1. Nikki Cairns, Bako Orionzi, Jennifer Janssen, Madia Ampey
LGBTQ Terminology
Nikki Cairns, Bako Orionzi, Jennifer Janssen, Madia Ampey

2. The Basics
People will self-identify, so no matter how many terms we define there are more identities than we can teach

3. The Basics
Terms change and not all terms mean the same thing to everyone
Absolutely ask: “what does that term mean to you?”
You will make mistakes, it’s okay
Apologize briefly and move on
Ex Gender and sexual minorities

4. Within the next twenty minutes you should understand this diagram and see how it applies to you and your future patients.

5. The Basics
Sex = Anatomy (i.e. reproductive organs) and Biology (i.e. hormones and genetics) assigned at birth
Bako
at birth, doctor looks at external genitalia and “assigns” or states what the sex of the neonate is

6. Beyond the Basics Sex is not binary (male or female)
Intersex: variation of sex characteristics (including chromosomes, gonads, and genitals) such that they do not align with the typical male or female designation
Intersex can be controversial. Let them self-identify (DSD, VSD)
DSD is the clinical term
Bako

7. Beyond the Basics Intersex:
Many identified at birth, some later (i.e. puberty)
Many do NOT identify with LGBT community
Disorder of Sex Development(DSD)is a clinical term
Try: Variation of Sex Development (VSD)
Avoid: “hermaphrodite”
Many genetic conditions- Klinefelter’s, Turner’s, hypospadias, gonadal dysgenesis, etc.
People born with a VSD have unique medical concerns different from LGBT patients. However, they do share some of the stigma and discrimination experienced by LGBT people within society and the healthcare system. Some VSD people identify as transgender or a gender minority but not all.
Bako

8. Beyond the Basics
Instead of biological sex, try using sex assigned at birth
Using this term will not isolate any of your patients.
This is mainly to ascertain the hormones, genetics and reproductive organs
Bako

9. The Basics
Gender = traditional or stereotypical roles, behaviors, activities and attributes that a given society consider appropriate for men and women (and non-binary genders)
Many cultures have more than two genders, such as the two-spirit gender in many Native American cultures
Jen - Many cultures, especially native populations have many genders, and not a binary male and female gender. In fact in many of these cultures such as in Hawaii transitioning throughout life is considered a growth process and moving closer to god. In these cultures transgender is not really even a term because transitioning across genders is not stigmatized.

10. The Basics Gender is Socially constructed
More than anatomy and hormones
Typically binary in the U.S.
EVERYWHERE especially language
Jen

11. Here are some examples of very gendered language.
Jen

12. Exercise
Try to tell the person next to you about the most recent tv show or movie you’ve seen without using any gendered language
Jen

13. Beyond the Basics Gender is not binary for everyone
A Gender Non-Conforming Person: someone who does not identify exclusively with the stereotypical masculine or feminine gender. They do not fit into the binary of male and female.
Nikki

14. Beyond the Basics Types of Gender Non-Conforming Identities
Androgynous (both masculine and feminine)
Intergender (between male and female)
Multiple gender identities (ex. bigender)
Genderfluid (gender identity changes with time)
Demigender (partial or weak connection to a specific gender)
Cultural gender from a culture with more than two genders
And many more...

15. The Basics
Gender Identity = innate, deeply-felt psychological identification as a man, woman, or non-binary gender

16. The Basics
The pronouns and names that people use in reference to themselves are often informed by their gender identity NOT their sex assigned at birth.

17. The Basics
Gender expression = how someone chooses to express themselves, which may or may not conform to socially defined behaviors and characteristics typically associated with being either masculine or feminine (or a non-binary gender)

18. The Basics Gender expression:
May or may not align with gender identity
Does not have to conform to masculine or feminine stereotype
EVERYONE expresses themselves in a gendered way

19. Beyond the Basics
Gender expression may not equate with gender presentation

20. Exercise
Talk to the person next to you about three decisions you made this morning that express yourself in a gendered way.
Give examples?
Nikki

21. The Basics Sexual Orientation
madia

22. Sexual Orientation Components Attraction: Behavior: Identity:
the gender(s) of the people whom you are attracted to, physically and romantically
Behavior:
who you have sex with
Identity:
how you self-identify
madia
Do not align predictably: •
~ 1/2 of women who report sex with women identify as straight
~ 3/4 of men who report sex with men identify as straight
~ 1/2 of older lesbian women reported past marriage to a man

23. http://lacigreen.tumblr.com/image/82437012695 madia
examples, not all inclusive
Heteronormativity….

