hello i'm julianne good and this is psych one-on-one we're here to make psychology understandable entertaining enlightening and informative with tips for creating a healthier state of mind for you your family and your friends welcome we're happy to have you here today uh my special guest is dr rick coons and we are going to be discussing lbgt issues in psychology now a little bit about dr coons he is the licensed clinical psychologist and is currently the clinical director of the dbt recovery center and works in private practice in beverly hills california specializing in individual and couple psychology therapy dr coons is also an adjunct professor at the chicago school of professional psychology downtown in los angeles campus after receiving his master's in clinical psychology from antioch university in los angeles with an emphasis in lgbt psychology he continued in the clinical psychology program at the california school of professional psychology in los angeles and received his doctorate in clinical psychology with an emphasis in multicultural and community psychology his doctoral project examined the relationship between homophobia as a form of sexualized abuse on a cultural level and the impact it has on gay male sexual behavior dr coons has worked as a therapist in several community health centers including aids project of los angeles the aids service center los angeles gay and lesbian center south central training consortium children's hospital los angeles division of adolescent medicine and high-risk youth program clearview addiction treatment programs and the institute for sexual health providing individual couples and group therapy welcome dr coons thank you thank you for having me so i would like to start off this issue with the question of what are some of the major psychological issues the lgbt community deals with sure well the lgbt community um definitely is in a very different place than it used to be in the early 2000s and early 2000s and that's when we first started to see that there was a lot of a lot of ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket messages of unworthiness, of pathology, of immorality, and you're five. And that young, all you know how to do is be yourself when you're that young. And when you're being yourself and you have an overwhelming message from teachers, peers, family, that you are not okay and who you are, that stays with you, that impacts you at your core. And so growing up with that, growing up with that sense of, not defection, but yeah, that there's just something wrong with you. Start, it gets into all areas of your life, relationships, achievements, work, anything. You know, and it looks very different for the individual, but at the core of it really is shame. And I would say that the biggest problem or the biggest issue that an LGBT individual has to overcome is the shame that is as a result of the abuse that they experienced growing up. And while facing shame or running away, away from shame, behaviors can look like addiction. They can look like depression, anxiety. It can look like compulsion. It can look like many things that are self-destructive. And until that shame is overcome and until the individual has a stronger, more positive sense of who they are, these are going to be the behaviors that we see time and time again. That sounds very complex and a lot to have to work. Through at a very young age. And can you, one of the things that you kept coming back to is the shame issue. And about personally, about what age did you start dealing with, with, with, you know, working through the shame and realizing that it wasn't stemming from you. It was stemming from your surroundings from what it sounds like. Sure. Well, and it's different for everyone. My coming out process started younger than, than most. I was 16 when I came out. However, I didn't directly deal consciously with shame issues until my late twenties when I started therapy myself. And that's, what's pretty typical is that we're not necessarily intervening with gay children. Cause the earlier would be of course, better. How, and what we are typically seeing are adults that have not had the opportunity or the resources to do this type of work. And, and they're there if they get the opportunity to receive help and work through these issues, it's not until later in life. And so it can be young people, or it can be people who are in midlife and fifties and sixties who are seeking therapy for the first time and have had a lifelong history of struggling and wrestling with this sense of overwhelming shame. So how long typically, Yeah. Yeah. How long would, would, would a person be dealing with, with these kind of issues and holding on and trying to just hang in there? I typically, the clients that you've seen over the years, I do, what's the typical timeframe for, for having to try to deal with it on their own for the most part? Is that right? So, so you're asking how long does one typically go like before therapy, just kind of dealing with it on their own? Right. Yeah. You know, I, I would say it's, it's so individual, cause you know, there's, there's some kids who don't make it and you know, when the, when the higher significant percentage of adolescent and teenage suicide are LGBT, then that's indication that, that's, that there's many that just don't make it. They can't get past it or they don't have the help or the resources for those who do survive it. I mean, if I, I think if you make it into adulthood, you're going to be able to get through it. But if you make it into adulthood as, as a gay person or a trans person or a bisexual person, if you just survive the, that environment and that experience, you have some strength and some resilience that you might not even know you have. But it really, it just really