Queermusictherapyforweb Bain Grzanka Crowe 2016
Queermusictherapyforweb Bain Grzanka Crowe 2016
Queermusictherapyforweb Bain Grzanka Crowe 2016
Music Therapy
Psychotherapy.]
Interest in music therapy with lesbian, gay, bisexual, transgender, and queer (LGBTQ)
individuals has increased in the last decade. The distinctive needs of the community have been
acknowledged through the publication of LGBTQ best practices in music therapy (Whitehead-
Pleaux et al., 2012). A survey of U.S. music therapists’ attitudes towards the LGBTQ community
received 409 responses in the first two months. These respondents demonstrated progress in
music therapists’ understanding and knowledge of LGBTQ issues, but at the same time, more
than half of the respondents did not feel adequately prepared to work with LGBTQ clients
(Whitehead-Pleaux et al., 2013). Queer, in the context of this paper, denotes both a) individuals
who identify as any non-conforming sexual or gender identity (including lesbian, gay, bisexual,
that reject heteronormative sexual and gender politics. Given the complicated and fraught history
of the medicalization of sexuality and gender (Bland & Doan, 1998; Bryant, 2006; Foucault,
1978; Terry, 1999), the constitution of LGBTQ youth in particular as an at-risk group (Cover,
2012; Waidzunas, 2012), and music therapists’ increased interest in conducting affirmative
therapy with sexual minority and gender nonconforming clients, it is critical to identify the
potential challenges of putting queer youth under the disciplinary microscope of music therapy.
In other words, developing multicultural competencies around LGBTQ issues in music therapy
may be more complex than simply including or incorporating diverse sexual orientation and
gender identity issues into an existing disciplinary framework that has been historically hostile
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towards non-normative sexualities and genders (Ahmed, 2012; Epstein, 2007). The challenges of
conducting music therapy with LGBTQ populations within community settings has been
documented in very few sources, and this deficit in music therapy literature inspired this
interdisciplinary framework to think through these challenges. Music therapists have called for
serious consideration of queer theory in music therapy (Hadley, 2013), but at this time, it appears
that such a call has remained unaddressed in the mainstream scholarship of the discipline.
Accordingly, this work attends to a critical area of music therapy research, training, and practice
insomuch as it constructs a distinct paradigm for approaching music therapy with LGBTQ
challenges the concept of normal and fixed identities (Stein & Plummer, 1994; Sullivan, 2003).
At the time of this publication, there were no published articles specifically on queer theory
applied to music therapy with LGBTQ clients. In order to address this dearth of literature on
what might be termed “queer music therapy,” this project investigates queer theory and applies
its theoretical concepts to music therapy interventions. The ideas of foundational queer theorists
Michel Foucault (1978), Eve Kosofsky Sedgwick (1990, 2005), and Judith Butler (1993) were
especially influential for this project. Foucault (1978) situates sexuality within historical and
cultural struggles over power and knowledge, and Butler (1993) applies this theory to
heterosexual identity into an unspoken imperative. Sedgwick (1990) argues that the structured
homo/hetero binary opposition is limiting and that language impacts understandings of sexual
identities. These perspectives – among many other emergent concepts in queer theory today –
can advance how music therapists currently approach working with this population and interpret
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music therapy experiences with LGBTQ clients. For example, statistics that circulate in the
media nearly uniformly posit LGBTQ youth as a fundamentally at-risk and vulnerable
within a music therapy setting, rather than focusing on their implied vulnerability (Butler, 2004;
Cover, 2012; Erwin, 1993; Grzanka & Mann, 2014; Puar, 2012; Rofes, 1983; Waidzunas, 2012).
Relatively little music therapy research has focused specifically on queer theory (Hadley,
2013), thus the literature for this project is richly interdisciplinary and includes scholarship from
sexuality studies, LGBT psychology, counseling psychology, and the psychology of music, in
addition to formative research in music therapy. We argue here that the theoretical insights of
these diverse fields can be synergized to empower queer youth within a therapeutic environment
that is radically – as opposed to superficially – inclusive. First, we introduce and survey key
developments in queer theory. Second, we explain how queer theory may complement and
challenge recent developments in inclusive and social justice-based music therapy approaches.
Then, we outline several potential therapeutic interventions for use with LGBTQ youth that
reflect queer theory. Finally we discuss the broader implications of queer theory for music
therapy, including both practice and research that might move the field toward a radically
Review of Literature
Psychological problems can arise from a function of interactions within relationships and
systems, including interpersonal relationships, family, community, society, and culture (Crowe,
2004). This model of viewing psychological issues is the most applicable to LGBTQ issues, as
their mental health and disorder in relationships typically has more to do with society and culture
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than biology or epigenetics. Heterosexism refers to the structural disadvantages faced by sexual
minorities, including the assumption that everyone must be heterosexual (Hadley, 2013).
