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Santa's little timewarp

Research Participation Request: Views of Mental Health Professionals about Asexuality

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Santa's little timewarp

This is not the typical research participation request. Julia from the University of Bath would like your feedback about a planned survey where the respondents are psychological therapists:


Hi,

I am a trainee Clinical Psychologist in the UK. As part of my degree I am conducting a survey study of psychological therapists to find out how familiar they are with asexuality, and to explore how positively or negatively they feel about it.

As part of this project I am designing a new questionnaire to include in the survey, which is designed to measure how much therapists endorse prejudiced or inaccurate views of asexuality in the context of their clinical work. (For anyone who is interested, this new questionnaire is closely modelled on an existing questionnaire called the Attitudes Towards Asexuals (ATA) scale by Mark Hoffarth (Hoffarth, Drolet, Hodson & Hafer, 2015).)

I have drafted some items for the new questionnaire (see below). Respondents will be asked to rate these statements from 1 (strongly disagree) to 9 (strongly agree).

I would appreciate any feedback or comments you may have about these statements. Do they reflect the kinds of views you may have come across, or could imagine a therapist thinking if they worked with an asexual client? Have I missed anything really obvious? My goal is to select the most relevant items and refine the wording based on feedback from this thread.

Thank you very much for taking the time to read this post, and thanks in advance for any feedback you may wish to offer! If you have anything you would like to contribute but would prefer not to say on this public thread, you are welcome to send me a private message (username: Halcyon Daze).

Many thanks,

Julia


Proposed items:

1) If a client told me they did not have any sexual desire I would assume this was a problem for them.

2) When an asexual person seeks support from a mental health professional, it is probably because their lack of sexual desire is causing them distress.

3) People who call themselves asexual have a fear of intimacy.

4) Asexuals are repressing their sexual desires for some reason.

5) Most asexuals have probably experienced some kind of abuse or trauma in the past.

6) If a client told me they do not desire sex I would wonder what has made them this way.

7) It is completely possible for someone who does not experience sexual desire to be happy and fulfilled.

8 ) Lacking sexual desire is a difficulty that we as mental health professionals have a responsibility to address.

9) Therapists should discuss with their asexual clients whether they want help reconnecting with their sexual feelings.

10) Asexuals would feel better if they allowed a therapist to help them discover their true sexuality.

11) If one of my “asexual” clients told me they have engaged in sexual activity in the past, I would question whether they are really asexual.

12) If a client of mine identified as asexual I would want to find out more about what this means to them as a person.

13) The idea of being “asexual” is a cultural trend which will sooner or later go out of fashion.

14) Lack of sexual desire is to be expected in certain clients, for example disabled or older clients.

This research request has been approved by the Research Approval Board for advertising on AVEN.

timewarp

Dedicated Research Contact

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Fioryn

I love all of these. They are all relevant questions. I look forward to seeing how your research goes!

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Soup Can

I told a psychiatrist that I was asexual and he immediately started asking me about my genitals and whether or not they worked properly. I was clearly uncomfortable by his questions. I was there to discuss my Asperger's not the details of my genitals. I don't know how you'd address it in a question, but the psychiatrist seemed to think that me mentioning my sexuality made it okay to ask me very personal and irrelevant questions about my body rather than about what I was actually there for.

That guy also suggested he could "fix" my sexuality. When I first mentioned that I was asexual, he laughed and asked me if I knew what that meant (I explained to him that it was different to asexual reproduction). I really should've been seeing someone about my social anxiety but the whole experience was so distressing and made me so uncomfortable with the idea of therapy that it took me ages before I was willing to give another doctor a chance.

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Halcyon Daze

Thanks for your kind feedback, Fiorya!


Thank you for sharing, Soup Can. I'm sorry you went through such an unpleasant experience and were disrespected so badly. I hope any subsequent experiences you've had with mental health professionals have been more positive. I'll have a think about your comments and see if I can use them to adapt or add to any of the proposed scale items.

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Cimmerian

The only thing I can think of at the moment that I'm not sure is addressed is that some therapists may believe "asexuals can't have a healthy relationship".

I'll be interested to see how this research turns out. :)

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thylacine

Soup Can, your shrink sounds like a creepster. I think he has an "agenda," if yah catch my drift.

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Ladyinred

Great idea for a study! Good questions.

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Halcyon Daze

Thanks, Ladyinred!

