whom actively and separately solicit membership. Which of these various organizations to join can be confusing and expensive, and further illuminates the question of where professional loyalty should lie: with the national organization, specialty division, state affiliate, state specialty affiliate or local organization. In many states, separate organizations representing school counselors, mental health counselors, rehabilitation counselors and the state affiliates of ACA compete for membership, hold separate conventions, publish separate state journals and engage in separate lobbying efforts. Such duplication and splintering cannot be healthy for the profession.

Duplication concerns are not confined to the U.S. In Australia, where this author taught in a counseling program, three different organizations claimed to represent the counseling profession. It is likely such scenarios are common worldwide. While there is no easy resolution to this complex identity dilemma, it would seem prudent for leaders of all counseling organizations to recognize antagonism, division and duplication of resources that are working against the overall goal of establishing counseling as a strong, unified, and influential profession. Ironically, counseling’s most insidious adversary may not be psychiatrists, psychologists, or social workers, but the counseling profession itself. Unification is arguably the counseling profession’s most pressing challenge and if left unresolved, potentially leads to the counseling profession’s own “Tower of Babel” with confusion over what’s being said, who’s speaking, and which organization actually represents the profession. Perhaps former ACA president Samuel Gladding (2009) said it best:

“Since 1952 most counselors in the United States and a number of other countries have held membership in ACA…with an emphasis on the specialties of counseling as opposed to the overall profession…other professions, such as medicine, have overcome the divisiveness that comes within a profession where there is more than one professional track practitioners can follow. ACA has not been as fortunate (pp. 26–27).”

The motto “e pluribus unum” (one out of many) has much relevance for the counseling profession as a large, vibrant flagship likely is in a stronger advocacy position than numerous smaller ones. The American Psychological Association (APA) is one professional model to emulate as APA, despite representing scores of branches, remains a vibrant flagship organization. For any hope of achieving parity with its mental health colleagues, the various counseling “professions” must set aside differences and unite around core national organizations. Fortunately, there has been recent movement in this direction. The 20/20 counseling initiative, composed of 29 different counseling-related organizations, has recently reached consensus on how counseling is defined and ACA as the flagship organization (Cashwell, 2010). Unfortunately, ASCA, the largest divisional affiliate, has yet to sign onto the 20/20 initiative. The 20/20 initiative likely represents the counseling profession’s best chance at unity. One can only hope the initiative will be an opportunity seized and not one missed.

Besides splintering, the profession faces additional “in-house” challenges. During the 1960s and 1970s a significant debate involved humanistic versus behavioral approaches. Different views of mental health counseling have evolved, including those that are developmental (Ivey, 1989); relationship focused (Ginter, 1989); and slanted towards treatment, advocacy, or personal and environmental coping (Gladding, 2009; Hershenson, Power, & Seligman, 1989). The argument has now shifted to one of maintaining counseling’s traditional developmental, wellness approach moving towards an outcomes-oriented, pathology-based medical model (McAuliffe & Eriksen, 1999), or yet to be defined approach (J. S. Hinkle, personal communication, May 12, 2011). In the U.S., the influence of insurance corporations (e.g., HMOs) has moved the field towards cheaper, time-limited therapy, requiring particular Diagnostic & Statistical Manual-Fourth Edition-Text Revised (DSM-IV-TR; 2000) Axis I diagnoses to bill for counseling services (Remley & Herlihy, 2007). Faculty educated in a traditional wellness model are likely dismayed when counselor education programs adopt a pathology-based approach (Hansen, 2005; Remley & Herlihy, 2007). CACREP accreditation standards for mental health counselors appear to be aligned to a psychiatric rather than a developmental philosophy (CACREP, 2009) and credentialing boards (e.g., for licensure and certification) and influential organizations such as the World Health Organization (WHO) and related mental health professionals (e.g., psychiatrists, psychologists) create pressure on counselor education programs to educate their students in the DSM-IV-TR nomenclature. Accreditation standards and the marketplace demand adherence to a psychiatric model making it critical for counselors to become facile in understanding and applying the DSM-IV-TR. Although the psychiatric model has many critics (Gladding, 2009; Glasser, 2003) it remains the standard within the mental health field (Maddux & Winstead, 2010; Gladding, 2009; 2008; Remley & Herlihy, 2007).

University counselor education departments also have expanded and diversified. School counseling programs frequently are offered alongside mental health counseling programs; two counseling disciplines moving in radically different directions. Given that the emphasis in counseling divisions varies from a developmental model (e.g., school counseling) to a DSM-driven model (e.g., mental health counseling), can traditionally-minded, developmentally-oriented counselor education faculty ethically support a pathological, DSM-based approach? Conversely, can mental health counseling faculty support a non-pathology driven approach? What about the potential confusion among graduate counseling students enrolled in programs offering these disparate philosophies? Do the philosophical differences dividing the various counseling specialties mean such divisions will be perpetuated in the classroom and among the faculty? Furthermore, what should be the driving force in shaping counselor education programs: philosophical orientation or marketplace demands (e.g., the need to be facile with and use the DSM-IV-TR)? According to Hansen (2003), “It is not unreasonable to assume that the juxtaposition of these completely opposite models in counselor training has an impact on the development of counselor trainees and the profession as a whole” (p. 98).These foundational fault lines within counselor education have yet to be adequately resolved, as developmental approaches are taught alongside medical-pathological approaches, likely resulting in confusion for students and disharmony among faculty. Perhaps the most realistic statement to make is that counseling is a broad profession encompassing both developmental approaches (e.g., school counseling) and clinical, diagnostic approaches (e.g., mental health counseling) for the purposes of insurance reimbursement.

