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ID ≠

GENDER IDENTITY Psychological Sense of Self Male Two-Spirit Agender Genderless Gender- Gender-Fluid Enby

PRONOUNS Respectful Communication he/him/his she/her/hers they/them/theirs ze/hir/hirs none (use name) something else

SEXUAL ORIENTATION Romantic/Erotic Attraction to Men, Women or Multiple heterosexual asexual demisexual pansexual bisexual queer homosexual

ASSIGNED SEX Anatomy/Chromosones/Hormones male female

GENDER EXPRESSION Overall Communication/Perception of Gender masculine feminine gender-neutral gender-variant hyper-masculine hyper-feminine butch androgynous gender non-conforming

CISGENDER Your biological sex Your biological sex aligns with your does not align with your gender identity

Johanna M. Dolan B.Msc., SIC, RCP, RPS . . [email protected] www.DOLANASSOC.com

© 2019 Dolan Research International Infographic created by

Additional Participant Resources

General LGBT and LGBT Health Human Rights Campaign (HRC): www.hrc.org HRC advocates on behalf of LGBT Americans, mobilizes LGBT HealthLink: www.lgbthealthlink.org grassroots actions in diverse communities, invests strategically LGBT HealthLink works to support the many local tobacco to elect fair-minded individuals to office and educates the public control and health equity advocates to eliminate tobacco use about LGBT issues. and other health disparities for all LGBT people. o Healthcare Equality Index: http://www.hrc.org/hei o It’s Time for Smoking to Come Out of the Closet infographic: https://www.lgbthealthlink.org/Assets/U/Documents/smoki o Health and Aging resources: ng%20infographic-05-15.pdf https://www.hrc.org/explore/topic/health-and-aging

GLAAD: www.glaad.org Gay and Lesbian Medical Association (GLMA): GLAAD works with print, broadcast and online news sources www.glma.org to bring people powerful stories from the LGBT community GLMA is the world’s largest and oldest association of lesbian, that build support for equality. And when news outlets get it gay, bisexual and transgender (LGBT) health care professionals. wrong, GLAAD is there to respond and advocate for fairness GLMA’s mission is to ensure equality in health care for lesbian, and accuracy. gay, bisexual and transgender individuals and health care providers. o GLAAD’s Media Resource Guide: https://www.glaad.org/reference o GLMA’s LGBTQ-affirming healthcare provider directory

Gay, Lesbian, and Straight Education Network o Cultural Competence webinar series: (GLSEN): www.glsen.org http://www.glma.org/index.cfm?fuseaction=Page.viewPage GLSEN works to ensure that LGBT students are able to learn &pageId=1025&grandparentID=534&parentID=940 and grow in a school environment free from bullying and harassment. Institute for Gay Men’s Health: www..org National Coalition for LGBT Health: The Institute for Gay Men’s Health (IGMH) at GMHC is com- https://healthlgbt.org/ mitted to HIV prevention in the context of wellness among gay The Coalition is committed to improving the health and men, men who have sex with men (MSM) and their affiliated well-being of lesbian, gay, bisexual, and transgender individuals communities. through federal advocacy that is focused on research, policy, education, and training. Gay Health Advocacy Project at Columbia University: https://health.columbia.edu/content/gay-health- National LGBT Health Education Center at Fenway advocacy-project Health: www.lgbthealtheducation.org A group of concerned students and medical staff at Columbia The National LGBT Health Education Center provides University organized the Gay Health Advocacy Project in 1985 educational programs, resources, and consultation to health care to address the health-related needs of gay men affected by the organizations with the goal of optimizing quality, cost-effective emerging HIV epidemic. health care for lesbian, gay, bisexual, and transgender (LGBT) people.

Lesbians National Center for Transgender Equality: www.transequality.org The Mautner Project: www.whitman-walker.org/ The National Center for Transgender Equality (NCTE) is a The Mautner Project of Whitman-Walker Health is committed 501(c)3 social justice organization dedicated to advancing the to improving the health of women who partner with women equality of transgender people through advocacy, collaboration including lesbian, bisexual and transgender individuals, through and empowerment. primary medical care, support services, education and advocacy.

