The Netflix series Wanderlust is but the latest example of how consensual non-monogamy is becoming more mainstream. While it’s wonderful that an increasing number of people are becoming more intentional about the structure of their relationship, what happens when they want to seek support and are instead met with judgment? The very system that is designed to support people who are struggling is grossly unprepared to meet this demand.
Imagine you are in the early stages of exploring your sexual orientation and the very person you trust to guide you through this tender time blames your depression on being queer suggests that you’re not actually queer. Imagine being told that your sexual orientation or gender identity didn’t matter when choosing your mental or medical healthcare provider. This is the current reality for people in the CNM community and we want to see this change.
Healthcare Provider Directory Campaign
Consensual non-monogamy (CNM) is a rising issue in a number of professional circles. This past year, Division 44 of the American Psychological Association established a Consensual Non-monogamy Task Force and I am honored to serve as one of the co-chairs. In light of the difficulty many people in the CNM community have trying to find a CNM-affirming medical or mental health provider, we have established a Healthcare Provider Directory Campaign to raise awareness of this issue and work with healthcare provider directories to make their directories CNM-inclusive.
For those of you currently looking, there are a few current directories available for finding a CNM-affirming therapist. It is time, however, for mainstream healthcare provider locator directories to start including consensual non-monogamy (and/or related terms) as a searchable criteria as well. I have included five reasons why I believe this to be true.
1. CNM is Highly Stigmatized
Despite the prevalence and increasing interest of CNM, people who challenge the monogamous status quo are broadly and pervasively stigmatized. Recent surveys point to how CNM is judged negatively in a number of ways, such as being perceived as being more risky, immoral, less trusting, less meaningful, and less satisfying compared to monogamy. Notably, this stigma has been found to be untrue, as research looking into this has found CNM relationships are just as satisfying as monogamous relationships and an equally viable alternative to monogamy.
2. CNM Minority Stress is Associated with Psychological Distress
People who are part of sexual minorities are disproportionately exposed to rejection, discrimination, and victimization compared to heterosexual individuals. As a consequence, these individuals tend to experience more mental health burdens and as a result, utilize mental health services more frequently. The process in which stigma and discrimination create a hostile environment that leads to increased mental health problems is known as minority stress. Forthcoming research indicates that more than half of CNM-identified individuals have experienced discrimination in some form, despite frequently concealing their CNM practices. Recent research has also shown that CNM-related minority stress is positively related to increased psychological distress, such as higher self-reported depression and anxiety symptoms.
3. Most Healthcare Providers Do Not Receive Training on CNM
Mental and medical health providers are uniquely positioned to either help relieve or compound the impact of stigma experienced by their CNM clients. Ideally, healthcare providers would be trained on how to engage in CNM-affirming practices and effectively counteract CNM-stigma. However, it is currently rare for providers to receive explicit training on CNM, and individuals engaged in CNM who seek psychotherapy frequently encounter discriminatory or microaggressive attitudes and practices by medical and mental health care providers.
4. Searching for a CNM-affirming Therapist is Linked to Better Therapy Outcomes
In our study of 249 people engaged in CNM who sought therapy, we found that nearly half of our participants specifically looked for a therapist who was CNM-affirming, highlighting how important finding a CNM-affirming therapist was to them. Notably, those who did search for a CNM-affirming therapist had better treatment outcomes than those who did not search. One-fifth also rated their therapist as lacking the basic knowledge of consensual non-monogamy issues necessary to be effective. These findings highlight the importance of therapist education and creating avenues for CNM clients to find therapists who have been adequately trained about CNM.
5. CNM is a Large and Growing Population
More than one in five people in the United States have engaged in a consensually non-monogamous (CNM) relationship at some point in their life and approximately 4-5% of people in the US are currently in a CNM relationship, which is roughly the size of the LGBTQ community combined. Many healthcare provider locator directories already include search terms related to LGBTQ concerns, but it cannot be assumed that a provider who holds affirming attitudes and/or has received training for working with LGBTQ clients will necessarily hold affirming attitudes or received trained to work with CNM clients.
