The Story of LGBTQIA: What Do All These Letters Really Mean


LGBT, LGBTQ, LGBTQIA…..In previous articles, I have used several of these acronyms, and  I want to use this article as a way to clarify what they all mean. I know sometimes the alphabet soup can be a bit confusing, but hopefully this will break it down for you. Let’s go!

Lesbian: A female-identified person who is attracted romantically, physically, or emotionally to another female-identified person.

Gay: A male-identified person who is attracted romantically, physically, or emotionally to another male-identified person.

Bisexual: Individuals who are attracted to both men and women romantically, physically, or emotionally.

Transgender: Individuals whose biological sex is different than the gender with which they identify. Sometimes the term “born in the wrong body” is used, however, this depends on the individual’s preference.

Transsexual: Transsexual individuals have physically altered their body in order to better match their gender identity. It is a term that refers to biology, not to identity necessarily, and it is indicative of a change in one’s physiology.

Queer: queer is an all-inclusive term referencing lesbians, gay men, bisexuals, transpeople, and intersex persons.

*It was previously a derogatory term in the 1980s, however, it has currently been reclaimed when referring to the LGBTQIA community. Queer attempts to reject the idea that the labels of lesbian, gay, bisexual, or transgender are able to explain any one person’s identity.

Intersex: Someone whose physical sex characteristics are not categorized as exclusively male or exclusively female.

Asexual: A person who is not attracted to anyone or does not have a sexual orientation.

Ally: A person who does not identify as LGBTQIA but supports the rights and safety of those who do.

In my previous article ENDA, I spoke briefly about the differences between sexual orientation and gender. I find the Ginger Bread Person to be a very useful tool to provide interventions and education to both clients and individuals in the community. The following link is an additional resource that will help clarify any additional questions you may have regarding gender and sexuality. Here is a preview:

Love the Genderbread Person? Then you’re going to love the book I wrote. It’s called The Social Justice Advocate’s Handbook: A Guide to Gender, and it’s a couple hundred pages of awesome – Sam Killermann

Download Genderbread PDF

What Does the Employment Non Discrimination Act (ENDA) of 2013 Actually Cover

On July 10, 2013, just two weeks after DOMA was ruled unconstitutional, members of the Senate Committee ruled 15-7  in favor of  Senate Bill 815 called the Employment Non Discrimination Act (ENDA) of 2013. This is the eighth revision since being introduced in 1994. The purpose of ENDA is to ban workplace discrimination based on sexual orientation and gender identity.

This update is a significant improvement upon previous revisions. In the past, it has been unable to fulfill its intended purpose due to significant language that has been excluded.  Gender identity was not proposed in the wording of the bill until 2007 when introduced in the Senate and then removed once making its way to the House. On two occasions in 2007 and 2009 have attempted to include gender identity in the wording only to have failed and died in committee.

So what does all this talk about sexual identity and gender really mean?

Sexual identity and gender are completely different concepts:

  • Sexual orientation refers to the sex of those to whom one is sexually and romantically attracted.
  • Gender refers to the attitudes, feelings, and behaviors that a given culture associates with a person’s biological sex.WorkplaceDiscrimination

Across the United States, LGBT  individuals are being fired from their place of employment due to discrimination. According to a June 13 poll by the Pew Research Center, 21 percent of LGBT adults say they have been treated unfairly by an employer in hiring, pay, or promotions.

In addition to workplace discrimination, LGBT employees face wage disparities, and studies show that the transgender population is disproportionately affected.

Currently, 29 states provide no state law to protect lesbian, gay, and bisexual employees from being fired and 33 states lack state laws protecting transgender individuals.

North Carolina is an employment-at-will state which means that an employee can be fired for no reason except in cases of discrimination. Federal protection legislation such as ENDA is important because statutes will prohibit employers from discharging employees based on impermissible considerations such as sexual orientation or gender.

