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Queer Mind: LGBTQ and Beyond
Recent published reports woefully miss the mark with regard to treatment pertaining to transgender and gender-nonconforming children. Read Margie's latest GoodTherapy.org blog here:
by Margie Nichols
The neatly categorized notions most people apply to sexual orientation, expression, and gender identity may not be inclusive enough.
Read the full blog, published on GoodTherapy.org, here!
by Dr. Margie Nichols
My blog on the loss of the incomparable Lou Reed has been published on Out In New Jersey.
'When Lou Reed's New York album came out in 1989, many friends and I related instantly. It was hard, harsh and gritty. It expressed the anger, cynicism and mistrust of the government that we all felt. Although only one song, 'Halloween Parade,' explicity referenced gay people and AIDS, it was easy for us queers who were surrounded by the disease and faced with society's hatred of gay men and the government's homicidal negligence to identify with Reed's polemical songs about classism, racism, xenophobia and environmental plunder. They also expressed pain, hopelessness, despair – and yet, in addition, a shred of hope and mysticism. And some songs did all of this in one, like 'Busload of Faith.' One of my most vivid memories of that era, one that makes me smile and cry at the same time, is of IPG therapist Curt Schulze and me singing that song together at the top of our lungs. Curt died a couple of years later, of AIDS.'
Read the full blog here.
by Margie Nichols
The blog I wrote for Goodtherapy.org about bisexuality must have touched a nerve - more people have commented than any other blog I've written. Who knew, more than 20 years after I came out as 'bi' in the 1980's, that it would still be such a hot-button topic?
Read it HERE
by Margie Nichols
Check out Margie's blog on Goodtherapy.org about the problem of suicide among LGBT teens and young adults. Gay, lesbian, bi and trans and gender non-conforming kids make more suicide attempts than other adolescents - but we can do something about this!
by Margie Nichols, Ph.D.
On August 11 2013, The New York Times published an article by Judith Warner in its Sunday Magazine, entitled “The Opt-Out Generation Wants Back In,” a revisiting of the women interviewed in Lisa Belkin’s 2003 Times article “The Opt-Out Revolution.” The women, who had all given up high-powered jobs to be full-time mothers, now were working - or wanted to be. Sixty percent had returned to work, and some others were trying unsuccessfully. Not surprisingly, given that Warner’s sample is upper middle class, some had re-entered the work force with ease. But others could not find paying jobs and still others had to take whatever they could find because they had to bring in money after divorce or because husbands lost jobs. After the publication of the article, some reporters focused on the clear class bias and how working class and many middle class families cannot afford the choice to ‘opt-out.’ Some commentary focused on another problem highlighted by the account: none of the women wanted to return to the 50-70 hour work week they left, but there are still few employers who take part-time workers seriously.
As a feminist, I resonate with this second critique. The original goals of the second wave of feminism, at least the more radical branch, did not include simply succeeding in traditionally male workplaces, but instead, when we attained power ourselves, to transform the game itself into something more family-friendly, balanced and fair. We were all about day care, employment opportunities for women, job-sharing and becoming an active participant in the marketplace, knowing that in order to change the rules of the male-dominated business world, you needed power and money.
Instead, we got women ‘opting-out.’
As a white-collar, educated professional, I have a privilege and freedom most of my working sisters don’t have. But I also have a perspective that comes from a different place, informed by the fact that I am a queer Mom who, together with her female partner, chose to mother and raise a child who is now nearly 30. I’ve lived and worked my whole life in the LGBT community, where I’ve raised and shared in the raising of four kids, three still living, and worked soon after the birth or adoption of all of them.
Thirty years ago, when pregnant with our son, an older and wiser working mom gave me invaluable advice: “Never make friends with a stay at home mom,”. She was referring to the fact that many full time mothers look down on working mothers, subtly and not so subtly. The judgment can be particularly harsh for women who chose to work even though, with some lifestyle adjustments, they could afford to stay home fulltime. The upper middle class heterosexually married ‘opting out’ moms portrayed by Lisa Belkin and now Warner are not the poor and working class women who stay home because childcare is too expensive and/or of low quality, but the ones who have a personal choice. These "opting out" moms often seem to believe that their choice is the one more virtuous, the one made ‘for the children.’ And their husbands believe it too. As does the whole culture, really.
