Defining the Elements of GLBT
Sexual orientation is defined as the direction of romantic, sexual, and emotional feelings. This orientation can be towards the same sex, the opposite sex, or both. No exact factors have been found to explain the development of sexual orientation, but scientists have examined the interaction of cognitive, biological, and environmental factors as possible contributors (American Psychological Association, 2008). The process by which a person establishes their sexual identity is very complex. McAuliffe (2005) describes a model of gay and lesbian sexual identity development. The first phase, Being Different/Identity Confusion, involves feeling different than peers and beginning to wonder if one is lesbian or gay. Identity Acceptance/Coming Out is the second phase and involves sharing a preferred sexual orientation to oneself and others. The third and final phase is Identity Synthesis, which allows assimilation of one’s sexual identity into other aspects of the self (McAuliffe, 2005).
Sexual orientation is a continuum ranging from exclusively heterosexual to exclusively homosexual; individuals may identify with either extreme or one or more places in-between (Gilbert, 2003). Usually emerging in adolescence, sexual attraction occurs without any sexual experience (Szymanski, 2008). It is vital to consider a person’s sexual identity as an orientation, not a preference. A preference implies that there was a choice in a person’s orientation, which is not supported by empirical evidence. An orientation implies that the person was created to be gay, lesbian, bisexual, or transgender. According to the American Psychological Association (2009), when describing orientation, it is best to use terms such as “gay male sexual orientation” and “lesbian sexual orientation” over “lesbianism” and “homosexuality.” To describe behaviors, it is appropriate to use terms such as “same-gender behavior” or “female-female behavior” (American Psychological Association, 2009).
The language describing persons of homosexual sexual orientation is often misused. Homosexuality is correctly defined as the sexual orientation of any person who is attracted to the same sex. A gay person is defined as a male attracted to a male, while a lesbian is a female attracted to a female. However, the term gay has been used to describe all gay, lesbian, and bisexual persons. Some people may be used to seeing gay and lesbian in literature and the media, and assume that gay only refers to men; others may believe it refers to men and women alike. It is important to use the same terminology as your client. Bisexuality describes persons who currently have or have previously had relationships with members of both genders. There are several myths about bisexuality that have arisen out of societal assumptions. They include the idea that bisexuals are “closeted” gays or lesbians, they are stuck in transition between a homosexual and a heterosexual, that they are incapable of monogamy, and that they have relationships with both genders for their own personal satisfaction (Szymanski, 2008). A pansexual person has the potential to be attracted to any person, independent of their sex or gender.
The terms gender and sex are often used interchangeably; however, they have different meaning. Sex is the anatomy of a person’s genitalia along with his or her genetic makeup. A person can be male, female, transitioning, or intersex. Intersex is the sex designated to persons born with ambiguous genitalia. Gender is defined as who one believes oneself to be emotionally and psychologically, whether it agrees with one’s assigned sex or not. A person can feel that they are a male or a female or may not identify with either gender. Gender assignments are merely a social construct, created and enhanced by culture to designate behaviors to male or female (Gama, 2002). These behaviors are enforced by media, politics, law, religion, and most of all, family. The so-called “norms” for male or female genders cause difficulty for people who self-identify themselves with the gender that is not their sex or those who do not identify with any sex at all. Individuals who do not identify with their assigned sex are transgender. Transgender persons challenge the conventional descriptions of male and female. Transgender is not a sexual orientation; rather transgender persons can be heterosexual, homosexual, pansexual or bisexual, including both males and females and pre-operative and post-operative persons.
The scope of this module does not include further discussion of issues related to counseling transgender persons. However, we encourage you to watch one or more of the following videos to hear the voices of transgender individuals and to appreciate some of the health care challenges they face.
Voices of Transgender Adolescents in Healthcare