As interest in CNM has grow and is becoming more mainstream, some are questioning whether CNM is the future of love. In light of this growth, healthcare organizations will face increasing pressure to adopt inclusive practices and systems or risk being labeled oppressive and ostracizing themselves from a large and growing market. We are just starting to include CNM on demographic forms, and I recently received data verifying that 16% of the students accessing mental health services across the 10 University of California Counseling Centers self-identified as something other than monogamous (i.e., CNM 3%, questioning 5%, other 1%, or preferred not to answer 7%). Given the increasing awareness and tolerance of CNM, I anticipate these numbers will continue to rise.
Recent research suggests that the CNM population is large and highly stigmatized, that this stigma is associated with additional mental health burdens, and that when seeking therapists CNM clients frequently experiences discriminatory or microaggressive practices from their healthcare providers. We also know that finding a CNM-affirming therapist is associated with better treatment outcomes (e.g., experiencing fewer discriminatory practices and experiencing their therapist as more helpful), but CNM clients currently do not have widely accessible avenues to access these therapists. While there are a few available resources (that are wonderful), they are not likely to be known to the masses.
Restricting consensual non-monogamy as a search term on healthcare provider locator directories (whether intentional or not) functionally becomes tangible form of discrimination because it reinforces a harmful erasure of the CNM identity and creates a barrier for this stigmatized population from accessing the mental health care providers that are best equipped to support them. Healthcare provider locator directories play a key role as gatekeepers, and have an opportunity to help alleviate some of the additional burden this community has to go through in order to find the culturally competent healthcare they need and deserve.
Providing education is an important first step to promoting equity and inclusion. My hope is that outlining these arguments will help raise our collective awareness about an important relationship structure diversity issue, and provide ample evidence to bring about tangible change. It is also my hope that there will not be too much resistance from healthcare locator organizations because including consensual non-monogamy is a relatively simple change to make.
How You Can Help
In the 1970s, during the early stages of the LGBTQ movement, individuals were provided opportunities to take a stand for justice and compassion by supporting a community that was misunderstood and unjustly stigmatized. Similar opportunities with regard to consensual non-monogamy are presented today.
This past year, APA’s Society for the Psychology of Sexual Orientation and Gender Diversity (Division 44), which was birthed through the LGBTQ movement, endorsed the legitimacy of CNM through formally sanctioning the Consensual Non-monogamy Task Force. We see this as a historic opportunity for therapist locator organizations to join us in creating avenues for CNM provider/client matching. Our team is formally launching our campaign and we could use your help spreading the word and taking these steps:
Message Healthcare Provider Directories. Send this article to all the the healthcare provider directories you know or use through your preferred social media platform.
Share this article with your network. We appreciate your support in sharing this article on social media or any other relevant networks to help spread the word about our Healthcare Provider Locator Campaign.
Sign our petition. On our petition, you can indicate your support for adding consensual non-monogamy to healthcare provider locator directories. You can also express your support for a number of other CNM-related issues and sign up for our mailing list, which is how we’ll keep you posted on the progress of all our initiatives.
Connect us. Do you know someone who works at an organization with a therapist database (e.g., Psychology Today, an insurance company, etc.)? Even if they don’t work in the department, we would love for you to connect us because they may know who we should speak to. We would love your help connecting with these organizations so we can effectively advocate for inclusion. If you have contacts who may be helpful, please email us at Div44CNM@gmail.com.
It’s hard enough being criticized for being different. We owe it to the CNM community to acknowledge that monogamy is not the only viable option by educating healthcare providers about CNM and creating widely accessible avenues for connecting to culturally competent care. Please join us in taking up this cause.
*I used the term consensual non-monogamy for this article because it is currently the most widely used term that is inclusive of the vast ethical forms of non-monogamy. I acknowledge that this term is problematic by defining itself by what it is not (monogamy), acknowledging (and potentially reinforcing) a less-privileged position.
Heath Schechinger, Ph.D., is a licensed psychologist at the University of California, Berkeley, and Co-chair of the American Psychological Association Division 44 Consensual Non-monogamy Task Force. He has multiple peer-reviewed publications and his work has been featured on popular media outlets such as Goop, Psychology Today, and Vogue Australia. Dr. Schechinger’s private practice specializes in ethical non-monogamy and other queer and non-traditional lifestyles, and he is an advocate for the acceptance and normalization of gender, sexuality, and relational identification variances.