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Article 46

The Counselor’s Role in Helping Students With Sexual Identity Issues

A Case Study of a Mother and Daughter

Rochelle C. Moss, Kristi L. Perryman, Katherine M. Cochran, & Edward F. Hudspeth

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Issues related to sexual orientation have garnered increased attention in recent years, especially with increased awareness of bullying and suicides of lesbian, gay, bisexual, and transgender (LGBT) adolescents. Studies show that LGBT youth are “far more likely” to report being bullied, sexually harassed, and/or physically abused than heterosexual peers (Bidell, 2012), and Russell, Ryan, Toomey, Diaz, and Sanchez (2011) found that over 85% of LGBT youth report being verbally harassed because of their sexual orientation. When studying lesbian, gay, and bisexual (LGB) suicidality rates, D’Augelli et al. (2005) found nearly one-third of LGB youth reported a past suicide attempt.

While a great deal of research focuses on the experiences of LGB identified individuals, research also shows that the process of formulating a sexual identity is an important aspect of health for adolescents. Feldman and Wright (2013) found a positive correlation between a strong sexual identity and more positive mental health, and cite multiple studies showing similar results. Furthermore, self-identification of sexual minorities is happening at increasingly earlier ages (Bilodeau & Renn, 2005). These factors combined highlight the need for increased counselor intervention and support for LGB individuals during adolescence.

Theories of Sexual Identity Development

Cass’ 6-Stage Model

The most widely regarded model of sexual identity formation was created by Vivienne Cass in 1979 (Cass, 1984). Cass identifies a stage model of sexual identity formation and separates this process into six stages. In Stage 1, Identity Confusion, the individual questions the heterosexual assumption and explores the possibility of a homosexual identity, and may seek information on gay and lesbian identities. If the individual accepts the possibility of a non-heterosexual identity, the individual moves into Stage 2, Identity Comparison, which is characterized by a comparison and attempt to reduce the incongruence between same-sex attractions and view of one’s self as heterosexual. This stage also includes the comparison of one’s non-heterosexual attractions to one’s heterosexual peers. In order to help relieve some of the confusion of earlier stages, the individual then moves into Stage 3, Identity Tolerance. In this stage, the non-heterosexual identity is tolerated and the individual seeks out other individuals who identify as non-heterosexual, and may adopt an asexual role, or hide homosexual behavior, to increase social connections (Cass, 1984).

The following stage of sexual identity development is Stage 4, Identity Acceptance. During this stage, the individual develops a more clearly delineated non- heterosexual identity. The need for contact with other LGB individuals is greater during this stage, and feelings of loneliness or alienation may be more severe if these peers are not available. The increased identification with the non-heterosexual identity can also lead to selective disclosure to other heterosexual individuals during this stage. After this, the individual moves to Stage 5, Identity Pride. This stage includes a strong sense of pride with homosexuals as a group and can include a devaluation of heterosexuals as a group. Experiences that do not support this dichotomy lead the individual into Stage 6, Identity Synthesis. In this stage, the individual synthesizes the LGB identity into a greater sense of identity and no longer engages in an “us vs. them” attitude of homosexuality and heterosexuality. Non-disclosure is largely a non-issue during this stage, as the individual has synthesized the LGB identity into a greater sense of identity and is no longer hiding this identity (Cass, 1984).

D’Augelli’s “Identity Processes” Model

Another, non-stage model of sexual identity development is the “life span” model proposed by D’Augelli. According to Bilodeau and Renn (2005), this model “addresses issues often ignored in other models, presenting human development as unfolding in concurring and multiple paths” (p. 28). This model includes six “identity processes” that are non-linear and do not occur in stages. They are as follows:

• Exiting heterosexuality

• Developing a personal LGB identity

• Developing an LGB social identity

• Becoming an LGB offspring

• Developing an LGB identity status

• Entering an LGB community

These stages are largely independent of one another, and the individual can move through one, some, or all processes at varying paces and simultaneously (Bilodeau & Renn, 2005, pp. 28-29).