depends. People seek out help at all times. Typically I would say, there's, there's kind of a late twenties, thirties I would say average with, with the community. And maybe that is just because that may be a, an age where what you've been doing and what you've been trying to accomplish, maybe you've reached stagnation and you want to kind of, it's kind of like a, an early midlife crisis of trying to, you know, to really trying to figure out who you are and be authentic. And, and have some comfort with who you are. And maybe for whatever reason that tends to come out more in the late twenties, early thirties. That's interesting. And do you think that's partly because there's been more media attention now because there have been more abuse situations happening and murders and just horrendous crimes with the LGBT community? Yeah, absolutely. And I think the, the awareness is essential and, and the, really the key to overcoming this cultural judgment or rejection of gay identities. And, you know, when I was just in early high school, I remember seeing one person who was out on television and it was the first person I saw, another gay person. Yeah. Yeah. Yeah. Yeah. Yeah. In any form that was out and identified themselves as such. And now we have access to, to more information than you could ever possibly ever get to. And I think that, that access to information is what's helpful to gay youth. It, it perhaps gives people resources that they wouldn't have known about otherwise. And so maybe they're starting to seek out help earlier, which would be nice. It'd be nice to see, you know, you know, you know, you know, you know, you know, you know, interventions beginning the younger, the better, so that the rest of their life can be more fulfilling and what they want it to be. Definitely. And yeah, and I think that as we continue, we're going to see healthier development faster with LGBT youth as the years go on. Yeah, that's wonderful. Do you think that the society in general is becoming more acceptable of LGBT? And how much more so do you think the general public is becoming more accepting and compassionate? Absolutely. I know in just in my lifetime, there's been dramatic shifts that we've never seen in history. I mean, we've gone centuries with the same stigmatization and the same stigma and the same stigma that we've had over the years. And I think that's and what's interesting is that before the spreading of monotheism, LGBT, well, it wasn't the LGBT identities that we know of today, but those individuals were accepted as part of the community in many, many different cultures. And then for whatever reason, the stigmatization of sexuality. In general, really impacted LGBT individuals. And we went for many, many, many centuries as a very, I would say, marginalized minority. And only since really the late 60s, have we seen the massive shifts in the acceptance of the LGBT community. And then even just, it keeps getting faster and faster and faster to where now we're on the 12th, 13th state, like I've lost count of how many states now have legalized same-sex marriage. And it's, you know, I think there was three states just in the last week and a half or two, you know, that, you know, so I think we're seeing it speed up. And I think we're going to get to a point, hopefully that one day we don't even need to talk about it anymore because no one really cares. It'll just be part of the process. It'll just be part of the culture. It'll just be part of the culture. Exactly. And, you know, I see that happening more and more. I think, can you make a comment a little bit about if religion has any comp, you know? Oh yeah. Yeah. Absolutely. Well, probably the most influence when it comes historically, because it was really the birth of monotheism that we really started seeing a shift. And what do you mean by monotheism? So belief in one God, so Christianity, Judaism. Yeah. But even in, you know, in ancient Islam, it was much more acceptable, very accepting culturally. And then we had different shifts in history where it was about a morality issue. And then it became a medical, well, no, then it became a criminal issue, right? It became a moral issue. And then it turned into a criminal issue where you could be arrested. And then it became a medical issue where the term homosexuality comes from, was from that, was giving, a name to a condition. And then we had that all the way up into the seventies with homosexuality being a psychological disorder up until the early seventies. And now all of those things I just mentioned, never, one didn't stop and the other one began. They all, they're still with us today. The morality issue, the criminality issue, the medical issue, all of those frames of understanding, or conceptualizations of understanding sexuality are still with us today. And we can still hear it fairly frequently. And only since, since, only since gay people have been starting to be seen as an oppressed minority, have we been started to be accepted as a disempowered community, Yeah. that now is much more empowered, thankfully. Yeah. And we're moving thankfully away, much further away from all those other models that weren't serving the LGBT community. Yeah. I, it's amazing how many societal hurdles the LGBT community has had to go through. And I've heard so many stories and it just I'm appalled that human beings could be so cruel to one another. And I think a lot of people do not understand too is, and we had a class about this, about that LGBT is almost wired within a person. Oh, yeah. Can you talk about that a little bit? Yeah. I mean, time and time again, when you ask an LGBT individual, have they always known? Usually the answer is yes, that there's no other way they've known themselves. And it's really a simple question. If you ask any