Gazing into the Future: Challenges and Opportunity

Besides fractionalization, differences in training and concerns regarding marketplace parity, additional challenges have recently emerged. The highly technical nature of the twenty-first century has created challenges and opportunities unforeseen in previous eras. In his seminal opus The World is Flat, Friedman (2005) argues the Internet age has transformed the media, financial markets, the military, education and virtually everything else. For the counseling profession, the Internet represents more tidal wave than ripple effect, impacting types of institutions offering programs (e.g., traditional vs. virtual), where and how they are offered (e.g., residential vs. web delivery) and who will teach them (e.g., full-time faculty or adjunct faculty). In June 2010, a national conference titled “Who Needs a College Campus” was held (EduComm, 2011).The past decade has seen a spike in the numbers of college students enrolled in virtual institutions. The University of Phoenix, primarily a virtual, for-profit institution, sports a CACREP-accredited counseling program and though they hold counseling classes in-person, one wonders if this will soon change. The University of Phoenix now boasts the largest collegiate enrollment in the U.S. with over 400,000 students (Lederman, 2010). Many elite brick-and-mortar institutions including Harvard University now offer virtual degrees. Small liberal arts institutions have begun offering web degrees and using satellite campuses. For example, Tiffin University, a small institution in the U.S. Midwest, has doubled the number of its graduate students and seen its total enrollment rise more than 50% in five years (Blumenstyk, 2008). The increasing options and delivery methods for course offerings and degrees are likely to change the number and types of counselor education programs as well.

Internet delivery means institutions and programs are no longer thwarted by geography, nationality, enrollment restrictions, number of faculty, distance, language, culture, etc. Instead of strolling through ivy-covered campuses, students can simply walk across their living room to access a college or graduate education through numerous virtual options. Besides the University of Phoenix, several online universities such as Capella University (2011) and Walden University (2011) also offer CACREP-accredited counseling programs. Web-based education poses several challenges for the counseling profession: advising and mentoring are virtual, not in person; web programs are staffed primarily by part-time faculty; when courses are delivered across state and international borders, which state or nation’s rules apply? Technology occasionally fails, leaving students and faculty “virtually” stranded. Finally, given huge enrollments and reliance on adjuncts as opposed to full-time faculty, questions regarding for-profit institutions’ principal concern (e.g., profit over academic quality) are likely to be raised.

There also is pressure for U.S. institutions to establish international partnerships to educate students on diverse cultures and plan for a global, interconnected world (American Council on Education, 2008). The Under Secretary of Commerce recently was quoted saying, “Education is one of our most valuable exports” (Sanchez, 2011). Numerous U.S. institutions have built satellite campuses in Europe, the Middle-East, Asia and Australia. Madeline Green, Vice President for the American Council on Education’s International Initiatives, along with her colleagues, opined current international initiatives are insufficient and pressed further: “Every institution needs to pay attention to internationalization if it is to prepare students for the multicultural and global society of today and tomorrow” (American Council on Education, 2008, p. 2). Even non-elite institutions have heeded Green’s message. A job advertisement in a recent edition of The Chronicle of Higher Education (Chronicle Careers, 2010) revealed that Troy University in rural Alabama has locations in 15 states and 14 countries.

The counseling profession also has begun to heed the call for globalization. Edith Cowen University in Perth, Western Australia, offers an off-shore counseling program in Singapore (Edith Cowen University, 2011) and California State University-Fullerton offers a joint counseling doctoral program with the University of New England in Australia (J. Kottler, personal communication, July 23, 2010). International partnerships offer numerous advantages. For example, perhaps a program in New York doesn’t offer a specialty course in trauma counseling, but a cooperating institution in New Zealand does. In this scenario, students could access the missing course via the Internet. Furthermore, students could travel to, say, Bhutan for an internship, profoundly enhancing a student’s multicultural experience. International partnerships also pose challenges for accrediting organizations such as CACREP (e.g., creating global, unifying standards), sponsoring institutions (e.g., differing guidelines), credentialing boards (e.g., licensure and certification bodies), faculty (e.g., full vs. part-time), ethical codes (e.g., cultural variations), and the future direction of the counseling profession (from Euro-American to an international focus). CACREP’s response was to create the International Registry of Counsellor Education Programs (IRCEP) in 2008 (IRCEP, 2011). IRCEP is not a credentialing body like CACREP, but a branch of CACREP designed to empower international counselor education programs appropriate to their country (IRCEP, 2011). IRCEP represents CACREP’s recognition that a uniform accreditation credential may not be realistic given the wide variation in global social and cultural norms.