Current Study

Purpose and Emerging Research Questions

In the current phenomenological case study, the researchers began by exploring the topic of an adolescent female’s process of working through her sexual identity crisis. In a parallel process, the researchers also were examining the related issues of the girl’s mother. As the qualitative research continued, the major question emerged: How can counselors be most effective in helping an adolescent during a sexual identity crisis? In addition, it also became clear in working with this adolescent that she was going through a developmental process which loosely followed Cass’ (1984) sexual identity formation stages, allowing for a grounded theory to emerge, utilizing these stages for comparative analysis. A second research question then emerged regarding the developmental stages of parents as they journey through this crisis with their child.

The Case Study

The case example is from previous clinical work conducted in a private practice setting. It has been presented in a way to protect the client and her mother’s identity. Molly, an athletic 16-year-old female, was brought to counseling by her mother, Sue, who explained that Molly was contemplating suicide and was going through a “tough time.” Sue knew the counselor (who is the major researcher in this study) from a school counseling program in a rural Southern university where she attended several years before, and this counselor was a faculty member there. In the first session, Molly appeared emotional and told of her recent conflict with her best friend’s parents, who had recently decided that they no longer could see each other. As the session continued, Molly hesitantly discussed the conflict, which began when her friend’s parents became concerned and suspicious about the closeness of the relationship. She went on to describe their fears, which mainly focused on their daughter and Molly possibly having a homosexual relationship. Molly stated that she did not want to live without being able to see her friend and that she was obsessed with her and could think of nothing else. Molly tentatively explained that she was not sure about the relationship herself. She knew that she loved her friend in a different way than she had ever loved anyone else and that she had never felt this way about the few boys she had dated. The suicidal thoughts were discussed with her mother and safety precautions were put into place.

Molly continued in therapy for three sessions. During these sessions she worked through her sexual identity questions and became certain that she was homosexual. She was truthful to her parents, and they accepted and supported her in this revelation. It was at this time that she reminisced about her favorite aunt, who was deceased and who she now realized was a lesbian, and told of the fondness that she felt for her and wished that she could talk to her. She continued to struggle with the restrictions placed on the relationship with her girlfriend and also struggled with when she should “come out.” She questioned whether she should wait until she went away to college or if she should go ahead and “come out” to her high school friends and classmates.

Molly’s mother, Sue, was working as a school counselor in a small, rural school during this event, and she was dealing with her own issues both as her daughter’s school counselor and as her mother. Although Molly discontinued therapy after a short time, Sue continued to keep Molly’s counselor updated on her progress, as well as her own struggles as her mother. Because both Sue and Molly were extremely open and honest about Molly’s journey through her sexual identity crisis, Molly’s counselor (the main researcher in this study) asked if they would be comfortable participating in some interviews to explore her seemingly successful progression, and they both agreed.

Methods

Purposeful sampling was used in this study to choose participants. This involved choosing individuals who were considered “information rich” and offered “useful manifestations of the phenomenon of interest” (Patton, 2000, p. 40). The phenomenon of interest is an adolescent female’s process of working through her sexual identity crisis and the parallel process of her mother. This mother and daughter were a rich source of information regarding this topic, thus providing purposeful sampling. Grounded theory was also utilized in this study. “Grounded theory focuses on the process of generating theory rather than a particular theoretical content” (Patton, 2000, p. 125). For the current study, prior research regarding sexual development of adolescents was utilized to develop the framework for further research questions and for comparative analysis with the current findings.

Semi-structured interviews were conducted over a 2-year period of time for data collection. These interviews were done with Molly and Sue individually, as well as together. There were approximately 7 hours of interviews. They were conducted at various sites, but the videotaped interviews were done in a counseling lab at the university in which the main researcher worked. The videotapes were transcribed, and all data was organized according to dates. For the interviews which were not videotaped, the responses were written by the researchers, and observations were documented. Molly’s interviews were then coded separately from Sue’s interviews. Data included the transcriptions and written responses from the interviews and a video recording of the interview. Also, the researchers used the therapy notes from the counseling sessions (with participant consent), especially for the case study description. Additional data was comprised of written observations and personal journal notes entered after each interview session. Utilizing these varied methods of collection allowed for triangulation to occur, ensuring the trustworthiness of the data. This process also ensured generalizability and transferability of the findings from this study.

