Homophobia and Heterosexism in Social Workers

Cathy S. Berkman and Gail Zittberg Evidence suggests that social workers may be biased when dealing with gay and lesbian populations. The study discussed in this article attempted to measure the extent of homophobia and heterosexist bias and their correlates in a cohort of 187 social workers using the Index of Attitudes toward Homosexuality, the Attitudes toward Lesbians and Cay Men Scales, and a newly created scale to measure heterosexist bias. We found that 10 percent of respondents were homophobic and that a majority were heterosexist. Levels of homophobia and heterosexism were negatively correlated with amount of social contact with homosexual men and women. Religiosity was associated with higher levels of homophobia and heterosexism, and having been in psychotherapy was associated with more positive attitudes toward gay men and lesbians. Amount of education on topics related to homosexuality was not correlated with levels of homophobia and heterosexism. Key words: gay men; heterosexism; homophobia; lesbians; social workers

ocial workers, although trained to put aside biases and to respect the diversity of cultures reflected in client populations, are susceptible to absorbing the explicit and implicit biases held by mainstream society. Gay male and lesbian populations have historically been seen not simply as different from but as somehow less than their heterosexual counterparts. Evidence suggests that social workers may be biased when dealing with gay and lesbian populations. The problems these populations experience when encountering heterosexual social workers are partially related to social workers' often unconscious bias and partially to an

information deficit concerning the gay and lesbian communities and the unique difficulties that homosexual men and women encounter living in a predominantly heterosexual society. Although homosexual clients are apt to bring many of the same problems to counseling as heterosexual clients, these problems are often exacerbated both by the heterosexual bias (or "heterosexism") of the mainstream culture and hy the real or imagined heterosexism of those to whom they turn for help. The study discussed in this article was designed to determine the nature of heterosexual social workers' attitudes toward gay men and lesbians. We also hoped to
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understand how these attitudes are related to gender, contact with gay men and lesbians, education about homosexuality, and religiosity. Review of the Literature Until 1973 the American Psychiatric Association (APA), which has historically determined the nomenclature and diagnostic criteria for clinical social work, regarded homosexuality as a psychopathology. At that time, 37 percent of the members of the APA opposed depathologization (Bayer, 1987). Homosexuality as pathology was replaced in 1973 with "ego-dystonic homosexuality," a concept that defined dissatisfaction with same-sex orientation as illness. In 1988 ego-dystonic homosexuality as well was removed from the Diagnostic atjd Statistical Manual of Mental Disorders (Haldeman, 1991). Homosexuality is still a classification category in the International Classification of Diseases (World Health Organization, 1997). Although homosexuality has ceased to be regarded as a mental illness, heterosexuality continues to be referred to as the norm, and homosexuality is still often inadvertently discussed within the context of pathology (Morin, 1977; Rudolph, 1988). Negative attitudes toward homosexuality exist on a continuum from homophobia to heterosexism. Homophobia is traditionally defined as "fear, disgust, anger, discomfort and aversion that individuals experience in dealing with gay people" (Hudson & Ricketts, 1980, p. 358) or as a "dread of being in close quarters with homosexuals" (Weinberg, 1972, p. 4). The term has come to be more broadly defined as "any belief system which supports negative myths and stereotypes about homosexual people" (Morin & Garfinkle, 1978, p. 30) and "any of tbe varieties of negative attitudes which arise from fear or dislike of homosexuality" (Martin, 1982, p. 341). Heterosexism is "a belief system that values heterosexuality as superior to and/or more 'natural' than homosexuality" (Morin, 1977, p. 629). Heterosexual bias is a more subtle concept than homophobia and entails the belief that heterosexuality is normative and that nonheterosexuality is deviant and intrinsically less desirable. Heterosexism is often manifested by individuals who would not be considered as