Widely varying social and cultural norms inherent in the emerging global counseling movement also pose numerous challenges for the profession. Western counseling organizations have taken a social justice stance in promoting multiculturalism, gender equality, freedom of and from religion, and pluralism for sexual minorities in their various codes of ethics. ACA’s support in a high-profile court case involving the Eastern Michigan University counseling program and a conservative Christian dismissed from the program for refusing to counsel a gay client is a notable example of advocacy (Shallcross, 2011. “The EMU ruling upheld the ideals of the profession,” (Kaplan, 2011, p. 33). Such advocacy is commendable, especially as culturally relevant counseling practice is imperative in a global age (Arthur & Pedersen, 2008; Sue & Sundberg, 1996). Nevertheless, even within segments of Western civilization, issues of ethnicity, gender, religion and sexual orientation often form contentious points of debate. Though tensions can run high, Western academia offers a forum for discussing controversial issues. But what happens when constructivist, post-modern, pluralistic-oriented counselor education programs are offered in countries where discrimination plays a pivotal role? Saudi Arabia, for example, is an absolute monarchy that prohibits men and women from sharing the same classroom, restricts women’s movement outside the home, prohibits women from divorcing their husbands and provides no legal protection against domestic abuse. Furthermore, homosexuality and a Saudi’s practice of a religion other than Islam are potentially punishable by death (Saudi Arabia Guide, 2011). How will a Western social justice-oriented counseling profession address such restrictions on gender roles, religious identity, and sexual orientation in restrictive societies? Equally problematic, how will the counseling profession advocate equality without, ironically, appearing culturally insensitive in societies with rigid social caste systems? Moreover, is it even realistic to expect unilateral agreement on social and cultural issues in an increasingly internationalized counseling profession spread across diverse cultures? A larger question remains, however: are there some universal social justice principles the counseling profession should promote regardless of culture (e.g., gender and sexual equity, religious freedom, freedom to have no religion, etc.)? In this writer’s opinion, ACA, AMHCA, NBCC, etc. should encourage an ongoing dialogue about the realities and parameters of Western, social justice-oriented counseling expectations, particularly with regard to nonwestern societies.

Ironically, the counseling profession’s advocacy of pluralism, although noble and well-intentioned, is a concept framed largely through a Western mindset. This gulf between a pluralistic counseling profession and rigid, non-democratic societies creates great potential for conflict. Consequently, debate regarding cultural competence will likely become more complex and contentious with the counseling profession’s continued global expansion. The point is not that the profession should abandon its support for equality, nor should it force our social justice model on other societies, but rather it must be strategic in where and how it advocates pluralism.

Counselor education also must make programmatic adaptations in this new era. In the 1970s, Psy.D. programs emerged as an alternative to the traditional research-oriented doctorate for psychologists seeking careers outside higher education. Psy.D. programs have become quite popular and psychologists with such degrees now hold academic appointments. As the counseling profession evolves, it may be worthwhile to develop a Psy.D.-like degree. Some counseling programs already offer practitioner-oriented doctorates. In 2007, I taught as a visiting counselor education scholar at the University of Notre Dame–Australia (UNDA). UNDA’s counselor education program offers a Doctorate of Counselling (D.Coun.) modeled roughly on the Psy.D. (M. Philpott, personal communication, February, 18, 2008). Traditionally, the Ph.D. in counselor education has been a research degree specifically developed and marketed for counseling professionals planning academic careers. A D.Coun. doctorate with an emphasis on professional practice, clinical supervision, and developing management expertise, and less on research might seem more compelling to masters’ level counselors in community clinics or schools who desire a doctorate, but are not contemplating research careers. Moreover, doctoral students in counselor education are largely supervised in clinical internships by non-counselors due to a dearth of clinical counselors at the doctoral level (J. S. Hinkle, personal communication, May 12, 2011).

Along similar educational lines, the front end of the higher educational spectrum also presents opportunity for the counseling profession. For decades, bachelor’s-level addictions counselors have worked at the margins of the profession. In many countries, BA/BS degree professionals are the norm, not the exception (Arthur & Pedersen, 2008; Selles et al., 2007). The University of Notre Dame–Australia offers a baccalaureate counseling degree, with a job placement rate for graduates approaching 100% (M. Philpott, personal communication, February, 18, 2008). Although the profession maintains the masters’ degree is the entry-level degree, large numbers of bachelor’s degree counselors continue to work in addictions. Perhaps it’s time to recognize baccalaureate counselors as legitimate professionals. Counselor education programs could create baccalaureate programs, market them for entry-level positions, educate undergraduates regarding the counseling profession, and steer them into graduate counselor education programs. While counselor educators may be aghast at such a proposal, it’s worth remembering that our social work colleagues have long maintained bachelor’s degree programs with no noticeable detriment to their profession. In addition, bachelor’s degrees in human services are dramatically on the rise (J.S. Hinkle, personal communication, May 12, 2011).Undergraduate psychology departments also are among the most vibrant on any college campus even though the American Psychological Association maintains that psychology is a doctorate-level profession (APA, 2002). Moreover, undergraduate social work and psychology programs provide a forum to guide and mentor future social workers and psychologists. Counselor education’s undergraduate mentoring role has been abdicated to social work and psychology faculty, neither of whom have a stake in supporting a separate, competing profession. Undergraduate counseling programs would create a stronger professional identity at the baccalaureate level, provide early mentoring for future counselors, and preferably increase membership in national as well as affiliate counseling organizations.

Rapid changes brought about by our technologically advanced era require an increasing need for the counseling profession to develop flexible, visionary leadership and set planning priorities (Gladding, 2009; Glasser, 2005). While on one hand graduate counseling programs do a good job providing leadership and clinical skills training, on the other hand, performance reviews, political networking, and entrepreneurship are seldom covered in the curriculum (Curtis & Sherlock, 2006). Curtis and Sherlock (2006) use the term managerial leadership (p. 121) as a means of becoming more strategic with regard to future development. ACA certainly is engaged in leadership development regionally and nationally, and strategic planning has recently become a major focus of the ACA’s 20/20 initiative (Gladding, 2009). Given its importance, strategic planning and management training should become an integrated part of counselor education curricula as counselors essentially are managers in schools, community clinics, university and community college counseling centers, and in professional organizations such as ACA.