perceived to be gay, lesbian, or otherwise non-heterosexual (Cerny & Polyson, 1984; Herek,
2004; Morrison & Morrison, 2002). Heterosexual relationships are celebrated and reinforced
while queer relationships are marginalized. Similarly, transphobia denotes prejudicial attitudes
with the sex they were assigned at birth (i.e., those who are not “cisgender,” the term used to
denote persons who identify with the sex they were assigned at birth (Schilt & Westbrook,
2009)). Due to these systemic social forces and cultural attitudes, LGBTQ adolescents in the 21st
century United States are particularly vulnerable to mental and physical health issues. Many of
these youth are members of non-accepting families and also experience verbal harassment,
exclusion from activities, fear of being open about their identity, and issues with depression
(Human Rights Campaign, 2013). Research also reveals that LGBTQ youth are at increased risk
of suicidal ideation (Clements-Nolle, Marx & Katz, 2006; Liu & Mustanski, 2012; Silva, Chu,
Monahan, & Joiner, 2015) and homelessness (Durso & Gates, 2012). Thus, despite some
evidence suggesting changing attitudes toward sexuality and gender (McCormack, 2012), openly
identifying as LGBTQ in today’s social and political climate may have social, legal, physical,
For LGBTQ youth, these common struggles may also interfere with identity
development, one of the major tasks of adolescence, if youth are not provided with a support
system and effective coping tools (Fassinger & Arseneau, 2007). Psychologists have determined
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that music is a strong influence on today's youth and adolescents use music as a tool to express
and formulate identity (Tarrant, North, & Hargreaves, 2002). Forming musical preferences
generational identity that is independent of parents and teachers, and corresponds with the shift
from family to peer orientation (Hodges & Sebald, 2011). Conclusively, adolescents’ use of
music for impression management helps facilitate the transition to adulthood, as a sense of
personal identity guides interpersonal behavior and signifies optimal psychological health
(Schlenker, 1985; Waterman, 1992). LGBTQ adolescents may turn to listening to music
congruent with their sexual identity for support while growing up. Therefore, music therapy may
be an effective treatment for LGBTQ adolescents who are struggling with intolerance and need
professional support.
Due to the increased amount of research in the past 30 years on stigma against the
LGBTQ population (Sullivan, 1994), there is an increased awareness of LGBTQ youth facing an
array of problems in their respective homes, schools, and communities (e.g., Cianciotto & Cahill,
2012; Gray, 2009; Pascoe, 2007). Knowledge of their issues is critical to provide quality care for
this population. Family acceptance is a critical indicator of positive mental and physical health
for LGBTQ adolescents (Ryan et al., 2010), however, recent survey research revealed one-third
of these adolescents are experiencing family rejection and one-half report that they often hear
negative messages about being LGBTQ at home (Human Rights Campaign, 2013). Many
LGBTQ adolescents – and those who are perceived to be LGBTQ – also report verbal
harassment because of their sexual orientation or the way they express their gender (Cianciotto &
Cahill, 2012; Pascoe, 2007; Watson & Miller, 2012; Robinson, Espelage, & Rivers, 2013).
Recent survey results additionally found that more than half of LGBTQ students experience
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some form of cyber-bullying, four out of ten LGBTQ students have been physically harassed at
school, and one of five have been the victim of physical assault at school (Kosciw et al., 2011).
The prevalence of these issues demonstrates that these problems are a social and public health
issue, and those in health and human service professions should receive training on LGBTQ
cultural competence.
The increased dissemination of alarming statistics regarding LGBTQ youth has helped
construct “gay youth” as an at-risk identity category (Waidzunas, 2012). The LGBTQ youth
population is often associated with mental illness and suicide risk, which has made LGBTQ
youth an area of clinical investigation. According to Waidzunas (2012), Cover (2012), and others
(e.g., Essig, 2010) this is potentially problematic for queer youth insomuch as this research may
queer people and mental illness (Foucault, 1978). Further, as Grzanka and Mann (2014) argue,
public discourse on queer youth suicide reveals the perception of suicide as the product of an
homonegativity manifested in bullying and social exclusion. For example, the “It Gets Better”
project was a widely viewed suicide prevention Internet-based campaign that began in 2010 as a
response to the increased media attention of queer youth suicides. The goal of these videos was
to prevent suicides of gay teenagers by telling this population that their lives would improve
(Cover, 2012; Grzanka & Mann, 2014). Overall, “It Gets Better” tries to inspire hope and
encourages queer youth to wait patiently through the challenges of their youth for the “better”
life of adulthood. However, some scholars argue that this campaign narrowly focuses on
individual resilience and does not address sexuality as a system of power and inequality
(Grzanka & Mann, 2014). These queer theory-informed criticisms of advocacy grounded in
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spurious statistics and popular psychology have implications for therapeutic interventions with
LGBTQ youth. They suggest a therapeutic orientation that resists undefined ideas of hope in the
face of attributed vulnerability, and instead focus on understanding and negotiating systems of
oppression while providing opportunities for empowerment (cf., Goldstein, 2012; Pascoe, 2013).