Senator Richard Burr(R-NC) was quoted stating:

“Like most Americans, I strongly oppose and condemn unjust discrimination, it is my hope that our society can be tolerant of different people and ideas. That said, whenever we consider new legislation we must always consider the interplay of new laws with existing rights. I am concerned that the ENDA bill would go beyond our existing laws protecting individuals’ employment rights and would impose new burdens and legal uncertainties regarding the exercise of religious liberties. Therefore, I plan to oppose the bill.”

Despite Richard Burr’s comment, a poll released on June 17, 2013, by Public Policy Polling (PPP) found that a strong majority of North Carolinians 71% think employers should not be able to discriminate against employees based on their sexual orientation compared to just 20 percent who think they should be able to.

ENDA is now one next step forward to being approved by the senate where it will hopefully be approved. It must be passed by both the senate and the house before President Obama can sign it into law.  Click here to track the progression of the bill.

A How To on Health Care for LGBTQ

The United State’s system of health care continues its progression in providing all-inclusive services since the repeal of the Defense of Marriage Act. Monday, July 1st, the Centers for Medicare and Medicaid Services (CMS) issued an official policy announcement declaring same-sex partners be given equal visitation rights at long-term care facilities regardless of their marital status. This new guidance policy applies to all long-term care health facilities receiving Medicare and Medicaid funding to include nursing homes and hospice facilities.

How does this affect agencies and staff?

Now that medical facilities are encouraged to be more inclusive of LGBTQ individuals and families, agencies are encouraged to evaluate existing programs and services as well as staff support.

A useful tool that can be used by agencies is the Health Equality Index (HEI) developed by the Human Rights Campaign and the Gay and Lesbian Medical Association (GALMA). The HEI measures the effectiveness of services provided to LGBTQ individuals.

2012 Health Equality Index Leader
Courtesy Human Rights Campaign

The HEI tests for the “core four”

  1. Patient Non-Discrimination
  2. Equal Visitation
  3. Employment Non-Discrimination
  4. Training in LGBT Patient-Centered Care

Responses to these questions are returned to the participating agencies in a comprehensive document for their use in service planning.

The U.S. Department of Health and Human Services Secretary Kathleen Sebelius describes the HEI as “an important tool for making sure LGBT individuals and families are treated with the same respect and care in these situations as anyone else.  It shines a light on what our country’s health institutions are doing to better serve LGBT patients.  And it’s very encouraging to see more institutions being recognized as “Leaders in LGBT Healthcare Equality.” Read More…

Participating organizations reap several benefits including free online training for staff at all levels,a customized needs assessment for planning, as well as featured status in the HEI report as Equality Leaders.

Registration is free and open to all healthcare organizations in the U.S. with ten or more employees, whether inpatient or outpatient, network or individual facility.

The following are some Suggestions for Medical Staff interacting with LGBTQ Patients:

  • Assumptions: Do not assume the sexual identity or orientation of your patient please ask in a proper manner.
  • Education: Learning about LGBTQ sexuality and sexual practices will allow healthcare providers to better assess patients’ support.
  • Language: Be aware of the language used as well as cultural nuances of the LGBTQ population, including celebrations of the community such as gay pride, symbols that are representative such as rainbow flags and pink triangles and terms like butch, femme, dyke, and queer.
  • Communication: Properly educate patients about the effect of illnesses and medical treatments on sexuality.
  • Compassion: Provide sensitive and compassionate service, if uncomfortable with learning about a patient’s sexuality be honest and let a patient know.
  • Respect: Be respectful of a patient and the information they are sharing, this includes confronting coworkers of inappropriate comments.

DOMA Repealed Whats Next?

Across the nation, supporters of LGBTQ legislation joined Edie Windsor of New York in celebrating the Supreme Court ruling to repeal  DOMA (Defense of Marriage Act) in a 5-4 vote. On November 9th, 2009, Edie Windsor sued the federal government after being taxed $363,000 after the death of her spouse Thea Spyer in 2009.

For those who are not familiar with DOMA , it is a piece of legislation signed into law by President Bill Clinton in 1996 as a way to define and protect the institution of marriage. It was meant to establish a Federal definition of: (1) "marriage" as only a legal union between one man and one woman as husband and wife; and (2) "spouse" as only a person of the opposite sex who is a husband or wife.