Summary

APGA’s original narrow, guidance-oriented, Eurocentric profession now consists of multiple identities, numerous theoretical approaches, a comprehensive research base, Internet-based institutions, and a global, multicultural presence (Arthur & Pedersen, 2008; Herr, 2004). Multiculturalism and a social justice approach to counseling have become ubiquitous in counseling, permeating professional organizations, ethical codes, and mission statements, and they are prominently featured in journal articles and textbooks. Though disagreement on multicultural parameters continues (Dunn, Smith, & Montoya, 2006; Weinrach, 2003) with the profession’s internationalization, cultural issues will become even more significant and complex given the broad social, geographic, ethnic, religious, and political variations among global societies.

Because of the dynamic, interconnected, global nature of the 21st -century marketplace (Friedman, 2004), the counseling field is likely to undergo dramatic change. Some 150 years ago Charles Darwin (1859) theorized it wasn’t necessarily the smartest or strongest organisms that survive, but those most willing to adapt to external demands. Demands challenging the counseling field include unifying a fractious profession, achieving market place parity, maintaining relevant counselor education programs, addressing global cultural conflicts, and proactively responding to the vast challenges and opportunities of a dynamic era. To flourish, the counseling profession must chart a bold, progressive, global, strategic course of action to address post-modern challenges. An effective course of action is likely to result in numerous changes both for counselor education training and in the delivery of counseling services to an increasingly diverse, global clientele. How effectively the counseling profession adapts to meet 21st-century demands will largely determine its future success and viability.

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Shannon Hodges, NCC, is an Associate Professor of Counseling in the College of Education at Niagara University. Correspondence concerning this article can be addressed to Shannon Hodges, Niagara University, College of Education, Niagara University, NY, 14109, shodges@niagara.edu.

The Development of a Sexual Orientation Scale for Males

Sep 2, 2014 | Article, Volume 1 - Issue 3

Sachin Jain, Santiago Silva

One of the major flaws in current psychological tests is the belief that a prediction/diagnosis can be made that would tell an individual whether he is heterosexual, homosexual or bisexual. What is needed within the profession, however, is an assessment that has the sensitivity to help clients explore their sexual orientation. A pilot 100-item Sexual Orientation Scale was developed after interviewing 30 self-identified gay men who considered themselves happy/satisfied. The items summarized the thoughts and feelings of these 30 men during the discovery process and ultimate acceptance of their sexual orientation. The scale was then completed by 208 male participants. The Cronbach’s Alpha Coefficient was calculated for the initial 100-item version of the Sexual Orientation Scale along with item analysis and factor analysis. These statistical manipulations were computed to help eliminate items that did not discriminate well. The final version of the Sexual Orientation contains 43 items. Implications for the use of this scale and future directions in research are further explored.

Keywords: sexual orientation, scale development, males, assessment, exploration

As children grow up in our society, they are introduced to a wide range of knowledge about sexual behavior by their parents, siblings, and peers. Part of their education addresses the ideas of sexual orientation and/or preference. The inherent messages in this education are that a person is either heterosexual (sexually attracted to members of the opposite sex), homosexual (sexually attracted to members of the same sex), or bisexual (sexually attracted to members of both sexes).

Historical Overview of Sexual Orientation

A number of theories on the origin of homosexuality have attempted to define homosexuality. A number of these theories (c.f. Drescher, 2008; Ellis, 1936; Freud, 1922/2010; Krafft-Ebing, 1887/1965; Nuttbrock et al., 2009) place sexual orientation within the context of an individual’s overall sex role identity. These individuals link sexual attraction for men toward women with a masculine sex role orientation and sexual orientation toward men with a feminine sex role orientation (Axam & Zalesne, 1999; Mata, Ghavami & Wittig, 2010; Storms, 1980). Sexual orientation refers to a particular lifestyle (behavior) that an individual displays. Storms (1980) and Moradi, Mohr, Worthington, & Fassinger (2009) found most theories about the nature of sexual orientation emphasize either the person’s sex role orientation or erotic orientation. Although these assumptions have had a major impact on the development of theories, research, clinical practice, and even popular stereotypes, neither assumption has been adequately tested in past research. A homosexual person is one defined as having preferential erotic attraction to members of the same sex and usually (but not necessarily) engaging in overt sexual relations with them (Crooks & Baur, 2008; Marmor, 1980).

Cass (1984) and Harper & Harris (2010) identified four steps in the discovery process that people experience as they begin to identify their sexual orientation:
1. Individuals come to perceive themselves as a homosexual by adopting a self-image of what it means to be homosexual.
2. Individuals take this self-image a step further and allow it, through interaction with others, to become a homosexual identity.
3. Individuals assume the necessary affective, cognitive, and behavioral strategies in order to effectively manage this identity in everyday life.
4. Individuals find a way with which to incorporate the new identity into an overall sense of self.

Assessment of Sexual Orientation

Fergusson & Horwood (2005) wrote a review of the multitude of methods that have been used to assess sexual orientation. Conceptualization of sexual orientation as dichotomous (i.e., heterosexual and homosexual) was overturned over 60 years ago by Kinsey, Pomeroy, and Martin (1948) and by Kinsey, Pomeroy, Martin, and Gebhard (1953). These studies resulted in the development of a 7-point scale in which 0 represented exclusive heterosexuality and 6 represented exclusive homosexuality. Three on the scale indicated equal homosexual and heterosexual responsiveness. Individuals were rated on this continuum based upon their sexual behavior and physical reactions (i.e., physical attraction to desired partners) (Coleman, 1987; Fergusson & Horwood, 2005).