heterosexual, when did you choose to be heterosexual? Then that's when the heterosexual individual will usually get it like, oh, yeah, I've always known I've been heterosexual. Well, it's the same thing. There's no difference. There's nothing that happens that dramatically changes sexual orientation. It just really doesn't. Now, it's not to say that all people are born gay. I definitely know of individuals that say that they weren't, that they haven't been that way. And it was more of a development or what have you, an environment. But for many, many individuals, what they know is that this is how they were wired. This is how they've known themselves all their lives and they can't be any different. Right. It's just, it's part of you, period. Yeah, absolutely. Yeah. Because believe me, if a gay individual could change because they're in an environment that's overwhelmingly hostile, of course they would at that time. They're trying to. That's what being in the closet is about, is trying to maintain a heterosexual orientation. And no matter how hard the individual tries, time and time again, you just find it. It can't be changed. It can't be controlled in that way. And through, only through acceptance will someone find themselves and happiness. Right. And hopefully they have accepting people around them also. Yes, that makes a big difference. Huge. Absolutely. Definitely. Mm-hmm. Okay. Now you practice what is called gay affirmative psychotherapy. Can you discuss that? Sure, absolutely. The origins of gay affirmative therapy are based in really three things. The gay civil rights movement, that started in the late 60s. The removal of homosexuality from the DSM and just changing general attitudes. So those are really the roots of gay affirmative therapy because before that, where we came from in the psychology community, the treatments were castration. The treatments were electric shock. The treatments were lobotomies. And it was all an attempt to forcibly destroy, to force the treatment to be effective. And so, I think that's really important. And I think that's really important. How ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket of the other side, which is to celebrate and to affirm gay identities, LGBT identities. It's to claim the bias that you believe as a therapist, that being gay, lesbian, bisexual, transgender is not only acceptable, it's not only normal, but it's essential, that it's a positive thing for society, that it's always been a helpful thing for society. And we make that known to our clients. So it really is taking, it's an advocacy approach in many ways, so that it's not just celebrating the identity, but it's also advocating and helping them advocate for themselves. That's wonderful. And then, you know, your clinic is a safe haven. And I think there's more safe havens that need to be set up. Absolutely. So that the individual can experience themselves in their authentic, you know, as their authentic self. In environments where that's not possible, you miss those chances of being able to get to know what you think, what you operate, how you feel. And in a safe environment where there's not going to be judgment, and in fact, you're going to be supported in exploring and developing an authentic sexual identity, that to create that safe environment is what is essential for the individual to be able to do. Right. And that might be the first time ever, a person has ever felt that way. Absolutely. And it's just, that is a wonderful, wonderful service to offer. Absolutely. So what makes gay affirmative psychotherapy different from traditional psychotherapy? So just like I said a moment ago, the traditional therapy takes more of, well, depending on the therapy, but there's more of a neutrality, there's more of acceptance. And that's an essential part of all therapy or all effective therapies is a level of acceptance and genuine regard for the client. Whereas LGBT or gay affirmative therapy is specifically biased. It's intended to be biased. It's intended to hold on to the understanding that to be gay, lesbian, bisexual, transgender is a great thing. And it's not just about learning to accept, it's learning to thrive with this identity. And it's learning self-love, I would imagine in a lot of cases. Self-love, self-acceptance. Absolutely. Because one of the things that gets complicated is that even if an individual has come out and let's say, um, um, owns their, their, uh, LGBT identity, the years of, of shame and the years of hostility, uh, doesn't go away just because you've come out of the closet. Um, there still might be a sense of not being enough. There still might be a sense of being defective. Um, and that can play out in, in many ways. So, uh, the individual, uh, is unsuccessful at creating and maintaining a healthy relationship because that, because, that intimacy is so difficult because if they believe that there's something wrong with them inherently, and they might not say that being gay is wrong, they might, might have come to the awareness that, no, I like being gay. However, that sense of, of, um, some, something being wrong with them still remains and therefore relationships are compromised. Work can be compromised. It can look like, um, it can look like, um, sabotage, self-sabotage, or it can look like, overcompensating and to where you are quite successful in, in what you do, but it's driven by a sense of not enough and not good enough. And it's, that's even with the achievements and the successes that one might experience from that, uh, it's, it's driven by a force that is very destructive. Um, and so learning how to accomplish what you want in life from a place of joy, um, is part of the work as well. So what are some of the beginning steps that you would take with a person who is feeling just multiple layers