There is currently a limited amount of research on LGBTQ issues in music therapy, and
much (if not all) of the available research has been published within the last 15 years. A review
of current music therapy literature revealed little exploration of queer theoretical ideas. Though
not directly related to queer theory, the recently published music therapy articles regarding
working with LGBTQ populations demonstrate a trend towards the issues raised by queer theory.
A team of music therapists recently conducted a survey designed to explore the attitudes and
actions of music therapists regarding LGBTQ issues, and they found that over half of the 409
respondents did not have any training regarding LGBTQ issues, and a majority of those who did
have training still reported that they did not feel prepared to work with the LGBTQ community
(Whitehead-Pleaux et al., 2013). Many respondents also reported that they do not use gender-
neutral music or language and that their choices of songs for music therapy interventions were
not at all influenced by a client's sexual orientation. When working with LGBTQ clients, an
examination of a music therapist's attitude towards this population is critical because it has the
therapist, one consequence of being a part of the dominant, heteronormative culture is the
extended amount of time it will take to build rapport with a client who identifies differently;
however, Chase (2004) suggests learning more about sexual minorities by researching their
cultures. A team of music therapists recently compiled a list of best practices with LGBTQ
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clients that emphasized inclusivity, creation of a safe space, preferred language, knowledge of
LGBTQ culture and music, and affirmative therapy (Whitehead-Pleaux et al., 2012). The current
literature reveals that music therapy approaches when working with the LGBTQ community are
progressing, but it also demonstrates a need for a queer theoretical framework in music therapy.
Queer music therapy would extend beyond the scope of current methods and further recognize
the complexities of sexuality and gender identity and consider LGBTQ individuals as more than
theory may suggest a sustained interrogation of the very categories and terms on which the social
science of sexual orientation and gender diversity rests (Fassinger & Arseneau, 2007; Seidman,
Given the heterogeneous ways in which queer theory has been articulated, including
distinct disciplinary origins, methodological proclivities, and even political goals (Sullivan,
queer theory as a monolith. Queer theory loosely refers to a field of critical theory that
challenges heteronomative ideologies by arguing that sexual identities are fluid rather than fixed.
This field encompasses numerous critical inquiries, including the queer of color critique
(Ferguson, 2003; Muñoz, 1999), studies of performativity (Butler 1990, 1993), and transgender
studies (Stryker & Aizura, 2013). These bodies of knowledge are so diverse that the field of
queer theory necessarily resists synthesis (Sullivan, 2003; Warner, 2012). “Queer” is a
historically stigmatized word that has been reclaimed by the LGBTQ community as a political
term denoting those who do not conform to traditional notions of gender and sexual identity. A
robust critique of power relationships as opposed to individual psychologies links the work of
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foundational queer theorists such as Foucault (1978), Sedgwick (1990, 2005), and Butler (1993).
Expanding on the notion that sexuality is produced in unequal relations of power, the “queer of
color” critique investigates the inseparable intersections of sexuality with race, gender, and class
(Johnson & Henderson, 2005; Lorde, 1984). Queer of color scholarship has posited that Black
and Latina/o bodies have historically been viewed as not only racially but sexually deviant in the
contexts of colonialism and in the legacy of White supremacy (Ferguson, 2003). Another
expansion of queer theory includes contemporary trans criticism. Trans is an umbrella term that
includes all non-cisgender gender identities, including transgender, transsexual, genderqueer, etc.
Trans studies have illuminated how representations of the transgendered body in media, science,
and everyday life reinforce cisgenderism and heteronormativity by framing gender and sexuality
in binary terms and using gender pronouns to mislabel and describe transgender individuals
(Ansara & Hegarty, 2012; Bryant, 2006; Sloop, 2004). Butler (1993) likewise challenges the idea
of “natural” gendered behavior in her theory of gender performativity, asserting that the
gendered body is characterized by public or shared repetitive acts; to Butler, gender is not a
choice per se, but produced by the social imperative to “do” gender in terms of sociohistorical
precedent. In other words, to Butler (1993), gender performance is a kind of citational practice
whereby individuals “cite” gender norms by doing gender, even when they attempt to subvert or
undermine heteronormativity (see also Butler, 1990). These modes of discourse foreground how
queer communities have embraced an ethic of radical inclusivity, in which structures are
critiqued for how they subtly reinforce oppression so as to make environments safe and
accepting of human cultural diversity. This approach contrasts with the kinds of superficial
inclusivity and diversity that seeks to incorporate different people and bodies into dominant
organizations and institutional settings that lack critical reflexivity (Ahmed, 2012). Radical
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inclusivity has implications for how music therapists might provide a safe and inclusive space for
In order to provide therapy for sexual minorities dealing with mental health issues related
to their identities, it is critical to examine how the foundations of LGBTQ oppression are actually
linked to psychological institutions and discourses. Queer theorists explore and critique how the
sexuality reveals that homosexuality and heterosexuality are recent culturally constructed social
(Hacking, 1986; Somerville, 1994). The modern concept of homosexuality, for example, evolved
from deviant or criminalized sexual behaviors (e.g., sodomy) into a form of identity (Foucault,
1978). Once seen as merely crimes or aberrations, homosexual behavior began to be observed as
an inextricable expression of a person’s identity in the late 19th and early 20th century.