Although this notion that people fall in a continuum better represented the realities of the world (Bagley & Tremblay, 1997; Silenzio, Pena, Duberstein, Cerel, & Knox, 2007), the Kinsey Scale has many limitations for accurately describing an individual’s sexual orientation. The scale assumes that sexual behavior and erotic responsiveness are the same within individuals. In response to this criticism, Bell and Weinberg (1978) used two scales in their extensive study of homosexuality. They examined two scales: one for sexual behavior, and one for erotic fantasies. Bell & Weinberg (1978) found discrepancies between the two ratings. Paul (1984) and Garnets & Kimmel (2003) also reported discrepancies in approximately one-third of their homosexual samples. It was reported that most men saw their behavior as more exclusively homosexual than their erotic feelings (Coleman, 1987; Fergusson & Horwood, 2005; Schwartz, Kim, Kolundzija, Rieger & Sanders, 2008).

Coleman (1987) and Fergusson & Horwood (2005) suggested that while this dichotomous and continuous view of sexual orientation represented an improvement in assessment of sexual orientation, several clinicians and researchers have recommended additional dimensions (Fox, 2003). These dimensions are those based upon both the biological sex of the partner and the biological dichotomous sex of the individual.

As the literature on psychological testing and homosexuality unfolded, it became clear that tests were not very effective in creating special scales, signs or scoring patterns that could differentiate homosexuals from heterosexuals (Garnets & Kimmel, 2003; Paul, Weinrich, Gonsiorek, & Hotvedt, 1982). Homosexuality was no longer being studied as an illness. Contrastingly, literature has brought forth strong data that dismiss the notion that homosexuality is a disorder (Cass, 1984; Coleman, 1982; Harper & Harris, 2010; Henchen & O’Dowd, 1977; Morin & Miller, 1974; Tripp, 1975; Troiden, 1977; Weinberg, 1978).

One of the major flaws in current psychological tests is that there is a belief that a prediction/diagnosis can be made that would tell an individual whether he is heterosexual, homosexual, or bisexual. It is the authors’ belief that it is inappropriate to predict what kind of lifestyle an individual will/should follow. What is more feasible is to assist an individual as he or she explores the experience of uncertainty. Therefore, an instrument is needed that has the sensitivity to help clients explore their sexual orientation, not one that identifies levels of disturbance.

Purpose of the Study

The purpose of the study was to construct an instrument that would help counselors in assisting clients who wish to explore sexual orientation. The instrument was to:
• Identify issues that need to be addressed by the client during the discovery of sexual orientation.
• Focus on issues such as self-definition, self-acceptance, fears, sexual fantasies, and understanding of lifestyle.
• Provide an information base for counselors as they help their clients unfold significant characteristics of their personality.
• Provide counselors a tool for helping clients meet the challenges they face now and will face in the future.

Method

Participants
The volunteer population of this study consisted of males who were either a) receiving personal counseling at a university counseling service, community mental health agency, and/or private practice; b) enrolled in introductory psychology classes at universities or community colleges; or c) participating in local men’s groups (i.e., Jaycees, Lions Clubs, support groups, etc.).

Two universities in California, eight universities in Texas, and one university in Wisconsin assisted in the collection of data. Three mental health agencies and four private counseling centers also were recruited for assistance in data collection. The private counseling centers served primarily gay and lesbian clients from the Dallas/Ft. Worth area.

Directors and/or counselors at the mental health sites mentioned above were visited. The purpose of the study was explained and they were asked if they would approach their clients (straight and gay) to determine their willingness to participate in the study. If the counselors were willing to speak to their clients, they were given instructions to share with clients who agreed to participate. They were instructed to give the client the research packet and return the completed information in the enclosed addressed/stamped envelope. Seventy-five agreed and completed packets from this group of mental health agencies were obtained.

Permission from psychology professors at the universities and/or colleges to address their introductory psychology classes was obtained for recruiting more subjects. The purpose of the study was shared with the class, willing participants were moved to another classroom, and they completed the research packet. One hundred and six packets were completed through this procedure.

Men’s groups were approached to obtain additional participants. Groups such as Jaycees, Lions Clubs, and Gay Men’s Support Groups were contacted and visited. A presentation was made that addressed the purpose of the study. Willing participants were provided with information packets, which they returned in enclosed envelopes. Thirty-three completed packets from representatives of the men’s groups were received. Twenty-eight of the 33 came from gay men’s support groups.

Demographic information from the personal data form was summarized and examined across the variable of sexual orientation on the following factors: educational level, socio-economic status, age, ethnicity, self-rating on the Kinsey Sexuality Scale and whether or not the participant was currently in counseling or psychotherapy. The males in the sample identified themselves as being either homosexual (gay) or heterosexual (straight). The males self-identified as gay or straight by rating themselves on the seven-point Kinsey Sexuality Scale (0=exclusively heterosexual to 6=exclusively homosexual). Straight responses were identified as those of which the men rated themselves as zero (0) or one (1) and gay responses were identified as those in which the men rated themselves as five (5) or six (6) on the Kinsey scale. Only six subjects rated themselves as 2, 3 and 4. The scales completed by these 6 subjects were not used in this study.

