photo of Bobbi with link to home page

DRAFT – Bi competence
workshop outline 3/8/07

(workshop presented at the National Joint Conference on Aging, Chicago, Illinois, USA American Society on Aging & the National Council on Aging)

Welcome to Bisexual Competence in Counseling, Therapy and Other Services for Older Bisexual Women and Men

I'm Bobbi Keppel, LCSW, ME

I'm curious to know a little about you. Could you share your names and a little about what each of you does?
(go around room)

How many of you have been to a workshop or training on bisexuality before? And how many of you have been to one on bi aging?

Transparency: Agenda for Bisexual Competence Workshop

This is what I'm planning to cover in the workshop, but I'm here for you, so I want to know what are your burning questions or issues? What do you want to be sure to know when you go out that door? It may be in here already but not visible, or I can add it, or you might be first on the list during the question period.

Learning about bisexuality is all about fluidity, flexibility, and change. It's about thinking outside the box; in fact, of giving up some boxes and blurring lines. It can be fun - and it may be a bit scary. Hang in there.

During this workshop, I'm sure to use some language that offends almost everyone. Like everyone else, I get tired of using BGLT or GLBT or TGLB or whatever. Besides, those initials aren't as inclusive as our thinking needs to be.

Sometimes, I use "queer" or "que-ah" as an umbrella term for non-heterosexuals, partly because younger folks use queer a lot as a more descriptive and inclusive than BGLT. Older folks are usually very uncomfortable with queer because it was used to put them down and taunt them.

I also have another current favorite: BAGILQQTT, pronounced "bagel cutie", which is the acronym for bisexual, asexual, gay, intersex, lesbian, queer/questioning, transsexual and transgender. What I like best about it, beside inclusivity, it that I can't say it without smiling. Can you? Try it.
I'll explain some other terms as we go along.

(Left out heteroflexible, homoflexible, and polyamory.)

Sexual orientation and identity are easier to understand if approached developmentally; that is, sex, then gender, then sexual orientation/gender attraction/sexual identity which is the order in which they happen. We follow that sequence in this workshop.

Let's start with sex. Anyone want to guess how many human sexes there are? In my college biology class, we learned about XX and XY chromosomes: female and male. A few years ago, I started hearing and reading about more sexes. When I asked my friend who is a genetic counselor, she said, "They're on a continuum so there are many."
Transparency: show XX and XY.
Transparency: "Sex, by chromosomes" shows additional Xs and Ys, up to 5 extra of each.
After 5 extra chromosomes, the fetus isn't viable, so we don't have people with 6X or 6Y.

That's just sex chromosomes. There are also people who are androgen insensitive which means they make sex hormones but their bodies can't seem to use them, so that more choices to add to the mix.

Joan Roughgarden (she's on the Bi Resources and References handout) is a professor of developmental biology at Stanford University. She writes we could think about sex as coming from a conference where the chromosomes and the body chemicals sit down and have a discussion about the person's sex. That particular person's sex is the outcome of the discussion between all of the determining factors.
Pretty far from simple old XX and XY isn't it?
But legal sex is assigned at birth based one someone's observation of the newborn. Ordinarily, there are not tests to find out if the child is, in fact, XX or XY, and the body's owner doesn't get to vote.

Transparency: Sex
If we put the possibilities on a circle, we'd have female over here. across from male. In between, along the arcs, we'd have intersex, on one arc and "other" on the other arc.

Intersex. People are born with the sexual equipment of more than one sex. For example, a baby might have a penis and ovaries, or a vagina and a penis, or a vagina and testes. Or sometimes, the organ sizes are different from what the pediatricians have defined as normal: a penis is smaller or a clitoris is larger. Some pediatricians define these differences as "pediatric emergencies" requiring corrective surgery. Fortunately, some intersex adults have started a movement to prevent surgery until the individual is old enough to make her/his own decision. The people in the movement believe the so-called corrective surgery is really a form of genital mutilation. That's something our government objects to when it happens in other countries.

