Models of Sexual and Relational Orientation: A Critical Review and Synthesis

Counselors and psychologists are encouraged to avoid discriminating against clients based on their sexual orientation (American Counseling Association [ACA], 2005), and empirical scholarship continues to support the use of affirmative approaches as the standard of care when working with clients that experience same-sex sexual romantic and physical attraction (APA [American Psychological Association] Task Force, 2009). Despite these developments, counselors continue to report overt (Matthews, Selvidge, & Fisher, 2005) and subtle biases against clients who self-identify as lesbian, gay, bisexual, transgender, or questioning (LGBTQ) of their sexuality (Israel & Hackett, 2004). These biases are influenced in part by counselors' lack of both conceptual knowledge and practical experience working with same-sex sexual clients (Israel & Hackett, 2004; Matthews et al., 2005). Inquiry into what motivates sexual behavior, desire, and identification has a long and interdisciplinary history (Gamson & Moon, 2004), and counselors may feel overwhelmed as they review past and current developments in theory related to same-sex sexual and relational attraction. The purpose of the present article is to provide an overview and critique of models that have been and are used to conceptualize same-sex sexual and relational attraction in order to familiarize counselors with the developments in theory related to this subject. These past frameworks are (a) the heterosexual--homosexual dichotomy, (b) biological evidence for sexual orientation, (c) social constructionism, (d) lesbian and gay identity development, and (e) two-dimensional models based on sexual and relational orientations. We also describe the sexual life course development model as put forth by Hammack (2005) to serve as a theoretical base for an alternative conceptual framework termed the multiple continua model of sexual and relational orientations (MCM). The MCM is offered as a working model to improve counselors' ability to conceptualize same-sex sexual clients' behavior relative to sexuality and is based on a critical synthesis of previous theory, research, and our own clinical experiences. * The Heterosexual--Homosexual Dichotomy Counselors are likely familiar with the phenomenon of same-sex attraction in human beings and with the use of the words heterosexual and homosexual to differentiate an individual's exclusive sexual attraction to members of the same or to a different biological sex (Diamond, 2003). The term homosexual was invented in the late 19th century to describe a type of male person viewed as an antisocial deviant, pervert, and even a criminal driven by unnatural sexual motives (Silverstein, 1996). Ultimately, the terms homosexual and homosexuality came to connote a difference in kind or type from the heterosexual norm (Gamson & Moon, 2004). The heterosexual--homosexual dichotomy rests in part on the assumptions that other-sex sexual attraction (a) is normal (i.e., heteronormativity; Gamson & Moon, 2004), (b) is superior to same-sex sexual attraction (i.e., heterosexism; Herek, Gillis, & Cogan, 2009), and (c) is dictated by strict adherence to the social roles prescribed by biological sex (i.e., sexism; Konik & Stewart, 2004). Counselors who rely on the dichotomous model may favor heteronormative and heterosexist attitudes and strict gender role stereotyping (Herek et al., 2009; Israel & Hackett, 2004). This is problematic because expecting people to conform to rigid gender and sexual roles will cause confusion as counselors encounter masculine gay males, feminine lesbians, or same-gender attracted transgender people. The dichotomous model is closely associated with the oppression of same-sex sexual people because it creates a conceptual binary where exclusive heterosexuality is favored (Gamson & Moon, 2004). Commitment to the dichotomous and totalizing heterosexual-homosexual model leads to further confusion as counselors encounter clients who express changes in identity over the life span and/or bisexual identities, attractions, and behavior (Chung, Szymanski, & Amadio, 2007; Diamond, 2003). …