24. Beyond the Basics
LGB identities are often used in mainstream white Western culture
Some people may prefer Same Gender Loving (SGL) or two spirit (in reference to their gender or sexual orientation)
madia
sometimes used homosexual and gay have negative connotations (usually in reference to masculinity) -- seen in black community
native american; refer to bisexual or pansexual usually can be seen with gay or lesbian; non-binary

25. Beyond the Basics
MSM (Men who have sex with men), WSW, TMSM(Trans men who have sex with men),TWSM, etc. can be considered problematic
MSM was coined in HIV research and is established in research and education.
These terms supposedly eliminate the issues with seuxal identity, however they are obscure definitions that may have little impact on identity groups
madia
Public health terms, not how people identify

26. Birth Assigned
Nikki

28. Key Take Aways
Sex assigned at birth is NOT always the same as gender identity
Someone’s gender expression does NOT tell you what their gender identity is
Gender identity and expression are NOT the same as sexual orientation
Don’t assume, ask!
Nikki

29. Exercise
Take a few moments to think about your sex, gender identity, gender expression, and sexual orientation.
If you have questions about any the terms or definitions we can help!
Break
Nikki

30. Beyond the Basics-Intersectionality
Sexual orientation, gender identity and gender expression are all influenced by cultural norms, environmental factors, societal and/or familial pressures
Bako
This also includes race, socioeconomic status others, as well. How a person living in Brainerd, MN will have different factors influencing their identity compared to a person living in Atlanta, GA.

31. Beyond the Basics-Fluidity
Gender identity, gender expression, and sexual orientation can be fluid
People’s understanding of these aspects of themselves can change as they learn more about terminology and themselves
Bako
It can change over time as it fits their mindset and understanding of themselves. Caveat, if someone’s relationship status changes, only the person they are attracted to and having a relationship has changed, not necessarily their gender identity, expression or sexual orientation.

32. Beyond the Basics
Fluidity does not mean that people’s current gender identity, gender expression, or sexual orientation is not valid.
Respect people where they are. Trust people to know who they are.
Youth especially. Not a phase, not experimental.

33. Transgender
Is an umbrella term for people whose gender identity or expression is different from those typically associated with their sex assigned at birth
Is an adjective not a noun: a transgender person not a transgender
DON’T use transsexual this is an outdated term
madia
Transsexual is sometimes used for trans individuals who decide to use medical interventions

34. Transgender
Not everyone with non-stereotypical gender expression will identify as transgender
Is NOT the same as intersex
Transgender people can have any sexual
orientation, just like cisgender people
madia Maybe instead of the word Intersex, use VSD? I think intersex is becoming a non preferred term now

35. Transgender
Transition= the process of changing one’s sex characteristics, gender expression and/or lifestyle in order to better align with one’s gender identity
including social, legal, and medical transitions
madia

36. Transgender
Social transition when a person makes others aware of their gender identity. It can include:
Telling people their gender identity
Changing the name they use in social interactions
Asking others to use different pronouns, titles and other gendered language
Changing gender expression
Jen
Emphasize that these transitions do not occur at the same time
Socially, someone may express their gender differently at work versus in social life until they are ready to transition

37. Transgender
Legal transition refers to changing one’s gender as recognized in legal contexts in one’s country of residence.
This can include changing one’s name and/or gender on forms of identification including driver’s licenses and passports.
Jen
can change gender marker on birth certificate legally (not in all states but you can in MN)
can change SS # but if you live in a state that does not allow for gender marker change, this can result in mismatch of license and SS#

38. Transgender
Medical transition refers to the use of hormones and/or gender-affirming surgery to better align with one’s gender identity.
NOT all trans folks want medical and/or surgical interventions and many insurance companies do not cover these services
Jen
88% of LGBTQ respondents have health insurance, compared to 95% of the general population of Minnesota
Most people in the US DO NOT have surgical transition (bottom surgery especially is not common)

39. Queer
Is an umbrella term for people who want to identify as queer and/or who feel outside of societal norms in regards to gender or sexuality
Nikki

40. Queer Was used as a derogatory term
Has been reappropriated by the LGBT community
Is an offensive term to some people
Do NOT call someone queer unless they told you that you can

41. Queer People may identify as queer
if they reject conventional identity categories
in addition to L,G,B, and/or T
even if they are heterosexual and embrace non-normative sexual practices

42. When Communicating with Patients
People may use different pronouns in different contexts
Do NOT assume what pronouns someone uses
Ask what name and pronouns a patient would like you to use in reference to them

43. When Communicating with Patients:
Use open ended questions and allow patients to self identify:
What would you like me to call you?
What pronouns would you like me to use?
What words would you like me to use to describe your body parts?
Tell me about your family.
Just to make sure I understand what you mean, could you tell me how you define ___?
More to come, 3rd question especially during sensitive exams even with cis people
Nikki

44. References
Trans Student Education Resources. Retrieved 8/26/2015 from
The Trevor Project. Coming Out as You: The Spectrum. Retrieved 8/26/2015 from