The SAGE Encyclopedia of LGBTQ

Studies
Editorial Board

Editor
Abbie E. Goldberg Clark
University

Editorial Board
Katherine R. Allen Virginia
Tech
Meg John Barker
The Open University
José A. Bauermeister
University of Michigan
Lisa Diamond
University of Utah
Nancy J. Knauer
Temple University
Ramona Faith Oswald
University of Illinois at Urbana-Champaign

The SAGE Encyclopedia of

LGBTQ Studies

1
 Edited by
Abbie E. Goldberg
Clark University
 Copyright © 2016 by SAGE Publications, Inc.
FOR
INFORMATION: All rights reserved. No part of this book may be reproduced or
SAGE Publications,
utilized in any form or by any means, electronic or mechanical,
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SAGE Publications India Pvt. Library of Congress Cataloging-in-Publication Data
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B 1/I 1 Mohan Cooperative Industrial
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Mathura Road, New Delhi 110 Names: Goldberg, Abbie E., editor.
044
Indi
a Title: The SAGE encyclopedia of LGBTQ studies / edited by
SAGE Publications Asia-Pacific Pte. Abbie E. Goldberg.
Ltd.
3 Church
Street Samsung
#10-04 Description: Thousand Oaks, California : SAGE, [2016] |
Hub
Singapore Includes bibliographical references and index.
049483
Identifiers: LCCN 2015038930 | ISBN 9781483371306
(hardcover: alk. paper
)

Subjects: LCSH: Gay and lesbian studies–Encyclopedias. |

Gays–Encyclopedias. | Sexual minorities–Encyclopedias.

Classification: LCC HQ75.15 .S24 2016 | DDC 306.7603–

dc23 LC record available at http://lccn.loc.gov/2015038930
Acquisitions Editor: Maureen
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Enobakhare
Developmental Editor: Sanford J.
Robinson Editor: Tracy
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Reference Systems Manager: Leticia
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Stefanski
Contents

Volume 1
List of Entries
Reader’s Guide
About the Editor
Contributors
Introduction

Entries

A 1 E 349
B 103 F 391
C 179 G 425
D 279

Volume 2
List of Entries vii
Reader’s Guide xiii
Entries

H 467 M 729
I 575 N 807
J 627 O 829
K 637 P 833
L 639 Q 895

Volume 3
List of Entries vii
Reader’s Guide xiii
Entries

R 921 V 1279
S 977 W 1295
T 1167 Y 1317
Appendix: Organizations and Publications Providing Resources on LGBTQ Studies 1321
Index 1331
Li
st
of
E
n
tr
ie
s
Abstinence Adoption,
Only Until Openness in
Marriage Adoption and
Access to Foster Care
Health Care. Discrimination
See Health Adoption Type
Care System Adoption via
Activists in the Child
College Welfare
Adolescent System
Pregnancy Adults With
Adoption, LGBQ Parents
Choices Advance
About Health Care
Adoption, Planning
International Affirmative
Adoption, Therapy
Legal A
Consideration f
s in r
i
viii

c Aging, Social
a Relationships,
n and Support
Aging and
A Bisexuality
m Aging and Gay
e Men
r Aging and
i Lesbian
c Women
a Aging and
n Transgender
People
S Ally
e Development
x and
u Programming
a Ally
l Experience
i American
t Indian
i Sexualities.
e See Native
s American/
First Nation
A Sexualities
g Antigay Ballot
e Initiatives (and
LGBTQ
o Activism)
f Anxiety
Asexuality
C Asian
o American/Pacif
n ic Islander
s Sexualities
e Assisted
n Reproductive
t Technologies
Ageisms in (ARTs)
LGBTQ Athletes. See
Cultures College
Aging, Sex, Athletes;
and Sexuality Sports,
SexualMinor
ity Men in;
 Sports, Eating Disorders
Sexual- in
Minority LGBTQ
Women in People
Body
Ballroom Modification
Scene, The Body Size and
Bear Weight
Community Bondage,
Bereavement. Dominance/Su
See Dying, bmission,
Death, and Sadism/
Bereavement Masochism
Bias in the (BDSM)
Criminal Justice Bondage and
System Discipline/Domin
“Big Data” Bias ation and
in LGBTQ Submission
Research (BDSM). See
Binational Bondage,
Same-Sex Dominance/
Couples and Submission,
Families Sadism/Masoc
Biphobia hism (BDSM)
Bisexual Breast Care for
Inclusion in the Transgender
LGBTQ Rights People
Movement Bullying, Legal
Bisexual People Protections
and Community Against
Bisexualities Bullying, Rates
Bisexuality, and Effects of
Female Bullying, School-
Bisexuality, Based
Male Interventions for
Black Colleges. Business
See Butch–Femme
Historically
Black Campus Climate
Colleges and Cancer and
Universities, Social Support
LGBTQ Cancer in the
Students at LGBTQ
Body Image Community
Disturbance and
x

Career Children With

Development LGBQ Parents,
and Trajectories Stigmatization
Caregiving Children With
Catholic Transgender Parents,
LGBTQ People Psychosocial
Causes of Outcomes
Sexual Christian LGBTQ
Orientation. See People
Essentialist– Chronic Illness
Constructioni Cisgenderism
st Debate on Closet, The
the Origins COLAGE
of College Athletes
Sexual College Students
Orientation Colorado Designated
Child Support Beneficiary
After LGBQ Coming Out,
Divorce/Separat Disclosure, and
ion Passing
vii Commitment
List of Ceremonies
Entries Community Climate
Coparenting
Corrective Rape
Children With
LGBQ Parents, Couples Therapy
Academic Criminal Legal
System and LGBTQ
Outcomes
People
Children With
LGBQ Parents, Cross-Category
Female/Male Role Friendships
Cultural
Models
Dissemblance (of
Children With
African Americans)
LGBQ Parents,
Gender Custody and
Litigation, LGBQ
Development
Parents
and Identity
Custody Issues in
Children With
Transgender
LGBQ Parents,
Parenting
Psychosocial
Outcomes
DADT. See Gay
Children With
Exclusion in the
LGBQ Parents,
U.S. Military:
Sexual Identity
 Evolution and Discrimination on
Demise of Don’t the Basis of
Ask, Don’t Tell HIV/AIDS in
Dating, Sexual- Health Care
Minority Men Division of Labor in
Dating, Sexual- LGBTQ-Parent
Minority Women Families
Deciding Whether Divorce, Legal
to Parent Issues in
Defense of Divorce and
Marriage Act Relationship
(DOMA) Dissolution,
Dementia Psychological
Demographics and Experience of
the LGBTQ Divorce and
Population Separation,
Depression Historical
Developmental Perspective on
Aspects of DOMA. See Defense
Sexuality of Marriage Act
Developmental Domestic
Disabilities. See Partnership
Intellectual Domestic Violence,
Disabilities Female. See
Disabilities Among Intimate Partner
LGBTQ Elders Violence, Female
Disciplinary Domestic Violence,
Tensions in Male. See Intimate
Studying LGBTQ Partner
Populations Violence, Male
Discrimination Don’t Ask, Don’t
Against LGBTQ Tell and Public
Elders Opinion
Discrimination Down Low
Against LGBTQ Drag
People, Cost of Dying, Death, and
Discrimination Bereavement
Against LGBTQ
People by Law East Asian
Enforcement Sexualities
Discrimination Education
Against Effeminacy
LGBTQ Elder Abuse
People in the Embodiment
Public Sector
xii

Employment Non- Freedom to Marry

Discrimination Act (and Other Marriage
(ENDA) Equality
Essentialist– O
Constructionist r
Debate on the g
Origins of a
Sexual n
Orientation i
Ethical Debates z
About Surrogacy a
Ethical Research t
With Sexual and i
Gender o
Minorities n
Evolutionary s
Theory )
Ex-Gay Movement
Exotic F
Becomes r
Erotic: A i
Developmen e
tal Theory of n
Sexual d
Orientation s
h
Families of Choice i
Families of Origin, p
Relationships With s
Fertility Tourism.
See International Gaming
Surrogacy/ Gangs
Reproductive Gay, Lesbian
Outsourcing & Straight
Film Education
Focus Groups Network
Foster Care (GLSEN)
Foster Parenting Gay Exclusion
List of Entries ix

Foster Parenting, in the U.S.

Legal Military:
Considerations in Evolution
Fraternities and and Demise
Sororities of Don’t
 Ask, Don’t Health Care
Tell Plans
Gay Health Care
Gentrification Providers,
Gay Sperm Disclosure of
Donors Sexual
Gayborhoods Identity to
Gaydar Health Care
Gay–Straight System
Alliances Health
(GSAs) Disparities
Gender Health
Binaries Disparities,
Gender Transgender
Clinics People
Gender Health
Identity Insurance
and Coverage
Pregnancy. for
See Transgender
Masculinit People,
y and Access to
Pregnancy Heteronormati
Gender vity
Identity Heterosexism
Discriminatio Heterosexist
n as Sex Bias in
Discrimina Research
tion Historically
Gender Black Colleges
Nonconformi and
ty, Youth Universities,
Gender LBGTQ
Spectrum Students at
Gender History of
Transition at Transgender
Work Medicine in the
Genderqueer United
GLAAD States
GSAs. See HIV and
Gay–Straight Treatment
Alliances HIV/AIDS and
(GSAs) Aging
HIV/AIDS and
Hate Crimes Gay
Masculinity
xiv

HIV/AIDS and Infertility and

Racial/Ethnic Reproductive Loss
Disparities Intellectual
HIV/AIDS and Disabilities
Social Support Intentions and
HIV/AIDS in Motivations to
Prison Parent
HIV/AIDS Internalized
Treatment and Homophobia
Care, International
Psychosocial Surrogacy/Reproduc
and Structural tive
Barriers to Outsourcing
Homelessness Interracial
Home–School Relationships
Partnerships in Intersections
LGBTQ-Parent Between Sex,
Families Gender, and Sexual
Homonormativity Identity
Homophobia Intersex Society of
Homophobic North America
Language in the Intersexuality
Peer Group Intimate Partner
Homosexuality, Violence, Female
Female Inti
Homosexuality, mat
Male e
Hormones and Part
Surgery During ner
Gender Vio
Transition len
Hospital Visitation ce,
Housing, Mal
Protection Against e It
Discrimination in Get
HRC. See Human s
Rights Campaign Bet
(HRC) ter
Human Rights
Campaign (HRC) Jewish LGBTQ
Hypermasculinity People
Joint Adoption
Immigration Juvenile Justice
Incarceration System

Kink
Lambda Legal Contexts
Latina/o LGBTQ Online
Sexualities Communications:
Laws Banning Building
Homosexuality and Community
Sodomy Through Blogs,
Leadership Vlogs, and
List of Facebook
Entries LGBTQ People of
Color
Leather Culture LGBTQ Social
Movements
Legal
(Assimilation vs.
Consciousness
Liberation)
Legal Recognition
of Nonmarital LGBTQ Umbrella
Same-Sex LGBTQ-Parent
Relationships Families With More
Than Two
Legal Rights of
Nonbiological Parents
Parents LGBTQ-Parent
Leisure Involvement and
Advocacy in
Lesbian “Bed
Death” Schools
LGB Parenting LGBT/Queer
Styles and Values Studies Programs
LGBQ Parents, Living
Coming Out to Arrangements of
Children Children After
LGBQ
LGBQ Parents and
the Health Care Divorce/
System Separation
LGBT Consumer Long-Term Same-
Market, The Sex Couples
LGBTQ
Grandparenting Marriage, Reasons
LGBTQ Health in for and Against
Non-Western Marriage Equality,
Contexts Effects on Well-
LGBTQ Being and
(In)Visibility Relationships
Within College Marriage Equality,
Contexts Landmark Court
LGBTQ Issues in Decisions
K–12 Education Masculinities
Across Global
xvi

Masculinity and National Center for

Pregnancy Lesbian Rights
Masculinity (NCLR)
Stereotypes Native
Media American/First
Representations of Nations Sexualities
LGBTQ People New Family
Men Who Have Structures
Sex With Men Survey. See
(MSM) Methodologic
Mentoring al Decisions
Methodological by
Decisions by Researchers
Researchers of of
LGBTQ LGBTQ
Populations Populations
Microaggressions No Promo Homo
Military and Policies
LGBTQ People Nonbinary Genders
Military and Nonbiological,
Transgender Nongestational
People Mother
Minority Stress Nondiscrimination
Mixed-Orientation Protections, State
Marriages and Local
Monogamy and Nonheterosexual
Non-Monogamy Children of LGBTQ
Monosexism Parents
Morality and
Respectability Online
MSM. See Men Communications.
Who Have Sex See LGBTQ Online
With Men Communications:
(MSM) Building
Multira Community
cial Through Blogs,
LGBT Vlogs, and
Q- Facebook
Parent Online Surveys
Familie Origins of
s Heterosexuality and
Muslim Nonheterosexualit
LGB y. See
People EssentialistConstr
uctionist Debate
Naming Practices on the Origins of
 Sexual Gender
Orientation Identity
Pornography
Pansexuality Posttraumatic
Parent Gender Stress
Transition and Poverty
Intimate Powers of
Relationship Attorney
Changes Prison Rape
Parent Relationship Professional
Quality Athletes
Parental Well- Psychological
Being Approaches to
Parent–Child Studying
Relationships LGBTQ
Parents and People
Friends of
Lesbians and Gays. Qualitative
See PFLAG Research
Partners in Quantitative
(Gender) Research
Transition Queer
Passing. See Queer
Strategic Anticapitalism
Disclosure Queer
PFLAG Ethnographies/
Physical Autoethnograp
Disabilities hies
Physicians Queer Politics
Police Queer Theory
Officers/Law Queering
Enforcement Heteromasculi
Officials nities
Policing
Masculinities and Racialized
Femininities Masculinity
Polyamorous Relationships
Parenting With Families
List of Entries xi

Polyamory Who Share the

Population-Based Same
Surveys, Donor
Collection of Relationships
Data on Sexual With Former
Orientation and Spouses
xviii

Relationships Romantic
With Parents, Friendships
Youth Rural and
Relationships Urban
With Communities
Siblings,
Youth Same-Sex
Religion and Weddings
Spirituality, Sampling
Youth School Choice
Religion/ in LGBTQ-
Spirituality Parent Families
and LGBTQ School Climate
People School
Religious Professionals’
Freedoms and Responses to
LGBTQ LGBTQ
Rights Training
Religious School Selection.
Identity and See School Choice
Sexuality, in
Reconciliat LGBTQ-Parent
ion of Families
Religious Schools as
LGBTQ Heteronormative
Youth Spaces
Reproductive School-to-Prison
Outsourcin Pipeline
g. See Scientific Integrity,
Internation Debates About
al Second-Parent
Surrogacy/ Adoption
Reproducti Self-Insemination
ve Senior Living
Outsourcin Programs and
g Policies
Research, Sense of
Use of Large Belonging/School
Datasets in Climate in
Resilience LGBTQ-Parent
and Families
Protective Services and
Factors, Advocacy for GLBT
Youth Elders (SAGE) Sex
Retirement Positive Movement
Sex Reassignment Discrimination
Surgery. See Sexual Risk-Taking
Vaginoplasty for Sexual-Identity
Transgender Labels
Women Sexualities at School
Sex Therapy Sibling
Sex Work and Relationships
Criminalization Single-Parent
Sex Work and Adoption
Prostitution, Sissyboy Experience
Female Smoking
Sex Work and Social Class
Prostitution, Male Social Class and
Sexology Sexuality,
Sexual Addiction Intersections
and Compulsions Between
Sexual Agreements Social Media, Use
and Arrangements for Recruitment
Sexual Attraction, Sororities and
Behavior, and Fraternities. See
Identity Fraternities and
Sexual Sororities
Compulsivity, Spatial/Social
Treatment of Location of LGBT
Sexual Consent Persons
Sexual Desire and Sperm Donor,
Relationship Choosing a
Quality List of
Sexual Education Entries
Mandates for
Inclusion
Sperm Donor
Sexual Fluidity
Selection and
Sexual Minorities
Race/Ethnicity
and Violence
Sperm Donors,
Sexual Norms and
Known
Practices
Sperm Donors,
Sexual Orientation
Unknown
Among
Sperm Donors’
Transgender
Involvement in
People
Children’s Lives
Sexual Orientation
Sports, Sexual-
Conversion
Minority Men in
Therapy
Sports, Sexual-
Sexual Orientation
Minority Women in
Discrimination as
Sex
xx

Stealth Therapy With

(Transgender Children of LGBQ
Passing) Parents
Stepfamily Therapy With
Division of Labor Families During and
and Money After Parental
Management Gender Transition
Stepfamily Family Therapy With
Functioning and
LGBTQ Parents
Relationship Therapy With
Stability LGBTQ Youth
Stonewall Therapy With
Strategic Transgender,
Disclosure Transsexual, and
Substance Abuse Gender-
and LGBTQ Nonconforming
People People
Substance Abuse Therapy With
Treatment and Transgender
Recovery Individuals:
Substance Mental Health
Abuse/Dependence Considerations
and Transgender Tomboy Experience
People Training of Teachers
Substance in LGBQ Sensitivity
Use,
Youth and
Suicide, Effects on Competence
Family and Friends Transgender and
Suicide, Gender-
Risk
Factors for and Nonconforming
Prevention of Individuals and
Support Groups Bathrooms
and Resources Transgender and
Surrogacy Gender-
Surrogacy, Legal Nonconforming
Considerations of Youth and the
Legal System
Theories of Sexual Transgender and
Orientation Gender-
Therapists, Nonconforming
Training of Youth of Color
Therapists’ Biases Transgender
Regarding LGBTQ Ethnographies
People Transgender
Geographies
Transgender Transgender Youth
Health Care and Cross-Sex
Transgender Hormones
Identities Transgender Youth
Transgender and Family
Inclusion in the Relationships
LGBTQ Rights Transgender Youth
Movement and Puberty
Transgender Suppression
Inclusion on Transgender Youth
College Campuses and Well-Being
Transgender Transition to
Inmates Parenthood and
Transgender Parental Roles
Medicine. See Transition to
History of Parenthood for
Transgender LGBTQ People
Medicine in the Transphobia
United States Transrac
Transgender ial
Parents and Well- Versus
Being Inracial
Transgender Adoptio
People and n Trevor
Binding, Tucking, Project,
and The
Packing
Transgender Vaginoplasty for
People and Transgender Women
Division of Labor Veterans
Transgender Violence and
People and Victimization of
Religion/Spiritualit Youth
y Visual Arts
Transgender
People and Wills and Trusts
Violence Work Environments
Transgender Work–Family
Sexualities Interface, LGBQ
Transgender Parents
Students: Access Workplace
to Sex-Segregated Discrimination
Facilities and Workplace
Programs Friendships
Workplace Policies
 xxii

Workplace Activism)
Relationships Employment
World Professional Non-
Association for Discrimination
Transgender Act (ENDA)
Health Freedom to
WPATH. See Marry (and
World Other Marriage
Professional Equality
Association for Organization
Transgender s)
Health Gay, Lesbian
& Straight
Youth and Dating Education

Reader’s Guide

The Reader’s Guide is provided to aid readers in identifying entries on related topics. It classifies entries into
15 general topical categories: (1) Activism and Advocacy; (2) Family, Kin, and Friendship Networks; (3)
Intersectionalities; (4) LGBTQ Identity and Politics; (5) LGBTQ People and Aging; (6) LGBTQ People,
Health, and Well-Being; (7) LGBTQ Youth; (8) LGBTQ College Students/Young Adults; (9) Marriage and
Divorce; (10) Parenting; (11) Research Methods; (12) Routes to Parenthood; (13) Sexuality and
Intimate Relationships; (14) Societal Institutions and LGBTQ Issues; and (15) Work. Entries may appear
in multiple Network
categories, and (GLSEN)
often do. Gay–Straight
Alliances
(GSAs)
Activism and
Gender
Advocacy
Spectrum
Activists in GLAAD
College Human Rights
Ally Campaign
Development Intersex
and Society of
Programming North America
Ally It Gets Better
Experience Lambda Legal
Antigay National
Ballot Center for
Initiatives Lesbian Rights
(and LGBTQ (NCLR)
 No Promo Community
Homo Through Blogs,
Policies Vlogs, and
PFLAG Facebook
School Mentoring
Professionals PFLAG
’ Responses Relationships With
to LGBTQ Families Who Share
Training the Same
Stonewall Donor
Trevor Relationships With
Project, The Parents, Youth
World Relationships With
Professional Siblings, Youth
Association Romantic
for Friendships
Transgender Services and
Health Advocacy for GLBT
Family, Kin, and Elders (SAGE)
Friendship Sibling
Networks Relationships
Suicide, Effects on
Aging, Social
Family and Friends
Relationships, and
Support Groups and
Support
Resources
Ballroom Scene,
Transgender Youth
The
and Family
Bisexual People
Relationships
and Community
Workplace
Cancer and Social
xiii
Support Relationships
Caregiving Reader’s Guide
Cross-Category
Friendships
Intersectionalities
Families of Choice
Families of Origin, African American
Relationships With Sexualities
Friendships Asian
HIV/AIDS and American/Pacific
Social Support Islander Sexualities
LGBTQ Binational Same-Sex
Grandparenting Couples and
LGBTQ Online Families
Communication Catholic LGBTQ
s: Building People
xxiv

Christian LGBTQ Reconciliation of

People Religious LGBTQ
Cultural Youth
Dissemblance (of Rural and Urban
African Communities
Americans) Social Class
East Asian Social Class and
Sexualities Sexuality,
HIV/AIDS and Intersections
Gay Masculinity Between Sperm
HIV/AIDS and Donor Selection and
Racial/Ethnic Race/Ethnicity
Disparities Transgender and
Intellectual Gender-
Disabilities Nonconforming
Interracial Youth of Color
Relationships Transgender People
Intersections and
Between Sex, Religion/Spirituality
Gender, and Transgender
Sexual Sexualities
Identity
Intersexuality LGBTQ Identity and
Jewish LGBTQ Politics
People
Latina/o Asexuality
Sexualities Ballroom Scene, The
LGBTQ People of Bear Community
Color Bisexual Inclusion in
Multiracial the LGBTQ Rights
LGBTQ-Parent Movement
Families Bisexual People and
Muslim LGB Community
People Bisexualities
Native Bisexuality, Female
American/First Bisexuality, Male
Nations Sexualities Bondage,
Physical Dominance/Sub
Disabilities mission, Sadism/
Racialized Masochism
Masculinity (BDSM)
Religion/ Butch–Femme
Spirituality and Cisgenderism
LGBTQ People Closet, The
Religious Identity
and Sexuality,
Coming Out, LGBTQ Social
Disclosure, and Movements
Passing (Assimilation vs.
Community Liberation)
Climate LGBTQ Umbrella
Demographics and Masculinities
the LGBTQ Masculinity
Population Stereotypes
Down Low Morality and
Drag Respectability
Effeminacy Nonbinary Genders
Embodiment Pansexuality
Essentialist– Psychological
Constructio Approaches to
nist Debate Studying LGBTQ
on the People
Origins of Queer
Sexual Queer
Orientation Anticapitalism
Evolutionary Queer
Theory Ethnographies/Auto
Ex-Gay Movement ethnographies
Exotic Queer Politics
Becomes Queer Theory
Erotic: A
Developmen
tal Theory of
Sexual
Orientation
Gay Gentrification
Gayborhoods
Gaydar
Gender Binaries
Gender Spectrum
Genderqueer
Homosexuality,
Female
Homosexuality,
Male
Hypermasculinity
Internalized
Homophobia
Intersexuality
Kink
xxvi
Queering Heteromasculinities Body Size and Weight
Religious Identity and Sexuality, Reconciliation of Breast Care for Transgender People
Sexual Fluidity Cancer and Social Support
Sexual Identity Labels Cancer in the LGBTQ Community
Sexual Orientation Among Transgender People Chronic Illness
Sissyboy Experience Couples Therapy
Stealth (Transgender Passing) Dementia
Strategic Disclosure Depression
Theories of Sexual Orientation Disabilities Among LGBTQ Elders
Tomboy Experience Discrimination on the Basis of HIV/AIDS in
Transgender Ethnographies Health Care
Transgender Identities Dying, Death, and Bereavement
Transgender Inclusion in the LGBTQ Rights Ex-Gay Movement
Movement Health Care Plans
Health Care Providers, Disclosure of Sexual
LGBTQ People and Aging Identity to
Health Care System
Advance Health Care Planning
Health Disparities
Ageisms in LGBTQ Cultures
Health Disparities, Transgender People
Aging, Sex, and Sexuality
Health Insurance Coverage for Transgender
Aging, Social Relationships, and Support
People, Access to
Aging and Bisexuality
History of Transgender Medicine in the United
Aging and Gay Men
States
Aging and Lesbian Women
HIV and Treatment
Aging and Transgender People
HIV/AIDS and Aging
Caregiving
HIV/AIDS and Gay Masculinity
Dementia
HIV/AIDS and Racial/Ethnic Disparities
Disabilities Among LGBTQ Elders
HIV/AIDS and Social Support
Discrimination Against LGBTQ Elders
HIV/AIDS in Prison
Dying, Death, and Bereavement
HIV/AIDS Treatment and Care, Psychosocial and
Elder Abuse
Structural Barriers to
HIV/AIDS and Aging
Hormones and Surgery During Gender
Powers of Attorney
Transition
Retirement
Hospital Visitation
Senior Living Programs and Policies
Intellectual Disabilities
Services and Advocacy for GLBT Elders (SAGE)
LGBTQ Health in Non-Western Contexts
Wills and Trusts
LGBTQ Parents and the Health Care System
Marriage Equality, Effects on Well-Being and
LGBTQ People, Health, and Well-Being
Relationships
Advance Health Care Planning Men Who Have Sex With Men (MSM)
Affirmative Therapy Parental Well-Being
Anxiety Physical Disabilities
Biphobia Physicians
Body Image Disturbance and Eating Disorders in Posttraumatic Stress
LGBTQ People Powers of Attorney
Reader’s Guide Reader’s Guide

Body Modification Sex Therapy


Sexology
Sexual Addiction and Compulsions
Sexual Agreements and Arrangements
Sexual Compulsivity, Treatment of
Sexual Orientation Conversion Therapy
Sexual Risk-Taking
Smoking
Substance Abuse and LGBTQ People
Substance Abuse Treatment and Recovery
Substance Abuse/Dependence and Transgender
People
Substance Use, Youth
Suicide, Effects on Family and Friends
Suicide, Risk Factors for and Prevention of
Support Groups and Resources
Therapists, Training of
Therapists’ Biases Regarding LGBTQ People
Therapy With Children of LGBTQ Parents
Therapy With Families During and After Parental
Gender Transition
Therapy With LGBTQ Parents
Therapy With LGBTQ Youth
Therapy With Transgender, Transsexual, and
Gender-Nonconforming People
Therapy With Transgender Individuals: Mental
Health Considerations
Transgender Health Care
Transgender Parents and Well-Being
Transgender People and Binding, Tucking, and
Packing
Transgender Youth and Cross-Sex Hormones
Transgender Youth and Puberty Suppression
Transgender Youth and Well-Being
Trevor Project, The
Vaginoplasty for Transgender Women
LGBTQ Youth
Abstinence Only Until Marriage
Adolescent Pregnancy
Age of Consent
Bullying, Legal Protections Against
Bullying, Rates and Effects of
Bullying, School-Based Interventions for
Developmental Aspects of Sexuality
Foster Care
Gaming
Gangs
xxvii
Gay, Lesbian & Straight Education Network
(GLSEN)
Gay–Straight Alliances (GSAs)
Gender Clinics
Gender Nonconformity, Youth
Homophobic Language in the Peer Group
It Gets Better
LGBTQ Issues in K–12 Education Across Global
Contexts
LGBTQ Online Communications: Building
Community Through Blogs, Vlogs, and
Facebook
No Promo Homo Policies
Nonheterosexual Children of LGBTQ Parents
Relationships With Parents, Youth
Relationships With Siblings, Youth
Religion and Spirituality, Youth
Religious LGBTQ Youth
Resilience and Protective Factors, Youth
School Climate
School Professionals’ Responses to LGBTQ
Training
Schools as Heteronormative Spaces
School-to-Prison Pipeline
Sexual Education Mandates for Inclusion
Sexualities at School
Substance Use, Youth
Therapy With LGBTQ Youth
Therapy With Transgender, Transsexual, and
Gender-Nonconforming People
Tomboy Experience
Training of Teachers in LGBQ Sensitivity and
Competence
Transgender and Gender-Nonconforming
Individuals and Bathrooms
Transgender and Gender-Nonconforming Youth and
the Legal System
Transgender and Gender-Nonconforming Youth of
Color
Transgender Students: Access to Sex-Segregated
Facilities and Programs
Transgender Youth and Cross-Sex Hormones
Transgender Youth and Family Relationships
Transgender Youth and Puberty Suppression
Transgender Youth and Well-Being
Trevor Project, The
Violence and Victimization of Youth Youth
and Dating
xxviii
LGBTQ College Students/Young Adults
Abstinence Only Until Marriage
Activists in College
Ally Development and Programming
Ally Experience
Campus Climate
Career Development and Trajectories
College Athletes
College Students
Fraternities and Sororities
Historically Black Colleges and Universities,
LGBTQ Students at
LGBTQ (In)Visibility Within College Contexts
LGBT/Queer Studies Programs
Transgender Inclusion on College Campuses
Transgender Students: Access to Sex-Segregated
Facilitates and Programs
Marriage and Divorce
Child Support After LGBQ Divorce/Separation
Colorado Designated Beneficiary
Commitment Ceremonies
Defense of Marriage Act (DOMA)
Divorce, Legal Issues in
Divorce and Relationship Dissolution,
Psychological Experience of
Divorce and Separation, Historical Perspective on
Freedom to Marry (and Other Marriage Equality
Organizations)
Legal Consciousness
Legal Recognition of Nonmarital Same-Sex
Relationships
Living Arrangements of Children After LGBQ
Divorce/Separation
Long-Term Same-Sex Couples
Marriage, Reasons for and Against
Marriage Equality, Effects on Well-Being and
Relationships
Marriage Equality, Landmark Court Decisions
Mixed-Orientation Marriages
Naming Practices
Partners in (Gender) Transition
Reader’s Guide
Powers of Attorney
Relationships With Former Spouses
Same-Sex Weddings Wills
and Trusts
Parenting
Adoption, Legal Considerations in
Adoption, Openness in
Adults with LGBQ Parents
Caregiving
Child Support After LGBQ Divorce/Separation
Children With LGBQ Parents, Academic
Outcomes
Children With LGBQ Parents, Female/Male Role
Models
Children With LGBQ Parents, Gender
Development and Identity
Children With LGBQ Parents, Psychosocial
Outcomes
Children With LGBQ Parents, Sexual Identity
Children With LGBQ Parents, Stigmatization
Children With Transgender Parents, Psychosocial
Outcomes
Coparenting
Custody and Litigation, LGBQ Parents
Custody Issues in Transgender Parenting
Division of Labor in LGBTQ-Parent Families
Foster Care
Foster Parenting
Foster Parenting, Legal Considerations in
Home–School Partnerships in LGBTQ-Parent
Families
Joint Adoption
Legal Rights of Nonbiological Parents
LGB Parenting Styles and Values
LGBQ Parents, Coming Out to Children
LGBQ Parents and the Health Care System
LGBTQ Grandparenting
LGBTQ-Parent Families With More Than Two
Parents
LGBTQ-Parent Involvement and Advocacy in
Schools
Living Arrangements of Children After LGBQ
Divorce/Separation
Multiracial LGBTQ-Parent Families
Naming Practices
Reader’s Guide
Nonbiological, Nongestational Mother
 xxix
Nonheterosexual Children of LGBTQ Parents Adoption, International
Parent Gender Transition and Intimate Relationship Adoption, Legal Considerations in
Changes Adoption and Foster Care Discrimination
Parental Well-Being Adoption Type
Parent–Child Relationships Adoption via the Child Welfare System
Polyamorous Parenting Assisted Reproductive Technologies (ARTs)
Relationships With Families Who Share the Same Deciding Whether to Parent
Donor Ethical Debates About Surrogacy
Second-Parent Adoption Foster Care
Sense of Belonging/School Climate in LGBTQ- Foster Parenting
Parent Families Foster Parenting, Legal Considerations in
Single-Parent Adoption Gay Sperm Donors
Sperm Donors’ Involvement in Children’s Lives Infertility and Reproductive Loss
Stepfamily Division of Labor and Money Intentions and Motivations to Parent
Management International Surrogacy/Reproductive
Stepfamily Family Functioning and Relationship Outsourcing Joint
Stability Adoption
Surrogacy, Legal Considerations of Masculinity and Pregnancy
Therapy With Children of LGBTQ Parents Nonbiological, Nongestational Mother
Therapy With Families During and After Parental Second-Parent Adoption
Gender Transition Self-Insemination
Therapy With LGBTQ Parents Single-Parent Adoption
Transgender Parents and Well-Being Sperm Donor, Choosing a
Transition to Parenthood and Parental Roles Sperm Donor Selection and
Transition to Parenthood for LGBTQ People Work– Race/Ethnicity
Family Interface, LGBQ Parents Sperm Donors, Known
Sperm Donors, Unknown
Surrogacy
Research Methods Surrogacy, Legal Considerations of
“Big Data” Bias in LGBTQ Research Transracial Versus Inracial Adoption
Disciplinary Tensions in Studying LGBTQ
Populations Sexuality and Intimate Relationships
Ethical Research With Sexual and Gender Minorities
Focus Groups Adolescent Pregnancy
Heterosexist Bias in Research Age of Consent
Methodological Decisions by Researchers of Aging, Sex, and Sexuality
LGBTQ Populations Bear Community
Online Surveys Bondage, Dominance/Submission, Sadism/
Population-Based Surveys, Collection of Data on Masochism (BDSM)
Sexual Orientation and Gender Identity Butch–Femme
Qualitative Research Dating, Sexual-Minority Men
Quantitative Research Dating, Sexual-Minority Women
Research, Use of Large Datasets in Developmental Aspects of Sexuality
Sampling Down Low
Scientific Integrity, Debates About Interracial Relationships
Social Media, Use for Recruitment Intersections Between Sex, Gender, and Sexual
Routes to Parenthood Identity
Intersexuality
Adoption, Choices About Intimate Partner Violence, Female
xxx
Intimate Partner Violence, Male Corrective Rape
Kink Criminal Legal System and LGBTQ People
Leather Culture Custody and Litigation, LGBQ Parents Custody
Lesbian “Bed Death” Issues in Transgender Parenting DADT. See Gay
Long-Term Same-Sex Couples Exclusion in the U.S. Military:
Men Who Have Sex With Men (MSM) Evolution and Demise of Don’t Ask, Don’t Tell
Mixed-Orientation Marriages Defense of Marriage Act (DOMA)
Monogamy and Non-Monogamy Discrimination Against LGBTQ Elders
Monosexism Discrimination Against LGBTQ People, Cost of
Pansexuality Discrimination Against LGBTQ People by Law
Parent Gender Transition and Intimate Relationship Enforcement
Changes Discrimination Against LGBTQ People in the
Polyamorous Parenting Public Sector
Polyamory Discrimination on the Basis of HIV/AIDS in
Pornography Health Care
Prison Rape Don’t Ask, Don’t Tell and Public Opinion
Romantic Friendships Education
Sex Therapy Employment Non-Discrimination Act (ENDA)
Sex Work and Criminalization Foster Care
Sex Work and Prostitution, Female Foster Parenting, Legal Considerations in
Sex Work and Prostitution, Male Gay Exclusion in the U.S. Military: Evolution and
Sexology Demise of Don’t Ask, Don’t Tell
Sexual Addiction and Compulsions Gender Identity Discrimination as Sex
Sexual Agreements and Arrangements Discrimination
Sexual Attraction, Behavior, and Identity Hate Crimes
Sexual Compulsivity, Treatment of Health Care System
Sexual Consent Health Insurance Coverage for Transgender
Sexual Desire and Relationship Quality People, Access to
Sexual Education Mandates for Inclusion Heteronormativity
Sexual Fluidity Heterosexism
Sexual Norms and Practices HIV/AIDS in Prison
Sexual Risk-Taking Homelessness
Transgender People and Division of Labor Homonormativity
Transgender Sexualities Youth Homophobia
and Dating Housing, Protection Against Discrimination in
Immigration
Societal Institutions and LGBTQ Issues Incarceration
Adoption, Legal Considerations in Juvenile Justice System
Adoption and Foster Care Discrimination Laws Banning Homosexuality and Sodomy
Bias in the Criminal Justice System Legal Consciousness
Binational Same-Sex Couples and Families Microaggressions
Biphobia Military and LGBTQ People
Bullying, Legal Protections Against Military and Transgender People
Reader’s Guide Minority Stress
Reader’s Guide

Bullying, School-Based Interventions for

Business Monosexism
Community Climate No Promo Homo Policies
 xxxi
Nondiscrimination Protections, State and Sports, Sexual-Minority Women in
Local Strategic Disclosure
Police Officers/Law Enforcement Officials Transgender and Gender-Nonconforming
Policing Masculinities and Femininities Individuals and Bathrooms
Pornography Veterans
Poverty Visual Arts
Prison Rape Work Environments
Religion/Spirituality and LGBTQ People Work-Family Interface, LGBQ Parents
Religious Freedoms and LGBTQ Rights Workplace Discrimination
Rural and Urban Communities Workplace Friendships
School Climate Workplace Policies
Schools as Heteronormative Spaces Workplace Relationships
School-to-Prison Pipeline
Sex Work and Criminalization
Sexual Minorities and Violence
Sexual Orientation Discrimination as Sex
Discrimination
Social Class
Spatial/Social Location of LGBT Persons
Sports, Sexual-Minority Men in
Sports, Sexual-Minority Women in
Transgender and Gender-Nonconforming
Individuals and Bathrooms
Transgender and Gender-Nonconforming Youth and
the Legal System
Transgender Geographies
Transgender Inmates
Transgender People and Violence
Transphobia
Violence and Victimization of Youth Workplace
Discrimination

Work
Business
Career Development and Trajectories
Employment Non-Discrimination Act (ENDA)
Education
Gender Transition at Work
Health Care Plans
Leadership
Leisure
LGBT Consumer Market, The
Mentoring
Physicians
Police Officers/Law Enforcement Officials
Professional Athletes
Sports, Sexual-Minority Men in
Abo
ut
the
Edit
or
Abbie E. Goldberg technologies, and
is an Associate other related topics.
Professor in the She is currently on
Department of the editorial boards of
Psychology at Clark eight journals,
University in including the Journal
Worcester, of Marriage and
Massachusetts. She Family, the Journal
received her PhD in of
clinical psychology Family Psychology, and
from the University Adoption Quarterly. She
of Massachusetts
Amherst and
completed her
clinical psychology
internship at Yale
Medical School. She
has published over 70
peer-reviewed
articles on
lesbian/gay
parenting, children of
lesbian and gay
parents, families
formed through
adoption, families
formed via
reproductive
 Contributors xxxiii

xxi Springer). She has

is the author of two received funding from
books: Lesbian and Gay the
Parents and Their National Institutes of
Children: Research on Health, the American
the Family Life Cycle Psychological
(2010, APA), and Gay Association, the Alfred
Dads: Transitions to P. Sloan
Adoptive Fatherhood Foundation, the
(2012, NYU Press). She Williams Institute, the
is also the editor, with Spencer Foundation, the
Katherine R. Allen, of Gay and Lesbian
LGBT-Parent Families: Medical Association,
Innovations in and the Society for the
Research and Psychological Study of
Implications for Practice Social Issues.
(2013,

Cont
ribut
ors

Kira Abelsohn
University of Calgary
Gender
Dysphoria
Roberto L. Abreu
University of Kentucky
Arthur
Rhode
Island
Colle
ge
Katie L. Acosta
Georgia State University
 East
Carol
ina
Unive
rsity
Tony E. Adams
Northeastern Illinois University
Balsam
P
alo Alto University Madelaine Adelman
Arizona State University
The
Open
Unive
rsity
Alex Ajayi
University of Minnesota
Louisi
ana
Tech
Unive
rsity
John D. Allen
Rainbow Support Group
Katherine R. Allen
Virginia Tech
Leslie C. Allen
State
Temple University
Unive
rsity
of
Hamb
urg
Louisa Allen
University of Auckland
U
niversity of Michigan Kathryn Almack
University of Nottingham
 Contributors xxxv

G
ender Spectrum Ellen Ann
Andersen
University of Vermont
Unive
rsity
of
Houst
on
Eric Anderson
University of Winchester
Unive
rsity
of
Mass
achus
etts
Amhe
rst
Simon Andrade
New York City Department of Health and
Bem
Mental Hygiene
Y. Gavriel Ansara Diana C. Bennett
University of Surrey University of
Utah

xxii
Kristen E. Benson Karen L. Blair
North Dakota State University of Utah
University
Lucy Blake
Israel Berger Centre for Family
University of Sydney Research
Dana Berkowitz Bernadette
Louisiana State Blanchfield
University University of
Virginia
CJ Bishop
University of Madelyn J. Boesen
Saskatchewan GLSEN (Gay,
Lesbian & Straight
Kaitlin A. Black
Education
Clark University
 Network) New York
Derek M. Bolen David Brodzinsky
Angelo State Nationa
University l
Cent
Alexander A. Boni-
er on
Saenz
Adop
IIT Chicago-Kent
tion
College of Law
and
Amy Brainer Per
University of man
Michigan–Dearborn ency
Ana Maria Brandão Taylor N. T.
University of Minho Brown
University of
M
California, Los
ar
Angeles, School
k
of Law
B
re Kath Browne
n University of
n Brighton
a
Michael D.
n
Brubaker
-
University of
I
Cincinnati
n
g Douglas Bruce
A DePaul University
C Stephanie Budge
R
University of
I Wisconsin–
A Madison
Barbara G. Brents Joan M. Burda
University of Nevada, Lawyer, Lakewood,
Las Vegas Ohio
Melanie E. Brewster Case Western
Teachers College, Reserve
Columbia University University
School of Law
Tristan Bridges
College at Brockport, Carol M.
State University of Burns-
 Contributors xxxvii

Wortham University of
Oakland Montana
University
Christopher C.
Catherine Butler Collins
University of Bath Angelo State
University
Thomas Stone
Carlson
North Dakota State
University
Mark Carrigan
University of
Warwick
She
ila
L.
Cav
ana
gh
Yor
k
Uni
ver
sity
Peter J. D. Ceglarek
University of
Michigan
Michael P. Chaney
Oakland University
Shannon
D. Chaplo
Universit
y of Utah
Lisa Chauveron
Montclair State
University
John L. Christensen
University of
Connecticut
Bryan N. Cochran
xxxviii
Contributors Loyola University Chicago
Lisa Diamond
Devin B. Collins University of Utah
Angelo State University Lore M. Dickey
D’Lane R. Compton Louisiana Tech University
University of New Orleans Brian Dodge
Ingrid Arnet Connidis Indiana University–Bloomington
University of Western Ontario Daniela G. Domínguez
Loree Cook-Daniels Our Lady of the Lake University
FORGE Jordan B. Downing
Jacqueline E. Coppock Tewksbury Hospital
Our Lady of the Lake University Harley Dutcher
Caroline Mala Corbin University of University of Michigan
Miami Rebecca Eaker
Robert W. S. Coulter University of Georgia
University of Pittsburgh Jennifer Earles
Betsy Crane University of South Florida
Widener University Shiri Eisner
Christa Craven Tel Aviv University
College of Wooster John P. Elia
Sara L. Crawley San Francisco State University
University of South Florida Michele J. Eliason
Jason Lee Crockett San Francisco State University
Kutztown University of Pennsylvania Autumn Elizabeth
John Marc Cuellar Otto-Friedrich Universität/Université Paris 7
Angelo State University Kate Ellis-Davies
John G. Culhane University of Cambridge
Widener University School of Law Rachel Epstein
Elizabeth Currans LGBTQ Parenting Network, Sherbourne Health
Eastern Michigan University Centre
Nicola Curtin Chana Etengoff
Clark University Barnard College, Columbia University
Roshan das Nair Breanne Fahs
University of Nottingham Arizona State University
Jack K. Day Rachel H. Farr
University of Texas at Austin University of Massachusetts Amherst
Karin De Angelis Ruth E. Fassinger
U.S. Air Force Academy University of Maryland, College Park
Deborah Dempsey Alicia L. Fedewa
Swinburne University University of Kentucky
Michael P. Dentato Brian A. Feinstein
 Contributors xxxix
Stony Brook University Susan Golombok
University of Cambridge
Matthew B. Feldman
New York City Department of Health Andrew Gorman-Murray
and Mental Hygiene University of Western Sydney
Leigh E. Fine Erika L. Grafsky Virginia
Kansas State University Tech
Joseph Fischel Jamison Green
Yale University California Institute of Integral Studies
Jessica N. Fish Emily A. Greytak
University of Arizona GLSEN (Gay, Lesbian & Straight Education Network)
Corey Flanders Pat Griffin
Centre for Addiction and Mental Health University of Massachusetts Amherst
Sarah C. Fogel Beth A. Haines
Vanderbilt University Lawrence University
Karen I. Fredriksen-Goldsen Douglas C. Haldeman
University of Washington John F. Kennedy University
M. Reuel Friedman Corie Jo Hammers Macalester
University of Pittsburgh College
Megan Fulcher Sela Harcey
Washington & Lee University Iowa State University
Jacqui Gabb Debra A. Harley
The Open University University of Kentucky
Leslie J. Gabel-Brett Gary W. Harper
Lambda Legal University of Michigan School of Public Health
M. Paz Galupo Angelique Harris
Towson University Marquette University
Gary J. Gates Amira Hasenbush Williams
University of California, Los Angeles, Institute
School of Law
Kristina M. Hash
Trevor G. Gates West Virginia University
College at Brockport, State University of
Nikki Hayfield
New York
University of the West of England
Rod Patrick Githens
Brian Heaphy
University of the Pacific
University of Manchester
Hillary A. Gleason Contributors
University of Montana
David Godfrey
Robert B. Heasley
American Bar Association
Indiana University of Pennsylvania
Abbie E.
Anna Heller
Goldberg Clark
Anna Heller Psychotherapy
University
Shane B. Henise
xl
Towson University Lakehead University
Alyssa J. Henry Michelle Marie Johns CDC
Independent Practice Foundation
Cara Herbitter Lon B. Johnston
University of Massachusetts Boston Texas A&M University–Commerce
Jody L. Herman Tim R. Johnston
Williams Institute SAGE (Services and Advocacy for GLBT
Elders)
Amy L. Herrick
University of Pittsburgh Marjorie Jolles
Roosevelt University
Darryl B. Hill
College of Staten Island Rebecca L. Jones
The Open University
Jennifer Hillman
Penn State University, Berks College Courtney G. Joslin
University of California, Davis
Laura Hills
Brunel University London Adam Jowett
Coventry University
Lisa Hollis-Sawyer
Northeastern Illinois University Christine Elizabeth Kaestle Virginia Tech
Elizabeth G. Holman David M. Kaplan
University of Illinois at Urbana- Saint Louis University
Champaign
Emily Kazyak
Stacy Holman Jones University of Nebraska–Lincoln
California State University, Northridge
Kristin Kelley
M. Morgan Holmes Indiana University
Wilfrid Laurier University
Janna Kellinger
Warwick Hosking University of Massachusetts Boston
Victoria University
Joshua G. Kellison
David M. Huebner U.S. Department of Veterans Affairs
University of Utah
Brian L. Kelly
Kim Hughes Loyola University Chicago
University of Georgia
Suzanne A. Kim
Áine M. Humble Rutgers University
Mount Saint Vincent University
Shawn D. King
Marcus Anthony Hunter West Virginia University
Yale University
Lori Kinkler
Caroline J. Huxley Hampshire College
University of Warwick
Christian Klesse
Kipp Jarecke-Cheng Manchester Metropolitan University
Nurun
Nancy J. Knauer
Rusi Jaspal Temple University
De Montfort University
Emily Knox
Sandra Jeppesen Texas A&M University
 Contributors xli
Joseph Kosciw Phillip M. Lyons
GLSEN (Gay, Lesbian & Straight Sam Houston State University
Education
Megan C. Lytle
Network)
University of Rochester Medical Center
Katrina Kubicek
Tiffany G. Maglasang
Children’s Hospital Los Angeles
University of Oklahoma
Kiersten Kummerow
Gerald Mallon
Georgia State University
Hunter College
Katherine A. Kuvalanka
Christy Mallory
Miami University
Williams Institute
Samantha Kwan
Marianne Mankowski
University of Houston
West Virginia University
Pamela Lannutti
Emily S. Mann
La Salle University
University of South Carolina
Erin S. Lavender-Stott
Jimmie Manning
Virginia Tech
Northern Illinois University
Marianne LeBreton
Liz Margolies
McGill University
National LGBT Cancer Network
Stephen Lee
Robin Maril
Santa Clara University
Human Resource Campaign
Kari Lerum
Robin Marquis
University of Washington, Bothell
COLAGE
Arlene Istar Lev
Laura Maycock
University at Albany, State University of
Pioneer Women’s Health
New York
Sara I. McClelland
Jennifer Levi
University of Michigan
Western New England University
Emily McCormick
Heidi M. Levitt
University of California
University of Massachusetts Boston
Jeffrey Q. McCune Jr.
Michele K. Lewis
Washington University in St. Louis
Winston-Salem State University
Elizabeth McDermott Lancaster University
Rachel Lewis
George Mason University Contributors

Nicholas A. Livingston
University of Montana Christi R. McGeorge
North Dakota State University
Catherine A. Lugg
Rutgers University Dianah McGreehan
Angelo State University
Jason Lydon
Black and Pink Jenifer K. McGuire
University of Minnesota
Anthony Lyons
La Trobe University Sarah M. Merrill
Cornell University
xlii
Mallory Merryman Kevin L. Nadal
Smith College John Jay College
Nancy J. Mezey Joel T. Nadler
Monmouth University Southern Illinois University Edwardsville
Shannon Minter Margaret Nichols
National Center for Lesbian Rights Institute for Personal Growth
Renae C. Mitchell Elly-Jean Nielsen
Towson University University of Saskatchewan
Ayako Miyashita Nkiru Nnawulezi
Williams Institute Michigan State University
Lauren Mizock Petra Nordqvist
Worcester State University University of Manchester
Joey L. Mogul Isabelle Notter
People’s Law Office Brown University
Lyndsey Moon Gillian Oakenfull Miami
Roehampton University University
Mignon R. Moore Kathryn M. Oost
Barnard College–Columbia University University of Montana
Todd G. Morrison Nancy A. Orel
University of Saskatchewan Bowling Green State University
Alison Rose Moss Jason Orne
University of Illinois at Chicago University of Wisconsin–Madison
Indiana University South Bend
Ramona Faith Oswald
Lauren Moss University of Illinois at Urbana-Champaign
Kutztown University
Sara B. Oswalt
Sarah Mountz University of Texas at San Antonio
California State University, Northridge
James E. Parco
April M. Moyer Colorado College
Clark University
C. J. Pascoe
Jason P. Murphy University of Oregon
Rutgers, The State University of New
Kenneth M. Pass
Jersey Frank Muscarella Barry
University of Michigan School of Public Health
University
Charlotte J. Patterson
Omar Mushtaq
University of Virginia
University of California, San Francisco
Crystal Paul Jennifer J. Reed
Louisiana State University University of Nevada, Las Vegas
Elizabethe Payne Sari L. Reisner
QuERI Harvard School of Public Health/Fenway Health
Rodney Pennamon Kristen A. Renn
Webster University Michigan State University
 Contributors xliii
Carla A. Pfeffer Ryan T. Ricarte
University of South Carolina University of Pittsburgh
Erich N. Pitcher Christina Richards
Michigan State University Nottinghamshire Healthcare NHS Trust
Charles Joseph Polihronakis Hannah B. Richardson
Columbia University–Teachers College Cambridge Health Alliance/Harvard Medical
School
Nancy D. Polikoff
American University Washington College of Law Niall Richardson
University of Sussex
Amanda M. Pollitt
University of Arizona Damien W. Riggs
Flinders University
V. Paul Poteat
Boston College Christina Rincon
Palo Alto University
Daniel Potter
American Institutes for Research Rachel G. Riskind
Guilford College Emma C.
Potter
Virginia Tech Ian Rivers
Brunel University London
Brian Powell
Indiana University Karen A. Roberto
Virginia Tech
Jennifer Power
La Trobe University Tonette S. Rocco
Australian Research Centre in Sex, Florida International University
Health and Society
Eric M. Rodriguez
Sharon E. Preves New York City College of Technology
Hamline University
Carlos Rodríguez-Díaz
Elizabeth Price University of Puerto Rico
University of Hull
Katrina Roen
Anastasia Prokos University of Oslo
Iowa State University
Adam P. Romero
Victoria Rawlings Williams Institute, University of California, Lancaster University Los Angeles,
School of Law
Victor J. Raymond Margaret Rosario
Madison College City University of New York
Contributors Suzanna M. Rose
Florida International University
xliv
Dana Rosenfeld Ray Siebenkittel
Keele University Louisiana State University
Emily Rothman Tony James Silva
Boston University School of Public Health Southern Illinois University–Carbondale
Alice Ruby Erin Silver
Sperm Bank of California University of Southern California
Nick Rumens Paul Simpson
Middlesex University University of Manchester
Maya Rupert Anneliese Singh
National Center for Lesbian Rights University of Georgia
Glenda M. Russell Susan E. Smalling St. Olaf
University of Colorado College
Stephen T. Russell David G. Smith
University of Texas at Austin U.S. Naval Academy
Sage E. Russo Melissa J. Smith
San Francisco State University QuERI
Maura Ryan Georgia State Shannon Snapp
University California State University, Monterey Bay
Elizabeth M. Saewyc Jorge Soler
University of British Columbia University of Michigan
Ritch C. Savin-Williams Cornell Sarah M. Steelman Virginia Tech
University
Amy C. Steinbugler
Joanna E. Scheib Dickinson College
University of California, Davis
Lauren Charles Stewart University of
Vanessa Schick Oregon
University of Texas
Matthew C. Stief
Mimi Schippers Cornell University
Tulane University
Mindy Stombler
Leighton Seal Georgia State University
West London Mental Health NHS Trust
Amy L. Stone
Brad Sears Trinity University
Williams Institute, University of California, Los
Rebecca L. Stotzer
Angeles, School of Law
University of Hawaii
Lori Sexton
Jennifer Sumner
University of Missouri–Kansas City
California State University, Dominguez Hills
Julie Shapiro
Jason Sumontha
Seattle University
University of Virginia
Elisabeth Sheff
Francisco I. Surace
Sheff Consulting Group
University of Massachusetts Boston
David L. Shmerler
Elizabeth A. Suter
Kings County Hospital Center
University of Denver
 Contributors xlv
Eric Swank Sarah Warbelow
Arizona State University Human Rights Campaign
Ariella Tabaac Sue Westwood
Virginia Commonwealth University University of Surrey
Joshua A. Tabak Chassitty N. Whitman
Cornell University John Jay College of Criminal Justice
Fiona Tasker Chris Wienke
Birkbeck University of London Southern Illinois University–Carbondale
Yvette Taylor Tarynn M. Witten
Weeks Centre for Social and Policy Research at Virginia Commonwealth University
London South Bank University
Carolyn Wolf-Gould
Cynthia J. Telingator A.O. Fox Memorial Hospital, Bassett Health Care
Harvard Medical School
Evan Wolfson
Brian C. Thoma Freedom to Marry
University of Utah
Gust A. Yep
Charee M. Thompson Ohio San Francisco State University
University
Adam F. Yerke
Russell B. Toomey Chicago School of Professional Psychology
University of Arizona
Sheila York
Samantha L. Tornello York University
Pennsylvania State University–Altoona
Mark Totten
Humber College
Noah Tsika
Queens College, City University of New York
Debra Umberson
University of Texas at Austin
Pamela Valera
Columbia University Medical Center
Brad van Eeden-Moorefield Montclair
State University
Reid Vanderburgh
Author and Retired Therapist
Amanda Veldorale-Griffin The
Family Alliance
Muriel Vernon
University of California, Los Angeles
Jay C. Wade
Fordham University
Ryan M. Wade
University of Michigan School of Public Health
I
n
t
r
o
d
u
c
t
i
o
n
Fifty years ago, interest in—and
or even 10 years research on—
ago, many of issues related to
the entries in LGBTQ lives
this and concerns in
encyclopedia the United
could not have States and
been produced. beyond have
Although been
proliferating in Beyond
recent years, Tolerance,
both have seen Defeating
particularly Homophobia,
rapid growth in and Winning
the past decade True Equality,
or so. Today, a there are many
careful reading areas in which
of the New York LGBTQ people,
Times or other and particularly
national media transgender and
outlets reveals genderqueer
almost daily people, face
coverage of continued
some aspect of discrimination
LGBTQ life or and associated
politics. challenges.
Further, in the Signorile
past 5 years in highlights the
particular, high rates of
major violent crimes
legislative shifts against LGBTQ
have occurred people— and,
(e.g., the repeal in particular,
of Don’t Ask, trans women of
Don’t Tell in color—as an
2011; example of
nationwide evidence that
recognition of the fight for
same-sex equality for
marriage in LGBTQ people
2015), is far from over.
reflecting and He also points
marking the out the
ways in which continued
societal difficulties
attitudes toward surrounding fair
LGBTQ people housing and
have shifted. Of employment
course, as opportunities
journalist that LGBTQ
Michelangelo people continue
Signorile warns to face, given
in his 2015 the absence of
book, It’s Not national laws
Over: Getting prohibiting
discrimination Researchers
in these areas from numerous
on the basis of disciplines have
sexual turned to, or
orientation or intensified their
gender identity. focus on,
But LGBTQ issues;
regardless of this research, in
whether one turn, has been
views the past used to inform
decade or so as key political and
a time of legislative
considerable decisions, such
achievement as the recent
with regard to U.S. marriage
LGBTQ rights equality
issues, or as a decision.
time of Indeed, once
advancement in regarded by
some areas and some as a
stalled progress relatively small
in others, it is minority with
certain that little public
issues related to influence or
LGBTQ lives— voice, the
including those LGBTQ
related to school community, and
experiences, its allies, has
violence, established
suicide, itself as a
activism, visible, diverse,
resilience, and influential
family presence in
formation, and society—one
aging—have worthy of an
increasingly encyclopedia on
moved away topics as diverse
from the distant as
margins of homelessness,
societal military
awareness, thus involvement,
demanding and
attention from reproductive
legislators, experiences.
policy makers, The
and researchers. disciplines
represented in enrich each
the other, such that
encyclopedia a scholar or
are diverse. student
Some of the interested in
more central LGBTQ aging,
disciplines for example,
represented are could deepen
psychology, his or her
sociology, understanding
family studies, of this topic by
legal studies, reading entries
and social work; on aging from
however, the multiple
work of scholars disciplines and
in other vantage points
disciplines, such (e.g., there are
as anthropology separate entries
and marketing, on lesbian, gay,
are also bisexual, and
represented. The trans aging;
wide range of there are also
topics in this entries on
encyclopedia advance health
required an care plans,
interdisciplinary health care
team of top discrimination,
scholars. In retiring, and
turn, the dying and
resulting entries bereavement).
complement and
xxxiii xxxiv Introduction

Why an high is in the

Encyclopedi university
a on LGBTQ setting. As
Studies? undergraduate
and graduate
General interest courses
in and research increasingly
on LGBTQ acknowledge
studies have LGBTQ-related
proliferated. issues and
One place topics, even
where interest offering
in this area is opportunities to
particularly
do papers and societal interest
projects related in and research
to LGBTQ on LGBTQ-
studies, students related topics,
increasingly led me (Abbie
look for E. Goldberg) to
resources and develop the
reference initial concept
materials to for this project
assist them in with Maureen
learning and Adams,
writing about acquisitions
such issues. editor at SAGE.
Librarians and Initial
professors alike conversations
are often with colleagues
uncertain where —some of
to turn for a whom were
comprehensive ultimately
and diverse set invited to join
of articles or the editorial
chapters that are board—enabled
introductory us to further
enough for a develop and
student to gain a refine this initial
basic vision. Careful
understanding selection of the
of the topic, but editorial team
also sufficiently resulted in an
nuanced and interdisciplinary
well-referenced team of top
for graduate scholars with
students and complementary
faculty to gain expertise.
something from Namely, the
them as well. editorial team
Knowledge consisted of
of student and Katherine Allen
faculty (human
concerns, development
combined with and family
an innate studies), Meg
interest in and Barker
excitement (psychology),
about the José
explosion of Bauermeister
(psychology), disciplines. We
Lisa Diamond sought to put
(psychology), together a list of
Nancy Knauer potential topics
(law), and that was both
Ramona Oswald representative
(human of the field—
development that is, popular
and family and important—
studies). Upon but also cutting-
assembling a edge and
top-notch timely. In this
editorial team, way, there are
we then reached topics that are
out to a diverse both broad, and
and about which
interdisciplinary much has been
group of written (e.g.,
potential LGBTQ
authors. adoption,
depression in
The Process sexual
minorities) as
The editorial well as topics
team began by that are specific
selecting or understudied
potential topics (e.g., breast care
for the for transgender
encyclopedia, people,
conducting pregnancy in
online searches LGBTQ youth).
of books, In determining
journals, and what ground we
textbooks on would cover,
various topics we also sought
related to to emphasize
LGBTQ (a) LGBTQ
studies. Effort experiences
was made to across the life
emphasize cycle (youth,
sources in the parenthood,
social sciences, aging), (b)
but also to intersections
consider topics among sexual
that appeared orientation and
central to other other key
identities (race, Friends of
ability, gender), Lesbians and
(c) key contexts Gays (PFLAG),
and systems and a number of
that impact entries on
LGBTQ lives therapeutic
(schools, interventions
workplaces, with LGBTQ
neighborhoods, people, couples,
the military), and families.
and (d) theories These
and methods distinctive
that have been features of the
used in research encyclopedia
on LGBTQ make it an
people. A essential and
particularly broad reference
distinctive book for a wide
feature of the range of
encyclopedia, individuals and
about which we organizations.
are especially Upon
proud, is the establishing a
large number of near-complete
entries related list that had
to trans/ been reviewed
transgender and re-reviewed
issues and lives by all members
(there are of the editorial
entries on trans team, we began
inmates, health the process of
care issues, and identifying
violence, to authors for
name just a entries. We
few). There are sought out
also a number accomplished
of entries on researchers and
major LGBTQ scholars with
organizations, established
such as Gay, expertise on the
Lesbian & given topic to
Straight write the
Education entries. The
Network majority
(GLSEN) and accepted, and
Parents & some offered to
write multiple the editorial
entries. Some team—in just
Introduction xxxv

chose to enlist over a year.

the help of The Audience
coauthors, such
As noted
as advanced—
earlier, we want
and promising
college students
—doctoral
to access and
students.
read the entries
Invitations to
in these
contribute were
volumes. We
sent out
also want
beginning in
graduate
May of 2014.
students and
The majority of
scholars of
authors were
LGBTQ
asked to revise
sexualities and
their entries at
lives to read and
least once. By
learn from this
June 2015, we
encyclopedia.
had successfully
But, we are also
received all
hopeful that
revised and
scholars in law,
final entries.
psychology,
The editorial
anthropology,
team worked
history, family
quickly and
studies, social
carefully,
work,
delivering
counseling, and
feedback in
other diverse
remarkably little
fields—who
time—
may know little
especially at the
or nothing
tail end of the
about many of
project, when
the topics
we had only a
represented here
few remaining
—will read and
entries to
incorporate the
review and re-
information in
review. We are
this collection
all amazed at
into their
what has been
thinking,
accomplished—
writing, and
by authors and
teaching. We
are hopeful, too, multifaceted,
that librarians well-researched,
and other and complex,
university staff and thus receive
and attention in
administrators multiple entries.
may find this Long entries
collection to be (i.e., those that
a useful and are about 3,000
interesting tool words in length)
for advancing represent the
their own most significant
understanding and
of these issues, welldeveloped
in order to topics in the
inform the work field. These are
that they do. typically the
Finally, this entries about
book is for which the most
individuals who research has
identify as been done.
LGBTQ Medium-length
themselves, and entries (about
who are seeking 2,000 words)
a resource in address core
which they are topics in the
at the center of field, but topics
thinking, that are perhaps
theorizing, and less central (or
research, about which
instead of at the less research
margins. has been done).
Short entries
The Structure (1,000 words)
describe less
Topics are in central or newer
alphabetical topics to the
order, from A field.
(Abstinence In addition,
Only Until we provide a
Marriage) to Y thematic
(Youth and Reader’s Guide
Dating); no that groups
suitable Z related entries
topics appeared. by topic (15 in
Some topics are total). Many
individual initial stage
entries cut helped launch
across more the project into
than one topical reality. Sanford
area and appear Robinson, our
under several developmental
headings. editor, was
Furthermore, patient,
suggestions for available, and
further readings careful, and his
are provided attention to
with each entry detail—as well
so that the as the big
interested reader picture—was
can pursue instrumental to
avenues for the successful
deeper topical and timely
exploration. completion of
Finally, an the project.
appendix Leticia
presents a list of Gutierrez
organizations, helped ensure
journals, and that SAGE’s
websites related versatile
to various topics Reference
within the larger Tracking
field of LGBTQ system was
studies. working for
Acknowledgm both editors and
ents authors, and she
frequently came
This project to the aid of the
reflects the editorial board
contributions of members when
many. Maureen we had a
Adams, the question we
acquisitions could not solve
editor, worked on our own. I
with me to am deeply
develop the grateful to the
initial idea for committed
the editorial team.
encyclopedia. They all gave of
Her insight and themselves in
enthusiasm ways that
during this deepened and
nuanced the members, of
resulting whom there are
product. They many, for
provided maintaining—or
invaluable feigning—
suggestions interest in the
regarding varied topics in
authors; this volume as it
provided astute came to fruition.
and remarkably In some cases,
fast feedback to too, informal
authors; served questions or
as sounding suggestions
boards when I about potential
needed them; topics (“What
and maintained about ___?”)
a cheerful led me to pursue
enthusiasm for potential topics
the project, for inclusion in
even when the
entries were encyclopedia.
coming in faster Finally, I’m
than we could grateful to the
keep up. support and
I am very patience of my
grateful to the own family,
LGBTQ who has
activists, endured yet
researchers, and another book
pioneers—both project with me
living and dead —this one
—whose tireless bigger and
work on behalf longer than any
of the LGBTQ of those that
community preceded it. I
ensured that a am proud of the
volume like this final product
would be both and grateful to
relevant and the many
eagerly contributors
consumed. I’m whose hard
also indebted to work ensured
my dear that it would
LGBTQ friends, become a
colleagues, and reality.
family
 Abbie E. Clark
University
SAGE was founded in 1965 by Sara
Miller McCune to support the
dissemination of usable knowledge
by publishing innovative and high-
quality research and teaching
content. Today, we publish over 900
journals, including those of more
than 400 learned societies, more
than 800 new books per year, and a
growing range of library products
including archives, data, case
studies, reports, and video. SAGE
remains majority-owned by our
founder, and after Sara’s lifetime will
become owned by a charitable trust
that secures our continued
independence.