Because the principal researcher who interviewed the participants was both the former counselor and professor from the mother’s former program, there were natural elements of differences in power and authority. The researcher utilized person-centered techniques of empathy and reflective listening to establish a non-threatening, nonjudgmental setting for the interviews. She also utilized peer debriefing with two of the co-authors of this article to ensure that the information gleaned was accurately represented. The co-researchers viewed the videotape and discussed the themes derived.

The initial interview questions were derived from previous research findings on sexual identity formation and the “coming out” process. Because we used a semi- structured interview format, the interviewer’s questions often were dependent upon the responses of the participant(s). The questions were intended to be open and unbiased in order to allow the data or phenomenon to emerge. Examples of interview probes/questions for Molly include:

1. Tell me about the process you went through.

2. What did you need most from your counselor to help you in your sexual identity crisis?

3. How could the school counselor provide the support you needed in each stage of your sexual identity development?

4. How could a school counselor help you with bullying by your classmates?

5. How could a school counselor help you in dealing with your suicidal thoughts?

For Sue the questions/probes include:

1. Tell me about your process as a parent as your daughter was dealing with sexual identity issues.

2. What new awareness do you have as a parent?

3. How will this experience affect your role as a school counselor working with students dealing with sexual identity issues?

We, as the researchers, each watched the videotapes and perused the transcriptions and other forms of data to first do our own open coding process. Researchers then developed both axial and selective codes from the data. Emerging themes were compared and agreed upon. By participating in this peer debriefing process with the primary investigator, the researchers ensured the accuracy of the themes as they emerged. This was imperative since the primary investigator was also the counselor working with Molly and Sue. These themes were fairly evident, and after examining all the forms of data, there was no disagreement regarding the accurate representation of the experiences of Molly and Sue. From this process, a grounded theory regarding the lived experiences of this client and her mother emerged.

Data Analysis

A phenomenological approach, using grounded theory, was implemented in this study to convey the experiences of an adolescent female’s process of working through her sexual identity crisis and the parallel process of the individual’s mother. The purpose of a phenomenological, qualitative, research inquiry approach is to understand the meaning of participants’ lived experiences, or life instances specific to each individual’s perception. “Phenomenology aims at gaining a deeper understanding of the nature or meaning of our everyday experiences” (Patton, 2000, p. 104). For the current study, the phenomenon is the experiences of a homosexual adolescent female dealing with a sexual identity crisis and the parallel experiences of her mother in this process. Mother and daughter were asked to share their lived experiences with the principal researcher. The subjective nature of each of their experiences is considered valuable as the source of information.

A grounded theory approach was also utilized in this study in that comparative analyses were made between current research regarding sexual identity formation stages (Cass, 1984) and this developing research theory. This research guided the emerging theory in the current study.

Results

In the following section, we will detail the themes that emerged from data gathered, during an interview, with the two participants.

Themes for Molly

Transcriptions of interviews as well as other forms of data (i.e., observations, notes, and journal entries) were first coded, beginning with the earliest interview and data collection dates. These codes, which indicated significant information, were then grouped into categories. The themes derived for Molly include: (a) feelings of distress, (b) questions about being different and the effects of being different, (c) awareness, (d) certainty and relief, (e) feelings of pride, (f) feeling comfortable with self, and (g) helpful counselor behaviors. Each of these themes corresponds to a stage of development in Cass’ (1984) model.

Feelings of distress. When examining the codes of Molly’s early data when she was in the beginning of her sexual identity crisis, the first category was feelings of distress. Molly’s words included “crazy,” “weird,” “unsure,” “afraid,” “lost,” “worried,” and “not my usual happy self.” Molly’s explanations of how she was feeling fit with Stage 1, Identity Confusion, in Cass’ model of sexual identity formation.

Questions about being different and the effects of being different. Another category which was evident when examining the codes from the earlier interviews was questions about being different and the effects of being different. This category also applied to both Molly and Sue. Molly’s questions included: “Am I really gay?” “Is it just a phase?” “Is it just this one girl?” “How can I tell her?” “How can I tell anyone?” “What am I going to do?” “Where do I start?” These questions correspond to Cass’ Stage 2, Identity Comparison, as she tries to understand her attraction to the same sex and how this contradicts with her views of herself as heterosexual.