Cimmerian, you're absolutely right about the questionnaire lacking any items about relationships. Mark Hoffarth's Attitudes Towards Asexuals (ATA) scale has one about romantic love requiring sexual attraction and another about asexuals in relationships being unfair to their partners. I'll have a think about how I can word a relationship item for this scale which is more therapy-focussed. Thank for the feedback!

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Halcyon Daze

For a relationship question, I was thinking something like the following:

"A relationship in which one or both partners do not desire sex is bound to run into problems."

or

"If my client told me either they or their partner never wanted to have sex, I would assume their relationship is in trouble."

Any thoughts/feedback?

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Halcyon Daze

Thanks for the feedback, everyone. For anyone who is interested in how the research turns out, I will be posting about the results on a Facebook page called "CATA research" (CATA stands for Clinician Attitudes to Asexuality) from May 2017.

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chandrakirti

These questions are going to be great for smoking out the assumptions made in general society. It'd be hard for a respondant to get out of answering honestly.

IMHO as an ex-psych, there's a poor history of understanding/defending 'differently sexually motivated people' in a heteronormative society, never mind a sexually motivated one. hope you can shed light.

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Demiheart

Can you keep me updated on this? I'd love to know how the study goes!

 

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Starfall
On August 9, 2016 at 2:23 AM, timewarp said:

1) If a client told me they did not have any sexual desire I would assume this was a problem for them.

You have a number of questions like this that use the word 'desire'. There is nothing inherently wrong with these questions, but the combination of all of them seems to suggest that you are using lack of sexual desire to be what defines asexuality. There is much debate among asexuals as to whether this is a good definition, because while many asexuals do not experience sexual desire, others do - including sex-positive aces, and those who are sex repulsed while still desiring sex. The main argument is that the 'lack of sexual desire' definition excludes such aces, and that a more inclusive definition would be to describe asexuality as a lack of sexual attraction, which seems to be something all asexuals experience. (Excluding demisexuals and gray-aces, who are on the ace spectrum, but need their own definitions.) I don't know how much of this you are aware of. It doesn't necessarily invalidate your questions, as the purpose of this survey is to explore how much therapists know about asexuality, but you might consider asking a question that makes the distinction between sexual attraction and desire. Or just change the word 'desire' to 'attraction' everywhere appropriate if you wanted these questions to be based around the definition of asexuality.

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Halcyon Daze

Thanks for that feedback, Starfall.  I think "attraction" would be a better word than "desire" for these questions.  I possibly hadn't thought that through quite enough, and it's a helpful thing to be aware of for using this scale in the future.  

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Halcyon Daze

Demiheart, I'm planning to publish a written summary of the results on the study's Facebook page (CATA Research) in July.  This will give me a chance to make any amendments that are required after my viva exam and provide the most up-to-date results and conclusions. Thanks for your interest in the project!

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Day-Z

is this still going on? where would i put my answers hehe?

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Halcyon Daze

Hi everyone, thanks to all of you for your feedback! The study is now over and I wanted to post my results here in case anyone is still interested.  You can also find a similar summary on the study's Facebook page "CATA Research".

 

What's the problem? Exploring psychological therapists' attitudes towards asexuality

 

Background to the study

Asexuality is defined as a lack of sexual attraction to either sex.  About 1% of the population is estimated to be asexual, based on Bogaert’s (2004) analysis of 18,000 respondents to a 1994 UK survey on sexual attraction. 

 

There is an ongoing debate within the asexual and medical communities about whether or not asexuality should be considered a sexual dysfunction. Following campaigning by asexual activists, the DSM-IV diagnosis Hypoactive Sexual Desire Disorder (HSDD) was redefined in DSM 5 so that people who identify as asexual would not be included under this diagnosis.   

 

There is evidence that asexuals may suffer mental health problems at a higher rate than heterosexuals.  This may be due to ‘minority stress’ (Meyer, 2003), whereby members of minority groups suffer mental health problems as a result of stigma, prejudice and discrimination.  We live in an extremely sexualised society in which sexual relationships are highly valued.  This may cause asexuals to feel marginalised and different from others, contributing to the development of mental health problems.

