Sexuality and gender for mental health professionals: a practical guide Christina Richards and Meg Barker

Abstract

Christina Richards and Meg Barker, Sexuality and gender for mental health professionals: a practical guide, Sage: London, 2013: 246 pp. ISBN 085702843X

Reviewed by: Manuela Thomae, University of Winchester, UK

There are multiple perspectives from which to read Richards and Barker's Sexuality and Gender for Mental Health Professionals: A Practical Guide. Predominantly, as the title states, this book is targeted at mental health professionals who wish to obtain more information on different sexualities, genders and relationship structures. However, Sexuality and Gender will also be helpful reading for any other practitioner, teacher or lay person interested in the topic. Since I am currently undergoing systemic training, I approached this review by asking myself what this book brings to my own outlook and experiences in the framework of systemic thinking and family work. In the review below, I will therefore put a particular emphasis on the systemic ideas of sexuality and gender as ‘social graces’ (e.g. Burnham, 2012), the importance of curiosity (Cecchin, 1987) and the family life cycle (e.g. Johnson & Colucci, 2005).

Sexuality and Gender is structured around three main topics. Section 1 describes gender practices and identities and includes chapters on Transgender, Intersex, Cisgender and Further Genders. In Section 2, the book moves on to Sexuality, particularly to practices and identities. This section includes chapters on BDSM and Kink, Asexuality, Bisexuality, Lesbian and Gay Sexuality, Heterosexuality, Cross-dressing and Further Sexualities. The final section concludes the book with two chapters, one on Monogamous Relationships and one on Non-monogamous Relationships. In the introduction, Richards and Barker outline their focus as considering a broad range of diverse sexualities, genders and relationship structures. They also clarify their use of terminology. The authors supplement the book with a website containing additional case studies and further readings (www.sexandgender.org) as well as a very helpful glossary and a shadow glossary at the end of the book. Overall, Richards and Barker adopt a pluralistic point of view with regard to psychotherapy and professional practice, writing from a minority standpoint of contemporary Western culture.

Sexuality and Gender fills an important gap in the available literature. The book focusses on often neglected topics, including non-monogamous relationships or different aspects of LGBT* communities. Richards and Barker take a clear stance against pathologising the unknown, such as sexual practices or ways of conducting relationships outside a perceived cultural norm. The book also refers to the embedded nature of genders, sexualities and relationships within the context of wider society. Richards and Barker discuss the responses clients may receive from their respective communities and in the context of interpersonal relationships. Importantly, the authors emphasise that in the majority of instances, clients will present to a mental health professional for reasons entirely independent of their gender practices and identities, sexualities and relationship structures so it is important to treat these as incidental, they argue, and not make them the focus of therapy in such cases.

Sexuality and Gender enhances our understanding of possibly marginalised ‘social graces’ (e.g. Burnham, 2012). The social graces encourage practitioners to position themselves in relation to aspects of difference and similarity between themselves and their clients. Although gender, sexuality and sexual orientation are part of such reflections on difference and similarity, I wonder how often genders like Trans* or Intersex, sexualities such as cross-dressing or BDSM/Kink, or non-monogamous relationships actually enter the thinking, teaching, research and clinical work of mental health professionals. In this respect, the book is a true eye opener, providing information on aspects of gender, sexuality and relationship structures which often remain unvoiced, invisible or both (Burnham, 2012). Yet, the book also points out situations in which aspects of gender, sexuality or relationship forms should remain unvoiced and the practitioner should not assume that these need to be discussed, just because they challenge the practitioner's preconceptions.

Cecchin (1987) defines curiosity as leading ‘to exploration and invention of alternative views and moves, and different moves and views breed curiosity’ (p. 1). Implicitly, Sexuality and Gender makes a case for curiosity. Richards and Barker encourage mental health professionals to practise in a non-judgemental, open-minded way, avoiding further marginalisation, judgement and victimisation of clients who do not define themselves within the boundaries of the sex-dichotomous, heterosexist, monogamous mainstream culture. Yet, Sexuality and Gender also emphasises the obligation of mental health professionals to educate themselves and not use therapeutic sessions to have clients educate the practitioner. Hence, the message is clear: practise with curiosity in the way that authors like Cecchin (1987) had in mind, not with ignorance or obliviousness.

Sexuality and Gender enhanced my understanding of families. Much mainstream thinking still subscribes to a family model consisting of a core family of a mother, father, children and the extended family around them. This book fills a gap by pointing out that family can and should be defined in a much wider sense to include communities, families of choice and adoptive families. Moreover, Richards and Barker brought home for me how fluid a family life cycle and periods of transition can be. For example, Johnson and Colucci (2005), in a chapter on the lesbian and gay life cycle, acknowledge that the popular systemic life cycle models may not apply to lesbians and gays. Indirectly Sexuality and Gender nudges the reader into thinking one step further by including further sexualities, genders and relationship structures. For example, Richards and Barker discuss the possibility of a second adolescence in Trans* people or (briefly) the practicalities of parenting in BDSM/Kink relationships. These lived realities of clients thus call for a much more flexible approach in the work of mental health professionals.

For mental health professionals, Sexuality and Gender is an essential tool to non-discriminatory and informed practice. Moreover, the book is a useful addition to the knowledge of any practitioner, student, teacher, leader or lay person. For the purposes of this review, I read this book cover to cover; however, the busy professional can approach Sexuality and gender as a reference book to use as and when the need arises. Richards and Barker maintain a very clear and organised structure across chapters which allows a reader to go back and forward between different parts of the book. Whatever the reader's approach, Sexuality and Gender will be an essential addition to the bookshelf of any mental health professional or other interested academic.

References

Burnham, J. (2012). Developments in Social GRRRAAACCEEESSS: Visible-invisible and voiced-unvoiced. In I.-B. Krause (Ed.), Culture and reflexivity in systemic psychotherapy: Mutual perspectives (pp. 139--160). London, UK: Karnac Books Ltd.

Cecchin, G. (1987). Hypothesizing, circularity, and neutrality revisited: An invitation to curiosity. Family Process, 26(4), 405--413.

Johnson, T. W., & Colucci, P. (2005). Lesbians, gay men, and the family life cycle. In B. Carter and M. McGoldrick (Eds.), The expanded family life cycle: Individual, family, and social perspectives (3rd ed., pp. 346--361). Boston, MA: Allyn and Bacon.