LGBTQIA Affirming Ethics Across Fields

by Worner Leland, MS, BCBA and August Stockwell, PhD, BCBA-D, Upswing Advocates

As helping professionals working with marginalized populations, it is important to be cognizant of the ways in which the LGBTQIA community faces disparity in access to services from helping professionals, in spite of the disproportionate need. According to the National Association for Mental Illness, “LGBTQ individuals are almost 3 times more likely than others to experience a mental health condition such as major depression or generalized anxiety disorder,” (NAMI, 2018) and additionally, “LGBTQ youth are 4 times more likely and questioning youth are 3 times more likely to attempt suicide, experience suicidal thoughts or engage in self-harm than straight people,” (NAMI, 2018).

It is also important as behavior analysts to recognize that LGBTQIA affirmation is a behavior analytic issue. Some studies (George & Stokes, 2016) suggest a correlation between autistic traits and gender nonconforming identities, however many autistic transgender authors take issue with the current measurement system’s bias. Further research that centers transgender perspectives and neurodivergent perspectives is needed. However, the Asperger/Autism Network (AANE) notes that, “While many with Asperger/Autism firmly identify as heterosexual others firmly identify as gay, lesbian or bisexual. Still others may be more flexible regarding wh Howom they are attracted to; being sexually attracted to an individual for who they are as a person regardless of the other person’s biological gender, gender identity or gender expression. Other Asperger/Autistics may identify as Asexual or Aromantic in higher numbers than in the general population.”

When considering ethical behavior, behavior analysts look not only to our own code, but to codes of other helping professions, to guide our behavior. At the forefront is the commitment to avoid discrimination based on sexuality or gender, (BACB 1.05 c, d, e; APA 3.01; NASW 4.02; & NBCCC 26). This could look like refusal of care or harassment, however it may also be more subtle and include things like restricting gender presentation of a client, or targeting behaviors for decrease solely because they are gender non-conforming.

Secondly, it is crucial to act in the best interests of the client, (BACB 2.0; NASW 1.01, 1.14; & NBCCC 27). Regarding gender and sexuality, the best interests of our clients may differ from the wishes of parents, guardians, or others in the client’s environment. We must be willing to sit with the discomfort involved in navigating these differences while continuing to support our client.

Thirdly, it is important to disseminate behavior analytic ethics through engaging in social and political action, (NASW 6.04). The National Association of Social Workers provides excellent guidance, noting that [we] “should act to expand choice and opportunity for all people, with special regard for vulnerable, disadvantaged, oppressed, and exploited people and groups,” (b), and that also [we] “should act to prevent and eliminate domination of, exploitation of, and discrimination against any person, group, or class on the basis of race, ethnicity, national origin, color, sex, sexual orientation, gender identity or expression, age, marital status, political belief, religion, immigration status, or mental or physical ability,” (d). This call to action necessitates not only advocating for our clients’ ontogenic rights, but behavior analytically bringing about change on a systemic, cultural level.

References:
American Psychological Association (2002). “Ethical principles of psychologists and code of conduct” (PDF). American Psychologist. 57: 1060–1073.
Behavior Analyst Certification Board (2016). Behavior Analyst Certification Board professional and ethical compliance code for behavior analysts.
George, R., & Stokes, M. (2016). “Gender Is Not on My Agenda!”: Gender Dysphoria and Autism Spectrum Disorder. In Psychiatric Symptoms and Comorbidities in Autism Spectrum Disorder (pp. 139-150). Springer International Publishing.
National Board for Certified Counselors. (2016). NBCC Code of Ethics.
Workers, N. A. (2008). NASW Code of Ethics (Guide to the Everyday Professional Conduct of Social Workers). Washington, DC: NASW.

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