being blatantly homophobic or holding negative attitudes. This often subtle heterosexism permeates the culture in which social institutions and social work practice are built. Rudolph (1989) demonstrated heterosexism among mental health practitioners; his sample of master's- and doctoral-level clinicians and clinicians in training clearly held strongly positive attitudes about homosexuals in areas such as civil liberties, psychological character, and morality, yet had negative attitudes when addressing the suitability of homosexuals in sensitive professional positions. GarfinkJe and Morin (1978) found that psychologists rating case studies of hypothetical clients that were identical except for sexual orientation perceived the homosexual clients as less healthy than the heterosexual clients. Glenn and Russell's (1986) study of counseling psychology trainees found a heterosexual bias in ratings of hypothetical clients. Most studies of homophobia have been conducted with samples of undergraduates (for example, Glassner & Owen, 1976; Hansen, 1982b; Millham, San Miguel, & Kellogg, 1976; O'Hare, Williams, & Ezoviski, 1996) and other mental health professionals (Buhrke, 1989; Hayes & Gelso, 1993; Pagtolun-An & Clair, 1986; Rudolph, 1989; Smith, 1993). We are aware of only two studies that examined the nature and extent of homophobia among social workers. Both studies found that almost one-third of social workers with MSW degrees were homophobic (Wisniewski & Toomey, 1987), and one study found that social workers were more homophobic than psychologists and other mental health professionals (De Crescenzo, 1984). There is concern that inadequate attention is given to homosexuality in social work education (Hidalgo, 1992; Murphy, 1992) and that social workers and counselors who maintain homophobic attitudes are less effective, if not actually harmful, in delivering social services to gay and lesbian clients (Dulaney & Kelly, 1982; Greene, 1994; Rudolph, 1988). The consequences of these homophobic or heterosexist attitudes may be refiected in client evaluations. Rudolph reported that the source of dissatisfaction with treatment in the gay and lesbian populations was often the counselors' heterosexual bias.

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However, these findings are based on data from the 1970s and may not reflect current practice. It is clearly necessary to explore the extent of bias with more recent research because of changes that might have occurred over the past two decades as a result of the gay rights movement and the AIDS epidemic. Describing the extent of social workers' bias and its correlates is critical to understanding how bias affects clients and to modifying social work education and training to change negative attitudes. Methods Purpose of the Study The study discussed in this article included a large probability sample of social workers that has greater generalizability than the two previous studies of homophobia in social workers that relied on nonprobability samples. We used three standardized measures of homophobia, including one that distinguishes between attitudes toward gay men and lesbians, as well as an original scale that measures the more subtle attitude of heterosexism. The classification of contacts by type of relationship enabled us to test the contact theory of reduced prejudice against members of a minority group resulting from equal-status contact (Allport, 1954). We also included measures of a variety of factors that might be correlated with these attitudes. Because there have been relatively rapid changes on the societal level in issues related to homosexuality, including the gay rights movement, the AIDS epidemic, and the rise in political opposition to gay rights, it is important to have timely empirical findings on this issue. On the basis of the results of previous studies, we expected to find that heterosexual bias among social workers would be negatively correlated with education about homosexual issues (Glenn & Russell, 1986; Iyriboz & Carter, 1986; Rudolph, 1989; Serdahely & Ziemba, 1984; Uribe & Harbeck, 1991; Wells, 1991) and contact with gay men and lesbians (Glassner & Owen, 1976; Herek & Glunt, 1993; Lance, 1987; Millham et al., 1976; Pagtolun-An & Clair, 1986). The relationship between gender and homophobia was also of interest because of conflicting reports in the literature (see review

by Kite, 1984). We also explored the association established between religiosity and homophobia (for example, Herek & Glunt, 1993). The following hypotheses were tested: 1. Male social workers are more homophobic and heterosexist than female social workers. 2. Homophobia and heterosexism are greater when the gender of the respondent is the same as the gender of the target group. 3. There is a negative correlation between the number of relationship categories with a gay or lesbian acquaintance and levels of homophobia and heterosexism. 4. There is an association between the type of relationship with gay men and lesbians known and degree of homophobia and heterosexism. 5. There is a negative correlation between the extent of contact with gay men and lesbians, especially in peer relationships, and levels of homophobia and heterosexism. 6. There is a negative correlation between the amount of education on topics related to homosexuality and levels of homophobia and heterosexism. 7. Social workers who are less religious are less homophobic and heterosexist. Sample The target population for this study was heterosexual social workers holding MSW degrees. The study population was members of NASW in January 1994 who had MSW degrees. The sample frame was a random sample of 1,000 names randomly selected from NASW members in the United States. Questionnaires were sent to a systematic random sample of 376 respondents, including 188 men and 188 women. Anonymity was guaranteed, and a self-addressed stamped envelope was enclosed. Tbe response rate was 54 percent, with a total of 202 returned questionnaires, of which 189 met the eligibility criteria of heterosexual orientation as determined by an item in the questionnaire regarding sexual orientation. Two respondents were dropped from the sample because of improperly completed responses to questions