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A
ABSTINENCE contested
approach to
ONLY UNTIL sexuality
education,
MARRIAGE which exists
predominantly
Abstinence in the United
only until States. The
marriage is a main tenets of
term used most this form of
recently to sexuality
describe a education
deeply include, but are
not limited to, a broad
teaching youth overview of
that (1) to the topic and
enjoy good then offers a
overall health, concise
abstaining historical
from sexual sketch of
activities with abstinence
others is only until
necessary; (2) marriage.
abstaining Next, the main
from sexual arguments of
contact outside the proponents
of marriage is and opponents
not only an of
expected abstinenceonly
societal norm, -until-marriage
but also the sexuality
only way to education are
fully protect provided.
against Finally, the
contracting implications
sexually abstinence
transmitted only until
conditions and marriage has
prevent for lesbian,
teenage gay, bisexual,
pregnancies; transgender,
(3) marriage and queer
and monogamy (LGBTQ)
within individuals and
marriage are communities
socially are explored.
expected; and Abstinence
(4) engaging in only until
sexual contact marriage, as a
with others concept, has
outside of had a long
marriage is history in the
likely to result Western world.
in a number of Specifically, it
harmful mental refers to
and physical individuals
health abstaining
problems. This from sexual
entry provides contact until
married and particular would
confining adhere to being
sexual sexually
abstemious or
1 else run the risk
activities to those of being
between two stigmatized as
individuals “whores” or
within the “sluts.” This was
context of a clearly a double
monogamous standard as
marriage. young men were
Historically, in many ways
abstinence only societally
until marriage encouraged to
has been engage in sexual
sanctioned by contact with
organized females even to
religion. Both the extent that
Judaism and their masculinity
Christianity, for and manhood
instance, have was tied to, and
traditionally defined by,
promoted an sexual
abstinence-only experiences.
approach. The concept
A term of abstinence
common in the only until
20th century was marriage found
“premarital sex,” its way into the
which referred to sexuality
violation of the education arena
abstinence-only- first in the late
until-marriage 19th and early
societal 20th centuries,
expectation. when the social
Although both hygiene
young men and movement began
young women to reinforce the
were expected to notion that
be sexually sexual contact
abstinent before was dangerous in
marriage, there terms of
was a higher spreading
expectation that sexually
young women in transmitted
diseases (then
referred to as
venereal or social
diseases) and
sexual morality
was inculcated
into the minds of
the young.
Abstinence only
until marriage
was a key
concept of
schooling efforts
as well as in the
Boy Scouts of
America, Girl
Scouts, and other
social
organizations.
2
Activists in College contraception, safer sexual expression, various
sexual and gender expressions, and a number of
aspects about reproductive health in general in an
Sexuality education has promoted abstinence only
effort to promote sexual health.
for more than a century. The United States federal
The premise upon which abstinence-only- until-
government became involved in officially promoting
marriage sexuality education is based is
it in the 20th century. Specifically, in 1981, with the
fundamentally heterosexist and sex-negative. The
Adolescent Family Life Act in the United States,
discourse has centered exclusively on heterosexuality
abstinence only until marriage became a stronger and
and heterosexual marriage and has silenced LGBTQ
more pronounced (even centrally featured) part of the
individuals and sexualities. Given the pervasiveness
educational mandate. Perhaps the most significant
of this form of sexuality education in schools in the
moment when abstinence only until marriage was
United States until very recently, countless LGBTQ
featured in school-based sexuality education was in
youth have experienced alienation, silencing, and
1996, when the U.S. federal government allocated
invisibility in school settings. LGBTQ individuals
millions of dollars of federal funding to both school-
are often seen as illegitimate sexual citizens, and
based and community-based sexuality education.
abstinence-only-until-marriage sexuality education
There were strict stipulations that the schools and
has reinforced this notion.
community-based organizations were required to
follow to receive and maintain such funding, such as John P. Elia
focusing solely on the virtues of sexual abstinence.
Those who support abstinence-only sexuality See also Education; Heteronormativity; Heterosexism;
education tend to hold conservative views about LGBTQ Issues in K–12 Education Across Global
sexuality in general. Often they espouse the Contexts; School Climate; Schools as Heteronormative
abstinence-only-until-marriage approach because Spaces; Sexualities at School
they believe that it is an effective way of preventing
HIV/AIDS, other sexually transmitted conditions, Further Readings
and unintended teenage pregnancies. What Elia, J. P., & Tokunaga, J. (2015). Sexuality education:
frequently undergirds the staunch commitment to this Implications for health, equity, and social justice in the
form of sexuality education is the view that sexual United States. Health Education, 115(1), 105–120.
contact should be reserved for married individuals Fisher, C. M. (2009). Queer youth experiences with
for the express purpose of reproduction. Despite such abstinence-only-until-marriage sexuality education: “I
support for abstinence-only-untilmarriage sexuality can’t get married so where does that leave me?” Journal
education, there are virtually no data that support the of LGBT Youth, 6(1), 61–79.
efficacy of this approach. In fact, the results of the Santelli, J., Ott, M. A., Lyon, M., Rogers, J., Summers, D., &
evaluation studies show that abstinence-only-until- Schleifer, R. (2006). Abstinence and abstinence-only
marriage sexuality education does not prevent education: A review of U.S. policies and programs.
sexually transmitted conditions or reduce the number Journal of Adolescent Health, 38(1), 72–81.
of teenage pregnancies.
The opponents of abstinence-only-until-marriage
sexuality education invariably claim that this is
neither a responsible nor an effective mode of ACCESS TO HEALTH CARE
education and that it is an oppressively restrictive
form of sexuality education that focuses on
abstaining from sexual activity and neglects to cover
See Health Care System
comprehensive aspects of sexuality education such as
the sociocultural, ethical, biological, and
psychological aspects
of sexuality. In addition, those opposed to ACTIVISTS IN COLLEGE
abstinence-
only-until-marriage approaches argue that it is
important to teach school-aged individuals about

LGBTQ activists in college are postsecondary
students who engage in individual or organized
behaviors, activities, and strategies designed to
improve conditions on campus for LGBTQ
individuals. The purpose of the activism may be to
create visibility for the existence of LGBTQ people;
to draw attention to discrimination or violence
against them; to change policies, improve programs,
or implement curriculum; or to make other demands
on behalf of LGBTQ people on campus. Activism
may be a solitary activity, or it may involve other
LGBTQ and allied participants. Some activists
identify themselves as student leaders, while others
prefer not to see themselves in those terms. LGBTQ
activists may have any sexual orientation and gender
identity, and not every college student engaged in
LGBTQ activism identifies as lesbian, gay, bisexual,
transgender, or queer. This entry addresses (a) forms
of campus activism, (b) the influence of activism on
colleges and universities, (c) the influence of
activism on those students who participate in it, and
(d) connections between LGBTQ campus and
community activists.
Forms of Campus Activism
LGBTQ activism in higher education takes on many
forms. Some forms of activism involve physical
actions common among campus social justice
activists: marches, protests, demonstrations, pickets,
sitins, vigils, or even building takeovers. Particular to
the LGBTQ community are the “kiss-in,” during
which pairs of same-sex couples kiss in public, to
bring visibility to same-sex affection, and “die-ins,”
a form of AIDS activism during which participants
lie on the ground as though dead, typically in a place
that will disrupt usual activities taking place there, to
represent deaths from HIV/AIDS. Compatriots may
spray paint or chalk around the bodies in the manner
of a police crime scene, to portray these deaths as
homicides at the hands of an uncaring public or civic
authority. The Day of Silence (www .
dayofsilence.org) is an annual action in which
LGBTQ students and allies remain silent for a day,
handing out information about how this action
symbolizes the silencing of LGBTQ people. Many
campuses hold a vigil for the Trans Day of
Remembrance to honor those who have lost their
lives due to antitrans hatred and violence. LGBTQ
college graduates
3
Activists in College
may engage in philanthropic activism, through
donations targeted toward particular programs and
services; or they may make substantial gifts to the
institution as a whole, with the stipulation that the
institution adopt particular policies (e.g., sexual
orientation and gender-identity nondiscrimination).
Other LGBTQ campus activist strategies involve
communication through letter writing or e-mail
campaigns, traditional (print) media opinions and
editorials, or digital and social media. On a single
campus, in alliance with activists at other institutions,
or with off-campus allies, communication strategies
can be effective in bringing internal and external
awareness to activists’ targeted concerns (e.g., the
need for improved policy, programs, campus
climate). Popular grassroots campaigns that address
youth and college students include the It Gets Better
videos aimed at preventing suicide among LGBTQ
youth by providing encouragement designed to
counter anti-LGBTQ bullying in schools, and the
You Can Play videos, many of which were made by
college athletic teams and departments, with the
message that talented LGBTQ athletes are welcome
on their teams. LGBTQ activists and their allies use
Facebook, YouTube, Tumblr, Instagram, and other
social media platforms to implement media
campaigns and to organize online and in-person
actions.
The No H8 (No Hate) Campaign
(http://www .noh8campaign.com), described as a
photographic silent protest, has also been a
prominent activist strategy on campus. In this action,
college students paint their faces with the campaign
logo and take photos with duct tape over their
mouths, demonstrating the silencing that LGBTQ
individuals often experience. The campaign is a
multimedia action that has spread through social
media and attracts celebrities, family and community
members, and students from elementary and
secondary education.
There have also been significant activist efforts to
increase inclusion at religiously affiliated
institutions. For example, LGBTQ alumni of Gordon
College, a leading Christian institution, formed a
group called OneGordon
(http://www.onegordon .com) to support current
students and alumni of the institution. LGBTQ
4
activists within a campus religious context and straight members. Early activist organizations
sometimes wear a rainbow button, emerged at a few other institutions, with names like
Activists in College the Gay Liberation Front, Homosexuals
Intransigent!, Lambda Union, and even a Queer
Student Cultural Center (at the University of
emblem, or sash to worship services in order to
Minnesota in 1969). Gay student unions, gay and
disrupt the notion that LGBTQ people are not also
lesbian student organizations, and eventually lesbian,
people of faith.
gay, bisexual, transgender, and queer alliances took
on activist roles at hundreds of postsecondary
Influence of Activism on Colleges and institutions. Campus activists remained in loose
Universities connection with community activists throughout the
1980s and 1990s, coming together to protest against
Since the mid-1980s, LGBTQ activism has
public and government responses to the AIDS crisis
transformed postsecondary institutions. Campus
and when local communities faced particular threats
activism—mainly by students, but also by some
through harassment, discrimination, or violence.
faculty and staff—has been responsible for
Among the first orders of business for student
(a) causing or contributing to the formation of
organizations in the 1970s was to seek legal
committees (sometimes called commissions) that
permission to organize and hold events on campuses
conduct campus climate studies and/or address
where they were banned, lawsuits being a form of
homophobic/transphobic incidents on campus; (b)
activism. Nascent student groups at public
the implementation of nondiscrimination policies for
institutions faced the most stringent restrictions on
sexual orientation and, increasingly, gender identity
organizing. Gay and lesbian students at Virginia
in hiring and educational practices; (c) the provision
Commonwealth University and the Universities of
of domestic partner benefits for employees; (d) the
Kansas, New Hampshire, Missouri, and Oklahoma
establishment of LGBTQ campus resource centers;
sued their institutions for the right to meet and
(e) the introduction of gender-inclusive (sometimes
sponsor activities on campus.
called gender-neutral) restrooms and housing; (f) the
development of LGBTQ/queer studies curricula; (g)
the increase in genderconfirming medical care; and Influence of Participating in Campus
(h) the increased visibility of LGBTQ people on Activism on LGBTQ Students
campus. Some of these changes to policy and
Campus activism influences the identities and
programs might have occurred without the pressure
experiences of LGBTQ students who participate in
and visibility brought about by campus activism, but
it. Abundant evidence supports the claim that
the consensus among scholars of LGBTQ issues in
students who are more involved in their college
higher education is that activism has been an
experience learn more, graduate at higher rates than
essential element in the timing and progression of
less involved peers, and further their development of
these changes. As the visibility of trans issues
a number of desirable characteristics such as civic
increases and attitudes toward them become more
engagement, volunteerism, and intercultural
positive, trans-student activism related to issues of
competence. On the whole, LGBTQ student activists
housing, safety, and restroom access is increasingly
make gains in these areas, regardless of sexual
common. This phenomenon illuminates the larger
orientation or gender identity. They report becoming
one of LGBTQ activism: The more visible the
more connected to institutional administrators and
community is, the more attitudes change toward the
faculty, as well as developing leadership skills that
positive, which promotes more activism, in a cycle
they use in other contexts on campus as well as in
of visibility and activism.
their post-college careers.
LGBTQ campus activism shares a history with
Not all LGBTQ activists identify themselves as
LGBTQ community activism. The student
such. They may consider themselves leaders, not
homophile movement emerged in a few campuses in
activists, or they may not view themselves through
the late 1960s, alongside gay and lesbian movements
either of those lenses. Some students who engage in
in some cities. The Student Homophile League was
LGBTQ activism are cisgender and/or heterosexual;
founded at Columbia University in 1967 and had gay

some are hesitant to consider themselves as agitators
for change. They may connect their activism to long-
held commitments to social justice, with LGBTQ
issues being their current focus. They may also see
their LGBTQ activism as preparation for a career in
social change work.
Some subpopulations of LGBTQ students may
have less access to activist outlets than others.
International students from conservative nations, for
example, may be concerned that engaging in LGBTQ
activism will lead to negative consequences, either in
visa status or in life back in the home country.
Domestic students on financial aid may worry that an
arrest record could hinder future scholarship
opportunities. Any number of other students may not
want to carry an activist engagement through to the
point of arrest for civil disobedience, for fear of
consequences on and off campus. Students in any of
these groups might find less risky or public ways to
participate in LGBTQ activism, such as online
activism and behind-thescenes contributions to
public actions.
Connections Between Campus and
Community Activists
National LGBTQ advocacy organizations mobilize
college students as activists. The National Gay and
Lesbian Task Force (NGLTF); Human Rights
Campaign; National Black Justice Coalition; Trans
Student Equality Resources; Gay, Lesbian and
Straight Educators Network (GLSEN); Gay and
Lesbian Alliance Against Defamation (GLAAD);
and Campus Pride are prominent supporters of
LGBTQ campus activism, sponsoring media sites
and training opportunities for activists and student
leaders. The Point Foundation provides scholarships
for LGBTQ students “to achieve their full academic
and leadership potential— despite the obstacles often
put before them—to make a significant impact on
society” (https:// www.pointfoundation.org). These
organizations recognize the potential of college
student activists to create change in society beyond
campus.
A number of LGBTQ community and national
organizers got their start as campus activists. For
Activists in College
example, Derek Charles Livingston, a co-chair of the
1993 National March on Washington for Lesbian,
5
Gay, and Bi Equal Rights and Liberation, was an
undergraduate student activist at Brown University.
Urvashi Vaid was an activist at Vassar College
before beginning a career that took her into
leadership of the National Gay and Lesbian Task
Force (NGLTF) and Arcus Foundation, both of
which are committed to multiracial LGBTQ social
justice activism. T. J. Jourian, trans activist and
community organizer, led student actions at
Michigan State University while an undergraduate
and graduate student there. Being a campus activist
—or going to college at all—is not a prerequisite for
community activism, but the viability of colleges and
universities as training grounds for community
organizers is undeniable.
While LGBTQ campus and community activists
share some history, LGBTQ campus activists have a
complicated history of collaboration with other social
justice activists. Depending on the specifics of
campus racial, gender, religious, and social climate—
and depending on the awareness, interests, and
abilities of the leaders of LGBTQ activist movements
at a given time—LGBTQ activists may seek
coalitions and participate in collective actions for
social justice. Alternately, they may retain a closer
focus on LGBTQ activism. The trend appears to be
toward greater collaboration and coalition building,
though progress in this direction is uneven. Racism
in the
LGBTQ community and homophobia and
transphobia in some communities of color, for
example, impede efforts to build multiracial
movements for social justice related to sexual
orientation and gender identity.
Kristen A. Renn and Erich N. Pitcher
See also College Students; Education; Leadership
Further Readings
Beemyn, B. (2003). The silence is broken: A history of the
first lesbian, gay, and bisexual college student groups.
Journal of the History of Sexuality, 12(2), 205–223.
Marine, S. B. (2011). Stonewall’s legacy—bisexual, gay,
lesbian, and transgender students in higher education.
ASHE Higher Education Report, 37(4). San Francisco,
CA: Jossey-Bass.
Adolescent Pregnancy
6
McEntarfer, H. K. (2011). “Not going away”: Strategies
used by students, faculty, and staff members to create
gay-straight alliances at three religiously affiliated
universities. Journal of LGBT Youth, 8(4), 309–331.
Renn, K. A. (2007). LGBT student leaders and queer
activists: Identities of lesbian, gay, bisexual,
transgender, and queer identified college student
leaders and activists. Journal of College Student
Development, 48(3), 311–330.
ADOLESCENT PREGNANCY
Although it may seem counterintuitive, nearly two
decades of population research have documented that
lesbian, gay, and bisexual adolescents have a higher
risk for pregnancy involvement (either becoming
pregnant or causing a pregnancy) than their
heterosexual peers. This entry describes the extent of
the risk for adolescent pregnancy among LGBTQ
youth, outlines the various hypotheses about why
they might be at higher risk, and describes some of
the evidence that supports these possible reasons for
higher rates of pregnancy among LGBTQ
adolescents.
A growing number of population-based
adolescent health surveys administered in schools
include a question assessing sexual orientation. Such
surveys also often ask about sexual health issues,
including whether an adolescent has ever had sexual
intercourse, number of sexual partners they have had,
whether contraception was used the last time they
had sex, and whether they have been pregnant, or
(for boys) whether they have ever caused a
pregnancy. Although most of the sexual health
questions on these surveys focus on penile-vaginal
intercourse between male and female sexual partners
as the sexual activity in question, and are not
necessarily inclusive of the variety of sexual
behaviors that LGBTQ youth might engage in, some
of the surveys do ask about gender of sexual
partners, and about oral or anal sex. These surveys
provide some of the strongest population evidence
concerning adolescent pregnancy among LGBTQ
youth.
The research evidence to date is primarily from
North America, but on regional and national surveys
from Canada, New Zealand, and the United States,
LGBTQ youth report 1.5 to 4 times the prevalence of
pregnancy involvement than do their heterosexual
peers. In adolescent health surveys that are large
enough to analyze sexualminority groups separately,
lesbian and gay adolescents as well as bisexual males
and females report higher rates of ever being
pregnant or causing a pregnancy. Unfortunately, only
one population-based adolescent survey to date, from
New Zealand, reported including a measure of
transgender identity, but did not report pregnancy
comparisons, so it is unknown whether transgender
youth also have higher risk for pregnancy
involvement.
Why might LGBTQ youth have a higher risk for
pregnancy involvement? One approach to answering
this question is to first focus on those common
contributors to pregnancy involvement in the general
population—that is, both risk and protective factors
linked to higher or lower odds of adolescent
pregnancy. If LGBTQ youth have higher rates of
common risk factors, and lower levels of protective
factors, these together might explain their higher risk
for pregnancy. Another approach is to focus on risk
factors unique to LGBTQ youth, as well as
interventions to prevent unwanted pregnancy for
them.
Getting pregnant (or causing a pregnancy)
typically requires unprotected penile-vaginal
intercourse between sexually fertile people. A single
episode of unprotected intercourse sometimes (but
rarely) results in pregnancy. The sooner adolescents
start having sex, and the more often they have sex,
especially without contraception, the greater their
chance of pregnancy during the teen years. Other
factors that increase these risks are also important to
consider: for example, a history of sexual abuse
during childhood or adolescence, or having sex while
intoxicated. In nearly all population-based studies of
LGBTQ youth, LGBTQ youth are more than twice as
likely to report a history of sexual abuse or sexual
assault as are heterosexual students. In most surveys,
LGBTQ youth are also more likely to report ever
having sexual intercourse, an earlier age at first sex,
sex under the influence of alcohol or drugs, and more
sexual partners than heterosexual students.
Assumptions that LGBTQ youth only have sex with
same-gender partners are inaccurate; most LGBTQ
youth don’t have sex at all, but many bisexual youth,
and those who identify as gay or lesbian, also report
sex with people of other genders. Condom or
contraceptive use, however, shows inconsistent
results across studies; in some studies, LGBTQ youth

are just as likely to use condoms or birth control the
last time they had sex as heterosexual students, while
other studies report they are less likely to use
contraception. LGBTQ youth are also more likely to
run away or be kicked out, and to engage in survival
sex while homeless or street-involved, which are also
contributors to adolescent pregnancy involvement.
They also report lower levels of protective factors,
such as positive family relationships or school
connectedness, than do their peers. Their higher
exposure to risk factors and lower levels of
protective factors may explain the higher risk of
pregnancy.
In addition to factors that contribute to adolescent
pregnancy in the general population, some studies
have identified possible factors specific to LGBTQ
youth. Some studies have suggested that pregnancy
might serve as “camouflage”—that is, to appear to be
heterosexual, in order to avoid further stigma and
discrimination. Qualitative studies have documented
this phenomenon, and at least one population study
noted that many LGBTQ youth who reported
adolescent pregnancy involvement also reported
higher levels of sexualorientation-related
discrimination and violence. It has also been
suggested that LGBTQ youth may get pregnant
because sex education at school does not include
LGBTQ-relevant content, or because programs
targeted toward sexual health among LGBTQ youth
do not include pregnancy prevention information, but
no studies have tested these hypotheses so far. There
is almost no research about the outcomes of LGBTQ
youth’s adolescent pregnancies—that is, whether
they miscarry, terminate the pregnancy, or give birth,
and whether they become LGBTQ teen parents, or
place the baby for adoption. There is also limited
research on
Adoption, Choices About
interventions to prevent unintended pregnancy
among LGBTQ youth, whether focused on reducing
contributing factors such as abuse, or reducing
sexual risk behaviors, or addressing other
contributing factors, such as homelessness. Such
approaches, as well as interventions to foster
protective factors, may help reduce unintended
adolescent pregnancy among LGBTQ youth, but
such evidence is still needed.
Elizabeth M. Saewyc
7
See also Developmental Aspects of Sexuality; Resilience and
Protective Factors, Youth; Sexual Education Mandates for
Inclusion; Sexual Risk-Taking
Further Readings
Reed, S., Miller, R. L., & Timm, T. (2011). Identity and
agency: The meaning and value of pregnancy for
young Black lesbians. Psychology of Women, 35, 571–
581.
Saewyc, E. (2014). Adolescent pregnancy among lesbian,
gay and bisexual teens. In A. Cherry & M. E. Dillon (Eds.),
International handbook on adolescent pregnancy (pp. 159–
169). New York, NY: Springer. Saewyc, E. M., Poon, C.,
Homma, Y., & Skay, C. L. (2008). Stigma management?
The links between enacted stigma and teen pregnancy trends
among gay, lesbian and bisexual students in British
Columbia. Canadian Journal of Human Sexuality, 17, 123–
131.
Travers, R., Newton, H., & Munro, L. (2011). “Because it
was expected”: Heterosexism as a determinant of
adolescent pregnancy among sexually diverse youth.
Canadian Journal of Community Mental Health, 30,
65–79.
ADOPTION, CHOICES ABOUT
Adoption is the legal securement of a parent’s
relationship with a child not biologically related to
the parent. Approximately 1 million children in the
United States live with adoptive parents and 2.5% of
families include an adopted child. Estimates suggest
that around 4% of adopted children are living with
LGBTQ parents. People may choose to adopt
Adoption, Choices About
a child rather than have a biological child for a
variety of reasons. These may include the inability to
conceive one’s own children, preference for
providing a home to a child in need, or to secure
parental rights for a nonbiologically related parent
(e.g., a partner choosing to adopt the biological
children of their partner/spouse). This entry describes
the issues related to adoption choices for LGBTQ
potential parents. It discusses the practical and
emotional decisions related to adoption for LGBTQ
parents. It explains the key factors related to LGBTQ
parents adopting and the pathways for adoption.
Relevant research related to these choices is
8
discussed, although there is no research base
regarding transgender parents’ adoption experiences
specifically; the research is largely focused on issues
related to gay and lesbian parents.
Overview of LGBTQ Adoption
In general, like their heterosexual and cisgender (i.e.,
not transgender) counterparts, many members of the
LGBTQ community express a desire to become
parents. For some, this need may include a desire to
have a biologically related child. However, unlike
their heterosexual and cisgender counterparts,
typically only one parent is biologically related to the
child in LGBTQ partnerships. Though some LGBTQ
people opt for a parenthood route that allows for a
biological relationship for at least one parent
(namely, via donor insemination or surrogacy),
studies suggest lesbian and
gay parents have lower expressed need for a
biological child and still need to secure the rights of
the second parent when they do. Therefore, adoption
is often the first choice to achieve parenthood for
both potential parents in LGBTQ partnerships.
For many decades, LGBTQ individuals and
couples have been adopting children, though with
varying levels of openness about their gender and/ or
sexuality in the process. In many cases, parents hid
their sexuality or gender identity throughout the
adoption process in order to avoid potential
discrimination or legal bans on their adopting.
However, doing so often left one parent in the
partnership without legal rights to their child and/ or
resulted in psychological distress during the adoption
process for both adopting parents. LGBTQ parents
have also faced vastly varied legal and systemic
facilitators and barriers to adoptions depending on
their geographic location and people involved in the
adoption process. Today, legal changes, including the
legalization of same-sex marriage and successful
challenges to adoption bans as well as shifting
societal attitudes toward LGBTQ couples generally
and LGBTQ adoption in particular, decrease the need
to hide sexual and gender identity during the
adoption process. However, it is still challenging for
LGBTQ individuals or couples to openly adopt in
many states in the United States and in many
countries around the world. In some areas, such
adoptions are illegal, while in others, they are
encumbered by individuals involved in the adoption
process (e.g., social workers, judges, birth parents)
who are opposed to or biased against such adoptions.
Issues Affecting the Decision to Adopt and
the Process of Adoption
Multiple factors may ease or inhibit the process of
adoption for LGBTQ potential parents. For example,
family of origin support, overall social support, the
political and social climate of communities, and
general political issues such as the presence or
absence of marriage equality may all affect an
LGBTQ individual or couple’s decision to adopt. For
example, parents with greater support and
community resources specific to LGBTQ parents
(e.g., support groups) may be more likely to pursue
adoption than parents with less support in
communities with no specific resources. Another
factor affecting the decision to adopt may be the
confidence LGBTQ potential parents have in their
future parenting. Despite all research evidence to the
contrary, some may also question their ability on the
basis of their gender or sexual identity to meet the
needs of an adopted child.
Deciding to adopt may be fraught with emotional
struggle and hardship both for individual LGBTQ
parents and for couples as a unit. The arduous nature
of the process may strain relationships due to the
invasive nature of the pre-adoption process or the
disappointment of adoptions falling through. Parents
may also struggle with agreeing on the parameters of
their adoption including the age, cultural
background, and origin of potential adoptees.
LGBTQ parents may face a double layer of stigma
because of their choosing to adopt: that is, they face
stigma due to their sexual orientation/ gender identity
as well as the adoptive/nonbiological status of their
families.
Choosing a Path to Parenthood
Potential parents with the biological ability to do so
must first choose whether they want to have a
biologically related child. In the case of LGBTQ
parents wanting a biological child, they may try
artificial insemination (of a biological woman) or use
of a surrogate implanted with the sperm or egg of a
parent or from another donor. When one parent is
biologically related to the child, the second parent
may need to go through an additional legal process to

secure their rights as a parent to the child, referred to
as second-parent adoption. The second-parent
adoption process adds an additional layer of
psychological stress and financial investment for
same-sex couples.
If potential parents choose to adopt a child, they
must decide whether to adopt domestically or
internationally. If adopting internationally, one
member of the couple might need to adopt as a single
person, as some countries do not allow same-sex
parents to adopt but will allow singleparent adoption.
In these cases, parents can pursue second-parent
adoption once the child is in the United States.
If adopting domestically, parents have to choose
between a public or private adoption. Public
adoptions tend to involve children who have been
removed from their biological parents’ care due to
abuse or neglect and are facilitated by public child
welfare agencies. Private adoptions typically include
children voluntarily given up by their biological
parents and may be facilitated through an agency or
independently with the help of a lawyer.
Adoption, Choices About
For all potential parents, financial resources
largely influence these decisions, as each can be
quite expensive. For all people, higher income is
linked to an increased likelihood to adopt in general.
Economists suggest the cost of children is even
higher for lesbian and gay parents who choose to
adopt, because they have to extend not only
monetary resources but additional work and time to
overcome barriers related to overt and covert
discrimination based on their sexual or gender
identity.
The Adoption Process
Adoption is not a single event; rather, it is a
multistage process that unfolds over time. Prior to
adoption, potential parents face a myriad of
decisions, as described above, while also considering
the impact a child or children will have on their lives.
In the actual adoption process, potential parents must
contend with multiple interviews and home visits to
determine their eligibility. Once this process is
complete, the waiting often begins, especially for
those attempting to adopt an infant. Following
adoption, parents face all the challenges of newly
adoptive parents in addition to potential additional
9
issues related to their sexual or gender identities,
such as discrimination on the part of the health care
system or their children’s schools.
Complications of the adoption process are further
compounded by LGBTQ parents having to consider
the unique legal issues related to their gender and/or
sexual identity and potential stigma their children
and family may face during and after the adoption
process. The little available research suggests
LGBTQ potential parents do face both overt and
covert discrimination in legal settings (e.g., judges
refusing to approve adoptions for same-sex parents)
as well as organizational settings (e.g., adoption
agencies refusing to complete adoptions with same-
sex parents), even in cases where legal or policy
protections do exist. For example, the organizational
policy of an adoption agency may indicate that
LGBTQ parents have all the same rights to adopt as
heterosexual parents.
Adoption, Choices About
However, an individual adoption worker may show
preference to heterosexual parents in actual practice.
Matching the Needs of Children and
Parents
Potential adoptive parents must make several
decisions about the types of children they feel
prepared to adopt. Parents must choose the age range
of children, determine whether they have preferences
regarding the child’s cultural background, and if they
are willing to adopt a child with special needs (and,
if so, what type and how severe). Many parents
prefer an infant, although the waiting period tends to
be longer for infants and longer still if the parents
wish the child to match their cultural or ethnic
backgrounds. Parents willing to adopt older children
may find the process quicker and cheaper as they are
more able to adopt domestically and through the
child welfare system rather than paying a private
agency. However, adopting older children may create
its own set of challenges as older children may
struggle more with attachment (being able to form
stable and healthy bonds with their parent or parents)
and adjustment to their new families.
Some parents may prefer to adopt within their
own racial and/or ethnic group(s) for a variety of
reasons, including wanting the child to look more
like them or feeling better prepared to meet the
10
child’s cultural needs, while others will feel
comfortable with a child from different or multiple
races/ethnicities. Similarly, LGBTQ potential parents
may prefer to adopt a child of their own gender due
to doubts about being able to meet the gender-
specific needs of their child in a same-sex parent
household. Studies suggest, however, that outcomes
for children show little difference in relation to the
gender identifications of their parent or parents.
Some parents may choose to adopt children with
any of a variety of special needs. When doing so, it is
important that they make informed decisions about
what type of issues they feel competent managing for
a child or children. Special needs for children may
include issues with attachment, fetal alcohol
syndrome (a cluster of symptoms related to prenatal
exposure to alcohol, which may include behavioral
or learning problems), or a variety of behavioral
(e.g., lack of impulse control) and mental health
issues (e.g., attention issues, anxiety).
Conclusion
LGBTQ prospective parents face multiple decisions
when considering adoption, including what process
to use and the type of child they are best suited to
parent. These decisions are further complicated by
the social and political contexts in which they are
making their choices. Notwithstanding, increasing
numbers of LGBTQ parents are successfully
engaging in the adoption process to start and expand
their families.
Susan E. Smalling
See also Adoption, International; Adoption, Legal
Considerations in; Adoption, Openness in; Adoption
and Foster Care Discrimination; Adoption Type;
Adoption via the Child Welfare System
Further Readings
Farr, R. H., & Patterson, C. J. (2013). Lesbian and gay
adoptive parents and their children. In A. E. Goldberg &
K. R. Allen (Eds.), LGBT parent families: Innovations in
research and implications for practice (pp. 39–55). New
York, NY: Springer.
Gianino, M. (2008). Adaptation and transformation: The
transition to adoptive parenthood for gay male couples.
Journal of GLBT Family Studies, 4(2), 205–243.
Goldberg, A. E., Downing, J. B., & Sauck, C. C. (2007).
Choices, challenges, and tensions: Perspectives of
lesbian prospective adoptive parents. Adoption
Quarterly, 10(2), 33–64.
Javier, R. A., Baden, A. L., Biafora, F. A., &
CamachoGingerich, A. (2007). Handbook of adoption:
Implications for researchers, practitioners and families.
Thousand Oaks, CA: Sage.
National Adoption Information Clearinghouse. (2000).
Gay and lesbian adoptive parents: Resources for
professionals and parents. Retrieved from https://
www.childwelfare.gov/pubs/f_gay/f_gay.pdf
Ryan, S., & Whitlock, C. (2007). Becoming parents: Lesbian
mothers’ adoption experience. Journal of Gay and
Lesbian Social Services, 19(2), 1–23.
ADOPTION, INTERNATIONAL
Adoption by lesbians and gay men is becoming
increasingly common, not only in most areas of the
United States but in many other countries around the
world including Canada, the United Kingdom,
Germany, Denmark, the Netherlands, Belgium,
Norway, Sweden, Iceland, Israel, Spain, Argentina,
Brazil, South Africa, New Zealand, and parts of
Australia. In each of these countries, laws have been
passed supporting adoption by nonheterosexual
individuals and/or couples. Most children adopted by
sexual-minority families are born and placed for
adoption domestically, either by their birth parents
during infancy, or by the country’s child welfare
system, after the children have been removed from
their birth families because of adverse living
conditions. In other cases, lesbians and gay men have
become parents through international adoption (i.e.,
they adopt from other countries). This pathway to
parenthood, however, more often entails significant
barriers and complications for sexual-minority
couples.1
Barriers to International Adoption by Sexual-
Minority People
International adoption involves the legal placement
of an orphaned child from one country— often
referred to as the “country of origin” or “sending
country”—into a family living in a different, or
“receiving,” country. Standards for international
adoption were established by the United Nations
Convention on the Rights of the Child in 1989 and

by the Hague Convention on Protection of Children
and Cooperation in Respect of Intercountry Adoption
in 1993. These standards prioritize the rights of
sending countries to establish laws and practices that
define adoptive parent
Adoption, International
suitability and the best interests of the child; in other
words, the authorities in sending countries set the
eligibility criteria for prospective adoptive parents
for the children being placed from their country.
Receiving countries are expected to respect and
follow the guidelines established by legal and child
welfare authorities in the country of origin.
Unlike the growing number of receiving countries
that support adoption by sexual-minority families, no
sending countries around the world— with the
exception of the United States and South Africa,
which are both sending and receiving countries—
have adoption laws or policies that support the
placement of children with nonheterosexual people.
In fact, in many sending countries, homosexual
behavior is still criminalized, thereby making it
impossible for the authorities to consider placing
children with sexual minorities. Even in countries
where homosexuality is not criminalized,
discrimination against these individuals based upon
cultural mores, religious beliefs, stereotypes, and
misconceptions often result in LGBTQ people being
labeled as deviant, ill, sinful, and dangerous to
children.
China and Russia, for example, expressly prohibit
the adoption of children by lesbians and gay men.
Other countries require that prospective adoptive
parents be married, but only recognize marriages
between a man and a woman.
In short, legal, cultural, religious, and
discriminatory barriers make it extremely difficult,
and, in many cases, impossible for openly, self-
identified sexual-minority women and men to
become parents through international adoption. And
yet, many have been successful in adopting children
from other countries.
Current Trends and Agency Practices
The number of international adoption placements has
declined around the world for a variety of political,
legal, ethical, and economic reasons. In the United
States, for example, the number of placements
11
peaked at nearly 23,000 children in 2004; by 2013,
the figure had been reduced to slightly more than
7,000.
Adoption, International
A 2003 survey by the Donaldson Adoption
Institute, of U.S. adoption agency policies and
practices related to adoption by lesbians and gay men
in 1999 and 2000, indicated that over two thirds of
private agencies involved in international adoption
were willing to accept adoption applications from
sexual-minority individuals and couples. Moreover,
51% of these agencies reported having made at least
one adoption placement with lesbian or gay clients.
On the other hand, slightly less than 20% of agencies
reported actively recruiting sexual-minority
individuals or couples as prospective applicants for
their international adoption program.
In some cases, nonpartnered LGBTQ people apply
to adopt from other countries as single parents, often
without revealing their sexual orientation to the
adoption worker; at other times, their sexual
orientation is known by the adoption agency but is
not revealed as part of the home study or
documentation sent to the authorities in the child’s
birth country. When coupled LGBTQ people seek to
adopt internationally, including those who are
married or in domestic partnerships, one of the
partners is identified as the preadoptive parent in the
adoption paperwork and the other partner is either
not included in the description of the family
composition or is identified as a family friend or
support person. Although the couple’s sexual
orientation is almost always known by the adoption
agency in these cases, it is often not discussed with
the clients and is unlikely to be included in the home
study and adoption paperwork. Depending upon the
state in which the couple resides, once the child is
living with them and has been legally adopted by one
parent, the other parent often seeks a second-parent
adoption.
Don’t Ask, Don’t Tell has been the predominant
strategy used by agencies in dealing with clients’
sexual orientation for international adoption
placements. Although this practice often leads to a
successful adoption, it poses a significant ethical
dilemma for agencies involving the choice between
adhering to the laws, cultural values, and religious
beliefs of the child’s birth country—which in
virtually all cases would preclude placement of a
12
child with LGBTQ applicants—and the desire to find
a stable, safe, and nurturing home for a child in need,
regardless of the parents’ sexual orientation, as well
as the desire to support their clients’ goal of
becoming adoptive parents. It also poses a conflict
for sexual-minority applicants regarding their deep
desire to become parents to a child from another
country and their commitment to leading an open,
proud, and self-confident life as a sexual-minority
group member. To achieve the former goal, they
often have to “return to the closet” regarding their
sexual orientation when working with the adoption
social worker or when meeting adoption authorities
in the child’s birth country.
The policy of Don’t Ask, Don’t Tell poses other
problems for adoption agencies and their clients. If
the agency does not know their clients’ sexual
orientation, or if they choose not to discuss the
matter with their single or partnered clients during
the application process, there is a risk that effective
adoption preparation and support for these
nonheterosexual adoptive families will be
compromised. Guidelines for working with LGBTQ
adoptive applicants emphasize the importance of
addressing a number of issues related to sexual
orientation, including how the clients’ sexual
orientation will be represented in the home study; the
extent to which clients are “out” and with whom; the
support of extended family, neighbors, coworkers,
and the community in general, related to sexual-
minority issues; how to talk with children about
parental sexual orientation; how to help children
cope with prejudice, homophobic comments, and
discriminatory behavior; protecting the parent-child
relationship when state law precludes a second-
parent adoption; and referral to LGBTQaffirmative
community resources. In addition, the failure to
address sexual orientation issues in the adoption
process makes it impossible for professionals to
prepare older children and explore their
understanding and comfort level in being placed in a
home headed by LGBTQ parents.
Research and social casework practice also
suggest that sexual-minority individuals often
experience heightened minority stress when they are
forced to keep secret their sexual orientation, not
only from adoption agency personnel but also when
meeting the child’s current caregivers and the
adoption authorities in the child’s birth country.
International adoption often requires parents to travel
great distances to meet their child and complete the
adoption process in the country of origin. Sometimes
more than one trip is necessary, and it is not
uncommon for the parents to be required to spend a
number of weeks in the birth country while the
adoption is being finalized. Deciding which one of
the couple will be identified as the adoptive parent to
the U.S. adoption agency and the authorities in the
country of origin, and whether only one or both of
them will travel to the child’s birth country, can put
pressure on the couple, complicating their transition
to adoptive parenthood. So, too, does having to
manage this process alone, when only one parent
makes the trip. Furthermore, when both travel to the
birth country to finalize the adoption, managing the
secret about the nature of their relationship when
meeting local child-care providers and adoption
authorities adds additional stress for the couple.
International adoption is predicated on the
assumption that adoptive parents will support their
child’s connection with his or her birth culture. In
support of this goal, a growing number of families
are engaging in heritage travel as their children get
older, returning to the birth country, exploring the
culture, visiting the orphanage or foster home where
the child previously lived, and sometimes even
making contact with birth family members. In
situations where birth countries have strict legal or
cultural prohibitions against homosexuality, such
trips could increase the stress on all family members,
who may feel the need to maintain the secret of the
parents’ sexual orientation from the people they
encounter. It could also increase the risk of the child
experiencing another form of rejection in response to
homophobic attitudes and reactions, including those
from birth family members.
Looking to the Future
As the number of international adoption placements
has dramatically declined over the past decade,
opportunities to adopt orphaned children
Adoption, International
from other countries have been reduced for citizens
of all receiving countries, including LGBTQ people.
The fact that almost all sending countries prohibit
placement of their children with sexualminority
individuals and couples makes the current prospects
of international adoption for this group increasingly

challenging. Adoption agencies need to be open and
frank with LGBTQ applicants about the difficulties
they will encounter in trying to adopt from another
country, and when appropriate, help their clients to
examine other adoption options. They also need to
confront their own policies and practices related to
the ethical and adoption preparation dilemmas they
face in working with sexual-minority clients who
seek to adopt internationally.
As more and more societies become accepting of
same-sex relationships, and are better informed about
the sizable body of research showing that sexual-
minority adults have the same parenting sensitivities
and skills as heterosexual adults, and that children
are not disadvantaged when raised by lesbians or gay
men, perhaps in the future there will be fewer
barriers and less stress for sexual-minority couples in
their efforts to adopt from other countries. Continued
work to overcome the misconceptions and
stereotypes among legal and adoption authorities in
sending countries through education, advocacy, and
respectful dialogue will hopefully pave the way for
these professionals to understand and accept that
families headed by sexual-minority parents offer
orphaned, and often traumatized, children
opportunities for lifelong family stability, safety,
nurturance, and healing.
David Brodzinsky
See also Adoption and Foster Care Discrimination;
Adoption Type; Families of Origin, Relationships
With; Minority Stress; Second-Parent Adoption;
Single-Parent Adoption; Transition to Parenthood for
LGBTQ People
Note
1. Virtually no information exists on the experiences of
transgender people who seek to adopt children, either in the
United States or elsewhere. Moreover, research on Adoption,
Legal Considerations in
parenting by sexual-minority people has focused almost
exclusively on lesbians and gay men.
Further Readings
Brodzinsky, D. (2011). Expanding resources for children III:
Research-based best practices in adoption by gays and
lesbians. New York, NY: Donaldson Adoption Institute.
Retrieved from http://www.adoptioninstitute.org
13
Brodzinsky, D. (2012). Adoption by lesbians and gay men:
A nationwide survey of adoption agency policies and
practices. In D. Brodzinsky & A. Pertman (Eds.),
Adoption by lesbians and gay men: A new dimension in
family diversity (pp. 62–84). New York, NY:
Oxford University Press.
Brodzinsky, D. M., & Pertman, A. (Eds.). (2012). Adoption
by lesbians and gay men: A new dimension in family
diversity. New York, NY: Oxford University Press.
Dambach, M. (2011). The international legal context
governing intercountry adoptions by gay men and
lesbians. Adoption & Fostering, 35, 65–77.
Goldberg, A. E., & Allen, K. R. (Eds.). (2013).
LGBTparent families: Innovations in research and
implications for practice. New York, NY: Springer.
Goldberg, A. E., Downing, J. B., & Sauck, C. (2007).
Choices, challenges, and tensions: Perspectives of
lesbian prospective adoptive parents. Adoption
Quarterly, 10, 33–64.
Mallon, G. P. (2011). The home study assessment process for
lesbian, gay, bisexual, and transgender prospective foster
and adoptive families. Journal of GLBT Family Studies,
7, 9–29.
ADOPTION, LEGAL
CONSIDERATIONS IN
Despite increasing rates of adoption by LGBTQ
individuals and couples, there are legal barriers that
continue to make this route to parenthood
challenging for members of the LGBTQ community.
This entry addresses the legal considerations faced
by LGBTQ individuals as they pursue adoption. It
presents the types of adoption available to LGBTQ
individuals and couples, discusses legal policies and
second-parent adoptions, and covers interactions
with the legal system, including judges and
attorneys.
Adoption Options
LGBTQ individuals and couples have options when
they decide to pursue parenthood. One of the most
common paths to parenthood that samesex couples
choose is adoption. The number of same-sex couples
who become parents through adoption has increased
over the past few decades. In fact, same-sex couples
14
are more likely than heterosexual couples to be
raising a child whom they adopted.
Upon choosing the path of adoption, couples or
individuals (i.e., single parents by choice) are faced
with the decision to choose the type of adoption they
wish to pursue. Most commonly, couples adopt via
either public domestic adoption (i.e., through the
U.S. child welfare, also known as foster care,
system), or private domestic adoption (e.g., the
parent hires a lawyer or uses a private adoption
agency to facilitate the adoption of an infant in the
United States). Private domestic adoptions can be
“open” or “closed.” An open adoption is one that
allows birth parents and adoptive parents to have
information about each other (e.g., names, contact
information). In a closed adoption, birth parents and
adoptive parents are not provided identifying
information about each other and there is no contact
between them. International adoptions have
historically been an option, but are increasingly
difficult for LGBTQ individuals and couples. This is
because the countries most commonly accessed for
international adoption (e.g., China, Russia,
Guatemala)
are becoming more rigid in their requirements for
adoptive parents; many will not consider applicants
who are single/not married or are “out” as sexual
minorities.
Legal Policies
LGBTQ individuals and couples encounter numerous
barriers in achieving the legal status of “parent.”
Some states do not allow openly LGBTQ individuals
or couples to co-adopt (i.e., to adopt their child
together), for example. In some of these
jurisdictions, same-sex couples have had success
adopting serially. That is, one partner initially adopts
the child as a single parent and then the other partner
petitions for a second-parent adoption, allowing both
partners to be legally recognized as the child’s
parents. Second-parent adoptions are employed by
female same-sex couples in which one partner has
given birth to the child; in this case, the
nonbiological mother does not have automatic legal
rights to the child (although in some states, the
nonbiological mother may have legal status as a
parent, if the women are married). Similarly, male
samesex couples that pursue surrogacy may also seek
second-parent adoptions for the nonbiological father.
Notably, second-parent adoptions by same-sex
partners are not universally available. Some states
explicitly permit them, some states explicitly prohibit
them, and in some states, whether or not they are
granted depends upon where the couple lives, and/or
which judge hears their case. Thus, in the absence of
a second-parent adoption, the child has two social
parents but only one legal parent—the partner who
adopted the child. In the cases where only one
member of an LGBTQ couple is a legal parent and
the other is not, the legal parent has a nearly
insurmountable advantage in any dispute with a
nonparent, including a nonparent partner (or, more
likely, former partner). And this difference in
parental legal rights within couples may contribute to
feelings of anxiety and stress, particularly for the
legally invisible parent. Thus, legal inequities
between same-sex partners create a substantial power
imbalance even in intact families. Further, it also
disadvantages the child to have only one legal parent
in terms of inheritance and benefits. Options that
families have pursued in order to increase the legal
rights of the “second” parent when second-parent
adoption is not permitted include legal
documentation of the parents’ relationship (e.g., in
wills, via shared finances and
Adoption, Legal Considerations in
property) and hiring an attorney to establish de facto
parentage (i.e., legal recognition to a person who has
acted like a parent for a substantial period of time).
Interactions With the Legal System
The legal landscape concerning LGBTQ adoption is
complex, shifts constantly, and varies by state and
sometimes by county within the same state.
Depending on where they live, some same-sex
couples must face the reality that they will need to
closet their relationship if they pursue adoption (both
domestic and international adoption). That is, one
parent is acknowledged by the agency or country
issuing the adoption and the other parent is not. This
situation can create intrapersonal and interpersonal
stress, in that one partner is virtually invisible in the
adoption process, having little or no direct contact
with the agency, birthparent(s), and/or the child prior
to the finalization of the adoption.
Little research has examined lesbian and gay
adoptive and prospective adoptive parents’
 15
experiences with attorneys, judges, and adoption
agencies, which may reflect and perpetuate societal
heterosexist values. Out of awareness of such values,
and the potential for discrimination, LGBTQ parents
often seek professionals who are familiar with family
law and the specifics of handling second-parent
adoptions. In addition, they seek attorneys, judges,
and agencies that are known to be “friendly” to the
LGBTQ community. Some view these professionals
as advocates who help them to navigate a potentially
discriminatory legal system. Many parents search for
these professionals by talking with other parents who
have successfully adopted children; some
communicate with each other in online forums and
create a support network of LGBTQ parents seeking
to adopt. In addition, research has shown that some
potential adoptive parents travel to different counties
or states to ensure that their adoptions are overseen
by gay-friendly judges.
Although there is little research that has examined
the legal considerations faced by lesbian and
16 Adoption, Openness in
gay individuals and couples who have adopted
children, there is an even larger gap in the literature
concerning bisexual individuals as well as
transgender individuals. Little is known about how
they navigate legal challenges as they pursue
adoption. Members of the bisexual and transgender
communities likely face similar barriers (e.g.,
discriminatory legislation, heterosexist policies,
prejudice from agencies) but may also face unique
challenges stemming from societal lack of
acknowledgement and understanding of their
sexuality and/or gender.
April M. Moyer and Abbie E. Goldberg
See also Adoption, Choices About; Adoption, Openness in;
Adoption and Foster Care Discrimination; Adoption
Type; Foster Parenting, Legal Considerations in
Further Readings
Downing, J. B., Richardson, H. B., Kinkler, L. A., &
Goldberg, A. E. (2009). Making the decision: Factors
influencing gay men’s choice of an adoption path [Special
issue: Lesbian and gay adoptive parents: Issues and
outcomes]. Adoption Quarterly, 12, 247–271.
Goldberg, A. E., Moyer, A. M., Weber, E. R., & Shapiro, J.
(2013). What changed when the gay adoption ban was
lifted? Perspectives of lesbian and gay parents in Florida.
Sexuality Research and Social Policy, 10, 110–124.
Goldberg, A. E., Weber, E. R., Moyer, A. M., & Shapiro, J.
(2014). Seeking to adopt in Florida: Lesbian and gay
parents navigate the legal process. Journal of Gay &
Lesbian Social Services, 26, 37–69.
Shapiro, J. (2013). The law governing LGBT-parent
families. In A. E. Goldberg & K. R. Allen (Eds.),
LGBT-parent families: Innovations in research and
implications for practice (pp. 291–304). New York,
NY: Springer.
ADOPTION, OPENNESS IN
Openness arrangements describe possibilities for
contact and information sharing between birth and
adoptive families. Contact can involve different
members of the adoptive kinship network, which
includes the adoptee, birth family, and adoptive
family members; and contact can vary in frequency
and type (e.g., in-person visits, phone calls, letters, e-
mails, texts, social media contacts, and/or gifts).
There have been growing trends toward greater
openness in adoption over the past several decades in
the United States, particularly with domestic
adoptions.
While sparse research has examined this topic
among nonheterosexual adoptive parents, broader
literature about adoption has demonstrated that
options for openness between birth and adoptive
families are generally linked with positive outcomes
for adoptees, birth parents, and adoptive parents.
Specifically, among lesbian and gay adoptive
parents, there have been several recent studies that
are aligned with the overall knowledge base about
openness arrangements. This entry focuses on the
openness arrangements among sexualminority
parents and their adopted children’s birth family
members. It addresses questions about the
prevalence, perceptions, and dynamics of openness
arrangements among sexual-minority adoptiveparent
families. The discussion is particularly attentive to
the perspective of adoptive parents, as no existing
research has examined these topics from the
viewpoint of birth family members or adopted
children.
Motivations for Openness in Adoption
Longitudinal interview-based research with lesbian,
gay, and heterosexual couples who have adopted
children has yielded important information about
adoptive parents’ motivations for open adoption,
how adoptive parents are navigating relationships
with their child’s birth family, and how adoptive
parents expand their notions of family to include
birth parents. Some couples, regardless of sexual
orientation, feel that open adoption is “the healthier
approach,” given the lack of secrecy and full
disclosure that they believe to positively influence
their children’s psychological development (as well
as benefiting everyone involved). A small number of
parents want to pursue open adoption specifically
because of the greater likelihood of access to detailed
medical information and health history regarding
their child. Some sexualminority parents note that
one of the most desirable features of open adoption is
the possibility of gaining a male or female role
model through the process. These parents express the