homosexuality (Sullivan, 2003), creating what queer theorists today conceptualize as a pervasive
system of oppression that organizes virtually all aspects of social life, including education,
The discipline of sexology, or the academic study and classification of sexual bodies,
emerged in the late 19th century and relocated sexual concerns from the church’s authority
towards the domain of medicine (Bland & Doan, 1998; Foucault, 1978). Science and medicine
began investigating the “cause” of homosexuality, which was initially viewed as sexual
specimens (Terry, 1999). Scientists later posited that both nature and nurture play a role in the
interventions that aim to change sexual orientation (Liddle, 2007; Sullivan, 2003; Whitehead-
non-normative sexuality as a medicalized object; in the context of science and medicine, this
creates a framework, according to Foucault (1978), of the observer (e.g., the psychologist) and
the observed (e.g., the patient). Thus, working with LGBTQ adolescents in a therapeutic setting
may perpetuate oppression if the history of medicalized sexuality is not carefully considered.
This historical context illustrates the potential risks of putting LGBTQ adolescents under the
perspectives provide a lens to think through these challenges and highlight therapeutic methods
focused on empowerment.
The growing multidisciplinary literature addressing the ways in which sexual orientation
develops through childhood and adolescence is pertinent to working with LGBTQ adolescents.
Many of these youth struggle through this complicated process. Furthermore, the coming out
process is also fraught with potential challenges to mental health, not the least of which is the
a rethinking of sexual and gender nonconformity in order to challenge the concept of “normal”
itself (Stein & Plummer, 1994). Within the field of queer theory, most scholars conceptualize
gender and sexuality as continuous and fluid, rather than as a static binary (Butler, 1993;
development because it forces clients into the role of the "other," but foregrounding queer
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theorists' ideas when working with LGBTQ adolescents can minimize heterosexist assumptions
important for understanding the influence of an individual's sexual orientation on their presenting
problems (Haldeman, 2007; Matthews, 2007). Accordingly, the amount of influence of sexuality
identity development models typically include the following common themes: identity confusion
and questioning, finding and creating identity labels, acceptance of identity, and resolution and
maintenance of identity (Bradford, 2004; Brown, 2002; Collins, 2000; Potoczniak, 2007;
Weinberg, Williams, & Pryor, 1994). Socialization facilitates this developmental process;
however, queer youth may not have access to community-building tools if they are still in school
or living at home (Liddle, 2007; Oswald & Culton, 2003). This highlights the importance of
using techniques that positively impact interpersonal relationships, because positive group
experiences can counteract the negative social pressures that may be contributing to identity
theory can help direct attention toward structural barriers (i.e., heterosexism) rather than
dynamics makes queer theory a potentially efficacious paradigm for helping adolescents through
the recent literature on anti-oppressive music therapy practice provides implications for a queer
music therapy paradigm, because it attends to music’s capacity to connect individuals with
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stigmatized identities. Anti-oppressive practice emphasizes that societal power imbalances, (e.g.,
sexism, heterosexism, racism) and personal struggles are inextricably connected (Baines,
2013). Although anti-oppressive music therapy practice is still nascent, music therapists have
started exploring how this paradigm can promote social justice by using music to encourage
positive relationships and supportive social networks among stigmatized groups (Baines,
aware that music has social functions that can unconsciously perpetuate oppression (Adrienna,
2006). To illustrate anti-oppressive practice in relation to music, Bennett (2000) suggests that
music can act as a vehicle for oppressed youth to collectively communicate hegemonic struggle.
For example Beadle (1993) argues that rap music empowers African-American youth to assert
anger, pride, self-worth, and their African-American identity. Thus, music may likewise enable
queer youth to also express their unique internal and external conflicts.
2013), because both address the nature of power imbalances and oppression based on gender or
sexual identity. Exploring feminist perspectives in music therapy has revealed that some music
therapists have various methods of addressing power imbalances. Adrienna (2006) asserts that
music therapy processes and relationship dynamics are not free from cultural constructions and
that music used in therapy may inadvertently reinforce oppressive ideologies. Her feminist music
therapy principles can complement a queer theoretical framework by challenging not only
sexism, but also challenging heteronormativity and the gender binary in music. Awareness of
social inequalities is critical in music therapy because eliding social relations in music therapy
repertoire may contribute to harmful power systems by reconfirming a client's label, stigma, and
social position within the musical experience. O’Grady & McFerran (2006) emphasize a feminist
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approach in community music therapy because it emphasizes therapy as something clients "do,"
as opposed to therapy being done "to" them or "for" them. In this framework, roles are
therapist (Jordan & Hartling, 2002). This paradigm does not imply that the power balance is
equal or nonexistent, as queer theorists assert that power relations are everywhere (Foucault,
authenticity, openness to change and difference, and a connection that can be constructed
regardless of abilities, or in this case, sexual or gender identity (Rolvsjord, 2006a; Sprague &
Hayes, 2000).