Lesbian Health and Research Center: Center of Excellence for Transgender Health: The Lesbian Health and Research Center at the University of transhealth.ucsf.edu California at San Francisco works to speed up the pace of re- The mission of the Center of Excellence for Transgender Health search for the LBTQ community and to close the gap in LBTQ is to increase access to comprehensive, effective, and affirming health disparities. health care services for trans and gender-variant communities.

Bisexual Men and Women o Acknowledging Gender and Sex: An online course for healthcare providers: Bisexual Resource Center: www.biresource.net https://prevention.ucsf.edu/transhealth/education/acknow The Bisexual Resource Center envisions a world where love is ledging-gender-sex celebrated, regardless of sexual orientation or gender expression. Because bisexuals today are still misunderstood, o Primary Care Protocol for Transgender Patient Care: marginalized and discriminated against, the BRC is https://transcare.ucsf.edu/guidelines committed to providing support to the and raising public awareness about and bisexual o Transgender Issues in HIV: people. https://lgbthealtheducation.org/wp- American Institute of Bisexuality: content/uploads/2018/03/Delivering_HIV_Prevention_Car www.americaninstituteofbisexuality.org e_Transgender_People.pdf The American Institute of Bisexuality encourages, supports and Intersex assists research and education about bisexuality, through pro- grams likely to make a material difference and enhance public Intersex Society of : knowledge, awareness and understanding about bisexuality. www.isna.org The Intersex Society of North America Transgender and Genderqueer (ISNA) is devoted to systemic change to end shame, secrecy, and unwanted genital surgeries for people born with an Transgender Legal Defense Fund (TLDEF): anatomy that someone decided is not standard for male or www.transgenderlegal.org female. Transgender Legal Defense & Education Fund is committed to o Clinical Guidelines for the Management of Disorders of Sex ending based upon gender identity and Development in Childhood: expression and to achieving equality for transgender people https://isna.org/books/clinical_guidelines/ through public education, test-case litigation, direct legal services, and public policy efforts. o Teaching Intersex Issues: http://www.isna.org/teaching_kit

o Tips for Parents: http://www.isna.org/articles/tips_for_parents MyPronouns.org: www.mypronouns.org Advocates for Informed Choice: A practical resource dedicated to the empowering and https://aiclegal.wordpress.com/ inclusive use of personal pronouns in the English language. Advocates for Informed Choice (AIC) founded in 2006 This website will help you understand what and how to use through an Equal Justice Works Fellowship and continued with the pronouns someone goes by. an Echoing Green Fellowship, AIC is the first, and only, organization in the U.S. to undertake a coordinated strategy of legal advocacy for the rights of children with intersex conditions or DSDs (differences of sex development).

People of Color Youth The Project: www.alp.org Make the Road: www.maketheroad.org The Audre Lorde Project Lesbian, Gay, Bisexual, Two Spirit and The Globe Project at Make the Road NY works with schools in Transgender People of Color center for community organizing, and Queens to address the institutional focusing on the City area. Through mobilization, that drives students to drop out of school. Globe also fights job education and capacity-building, works for community wellness discrimination against transgender New Yorkers and promotes and progressive social and economic justice. community awareness and understanding of LGBTQ discrimination and . o The SOS Collective Anti-Violence Program: FIERCE! www.fiercenyc.org https://alp.org/programs/sos A community organizing project for transgender, lesbian, gay, bisexual, Two Spirit, queer, and questioning (TLGBTSQQ) o Trans Justice political group for trans and gender nonconforming people of color: youth of color in . FIERCE includes the https://alp.org/TransJustice Education for Liberation Project (ELP), a paid training program which provides comprehensive community organizing, Gay Men of African Descent: www.gmad.org political education, and anti-oppression trainings to our GMAD offers a wide range of programs for the black gay constituency. community, including HIV testing, support groups, technical assistance, training and advocacy. o and the prison industrial complex: https://srlp.org/trans-youth-and-the-prison-industrial- APICHA: www.apicha.org complex/ APICHA is a community health center in Chinatown, New York Hetrick Martin Institute: www.hmi.org City, that specializes in care for Asian and Pacific Islanders, trans* A comprehensive package of direct services, including a high people, LGB people, HIV+ people, and other underserved school and referrals, for youth ages 12-21. populations.