of shame and, and, and guilt and not feeling good enough and everything else that comes along with it? What are some of the beginning steps that you do to work with your clients? Absolutely. So it all depends on what stage of development, uh, the, the, the individual is in. Um, if someone is, is, um, still very unaccepting or unaware, even, even if they're not, even if they're not, even if they're not, even if they're not, even if they're not, it's just more of a, a stage of confusion. Then that approach looks like a safe exploration. Um, it looks like also, um, uh, being really aware of, of, of suicidality, of, of real danger to the self, because it's a real scary and, and torturous stage to be in, in that first one. Um, later stages, as they start to have more tolerance and more acceptance, of who they are, it can look like, um, reaffirming that it can look like, um, um, exploration, education, uh, connections to the community connection to others, right. Uh, new relationships starting. And, and one thing to remember is that as a, as a gay, uh, child growing up, when it's the time to start dating and the time to start learning how to have relationships and intimacy, um, that child is usually in the closet and in a stage of, of faking it. And so they don't have the opportunity to really develop, uh, those skills that is required to develop healthy intimacy and healthy connection with, with others. Um, so whenever they come out, that's when it really begins. So you can have, uh, um, a young person, or you can have someone in their fifties acting like a 13 year old adolescent, because they are in that stage where they're learning, just like an adolescent would how to, um, how to do it, how to create relationships. And so in those early stages, it can be about that and one normalizing that. And, and so that the self blame of why can I have a relationship? Why am I always doing this wrong? Why, you know, all that self blame can be reduced with the understanding that, Hey, everyone has to go through this, just that some individuals have to go through it later because they don't get the chance when they're younger. Um, so it sounds like it's almost like a normal stage then of self-discovery and coming to terms. Yeah. Yeah. And think about, you know, any adolescent, think about, you know, anybody who's adolescent, think about those, those first kisses, those first dates, those first relationships that lasted for two weeks. And, you know, you thought it was going to last forever. And then awkward, horribly awkward period of time for most everyone. Yes. And so, and so especially though, when you're a 30, 40, 50, and you're going through this stage, it's the same, it's no different. And, and to how, and it doesn't take as long usually because you're dealing with an adult mind that can go through these, these, these experiences quicker. However, however, there's, they still have to go through those first kisses and those first dates and those first relationships that for most people are, are filled with a lot of, of missteps and falling down and getting bruised and getting back up so that you can get to the point where you've learned. Right. You've learned enough to know how to create that relationship, relationships that are going to really, really work for you in your life. Right. And then being okay with making mistakes at the beginning stages, because that's a learning process. Absolutely. You got it. You got to learn, you got to go through it. And especially for gay children that didn't have models of what gay relationships look like, that didn't have parents to explain what those birds and the bees looked like. Right. So you've missed, you've missed a lot. You've missed out on a lot of, of education of development that other children who don't have a gay identity who they get to have that. And so having, having to, to being able to explain that really helps to reduce that shame and really helps to increase the ability to accept and, and go through that process in the way that you need to in order to, to, um, um, accomplish it successfully. Yeah, that sounds hopefully like people have that opportunity within their community to be able to do that. They've got the services that are available for that. Not every community is as fortunate as we are as in Los Angeles, they have all these great services available to us. Absolutely. Yeah. I mean, I grew up in Tennessee and, um, um, there were no gay and lesbian Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. Right. There were no student gay organizations. Um, and it's also where I came out and, um, uh, what I found was though, that even in those, those smaller communities, uh, there still can be a lot of acceptance and a lot of support if you know where to look and if you know who to talk to and who's safe to talk to. And that can be one of the things that a therapist can be really helpful with is helping to the individual identify who are the people that are going to be really supportive. Um, and so I think that's, I think that's, I think that's, I think that's, I think that's Who are the people that you might want to avoid telling at this point, you know, and just, and really help with that process so that it can be less traumatic. Exactly. And then wonderful thing is too, there are a lot of support groups out there right now. And it seems that the number are growing. Absolutely. And support, physical support groups like in Los Angeles. I mean, there's tons. You can, you can find them almost anywhere. And then for those in more rural areas, just the internet and being online, you can find all sorts of support that way too. So I would say being in person is definitely more ideal. But if you don't have that option in your town, then, then seek it out, find that support so that it can