The sample consisted of a total of 208 men from cities in Texas, Wisconsin, and California: 132 were between the ages of 18–25 (63.5%); 52 were between the ages of 26–33 (25.0%); and 24 were between the ages of 34–40 (11.5%). According to the Kinsey Scale Rating, 104 were straight (50%) and 104 were gay (50%). Of the men who participated in the sample, 85 (40.9%) had received counseling and 123 (59.1%) had not.

Procedure

The first procedure consisted of the development of the items for the Sexual Orientation Scale. In order to achieve this task, thirty gay men who described themselves as being happy/satisfied with the gay lifestyle were interviewed. The men were identified via personal contacts and gay organizations. Their input was used to develop items for the Sexual Orientation Scale.

Three small group meetings of approximately two hours each with about ten men were scheduled. Each meeting began with a statement of the purpose of the groups and the study. It was explained that data was being collected to formulate a scale that would help people clarify questions about their sexual orientation. It was explained that the scale was not designed to label whether someone was gay or straight, but simply to identify issues surrounding sexual orientation. Time was allotted for questions and answers.

Participants were asked for permission to record the group session. When permission was obtained, participants were asked about their experience of the discovery process of their sexual orientation (e.g., “What struggles did you experience?” “What questions did you ask yourself during this discovery process?” “What were you feeling?” “Did you get in touch with any fears?” “What kind of sexual fantasies did you experience?”). These questions were asked in order to help the participant recall their discovery process. Participants were allowed to ask each other questions and/or identify with what was being shared in a casual and informal atmosphere. Recordings of the three small group meetings provided the source for the 100 items that represented thoughts and feelings the men experienced during their discovery process. These 100 items consisted of Phase 1 of the Sexual Orientation Scale development.

After the pilot scale was developed, packets were sent out to university counseling services, psychotherapists in private practice, and community mental health agencies. The packet consisted of: (a) a personal data form, (b) the 100-item Sexual Orientation Scale, (c) an informed consent form, and (d) an addressed and stamped envelope. Data on the 100-item Sexual Orientation Scale also was collected from different men’s groups and from the introductory psychology classes both at universities and community colleges.

Two hundred and eight packets were completed. Coincidently, 104 responses were from gay individuals, and 104 were straight responses. The responses were then transferred onto Scantrons and submitted for analysis.

Instrument Development
Item construction. Tests are composed of a number of items that are used to measure a particular subject. According to Wesman (1971), an item may be defined as a scoring unit. Creating an item should be taken seriously because each item in a test produces a unit of information regarding the person who takes the test.

Writing a test item is an involved process. Test items need to be subjected to constant evaluation in order to ensure, as much as possible, that they are measuring what they are intended to measure. The items developed for the Sexual Orientation Scale represent two variables: self-image and eroticism. These variables have been continuously identified in sexual-orientation literature (Cass, 1984; Coleman, 1982; Eliason & Schope, 2007; Grace, 1979) as variables that must be examined when attempting to answer questions regarding sexual orientation. Self-image is defined as involving self-definition, self-acceptance, fears and an understanding of lifestyle. Eroticism is defined as sexual fantasies.

Item analysis. According to Anastasi (1988), items on an instrument may be analyzed quantitatively, in regards to their statistical properties. When examining items qualitatively, content validity is considered as well as the evaluation of items in terms of effective item-writing procedures. Quantitative analysis primarily includes the measure of item difficulty and item discrimination (Anastasi, 1988).

Item difficulty answers the question: How hard or easy was a particular item for the group of participants? Item discrimination refers to the degree to which an item differentiates correctly among test takers in that behavior that the test is designed to measure (Anastasi, 1988, p. 210). Item discrimination was calculated as a correlation coefficient between the item score and the total score. Correlation coefficient indicates the strength and direction of a linear relationship between two random variables.

Results and Discussion

Item Design for the Sexual Orientation Scale
In designing the Sexual Orientation Scale, two areas of interests were salient. They were self-images and eroticism. The literature on sexual identity formation strongly supported the examination of these two interest areas during the discovery process of one’s sexual orientation. The importance of examining self-images and eroticism was further supported in the early stages of this study that resulted in the identification of the initial 100 items of the Sexual Orientation Scale.

Thirty self-identified gay men were interviewed regarding their discovery process. While reviewing interviews, items were generated that represented their thoughts and feelings. Examination of items clearly indicated that issues such as self-acceptance, understanding fears, and eroticism were being confronted during the discovery process.

Next, these 100 items were then subjected to an item analysis that resulted in identifying 45 items with item discrimination indices of 0.50 or higher. These 45 items were then further subjected to a factor analysis and an alpha coefficient.

An arbitrary decision was then made to use a 0.5 or higher factor loading in examining items. A strict convention of 0.5 or higher was used in order to identify the most discriminating items. The factor analysis identified the same items the item analysis identified. The alpha coefficients were as follows: overall= 0.924; straights= 0.723, gays= 0.653.

The factor analysis also identified four factors that were consistent with issues identified by both the literature and the initial 100 items. After reviewing the items in these factors, they were labeled as:
attraction to same sex
attraction to opposite sex
self-acceptance of gay behavior/attitudes
fears

Item Analysis
Anastasi (1988) pointed out that items on an instrument may be analyzed qualitatively, in terms of their content and form, and quantitatively, in terms of their statistical properties. The item analysis performed on the initial 100 items of the Sexual Orientation Scale focused on a quantitative analysis and more specifically on the measures of item difficulty and item discrimination.