National Youth Advocacy Coalition: www.nyacyouth. National Black Justice Coalition: www.nbjc.org org The National Black Justice Coalition is a civil rights organization A series of youth-directed articles and resources supporting dedicated to empowering Black lesbian, gay, bisexual, and trans- leadership and wellness for LGBT youth and their allies. gender people. Elders o LGBT Families of Color: Facts at a Glance: http://www.lgbtmap.org/lgbt-families-of-color-facts-at-a- Services and Advocacy for GLBT Elders (SAGE): glance www.sageusa.org SAGE offers social services, programs and community-building o Community Action Toolkit for addressing intimate partner to LGBT seniors in and around New York City and provides violence against transgender people: education and advocacy on LGBT aging issues nationwide. https://avp.org/ncavp/ncavp-toolkits/ Griot Circle: www.griotcircle.org GRIOT Circle is an intergenerational and culturally diverse UNID@S: The National Latin@ LGBT Human community-based organization dedicated to enriching the lives Rights Organization: of older lesbian, gay, bisexual, and transgender persons, especially https://www.facebook.com/UNIDOSLGBT/ elders of color. The mission of Unid@s, The National Latina/o Lesbian, Gay, Bisexual & Transgender (LGBT) Human Rights National Resource Center on LGBT Aging: Organization is to create a multi-issue approach for advocacy, www.lgbtagingcenter.org education and convening of and for our communities. A project of SAGE offering both physical and virtual resources and training for LGBT elders and the organizations that serve Trikone: www.trikone.org them. Trikone offers a supportive, empowering & non-judgmental environment where LGBTQ South Asians & their allies can meet, make connections, & proudly promote awareness & acceptance of their .

HIV/AIDS Incarceration Housing Works: www.housingworks.org Law Project: www.srlp.org Provides job training programs, day treatment, and direct legal SRLP serves low-income people and people of color who are help to HIV+ clients. Immediate services for homeless and transgender, intersex, or gender non-conforming by assisting detox referrals. Housing Works also has support groups and a with identity documents, Medicaid, discrimination in sex transitional housing program for transgender clients. segregated facilities, prisoner’s rights, and . Services in English, Spanish, . GMHC: www.gmhc.org HIV/AIDS organization including direct services, legal services, o Trans health care brochure: education, advocacy, testing and more. https://www.plannedparenthood.org/files/4414/0606/9716 /PPSFL_Providing_Transgender_Inclusive_Healthcare_Ha Cancer ndbook.pdf National LGBT Cancer Network: www.cancer-network. o “It’s War In Here: A report on the treatment of transgender org and intersex people in New York State men’s prisons” The National LGBT Cancer Network is the only program in the country addressing the needs of all LGBT people with cancer https://srlp.org/files/warinhere.pdf and those at risk. Our work focuses on education, advocacy and training. o NYS Prison Policies for Trans Health Care: https://www.npr.org/sections/thetwo- Lesbian Cancer Initiative: www.gaycenter.org/wellness/ way/2018/05/12/610692321/the-guidelines-for- health#cancer protection-of-transgender-prisoners-just-got-rewritten The Lesbian Cancer Initiative at the Center offers services to LBT community members, caregivers, partners and loved For Medical Students ones before, during, and after cancer diagnosis. American Academy of Family Physicians’

Sexual Health Recommended Curriculum Guidelines for Family Medicine Residents: LGBT Health: LesbianSTD.com: www.lesbianstd.com A project of the University of Washington, providing https://www.aafp.org/dam/AAFP/documents/medical_education information and resources regarding sexual health and sexually _residency/program_directors/Reprint289D_LGBT.pdf transmitted diseases in women who have sex with women.

American Sexual Health Association: http://www.ashasexualhealth.org/sexual- health/lgbtq/ The American Sexual Health Association promotes the sexual health of individuals, families and communities by advocating sound policies and practices and educating the public, professionals and policy makers, in order to foster healthy sexual behaviors and relationships and prevent adverse health outcomes.