belief that having a male or female role model would
benefit their child’s gender development. Gay
adoptive fathers in particular appear to be likely to
express a desire for a “mother figure” for their child,
which is aligned with societal discourse about the
necessity of women in children’s lives. Most lesbian
mothers, however, do not appear to highlight the role
of birth father as important in providing this “male”
role. Interestingly, same-sex couples do not seem to
feel “pushed” toward open adoption by their
adoption agency, whereas some heterosexual couples
report feeling that they had little choice about
openness if they hoped to complete an adoption in a
reasonable amount of time. To the contrary, sexual-
minority parents often specifically want to pursue
open adoption because they can be “out” about their
sexual orientation during the whole adoption process.
Pathways to Adoption and the
Possibility of Openness
Motivations for greater openness in adoption have
been identified among lesbian and gay parents in
research about how participants became parents. For
example, factors that push gay fathers toward or
away from various adoption paths—namely
international, public, and private domestic open
adoption—have been examined. Interviews with gay
male couples pursuing domestic open adoption
reveal that a desire for an infant is common, as they
want to be there for their child from the start to be
able to play a strong role in their development and
develop a healthy bond and attachment. Some gay
fathers feel having an infant is the closest they can
come to having a biological child, and a few report
the role of racial preferences. Gay men who adopt
via domestic open adoption also note insecurity
about adopting through the public child
Adoption, Openness in
welfare system and no desire (or choice) to adopt
internationally due to legal barriers and/or having to
“hide” their relationship (as international “sending
countries” typically prefer or require married
heterosexual couples). As noted earlier, some gay
fathers find domestic open adoption appealing
because of the inherent honesty and openness
involved, and some appreciate the practical reasons
17
involved (e.g., perceived convenience). Similarly,
many lesbian couples note that their desire to be
“out” fits well within the larger philosophy about
open adoption, and they feel a sense of integrity
around representing themselves truthfully to birth
mothers. Yet, at the same time, lesbian preadoptive
parents express sadness, powerlessness, and a sense
of injustice about the likelihood of experiencing
rejection by birth parents based on their sexual
orientation. Other gay male couples note that they
want to adopt via the public child welfare system for
financial reasons (e.g., perceived lower costs), or as a
result of not being able to pursue another type of
adoption due to legal barriers (e.g., international
adoption), and/or not wanting birth parent contact.
Likewise, lesbian and gay parents who pursue
international adoption perceive it as the fastest and
most secure pathway to parenthood. Some express
not wanting direct birth parent involvement (or fears
about their child being “taken back”), and some
report discomfort about having to be “chosen” by a
birth mother.
“Chosen” by Birth Parents
Among lesbian and gay parents who adopt via
different pathways, it appears that at least some
parents (around one-third in one survey) are directly
chosen by the birth parents to be the adoptive
parents, have met one or both birth parents prior to
adoption, have ongoing contact with the birth parents
or other birth family members after adoption, and
report that birth parents know of their sexual
orientation. All four of these factors (being directly
chosen, meeting birth parents prior to adopting,
having birth family contact after adopting, and
disclosure of sexual orientation) are more common
among lesbian and gay parents who adopt privately
or with an attorney as compared with other routes to
adoption.
Perceptions of Birth Family Contact
Indeed, lesbian, gay, and heterosexual adoptive
couples who have completed private or public
domestic adoptions appear likely to have some
contact with their child’s birth mother—consistent
with overall trends toward greater openness in
adoption in the United States. Regardless of family
18 Adoption, Openness in
type, most adoptive parents report positive feelings
toward birth mothers and are satisfied with their level
of birth family contact (whatever it is). Lesbian and
gay adoptive parents, however, more so than
heterosexual parents, tend to describe their child’s
birth parents (typically the birth mother) as family,
reflecting inclusiveness and expanded notions of
family. This notion runs parallel to Kath Weston’s
concept of “families of choice” that describes the
extended communities of support (not defined by
biological ties) that sexual-minority individuals often
draw from in the absence of support from families of
origin.
Trends in Openness Arrangements Among
Lesbian and Gay Adopters
Consistent with previous research, studies that
include lesbian and gay adoptive parents indicate that
earlier contact predicts greater contact later on, and
satisfaction with contact is likely to be higher among
families with ongoing birth family contact. In
addition, lesbian and gay adoptive parents’ feelings
toward the birth mother and satisfaction with contact
do not appear to be related to the actual levels of
birth family contact. In the same way, other
demographic variables, such as the child’s race, do
not seem to influence the level of birth family
contact among lesbian, gay, and heterosexual
adoptive parent families.
Similar to broader research about openness in
adoption, the degree to which contact increases,
decreases, or is maintained over time across the pre-
and postadoption periods varies among adoptive
lesbian, gay, and heterosexual parent families.
Some couples describe becoming increasingly
invested, while others become less open over time.
Several parents across family types mention
hesitation or concerns about open adoption before
being placed with their child, and they describe few
changes in their attitudes following placement.
Others, despite a high level of investment in contact
initially, experience a decline in expectations for
contact due to a lack of response from birth parents.
One factor that is associated with less birth mother
contact among all adoptive families, including those
with lesbian and gay parents, is substance use by the
birth mother during pregnancy.
Tensions Between Birth and Adoptive
Parents
For those families with ongoing contact, a minority
of adoptive parents describe feeling as though the
birth mother is overstepping her boundaries in some
way. Interestingly, gay men appear to be the most
tolerant of these types of behaviors, and at least some
evidence has suggested that gay fathers may be most
likely to maintain postplacement contact. While
other data from several studies indicate that all
families are equally likely to have some form of
ongoing or planned contact, gay fathers may be
likely to have the most contact in particular formats
—such as by phone—perhaps as a result of fewer
perceived barriers to open communication among
birth mothers and gay fathers. Similarly, gay fathers
may be particularly likely to be chosen by birth
mothers, as men may be perceived by birth parents to
be less challenging to work with than women.
Perhaps birth mothers are seeking to minimize
competition or jealousy in selecting gay fathers, as
compared with selecting additional “mothers” in
lesbian couples.
Foster Parenting
Lesbian, gay, and heterosexual parents whose
children joined the family specifically via foster-
toadoption placements report a number of challenges
with birth family contact. Parents describe their own
anxiety and stress related to their children’s visits
with birth parents, and that their children sometimes
become upset and agitated following visits. Even
with a commitment to keep a positive attitude toward
birth parents, some adoptive parents also note
distress around having an increased level of conflict
with their partners related to differences of opinion
about how to navigate birth family contact. Lesbian
and gay couples who foster-to-adopt report that not
all birth parents are accepting of same-sex couples,
and some contend with direct homophobia from birth
families. In these cases, it appears that social workers
may be withholding information from the birth
family about the foster/adoptive parents’ sexuality.
LGB foster parents with birth family contact also
frequently report hiding their sexual orientation
because they often feel it makes the birth family
uncomfortable (and this may be more common

among sexual-minority men than women). Some
adoptive parents are disheartened by a lack of birth
family contact when they had hoped for a greater
degree of openness postplacement, and many foster
parents also report a lack of contact with their foster
youth’s birth family. In contrast, a smaller
percentage of parents also do explicitly identify
positive aspects of contact with their child’s birth
family and/or feel their relationships with their foster
child’s birth family are close. (Among foster parents,
these dynamics appear to be more common among
lesbian and bisexual women rather than gay men.)
Legal Adoption Finalization
With regard to legal finalization of adoption,
available data indicate that contact with birth
families is in no way a hindrance to the legal
adoption process moving forward. In contrast,
contact may be facilitative in some ways—
challenging some adoptive parents’ “worst fears”
that birth family contact will somehow derail or
compromise the stability of the placement. This idea
has also been disconfirmed by other studies
indicating that birth family contact does not interfere
with adoptive couples’ sense of entitlement, nor does
it
Adoption, Openness in
exacerbate fears that birth parents might attempt to
reclaim their child.
Withholding Adoption Information From
Children
A final area of interest about open adoption within
adoptive families is the extent to which parents share
openly with their child about adoption and birth
family. While it seems common that adoptive parents
(sexual-minority and heterosexual) do not
purposefully withhold adoption information from
their children, those who have plans to withhold have
strong rationales for doing so, such as considering
the developmental appropriateness of sharing
difficult information with their children. Thus, in the
same spirit of honesty and openness regarding
contact with birth families, lesbian and gay adoptive
19
parents also tend to be committed to openness of
communication about adoption with their children.
Conclusion
Given that this growing body of research comparing
openness dynamics among lesbian, gay, and
heterosexual adoptive parent families reflects few
differences in birth family contact, this may suggest
that all adoptive parents, regardless of sexual
orientation, navigate dynamics of openness in
adoption in similar ways. This is in contrast to
notions that sexual-minority adoptive parents are
subject to different influences than are heterosexual
parents in making decisions about birth family
contact. While lesbian and gay adoptive parents may
have different experiences than do heterosexual
adoptive parents throughout the adoption process
(e.g., encountering legal barriers and/or
discrimination based on sexual orientation), it does
not appear that these differences are linked with
distinct and consistent discrepancies in the level of
contact or dynamics surrounding relationships with
birth family members.
Policy and practice surrounding adoption by
lesbian and gay parents have largely outpaced the
research on this topic, and greater information about
the dynamics of postadoption birth family contact is
beneficial to those working to navigate these
complex relationships—including adoptive kinship
network members and those adoption professionals
who work with them. Results from empirical
research may also provide valuable information to
prospective adoptive parents who are curious about
how openness between birth and adoptive families
can be managed postplacement. Decisions about
openness arrangements should be carefully
considered, as the factors involved are unique to each
individual adoption placement, and there is no “one-
size-fits-all” approach with regard to successfully
navigating open adoptions.
Future research could provide insight into the
“best practices” for helping prospective and current
adoptive parents (and birth family members) making
decisions about contact and information sharing.
With specific regard to the prejudice experienced by
adoptive parents from birth parents on the basis of
sexual orientation, as well as related decisions about
parents’ disclosure about sexual orientation to birth
20 Adoption, Openness in
parents, intervention with birth family members
might be particularly useful. Perhaps research could
investigate the impact of education and training
about families led by lesbian and gay parents on birth
parents’ attitudes toward placing children with
sexual-minority parents, and also on subsequent
relationship dynamics among birth and adoptive
family members. Future longitudinal work would
also help to address the role of satisfaction with
contact and feelings toward birth mothers (and other
birth relatives) in influencing birth family contact.
Particularly among lesbian and gay adoptive parents,
exploring the role of the adoption agency in
encouraging (or discouraging) contact, as well as
legal parenting status issues, would be informative.
Further research would benefit from larger and more
diverse samples and longitudinal examinations to
decipher what factors related to openness
arrangements are linked with positive and healthy
outcomes for all involved over time.
Rachel H. Farr
See also Adoption, Choices About; Adoption,
International; Adoption, Legal Considerations in;
Adoption and Foster Care Discrimination; Adoption
Type; Adoption via the Child Welfare System;
Deciding Whether to Parent; Families of Choice;
Foster Care; Foster Parenting
Further Readings
Brodzinsky, D. M. (2011). Expanding resources for children
III: Research-based best practices in adoption by gays
and lesbians. New York, NY: Donaldson
Adoption Institute. Retrieved from http://www
.adoptioninstitute.org
Brodzinsky, D. M., Green, R. J., & Katuzny, K. (2011).
Adoption by lesbians and gay men: What we know, need
to know, and ought to do. In D. Brodzinsky & A.
Pertman (Eds.), Adoption by lesbians and gay men: A new
dimension in family diversity (pp. 233–254).
New York, NY: Oxford University Press.
Downing, J., Richardson, H., Kinkler, L., & Goldberg, A.
(2009). Making the decision: Factors influencing gay
men’s choice of an adoption path. Adoption Quarterly,
12(3–4), 247–271.
Downs, A., & James, S. E. (2006). Gay, lesbian, and
bisexual foster parents: Strengths and challenges for
the child welfare system. Child Welfare, 85(2), 281–
298.
Farr, R. H., & Goldberg, A. E. (2015). Contact between
birth and adoptive families during the first year
postplacement: Perspectives of lesbian, gay, and
heterosexual parents. Adoption Quarterly, 18(1), 1–24.
Goldberg, A. E., Downing, J. B., & Sauck, C. C. (2007).
Choices, challenges, and tensions: Perspectives of
prospective lesbian adoptive parents. Adoption
Quarterly, 10(2), 33–64.
Goldberg, A. E., & Gianino, M. (2011). Lesbian and gay
adoptive parent families: Assessment, clinical issues,
and intervention. In D. Brodzinsky & A. Pertman (Eds.),
Adoption by lesbians and gay men: A new dimension in
family diversity (pp. 204–232). New York, NY: Oxford
University Press.
Goldberg, A. E., Kinkler, L. A., Richardson, H. B., &
Downing, J. B. (2011). Lesbian, gay, and heterosexual
couples in open adoption arrangements: A qualitative
study. Journal of Marriage and Family, 73(2), 502–518.
Goldberg, A. E., Moyer, A. M., Kinkler, L. A., &
Richardson, H. B. (2012). “When you’re sitting on the
fence, hope’s the hardest part”: Challenges and
experiences of heterosexual and same-sex couples
adopting through the child welfare system. Adoption
Quarterly, 15(4), 288–315.
Grotevant, H. D. (2012). What works in open adoption. In P.
A. Curtis & G. Alexander (Eds.), What works in child
welfare (pp. 309–328). Washington, DC: Child Welfare
League of America.
ADOPTION AND FOSTER CARE
DISCRIMINATION
Historically, formal adoption and foster care were
restricted to heterosexual married couples. Over the
past two decades such restrictions have been lifted in
many countries to allow single people and/ or people
who do not identify as heterosexual and cisgender
(i.e., people whose gender identity normatively
accords with that expected of their assigned sex) to
become adoptive or foster parents. In some countries,
however, restrictions upon who is eligible to adopt or
foster remain, and indeed this is differentiated within
countries by state or province. Yet despite the
gradual lifting of restrictions, and as is the case with
many such legislative and policy changes, practices
within adoption and foster care agencies often lag

behind the laws and policies that guide them. As
such, some lesbians, gay men, and bisexual and
transgender people may continue to experience a
range of discriminatory practices from adoption and
foster care agencies.
This entry addresses the contemporary
experiences of lesbian, gay, bisexual, transgender,
and queer (LGBTQ) people seeking to foster or
adopt. In focusing on locales where formal
restrictions have been lifted, this entry highlights
how discrimination continues, despite the changing
of legislation and policies. Specifically, the entry
focuses on the effects of social norms upon LGBTQ
applicants (in the form of heteronormativity and
cisnormativity), instances of explicit discrimination
in the context of adoption and foster care assessment
and practice (in the form of homophobia, biphobia,
and transphobia), and the injunctions placed
Adoption and Foster Care Discrimination
21
they take cisgender people as the norm or enforce
normative gender binaries upon transgender people.
Another common experience reported by LGBTQ
foster care and adoption applicants is the expectation
that they will disclose and explain their sexual
orientation and/or gender identity to the agency
worker undertaking their assessment. In other words,
rather than agency workers who assess LGBTQ
applicants being knowledgeable about these
populations, applicants often report that they have to
educate agency workers in order to receive a fair
assessment. For lesbian or gay applicants who apply
as couples, this can result in having to provide
information about the dynamics of same-sex
relationships. For transgender applicants, agency
workers may often hold little or no knowledge about
the lives of transgender people, or conversely may
hold a range of normative

specifically upon LGBTQ adoptive and foster

parents by agencies in regard to their sexual
orientation and/or gender identity. The entry focuses
primarily on adoptive and foster care where longterm
placements are provided to children removed from
their birth parents, rather than short-term or
temporary placements.

Effects of Social Norms

As tools for understanding the effects of social
norms, the concepts of heteronormativity and
cisnormativity offer much leverage in gaining insight
into some of the subtle ways in which lesbian, gay,
bisexual, and transgender foster care and adoption
applicants experience discrimination. Perhaps the
most common effect of social norms upon lesbian,
gay, bisexual, and transgender applicants is the
presumption that all people are heterosexual (i.e.,
heteronormativity) and that all people are
cisgendered (i.e., cisnormativity). These
presumptions can mean that when a potential
applicant initially calls an agency and talks about a
partner, the person on the phone presumes that the
partner is of a different gender than the applicant. It
can mean that promotional and training materials
only feature heterosexual people. It can mean that
when issues related to transgender people are
addressed in assessment procedures and training,
22
Adoption and Foster Care Discrimination and/or cisgender are vetted out early in the assessment
process, or ultimately not approved. Research suggests
that some lesbians and gay men in particular attempt to
presumptions about what it means to be transgender
circumvent this by presenting as single people and by
(i.e., that all transgender people will take hormones
not mentioning their lesbian or gay identity.
and/or have gender-affirming surgery). For bisexual
Being approved to foster or adopt does not mean that
applicants, a lack of knowledge among agency workers
LGBTQ people are free from experiencing
can result in having to dispel myths about bisexual
discrimination. Research suggests that in some
people.
instances agency workers can be explicitly
Research in the field also suggests that assessment
homophobic, biphobic, and/or transphobic. This can
processes can contribute to the invisibility of bisexual
include refusing to place children; refusing to support
people. For example, if two bisexual women in a
applications for permanent placements (in the context
relationship apply to foster or adopt, research suggests
of conversions from foster care to adoption); seeing
that they are often treated as lesbians, even if they
LGBTQ foster and adoptive parents as “second class
explicitly state that this is not the case. Similarly, when
parents” deserving of “second class children” (i.e.,
a male and female couple present for assessment,
placing these parents with children with extremely
research suggests that they are normatively presumed to
challenging behaviors, significant mental and physical
be heterosexual, even if they explicitly state that one or
health problems and/or disabilities); making
both identify as bisexual. Indeed, it can often be the
discriminatory remarks in the presence of foster and
case that agency workers willfully ignore statements
adoptive parents; and terminating placements.
about bisexuality and refuse to include it in assessment
Another specific form of discrimination reported in
reports, instead labeling applicants as either
the literature relates to the refusal to place
heterosexual, lesbian, or gay.
LGBTQ young people with LGBTQ foster or adoptive
A final example of the effects of social norms upon
parents. Though it would seem appropriate and
LGBTQ applicants is a lack of supports and resources.
productive for such placements to occur (i.e., so that it
This may include training materials, case examples, and
is more likely the young person will be supported and
assessment documents not being inclusive of LGBTQ
accepted), research suggests that some agencies view
people. Agencies may not collect or release information
such placements as endorsing non-normative sexual
about applicants who identify as members of these
orientations and gender identities among young people,
populations, making it more difficult for peer support
that there may be the potential for abuse, and that
groups to be developed. Heteronormativity and
young people are better placed within heterosexual,
cisnormativity can also lead to agencies conceptualizing
cisgender-parent households. These types of views are
lesbians, gay men, bisexuals, and transgender people as
reflective of homophobia, biphobia, and transphobia.
“just like” heterosexual and/or cisgender people, under
Finally, it has been suggested that some agencies
rhetoric of liberal inclusivity. This can mean that
allow birth parents to vet the placement of their child
opportunities to target the specific needs of these
with LGBTQ people. While in many instances it is
populations are missed.
important that birth parents are actively involved in
placement decisions, the existence of homophobia,
Explicit Discrimination biphobia, and transphobia can mean that placement
decisions are made that are not in the best interests of
Despite legislative and policy changes in many locales the child, and are instead made in accordance with the
removing restrictions upon who is eligible to foster and discriminatory views of some birth parents, which are
adopt, this does not mean that LGBTQ people are then endorsed or supported by the agency.
always welcomed by agencies. In many locales,
agencies with religious affiliations continue to
discriminate, and often this is protected by legislation Injunctions Placed Upon LGBTQ Adoptive and
that allows organizations to exercise religious freedom. Foster Parents
Of course, even if such active discrimination is not the
Echoed repeatedly across research on LGBTQ foster
case, the views and beliefs of agency workers can mean
and adoptive parents is the reported expectation that
that applicants who do not identify as heterosexual

they be “perfect parents.” Applicants report that they
feel an injunction to present a “perfect” home, to be in a
normative relationship (i.e., monogamous, long-term,
completely conflict free), and to have a past free from
any forms of non-normative behaviors (i.e., for public
and prominent expression of their sexual orientation
and/or gender identity). Research suggests that this
injunction can stymie accessing support once approved,
under the tacit understanding that LGBTQ foster and
adoptive parents should have exceptional parenting and
coping skills, and that to present as otherwise may
result in the placement being terminated.
Another injunction that is widely reported across the
literature on lesbian, gay, bisexual, and transgender
parenting is the expectation of providing appropriate
“role models” to children. For lesbian and gay foster
and adoptive parents, for example, this can involve the
expectation that they will involve adults of different
genders in the raising of children (i.e., so that children
are exposed to both cisgender men and women). For
transgender foster and adoptive parents, the expectation
can be that they ensure children interact with cisgender
adults. In addition to this injunction to expose children
to “difference,” there can be an accompanying
injunction for LGBTQ foster and adoptive parents not
to expose children to too much difference (i.e., to shield
them from LGBTQ communities).
A final injunction placed upon LGBTQ foster and
adoptive parents is not to cause trouble: to be thankful
for the forms of inclusion they are offered, and to
refrain from challenging any exclusion they experience.
This can be explicit (in terms of parents
Adoption and Foster Care Discrimination
being advised not to challenge discrimination for fear of
placement termination), or implicit (in terms of the
sense that support is lacking within agencies). Research
suggests that many LGBTQ foster and adoptive parents,
when they experience a supportive agency worker, are
fearful of what may happen if their case is reassigned
and they are allocated a less supportive worker. This
can result in a sense of having to be thankful for
conditional support, rather than experiencing support as
something that is guaranteed and ongoing.
In sum, while in many locales restrictions have been
lifted in terms of who is eligible to become a foster or
adoptive parent, this does not necessarily mean that
LGBTQ applicants are welcomed, nor that they are
fully included and supported if their application is
23
accepted. Research suggests that both mundane and
hostile forms of discrimination continue, and that this
leaves LGBTQ foster and adoptive parents with the
sense that the support they experience is contingent and
limited.
Damien W. Riggs and Clare Bartholomaeus
See also Adoption via the Child Welfare System;
Discrimination Against LGBTQ People, Cost of;
Discrimination Against LGBTQ People in the Public
Sector; Foster Parenting; Heterosexism
Further Readings
Brown, S., Smalling, S., Groza, V., & Ryan, S. (2009). The
experiences of gay men and lesbians in becoming and being
adoptive parents. Adoption Quarterly, 12(3–4), 229–246.
Downs, A. C., & James, S. E. (2006). Gay, lesbian, and
bisexual foster parents: Strengths and challenges for the
child welfare system. Child Welfare: Journal of Policy,
Practice, and Program, 85(2), 281–298.
Eady, A., Ross, L. E., Epstein, R., & Anderson, S. (2009). To bi
or not to bi: Bisexuality and disclosure in the adoption
system. In R. Epstein (Ed.), Who’s your daddy? And other
writings on queer parenting
(pp. 124–132). Toronto, Ontario, Canada: Sumach Press.
Goldberg, A. E., Downing, J. B., & Sauck, C. C. (2008).
Choices, challenges, and tensions: Perspectives of lesbian
prospective adoptive parents. Adoption Quarterly, 10(2), 33–64.
Adoption Type
Hicks, S. (2000). “Good lesbian, bad lesbian . . .”: Regulating
heterosexuality in fostering and adoption assessments.
Child and Family Social Work, 5(2), 157–168.
Riggs, D. W. (2011). Australian lesbian and gay foster carers
negotiating the child protection system: Strengths and
challenges. Sexuality Research and Social Policy, 8(3), 215–
226.
Ross, L., Epstein, R., Goldfinger, C., Steele, L., Anderson, S., &
Strike, C. (2008). Lesbian and queer mothers navigating the
adoption system: The impacts on mental health. Health
Sociology Review, 17(3), 254–266.
ADOPTION TYPE
LGBTQ people are increasingly becoming adoptive
parents within the context of same-sex relationships.
Rates of adoption by same-sex couples have doubled
24
over the last decade, and approximately 2 million Barriers to International Adoption
lesbian, gay, and bisexual people report being interested
International adoption has become increasingly
in adopting. In realizing their desires to parent,
difficult for same-sex couples to pursue as a result of
prospective adoptive parents must choose between three
discriminatory intercountry laws prohibiting same-sex
central adoption types: international adoption, private
couples from adopting. Same-sex couples have
domestic adoption, and public domestic adoption. The
historically found ways to adopt internationally by
process of choosing an adoption route entails complex
having one partner hide their sexual orientation and
intersections of personal desires, social norms and
adopt as a single parent. For many same-sex couples
expectations, financial constraints, and legal
this requirement is considered antithetical to their
regulations. All prospective adoptive parents negotiate
values of openness and honesty, and they are unwilling
the perceived benefits and challenges of various
to compromise their values and risk the legal
adoption routes, and same-sex couples must
uncertainties in order to adopt internationally.
additionally navigate societal discrimination and legal
International adoption has become especially
challenges in pursuing adoption. This entry provides an
prohibitive for gay men as a result of some intercountry
overview of the central benefits and challenges
laws that also prohibit single men from adopting.
associated with each type of adoption for same-sex
Same-sex couples that decide to have one partner
couples.
legally adopt their child often choose to complete a
second-parent adoption after the first parent’s adoption
International Adoption is finalized. Second-parent adoptions protect children’s
rights and provide both parents the legal rights of
International adoption has become increasingly difficult
guardians. However, not all states allow second-parent
for sexual minorities as a result of intercountry laws
adoptions, which leaves same-sex couples without basic
that prohibit lesbians and gay men from adopting.
legal protections. For instance, the noncustodial
Same-sex couples have historically pursued
parent’s rights may be called into question if the couple
international adoption by hiding their sexual orientation
separates or the legal primary parent dies. Finally, in
and adopting as single parents.
addition to the legal uncertainties and discriminatory
Perceived Benefits of International Adoption
laws associated with international adoption, the
Despite barriers to adopting internationally, there are financial cost of adopting internationally is a significant
numerous reasons why some same-sex couples may barrier for many prospective adoptive parents.
choose this type of adoption. Like heterosexual couples,
same-sex couples may choose to adopt internationally Private Domestic Adoption
because of a strong connection to another country.
Prospective parents may also conceptualize Private domestic adoption entails the adoption of
international adoption as a way to actualize their strong children, typically infants, through an arrangement with
desire to help a child in need. Some prospective parents an agency or lawyer that helps “match” a birth mother
choose international adoption because they can adopt a or birth family with adoptive parents. This is an
child of a specific racial or ethnic heritage to which increasingly common type of adoption within the
they have a connection (e.g., one that matches their United States, and one that many samesex couples find
own). Additionally, in contrast to domestic adoptions, appealing. There are nevertheless barriers that can make
prospective parents may feel more comfortable pursuing a private domestic adoption challenging.
choosing a type of adoption where they do not have to
directly navigate birth family relationships. Finally, Perceived Benefits of Private Domestic Adoption
some couples perceive international adoption as
Adoptive parents often cite the desire for an infant as
entailing a clearer wait time before a child is placed
a primary motivating factor for choosing private
with them compared with domestic adoptions. For
domestic adoption. Unlike international and public
instance, same-sex couples may be concerned about
adoption, domestic adoption allows parents to raise
waiting indefinitely for birth parents to choose to place
their child from birth and thereby limit early risk factors
their child with a same-sex couple if they adopt
related to possible maltreatment, neglect, or abuse.
domestically.

Private domestic adoptions typically entail some
form of contact between adoptive parents and birth
family members, typically the birth mother. Over the
last 20 years, openness between adoptive and birth
family members has increasingly become the norm.
Research suggests that in contrast to some heterosexual
couples who may feel threatened by the presence of
birth parents or the birth mother, gay male couples may
feel less threatened by birth mothers and may be drawn
to open adoptions precisely because it allows them to
provide their child with a mother figure. Furthermore,
same-sex couples may choose to pursue private
Adoption Type
domestic adoptions because they can adopt without
hiding their sexual orientation. Finally, many parents
pursue private domestic adoptions for practical reasons,
such as perceiving this type as the most common type
of adoption and because it is considered convenient,
local, and financially feasible.
Challenges of Private Domestic Adoption
Although same-sex couples may appreciate the
philosophy of private domestic adoptions in allowing
couples to openly adopt, same-sex couples may
nevertheless have to confront discriminatory practices
and legal regulations at the agency and state level.
Although there is increasing recognition of best
practices for adoption agencies working with same-sex
couples, many same-sex couples continue to face
discrimination by adoption professionals, social
workers, and adoption agencies. Agency professionals
may be blatantly discriminatory or may lack knowledge
regarding issues relevant to LGBTQ adoptive parents.
Furthermore, even if adoption agencies openly work
with same-sex couples, many couples experience
discriminatory state laws that make it difficult to co-
adopt or to secure second-parent adoptions. Numerous
states do not allow same-sex couples to co-adopt, and
thus one partner must initially adopt the child and the
other parent must petition for a second-parent adoption
—an option that, again, may not be available in the
couple’s state or jurisdiction. Research suggests that as
state laws change to further protect the rights of
LGBTQ adoptive parents, there are significant practical
and symbolic benefits to increased sociolegal security,
such as decreased anxiety during the adoption process,
greater security and legitimacy for adoptive children,
and increased ability to bond with the adoptive child.
25
Although open adoption arrangements may be
desirable for many adoptive parents, navigating birth
parent relationships can pose numerous uncertainties
and challenges. For instance, samesex couples may
have to endure longer wait times for birth parents to
choose them than heterosexual couples. Finally, similar
to international adoptions,
Adoption Type
private domestic adoptions may be considered
prohibitively expensive for some couples.
Public Domestic Adoption
Public domestic adoption entails the adoption of foster
care children through child welfare. Prospective
adoptive parents are often required to initially foster
children prior to legally adopting them, and are referred
to as foster-to-adopt parents.
Perceived Benefits of Public Domestic Adoption
Many heterosexual and same-sex couples view
adopting children as a moral imperative in which
adopting is an avenue for helping children in need.
Foster-to-adopt parents are typically open to adopting
older children and less tied to the idea that adopting an
infant is the only viable way to start a family.
Additionally, public domestic adoption is inexpensive
and entails a number of financial and legal supports and
services to help with the costs of parenting children
from the child welfare system. For instance, foster-to-
adopt parents may be eligible for child care subsidies,
health insurance benefits, and other types of state-
provided benefits.
Transracial adoptions are common in public
adoptions, in that there is a disproportionate number of
White adopters and a disproportionate number of racial-
minority children in foster care. Research suggests that
same-sex couples are more likely to adopt transracially
than heterosexual couples. Same-sex couples may
therefore be drawn to public adoption given that they
can meet the needs of foster-to-adopt children through
their openness to adopting transracially.
Challenges of Public Domestic Adoptions
Foster-to-adopt parents confront unique challenges
in adopting. Children in child welfare are often older
and have experienced numerous risk factors, including
26
prenatal substance abuse exposure, prematurity, dismissive, or disapproving of the foster parents’ sexual
parental neglect or abuse, poverty, and parental mental orientation.
illness. Compared with children adopted as infants
through private adoptions, these children are more
likely to demonstrate behavioral, emotional, and
attachment issues. These challenges can lead to
increased adoption disruptions and lower parenting
satisfaction. Research suggests that samesex adoptive
parents may be more inclined than heterosexual couples
to consider adopting children with serious emotional,
physical, and behavioral problems. Despite the possible
stress and uncertainty related to adopting children from
child welfare, the majority of gay, lesbian, and
heterosexual parents are very satisfied with the adoption
overall, particularly two years after the placement of the
child.
Within the child welfare system, same-sex couples
may confront a lack of support, continued legal
challenges, and increased scrutiny. Prospective adoptive
parents often face the reality that they do not have legal
custody of their foster children until the adoption
process is finalized. Legal uncertainties and delays in
the legal finalization of the adoption can add increased
stress and uncertainty. Similar to challenges
experienced adopting internationally or privately, same-
sex couples adopting through child welfare also face
discriminatory state laws that impact whether both
partners can jointly adopt their child.
Positive relationships between foster parents and
agency staff are particularly important given that
positive relationships are associated with placement
success whereas negative relationships with agency
staff are linked to placement disruption and parental
dissatisfaction. Inadequate support services, insufficient
information about the child, and poor communication
are some of the central challenges that some foster-to-
adopt parents face. These challenges may be
compounded for same-sex parents who may encounter
heterosexist beliefs by agency workers and may feel
inappropriately scrutinized by social workers.
Foster-to-adopt parents often desire positive
relationships with birth parents, but this can be
challenging if the biological parent or parents are
actively seeking to secure legal custody of the child.
Thus, adoptive parents may feel frustrated or angry with
birth parents who are actively seeking to disrupt the
adoption process. Such relationships may be
particularly difficult for same-sex parents in contexts in
which birth families are actively uncomfortable,

Conclusion
Same-sex couples are increasingly becoming parents
through adoption, and in choosing how to become
adoptive parents, same-sex couples must consider the
various positives and challenges associated with each
type of adoption. Although same-sex couples
consider many of the same factors as heterosexual
couples in choosing an adoption path, same-sex
couples must also navigate prevailing social norms,
legal regulations, discriminatory practices, and the
specific sociolegal context in which they are
adopting. Future research is needed that addresses
the unique issues relevant to transgender adoptive
parents. There is currently a lack of legal precedent
for transgender parents, and transgender people may
be discriminated against and denied parental rights
despite research and professional advice indicating
that gender identity is not a determinant of parenting
ability.
Jordan B. Downing
See also Adoption, Choices About; Adoption, Legal
Considerations in; Adoption, Openness in; Adoption
and Foster Care Discrimination; Adoption via the Child
Welfare System
Further Readings
Brown, S., Smalling, S., Groza, V., & Ryan, S. (2009). The
experiences of gay men and lesbians in becoming and
being adoptive parents. Adoption Quarterly, 12, 229–
246.
Downing, J., Richardson, H., Kinkler, L., & Goldberg, A.
(2009). Making the decision: Factors influencing gay
men’s choice of an adoption path. Adoption Quarterly,
12, 247–271.
Farr, R. H., & Patterson, C. J. (2009). Transracial adoption by
lesbian, gay, and heterosexual couples: Who completes
transracial adoptions and with what results? Adoption
Quarterly, 12, 187–204.
Goldberg, A. E., Moyer, A. M., Kinkler, L. A., &
Richardson, H. B. (2012). “When you’re sitting on the
fence, hope’s the hardest part”: Challenges and
experiences of heterosexual and same-sex couples
adopting through the child welfare system. Adoption
Quarterly, 15, 288–315.
Goldberg, A. E., Moyer, A. M., Weber, E. R., & Shapiro, J.
(2013). What changed when the gay adoption ban was
lifted? Perspectives of lesbian and gay parents in Florida.
Sexuality Research and Social Policy, 10, 110–124.
Adoption via the Child Welfare System 27
Jennings, S., Mellish, L., Tasker, F., Lamb, M., & Golobok,
S. (2014). Why adoption? Gay, lesbian, and heterosexual
adoptive parents’ reproductive experiences and reasons
for adoption. Adoption Quarterly, 17(3), 205–226.
Lavner, J. A., Waterman, J., & Peplau, L. A. (2014). Parent
adjustment over time in gay, lesbian, and heterosexual
parent families adopting from foster care. American
Journal of Orthopsychiatry, 84(1), 46–53.
ADOPTION VIA THE CHILD
WELFARE SYSTEM
This entry describes the general phenomenon of
adoption from the child welfare system and
specifically by LGBTQ people. It explains the basis
for those relationships in terms of adoption practice
and highlights the emerging changes in policies and
practices that have impacted LGBTQ people’s
experiences in adoption. The entry identifies the
important qualities of adoption and highlights some
of the key variables of adoption.
Adoption is defined as a process whereby a person
assumes the parenting of another, usually a child or
youth, from that person’s biological or legal parent or
parents, and, in so doing, permanently transfers all
the rights and responsibilities, along with filiations,
from the biological parent or parents. Unlike legal
guardianship or other systems designed for the care
of the young, adoption is intended to effect a
permanent change in status, and as such requires
societal recognition, through either legal or religious
sanction. Modern systems of adoption, arising in the
20th century, are governed by federal and state-based
comprehensive statutes and regulations. Each state
has an obligation to protect the health and welfare of
children. There are many ways to adopt, but this
entry focuses on adoption from the child welfare
system.
Adoption via the Child Welfare System
Although adoption is an age-old tradition in most
societies, it has changed considerably over the
centuries, with its focus shifting from closed infant
adoptions to a greater openness about adoption and
the issues of adoption.
28
Adoption, as defined by law, terminates the rights
and responsibilities of birth parents and vests them in
an adoptive parent or parents. Adoptions are
officially sanctioned through public or state-licensed
private agencies or via private placement
arrangements. Courts, guided by the child’s best
interest, must review all adoption petitions; in
addition, the agency’s consent is required for agency
adoptions, and in most states, judges hearing private
adoption petitions must consider agency or social
worker recommendations.
LGBTQ People and Adoption
In recent years, data has focused increasingly on
LGBTQ people and their desire to adopt. According
to a 2011 Williams Institute study that used multiple
data sources, an estimated 37% of LGBTQ-identified
adults have had a child at some time in their lives.
An estimated 3 million LGBTQ Americans have had
a child and as many as 6 million American children
and adults have an LGBTQ parent.
More than 111,000 same-sex couples are raising
an estimated 170,000 biological, step-, or adopted
children. Additionally, these same-sex couples who
consider themselves to be spouses are more than
twice as likely as heterosexual couples to be raising
biological, step-, or adopted children. Same-sex
couples raising children are 4 times more likely than
their different-sex counterparts to be raising an
adopted child. Specifically, an estimated 16,000
same-sex couples are raising more than 22,000
adopted children in the United States. Further, same-
sex couples are 6 times more likely than their
heterosexual counterparts to be raising foster
children. Approximately 2,600 same-sex couples are
raising an estimated 3,400 foster children in the
United States.
LGBTQ Adoption Policies
Utah and Mississippi were the two states with the
most restrictive adoption policies for LGBTQ people
at the time of this writing. In Utah, where gay
marriage was not allowed before 2015, the law
banned all unmarried individuals in cohabiting
relationships from being adoptive or fostercare
parents, while Mississippi only banned same-gender
couples from those roles. In response to the growing
need to find permanent parents for children and
youth in need of permanent homes, many states have
moved toward safeguarding the interests of the
children of LGBTQ people by strengthening their
legal relationships with their families.
States sometimes discriminate against LGBTQ
couples that want to adopt as a couple (that is, they
do not allow both partners to jointly adopt a child),
but will allow single LGBTQ persons to adopt.
Usually, if a couple wants to coparent an adopted
child, one partner adopts the child first, and then the
other partner asks a court to grant a secondparent or
co-parent adoption. At the time of this writing, at
least 14 states have granted second-parent adoptions
to LGBTQ parents, ensuring that their children can
enjoy the benefits of having two legal parents; in
seven other states, parents can make the request with
some restrictions. In states that do not permit second-
parent adoption for LGBTQ families, adopted
children are denied equal protection under the law
and its benefits.
Discrimination against lesbian, gay, bisexual, and
trans people may continue to exist on many levels of
society, but the marriage issue for LGBTQ people
was resolved in 2015 with the U.S. Supreme Court
decision outlawing state bans on same-sex marriage.
The benefits bestowed on couples by virtue of
entering into a legal bond of marriage are economic,
legal, and emotional. These benefits are meant to
support not only both partners but also their children.
Research Findings: LGBTQ People Make
Good Adoptive Parents
As ethical debates may continue over the
appropriateness of LGBTQ people parenting children
and youth, are we losing track of the point? The real
issue is that children and youth need responsible,
loving parents. We must keep in mind two vital
points in this debate: First, research findings indicate
that gender-identity expression and sexual
orientation are unrelated to whether or not someone
is a good parent. Second, research findings show that
children in LGBTQ-parented families are as well-
adjusted, happy, and successful as their counterparts
raised in heterosexual-parented families. It is time
that child welfare providers recognize and embrace
the fact that some LGBTQ people would be
wonderful parents to children and youth who are in
desperate need of permanent homes.

Although the majority of states no longer
officially deem LGBTQ people as unfit to rear a
child, each state decides independently who can
adopt, and legislators continue to introduce bills
barring adoptions by LGBTQ people into state
legislatures every year.
Restrictions on the ability of LGBTQ people to
provide foster or adoptive homes for needy children
run counter to the welfare of children needing such
homes. States’ and agencies’ refusal to place children
with sexual minorities is also sometimes based on the
perceived potential harm to children (i.e., fear of
molestation, fear that the child will be stigmatized,
and fear that the child will become
homosexual/bisexual). Refusals to permit LGBTQ
people to adopt stem in part from a fear of appearing
to accept LGBTQ people and same-gendered
relationships to any degree.
Assessment of LGBTQ Foster and Adoptive
Parents
Deciding to adopt from the child welfare system is a
huge decision and commitment. All potential parents
are understandably apprehensive about what the
process entails, and—given the apparent
misperceptions held by some about LGBTQ people
choosing to parent—these potential parents may
have even greater reasons for concern. Overall, large
numbers of LGBTQ people have successfully
fostered or adopted, but the view that LGBTQ people
will simply be rejected as foster or adoptive parents
is still a commonly held perception.
It is well established that most professionals who
provide health and social services to adopted children
and their families are heterosexual.
During the past decade, child welfare agencies have
made various efforts to enhance the ability of such
professionals to respond effectively to the needs of
people who are not heterosexual. These efforts have
been largely sporadic, with an emphasis on raising
awareness and sensitivity. Additional efforts have
sought to increase knowledge and understanding
about the history and culture of specific groups of
lesbian, gay, bisexual, and trans people. These
attempts, however, have not fully addressed the issue
of effective practice in a way that builds capacity in a
comprehensive, sustained manner; though these
efforts represent a good beginning, they are less than
adequate.
Adoption via the Child Welfare System 29
The Challenge for Professionals
States have a clear imperative to provide effective
services for prospective lesbian, gay, bisexual, and
trans adoptive parents. This shift requires
organizational, cultural, and systemic shifts to be
implemented throughout an organization. Social
work educators, as well as practitioners, often
assume that competence with LGBTQ groups can be
achieved through short-term, and often “oneshot,”
workshops or LGBTQ guest speakers in lectures or
in panels. These assumptions reflect a short-sighted,
simplistic view of a complex process. Restructuring
one’s views and developing a sound base of
organizational, cultural, and systemic knowledge and
skills should be long-term professional endeavors.
Thus, any serious initiative to work effectively
with LGBTQ populations begins with these
premises: to review and revise all policies, assuring
that procedures are LGBTQ-affirming for all
children, youth, and families; to develop practices
that are supported by these policies; to utilize
competencybased training for all levels of staff in
child welfare agencies and capacity-building
technical assistance, especially for program
supervisors who will supervise these changes; and,
finally, to integrate and promote an LGBTQ-
affirming approach into all aspects of the child
welfare system.
Child welfare agencies must pursue preparation
for serving LGBTQ populations effectively on a
multidimensional front. A unimodal focus on raising
awareness or sensitivity is required, but is
Adoption via the Child Welfare System
inadequate by itself. It is unacceptable to believe that
increasing one’s level of understanding of LGBTQ
people is all one needs to do. Nowhere is this issue
more relevant than during the adoption assessment
process.
The Assessment Process
The assessment processes for lesbian, gay, bisexual,
and trans adoptive parents can become skewed if the
assessing worker is either overfocusing on sexuality
or totally ignoring it. Workers cannot ignore gender-
identity expression and sexual orientation in the
assessment process, because an individual’s sexuality
is an aspect of who they are as a total person and will
affect their life as a parent. Although it may not
30
always be an issue for the applicant, the worker
should be able to assess the applicant’s ability to
constructively manage bi/trans/homophobia in his or
her own life.
The child welfare field has moved from the model
that has treated LGBTQ applicants as being the same
as their heterosexual counterparts to acknowledging
the different experiences that being an LGBTQ
parent brings to fostering and adoption. As LGBTQ
parents have demonstrated their unique strengths as
foster/adoptive parents, they have had less need to
argue that they are “just as good” as heterosexual
parents, challenging the underlying presumption that
the heterosexual model of family life is best.
Adoption agencies are required by law to carry
out a full assessment of applicants before approving
them as foster or adoptive parents. The information
to be collected and required safety and reference
checks are detailed in the relevant state regulations
and standards. Although this process may vary from
state to state, agencies should make prospective
parents aware of the flow of this process at the start
of their initial engagement with the agency. All
applicants should understand the process so that no
individual group thinks they are being asked to do
something that other groups are not. The Human
Rights Campaign’s (HRC) website identifies eight
questions to consider before starting the adoption
process (see http://www.hrc.org/resources/ entry/8-
questions-to-ask-before-starting-the- adoption-
process):
1. Should potential parents adopt via a public or
private agency?
2. What child is right for me/us?
3. Do you have the necessary investments childrearing
requires?
4. Do you have the patience to wait for your child to
show you love?
5. Do you have the social and community resources
around you that will help you and them along the
way?
6. Are you patient enough to successfully complete
pre- and postadoption placement counseling?
7. Are you ready to be 100% honest and transparent
with the agency worker?
8. Have you had a major life event in the past 12
months?
The Adoption Process
The process of adopting through the child welfare
system typically proceeds in several discrete steps.
These steps are outlined below, in a format that is
geared toward the prospective adoptive parent.
Step 1: Contact Your Local Adoption Agency.
Prospective adoptive parents should contact the
Parent Recruitment Hotline to receive an information
packet by mail. They can pick up the information
packet, as well.
Step 2: Attend an Orientation. After the prospective
adoptive parent(s) receive their packet of
information, they should call one of the recruitment
agencies and make an appointment to attend an
orientation or register online. At the orientation,
adoption professionals will give prospective adoptive
parent(s) an overview of the adoption process, guide
them through every step of the process, and answer
their questions.
Step 3: Complete the Adoption Application. At the
end of the orientation, prospective adoptive parent(s)
will be given an application to fill out. Prospective
adoptive parent(s) must return the completed
application to their adoption recruitment agency.
Once social workers have reviewed it and are
satisfied that the basic elements are in place, they will
contact the prospective adoptive parent(s) to begin a
home study.
Step 4: Have a Home Study Prepared. The home
study provides the child welfare agency and the
courts with comprehensive information needed to
place a child in the care of the prospective adoptive
parent(s). Parents and their social worker will meet
several times during the process. Parents will submit
various documents including copies of birth
certificate(s), a marriage license (if applicable),
income tax returns, and medical reports completed
by a physician. All adults in the prospective adoptive
parent’s home must be fingerprinted and cleared
through the State Central Registry for Abuse and
Neglect. Depending on the particular circumstances,
a home study can take up to several months.
Step 5: Complete a Training Series. While the home
study is under way, prospective adoptive parent(s)
will attend an 8- to 10-week Model Approach to

Parenting Preparation (MAPP) or Parent Resource
for Information, Development, Education (PRIDE)
training course, where they will learn parenting
skills, assess their own strengths as a parent, and
better understand the particular needs of adoptive
children.
Step 6: Be Matched With a Child. Once the training
series has been completed, the prospective adoptive
parent(s) are ready to begin the matching process.
Prospective adoptive parent(s) will have the
opportunity to look at Web-based catalogues of
children waiting for adoption. The local child welfare
agency will assist both the prospective adoptive
parent(s) and the child to make the right match.
Visiting will begin at this point.
Step 7: Get to Know Each Other. After visiting, the
child(ren) will move into the adoptive family’s
home. During this preadoptive phase, the family and
the child will get to know each other. The family will
learn about the child’s medical and family history.
The family will also learn about adoption subsidies
and reimbursements. The family will sign an
Adoptive Placement Agreement. The agreement says
that the family will take care of the child and intend
to adopt.
Step 8: A Child Is Placed in the Family’s Care.
After the children move into their new home with the
family, it will take approximately 6 to 8 months—
and in some cases longer—before the adoption can
be finalized. The agency will remain involved with
both the family and the child during this time.
Step 9: Choose an Attorney to File the Adoption
Petition. When the family is ready to finalize the
adoption, they will hire an attorney and work with
the agency to file the adoption petition in family
court. Fees for an adoption attorney will, in most
cases, be reimbursed by the local agency.
Step 10: Finalize the Adoption. The adoption
petition will be reviewed in family court. When the
judge approves the match, the family and the child
can go to court to sign the final adoption papers.
Conclusion
Social work—and more specifically, child welfare’s
response to lesbian, gay, bisexual, and trans adoption
Adoption via the Child Welfare System 31
applicants—has been varied and sometimes
unpredictable. Although not all social workers are
biased against LGBTQ families, and though there
have been many changes in policy during the past
decade, a major issue continues to be the lack of
federal law to guide social work practice. Going out
on a limb to approve or work with an LGBTQ
parent, or quietly implementing a home study, have
been common themes in child welfare.
It is important that agencies and social workers
are prepared for issues that will arise, both
professionally and individually, in working with
LGBTQ prospective adoptive parents. Professionals
need to be aware of assumptions and stereotypes that
previously may have shaped policy and legislation
and may have informed practice that was less than
Adults With LGBQ Parents
competent. Social workers also need to examine their
own personal attitudes about LGBTQ people.
They need to be careful not to assume automatic
parenting skills in heterosexual applicants, just as
they need to be careful not to assume unsuitability
for parenting in LGBTQ applicants. The
genderidentity expression and sexual orientation of a
potential parent does not, of itself, indicate anything
about that person’s ability to care for children who
may have had difficult experiences. Social workers
need to explore openly with each individual or
couple their experience and skills in relation to
caring for and parenting a child or adolescent though
adoption from the public child welfare system.
Gerald Mallon
See also Adoption, Choices About; Adoption,
International; Adoption, Openness in; Adoption and
Foster Care Discrimination; Joint Adoption; Second-
Parent Adoption; Single-Parent Adoption
Further Readings
Brown, S., Smalling, S., Groza, V., & Ryan, S. (2009). The
experiences of gay men and lesbians in becoming and
being adoptive parents. Adoption Quarterly, 12, 229–246.
Gates, G. J. (2011). How many people are lesbian, gay,
bisexual, or transgender? Retrieved August 24, 2013, from
http://williamsinstitute.law.ucla.edu/wp-content/
uploads/Gates-How-Many-People-LGBT-Apr-2011.pdf
Mallon, G. P. (2014). Issues in adoption practice. In
32
G. P. Mallon & P. Hess (Eds.), Child welfare for the
21st century: A handbook of practices, policies, and
programs (2nd ed., pp. 219–231). New York, NY:
Columbia University Press.
Mallon, G. P. (2014). Lesbian, gay, bisexual and trans foster
and adoptive parents: Recruiting, assessing, and
supporting an untapped resource for children and youth
(2nd ed.). Washington, DC: Child Welfare League of
America.
Patterson, C. J. (1996). Lesbian mothers and their children:
Findings from the Bay Area families study. In J. Laird &
R.-J. Green (Eds.), Lesbians and gays in couples and
families: A handbook for therapists (pp. 420–438). San
Francisco, CA: Jossey-Bass.
Most studies on the offspring of LGBQ parents
that followed were conducted with children;
however, in 2000, freelance writer Noelle Howey
and poet Ellen Samuels coedited an important
anthology of essays written by grown children of
lesbian, gay, and transgender parents. This
represented one of the first efforts to collect and
share the experiences of adults with sexual and
gender minority parents; further, these accounts were
uniquely written from these adults’ own perspectives.
Soon

ADULTS WITH LGBQ PARENTS

Adults with lesbian, gay, bisexual, and queer

(LGBQ) parents are a diverse group. Many of these
adults had LGBQ parents who came out in the
context of a heterosexual relationship, while others
were born to or adopted by one or more “already-
out” LGBQ parents. Adults with LGBQ parents vary
in regard to their social and demographic
backgrounds such as their races and ethnicities and
their sexual and gender identities, which may be the
same as or different from their parents’.
Early research on this population primarily grew
out of the need for social science research to
investigate the effects of parental sexual orientation
on children’s well-being to aid in family court
custody decisions. As was typical in the 1970s and
1980s, when LGBQ parents came out in the context
of heterosexual marriages, LGBQ parents’ parental
rights could be, and often were, challenged based
solely on their sexual orientations. Groundbreaking
research, published in the mid1990s by United
Kingdom psychologists Fiona Tasker and Susan
Golombok, longitudinally examined the experiences
of adults with lesbian parents. In regard to
psychological well-being outcomes, their sample of
25 young adults with lesbian mothers was
indistinguishable from the comparison group of 21
young adults with heterosexual parents. The groups
did not differ in regard to their likelihood of having
been teased while growing up; however, the young
adults with lesbian mothers, especially boys, were
more likely to recall being teased in regard to their
sexuality.