Section three of DOMA prohibited the federal government from recognizing marriages between gay or lesbian couples despite a legal marriage certificate within their state. Meaning these couples could not benefit from federal programs including healthcare and spousal supports, therefore limiting the rights of LGBTQ families. IMG_5788

What does it mean now that DOMA has been repealed?

  • The federal government now recognizes legal marriages of same sex couples.
  • Binational couples will now have the ability to sponsor United States residency for their partners.
  • Military families will now receive military health insurance, relocation assistance, and surviving spousal benefits.
  • Health insurance and pension protections are now available for deferral employees’ spouses.
  • Social security benefits will now be accessible for widows/widowers.
  • Joint income tax filing and exemption from federal state taxes.

Also in California, Proposition 8 has also been ruled unconstitutional.  The Proposition 8 decision now eliminates the confusion that plagued same sex couples since being legalized and then banned in 2008.


Chief Justice Roberts writes:  “We have never before upheld the standing of a private party to defend the constitutionality of a state statute when state officials have chosen not to. We decline to do so for the first time here.” If you think there is a little disconnect here — the U.S. government didn’t defend DOMA in the Windsor case yet the court ruled in that case — you have a point.  But this only serves to reinforce the new ground rules in same-sex marriage: We still don’t know what states can and cannot do regarding their own same-sex marriage laws. Read More…

What Does the Future Hold?

Although there is now recognition on the federal level, many states are still struggling with marriage equality. Currently, 13 states now acknowledge same sex marriage, and over 30 states ban it. There is still work to be done.


It’s LGBT Awareness Month Around the Globe

On June 13th, President Barack Obama held the fourth LGBT Pride reception since taking office in 2008. On Friday, the President reintroduced his 2009 declaration that the month of June will be Lesbian, Gay, Bisexual, and Transgender Pride Month.  President Obama is the second president to declare Pride month after President Bill Clinton declared June Gay & Lesbian Pride Month on June 2, 2000.

President Obama addressed several key issues regarding the LGBTQIA (Lesbian, Gay, Bisexual, Transgender, Queer, Intersex and Asexual, Ally) community including ending discrimination within the workplace, healthcare issues, the repeal of Don’t Ask Don’t Tell, as well as VAWA (Violence Against Women Act), stating “We’ve become not just more accepting; we’ve become more loving, as a country, and as a people.

Hearts and minds change with time. Laws do, too. Change like that isn’t something that starts here in Washington, but it’s something that has the power that Washington has a great deal of difficulty resisting over time. It’s something that comes from the courage of those who stood up, sat in, and came out. It’s something that comes from the compassion of family and friends and coworkers and teammates who show their love and support.”

LGBT Pride month would not be possible without the Stonewall Riots of 1969. These riots were a major turning point in the modern gay civil rights movement in the United States and around the world. When police raided the Stonewall Inn, a popular gay bar in the Greenwich Village section of New York City on June 28, 1969, the streets erupted into violent protests that lasted for six days.  The actions of those participating in the riots and following the riots paved the way for the modern fight for LGBTQIA rights within the United States

Social workers are bound by a Code of Ethics to regularly seek out education, understand, and respect those of diverse backgrounds. According to the National Association of Social Workers Code of Ethics, social workers should obtain education about and seek to understand the nature of social diversity and oppression with respect to race, ethnicity, national origin, color, sex, sexual orientation, gender identity, or expression, age, marital status, political belief, religion, immigration status, and mental or physical disability. Therefore as social workers, it is our responsibility to advocate for various populations.

After witnessing several friends within the LGBTQIA community struggle with the denial of basic human rights, inadequate healthcare services, and bigotry, I have since made a decision as a social worker to become an advocate for this population.

Celebrations are being held globally and throughout the nation, and North Carolina Pride events can be found here. I encourage my fellow social workers to attend their local Pride event if possible.

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