The myth, rarely articulated but widely shared, is that women are ‘naturally’ more skilled at parenting and that children need a full-time mother at home with them. Most men and women accept this myth despite decades of research showing that it makes no difference to kids’ well-being whether they are in raised in quality daycare or with a full time parent. Being a stay at home Mom can be hard work when there are several kids and a large household to run. For upper middle class women who have housekeepers and nannies – not so much. But because of the myth, straight women feel entitled to more options than their husbands, so they are invested in actually believing that their children need them to stay home. Women who consciously and willingly choose to go back to work and utilize daycare and childcare are seen somehow as selfish or at least as less adequate mothers. This post-modern version of the belief in the sanctity of motherhood has morphed into a ‘women’s choice and freedom’ issue. The practice of ‘opting out’ seems to blend traditional values with more modern notions of egalitarianism. The Opt-Out women feel entitled to choose work or home life while their husbands continue to work, and at the same time they maintain the feminist expectation that Dad share housework and childcare.
But according to Warner, the choice to stay home didn’t turn out as well as they had expected. Over time, some women experienced a loss of personal self-confidence and self-esteem, and some began to feel like they really were inferior to their husbands. For some, conflicts arose when husbands resented having to share household chores they expected be done by their wives during the day, or resented that they never had the choices that their wives had to incorporate better work-life balance into their lives. It seemed that Opting-Out had as many problems as Leaning In.
How can the study of same-sex relationships inform the discourse about work versus full-time motherhood? How can we queers help the heterosexual family? We can learn a lot from the research on how same sex couples function relative to straight marriages, most aptly summarized in Liza Mundy’s June 2013 Atlantic piece titled ‘The Gay Guide to Wedded Bliss.’ Gay and lesbian couples with children do it differently than straight ones. First, lesbian families are the most egalitarian and least ‘specialized’ of all – there is less likely to be an arrangement where one parent stays home and the other is the sole breadwinner. It is more likely that both make modifications to their work schedules, or they take turns – one stays home a year or two then they switch. Lesbian moms share chores and child care more than other couples, and they even frequently ‘blend’ their incomes, both to mirror straight relationships and to neutralize the power that comes with one making more money than the other. Observational studies comparing lesbian moms to heterosexual parent pairs show that when interacting with kids together, two women tend to reinforce and support each other's parenting while straight couples often obstruct each other. Lesbian parents seem to have more inherent respect for each other’s abilities – and the right to share in parenting decisions. Gay Dads are egalitarian as well, but they tend to ‘specialize.’ In contrast to heterosexual couples, gay men argue over who ‘gets to’ work, not who ‘gets to’ stay home.
What can same-sex couples teach us? First, that no parent is ‘entitled’ to decide for both parents who will work and whether to work, and who will stay home. This is something I rarely hear broached in the ‘Opt Out’ vs. ‘Lean In’ discourse. Second, that money equals power. The partner who is the sole breadwinner may make you feel, perhaps unwittingly, like you are inferior – and you may feel that you are as well, deferring to the one who earns the money. Whether because of lack of social recognition for the importance of homemakers, having a husband who equates earnings with privilege, or something inherent in the role itself – it’s hard to maintain self-confidence and self-esteem when you are solely a stay-at-home mom for an extended period. For many women, it gets to be a boring and thankless role in life, especially when housework is a big part of it. There’s a reason gay Dads who ‘specialize’ fight to be the one to go to work – they recognize the inherent boredom in much of the routine of childcare as well as the power that money brings. Note I’m not denigrating ‘specialized’ households, as long as decisions are reached fairly by two partners with equal power. And as long as it is done with understanding that though this may the best choice for your particular household, it is not the best choice for all children, and this arrangement is no more inherently structured to raise healthy children than any other quality arrangement. There are pluses and minuses to all childcare and parenting options.