Core Vocabulary Some terms people may use to understand SOGIE

ally / “al-lie”/ – noun: a (typically straight and/or – noun: the decision to abstain from sex. ) person who supports and respects members of the LGBTQ community. We consider people to be active cisgender / “siss-jendur”/ – adj.: a person whose sex allies who take action on in support and respect. assigned at birth and gender identity align (e.g., someone who was assigned male at birth and identifies as a man). A androgynous /anˈdräjənəs/ adj.: Identifying and/or simple way to think about it is if a person is not presenting as neither distinguishably masculine nor feminine. transgender, they are cisgender. The word cisgender can also be shortened to “cis.” aromantic /ārōˈman(t)ik/ – adj.: a person who does not experience romantic attraction. – noun: 1. the process by which a person accepts and/or comes to identify one’s own sexuality or asexual – adj.: experiencing little or no sexual attraction to gender identity (to “come out” to oneself). 2. The process others and/or a lack of interest in sexual by which one shares one’s sexuality or gender identity with relationships/behavior. exists on a continuum others (to “come out” to friends, etc.). from people who experience no sexual attraction or have any desire for sex, to those who experience low levels, or cross dresser– adj.: A person who enjoys dressing in sexual attraction only under specific conditions, and many of clothes typically associated with another gender, often these different places on the continuum have their own heterosexual men. identity labels (see demisexual). May experience other forms of attraction (e.g. intellectual or emotional). cultural competence – noun: The ability to know one’s Sometimes abbreviated to “ace.” culture and to interact effectively with people of different cultures. In a school this includes behaviors, attitudes, biological sex – noun: a medical term used to refer to the policies and structures that enable educators to work chromosomal, hormonal and anatomical characteristics that effectively cross-culturally. are used to classify an individual as female or male or intersex. Often referred to as simply “sex,” “physical sex,” demisexual – adj.: a person who experiences sexual “anatomical sex,” or specifically as “sex assigned at birth.” attraction only after making a strong emotional connection with a specific person. – noun: a range of negative attitudes (e.g., fear, anger, intolerance, invisibility, resentment, erasure, or king adj.: A woman, usually a lesbian, who dresses in discomfort) that one may have or express towards bisexual men’s clothing and entertains. This is different from individuals. Biphobia can come from and be seen within the transgender. LGBTQ community as well as straight society. drag adj.: A man, usually a gay man, who dresses biphobic – adj.: a word used to describe an individual who in women’s clothing and entertains. This is different from harbors some elements of this range of negative attitudes transgender. towards bisexual people. DSD – abbreviation: shorthand for Differences in Sexual bisexual – adj.: 1 a person who is emotionally, physically, Development and/or sexually attracted to some males/men and /women. 2 a person who is emotionally, physically, DSG – abbreviation: shorthand or umbrella terms for all and/or sexually attracted to people of their gender and folks who have a non-normative (or queer) gender or another gender. This attraction does not have to be equally sexuality, there are many different initialisms people prefer. split or indicate a level of interest that is the same across DSG is Diverse Sexualities and Genders. the genders or an individual may be attracted to. Sometimes abbreviated to “bi.” adj.: Slang for gay. Usage is less common today than it was pre-Stonewall. Refers to Judy butch adj.: Commonly used to refer to masculinity Garland’s following among many gay men. Often seen as displayed by a female but can also refer to masculinity by a F.O.D. male.

Sources: National LGBT Cancer Network, Human Rights Campaign, The Safe Zone Project