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measuring attitudes toward homosexuality. However, dropping these respondents did not change the sociodemographic characteristics of the sample or the overall response to any outcome measures (for example, means or proportions) that could be scored. Most of the 187 participants were female (72.2 percent), and the mean age was 46 years (SD = nine years). The respondents were predominantly white (91.4 percent), and the remainder were primarily African American {5.3 percent), Latino (1.2 percent), Asian (0.5 percent), and "other" (0.5 percent); 1.1 percent did not answer the question. Over two-thirds were married (70.1 percent), and the remainder were divorced or separated (13.4 percent), never married (7.5 percent), in a committed relationship (6.4 percent), or widowed (2.1 percent); one respondent did not provide a clear answer to this question. Many (71.1 percent) reported having children. The median household income was in the $65,000 to $80,000 category. Measures Hudson and Ricketts's (1980) Index of Attitudes toward Homosexuality (IAH) measures homophobia as an affective response of nonhomosexual people toward homosexual men and women. It follows Weinberg's (1972) definition of homophobia and thus differs from previous measures, which focused on attitudes toward homosexuality rather than homosexual people and on affective responses rather than cognitive or emotional responses. The IAH scale was chosen for its high reliability (.90) and good content and factorial validity. The items include statements such as "1 would feel comfortable working closely with a male homosexual" and "I would feel disappointed if I learned that my child was homosexual." Participants were asked to respond to each of the 23 statements using a five-point Likert scale ranging from 0 = strongly agree to 4 - strongly disagree, with 2 = neither agree nor disagree. We modified several items for greater relevance to the target population of social workers; the original instrument had been administered to undergraduate college students. For example, the item "I would like to have my parents know that I had gay friends" was modi-

fied to read "i would like my colleagues to know that I had gay friends." Negative items were reverse scored. Two items were dropped from the scale because they appeared to be ambiguous for the purpose of this study: "I would feel uncomfortable if I learned that my spouse or partner was attracted to members of his or her sex" and "I would feel uncomfortable kissing a close friend of my sex in public." The theoretical score range of this reduced scale is 0 to 92, with a higher score reflecting a greater level of homophobia. The reliability of the IAH in this sample, as calculated with Cronbach's alpha, was .94. A score of 0 to 22 indicates a high-grade nonhomophobic, 23 to 45 a low-grade nonhomophobic, 46 to 69 a low-grade homophobic, and 70 to 92 a highgrade homophobic. Herek's (1988) Attitudes toward Lesbians and Gay Men (ATLG) comprises two subscales: a 10-item Attitudes toward Lesbians (ATL) scale and a 10-item Attitudes toward Gay Men (ATG) scale. Sample items in the ATL scale include "A woman's homosexuality should not be a cause for job discrimination" and "Lesbians just can't fit into our society." Sample items in the ATG scale include "The idea of male homosexual marriage seems ridiculous to me" and "Male homosexuality is merely a different kind of lifestyle that should not be condemned." These two scales were originally administered with nine-point Likert-type response categories (Herek, 1988) and also with three-point response categories (Herek & Glunt, 1993). We modified the items to be rated according to the same five-point response categories as the IAH. The items were coded from 1 to 5, and negative items were reverse scored. We dropped one item from each of the ATL and ATG scales because of similarity to other items in the questionnaire. Each nine-item scale had a theoretical score range of 9 to 45, with a higher score reflecting a more homophobic attitude. For the present study, the internal consistency (alpha) coefficients were .90 for the ATG scale and .92 for the ATL scale. An original 13-item scale was designed to measure heterosexism. We also scored this scale using the five-point response categories used for the IAH and ATLG scales. Negative items

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were reverse scored. The theoretical range of scores is 13 to 65, with a higher score reflecting a greater level of heterosexism. The Cronbach's alpha is .82. The Marlowe-Crowne Social Desirability Scale (Crowne 8c Marlowe, 1960) was included to determine the degree of response bias by assessing the tendency to respond in a culturally acceptable manner. The theoretical scoring range of this scale is 10 to 20, with a higher score reflecting a greater socially desirable response set. We created the Relationship Categories Known Scale, which lists 22 types of relationship and asks respondents to indicate whether they are acquainted with at least one person in that category who is or might be gay or leshian. This list includes spouse, former spouse, lovers, former lovers, parents, children, siblings, friends, neighbors, classmates, supervisors, colleagues, clients, teachers, employers, employees, interns, secretaries, messengers, hairdressers, shopkeepers, and others (write-in category). The scores were determined hy summing one point for each relationship category in which the respondent knew someone who was gay or lesbian. The scale has a theoretical scoring range ofOto22. The following subscales were also created: Categories of Relatives Known Scale (parents, children, siblings). Categories of Peers Known Scale (friends, neighbors, classmates, and colleagues). Categories of Superiors Known Scale (supervisors, teachers, and employers). Categories of Clients and Subordinates Known Scale (clients, employees, interns, and secretaries), and Categories of Distant Persons Known Scale (messengers, hairdressers, and shopkeepers). Clients were included in the category with subordinates because social workers are actually or perceived to be in a position of authority over clients. The intercorrelations between the pairs of subscales indicated that the relatives subscale was very weakly and not significantly correlated with the other subscales, but that there were moderate or strong correlations between each of the other pairs of subscales. We created the Contact with Homosexuals Scale by asking respondents whether they had a great deal of contact, a moderate amount of

