ABSTRACT
We begin our book with this chapter on sexual minorities by Margaret Nichols because it provides such a clear example of the limitations of an ethnocentric approach to the understanding and treatment of sexuality related problems.
Traditional notions of gender and sexuality are challenged in this provocative chapter. Surveying how other cultures understand same sex sexuality and gender, we are forced to confront the fact that the Western-style notion of a fixed lifetime sexual and gender identity is an artifact of culture. It is perhaps the way in which Western society makes homosexuality (and more recently, transgender issues) acceptable: homosexuality is not just a sexual orientation but an identity—the way someone is born, not a choice or a preference. Similarly, the idea that there are only two genders is not true worldwide, as many cultures allow for at least a third option. Trying to fit a client into a fixed identity is often counterproductive and countertherapeutic, as the clinical cases presented in this chapter clearly demonstrate. People who are both sexually and culturally in a dual minority class often face societal discrimination without the support of their family or cultural group, as well as discrimination and misunderstanding by health care professionals and therapists. This chapter illustrates a culturally sensitive approach to working with dual minority clients.