after, in 2004, writer and journalist Abigail Garner
published her own groundbreaking book, Families
Like Mine: Children of Lesbian and Gay Parents
Tell It Like It Is, for which she interviewed more than
50 adults (in their 20s and 30s) with lesbian, gay,
bisexual, and transgender parents. In an LGBTQ-
affirming way, Garner explicitly steered away from
the notion that kids with LGBTQ parents are “no
different” from kids with heterosexual parents. For
example, she highlighted the “pressure to be perfect”
that many youth with LGBTQ parents feel as a result
of their families being under scrutiny. She also
discussed the notion of heterosexual offspring of
LGBTQ parents being “culturally queer, erotically
straight”—a concept of bicultural identity first used
by Stefan Lynch, executive director of COLAGE
(see the COLAGE entry in this volume), to describe
how adults with LGBQ parents, even if heterosexual,
can be linked to queer culture via their heritage.
Academic works since then have followed this
lead and have aimed to describe the varied and rich
experiences of adults with LGBQ parents—
primarily in the United States—as they have
navigated a heteronormative society. Psychologist
Abbie Goldberg published two papers in the
mid2000s to explain how adults with lesbian, gay,
and bisexual (LGB) parents handled disclosure of
their familial identities to friends, significant others,
and coworkers, and how these adults perceived their
familial backgrounds as having influenced their adult
lives. Many of them felt that growing up with LGB
parents allowed them to be more openminded and to
develop more flexible notions of gender and
sexuality than they might have otherwise. Although
these adults felt proud or ashamed of their families at
various points in their lives and had various reasons
for and degrees of disclosure to others, all faced the
challenge of, as Goldberg stated, “negotiating the
pressures of heteronormativity (and a desire to
protect oneself from marginalization and derision)
with one’s lived experience in a particular (often
invisible, often marginalized) family structure.”
In 2009, extending Garner’s writing on the
“second generation,” family researchers Katherine
Adults With LGBQ Parents
Kuvalanka and Goldberg published the first study of
LGBTQ individuals with LGBQ parents in the social
science literature (see the Children With LGBQ
Parents, Sexual Identity entry in this volume). They
33
found that, for some second-generation individuals,
having lesbian and bisexual parents made their own
coming out easier; however, others felt that their own
coming out was hindered due to social pressures,
such as to counteract the notion that “gay parents
make gay kids.”
From 2011 to 2013, Goldberg first-authored four
more papers from another dataset of qualitative
interviews with individuals with LGBQ parents. To
begin, Goldberg and her colleagues conducted an in-
depth examination into the connection of adults with
LGBQ parents to the LGBTQ community, revealing
different strengths of connection, as well as changes
in connection over time. In 2012, as marriage
equality debates raged on in the United States,
Goldberg and Kuvalanka reported how a sample of
(mostly) adults with LGB parents felt about their
parents having access to, or being denied the right to
enter into, civil marriage. Although the vast majority
of these participants favored marriage equality and
pointed out both the tangible and symbolic benefits
of marriage that their parents and families had been
denied, others echoed critiques of marriage as
heteronormative and emphasized how their families
had not needed marriage to make their families
“whole.” In 2013, Goldberg reported on how some of
these same adults felt about marriage for themselves
in light of a lack of marriage equality for their
parents; findings revealed great diversity in responses
in that many participants held romantic hopes and
ideals for themselves in regard to marriage, while
others held more pragmatic or conflicted views. Also
that year, Goldberg and family researcher Katherine
Allen shared their investigations of subsets of these
same adults with LGBQ parents, exploring the topics
of LGB stepfamilies and relationships with donor
dads. For the vast majority of these participants, LGB
stepfamily formation happened outside of legal
influence, posing both advantages and disadvantages,
while participants with known donors had
relationship ties
Advance Health Care Planning
with their donor “fathers” that ranged from minimal
to parental.
Since the early works of Tasker and Golombok in
the mid-1990s, studies involving adults with LGBQ
parents (most of which have studied adults with
lesbian parents specifically) have shed additional
light on the experiences of these individuals and their
34
families. Some researchers have utilized a minority
stress perspective to understand how interpersonal
homophobia and institutionalized heterosexism have
continued to influence these individuals’ lives
beyond their childhoods. In 2013, psychologist David
Lick and colleagues surveyed more than 90 adults
with LGB parents with the aim of identifying how
individual differences in childhood and adolescent
experiences of social stigma had later impact on
adults’ psychological adjustment. Participants
experienced varied degrees of stigma during
childhood and adolescence, yet there were no
differences in participants’ later psychological
adjustment; indeed, these participants generally
reported that their social experiences relating to their
families grew significantly more positive over time.
Meanwhile, in 2014, Kuvalanka and colleagues
provided an in-depth examination into the various
types of sexual stigma that adults (both heterosexual
and LGBTQ) with lesbian parents faced during their
adolescence and how they coped. In response to the
interpersonal and institutional stigma that
participants experienced, participants generally
reacted in fearful, defiant, or distancing ways to that
stigma. Those who were fearful often tried to “blend
in,” while those who were defiant usually confronted
the source of the stigma or got involved in political
activism, and, finally, those who distanced
themselves from stigma simply ignored the
heteronormativity that they encountered. Findings
from all of these studies reveal the complex interplay
among individual, familial, and social influences
resulting in vastly varied—and still, as of yet,
unexplored— experiences of adults with LGBQ
parents.
Katherine A. Kuvalanka
See also Children With LGBQ Parents, Gender
Development and Identity; Children With LGBQ
Parents, Psychosocial Outcomes; Children With LGBQ
Parents, Sexual Identity; Children With LGBQ Parents,
Stigmatization; COLAGE
Further Readings
Goldberg, A. E. (2007). (How) does it make a difference?
Perspectives of adults with lesbian, gay, and bisexual
parents. American Journal of Orthopsychiatry, 77, 550–
562.
Goldberg, A. E., & Kuvalanka, K. A. (2012). Marriage
(in)equality: The experiences and perspectives of young
adults with lesbian, gay, and bisexual parents. Journal
of Marriage and Family, 74, 34–52.
doi:10.1111/j.1741-3737.2011.00876.x
Kuvalanka, K. A., Leslie, L. A., & Radina, R. (2014).
Coping with sexual stigma: Emerging adults with
lesbian parents reflect on the impact of heterosexism and
homophobia during their adolescence. Journal of
Adolescent Research, 29, 241–270.
doi:10.1177/0743558413484354
Lick, D. J., Patterson, C. J., & Schmidt, K. M. (2013).
Recalled social experiences and current psychological
adjustment among adults reared by gay and lesbian
parents. Journal of GLBT Family Studies, 9, 230–253.
doi:10.1080/1550428X.2013.781907
Tasker, F. L., & Golombok, S. (1997). Growing up in a
lesbian family: Effects on child development. London,
England: Guilford Press.
ADVANCE HEALTH CARE PLANNING
The goal of advance health care planning is to assure
that when a person lacks capacity, the health care
decisions that are made reflect the decisions that the
person would have made if he or she had been
capable of doing so. This entry explores why
advance health care planning is important for
LGBTQ adults, the basis of the right to make health
care decisions, and the advance health care planning
process.
Advance Health Care Planning for
LGBTQ Adults
Advance health care planning for LGBTQ adults
made headlines in 2007 with reports of the ordeal of
Lisa Pond and Janice Longbehn. Lisa suffered a
brain aneurysm in Miami, Florida, shortly before she,
Janice, and their four children were to depart on a
cruise. Despite Janice’s offer to have Lisa’s living
will faxed, hospital staff denied Janice and the
children visitation and participation in health care
decisions, until Lisa’s biological family arrived
shortly before her death. Hospital staff told Janice
that she was “in an antigay city and state.” In the
aftermath, the hospital agreed to change policies and
training, and President Obama directed the
Department of Health and Human Services to assure

that advance directives are honored and that LGBTQ
families are assured visitation.
Complicating Factors
Several factors complicate advance health care
planning for LGBTQ adults. Standard medical
protocols look to the spouse and biological family or
for documentation for the health care decision maker.
The “chosen family” of LGBTQ adults is not widely
recognized in law or protocols. The expansion of
same-sex marriage will minimize the health care–
related complexities that arise inasmuch as more
LGBTQ adults will be able to document their spouse.
Strained relationships between LGBTQ adults and
biological family can lead to conflict. Homophobia
on the part of family or health care providers can
interfere with health care
decision making. When an LGBTQ person has a
health crisis, these factors can be stacked on top of
one another, with an LGBTQ family not fitting into
the standard health care provider protocol, the
biological family under stress asserting their legal
right as “family” to make health care decisions, and
homophobic care providers being uncomfortable or
hostile to LGBTQ families.
The Right to Make Health Care Decisions
Every adult has a fundamental right to make health
care decisions. This right is based on informed
consent. Informed consent categorizes any
unauthorized touching, including treatment by a
doctor, as a battery. Although the U.S.
Advance Health Care Planning
Constitution does not make explicit mention of the
right to make health care decisions, courts have
consistently inferred the right to make such decisions
as a constitutionally protected privacy or liberty
interest.
End-of-life health care decisions came before the
United States Supreme Court in Cruzan v. Director
of the Missouri Department of Health in 1990.
Everyone agreed that Nancy Cruzan was
permanently and irreversibly unconscious, kept alive
with a feeding tube. Her family sought to have the
feeding tube removed, and others disagreed. The
Court confirmed that adults have a constitutional
35
right to make health care decisions, including the
decision to refuse care, and the authority to make
advance health care directives and appoint a health
care surrogate, but struggled with the level of
evidence necessary to withhold or withdraw life
support. The Court ruled that the state could require
“clear and convincing” proof of the patient’s wishes
for withholding or withdrawing a feeding tube. This
issue was revisited in 2005, when the family of a
patient, Terri Schiavo, who had been hospitalized in
an irreversible vegetative state since 1990, disagreed
about removing her feeding tube. In both of these
cases there was no formal advance health care
planning, no appointment of a health surrogate; the
patient’s wishes were unwritten, subject to varying
interpretation, and there was disagreement as to what
to do. These cases highlight the importance of
advance health care planning.
First Steps
The first step in advance health care planning is for
individuals to consider the kind of health care they
want to receive or not receive, and whom they trust
to make health care decisions for them. Factors to
consider include health care goals, personal values,
and beliefs. There are some excellent tools to guide a
person through the planning process, such as “Five
Wishes” from the organization Aging with Dignity,
“Your Conversation Starter Kit” from the
Conversation Project, and the American Bar
Association’s “Consumer’s Tool Kit for Health
Care Advance Planning.”
Advance Health Care Planning
Who Will Make Health Care Decisions
When an adult lacks the capacity to make health care
decisions, the authority to make decisions transfers to
a person known as a health care surrogate. The
transfer happens when a health care provider decides
that a patient lacks the capacity to make health care
decisions. In most situations the determination is
made by the treating physician; some circumstances
require the concurrence of two doctors. The exact
standards for the transfer of health care decision
making to a surrogate vary from state to state.
If an adult has not named a health care surrogate
in writing, most states have laws that name a default
health care surrogate. The remaining states use
36
medical protocol to allow marital or biological
family to make health care decisions. The laws and
protocols turn first to a spouse or biological family.
Most commonly they ask the spouse of the patient
first. If there is no spouse, they ask the adult children.
If there are no children, they ask the parents. If the
parents are unavailable, they ask siblings and so on
through the family tree. This strategy does not fit
well with the family situation of many LGBTQ
adults. Domestic partners are included on the
statutory lists in 5 states, and best friends are
included in 23 states—but generally only if there is
no spouse or biological family higher up in the
statutory list. The default provisions are overcome by
appointment of a health care surrogate named in a
power of attorney for health care, or other document.
Putting It in Writing
For LGBTQ adults, it is critical that the appointment
of a health care surrogate be recorded in writing.
This avoids the default of the spouse or biological
family. Some states have standard forms for
appointing a health care surrogate or include the
appointment of a health care surrogate in a statutory
living-will form. The process for appointing a
surrogate is state-specific, and it is essential that the
formalities be followed precisely; simple mistakes
can invalidate the document. A good place to look
for statutory or standard forms is the website of the
state attorney general or state department of health.
A form that works in approximately 40 states was
developed by the American Bar Association
Commission on Law and Aging.
Guidance for the Surrogate
Tools such as “Five Wishes,” “Your Conversation
Starter Kit,” and the “ABA Consumer’s Tool Kit for
Health Care Advance Planning” can be used to
document health care goals, values, and specific
directions on the use of feeding tubes and other
forms of life-prolonging care. It is important to be
specific regarding withholding or withdrawal of a
feeding tube in the event of permanent
unconsciousness. In the event of disagreement, the
courts look for “clear and convincing” evidence of
wishes concerning the use of a feeding tube. While
oral testimony may be used to establish the desire not
to be kept alive with a feeding tube, written evidence
is very helpful.
The most common advance health care directives
are “living wills” and Do Not Resuscitate (DNR)
orders. A “living will” leaves directions for life-
prolonging care and artificially provided nutrition
and hydration, when a person’s condition is terminal
or when death is imminent. DNRs are specific
medical orders that affirm if a person stops breathing
or the person’s heart stops beating, no artificial
measures should be taken to restore respiration or
heartbeat. DNRs are only appropriate when death is
expected. Many states require a health care provider
to sign off on a DNR order.
The latest kind of directive is known as Physician
Orders for Life Sustaining Treatment (POLST).
POLST covers DNR, pain control, life-prolonging
care, and artificially provided nutrition and
hydration. POLST is incorporated into medical
orders when serious illness or frailty makes death
likely. POLST orders are more likely to reflect the
current wishes of the patient. If the patient lacks the
capacity to make health care decisions, the health
care surrogate can generally consent to POLST. Not
all states recognize POLST; the protocol is still in
development in many states.
How to Create Advance Directives
You can do it yourself (DIY) or use a lawyer to
create advance health care directives. The advantage
of DIY is cost. There are many standard and
statutory forms that can be used. But there are risks
inherent in DIY planning. Many forms are not
clearly written and do not have clear instructions. A
person needs help from a lawyer to make any
changes in the form without invalidating the form.
The formalities for signing the documents vary from
state to state and must be followed precisely. For
LGBTQ adults who might have a challenge to the
validity of advance directives, the assistance of a
lawyer adds a layer of assurance. Receiving
assistance from a nonmarital partner or person
named in the documents opens the door for
challenges based on undue influence and should be
avoided.
The Conversation
All too often, advance health care planning occurs in
a vacuum. The person completes the paperwork, files
it away with estate planning documents, and never
mentions it to anyone. When a health crisis occurs,
no one knows who the health care surrogate is or

what guidance was provided. It is essential that
chosen family, marital family, and biological family
know that advance health care planning has been
done, who the surrogate is, and what the health care
goals and values are. For LGBTQ families this is
especially important because of the mixture of
chosen, marital, and biological family and the
potential for conflict among them. Advance care
planning conversations are the most effective way to
make sure everyone knows the plan. This can be
done as one conversation or a series of
conversations. Each conversation should discuss who
the health care surrogate is, and what the health care
goals and values are. Advance directives should be
shared among all. The Conversation Project
publishes a guide for getting ready for this
conversation.
Health care providers need to be included in the
conversation. Health care providers need to know
who the surrogate is, and the person’s health care
goals and personal values. Health care providers can
provide essential understanding of health care
Advance Health Care Planning
status, treatment options, disease progressions, and
possible outcomes. For an LGBTQ adult, talking
with health care providers about being LGBTQ and
about chosen family needs to take place early. There
needs to be a level of comfort, understanding, and
trust. If there is not, the time to look for another
health care provider is now, not when a health crisis
has occurred. The Conversation Project publishes a
guide with tips for starting the conversation with
health care providers.
Conclusion
The default provisions for health care decision
making when an adult is unable to make those
decisions are not a good fit for many LGBTQ adults;
thus, advance health care planning is essential.
Naming a health care surrogate, documenting health
care goals, and having meaningful conversations
with loved ones and health care providers increase
the odds that the person one prefers to make one’s
health care decisions ultimately does so, and that
those decisions most closely reflect the decisions the
person would make if he or she could. David
Godfrey
37
See also Families of Choice; Families of Origin,
Relationships With; Health Care Providers, Disclosure of
Sexual Identity to; Homophobia; Hospital
Visitation; Mixed-Orientation Marriages; Powers of
Attorney; Wills and Trusts
Further Readings
Aging with Dignity. (2015). Five wishes. Retrieved from
http://www.agingwithdignity.org/five-wishes.php
American Bar Association Commission on Law and Aging.
(2005). Consumer’s tool kit for health care advance
planning. Washington, DC: American Bar Association.
Retrieved from http://apps.americanbar
.org/aging/publications/docs/consumer_tool_kit_bk.pdf
American Bar Association Commission on Law and Aging.
(2011). Giving someone your durable power of attorney
for health care. Washington, DC: American Bar
Association. Retrieved from
http://www
.americanbar.org/content/dam/aba/administrative/law_
aging/2011/2011_aging_hcdec_univhcpaform_4_2012_
v2.authcheckdam.pdf
Affirmative Therapy
American Bar Association Commission on Law and
Aging. (2014). Default surrogate consent statutes as of
June 2014. Washington, DC: American Bar
Association. Retrieved from
http://www.americanbar
.org/content/dam/aba/administrative/law_aging/2014_
default_surrogate_consent_statutes.authcheckdam.pdf
Conversation Project. (2015). Your conversation starter kit.
Retrieved from www.theconversationproject.org
National POLST. (2015). Physician orders on lifesustaining
care. Retrieved from http://www.polst.org
AFFIRMATIVE THERAPY
LGBTQ affirmative therapy is defined as a set of
skills and clinical practices that are informed by a
positive view of LGBTQ individuals and
relationships and an awareness of the negative
influences of heterosexism and homophobia on the
wellbeing of LGBTQ individuals and relationships.
Based on this definition, in order to provide
competent and affirmative services with LGBTQ
clients, therapists have a responsibility to engage in
38
self-of-the-therapist work to explore their own
beliefs and biases related to LGBTQ identities and
relationships. An entry on LGBTQ affirmative
therapy is particularly relevant to examining and
understanding the lives and experiences of LGBTQ
individuals given that research has shown that
LGBTQ persons seek therapy services at more than
twice the rate of heterosexual individuals and the
therapeutic community has a history of using
harmful and misinformed approaches when working
with LGBTQ clients. This entry provides a
discussion of the need for LGBTQ affirmative
therapy as well as an overview of the three essential
components of LGBTQ affirmative therapy, namely,
(1) conceptual knowledge, (2) clinical skills, and (3)
self-exploration.
The Need for LGBTQ Affirmative Therapy
One possible rationale for the development of
LGBTQ affirmative therapy is that LGBTQ persons
seek therapy services at a higher rate compared with
heterosexual individuals, which increases the
likelihood that all therapists, regardless of
specialization, will work with LGBTQ clients. Given
that therapists are likely to work with LGBTQ
clients, there needs to be an approach to therapy that
both affirms LGBTQ clients and ensures that therapy
results in positive outcomes for this population.
Additionally, the development of LGBTQ
affirmative therapy grew out of the documented harm
caused by the therapeutic community as a result of
certain therapeutic practices, such as conversion
therapy (also known as reparative or reorientation
therapy). Conversion therapy is an approach to
therapy that seeks to change the sexual orientation of
LGBTQ persons to a heterosexual sexual orientation.
This approach is based on the belief that any sexual
orientation other than heterosexual is deviant,
pathological, and/or sinful. Existing research has
documented a number of harmful effects of
conversion therapy, including increased rates of
suicidal ideation and attempts, drug and alcohol use,
depression, and anxiety. Due to the documented
harmful effects of conversion therapy, many
professional mental health organizations (e.g.,
American Association for Marriage and Family
Therapy, American Counselor Association,
American Psychological Association, and National
Association of Social Workers) have cautioned their
members against any approach to therapy that seeks
to alter clients’ sexual orientation. Conversion
therapy is just one example of the ways the
therapeutic community has pathologized LGBTQ
identities and relationships.
Conceptual Knowledge of Key Constructs
Related to Working With LGBTQ Clients
The first essential component to the practice of
LGBTQ affirmative therapy is the development of
conceptual knowledge about key constructs related to
working with LGBTQ clients. In particular,
therapists need to be knowledgeable about
homophobia, heterosexism, heterosexual privilege,
and minority stress. Homophobia is commonly
defined as unsupported negative beliefs about
LGBTQ individuals that are based on stereotypes
and unfounded fears. Homophobia can negatively
influence the therapy process for both therapists and
clients alike. For example, therapists may
consciously or unconsciously hold homophobic
beliefs such as the belief in the inability of LGBTQ
couples to develop long-term monogamous
relationships, which limits their ability to provide
effective couples therapy to LGBTQ clients. This
highlights the need for therapists to explore the ways
in which homophobia has influenced their conscious
and unconscious beliefs. LGBTQ clients may also
struggle with internalizing homophobic messages,
which negatively impact their sense of self-worth
and well-being. By being knowledgeable about
homophobia, therapists can assist LGBTQ clients in
challenging the internalization of homophobia and
the negative effects that internalized homophobia has
on their lives.
Heterosexism is another key construct that
therapists need to be knowledgeable about in order to
provide LGBTQ affirmative therapy. Heterosexism is
defined as a societal belief system that is based on
the assumption of the superiority of heterosexual
identities and relationships and the inferiority of
LGBTQ identities and relationships. Examples of
heterosexism include laws that explicitly deny
marital rights to LGBTQ couples, regulations that
only grant health insurance access to married
heterosexual couples, and the decision of the Federal
Drug Administration (FDA) to restrict gay men from
donating blood. It is important for therapists to be
knowledgeable about the concept of heterosexism in
 39
order to begin to understand the unequal treatment LGBTQ Affirmative Therapy Clinical Skills
and marginalization that LGBTQ clients experience
The second essential component to the practice of
and the impact this has on their lives and
LGBTQ affirmative therapy is the development of a
relationships.
specific set of clinical skills. In particular, therapists
The third construct that therapists need to
need to be able to communicate an LGBTQ
understand in order to provide LGBTQ affirmative
affirmative stance, use nonheteronormative language,
therapy is heterosexual privilege. Heterosexual
and directly explore the influence of heterosexism on
privilege refers to the unearned civil rights and
the lives of their LGBTQ clients. An important initial
societal advantages granted to heterosexual persons
step in the practice of LGBTQ
based solely on their sexual orientation. Examples of Affirmative Therapy
heterosexual privilege include having one’s sexual
orientation affirmed at any mental health or medical
center, being able to freely discuss one’s relationship affirmative therapy involves communicating an
without fear of negative affirmative stance to all clients. Some of the ways
Affirmative Therapy that therapists can communicate an LGBTQ
affirmative stance include adding a statement of their
commitment to provide affirmative therapy services
reprisal, and easily finding positive portrayals of
to the LGBTQ community in their marketing
one’s sexual orientation in textbooks and in the
materials (e.g., website, brochures, etc.) and intake
media. The cumulative effect of these privileges for
paperwork, verbally sharing this commitment with
heterosexual persons is the increased sense of
all clients during the first session, and displaying
belonging and self-worth that is associated with
books and magazines relevant to the lives of LGBTQ
being a member of the dominant socially sanctioned
individuals in their therapy offices or waiting rooms.
group. This increased sense of belonging and self-
Communicating an LGBTQ affirmative stance
worth serves as a protective factor from negative
before a therapist knows the sexual orientation of a
effects of daily stress. For heterosexualidentified
client is important as it creates an opening for
therapists, an awareness of heterosexual privilege is
LGBTQ individuals to disclose their sexual
particularly important to the practice of LGBTQ
orientation and provides a needed measure of safety.
affirmative therapy in order to avoid the problematic
Another important clinical skill associated with
assumption that all people are treated in the same
LGBTQ affirmative therapy is the intentional use of
way that they are and have the same access to social
nonheteronormative language, which involves the
support and civil rights. Additionally, this construct
use of gender neutral or inclusive terms to describe
is important for all therapists, regardless of sexual
committed relationships. An example of this practice
orientation, so they are aware of the negative effects
would involve the use of the term “partner” instead
that the absence of such privileges has on the mental
of “husband” or “wife.” The use of
and relationship health of LGBTQ individuals.
nonheteronormative language communicates to
Another important construct related to the practice
clients that therapists are not assuming that all clients
of LGBTQ affirmative therapy is minority stress.
have an opposite-sex partner and are open to the
Minority stress refers to the added stress that LGBTQ
possibility that their clients may be in an LGBTQ
persons experience due to living in a homophobic
relationship. Another example of the use of
and heterosexist society, which is above and beyond
nonheteronormative language is replacing the typical
the normal stressors of everyday life. Some of the
binary options for gender (i.e., woman or man) with
effects of minority stress on the LGBTQ community
an open-ended question, such as “How would you
include increased rates of depression, anxiety,
describe your gender?” on client paperwork.
suicidal ideation and attempts, and alcohol and drug
In order to provide LGBTQ affirmative therapy,
misuse. Knowledge of minority stress is important
therapists also need to explore the potential negative
for therapists as it helps them interpret these
influence that heterosexism has on the lives of
increased rates as resulting from living as
LGBTQ clients. While it is important that therapists
marginalized persons in a homophobic and
avoid the assumption that LGBTQ clients only seek
heterosexist society and not as a sign of pathology
therapy on account of their sexual orientation or
within the LGBTQ community itself.
40
gender identity, it is essential for therapists to
consider the ways that heterosexism may be
influencing clients’ experience of the presenting
problem (i.e., the reason clients sought therapy). One
way that therapists can explore the influence of
heterosexism is by asking clients such questions as
• What effect does living in a homophobic and
heterosexist society have on your sense of self and
your relationships?
• What influence do the negative societal messages
you receive as an LGBTQ person have on the
struggles you are experiencing in your life and
relationships?
Questions that explore the influence of
heterosexism help LGBTQ clients situate their
struggles and challenges within a larger societal
context that acknowledges the ways that LGBTQ
persons are marginalized in society and removes
some of the unfair blame that is placed upon LGBTQ
individuals for their problems.
Therapist Self-Exploration
The final and perhaps most important component of
LGBTQ affirmative therapy is for therapists to
engage in a critical self-exploration process that
explores their heteronormative assumptions, biases,
and privileges. Heteronormative assumptions are
automatic, and often unconscious, beliefs based on
the notion that all people are heterosexual or in a
heterosexual relationship. The exploration of
conscious and unconscious heteronormative
assumptions and biases is important for all therapists,
regardless of sexual orientation, given that
heteronormative assumptions are the cultural norm.
In order to lessen the influence of heteronormative
assumptions and biases on clinical work, therapists
need to engage in a process of self-exploration
related to their beliefs about healthy coupling
practices, family formation and composition, and
human sexuality, and how those beliefs might be
informed by heteronormative assumptions.
In addition to exploring heteronormative
assumptions and biases, heterosexual therapists need
to engage in a critical self-exploration process about
the ways in which they are privileged by society and
how they came to develop a heterosexual sexual
orientation. In particular, it may be helpful for
heterosexual therapists to develop a list of privileges
they experience due to their sexual orientation in
order to enhance their sensitivity to how
heterosexism operates to both privilege heterosexual
persons and discriminate against LGBTQ
individuals. One important heterosexual privilege
that is often overlooked is the fact that heterosexual
individuals are not required to explore how they
developed their sexual orientation identity, which is
something that LGBTQ persons are required to do by
society in the coming-out process. Therefore, an
important aspect of LGBTQ affirmative therapy for
heterosexual therapists involves a willingness to
explore how they came to develop a heterosexual
sexual orientation. By increasing the knowledge that
heterosexual therapists have about their sexual
identities, they can decrease the extent to which
heteronormative assumptions and heterosexual
privilege influence the therapy process.
Thomas Stone Carlson and
Christi R. McGeorge
See also Couples Therapy; Therapists’ Biases Regarding
LGBTQ People; Therapy With Children of LGBQ
Parents; Therapy With LGBTQ Parents; Therapy With
LGBTQ Youth
Further Readings
Bigner, J. J., & Wetchler, J. L. (Eds.). (2012). Handbook of
LGBT-affirmative couple and family therapy. New York,
NY: Routledge.
Matthews, C. R. (2007). Affirmative lesbian, gay, and
bisexual counseling with all clients. In K. J. Bieschke, R.
M. Perex, & K. A. DeBord (Eds.), Handbook of
counseling and psychotherapy with lesbian, gay, bisexual,
and transgender clients (2nd ed., pp. 201–219).
Washington, DC: American Psychological Association.
McGeorge, C. R., & Carlson, T. S. (2011). Deconstructing
heterosexism: Becoming an LGB affirmative heterosexual
couple and family therapist. Journal of Marital and
Family Therapy, 37(1), 14–26. doi:10.1111/j.1752-
0606.2009.00149.x
AFRICAN AMERICAN SEXUALITIES

This entry addresses the important themes and ideas
that constitute the scholarship and research in and
about African American sexualities with a special
focus on African American LGBTQ people. It begins
by showing how the roles of theory, family, identity
politics, and urban life have helped provide key
insights into the sexual attitudes and practices of
African American people.
African American Sexualities
This entry concludes by highlighting the broader and
continued significance of scholarship and research on
African American sexualities generally, and African
American LGBTQ sexualities more specifically.
The study of the sexual practices, perspectives,
and experiences of African Americans is a broad and
varied area of research and scholarship. Research
addressing how sexuality shapes the experiences of
African Americans has produced key information
about the role of race and sexual orientation in social
institutions and everyday life. To address and convey
the key facets of this broad area of inquiry and
scholarship, this entry focuses on four primary
themes central to the literature: theory, family,
identity politics, and urban life. As will be shown,
each offers an important window into the key ideas
and scholarship on African American LGBTQ
sexualities. To be sure, these themes are not meant to
be exhaustive but instead help to distill many of the
key features and contributions of research and
scholarship on and about the sexual behaviors and
perspectives of African Americans.
Theory
The study of African American sexualities has
produced numerous theories and models for
analyzing the broader social world. For example, the
popular idea of intersectionality, which emphasizes
the multiple and overlapping identities of people,
builds from the lives and experiences of African
Americans across sexual orientation. The idea of
intersectionality holds that individuals are marked by
multiple identities. These identities include race,
gender, class, and sexual orientation, among others.
Further, intersectionality suggests that these identity
categories influence an individual’s worldview and
interactions with others; it also seeks to help the
researcher identify how systems of oppression and
41
marginalization impact the livelihoods of individuals,
especially African Americans.
Other prominent theories illustrate the inequities
and discrimination among African Americans on the
grounds of sexual orientation. For instance,
heteronormativity has been used to convey the
systematic privilege bestowed upon heterosexuals
African American Sexualities
even among African Americans and other minorities.
Focused on heterosexual privilege, scholars have
shown that sexual orientation has a clear impact on
the ability of African American LGBTQ people to
get gainful employment, enjoy positive familial
support, and access resources that their heterosexual
counterparts readily access. Moreover, the concept of
heteronormativity seeks to show that sexual
orientation is a source and site of inequality.
Whereas LGBTQ people of all races had been
previously considered primarily through the lens of
deviance, heteronormativity illustrates that normative
notions of morality and sexuality are subjective and
have been used to subjugate a large subsection of the
American population.
These two aforementioned theories reveal the
complexity of African American sexuality and the
prejudices and oppressions that African American
sexual minorities face. Theories derived from the
sexual lives and experiences of African Americans,
such as intersectionality and heteronormativity,
challenge the idea that African American sexualities
are inherently pathological. Rather, scholars using
intersectionality and heteronormativity as analytical
themes and lenses show that African Americans have
a diverse range of sexualities and sexual practices
influenced by their many different classed and
gendered identities. Emphasis is often placed on the
standpoint of African Americans as related to gender,
sex, sexual orientation, and family to bring attention
to evolving sex practices and perceptions of Black
people. Here, ideas of masculinity and femininity
have also helped to illustrate the various gender roles
and perceptions of African Americans. Ultimately
these theories reveal that people of African descent,
before, during, and after the era of enslavement in the
United States, have developed important and
instructive practices and understandings about sex
and sexuality.
42
Family their sexual orientation, others find more powerful
links with being LGBTQ despite their racial identity.
The study of African American sexualities has also
For example, it has been shown that African
often focused on the role and influence of family,
American women prefer to self-identify as “gay”
especially the changing patterns of family formation
rather than lesbian, due to the perceived White racial
in the United States over time. African American
origins of the term lesbian.
families tend to have and make less money than their
Here, then, scholars have shown that the identity
White counterparts. This tendency is especially true
politics of African Americans is not easily predicted.
for African American families with same-sex
Instead, the identity politics, especially relative to
partners as heads of household. Further, even among
feelings of membership and belonging, varies greatly
African Americans, LGBTQ-headed families have
among African Americans especially when
lower household incomes and educational outcomes.
accounting for the role of sexuality. For instance, a
These tendencies point to enduring patterns of
variety of scholars have found that being African
inequality and discrimination acutely experienced by
American and LGBTQ does not predict gender
African American LGBTQ people. African American
performances, roles, or preferences. Indeed,
sexualities are a valuable source of insights for
investigations of African American lesbians’
understanding and investigating trends in marriage in
experiences have shown that gender performance and
the United States. With the decline of traditional
roles can vary greatly, breaking away from
marriage post-1950 and recent progress toward
traditional categories of butch and femme.
marriage equality in the United States, family and
Identity politics has also been a helpful lens for
marital arrangements have varied greatly among
understanding and uncovering the process of
African Americans.
transitioning one’s gender and/or sexual orientation.
The sexual decisions of African Americans across
Indeed, some African Americans have transitioned
sexualities have major implications for family
from one gender to another and/or from heterosexual
arrangements ranging from the traditional nuclear
to gay, lesbian, or bisexual. As scholars have shown,
family model, to cohabitating unmarried co-parents,
the transition of one’s sexuality and/or gender
to same-sex married households with adopted and
involves experiences of prejudices and oppression
biological children. African American gay men, for
within and outside of African American
example, have historically created fictive kin
communities.
networks to establish familial ties among community
In recent decades, the term queer has also become
members to enable them to survive and thrive even if
a common, though not universal, means of
shunned by loved ones who are biologically related.
identification within African American sexualities.
African American lesbians’ familial arrangements
The category of queer is meant to affirm the fact that
have been shown to have gender roles and divisions
for most people sexuality is more fluid than the
of labor that can be comparable to those in
binary categories of heterosexual and homosexual
heterosexual families. Taken together, the theme and
allow. Further, queer has also become a viable way
role of family for understanding sexual patterns and
to connect and develop a broader LGBTQ politics
practices of African Americans highlights the
that seeks to ensure that citizens are not
important links between sexual orientation and
discriminated against or relegated to second-class
African American familial arrangements.
citizen status because of their sexual orientation. This
point is especially instructive for understanding the
Identity Politics distinctions among African American LGBTQs. It
should be noted that being transgendered is not
Researchers have investigated the impact of sexuality primarily a sexual identity as is the case for lesbian,
and sexual orientation on the identity and politics of gay, and bisexual, as there are many African
African Americans. The focus on identity politics has American transgendered citizens who identify as
helped to explain the perspectives and experiences of heterosexual. Rather, queer is
the African American lesbians, gays, bisexuals, and African American Sexualities
transgendered and queer citizens encompassed in the
LGBTQ category. While some African Americans
may likely identify more strongly with their race than

meant to bring together these different modes of
sexual and gender expression that differ from
normative and conventional standards and binaries.
Researchers have also spent a lot of time detailing
the continued role of pervasive homophobia and how
it has influenced the identity politics of both
heterosexual and LGBTQ African Americans.
Though it has been conventional wisdom that
homophobia is especially acute among African
Americans, recent surveys indicate this link to be a
spurious one. While homophobia is present, other
factors such as class, region, and age are also key in
shaping African American perspectives on sexual
orientation. Further, though religion has often been
the source of homophobic rhetoric and claims, in
recent decades many within religious communities
have looked to more inclusive theologies to broaden
their appeal and welcome African American
LGBTQs.
Urban Life
That place matters is not lost on scholars of African
American sexualities. Indeed, census reports indicate
that the vast majority of African Americans live in
cities. As a result, the city and urban life more
generally have played a key role in ascertaining
insights into and about the sexual attitudes and
practices of African Americans. The Great Migration
(1910–1970) reshaped the landscape of urban
America. Moving individually and in large groups,
African Americans traveled throughout the urban
landscape to find new neighborhoods, homes, and
refuges from the discrimination they endured in
much of the rural South. In many cases romantic
interests were instrumental in drawing African
American men and women from rural to urban
America. Following lovers, husbands, and wives,
African Americans sought to establish new lives in
some of America’s most vibrant cities.
Across the nation, this movement led to the
establishment of Black urban neighborhoods and a
range of nightlife practices and venues that provided
a space to express sexual desires. Researchers have
focused on this link between cities and African
American sexualities. For example, urban African
Americans tend to live in predominantly
Age of Consent
43
Black neighborhoods and choose their sexual
partners within a network of urban Black
communities. Studies on urban inequality have
especially focused on the sexuality of African
Americans.
Investigating the prevalence of single African
American mothers in urban America, research has
shown that racial residential segregation, poverty,
and mass incarceration have influenced African
American sexual outcomes. From delayed marriage
to single motherhood to absentee fatherhood, the link
between place and African American sexuality has
been used by researchers to show the continued
impact of enduring White–Black health and
economic disparities over time. African American
sexualities shape cities just as cities are shaping
African American sexual practices and beliefs.
Conclusion
The role of sex and sexual orientation in organizing
human life is clearly significant, and critically
important for explaining and apprehending the social
world. African American sexualities are varied in
their expression and have been a key subject for
study by researchers. How African Americans think
about themselves and their bodies has been shown to
have a real impact on their actions and attitudes
toward other Black people, sexual partners, and
familial arrangements. Research confirms that there
is a vibrant African American LGBTQ population,
and scholars have shown that many African
Americans across sexual orientation hold positive
perspectives about sex and sexuality, creating a
variety of family and romantic practices as a result.
Marcus Anthony Hunter
See also Cultural Dissemblance (of African Americans);
Racialized Masculinity
Further Readings
Battle, J., & Barnes, S. (Eds.). (2010). Black sexualities.
New Brunswick, NJ: Rutgers University Press.
Cohen, C. J. (1997). Punks, bulldaggers, and welfare queens:
The radical potential of queer politics. GLQ, 3, 437–465.
Collins, P. H. (2004). Black sexual politics. New York, NY:
Routledge.
Crenshaw, K. (1991). Mapping the margins:
Intersectionality, identity politics, and violence against
women of color. Stanford Law Review, 43, 1241–1299.
44
Ferguson, R. (2004). Aberrations in Black. Minneapolis:
University of Minnesota Press.
Guy-Sheftall, B. (Ed.). (1995). Words of fire. New York, NY:
New Press.
Hawkeswood, W. G. (1997). One of the children: Gay Black
men in Harlem. Chicago, IL: University of Chicago Press.
Hemphill, E. (Ed.). (1991). Brother to brother: New writings
by Black gay men. Boston, MA: Alyson Publications.
Hunter, M. A. (2010). All the gays are White, All the Blacks
are straight: Black gay men, identity and community.
Sexuality Research & Social Policy, 7(2), 81–92.
Johnson, E. P. (2008). Sweet tea. Chapel Hill: University of
North Carolina Press.
Johnson, E. P., & Henderson, M. G. (Eds.). (2005). Black
queer studies: A critical anthology. Durham, NC:
Duke University Press.
Moore, M. R. (2010). Invisible families. Berkeley:
University of California Press.
Smith, B. (Ed.). (1983). Home girls: A Black feminist
anthology. New Brunswick, NJ: Rutgers University Press.
AGE OF CONSENT
Age of consent commonly refers to the minimum age
at which a governing body permits persons to engage
in sexual conduct. However, the question “What is
the age of consent in location x?” elides an often
varied array of statutes regulating the sexual conduct
of young people. In the very same jurisdiction there
are often multiple “ages of consent,” depending on
the type of sexual contact, the genital sex of the
participants, and/or the marital status of the
participants. For example, in India, although the age
of consent is 18 (if unmarried), there is no “age of
consent” for same-sex sex, since same-sex sex,
across all ages, was recriminalized in 2013. And
while most states in the United States set the age of
consent at 16, marriage generally provides an
exemption. Most states also specify age-span
exemptions. Sexual conduct with someone between
the ages of 13 and 16 is usually a felony, but if the
other partner is within four or five years of the
younger partner, the conduct may be a misdemeanor,
or fully permitted.
The term age of consent is somewhat misleading.
Sexual assault laws cannot nor could not locate the
exact age where someone transforms from a
dependent subject incapable of making decisions for
herself to an independent, rational actor. It might be
more apt to understand such laws as reflecting and
reinforcing an age of sexual citizenship. The
remainder of this entry thus uses the term age of
consent reservedly.
Overview (United States)
Until the 1890s, U.S. states adopted British common
law and set the age of consent at 10 or 12. Age-of-
consent laws have historically served the purpose of
securing fathers’ proprietary rights over their
daughters. Nonvirgin girls were less marketable for
marriage, and so age-of-consent laws were designed
to protect girls’ value (their virginity). At the turn of
the 20th century, temperance, suffragist, and social
purity reformers successfully lobbied legislators to
raise the age of consent from 10 or 12 to 16 or 18.
These campaigns shifted what was understood as the
governing principle of age-ofconsent laws—no
longer only about protecting virginity, these statutes
were now also intended to protect (usually White)
girls from sexual aggressors.
As a result of postwar liberalization and second-
wave feminist activism, all states in the United States
overhauled their age-of-consent statutes beginning in
the 1970s. First, states genderneutralized the laws.
Whereas historically only (White) girls could be
victims of sexual assault and only men could be
perpetrators, revisions to the criminal codes
unspecified the gender of both victim and
perpetrator. Second, states instituted aforementioned
age-span provisions, intended to target abuse and
manipulation.
A third round of age-of-consent reform in the
United States occurred in the mid-1990s, with
legislative and prosecutorial emphasis on stricter
enforcement and enhanced criminal sentencing.
Age of Consent
Conservative and some liberal politicians argued that
adolescent pregnancy was a leading cause of urban
poverty, and that such poverty and consequent state
spending could both be reduced if the men fathering
teenage girls’ children were more vigorously
prosecuted for violating age-of-consent laws.
Criticisms
From the Progressive Era onward, feminists and
libertarians have voiced concern that age-ofconsent
 45
statutes criminalize young female sexuality. These
laws, such critics argue, disqualify and devalue
young girls’ expressed desires. From the 1970s
onward, some gay rights activists have argued that
age-of-consent laws have been enforced
disproportionately and homophobically against gay
men, criminalizing consensual, cross-generational
sexual activity (in 2000, after a decade of gay rights
activism around the issue, the United Kingdom
equalized its age of consent to 16; the age was
formerly 16 for “heterosexual” sex and 18 for
“homosexual” sex). And from the 1990s onward,
liberal and feminist legal scholars have protested that
the most recent changes in enforcement and
sentencing were motivated by two racist and
inaccurate assumptions: first, that teenage girls of
color having children were the primary cause of
urban poverty, and second, that sexually aggressive,
older men of color were responsible for such
pregnancies.

Countercriticism
On the other hand, age-of-consent statutes, like
sodomy and seduction laws, have been used by
prosecutors and legislators to reach forms of sexual
violence that may not meet the force or nonconsent
thresholds of rape law. Because age-of-consent
statutes are usually strict liability offenses, violations
are sometimes easier to prove than rape. Likewise,
age-of-consent prosecutions bypass the other well-
known problem associated with rape prosecutions:
judge and jury bias regarding determinations of force
and nonconsent. So while reform campaigns to raise
the age of
46 Ageisms in LGBTQ Cultures
consent—at the turn of the 20th century and beyond
—have been waged in the name of childhood
innocence, such campaigns have also sought to
protect young people from sexual violence.
Age-of-consent laws are complicated and
historically contentious. The rationales for these laws
—property transfer, the upholding of gender norms,
the upending of gender norms, the protection of
young people’s innocence, the protection of young
people’s sexual autonomy, the reduction of state
spending—quite often directly conflict with one
another. Contemporary codifications of ageof-
consent law reflect these differing moral principles
and political investments.
Joseph Fischel
See also Adolescent Pregnancy; Heteronormativity; Laws
Banning Homosexuality and Sodomy; Youth and
Dating
Further Readings
Califia, P. (2000). No minor issues: Age of consent, child
pornography, and cross-generational relationships. In P.
Califia (Ed.), Public sex: The culture of radical sex (pp.
54–93). San Francisco, CA: Cleis Press.
Cocca, C. E. (2004). Jailbait: The politics of statutory
rape laws in the United States. Albany: State
University of New York Press.
Freedman, E. B. (2013). Redefining rape: Sexual violence
in the era of suffrage and segregation. Cambridge, MA:
Harvard University Press.
Oberman, M. (2000). Regulating consensual sex with minors:
Defining a role for statutory rape. Buffalo Law Review,
48, 703–784.
Waites, M. (2005). The age of consent: Young people,
sexuality, and citizenship. Basingstoke, England: Palgrave
Macmillan.
AGEISMS IN LGBTQ CULTURES
LGBTQ individuals experience aging and ageism
differently from heterosexuals and from each other.
LGBTQ individuals can experience ageism, which
excludes them from their own “kind” and from
general forms of social participation. While
increasing attention has been given since the 1990s
to how ageism affects gay men’s experiences of
aging, this work has overshadowed the ageisms
experienced by lesbian, bisexual, trans, and queer
persons. To address the above-identified knowledge
gaps, this entry examines ideas within the literatures
on LGBTQ experiences of aging and ageism.
Definitions
Aging and Ageisms
Aging is viewed as a natural, biological process,
but aging and ageism are not reducible to physical
experience; they are social constructs. Aging is
defined as material and symbolic—consisting of
changes to our bodies and our ideas about the passing
of time (e.g., the symbolism of being ages 5, 18, 40,
65, 100) and occurring within social relations where
differently aged selves are accorded different
meanings and values. Aging is commonly
constructed as a phased experience as reflected in
“life stage” models of aging that involve the
progression from birth, nursery, school,
further/higher education, work, marriage/children,
and retirement to death. Such models pivot around
the changing socioeconomic fortunes of individuals
who at different life stages experience greater or
lesser involvement in waged work and child care.
This model is heteronormative (i.e., takes
heterosexuality as the norm) and cannot serve
LGBTQ people well. This is one reason why the
more contingent, pluralized, and fluid concept of
“life course” has gained currency in studies of aging.
Ageism, too, is less the inevitable result of natural
age differences than historically and culturally
constructed. It is constituted through power relations
and expressed in how individuals and groups
stereotype each other. Ageism is believed to result
from societal discourses (i.e., ways of thinking) that
emphasize an age hierarchy wherein youth is
overassociated with vigor and older people become
overassociated with decline. Even theories of
“successful aging” and “aging well” contain the
ageist assumption that old(er) people are valuable
when they emulate or invoke qualities associated
with youth or a younger self considered trapped
within an older body. But, while ageism weighs more
heavily on old(er) people, young people can

experience ageism that relies on stereotypes of them
as immature, irresponsible, and insubstantial.
The meanings of aging are never fully fixed and
have been understood differently across time and
various cultures. Unlike consumer societies, the
Kaliai society of Papua New Guinea regards old
women as sexual citizens. Increasing longevity
across Europe since the mid-20th century has
encouraged expectations of a prolonged, healthy, and
active midlife that would not have been possible
during Victorian times characterized by high levels
of mortality when individuals might be considered
old at 40.
Genders and Sexualities
Whereas lesbian and gay identity rests on erotic
attraction to people of the same sex, bisexuality, like
queer, could involve being attracted to various
expressions of gender not included in the male/
female binary. The category trans is also diverse and
fluid. Indeed, through their actions, self-
presentations, and self-definitions, trans individuals
“queer” or challenge the binary of male/female and
conventional notions of masculinity and femininity.
Note that not every trans individual transitions from
male to female or female to male. The extent of
medical intervention has little bearing on how
individuals self-identify, in that gender is distinct
from the physical body. Gender and sex are
cultural/social constructions, not biological facts.
Also, trans can involve identifying as male (e.g., gay,
straight, or neither), female (e.g., lesbian, straight, or
neither), or gender-neutral (i.e., defining oneself
outside of and presenting a challenge to conventional
gender binaries). How people present or define
themselves can vary according to context (e.g.,
where/whether they disclose their trans status, how
they identify in a given situation, and the spectrum of
identification that they might pass through).
Gender is defined as resulting from the
socialization of human beings on the basis of bodily/
genital features and into a hierarchy of male or
Ageisms in LGBTQ Cultures
female that privileges the former in most social
realms. While individuals are sorted at birth into
male and female, this rigid binary has been
challenged more recently by queer academics and
activists arguing that gender is much more fluid and,
47
as indicated, includes a range of expressions.
Similarly, the simple binary of straight/gay excludes
diverse forms of sexual expression. Individuals can
identify queerly as ambiguous, bisexual,
heteroflexible/homoflexible, or pan/polysexual.
Sexuality is defined as a product of socialization
processes, which shape sexual experience. It is based
on a hierarchy of sexual expression that privileges
opposite-sex attraction between individuals who are
cisgendered—that is, content with the gender into
which they were assigned at birth and into which
they have become socialized/accustomed.
LGBTQ Individuals’ Experiences of
Generic Ageism
LGBTQ individuals can experience ageism just like
cisgendered heterosexuals. Older people can be
stereotyped as less productive or less flexible. This is
reflected in the proverb “You can’t teach an old dog
new tricks.” Regardless of how individuals identify,
they can be seen as no longer sexually active, though
compared with heterosexual men, ageism might
occur earlier for and impact more heavily on women,
gay men, and transmen identifying as gay. Influences
of social class can trump influences of
gender/sexuality in shaping whether individuals
experience growing older and being old in more or
less positive ways. This appears less applicable to
privileged individuals for whom age is reworked into
an asset, such as male executives, broadcasters, and
politicians. Ideas about “aging well” might empower
those with the right economic and cultural resources
but contribute to the stigmatization of individuals
who are blamed for “aging badly” because of their
poorer life chances. Life chances are affected by
social class in ways that intersect with influences of
gender. Women’s career breaks for child-rearing
affect the ability to build up a pension or develop
skills and knowledge necessary for career
advancement. However, older LGBTQ individuals
can experience ageism made worse by prejudice and
discrimination concerning their sexual/gender
difference.
Gay Men’s Experiences of Aging:
Accelerated Aging
48 Ageisms in LGBTQ Cultures
The topic of older gay men, aging, and ageism is Lesbian Experiences of Aging/Ageism:
addressed first because there is more literature Communities of Understanding?
devoted to this topic. Ageism combines with
The United States–dominated literature on lesbian
homophobia (i.e., fear of gayness that combines
aging indicates that ageism is much less a problem
hostility and discrimination) to construct the
within lesbian cultures. Indeed, females are
desperate “old queen” as predatory on younger men
socialized in ways that encourage them to be more
who are enticed into an unnatural or less eligible
compassionate and other-directed than males. The
sexuality. This stereotypic old gay man is also
bonds that develop from common experiences of
assumed to be devoted to selfish promiscuity and
socialization might be intensified considering that
thus held responsible for having chosen to exist
lesbian-identified women have united to challenge
outside of legitimate kinship—that is, the
“lesbophobia” (i.e., the fear of lesbianism that leads
heterosexual family.
to prejudice, discrimination, and hostility),
There are signs that ageist thinking becomes
heteronormativity, and sexism. These factors are
modified within gay culture. Indeed, the dominant
expressed in assumptions about woman’s natural
motif within the specific literature on gay aging is
dependence on men that wonder how women
that gay men’s obsession with youth leads to a
manage without a man. Researchers of lesbian
distorted view of what constitutes legitimate sexual
experience have drawn attention to how the exacting
citizenship (i.e., the quality of being sexual and
aesthetic standards required of gay men and
having one’s sexual preferences recognized) and
heterosexual women barely apply to lesbian-
automatically excludes those who bear the signs of
identified women. Shaped by feminist thought since
age. Aging is seen as “accelerated,” meaning that, in
the 1960s, older women are more accepted if not
contrast to heterosexuals, gay men are considered old
positively valued in lesbian social networks where
before their time. While this explains why older gay
attractiveness is generally thought to exceed bodily
men can report feeling their age and excluded mostly
surface. Indeed, experiences of social exclusion on
when on the (commercial) gay scene of bars/clubs,
the grounds of ageism are more likely to come from
saunas, and gay websites, this concept is too limited
outside lesbian society and to be linked to their
to explain the variety of older gay men’s responses to
identities as older women per se.
ageism. Research conducted in Manchester, Britain,
While this thinking is widely accepted in lesbian
recognizes how gay men develop resources of aging
cultures, there is little evidence to support these
to question gay ageism and construct their own
claims. Although lesbian cultures provide many
legitimate older gay identity. This is accomplished
opportunities for support and can function as
largely through the notion of an “authentic” aging
communities of understanding able to hear concerns
self that exceeds concerns with the body and where
relating to growing older, this idea is overly
outward appearance should reflect a more real inner
romanticized and is based on the assumption of a
self consisting of personality and values. However,
harmonious lesbian community untainted by ageism
this authentic older self can also work in
in a society where ageism is pervasive. Ageism
contradictory ways. It can be used to distinguish
might operate less acutely within lesbian cultures
older selves from younger gay men and reproduces
compared with heterosexual and gay male social
an ageism that stereotypes the latter as the selfish and
networks, but these cultures cannot be completely
“superficial” dupes of consumer and gay cultures.
immune from ageism.
Middleaged gay men can also distinguish and
The situation is likely to be more complicated,
distance themselves from old gay men who are
contradictory, and diverse than the above account
associated with morbidity (i.e., ill health) and
acknowledges. In a U.S. context, researchers have
mortality. Looking at gay male aging in more
indicated that ageism encourages lesbian-identified
nuanced ways that recognize men’s experiences of
women to distance themselves from growing older
exclusion, opportunities for agency, and ambivalence
and take pride in looking younger than their actual
toward ageism provides insight into the power
years. Lesbian subjects who are committed to
relations in gay male culture where ageism works in
challenging gender norms concerning the body may
multidirectional ways.
find themselves restricted by these same norms in

relation to maintaining a youthful appearance
through weight management and the like.
Researchers have also noted how some older lesbian
subjects are avoiding contact with their same-aged
peers to seek out the company of younger women.
While this is plausible, different generations of
women have developed conflicting ideas in relation
to feminism and women’s status. Some older
lesbians who remember the women’s and gay
liberation movements in the 1960s and 1970s may
feel divided from younger postfeminist lesbians
whom they regard as nonpolitical.
Bisexual, Trans, and Queer Experiences of
Aging and Ageism: Challenges to Fixity
Bisexual, trans, and queer experiences of aging are
not identical but are covered here under a single
heading because BTQ individuals and scholars have
been particularly active in challenging binaries of
gender and sexuality as natural and inevitable. Those
self-defining as queer understand gender, sexuality,
and aging as ambiguous, shifting, unstable, and thus
socially constructed. However, ageism often works
below the radar of consciousness and can be
expressed in queer spaces.
Although less is known about aging and ageism in
relation to bisexuality, aging as bisexual can involve
double invisibility on the grounds of age
Ageisms in LGBTQ Cultures
and sexual difference and exclusion from both gay
and straight cultural spaces. Older bisexual
individuals might experience ageism in gay/lesbian,
straight, and hybrid spaces/cultures, that is, various
combinations. Older bisexual people can find
themselves excluded from social relations on account
of common stereotypes expressed by gay and straight
people that demonize them as unreliable, immature,
or promiscuous for their failure to commit to one
gender. Challenging this stereotypical view,
researchers have observed how non- normative
futures are envisioned in the lives of bisexual people.
Being defined as bisexual can prompt critical
questioning and encourage the imagination of
positive futures involving ethical polyamory (i.e.,
emotional and sexual involvement by consent with
more than one partner). This idea simultaneously
registers the problems related to aging and ageism
49
faced by bisexual individuals and challenges the idea
of bisexual aging as characterized by misery and
exclusion.
Moreover, older transwomen could encounter
ageism, sexism, and transphobia whereby individuals
are assumed to have breached the most fundamental
human divide and are viewed as a subspecies of
female or male and therefore not “real,” acceptable
expressions of these gender categories. People tend
to become trans later in life having developed the
political, cognitive, and emotional resources to make
the necessary changes. It is possible, however, that
transwomen can “pass” in their chosen gender less
easily than transmen, who could benefit from the
value attached to being seen as an older male. There
is very little scholarship on trans aging, though this
process appears subject to a range of cultural,
psychological, material, legal, and health-related
constraints and disadvantages. Tina Donovan has
provided a first-person account that shows how as a
transwoman she found difficulty securing health care
and employment to help her prepare for later life.
Louis Bailey has examined the idea and
consequences of a “second puberty.” People who
have transitioned are thrust into a second puberty as
their bodies develop the secondary sex characteristics
associated with their new gender identity as enabled
through hormonal therapy and as they undergo new
social experiences navigating the world in their new
gender roles. Louis Bailey’s writings consider how
trans people can rework meanings of aging that
disrupt conventional understandings of aging. Such
experiences challenge the solidity of age categories
and the workings of ageism itself.
Conclusion
Although older LGBTQ individuals experience
certain forms of oppression in common with
heterosexuals and with each other, there are clear
differences between their experiences of aging and
ageism. The main experience of ageism in gay male
cultures is that men are encouraged to see themselves
as old(er) before their time and are more likely to be
rejected as possible sex partners and friends than
younger men. It has been noted, however, that older
gay men develop resources of aging to challenge gay
ageism and reclaim value on their own terms, though
sometimes by expressing ageism toward younger gay
men.
50 Ageisms in LGBTQ Cultures
For lesbian-identified women, especially in a U.S.
context, being old(er) is considered to be less of a
barrier to being valued. However, this romanticized
assumption of lesbian communities as largely
untainted by ageism is questionable in societies
where age-negativity is endemic. Further, older
bisexual individuals can find themselves excluded by
gay and straight people as unreliable closet cases
who are immature or indecisive for not having settled
for one gender. Older trans and queer-identified
individuals’ challenge to sexual/ gender fixity can
result in their rejection by gay and straight-identified,
cisgendered people. However, it has been noted that
older bisexual and trans individuals too can develop
the knowledge that enables them to envision
polyamorous futures and challenge the rigidities of
monosexuality (i.e., being attracted to only one
gender), as well as gender and age categories. In
order to develop a fuller understanding of aging and
ageism, there needs to be more research particularly
on lesbian, bisexual, trans, and queer experiences of
these complex social processes.
Paul Simpson
See also Aging and Bisexuality; Aging and Gay Men;
Aging and Lesbian Women; Aging and Transgender
People; Discrimination Against LGBTQ Elders;
Intersections Between Sex, Gender, and Sexual
Identity; Transgender Identities
Further Readings
Bailey, L. (2012). Trans aging and later life. In R. Ward, I.
Rivers, & M. Sutherland (Eds.), Lesbian, gay, bisexual
and transgender aging: Biographical approaches for
inclusive care and support (pp. 51–66).
London, England: Jessica Kingsley.
Barker, J. (2004). Lesbian aging: An agenda for research. In
G. Herdt & B. de Vries (Eds.), Gay and lesbian aging:
Research and future directions (pp. 29–72).
New York, NY: Springer.
Bennett, K., & Thompson, N. (1991). Accelerated aging and
male homosexuality: Australian evidence in a continuing
debate. Journal of Homosexuality, 20(3–4), 65–75.
Cook-Daniels, L. (2006). Trans aging. In D. Kimmel, T.
Rose, & S. David (Eds.), Lesbian, gay, bisexual and
transgender aging: Research and clinical
perspectives. New York, NY: Columbia University
Press.
Donovan, T. (2002). Being transgender and older: A first
person account. Journal of Gay & Lesbian Social
Services, 13(4), 19–22.
Jones, R. (2011). Imagining bisexual futures: Positive,
non-normative later life. Journal of Bisexuality, 11(2–
3), 245–270.
Kehoe, M. (1986). A portrait of the older lesbian. In M.
Kehoe (Ed.), History, culture and erotic aspects of
lesbianism. Binghamton, NY: Haworth Press.
Simpson, P. (2013). Alienation, ambivalence, agency:
Middle-aged gay men and ageism in Manchester’s gay
village. Sexualities, 16(3–4), 283–299.
Slevin, K. (2006). The embodied experiences of old
lesbians. In T. Calasanti & K. Slevin (Eds.), Age
matters: Realigning feminist thinking (pp. 247–268).
New York, NY: Routledge.
Slevin, K., King, N., & Calasanti, T. (2006). Ageism and
feminism: From “et cetera” to center. National Women’s
Studies Association Journal, 18(1), 13–30.
Slevin, K., & Mowery, C. (2012). Exploring embodied aging
and ageism among old lesbians and gay men. In L.
Carpenter & J. DeLamater (Eds.), Sex for the life course:
From virginity to Viagra, how sexuality changes
throughout our lives (pp. 260–277). New York, NY: New
York University Press.
AGING, SEX, AND SEXUALITY
Sexuality within the context of aging can be defined
broadly as sexual activity (e.g., kissing; petting; anal,
oral, and vaginal intercourse; masturbation), sensual
activity (e.g., holding hands, hugging, dancing,
wearing body lotion), and emotional intimacy
experienced by middle-aged (aged 50–64) and older
adults (aged 65 and older). Although research
suggests that many adults engage in sexual activity
well into their 80s, aging LGBTQ adults often face
significant challenges to the expression of their
sexuality. This entry will discuss what is known
about the sexuality of middle-aged and older
LGBTQ adults, and how it is influenced by
ecological factors such as age cohort, stigma,
discrimination, sexual dysfunction, health disparities,
socioeconomic status, ethnicity, and institutional
factors.
 51
Sexual Activity and Satisfaction No large-scale studies are available to provide
information regarding the frequency of sexual
Unfortunately, few large-scale research findings are
activity among aging bisexual and transgender
available regarding the sexuality of lesbian and gay
adults. An online survey of middle-aged and older
elders, and most of those studies feature convenience
transgender adults revealed that more than 75%
samples of primarily White, middle-class
reported having sex with a partner within the last
participants. Significantly less is known about the
year. Challenges reported by some transgender elders
sexuality of aging bisexual and transgender adults, as
included the need to make negotiations about sex,
well as ethnic-minority and rural LGBTQ elders.
such as whether certain body parts would be “on” or
Findings from a national MetLife survey suggest that
“off limits.” Because such limited empirical data is
both heterosexual and LGBTQ adults maintain
available regarding the frequency and types of sexual
moderate to high levels of interest in sexual activity
activity among older bisexual and transgender adults,
(consistent with their previous levels of interest as
it remains essential to avoid making generalizations
young adults), and continue to engage in sexual
about these often invisible elders.
activity, well into their advanced age. Although
aging lesbian, gay, bisexual, and transgender adults
Ecological Factors
must be regarded as distinct populations, overarching
factors that reduce participation in sexual activity Ecological factors including age, age cohort,
include health problems and the lack of an available ethnicity, and health disparities can play a major role
partner. in the expression of sexuality. LGBTQ adults over
Studies of middle-aged and older lesbians report the age of 65 are continually in fear of being
consistently that lesbian couples engage in sexual
Aging, Sex, and Sexuality

activity less frequently than both gay male and

heterosexual couples, sometimes referred to as
“lesbian bed death.” However, older lesbians report
placing more emphasis upon commitment,
compatibility, and affection than upon sex, and those
who have had sex with both male and female
partners have described their lesbian relationships as
more sexually and emotionally satisfying. Unlike
their heterosexual counterparts, aging lesbians
appear less likely to suffer from body image
dissatisfaction, as lesbians are influenced less by
mainstream cultural values in which standards of
female beauty are narrowly defined and youthful.
Celibacy among aging lesbians has been attributed
primarily to a lack of opportunity rather than choice.
The myth of the older gay man in the 1970s as
lonely, single, and desperately seeking sexual
encounters with younger men in bars or bath houses
has been dispelled in a series of research studies. One
study revealed that older gay men tended to have
fewer partners as they aged, and that 75% were
happy with their sex lives. Older gay men also tend
to have sex with men close to their own age, and
continue to have meaningful long-term sexual and
platonic relationships.
52
Aging, Sex, and Sexuality
actively persecuted for their sexual orientation or
identity. In contrast, LGBTQ baby boomers witnessed
the 1969 Stonewall riots and the beginning of gay
activism in the 1970s as young adults. Although
homosexuality was no longer considered pathological
by the American Psychiatric Association as of 1973,
transgender and bisexual elders have never experienced
a time when their sexual identity was not considered
pathological or problematic. LGBTQ minority group
elders face at least “double jeopardy” (i.e., the
additional stigma faced by members of multiply
disadvantaged or minority groups) through
heterosexism and ageism, and they may face additional
challenges of sexism or racism.
According to the Centers for Disease Control (CDC)
and the Institutes of Medicine, LGBTQ adults
experience significant physical and mental health
disparities. For example, more than 40% of middle-
aged and older LGBTQ adults suffer from at least one
disability or chronic illness, and they are significantly
more likely to smoke and engage in binge drinking than
their heterosexual peers. LGBTQ elders also are 2 times
more likely to live alone, to be at risk for elder abuse
and neglect, and to delay treatment-seeking behaviors.
Nearly 1 in 3 LGBTQ elders report being depressed,
and more than half report feeling socially isolated and
lonely. These health disparities (e.g., binge drinking,
feeling lonely) can also lead to participation in highrisk
sexual behaviors.
LGBTQ elders are also 80% less likely than their
heterosexual peers to seek needed health and social
services, and less than 25% of LGBTQ baby boomers
are willing to disclose their sexual orientation when
they do. Physicians receive less than five hours of
education in LGBTQ-related health care, and many care
providers report feeling “uncomfortable” when treating
lesbian or gay patients. Discrimination reported by
LGBTQ patients includes condescending remarks,
refusal to provide treatment, breaches of confidentiality,
and excessive curiosity. Such discrimination is reported
by 1 in 3 older transgender adults. Unfortunately,
concealing one’s sexual orientation or identity can lead
to ineffective or deleterious health care screening and
treatment, particularly in relation to sexual health.
Erectile Dysfunction (ED) and Prostate
Cancer
Data from the Urban Men’s Health Study indicate that
nearly 40% of gay and bisexual men reported some
degree of sexual dysfunction such as erectile
dysfunction (ED). Health problems including
cardiovascular disease and diabetes, medication side
effects, and psychological matters were identified as
contributing factors. Because gay men may place
significant value upon their ability to have an erection
and to ejaculate, ED may be particularly distressing.
Virtually no population studies are available regarding
the prevalence or etiology of sexual dysfunction among
bisexual or transgender elders.
The risk of prostate cancer increases with age, and
more than 20,000 older gay men annually are diagnosed
with prostate cancer. Research suggests that older gay
men, like their heterosexual peers, maintain limited or
incorrect knowledge about prostate health. A common
myth among gay men is that participating in rough sex
or using a dildo can increase their risk of prostate
cancer. Older gay men with limited income and
education, and those who are African American,
typically have the lowest level of accurate knowledge.
Virtually all studies of older gay and bisexual men
show, however, that these men are concerned and
fearful about prostate cancer, including potential
treatment side effects such as ED. Aging transgender
women, who retain their prostate even after
reconstructive surgery, face additional health disparities
including a lack of routine care and screening for
prostate cancer. Transgender elders also may be at
increased risk for breast, ovarian, and uterine cancer as
a result of hormone therapy.
Sexually Transmitted Diseases, Including HIV/AIDS
Although many aging lesbians and their health care
providers subscribe to the myth that lesbians are
immune from sexually transmitted diseases (STDs)
including HIV, nearly half of middle-aged and older
lesbians report that they engaged in heterosexual
intercourse at least once in their lives. Although rare,
female-to-female transmission of the HIV virus has
been documented. Research also shows that
approximately 20% of women who report that they
never had heterosexual contact are infected with the
human papilloma virus (HPV), the primary cause of
cervical cancer. Accordingly, aging lesbians and
bisexual women should receive routine screenings and
appropriate preventive care messages.
As of 2015 it is estimated that more than half of all
adults living with HIV are over the age of 50. This