Some music therapists have started critiquing traditional dominant structures in music
therapy, and as a result, there is currently a resurgence of the Community Music Therapy model
beyond work on individual problems and instead are working towards strengthening entire
communities (Ruud, 2004; Vaillancourt, 2012). Because this approach promotes social justice,
Community Music Therapy may have implications for a queer music therapy paradigm.
However, some queer theorists have critiqued the notion of community as problematic for queer
1991; Phelan, 1994; Sullivan, 2003; Young, 1986). Instead, they advocate for a queer community
model that supports productive differences and diversity (Secomb, 1997), rather than superficial
(nondominant) differences can act as forces for social change, and notions of community do not
have to ignore differences (Lorde, 1984). Consequently, “queering” the Community Music
Therapy model would entail using music to simultaneously build relationships and recognize
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diverse, fluid, and individual identities. Vaillancourt (2012) advocates for a community music
therapy model that promotes social justice by focusing on themes of acceptance and emphasizing
inclusiveness, interdependence, and equal participation. These guidelines have implications for
LGBTQ adolescents because these youth commonly experience exclusion from peers (Human
Rights Campaign, 2013). Accordingly, an analysis of both queer critiques of "community" and
social justice-focused community music therapy may provide the foundation for music therapy
Theoretical Orientation
Music is highly influential during adolescence and is also used as a medium to construct
identity (Tarrant, North, & Hargreaves, 2002). Therefore, an anti-oppressive music therapy
informed by queer theory may be efficacious for working with LGBTQ youth, a population that
faces marginalization and discrimination in personal interactions and society at large. This
oppression may lead to issues with social and personal identity development, as well as other
psychological problems, including internalized oppression. For this reason, there are many
existing support groups in school systems and communities for youth who have conflicts with
their parents or have developed mental health issues. Not all youth who identify as LGBTQ
require therapeutic remediation, especially if they have familial or other social support.
However, research indicates that many LGBTQ individuals currently need therapeutic support
due to experiences of prejudice and internalized heterosexism (Carter, Mollen, & Smith, 2014).
Therefore, music therapists working in mental health settings are likely to encounter LGBTQ
individuals in their practice, or social justice-oriented music therapists may seek out
theoretical orientation of this project is grounded in queer theory literature. Based on findings
orientation,
Because music is a means of communication (Peters, 1987; Sears, 1968), it can construct
knowledge of sexuality within music therapy experiences. This implies that music can
and the gender binary. However, a music therapy program using a queer theory paradigm to
frame interventions can combat heteronormativity by changing the language of music to consider
the complexity and fluidity of sexual orientation. As an example, a music therapy intervention
Music can also be used as a purely nonverbal form of communication (Peters, 1987).
emotions towards societal discrimination, safely express their identity, and receive validation
from the therapist or others in a music therapy group. Further, an expansion of Butler’s (1993)
assertion that the gendered body is performative suggests music is a potential medium for
performing gender and sexual identity. According to Ruud (1998), performing, listening to, and
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talking about music are all methods of performing personal identity. Thus, participating in music
therapy can affirm an individual’s identity by allowing a client to: determine the language of
their music, talk critically about LGBTQ music, and perform music in a manner that affirms their
identity. Queer theory emphasizes the deconstruction of language, and applying this concept to
music therapy prompts a deconstruction of music itself. However, to further advance this idea for
the broader goal of promoting social justice and health among LGBTQ youth, music therapy
within a queer theoretical framework may facilitate a reconstruction of language and the
(Lorde, 1984) – with others who experience sexual and gender stigmatization. Accordingly, this
individuals.
When working with queer youth who are in the process of developing their identity, it is
critical to affirm all dimensions of their social identities throughout therapy, including their
sexual orientation and gender identity. A music therapist can achieve this by using appropriate
terminology (including preferred gender pronouns) and demonstrating cultural sensitivity during
with the sex they were assigned at birth. This demonstrates a commitment to rethinking the
dominant ideologies of gender and supports clients’ differences (Ansara & Hegarty, 2012; Sloop,
2004). A music therapist can also create a safe space by: not tolerating bullying, hate speech, or
sexual-gender microaggressions and by naming and challenging such behaviors where they
inevitably occur; avoiding assumptions about client’s sexual orientation and/or gender
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expression while simultaneously recognizing that we all – regardless of our sexual or gender
identities – carry these assumptions as part of our acculturation into a heterosexist, cisgenderist
society; respecting a client’s right to privacy (and whether or not they are “out” about their
identity); and demonstrating an open and affirming attitude (Whitehead-Pleaux et al., 2012). The
musical experience itself also facilitates a safe therapeutic environment, because the wordless
meanings of music help emotional expression when words alone have failed (Gaston, 1968). The
most important consideration of working with LGBTQ youth is to create a safe space for all
clients while acknowledging that many LGBTQ youth may have learned that few such spaces
Based on the theoretical framework developed in the literature review, the following
goals may be appropriate for this population: support gender identity and expression, improve
self-esteem and self-image, promote a sense of control over life (Carter, Mollen, & Smith, 2014),
affirm differences and celebrate diversity, combat heteronormativity and cisgenderism, improve
group cohesion, facilitate emotional expression and identity expression, and promote
empowerment.
