Using LGBTQIA Culturally Sensitive Language in an Ever Changing World
By: Heather Cassandra Blessing, LMFT

The irony of this article is that I had already written it, when I made a mistake and did not properly proof read our October event announcement.  So this article is even more relevant than it was before. I want to start off by stating that what is deemed culturally sensitive can change.

Lesbian
I am a lesbian, which means I am mostly sexually attracted to women.  Some lesbians (and) like spelling women as womyn or womxn so as to not have "man" as part of the word.  Unless a lesbian labels or identifies herself, it is not appropriate in general conversation to put a label on them.  In general you should also not state someone's sexuality without prior permission.  There are many terms used the LGBTQIA community.  Tomboy/Tomboi is meant as a lesbian who likes to do culturally "male" things (although many would question why those things are considered "male").  Butch is another common term, which identifies a lesbian that not only likes doing "typical male" things but also dresses more masculine than feminine.  Then there is the term femme which is a lesbian who dresses more feminine.  Inside lesbian culture, femme's often complain about being invisible  because they assumed to be straight.  Now comes an interesting issue butch-femme.

When discussing a lesbian couple it is not appropriate to try and figure out who is "the man" or "the woman" in the relationship as the dynamics can be fluid.  This thought process has caused quite a split in thought as to whether the butch-femme dynamic is appropriate.  Some of the community find the concept of the butch-femme (masculine-feminine) relationship dynamic to be outdated and created by a patriarchal society and others in the community find the dynamic wonderful and actually look to create the dynamic with another.  There is no rule that femmes cannot date femmes or butches cannot date butches or any other concept.  Just like heterosexuals, everyone has their own attractions.  Each culture within the LGBTQIA subculture has its own terms.  So if you have a client who identifies as LGBTQIA it is important to ask the meaning of the terms they use. 

Gay
It is not culturally sensitive to use the word homosexual anymore.  As with all parts of the LGBTQIA culture some prefer to remain in the closet or not disclose their private information.  Also as important is to not assume based on stereotypes.  There are many men that may seem effeminate that are not gay or bisexual, just as a man that someone would term as a "jock" or "just a normal guy" (whatever that means), is gay.  Dragqueens are (usually gay) male performers that impersonate females, often embellishing female stereotypes.   Not all dragqueens are gay, so it is best not to make assumptions.  Queens are often very flamboyant gay men, but unless you know the person and have an understanding to how they label themselves, it is inappropriate to just point out that someone is a Queen or is being a Queen.  While there are a lot of stereotypes and subcultures in the gay community, if you are not in that subculture, it is inappropriate to use many of the terms.  If you have a client who uses terminology that you are not familiar with, ask.  As with all cultures and subcultures (not just LGBTQIA), our clients will have a unique view of their culture.

Bisexual
Bisexual has been a term that has a history of negative stereotypes in both the LGBTQIA culture and the public at large.  Often those in the LGBTQIA community will call bisexuals "fence sitters" or other such terms believing that they just cannot make up their mind.  Others consider bisexual people as unable to be monogamous and just wanting to have "sex with anything that moves".  Both of these ideas are a negative stereotype.  Some consider bisexuals just people who are attracted to people and they don't pay attention to gender, others consider bisexuals as more like in the middle of the Kinsey Scale.  Plenty of research has been done on fluid sexuality and many people consider themselves bisexual if they have had a relationship with both sexes (not at the same time).  It is important to look at our biases and stereotypes when we look at sexual orientation or gender and realize what is right for us and how we define ourselves, is not necessarily right for someone else nor how they would define themselves.  Again it is important to ask people how they identify or relate to such labels. 

Transgender
I want to start off by stating that what is deemed culturally sensitive can change.  One of the most obvious terms that is still is hotly debated is transsexual vs. transgender.  Many of my friends who transitioned more than a decade ago use the term transsexual.  I just discussed it with one and she said transgender bothers her because she has always identified her gender as female so therefore using the prefix trans and then gender would have meant she changed genders but she did not.  She states that she is a transsexual woman because what she changed was her sex.  She had sexual reassignment surgery where they changed her sex from male to female therefore she is a transsexual woman.  On the flip side many others feel that when you use the word sex as in transsexual, it alludes to there being a sexual issue when this has nothing to do with sex (as in the act) or sexual orientation.  They feel they are a transgender person as they are expressing their gender in a different way than they were born and therefore they are a transgendered person.

When working with the transgender community it is common to her the term cisgender woman or cisgender man.  the cis pre-fix means on the same side so I am a cisgender female or cigender woman as in the body I was born with matches my identity and my gender expression (also female).  By using the term cisgender it automatically puts transgender people and cisgender people on the same level as you are basically saying someone who has the same gender as their body and someone who has a different gender than their body.  Otherwise you are phrasing things in terms as a subculture.  For example, if you are discussing whether transgender students can use a certain bathroom, you have separated out a subclass of students rather than talking about bathroom that are for cisgender students and transgender students.  Often used instead of cisgender is non-transgender.

Another recent debate is the terms gender non-conforming vs. gender expansive.  Both mean the same thing - that the person does not match our "binary" system of how we define people as male or female.  The idea of a "Tom Boy" is considered gender non-conforming or gender expansive.  So the reason for the debate about the terms - non-conforming gives the idea that we should conform to certain standards and that this person is refusing to conform whereas expansive means that it is expanding over the current definition and does not have as negative connotation as non-conforming.

Pronouns - it is important to know which pronouns someone feels are correct for them.  I have on my intake sheets in my private practice the lines:

Gender ______________ Preferred Name________________ Pronouns________________

I do not give options (like check marks or boxes) just a place for them to write in what they feel is relevant to them.   Some pronouns are like She\Her and He\Him and other pronouns are They\Them or Ze\Zim.  A pronoun is an identifier and just like a name it helps identify and define the person  so it is important to ask someone how they want to be identified.

What is most important is to ask a person what words they wish to use and how they describe their life and self.

A resource to use is http://www.glaad.org/reference/transgender for up to date terms and what is considered culturally sensitive at present.  However, always remember that there are generational differences and regional differences in many terms to when in doubt ask. 

Queer/Questioning
Queer is a cultural sensitivity quagmire.  The original definition of queer was something strange or an oddity.  So when it became something people labeled people in the LGBTQIA community, it was considered derogatory.  But as with many words, some of the LGBTQIA community has taken the term back and it can mean gay or it can mean somewhere in the middle or fluid.  Such as someone may say they are genderqueer, meaning they either do not wish to define their gender or they are neither male nor female but somewhere in the middle.  Others use queer to describe their sexual orientation meaning cannot be defined.    Questioning is of course anyone who exploring their gender and/or sexuality.  Some have found that they feel their gender or sexual orientation is fluid and may change so they are questioning where they are at the moment.

Intersexed
What used to called hermaphrodite is now termed intersexed.  There are at least 16 known conditions from chromosomal to issues with hormones which a person is born with a reproductive or sexual anatomy that doesn’t seem to fit the typical definitions of female or male.  Whether the genitalia is noticeably different or whether puberty or infertility diagnoses the condition, being intersexed creates an issue of the person not being able to be defined as a binary (male/female) sex.  Some may look exactly like a particular sex, but internally or chromosomally not be that sex.

Asexual
Someone who has no sexual attraction to anyone.  This is not celibacy as celibacy or abstinence as both of those are a choice, to be asexual is to not be sexually attracted to any sex, so they are not gay, lesbian, heterosexual or bisexual.

As I have said throughout this article, the most important thing is to ask the person you are working with how they define themselves and what words, pronouns, labels and cultures they feel part of.  We must as always treat our clients like the unique individuals they are.