FTM adj.: A term referring to a person, assigned female at genderqueer – adj.: 1 a gender identity label often used by birth, who identifies and lives as a male. Also transgender people who do not identify with the binary of man/woman; boy or man. 2 an umbrella term for many gender non-conforming or non-binary identities (e.g., agender, bigender, genderfluid). gay – adj.: 1 individual who are primarily emotionally, This is a more political term than “Gender Variant” physically, and/or sexually attracted to members of the although it describes a similar concept. same sex and/or gender. Can be used to refer to men who are attracted to other men, and can be applied to women as gender transition– noun: The process by which some well. 2 An umbrella term used to refer to the queer people strive to more closely align their outward identity community as a whole, or as an individual identity label for with the gender they know themselves to be. To affirm anyone who does not identify as heterosexual. their gender identity, people may go through different types of transitions. – noun: The “ability” to know if somebody is gay enough, used primarily as a joke. • Social transition: This can include a name change, change in pronouns and change in appearance, gender– noun: A person’s internal sense of self as male, clothes or hairstyle. female, both or neither (gender identity), as well as one’s • Legal transition: The process of updating identity outward presentation and behaviors (gender expression). documents, such as birth certificates and drivers’ Gender norms vary among cultures and over time. licenses, to reflect a person’s authentic gender and name. Different states and localities have different – noun: The idea that there are two rules, often making this process very challenging. distinct and opposite genders––male and female. This model • Medical transition: For children, this may include the is limiting and doesn’t account for the full spectrum of use of hormone blockers to delay the onset of gender identities and gender expressions. puberty. It may also include cross-sex hormones to induce a puberty that is more consistent with the gender-expansive– adj.: used to describe people that child’s gender identity, or for adults, to promote identify or express themselves in ways that broaden the physical changes. It can also include gender culturally defined behavior or expression associated with affirmation surgery. one gender. gender variant - noun: Behavior or gender expression – noun: A set of social and cultural beliefs or that does not match socially accepted gender norms of male expectations about appropriate behavior for men/boys or and female in their appearance, behavior and/or voice. women/girls. Gender roles can vary from culture to culture. Strict gender roles can limit a person’s development. GSM– abbreviation: shorthand or umbrella terms for all folks who have a non-normative (or queer) gender or gender role stereotyping– noun: Stereotypes based on sexuality, there are many different initialisms people prefer. social and cultural beliefs or expectations about appropriate GSM is Gender and Sexual Minorities. behavior for men/boys or women/girls. This can limit children’s aspirations, achievements and well-being. – noun: the assumption, in individuals and/or in institutions, that everyone is heterosexual, and gender spectrum– noun: The broad range along which that is preferred to all other sexualities. people identify and express themselves as gendered beings Leads to invisibility and stigmatizing of other sexualities: or not. when learning a woman is married, asking her what her husband’s name is. Heteronormativity also leads us to gender expression – noun: the external display of one’s assume that only masculine men and feminine women are gender, through a combination of dress, demeanor, social straight. behavior, and other factors, generally made sense of on scales of masculinity and femininity. Also referred to as – noun: The attitude that heterosexuality is “gender presentation.” the only valid or “normal” sexual orientation. This can take the form of overt negative comments or actions towards gender identity – noun: the internal perception of an LGBTQ people or subtle actions or assumptions that one’s gender, and how they label themselves, based on how marginalize LGBTQ people. much they align or don’t align with what they understand their options for gender to be. Common identity labels heterosexual– adj.: A term describing a person who is include man, woman, genderqueer, trans*, and more. Often emotionally, romantically or sexually attracted to people of confused with biological sex, or sex assigned at birth. a different gender. Also known as straight.

Sources: National LGBT Cancer Network, Human Rights Campaign, The Safe Zone Project

heterosexual privilege– noun: A system of institutional own expression and identities. Other terms for this might and cultural beliefs, norms, and practices that advantages include gender expansive, gender creative, or genderqueer. heterosexuals. Some non-binary people also identify as Transgender. homophobia – noun: an umbrella term for a range of – noun: Exposing someone’s sexual orientation or negative attitudes (e.g., fear, anger, intolerance, resentment, gender identity to others without their permission. erasure, or discomfort) that one may have towards members of LGBTQ community. The term can also pansexual – adj.: a person who experiences emotional, connote a fear, disgust, or dislike of being perceived as sexual, romantic, physical, and/or spiritual attraction for LGBTQ. members of all gender identities/expressions. Often shortened to “pan.” Pansexual is used more frequently as homophobic – adj.: a word used to describe an individual people acknowledge that there are multiple genders. who harbors some elements of this range of negative attitudes towards gay people. – adj. & verb: 1 trans* people being accepted as, or able to “pass for,” a member of their self-identified gender homosexual – adj. & noun: a person primarily emotionally, identity (regardless of sex assigned at birth) without being physically, and/or sexually attracted to members of the identified as trans*. 2 An LGB/queer individual who is same sex/gender. This medical/scientific term is considered believed to be or perceived as straight. stigmatizing (particularly as a noun) due to its history as a category of mental illness, and is discouraged for common – noun: A symbol of reclaimed by use (use gay or lesbian instead). gay activists from the patches Nazis forced gay men to wear on their clothing. intersex – adj.: term for the naturally occurring variation of chromosomes, gonads, hormones, internal sex organs, and – noun: the practice or condition of being in genitals in a person that differs from the two expected more than one serious romantic or sexual relationship with patterns of male or female. Formerly known as the knowledge and consent of all partners involved. (or hermaphroditic), but these terms are now outdated and derogatory. queer – adj.: used as an umbrella term to describe individuals who don’t identify as heterosexual or cisgender. lesbian – noun & adj.: women who are primarily attracted Also used as a political affiliation. Due to its historical use as romantically, erotically, and/or emotionally to other women. a derogatory term, it is not embraced or used by all members of the LGBTQ community while some embrace LGBTQ – abbreviation: shorthand or umbrella terms for the term as an identity. The term “queer” can often be used all folks who have a non-normative (or queer) gender or interchangeably with LGBTQ (e.g., “queer folks” instead of sexuality, there are many different initialisms people prefer. “LGBTQ folks”). It is seen in academic fields, such as queer LGBTQ is Lesbian Gay Bisexual Transgender and or . and/or Questioning (sometimes people at a + at the end in an effort to be more inclusive; an A for “asexual” or “ally”, questioning – verb, adj.: an individual who, or time when, and I for “intersex”. someone is unsure about or exploring their own sexual orientation or gender identity. The term “questioning” can – noun: a relationship where two people are often be used interchangeably with LGBTQ (e.g., Lesbian, committed to each other. Gay, Bisexual, Transgender, and Questioning).

