Understand and define the differences between sex, sexual orientation, gender, and gender identity.
Describe the disparities and health threats unique to LGBT patients.
Identify measures that can help create a positive environment in your ambulance or sphere of care.
Creating a positive space for patients is difficult at the best of times. Having called 9-1-1, few patients would describe their day as going well. Developing rapport and building trust are essential abilities of today’s healthcare practitioner.
Words mean different things to different people. Here are some commonly accepted definitions relevant to LGBT populations:
Acceptance — Regarding something as proper, normal, or inevitable.
Ally — A person who confronts homophobia, heterosexism, transphobia, and heterosexual privilege in themselves and others; respectfully shows concern for the well-being of people who identify as LGBTQ; and believes that heterosexism, homophobia, and transphobia are social justice issues.
Bisexual — A person who is attracted to more than one gender in an emotional or physical sense. They may have a preference for one gender over others.
Cisgender — A person whose gender identity is congruent with their biological sex.
Coming out — May refer to the process by which one recognizes, acknowledges, and/or embraces one’s own sexuality or gender identity (to “come out” to oneself). This term may also refer to the process by which one shares one’s sexuality or gender identity with others (to “come out” to friends, family, etc.).
Cross-dressing — In and of itself, this refers to a behavior that’s independent of gender identity and not synonymous with a transgender identity.
Gay — A man who is attracted to men in an emotional or physical sense. Not all men who engage in same-sex sexual intimacy identify as gay.
Gender — The social construct associated with men (masculinity) and women (femininity). Social constructs, or “gender norms,” that define what it means to be a man or a woman differ historically and culturally.
Gender identity — An individual’s own sense of their gender. It may or may not conform to the sex at birth and can be linked to a feeling of being male, female, both, or neither. Various nonbinary (male or female) descriptions are included in this category, including gender-fluid (moving between male and female), gender-queer (an intermediate between male and female), agender (having no gender), or poly- or bigendered (being both or many genders).
Heterosexism — The assumption made by institutions or individuals that everyone is heterosexual and/or that heterosexuality is inherently superior to homosexuality or bisexuality; any prejudiced attitude, action, or practice that subordinates people because of their nonheterosexual identity.
Homophobia — The fear of, discrimination against, or hatred of people who do not conform to rigid sex roles and sexuality stereotypes.
**Lesbian—A woman who is attracted to women in an emotional or physical sense. Not all women who engage in same-sex sexual intimacy identify as lesbian.
Queer — An umbrella term that embraces a variety of sexual orientations and gender identities. The term “queer” may not be adopted by all people who self-identify as LGBT.
Questioning — A person who is in the process of questioning their gender identity and/or sexual orientation.
Sex — The anatomic distinction between male and female. Sex can be chromosomal (XY for male, XX for female) or anatomical (testes for men, ovaries for women). Many developmental conditions result in being intersex, where external genitalia may not be congruent with internal sex organs, hormone function, or chromosomes.
Sexual orientation — How a person thinks of him- or herself in terms of whom they are either emotionally or physically attracted to.
Tolerance — The act of putting up with something.
Transgender — A person whose gender identity is not congruent with their biological sex. Sexual orientation is separate from gender identity.