The American Psychiatric Association’s Principles of Medical Ethics emphasize competence, respect and up-to-date knowledge as a basis for appropriate professional behavior toward lesbian, gay, bisexual, transgender and queer (LGBTQ) patients. After providing some definitions of helpful terms, this presentation then reviews historical psychiatric attitudes towards LGBTQ patients that could be construed, at best, as patronizing and, at worst, overtly hostile. In modern clinical practice, as opposed to trying to “cure” homosexuality or “transsexualism,” LGBTQ patients are helped to live their lives according to their own natures and desires. This presentation outlines some common clinical questions raised by LGBTQ patients—what is known and not known about the origins of homosexuality and transgender expression, sexual orientation conversion efforts (SOCE), therapist self-disclosure, how therapists should address LGBTQ patients, and controversies surrounding treatment of transgender children—as well as ethical issues raised in these clinical encounters.
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