Take a few minutes to look at this circle or visualize it in your head and try putting yourself at several different positions on the circle. You might want to put your sex as you were legally labeled at birth, the sex you are now, and some other possibilities. This is just to help all of us consider the rich diversity that exists instead of the binary limits we probably learned about first.

(With a larger group and more time, I use blue painter's tape to make a circle on the floor, add labels on cardstock, and invite people to walk to various positions on the circle and think about what they might be like if they lived in that body.)

Now, let's think about gender.
Gender is how we perform our social role as a boy/man or girl/woman. We learn how to behave, feel, and think. Initially the instructions come from outside ourselves. Generally, they last a lifetime. Notice again that the owner starts without a vote; that is, all of the messages about how to perform our gender come from outside. Starting in the delivery room, newborns are held and talked to differently based on their observed and assigned sex. Can't start a moment too soon.
Over time, the owner may accept or reject those messages; but messages about girl and boy behaviors pervade growing up.
Suppose the parents know the child's sex before birth, what might they do differently depending on what they expect?
colors & decorations of room
send out announcements, or not

Here is the next exercise.
Transparency: Gender
Here is a circle. On one side, we have feminine/girl/woman. Opposite, we have masculine/boy/man. Along the circle are other possibilities: gender bending and blending, gender nonconformist, and androgynous. Take a few minutes to look at this circle or visualize it in your head and try putting yourself at several different positions on the circle. Try out various possibilities. Recall some of society's expected gender differences like dress, hair, work, social groups, earnings, and family roles and try out where some of them might put you on the circle. Or try out varying shades of masculinity and /or femininity.

(With a larger group and more time, I use blue painter's tape to make a circle on the floor, add labels on cardstock, and invite people to walk to various positions on the circle and think about what they might be like if they lived in that body.)

[Omitted from this presentation: In a few minutes, I'm going to ask you to pair up with someone near you, preferably someone you don't know already, and talk a little about what felt right and what felt most uncomfortable for you in doing this exercise.]

The next part of this workshop is about sexual orientation, gender attraction, and sexual identity which build on sex and gender identity. Although usually referred to as sexual orientation, we're really talking mostly about gender attraction; that is, attraction to others based on what sex we believe them to be. Based on someone's gender presentation, I may believe I know that person's sex. But I've been wrong many times that I know about - and probably some I never figured out.

First, let's think about sexual behavior which is one part of sexual orientation/gender attraction.

Transparency: Kinsey Heterosexual – Homosexual Scale
Alfred Kinsey used a 0-6 scale of sexual behavior - a continuum from exclusively heterosexual to exclusive homosexual which we might refer to as other sex/gender or same sex/gender sexual behavior. But that was only one part of gender attraction/sexual orientation.

Transparency: Sexual behavior.
We liked the continuum but saw it was limited to sexual behavior which only a part of one's sexual orientation/gender attraction. Fritz Klein added more aspects of sexual orientation, but he used a grid which forced choices rather than a continuum. So we combined the two ideas and added some of our own.

Let's look at sexual attraction defined as "to whom are you sexually attracted?" or "who gives you your tingles?"
Transparency: Sexual attractions
Again, there is a continuum from same to other gender.
If we put these 2 scales together, (put previous 2 transparencies on top of each other so that 2 scales are showing at once.)
Notice that a person might be at different places on the 2 scales - maybe attracted over here (point) and behaving over here (point to different number.)

What about sexual identity - how people label themselves?
Transparency: Self(sexual) identity
Here, we have the same 7 point scale but with the labels of heterosexual, bisexual, and gay or lesbian.

Transparency: previous 3 scales all on one page.
See how rich this can be?

Transparency: "Sexual behaviors" with time dimensions "past," "present," and "ideal," added.

We can add the dimension of time too which Kinsey didn't do.
You could pick different time spans for "present" and "past" and get different results. If "present" were 2 years or 5 years, and those years included a person's coming out, the different time lines might be very different from each other.
"Ideal" is the closest we can get to future.
So, now, for each aspect, we have 3 time spans.