One negative to the stay-at-home option that people rarely discuss: the things you can’t do for your kids because you may not have the money. Kids are expensive, and some kids more expensive than others. While research doesn’t show any superiority of constant mother presence, it does show the superiority of better schools, better health care, better mental health care and the ability to pay for college. Because I’ve worked as hard as I have, my three surviving children have had tremendous educational resources, special services for their learning disabilities, life-broadening experiences – and all will graduate from college with zero student debt. Which is more important parenting? Being always physically close by when Junior is young? Or being there when it matters, giving her unconditional love and guidance as needed, as well as giving her the education, life experiences and a financial head start when she is in her twenties? I imagine it is different for different children and families; people have different values and beliefs about child-rearing priorities.
I think straight couples should take a lesson from this. For starters, I’d like to see women give up the sole privilege of choice, and start assuming that their spouses have equal footing when it comes to work-life balance and choice issues. At the same time, men have to give up the sometimes unconscious tendency to dominate their spouses through financial power, using their stay-at-home wife as a 'status symbol' or expecting they will be ‘taken care of’ by women.
In gay and lesbian couples, there are no inherent gender divisions because both partners are the same sex. So when responsibilities are divided, they can be portioned according to guidelines more rational than gender stereotypes. And there's more fluidity. The partner who seems ‘butch’ may do the cooking and the ‘femme’ change the oil in the car, because two women or two men aren’t locked into behavior based on appearance. The assumption of equality in same sex relationships automatically leads to more mutual respect and more balanced power relationships, eliminating a major source of relationship strife. Same sex couples interact better as a team than straight couples when parenting - because they have better teamwork in general. Isn’t that better for the kids, to see cooperation between parents and not discord? And getting a uniform message from both their parents?
Another way same sex parents can serve as role models is in how they tend to stay friends with ex-partners. I have seen nasty divorces in gay families, usually when one partner experiences a religious conversion and comes to believe their gay partner will corrupt their children. And the LGBT community has its fair share of insane and immature people who care more about revenge for hurt feelings than they do for their children’s welfare. But queer life has long normalized friendships among exes. It is the norm rather than the exception, so new partners are usually accommodating. When children are involved, this means that children do not experience being ripped apart between battling parents. The transition to blended households and step-parenting is made easier, and children have a resulting extended support system of relatives that care for them.
Heterosexual men and women have to give up the fiction that stay-at-home mothers are better for children. That assumption may seem to privilege women with choice, but once assumed, it chains women to domesticity. Feminists dating back to the 1960’s were aware of the dangers attached to the pedestal of motherhood, and some heterosexual women are learning it again in the 21st century. Heterosexuals have to stop pretending they are engaging in work/homelife specialization because it is for the good of the children. It’s a choice – like all parenting decisions – based partly on self-interest. It’s not inherently more child-friendly than many others.
There is nothing radical about opting out of the work world to be a full time mother. What will be more radical is if heterosexual men and women are inspired by the egalitarian nature of same sex relationships to fully share decisions about who does what with housework, childcare and working. Only if both men and women, gay and straight, are involved in a cultural push for more human work ethics, more European, less classically American lifestyles, do we have a chance of radically changing a culture that makes work/life balance next to impossible. Now THAT will be a movement.
by Margie Nichols
Starting in the 1980's a small handful of social science researchers began to study same sex couples, mostly to see their relationships lasted as long as straight folk and whether kids raised in gay households grew up to be 'normal.' Along the way, the studies have revealed a lot more about similarities and differences of heterosexual versus gay and lesbian relationships. Read the blog article I wrote for GoodTherapy.org:
by Margie Nichols
Marriage equality laws continue to make change, but in the therapy world, people are still fighting Sexual Orientation Change Efforts. Also called 'conversion therapy' 'reparative counseling' or simply 'ex-gay' therapy, SOCE is considered unethical by all major professional counseling or therapy organizations worldwide. Yet in the United States, it is still practiced, mostly by Christian Right groups.