contact, a little contact, or no contact with at least one gay or lesbian person in each of the 22 categories of relationship. The scores were determined by summing the responses to these items; a higher score reflected a greater amount of contact. Subscales of the contact scales were created according to the same categories as the Relationship Categories Known subscales. We created an Education Scale to measure the amount of education that respondents had received on topics related to homosexuality either in an MSW program or subsequently. Topics included HIV/AIDS, family issues, psychopathology, transference and countertransference, parenting, public policy, human development, substance abuse, and others. Participants were asked to indicate the amount of education they had received on each topic on a scale ranging from 0 = none to 3 = a great deal. The theoretical scoring range of this scale isO to 81, with a higher score reflecting a greater amount of education on issues related to homosexuality. The Cronbach's alpha is .96. To measure sociodemographic characteristics, participants were asked what their highest social work degree was, the year it was received, the number of years as a social worker, and current work capacity. Religiosity was measured by asking respondents to indicate true or false to the statement, "Religion is an extremely important aspect of my life." Respondents were also asked whether they had undergone any form of psychotherapy either currently or in the past.
Results

According to norms established by Hudson and Ricketts (1980), slightly more than one-quarter (26.7 percent) of the respondents were highgrade nonhomophobic, 62.0 percent were lowgrade nonhomophobic, 10.7 percent were lowgrade homophobic, and only one respondent (0.5 percent) was high-grade homophobic. Normative cutoff points are not available for the ATL, ATG, and Heterosexism scales; however, the item mean scores for these scales are informative (Table I). The item means for the ATG and Heterosexism scales indicate that, on average, respondents agreed, but not strongly, with the positive statements about gay men and

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all homosexual people, respectively. The item

mean for the ATL scale indicated that, on average, respondents were midway between agreeing and strongly agreeing with positive statements about lesbians. Gender Differences Men were more homophobic than women on each of the three scales measuring homophobia, although these differences were not statistically significant. A significantly greater degree of homophobia was expressed by both genders toward gay men (ATG scale) than toward lesbians (ATL scale), but this difference was virtually the same for both genders. The concordance of gender did not appear to be a factor, and the differential between men and women was slightly greater in relation to lesbians than gay men. There were no significant differences in mean scores on the IAH and ATG and ATL scales according to age, marital status, being a parent, income, highest graduate degree (MSW or doctorate), or whether primary work capacity was in direct service provision. Scores on the Heterosexism Scale indicated that men were significantly more heterosexist than women. Age was also associated with scores on the Heterosexism Scale, with younger respondents having lower scores (age 28 to 40 = 26.8, age 41 to 50 =28.6, age 51 to 70 = 30.4,p<.05).

There were weak but significant positive correlations between the Crowne-Marlowe Scale
and the IAH and ATL and ATG scales. The correlation between the Crowne-Marlowe Scale and the Heterosexism Scale was not significant. However, the direction of these correlations was opposite that which would be expected if a socially desirable set was influencing responses to the items on the homophobia scales. These analyses increase our confidence in the validity of scores on the four attitude scales. Categories of Relationships with Gay Men and Lesbians We tested the first hypothesis by analyzing the intercorrelations between the Relationship Categories Known Scale and subscales with each of the four attitude scales. We found a negative correlation between the number of relationship categories with a homosexual acquaintance and levels of homophobia and heterosexism (Table 2). The strongest correlations were seen for the total Relationship Categories Known Scale, with strong correlations for the Categories of Peers Known Scale and the Categories of Distant Persons Known Scale. It appears that relationships with peers and superiors had a more positive influence on levels of homophobia and heterosexism than did relationships with people of a lower status. The low correlation with relatives known may resuh from the extremely low mean for this subscale.