population includes both long-time survivors and newly
infected middle-aged and older adults. Reports from the
CDC also reveal that gay and bisexual men are 44 times
more likely to contract HIV than other men, and
African Americans and Latinos are 12 and 5 times,
respectively, more likely to be HIV positive than their
White peers. Transgender elders also are at high risk for
HIV. The most likely forms of viral transmission
include unprotected sex with men and the sharing of
HIVinfected needles.
Despite the rapid increase in older adults affected by
HIV/AIDS, no national prevention programs are
targeted at older adults, much less older LGBTQ adults.
The CDC’s current recommendations only call for
routine HIV testing for patients up to 64 years old.
Older adults, including older LGBTQ adults, are less
likely to be tested for HIV than both their younger
LGBTQ counterparts and younger adults in general,
because health care providers typically believe they are
unlikely to engage in high-risk behaviors. In fact, less
than half of health care providers even broach the topic
of sex with their older patients. Older adults also tend to
receive their HIV diagnosis within the context of a
hospital visit versus routine care, are more likely to be
diagnosed with AIDS versus HIV, and are more likely
to die sooner than those diagnosed at younger ages. As
noted, LGBTQ elders often delay seeking medical care
due to fear of discrimination.
Sexuality in Institutional Settings
The issues surrounding the authentic expression of
sexuality for the more than 3 million older adults living
in institutional settings, including nursing homes and
prisons, are particularly complex for older LGBTQ
adults. Although research suggests that the majority of
nursing home residents regard sexuality as at least
moderately important in their
Aging, Sex, and Sexuality
lives, many staff subscribe to the myth that older adults
are asexual and express more negative and restrictive
attitudes toward sexual activity among gay and lesbian
versus heterosexual residents.
Although the federal Nursing Home Reform Law of
1987, which includes a robust section on nursing home
residents’ rights, dictates that residents have the right to
dignity and privacy, the right to espouse an LGBTQ
identity or to engage in an LGBTQ relationship is not
protected. The limited empirical research available
53
regarding the sexuality of older LGBTQ nursing home
residents suggests that many who were previously open
about their sexual orientation feel compelled to “go
back in the closet.” Examples of this process can
include changes in the way an LGBTQ resident dresses
or acts, and hiding photos of their partner. Out of fear of
discrimination from staff and other residents, some
LGBTQ residents even identify a same-sex partner as a
cousin or other relative. Some facilities do cater to
LGBTQ populations, but they represent the exception
rather than the rule. Options for low-cost, LGBTQ-
friendly, public elder housing are virtually nonexistent.
By 2030, nearly 40% of all U.S. prisoners will be
considered elderly, yet little is known about older
LGBTQ inmates. Research suggests that LGBTQ
prisoners face significant sexual abuse and related,
increased risk for HIV infection. Specifically, male
bisexual and gay inmates are 10 times, and female
bisexual and lesbian inmates are 2 times, more likely to
be raped than their heterosexual counterparts.
Additional concerns for aging transgender prisoners
include a lack of privacy, and their needs for personal
care, which may inadvertently reveal their sexual
identity. Unfortunately, no nationwide programs exist
for required HIV prevention or testing among older
LGBTQ inmates.
Conclusion
Like their heterosexual peers, LGBTQ elders typically
sustain interest in sexual activity well into advanced
age. Factors that limit LGBTQ elders’ participation in
sexual activity, however, include the availability of a
partner, health status, sexual dysfunction, health
disparities, stigma, and fear of discrimination and lack
of privacy in institutional
Aging, Social Relationships, and Support
settings. Additional research is needed to better
understand the issues related to sexuality among
bisexual and transgender elders. Advocacy and
education is needed for both LGBTQ elders and their
health care providers.
Jennifer Hillman
See also Discrimination Against LGBTQ Elders; Health
Disparities; HIV/AIDS and Aging; Lesbian “Bed Death”;
Senior Living Programs and Policies; Services and Advocacy
for GLBT Elders (SAGE); Sexual Norms and Practices;
Sexual Risk-Taking
54
Further Readings
Fredriksen-Goldsen, K. I., Kim, H.-J., Emlet, C. A.,
Muraco, A., Erosheva, E. A., Hoy-Ellis, C. P., … Petry, H.
(2011). The aging and health report: Resilience and
disparities among lesbian, gay, bisexual and transgender
older adults. Seattle, WA: Institute for Multigenerational
Health.
Grant, J. M. (2010). Outing age 2010: Public policy issues
affecting lesbian, gay, bisexual, and transgender elders.
Washington, DC: National Gay and Lesbian Task Force
Policy Institute. Retrieved from http://
www.lgbtagingcenter.org/resources/resource.cfm?r=30
Institute of Medicine. (2011). The health of lesbian, gay,
bisexual, and transgender people: Building a foundation for
better understanding. Washington, DC:
Institute of Medicine of the National Academies.
Kimmel, D., Rose, T., & David, S. (Eds.). (2006). Lesbian, gay,
bisexual, and transgender aging: Research and clinical
perspectives. New York, NY: Columbia University Press.
MetLife. (2010). Still out, still aging: The MetLife study of
lesbian, gay, bisexual and transgender baby boomers.
Westport, CT: MetLife Mature Market Institute.
Perlman, G., & Drescher, J. (Eds.). (2005). A gay man’s
guide to prostate cancer. Binghamton, NY: Haworth
Press.
AGING, SOCIAL RELATIONSHIPS,
AND SUPPORT
Lesbian, gay, bisexual, transgender, and queer
(LGBTQ) older adults are emerging from the margins,
creating an increasingly diverse older adult population.
Approximately 2.4% of American adults ages 50 and
older self-identity as LGBTQ, representing more than
2.4 million people; this number more than doubles
when taking into account same-sex sexual behavior and
romantic relationships. In addition, the number of
LGBTQ older adults is increasing dramatically, due to
the aging of the baby boom generation, and is expected
to double over the next 15 years.
LGBTQ Aging, Health, and Well-Being
To date, LGBTQ older adults are rarely considered in
aging or health research. Yet, they remain an
underserved and at-risk population. Health disparities
are gaps in quality of health, resulting from
disadvantages and differences in group status such as
race, ethnicity, income, educational level, and sexual
and gender identity. Such gaps exist for LGBTQ older
adults because of environmental, economic, and social
disadvantage. Lesbian, gay, and bisexual adults, age 50
and older, compared with heterosexuals of similar age,
have been found to be at increased risk of health
disparities, including elevated rates of disability and
psychological distress. In addition, older lesbian and
bisexual women have higher rates of cardiovascular
disease and obesity compared with older heterosexual
women; gay and bisexual older adult men, compared
with heterosexual men, are at greater risk of poor
health, living alone, and HIV/AIDS. There are also
important differences in health among LGBTQ older
adults by socioeconomic status, geographic location,
and race/ethnicity. Promoting health equity, within a
life course perspective, is critical for understanding
LGBTQ aging because it takes into account how both
risks and resources influence aging over time as well as
identifies ways in which LGBTQ older adults can
achieve their full health potential.
Social Relationships and Support
Although there are health disparities among LGBTQ
older adults, most experience good health; their social
relationships and other resources offset many of the
challenges they have faced during their lifetime. Social
relationships are multidimensional, existing within
historical, social, political, and geographical
environments. Given the shifting sociohistorical
context, the configurations of social relations are unique
and changing in many important ways for LGBTQ
older adults.
Like older adults in the general population, LGBTQ
older adults have a variety of important relational ties,
including spouses and partners, children, intimate
friends, and others, such as neighbors. The term family
of choice refers to alternative LGBTQ relational
networks that include relationships with partners,
friends, and others in their communities who provide
support, in addition to, or instead of, biological and
legal family. Partners and spouses provide a broad
range of physical, emotional, and economic benefits,
and evidence suggests that these benefits extend to
sexualminority couples, especially when they are
supported by important others, such as biological and
other family members. Having a partner is associated
with better physical and mental health; however, legal

marriage, as compared with other types of partnerships,
seems to have a more protective effect on health and
well-being. Ex-partners can also play a critical role in
providing emotional and practical forms of support and
assistance to older LGBTQ adults.
While today’s lesbian and gay midlife and older
adults are less likely to have children than their
heterosexual counterparts, the rates of same-sex
parenting are on the rise, suggesting that future cohorts
of older lesbian/gay elders will be increasingly likely to
have, and to possibly receive support from, adult
children. Information from the American Community
Survey indicates that the proportion of samesex couples
reporting having children rose from 12% to 17% from
1990 to 2009. According to data from the 2011
American Community Survey, there were more than
600,000 same-sex couple households in the United
States, and 16% of those households included one or
more children. By sex, 10% of male-male households
included children and 22% of female-female
households did. These families often face bias and
discrimination on account of stigma as it relates to
sexuality and same-sex relationships in the United
States.
Most LGBTQ older adults receive their primary
support from partners or spouses, friends, and
Aging, Social Relationships, and Support
55
and gender minority groups, women and transgender
older adults have the largest and most diverse social
networks; bisexual older women and men report smaller
social networks than lesbians and gay men of similar
age.
Among LGBTQ midlife and older adults, social
support is strongly associated with health and well-
being. The availability of social support is likely
influenced by the broader social context. For example,
living in states with legal same-sex marriage and higher
concentrations of same-sex couples is protective in
terms of health. The quality of relationships may vary
by type of relationship as well. Among LGBTQ older
adults, support from friends is associated with higher
quality of life and lower incidence of stress and
depression. However, support from biological family is
often not associated with better health, suggesting that
LGBTQ individuals may rely more heavily on their
friends and family of choice for positive social support.
Among LGBTQ older adults, like those in the general
population, there are many benefits associated with
intimate and close relationships and support, although
much less is known about the differing types and
functions, structures, and quality of

others in LGBTQ communities as opposed to biological

or legal family members. Connectedness to LGBTQ
communities provides important social resources such
as protection against social isolation and having others
to turn to when one experiences an unfair or hostile
environment. Like older adults in the general
population, LGBTQ older adults with strong social ties
enjoy better health and quality of life. When needed,
kin in LGBTQ communities often provide instrumental
and emotional support through informal caregiving,
which benefits both caregivers and those receiving care.
As was evident during the HIV/AIDS crisis, caregiving
is often extensive in these communities, and the
dynamics of caregiving can alter and challenge personal
relationships in new ways.
Social networks reflect the structure of social
relationships and the characteristics of relational ties,
including size, contact frequency, geographic
proximity, composition, and density. Diversity of social
networks is related to social bridging, in which an
individual’s position in a social network creates
connections between other individuals. Among sexual
56 Aging and Bisexuality
these relationships, and the mechanisms by which they
influence change in aging and quality of life over time
in these communities.
Conclusion
Social relationships are a key resource for LGBTQ
people of all ages and critically important to aging,
health, and well-being over the life course. While the
study of social relations among LGBTQ people is
growing, there remain critical gaps in existing
knowledge. To date, most research examining the social
relations of LGBTQ people are relatively
homogeneous, with limited representation of older
adults, racial and ethnic minorities, and bisexual and
transgender people. Future research work needs to
better investigate the full range and complexity of
sexual and gender identities, and the role of social
relations in the lives of demographically diverse
LGBTQ people and their families. Understanding the
social relationships of LGBTQ midlife and older adults,
as a resilient yet at-risk population, will offer important
insights into the increasing diversity and strengths of
our aging society.
Karen I. Fredriksen-Goldsen
See also Ageisms in LGBTQ Cultures; Aging, Sex, and
Sexuality; Aging and Bisexuality; Aging and Gay Men;
Aging and Lesbian Women; Aging and Transgender
People; Caregiving; Families of Choice
Further Readings
Barker, J. C., Herdt, G., & de Vries, B. (2006). Social support
in the lives of lesbians and gay men at midlife and later.
Sexuality Research & Social Policy, 3(2), 1–23.
de Vries, B. (2007). LGBT couples in later life: A study in
diversity. Generations, 31(3), 18–23.
Emlet, C. A., Fredriksen-Goldsen, K. I., & Kim, H.-J. (2013).
Risk and protective factors associated with health-related
quality of life among older gay and bisexual men living
with HIV disease. Gerontologist, 53, 963–972.
Fredriksen-Goldsen, K. I., & Kim, H.-J. (2015). Count me in:
Response to sexual orientation measures among older adults.
Research on Aging, 37(5), 464–480.
doi:10.1177/0164027514542109
Fredriksen-Goldsen, K. I., Kim, H.-J., Barkan, S. E., Muraco,
A., & Hoy-Ellis, C. P. (2013). Health disparities among
lesbian, gay, and bisexual older adults: Results from a
population-based study. American Journal of Public
Health, 103, 1802–1809.
Fredriksen-Goldsen, K. I., Kim, H.-J., Emlet, C. A.,
Muraco, A., Erosheva, E. A., Hoy-Ellis, C. P., … Petry, H.
(2011). The aging and health report: Disparities and
resilience among lesbian, gay, bisexual, and transgender
older adults. Seattle, WA: Institute for Multigenerational
Health.
Gates, G. J. (2011). Family formation and raising children
among same-sex couples. National Council on Family
Relations (NCFR) Report (Issue FF51). Los Angeles, CA:
Williams Institute.
Grossman, A. H., D’Augelli, A. R., & Hershberger, S. L.
(2000). Social support networks of lesbian, gay, and
bisexual older adults 60 years of age and older. Journal of
Gerontology Psychological Sciences, 55B, 171–179.
Kim, H.-J., & Fredriksen-Goldsen, K. I. (2013). Nonresponse to
a question on self-identified sexual orientation in a public
health survey and its relationship to race and ethnicity.
American Journal of Public Health, 103, 67–69.
Muraco, A., & Fredriksen-Goldsen, K. I. (2011). “That’s what
friends do”: Informal caregiving for chronically ill midlife
and older lesbian, gay and bisexual adults. Journal of
Social and Personal Relationships, 28, 1073–1092.
Weston, K. (1991). Families we choose: Lesbians, gays,
kinship. New York, NY: Columbia University Press.
Williams, M. E., & Fredriksen-Goldsen, K. I. (2014).
Same-sex partnerships and the health of older adults. Journal
of Community Psychology, 42, 558–570.
AGING AND BISEXUALITY
Aging is a lifelong process, not just something that
affects people in the last decades of life. Many
experiences in later life can most helpfully be thought
of as on a continuum with experiences earlier in the life
course. Experiences of aging differ hugely between
individuals and depending on the context and historical
period in which someone lives. These general points
about aging are as true for bisexual people as for any
other group.
Research and work with sexual and gender
minorities around aging usually takes age 50 or 55 as
the starting point of being “older” or an “elder.” This
entry follows that convention although it is important to
recognize that it represents an arbitrary starting point
and also that this very broad definition of aging may
obscure differences between very wide age ranges (e.g.,
someone aged 50 and someone aged 100 or older). This
entry also defines bisexuality broadly, as romantic or

sexual attraction to more than one gender. This
definition differs from the more common one of
“attraction to both genders” by allowing for the
possibility of more than two genders. This definition
also intentionally includes those who identify as
bisexual, those who behave bisexually but do not
identify as bisexual, and those who experience bisexual
attraction but do not behave or identify as bisexual.
Many issues that affect bisexual people as they grow
older are also common to most people as they grow
older. These issues include adjusting to bodily change;
changes to lifestyle and income, especially around any
retirement from paid work; changes to generational
position and status within families; increased
prevalence of disease and disability; and, for older
people in many parts of the world, coping with living in
societies that systematically devalue and stigmatize
aging. Other issues affecting bisexual people as they
grow older are common to many LGBTQ people, such
as the expectation that all older people are heterosexual
and cisgendered (that the sex they were assigned at
birth matches their experience of gender), and often
increased pressure to stay silent about some aspects of
life and experiences, such as same-sex partners or a
relatively large number of former partners in cultures
that privilege longlasting couple relationships. Issues
affecting bisexual people earlier in life also continue to
affect them in later life, such as the invisibility or
erasure of bisexuality as a legitimate sexual identity,
and encounters with biphobia (discrimination and
prejudice against bisexual people). However, there are
also distinctive features of
Aging and Bisexuality
being bisexual and growing older, and it is on these that
this entry focuses.
Following a brief overview of varieties of bisexuality
across age categories, the entry presents a discussion of
the components of bisexuality and the stability of
bisexual identity in later life. Next, the
underrepresentation of older bisexual people in the
research literature is considered, particularly with
respect to those who identify not only as bisexual but
also as belonging to an ethnic minority. Issues
associated with coming out as bisexual in later life are
then addressed, followed by an examination of the role
of generational and historical cohorts in the formation
and expression of bisexual identity. The entry
concludes with a look at the nature and duration of
57
relationships among older bisexual individuals, and
considerations affecting bisexual people who are
approaching the end of life.
Identity, Behavior, and Attraction
As with bisexual people of all ages, it is important to
distinguish between those who identify as bisexual,
those who behave bisexually, and those who experience
bisexual attractions. People who identify as bisexual
make up a much smaller group than those who have
sexual and romantic relationships with people of more
than one gender or those who experience attraction to
more than one gender. This pattern continues into later
life with relatively few older LGBTQ people
identifying as bisexual. Older people who do identify as
bisexual are more likely to be able to access services
and groups designed for older LGBTQ people than
those who identify as heterosexual but behave
bisexually. However, generic LGBTQ services and
groups are often experienced as not fully welcoming or
inclusive of bisexual people, due to biphobia within
LGBTQ communities, and these experiences may
impact older bisexual people’s willingness to use
generic LGBTQ services and groups. Older people who
identify as homosexual and behave bisexually may feel
able to access services and groups for older LGBTQ
people but often at the price of minimizing or
remaining silent about their bisexual behavior or
attractions.
The Continuing Significance of Bisexuality
in Later Life
Sexual identity, behavior, and attraction are all
commonly assumed to become less significant as
people grow older. Research among heterosexual, gay,
and lesbian populations shows that sexual behavior and
attraction may lessen for some people as they grow
older (although not for all) but that sexual identity
generally remains relatively constant (the exception
being people who “come out” in later life, as discussed
later in this entry). Since bisexuality is often thought of
as a fluid or transient identity, it might be anticipated
that this finding would not hold true for bisexual
people. However, research is building that bisexual
identities, especially long-established ones, also remain
stable in later life.
A study of a group of midlife (ages 35–67, average
age 50) bisexually identified people living in San
Francisco in the 1980s and 1990s, undertaken by Martin
58 Aging and Bisexuality
Weinberg and his colleagues, found that most
participants’ sexual practices had changed as they grew
older. They were having less sex with fewer partners,
which participants attributed partly to the effects and
responsibilities of being older, including life-stage
effects such as being very busy with work and children.
Participants were more likely to be having sex with
only one gender than when they were younger—about a
third were having sex only with people of a different
gender and about a fifth were only having sex with
people of the same gender. Participants were also more
likely to be monogamous than when they were younger.
They were less involved in organized bisexual
communities and politics, especially since the local
bisexual resource center had closed. However, many
participants in this study reported that their identity as
bisexual had remained constant and indeed was more
stable than when they were younger. The researchers
argued that, in contrast to earlier in their lives, most had
now “obtained closure” on their identity. They based
their identity as bisexual on their attractions rather than
on their behaviors. The stability of their identity as
bisexual as they grew older came from recognizing the
long-standing nature of those attractions. A different,
more recent study, by Rebecca Jones, which examined
how bisexually identified adults predominantly from
the United Kingdom and the United States imagined
their own aging and later life, also found that most
people imagined and experienced long-standing
bisexual identities that continued throughout the life
course. These studies, taken together, suggest that
bisexual identities in later life may be as stable as any
other sexual identity. They also counter the common
assumption that bisexuality is primarily about sexual
behavior. Rather, they suggest that bisexuality, like
other sexual identities, is made up of many components,
which include those of behavior, identity, and
attraction.
Underresearched Groups
Older bisexual people as a whole constitute an
underresearched group—there is hardly any empirical
research looking specifically at the experiences of older
bisexual people, apart from the two studies already
discussed. Empirical studies of LGBTQ aging as a
whole usually include very small numbers of bisexual
respondents and usually analyze their findings by
gender, not by sexuality. Thus, “gay and bisexual men”
are treated as one group and “lesbian and bisexual
women” are treated as another. This analytic practice
makes it impossible to identify what, if anything, is
distinctive about bisexual experiences of aging.
We know very little about the experiences of people
who behave bisexually but do not identify as such. This
is a common limitation of all work with sexual
minorities, whether academic or not, since making
contact with people who do not identify as members of
a sexual minority is extremely challenging. It is a
particular issue for research and services targeting older
bisexual people since they constitute a minority within
a minority.
We know very little about older bisexual people who
have not been activists around bisexual issues and those
who are not connected to wider bisexual communities.
Someone who has been an activist or has had strong
connections to a bisexual community may be more
likely to have a stable identity as bisexual than someone
who has not.
We also know very little about the experience of
bisexual people in their seventies, eighties, nineties, or
older. This means that we have very little information
about what it means to be bisexual at the stage of life
where disabilities and ill health become more likely and
when the end of life may come into view.
Intersections With Bisexuality and Aging
The literature on bisexual aging has focused on
predominantly middle-class, White, and relatively
highly educated people living in Western nations. This
means that we know very little about how
socioeconomic situation, ethnicity, culture, religion,
educational background, disability, and geographical
location intersect with bisexuality in later life. It is
important not to generalize from the participants in the
limited empirical literature to older bisexual people
who may be living very different lives.
Understandings and experiences of bisexuality,
including use or not of the self-description bisexual,
vary across cultures and parts of the world, across
social and economic classes, between genders, and
according to age cohorts. Some people reject use of the
term bisexuality (and the rest of LGBTQ referents) as
inherently middle-class, metropolitan, White, and
Western.
Empirical research focusing on bisexuality and non-
White ethnicity at any stage of the life course is rare,
but what there is reports recurrent difficulties for Black

and minority ethnic (BME) bisexuals in accessing
organized bisexual communities, which are
predominantly White. BME bisexual people often
experience racism within bisexual and LGBTQ
communities as well as outside them. Racism
compounded with biphobia can lead to very painful
experiences of exclusion and denial of identity. In later
life, such exclusion can be further compounded with
ageism.
Another underresearched area is how gender
differences affect aging as a bisexual person. Although
research about LGBTQ aging in general
Aging and Bisexuality
does suggest some differences between male and
female experiences of nonheterosexual aging, it is not
clear that these findings hold true for bisexual older
people. Gender may be experienced and affect bisexual
people differently from lesbians and gay men, because
their own gender and the gender of people to whom
they are attracted are not synonymous for bisexual
people. There is also evidence that genderqueer and
nongendered identities are more common in some
bisexual communities than elsewhere, which is a further
reason that it is not possible to extrapolate from studies
that categorize responses only by male or female
gender.
Coming Out as Bisexual in Later Life
Although “coming out” is often thought of as
something that younger people do, in fact many people
come out as L, G, B, T, or Q later in life. Midlife,
retirement, or when any adult children leave home are
all common points at which people come out later in
life. It seems likely that this extends to bisexual people
too. Some people who come out as bisexual in later life
may be describing themselves as bisexual in order to
signal their continuing commitment to an existing long-
standing relationship, while pursuing new relationships
only with people of a different gender from their
existing partner. Others may be seeking relationships
with any gender or transitioning to a heterosexual or
homosexual relationship. Stigma and misunderstanding
as to what a bisexual identity implies may mean that
older bisexual people who come out later in life lose
contact with grandchildren. This loss is especially the
case for older bisexual men because of the combination
of two prejudices, first that bisexual men are predatory
59
and second that older men’s sexuality is disgusting or
dirty. Older bisexual men thus can suffer from a double
stigma.
Historical and Cohort Effects on
Bisexual Aging
Individuals’ experiences of aging are affected by the
historical period in which they live and the generational
cohort to which they belong, but they are not
determined by them. Examining differences between
historical cohorts can be helpful in determining whether
something is due to aging per se or just to aging in one
particular time and place. A bisexual person who is
aged 80 in 2015 will have been born in 1935, so will
have grown to adulthood before the first gay rights
movements and before the decriminalization of
homosexual sex in many jurisdictions. A bisexual
person who is aged 50 in 2015 will have been born in
1965, so will have grown into adulthood after the first
gay rights movements arose, and is likely to have
encountered the AIDS crisis in early adulthood. These
kinds of generational differences are significant in the
aging experiences of older lesbians and gay men; it
seems likely that this is also the case for bisexual older
people. For example, older people who have been out
about their sexual identity for most of their lives may be
more likely to remain out if they start receiving care
services. The visibility of older bisexual people may
therefore increase in the next few decades. Experiences
of aging are always historically and culturally
contingent, so different cohorts and generations of
bisexual people may age very differently.
Relationships
Older bisexual people, like younger ones, are found in a
variety of different relationship types, ranging from
monogamy to polyamory and swinging. Being older
means that it is possible that a bisexual person’s
relationship(s) may have been of very long duration.
But longevity also means that someone has had a longer
opportunity for forming and breaking relationships, so
they may have had a large number of relationships over
the years. Older age status is not predictive of the types
or numbers of relationships that bisexual people may
have.
Older bisexual people may be married to different-
sex partners or to same-sex partners in jurisdictions
where same-sex marriage or civil partnership exists. In
60 Aging and Bisexuality
the future, when same-sex marriages will have been Sexuality; Aging and Gay Men; Aging and Lesbian
available longer and on a broader scale, it seems likely
that the numbers of older bisexual people in same-sex
marriages will increase just as the numbers are likely to
increase for lesbian and gay older people, because
same-sex marriage will have been a possibility for a
greater proportion of someone’s life. A study of
bisexual men in monogamous marriages to women,
40% of whom were aged 46 or older, found that these
marriages were successful and sexually happy, with
good communication and acceptance of the men’s
bisexual attractions being seen as key to their success.
Older bisexual people who are not in statesanctioned
relationships, and especially those who are in
polyamorous relationships, may experience difficulties
in their relationships being recognized socially and
legally. These difficulties can be a particular issue later
in life and in end-of-life care, when health and care
services may not recognize the significance of family-
of-choice and may privilege family-of-birth or family-
by-marriage inappropriately. This extends to funeral
and other after-death arrangements, when someone’s
wishes may not be observed and surviving partners may
not be acknowledged or provided for. Making legal
provision and discussing end-of-life arrangements and
wishes can be extremely beneficial for older bisexual
people, as indeed for all LGBTQ people.
Thus, the experiences of bisexual people as they
grow older are both similar to and distinctive from the
aging experiences of other LGBTQ people. Older
bisexual people’s experiences are also both similar to
and distinctive from the experiences of younger
bisexual people. It is clear that more empirical work is
needed to explore all aspects of bisexual aging,
including the diversity of bisexual people’s experiences
of aging. The distinctions between identity, attraction,
and behaviors that are so significant in the study of
bisexuality in later life also carry potential benefits for
work with other sexual and gender minorities.
Rebecca L. Jones

See also Ageisms in LGBTQ Cultures; Aging, Sex, and


Women; Aging and Transgender People; Biphobia;
Bisexual Inclusion in the LGBTQ Rights Movement;
Bisexualities
Further Readings
Barker, M., Richards, C., Jones, R., Bowes-Catton,
H., Plowman, T., Yockney, J., & Morgan, M. (2012).
The bisexuality report: Bisexual inclusion in LGBT
equality and diversity. Milton Keynes, England: Open
University, Center for Citizenship, Identity and
Governance/Health and Social Care.
Dworkin, S. H. (2006). Aging bisexual: The invisible of the
invisible minority. In D. Kimmel, T. Rose, & S. David
(Eds.), Lesbian, gay, bisexual and transgender aging:
Research and clinical perspectives (pp. 36–52).
New York, NY: Columbia University Press.
Edser, S. J., & Shea, J. D. (2002). An exploratory
investigation of bisexual men in monogamous,
heterosexual marriages. Journal of Bisexuality, 2(4), 5–
43.
Firestein, B. (Ed.). (2007). Becoming visible: Counseling
bisexuals across the lifespan. New York, NY:
Columbia University Press.
Jones, R. L. (2011). Imagining bisexual futures: Positive,
non-normative later life. Journal of Bisexuality, 11(2–
3), 245–270.
Jones, R. L. (2012). Imagining the unimaginable: Bisexual
roadmaps for ageing. In R. Ward, I. Rivers, & M.
Sutherland (Eds.), Lesbian, gay, bisexual and transgender
ageing: Biographical approaches for inclusive care and
support (pp. 21–38). London, England: Jessica Kingsley.
Keppel, B. (2006). Affirmative psychotherapy with older
bisexual women and men. Journal of Bisexuality, 6(1/2),
85–104.
Keppel, B., & Firestein, B. (2007). Bisexual inclusion in
addressing issues of GLBT aging: Therapy with older
bisexual women and men. In B. Firestein (Ed.),
Becoming visible: Counselling bisexuals across the
lifespan (pp. 164–185). New York, NY: Columbia
University Press.
Rosenfeld, D. (2003). The changing of the guard: Lesbian
and gay elders, identity and social change. Philadelphia,
PA: Temple University Press.
Weinberg, M. S., Williams, C. J., & Pryor, D. W. (2001).
Bisexuals at midlife: Commitment, salience and identity.
Journal of Contemporary Ethnography, 30(2), 180–208.
Yuen Thompson, B. (2012). The price of “community”
from bisexual/biracial women’s perspectives. Journal
of Bisexuality, 12(3), 417–428.
Aging and Gay Men 61
AGING AND GAY MEN
As the human population ages, so do gay men, and
research into this aging population has been steadily
growing since the 1970s, when scholars began to
document the distinctive social factors affecting gay
men’s later years. Determining the number of older
gay men is difficult because same-sex erotic
encounters and romantic relationships do not
necessarily result in identification as gay, and those
who do adopt a gay identity do not necessarily
disclose these identities to others. But the fact that
estimates of the gay male population at any given
time range from 2% to 10% of the population, and
the fact that the average life expectancy in the West
has virtually doubled over the past century, make the
older gay male population a group whose
experiences, circumstances, and needs are worthy of
investigation, as does their distinctive placement in a
context of rapid social change implicating sexual
identity, sexual and other relationships, political
ideology, and personal and community health that
has unfolded across their own lifetimes. This entry
begins by reviewing the range of approaches applied
in aging research. Then, it considers the challenges
to representative sampling of older gay men. It then
summarizes research findings that highlight the
significance of historical/generational context and
social support for older gay men’s lives,
circumstances, and health. The entry concludes with
a review of research into older gay men living with
and/or affected by HIV/AIDS.
Aging Studies: Competing Approaches
Aging can be defined and approached in several
ways. From a biomedical perspective, it is typically
approached as a biological process of, for example,
the slowing of cell regeneration, with the body
becoming slower, weaker, frailer, and more prone
Aging and Gay Men
to such illnesses as coronary heart disease, stroke,
cancer, and Alzheimer’s disease. A more
psychological approach tends to view aging as
driven by internal mental processes, and focuses on
mental or cognitive functioning and health. Social
gerontologists (social scientists specializing in
human aging) variously focus on social structures,
62
processes, practices, roles, relationships, networks,
experiences, and identities related to aging. For
example, some social gerontologists approach aging
as a social role, structured by social institutions and
cultural assumptions, which people adopt in later
life. Other social gerontologists consider aging to be
a lifelong process of moving not only through the
physical process of aging, but also through
sequential stages of life that have been culturally and
institutionally constructed (for example, formal
education, work and career, marriage and
parenthood, and finally retirement and
grandparenthood). These life stages are connected to
specific chronological ages, so that people are
deemed to be “on” or “off” time (for example,
teenaged mothers are now viewed as “off time”).
Social gerontologists interested in policy and social
justice are generally concerned with the fair
distribution of social resources and human rights
across age-groups, working to ensure that older
people are not discriminated against in the
workplace, education, health and social care, and
law, and that their needs are met within these and
other fields.
These approaches are similar in that they tend to
focus on the lives, needs, and circumstances of
people over the age of 65 (the age at which people
living in the Global North typically retire), and
approach older persons as either objectively unique
(with distinctive social, physical, and psychological
characteristics and needs) or as socially and
culturally constructed as unique in ways that do not
reflect the realities of their capacities and their lives.
But there are often tense debates and divisions within
this wide field of aging studies. Social gerontology
has critiqued medically focused studies of aging for
disregarding the social and historical context in
which people age. Critical gerontology has taken
much aging-related research to task for
overemphasizing the elderly’s frailty and
vulnerability, unintentionally depicting them as more
needy and vulnerable, and less resilient and
resourceful, than they actually are, and thus as a
strain on the social system rather than as productive
members of society. Many studies of aging have
been critiqued for failing to explore and represent the
vast diversity of the aging population, or for
exaggerating the distinctiveness of specific aging
groups. Finally, even within social gerontology,
tensions have emerged over the universality of the
aging process, with some scholars arguing that
distinctive generations have aged within such unique
sociohistorical circumstances that generalizing
across generations is problematic at best. This
tension, and the tensions identified above, can be
seen in the literature on aging “in general,” and are
particularly evident in studies of gay male aging.
Aging Gay Men and the Problem of
Representation
Just as the term aging is difficult to define, with
various definitions linked to investigators’ host
discipline, so is the term gay male. Men who
experience and/or pursue same-sex desires, erotic
attachments and arrangements, and romantic
relationships do not necessarily identify as gay,
bisexual, or queer, and those who do may redefine
their sexual identity at certain points in their lives.
Scholars of public health constructed the term men
who have sex with men (MSM) to better quantify
men who engage in same-sex sexual practices. But
this category does not capture the social roles or
identities that these men adopt or, indeed, the social
relationships and social worlds in which these men
engage. As a result, research into the lives of aging
gay men, as well as the lives of younger gay men,
focuses on data gathered from men who are willing
to identify as gay, to the exclusion of those whose
sexual identities are more fluid or complex.
Moreover, as many men who do identify as gay
decline to identify as such to those whom they do not
personally know (e.g., researchers), studies of gay
men of all ages typically rely upon data related to
gay men who are relatively open about their personal
lives, to the exclusion of many others. Men who do
tend to agree to participate in research into gay male
experiences are typically recruited through formal
gay organizations, and thus research often
overrepresents middleclass, White men living in
cities. This overrepresentation is particularly likely
in studies of older gay men who faced much harsher
treatment by formal institutions and friends, family,
and coworkers in their early lives than have younger
gay men who grew up during or after gay liberation
(generally dated as beginning with the Stonewall
uprising of 1969), and who are thus generally less

willing to disclose their gay male identity to
researchers.
Gay Male Aging in Historical Context: The
“Problem” of Generations
Early studies of gay male aging were launched in the
1970s in the United States by scholars committed to
disproving the prevailing myth (held by the general
public and alleged “aging experts” alike) that older
gay men (and women) were more isolated, less
physically and mentally healthy, and lonelier than
were older heterosexuals, as the former allegedly
suffered from weak romantic and family
relationships and were prone to youthful promiscuity
as well as victimized by a gay culture that excluded
gay people over the age of 40. Displaying a lack of
knowledge about gay aging, this “expert opinion”
drew on social gerontology’s focus, at the time, on
the presumed danger of people becoming less
socially integrated and satisfied in later life
(allegedly linked to the “crisis of role loss,” meaning
the loss of positive social roles as workers and
parents due to mandatory retirement and to their
children leaving home). But these early small-scale
empirical studies showed that older gay men were
not, in fact, as isolated or unsatisfied as had been
assumed (e.g., most of these studies’ informants
were in long-term relationships), nor were they
experiencing worse mental health than were older
heterosexuals. These studies also argued that gay
men’s experience with surviving various crises
(coming out, struggling with sexual identity,
rejection by friends and family) made them more
capable of managing crises of role loss, but this line
of reasoning was later questioned.
Importantly, the men interviewed for these early
studies, and who exhibited good social integration
and positive life satisfaction, had grown up in the
pre–gay liberation era, when the dangers of
disclosing one’s homosexuality or of having it
discovered by others led most to keep their
homosexuality private; much of the gay politics and
discourse prevailing at the time these studies were
published had assumed that being “in the closet”
carried with it psychological strain, fear, and guilt
which would express itself in later life in negative
ways. These early studies challenged this
assumption, pointing to a much richer inner life, and
Aging and Gay Men 63
much stronger and more complex social relations,
among older gay men than had previously been
assumed. These studies, and some conducted later
with this generation of gay men, showed the “closet”
to have provided a sense of safety and security in
dangerous times—a feeling that endured as these gay
men entered their later years.
Thus these early studies uncovered two important
findings related to older gay men, particularly those
who had come of age in the pre-Stonewall era. First,
according to the sociologist John Alan Lee, the pre-
Stonewall emphasis on “passing” as heterosexual
placed older gay men in the valued position of
guiding younger gay men through a private gay male
network to introduce them to other “passing” gay
men and school them in the codes of the gay male
subculture. This granted older gay men a positive
social status that, as the gay world became more
open and accessible, older gay men have lost.
Second, these studies uncovered intergenerational
tensions between the pre–gay liberation generation
of gay men who had come of age before gay identity
politics and its mandate to “come out” to
homosexuals and heterosexuals alike, and the post–
gay liberation generation of gay men, who had come
of age in the post–World War II era and within a
sociopolitical milieu in which that mandate held a
central role.
In 1990, the gay activist and oral historian John
Grube distinguished between “natives” of the pre–
gay liberation gay male community and the
Aging and Gay Men
“settlers” (gay liberationist men who embraced a
new way of life based upon a politicized gay
identity). From the perspective of “natives,” gay
liberation threatened and derided their way of life
based upon sequestering their gay lives in a private
world. More recently, Dana Rosenfeld, a sociologist,
found these same ideological tensions in her
interviews with gay men born before 1930, who
came of age—and identified as gay—before or after
1969. In her study, those gay men who had identified
before 1969 viewed gay liberation’s politicization,
and its call for public disclosure of one’s own
homosexuality, as foolhardy and dangerous—just as
their gay male contemporaries who had identified as
gay after 1969, and thus through the ideological
parameters of gay liberation, viewed those who
64
rejected gay liberation, and continued to “pass” as
heterosexual, as repressed and inauthentic.
Rosenfeld’s work points to ideological divisions
within the same generation of gay men based on
when in the history of gay politics and culture they
identified as gay. To capture the intersection
between these and similar historically specific
ideological divisions, on the one hand, and
identification as a member of a specific category of
person, on the other, Rosenfeld introduced the
concept of the identity cohort, which she defined as
those who identified as a member of a particular
category (here, gay men) at the same historical
moment on either side of a significant historical shift
in ideologies of the self. Rather than posit a unitary,
invariable “coming out” process, then, Rosenfeld
drew on insights from social gerontology and life
course theory, both of which view the aging process
and the experience of later life as causally connected
to processes of social change.
These findings brought to the fore the significance
of the historical era in which gay men came of age
and identified as gay for sexual identity, social
relationships with other gay men and with
heterosexuals (including family), and management of
information regarding their sexuality. Although gay
male culture is still changing, and will no doubt
ground different sexual identities, experiences, and
relationships among future generations of older gay
men, current research into gay male aging
necessarily relies on gay men who are currently over
the age of 65 (although many studies of “gay aging”
use data about or collected from people in their 50s,
a group that social gerontologists would consider
middle-aged rather than elderly). For these men, the
major social shifts in gay politics, culture, and social
organization that shaped their later lives are (a) the
emergence of gay liberation, as the pre-Stonewall
gay world— organized around relatively secret, even
underground, gay societies—evolved into a gay
community that was increasingly politicized, vocal,
visible, and organized, and (b) HIV/AIDS.
Following the early wave of studies into gay male
aging summarized above, later studies of gay aging
began to focus on gay men born in the post–World
War II era, who had formed their gay male identities
in a gay liberationist context. These gay men lived
within a relatively open gay world that was,
increasingly, taking the shape and identity of a gay
community celebrating same-sex practices and
culture in open as well as in private, closed settings.
Social Networks, Social Support, and
Mental Health
The most recent studies of gay men and aging have
been less concerned with disproving myths about
gay aging than with documenting gay men’s social
networks and relationships. In contrast to many
younger gay men today, these currently older gay
men had not come of age with access to legalized
same-sex marriage. But a number were found to
have been heterosexually married and to have
fathered children before they adopted a gay identity,
and thus to have adult children on whom they can
rely for support in later life, although they are less
likely to have children than do their heterosexual
peers, which limits their access to childbased
caregiving and support. Moreover, for these and for
childless older gay men, the gay community’s
reliance on “friends as family” has been found to
ground social support networks in later years to a
much higher degree than is the case among
heterosexual men. Gay men rely on these networks,
and on partners and formal gay community
organizations, in ways that distinguish them from
heterosexual elders.
Given the significant and well-substantiated
correlation between social support and mental health
and well-being across the life course and into older
age, the role of these social support resources has
particular salience for studies of gay male aging,
especially as recent research has questioned earlier
findings that older gay men’s mental health is
equivalent to that of their heterosexual peers.
Evidence has emerged that compared with older
heterosexual men, older gay men report higher levels
of poor health, depression, and psychological stress,
and have a higher risk of disability, than do older
heterosexual men (although, regardless of sexual
orientation, romantic partnerships protect against
poor physical and mental health). While research has
yet to identify the causes of these differences,
researchers suggest that the most likely factors are
the current and the lifelong consequences of stigma
and related fears of (and, indeed, actual instances of)
discrimination, harassment, and abuse; the stresses of
keeping their sexual identity secret from others; and

the personal, social, and psychological costs of the
AIDS epidemic of the 1980s and 1990s, and of the
high incidence of HIV within the gay male
population.
Other likely factors are the ageism that many
older gay men experience as a core feature of gay
male social worlds, and that is likely related to the
changes in these worlds identified above and noted
by John Grube decades ago, and concerns over
entering formal health and social care institutions in
later life that may discriminate against, marginalize,
or otherwise disadvantage them due to staff or other
residents’ homophobia. Several scholars have
predicted that the baby boom generation of gay men,
who formed their gay male identities according to
gay liberationist principles, will enter later life with a
different set of expectations regarding their treatment
and care than had the pre-Stonewall generation, with
a central expectation of being able to live openly as
gay men within nursing homes and other long-term
settings. There is strong evidence that older gay men
and women feel trepidation about seeking medical
help from a system with a history of discriminating
against them (and that, indeed, had defined
homosexuality as a medical condition within their
own lifetime), although observational and other
empirical studies of the experiences of older gay men
in long-term settings has yet to be conducted.
That said, there is also evidence that older gay
men “age successfully,” provided that they have
developed the skills to master or resolve adversity,
negotiate the realities of aging, and develop
necessary resources.
Gay Male Aging and HIV/AIDS
These concerns over long-term care in later life take
on added significance when considering the
disproportionate number of gay men living with HIV
in comparison with heterosexual men. Gay men over
the age of 50 are members of a generation that
witnessed and experienced the highest rates of
AIDS-related deaths at the peak of the AIDS
epidemic (1981–1996), when AIDS-related deaths
were at their highest in the Global North. These gay
men, many of whom are now living with HIV, lost a
substantial and disproportionately high number of
friends and partners to AIDS in these earlier years,
so that their current friendship and social support
Aging and Gay Men 65
networks are so depleted as to potentially
compromise their desired friendshipbased care in
later life. The psychological effects of these losses
are so significant as to have spurred several studies
into AIDS-related “multiple loss syndrome” in the
1990s, and we have yet to fully understand how they
affect the mental health and quality of life of older
gay male survivors of the AIDS epidemic, including
those who have been living with HIV for decades.
These long-term survivors constitute a population in
themselves, but the number and proportion of gay
men aged 50 and above has also grown in recent
years.
The aging of HIV has sparked a wave of studies
across disciplines into the physical and mental health
of older gay men (as well as older heterosexual men
and women) living with HIV, which has uncovered
both “successful aging with HIV” and poor health;
challenging personal, social, and financial
circumstances; compromised social support systems;
and distressing feelings of uncertainty about their
future health and social stability
Aging and Lesbian Women
as gay men age. Some recent research has found that
AIDS-related bereavement exacerbates the already
significant toll that homophobia takes on the mental
health of older gay men. For this population,
experiences and fears of antigay discrimination and
ageism within the gay male community combine
with concerns over HIV-related stigma, both within
and outside of the gay male community, the
challenges of living with a chronic condition, and
uncertainties over the long-term impact of HIV and
HIV medications. Not surprisingly, this introduces
high levels of mental stress. In this context, the role
of community-based support, friends-as-family, and
romantic partnerships become especially salient for
aging gay men.
Dana Rosenfeld
See also Ageisms in LGBTQ Cultures; Aging, Social
Relationships, and Support; Families of Choice; Health
Care Providers, Disclosure of Sexual Identity to;
HIV/AIDS and Aging; HIV/AIDS and Social Support;
Sexual Fluidity; Stonewall; Support Groups and
Resources
66
Further Readings
AGING AND LESBIAN WOMEN
Dannefer, D., & Phillipson, C. (Eds.). (2010). The SAGE
handbook of social gerontology. Thousand Oaks, CA:
Sage.
The aging experience for lesbian women is often
Fenkl, E. A., & Rodgers, B. L. (2014). Optimistically
engaging in the present: Experiences of aging among
discussed in the research literature as the experiences
gay men. SAGE Open, 4(3). doi:10.1177/ of “older lesbians”—that is, women over the age of
2158244014545463 55 who identify their sexual orientation as lesbian.
Fredriksen-Goldsen, K. I., Emlet, C. A., Kim, H.-J., Although exact numbers are currently not known, it
Muraco, A., Erosheva, E. A., Goldsen, J., & Hoy-Ellis, C. has been estimated that there are anywhere from
P. (2013). The physical and mental health of lesbian, gay 500,000 to 2 million older lesbians in the United
male, and bisexual (LGB) older adults: The role of key States, and this number is projected to double by
health indicators and risk and protective factors. The 2030. This entry first discusses the need for specific
Gerontologist, 53(4), 664–675. and separate knowledge that focuses exclusively on
Grube, J. (1990). Natives and settlers: An ethnographic note the lesbian experience of aging. Next, the entry
on early interaction of older homosexual men with describes several key areas of need and struggle, as
younger gay liberationists. Journal of Homosexuality, well as areas of strength and resilience in the areas of
20(3/4), 119–135. identity and health. These issues are examined
Halkitis, P. N. (2013). The AIDS generation: Stories of within the current historical
survival and resilience. New York, NY: Oxford
University Press.
Klein, S. J. (1994). AIDS-related multiple loss syndrome.
Illness, Crisis, & Loss, 4(1), 13–25.
Lee, J. A. (1987). What can homosexual aging studies
contribute to theories of aging? Journal of
Homosexuality, 13, 43–71.
Lyons, A., Croy, S., Barrett, C., & Whyte, C. (2014).
Growing old as a gay man: How life has changed for the
gay liberation generation. Ageing and Society, 35(10),
2229–2250.
Lyons, A., Pitts, M., Grierson, J., Thorpe, R., & Power, J.
(2010). Ageing with HIV: Health and psychosocial well-
being of older gay men. AIDS Care, 22(10), 1236–1244.
Rosenfeld, D. (2003). The changing of the guard: Lesbian
and gay elders, identity, and social change.
Philadelphia, PA: Temple University Press.
Rosenfeld, D., Bartlam, B., & Smith, R. (2012). Out of the
closet and into the trenches: Gay male baby boomers,
aging, and HIV/AIDS. The Gerontologist, 52(2), 255–
264.
Sagie, O. (2015). Predictors of well-being among older gays
and lesbians. Social Indicators Research, 120(3), 859–
870.
Wight, R. G., LeBlanc, A. J., De Vries, B., & Detels, R.
(2012). Stress and mental health among midlife and older
gay-identified men. American Journal of Public Health,
102(3), 503–510.

context and provide future considerations as lesbian
women continue to age. The current research on aging
lesbians is growing, but it is still quite limited; the
limitations in knowledge are also discussed.
Specific Focus on Aging Lesbians
Lesbians are a subgroup that falls under the larger
umbrella term of LGBTQ. Although it is often
important for political strength and in terms of
solidarity for the LGBTQ community to be discussed as
one (i.e., “LGBTQ people”), the reality is that in daily
life each subgroup often has very different experiences
and needs. Specifically, lesbian aging has been shown
to be dissimilar from gay male aging. For example,
research has found that aging gay men report concern
with their physical appearance and attractiveness as
they age; however, research on aging lesbians has
found that they express minimal concerns about
physical appearance and attractiveness, and in fact feel
that their decreased experience as sexual and physical
objects as women is a welcome change. Another
example of how lesbians and gay men’s experience of
aging differs is in the area of health, such that aging
lesbians have been found to be at risk for specific
cancers that are not applicable to gay men (discussed
further below). Thus, it is very important that the aging
lesbian experience be discussed and studied
independently from the other subgroups within the
LGBTQ community. Past research has not always
considered the experiences of each subgroup separately.
Historically, the bulk of the research on LGBTQ aging
has been primarily about aging gay men, and,
specifically, about the upper-middle-class, educated,
White gay male experience. Newer studies are
increasingly likely to analyze data from lesbians and
gay men separately, and current trends have also
included focusing only on one sexuality/identity in a
study.
Identity and Sexual Orientation
One very specific concern in terms of lesbian aging is
that of invisibility. Several studies have addressed
Aging and Lesbian Women
the reality that older lesbians are nearly invisible in
society, mainly as a result of heterosexism (the
assumption that all people are heterosexual). However,
67
specifically for older lesbians, there is the experience of
having once been defined by society in terms of their
sexual behaviors, but now as older adults they are then
ignored, as they are assumed sexless. Thus as they age
their sexual orientation is not of concern to most of
society. As well, the research literature suggests that
older lesbians are at risk for a triple threat of
oppression:
As women: Women today still face and must navigate
many situations where they are limited as a result of their
gender and sex;
As lesbians: Sexual minorities, such as women with a
lesbian identity, face potential oppression in a variety of
settings and situations;
As older persons: Ageism and the resulting oppression are
well-documented experiences for older persons.
An additional factor that adds to older lesbian
invisibility is that many older lesbians will intentionally
return to “the closet” in several areas of their life as a
response to feeling vulnerable in older age to increased
oppression. Many older lesbians are not “out” in public
situations such as in health care or employment settings
due to fear of discrimination or biased treatment. They
do, however, typically remain out in social
relationships, with the majority being out in their family
relationships and friendships.
In fact, aging lesbians have reported a lifetime of
varying experiences in terms of sexual behaviors,
relationship orientations, and identity. Specifically, one
of the largest studies to date on older lesbians found
that approximately half of the women had been married
to men, had sexual fantasies that included men, and had
engaged in sexual relationships with men. Many of the
women reported midlife transitions to a lesbian identity,
but the majority reported lesbian identification at very
young ages. Thus, it appears that aging
Aging and Lesbian Women
lesbians who were once married to men did so to hide
their sexual orientation and to fit into general society,
while some have experienced attraction to men at
various points in their life. A very small subset of older
lesbians remain married to men for legal and financial
protections, with some reporting marriages to gay men
so that both might have the safety and benefits that
marriage can provide. It is believed that as LGBTQ
68
marriage rights increase, future cohorts of older
lesbians will be less likely to marry men.
The majority of older lesbians, however, are
involved in current long-term relationships with
women, with these relationships having lasted longer
than the average for heterosexual marriages in the
United States. However, because of the lack of federal
government recognition of these relationships, older
lesbian couples do not benefit from the financial and
legal protections that marriage includes (i.e.,
preferential tax rates, social security, retirement
benefits, health insurance, disability, housing rights,
guardianship of children and grandchildren). Older
lesbians report many stressors and difficulties as a
result of these lacking rights. As marriage rights
increase for the LGBTQ population, it is expected that
future cohorts of aging lesbians will have decreasing
concerns in this area. However, it is interesting to note
that the majority of older lesbians describe resistance to
the traditional experience of marriage because of its
historical roots in patriarchy and female role
expectations within marriage. Thus the older lesbians in
future cohorts could provide new information on the
organization of relationships, and the experience of
identity, within marital relationships.
It is important to note that despite a lifetime of
various sexual experiences and interests, and regardless
of how out or closeted they are, the women in these
studies did indeed identify as lesbian, and not as
bisexual or another identity label. This may be the
result of the current cohort of older lesbians coming of
age in the 1970s when both the second wave of
feminism and the Stonewall riots were occurring, when
sexuality and sexual orientation were brought to the
forefront of the political arena, and when a lesbian
identity label was an important part of those historical
movements. Current trends that show a variety of
sexual orientation terms and identity labels (queer,
pansexual, etc.) suggest that the dominant use of
“lesbian” as a sexual orientation label will decrease in
future cohorts.
It is also important to note that despite sometimes
returning to the closet (as discussed earlier), the
majority of older lesbians report feeling very positive
about their lesbian identity and about the aging
experience in general. The current cohort of aging
lesbians is in fact more positive about their lesbian
identity and their own aging than the last studied cohort
of aging lesbians. It is believed that these positive
experiences will also increase with future cohorts, as
increased acceptance of the LGBTQ community occurs
and if aging continues to be a focus within the social
and health arenas.
Health: Physical and Emotional
Part of why the current cohort of aging lesbians is
positive about their own aging is that thus far, they are a
fairly physically healthy group with selfreports of
excellent or good health. The health literature on older
lesbians reports that the most common health-related
issues include obesity, high blood pressure, and
arthritis. Although historically a physically active
group, the current cohort of aging lesbians has reported
a decrease in physical activity, which parallels the
general decrease in physical activity seen in the overall
population of the United States.
Aging lesbians are known in the health literature to
be at greater risk for both ovarian and breast cancer due
to fewer pregnancies and fewer months of breastfeeding
when compared with heterosexual women. Thus it is
important that health care providers are aware of the
sexual orientation of their female patients so that
lesbians are screened more aggressively for these
conditions. It should be noted, however, that as legal
and medical benefits are increased and extended to
lesbian couples, there will most likely be a
corresponding increase in childbearing, thus an increase
in pregnancies and in breastfeeding, and thus a
corresponding decrease in being at risk for these types
of cancers.
Thus what is true in terms of at-risk health conditions
for the current cohort of aging lesbians will not
necessarily be true for the next cohort.
Similarly, lesbians are known to have higher rates of
both cigarette and alcohol use than their heterosexual
counterparts. However, this rate is seen to decline with
age, and the majority of older lesbians do not smoke or
drink to excess; however, many older lesbians do report
past use of both. Again, these rates may continue to
decline with future cohorts as they have decreased
within the past two cohorts of older lesbians. These
decreases are seen as a result of both overall general
population decreases and also decreases specifically
within the LGBTQ community as a result of social
acceptance. That is, historically, the higher-than-
average rates of both smoking and alcohol use by
LGBTQ community members has been understood as

an adaptation to “minority stress,” and thus recognized
as a means of coping with nonacceptance, hostility, and
discrimination on account of sexual orientation. As
acceptance and rights increase for LGBTQ community
members, rates of both alcohol and cigarette use (as
well as drug use) are expected to decrease. Health care
providers should be aware of the risks associated with
minority stress and how aging lesbians experience
them. Although rates of substance use are lower in
older lesbians, there is still the possible history of these
behaviors, which may result in health problems, and
thus requires proper screening by health care providers.
The current cohort of aging lesbians report
experiencing multiple difficulties in accessing health
care such as lack of insurance, distance from providers,
and limited treatment options, with more than half of
this population not being out to their health care
providers. As well, the overwhelming majority of aging
lesbians has expressed interest in aging, lesbian-only
communities and is fearful and resistant to traditional
retirement, rehabilitation, assisted living, and nursing
homes with heterosexual couples or men present. This
is likely a result of their experiences of being
discriminated against and general discomfort with aging
as members of a minority.
In terms of emotional health, the current cohort of
older lesbians rated their emotional health as
Aging and Lesbian Women
69
orientation alone. Despite this they remain an active,
engaged, highly educated group that feels positive and
hopeful about their own aging, their lesbian identity,
their health, and their relationships. Many older lesbians
are still working, involved in the raising of their
grandchildren, and active in political and social groups.
Limitations to Our Knowledge
The current state of knowledge about aging lesbians
should be understood within the historical context of
their cohort and in consideration of the social and
political environment. How culture and legal barriers
impact the women in these cohorts changes with each
cohort. Additionally, the age, race, socioeconomic
status, and education level of the older lesbians that are
being studied also impact our current state of
knowledge. Most of the knowledge we have is based on
research conducted with small numbers of older
lesbians who are typically young-old (i.e., 55 to 65)
rather than old-old (i.e., 75 and older), are
predominantly White (with little to no African
American or other racial minorities represented), report
high incomes, and are

excellent or good when responding to a national survey.