 

There is growing evidence that asexuals experience prejudice from the general population.  Anecdotally, asexuals frequently report encountering dismissive and minimising attitudes from family, friends and acquaintances; for example, that they have not yet met the right person or that asexuality is a symptom of some deeper problem.  Research has found that heterosexuals view asexuals as less human than other sexual minority groups, and that prejudice towards asexuals is associated with right wing authoritarianism (RWA), social dominance orientation (SDO), religious fundamentalism, sexism and gender role identification.  Heterosexuals who are familiar with asexuality and know at least one asexual person have been found to be less prejudiced towards asexuals.  This is consistent with intergroup contact theory (Allport, 1954), which states that interpersonal contact is one of the best ways to reduce prejudice towards minority group members.

 

An online survey of asexuals who have experienced psychological therapy found that some participants feared negative and invalidating treatment from clinicians, and did not disclose their asexual identity as a result.  This may be depriving asexuals with mental health difficulties of opportunities to access appropriate care and support.  Research over the past few decades has found evidence that some psychiatrists and psychotherapists hold negative attitudes towards lesbian and gay clients, and a 2009 survey of mental health practitioners found that 17% of respondents had attempted to help at least one homosexual client change their sexual orientation.   In light of these findings and the recent debates around whether asexuality should be classed as a sexual dysfunction, it seems likely that some mental health professionals may hold negative attitudes towards asexuals.

 

Aims of the current study

This research study aimed to find out how familiar with asexuality psychological therapists claim to be, to what extent they view asexuality as a problem or sexual dysfunction, and to what extent their attitudes are related to their familiarity with asexuality and other factors such as gender, sexual orientation and right wing views.  It was expected that being familiar with asexuality would be associated with more positive attitudes towards it.

 

Method

Psychological therapists in the UK were invited to take part in the study via social media, the researchers’ professional contacts and emails via lead clinicians working in several local NHS trusts.  209 psychological therapists working in the NHS and in private practice took part, including clinical psychologists, counselling psychologists, CBT therapists, family therapists and psychodynamic psychotherapists. 

 

Participants filled out an online questionnaire including measures of familiarity with asexuality, attitudes towards asexuals, a new measure of how much clinicians view asexuality as a problem, right wing authoritarianism, social dominance orientation, and bias against single people.

 

Results

Participants tended to have low scores on the attitude measures, suggesting they held low levels of prejudice and generally did not view asexuality as a problem. Results showed that, where asexuality was viewed as a problem, this was associated with prejudice towards asexuals, bias against single people, right wing authoritarianism and social dominance orientation. 

 

As expected, participants who said they had met someone asexual were less likely to view asexuality as a problem. However, this was not the case when controlling for bias against single people (singlism).  Women were less likely to view asexuality as a problem than men, however being a member of a sexual minority group did not affect participants’ views.  There was no difference in views between trainee and qualified therapists.

 

94% of the sample claimed to be familiar with asexuality.  This knowledge came mainly from participants’ own reading and personal experiences rather than through professional training.

 

Discussion

Therapists’ average scores on the CATA suggest relatively low levels of pathologisation in the current study’s sample.  However, as this is a new scale we have relatively little to compare this result to at the moment.  The range of scores on the CATA was also quite broad, with some participants scoring relatively high on the scale.  This suggests that a portion of the sample held more pathologising attitudes towards asexuality.

 

The difference in CATA scores between participants who claimed to have met someone asexual and those who did not became non-significant when controlling for singlism. It is possible that bias against single people and pathologisation of asexuality may be underpinned by similar attitudes, such as sexual normativity (i.e. the assumption that sexual attraction is the norm). This hypothesis is highly speculative, but may be worth investigating further in future research.

 

There were several limitations to the current study.  It was cross-sectional in design, so long-term outcomes and predictors of attitudes towards asexuality could not be measured.  The quantitative methodology also meant more in-depth investigation of therapists’ views was not possible. 

 

Future research should now investigate how therapist pathologisation of asexuality affects therapeutic relationships and outcomes.  This could be achieved by exploring the views and experiences of therapists and asexual clients in greater depth, perhaps using qualitative methods.  Given that familiarity with asexuality may make therapists less likely to pathologise asexual clients, it may also be helpful to investigate whether educational interventions on asexuality are associated with improved therapeutic relationships and service user experiences.  Future research could also explore the apparent overlap between pathologisation of asexuality and bias against single people, in order to find out whether any common attitudes underlie these two concepts.

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Charlie Weasley

A health practitioner said I could "go van Gogh" since I too paint and he was more interested in painting than wo\men . :P she was being sarcastic and half-laughed! Like, suggestive. ...

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