ARQ2: Question A2 - Sexual Orientation

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How would you identify your sexual orientation? straight/heterosexual lesbian gay WSW (woman who has sex with women) bisexual MSM (man who has sex with men) queer transensual (person attracted to transsexual or transgendered people) polysexual two-spirit questioning asexual autosexual unsure other _____________________ prefer not to answer

Do you have concerns related to your sexual orientation, or do you ever feel awkward about your sexual orientation? not at all a little somewhat a lot unsure prefer not to answer

Relevance/intent

This item is meant to include the most common terms clients may use to identify their sexual orientation. The list is not exhaustive; clients may have other words to define their sexual orientation. This item also helps to identify clients who may be questioning or struggling with their sexual orientation. Clients may check more than one term.

Significant relationships (and sexual behaviour) are distinct from sexual orientation, and one does not necessarily or consistently predict the other. Sexual orientation should always be asked about regardless of relationship status. For example, someone may indicate being in relationships with only men, but may identify as bisexual, or someone is married to a person of the opposite gender but identifies as gay.

For some people, sexual orientation is continuous and fixed throughout their lives. For others, sexual orientation may be fluid and change over time.

There is a broad spectrum of sexual orientations. One way to think about sexual orientation is as a fluid continuum that ranges from exclusive same-gender attraction to exclusive opposite-gender attraction, with many points in between.

Exclusively Straight Heterosexual

Bisexual Polysexual

Exclusively Lesbian Gay

It is important to note that not everyone who identifies as the same sexual orientation will fit in the same place on the continuum. For example, one bisexual person may fit directly in the middle of the continuum, but another bisexual person may fit away from the middle and closer to one end of the continuum than to the other.

When people are exploring their sexual orientation, they may try to find where they fit along the continuum. Clinicians are invited to reflect on their own sexual orientation to increase awareness of feelings and biases of this issue. A clinician’s own feelings and biases may help or inhibit discussion of sexual orientation with clients.

Sometimes, people from marginalized ethnocultural/racial communities may not identify as or use labels they associate with the predominantly white (and often racist) LGBTTTIQ communities. For example, a woman of colour may choose a different label, such as “woman loving women” instead of lesbian. However, this example may not apply to all women of colour.

Client perceptions

“Although I think a person’s sexual orientation is a small aspect of their being, it can be a very big part of their life and it can be a very big part of the therapy process, because that’s how we learn about ourselves, through our relationships. And while you’re in therapy, you’re going to have relationships, and you’re going to bring it into therapy. You can’t go and see a psychiatrist and never tell them that you’re gay if you’re gay. There has to be that open exchange.”

“On the demographics form, did it say choose all that I apply? I always identify as bisexual and queer. And I am married to a male. So that can be interesting in assessment and counselling situations.”

Therapist/counsellor perceptions

“Allow the client to identify as gay, straight, etc. Don’t worry about using a question regarding sexual orientation with a client who is straight. Use a preamble such as: ‘We recognize all walks of life and welcome them all….’ Set it up for all clients to answer questions truthfully.”

Polysexuality is an orientation that does not limit affection, romance or sexual attraction to any one gender or sex, and that recognizes more than just two genders.

Someone who identifies as asexual may not be sexually and/or romantically active, or not sexually and/or romantically attracted to other persons.

Autosexual describes someone whose significant sexual involvement is with oneself or someone who prefers masturbation over partnered sex.

Sexual behaviour is distinct from sexual orientation. These concepts should not be used interchangeably. For this reason, we include the terms man who has sex with men and woman who has sex with women.

A transsensual person has a primary sexual or romantic attraction to transgendered and/or transsexual people.

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Asking the Right Questions 2

• Acknowledgments
• Introduction
• Using the manual
• Background information:
  • Part A — Client Questionnaire
    • A1: Significant relationships
    • A2: Sexual orientation
    • A3: Gender identity
    • A4: Relationship between sexual orientation/gender identity and substance use and/or mental health concerns
  • Part B — Conversation Guide
• Counsellor competence
• Resources
• References
• Appendix

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