Item difficulty refers to the percentage of subjects that endorse certain items on the scale. The closer the difficulty level approaches 0.50, the more differentiations the items can make (Anastasi, 1988).

Item discrimination refers to how effective the item discriminates between the two groups. Therefore, the higher the item discrimination score, the more effectively the item will differentiate between the two groups (gays/straights). Table 1 shows how the sample was grouped in order to establish an item-to-total score correlation, which is identified as a useful exercise to select items.

Based on the total score, the respondents were divided into quintiles (groups of approximately 40 subjects). A total score was established by assigning a value of 1 to true responses and a value of 2 to false responses. A true response indicated the way a gay man would respond. An item difficulty, identified in the item analysis as proportion of subjects that responded correctly to the item (PROP) and item discrimination, identified in the item analysis as a point biserial correlation coefficient (RPBI), were calculated for each item.

Table 2 outlines the item difficulty and item discrimination score and the scoring key of the initial 100 items. The asterisks identify the scores for the 43 items on the final version of the Sexual Orientation Scale. Of the final 43 items, approximately 76.7% of the items have a difficulty score that range from 0.40 to 0.60. Since Anastasi (1988) stated that the closer the difficulty level approaches 0.50, the more differentiations the item can make, it is safe to infer that the majority of the items on the Sexual Orientation Scale possessed good potential for differentiating between responses of the two groups. The remaining 23.3% of the items were not far behind. None of the item difficulty scores were less than 0.32 or higher than 0.76. This shows that the result of these items do not differentiate as well, but well enough to contribute to the overall reliability and validity of the Sexual Orientation Scale.

According to Anastasi (1988), the items that have low correlations with total score should be deleted and the items with the highest average inter-correlations will be retained. These items were retained because they are the ones that discriminate well and increase the validity of the test.

Analysis showed that 43 items on the initial 100-item Sexual Orientation Scale scored 0.50 or higher on the item discrimination index. Since the item discrimination refers to the degree to which an item differentiates correctly among test takers in the behavior that the test is designed to measure, one could assume the majority of the items on the Sexual Orientation Scale effectively differentiates between the two groups (gay/straight) that were tested.

Results of Item Analysis

The 45-item version of the Sexual Orientation Scale was a result of an item analysis done on the initial 100-item scale. The original data analysis identified 17 factors. An item discrimination index of 0.50 or higher was used to identify the items for the final version of the scale. Items that exhibited a higher level of commonality were selected. The 55 items that were deleted did not discriminate as well.

The 45 items were then submitted to the following statistical procedures: (a) Cronbach’s alpha coefficients were calculated for the overall sample, for the straight sample, and for the gay sample; and (b) a factor analysis was conducted via the running of five, four, three and two factor solutions on the overall sample (N=208). The factor analysis was done for the purpose of further validating the Sexual Orientation Scale.

Naming of the Factors
After creating and reviewing a SCREE Plot with the Eigen values of the 45 items, the researchers identified a bend that began to occur around the three, four and five factors. All factor solutions were investigated, and a decision was made to use the four-factors solution because (a) the items fit the four factors very well, and (b) the addition of a fifth factor accounted for negligent increase in the total variance. Every item in each factor carried a common theme.

The items in the four-factor solution were reviewed. Finally, two of the 45 items did not have a factor loading of 0.5 or higher. In keeping with the arbitrary decision of only using those items with a 0.5 factor loading or higher (for the purpose of implementing a stricter convention), items 36 and 15 were deleted. The final version of Sexual Orientation Scale resulted in having 43 items.

Table 3 summarizes the four factors solution by identifying the sorted rotated factor loadings of each item in each factor. Items 12, 22, 29, 39, 42, 45, 46, 49, 50, 59, 64, 65, 66, 67, 68, 72, 73, 80, 83, 88, 97, 98, and 99 loaded on Factor One with factor loadings ranging from 0.58 to 0.73. The common theme was sexual attraction to members of the same sex. The items in Factor One identified issues such as being attracted to nude males, erotic thoughts about men, masturbatory fantasies involving men only, relationships with males, etc. Therefore, Factor One was named “Attraction to Same Sex.”

Items 6, 14, 17, 41, 44, 48, 60, 63, 70, and 82 of Factor Two in Table 3 also had sexuality as their common theme. However, the sexual attraction addressed in the above items was towards members of the opposite sex. Their factor loadings ranged from 0.55 to 0.78. The items in Factor Two brought to surface issues dealing with erotic fantasies about women only, thoughts about women that led to sexual arousal, etc. Due to a common theme in these items, Factor Two was named “Attraction to Opposite Sex.”

Factor Three in Table 3 was comprised of items 16, 25, 33, 56, 89, and 91. These items had factor loadings ranging from 0.53 to 0.78. In examining these items, it was evident that the common theme surrounding the items was that of self-image and self-concept. The items in Factor Three addressed issues such as self-expression, expression of affection to another male, the acknowledgement of individual differences and the normalcy of being attracted to other men. Factor Three was named “Self-Acceptance of Gay Behaviors/Attitudes.”

Items 31, 32, 81, and 90 in Table 3 loaded onto Factor Four with loadings that ranged from 0.52 to 0.60. The common theme among these items was fear, which pertained to issues faced more often than not by gay men. The items addressed concerns in areas such as wanting to be sexually active with other men, jealousy, noticeable reactions to other men and fear of being gay. Because of the obvious common theme, Factor Four was named “Fears.”