MSM– abbreviation: Clinical abbreviation for Men Who romantic attraction – noun: a capacity that evokes the Have Sex with Men. This term is commonly used by and want to engage in romantic intimate behavior (e.g., dating, about men who do not identify as gay but who engage in relationships, marriage), experienced in varying degrees sexual activity with other men. This term stands for men (from little-to-none, to intense). Often conflated with sexual who have sex with men, which is different than gay or attraction, emotional attraction, and/or spiritual attraction. lesbian. This term is behavior focused, rather than identity focused. sex– noun: One’s biological and physical attributes–– external genitalia, sex chromosomes and internal MTF– adj.: A term referring to a person, assigned male at reproductive structures––that are used to assign someone birth who identifies and lives as female. Also transgender as male or female at birth. girl or woman. sex assigned at birth– noun: This is generally determined non-binary– adj.: An umbrella term for people who by external genitalia at birth––female, male or intersex. transcend commonly held concepts of gender through their

Sources: National LGBT Cancer Network, Human Rights Campaign, The Safe Zone Project

sexual attraction – noun: a capacity that evokes the want trans*/transgender – adj.: An umbrella term covering a to engage in physically intimate behavior (e.g., kissing, range of people whose gender identity differs from the sex touching, intercourse), experienced in varying degrees they were assigned at birth. (from little-to-none, to intense). Often conflated with romantic attraction, emotional attraction, and/or spiritual – noun: the fear of, discomfort with, attraction. discrimination against, or hatred of trans* people, the trans* community, or gender ambiguity. Transphobia can be seen sexual orientation – noun: Describes a person’s within the queer community, as well as in general society. emotional, romantic or sexual attraction to other people. Some examples of sexual orientations are gay, lesbian, transphobic – adj.: a word used to describe an individual bisexual, asexual or pansexual. who harbors some elements of this range of negative attitudes, thoughts, intents, towards trans* people. sexuality– adj.: Describes how one experiences and expresses one’s self as a sexual being. It begins to develop in two spirit – adj.: A third-gender term common to many early childhood and continues over the course of one's First Nation cultures that implies a masculine spirit and lifetime. feminine spirit residing in the same body. Some people consider two-spirit a term that can refer to lesbian, gay, Stonewall– noun: On June 28, 1969, New York City police bisexual, and transgender people, while others think it is attempted a routine raid on a bar with this name, a best used only for transgender people. working-class gay and lesbian bar in . Unexpectedly, the patrons resisted, and the incident WSW– abbreviation: Clinical abbreviation for Women escalated into a riot that continued for several days. Most Who Have Sex with Women. This term is commonly used people look to this event as the beginning of the American by and about women who do not identify as but movement and all subsequent LGBTQ who engage in sexual activity with other women. This term movements. stands for women who have sex with women, which is different than gay or lesbian. This term is behavior focused, straight – adj.: a person primarily emotionally, physically, rather than identity focused. and/or sexually attracted to some people who are not their same sex/gender. A slang term for the word heterosexual.

Sources: National LGBT Cancer Network, Human Rights Campaign, The Safe Zone Project