help you when you need it. Exactly. And like I tell my listeners every week, go onto the internet, do your research and find out what's going to click. And I think that's going to be a big click for you because there, there hopefully are going to be a lot of options within your area that you can choose from. And you can also call up the groups. You can call up the therapist and say, Hey, you know, this is the service I'm looking for. Talk to them a little bit. See if you're going to click over the phone. Yeah. Because I think intuitively most people can get that. Yeah. And it saves a lot of time and travel and maybe even a little trauma. Because some, sometimes this can be a difficult process to come to the point where it's like, you know what, I'm, I'm dealing with these issues and I don't want to deal with these alone. I'm going to go get some support. Absolutely. And know to ask the right questions of, of the therapist or the group. Ask them if, if they are trained in gay affirmative psychotherapy. Ask them what experience they've had. It's not necessarily as important to have a gay therapist as well. It's definitely a common request for, for, for that kind of understanding and immediate acceptance one might, one might be looking for. However, there are many wonderful straight therapists that are also very competent in LGBT issues. And so it's not necessarily about the sexual orientation of the therapist, but definitely about their experience and to really ask. And if, if you get a sense that there's, if you get a sense that there's just a lack of experience, keep looking. Because you really want to find someone that really gets in and you're not having to educate them about what an LGBT experience is like. You really want someone who, who really knows what that, what that experience looks like. And somebody you can be really comfortable with and really explore and tell the stories and not have the hesitations or the fear or anything else. Yeah. And that's something that a lot of our conversation has been exposed to already from the outside community. Yes. And it's just so, it sounds like so many issues to bring onto the table. Yes. Yeah, absolutely. And there's a lot of well-meaning therapists. So, you know, you have your very intentional hostile practices that now luckily are outlawed in California. If you're under the age of 18 of reparative therapy or conversion therapy, which is just psychologically traumatic for, for a young, for a young LGBT individual. But also there's very, just well-meaning, very accepting therapists that, that would, would love to work with an LGBT individual. They just don't know that world. They don't understand the, the components of, of, you know, the, the, the psychology of, of the LGBT individual. And so the well-meaning therapist that doesn't have the experience just might be coming from a limited perspective. Yeah. Yeah. Yeah. A limited point of view that might not, not, might not only just not be helpful, but it also might be more damaging, more shaming. Right. Yeah. So, so in a consumer needs to be careful. Yes. Period. Yes. And, you know, again, if you're going for therapy and you do one or two sessions, it seems to be going pretty decently and stuff. And then all of a sudden the therapist just throws something in there, you know. Throws a, throws a wrench into the machine that you don't like. You've got the right to sit there and say, no, this isn't right. I need to walk out of this or just end the session and go find another therapist. But just realize because you've had one bad therapy session doesn't mean that you're going to have another. You just need to find the right therapist. You need to find the right support group and be patient with the process because just like anything else that is really deep and meaningful in life. Yeah. It's a process. You just can't fix anything real quick. That would be lovely. I mean, that's kind of the American ideology, but in real life, it's especially with psychological issues that are really deep. It takes time and you have to be gentle with yourself in the process. I want to reach out to the listeners at this point. If you would like to join us in our conversation, the number is 800-893-9562. Again, that's 800. 800-893-9562 to speak with Dr. Rick Coons. And I'd also like to mention if you can't listen to this whole program right now, we are also downloadable from iTunes. Just type in psych one-on-one. That's P-S-Y-C-H, the number one, O-N, and another number one. So you can download us at any time and take us with you and really listen to the programs. Because sometimes it takes more. It's more than one lesson to really get all the little bits and pieces of information that we're trying to get through to you. So the next thing I'd like to ask you is, is it different depending on if you're a lesbian, gay, bisexual, or transgender as to the therapy? Absolutely. I mean, when I say LGBT affirmative therapy, it has to be known that you're also speaking about four very distinct communities. There's a lot of commonalities, of course, with LGBT, well, especially LGB, because LGB is about sexual orientation, whereas transgender community is about gender identity. And so there's very, very important differences that one needs to be aware of. And depending on what particular group you're affiliated with, just because someone is a gay affirmative therapist, they might be more of a gay affirmative therapist. They might be more of an expert in gay men. They might be more of an expert in transgender. And so to really make sure that you're seeking out someone that is specifically trained and specifically educated in the particular community. And so there's very different issues that each community faces. Because, you know, gay men don't necessarily have to be a gay. They