Table I

Social Workers' Mean Scores on Scales Measuring Attitudes toward Homosexuality and Heterosexism, by Gender {N = 187)
Gender IAH ATL ATG Heterosexism Scale ATG-ATL'

4.1*** 30.5 15.5 19.6 Men ( n - 5 2 ) 31.7 27.9 Women (ti = 135) laa 2.6* Men-women'' 2.1 1.7 1.S 4.2*** 30.2 183 Total sample ai4u 2.1 2.2 1.3 1.6 Item means for total sample NOTES: IAH = Index of Attitudes toward Homosexuality (Hudson 8c Ricketls, 1980); ATL = Attitudes toward Lesbians scale (Herek, 1988); ATG = Attitudes toward Gay Men scale (Herek, 1988). Range for IAH item.s was 0 to 4; range for the other scale items was 1 to 5, with the low score representing less homophobia or beterosexism. Paired / test on difference between means for tbe ATG and tbe ATL scales. ''Independent samples rtest on difference between means for men and women. *p<.05. ***p<-001. Social Work j Volume 42, Number 4 / July 1997

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Table 2

Correlation Coefficients for the Relationship Categories, Contact, and Education Scales and Subscales with Scales Measuring Attitudes toward Homosexuality and Heterosexism (N = 187)
Heterosexism ATG Scale Relationship Categories Known Scale _ 29*** 5.02 -.41*** -.36*** -.36*** Categories of Relatives KnownScale .09 -.05 -.00 -.02 -.05 Categories of Peers Known Scale -.34*** 2.26 -.26*** -.31*** -.33*** Categories of Superiors Known Scale .66 -.27*** -.15* -.22** -.20** Categories of Clients and Subordinates Known Scale 1.12 -.21** -.18** -.23*** -.23*** Categories of Distant Persons Known Scale .59 -.30*** -.26*** -.26*** -.26*** Contact with Homosexuals Scale _ 42*** 8.81 -.24*** -.34*** -.38*** Relatives Contact Scale .26 -.14 -.05 -.07 -.09 _ 42*** Peers Contact Scale 4.12 -.25*** -.34*** Superiors Contact Scale .98 -.24*** -.11 -.18** -.17** Clients and Subordinates Contact Scale _ 29*** 2.21 -.26** -.16* 22** Distant Persons Contact Scale .81 -.32*** -.23** -.29*** -.28*** Education Scale 26.4 .02 .08 .003 -.02 Ks: IAH = Index of Attitudes toward Homosexuals Scale (Hudson & Ricketts, 1980); ATL = Attitudes toward Lesbians scale (Herek, 1988); ATG = Attitudes toward Gay Men scale (1988). The means for Relationship Categories Known Scale and the Contact with Homosexuals scale are slightly higher than the sums of the subscale means because of the inclusion of "others" in the total scales. */)<.O5. **/)<.Ol. ***p<.001. Variable M

IAH

ATL

Amount of Contact with Gay Men and Lesbians The patterns seen in the correlations between the number of gay men and lesbians known and the attitude scales were very .similar to those seen between the Contact with Homosexuals Scale and the attitude scales (Table 2). As with the Relationship Categories Knovm Scale, correlations tend to be weaker in relation to the ATL scale compared to the other three attitude scales. Education on Topics Related to Homosexuality The hypothesis that amount of education received on topics related to homosexuality is negatively correlated with homophobia and heterosexism was not supported. The correlations between the Education Scale and the IAH and the ATL, ATG, and Heterosexism scales were all weak and not significant (Table 2). Respondents had a mean scale score of 26.4, although there was wide variability in scores {SD - 15.7). The item mean score was 1.1 {SD = .31), indicating that most respondents had only "a little" education on any of the 27 topics. Religiosity and Psychotherapy Analyses of the relationship between religiosity and homophobia were based on a priori reports

in the literature, whereas analysis of the relationship between psychotherapy and homophobia was exploratory. We found that both religiosity and psychotherapy were associated with homophobia and heterosexism as measured by the four attitude scales (Table 3). The mean scores for each of the four attitude scales were significantly greater, indicating a higher level of homophobia and heterosexism, for social workers who responded that religion was an extremely important aspect of their lives. Respondents who were currently undergoing or had undergone some form of psychotherapy in the past had significantly lower mean scores on each of the attitude scales, an indication of lower levels of homophobia and heterosexism among these individuals. Hierarchical Regression Hierarchical regression models were estimated by regressing each of the attitude scales on the independent variables examined in the analyses shown in Tables I through 3 and potential modifying variables. We found that either the Relationship Categories Known Scale or the Contact with Homosexuals Scale, but not both, was significant in each of the models. The Edu-

