Music Therapy with LGBTQIA Clients
In honor of Pride Month, this blog post highlights how music therapy can be impactful for LGBTQIA clients at different life stages. Drawing from my diverse experiences as a music therapist, I reflect on ways music therapy can empower individuals to embrace their identity and feel more secure navigating life challenges. From teenagers questioning their sexual orientation to families coping with loss and individuals battling terminal illnesses, music therapy can provide a transformative outlet for self-expression and healing.
Wanting to Live as Your Authentic Self
Many people struggle to live as their authentic selves. Societal norms and the expectations of loved ones, or the messages received from other people over the years, can make it difficult, if not impossible, to know who you are. Sadly, in some situations, it can even be literally unsafe to be who you are, so you are forced to mask and deny vital aspects of yourself.
That is especially true if you are LGBTQIA. And even more so if you are also a transgender person of color, as many transgender people murdered are women of color. [1]
And those rates could increase due to the various legislation being passed, or attempted to being passed, in different states against gender-affirming care. That is especially true among transgender youth, as suicide is a leading cause of death for them, with about 45% considering suicide, according to The Trevor Project’s 2022 National Survey on LGBTQ Youth Mental Health. [2]
Additionally, LGBTQIA older adults face increased risks since they are 4 times less likely to have children to assist them with their care. As well, they generally have fewer financial resources than the general public. While at the same time, they may have increased health needs and may be reluctant to pursue medical care due to potential discrimination from healthcare providers.
Why LGBTQIA Rights Matter to Me
While I’m not gay, LGBTQIA rights are near and dear to my heart. As a young woman, my gay friends helped me learn a lot about myself, my relationships, and the kind of world I wanted to live in. Having studied music performance in undergrad, some of my best college experiences were with my gay male friends.
But even before college, one of my first roommates after I graduated high school, was a gay man 20 years my senior who helped open my eyes to the lives and challenges faced by those who came from different backgrounds than I did with my working middle-class suburban upbringing. The people with whom I came into regular contact living downtown with him helped me learn to be grounded and open-hearted to the pain and struggles of others.
Who I am today as an adult was partly inspired by what I learned while living with him about how social justice issues intersect. I as well learned what resiliency looks like despite poverty and oppression. These experiences were helpful to me as a young woman struggling with mental health issues who was looking for direction and purpose in life.
And these experiences continue to inform who I am as a therapist who wants to see a more just, equitable, and life-affirming society for all people.
My Experiences Providing Music Therapy to LGBTQIA Clients
Given my professional background, I have had the opportunity to work with LGBTQIA clients of all ages in mental health and end-of-life care settings. All of these clients were facing unique challenges to which their sexual orientation and identity contributed in some way. Below you can learn more about these challenges and how music helped them become more of their authentic selves.
LGBTQIA Kids and Teens
Through the years, I’ve worked with teens questioning their sexual orientation and wondering if they were “normal.” They worried about how their parents would respond if they came “out” to them. And while it may be hard or painful to believe, being rejected by their parents is a valid concern since parental rejection is a primary reason for homelessness or the risk of homelessness among LGBTQIA youth. [3]
Likewise, some of these teens were starting to learn how to navigate early romantic relationships, such as being able to identify and enforce boundaries, engage in healthy and effective communication, and manage feelings of longing and lust. While these things can be challenging for straight, cisgender teens and adults, LGBTQIA youth can face increased violence in these early romantic relationships due to their sexual orientation and/or gender.
According to the Gay, Lesbian, and Straight Education Network’s (GLSEN) 2019 National School Climate Survey [4]:
- 86.3% of LGBTQIA students experienced harassment or assault based on their identity or sexual orientation
- 58.3% of these students had been sexually harassed
And according to a report put out by the Human Rights Campaign [5]:
- 18% of LGBTQIA youth had experienced physical dating violence
- 16% of LGBTQIA youth experienced sexual dating violence.
Using Music in Working with LGBTQIA Kids and Teens
Some of the ways we used music in my work with LGBTQIA teens were through:
- Singing or listening to songs they chose and then discussing the meaning the song had to them
- Improvising vocally or on an easy-to-play melodic or percussion instrument
- Song-writing
These activities were to help them:
- Find ways to safely and positively express themselves
- Enhance self-confidence and self-esteem
- Cultivate personal insight and awareness
- Explore different perspectives of thought and being.
Adult Family Members of Hospice Patients
As a hospice music therapist, I saw firsthand that families come in all different forms. Sometimes families are large and extended, while others are small. Some families are biological, while others are not, whether through marriage or through friends who took the place of biological family.
When working with pre-bereaving and grieving families, giving them time and space for them to share their thoughts and feelings are necessary. With LGBTQIA family members (married, biological, and chosen), it’s also necessary to be aware of how their grief may be impacted, due to discrimination faced by society, lack of legal rights if they weren’t married, or a culmination of losses associated with the death of their loved one.
Using Music with Adult Family Members of Hospice Patients
When working with gay family members or same-sex couples, I use music the same way I would with any family member in their situation. These ways include:
- Singing or listening to songs they selected and sharing meaningful memories associated with them
- Song-writing
- Making music by playing small, easy-to-play percussion instruments.
Using music in these ways allowed for:
- Opportunities to express and process their feelings
- Engage with their loved ones in a deep, profound way. Using music to do this was especially helpful if their family member had Alzheimer’s or some other cognitive impairment which made it difficult for them to communicate otherwise
- Create positive memories and experiences of joy with their loved one
- Say what needs to be said and resolve what needs resolution.
LGBTQIA Adults with a Terminal Illness
Sometimes in my work as a hospice music therapist, I would work with an LGBTQIA patient. Often the family makeup looked quite different. Chosen family, or friends who are like family, helped provide care, in addition to the patient’s partner, if they had one.
Since these experiences were before same-sex marriage became legal, I knew these patients and families might have additional end-of-life care needs that didn’t apply to heterosexual married couples. For example, a reluctance to go to the doctor due to a lack of trust in the healthcare system could negatively affect pain management or getting other medical needs met. Additionally, there could be concerns about their partner’s well-being since they had no legal rights as heirs. There could also be estrangement from their biological family that would be considered heirs, which could create conflict and worry.
Using Music with LGBTQIA Hospice Patients
Some of the ways I would use music to engage with these patients and their family members were:
- Singing or listening to songs they selected and sharing meaningful memories associated with them
- Listening to songs and discussing the relevance of the lyrics to their life
- Improvising vocally or on an easy-to-play melodic or percussion instrument
- Song-writing.
The music helped them to:
- Manage physical and psychological pain
- Say what needed to be said and resolve what needed resolution
- Engage in life review
- Feel validated and heard
- Find courage, strength, and meaning
- Engage with their loved ones in a deep, profound way
- Experience positive moments with their loved ones
The Courage to Be Your Authentic Self
One of the beautiful things about music is that it can help us to cultivate the courage to live as our authentic selves without shame or guilt. Music can help us create meaning and beauty out of chaos and pain. Music can help us better understand ourselves and discover who we want to be. During this Pride month and beyond, I hope you will have the courage to be your authentic self.
If you could use some additional mental health support to help you with this, please reach out and we can schedule a consultation call.
Resources
[2] The Trevor Project 2022 National Survey on LGBTQ Youth Mental Health
[3] The Trevor Project: Homelessness and Housing Instability Among LGBTQ Youth
[4] GLSEN: The 2019 National School Climate Survey