don't necessarily have to deal with sexism as much. They do. But it's, you know, for a lesbian woman, that's going to be a very different experience. For bisexuality, there's rejection on both sides. There's rejection from the straight community and there's rejection from the gay community. And they're a very invisible community. And so they're wrestling with very unique issues. And then again, with trans issues, I think more than any community of the LGBT community, they're still the most marginalized. They're still the most, there's still the most hostility for the trans community. And again, that's going to bring up very different issues to deal with. So make sure that the therapist that you're working with is not grouping all of those communities into one and treating them the same way because they're definitely not the same. That's good to know. Because I think a lot of people would take that assumption on and just say, okay, it's LGBT. It's under one umbrella. And it really isn't. Right. And I think it is very interesting that a lot of transgendered people are, the LGB community is hostile towards them. Very much so. So that must, you know, that brings on the extra added burden to the transgender community of having to deal through that also. Can you talk a little bit about that, about how you would do specialized therapy for the transgender community? Sure. Sure. Well, with the trans community, there's sexual orientation issues that you're dealing with, but gender is really at the core of what we're talking about. And then within the, even in the trans community, there's, that's an umbrella that has many different communities underneath that, which are all very different psychologies. So that's also another reason why someone working with trans individuals needs to be a real expert in trans psychology, apart from LGB, because there's so many facets. Of that community as well, that's different and unique. However, you know, if you're dealing with, with an individual who's transsexual, someone who feels that they were born in the wrong body, you know, you're dealing with, with an individual that feels that they have a, a, a body defect, basically. And, and, and if you imagine an individual who's not trans can imagine them waking up one day being in the body of a, of a different, of a different person. Right. Right. Right. Right. Right. Right. Of the opposite sex, just dramatically. And, but still feeling the same. You maybe get, start to get a sense of what it must be like to, to feel one way about who you are and how you see yourself and then what the actual physical body is. So those, and then those who might want transitioning, you know, might want to transition, might want to do body modification. Those who don't, there's no right answer. Right. There's no right way to do it. So it's figuring out. What's right for that particular individual, whether they want to adapt the body to be more of who they are authentically or not. And then you have other trans individuals that it's not about feeling like they're in the wrong body. It's more about gender expression, about a fluidity, about how they see themselves as male and female. And, and so, and so that becomes more of the focus of the work than necessarily sexual orientation. Sexual orientation though, when it comes to the trans community is fascinating because if you think about it, sexual orientation is, is about who we're attracted to, what gender we're attracted to. And if you are one way, you know, as a trans individual and then change genders, right, then what happens to sexual orientation? Right. What, what, who, how do you define yourself? How do you identify when you, if you were, were attracted, let's say to the same sex, but now you're attracted to the opposite sex because your gender has changed. Right. What are those issues that come up? What are the issues for the partners of that individual? So there's, and, and those are issues that LGB individuals usually don't really have to deal with because they're, they're in sync with their, with their gender identity. Right. So really when it comes to affirmative therapy, LGB affirmative therapy, which is all about sexual orientation really has more commonalities than trans affirmative therapy, which, which the gender is more common. How ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket ket be expressive, let's say, or have interests in what are not typically gender appropriate. And so we definitely can relate and understand what it's like to be rejected based on gender stereotypes and gender roles, however, not to that extent of a trans individual. And so that, I think, can be a huge part of the divide, is just that not being able to relate on that level, on the gender level. I think it's also, too, just still a very acceptable group to marginalize. We see it on television, we see it in conversations, I hear it in conversations with close friends or colleagues that are well-educated and well-meaning. It's just a lack of awareness that certain terms are derogatory, certain misunderstandings, not even knowing the difference between transgender and transsexual and drag queen and cross-dressing and all of that. And so, that lack of understanding, I think, is also at play when it comes to how trans people are understood and ultimately how they're treated. Yeah, and lack of education. Lack of education, yeah. In general. Yeah. This is one of the reasons why, you know, I put in Psych 101, because I think it's so important that we do get into the conversation about how we can be more open about how we're dealing with the gender, how we're dealing with the gender, how we're dealing with the gender, how educated no matter which way we go with trying to get this information in because it's really not out there unless we