Awareness. When studying the codes, an additional category that became evident was awarenesses. Molly’s early awarenesses included: “I noticed that my feelings changed for my best friend. I no longer wanted her to be my friend. I wanted her to be my girlfriend.” “I was aware that I wasn’t my normal, happy self.” “I knew I had to tell someone. I had to tell for me.” In this stage, Molly begins to tolerate her homosexual feelings but wants to keep them mainly hidden, only telling her mother. Stage 3 of Cass’ model, Identity Tolerance, corresponds to these behaviors and feelings.

Certainty and relief. As Molly moved through the next stage, which is tolerance and acceptance of one’s homosexual tendencies, codes were categorized into certainty and relief. Molly indicated the idea of certainty through her statements: “The more I looked at girls, the more I knew that I didn’t want to date boys.” “When Mom asked again, I answered ‘yes, I’m sure.’” The relief was expressed in the statements: “It was a complete weight lifted.” “I felt better. If a person didn’t accept me, I would move on to someone who did.” Molly’s views of accepting herself and feeling certain fits with Stage 4, Identity Acceptance, in Cass’ model.

Feelings of pride. When examining the coding of later interviews, Molly was using phrases such as “I knew I had to be myself.” “It felt good to have people’s support.” She made these statements after she “came out” to the school population, and they seem to indicate feelings of pride in who she was, which was Molly’s next category derived from coding. Stage 5 of Cass’ model is entitled Identity Pride and fits Molly’s progression. However, Molly never reported any feelings of “us” against “them” (homosexuals against heterosexuals), and this was one of the tenets of Cass’ Identity Pride stage.

Feeling comfortable with self. The most recent data was derived from an interview in which Molly detailed her college life. The coding for Molly’s interview indicated a category of feeling comfortable with self. Phrases included: “pretty good grasp of who I am”; “plenty of friends and comfortable being myself”; “don’t have to announce my sexuality to everyone I meet…it’s only one part of who I am”; “I’m just Molly.” Molly’s process follows the last stage of sexual identity development known as Identity Synthesis, which includes rejoining supportive heterosexuals and renewed interest in other roles, such as work, family, and school.

Helpful counselor behaviors. When examining the data, the remaining information focused on what Molly expressed that she would want from her counselor to best help her through this process. Supportive statements identified include: “supportive, open minded, wouldn’t judge, will treat me like any other student, makes me feel safe, what I say doesn’t leak out, lets me talk about what I need to (deep stuff, not just on the surface), makes me feel like I’m not different or alone, like I’m not the only one who has these feelings.”

Themes for Sue

Sue’s themes were very similar but varied somewhat as she experienced this crisis from a parent perspective. Her themes include: (a) feelings of distress, (b) questions about being different and the effects of being different, (c) awareness, (d) fear and consequences, (e) acceptance, (f) anger, (g) pride in her daughter, and (h) helpful counselor behaviors.

Feelings of distress. Sue’s initial codes were the same as Molly’s. Her feelings of distress which she emphasized included “worried,” “afraid,” and “unsure.” Both Molly and Sue stated almost the exact sentence, “I cried all the time about everything,” which indicated their sadness and distress.

Questions about being different and the effects of being different. Sue’s theme included questions very similar to those of Molly. These questions included: “Could she be (gay)?” To Molly, “Are you sure?” “Are you sure?” “Are you sure?” (This question by Sue was emphasized many times.) Both mother and daughter began with questions of sexual identity confusion, which is Stage 1 of the Sexual Identity Development model (Cass, 1984).

Awareness. Sue had the same theme as Molly at this stage. Sue’s awareness at this time was that she “had an inkling that Molly could possibly be homosexual. Sue had noticed how “Molly was always attracted to beautiful, athletic girls, but I brushed it aside.” These statements correspond to Stage 2 of the Sexual Identity Development model (Cass, 1984), which focuses on Identity Comparison.

