Covering the Basics: LGBTQ+ Terminology

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SPECIAL REPORT: PSYCHOEDUCATION

SIDEBAR

This is the Sidebar of the article "Affirming Evidence-Based Care for Young Patients Who Are Transgender or Gender Diverse."

Being well versed in correct terminology is fundamental to building affirming clinical environments and psychosocial rapport with patients. Physicians are not expected to get everything right, but to take responsibility for their education and apologize in the event a mistake is made.

First, a key distinction to make is between sex and gender. Sex is assigned at birth by a medical professional most often based on biological criteria, such as external genitalia. Gender refers to a person’s internal sense of self, which can be expressed through a diverse range of social, cultural, physical, and behavioral cues, such as clothing, pronouns, and physical embodiment. The Figure defines these terms and their key differences.

Second, neither sex nor gender are binary, as evidenced by the existence of intersex and TGD individuals. And neither sex nor gender are categorical. Someone’s gender identity can change through their life, and someone’s sex can, too (eg, a person can change their gender expression, sex hormone levels, and the appearance of their genitalia).

Third, another common misconception is that gender identity is the same as sexual orientation, which refers to the gender(s) of the individuals to whom a person is attracted. This includes asexual people, who do not experience sexual attraction. Many TGD individuals identify as “straight,” or heterosexual. Self-disclosing a TGD identity does not necessarily mean that the person is “gay/lesbian,” or homosexual.

Last, terminology changes depending on geography and demography. For example, in Latin America, terms such as transexual and travesti are used as synonyms for transgender. However, these may be considered derogatory in the United States and Europe due to their medical implications.

Ms Roldán is a sixth-year medical student at Universidad Peruana Cayetano Heredia in Lima, Peru. She aspires to become a neurologist and to continue advocating through research and policymaking for the transgender community. Dr Lerario is a board-certified neurologist and graduate student of social service at Fordham University, where they perform activism and research for the transgender community.