Transparency: Sexual & Affectional Orientation & Identity Scales (SAOIS)

And then, we can add other aspects of affectional orientation, identity, and allegiance:
sexual fantasies, emotional preference (your best friends)
physical affection (who do you hug?)
social preference ( who do you hang out with?)
political identity (not red or blue)
community affiliation which may include bi, gay male, lesbian, straight, or all

Note that "no label" and "other label" are additional options for "self identity." Now, we're back to the possibility of "queer" or other umbrella or alternative terms as labels, like heteroflexible or homoflexible. And this is where it gets very interesting because we can have people with the same attractions and behaviors using different labels.

Note that not all aspects may apply to any one person, and the importance of aspects may vary too. In fact, recent research points to lesbians being more likely to prioritize emotional and social preference in choosing a label while gay men are more likely to label according to sexual behavior.

You have a copy of this in the handouts and can download it from my website. There are some further comments and questions there.

Most people want to try it out in the privacy of their own space, so keep a clean copy to share with others and mark up a different one for yourself. Copies lose some definition with each successive generation. The SAOIS is easier to read with the gray scale; but if you are going to make copies which will be copied and recopied and so on, use the black version for reading ease. Both are on the website.

That was sex, gender, and gender attraction/sexual orientation 101. So rich. So much diversity.

Now, let's look specifically at bisexuality.

We'll start with myths, stereotypes, and misconceptions about bisexuality. What have you seen and heard about bis. I know some of these will sound really rude, but we can't talk about them if we don't hear and see them.

Transparency: write myths and stereotypes as participants volunteer them. Add some myself, especially the ruder ones like "fucks anything that moves." Discuss basis of each.

Examples: confused, greedy, promiscuous, developmentally inappropriate, desperate, afraid to commit, fence sitters, apolitical, disease spreading vermin, down low, reap benefits of lesbians, leave you for the other sex, traitors, polyamorous…

Being bi = living through many oppressive experiences. Wherever we start a discussion of bisexuality, it always comes back to oppression as the most common feature of our lives.

To some extent, oppressive experiences vary according to age cohorts; that is, the decade in which a person became an adult and the decade in which they came out. After all, "senior" or "elder" is construed as over 50, so we have a population group with an age span of 50 years or more. No one would dream of cramming folks 30 to 80 into one group. Doesn't make any sense, and neither does 50 – 100. They have had very different life experiences, and that includes their experiences of oppression.

What do you know about the decades of the 20s, 30s, 40s, 50s, 60s? Let's characterize each.
20s – sexual liberation for straight young folks
30s – hide any differences that might keep you from getting work.
40s – wartime. A chance to live with people of other races, classes, religions, ethnicities, and in different places, away from hom.
50s – McCarthyism. Connect communism with sexual deviance.
60s – civil rights movements
70s – declassify homosexuality in DSM

So, what does bi oppression look like? The biggest part is invisibility. We just aren't there. Take LGAIN, for example (Lesbian and gay aging issues network of the American Society on Aging) the organization which sponsors this workshop. It's "lesbian and gay." We're not included. The name implies everyone is gay, lesbian, or straight. We're erased from our place with other "queers."

Sometimes, we're included in the name, as in "GLBT", but not in the content. In the years I have been attending these conferences and reading OUTWORD, I have seen "GLBT" in articles and workshop descriptions. It's politically correct to imply that all are included, and only takes "find and replace" on a computer. However, when I read the articles and attend the workshops, we aren't actually in the content. When I asked the presenter(s) about how their material applies to bisexuals, they seem surprised and admit they don't know whether or not bis would be the same. Note that the MetLife study that's being presented at this conference is listed as "gay & lesbian" even though it actually contains some information about bis.

[Workshop attendees mentioned how many layers they had to dig down to find out there was actually a workshop on bisexuality and aging at this conference.]