Read about the efforts to make it illegal to force this therapy on children in my first blog for Goodtherapy.org:
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by Margie Nichols
In a move that is causing consternation among psychiatrists, Thomas Insel, Director of the National Institutes of Mental Health, announced that NIMH will be ‘re-orienting its research away from DSM categories.’ Insel called the Diagnostic and Statistical Manual, the Bible of psychiatry, nothing more than a dictionary at best. He made it clear that it is founded on symptom-based categories, and that this method of classifying disease has become outmoded in every other area of medicine. He says NIMH will replace the DSM with what he is calling RDoC, or ‘Research Domain Criteria.’ In this new system, mental illnesses will be categorized not by symptoms but by genetic, neural, and cognitive data. Only problem – the system doesn’t exist yet – because the data doesn’t exist.
In other words, Insel is saying having no category system at all for mental disorders is better than the current DSM. He did acknowledge that the DSM will still be useful for mental health treatment (although that is questionable) and will certainly be in place for insurance purposes for quite some time. But he was emphatic in stating that it would be a disaster to base scientific research on the DSM categories. There just isn’t any evidence tying DSM categories to underlying brain/biological based entities. As Insel said, “Biology didn’t read the book.”
Validity has been a chronic problem with the DSM. The first DSM begun in the 1950’s constructed mental illness categories based on psychoanalytic theory. But the tenets of psychoanalysis have never been proven scientifically and few professionals use that model in their work today. In 1980 the psychoanalytic system was replaced with a model based on symptoms; DSM III was a major departure from the past.
In other words, the DSM was first based on a theory never backed up with scientific evidence, and then by a system that assumed that things that looked alike were the same. This is like assuming that all illnesses with the symptom of ‘high fever’ were caused by the same pathogen. As Insel points out, the rest of medicine progressed beyond symptom-based models sometime in the mid-20th century. Today, most medical diagnosis is based on physical and structural evidence and some on etiology: we know that the HIV virus causes certain changes in the immune system which result in a dizzying array of mostly dissimilar symptoms, we realize that Kaposi’s Sarcoma and PCP pneumoni, despite their dissimilarities, are both the end result of the HIV infection, and we know how the infection is transmitted. By contrast we merely hypothesize that, for example, Major Depressive Disorder is different from Generalized Anxiety Disorder, because the symptoms are different, and we then presume that the brain mechanisms underlying the two are different as well.
But we are beginning to accumulate evidence that turns the DSM categories upside down. For example, the same genetic anomalies found in schizophrenics are also found in some people diagnosed with autism and others with bipolar disorder. The same drugs that treat depression also work for panic attacks and obsessive-compulsive disorder, and medications developed for psychosis also help those with anxiety. In other words – categories based on symptoms may be very misleading. And research based on these categories will be both wrong and often irrelevant. Based on psychopharmacology , it is a reasonable working hypothesis that some underlying structure and etiology are similar in conditions that respond to the same medication. We should be looking at these similarities, but we won’t do that if our category system, our theory, considers them different and unrelated.
Insel is proposing a system he calls RDoC – Research Domain Criteria – which would be based on genetic, neural, and cognitive data. Data we are only just beginning to gather.
Basically, Insel is saying until we have the data it is better to have no theory and no categories than to use the DSM. And he is completely right. The designers of the DSM actually realized that their categories were basically stabs in the dark, a tentative work-in-progress model. But the DSM quickly became reified, and now we act like there actually is a distinct disease of ‘Major Depressive Disorder’ that has a precise location in the brain. And once we do that – we stop looking at the issue with what the Buddhists call ‘Beginner’s Mind,’ or ‘Don’t Know Mind.’
The truth is, we should have ‘Don’t Know Mind’ about psychology and psychiatry because – we really don’t know. And it’s not just categories of ‘mental illness’ we don’t know about. Our psychological theories are as flawed as the DSM, but that’s the subject of Part II of this blog.