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Table 3

Mean Scores on the Scales Measuring Attitudes toward Homosexuality and Heterosexism, by Religiosity and Psychotherapy Measures {N = 187)
Measure IAH ATL ATG 20,6*** Heterosexism Scale 30.6*** 26.5 27.6** 31.5

Religiosity 33 4*** 16.2*** Yes 26.8 . 12.4 No Psychotherapy 27.9*** 13.4** Yes 16.8 36.6 No IAH = Index of Attitudes toward Homosexuals (Hudson & Ricketts, scale (Herek, 1988); ATG = Attitudes toward Gay Men scale (Herek, 1988). Results of t tests: *p < .05. **p < .01. ***p < .001.

16.4
17.4*** 21.7

1980); ATL = Attitudes toward Lesbians

cation Scale had a small but significant effect in the model estimated for tbe IAH and was not significant in any of the other models. Having undergone psychotherapy reduced the homopbobia score on each of the attitude scales by approximately 5 percent (for tbe Heterosexism Scale) to 9 percent (for the ATG Scale) of the theoretical range, depending on tbe scale. Social workers who responded that religion was extremely important to them had homophobia scores on each of the attitude scales that were 4 percent (for the IAH Scale) to 9 percent (for tbe ATG Scale) bigber than those wbo said religion was not very important. Discussion We found tbat the overwhelming majority (almost 90 percent) of tbese social workers were not homophobic. Social workers in this study were significantly less homophobic [xH3, N 264) = 229.98, p < .001 ] than those who participated in Wisniewski and Toomey's (1987) study. Compared with a national sample of adults who were asked five of tbe items in the ATG scale (Herek & Glunt, 1993). social workers in our sample were significantly less bomophobic on all five items [xH2, N = 1,138 to 1,189) ranged from 67.12 to 327.25, p < .001]. However, in addition to the approximately 10 percent who were homophobic, a majority of respondents had heterosexist attitudes. A score of 13 on the Heterosexism Scale represents the absence of beterosexist attitudes, and the mean

for tbis study was over 15 points higher. Although further work in establishing the reliability, validity, and meaningful cut points for the Heterosexism Scale is necessary, the face and content validity of this scale lend credence to the importance of this finding. Gender Differences Although a number of studies found higher levels of homophobia in men than in women (for example, Glassner & Owen, 1976; Hansen, 1982b; Herek, 1984, 1988; Herek & Glunt, 1993; Kite, 1984; Millham, San Miguel, & Kellogg, 1976; Weinberger & Millham, 1979), " our finding that level of homophobia did not differ according to gender was consistent with more recent reports (O'Hare et al., 1996; Royse & Birge, 1987; Royse, Dhooper, & Hatch, 1987). including a meta-analysis of 24 studies (Kite, 1984), and with the study of homophobia in social workers (Wisniewski & Toomey, 1987). The Heterosexism Scale did indicate that women were significantly less heterosexist than men. We also found that levels of homophobia were significantly greater in relation to gay men than lesbians, and this was the case for both men and women. This result may be due to less rigid views about sexuality in relation to women than men; stereotypes about predatory sexual behavior and pedophilia in gay men; and, more recently, fear of AIDS. We replicated the finding of higher levels of homophobia in relation to gay men among

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heterosexual men compared with women (for example, Herek, 1988; Kite, 1984; Millham et al., 1976; Yarber & Yee, 1983), although this difference was not significant. We did not find a higher level of homophobia in relation to lesbians among heterosexual women compared with men. Although Herek (1988) did find higher levels of homophobia toward lesbians among his female respondents, the magnitude of this difference was smaller than seen in relation to gay men, and be noted that previous studies have often found no differences between male and female respondents in attitudes toward lesbians. Age Our finding of no significant differences in levels of homophobia by age is supported by previous studies (Herek & Glunt, 1993). Our findingof significantly lower levels of heterosexism among younger respondents remains to be replicated. Knowing a Gay or Lesbian Individual We confirmed previous reports of a negative association between knowing a gay or lesbian person and homophobia (Allport, 1954; Hansen, 1982b; Herek & Glunt, 1993; Lance, 1987; Millham et al., 1976; O'Hare et al., 1996; Pagtolun-An & Clair, 1986). By examining findings according to the type of relationship, we found that the number of types of homosexual relatives and amount of contact with them were not related to level of homophobia or heterosexism, although this may be due to the extremely low numbers of homosexual relatives reported. Our data supported Allport's (1954) findings that prejudicial attitudes are reduced when there is peer contact with members of the minority group. Marmor (1980) suggested that interactions with gay men and lesbians provided information that reduced ignorance and minimized negative stereotypes. It is possible that there is a reverse causal direction and that people with lower homophobia and heterosexism choose to have friends who are homosexual more often than do those who are homophobic or heterosexist. It is unlikely that this temporal sequence entirely explains this correlation for two reasons. First, the three