Fear and consequences. In this stage, Molly and Sue differed. Molly seemed to move to the acceptance stage earlier than Sue. Sue’s codes indicated the category of fear and consequences, as some of her statements revealed: “I didn’t want her to come out.” “I felt very protective of her.” “Am I being selfish?” “How is this going to affect my job as a school counselor?” “How are people going to treat Molly?” She also expressed concern about the relationship Molly was in, saying “they were enmeshed. It was unhealthy. Molly couldn’t think of anything else. That was my focus.” These thoughts are indicative of the Identity Tolerance stage, in which there is a tolerance of the sexual identity, but there remains a need to be secretive and in the mother’s case, protective.

Acceptance. Soon after Sue’s expression of fear and consequences, her statements, suggested a change from fear and consequences to acceptance. “When Molly said that she had thought about suicide, it got real. Nothing else mattered.” “If she was gay, then she was gay. It would be a tough row to hoe, but together we would do it.” Stage 4, Identity Acceptance, fits with the mother’s expressions of accepting her daughter and helping her through the difficult process.

Anger. At this time, Sue’s codes indicate anger, mostly due to people at the school “reporting to me” about Molly’s homosexual behavior, “like I should stop it.” “I was still in the process of accepting it myself.” She was also questioning her role as a school counselor, saying “I should be unbiased. How can I be unbiased when I know what some of these students are saying about my daughter?” Though her earlier theme was acceptance of her daughter being gay, it seems that dealing with those around her reignited her earlier themes of fear and consequences. This resulted in fear for her daughter and anger toward those who could potentially be hurtful to her. This theme did not correspond to Cass’ model of sexual identity development. Perhaps there needs to be an additional stage between acceptance and pride. Although both mother and daughter were accepting of her sexual identity, there were still many feelings of ambivalence in the coming out process and being accepted by others.

Pride in her daughter. Sue’s final theme was expressed as a sense of pride. “I’m a mom first.” Sue later made the transition to “wanting Molly to be herself,” and stated that “we worked on being less enmeshed and having a much healthier relationship.” Feelings of pride in her daughter were definitely expressed in the last interviews, which became a category of Sue’s codes. Sue also expressed similar feelings of comfort and pride with who Molly is. She also stated that “I know how to better help students with similar issues” and that “these students feel more comfortable with me because they know I get it.” In these statements, it is evident that the mother has moved to Stage 5, Identity Pride, and is in the process of working toward Stage 6, Identity Synthesis.

Helpful counselor behaviors. Sue expressed needs similar to Molly’s – “to be listened to; to feel supported; for people to be sincere and not say one thing to your face but their actions are different.” These codes were categorized as helpful counselor behaviors.

Findings and Discussions

Through the process of coding and categorizing the data, it became evident that Molly was following the stages of sexual identity development. One of the most interesting and surprising themes which emerged was that the mother had a similar and parallel developmental process. At times, Sue was slightly behind Molly in the stages, especially of acceptance. Sue also expressed feelings of anger and protectiveness that were not expressed by Molly. But on the whole, Sue and Molly were fairly close in their journey through the developmental stages.

When studying the emerging themes of both the client and her mother, it was clear that their feelings of distress in the beginning of the crisis were similar. They both expressed worry and fear; however, the client expressed feelings of being lost and feeling weird and crazy. The mother’s eventual acceptance came only after being fearful that her daughter might attempt suicide.

Other emerging themes are indicative of the developmental process. When listing in order the categories of codes, the emerging theme is that a sexual identity crisis unfolds developmentally. First, there must be a questioning of one’s sexual identity and then a search for truth. After examining one’s truths (derived from feelings, thoughts, and experiences), the individual gains some new awareness about personal sexual preference. This awareness helps a person feel surer of his or her sexual identity and provides a sense of relief followed by acceptance of “this is who I am.” The integration and synthesis of the individual’s new identity takes place over a period of time in which positive interactions with peers and/or family members seem to be an important part. Feeling comfortable with oneself is the end product.

In the last stage of sexual identity development, according to Cass (1984), the individual has synthesized the LGB identity into a greater sense of identity. Non- disclosure is largely a non-issue during this stage, as the individual is no longer hiding this part of their identity. When examining the data, it appears that Molly had reached this last stage as she described her comfort with herself among her college friends and her belief that her sexual identity was only a part of who she was as a person. However, Molly did note some concern about the future for her family of origin. She has an older brother and sister who are beginning to have children, and both she and her mother expressed some trepidation regarding what to tell her nieces and nephews about Molly’s different lifestyle. This concern seems to be more about how to explain the issue to young children rather than about her current stage of sexual identity development.