can be facilitated. These interventions using the above theoretical orientation can promote self-
esteem, coping skills, and empowerment for LGBTQ youth experiencing issues related to their
identity, including: musical autobiographies, songwriting, lyric analysis, music and creative arts,
For initial assessments with LGBTQ youth music therapy clients, it is important to assess
musical interests and preferences, psychosocial functioning, emotions (American Music Therapy
Association, 2013; Hanser, 1999) and where clients are in their sexual orientation and gender
identity development. Adolescents, in particular, often use music as a tool to express and
formulate identity (Tarrant, North, & Hargreaves, 2002), which highlights why it is especially
important to assess musical interests and preferences during assessment. Assessing musical
preferences is also critical for the development of an intervention plan because it provides
client’s needs in music therapy. In this therapeutic process, clients are prompted to brainstorm
songs representative of their past, present, and expected future. Then, clients are asked to share
the tracks on their list, select one song to listen to, and process the experience with the music
therapist and group. This intervention allows music therapists to record musical interests and
preferences, evaluate psychosocial functioning based on self-report and social behaviors, and
Emotional functioning should also be evaluated, including affect, feelings, and emotional
awareness. For LGBTQ adolescents, assessing sexual orientation and gender identity
development is critical because it is indicative of need areas for this population (Matthews,
2007).
To “queer” this intervention and affirm LGBTQ adolescents’ identities, a music therapist
should prompt clients to consider their sexual orientation and gender identity in their musical
autobiographies. This will provide an opportunity for clients to rethink gender and sexual
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identity nonconformity and for the music therapist to acknowledge the fluidity of identity
expressed in the language or musical elements of their song choices (Stein & Plummer, 1994).
By emphasizing sexual orientation and gender identity in this assessment, LGBTQ adolescents’
song choices may reflect how they are experiencing stigma and oppression – and the different
ways these clients negotiate and cope with discrimination and prejudice in their everyday lives.
A music therapist should also acknowledge the differences between the identities of each client
and be careful to recognize the tremendous diversity among sexual minorities and gender
heterosexuals (Secomb, 1997; Sullivan, 2003; Lorde, 1984; Vaillancourt, 2012). A “queer”
processing, identity affirmation, and empowerment in ways that resist rather than reinforce
heteronormativity.
underlying issues (Wigram & Baker, 2005). As an introduction to the songwriting process, music
therapists may facilitate a basic songwriting exercise called a song parody (Cassity & Cassity,
1998). Song parody interventions involve rewriting lyrics of songs based on therapeutic themes,
and using an existing song helps a client feel safer when sharing their lyrical ideas. These
exercises typically involve listening to a song with its original lyrics, and then instructing clients
to write their own words on “fill-in-the-blank” lyric sheets. Once they fill in their own lyrics, the
new version, or song parody, is performed. Clients should also be encouraged to sing along if
they are comfortable. Used within this context, a music therapist can help clients process the
relationship of the product (the re-written song) to their identity. LGBTQ clients may benefit
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from writing a parody with the assistance of a music therapist because they have the freedom to
change gender pronouns in their own preferred music and sing lyrics reflecting either their
gender or sexual identity. In this sense, a music parody exercise may enable LGBTQ youth to
classic form of queer theory-informed politics – what Stein and Plummer (1994) call the politics
of camp and carnival. Another “gender-bender” intervention could involve teaching a client one
This intervention supports the goals of improving self-esteem and promoting a sense of
control over life (i.e., locus of control) because it provides an opportunity for self-expression
(Carter, Mollen, & Smith, 2014). The client has the freedom to change gender pronouns in music
to fit their identity, and this is beneficial for them, especially since they may not have the
freedom to express their gender or sexual identity outside of the session. The nature of the
intervention itself combats heteronormativity because a client has the power to choose their
gender pronouns, and their gender is thus not assumed. When a group and/or therapist validate a
client’s self-expressions, it can help support gender identity and affirm identity. Performing the
song after doing a gender-bender can also improve self-esteem by allowing the client to achieve
success in a therapeutic process (Sears, 1968), amid a culture that emphasizes their capacity for
failure (Halberstam, 2011). This intervention ultimately allows clients to reconstruct language in
music to fit their personal identity and allows them to relate to others in a group setting.