The implications of the RDoC approach, when applied to sexology ,are profound, particularly the sexology of GSD (Gender and Sexually Diverse) people. First, RDoC, if it is truly atheoretical, must start with a neutral view, not a disease model. Without concepts like ‘Gender Identity Disorder,’ and ‘Paraphilias’ we are free to simply investigate the broad diversity of human gender and sexual behavior. This research has already begun. There are neuroscientists and biologists examining the role of genetic and epigenetic factors in influencing all aspects of sexuality, especially gender variation and same/opposite sex attraction. Second, the continuum concept will replace the categorical system we have now, making judgments about ‘normal’ vs. ‘variant’ a matter of judgment and debate. A new paradigm , being neutral, would have to assume that sex and gender diversity is innocent until proven guilty – i.e., variation, not disease. And that would have immense social implications: unusual gender presentations and expression, uncommon sexual desires, would not be assumed to be problematic unless evidence is discovered to suggest that they are.
Insel’s system would radically affect the science of sexology as well. Few people realize how much the category system we use to look at GSD has been influenced by modern psychiatry. We label some people ‘homosexual’ because psychiatry classified same-sex attraction as a ‘perversion:’ historically, the category came into being via psychiatrists. We label others trans* because psychiatry has categories based on the concept that atypical gender expression is an illness. Other cultures, and other time periods, have sliced up the GSD pie differently. Both the DSM and the culture at large draw a bright line between sexual orientation (narrowly defined as same vs. opposite sex attraction) and gender identity. But most cultures have not, and earlier, non-disease sexology models blended the two, as in the concepts of ‘inverts,’ or a ‘third sex.’
As Maria Konnikova explains in the New Yorker, the RDoC system is a dynamic one: as data continues to be accumulated from different sources, inter-relationships between variables will continuously evolve. Eventually, dimensions and processes that underly the behavior we observe will become clear, and they may have nothing to do with the categories we use now. Consider the above example, the bright-lining the distinction between same-sex attraction and gender. The fact is, we don’t actually know if there is a genetic/neural/cognitive difference between gender variation and sexual orientation, we don’t even know what ‘orientation’ is and whether other sexual drives (kink, nonmonogamy) should be considered ‘orientation.’ We have some reason to believe all these things are related: there is a good deal of overlap among people who are LG or B with those who are T, kinky, and nonmonogamous. Moreover, research on neuroanatomy, genetics, and prenatal hormonal influences is turning up similar results for transgender people and same-sex oriented people, suggesting some similar developmental pathways for both.
I ran across an obvious example of how the DSM categories hinder sexology very recently. The April 2013 issue of the Journal of Gay and Lesbian Health contains two excellent reviews of the current biological science regarding male to female transgender people and gays and lesbians, respectively. A number of findings turned up in both reviews: fraternal birth order, for example, and digit ratios. But neither author seemed aware of the other area of research – because the research parameters were set by the DSM categories of homosexuality and transsexualism, and these two ‘conditions’ are presumed distinct.
If we get rid of our current categories based on the DSM, as Insel suggests, and replace it with a dynamic, atheoretical, data-based paradigm, we can truly investigate the similarities between gender identity, expression, and behavior and different sexual ‘orientations’, or desires and preferences. In short, if RDoC is implemented in the study of GSD, we might actually learn something.
by Margie Nichols
A couple of weeks ago, the Pink Therapy group in the UK made news by proclaiming ‘GSD’ – Gender and Sexual Diversities – as the new umbrella term for a community that seems to add letters by the season. Seriously, I’ve seen: LGBTQQIAA- lesbian, gay, bisexual, transgender, queer, questioning, intersex, asexual, allies. And lots of groups - nonmonogamous people, kinky people, those who identify as pansexual, for example- aren’t included in that mouthful of letters.
At first I thought it was just the brilliant Brits. And then I did a little research and discovered that the term is already in use in some academic and educational circles here in the U.S. Pink Therapy is publicizing a growing cultural shift. I'm jumping for joy! I feel like I’ve waited a lifetime for this trend.