go searching for it, you know, and trying to understand each other a little bit more, have a little more compassion. I think doing the research and getting educated and be open-minded on the whole. Yes. That's huge. Be open-minded. There's just so much going on in life right now. And I think we need to be more compassionate as to where everybody is and accepting. Absolutely. And that open-mindedness part is really crucial because we get so boxed into a limited amount of what we consider acceptable. And, you know, for example, only considering that there's two genders, only considering that, I mean, used to be just heterosexuality and then it's now, you know, okay, heterosexual and homosexual. And, and maybe bisexuality with three little boxes there when it comes to sexual orientation. But the fact is, is that there's a spectrum where there's more diversity in sexual identity and sexual expression that we'll ever possibly know. And so to be very open to, to learning about how others will identify, how others will, you know, who, how they express themselves, who they're attracted to and, and know that you can't know everything. You can't know, um, every identity out there and that there's always going to be identities that are new and that are going to be surprising and that are going to be hard to understand. However, that open mindedness is what's going to allow us to connect and find that commonality, find that acceptance, um, by not, by not getting stuck in a limited, uh, amount of, of boxes and know that there's more, you know, that get rid of the boxes and just look at it more of a spectrum that, that can, that can, uh, take the form of many, many things and, and make it interesting, make it something that, that helps develop more curiosity about all the ways, uh, human beings can, can form a sexual identity or a gender identity. Yes. That was wonderfully worded. I really appreciate that. Exactly. Um, I want to go back to, uh, now your project, your doctorate project, examine homophobia as a form of sexualized abuse. Can you comment, on this? Sure. Um, I originally, the original idea I read from, uh, um, a fellow therapist named Joe court, and he wrote an article about what was called covert cultural sexual abuse. And that really struck me. And it was actually really remarkable how it struck me because I never had thought of homophobia or heterosexism in that way. Um, and the way he conceptualized it and what I expanded on in my project was understanding homophobia as a form of abuse that's, that's similar to sexual abuse. And what I mean by that is, is, uh, with sexual abuse, we were more familiar with overt sexual abuse. That that's abuse that, that is about, um, uh, physically, um, assaulting a child. Um, covert sexual abuse doesn't involve touching at all, but it's still a section, a form of sexual abuse, uh, cause it might, uh, uh, it might be exposure. It might be pornography or, you know, something inappropriate sexually for the child. Um, similarly, uh, to homophobia, the abuse that's experienced is sexualized usually in nature. And, you know, so the name calling is usually sexualized. Uh, the focus is on this gay sex. And so here's a young child, um, five, six, seven, eight years old, um, being, uh, um, traumatized sexually way before they're mature enough to, um, understand it, to process it. They're not even, they don't really see themselves in a sexual way. And yet now they're being forced to because people are, are attacking them with it. And so, and so it's similar to covert sexual childhood, sexual abuse in that, um, the abuse is, is, is usually a form of, of, uh, um, a sexual nature. And then looking at the research, what, what was really just evident was that the consequences of the abuse of the two abuses are just very, very, very, very, very, very, very, very, very, very, very, very similar. They're, they're pretty much identical in, in that, um, uh, in, in the, uh, the fact that the, well, uh, not only the consequences are similar, but the, uh, dynamics are very similar. Let me start with that because the dynamics are of a perpetrator disregarding the, the, um, uh, what is sexually appropriate for a child and making their own needs primary. It's a process of, of dehumanizing, humiliating, degrading, overpowering. Um, and it's similar with, with, uh, homophobia in that the perpetrator, whoever that might be is degrading, humiliating, um, overpowering, um, and that they are making, uh, heterosexuality, they're making their own sexuality primary and disregarding and degrading the sexuality of the child. And, and, uh, the consequences then look very similar in that the victim usually blames themselves. Um, the, um, uh, later consequences of addiction, of sexual compulsivity, of, uh, inability to, to have relationships, all, all of these consequences down the line are similar when it comes to a child that has been, uh, sexually abused and a child, uh, a gay child that has been experiencing homophobia during their childhood. The brain registers abuse as abuse period. And the brain changes chemically. Mm-hmm. When that happens. Mm-hmm. And that opens up the gateway for addiction. Mm-hmm. And, and other destructive behaviors to come through. Right, right. Cause I mean, when you internalize that shame and you feel it's your fault and that you are disgusting and that you are at fault for the, the treatment that you got, um, why would you take care of yourself? Right. And then, and, and some of those behaviors, that's the only way that one can know peace for a while. That's the only way they can, they can, they can numb out. Um, and of course it makes sense. It makes sense when you think of addiction in those terms, after experiencing all that pain, all that suffering, you would want, of course, numb out. Um, and, and