Gender and Sexual Orientation in Family Therapy: Toward a Postgender approach

Abstract: We examine how the issues of gender and sexual orientation have been addressed in family therapy and identify critical issues as the field defines itself in a postmodern, inclusive era. We show how unintentional bias and creation of the category of "other" persist throughout the history of clinical practice despite a rise of interest in diversity. We suggest that family therapy approaches have been based on a view of sex-gender that creates dichotomous categories, confounds gender and sexual orientation, and limits flexibility. A postgender approach organized around a relationship model based on equality rather than gender is advocated. Obstacles to postgender practice are identified, and guidelines for practice and challenges for the future are discussed. Key Words: couples, equality, family therapy, gender, sexual orientation. Gender and sexual orientation are core organizational categories that shape human relationships. Their meaning and consequences are at once a focus of intense interest and debate and, paradoxically, so taken for granted that much of their meaning and impact remain hidden and beyond conscious awareness. As the clinical field that focuses on human relationships, marital and family therapy (MFT) is intricately connected to how therapists approach issues of gender and sexual orientation. We examine the history of MFT and identify critical current issues related to gender and sexual orientation as the field continues to define itself in a postmodern, inclusive era. We build on the field's contextual legacy, viewing gender and sexual orientation as constituted within ongoing and changing interpersonal and social processes rather than as individual traits or group membership. First, we address why gender and sexual orientation are important to the practice of marital and family therapy. We then examine how unintentional bias and creation of categories of "other" persist throughout the history of clinical practice despite a rise of interest in diversity during the 1990s. We conclude with suggestions for how to move from ideas of diversity and alternative forms to a more inclusive postgender relationship model upon which to base clinical research, ethics, and practice. Importance of Gender and Sexual Orientation Issues in MFT We define gender and sexual orientation as socially constructed processes (Knudson-Martin, 1997). They are continually created through daily interpersonal experience and shaped and limited by the opportunities available to each in the social environment (see Risman & Schwartz, 1989). Therapy is itself a part of these processes. Because families today are subject to multiple discourses in society, it is important that therapists use models that avoid dualistic dichotomies (Baber & Allen, 1992; Blume & Blume, 2003). People make transitory identifications with multiple discourses as they negotiate and construct gender and sexual orientation (Blume & Blume). We argue that therapists must leave room for families to negotiate the complexities of the tensions they face and allow for emergent possibilities. Gender Issues in Therapy Despite rapidly changing gender and relationship ideals, inequalities between the genders persist (Lindsey, 1997; Zimmerman, Haddock, Ziemba, & Rust, 2001). Many mental health and relational problems presented in therapy are related to the consequences of gender inequality, or to the ways that historic gender roles and constructions limit development for both women and men (Knudson-Martin, 2003; McGoldrick, Anderson, & Walsh, 1989; Meth, 1990). Old constructions of gender defined women as the "opposite sex" (Gilbert & Sher, 1999), and, as Kelly (1984) noted, "the social opposite, not of a class, a caste, or of a majority, since we are a majority, but of a sex: men" (p. 6). These early conceptions of gender found their base in power differences between women and men (Kimmel, 2004). …