other relationships that make up the Categories of Peers Known Subscale are not voluntary. Second, having a friend who is gay or lesbian accounts for only half of the scale score for over 90 percent of the respondents and only onethird of the scale score for almost two-thirds of the respondents. Similarly, amount of contact with a friend who is homosexual accounts for only half of the scale score for over 80 percent of the respondents and only one-third of the scale score for almost half the respondents. A possible shortcoming is the way the measures of number of types of relationships with a homosexual person and amount of contact were constructed. These variables did not count the total number of people known who were gay or lesbian or the total amount of contact with homosexual individuals. Rather, these items determined whether or not there was at least one person in that relationship category who was homosexual and the amount of contact with that individual. Although this method does not measure the number known or amount of contact, the scores may be valid as indicators of the relative differences in these measures between respondents, and more important, the relationships with the attitude scales may be correctly reflected. Future research that includes measures of the total number of gay men and lesbians known by the respondent and the amount of contact with those individuals is necessary to resolve this issue. Education on Gay and Lesbian Issues Our finding of no association between social workers' attitudes and education was at first surprising in view of previous research that indicated that education has been effective in changing attitudes (Anderson, i981;Christensen & Sorensen, 1994; Iyriboz & Carter, 1986; Rudolph, 1989; Serdahely & Ziemba, 1984; Uribe & Harheck, 1991; Wells, 1991). It should be noted that many of these studies did not use an experimental design, did not have appropriate comparison groups, and measured only short-term effects of the targeted educational intervention in which participants, often undergraduates, were most likely aware of the goals of the intervention. Although it is possible that our measure of education may not be sensitive to

Berkman and Zinberg / Homophobia and Heterosexism in Sociai Workers 327

factors that are salient to homophobia and heterosexism, it appears that whatever education is received is of negligible long-range effectiveness. Religiosity The meaning of the association between attitudes and religiosity is complex. Previous studies have found that people who are more religious, have more conservative religious beliefs, and attend church frequently are more homophobic (Cameron & Ross, 1981; Glassner & Owen, 1976; Hansen, 1982a; Herek & Glunt, 1993). Allport and Ross (1967) made a distinction between extrinsic and intrinsic orientations to religion. An extrinsic orientation reflects a conventional, instrumental approach, whereas an intrinsic orientation reflects an internal, meaning-based approach. They found that an extrinsic orientation tends to be positively associated with prejudice, whereas an intrinsic orientation stresses love, tolerance, and acceptance of differences. Herek (1987) explored the association between religion and attitudes toward gay men and lesbians and found no significant correlation between intrinsic versus extrinsic orientation and homophobia. Instead, degree of orthodoxy, whether extrinsic or intrinsic, was positively correlated with homophobia. Our measure of religiosity was based on a single item that did not allow us to fully explicate the nature of the association with homophobia and heterosexism. Future studies would benefit from a more comprehensive conceptualization and measurement of religion, including denomination and religiosity, to understand their meaning in relation to attitudes toward homosexual people. Having Been in Psychotherapy The association between having been in psychotherapy and more positive attitudes toward gay men and lesbians was intriguing. This association was based on an exploratory analysis for which there was no a priori hypothesis. It is possible that psychotherapy leads to questioning and subsequently reducing one's biases toward gay men and lesbians, either consciously or unconsciously. Alternatively, social workers

