Sexuality and Gender for Mental Health Professionals: A Practical Guide

257 Pages·2013·8.569 MB·English

by  Christina Richards, Meg Barker

‘A cogent, carefully crafted and comprehensive introduction to the complexities of
genders, sexualities and relationships which challenges our assumptions about normality
and difference, refreshingly including heterosexuality, asexuality and BDSM alongside
LGB and T*.’ FS
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Dominic Davies, Founder of Pink Therapy E
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‘Filling an enormous void in the literature, this book teaches health professionals the
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essentials of cultural sensitivity when working with issues of sexuality and gender.’ N
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Charles Moser, Fellow of the European Committee of Sexual Medicine and Professor A
and Chair of the Department of Sexual Medicine at the Institute for Advanced Study LL

of Human Sexuality HI
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Questions of sexuality and gender affect everyone and therefore have an inevitable
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varying greatly from person to person, understanding the inherent complexities of RG
sexuality and gender can be a daunting task for the health professional. Breaking down O
these complexities this practical guide familiarises the reader with all of the common FE
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• Explanations of various forms of sexuality, gender and relationship structures N
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• Common concerns relating to specific groups
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• Details of some rules and ideals that are commonly found within specific groups
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Ideal for all members of the multidisciplinary team, this accessible book is relevant to
practitioners across theoretical backgrounds. Whether you are a trainee or qualified
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psychologist, this is a vital text for your professional practice. I
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CHRISTINA RICHARDS is Senior Specialist Psychology Associate at the West London R
Mental Health NHS Trust (Charing Cross) Gender Identity Clinic. D
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MEG BARKER is a senior lecturer in psychology at the Open University and a sex and

relationship therapist. &

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www.sagepub.co.uk/sexuality K
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Cover Image © Ron Chapple Stock / Alamy
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S E X U A L I T Y

G E N D E R
&
FOR MENTAL HEALTH PROFESSIONALS
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SAGE has been part of the global academic community
since 1965, supporting high quality research and learning
that transforms society and our understanding of individuals,
groups, and cultures. SAGE is the independent, innovative,
natural home for authors, editors and societies who share
our commitment and passion for the social sciences.
Find out more at: www.sagepublications.com
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S E X U A L I T Y