Creative arts interventions permit individuals to express their thoughts and feelings
beyond verbal communication (Robbins & Sibley, 1976). When facilitating this type of
intervention within the context of music therapy, music is played or performed while clients
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create art, and the music is chosen to evoke a response from participants. For this intervention,
clients are provided with art materials and instructed to sit at a table. Each client receives 3 blank
sheets of large cardstock paper and are asked to write their name and preferred gender pronoun
on the back of each sheet of paper. This motivates participation because writing their names
artistically “breaks the ice,” and the sheet of paper becomes their own personal canvas. The
clients are told that the canvases represent the past, present, or future, as providing structure
For the first canvas, they are told to explore the paths they have encountered in regards to
their LGBTQ identity by listening to the first song and focusing on how the music makes them
feel about their past. A music therapist should emphasize that there is no right or wrong response
in this process, and that they may draw freely or write words in their picture. Clients are asked to
share their artwork after each drawing. For the second canvas, clients are told to let the music
guide them while they complete a second drawing to represent the present. For the third and final
canvas, clients are asked to think about what they want from society, their family, or their
community in the future. As a closer, clients are asked to state one word that describes what they
want in their future. Music combined with creative arts processes provides the opportunity for
clients to reflect and construct personal meanings, and the prompt of considering the past,
For lyric analysis interventions, music therapists facilitate a dialogue among clients based
upon the lyrical content of the song. This type of intervention can be used to facilitate thematic
music therapy and build therapeutic rapport (Silverman, 2009). Within a queer theoretical
paradigm, a music therapist’s role in this group is to ask questions to prompt a critical analysis of
23
songs and help clients verbally process how the song relates to their own identity and their
An example of a critical lyric analysis would be a song comparison between Same Love
by Macklemore and Ryan Lewis featuring Mary Lambert (Macklemore & Lewis, 2012, track 5),
and Angel Haze’s re-written version of the song (Fambrough, n.d.) (see appendix for lyrics and
dialogue prompts). The critically acclaimed song Same Love has gained a reputation as an
anthem for the LGBTQ movement since its release in 2012. Some sources report that it is
socially relevant and empowering for the movement because it supports equality for the gay
community (Mincher, 2014; Mlynar, 2013). The song has also simultaneously been the subject
of much criticism. Some critics point out that within the song’s lyrics, Macklemore and Lewis
promote mere passive acceptance of the gay community, and focuses on homophobia in a black
while not acknowledging his own white, heteronormative privilege (Ambrosino, 2014; Nichols,
Approximately one year after the song’s release, rapper Angel Haze, who has previously
identified as pansexual (Hoby, 2012), freestyle rapped over Macklemore and Lewis’s Same Love
beat. They rap about their own experiences with prejudice and they quote Andrea Gibson’s poem
In addition to using Same Love as a lyric analysis, a follow-up song-writing intervention can also
be facilitated. Music therapists can assist clients in writing their own versions of the song, using
their own experiences and beliefs about identity to guide their writing. This can also function as
a product-oriented intervention, where clients can perform and record their personal versions of
the song.
Group process, which refers to the dynamic interactions of a group (Yalom, 1975), is a
critical element of music therapy for LGBTQ adolescents because of their marginalized
identity and self-concept (Edgerton, 1990). A group of LGBTQ adolescents can benefit from
writing a group anthem and performing the anthem at the beginning of every session. The
anthem should address the differences within the group while still emphasizing inclusiveness. It
can also be geared towards queer identity in general and the goals of the therapy program. The
music therapist should assist the group by helping clients with the aesthetic aspects of the song
and helping the group verbally process what they want to express in the song’s contents. This
provides an opportunity to construct their own image of their group identity, and then perform
their identity using music. Using this song at the beginning of every session also establishes a
25
structure for the music therapy program. This intervention is both process and product-oriented,
This theoretically informed praxis outlined above describes “queer music therapy”
practice with LGBTQ adolescent clients. Many LGBTQ adolescents battle pervasive stigma in a
multitude of settings, including mental health institutions, which indicates a need for anti-
oppressive music therapy techniques grounded in queer theoretical perspectives. Evidence of the
strong impact of music on identity development during adolescence provides a rationale for
music therapy with this population, and the theoretical concepts examined in this paper highlight
the efficacy of a music therapy program grounded specifically in queer theoretical perspectives.