it's quick and it's easy and it works for, for a short term. And then of course the long-term consequences that, that addiction can have in any form, whether it be drugs or behavior. Um, uh, yeah. So how often do you see clients from an LGBT, community that are what's called dual diagnosis? They have the psychological issues, probably of depression going on, on top of addiction. How often do you see clients that would fit that? Very often. Um, very often. Um, um, yeah. Addiction, addiction is, is rampant in, in the gay community with, uh, especially with meth being, um, set a crystal meth with that being such a destructive drug. Um, and, and, and it's, it's, it's just very easy for one to revert, uh, to, um, um, go to those, those, uh, behaviors, uh, when they have, when, when they're suffering so much from what they've experienced, it, it makes sense. Um, the, the, the need for validation, right? So, um, the, the seeking out of approval makes sense when you've been disapproved of for many, many, many years. Um, and, and, and, and, and, and, and, and, and, and, and, and, and, and, and, and, and, and, and, and, and, and, and, and, and, and, and, and, and, and, and, and, and, and, and, and, and, um, now you're constantly seeking out that validation from others. And, and what I find mostly with working with LGBT clients is that it's empowerment that's needed more than anything. Uh, they have so internalized the, the, the blame for everything they've done wrong. Um, and there's so much negative, um, um, negative thinking and the way they talk to themselves that mostly it's not about fixing anything. It's more about acceptance. It's more about being able to, um, be able to, um, be able to, um, be able to, um, be able to, um, be able to, more of yourself. Um, and that really is the majority of the work that I do. Yeah. And definitely the importance of being more of yourself. That's definitely, that's the, the self acceptance is such a huge component of, of, of starting to do really effective therapy. That's going to get down to the roots and, and, and start, you know, pulling out those roots, putting in new seeds so that they, grow and the empowerment of it. Yeah. And the rewiring of, you know, you're literally rewiring your brain. You are. Yeah. And to be able to, you know, through acceptance means change is actually more possible, right? Acceptance doesn't mean you accept behaviors that you're not happy with. Acceptance means that you accept yourself for everything that you are, good, bad, ugly, right, wrong, whatever, that you accept that as being human and that through acceptance, that's when we're freed to make the changes that are going to better our lives. Yeah. That's a wonderful way of putting that. Definitely. Dr. Koons, I'm going to start wrapping up with you. And I just want to let the listeners know if they would like to contact Dr. Rick Koons. He is at 323. 600-3348. Again, that's 323-600-3348. His email is rick, R-I-C-K at drrickkoons.com. And that's D-R-R-I-C-K-C-O-O-N-S.com. And can you tell the listeners about your first sessions? Oh, absolutely. And also, if you want more information about me and my work, you can go to drrickkoons.com. And in the first session, I always believe that a client should be able to find the right therapist for them. And that becomes much more difficult when you're having to pay hundreds of dollars each time you meet a new therapist. And so I have a no risk first session where you can come in, we have the first session, you can go away for a week, you can think about it. And if it feels right, then you come back and then we settle up and continue moving forward. But if it doesn't feel right, great. There's no loss financially to you. And you're free to keep looking because I want more than working with me. I want you to find the right therapist that's going to be the most helpful to you. Right. And you deserve it. You deserve to have the therapist connecting with you because you are the most important person in that therapy room, period. This is a time to do self-exploration and again, what Dr. Kuhn said, rewire yourself. You can rewire and change at whatever age or stage you are in life. And that is the wonderful thing about therapy. Researchers have found that just having the right connection with a therapist can be healing to the brain and healing to the soul, period. Absolutely. Yeah. And remember too, that you are the expert of your own life. And if it feels like a therapist, thinks that they know more about you than you do, then take that as a sign and that yes, the therapist might be an expert in psychology, but you are always the expert of yourself. That's a great way of putting it. I totally agree. You have to be comfortable in the sessions. Otherwise you will not progress and take care of any problems that you may have in your life and grow from them and learn the lessons that whatever you need to learn, if they make themselves available. That is when real change occurs and, and growth. Would you like to finish up with anything else? Um, you know, just to, just to really think about therapy as, as something, um, that is a way, kind of like personal training, that is a way for you to, um, seek improvement, seek growth, help with accomplishing goals. It's not necessarily just, for extreme mental health issues, but it can be for tune-ups every once in a while. And it can really, I mean, it changed my life and it changes many lives every day. Yes, I agree. And thank you for being a warrior within the LGBT community. Thank you. Thank you for the education. And I would like to thank our listeners for tuning in to Psych One-on-One. And stay tuned for the Qumran Report. And this is Julianne Good. I'd like to thank you and take care of yourself and take care of others. Bye now. Bye now. Bye now.