Ethical Aspects of Mental Health Care for Lesbian Gay Bi- Pan-Asexual and Transgender People: A Case-based Approach

摘要

The lives of lesbian, gay, bi-, pan-, asexual, and transgender (LGBTA+/LGBT)people are not considered to be standard in society, unlike those ofheterosexual cisgender people. This can lead to prejudices against LGBT peopleand may negatively influence their access to high-quality health care. Medicaland mental health care have been characterized by attitudes(psycho-)pathologizing LGBT lives and therefore supported the stigmatization ofLGBT people in the service of heteronormativity. Mental health professionals(MHPs) largely have transferred principles guiding counseling and psychotherapywith heterosexual (straight) cisgender persons to treatment of LGBT individualswithout considering the specific features of LGBT lives. This is true even ifthe treatment is not exclusively LGBT-related, but can address LGBT-unrelatedissues. To counteract this, the present paper aims to provide an insight intoethically sound mental health care for LGBT people. By applying the principlesof biomedical ethics, we have analyzed how LGBT individuals can be discriminatedagainst in mental health care and what MHPs may need to offer LGBT-sensitivehigh-quality mental health care. We argue that MHPs need LGBT-related expertiseas well as LGBT-related sensitivity. MHPs should acquire specialist knowledgefor the diverse lives and the challenges of LGBT people. We encourage MHPs todevelop an understanding of how their own implicit attitudes towards LGBT peoplecan affect treatment. However, the demand for special training should not bemistaken as a demand for a specific type of mental health care. The principlesof general psychotherapy are equally the basis of psychotherapy with LGBTpeople.