Queer theoretical perspectives have been criticized as jargon-laden and unintelligible (Duggan,
1994; Norton, 2002), but the application of these perspectives to music therapy can render these
abstract concepts into tangible reality, including the lived experiences of LGBTQ individuals in a
heterosexist, cissexist society. This type of critical inquiry can be applied to existing and future
popular music focusing on LGBTQ issues. The theoretical ideas developed here establish the
foundations of a music therapy paradigm that is not only geared towards LGBTQ clients, but is
and activists, we have proposed not simply a therapy for queer clients, but a queer therapy (Stein
This theoretical framework advances a conceptual model of queer music therapy that
LGBTQ individuals. Rather than promoting adjustment to a dysfunctional culture (e.g., a null
environment (Betz, 1989)), the theoretical orientation of these interventions encourages LGBTQ
26
systems of power within popular music transmits the ability to work through systematic
oppression beyond the music therapy session. Then, with the assistance of a music therapist,
queer youth can further battle the heteronormative patriarchy by writing their own music and
reclaiming their silenced voices. Queer theorists assert that power exists everywhere, and
critically examining how these systems exist within the safety of a music therapy session imparts
Synergizing queer theories with the principles of community music therapy suggests a
therapeutic orientation based on the fluidity of sexuality and gender performance, mutual
differences and similarities of gender, sexuality, race, and other dimensions of identity. From this
perspective, music therapy becomes a dynamic process where clients and their music therapist
engage in therapy together as opposed to therapy being done “to” them or “for” them. Queer
music therapy then aims to offer a safe space for clients to musically express their LGBTQ
identities openly, embrace differences (rather than emphasize sameness), acknowledge systemic
oppression (rather than minimize or disregard the reality of LGBTQ marginalization), and
celebrate their individuality and group identities. A queer and social justice-focused community
music therapy model would also welcome the participation of straight allies to foster radical
Even with the deficit of music therapy literature addressing queer theory specifically, this
interdisciplinary survey reveals opportunities for future contributions to queer music therapy
from a multitude of academic fields. Though the scope of this project is currently limited to
theoretical inquiry, the next step is be to produce qualitative data by developing more
27
LGBTQ youth, and analyzing the outcomes on the mental health of music therapy clients. Even
though such systematic empirical research remains nascent in other counseling fields
(Mallinckrodt, 2009), this is essential subsequent action because of the emphasis on evidence-
based clinical practice in music therapy (American Music Therapy Association, 2005). There is
currently a trend in music therapy literature toward a focus on LGBTQ issues, which highlights
the value of this kind of critical inquiry and the profound implications it has on the future of
music therapy with this population. Finally, our proposal for a radically inclusive queer music
therapy is a call to action for music therapists currently working with or considering working
with this population – not to mention those therapists who may find themselves unexpectedly
encountering a sexual minority or gender nonconforming client. Future work in this area is not
limited to early-career music therapists, but should be a priority for professionals/clinicians at all
career stages. These professionals can gain the appropriate training by reading pertinent journal
articles and participating in LGBTQ continuing education courses at national and regional
challenging the concept of normal and fixed identities. By creating a safe space, analyzing
systems of oppression, and using that knowledge to provide opportunities for empowerment,
queer music therapy may become a force of positive change for LGBTQ adolescents.
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Appendix
[Verse 2] [Verse 2]
If I was gay, I would think hip-hop hates I’ve walked the halls of my school
And I’ve seen kids hide behind walls and
me
footballs and things like pride
Have you read the YouTube comments I’ve seen innocent children suffer beneath
lately bruises
"Man that's gay" gets dropped on the Suffer beneath every single hand that
daily chooses
We've become so numb to what we're Ignorance, f--k your religion
F--k constitutions, f--k superstitions
sayin'
There are no lakes of fire; they’re here on
Our culture founded from oppression earth
Yet we don't have acceptance for 'em And the only thing to do is put love first
Call each other faggots And so I stand for the boy who died by his
Behind the keys of a message board hand
A word rooted in hate, yet our genre still To the sound of his father screaming “woman
ignores it loves man”
This is Adam and Eve, not Adam and Steve
Gay is synonymous with the lesser
And I stand for the girl with the cuts up her
It's the same hate that's caused wars from sleeve
religion And the heart in her hand and a chip on her
Gender to skin color shoulder
Complexion of your pigment And I stand for it all until ignorance is over
The same fight that lead people to walk- This is for you, for knowing who you are
For never letting your magic outside of your
outs and sit-ins
heart
Human rights for everybody Be you, be brave
There is no difference And understand that things do change
Live on! And be yourself! I accept you for you when I don’t understand
When I was in church And I love you for you cause this is who I am
They taught me something else I accepted you for you when I didn’t
understand
If you preach hate at the service
Now love me for me cause this is who I am
Those words aren't anointed
And that Holy Water, that you soak in,
Has been poisoned
When everyone else is more comfortable
Remaining voiceless
Rather than fighting for humans
That have had their rights stolen
I might not be the same
But that's not important
No freedom 'til we're equal
Damn right I support it
I don't know [Hook: Mary Lambert]
43
Dialogue Prompts:
1) What are the stereotypical characteristics of the social constructions of gender and sexual
orientation that Macklemore names?
2) Why do you think Macklemore, as a child, cried when he thought he was gay?
3) Which lines in Macklemore’s version do you agree with? Are there any lines you
disagree with?
4) Macklemore’s song has earned him awards and recognition as a leader of the LGBTQ
rights movement. Do you think this is beneficial or problematic?
5) What are the major differences between Macklemore and Haze’s versions of the song?
6) Why do you think Angel Haze chose to freestyle over the beat of “Same Love” instead of
writing a new, original song?
7) Where in the song does Haze move from anecdote to argument?
8) Are you able to relate any lines in Haze’s version to your own experiences identifying as
queer?