The Counseling Psychologist

Counseling psychologists can expect to encounter lesbian, gay, and bisexual (LGB) individuals in their lives, as students, colleagues, friends, clients, and/or family members. Most of the LGB individuals encountered by counseling psychologists have experienced the negative consequences of internalized heterosexism/internalized homophobia (IH). Yet many counseling psychologists are not adequately prepared to deal with the negative effects of IH on LGB persons' lives. This Major Contribution provides readers with a critical base of information about the construct of IH, including the historical context from which it emerged; controversies related to IH; theoretical approaches used to conceptualize IH; unique issues for women, men, and bisexuals; and the empirical research on measurement and psychosocial correlates of IH. In addition, it provides suggestions for future research and implications for counseling LGB individuals and for the training of counseling psychologists.

This article provides an integrated critical review of the literature on internalized heterosexism/internalized homophobia (IH), its measurement, and its psychosocial correlates. It describes the psychometric properties of six published measures used to operationalize the construct of IH. It also critically reviews empirical studies on correlates of IH in the areas of sexual identity formation and the coming-out process; mental, psychosocial, and physical health; substance use; sexual risk-taking behavior; intimate relationships; parenting and family issues; gender roles and feminism; race and ethnicity; religion; career issues; and counselor—client interactions and treatment interventions. Last, it discusses limitations of the body of research and provides suggestions for future research throughout the review.

This study examined the relationship of internalized oppressions to the psychological distress of 304 lesbian and bisexual women. In addition, it investigated whether self-esteem and social support mediated the relationship between internalized oppressions and mental health. Results indicate that after controlling for education, internalized sexism (IS) and internalized heterosexism/internalized homophobia (IH) are significant predictors of psychological distress and account for 17% of the variance. The interactions between IS and IH are not significant predictors of psychological distress. Furthermore, results reveal that self-esteem and social support fully mediate the relationships between IH and psychological distress. Social support was also found to fully mediate the relationship between IS and psychological distress. However, no support was found for the mediational role of self-esteem in the link between IS and psychological distress. Research and practice implications are discussed.

This study investigated risky sexual behavior in a sample of 209 gay and bisexual men. Using structural equation modeling, the mediating relations of substance use factors (expectations about the sexually enhancing effects of substance use and substance use during sex) between internalized heterosexism (IH) and sensation seeking and unprotected anal intercourse were examined. Expectations that substance use would enhance sexual activity mediated the relationship between IH and risky sexual behavior. Both substance use factors mediated the relationship of sensation seeking to risky sexual behavior. Greater sensation seeking was associated with greater expectations about the sexually enhancing effects of substances, which in turn was associated with greater unprotected anal intercourse. Unexpectedly, less sensation seeking was related to more substance use during sex, which in turn was associated with more risky sexual behavior. Overall, the variables in the model accounted for 66% of the variance in sexual behavior.

This article focuses on implications of empirical research on the construct of internalized heterosexism (IH) in lesbian, gay, and bisexual (LGB) individuals. First, suggestions for practice with LGB clients are provided using the framework proposed by Goodman et al. for social justice work at micro, meso, and macro levels. Second, ideas for the training of counseling psychologists on the construct of IH are presented. Ways in which counseling psychologists can train students beyond the traditional micro-level approach are included.

This reflection considers themes emerging from the Major Contribution on internalized heterosexism (IH), focusing on unexpected potentials emerging from the literature reviewed and research done. It discusses the importance of understanding multiple identities, intersections of social locations, and cultural coping strategies as a means of seeing resilience in the face of cultural and internalized stigma. It also examines questions of directionality of vulnerability that might contribute to higher rates of IH in some individuals.

This Major Contribution of The Counseling Psychologist has the potential to be a keystone for those counseling psychologists who will place emphasis in their research, scholarship, practice, or advocacy work on heterosexism as well as for the wider profession in recognizing the destructive power of heterosexism. Brief critical ideas that add to, or expand on, discussion in this Major Contribution are offered in this response article. The restricted range of research samples and the potential for ethnocentric bias in the current conceptual and empirical approach to internalized heterosexism (IH) is discussed first. The need for “experience-near” information in IH scholarship is then discussed as an approach both to becoming less ethnocentric and to bringing about a deeper and more serious accounting for heterosexism within the profession. Finally, the importance of attention to the long-term effects of having “survived” the internalization of heterosexism is illustrated.

Three themes found across the reactions to the Major Contribution are discussed: agreement on the destructive nature of internalized heterosexism; the importance of focusing on resilience and other strengths shown by lesbian, gay, and bisexual individuals that enable them to be healthy in the face of oppression; and the need for further research on internalized heterosexism, including the construct itself. Recent advances in research on correlates of internalized heterosexism are also described.