When reporting mental illness, depression and anxiety
are the most common symptoms found in the literature.
As a group, older lesbians are open to utilizing
therapists and mental health providers and report
having gone to therapy mainly for identity, relationship,
and depression issues. Widowed and celibate lesbians
report the highest rates of depression. Widowed
lesbians are at particular risk for depression due to the
issues they face as a result of stressful legal and
financial barriers due to their relationships not being
recognized (as discussed above). As well, widowed
lesbians report that emotionally their relationships and
loss are often neither recognized nor seen as legitimate,
which compounds their loss.
Overall, the current cohort of older lesbians is a very
resilient cohort who have lived in a time when they
could be committed to a psychiatric facility, could have
their children removed from their legal custody, and
could be legally fired on the basis of their sexual
70 Aging and Transgender People
highly educated. Although researchers are making
efforts to reach more diverse older lesbians,
attempts have been mostly unsuccessful. What we
know about lesbian aging could potentially be very
different if researchers were able to talk to members
of racial minorities, the very old, those of low
socioeconomic status, and those with comparatively
little formal education.
However, from what we do know, the experience
of lesbians as they age differs greatly from that of
gay men, heterosexual women, and even their older
lesbian “sisters.” This points to the importance of
continuing to study and report on the experiences of
lesbians as they age.
Paige Averett
See also Ageisms in LGBTQ Cultures; Aging, Sex, and
Sexuality; Aging, Social Relationships, and Support;
Discrimination Against LGBTQ Elders
Further Readings
Averett, P., & Jenkins, C. (2012). A review of the literature
on older lesbians: Implications for education, practice,
and research. Journal of Applied Gerontology, 31, 537–
561.
Averett, P., Yoon, I., & Jenkins, C. (2011). Older lesbians:
Experiences of aging, discrimination and resilience.
Journal of Women & Aging, 23, 216–232.
Claassen, C. (2005). Whistling women: A study of the lives of
older lesbians. Binghamton, NY: Haworth Press.
D’Augelli, A., & Patterson, C. (1995). Lesbian, gay and
bisexual identities over the lifespan: Psychological
perspectives. New York, NY: Oxford University Press.
Gabbay, S., & Wahler, J. (2002). Lesbian aging: Review of a
growing literature. Journal of Gay & Lesbian Social
Services, 14(3), 1–21.
Goldberg, S., Sickler, J., & Dibble, S. (2005). Lesbians
over sixty: The consistency of findings from twenty
years of survey data. Journal of Lesbian Studies,
9(1/2), 195–213.
Kehoe, M. (1989). Lesbians over 60 speak for themselves.
New York, NY: Harrington Park Press.
Meezan, W., & Martin, J. (2009). Handbook of research with
lesbian, gay, bisexual, and transgender populations. New
York, NY: Routledge.
AGING AND TRANSGENDER PEOPLE
Transgender and gender-nonconforming people face
many of the same aging-related challenges as other
individuals. However, they also have many unique
ways of experiencing the consequences of aging.
This entry outlines the variety of agingrelated
challenges present in today’s transgenderidentified
communities. It begins by discussing the prevalence
of elder trans-identified persons.
Aging and the Transgender Experience
Who Are the Current Trans and Gender-
Nonconforming Elders?
Here, we will consider the age of entrance into the
elder population to be 65 years old. The
Administration on Aging states that the U.S.
population of persons 65 years or older numbered
39.6 million in 2009 (the latest year for which data
are available). By 2030, it is projected that there will
be about 72.1 million older persons in the United
States. The National Institute on Aging global
projections for the 65-years-or-older cohort are 524
million in 2010 with this number expected to
increase to 1.5 billion in 2050.
Given the diverse number of gender descriptors in
the transgender community, it is difficult to provide
accurate estimates for the number of
gendernonconforming community members in the
United States and globally. We can, however, make
some reasonable estimates. Using 1999 census data
and an estimate of 3% to 7% transgender population
prevalence, Tarynn Witten, a scholar in transgender
aging, estimated that there were approximately
347,000 to 1,041,000 transgender-identified persons
in the United States over 65 years of age. Witten also
estimated that the worldwide population of
transgender-identified persons was in the range of
4,097,020 to 12,291,060. Based upon more recent
2010 population estimates, Witten has argued that
the U.S. population estimates should be revised to be
between 1.2 and 2.8 million transidentified
individuals over 65 years of age. There is little
information available to make population estimates

for gender-nonconforming elder populations in other
specific countries.
Social Factors in Aging
Ageism and Its Consequences
Western elders are often discriminated against as
a consequence of their actual chronological age or
for how old they appear. For example, some potential
employers may believe that elders are “too
expensive” to pay for, or that those elders cannot
“perform” certain predefined tasks, or that they have
a longer learning curve than younger potential
employee candidates. Trans elders face these and
additional barriers in employment due to being
transgender-identified. Many jobs depend upon how
a person looks; consequently “passing” may be
important. Transphobia can limit job availability
thereby diminishing hiring potential.
Different age cohorts are now appearing in the
trans community. Cohort effects are important in
understanding ageism and other factors within the
gender-nonconforming community. Trans elders
often hold viewpoints that come from different life
histories. For example, words like queer may mean
different things to different generational members.
This can create intergenerational conflict and thereby
generate subsequent ageist perspectives that may
propagate within the trans community. Complicating
matters is the intersectionality of ageism and trans
identity with racism and other isms. Little is known
about these complex intersections, and there has been
very little research into the challenges and
consequences of such intersections.
Social Support Networks
There is abundant gerontological research
literature supporting the importance of social
networks in aging. These networks may involve birth
families, legal families, families of choice, friends,
individuals from various social organizations (clubs,
religious organizations, service organizations, health
care systems), and other support individuals such as
caretakers and health caregivers. It is well known
that individuals with stronger social support
networks are less susceptible to the negative
Aging and Transgender People 71
consequences of aging. However, identifying as
transgender often profoundly affects network
structures and can actually increase susceptibility by
altering or reducing network structure and
connectivity.
Family Structure and Function. Many of today’s
trans elders came out after their children had reached
adulthood and left home. For some of these elders,
their family members were supportive of the
transition while others suffered strains and even
breaks in family connectedness. Estimates from
recent large cross-sectional research studies suggest
that 40% of the overall community has never been
married and as much as 55% of respondents have no
children. Further, research by Karen
FredriksenGoldsen, a senior researcher in LGBT
health and aging, as well as research by Tarynn
Witten, suggests that between 25% and 30% of
trans-identified individuals live alone. To
compensate for social network loss, many trans
elders created families of choice. Yet over 30% of
Witten’s respondents stated that they did not know
who would take care of them in the event of a major
illness or when the need arose.
Religiosity/Spirituality and Faith Support
Networks. The importance of spiritual/religious
networks in the lives of the elderly cannot be
overestimated. Trans-identified individuals belong to
a diverse array of religions and faiths, and issues
facing religious involvement within the trans-
identified community are complex. Positive religious
and spiritual experiences can enhance resilience,
reduce stressors, and create important social
networks. Negative religious experiences can result
in the opposite—heightened risk factors and more
negative physical and mental health outcomes.
Friendship and Intimacy Networks. As friends and
family die or move away, many elders find that their
friendship support networks gradually diminish.
Trans elders not only suffer these changes in network
support but also lose friends and family due to their
gender changes. Some individuals address this
challenge by acquiring a pet. Others build networks
via the Internet or by attending trans-related
community events. Some simply choose to live
72 Aging and Transgender People

alone. Of those that choose to live alone, research Financial Factors in Aging
shows a significantly greater number having
We do not know very much about the fiscal status of
“feminine” gender self-perceptions than having
the overall transgender-identified population. The
“masculine” self-perceptions. Many elders hope that
work of Fredriksen-Goldsen and her team shows that
the transition will not affect those family
47.56% of her respondents were below 200%
relationships that are in place prior to transition.
poverty level. Witten’s work showed 37% of her
However, it is rare that this is the case. Moreover, the
respondents (overall) were living below the 2013
results of transition are often disastrous, leading to
federal 200% poverty level for a family of one
subsequent divorce, isolation from family and
person and 56% were living below the poverty level
friends, and a significant degree of aloneness.
for a family of two persons. Considering only those
Intimacy, sexual or otherwise, is important across
individuals over the age of 65, Witten’s study
all ages. However, as the body ages, it is not often
showed that 28.9% were living below 200% poverty
perceived as being as attractive as it once was. In
level. Moreover, Witten found that individuals with
addition to the natural processes of aging, the trans
“feminine” gender self-perceptions had higher
body may age in ways that make it ambiguous in
income levels than those individuals with
ways that are uncomfortable for potential dating
“masculine” gender self-perceptions. Many of
partners. Further, the stigma of being trans-identified
Witten’s survey respondents stated that they did not
also diminishes the potential dating population pool.
have enough money, or had just enough money, for
Many potential partners, upon discovering that an
basic life requirements. Additionally, many felt that
individual is transidentified, feel violated, and the
they were under moderate-to-extreme financial
relationship will end, sometimes violently.
strain.
One common perception of elderly persons is that
they lose their desire for sexual intimacy. While age-
related changes may alter sexual ability, this does not Retirement and Pension Planning
mean that it alters sexual interest and a desire for
Like many other life phases, retirement can be
physical intimacy. In fact, many trans elders have an
complex. The differences between age cohorts and
increased desire to experience sexuality in their new
their plans for retirement are significant. Balancing
identity. This may lead to behaviors that are
the need to transition with the needs of a solid fiscal
considered a “second adolescence.” Elders of the
retirement can be problematic. When people think
population are frequently untrained in the important
about retirement, they typically consider such things
sexual protection measures for today’s world, and
as where they will live, how they will support
this can lead to increased risk of HIV/AIDS/STDs in
themselves, what kind of medical care they will be
later life.
able to afford, and how they would like to live out
Sexuality is a key component of quality of life and
the remainder of their lives. These are natural
well-being, and the need to express one’s sexuality
concerns for all individuals, trans and non-trans
continues into old age and may even continue into
alike. Witten’s research has shown that only 59.5%
nursing-home or at-home elder care environments.
of the respondents (across all ages) have a pension or
Caregivers in such environments may find
other form of retirement plan, and that this too varied
expressions of sexuality difficult in the general
by gender self-perception. When asked why
elderly population and more difficult with
individuals did not have pension plans, individuals
transidentified persons. This can be particularly
cited underemployment, needing everything they
complex when the trans person has dementia or when
earn just to survive, barely surviving day-to-day, and
the physical body and the gender expression do not
using retirement funds for transition expenses.
appear to be in sync with each other.

Health Care Factors in Aging

There are now many well-known considerations that
contribute to a healthy and satisfying quality of life

for all individuals across the life span, including
trans persons.
Self-Care
Self-care is essential. Exercise (walking, bike
riding, water-related exercise, and other aerobic
exercises) is crucial. Maintaining a quality diet is
important. Keeping cholesterol intake down,
watching for fatty liver disease, not overindulging in
sugary food and drink, and minimizing alcohol
intake are important contributors to a better level of
physical health. For individuals who take hormones,
stopping smoking should be a priority. Smoking
significantly increases the risk of cardiovascular and
cerebrovascular events. Aging increases the risk for
these events; smoking exacerbates that risk. Regular
monitoring for diabetes, HIV, and colon cancer are
all part of taking care of the elder trans body and
should be part of regular self-maintenance. Regular
oral hygiene should be part of the daily routine. As
individuals age, it is increasingly possible to lose
teeth due to cavities,
periodontitis, and general oral infection. Tooth loss
can lead to numerous negative medical
consequences. While there is no research on how
hormones may mediate this, research does show that
simple things such as dry mouth can exacerbate oral
health problems.
Medical Care
Some things require visits to a health care facility
(clinic, physician’s office). If one has the body part,
one has to take care of it (e.g., getting regular
cervical examinations and Pap smears; or getting
regular prostate examinations). While there are no
clear-cut data on risk factors around hormone use in
the trans population, research shows that hormones
can influence the occurrence of breast, uterine,
ovarian, and prostate cancer. Breast cancer screening
should be a regular part of every individual’s
physical examination. Periodic screening for
osteoporosis should also be a regular part of every
trans elder’s physical examination. Hormones can
mediate bone protection and bone loss. It is now
estimated that 1 in 3 people will develop Alzheimer’s
disease (AD). For trans-identified individuals, the
Aging and Transgender People 73
onset of AD means eventual loss of the current
identity and has severe implications for later-life care
and for the well-being of the individual. Periodic
monitoring for AD and other forms of dementia
should be a regular part of the trans elder’s medical
care.
The literature on trans persons and aging
documents the increased use of alcohol, drugs, and
smoking with age. As individuals age, social
networks begin to collapse, ageism becomes
increasingly present, financial difficulties increase,
and health begins to decline. Coupled with these
normative factors, elders begin to face their own
mortality. Moreover, along with these changes, trans
persons must face questions around self-
actualization. All of these factors can drive increased
substance abuse as the trans person ages.
Many of the current elders decided to transition or
transitioned in mid- to later life. Later-life transition
carries a number of additional challenges. Hormones
may or may not be desired. If desired, hormone
levels must be monitored carefully. There is very
little research literature on mid- to later-life hormone
dosing. Similarly, little is known about when to stop
hormone use. Moreover, in an effort to attain more
rapid transition, some elders may abuse/misuse
hormones, getting them over the Internet or from
illegal providers rather than seeking out competent
medical supervision. Side effects of abuse can range
from minor damage to loss of life.
Some trans elders desire gender-confirmation
surgery, while others do not, or cannot afford it even
if they so desire it. Surgery in mid- to later life
carries with it certain additional risks due to the
person’s age. While age is not an exclusion from
transition, age-related changes can affect the
transition process. Physical changes in the body may
make healing slower and can result in unsatisfactory
postsurgical results. Risk of cerebrovascular or
cardiovascular events may increase. Diabetes and
blood pressure changes are also risk factors.
Mental Health Care
Gerontological literature has established that
early-life and life course negative events can increase
later-life mortality and morbidity. Given the endemic
history of violence, abuse, discrimination, isolation,
74 Aging and Transgender People
and transphobia experienced by current trans elders,
it is not surprising that transidentified individuals
have significantly higher rates of stress, depression,
anxiety, and fear than either their LGB peers or
gender-nonconforming individuals. Suicidal ideation
has been shown to be significant in gender-
nonconforming individuals, and suicidal ideation
increases in all elders whether or not they are gender
nonconforming. Some trans persons have stated that
they have plans in place to commit suicide before
needing to access elder care.
Research and community reports document that
today’s elder trans persons have a history of
suffering violence and abuse (physical, mental,
financial, sexual, and verbal) across the life span.
Growing older increases vulnerability to such abuse.
Elder abuse can also appear in the form of not
allowing elders to live as their actualized selves in
elder care facilities, disrespect, denial of hormones,
outing the elder, and failure to provide needed
medical attention and sharing of medical
information. Research has shown that many trans
elders fear what will happen to them in elder care
facilities and that they would rather live out their
lives at home if at all possible.
Paying for Later-Life Care
Survey research data suggests that most trans
elders expect to use some combination of personal
savings and government support to pay for laterlife
care. Medicare Part B is the part of Medicare that
covers routine preventive care. However, trans
persons may face challenges in coverage when
medical identification does not match gender
presentation. Medicare Part D covers prescription
drugs. Many elders cannot afford Part D, and
problems may occur when Medicare deems
hormones as not medically necessary. And because
Medicare does not currently cover transitionrelated
surgeries, these additional costs must be borne by the
elder desiring them. For a number of elders, these
costs come out of retirement funds.
Although it was not true in the past, military
veterans are now able to obtain transition-related care
through the Veterans Health Administration (VHA).
All necessary preventive care, hormone therapy,
mental health services, preoperative evaluation, and
postoperative care are now available to veterans. The
VHA does not provide for transitionrelated surgeries.
In some states, incarcerated individuals may be
allowed to have prescribed hormones. Only one state
(California) currently has any provision for
transition-related surgeries for the incarcerated.
Legal Challenges in Later Life and at
End of Life
Later-life and end-of-life challenges provide many
complex scenarios for those who do not identify as
transgender. For those so identified, this time period
may become even more complex and difficult.
Transgender status can have a profound effect on
many later-life and end-of-life facets. Research study
data show that the trans-identified population as a
whole is significantly unprepared for any sort of end-
of-life issue, with less than 30% of survey
respondents having advance directives or powers of
attorney in place. Steve Rothaus’s 2014 news story
in the Miami Herald, about a male-tofemale
transperson who, against her wishes, was buried as a
man, illustrates the degree of significance in having
advance directives, living wills, power of attorney,
and health care power of attorney in place. Legal
documents should detail the trans elder’s wishes
should they be unable to speak for themselves, detail
final wishes, state who has control of the body, detail
visitation rights at any medical facility, provide for
one person to speak for the elder in the event that
legal and medical decisions need to be made, and
protect the trans elder should family relationships be
strained. Other legal documents impact partners and
families. Trans elders need to have carefully crafted
wills and estate plans in place to protect any
partnerships that developed during their lives. Wills
also speak to how possessions will be distributed,
and these are important, as families of choice are not
protected legally without such documents. Insurance
and social security can be problematic due to
marriage laws and name changes.
End-of-Life (EOL) Factors in Aging
Given the long history of negative interactions with
the health care system, trans elders are very reticent
to make use of traditional elder care facilities. Nearly
 Aging and Transgender People 75

40% of Witten’s survey respondents stated that they Funeral ceremonies can become challenging not just
had little to no confidence that they would be treated from the perspective of how to refer to the deceased
respectfully. Respondents stated worries and fears but also from the perspective that some religious
around being given the incorrect drugs, being denied organizations believe that being transgender is a sin
hormones, being denied needed care, physical and and refuse to allow ceremonies to take place in their
verbal abuse, fears of being forced to leave the facilities or to allow the deceased to be buried in
nursing home and becoming homeless, and of not their graveyards. Obituaries can become challenging
being allowed to live out the remainder of their days when one considers how to refer to the gender of the
as their true selves. Additionally, trans elders have deceased. Legal control of the body and of various
expressed fears that their last wishes would not be post-death decisions can also be complex when
carried out. Survey respondents’ concerns revolved considering whether the family of origin versus the
around such things as incorrect name/gender identity family of choice has final legal decision-making
on death certificates and/or gravestones. Others power.
expressed fear that funeral directives would not be
respected. The Miami Herald story by Steve Rothaus
documents denial of last wishes. Autopsy also
Conclusion
represents a challenge as some trans elders are not Aging is a complex process that involves many
out and their true birth sex may be discovered only challenges. Identifying as gender nonconforming
upon autopsy. As a result of these worries, some adds to those challenges. Today’s trans elders have
elders of the community have stated that they are endured a history of violence, abuse, discrimination,
prepared to de-transition (undo as much of the and denial of care. Trans identification can lead to a
previous surgeries and hormone treatments as complex state marked by depression, sadness,
possible), while some individuals have loneliness, anger and frustration, anxiety, regret,
selfeuthanasia plans in place in order to avoid having feelings of loss, and decreased levels of happiness. In
to worry about getting older. addition to psychological stressors, trans and gender-
As death approaches, many factors come into nonconforming people are frequently at increased
play. Pain management (palliative care) may become financial risk. Financial stability may be sacrificed
important, as will hospice care. Given that many due to lack of employment or the
trans elders are fearful of the kind of treatment they
will receive during this period of life, this fear may
lead to dissatisfactory end-of-life experiences for the
dying and their respective family, friends, and allies.
Religious/spiritual/faith needs can become critical
during this time, but may be problematic because of
the transgender identification of the dying person.
Closure events become important for both
individuals who are dying as well as those around
them. Self-identity may be lost due to dementia,
creating a strain for support staff and families.
Delirium may cause confusion and inhibit the ability
to meet someone’s final needs. Much research needs
to be carried out in this area. We also know little
about end-of-life issues for trans elders in Veterans
Affairs facilities or for those who are incarcerated.
For families of trans elders, death can also be
difficult. Numerous gender-related questions become
important. Should the funeral be open/ closed casket
and if so, how should the deceased be dressed?
76
Ally Development and Programming
high cost of surgeries. Loss of a job can undermine a
relationship or family, leading to anger, resentment,
frustration, depression, and isolation. The body of
literature for transgender experiences of later life and
end of life is relatively new and growing. As the
younger cohorts move into middle and old age, many
more questions will need to be answered. There is
still much to learn about patterns and implications of
the aging transgender life course.
Tarynn M. Witten
See also Transgender People and Religion/Spirituality
Further Readings
Finkenauer, S., Sherrat, J., Marlow, J., & Brodey, A. (2012).
When injustice gets old: A systematic review of trans
aging. Journal of Gay & Lesbian Social Services, 24,
311–330.
Fredriksen-Goldsen, K. I., Cook-Daniels, L., Kim,
H.-J., Erosheva, E. A., Emlet, C. A., Hoy-Ellis, C. P., …
Muraco, A. (2014). Physical and mental health of transgender
older adults: An at-risk and underserved population. The
Gerontologist, 54, 488–500. McFadden, S. H., Frankowski,
S., Flick, H., & Witten, T. M. (2013). Resilience and
multiple stigmatized identities: Older transgender/intersex
identified persons reflect on aging. In J. Sinnot (Ed.),
Positive psychology and aging (pp. 247–269).
New York, NY: Springer.
Meier, S. C., & Labuski, C. M. (2013). The demographics of
the transgender population. In D. L. Poston Jr. (Series
Ed.) & A. K. Baumle (Vol. Ed.), International handbook
on the demography of populations: Vol. 5. International
handbook on the demography of sexuality (pp. 289–327).
New York, NY: Springer.
Porter, K. E., Oala, C. R., & Witten, T. M. (2013).
Transgender spirituality, religion & successful aging:
Findings from the Trans MetLife survey. Journal of
Religion, Spirituality & Aging, 25(2), 112–138.
Redman, D. (2011). Fear, discrimination and abuse:
Transgender elders and the perils of long-term care. Aging
Today, 32(2), 1–2.
Rothaus, S. (2014, November 21). Transgender woman dies
suddenly, presented at funeral in open casket as a man.
Miami Herald. Retrieved from http://www
.miamiherald.com
Witten, T. M. (2014). End of life, chronic illness, and trans-
identities. Journal of Social Work in End-of-Life &
Palliative Care, 10(1), 34–58.
Witten, T. M. (2014). It’s not all darkness: Robustness,
resilience, and successful transgender aging. LGBT
Health, 1(1), 24–33.
ALLY DEVELOPMENT AND PROGRAMMING
Allies have been instrumental to many social
movements, including those for LGBTQ rights. The
term ally refers to individuals who engage in social
change efforts in coalition with social groups to
which they do not themselves belong. Allies may
have more social power, status, or privilege than the
group with whom they are allied. However, it is also
possible for alliances to form across different
marginalized social groups. Social change efforts can
include working on one’s own internal biases and
stereotypes (consciousness raising), interventions
(both interpersonal and institutional) designed to
raise awareness of the existence of different groups
and their right to equal treatment, and actions
intended to create broader communities of support
for marginalized people, as well as activism to
change policies and laws. This entry describes who
LGBTQ allies are, how researchers have attempted
to understand them, the development of ally
identities and activism, and intervention programs
designed to foster ally commitments. This research
has taken place almost entirely in the United States;
while some of the general points may translate to
different contexts, others may not.
Allies and LGBTQ Communities
Given the diversity of LGBTQ communities, there
are many possibilities for alliances between different
identity groups. Because space does not permit an
exhaustive overview of all allies in the LGBTQ
context here, we will address those most studied in
the social science literature.
Most often, the term LGBTQ ally is applied to
heterosexual people engaged in social change for
LGBTQ people. However, there is increasing interest
in understanding cisgender allies to transgender
people, and such allies can include cisgender people
who are LGBQ or heterosexual. Further, there are
periods in which alliances across other identity
differences within LGBTQ communities have

developed. For example, during the AIDS crisis,
many lesbians were activists alongside gay men
fighting for recognition of, and increased research on
and treatments for, AIDS. Lesbians could be
considered allies in this context as their personal
stake may sometimes have been different from that
of gay men, as was the degree to which AIDS
directly affected their respective communities (of
course, this also differed along lines of race). There
are also alliances built across class and race
differences that critique mainstream LGBTQ
organizations’ narrow focus on marriage equality, as
opposed to economic justice, or state-sanctioned
regulation of sexuality. These latter two examples
highlight the ways in which conceptualizing alliances
can be difficult within the context of a “community”
that includes diverse sexual and gender orientations,
preferences, and identities, as well as race, class, age,
and (dis)ability differences. This entry focuses on the
better-understood development of heterosexual allies,
with the acknowledgment that many of these
processes may be similar in the development of other
kinds of allies.
Methodological Overview of Research on Allies
Research on ally development has been based
primarily on either school- (K–12) or college-aged
individuals. Most nonstudent samples have included
clinical practitioners, such as therapists and social
workers. Further, the research on heterosexual allies
(and the small body of work on cisgender allies) has
been largely descriptive; there are relatively few
survey-based studies. Therefore, current knowledge
is based largely on first-person, or case-study,
accounts of ally awareness and development, with a
growing body of larger interviewbased or survey
studies. There are two broad ways in which one can
understand the literature on how people become
allies: (a) developmentally focused
Ally Development and Programming
models, which examine ally identity as well as ally
activism, and (b) research on the particular
characteristics, motivations, attitudes, and
experiences that predict ally social change behaviors,
with less consideration of ally identity. Although the
literature does not always make this distinction
77
between identity and behavior, it is an important one,
as discussed below.
Developmental Models of Ally Commitments
Based on existing racial/ethnic, as well as
feminist, identification models, developmental
models examine how LGBTQ ally identity and
commitments unfold across time. They involve
several stages that are presented as both discrete and
linear, although researchers acknowledge that they
are often neither. These stages are usually some
combination of the following: pre-encounter/pre-
consciousness; encounter; immersion; and
integration. These terms are borrowed from William
Cross’s model of Black identity development; they
are not terms that all researchers have used.
Pre-encounter or pre-consciousness is a period
during which the individual may not be aware of,
understand, or care about the oppression experienced
by LGBTQ people. Often, this period is also
characterized by a taken-for-granted quality or
unawareness of one’s privilege. Encounters may
involve an uncomfortable or upsetting event or
experience that raises one’s awareness of LGBTQ
oppression and/or one’s own privilege. For many
allies, this may be when they witness an LGBTQ
friend or family member experience discrimination.
For others, the encounter need not be negative; it
may take the form of a role model, friend, or
exposure to LGBTQ people in general. During the
immersion phase, people may educate themselves
about LGBTQ issues, build networks or friendships
with LTBTQ communities or people, feel alienated
from other heterosexual or cisgender people, or feel
ashamed of or uncomfortable with one’s privilege.
During integration (which may be difficult to
distinguish from immersion), individuals find ways
to enact their commitment to LGBTQ people and
social justice, while also acknowledging their own
position(s) of relative privilege and power.
Ally Development and Programming
This kind of linear, stage-based model of identity
development has been criticized. Lisa Diamond, in
discussing the application of stage-based models to
sexual identity development, has pointed out that
identity processes are more complex in actuality.
Individuals may “skip” some stages; the ordering of
78
stages may differ from person to person; people may
“revisit” or renegotiate stages as they are exposed to
new ideas or new social or political contexts; and the
transition between stages may not be smooth or even
discernable. In fact, empirical research on ally
activists has shown that some people first become
engaged in activism and then develop a political
consciousness around LGBTQ issues, thus
challenging the idea that consciousness always
precedes engagement. Case studies and interview-
based studies allow researchers to explore and
explicate these kinds of dynamic processes more
readily than survey-based research. Therefore, it is
not surprising that most research drawing on these
developmental perspectives has been largely
qualitative and/or has focused on individual accounts
of ally identity development.
Individual-Level Predictors of Ally Commitments
A growing body of work has examined individual
differences associated with ally behaviors (and
sometimes identity). Rather than looking at the
progressive development of ally identity over time,
this research has examined the role of individual-
level differences and experiences in predicting ally
commitments to LGBTQ issues.
Research has identified two broad sets of motives
among heterosexual allies: those based on
fundamental principles (such as commitments to
justice for LGBTQ people, commitment to legal
equality, and a desire to use their own heterosexual
or cisgender privilege on behalf of marginalized
sexual- or gender-identity minorities) and those
based on personal relationships, roles, or experiences
(such as having an LGBTQ family member, or
wanting to share the positive experience of
marriage). Other research has shown that knowing an
LGBTQ person, positive attitudes toward LGBTQ
people, and rejection of heteronormative beliefs are
all associated with LGBTQ ally activism.
Developing Allies Through Programming
Most evaluation research on programs to develop
allies is also based on school-aged and college
students. Programming includes the creation of
“gay– straight” alliances or “safe zones” for young
people,
educating non-LGBTQ people about LGBTQ issues
and communities via intergroup dialogue classes or
role-playing workshops, and “speaker panels” where
members of the LGBTQ community share their
experiences. A few universities also now offer
training or workshops with the explicit aim of
teaching individuals to be LGBTQ allies.
The goals of these programs may vary, but
generally include at least one of the following: to
challenge stereotypes about sexual- and gender-
identity minorities; to raise awareness of and
challenge the stigmatization and discrimination faced
by LGTBQ people; to raise awareness of
heterosexual/cisgender privilege; to teach people
how to recognize and act to stop discrimination,
bullying, or harassment; and to foster opportunities
for LGBTQ and nonLGBTQ people to interact and
talk with one another. Research has shown that these
interventions increase participants’ positive attitudes
and empathy toward LGBTQ people, their awareness
of anti-LGBTQ bias and heterosexual/cisgender
privilege, and their confidence in their ability to
recognize and interrupt harassment or bullying. A
challenge for research in this area is the question of
whether people who seek out these (usually
voluntary) experiences are more likely to want to
become allies in the first place. Therefore, the degree
to which programs would be effective with people
who are actively resistant to becoming allies is
unclear.
Conclusion
Allies have been of particular interest to researchers
not only because of the important role that they play
in social movements, but also because they are often
working to create social change that may reduce
some of their privilege. Further, the costs associated
with being stigmatized by association with
marginalized groups can be high. It is important to
find ways to raise consciousness without triggering
defensiveness and to acknowledge realistic fear of
stigmatization. Perhaps more important is the need to
provide potential allies with tools to act. Raising
awareness of bias against LGBTQ communities
without also teaching allies how to challenge that
bias may result in passive bystanders, not actors.
An important limitation in current research on
allies is that there is often not a distinction made
between ally identity and behaviors. Identity, while
predictive of behavior (depending on its specificity),
is distinct from it. Therefore, positive attitudes

toward LGBTQ people and feeling like an ally may
be different from acting as an ally. Most studies
examining behavioral outcomes have not tested
whether these same people identify as LGBTQ allies.
Practically, the distinction may not always be
important, but it may help us understand the
difference between sympathetic bystanders and
people who actually act on their beliefs.
Finally, most of the focus to date has been on
heterosexual allies. Given within-group differences
along lines of gender identity, race, class, age, and
(dis)ability, there is much work to be done to
increase our understanding of how alliances within
LGBTQ communities develop. The diverse needs of
different LGBTQ people, and the historical
inattention to these differences within LGBTQ social
change movements, means that there is promise for
forging new alliances that are not yet well
understood.
Nicola Curtin and Glenda M. Russell
See also Activists in College; Ally Experience;
CrossCategory Friendships; Gay–Straight Alliances
(GSAs); LGBTQ Social Movements (Assimilation vs.
Liberation)
Further Readings
Dessel, A. B., Woodford, M. R., Routenberg, R., & Breijak,
D. P. (2013). Heterosexual students’ experiences in sexual
orientation intergroup dialogue courses. Journal of
Homosexuality, 60(7), 1054–1080.
Evans, N. J., & Broido, E. M. (2005). Encouraging the
development of social justice attitudes and actions in
heterosexual students. New Directions for Student
Services, 2005(110), 43–54.
Ally Experience
Fingerhut, A. W. (2011). Straight allies: What predicts
heterosexuals’ alliance with the LGBT community?
Journal of Applied Social Psychology, 41(9), 2230–2248.
Myers, D. J. (2008). Ally identity: The politically gay. In
J. Reger, D. J. Myers, & R. L. Einwohner (Eds.), Identity
work in social movements (pp. 167–188).
Minneapolis: University of Minnesota Press.
Russell, G. M. (2011). Motives of heterosexual allies in
collective action for equality. Journal of Social Issues,
67(2), 376–393.
Wernick, L. J., Dessel, A. B., Kulick, A., & Graham, L. F.
(2013). LGBTQQ youth creating change: Developing
79
allies against bullying through performance and
dialogue. Children and Youth Services Review, 35(9),
1576–1586.
Woodford, M. R., Kolb, C. L., Durocher-Radeka, G., &
Javier, G. (2014). Lesbian, gay, bisexual, and
transgender ally training programs on campus: Current
variations and future directions. Journal of College
Student Development, 55(3), 317–322.
A LLY E XPERIENCE
Allies of the LGBTQ movement are heterosexually
identified people who support the rights of LGBTQ
people and who are active in that support.
Increasingly, LGB people who identify as cisgender
and who actively support transgender (trans) people
and their rights are also referred to as allies—in this
case, allies to the trans community. Allies to the
LGBTQ community have a very broad range of
experiences. The specific geographical and political
context within which allies engage exerts a large
influence on the tasks they are called upon to
undertake in counteracting anti-LGBTQ stigma, the
skills they draw on, the social resources they have at
their disposal, and the nature of the demands and
difficulties they encounter as they carry out their
work. This entry describes the range of activities that
allies undertake and the experiences they encounter,
including a consideration of the impact of the
political and social context on their involvement;
motives that facilitate and sustain ally work; the role
of stigma and stigma management; stressors of ally
work and resources to address these; and the rewards
of being an ally.
Ally Experience
The Importance of Context
Being an ally may be relatively easy in some
contexts, and may even reap social rewards. In other
contexts, working as an ally may expose someone to
a great deal of negative feedback and even danger.
To illustrate: Consider the situation of two allies
undertaking the same activity, such as writing a letter
to the editor of the local newspaper supporting
passage of a proposed hate-crimes law that includes
sexual orientation and gender identity protections.
The first ally lives and works in a small town in a
part of the country that is very politically
conservative. The second ally lives in a liberal urban
80
area in a region with generally liberal politics. The
two allies undertake the exact same activity, but the
social and political meaning of their action and its
potential to generate positive and negative reactions
from others differ markedly.
Generally, the degree of difficulty and the social
or even physical risk of allies’ roles depend on the
climate for LGBTQ people in that region. However,
there may be important exceptions. Sometimes allies
who are working in a relatively benign context may,
like LGBTQ people themselves, encounter
unexpected and seemingly incongruous homophobic
acts that can cause major disruption or distress.
Conversely, allies, again like LGBTQ people, may
find themselves in the midst of a virulently anti-
LGBTQ social climate, and yet encounter a touching
degree of support and concrete aid, sometimes from
unexpected sources.
Motives That Facilitate and Sustain Ally
Engagement
Allies’ experiences cannot be disentangled from the
motives that prompt them to engage in ally behavior
and that sustain their work in this area. Research has
identified two primary categories of motives
supporting ally behavior among heterosexual
persons. The first category comprises motives
associated with core values. Allies in this group tend
to articulate their motives as one aspect of a larger
understanding of and commitment to social and
political change. Prominent among the principles
described by allies as prompting them to act as allies
are justice, civil rights, patriotism, religious beliefs,
moral principles, and a felt need to make good use of
the privilege that comes with being in
nonstigmatized groups relative to sexual orientation
and gender identity. Allies in this general category
often engage in social action for multiple causes over
time.
Motives in the second general category are based
on specific roles and relationships. Allies in this
group often exhibit shorter-lived engagement in ally
activities, frequently describing more situationally
driven involvement. Among the points of emphasis
offered by allies in this general category are the
following: professional roles that result in their being
drawn into acting as an ally; relationships with
LGBTQ family members and friends; a desire to
share with others the riches of marriage; efforts to
gain closure on past experiences; efforts to transform
guilt through action; and anger related to perceived
unfairness in the social treatment of LGBTQ people.
Research suggests that the particular motives that
influence allies to become involved in collective
action for LGBTQ rights are not necessarily the same
as the motives that sustain engagement. An ally, for
example, may initially get involved because a gay
friend asks her to do so, in which case she is acting
on the basis of a relationshipbased motive. She may
then have increased contact with LGBTQ people
from whom she learns about the negative impact of
the stigma they face. This information provides
another level of motivation that may allow her to
draw on a long-term commitment to justice, which
sustains her engagement in pro-LGBTQ activism.
In addition to basic motivations to engage in
collective action for LGBTQ equality, certain
factors, both intrinsic and extrinsic to the person,
may serve to facilitate an individual’s participation as
an ally. These facilitating factors include a sense of
self-efficacy, the desire to make a difference,
willingness to take risks, tolerance for ambiguity, a
spouse/partner who supports the ally’s activism, and
the presence of a definable threat to the LGBTQ
community. Many allies report having held pro-
LGBTQ attitudes for a period of time before
becoming active in working for LGBTQ equality.
They further report, however, that it was difficult to
know how to get involved in collective action. In
many cases, being asked to undertake a specific task
was all that was needed to spur them to action.
Stigma and Stigma Management
Courtesy stigma—or as it has been termed more
recently, stigma contagion—sometimes adds a
degree of complexity to the experience of being an
ally. This sort of stigma occurs when individuals
who support the interests of a stigmatized group are
themselves seen in a very negative light. In fact,
these allies may be treated with an antagonism
similar to that directed toward members of the
stigmatized group. Allies, therefore, may—by virtue
of their activism—court the twin dangers of being
mistreated in a way that mirrors how
LGBTQ people are treated and having some of the
privilege normally reserved for heterosexuals
withdrawn. Because sexual orientation is typically

not a visible characteristic, heterosexual allies may
also face a reaction that is not usually encountered by
allies to stigmatized groups whose membership is
visibly apparent. That is, heterosexual and cisgender
allies’ sexual orientation and/or gender identity may
be called into question—and with it, their honesty—
by others who cannot understand that a heterosexual
and/or cisgender person would risk taking a stand in
support of a stigmatized group to which they do not
belong.
When faced with courtesy stigma or stigma
contagion, allies are well advised to call upon
strategies that LGBTQ people also can use when
confronting anti-LGBTQ bias. It is helpful for
members of both groups to adopt what has been
termed a “movement perspective,” which includes a
political analysis of their encounters with bias. This
perspective allows them to see their own negative
experiences with bias as less a personal problem and
more a manifestation of a collective social bias—that
is, sexual prejudice (an umbrella term for
homophobia, heterosexism, biphobia, transphobia,
and genderism). The movement perspective serves to
locate the problem at its origins— that is, in the
attitudes and behaviors that convey
Ally Experience
81
stereotypes when their involvement is sustained,
involves working with LGBTQ people together as
equals, and entails working toward a common goal.
Allies who have been relatively successful at this
process report several other factors that have helped
them overcome their automatic biases about LGBTQ
people. One strategy is to approach sexual prejudice
as a pervasive phenomenon that everyone needs to
work through and to see this as a process, not a cause
for shame. Some allies report that it is especially
helpful to have one or two members of the LGBTQ
community of whom they can ask questions,
especially questions about the LGBTQ community
that are generally not discussed. Notably, allies
indicate that when they are criticized for their lack of
knowledge, they are less likely to continue their
engagement in activism.
Stressors and Rewards of Ally Involvement
In addition to the challenges already described, allies
report a number of stresses associated with their
status and work as allies. These stressors include the
necessity of subjecting their own longterm beliefs to
scrutiny, strains with others in their

dislike for people based simply on group

membership. Further, this perspective, with its
identification of sexual prejudice as a collective
problem, allows allies to employ collective solutions
— working with others, developing political analyses
with others, and receiving support from others. In
addition to cultivating a movement perspective, allies
can help to sustain their commitment to their
collective action by taking periodic breaks from
more intense forms of activism.
Another source of complexity for allies is
confronting the internalized stereotypes,
misconceptions, and negative attitudes about
LGBTQ people that are part of the cultural
knowledge base that virtually everyone learns over
the course of his or her life. It appears that this task is
easier for allies than for many others, in part because
their involvement as allies provides extensive contact
with LGBTQ people, providing the opportunity for
them to acquire facts about LGBTQ individuals and
their communities. Allies’ contact with LGBTQ
people is especially helpful in challenging
82 Antigay Ballot Initiatives (and LGBTQ Activism)
social communities who disagree with their ally
activities, and guilt about past participation in
prejudicial feelings and behaviors.
On the other hand, allies are able to identify a
number of resources upon which they draw for their
ally work. These resources include learning facts
about the LGBTQ community; finding consistency
between their religious beliefs and their ally
behavior; having control over their own timing in
pursuing ally work; finding a balance between
recognizing sexual prejudice in the world and
working through one’s own internalized sexual
prejudice; support from family and friends;
recognizing areas in which they are privileged; and
refusing to allow anti-LGBTQ rhetoric to define the
terms of the debate about LGBTQ rights.
Despite the complexities and challenges
associated with being an ally, many allies have no
difficulty identifying the rewards that ensue from
their participation in collective action for LGBTQ
equality. Prominent among those rewards are
increased empathy, enhanced personal power, feeling
gratified by the opportunity to be of service,
enhanced courage, greater creativity, an expanded
sense of humanity, deepened religious beliefs, and
increased depth in personal relationships.
While research with allies in the cause for
LGBTQ rights suggests some general patterns, allies
—like members of any group—may differ greatly
from each other in many respects; no two are alike.
LGBTQ people who work with allies are advised to
get to know the unique aspects of those allies who
are a part of their movement.
Glenda M. Russell and Nicola Curtin
See also Activists in College; Ally Development and
Programming; Community Climate; Cross-Category
Friendships; LGBTQ Social Movements (Assimilation
vs. Liberation)
Further Readings
DiStefano, T. M., Croteau, J. M., Anderson, M. Z., Kampa-
Kokesch, S., & Bullard, M. A. (2000). Experiences of
being heterosexual allies to lesbian, gay, and bisexual
people: A qualitative exploration. Journal of College
Counseling, 3(2), 131–141.
Duhigg, J. M., Rostosky, S. S., Gray, B. E., & Wimsatt, M.
K. (2010). Development of heterosexuals into
sexualminority allies: A qualitative exploration. Sexuality
Research & Social Policy, 7(1), 2–14.
Fingerhut, A. W. (2011). Straight allies: What predicts
heterosexuals’ alliance with the LGBT community?
Journal of Applied Social Psychology, 41(9), 2230–
2248.
Horne, S. G., Rostosky, S. S., & Riggle, E. D. B. (2011).
Impact of marriage restriction amendments on family
members of lesbian, gay, and bisexual individuals: A
mixed-method approach. Journal of Social Issues, 67(2),
358–378.
Myers, D. J. (2008). Ally identity: The politically gay. In
J. Reger, D. J. Myers, & R. L. Einwohner (Eds.),
Identity work in social movements (pp. 167–188).
Minneapolis: University of Minnesota Press.
Russell, G. M. (2011). Motives of heterosexual allies in
collective action for equality. Journal of Social Issues,
67(2), 376–393.
AMERICAN INDIAN SEXUALITIES
See Native American/First Nations
Sexualities
ANTIGAY BALLOT INITIATIVES (AND
LGBTQ ACTIVISM)
One common tactic of those who oppose LGBTQ
rights in the United States is the use of referendum
and initiative processes to either pass new antigay
laws or rescind existing LGBTQ-positive laws.
These antigay ballot initiatives happen at the
municipal or state level and have been an effective
strategy for the religious Right, as the initiatives are
frequently successful. This entry reviews the history
of antigay ballot initiatives, the types of measures
used, and their effects on the LGBTQ movement and
community.
Historical Background
The use of antigay ballot measures in the United
States began quietly. In the 1970s, gay, lesbian, and
bisexual organizers were quietly passing municipal
nondiscrimination ordinances that provided
protections in housing, employment, and/or public
accommodations based on sexual orientation.
Because it was too challenging to pass a

nondiscrimination law at the federal or state level,
these municipal and county ordinances allowed for
some local protections for gay, lesbian, and bisexual
individuals. By 1974, 14 of these ordinances had
been passed in municipalities across the country with
little opposition. However, in Boulder, Colorado, in
1974, members of the community opposed to such an
ordinance collected petitions to put it on the ballot in
a referendum. In a referendum, voters get to decide
whether or not an ordinance remains law. In this
case, Boulder voters struck down the new ordinance
with a landslide of opposition to it.
This same process was repeated a few years later
in Dade County, Florida, but with much national
attention and fanfare. Celebrity Anita Bryant, former
Miss America contestant and spokesperson for
Florida orange juice, was a leader in opposing a Dade
County nondiscrimination ordinance. Bryant and her
Save Our Children campaign became quickly known
for their rhetoric about the dangers of gay rights,
specifically their arguments about religious rights
and influence on children, implying, for example,
that gay men were pedophiles looking to recruit
children. The national visibility of the campaign and
the victory in Dade County for Bryant’s organization
emboldened the growing religious Right, a pro–
traditional family conservative movement mobilized
in opposition to feminism, abortion, secularization,
and gay rights, among other issues.
Shortly after Dade County’s ballot measure,
California state senator John Briggs, who worked
with Bryant on her Florida campaign, sponsored the
California Defend Our Children Initiative, a response
to a 1975 California law that protected gay and
lesbian teachers from being fired. Popularly called
the Briggs Initiative, this new law would have
required the firing of teachers who were lesbian or
gay, or who “advocated homosexuality.” Rather than
a referendum to overturn an existing law, this
initiative was an attempt to write a new antigay law
through the ballot measure process. Overwhelmingly
opposed by teachers’
Antigay Ballot Initiatives (and LGBTQ Activism)
unions and then-governor Ronald Reagan, the Briggs
Initiative lost at the ballot box by a million votes.
These two forms of ballot measures—the
referendum and the initiative—have persisted as the
most common forms of antigay ballot measures since
1974. Between 1974 and 2013, 172 such measures
83
were put on the ballot, mostly by the religious Right.
The religious Right attempted at least another 150
ballot measures, circulating petitions and running
campaigns that did not collect enough signatures to
get a referendum or initiative on the ballot. Overall,
however, these ballot measures have been a
successful tactic for the religious Right to roll back
LGBTQ rights, as 70% of those ballot measures
resulted in either rescinding an existing LGBTQ
rights law or creating a new antigay law.
Types of Ballot Measures
Antigay ballot measures vary in their focus. Forty
percent of these ballot measures are attempts to
rescind municipal or state nondiscrimination laws
that include sexual orientation or gender identity/
expression. Nondiscrimination protections based on
gender identity/expression serve to protect
transgender people and other individuals with
nonnormative gender expression. Almost one quarter
of these ballot measures are legal restrictive ballot
measures, which are attempts to prevent all future
LGBTQ nondiscrimination laws in a given state or
municipality. An additional 30% of all ballot
measures are related to same-sex marriage or
domestic partnerships. State constitutional
amendments to ban same-sex marriage are the most
common form of these relationship-recognition
ballot measures. These same-sex marriage bans are
put on the ballot by the legislature or a citizen
petition process, depending on the requirements of
each state. This form of ballot measure is also the
most successful type of ballot measure, as the
religious Right has a higher success rate with these
than any other kind. There have also been ballot
measures on other subjects that impact the LGBTQ
movement, including a spate of ballot measures
about HIV/AIDS in California in the 1980s.
Although these ballot measures have been
sponsored from Hawaii to Maine, they are more
common in states and municipalities with a lenient
referendum and initiative process and a strong
religious Right presence. Thus, 64% of all ballot
measures are in the following seven states, listed in
order of frequency from highest to lowest: Oregon,
California, Michigan, Florida, Maine, Washington,
and Colorado. States like Oregon and California have
high rates of initiatives in general as they have a
straightforward petitioncollection process and little
84 Antigay Ballot Initiatives (and LGBTQ Activism)
judicial or legislative review of ballot initiatives. In
some states with no referendum and initiative
mechanism, state legislatures have sponsored
constitutional amendments that then must go to a
popular vote. This tactic is used most commonly to
pursue the enactment of same-sex marriage bans. It
has been used in states such as South Dakota,
Montana, and Louisiana, which have little history of
ballot measure campaigns.
The religious Right and the LGBTQ movement
typically go head-to-head in these ballot measure
campaigns. Both movements mobilize followers,
recruit volunteers, attract press attention, and frame
their arguments about the ballot measure through
political ads, flyers, and commercials.
Major Ballot Measures
Several ballot measures that have been important
milestones in the use of these methods by the
religious Right are Oregon Ballot Measure 9 (1992),
Colorado Amendment 2 (1992), California
Proposition 8 (2008), and the November 2012
initiatives.
Oregon Ballot Measure 9
The year 1992 was an important turning point in
the history of antigay ballot measures. Religious
Right campaigns in Oregon and Colorado sponsored
similar antigay ballot measures that were the first
major legal-restrictive initiatives. These initiatives
were an attempt to legally constrain the LGBTQ
movement by eliminating all existing and future
nondiscrimination laws along with general
“government promotion of homosexuality.”
In Oregon, the Oregon Citizen’s Alliance (OCA),
led by vocal antigay activist Lon Mabon, sponsored
legal-restrictive initiatives in the cities of Corvallis
and Springfield in early 1992, which were test cases
for the Oregon Ballot Measure 9 statewide initiative
in November 1992. Ballot Measure 9 was one of the
most extreme antigay initiatives in that it eliminated
all existing and future nondiscrimination laws, along
with requiring the firing of lesbian and gay teachers
in public schools (along with anyone openly
supportive of lesbian, gay, bisexual, transgender, or
queer rights), and the removal of all books approving
of homosexuality. Ultimately, Oregon voters rejected
Ballot Measure 9; however, Mabon and the OCA
persisted in sponsoring additional legal-restrictive
initiatives (often called “the son of 9”) at the state
and municipal levels for the next two years, passing
these initiatives in more than 30 towns across the
state. For the LGBTQ movement, the Ballot Measure
9 campaign was one of its first big victories, and
some of the tactics used in Oregon, such as door-to-
door canvassing and voter identification, were used
in campaigns across the country.
Colorado Amendment 2
In the same 1992 election, Colorado antigay
activists sponsored their own statewide
legalrestrictive initiative. The organization Colorado
for Family Values (CFV) sponsored Amendment 2, a
legalistic initiative that eliminated future and existing
gay rights laws in the state. CFV had originally
mobilized to defeat an ordinance in conservative
Colorado Springs. Colorado Amendment 2
distinguished between “true” minorities and gays by
using legal language about “protected classes” and
“minority status.” CFV innovated with a secular,
legalistic argument about LGBTQ rights that became
widely used by religious Right campaigns across the
country. This language included a legalistic argument
about how lesbian and gay rights were “special
rights” that usurped the rights of “true minorities”
like African Americans. Through this argument, the
religious Right was able to appeal to voters who were
(1) ambivalent about civil rights and (2) African
American community members.
Colorado voters passed Amendment 2, which led
to an almost immediate legal challenge. This legal
challenge resulted in a repeal of the Colorado
Amendment 2 law by the U.S. Supreme Court in the
1996 case Romer v. Evans. This ruling invalidated
state legal-restrictive initiatives but also affirmed the
legitimacy of sexual orientation as a minority-group
category. This case set an important precedent for
future Supreme Court rulings, including the abolition
of sodomy laws in Lawrence v. Texas (2003) and the
establishment of same-sex marriage rights in some
states in United States v. Windsor (2013).
California Proposition 8
In early 2008, the California Supreme Court
legalized same-sex marriage, and religious Right
organizations quickly collected petitions to put a

constitutional amendment on the ballot to ban same-
sex marriage in the state. When Proposition 8 was
voted on in November 2008, more than 18,000 same-
sex marriages had already been conducted in the state
of California.
There were two things that were historic about
California Proposition 8. The first was that it was the
first time there were both legal same-sex marriages in
a state and a ballot measure to rescind them. It
received a great deal of national attention and
funding due to this set of circumstances. Second, the
size and scale of the campaigns was remarkable. The
religious Right campaign to pass Proposition 8
successfully defeated the largest LGBTQ campaign
in U.S. history, a campaign that dwarfed any other
ballot measure campaign that came before it. There
were protests across the country when Proposition 8
was passed, and it inspired the play 8 by Dustin
Lance Black. Like Colorado Amendment 2, this
proposition was declared unconstitutional in the
federal courts, and California same-sex marriages
resumed in June 2013.
The November 2012 Initiatives
Same-sex marriage bans were the most successful
ballot measures for the religious Right, passing by
large margins in almost every state except for one
same-sex marriage ban in Arizona and a domestic
partnership referendum in the state of Washington.
The success of the religious Right in passing ballot
measures related to same-sex marriage came to a
Antigay Ballot Initiatives (and LGBTQ Activism)
head in the November 2012 election when the
LGBTQ movement won four major statewide ballot
measures about marriage. All four votes were
historic wins. In Minnesota, voters defeated a
proposed constitutional amendment aimed at banning
same-sex marriage, which allowed the later
legalization of same-sex marriage in the state. In
Maryland and Washington, where the state
legislatures had passed same-sex marriage measures,
voters elected to retain legal same-sex marriage
through referendum. And in another first, Maine
voters legalized same-sex marriage through an
initiative that was sponsored by the LGBTQ
movement.
85
Impact on the LGBTQ Movement and
Community
These ballot measures have impacted the LGBTQ
movement and community in multiple ways. First,
running large-scale campaigns puts a strain on
movement and community resources, time, and
energy. Campaigns require tremendous resources in
a concentrated period of time. Even a municipal
ballot measure may require more than 10,000
volunteers to make phone calls, go door-to-door to
talk to voters, put up yard signs, and organize rallies.
It took the LGBTQ movement decades to build
enough organizing skill, grassroots strength, and
funding to win campaigns, and even then same-sex
marriage bans have been difficult to defeat. The local
nature of ballot measure campaigns means that the
strength of a campaign is dependent upon the
resources of existing organizations in a given area.
Early lesbian and gay ballot measure campaigns
struggled with marshalling enough resources and
funding to run successful campaigns. This demand
for resources in ballot measure campaigns can cause
strain for social movements, drawing resources away
from organizations that are already strapped for cash.
Then these funds often disappear into thin air as
political ads or consulting fees rather than fueling
durable social movement organizations. These ballot
measures can also distract social movement
organizations from existing projects; for example, in
many states same-sex marriage bans interrupted
work on anti-bullying legislation or
nondiscrimination laws. Resources had to be diverted
to the most urgent pressing issue, an impending
ballot measure.
Campaigns also require a level of consensus about
tactics that can be challenging for any social
movement, but particularly challenging for one as
diverse as the LGBTQ movement. These campaigns
tend to increase movement dissent and marginalize
direct action and queer activism. Queer activism
challenges campaign work by advocating for the
importance of proud, diverse representations of the
LGBTQ community. In many campaigns, if LGBTQ
lives are represented at all, they are typically White,
gender-normative, middleclass gay men or lesbians
in monogamous relationships. In so representing the
LGBTQ community, diversity within the movement
is stifled and community members who are less
palatable to mainstream voters—such as drag queens,
transgender women, or leathermen—are hidden from
86 Antigay Ballot Initiatives (and LGBTQ Activism)
view. In addition, there are frequently tensions over
racial coalition building during ballot measure
campaigns that exacerbate existing tensions and
racial marginalization within the LGBTQ movement.
The effort that goes into fighting antigay
initiatives is rarely rewarded with success. The
referendum and initiative processes are unkind to
minority rights, particularly civil rights to protect
unpopular minorities. In areas where LGBTQ rights
are unpopular, even the most diligent LGBTQ
campaign cannot succeed. For example, even the
most effective campaign to fight same-sex marriage
bans had little success until there was a dramatic shift
in public opinion about same-sex marriage. This
situation, in which LGBTQ organizers and
volunteers work tirelessly for a campaign that loses,
can be demoralizing and challenging. At the end of a
campaign, particularly a losing campaign, there may
be little to show for all the resources used. For
example, in many campaigns to fight same-sex
marriage bans, the campaign aired ads that framed
the issue as a constitutional issue with little mention
of gay or lesbian lives. At the end of the campaign,
these ads were often criticized for taking money from
the community but not contributing to social
movement goals of acceptance for LGBTQ lives.
Finally, there is a psychological toll for LGBTQ
community members during ballot measure
campaigns. Religious Right campaigns often rely on
existing homophobia or transphobia in the local
population in order to win a campaign. Early
religious Right campaigns relied on messaging about
gay men as sexual predators, which was transformed
in the 1990s into legalistic arguments about “special
rights.” Same-sex marriage ban campaigns often
emphasize the benefits of children having one mother
and one father, along with the sanctity of marriage
and concerns about the teaching of samesex marriage
in elementary schools. Since the late 1990s, an
increasing number of religious Right campaigns to
rescind municipal nondiscrimination laws included
arguments about transgender individuals, specifically
transgender women. These arguments frame
transgender women as “men in dresses” trying to
invade the bathrooms of women and children. The
proliferation of these homophobic and transphobic
arguments can be psychologically painful for
LGBTQ residents and create a hostile and at times
dangerous community to live in.
Overall, these ballot measures are an integral part
of the movement for LGBTQ rights. They are a tactic
used by the religious Right to stall the progress of the
movement, and they have had a profound impact on
LGBTQ movements and communities across the
country.
Amy L. Stone
See also Defense of Marriage Act (DOMA);
Discrimination Against LGBTQ People, Cost of;
Discrimination Against LGBT People in the Public
Sector; Employment Non-Discrimination Act (ENDA);
Housing, Protection Against Discrimination in; LGBTQ
Social Movements (Assimilation vs.
Liberation); Marriage Equality, Landmark Court
Decisions; No Promo Homo Policies; Transgender
Inclusion in the LGBTQ Rights Movement; Workplace
Discrimination
Further Readings
Fejes, F. (2008). Gay rights and moral panic: The origins of
America’s debate on homosexuality. New York, NY:
Macmillan.
Fetner, T. (2001). Working Anita Bryant: The impact of
Christian anti-gay activism on lesbian and gay
movement claims. Social Problems, 48(3), 411–428.
Fetner, T. (2008). How the religious Right shaped lesbian
and gay activism. Minneapolis: University of Minnesota
Press.
Gallagher, J., & Bull, C. (1996). Perfect enemies: The
religious Right, the gay movement, and the politics of
the 1990s. New York, NY: Crown.
Russell, G. M. (2000). Voted out: The psychological
consequences of anti-gay politics. New York, NY:
New York University Press.
Stein, A. (2001). The stranger next door: The story of a small
community’s battle over sex, faith, and civil rights.
Boston, MA: Beacon Press.
Stone, A. L. (2012). Gay rights at the ballot box.
Minneapolis: University of Minnesota Press.
ANXIETY
This entry provides an overview of the experience of
anxiety among sexual minorities. First, it discusses
disparities in anxiety disorders related to sexual

orientation, including specific anxiety-provoking
situations for different groups of sexual minorities.
Next, it reviews etiological models for the
development and maintenance of anxiety in these
populations. The etiological models describe some of
the unique risk factors for anxiety and consequences
of anxiety in these populations. Additionally,
treatment considerations for mental health
professionals who work with sexual-minority clients
are reviewed. Special attention is given to social
anxiety disorder, given that it has received the most
empirical attention among sexual minorities and it
may be particularly relevant to these populations.
Given the paucity of research specifically focused
on anxiety among gender minorities, this entry
focuses primarily on sexual minorities. A section of
this entry is devoted to anxiety among transgender
individuals; readers are encouraged to consult
specific entries in this volume on gender minorities
for more nuanced discussions of their unique
experiences.
Sexual-Orientation-Related Disparities in
Anxiety Disorders
Population-based studies have documented higher
rates of anxiety disorders among sexual minorities
Anxiety
87
socially anxious individuals tend to perceive social
interactions as more threatening than non-socially
anxious individuals, and their symptoms are
maintained by their fear of negative evaluation.
In order to receive a diagnosis of social anxiety
disorder, an individual must recognize that his or her
fear is excessive or unreasonable. This has led
scholars to question the appropriateness of the
diagnosis for sexual minorities, given that their fears
of negative evaluation and rejection due to their
sexuality are often realistic possibilities. Sexual
minorities are at increased risk for experiencing
discrimination and violence as a result of their
stigmatized social status. Even for those who do not
personally experience discrimination or violence, the
general knowledge of stigma and prejudice related to
sexual-minority identities can lead to concerns about
negative evaluation, rejection, and possible
discrimination. Thus, regardless of one’s personal
experiences with discrimination or violence, sexual
minorities may learn to be vigilant toward cues of
potential rejection. In sum, among sexual minorities,
anxiety in social situations may be the consequence
of realistic possibilities of discrimination rather than
an indication of a psychiatric disorder.