G E N D E R
&
FOR MENTAL HEALTH PROFESSIONALS
A PRACTICAL GUIDE
A PRACTICAL GUIDE

CHRISTINA RICHARDS & MEG BARKER
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SAGE Publications Ltd  Christina Richards and Meg Barker 2013
1 Oliver’s Yard
55 City Road First published 2013
London EC1Y 1SP
Apart from any fair dealing for the purposes of research or
SAGE Publications Inc. private study, or criticism or review, as permitted under the
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New Delhi 110 044 reproduction outside those terms should be sent to
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Library of Congress Control Number: 2012955051
Editor: Kate Wharton
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Typeset by: C&M Digitals (P) Ltd, Chennai, India
Printed in India at Replika Press Pvt Ltd
ISBN 978-0-85702-842-6
ISBN 978-0-85702-843-3 (pbk)
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CONTENTS
About the Authors vi
Acknowledgements vii
1 Introduction 1
Section 1 – Gender Practices and Identities 17
2 Transgender (Trans) – Living a Different Gender
from that Assigned at Birth 19
3 Intersex/Diversity of Sexual Development (DSD) 43
4 Cisgender – Living in the Gender Assigned at Birth 57
5 Further Genders 71
Section 2 – Sexuality: Practices and Identities 83
6 Bondage and Discipline, Dominance and Submission,
and Sadomasochism (BDSM)/Kink 85
7 Asexuality 101
8 Bisexuality 112
9 Lesbian and Gay Sexuality 124
10 Heterosexuality 146
11 Cross-dressing 161
12 Further Sexualities 175
Section 3 – Relationship Structures 191
13 Monogamy 193
14 Non-monogamy 205
Glossary 220
Shadow Glossary 233
Index 236
Additional case studies and further reading for each chapter are available at
www.sagepub.co.uk/sexuality
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ABOUT THE AUTHORS
Christina Richards is Senior Specialist Psychology Associate at the West
London Mental Health NHS Trust (Charing Cross) Gender Identity Clinic.
She works in this capacity as an individual and group psychotherapist and
psychologist. She lectures and publishes on gender, sexualities and critical
mental health, both within academia and to statutory bodies such as police
forces and the UK National Health Service.
Meg Barker is a senior lecturer in psychology at the Open University and a
sex and relationship therapist. Meg has researched and written extensively
on relationships, gender and sexuality – particularly on bisexuality,
BDSM and polyamory – and co-edits the journal Psychology & Sexuality and
co-organises the Critical Sexology seminar series.
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ACKNOWLEDGEMENTS
CHRISTINA’S ACKNOWLEDGEMENTS
For Meg
And For Phil
Words can’t say enough.
This being my first book the reader will hopefully indulge me and forgive
the length of the following list. In many ways a book is the culmination of a
life so far, with thinking and morality being derived from events quite aside
from the matter under consideration. Consequently I have a great many
people to thank, many of whom space precludes including. Errors through-
out the book are, of course, entirely my own.
Many thanks to: Penny for being such a wonderful friend and mentor; Rob
and Simon for more years of friendship than I care to remember; Richard for
tea and wisdom; Erich and Karen for caring in different ways; Stef for not let-
ting me give up (I hope I’ve done you proud); Richard and Mike for those
memorable lunches; Helen for family; Andy for friendship in the wild; Alex
for wise advice; Darren for expecting nothing but the best; James for giving
me my life; my colleagues at the GIC for both friendship and seas of knowl-
edge; my patients for the wisdom and knowledge that books can’t hold; all of
the activists and academics who move the fields forward – Riki, Kate, Jamison,
Stephen and so many more. And to those clinicians who find a way with
grace – Maddie, Randall, Nick – a high cost we pay, but one worth paying.
MEG’S ACKNOWLEDGEMENTS
I would like to thank all of the community members and activists who have
been involved in my work over the past decade as participants, co-researchers,
co-authors, readers, critics and supporters. I do hope that this book does you
justice. Your courage and creativity continues to inspire, sustain and challenge
me, and I am more grateful to you than I could possibly express.
I am also extremely grateful to Darren Langdridge. I simply wouldn’t be
where I am now, writing books like this, if it wasn’t for your belief in me.
Thank you for everything.
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INTRODUCTION
1
Gender and sexuality are complex, and contested, to the point at which
no definition can adequately encompass them. They have excited debate in
academia, medicine, psychology and the personal, legal and political domains,
as well as elsewhere, and no doubt will continue to do so for the foreseeable
future. Of course, this creates a quandary for the busy professional who
needs quick, accessible information on these important topics in order to go
about the business of their day-to-day work. Should one reach for academic
theoretical texts, which may be lengthy and not grounded in the reality of
clients’ lives, or for a concise clinical text which risks compromising com-
plexity through brevity? Or should one look to community literatures
which give a grounded view, but may miss aspects relevant to clinical deci-
sion making? To some extent the answer is “Yes”. Given time, professionals
should engage with all of these literatures, and indeed in order to become
a specialist one would certainly need to. In this book, however, we have
included something of each so that professionals can be confident of having a
basic understanding, in a reasonable period of time, and a direction for future
education as time and necessity dictate.
THE CONTENT
Most books for professionals in this area that we have come across have
approached the topics in one of two ways. Some describe ‘normal’ human
sexuality and/or gender and include much briefer mention of those who
fall outside of this in some way (quite often in a tokenistic and/or patholo-
gising manner). Others focus specifically on genders and sexualities which
fall outside of normativity, for example concentrating on sexual and gender
minorities. In this book we have adopted a third way, giving equal consid-
eration to the diversity of sexualities, genders and relationship structures,
including those which are more and less normative in wider society, and
considering how such norms shift across time and within different groups.
Of course no book could give complete coverage to all possible identities
and practices, and we have been forced, of practical necessity, to include
some generalisation where in fact there is complexity, and to avoid some
repetition (where practices and identities have similar issues) in service of
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