We also experience overt oppression. We're often ostracized when we come out because we're not quite straight enough or not quite queer enough. When we own our label, we're different from the many lesbians and gay men who have the same sexual behaviors and attractions but keep them secret. Those differences are showing up in more and more research, especially among young adult who use the identity labels of gay and lesbian.

What happens when people come out later in life? "Bisexual" isn't in the common language of elders so they may try to fit into lesbian, gay, or straight. And bisexuals are less likely to have an identifiable community for the person coming out, especially for elders, unless they are in one of the few cities with large bi communities like Boston or San Francisco. Even then, the bi communities are smaller and less visible than the others: straight, gay, or lesbian. So the older bi person may find it confusing &/or just more difficult than younger bis.

Does it matter if they can't find bi communities? Yes, because living in the closet has negative consequences. Stress levels rise when people can't live as who they are. When stress levels rise, there are increases in health and mental health problems. Stress depresses immunity which already tends to decrease with age. Stress increases depression and anxiety. And stress increases isolation. All are rather dismal outcomes.

Professionals can play the roles of investigators and advocates. We can screen community and referral resources for our clients. Do providers use forms that include bis? Is their language inclusive? What kind of attitudes do they express toward bis?

Even if a presenting problem is bi related, the client will probably start with something else while testing the provider. We can assume that an older bi has experienced enough oppression to start very carefully with each new provider.

What about going to a straight or gay/lesbian health center? So far, research has shown bis would rather chance a straight facility than the almost certain oppression of a lesbian or gay one. At Fenway Community Health, in Boston, MA, where I work with the bi health project, we have always given everyone safer sex information suitable for all sorts of partners. That way, people can choose the information they need for a particular relationship. This is particularly important for elders because people over 50 have the fastest rising rate of HIV infections of any population group. Not the highest numbers, but the highest rate, and that has been true for a decade. At the same time, the general society sees seniors as non-sexual. They aren't asked about their sexual behavior or given safer sex information. This is especially true when the health care provider has parents or grandparents the same age as the clients, and where older clients never learned to talk about sex.

AA and other substance abuse programs are also generally not bi friendly even when there are specifically lesbian or gay groups. Since these programs require addressing personal shame, oppression which shames people for identifying as bi doesn't offer the person a place to do the appropriate work.

Senior centers and senior social programs offer more challenges for the bi person. You may need to screen these places for your clients to find out if bis are included and whether or not it would be safe for a bi person to be out there.

Like everyone else, seniors need to get connected and stay connected. And like other elders, these connections are harder to make and maintain as aging eyesight reduces ability to drive, long time friends die, diminishing social networks and increasing the need to make new friends.

Housing needs usually change too. You might be screening housing options, looking for congregate living where your client would be safe with visitors and partners, maybe even more than one partner. The available options may be problematic with straights not accepting same gender partnerships, and lesbians and gays not accepting other sexes. Sometimes, the individual has moved away from his or her whole elder support system to live near an adult child to whom she or he may not be out and with no idea of possible social options in the new area.

As we age, many of us explore our spirituality more deeply or in new ways. Again, how can we explore our spirituality when we are closeted? Are there welcoming faith resources for us in our communities? And what about end of life issues? Some of the typical questions can't be answered if we can't be out. Questions like
Did my life matter?
Did I find out who I was?
How will I be remembered?

So how can we change existing programs and plan better new ones?
Let's have a discussion here.
Have you been an activist? What works with racism, sexism, ageism?
What have you done as an activist?
How did you make changes?
How have you seen change made? Top down? Bottom up? Both?
What do you know about how change happens in organizations?

What does a bi competent program/practice look like?
Here are some things I look for:

Professionals can advocate everywhere they go, especially at professional meetings. Model using inclusive language. Point out variances from the NASW code of ethics. Ask questions when language is exclusive rather than inclusive.

You can find out more about my writings on my website which is given on each of the handouts.