compared with heterosexuals, including panic

disorder, agoraphobia, obsessive-compulsive
disorder, generalized anxiety disorder, and social
anxiety disorder (also referred to as social phobia).
Although most of these studies have focused on
adults, sexual-orientation-related disparities in
anxiety have been demonstrated as early as middle
school (approximately 11 to 13 years old). This
suggests that sexual minorities are at increased risk
for anxiety compared with heterosexuals, and that
this risk begins relatively early in life and extends
into adulthood.
Among the anxiety disorders, social anxiety
disorder is one of the most common and has received
the most attention among sexual minorities. Social
anxiety disorder refers to an extreme fear of social or
performance situations that involve exposure to
unfamiliar people or possible judgment by others.
Socially anxious individuals fear that they will act in
a way that will be embarrassing or that others will be
able to notice their anxiety symptoms. Further,
88
Anxiety gender and sexual orientation. Gay men tend to
experience anxiety in situations that involve mostly
or exclusively heterosexual men, such as in locker
In an effort to accurately characterize the anxiety
rooms at gyms or while watching sports with other
that sexual minorities experience, the construct of
men. Given that these situations often involve
rejection sensitivity has been expanded to explain the
stereotypical behavior of heterosexual men, gay men
difficulties that gay men often experience in their
may worry that their sexual orientation will be
interpersonal functioning. Rejection sensitivity refers
discovered or that others will react negatively to their
to the extent to which one anxiously expects to be
sexual orientation. Sexual-minority men are also at
rejected based on one’s stigmatized identity. It shares
risk for experiencing discrimination from medical
some features with social anxiety, such as concerns
professionals, given assumptions that gay and
about the reactions of others, thoughts about
bisexual men have HIV/AIDS. Thus, sexualminority
rejection, and emotional arousal in response to
men may experience anxiety in medical contexts,
interpersonal situations. However, rejection
such as getting blood drawn or having a physical
sensitivity is unique in that it acknowledges the
examination. In contrast, sexual-minority women are
realistic concerns about rejection that minority group
at risk for being sexually objectified by heterosexual
members may have. Thus, the anxiety that sexual
men. Heterosexual men often eroticize female same-
minorities experience in social situations may reflect
sex sexual behavior and they may proposition sexual-
realistic concerns based on their experiences with
minority women to have sex with them and another
and knowledge of societal stigma rather than a
female. Thus, sexualminority women may experience
psychiatric disorder. However, even if the anxiety is
more anxiety in situations that involve heterosexual
rooted in the realistic possibility of rejection or
men, given the possibility that they may be sexually
discrimination, it may be out of proportion to a given
propositioned. Finally, bisexual individuals may
situation. For instance, if a sexual-minority
experience anxiety among heterosexuals as well as
individual is anxious about the possibility of being
lesbians and gay men, given that they experience
rejected in a situation that involves people who he or
stigmatization and discrimination from both
she knows are accepting of sexual minorities, then
communities.
such anxiety may no longer reflect a realistic
possibility in that situation. Although sexual-
orientation-related rejection sensitivity was initially Etiological Models for Anxiety
applied to gay men, it has since been extended to
address the unique experiences of other sexual- The minority stress theory is the predominant
minority groups, including lesbians and bisexual conceptual framework for understanding why sexual
women. minorities are at increased risk for psychiatric
disorders, including anxiety disorders. Minority
stress theory posits that sexual minorities experience
Anxiety-Provoking Situations unique stressors related to their stigmatized social
status, which accounts for their increased risk for
Social interactions can be anxiety provoking for
psychiatric disorders. Several minority stressors
sexual minorities. Similar to other minority group
included in this model may be particularly relevant to
members, sexual minorities can experience increased
anxiety. First, sexual minorities are at increased risk
alertness and vigilance when interacting with
for discrimination and violence compared with
dominant group members, because they may fear
heterosexuals, which in turn are risk factors for
that they will be rejected or discriminated against.
anxiety. Second, sexual minorities learn to anticipate
Further, sexual minorities who try to downplay or
being rejected because of their sexual orientation,
conceal their sexual orientation may experience more
thus leading them to be vigilant for cues of potential
anxiety in social interactions than those who do not,
rejection during interactions with others. Finally,
because they face the possibility of having their
some sexual minorities attempt to conceal their
sexual orientation discovered.
sexual-minority identities in order to avoid potential
The situations in which sexual minorities
negative consequences, which can contribute to
experience anxiety can differ depending on their

ongoing anxiety about whether or not others know
about their sexual orientation.
Although minority stress theory is the prevailing
etiological model for psychiatric disorders among
sexual minorities, a specific etiological model for
anxiety among gay men has been developed. This
model posits that childhood gender nonconformity
and early parental disapproval of self-expression lead
gay men to anticipate negative reactions from others
and to protect against these reactions by downplaying
or concealing their sexual orientation. In turn, these
expectations of rejection and attempts to downplay or
conceal one’s sexual orientation can lead to ongoing
anxiety. The model overlaps with minority stress
theory in its emphasis on expectations of rejection
and sexual orientation concealment in the
development and maintenance of anxiety. However,
it is unique in its emphasis on childhood gender
nonconformity and parental disapproval of self-
expression as early life stressors for many sexual
minorities. Thus, the model provides a
developmental framework for understanding the
etiology of anxiety among sexual minorities. This is
consistent with general etiological models of anxiety,
which emphasize temperament, early stress,
relationships with parents, and perceptions of
environmental control.
Consistent with the model, there are particularly
rigid gender roles for boys, and those who violate
these norms are more likely to be targeted for
discrimination and violence, even from their parents
and other family members. Gay men tend to report
being more effeminate and engaging in more gender
atypical behavior during childhood compared with
heterosexual men. If parents (and others) disapprove
of gender atypical behavior and respond in a punitive
manner, then these boys may go on to develop self-
consciousness in public and, in turn, anxiety. Further,
downplaying or concealing one’s sexual orientation
is a common strategy used by sexual minorities to
cope with the potential for discrimination. For those
who have experienced disapproval of their gender
atypical behavior, they may be particularly likely to
monitor their
Anxiety
behavior in an effort to control who knows about
their sexual-minority identity. However, constantly
deciding whether or not to disclose one’s sexual
89
orientation can be a stressful process, and it can tax
one’s cognitive and emotional resources. Many
sexual minorities also monitor their behavior in an
effort to avoid engaging in behaviors that will be
perceived as gender atypical. For instance, gay men
may try to appear more masculine by monitoring and
attempting to reduce effeminate speech and behavior.
This too can be highly demanding of cognitive and
emotional resources, which can lead to ongoing
anxiety, particularly in social situations.
The model has not been extended to
sexualminority women or bisexual individuals, but it
is likely that some aspects will translate to different
gender and sexual orientation groups. Although
gender atypical behavior is more socially acceptable
among girls than among boys, there is still stigma
associated with it for girls. Thus, for gender atypical
girls who are raised in families or environments that
discourage such self-expression, these girls may go
on to develop more self-consciousness and to be
more likely to conceal their sexual orientation.
Further, bisexual individuals often experience
invalidation of their bisexual identities from
heterosexuals as well as lesbians and gay men. If
they experience such invalidation of their genuine
self-expression and self-identification, then this
could lead them to be more self-conscious in public
and to monitor their behavior in an effort to avoid
disclosing or referencing their bisexuality.
Although not explicitly mentioned in either
etiological model described, research has
demonstrated that the attributions that sexual
minorities make in response to perceived
discrimination also play an important role in the
development of social anxiety. Sexual minorities
appear to be at increased risk for social anxiety
subsequent to discrimination if they believe that
discriminatory events are costly and have widespread
implications. This attribution style appears to be
anxiety-provoking independent of how often
someone actually experiences discrimination, and it
also exacerbates the negative effects of
discrimination. Thus, if a member of a sexual
minority is discriminated against
Anxiety
and thinks that discrimination is going to have a
major negative impact on his or her life, then he or
90
she is likely to experience more social anxiety
subsequent to the discrimination.
Although this entry focuses on anxiety, it is worth
noting that anxiety can lead to additional mental and
physical health problems, including depression,
substance use, and risky sexual behavior. The extent
to which sexual minorities anxiously expect to be
rejected because of their sexual orientation is
associated with negative outcomes in multiple
domains, including social and academic functioning
as well as mental and physical health. Research has
also demonstrated that anxiety is associated with
substance use and risky sexual behavior among gay
and bisexual men. Sexual minorities may choose to
drink alcohol and use drugs as a way to self-medicate
or reduce their discomfort in uncomfortable
situations. For instance, if a sexual-minority member
is in an environment in which it is not clear if one’s
sexualminority identity will be accepted, then he or
she may use substances as a way to cope with the
anxiety. Further, once under the influence of alcohol
or drugs, then cognitive abilities may be impaired,
such that individuals may be less able to make
thoughtful decisions about the sexual behavior that
they engage in and the safety precautions that they
take.
Treatment
Despite the development of evidence-based
treatments for anxiety disorders, mental health
professionals may not recognize that sexual
minorities experience realistic concerns about
negative evaluation and rejection from others.
Mental health professionals can help sexual-minority
clients to differentiate between situations that are
dangerous and those that may be safe but perceived
as dangerous due to previous experiences.
Additionally, given the costs of concealing one’s
sexual orientation, therapists can provide
psychoeducation about the paradoxical effects of
concealing one’s sexual orientation in an effort to
increase accurate perceptions of the relative safety
and threat of selfexpression. Further, given evidence
that negative thoughts and feelings about one’s
sexual orientation and expectations of rejection may
be mechanisms through which discrimination
influences social anxiety, they may be important
areas to target as a way to reduce distress among
sexualminority clients. Although discrimination is
largely out of one’s control, the cognitions that result
and maintain anxiety can be reduced through
cognitive interventions. In the context of an LGB-
affirmative therapeutic environment, cognitive-
behavioral therapy can be an effective approach to
dealing with the negative consequences of
discrimination.
Additionally, heterosexual mental health
professionals who affirm sexual minorities have the
potential to provide sexual-minority clients with
corrective learning experiences that counteract their
expectations of rejection. For instance, if a gay male
client has a history of being discriminated against by
heterosexual men, then his involvement in a
therapeutic relationship with a heterosexual male
professional who is accepting of sexual minorities
has the potential to begin to counteract his previously
developed beliefs about how people are going to treat
him based on his sexual orientation.
Transgender Populations
Similar to sexual minorities (i.e., LGBQ individuals),
transgender individuals (i.e., those whose sex
assigned at birth is discordant with their current
gender identity) are also at increased risk for anxiety
compared with cisgender individuals (i.e., those
whose sex assigned at birth is concordant with their
current gender identity). Further, transgender
individuals experience unique stress associated with
stigmatized social status as gender minorities,
including variations of the stressors previously
described for sexual minorities. Scholars have
extended minority stress theory to explain the
increased risk for mental health problems, including
anxiety, among transgender individuals relative to
cisgender individuals. Transgender individuals
experience high rates of discrimination and violence
and, as a result, they are at risk for internalizing
negative societal attitudes toward gender
nonconformity as well as for expecting to be rejected
because of their gender minority identity.
Unfortunately, while societal attitudes toward sexual
minorities have become increasingly positive in
recent years, the same shift in attitudes toward
gender minorities has not occurred. Thus, the
realistic possibilities of discrimination and violence
remain for many transgender individuals. The issue

of concealment may be particularly relevant for
transgender individuals. There is some evidence that
transgender individuals at the beginning of their
transition experience more anxiety than those at later
stages of their transition. It is possible that this
anxiety relates to the extent to which they think
others will perceive them according to their current
gender identity.
Brian A. Feinstein
See also Closet, The; Hate Crimes; Heterosexism;
Homophobia; Internalized Homophobia;
Microaggressions; Minority Stress; Sexual Minorities
and Violence
Further Readings
Budge, S. L., Adelson, J. L., & Howard, K. A. S. (2013).
Anxiety and depression in transgender individuals: The
roles of transition status, loss, social support, and coping.
Journal of Consulting and Clinical Psychology, 81, 545–
557.
Burns, M. N., Kamen, C., Lehman, K. A., & Beach, S. R. H.
(2012). Minority stress and attributions for discriminatory
events predict social anxiety in gay men.
Cognitive Therapy Research, 36, 25–35.
Feinstein, B. A., Goldfried, M., & Davila, J. (2012). The
relationship between experiences of discrimination and
mental health among lesbians and gay men: An
examination of self-stigma and rejection sensitivity as
potential mechanisms. Journal of Consulting and
Clinical Psychology, 80, 917–927.
Hatzenbuehler, M. L. (2009). How does sexual minority
stigma “get under the skin”? A psychological mediation
framework. Psychological Bulletin, 135, 707–730.
Meyer, I. (1995). Minority stress and mental health in gay
men. Journal of Health and Social Behavior, 36, 38–56.
Meyer, I. (2003). Prejudice, social stress, and mental health in
LGB populations: Conceptual issues and Asexuality
research evidence. Psychological Bulletin, 129, 674–697.
Newcomb, M. E., & Mustanski, B. (2010). Internalized
homophobia and internalizing mental health problems: A
meta-analytic review. Clinical Psychology Review, 30,
1019–1029.
Pachankis, J. E., & Bernstein, L. B. (2012). An etiological
model of anxiety in young gay men: From early stress to
public self-consciousness. Psychology of Men and
Masculinity, 13, 107–122.
Pachankis, J. E., & Goldfried, M. R. (2006). Social
anxiety in young gay men. Journal of Anxiety
Disorders, 20, 996–1015.
91
Pachankis, J. E., Goldfried, M. R., & Ramrattan, M. E.
(2008). Extension of the rejection sensitivity construct to
the interpersonal functioning of gay men. Journal of
Consulting and Clinical Psychology, 76, 306–317.
ASEXUALITY
This entry describes asexuality, a form of sexual
identification that has become increasingly widely
recognized in a little over a decade. Commonly
defined as the absence of an experience of sexual
attraction, the recognition of asexuality complicates
many aspects of our existing understanding of
sexuality and raises important questions for how we
study it. Much academic and lay discussion of
sexuality assumes that everyone experiences sexual
attraction, but the emergence of the asexual
community demonstrates the falsity of this
assumption. This entry begins with an introduction
of the asexual identity and the different meanings it
can have for a self-identified asexual. It then turns to
common experiences shared by asexual people in
spite of the differences among them. Finally, the
difficulties faced by many asexual people and their
origins in the wider social context are introduced into
the discussion.
Asexuality as Identity and Sexual Orientation
An obvious response when confronted by asexuality
is to ask precisely what it is. The Asexuality
Visibility and Education Network (AVEN), integral
Asexuality
in the development of the contemporary asexual
community, describes an asexual person as someone
who does not experience sexual attraction. This view
of asexuality treats it as a sexual orientation, framed
as involuntary in contrast to the choice of celibacy. It
is frequently presented as a fourth sexual orientation
(following heterosexuality, bisexuality, and
homosexuality) that has heretofore gone largely
unacknowledged, a problematic exclusion that the
activity of AVEN and others seeking to promote the
visibility of asexuality intend to ameliorate. While
the psychological literature has tended to approach
92
asexuality in these terms, seeking to distinguish
asexuality as a sexual orientation from Hypoactive
Sexual Desire Disorder (HSDD), with which there
are superficial similarities, the sociological literature
has stressed the novelty of asexuality as a distinctive
form of social identification that emerged in the early
21st century. Recognizing the differences between
these approaches helps us retain a distinction
between asexuality as an identity and asexuality as a
sexual orientation. Drawing this distinction is
important because it prevents us from confusing
questions about asexuality as a term in increasingly
common currency through the world, with questions
of those underlying characteristics that lead people to
identify as such in contemporary circumstances.
Secondary analysis of the United Kingdom National
Survey of Sexual Attitudes and Lifestyles
(NATSAL) suggests that between 0.5% and 1% of
the population have never experienced sexual
attraction to anyone, but this research tells us nothing
about how widespread asexual identification has
become. Unless we distinguish between asexuality as
identity and asexuality as sexual orientation, it is
difficult to analyze the relationship between the
experiences identified by NATSAL and the process
through which people with such experiences choose
to identify as asexual when encountering it as a
social identity.
While the singular term asexual can seem to
imply uniformity, it is important to recognize the
diversity that exists among those identifying as
asexual and to understand how this has emerged and
continues to do so. Tracking this diversity can prove
challenging, at least initially, given it is expressed
through an elaboration of new terms and concepts
that can at times seem dizzying. There has been rapid
growth of a rich vocabulary for describing human
intimacy within the asexual community, one born out
of converging experiences of being rejected by the
wider sexual culture and a commitment to expressing
one’s own experience in a subjectively satisfying
way. Much of this terminology has relevance beyond
the asexual community alone, helping shed light on
aspects of intimate experience that tend to be
overlooked when we assume the universality and
uniformity of sexual attraction. This is one sense in
which understanding asexuality can help us
understand sexuality more broadly.
Outside of the discourse surrounding asexuality, it
is common to conflate romantic and sexual
attraction, understanding them as two sides of
“attraction” itself and failing to consider their distinct
characteristics. However, within the asexual
community, an important distinction is drawn
between romantic sexuality and aromantic
asexuality. Neither group experiences sexual
attraction, but the former experiences romantic
attraction while the latter does not, with romantic
attraction being experienced as a desire for proximity
and intimacy with partner(s) that nonetheless lacks
the sexual component that is commonly assumed to
accompany attraction of this form. It is important to
recognize that those who experience neither romantic
nor sexual attraction do not therefore lack any
inclination to form meaningful personal
relationships, instead simply not experiencing either
a romantic or sexual dimension to the formation of
these connections. The absence of sexual attraction
from such intimate relationships is frequently
experienced as complicating the binary categories of
partner/friend and has led asexual people to consider
which factors characterize intimate relationships and
to find new ways of expressing this intimacy.
There is a great deal of variation in how asexual
people feel about sexual activity, sometimes
described in terms of individuals being sex-averse,
sex-neutral, and sex-favorable. Some asexual people
experience an active aversion to sexual activity,
ranging from a mild distaste to an intense repulsion
at the idea of it. Others are simply indifferent to
sexual activity, manifesting in an absence of interest
in the idea and, in some cases, a willingness to
participate in sexual activity for reasons extrinsic to
it, such as enjoying the intimacy with a sexual
partner while deriving no satisfaction from the sexual
act itself. Sex-favorable asexuality has been a topic
of many recent discussions in online asexual
community spaces, with some making the case that
there has been a tendency to overlook the existence
of sex-favorable asexual people within the
community itself and within the academic literature.
Understanding sex-favorability necessitates
consideration of the distinction between sexual desire
and sexual attraction. While commonly invoked as
part of the “umbrella” definition introduced at the
start of this entry, the issue of sex-favorable
asexuality invites deeper interrogation into how this

distinction is understood. It has usually been framed
in terms of the notion of a “nondirected sex drive”
that leads to a desire for “release” but in a way that
involves no sexual object. However, in the case of
sex-favorable asexuals, this involves a stronger sense
of regarding sexual activity favorably but in a
manner not defined by sexual attraction to a partner,
encompassing a diverse range of possibilities that are
rendered invisible if asexuality is understood solely
in terms of sex-neutrality or sex-aversion.
While there are common experiences that invite
explanation, the diversity found within the category
of asexuality should caution us against reductive
attempts to explain what causes people to be asexual.
Recognizing this diversity should not lead to a
rejection of etiological questions but should lead us
to treat them with great caution; to ask about the
causes of “asexuality” might be a problematic
question in a way that is not the case with asking
about the causes of specific experiences that lead
people to define as such. Addressing these questions
can be difficult because they traverse disciplinary
boundaries.
Psychological research addressing such questions
has tended to consider the characteristics that
Asexuality
correlate with asexuality, while sociological research
has tended to address the social context within which
the asexual identity has come to be socially
recognized. Though the formation of the asexual
community was dependent upon the Internet
facilitating discussion between geographically
dispersed people, in the process elaborating upon
what it means to be asexual and allowing
collaboration that aims to increase its visibility, it
does not in itself explain what it was about the
circumstances of these people that impelled them to
seek such connections in the first place, or why
finding the asexual community spaces online can be
so important for people who are in the process of
coming to identify as asexual.
The Social Context of Asexuality
Most asexual people report strikingly similar lists of
typical responses received when they have attempted
to discuss their absence of sexual attraction with
family, friends, or peers who are not asexual. These
93
might include suggesting they are “late bloomers,”
proposing that they haven’t “met the right person
yet,” inquiring into their mental health, speculating
about past sexual abuse, and invoking “hormones” as
a means to explain their asexuality.
What these responses share is a refusal to accept
asexual experience and an inclination to explain it
away as a symptom of some underlying pathology. In
other words, sexual attraction is assumed to be
universal and so its absence must reflect something
being wrong with the person in question. The sheer
pervasiveness with which this assumption is upheld,
as evidenced in the near universality with which
asexual people report having received these
dismissive reactions, suggests we might best
understand this marginalization of asexuality in
terms of broader questions of the cultural status of
sex and sexuality. In this sense, we can see the
emergence of asexuality as a social identity as part of
a broader pattern of cultural change in sexual matters
that, in turn, might contribute in socially significant
ways to further changes in these aspects of social
life.
Asian American/Pacific Islander Sexualities
However, considering these broader issues must
not obscure the fact of prejudice against asexual
people in everyday life of a sort irreducible to this
basic failure to understand asexuality. Our
understanding of these issues is still at an early stage,
and empirical research faces the conceptual
challenge of distinguishing between behavior that is
unintentionally marginalizing (rendering asexual
experience invisible on the basis of unacknowledged
assumptions) and that which is intentionally
stigmatizing (seeking to dismiss or denigrate asexual
experience). Though both are likely to be harmful to
asexual people, there are at least prima facie
conceptual and empirical grounds for expecting the
former to be significantly less durable than the latter.
Unintentionally marginalizing behavior might
decrease as a function of greater cultural visibility,
but intentional stigmatization will not necessarily do
so and may perhaps even increase as an unintended
consequence of greater social recognition of
asexuality.
Invoking visibility raises an obvious question of
what explains its apparent increase. There are four
mechanisms underlying this. First, there is the
94
numerical growth in people identifying as asexual,
each one helping contribute to the spread of
knowledge about asexuality. Second, there is the
emergence of asexuality studies as an
interdisciplinary field of inquiry, predominantly
though not entirely in the anglophone world, leading
to research publications and public engagement
activities that contribute to the visibility of
asexuality. Third, there has been a rapid growth in
media interest in asexuality, encompassing both print
and broadcast media. Fourth, there has been the
visibility and education activism undertaken in an
organized way by those within the asexual
community. In practice, all four mechanisms have
been mutually reinforcing, with visibility activism
supporting the work of academics and journalists,
academic research providing talking points for media
coverage, media interest providing a motivating
factor for academic engagement, and all of these
factors both contributing to and benefiting from the
growing number of people identifying as asexual.
Mark Carrigan
See also Sexual-Identity Labels; Sexual Norms and Practices
Further Readings
Bogaert, A. F. (2004). Asexuality: Prevalence and associated
factors in a national probability sample.
Journal of Sex Research, 41(3), 279–287. Bogaert, A. F.
(2012). Understanding asexuality. Lanham, MD: Rowman
& Littlefield.
Carrigan, M. (2011). There’s more to life than sex?
Difference and commonality within the asexual
community. Sexualities, 14(4), 462–478.
Carrigan, M., Gupta, K., & Morrison, T. G. (2013).
Asexuality special theme issue editorial. Psychology &
Sexuality, 4(2), 111–120.
Chasin, C. J. (2015). Making sense in and of the asexual
community: Navigating relationships and identities in a
context of resistance. Journal of Community & Applied
Social Psychology, 25(2), 167–180.
Hinderliter, A. (2013). How is asexuality different from
hypoactive sexual desire disorder? Psychology &
Sexuality, 4(2), 167–178.
Scherrer, K. S. (2008). Coming to an asexual identity:
Negotiating identity, negotiating desire. Sexualities,
11(5), 621–641.
Scherrer, K. S. (2010). What asexuality contributes to the
same-sex marriage discussion. Journal of Gay & Lesbian
Social Services, 22(1–2), 56–73.
ASIAN AMERICAN/PACIFIC ISLANDER
SEXUALITIES
Queer and trans sexualities have existed across Asian
American/Pacific Islander (AAPI) countries and
communities over a long period of time; however,
there continue to be silences and gaps in
documenting and valuing these sexualities. Queer is
an umbrella term that encompasses lesbian, bisexual,
gay, and questioning as well as other sexual
orientation identities. Trans is also an umbrella term
that refers to gender identities such as transsexual,
genderqueer, male-to-female (MtF), and female-to-
male (FtM), among others. Estimating accurate
numbers of queer and trans people currently in the
United States is challenging because of societal
heterosexism, which fosters a homophobic and
transphobic environment where queer and trans
AAPI people may not feel comfortable disclosing
their sexualities and gender identities. In addition,
queer and trans AAPI people in the United States
also experience societal racism, which compounds
issues of heterosexism, resulting in minority stress.
Therefore, in order to understand the current lives,
resilience, and coping of queer and trans people and
communities, one must understand the influences of
family, intersectionality, and experiences of the dual
impacts of racism and heterosexism, in addition to
the historical legacies and colonization that queer
and trans AAPI people have experienced. The
current entry addresses AAPI sexualities, resilience
and coping of AAPI communities, and AAPI queer
and trans liberation movements.
AAPI Queer and Trans Sexualities
Current literature suggests that the U.S.
socioeconomic climate perpetuates the
marginalization of both people of color and
individuals identifying as LGBTQ. In contrast, the
stereotype of AAPIs as a “model minority” (which
asserts that AAPIs have equaled if not surpassed the
standards set by White majority culture) suggests
holistic success for AAPI citizens in the United
States. However, the concept of AAPIs as a model
minority adds an intricate layer of tension to the
enculturation of AAPI individuals, particularly for

those who identify as LGBTQ, who must balance
multiple complex identities.
While the largely accepted AAPI values of
collectivism and community may support the racial
identity development of AAPI individuals,
AAPIidentifying people who also identify as
LGBTQ often experience conflicting feelings
regarding their sexuality. For example, South Asian
individuals are often hesitant to use terminology such
as gay, lesbian, bisexual, and queer as identifiers due
to the fact that South Asian culture often qualifies
such identities as a Western disease, which in turn
causes fear of cultural alienation for AAPI
individuals who identify as LGBQ. Therefore, the
intersectionality of racial and sexual identity may
become cumbersome for individuals with AAPI
values who wish to honor their LGBTQ identity and
lifestyle. Many experience difficulty pairing their
racial/ethnic and sexual identities and
Asian American/Pacific Islander Sexualities
struggle with how to share their authentic self with
others, leading to a decreased likeliness to be out,
especially for AAPI LGBTQ men. For instance,
according to a 2004 survey, only 60% of LGBT
AAPI individuals reported being out to their parents.
Yet, in the same study, over 82% of AAPI LGBT
respondents indicated that they experience racism
within the White LGBT community, and 96% of
respondents said that homophobia and/or transphobia
was a problem in the AAPI community, thereby
suggesting extreme marginalization from multiple
communities for individuals identifying as both
AAPI and LGBT.
The multiple marginalizations that queer and trans
AAPI individuals experience contribute to increased
psychological distress. Specifically, research has
suggested that racist events, heterosexist
discrimination, and internalized heterosexism are
positively related to high levels of psychological
distress. The numbers of racist events reported by
AAPI LGBTQ individuals increase the higher their
levels of “outness.” Furthermore, health stressors
seem increasingly dire for individuals identifying as
AAPI and transgender. A 2011 report of the National
Transgender Discrimination Survey provides data
showing that individuals who identify as AAPI and
transgender experience particularly devastating
levels of discrimination, leading to extreme poverty,
95
increased rates of HIV, increased numbers of suicide
attempts, high rates of unemployment, increased
rates of physical and sexual assault, and increased
rates of homelessness in addition to experiencing
housing, education, employment, and health care
discrimination.
Health research has often excluded or neglected
AAPIs, a reality that is fueled in part by the belief
that they represent a model minority and also a
healthy minority based on national statistics that
point to a greater life expectancy. Asian Pacific
Islanders have also been called the “forgotten
minority.” A good example of the “forgotten
minority” experience is the scarcity of studies on
AAPI queer women, transgender people, young
people, and South Asians. There is a mistaken belief
that AAPIs are somehow perfect and do not make
mistakes like contracting HIV/AIDS. Moreover,
there is reluctance within the AAPI
Asian American/Pacific Islander Sexualities
community to accept or even recognize that HIV/
AIDS is a problem. A 2008 study by the Centers for
Disease Control and Prevention (CDC) found a
steady increase in the number of AAPIs being
diagnosed with AIDS in recent years. Asian Pacific
Islander transgender and gender-nonconforming
people show a devastatingly high rate of HIV
infection. Currently, the majority of AAPIs who are
infected with HIV are men who have sex with men,
which typically is connected to unprotected sex,
substance abuse, and low HIV testing rates. HIV
testing sites and programs that are culturally
sensitive to AAPI community identity and provide
early and regular testing and social support are most
effective in reducing the spread of HIV/AIDS among
the AAPI gay community. Although AAPIs are often
viewed as healthier than the rest of the population,
especially compared with other minority groups,
substance abuse is a contributing factor in the spread
of HIV/AIDS within this community, which has been
ignored or portrayed as a minor problem.
As with much of the research with AAPI groups,
study findings on substance use are limited.
Substance use disorders were historically thought to
be the lowest among AAPIs. However, recently
published data suggest otherwise for some AAPI
subgroups (i.e., Chinese, Korean, Filipino,
Vietnamese, Asian Indian, and Japanese). For
96
example, alcohol use remains very close to that of While AAPI queer and trans communities do face
non-AAPI population groups. An emerging trend is challenges in the form of microaggressions,
the use of and dependence on methamphetamines macroaggressions, and internalized heterosexism as
among Pacific Islanders. Many factors seem to discussed above, AAPI queer and trans people also
influence AAPI substance use, including develop resilience and coping strategies that assist
acculturation pressures related to immigration, them in navigating this oppression. For instance, in a
socioeconomic factors, and being U.S.-born, with 2011 study of AAPI queer college students, Mitsu
those AAPIs who were foreign-born facing greater Narui, a sociologist, found that his sample with
adjustment challenges. There are many barriers to certainty experienced multiple marginalizations, but
substance abuse treatment for AAPIs involving participants were simultaneously reflecting on these
cultural values, personal factors, and issues of experiences and using them to foster their own
practicality (e.g., accessibility). The model minority agency, self-exploration, and empowerment.
myth persists for AAPIs across many sociocultural Similarly, Aldalberto Aguirre and Shoon Lio, both
factors even in the area of domestic violence, which sociologists, discussed the experiences of AAPI
involves violent or aggressive behavior within the people in general in the United States being viewed
home in which violent abuse of a spouse or partner as “perpetual foreigners.” However, they
occurs.
Domestic violence within the AAPI community
exists, and yet researchers often overlook this social
problem. Furthermore, community and health service
providers have not clearly understood AAPI attitudes
and cultural differences (e.g., political and religious;
traditional social roles; an array of languages) that
contribute to domestic violence. Instead they view
AAPIs as one monolithic group, thereby ignoring
cultural influences. According to a 2009 study by
Mieko Yoshihama, a scholar in social work, and
Firoza Chic Dabby, a domestic violence advocate,
the literature points to a high prevalence rate of
intimate partner violence in AAPI homes. Further, a
2012 report by the National Coalition of Anti-
Violence Programs (NCAVP) found intimate partner
violence to be a disturbing and sometimes deadly
problem facing LGBTQ communities of color; and
this report found that AAPI survivors constituted 4%
of the respondents surveyed. The level of police
misconduct toward the LGBTQ community and
profiling that targeted immigrant communities were
also disturbing findings of the report. Since the
September 11, 2001, terrorist attacks, immigrant
communities have undergone greater scrutiny, and
the South Asian community has been especially
targeted. Currently, immigration reform has not
enjoyed great support from the AAPI LGBTQ
community.

Resilience and Coping of AAPI Queer and

Trans Communities

also describe opportunities for and examples of AAPI
resistance in venues such as AAPI neighborhoods,
college organizations, and activist and labor groups, in
addition to queer and feminist spaces. Queer and trans
AAPI narratives have also been published, such as Q &
A: Queer in Asian America (1998) by David L. Eng and
Alice Y. Hom; Keven K. Kumashiro’s Restoried
Selves:
Autobiographies of Queer Asian/Pacific American
Activists (2004); and Kim Fu’s For Today I Am a Boy
(2014). These narratives—along with efforts to
document queer and trans roots in AAPI countries and
communities—provide powerful examples of liberation
and resistance to oppression they face.
AAPI Queer and Trans Liberation
Movements
In large part because of the increasing accessibility of
the Internet, queer and trans people have used the
Internet and social media to support grassroots social
justice and liberation movements. For instance, in the
South Asian queer and trans community, the
organization Trikone has worked diligently in large
U.S. cities and in other countries (e.g., Australia) to
provide spaces where their members can gather,
socialize, and grow the movement for increased
acceptance and affirmation of South Asian queer and
trans people. In the United States, NQAPIA (National
Queer Asian Pacific Islander Alliance) was founded
with the explicit intention to highlight, affirm, and
empower queer and trans AAPI people in the United
States. NQAPIA is particularly important for the queer
and trans AAPI community, given its focus on
supporting immigration rights, advocating for queer and
trans workplace protections, and strengthening family
relationships in the lives of queer and trans AAPI
people. While national queer and trans organizations
often work on issues such as gay marriage, NQAPIA
also takes an intersectional approach to address the
issues of racism and heterosexism that uniquely
influence the lives of queer and trans AAPI
communities.
Anneliese Singh, Rodney Pennamon, and
Lauren Moss
See also African American Sexualities; HIV/AIDS and
Racial/Ethnic Disparities; Immigration; Intimate
Partner Violence, Female; Intimate Partner Violence,
Male; Latina/o Sexualities; Substance Abuse and
LGBTQ People; Substance Abuse Treatment and
Assisted Reproductive Technologies (ARTs) 97
Recovery; Substance Abuse/Dependence and
Transgender People
Further Readings
Dang, A., & Hu, M. (2004). Asian Pacific American lesbian,
gay, bisexual and transgender people: A community portrait.
New York, NY: Policy Institute of the National Gay and
Lesbian Task Force. Retrieved from
http://www.thetaskforce.org/downloads/reports/
reports/APACommunityPortrait.pdf
Fu, K. (2014). For today I am a boy. New York, NY:
Houghton Mifflin Harcourt.
Kumashiro, K. K. (2004). Restoried selves:
Autobiographies of queer Asian/Pacific American
activists. Binghamton, NY: Harrington Park Press.
National Queer Asian Pacific Islander Alliance. (n.d.).
Mission statement. Retrieved from http://www
.nqapia.org
Singh, A. A. (2008). A social justice approach to
counseling Asian American/Pacific Islanders. In C.
Ellis & J. Carlson (Eds.), Cross cultural awareness
and social justice issues in counseling (pp. 147–167).
New York, NY: Routledge.
Trikone. (n.d.). About us. Retrieved from http://www
.trikone.org/index.php/about-us/trikone
Yoshihama, M., & Dabby, C. (2012). Domestic violence in
Asian, Native Hawaiian and Pacific Islander homes. San
Francisco, CA: Asian and Pacific Islander Institute on
Domestic Violence. Retrieved from http://www
.apiidv.org/files/Facts.Stats-APIIDV-2012.pdf
ASSISTED REPRODUCTIVE TECHNOLOGIES
(ARTS)
The term assisted reproductive technologies (ARTs)
refers to a range of techniques that are used to assist in
the process of achieving a pregnancy. These methods
and techniques may also be referred to as infertility
treatment or fertility treatment.
LGBTQ individuals and couples typically lack a
partner of a different sex with whom they can
98
Assisted
Reproductive
Technologies
(ARTs)
conceive a child (a situation that is sometimes referred
to as “social infertility”). ARTs that use donated sperm,
eggs, and embryos provide LGBTQ individuals and
couples, or three or more individuals, the opportunity to
achieve pregnancy and to raise a child from birth.
This entry first examines exactly what ARTs are,
who uses them, and why. The various risks associated
with ARTS are then addressed, followed by a brief
summary of the outcomes of families created by ARTs.
What Are ARTs?
In-vitro fertilization (IVF) is a process in which an egg
is fertilized with a sperm in the laboratory, and the
resulting embryo is transferred to a uterus. This
procedure, resulting in the birth of the first IVF baby in
1978, typically involves the use of the intending
mother’s egg and uterus, and the intending father’s
sperm. The resulting child therefore has a genetic
relationship to both parents and has a gestational link to
the mother.
A number of ARTs involve the use of gametes
(sperm or eggs) that are provided by a third party, or
donor. These techniques are often referred to as
reproductive donation, or third-party assisted
reproduction. One of the oldest procedures of this
nature is sperm donation, a process in which a woman
is inseminated with the sperm of a donor (or a man who
is not her partner). This is a relatively straightforward
procedure in which semen is transferred to the vagina
via syringe.
ARTs have advanced at a rapid pace, and today IVF
is just one of many complex and sophisticated ARTs
that is available. Newer procedures that typically utilize
the sperm and egg of a heterosexual couple include
intracytoplasmic sperm injection (ICSI), which was
introduced in the early 1990s. This technique,
necessarily also involving IVF, is the injection of a
single sperm into an egg in vitro. It can be used to
overcome many male fertility problems, and for
heterosexual couples using ARTs, ICSI has to a
significant extent replaced the use of sperm donation.
Egg donation is a more complex and intrusive
procedure that utilizes IVF techniques. Following the
retrieval of an egg from a donor, sperm is used to
fertilize the donated egg in the laboratory, and the
resulting embryo is then transferred to the intending
mother’s uterus. It is only since 1984, following
advances in IVF, that it has been possible for a woman
to become pregnant and give birth to a child to whom
she is genetically unrelated.
Families can also be created through surrogacy
arrangements, in which a woman carries a child to term
for the intending parent(s). Surrogacy can be a
relatively low-technology procedure, in which
conception occurs using sperm of the intending parent
(or a donor) and the egg of the surrogate, who carries
the child to term (referred to as genetic or traditional
surrogacy). Surrogacy can also be a more high-
technology procedure involving IVF techniques,
whereby the sperm of one intending parent or donor and
the egg of the other intending parent or a donor are used
to create an embryo, which is then transferred to the
surrogate (referred to as gestational surrogacy). In the
latter kind of surrogacy arrangements, the surrogate
who carries the pregnancy to term and gives birth has
no genetic relationship to the child.
Another assisted reproductive technology that assists
in the process of achieving a pregnancy is embryo
donation. In families created through this procedure, the
child lacks a genetic relationship with the intending
parent(s), creating a situation that is similar to adoption.
Yet unlike adoptive parents, those who start their family
using donated embryos experience a pregnancy and
raise their child from birth.
More recently there have been advances in the field
of fertility preservation, with techniques and approaches
to freezing, and subsequently thawing, sperm, eggs,
embryos, and ovarian tissue, becoming more efficient
and reliable. Potentially, these techniques give
individuals the opportunity to conceive and achieve
pregnancy with a child with whom they are genetically
related, even though their most fertile years may have
passed due to advanced age or illness.
Who Uses ARTs?
Single and coupled LGBTQ individuals typically lack a
male or female partner with whom to conceive a child.
Third-party reproductive techniques, such as sperm
donation, egg donation, and surrogacy therefore assist
LGBTQ individuals and couples to achieve a
pregnancy.

In the absence of a male partner, single and coupled
LGBTQ women can become pregnant through sperm
donation. Women who conceive a child in this way
have a number of options from which to choose. They
can conceive using an anonymous sperm donor,
purchasing semen from an online sperm bank, or a
sperm bank provided by a particular fertility clinic.
These women may have very little or no information
about the donor, and they may wish for this
arrangement to be permanent. Others may wish to have
a great deal of information about the donor and want
their child to have the option to access identifying
information about him in the future. Others may ask a
friend, family member, or acquaintance, with whom
they have an existing relationship or with whom they
have come into contact online, to act as a sperm donor.
Some women may hope and intend for the donor to be
present in the child’s life, to varying degrees, whereas
others may wish for the donor to play no role in the
child’s life.
These different categories of donation (sometimes
referred to as anonymous, open-identity, and known)
may change over time. For example, an anonymous
donor about whom parents and children have basic
information might be easily located using an online
search engine. A man who registered as an open-
identity donor, who has agreed that the child can
contact him in the future, may move abroad and
become untraceable. The choices and decisions that
women make about the sperm donor will likely be
influenced and/or constrained by the regulation of
ARTs in their country of residence, financial
considerations (with certain options being more
expensive than others), and their personal beliefs and
preferences about what is important for their family and
for the future child’s well-being. These various options
may also seem relatively insignificant in comparison
with the goal of getting pregnant, or these options may
not all be known or obvious to intending parents who
may struggle to find information about the various
routes to parenthood that are available to them.
In addition to sperm donation, single and coupled
LGBTQ women may utilize IVF techniques. For
lesbian couples using IVF and donated sperm, both
women have the opportunity to have a biological link to
the child (i.e., an embryo may be created with the egg
of one woman, who will have a genetic relationship to
the child, and her partner may then carry the child to
term, having a gestational link to the child). Lesbian
couples using IVF also have the opportunity to take
turns in becoming a genetic parent. One mother may
Assisted Reproductive Technologies (ARTs) 99
have a genetic relationship to their first child, and her
partner may be the genetic parent of their second child.
Single LGBTQ women may also utilize IVF techniques
if they need assistance in getting pregnant with their
own eggs, or the eggs of a donor.
For LGBTQ individuals and couples who cannot
conceive due to the absence of a female partner,
surrogacy may be a viable option for starting a family.
For those who pursue gestational surrogacy, an embryo
might be created with the sperm from one man and the
egg of a donor, which is then implanted into the uterus
of a surrogate. As with lesbian couples, gay male
couples that want more than one child can potentially
take turns in becoming a genetic father. The children in
these families may therefore have a genetic link to one
father, and their sibling may be genetically related to
the other father. If two different egg donors have been
used, it is possible that the children growing up in these
families will have no genetic relationship with their
sibling(s).
Single and coupled LGBTQ individuals may also
have various options from which to choose when
pursuing parenthood through the use of ARTs. We are
now living in an era in which assisted reproduction is
global. In countries in which surrogacy is permitted, the
regulation of the procedure and process varies widely,
as does the cost. Single or coupled LGBTQ men may
therefore choose to pursue surrogacy outside of their
country of residence, be that in the United States,
Mexico, Canada, or elsewhere. Intending fathers in
these families may also have various options to
consider when selecting an egg donor. They may
choose to use a donor from the country in which their
surrogate resides or they may choose to select an egg
donor from their country of origin and/or residence, for
a variety of reasons (e.g., personal preference, cost,
availability). As with sperm donors, the egg donor may
be anonymous,
Assisted
Reproductive
Technologies
(ARTs)
open-identity, or known. It is worth noting once again
that the decisions that LGBTQ men face may likewise
be influenced and/or constrained by regulation and
legislation in their country of residence, financial
considerations, and personal beliefs and convictions as
to what matters for family relationships.
100
LGBTQ individuals and couples may become
parents through the use of embryo donation. They may
also decide to utilize various techniques of fertility
preservation, in the hope of conceiving a child in the
future to whom they may be genetically related. Most
recently, a child has been born following womb
transplantation, and this too may be an option for
LGBTQ individuals who cannot become pregnant or
give birth to a child.
Why Do People Use ARTs?
LGBTQ individuals and couples may choose to start
their family using ARTs for a number of different
reasons. ARTs allow parents to have a genetic and/or a
gestational link to their child, which is not typically
possible when building a family through adoption or
fostering. This genetic connection may be greatly
valued by parents, their families, and the communities
and cultures in which they live.
LGBTQ individuals and couples may not want to
pursue parenthood through adoption or fostering. They
may want to experience pregnancy and raise their child
from birth, which is a relatively unlikely option for
those who choose to foster or adopt, depending on their
country of residence (e.g., in the United Kingdom the
average age of the child at adoption is currently 3 years
old). Those who favor using ARTs over adoption may
not wish to raise children who may have emotional,
behavioral, or developmental problems as a
consequence of their early life experiences, which may
have involved neglect and abuse. Also important to
consider is that there are many countries in which
LGBTQ individuals and couples are unable to access
legal parenthood through adoption due to their sexual
orientation and/or marital status.
Another route to parenthood that LGBTQ
individuals may consider is that of coparenting, where
individuals and couples who are typically not in an
intimate relationship choose to raise children together.
Those who raise a child in this way may not have
access to legal parenthood status; therefore, creating a
family through the use of ARTs may be a more
appealing option. Even if legal parenthood following
the use of ARTs is not possible in their country of
residence, LGBTQ individuals and couples may
achieve the goal of parenthood by traveling abroad to
access treatments that are not available to them in their
own countries (often referred to as cross-border
reproductive care, or reproductive tourism).
Routes to parenthood are therefore influenced by
individuals’ and couples’ desire to experience a genetic
and/or gestational relationship with a child, as well as
discriminatory practices that make certain options
inaccessible to LGBTQ individuals and couples. Other
factors that influence routes to parenthood include cost,
prevailing cultural and/or religious attitudes, the beliefs
of their family and wider support network, and their
own personal beliefs and convictions about what is
important for family relationships and children’s well-
being.
Risks of ARTs
The path to parenthood through the use of ARTs may
be a long one. The success rates of techniques such as
IVF differ between countries and clinics (as well as the
age and health of the recipients using these
technologies). Although success rates have generally
increased over the last few decades, still less than a
third of all IVF treatment cycles result in the birth of
babies. This relatively low success rate in combination
with the cost of ARTs may be financially challenging,
if not prohibitive, for those who wish to become
parents. Surrogacy in particular can be a costly
procedure for prospective parents, who may need to pay
expenses to the surrogate and the egg donor, in addition
to agency fees, legal fees, and medical expenses.
Compared with children who are conceived through
sexual intercourse, there are risks associated with the
use of ARTs. In particular, there are risks associated
with the drugs used to stimulate egg production, the
surgical hazards of egg retrieval, and the process of
embryo transfer, resulting in heightened risks of ovarian
hyperstimulation syndrome and ectopic pregnancy. The
use of ARTs is also associated with an increased risk of
multiple births, with levels of risk varying between
countries and between clinics. The mortality and
morbidity of pregnancies are high for triplets and there
are significant risks for twins, most notably that of
being born preterm and at a low birth weight, which
may have implications for the child’s future physical
and psychological development.
In addition to the medical risks of ARTs, concerns
have been expressed that the stressful experience of
undergoing fertility treatment may have a negative
impact on parents’ psychological wellbeing and the
quality of the couple relationship. There have also been
concerns that the process of undergoing fertility
treatment may result in parents being excessively
 Assisted Reproductive Technologies (ARTs) 101
overprotective and emotionally overinvolved in their quality of family relationships, rather than the structure
child’s life, as their child may be seen as particularly of families, that is most important when thinking about
precious and/or special. children’s well-being.
There have also been a number of questions and
Lucy Blake
concerns as to how the children in these families will
feel about their families as they grow older. For See also Children With LGBQ Parents, Psychosocial
example, how will children feel if they learn that their Outcomes; Sperm Donor, Choosing a; Sperm Donors’
egg donor was paid a large sum of money? And how Involvement in Children’s Lives; Surrogacy
will children feel and think about the surrogate as they
grow older? The children in these families may
discover that they have a number of donor siblings (i.e., Further Readings
genetic half-siblings who were conceived using the
Freeman, T., Graham, S., Ebtehaj, F., & Richards, M.
same donor, sometimes referred to as “diblings”). Who
(Eds.). (2014). Relatedness in assisted reproduction:
will these children consider to be family members, and
Families, origins and identities. Cambridge, England:
why?
Cambridge University Press.
Golombok, S. (2015). Modern families: Parenting and child
Outcomes of ARTs development in new family forms. Cambridge, England:
Cambridge University Press.
ARTs continue to develop at a rapid pace. Alongside
Richards, M., Pennings, G., & Appleby, J. B. (Eds.). (2012).
these technological developments, a body of research
Reproductive donation: Practice, policy and bioethics.
has grown that has set out to examine and explore the
Cambridge, England: Cambridge University Press.
psychological adjustment of parents and children in
these families, and family functioning as a whole.
Studies of families created through sperm donation that
are headed by lesbian couples have generally found the AT HLETES
parents and children in these families to be functioning
well. Likewise, of the research that has examined sperm See College Athletes; Sports, SexualMinority
donation families headed by single women, parents and Men in; Sports, SexualMinority Women in
children have been found to be psychologically
adjusted and parent-child relationships have been found
to be characterized by high levels of warmth. There is
much more work to be done in this area; for example,
the literature that has examined families headed by
single women (often referred to as single mothers by
choice) has largely focused on families in which
children are young. We therefore know little or nothing
about family functioning with children in adolescence
and beyond. There is also very little empirical work
investigating family functioning where single and
coupled LGBTQ men have had a child through
surrogacy arrangements. Longitudinal research that
follows these families over time will be of great value.
These newer kinds of families, which did not exist
decades ago, have generally been found to be
functioning as well as, if not better than, more
traditional families in which heterosexual couples have
conceived naturally. This has led to the conclusion that
there is much that we can learn from these newer family
forms. As has been consistently acknowledged for
decades, this body of research concludes that it is the
B and
youn
BALLRO g
adults
OM
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SCENE, ballro
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THE cultur
e has
its
The roots
ballro in the
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104

perfor inclus
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in lesbia
elabor n,
ate gay,
femal bisex
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attire. transg
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entert TQ)
ainme youth
nt for from
specta a
tors at variet
these y of
annual racial
balls, and
young ethnic
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dresse round
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wome This
n’s entry
attire, is
or “in inten
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ted in provi
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titions iew
for of the
cash ballro
prizes. om
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the , and
years, what
the are
ballro know
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has and
becom ball
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 105

ies, as In
well additi
as a on,
brief the
revie singer
w of and
recent perfor
resear mer
ch Mado
identif nna’s
ying iconic
aspect and
s of popul
the ar
comm music
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that Vogu
offer e
both broug
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rt and signat
risks. ure
The move
ballro s of
om the
scene ballro
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attract scene
ed —
mainst vogue
ream danci
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after mains
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ng ed the
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film entert
Paris ainer
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was danci
releas ng
ed in along
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106

memb diverse
ers of racial,
the ethnic,
ballro sexual,
om and
scene. gender
Today identities
, ,
primarily
103 young
house African
and ball America
communi n men
ties can and
be found Latinos
in many who
large have sex
American with men
cities and
including transgen
New der
York, women.
Los Balls and
Angeles, houses
Oakland, function
Atlanta, as
Chicago, different
Philadelp entities,
hia, yet work
Detroit, together
Baltimor in
e, and forming
Washingt the
on, D.C. vibrant
In communi
general, ty often
the house known
and ball as the
communi ballroom
ties work scene or
in tandem communi
to ty.
develop Houses
and are
support a different
communi groups
ty of
involving individua
individua ls that
ls of compete
 107

against adulthoo
each d.
other Responsi
during bilities
balls— of the
undergro parents
und include
events creating
that rules
reward (which
individua are then
ls who passed
win down
competiti and
ons voted on
focused by other
around house
dance, members
athletics, ) and
and discussin
gender g
expressio importan
n. t house
House topics,
s are such as
social major
networks balls to
led by a attend
“mother” and
and/or assigning
“father.” status or
House selecting
parents members
serve for “of
roles akin the year”
to that of awards.
traditiona Furth
l mothers ermore,
and each
fathers house
and may be
generally led by
remain the
involved founding
in the parent(s)
house ,
and ball grandpar
communi ent(s),
ty past and/or
young godparen
108

t(s), at-arms
whose and
legendary secretary
status is . It is
important also
in common
lending for
credibilit house
y to a parents
house. to train a
House prince or
structure princess
varies to
across assume
regions the
and house
across leader
houses. position
Research in the
Ba future.
llr The
oo general
m
members
Sc
en of each
e, house
T are
he referred
to as the
“children
has found ”; they
that generally
additiona join the
l communi
individua ty during
ls who late
help run adolesce
a house nce to
can be early
titled adulthoo
governes d. House
s, size can
ambassad range
or, duke/ from as
duchess, few as 5
emperor/ active
empress, members
and to as
officers many as
such as a 100.
sergeant- Typicall
 109

y, Xtravaga
seniority nza,
dictates Khan,
those LeBeija,
who help Milan,
run a Mizrahi,
house, as Ninja,
these Omni,
members and
are likely Revlon.
to be Each city
establishe in which
d, win a
trophies, ballroom
travel communi
periodical ty exists
ly to may
other have as
states, few as 5
and have and as
been many as
involved 20
in the different
scene the houses.
longest. Nationall
House y, each
s are house is
typically usually a
named part of a
after larger
fashion network
designers with a
or other formal
entities board
involved and
in the hierarchi
fashion cal
industry. structure.
Examples Most
of house houses
names are run
include in a
the democrat
houses of ic
Balenciag fashion
a, and are
Chanel, led by
Blahnik, one or
Ebony, two
Escada, parents
110

at the ability to
local “pass” as
level. a
National specific
meetings type of
for each person.
house are Major
held at categorie
different s of
times and competiti
locations on
and offer include
members (1)
an fashion
opportuni (e.g.,
ty to labels,
network Europea
with each n/Americ
other. an
Balls runway,
are butch
events queen up
that bring in
members pumps);
of the (2)
different realness
houses (e.g.,
together executiv
to e
compete realness,
in a series schoolbo
of events. y
At the realness,
balls, butch/fe
house mme
members queen
compete realness)
in ; (3)
different performa
categorie nce (e.g.,
s that vogue,
showcase realness
their with a
dancing, twist);
athleticis and (4)
m, style, beauty
creativity (e.g., sex
, and siren,
“realness body,
”—or face).
 111

Balls are g and are

typically knowled
organized geable
by a about
house or what
by others each
working event
with requires.
LGBTQ Performe
communi rs
ties; a attempt
ball may to “get
focus on their
a theme tens”—
such as meaning
HIV that they
preventio meet the
n or other minimu
issues of m
importan requirem
ce. ents of a
Durin category
g and can
competiti move on
ons, to an
individua eliminati
ls on round
competin against
g in a their
specific competit
category ors.
come to These
the eliminati
ballroom on
floor and rounds
perform or
for a “battles”
panel of typically
judges. have
The competit
judges ors
are compete
typically one-on-
house one
parents, against
leaders, each
or others other;
who are eliminati
not on
competin rounds
112

continue work and

until a escorting
winner is among
declared. members
Prizes for .
winning a By
competiti contrast,
on can however,
include the
cash, a ballroom
trophy, or scene
another offers a
meaningf number
ul item. of
Resear supportiv
ch e
indicates mechanis
that these ms to
communi young
ties offer LGBTQ
both individua
support ls. For
and risk example,
to their there is
members, evidence
with high to
rates of suggest
HIV, that a
drug use, significa
and illicit nt
activities. proportio
For n of
example, ballroom
one study communi
in New ty
York members
found an were
HIV forced
prevalenc out of
e rate of their
17% homes
among on
house account
and ball of their
members. sexual or
Other gender
research identities
identified . The
high rates ballroom
of sex communi
 113

ty offers Katrina
a “fictive Kubicek
kin”
network See also
Drag;
complete
Famili
with es of
mother Choice
and ;
father Transg
and ender
siblings and
Gender
that can
-
support Nonco
its nformi
members. ng
In Youth
addition, of
the balls Color
themselv
es offer
F
the
u
participan r
ts a social t
environm h
ent where e
they are r
not only
accepted, R
but also e
have an a
opportuni d
ty to be i
celebrate n
d and g
rewarded s
for their
Chauncey,
talents
G. (1994).
and Gay New
creativity York. New
, qualities York, NY:
for which Basic
they have Books.
elsewhere Kipke, M.
only been D.,
ridiculed Kubicek,
K., Supan,
or
J., Weiss,
ostracize G., &
d. Schr
ager
, S.
114

(201 own
3). little
Layi world”
ng :
the
Resilie
grou
ndw nce as
ork a
for factor
an in
HIV partici
prev pating
entio
in the
n
ballroo
inter
venti m
on: comm
A unity
descr subcult
iptiv ure.
e AIDS
profi
and
le of
the Behavi
Los or,
Ange 17(4),
les 1524–
hous 1539.
e and Livingston
ball , J.
com (Produ
muni cer/Wr
ties. iter).
AID (1990).
S Paris
and is
Beha burnin
vior, g
17(3) [Motio
, n
1068 picture
– ].
1081 United
. States:
Kubicek, Miram
K., ax
McNeeley, Films.
M., Murrill,
Holloway, C. S.,
I., Weiss, Liu,
G., & K.,
Kipke, Guilin
M. D. , V.,
(2013). Colon
“It’s , E.
like our R.,
Dean,
 115

L., mainstre
Buckle am gay
y, L.
culture.
A., . . .
Torian
They
, L. V. have
(2008) construct
. HIV ed a
preval gender
ence expressi
and
on based
associ
ated
on body
risk acceptan
behavi ce and
ors in “natural”
New masculin
York ity. Their
City’s
presence
house
ball
within
comm the
unity. sexual-
Ameri minority
can commun
Journ ity has
al of
expande
Public
Health
d our
, understa
98(6), nding of
1074– gay
1080. masculin
ities by
includin
g
BEAR nurturan
ce,
COMM intimacy
UNITY , role
flexibilit
y, and
Bears, so emotiona
called, l
are a connecti
group of on. Also,
gay men bears
who have provide
positione critiques
d of the
themselv common
es classism,
outside perfectio
the nism,
116

and A Brief
intimacy History
avoidanc of the
e within
Bear
gay
Movem
culture.
This ent
entry The term
begins bear
with a became
brief a part of
history of the gay
the vernacul
developm ar in the
ent of the 1980s,
bear typically
communi used in
ty; the
continues context
with a of large
discussio cities
n of how such as
bears San
define Francisc
their o, New
identity, York,
gender, and
and Toronto,
sexuality; to refer
and to a
concludes subsectio
with an n of the
overview gay
of commun
controver ity.
sies that Some
have cultural
arisen in theorists
the trace the
history of beginnin
the bear gs of the
movemen term to
t. the
famous
article
publishe
d in the
Advocat
e on July
26,
 117

1979, n of the
titled 1960s
“Who’s and
Who in Girth
the Zoo: and
A Mirth of
Glossary the
of Gay 1970s,
Animals. organizat
” Others ions that
believe shared
that a
common
group of venues
gay men and held
within similar
the values.
communi Durin
ty began g the
self- 1980s,
identifyinbear
g as bearscommuni
as early ties
as the
began to
1970s. be
Still establish
others ed across
place the the
beginnin nation all
g of the the way
bear from
communi Californi
ty even a to Iowa
earlier, to New
all the
York.
way back Before
to the end
of Community
Bear the
decade,
bears
the
held
1960s.
their first
What is
official
clear is
communi
that the
ty party,
bear
called
identity
“Bear
develope
Hug.”
d out of
Bears
the
initially
leatherme
held
118

these order to
invitation increase
-only their
events visibility
with the .
intention Specifica
of lly, the
creating a bear
setting to moveme
socialize nt asked
and individua
engage in ls within
erotic and their
safe sex communi
play. ty to
However, engage
the early in a
unificatio second
n of the coming
bear out to
movemen claim
t was set their
in 1986 bear
and was identities
highly . The
influence commit
d by ment to
civil- the bear
rights identity
activism included
that displayin
resulted g a bear
from the appearan
AIDS ce and
epidemic holding a
and the critical
gay stance
liberation toward
movemen mainstre
t. At this am gay
time, culture.
bears The bear
borrowed culture
practices valued a
and “natural”
technique masculin
s from ity that
these was
movemen reflected
ts in in a
 119

heavier, tion
less phase of
sculpted the bear
body in communi
working- ty. The
class first bear
clothing magazin
as e began
opposed circulatin
to the g,
genteel displayin
masculini g erotic
ty that images
typified of bears.
the Soon, a
broader second
gay bear
communi magazin
ty and e was
was created
represent as well
ed by as the
youthful first bear
sculpted photogra
physiques phy
in stylish book,
dress. By The
the end of Bear
the Cult:
1980s, Photogr
the Lone aphs by
Star Chris
Saloon Nelson.
had The
opened in popularit
San y of bear
Francisco communi
, ties
becoming reached
the first its apex
official by the
bear bar. mid-
The 1990s,
1990s has with 40
been bear
described clubs
by some througho
writers as ut the
the United
formaliza States.
120

Each of m
these u
clubs ni
ty
would
hold
special Curre
events ntly,
such as many
bear bear
contests associati
in which ons
men continue
performe to exist
d runway across
shows the
wearing United
working States
men’s and hold
uniforms, major
appearing parties
as once a
constructiyear
on known
workers, as bear
mechanic weekend
s, ands and
plumbers. bear
These runs.
contests These
were so associati
well ons
attended establish
that the new
national clubs
and and hold
internatiodance
nal Mr. nights
Bear that are
competiti attended
ons were not only
created toby bear-
further identifie
unify the d men,
communi but also
ty. by their
Be “admirer
ar
s.” This
C
shift in
o
m the usage
of bear
 121

spaces ty
has connecti
helped ons. One
expand such
members website,
hip www .be
within ar411.co
the bear m, is a
communi major
ty. source of
Also informati
increasin on for
g those
members who
hip, the would
bear like to
communi learn
ty has more
become about
highly bear
organized culture,
in be
establishi informed
ng a about
strong communi
Internet ty
presence. events,
Multiple or find
associatio other
ns in the bear-
United identifie
States d men.
and Along
around with
the contemp
world, orary
including technolo
Canada, gical
Europe, shifts,
Central multiple
America, GPS-
and New based
Zealand/ applicati
Australia, ons for
use smart
websites phones
to that help
maintain men find
their others in
communi proximit
122

y has The
aided in Identity
the ,
communi
Gender,
cation
and
among
bears. Sexualit
Bear y of
media Bears
and Bears
cultural value the
artifacts aesthetic
circulate of the
within “natural”
the man, a
mainstrea look that
m gay may be
communi conceptu
ty, alized as
helping less
increase maintain
bear ed and
visibility. more
Referred rugged.
to as The
“bearpher physical
nalia,” character
these istics of
artifacts bears
include usually
plush include
teddy (1) facial
bears, hair
movies, (beards,
document moustac
aries, hes, and
books, goatees),
magazine (2)
s, flags, general
bumper body
stickers, hirsutene
shirts, ss, and
and (3) a
mugs. heavy-
set
(burly or
stocky)
mature
physique
 123

. The last typified

criterion, by
however, ripped
has jeans,
shifted baseball
over time caps, T-
and some shirts,
subclassif and
ications flannel
have shirts.
develope Essential
d within ly, bear
the culture
communi challeng
ty. For es not
instance, only
“muscle heterose
bears,” as xual
the name notions
suggests, of
have a masculin
more ity but
robust also the
physique, aesthetic
and portrayal
“otters” of
are mainstre
skinnier am gay
or lanky; men,
however, which
both has
styles usually
incorpora been
te facial character
and body ized as
hair. In youthful,
addition trim,
to their clean-
physical cut, and
appearan engaged
ce, bears in visual
are arts or
distinguis literary
hed by high
their culture.
blue- Assoc
collar or iated
working- with the
class ideals of
attire, “natural”
124

masculini y. Within
ty, the their
bear communi
communi ty, the
ty is values of
known bears are
for body juxtapos
acceptanc ed with
e as well and
as contraste
comfort d to
with those of
maturatio the
n and mainstre
aging. am gay
For this communi
reason, ty,
older usually
members depicted
are an as
active shallow,
part of petty,
their competiti
communi ve, and
ties. In exclusive
addition, .
the Wher
demeanor eas
of bears socially,
reflects a bear
relaxed identity
masculin provides
e attitude an
and easy- alternativ
going e to
outlook, mainstre
hence the am gay
comfort culture
with their and
bodies redefines
and age. gay
Socially masculin
these ity, their
attitudes gender
are expressio
translated n can
into result in
camarade invisibili
rie and ty in
inclusivit both gay
 125

and develop
heterosex relations
ual social hips and
spheres. support.
Bears The
may not sexuality
be of
perceived human
as gay by bears is
others quite
and different
sometime from that
s are not of the
accepted aggressiv
by other e,
gay men. dangerou
This s, and
creates a dominati
conflict ng
for some animal.
bears Bear
who want masculin
their ity
sexual incorpor
orientatio ates
n to be attitudes
acknowle of
dged. For nurturan
this ce,
reason, affection
bear , and
identity is emotiona
solidified l
via expressio
participat n—
ion in elements
internatio that in
nal, Western
national, contexts
and local tradition
events. ally have
These been
events attribute
provide d to
bears a femininit
place to y. In
encounter addition,
other actual
bears, sexual
and to acts and
126

positions a more
are receptive
negotiate and
d within a passive
particular role.
relationsh Also,
ip given the
wherein communi
being a ty’s body
top acceptan
(sexual ce, bear
insertive) sexuality
or bottom masculin
(sexual izes and
receptive) eroticize
is not s the
directly whole
linked body by
with emphasiz
masculini ing
ty. caressing
However, and
age does cuddling
play a as an
role importan
within t
relationsh relational
ips, with practice.
older The
partners structure
taking the s of bear
“daddy” relations
role and hips are
being varied
more and
assertive, differ
nurturing, from
and couple to
guiding; couple.
and Some
younger bears opt
or less for open,
experienc non-
ed monoga
partners, mous,
usually and/or
referred polyamo
to as rous
“cubs,” relations
adopting hips.
 127