In addition, we compared Molly’s journey to the non-stage model of sexual identity development, also known as the life-span model, proposed by D’Augelli, which includes several nonlinear identity processes (Bilodeau & Renn, 2005). In the last interview with Molly, it was evident that she had progressed through some of these processes. She had exited heterosexuality and had begun to develop an LGB personal and social identity. She had become an LGB offspring, but seemed to be in the process of developing an LGB identity status. It was unclear if she had entered an LGB community.

School Counselor’s Role and Recommendations

When considering what part a school counselor may play during an individual’s sexual identity development, it is of utmost importance that he or she be aware of his or her personal beliefs, values, attitudes, and biases (DePaul, Walsh, & Dam, 2009).

The Association for Lesbian, Gay, Bisexual, and Transgender Issues in Counseling (ALGBTIC) and Lesbian, Gay, Bisexual, Queer, Questioning, Intersex, and Ally Individuals (LGBQQIA) Competencies Taskforce (Harper et al., 2013) proposed competencies for counselors who are working with LGBQQIA individuals. These competencies support the needs identified by this study (i.e., identifying, understanding, and affirming; Harper et al., 2013). However, simply knowing the competencies is of little use during the identity development of clients. Much more is needed.

Education may begin the process of awareness, but only through introspection, reflection, and experience, can one begin to understand his/her, overt and covert, tendencies to respond from a personal worldview. Through consultation and supervision, counselors, with less experience, can be challenged to routinely process their motives.

As for specific roles a school counselor may play, the most natural is to be a listener and sounding block. The fundamental counseling skill of active listening can be the foundation for much more. In the resource, The Safe Space Kit: Guide to Being an Ally for LGBT Students by the Gay, Lesbian, and Straight Education Network (GLSEN, 2009), specific tips are offered for school counselors that include: (a) Offer support but don’t assume a student needs any help; (b) Be a role model of acceptance; (c) Appreciate the student’s courage; (d) Listen, listen, listen; (e) Assure and respect confidentiality; (f) Ask questions that demonstrate understanding, acceptance, and compassion; (g) Remember that the student has not changed; (h) Challenge traditional norms; and (i) Be prepared to give a referral. (pp. 14-15)

Summary and Recommendations

This data analysis allowed the researchers to have a clear view in to the phenomenon or lived experience of the adolescent girl and mother interviewed. In addition, a theory, grounded in the research regarding the stages of sexual development, emerged. The stages of sexual development for this adolescent girl matched those developed by Cass (1984). The sexual identity crisis for this adolescent unfolded developmentally, allowing the integration and synthesis of the individual’s new identity and emphasized the importance of the family and parents in this process. The data also uncovered a theory that the parent experienced a parallel developmental process, moving through similar stages at similar times. Furthermore, this research suggests that the developmental process continues as the LGB individual faces family and societal challenges.

Additionally, the ALGBTIC LGBQQIA Competencies Taskforce (Harper et al., 2013) proposed competencies for counselors who are working with LGBQQIA individuals. These competencies support the needs identified by this study (i.e., identifying, understanding, and affirming).

Limitations and Call for Further Research

It is important to note that Cass identified that an individual would either move through one stage to the next, remain in a stage, or truncate sexual identity development by engaging in identity foreclosure at a particular stage (Degges-White, Rice, & Myers, 2000). This further identifies the need for continued support of a counselor, as well as a parent, during this process.

It is also important to note, as stated in Bilodeau and Renn (2005), that most research has been done on sexual identity formation of adults, and “few models exist that specifically address developmental issues of lesbian, gay, and bisexual adolescents” (p. 26). Furthermore, Degges-White et al. (2000) applied Cass’ theory to lesbian identity development and found limited support for that particular stage model of identity development. Further research is needed that focuses on the identity development process specifically in adolescents.

Finally, as this research continued, an overarching question emerged: How can counselors be most effective in helping adolescents during a sexual identity crisis? This is an important question and direction for future research, not only for the process of counseling but also for the incorporation of LGBQQIA competencies in a counseling practice.