colorful people with colorful speech bubbles

The most important aspect of labels is understanding what they mean to each individual.

LGBT means Lesbian, Gay, Bisexual and Trans, right? But the full acronym is much longer: LGBTTQQIAAP.

What’s with the alphabet soup at the end–all the letters people leave off because it’s a mouthful?

The whole thing stands for Lesbian, Gay, Bisexual, Transgender, Transsexual, Queer, Questioning, Intersex, Asexual, Ally, Pansexual.

So often, we ask healthcare professionals to strive for cultural awareness and cultural competency. But frequently, education about gender and sexuality is simplified into the easiest letters to talk about: L and G, maybe B and not so likely T. Everything else, you can pretty much forget about.

The simplest explanation for this is that gender and sexuality are complicated. There are so many letters because there are that many identities and more. And each of those letters can be interconnected, they can be fluid and they are influenced by complex layers of identity and culture, such as socioeconomic status, ethnicity, religion, family, even geographic location.

With all of that going on, it’s no wonder we drop two-thirds of the acronym.

Gender and Sexuality Are Complicated. They Also Profoundly Influence Substance Use.

But people are people, right? Our bodies are inevitably the same regardless of how we name ourselves. Well, our bodies might be, but our health isn’t. That’s why gender and sexuality cultural competency is such a critical aspect of quality health care.

There are significant health disparities related to substance use for non-straight, non-gender conforming individuals. According to the Center for American Progress:

− Gay and transgender people smoke tobacco up to 200 percent more than their heterosexual and nontransgender peers.

− Twenty-five percent of gay and transgender people abuse alcohol, compared to 5 to 10 percent of the general population.

− Men who have sex with men are 3.5 times more likely to use marijuana than men who do not have sex with men.

− These men also are 12.2 times more likely to use amphetamines than men who do not have sex with men.

− They are also 9.5 times more likely to use heroin than men who do not have sex with men.

More data about substance use-related health disparities are available at the YMSM + LGBT Center of Excellence. This federal training center has been established to provide free and low-cost resources to health providers who know they need to learn more about serving these populations.

How Should I Approach Gender and Sexuality as a Healthcare Provider?

Every gender and sexual identity can be interpreted differently from person to person. The easiest way to heighten your level of cultural awareness is to ask questions. Labels might be constantly changing, but the most important aspect of labels is understanding what they mean to each individual.

As a health care professional, what types of questions about gender and sexuality should you ask your  patients to better understand their health?

A good first question: “What pronoun do you use?”

A good second question: “What gender and what sexuality do you identify with?”

Again, the recorded webinars/additional resources provided by the YMSM & LGBT Center of Excellence are a great place to increase your knowledge and awareness around LGBT issues.

About the Author

sarah king

Sarah King graduated from the University of Pittsburgh with a Bachelor of Science in Psychology and a undergraduate certificate in Gender, Sexuality and Women’s Studies in 2014. She joined the IRETA staff as project coordinator in February of 2015 where she works on training, event and meeting coordination as well as technical assistance projects, website development and maintenance, management of abstract submissions and research paper developments, bookkeeping functions and general administrative tasks.

Sarah writes:

My educational background is in Psychology and GSWS (Gender, Sexuality and Women’s Studies). Coming into the GSWS program in college I thought I was fairly culturally competent regarding LGBT issues. After my first day in my first class, I realized I was very wrong. It wasn’t that I was intentionally ignorant, more that I wasn’t aware of what I didn’t know. As a professional I often find myself questioning the inclusivity of my own perspective on a public health issue. For example, if we are talking about alcohol use, what about my own personal identity is narrowing my consideration of other interacting factors? I’m a non-white, light skinned, middle class, straight-passing female. My experiences relating to substance use are heavily swayed by my demographics. It would be ignorant to assume that a non-white, dark skinned, low SES, butch lesbian has the same experiences as me. I believe that is a significant step to becoming culturally aware: understanding of your own limitations and having a desire to address them.