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Book Reviews   |    
Affirmative Practice: Understanding and Working With Lesbian, Gay, Bisexual, and Transgender Persons
Reviewed by Jack Drescher, M.D.
Psychiatric Services 2005; doi: 10.1176/appi.ps.56.5.618
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by Ski Hunter and Jane C. Hickerson; Washington, D.C., NASW Press, 2003, 417 pages, $44.99

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Ski Hunter and Jane C. Hickerson are professor and assistant professor, respectively, in the School of Social Work at the University of Texas at Arlington. They have written Affirmative Practice: Understanding and Working With Lesbian, Gay, Bisexual, and Transgender Persons as a textbook for "graduate and undergraduate … students in applied human services fields (for example, social work, counseling, mental health, nursing, psychology, sociology, and education). In social work, where content on LGBT [lesbian, gay, bisexual, and transgender] persons is required, the book can be used in several of the core courses: human behavior, direct practice, and oppressed populations." I also think psychiatric residents—as well as any of their curious supervisors who are not knowledgeable about issues affecting lesbian, gay, bisexual, and transgender persons—will find much of value here.

The authors have done a thorough job of covering a wide range of topics in a text that is readily accessible to both uninformed readers and those with only a passing knowledge of these issues. Some of the areas they touch on are community development, "Sexual Orientation, Sexual Identities, and Evolving Identifications," coming out, parenting, "Requirements of Practitioners and Social Service Agencies," and practice interventions at the individual, family, and macrocultural levels. They also have written chapters focusing on the special needs of lesbian, gay, bisexual, and transgender youths; midlife; and aging.

There is much of value in this textbook. The authors' description of the nature and consequences of workplace discrimination is well written and informative. There are clear definitions regarding the contemporary understanding of sexual orientation and sexual identity, and attention is given to research involving ethnic and racial minority groups. Extensive references are provided at the end of the introduction and each of the text's 14 chapters. In fact, the book's bibliography is a resource for anyone who is interested in doing further research on these issues, because it covers much of the relevant social science literature on homosexuality.

The volume is unapologetically gay affirmative, which is its major strength but sometimes a weakness. Although the book is statistically informative, the authors are less then dispassionate when they touch on the subject of violence against lesbian, gay, bisexual, and transgender individuals. The authors often speak with the voice of forceful authority, which may be necessary in a text intended to help students decide how to think about a culturally charged subject. However, it can leave naive readers little room to question some of the authors' conclusions. For example, they cite one study to support the claim that people who hold antihomosexual values are "less empathic" or use "denial, isolate or turn from others, or look for blame outside themselves." Even to this sympathetic reader, that sounds like overkill.

However, such occasional lapses do not undermine the scholarship underlying the broad synthetic task of the authors. If a visitor from another planet were charged with learning about America's lesbian, gay, bisexual, and transgender culture in a brief period, that individual would undoubtedly find Affirmative Practice an invaluable guide.

Dr. Drescher chairs the American Psychiatric Association's committee on gay, lesbian, and bisexual concerns and is author of Psychoanalytic Therapy and the Gay Man.

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