Because this isn’t just a new alphabet soup. This is a different paradigm, a reversal of the pattern of making finer and finer distinctions of sex and gender that prevails in all areas from identity politics to scientific discourse.
They say in scientific thinking there are ‘splitters’ and ‘lumpers; ’different issues at different times require both approaches. LGBT activism started in the 1970's with organizations that just used 'gay' in their titles, e.g. the National Gay Task Force. Then lesbians argued that 'lumping' them with gay men made them invisible, and that started the trend of adding letters to distinguish the different groups who wanted to be included under the 'big tent.' Politically, this made sense. But science followed politics, and over time researchers as well as the culture at large have behaved as though each letter in the acronym represents a distinctly different group. And this has led to some problems- identity politics have become conflated with reality. This is a time for us to be ‘lumping’ together people who are outliers, minorities, nonconformers in their gender expression/ identity and/or their sexual expression/identity. This group of people includes those with same sex attractions, or both/pan gender attractions; it includes the whole spectrum of TGNC (transgender and gender nonconforming) people; but it also includes kinky, nonmonogamous, asexual, queer, refuse-to-label-myself people as well.
Here’s why we should all switch to GSD immediately:
- It’s easy. Say it a few times – it trips off the tongue.
- It’s inclusive. We like inclusivity, right? Well, actually some of us don’t, but I’m going to assume here that it’s a good thing.
- It’s politically advantageous. Strength in numbers. (And yes, I know the arguments against including people who are stigmatized even more than you. It's the reason why drag queens and other gender benders were excluded from gay politics for a long time. I disagree with the 'Virtually Normal' argument.)
- It encourages us to find our commonalities. And believe me, as a queer shrink for 30+ years – we have SO much in common.
- It encourages us to work together. Good karma, good communities – good politics, too.
- THERE IS A LOT OF OVERLAP AMONG THESE COMMUNITIES ANYWAY. Especially among gay men/nonmonogamy/bisexual/kinky folk.
- Which leads me to my last and not insignificant reason: IT IS VERY LIKELY SCIENTIFICALLY MORE CORRECT. Or at least it is a BETTER paradigm for scientific research than the one we are using now.
The paradigm that currently dominates the field of sex therapy and research is one that first and foremost is a pathology model, a medical/psychiatric model that tends to see all ‘outliers’ as indicators of disease. And it is a ‘splitting’ model: every time the psychiatric Bible, the DSM, is amended the fights are about adding new categories of sexual anomaly/pathology. This time around, in the preparation of DSM5, there was a group proposing that ‘hebephilia’ be added as a ‘paraphilia’ i.e., sexual perversion. (Hebephilia, by the way, means sexual attraction to teenagers. Perhaps a majority of men would qualify as hebephiles.)
And what I keep coming back to is – maybe our categories are just plain wrong. Different cultures at different historical periods have ‘sliced up’ the GSD pie in different ways. For example, although we draw a bright line between gender and sexual orientation, throughout history more commonly the two have been conflated: ‘Invert’ was the nineteenth century term for homosexual.
We ‘see’ gender and the gender to which one is attracted as the two most important dimensions of sexuality. What if there are others we are missing completely? What if there are reasons – perhaps including even biological reasons – why the kink, nonmonogamy, and LGBT communities overlap so much? More intriguing examples: young people are replacing 'bisexual' with 'pansexual,' and it is true that there is a huge overlap between the bisexual, kink, transgender, and open relationship communities. What if we are missing an important dimension of human sexuality like general openess to a multitude of sex and gender expressions? Or this - there is a growing phenomenon of previously lesbian identified transmen who become attracted to gay men after transition. What if 'same-sex' orientation is exactly that - attraction to others of the same gender as you.
What if we don’t have a clue? What if we are our understanding of sex/gender variation is in its infancy, as I believe? If there is a chance that is true – then the lens we need to use must be broad and inclusive. For now, GSD – Gender and Sexual Diversities – is the best paradigm we can use.