It is vital to note that the four factors identified via the factor analysis represented those themes continually found in sexual orientation literature. Cass (1979 & 1984), Grace (1979) and Coleman (1982) consistently addressed the importance of examining the variables of self-images and eroticism during the discovery process of one’s sexual orientation. All these factors are clearly identified in the 43 items in the four-factor solution done on the final version of the Sexual Orientation Scale.

Reliability
A Cronbach’s alpha coefficient was performed in order to establish the reliability of the final 43-item version of the Sexual Orientation Scale. An alpha coefficient was done on the overall sample (N=205), the straight sample (N=103), and the gay sample (N=102). The overall sample has an N of 208. Three completed scales (1 straight respondent and 2 gay respondents) were eliminated because they did not complete the initial 100 items. The alphas for the 43-item version were 0.93 for the overall sample, 0.72 for the straight sample and 0.65 for the gay sample.

Construct-Related Validity
Internal consistency is a procedure used to establish construct validity. A statistical procedure used in this study to establish internal consistency was Cronbach’s Alpha Coefficient; this statistic also was used to establish instrument reliability (Miller, 1987). Table 4 shows the alphas which clearly exhibit the homogeneity for the items on the Sexual Orientation Scale.

A factor analysis was performed on the 45 items to identify the prevalent factors. After the factor analysis was done, four factors were identified as the most important factors that need to be examined when struggling with the uncovering discovery process of an individual’s sexual orientation. They are Attraction to Same Sex, Attraction to Opposite Sex, Self-Acceptance of Gay Behavior/Attitudes, and Fears. The items and other data on each factor are summarized in the following table. Normative data also was generated on the overall sample, the gay sample, and the straight sample. This was done for interpretation purposes. Table 4 summarizes the established normative data.

Limitations

This study contained methodological features which resulted in limitations. The major areas of limitations were (a) the sampling procedures and (b) generalizability.

Sampling Procedures
The initial 100-item Sexual Orientation Scale resulted from interviews with self-identified gay men who stated they were happy/satisfied as gay men. Only 30 men were interviewed. Although this number was an acceptable number, a larger number of men interviewed may have provided additional insights.

Of this group of 30 men (participating in the development of the items for the Sexual Orientation Scale) from cities in the Rio Grande Valley (RGV) in South Texas, 90% were Hispanic college graduates. Being a Hispanic gay man in the RGV in South Texas is difficult. The machismo attitude is somewhat prevalent in this area. This, coupled with a strong Catholic belief about homosexuality makes life as a gay man very secretive in this area. Thus, it is important to note that the initial 30 subjects were men who are openly gay, educated, motivated, and obvious risk takers. The sample group, therefore, may not have represented the “typical” gay man in the United States. Moreover, a different or more thorough perspective about what is involved in the discovery process with respect to sexual orientation might have risen if there had been a more diverse group of gay men in terms of ethnicity and geographical area.

The sample size (N = 208) utilized for the statistical item analysis was small. Although acceptable for this study, a much larger sample would likely improve the scale’s reliability and validity. The sample in this study did not include women. Women were excluded because it was suspected that gay men and lesbian women experience a different discovery process and that a parallel, yet different study is necessary for females.

Lastly, the two samples (gay/straight) are not actually directly comparable because, in essence, they were not selected in the same way. For example, a large percentage (65.4%) of the gay sample compared to 16.3% of the straight sample was enrolled in counseling. One can ascertain that most of the gay samples were selected from university counseling centers, mental health agencies, and the private sector. Contrastingly, the straight sample was selected from introductory psychology classes and from the membership of men’s groups (civic and/or support).

Generalizability
The generalizability of the results of this study is limited to men who are between the ages of 18 and 40 and who are either receiving counseling services from university counseling centers, mental health agencies, or the private sector, or who are in introductory psychology classes or members of men’s groups. The generalizability of this study is further limited to Hispanic and Caucasian men who met the research criteria.

Recommendations

The following are recommendations to either improve the present study’s design or identify areas for future research:
• Obtain a more culturally diverse sample by including representatives of other ethnic groups along with representatives from the Hispanic and Caucasian groups. This would increase the potential of gathering different perspectives and insights as well as increase the generalizability of the results.
• Utilize a larger more diverse sample in order to compare the reliability and validity data obtained in this study with other studies. A test re-test might be considered so as to verify the reliability of the Sexual Orientation Scale.
• In order to minimize a client’s tendency to answer the way they think their therapist or counselor wants them to, a lie/consistency scale may need to be established for the Sexual Orientation Scale. This may be done by including items that emphasize the same information, but written in a different manner.

Once the Sexual Orientation Scale has undergone further empirical investigation and eventual modifications, the use of the scale in counselor training programs should be considered. This would be done in hopes of (a) educating future counselors in how to assist clients who are confused about their sexual orientation, (b) increasing one’s sensitivity to and knowledge about gay/lesbian issues, and (c) requiring to some extent that future counselors accept and understand their own biases in regards to individual differences and more specifically to gays and lesbian.

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Sachin Jain, NCC, is an Assistant Professor, Department of Counseling, Oakland University, Rochester, MI. Santiago Silva, is a Clinical Professor & Director of the Counseling Assessment Preparation Clinic (CAP) at the University of Texas-Pan American. Correspondence can be addressed to Sachin Jain, Oakland University, Department of Counseling, 2200 N Squirrel Road, Rochester, MI, 48309, sacedu@yahoo.com.