Introduction & Objectives
Conversations surrounding sex and gender can be difficult in even the most ideal settings. For some, the topic is one that was taboo in their families of origin and/or the communities in which they grew up. For others, even if they are comfortable having conversations about gender and sexual diversity, their patients/clients may not be. During this session on gender and sexual diversity, each of us will have the opportunity to listen to first-person narratives in order to reflect on our own reactions, biases and assumptions regarding gender and sexuality in order to examine how that may impact the way we care for patients.
Engage in discussions about this topic and have the opportunity to practice advanced communication skills. Contemplate how you handle challenging conversations in general, recognizing that a challenging conversation for one person may be an easy conversation for someone else, and vice versa. Through group discussion, we will benefit from a diversity of thought that will allow each of us to gain greater perspective for the communities we serve.
Prior to the panel, please select one of the above resources to review. Experience has taught us that taking a few minutes to read/watch/listen to one or more such resources makes the small group discussion much more rich.
Helpful Definitions – below are some definitions you may find helpful.
LGBT, LGBTQ, LGBTQA, TBLG: These acronyms refer to Lesbian, Gay, Bisexual, Transgender, Queer or Questioning, and Asexual or Ally. Although all of the different identities within “LGBT” are often lumped together (and share sexism as a common root of oppression), there are specific needs and concerns related to each individual identity.
Lesbian: A female who is emotionally, romantically, sexually, affectionately, or relationally attracted to other females.
Gay Male: A male who is emotionally, romantically, sexually, affectionately, or relationally attracted to other males.
Bisexual: An individual who is emotionally, romantically, sexually, affectionately, or relationally attracted to both men and women (or to people of any gender identity).
Transgender: Refers to a person whose gender identity does not correspond to their sex assigned at birth. Transgender (or the shortened version, ‘trans’) may be used to refer to an individual person’s gender identity and is sometimes used as an umbrella term for all people who do not conform to traditional gender norms.
Transsexual: A person whose gender identity is different from their biological sex, who may undergo medical treatments to change their biological sex, often times to align it with their gender identity, or they may live their lives as another sex.
Queer: An umbrella term sometimes used by LGBTQA people to refer to the entire LGBT community. It is important to note that the word queer is an in-group term, and a word that can be considered offensive to some people, depending on their generation, geographic location, and relationship with the word.
Questioning: For some, the process of exploring and discovering one’s own sexual orientation, gender identity, or gender expression.
Intersex: A person whose sexual anatomy or chromosomes do not fit with the traditional markers of “female” and “male.” For example: people born with both “female” and “male” anatomy (penis, testicles, vagina, uterus); people born with XXY.
Asexual: A person who generally does not feel sexual attraction or desire to any group of people. Asexuality is not the same as celibacy.
Celibacy: Abstention from sexual intercourse.
Pansexual: A person who experiences sexual, romantic, physical, and/or spiritual attraction for members of all gender identities/expressions, not just people who fit into the standard gender binary (i.e. men and women).
Homosexual: A clinical term for people who are attracted to members of the same sex. Some people find this term offensive.
MSM: An abbreviation for “Men who Have Sex with Men.” This term focuses on behaviors and does not indicate sexual orientation.
WSW: An abbreviation for “Women who Have Sex with Women.” This term focuses on behaviors and does not indicate sexual orientation.
Gender Identity: A person’s internal sense of their gender.
Sexual Identity: A culturally organized concept of the self. Labels can include lesbian, or gay, bisexual, or heterosexual.
Sexual Orientation: Distinct from gender identity and expression. Describes a combination of attraction, behavior, and identity for sexual and/or romantic partners.
Coming Out: To disclose one’s sexual identity or gender identity.
In the closet: Describes a person who chooses not to disclose their sexual orientation or gender identity from some or all people.
Heterosexism: The assumption all people are or should be heterosexual. Assumption that heterosexuality is inherently normal and superior to LGBTQ people’s lives and relationships.
Sex Assigned at Birth: Assigning a sex at birth is often based on the appearance of their external anatomy and is documented on the birth certificate.
Gender Expression: How one externally manifests their gender identity through behavior, mannerisms, speech patterns, dress, and hairstyles.
Ally: Those who support and respect sexual and gender diversity and challenges homophobic, biphobic, transphobic, and heterosexist remarks and behaviors.
Cultural competency: A set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals that enables effective work in cross-cultural situations.
Cultural humility: Described as a lifelong process of learning, self-examination, and refinement of one’s own awareness, knowledge, behavior, and attitudes on the interplay of power, privilege, and social contexts.
Reference Material: Below you will find reference material that may be helpful to you in the future:
- Advancing Effective Communication,Cultural Competence, and Patient- and Family-Centered Care for the Lesbian, Gay, Bisexual, and Transgender (LGBT) Community.A Field Guide https://www.jointcommission.org/assets/1/18/LGBTFieldGuide_WEB_LINKED_VER.pdf
- Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People https://s3.amazonaws.com/amo_hub_content/Association140/files/Standards%20of%20Care%20V7%20-%202011%20WPATH%20(2)(1).pdf
- DOD INSTRUCTION 1300.28 – In-Service Transition for Transgender Services Members http://www.defense.gov/Portals/1/features/2016/0616_policy/DoD-Instruction-1300.28.pdf
- Understanding the Health Needs of LGBT People, 2016 http://www.lgbthealtheducation.org/wp-content/uploads/LGBTHealthDisparitiesMar2016.pdf
- Top Health Issues for LGBT Populations Information & Resource Kit https://store.samhsa.gov/shin/content/SMA12-4684/SMA12-4684.pdf