who are more open-minded about homosexuality may also be more receptive to engaging in psychotherapy. Understanding the dynamics of this association will require more extensive study and may provide clues to methods for reducing homophobia and heterosexism. Study Limitations The response rate of 54 percent, although respectable for a mail survey, raises concern about selection bias and the generalizability of the results. There is also a possibility of misclassification of sexual orientation of respondents on the basis of self-report, despite the guarantee of anonymity. This possibility is more likely to resuh in underestimation of the levels of homophobia and heterosexism. i Effects on Treatment The existence of homophobia in social workers who work with AIDS patients (Wiener & Siegel, 1990) and the high prevalence of social workers who indicate their reluctance to work with people with AIDS (Dhooper, Royse, & Tran, 1987-88) are of particular concern. But the existence of negative attitudes toward gay men and lesbians in professional social workers is troubling regardless of a client's HIV status. Hayes and Gelso (1993) found that homophobia in male counselors predicted their discomfort with gay male clients and that even moderate levels of homophobia can interfere with counseling. Homophobia affects transference and countertransference and may lead to inappropriate choices of treatment modality and treatment goals (Cabaj, 1988; De Crescendo, 1984; Gelso & Carter, 1985; Singer & Luborsky. 1977). Greene (1994) noted that therapists may commit errors in the treatment of homosexual clients that can occur along a continuum ranging from minimizing tbe importance of the client's sexual orientation and the negative effects of heterosexism (Garnets, Hancock, Cochran, Goodchilds, & Peplau, 1991; Youngstrom, 1991) to viewing homosexual orientation as the pathological underlying cause of all of the client's problems (Garnets et al., 1991; Markowitz, 1991). The long history of antihomosexual bias and lack of acceptance of gay men and lesbians in American society is related

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to the higher rates of depression, anxiety, substance abuse, and other psychological distress among this population (Morrow, 1993; Rudolph, 1988,1989; Ziebold & Mongeon, 1982). It is important that social workers not only respond to clients in an unbiased manner but also understand how such biases may have contributed to the problems with which clients are coping. Increased Visibility of Gay Men and Lesbians The finding that social contact is correlated with homophobia and heterosexism underscores the importance of greater visibility of gay men and lesbians among social workers, both in schools of social work and in the workplace. Herek (1984) suggested that interactions among equal-status individuals with common goals should lead to a decrease in heterosexism. Schools and agencies alike can encourage more visibility from within by advocating gay-positive and lesbian-positive policies that directly and indirectly encourage visibility. For example, providing job-related benefits to same-sex domestic partners of faculty or staff not only would be an incentive to gay men and lesbians to be open about their sexual orientation, but also would make a powerful statement to all individuals at that institution. Visibility can be encouraged within social work schools through the existence of on-campus gay and lesbian organizations for students that provide on-campus visibility as well as student speakers to social work classes. Social workers need to be especially vigilant in opposing the ways, overt and covert, that visibility is discouraged. Education and Training Numerous suggestions have been made regarding the need for more training and education about gay and lesbian issues for mental health professionals (Buhrke, 1989; Cabaj, 1988; Garnets et al., 1991; Graham, Rawlings, Halpern, & Hermes, 1984; Greene, 1994; Murphy, 1992; Proctor & Groze, 1994; Youngstrom, 1991) and social workers in particular (Dulaney & Kelly, 1982; Gramick, 1983; Morrow, 1993). Herek (1991) suggested several possible reasons that might explain the effectiveness of educational programs in changing attitudes toward homo-

sexuality and proposed further research directed toward understanding which factors resulted in the attitude change. A formal policy on the inclusion of sexual orientation content in social work education is itself a relatively recent phenomenon. The Council on Social Work Education (CSWE) Curriculum Policy Statement in 1983 formally mandated schools of social work to address the area of sexual orientation (Murphy, 1992). Hidalgo (1992) emphasized the importance of integrating content on a wide range of topics related to homosexuality throughout all areas of the curriculum, including not only practice but also administration, human behavior, policy, research, and field work. Forrister (1992) suggested several modalities for integrating content on homosexuality into direct practice courses. Several authors (for example, Gramick, 1983; Morrow, 1993) have advised social workers to have self-awareness of their own homophobia and how it affects their practice with clients. Murphy (1992) maintained that mental health professionals should be taught tbat it is unethical for them to work with homosexual clients unless they have a positive view about homosexual lifestyles. She advocated that professional organizations such as NASW and CSWE become forums for ensuring that statements regarding the need to educate social workers about the concerns of gay men and lesbians are adhered to, that openly homosexual individuals are elected to offices within these organizations, that the CSWE accreditation board review the curriculum to determine the adequacy of information on gay and lesbian topics, and tbat content on homosexuality be included in licensing exams.
Conclusion

Research should be undertaken so that the profession may better understand how education about homosexuality might reduce homophobia and heterosexism. Social workers need to learn about the format and content that are most effective in communicating a lasting message. Research is also needed to understand how negative attitudes toward gay men and lesbians are related to service delivery outcomes, including effectiveness and client satisfaction.

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