Other o
couples
may be in t
closed/ h
monogam e
ous
relationsh B
ips. e
Despite
a
these
r
differenc
es, men
M
within
the bear o
communi v
ty believe e
that bears m
tend to e
have n
longer- t
lasting
Many
relationsh
perspecti
ips and
ves have
are more
been put
sexually
forth to
active
understa
than
nd the
other gay
complex
men.
interacti
on
Contro between
vmasculin
ity and
e
socioeco
r
nomic
s
class
i within
ethe bear
s commun
ity.
RSome
ecultural
l theorists
ahave
t viewed
ethe bear
dcommun
ity’s
t adoption
128

of a bear
working- moveme
class nt
aesthetic centers
as on its
problema relative
tic given racial
that a lot homogen
of these eity and
men the lack
belong to of
the represent
middle ation of
and bears
upper from
classes. different
Given racial
that and
many ethnic
bears do groups.
not hold Despite
blue- the bear
collar communi
jobs— ty’s
actually efforts to
most diversify
have , the
been majority
typified of men
as being are still
in the White
computer (and of
industry middle-
— this to upper-
practice class
of “blue- backgrou
collar nds).
drag” can There
be seen are few
as the bears of
reaffirma color
tion of present
these in what
men’s may be
class consider
privilege. ed “bear
A media,”
second such as
critique movies,
of the magazin
 129

es, and non-

advertise White
ments Bear Community
with bear
themes.
races to
Also,
animals.
bears of
Also,
color
White
who are
men are
present
labeled
within
just as
the
bears,
communi
and not
ty may
polar
object to
bears.
taxonomi
c
practices Conclusi
of White on
bears. For
The bear
instance,
moveme
terms
nt
such as
througho
“black
ut its
bears”
history
are used
has
to refer to
provided
Black
a space
men, and
for men
“panda
who
bears”
have
refers to
positione
Asian/Asi
d
an-
themselv
American
es
men. This
outside
taxonomy
the
is
mainstre
particular
am gay
ly
culture.
controver
They
sial given
have
the
formed a
history
type of
and
gay
dehumani
masculin
zing
ity that is
practices
based
of linking
within
130

an nism,
aesthetic and the
that avoidanc
values e of
naturally intimacy
hirsute .
and Ultimate
unsculpte ly, their
d bodies, visibility
relationsh not only
ips that has
prize helped
nurturanc move
e and their
intimacy, commun
and ity
sexuality forward
that but has
values diversifi
role ed the
flexibility typology
and and
emotiona expectati
l ons of
connectio gay men.
n.
Francisc
Perhaps
because o I.
of their Surace
adoption and
of Heidi M.
workingc Levitt
lass
See also
imagery, Leather
their Culture;
presence Masculinit
within ies;
the wider Sexual
gay Attract
communi ion,
Behavi
ty has
or, and
provided Identit
a critique y;
of Social
classist Class;
attitudes, Social
emphasis Class
on and
Sexual
physical
ity,
perfectio Interse
 131

ctions at
Betwee ?
n G
e
n
F d
u e
r r
t &
h S
e o
ci
r
et
y,
R 1
e 9(
a 1)
d ,
i 2
5
n
–
g
4
s 3.
Henn Hunt, D.
en (Producer/
, Director).
P. (2008).
(2 Bear run:
00 Celebr
5). ating
Be the
ar
bear
bo
di comm
es, unity
be [Motio
ar n
m picture
as
].
cu
lin United
ity States:
: Pearl
Re Wolf
cu Produc
pe tions.
rat Ingram,
io M.
n, (Produ
re cer/Dir
sis ector).
ta
(2010).
nc
e, Bear
or nation
ret [Motio
re n
132

picture] o, IL:
. Univer
United sity of
States: Chicag
o
View
Press.
Askew
Levitt, H.
Product M.
ions. (2006).
Langway, Butch,
D. femme,
(Producer/ bear and
Director). leatherma
(2010). n:
BearCity A
[Motio progra
n mmati
picture] c
. explor
United ation
States: of
BearCit gender
y identiti
Limits. es
Langway, Bi
D. as
(Producer/ in
Director). th
(2012). e
BearCity 2 C
[Motio ri
n picture]. m
United in
States: al
BearCity J
Limits II. u
Levine, M. st
P., Iardi, P. ic
M., & e
Gagnon, J. S
H. (1997). ys
In te
changi m
ng
times: within
Gay gay
men and
and lesbian
lesbian subcult
s ures.
encoun In K.-
ter S. Yip
HIV/ (Ed.),
AIDS. Psych
Chicag
 133

ology :
of Th
gender ou
identity gh
ts
: An
on
interna mi
tional dd
and le-
compre cl
hensive as
perspec s
er
tive
oti
(pp.
ci
105– za
121). tio
Hauppa n
uge, of
NY: w
Nova or
ki
Science
ng
. m
Manley, en
E., Levitt, ’s
H., & bo
Mosher, C. di
(2007). es.
Understan In
ding the L.
bear W
movement rig
in gay ht
male (E
culture. d.)
Journal ,
of T
he
Homos
be
exualit ar
y, bo
53(4), ok
89– :
112. R
ea
Rofes,
di
E.
ng
(19
s
97)
in
.
th
Ac
e
ad
hi
em
st
ics
or
as
y
be
an
ars
134

d AL:
ev Bear
olu Bones
tio Books.
n Willoughb
of y, B.
a L., Lai,
ga B. S.,
y Doty,
ma N. D.,
le Macke
su y, E.
bc R., &
ult Malik,
ur N. M.
e (2008).
(pp Peer
. crowd
89 affiliati
– ons of
99) adult
. gay
Bi men:
ng Linkag
ha es with
mt health
on, risk
N behavi
Y: ors.
Ha Psych
wo ology
rth of Men
Pre &
ss. Mascu
Smith, T., linity,
& Bale, C. 9(4),
(2012). 235–
Guide for 247.
the Wright, L.
modern (1997).
bear.
The
Townse
bear
nd,
WA: book:
Pixelita Readin
Press. gs in
Suresha, R. the
(2009). history
Bears and
on
evoluti
bears:
on of a
Intervie
ws and gay
discuss male
ions. subcult
Birmin ure.
gham,
 135

Bingha
AL
mton,
NY: JUSTICE
Hawort
h Press. SYSTEM
Wright, L.
(2001).
The Although
bear people
book common
II: ly refer
Further to the
reading criminal
s in the justice
history system
and in the
evoluti United
on of a States,
gay there are
male actually
subcult many
ure. criminal
Bingha justice
mton, systems
NY: —at the
Hawort federal,
h Press. state,
and local
levels—
each of
BEREAV which is
EMENT a
constella
tion of
agencies
See
working
Dying, toward
Death, (a)
and preventi
Bereave ng crime
ment and
disorder,
(b)
apprehen
BIAS IN ding and
punishin
THE g
CRIMIN criminal
offender
s who
136

commit have
crime, (c) been
rehabilita subjecte
ting d to
offenders especiall
, and (d) y harsh
restoring treatmen
victims t by the
of crime criminal
to make justice
them system.
whole. This
Crime, in entry
turn, is addresse
conduct s
that LGBTQ
threatens people’s
the attitudes
existing toward
social the
order criminal
and, justice
therefore, system
has been and vice
prohibite versa,
d; provides
sanctions an
attach to example
it. of why
Because the
our social attitudes
order is of
dominate criminal
d by justice
straight, personne
White, l matter,
male and then
Christian conclude
s, it is s with a
unsurpris descripti
ing that, on of
historical current
ly, and
women developi
and ng
minoritie employ
s— ment
including practices
LGBTQ affecting
people— LGBTQ
 137

people c
within e
this
system. S
y
s
L t
G e
B m
T
Understa
Qnding
the
Aattitudes
tof sexual
tminoritie
i s toward
tthe
ucriminal
djustice
esystem is
simportan
t for a
Tvariety
oof
wreasons.
First,
a
research
r
shows
dthat
sexual
tminoritie
hs are
edispropo
rtionatel
Cy likely
rto be the
i victims
mof hate
i crimes
ninvolvin
ag serious
l violence.
Second,
Jthe
uincrease
d harm is
s
exacerba
t
ted since
i many
138

victims identity
of these that
crimes helps
decide them
not to move
report past the
them to assault.
the police Research
because on the
they fear attitudes
hostility of
and LGBTQ
abuse at persons
the hands toward
of the the
police. criminal
Third, justice
restorativ system is
e and mixed.
other On one
services hand,
for these LGBTQ
victims people,
may as
require compare
more d with
nuanced their
approach straight,
es than gender-
those for conformi
other ng
victims. counterp
Male arts,
victims have
of abuse, been
for shown to
example, report
who (a) less
receive trust in
assistanc the
e in police,
learning (b) lower
to “fight perceive
back,” d
benefit legitimac
from a y of the
reconstru police,
cted, (c) less
nonvicti respect
m from the
 139

police, heterose
(d) xual
poorer counterp
treatment arts, the
by the attitudes
police, of
and (e) LGBTQ
less people
fairness are
from the related
criminal to a
justice plethora
system. of
On the variables
other ,
hand, includin
LGBTQ g age,
people victimiza
have tion
been history,
found income,
overwhel political
mingly to persuasi
be on, and
satisfied empathic
with the concern.
police.
Regardle
ss of the Crimin
extent to al
which J
sexual u
orientatio s
n or ti
gender c
identity e
might S
influence y
attitudes
st
toward
e
the
m
criminal
justice
system, it A
is clear t
that, like ti
their t
gender- u
conformi d
ng, e
140

s Georgia’
T s
o sodomy
w statute
ar constituti
onal, the
d
Supreme
L
Court
G
determin
B ed that
T
Q [t]h
P e
er issu
so e
ns pre
sen
The ted
evolution is
of wh
attitudes eth
within er
the the
criminal Fed
justice eral
system Co
toward nsti
sexual tuti
minoritie on
s is con
illuminat fers
ed by a a
review of fun
two da
important me
U.S. ntal
Supreme rig
Court ht
decisions upo
on the n
constituti ho
onality of mo
sodomy sex
laws. In ual
Bowers s to
v. eng
Hardwic age
k, a 1986 in
decision sod
ruling om
 141

y the
and Co
hen urt’
ce s
inva role
lidat in
es carr
the yin
laws g
of out
the its
man con
y stit
Stat utio
es nal
that ma
still nda
mak te.
e
such In a
con single
duct sentence,
illeg the Court
al laid out
and four
hav different
e rationale
don s for
e so authorizi
for ng the
a continuin
very g
long condemn
time ation of
. homosex
The ual
case
behavior
also
through
calls
criminal
for
law,
som
namely,
e
that (1)
judg
there is
men
no
t
fundame
abo
ntal right
ut
to
the
engage
limi
in
ts of
sodomy,
142

(2) issu
homosex e in
ual Bo
persons wer
should s
not be was
entitled sim
to special ply
treatment the
, (3) rig
citizens ht
have the to
right to eng
express age
their in
moral cert
opprobriu ain
m sex
through ual
state law, con
and (4) duc
same-sex t
behavior de
has been me
condemn ans
ed the
througho clai
ut m
the
history.
indi
Less than
vid
two
ual
decades
put
later, in
for
Lawrenc
war
e and
d,
Garner v.
just
Texas
as
(2003),
it
however,
wo
the Court
uld
would
de
judge this
me
approach
an
unfavora
a
bly:
mar
ried
To
cou
say
ple
that
wer
the
 143

e it part
to icul
be ar
said sex
mar ual
riag act.
e is The
sim ir
ply pen
abo alti
ut es
the and
righ pur
t to pos
hav es,
e tho
sexu ugh
al ,
inter hav
cour e
se. mo
The re
laws far-
invo rea
lved chi
in ng
Bo con
wer seq
s uen
and ces,
here tou
are, chi
to ng
be upo
sure n
, the
stat mo
utes st
that pri
purp vat
ort e
to hu
do ma
no n
mor con
e duc
than t,
proh sex
ibit ual
a
144

Bia for
s mal
in rec
the ogn
Cri
itio
mi
nal n in
Jus the
tic law
e , is
Sys wit
te hin
m the
libe
beha rty
vior of
, per
and son
in s to
the cho
mos ose
t wit
priv hou
ate t
of bei
plac ng
es, pun
the ish
hom ed
e. as
The cri
stat min
utes als.
do
seek Lest
to any
cont doubt
rol a exist
pers about its
onal view of
relat the
ions Bowers
hip decision,
that, the
whe Court, in
ther a
or stinging
not rebuke,
entit held that
led “Bowers
to was not
 145

correct sex
when it behavior.
was Many
decided, states
and it is subscribe
not to a lock-
correct and-key
today. It conceptu
ought not alization
to remain of
binding appropri
precedent ate
. Bowers human
v. sexual
Hardwic behavior
k should in which
be and anything
now is other
overruled than the
.” “right”
Althou key
gh it is going
tempting into the
to view “right”
this lock is
evolution consider
in ed
sodomy sodomy.
case law Thus,
as creative
evidence heterose
of a sea xual
change in behavior
tolerance, can run
such a afoul of
conclusio sodomy
n would statutes
be too as well.
hasty. At Moreove
the time r, in
of the Lawrenc
Lawrenc e only a
e bare
decision, majority
13 states of the
prohibite Supreme
d sodomy Court
and 9 held that
singled the right
out same- of
146

privacy to
extended maintain
to same- the
sex discrimin
sexual atory
intimacy. status
Justice quo.
Sandra
Day
O’Conno Police
r agreed Attitude
with the s
outcome, Toward
but for a LGBTQ
different Persons
reason.
As we Maintena
see nce of
unfolding the
now in status
the quo is
context the
of essence
marriage of
equality, conserva
justice is tism, the
available dominan
largely t
through philosop
the courts hy of
and even police
then, officers.
sometime Studies
s by thin of police
majorities have
. Finally, consisten
the tly
criminal shown a
justice strong
system is conserva
populated tive bias.
by Research
conservat has
ive repeatedl
employee y
s and demonstr
conservat ated that
ive ideals the
—all police
seeking generally
 147

have congruen
antiquate ce
d between
perspecti attitudes
ves on and
sexuality behavior
and tend . In fact,
to have studies
punitive generally
attitudes fail to
toward demonstr
sexual ate a
minoritie direct
s who relations
commit hip
crimes. between
They unfavora
tend to ble
subscribe attitudes
to toward
negative gays and
stereotyp lesbians
es of and
LGBTQ discrimi
people natory
and tobehavior
feel . This
superior. has not
Bi always
as been the
in case,
th
however,
e
Cr
as
im discrimi
in natory
al practices
Ju of the
sti past
ce were
Sy
much
ste
m
more
blatant
and led
On the to bitter
other conflict.
hand, On
there the heels
appears of the
to be a civil
lack of rights
148

movemen but. The

t for patrons
African resisted
American the
s during police,
the then
1960s, assaulted
the them,
LGBTQ and then
civil riots
rights broke
movemen out over
t was the
born out followin
of the g days.
crucible Years of
of such frustratio
conflict. n at
The being
flashpoint discrimin
occurred ated
in New against
York and
City in denied
the their
summer personho
of 1969 od
at a gay bubbled
tavern in up
Greenwic among
h Village. the bar’s
The patrons,
patrons and a
of the moveme
drag bar nt was
were born;
accustom enough
ed to was
frequent enough.
raids, but Unfortun
in the ately,
early police
morning harassme
hours of nt—or
June 28, the
1969, a perceptio
routine n thereof
raid —
became persists.
anything In 2013,
 149

a decade d
after the character
Supreme istics) of
Court perpetrat
held ors.
same-sex Recent
sexual research
intimacy suggests
to be that
constituti certain
onally character
protected, istics
East that vary
Baton among
Rouge LGBTQ
Parish people
(Louisian (e.g.,
a) Sheriff openness
Sid about
Gautraux sexual
targeted orientati
gay men on,
for arrest internaliz
on ed
account homopho
of bia, and
conduct connecti
that was on to the
clearly lesbian,
legal. gay, and
Harass bisexual
ment of communi
LGBTQ ty) may
persons, be
of course, associate
is d with
problema certain
tic. types of
Proper offendin
police g
practices, patterns.
though, Moreove
can and r, once
should be arrested,
informed sexual-
by the minority
LGBTQ detainees
status may
(and require
associate different
150

treatment entitled
with to
regard to protectio
housing n by and
decisions. vindicati
on
Restorin through
g the
criminal
Victims
justice
to Make system
Them as well.
Whole Because
Appropri sexual
ate orientati
responses on and
to gender
LGBTQ identity
persons may
involve influence
more differenti
than al
proper victimiza
treatment tion
when rates,
they are comfort
the levels
targets of with the
arrests criminal
and justice
prosecuti system,
ons. and
LGBTQ restorati
people ve
are also treatmen
victims t
of crime approach
—indeed es,
at higher among
rates than other
their factors,
gender- the
conformi system
ng, needs to
heterosex be
ual willing
counterpa and able
rts—and, to
therefore, respond
are with the
 151

kind of studies
sensitivit suggest
y, that gay
compassi and
on, and lesbian
competen applicant
ce other s for
victims criminal
have justice
come to system
expect. jobs are
less
likely to
The
progress
Crimin
beyond
al
initial
Justice screenin
Syste g in the
m as hiring
Emplo process.
yer Such
Although discrimi
the nation is
criminal more
justice likely (a)
system in some
cannot parts of
choose the
its country
perpetrat than
ors or others,
victims, (b) with
it can and jobs
must associate
choose d with
its stereotyp
employee ically
s. male and
Discrimi straight
nation traits
against than
LGBTQ those
persons without
in such
general is associati
well ons, and
document (c)
ed. against
Recent gay men
than
152

against gender
lesbians. identity
Once as part of
LGBTQ the
persons backgrou
are hired, nd
employer investiga
s often tory
treat process.
them as Thus,
outsiders. aspects
LGBT of their
Q sexuality
employee and
s in gender
general, identity
and gay pose
male added
police challeng
officers es that
in LGBTQ
particular employe
, report es must
feeling balance
pressure alongsid
to hide e the
their demands
sexual of their
orientatio jobs.
n.
Ironically
A
, this is
easier Brighter
now than Horizon
in the There
past are
because promisin
criminal g signs
justice that the
agencies criminal
are justice
increasin system
gly employ
refraining ment
from context
exploring for
matters LGBTQ
of employe
sexuality es is
and improvin
 153

g. Earl was
Warren populate
was chief d by
justice of professio
the nals who
United represent
States ed the
Supreme commun
Court ities they
from the served.
mid1950s This
through coincide
most of d with
the President
1960s. Kennedy
One of ’s
his Executiv
guiding e Order
principles 10925
, which directive
informed that
the agencies
overall “take
direction affirmati
of the ve action
Court, to ensure
was that that
the applicant
criminal s are
justice employe
system d, and
had to that
undergo employe
massive es are
reform to treated
safeguard during
and employ
guarantee ment,
the without
Constituti regard to
onal their
rights of race,
all creed,
citizens, color, or
thereby national
ensuring origin.”
that the As a
criminal result of
justice these
system develop
154

ments, Gay,
the all- lesbian,
White, and
all- bisexual
Christian, officers
allmale, are
all- serving
straight openly,
criminal and
justice agencies
agencies are
of the beginnin
1950s g to be
and more
1960s acceptin
gave way g of
to a more transgen
diverse der
workforc employe
e. es as
Althou well. As
gh noted
criminal above,
justice agencies
agencies are de-
have emphasiz
been ing these
slower to issues in
embrace backgrou
sexually nd
diverse investiga
and tions.
genderno Some
nconform agencies
ing are
employee changing
s than their
they have policies
been to to clarify
accept that
ethnic sexual-
and racial minority
minoritie and
s and genderno
women, nconfor
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 155

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156

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Q
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g
by Law
s
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ment; Bowers v.
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ration; 478 U.S.
Laws 186
Bannin (1986).
g Lawrence
Homos and
exualit Garner v.
y and Texas,
Sodom 539 U.S.
y; 558
Marria (2003).
ge
Equalit
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Landm
ark
Court
Decisio
ns;
Police
Officer
s/Law
 157

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158

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househol we
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160

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 161

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162

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164

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170

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 171

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172

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 173

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174

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 175

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176

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 177

and new balance

informati between
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178

large- inclusion
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 179

See also h, Use

Demograp of
hics and Large
the Datase
LGBTQ ts in;
Population Sampli
; ng
Heteros
exist
Bias in F
Researc u
h; r
Method t
ologica
h
l
e
Decisio
ns by
r
Researc
hers of R
LGBT e
Q a
Populat d
ions; i
Populat n
ion- g
Based
s
Survey
s, Gates,
Collecti G.
on of (2
Data on 01
Sexual 4).
Orienta L
tion G
and BT
Gender de
Identity m
; og
Psychol ra
ogical ph
Approa ics
ches to :
Studyin Co
g m
LGBT pa
Q ris
People; on
Qualita s
tive a
Researc m
h; on
Quantit g
ative po
Researc pu
h; lat
Researc io
n-
180

bas al
ed Sa
sur me-
vey Sex
s. Co
Los upl
An es
gel and
es, Fa
CA mili
: es
Wil
lia
ms Meyer, I.
Inst (2003).
itut Prejudi
e. ce,
Ret
social
rie
stress,
ved
fro and
m mental
htt health
p:// in
wil lesbian
lia , gay,
msi
and
nsti
tute bisexu
.la al
w.u popula
cla. tions:
edu Conce
Herek, G., ptual
Kimmel, issues
D., Amaro,
and
H., &
researc
Melton, G.
(1991). h
Avoidi eviden
ng ce.
heteros Psych
exist ologic
bias in al
psychol Bulleti
ogical
n, 129,
researc
h. 674–
Americ 697.
an Russell,
Psycho S., &
logist, Murac
46, o, J.
957– (2013).
963. The
Bina use of
tion represe
 181

ntative sexual
data orient
sets to ation
study on
LGBT survey
Q- s. Los
parent Angele
families s, CA:
: Willia
Challen ms
ges, Institut
advanta e.
ges, Retriev
and ed
opportu from
nities. http://
In A. willia
Goldbe msinsti
rg & K. tute.la
Allen w.ucla.
(Eds.), edu
LGBT-
parent
familie
s:
Innovat BINATI
ions in
researc ONAL
h and
implica SAME-
tions
for SEX
practic
e (pp. COUPLE
343–
S
356).
New AND
York,
NY: FAMILIE
Springe S
r.
Sexual Historica
Minorit lly, the
y topics of
Researc same-sex
h
marriage
Assess
ment and
Team. immigrat
(2009). ion
Best reform
practic have
es for been
asking
debated
questio
ns as
about separate
182

political other is a
issues. foreign
Both national.
issues, For
however, years,
have the
impacted ideologic
the lives al
of underpin
LGBTQ nings
immigran inherent
ts and in
their immigrat
American ion laws
partners. separate
Presently d
in the committ
United ed
States, couples,
families forced
that couples
include into
same-sex exile,
binationa and
l couples resulted
are part in the
of the deportati
increasin on of
gly partners/
diverse spouses
family of
landscape America
. ns under
Binationa the
l couples Defense
are of
defined Marriage
here as Act
same-sex (DOMA)
partnersh . This
ips in entry
which describes
one the
spouse or sociocult
partner is ural
an context
American in which
citizen or binationa
resident l couples
and the are
 183

situated U.S.
and the Supreme
challenge Court
s they struck
face down
today. In state
the bans on
following same-sex
sections, marriage
the entry .
presents Binatio
the nal
demogra Same-
phics of Sex
binationa Couple
l
s and
families,
Familie
the ways
in which s
DOMA
directly
The
impacted
Demo
immigrati
on law graph
and the ics of
lives of Binati
binationa onal
l Coupl
families, es
the As of
positive 2010,
ramificati data
ons from the
DOMA’s America
repeal n
has had Commun
on ity
binationa Survey
l estimate
families, d that
and the 12% of
challenge same-sex
s and couples
obstacles in the
binationa United
l families States
continue had at
to face least one
even noncitize
after the
184

n partner. are
The raising
Williams an
Institute estimate
found d 17,000
that children.
among Another
noncitize study
n publishe
partners d by the
in same- Williams
sex Institute
binationa in 2013
l couples, found
45% are that from
Latina/o 2005
and 14% through
are 2011,
Asian/Pa same-sex
cific couples
Islander. were as
The likely as
majority opposite-
of sex
noncitize couples
n to be
partners binationa
come l.
from
Mexico
(25%), DOMA’s
Canada
Impact
(8%), and
on
the
United Bination
Kingdom al
(6%). Couples
Data Designed
from the to define
study marriage
proposed as the
that a legal and
quarter of valid
male union
binationa between
l couples a man
and 39% and a
of female woman,
binationa DOMA
l couples
 185

ensured States.
that Instead,
same-sex America
marriages ns were
recognize forced to
d by decide
individua between
l states staying
would in the
not be United
entitled States
to more without
than their
1,000 partner
federal and
marriage starting a
benefits, new life
including with
immigrati their
on family
benefits. abroad.
Under To
DOMA, comply
American with
s in immigrat
same-sex ion law,
relationsh many
ips were binationa
not l couples
allowed alternate
to bring d
their between
noncitize living in
n the
partner/s United
pouse to States
the for a few
United months
States or and
provide abroad
citizenshi for the
p to their rest of
settled the year.
immigran Marri
t partner ed
living couples
with in which
them in one
the partner is
United transgen
186

der were perhaps,

required for a
to lifetime;
demonstr or move
ate that the
their family to
unions another
qualified country
as valid where
opposite- same-sex
sex binationa
marriages l families
under are fully
state law recogniz
to gain ed. In
immigrati many
on cases,
benefits. the
Foreign noncitize
nationals n
living in partner’s
the deportati
United on
States interfere
with their d with
American previousl
citizen y
partners establish
were ed
forced to househol
choose d
between relations
the hips and
following seriously
options: disrupted
face parent–
voluntary child
deportati attachme
on; apply nts. At
for a times,
temporar foreign
y visa; nationals
assume were
undocum deported
ented back to
status for countries
an that
indefinite criminali
period of ze
time or, homosex
 187

uality and Anusha

persecute Kassan
individua and
ls based Nadine
on their Nakamur
sexual a in 2013
orientatio found
n and that
gender binationa
identity l couples
or often
expressio immigrat
n; ed to
penalties Canada
currently when the
range pursuit
from of legal
small status by
fines to the
death foreign
sentences national
. through
American student
citizens or work
who visas in
followed the
their United
partners States
after was no
deportati longer a
on often viable
faced option.
several
challenge
s Hardshi
including p Under
leaving DOMA
their Because
support immigrat
network, ion
native control
language, is partly
career, responsi
and ble for
elderly nation
parents making
behind. and
Research national
conducte security,
d by
188

immigrati on into a
on disputed
officers sociopoli
rigorousl tical
y topic.
consider After the
sexuality Septemb
and its er 11,
overlappi 2001,
ng terrorist
identities attacks
including on the
gender, United
race, and States,
class at stricter
the time immigrat
of ion laws
admissio induced
n. Unique ongoing
barriers psycholo
surface gical
for stress for
LGBTQ immigra
immigran nt
ts as they families
are many living in
times the
situated interior
at the of the
intersecti nation as
on of they
homopho potential
bia, ly faced
racism, long-
and anti- term
immigran family
t separatio
sentiment n as a
. result of
Moreover deportati
, the U.S. on or
economic voluntar
crisis y
together departur
with the e.
declared In
“War on 2006,
Terror” researche
turned rs
immigrati working
 189

for as a
Immigrati defensiv
on e coping
Equality strategy
and that
Human protected
Rights families
Watch from
found experien
that cing
binational parent–
couples child
living in separatio
the n.
United Bination
States al
suffered parents
from had to
emotional navigate
hardship the
and persisten
feelings t tension
of between
immobilit recogniti
y, on and
isolation, protectio
fear, n.
anxiety, Further,
and terror they
as a result were
of the forced to
“forced make
confident importan
iality” t
that came determin
with ations
threats of about
facing disclosur
family e when
separatio interactin
n. In the g with
case of various
same-sex systems
binational (e.g.,
couples religious
with communi
children, ty,
invisibilit employm
y was ent, and
perceived educatio
190

n), barriers,
especially and
when racism
they inside
perceived mainstre
homopho am
bia LGBTQ
within groups
their may
immigran interfere
t with
communi their
ties. integrati
Same-sex on into
binational the local
couples LGBTQ
were communi
forced to ty. For
learn how example,
to Latina/os
function in same-
in a sex
social binationa
system l
while relations
dealing hips
with frequentl
heterosex y have to
ism, overt navigate
discrimin multiple
ation, cultural
violence, values
and the including
psycholo religious
gical beliefs, a
symptom strong
s that sense of
result masculin
from e pride
helplessn (i.e.,
ess. machism
In the o), and
case of family
LGBTQ loyalty.
ethnic They are
and racial often
minoritie forced to
s, decide
language, between
cultural living
 191

their life reject or

openly as challeng
members e the
of the cultural
LGBTQ beliefs,
communi values,
ty or and
following traditions
the of
conventio LGBTQ
nal ethnic
expectati and
ons of racial
their minoritie
family of s.
origin
and
church DOMA’s
communi Demise:
ties. A
During Victory
their for
coming- Binatio
out
nal
process,
LGBTQ
Couples
Latina/os While
often supporte
suffer rs of
major same-sex
losses marriage
including argued
family, that
church, DOMA
and endorsed
social and
support. legitimiz
Mainstrea ed the
m inequalit
LGBTQ y to
groups which
can same-sex
create an couples
atmosphe are
re of subject,
confusion opponent
and s of
distress same-sex
when marriage
they contende
192

d that “traditio
DOMA n”
legitimat should
ely not be
followed confused
a with
tradition discrimi
of male– nation
female and
unions. underlin
They ed the
argued constituti
that onal
providing promise
marriage of the
rights to equal
same-sex protectio
couples n of laws
would for all
lead to a America
downfall ns as the
of the foundati
“tradition on for
al” the
institutio fundame
n of ntal right
marriage to marry
and a person
damage of one’s
the health choosing
of .
children. On
Supporter June 26,
s of 2013,
Bina supporter
tion s of
al marriage
Sam
equality
e-
Sex claimed
Cou victory
ples when the
and U.S.
Fam Supreme
ilies Court
struck
family down
equality Section 3
claimed of
that DOMA
in
 193

United ips
States v. neglecte
Windsor d under
and DOMA
recognize were
d recogniz
marriages ed for
of same- purposes
sex of
couples citizensh
at the ip
federal sponsors
level. As hip and
a result, transmiss
President ion, and
Obama foreign
directed nationals
United married
States to U.S.
Citizensh citizens
ip and were
Immigrati given the
on opportun
Services ity to
(USCIS) obtain
to review immigra
immigrati nt visas
on visa for their
petitions children.
filed on This
behalf of was a
a same- partial
sex win for
spouse in same-sex
the same binationa
manner l families
as those residing
filed on in
behalf of nonrecog
an nition
opposite- states as
sex they
spouse. were
With this expected
victory, a to travel
number and
of marry in
parent– states
child that
relationsh recogniz
194

ed same- binationa
sex l couples
marriage married
to qualify prior to
for divorcin
immigrati g their
on spouses,
benefits. USCIS
Another may
challenge have
faced by consider
binational ed the
couples marriage
after the to be
U.S. polygam
Supreme ous and
Court’s invalid
Windsor for
decision immigrat
was the ion
issue of benefits.
divorce. After
For the
same-sex United
couples States v.
residing Windsor
in states decision,
that did some
not states
perform continue
same-sex d to
divorces, endorse
divorcing bans on
spouses same-sex
was a marriage
complex despite
process empirical
as there evidence
was that
contentio illustrate
us debate d the
over harmful
which psycholo
jurisdicti gical
on should effects of
perform policies
the restrictin
divorce. g
Thus, if marriage
same-sex rights for
 195

same-sex disorder,
couples. alcohol
In 2010, use
Mark L. disorders
Hatzenbu , and
ehler, psychiatr
Katie A. ic
McLaugh comorbi
lin, dity. In
Katherine contrast,
M. psychiatr
Keyes, ic
and disorders
Deborah did not
S. Hasin increase
proposed significa
that ntly
lesbian, among
gay, and LGB
bisexual responde
(LGB) nts
people living in
living in states
states without
with constituti
constituti onal
onal bans amendm
on gay ents
marriage prohibiti
demonstr ng same-
ated a sex
significan marriage
t increase . With
in the this and
Bination similar
al research
Same- in mind,
Sex supporte
Couples
rs of
marriage
and
equality
Families
advocate
d for the
prevalenc equal
e of protectio
mood n,
disorders, recogniti
generaliz on, and
ed mental
anxiety health of
196

same-sex divorce
couples regardles
nationwi s of
de. where
On the
June 26, couple
2015, the married.
Supreme This
Court’s decision
landmark gave
decision same-sex
in binationa
Obergefe l couples
ll v. living in
Hodges states
required that had
all states bans on
to issue gay
marriage marriage
licenses the
to same- freedom
sex to marry
couples, in the
including state of
same-sex their
binational choosing
couples. and
This enjoy
decision spousal
invalidate benefits
d state including
laws all state
banning tax
same-sex benefits.
marriage, It is
required importan
all states t to state
to that civil
recognize unions or
same-sex domestic
marriages partnersh
previousl ips are
y not
performe accepted
d in other for
jurisdicti immigrat
ons, and ion
provided purposes
the equal at this
right to time. It
 197

remains that their

unclear marriage
exactly s are
how valid.
relevant Same-
the sex
Supreme binationa
Court’s l couples
decision sometim
will be es have
for same- difficulty
sex proving
binational to the
families Departm
raising ent of
children Homelan
in a post- d
Obergefe Security
ll world. that their
marriage
is a
Today’s genuine
Struggle or “bona
fide
s
union”
When because
United they
States often
Citizensh lack the
ip and same
Immigrat forms of
ion evidence
Services or proof
(USCIS) that
reviews opposite-
immigrati sex
on visa couples
petitions have
filed on available
behalf of (e.g.,
a same- family
sex and/or
spouse, friend
the testimoni
governm es of the
ent asks marriage
couples ). As a
to result,
provide they may
evidence find
198

themselv openly
es facing declared
unsuppor their
ted marriage
accusatio to
ns of friends
marriage and
fraud. An families,
article same-sex
published couples
by may
Benjamin choose
Edwards to keep
in 2013 their
argues relations
that hip
immigrati private
on to avoid
officials having
should traumati
understan c
d the conversa
culture- tions
specific with
differenc relatives.
es Consi
between dering
same-sex available
and research
opposite- identifyi
sex ng the
marriages prevalen
before ce of
determini psychiatr
ng ic
whether a disorders
marriage among
is valid LGB
or populatio
fraudulen ns that
t. lived in
Although states
it may be with
suspiciou bans on
s when samesex
an marriage
opposite- , special
sex attention
couple should
has not be given
 199

to same- s from
sex service
binational providers
couples .
that lived
in those
states for Conclusi
years. on
Unfortun
ately, Overturn
although ing
LGBTQ Section
immigran 3 of
ts are in DOMA
need of yielded
quality significa
health nt
services, victories
including for
mental same-sex
health binationa
care, l
research families,
conducte such as
d by eligibilit
Karma R. y to
Chavez obtain
in 2011 immigrat
suggested ion
that when benefits
LGBTQ for
immigran foreign
ts needed national
help with partners
health and the
care potential
concerns, for
they children
turned to of
family foreign
and nationals
friends as in same-
they sex-
perceived binationa
a lack of l
cultural relations
competen hips to
ce and gain
cultural immigra
awarenes nt visas.
200

Neverthel the
ess, United
numerous States.
obstacles Thus,
and even in a
threats post-
continue Obergef
to affect ell
these world,
families same-sex
even couples
after the remain
Supreme vulnerabl
Court’s e to the
decision power
to Congress
invalidate holds to
state bans change
on same- immigrat
sex ion law.
marriage While
in marriage
Obergefe equality
ll v. provides
Hodges. undeniab
The le
U.S. positive
Constituti outcome
on grants s for
the same-sex
legislativ binationa
e and the l
executive families,
branches unrelenti
sole ng
power to hardship
regulate s uphold
all the
aspects of necessity
immigrati for
on law. continue
Congress, d
for attention
example, to this
has the populatio
power to n.
exclude On
immigran Novemb
ts from er 20,
entering 2014,
 201

President in mind,
Obama future
announce immigrat
d a series ion
of reform
executive needs to
actions to be
provide LGBTQ-
up to 5 inclusive
million and
undocum protect
ented undocum
immigran ented
ts LGBTQ
protectio immigra
n from nts from
deportati being
on. deported
Although to
these countries
measures that
aim to criminali
help ze
immigran homosex
ts who uality.
have U.S. Although
citizen many
children same-sex
and binationa
spouses, l couples
such have
protectio celebrate
n d the
excludes repeal of
more DOMA
than and the
267,000 Supreme
undocum Court’s
ented decision
LGBTQ in
immigran Obergef
ts, many ell v.
of whom Hodges,
are inclusive
unmarrie immigrat
d ion
LGBTQ reform
binational and
couples. policy at
With that the state
202

level are People

needed to by
Law
fully
Enforce
recognize
ment;
and
Freedom
protect to Marry
unmarrie (and
d same- Other
sex Marriag
binational e
families. Equalit
y
Organi
zations
);
Immig
ration;
Marria
G. ge
Equalit
y,
Landm
ark
Court
Decisi
ue ons

F
u
r
Ja
t
cq
h
ue
e
r
ne
R
e
a
d
i
oc
n
g
s
See also
Defense of Canaday,
Marriage M.
Act (2009).
(DOMA); The
Discrim straigh
ination
t state:
Against
LGBT Sexual
Q ity and
 203

citizens nal
hip in familie
twentiet s:
Resilie
h-
nt
century victims
Americ of
a. sexual
Princet prejudi
on, NJ: ce and
discri
Princet
minato
on
ry
Univers immigr
ity ation
Press. policie
Chavez, s.
K. R. Journa
(2011 l of
). GLBT
Identi Family
fying Studie
the s, 8(5),
needs 496–
of 508.
LGBT Edwards
Q , B.
immig P.
rants (201
and 3).
refuge Welc
es in omin
southe g a
rn post-
Arizo DO
na. MA
Journ worl
al of d:
Homo Sam
sexual e-sex
ity, spou
58(2), sal
189– petiti
218. ons
Domíngue and
z, D. other
G., post-
Solórza Win
no, B. dsor
H., & immi
Peña, grati
E. on
(2012). impli
Non- catio
heteros ns.
exual Fam
binatio ily
204

Law Watc
Quar h, &
terly, Immi
47(2), gratio
173– n
189. Equal
Hatzenbue ity.
hler, M. (2006
L., ).
McLau Famil
ghlin, y,
K. A., unval
Keyes, ued:
K. M., Discr
& imina
Hasin, tion,
D. S. denia
(2010). l, and
The the
impact fate
of of
instituti binati
onal onal
discrim same-
ination sex
on coupl
psychia es
tric under
disorde U.S.
rs in law.
lesbian, New
gay, York,
Biphob NY:
ia Autho
r.
Retrie
and ved
bisexua Febru
l ary
populat 16,
ions: A 2016,
prospec from
tive https:/
study. /www
Americ .hrw.
an org/si
tes/de
Journal
fault/f
of iles/
Public report
Health, s/Fam
100, ilyUn
452– value
d.pdf
459.
Kassan,
Human
A., &
Rights
Nakam
 205

ura, N. Insti
(2013). tute.
“This
was my
only
option”
: Career BIPHOB
transiti
ons of
IA
Canadi
an
immigr The term
ants in biphobia
same-
describes
sex
binatio
forms of
nal prejudice
relation and
ships. discrimi
Journal nation
of against
LGBT
bisexual
Issues
in
people.
Counse It covers
ling, antibisex
7(2), ual
154– sentimen
171. ts and
Konnoth negative
, C.
attitudes
J., &
Gates
regardin
, G. g
J. bisexual
(201 people
1). and their
Same (alleged)
-sex
character
coup
les
s,
and bodies,
immi relations
grati hips,
on in families,
the and
Unit
sexualiti
ed
State
es.
s. The
Los concept
Ange gained
les, currency
CA: within
Willi
bisexual
ams
activism
206

in the of
course of antigay
the discrimin
1990s. ation.
There is a The
family same
resembla applies
nce with to
the term biphobia
homopho and other
bia, related
which the concepts,
psycholo such as
gist lesbopho
George bia or
Weinberg transpho
defined bia.
in 1972 Bisexual
as an activists
“abnorma interpret
l dread” biphobia
of being as a
in distinctiv
proximity e mode
with of
homosex oppressi
uals. In on that is
its different
contempo from
rary homopho
usages, bia, even
the if there
meanings are
associate overlaps
d with the regardin
term g certain
homopho core
bia have themes.
broadene A major
d beyond differenc
the e is that
interperso bisexuals
nal to are likely
include to
also experien
cultural ce
and biphobia
institutio not only
nal in
features heterose
 207

xual but as
also inoversexe
lesbian d,
and gay promiscu
spaces. ous, and
Bipho greedy
bia people,
encompas who are
ses sets incapabl
of e of
stereotyp monoga
es, forms my,
of denial prone to
(e.g., the be
claim swingers
“bisexual , or high-
s don’trisk
exist”), orpartners
erasure with
through respect
appropria to
tion (e.g.,sexually
if transmitt
bisexuals ed
are seen diseases.
as These
closeted assumpti
or ons often
confused go hand-
homosex in-hand
uals orwith the
misguide view that
d bisexuals
heterosex are
uals). shallow
Major and
anti- narcissist
bisexual ic. The
Bi notion
ph that
ob “bisexua
ia
ls have
the best
stereotyp of both
es worlds”
include is a
the benign
represent variant
ation of of the
bisexuals oversexu
208

alization cowards
trope. (who do
The not have
belief the guts
that to face
bisexualit the
y does stigma of
not exist proudly
or is only being
a lesbian
transitory or gay)
phase or as
takes commit
manifold ment-
forms. It phobic
stamps voyeurs
everyone (who
who refuse to
identifies take part
as in the
bisexual work of
a liar or a building
self- institutio
deluding ns and
person. In communi
these ties). In
cases, politicize
bisexuals d lesbian
are seen and gay
as being circles,
as stuck bisexuals
in an also
immature often
state, experien
incapable ce
of misrepre
figuring sentation
out their as
(allegedly untrustw
) true orthy
orientatio allies,
n. The cop-outs,
popular or
metaphor traitors.
of the The
“fencesitt distinctiv
er” e
ridicules features
bisexuals of a
as stereotyp
 209

e depend and
on the sexist
wider assumpti
social ons. The
context discourse
and on of the
the “down
subjectivi low”
ties of the targets
people specifica
involved lly
in an African
interactio America
n. For n men
example, and
the Latinos
stereotyp through
e that their
bisexual descripti
women on as
will dishonest
always partners
leave and HIV
their carriers.
woman Biphobia
partner is not a
for a man uniform
remains discourse
largely , but a
confined differenti
to alist and
lesbian- differenti
feminist alizing
settings. practice
For Black that
and intersects
minority with
ethnic other
women, forms of
the oppressi
stereotyp on.
e of Accordin
oversexu g to
alization Kenji
is Yoshino,
aggravate heterose
d through xual and
a lesbian
confluenc and gay
e of racist cultures
210

conspire implies a
in an focus on
“epistemi individua
c contract l
of prejudice
bisexual rather
erasure” than
that structural
enforces forms of
bisexual oppressi
invisibilit on and
y. their
Bisexuals effects,
are such as
erased poverty,
both exclusio
individua n from
lly (as in services,
claims and
such as workplac
“they are e
not discrimin
bisexual, ation.
it’s just a Alternati
phase”) ve
and concepts,
collective such as
ly (as in bi-
claims negativit
such as y and
“bisexual monosex
ity does ism, aim
not to avoid
exist”). such
Critiq trappings
ues of the .
concept There
of has been
biphobia intense
have debate
focused on the
on its respectiv
fixation e value
on the of these
psycholo concepts
gical and and in
interperso particula
nal r on the
dimensio nature of
n. This the
 211

interrelati For
on Miguel
between Obradors
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212

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 213

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Bisexual Inclusion in the LGBTQ Rights Movement

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11(2–
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3),
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227–
244.
R
Obradors-
e Campos,
a M.
d (2010).
i Deconstru
n cting
g biphobia.
s Journa
l of
Eisner, S.
Bisexu
(2012). Bi:
ality,
Notes for a
11(2–
bisexual
3),
revolution.
207–
Berkele
226.
y, CA:
Seal Ochs, R.
Press. (1996).
Klesse, C. Bipho
(2011). bia: It
Shady goes
charact more
ers, than
untrust two
worthy ways.
partner In B.
s, and A.
promis Fireste
cuous in
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 215

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RIGHTS
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Henry led to the
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218

ment in United
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 219

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 221

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222

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 223

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224

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 225

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226

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 227

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228

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Research bisexual
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 229

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230

identity, the same

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ips with people,
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 231

particular of
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232

bisexual or
people stalking
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 233

communi locations
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234

F W. J.
u Blume
r nfeld,
t R.
h Castan
e eda, H.
r W.
Hackm
R an, M.
e L.
a
Peters,
d
& X.
i
Zuniga
n
(Eds.),
g
Readin
s
gs for
Barker, M. diversi
(2004). ty and
Includi social
ng the justice
B-
: An
word:
anthol
Reflecti
ogy on
ons on
racism
the
, anti-
place
Semiti
of
sm,
bisexua
sexism
lity
,
within
hetero
lesbian
and gay sexism
activis ,
m and ableis
psychol m, and
ogy. classis
Lesbia m (2nd
n and ed., pp.
Gay 276–
Psycho 280).
logy New
Review York,
, 5(3), NY:
118– Routle
122. dge.
Deihl, M., Eisner, S.
& Ochs, R. (2013).
(2009). Bi:
Biphobia. Notes
In M. for a
Adams, bisexu
 235

al
revoluti COMM
on. UNITY
Berkele
When
y, CA:
Sealdiscussin
Press.
g
Klein, F.
bisexual
(1993).
people
The
and
bisexua
commun
l option
(2ndity, it is
importan
ed.).
New t to first
York,
define
NY:
the term
Routled
ge. bisexual
and
Ochs, R.,
& clarify to
whom
Highley
the term
man, L.
(1999).
applies.
Bisexua
While
l
some
movem
people
ent. In
B. who
identify
Zimmer
man as
(Ed.),
bisexual
Lesbia
may be
n
attracted
historie
to only
s and
two
culture
sexes or
s: An
genders,
encyclo
pedia
many
(pp.people
112–
who
114).
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as
York,
NY: bisexual
are
Garland
. attracted
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spectrum
BISEXU of
AL people
inclusive
PEOPLE of more
than just
AND
236

cisgender identify
men and as
women. bisexual.
Thus, it They
is more may
accurate instead
to define identify
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y as a heterose
sexual xual or
identity gay or
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g or they
romantic may
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attraction with
to more another
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romantic another
behavior label,
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gender, es, for
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 237

and of the
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Sexual the
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sexual States is
behavior, from the
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important National
to Health
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238

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ately 2.2 actual
million populatio
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bisexual, people
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These underesti
numbers mated, as
likely data are
underesti collected
 239

face-to- zed
face groups.
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240

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 241

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242

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 243

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244

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 245

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246

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 247

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248

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 249

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250

for ual
bisexual people.
people to
Corey
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communi Biphobia;
ty. As Bisexual
people Inclusion
become in the
more LGBTQ
educated Rights
Move
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ment;
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effects of ualitie
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come out. e
In this r
way,
bisexual R
people e
could be a
their d
whole i
selves in n
environm g
ents that s
were not Dodge, B.,
specifical Schnar
ly rs, P.
dedicated W.,
Reece,
to
M.,
bisexual Goncal
and other ves,
non- G.,
monosex Martin
ez, O.,
 251

Nix, R., Firest

… ein
Fortenb (Ed.),
erry, D. Bisex
(2012). uality
Commu : The
nity psych
involve ology
ment and
among politi
behavio cs of
urally an
bisexua invisi
l men ble
in the minor
midwes ity
tern (pp.
USA: 240–
Experie 259).
nces Thousa
and nd
percepti Oaks,
ons CA:
across Sage.
commu Moshe
nities. r,
Culture W.
, D.,
Health Ch
& and
Sexuali ra,
ty: An A.,
Interna &
tional Jon
Journal es,
for J.
Resear (20
ch, 05).
Interve Sex
ntion ual
and beh
Care, avi
14(9), or
1095– and
1110. sele
Hutchins, cte
L. d
(1996) hea
. lth
Bisexu me
ality: asu
Politic res:
s and Me
comm n
unity. and
In B. wo
A. me
252

n Ameri
15– can
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s of
Public
age,
Unit Health
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Stat 100(3),
es, 496–
200 502.
2. Voss,
Adv G.,
anc Br
e ow
Dat ne,
a K.,
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l ,
and C.
Hea (20
lth 14)
Stat .
istic E
s, mb
362, rac
1– ing
56. the
Ross, L. “a
R., nd
Dobins ”:
on, C., Be
& tw
ee
Eady,
n
A.
qu
(2010). eer
Perceiv an
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nants ex
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the
mental
ory
health at
for Bri
bisexua ght
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people: Bi
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 253

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identify
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254

identify A
as History
bisexual. of
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current
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entry
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underpin
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nings and
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1800s to
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literature
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these
 255

relationsh ts such
ips would as Karl
have Heinrich
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sexual. Richard
What has von
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identity began
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sexologis Ulrichs
256

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1895) the
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sexologis persisten
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Ebing influence
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1902), “inversio
sometime n”
 257

theories other,
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258

to locate the shift

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However, “same-
reflecting sex”
 259

attraction gender
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260

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e
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t Bisexualit
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 261

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Identity bisexual
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In this
direction
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—toward
262

either homosex
men or uality
women; were
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Kinsey homosex
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of exclusive
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as a creating
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and identities
 263

where identity
bisexualit position
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264

located from the

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arise
 265

fixed social
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emotiona and
l and “heterose
266

xual” and
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to other ,
sexualitie eventuall
s. y, of
However, bisexuali
if fluidity ty itself.
is
defined
as a Bye-Bye
spectrum Bisexualit
or space y?
between Perha
homosex ps the
uality most
 267

radical inherent
way inlinks
which between
bisexualit them)
y hascan
been therefore
defined is be
when destabili
traditiona zed and
l identity deconstr
labels are ucted. In
explicitly queer
rejected accounts
and ,
instead identities
the term such as
queer is bisexuali
embraced ty and
. During transgen
the early der
1990s, trouble
philosoph conventi
er Judith onal
Butler stable
and and
others binary
critiqued understa
binary ndings
divisions of
of sex,sexuality
gender, and
and gender.
sexuality, Some
demonstr individu
ating that als
these are embrace
socially this
construct perspecti
ed and ve, and
that prefer to
Bi identify
se their
xu sexuality
ali
as queer
tie
s
rather
than as
bisexual.
they (and Howe
the ver, the
assumed deconstr
268

uction of without a
these distinct
categorie identity
s leaves label to
no unite
identity around,
labels disappea
with r
which to entirely.
articulate Further,
a shared even to
sense of talk
identity. about
This sexuality
makes it generally
that much requires
more drawing
challengi on the
ng to only
create available
communi language
ties and , which
shared is rooted
solidaritie in the
s. In turn, very
this limits binary
the models it
opportuni critiques
ties for and
political rejects.
strategies
that aim
to (Mis)Un
emancipa derstan
te a dings of
group, Bisexual
leading to ity
a risk of
continual How
stigmatiz bisexual
ation. people
This make
means a sense of
risk of and
perpetual define
invisibilit their
y for own
bisexual identities
people, may also
who be
 269

influence overlook
d by their , and/or
own dismiss
beliefs the
and by existence
whether of
they are bisexuali
involved ty.
in Bisexual
lesbian, ity has
gay, been
and/or consider
bisexual ed a
communi stigmatiz
ties. ed and
Research marginal
and ized
theory identity
has and
focused conceptu
not only alized as
on how invalidat
bisexual ed or
people invisible.
understan Bisexual
d their people
identities may
but also experien
on how ce
others biphobia
(mis)und from
erstand both
bisexualit heterose
y. There xual and
are a lesbian/g
number ay
of populati
misconce ons, a
ptions phenome
about non that
bisexualit has
y, often sometim
arising es been
from termed
binary double
models discrimi
of nation.
sexuality One
that key
simplify, misconce
270

ption This may

about be
bisexualit exacerba
y is that it ted by
does not develop
really mental
exist and models
that of
women sexuality
who that
claim to position
be bisexuali
bisexual ty as a
are part of
purely identity
performin develop
g ment.
samesex While
behaviors this can
(such as hold true
kissing) for some
in order lesbians
to titillate and gay
and men,
attract who may
heterosex temporar
ual men. ily
Others identify
consider as
bisexualit bisexual
y to be a before
temporar later
y state claiming
and a lesbian
position or gay
bisexual identity,
people as for
really others
heterosex bisexual
ual or identities
lesbian/ are valid
gay and
people enduring
who have .
yet to Anoth
“make up er
their assumpti
minds” or on is that
“pick a bisexual
side.” people
 271

are to
equally “prove”
attracted their
to men sexuality
and . Many
women. bisexual
(While people
some have
bisexual positione
people d their
may be, identity
not all based on
are.) attraction
Further, (rather
some than
believe behavior
that ) and
because may
bisexual never
people have
are engaged
attracted in a
to more sexual
than one relations
gender, hip
they must either at
therefore all, or
have to with
have more
multiple than one
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simultane Simil
ous) arly, the
sexual idea that
relationsh bisexual
ips to “be people
bisexual. are
” attracted
However, to
behavior “anyone
is not a and
prerequisi everyone
te of ” has
identity, meant
and that
heterosex bisexual
ual people’s
people ability to
are rarely be
required committe
272

d and with
monogam sexually
ous has transmitt
been ed
questione diseases.
d. Other
However, bisexual
current people
relationsh may
ip status have
does multiple
necessaril relations
y indicate hips that
identity, are non-
and many monoga
bisexual mous or
people do polyamo
continue rous.
to However
identify ,
as research
bisexual has
within shown
stable that
monogam openness
ous and
relationsh honesty
ips. (rather
Notions than
of non- cheating
monogam and
y have lying)
caused are
further highly
stigmatiz valued.
ation for These
bisexual (mis)und
people, erstandin
especially gs can
during have
the early negative
era of conseque
HIV/AID nces for
S, when bisexual
their people’s
(assumed sense of
) sexual self and
behaviors mental
were and
linked physical
 273

well- F
being. In u
summary, r
there are t
a range of h
understan e
dings and r
misunder
standings R
of e
bisexualit a
y that are d
likely to i
n
impact
whether, g
s
or how,
people Angelides,
define S. (2001).
themselv A history
of
es as
bisexualit
bisexual y.
and their Chicago,
experienc IL:
es of Univer
bisexual sity of
identifica Chicag
tion. o
Press.
Nikki Bowes-
Hayfield Catt
on,
See also H.,
Biphobia; &
Bisexuality Hayf
, Female; ield,
Bisexuality N.
, Male; (201
Pansex 3).
uality; Bise
Polyam xuali
ory; ties.
Queer; In C.
Sexual- Rich
Identity ards
&
Labels
M.
Bark
er
(Eds.
),
The
Palg
rave
274

hand Londo
book n,
of the Englan
psyc d:
holo Sage.
gy of Hayfield,
sexu N.,
ality Clarke,
and V., &
gend Halliw
er. ell, E.
London (2014).
, Bisexu
Englan al
d: women
Palgrav ’s
e underst
Macmil anding
lan. s of
Eisner, S. social
(2013). Bi: margin
alisatio
Notes for a
n:
bisexual “The
revolution. heteros
Berkele exuals
y, CA: don’t
Seal underst
Press. and us
Esterberg, but nor
K. G. do the
(2002). lesbian
The s.”
bisexua Femini
l sm &
menace Psych
: Or, ology,
will the 24,
real 352–
bisexua 372.
l please Hemming
stand s, C.
up? In (2002
D.
).
Richard
son & Bisex
S. ual
Seidma space
n s: A
(Eds.), geogr
Lesbia
aphy
n and
gay of
studies sexua
(pp. lity
215– and
227).
 275

gender
.
BISEXU
Londo ALITY,
n,
Englan FEMALE
d:
Routled
ge. This
Rust, P. entry
C. provides
(2004
an
).
Two introduct
many ion to
and female
not bisexuali
enoug ty. It
h: The begins
meani
with a
ng of
bisex discussio
ual n of the
identit definitio
ies. In n of
M. S. bisexuali
Kimm ty, with
el &
attention
R. F.
Plante to how
(Eds.) bisexuali
, ty may
Sexua intersect
lities, with
identi gender.
ties,
Next, it
behav
iors, discusses
and the
societ estimate
y (pp. d size of
216– the
229). female
Lond
on,
bisexual
Engla populati
nd: on in the
Oxfor United
d States.
Unive Finally,
rsity
it ends
Press.
with a
Bisexuality, Female
276

discussio to a
n of gender
various binary),
issues whereas
pertainin other
g to people
female define
bisexualit bisexuali
y. These ty much
issues more
include broadly.
diversity In the
within interest
female of
bisexualit inclusivit
y, y, the
prejudice definitio
and n used
discrimin here is a
ation, and broader
female definitio
bisexual n.
health. Specifica
lly,
bisexuali
Definitio ty is a
n of sexual
Bisexuali identity
ty that
describes
The
an
definition
individu
of
al who
bisexualit
(a) has
y can
the
vary, as
capacity
some
for
people
sexual
would
and/or
define
romantic
bisexualit
attractio
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n to
terms of
more
being
than one
sexually
gender
attracted
and (b)
to only
selfidenti
men and
fies as
women
bisexual.
(adhering
This
 277

definition bisexual.
highlight Second,
s two it is also
important importan
aspects t to
of consider
bisexual not only
identity. behavior
First, it is , but also
important attractio
to n, in the
recognize definitio
that self- n of
identifica bisexuali
tion is a ty. It is
necessary entirely
compone possible
nt of for a
bisexualit person to
y, as have
identity only
is not engaged
always in sexual
congruen or
t with romantic
behavior. behavior
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example, gender
some while
people still
may experien
experienc cing
e sexual attractio
attraction n to
to more more
than one than one
gender, gender.
or may There
even are also
engage in many
sexual terms
behavior people
with use to
more label
than one their
gender, sexual
but still identity
not other
identify than
as bisexual
278

that still gender,

may fall such as
under heterose
what xual and
Shiri gay and
Eisner lesbian.
describes Therefor
as the e,
“bisexual nonmono
umbrella. sexuality
” Similar , or what
to how is
the term sometim
queer is es
used as referred
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umbrella multisex
term to uality,
capture refers to
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of sexual identities
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minority people
identities, attracted
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y is at than one
times sex or
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an se
umbrella x
u
for all
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non- it
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ual F
sexual e
identities. m
Monosex al
uality is a e
term used
to gender.
describe Within
sexual the
and/or concept
romantic of the
attraction bisexual
to only umbrella
one sex , many
or
 279

people l or
will use omnisex
the label ual.
bisexual
in public
spaces Prevale
where nce of
they feel
Bisexual
other
ity
non-
monosex The
ual prevalen
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will not bisexuali
be easily ty is
understoo difficult
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example, estimate
some in the
people North
who America
identify n
as populati
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l, part due
omnisexu to some
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fluid may issues
tell describe
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they are For
bisexual instance,
if they how
feel that bisexuali
term also ty is
applies to measure
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speaker), amount
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feel the variance.
individua If
l they are research
interactin ers
g with measure
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know ty
what is strictly
meant by by
pansexua behavior
280

, meaning how they

that frame
researche question
rs impose s around
the label sexual
of orientati
bisexual on
on any identity.
individua For
l who example,
engages a
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e of women
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rate likely
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in a study question
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simply behavior
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identified the
. Often, participa
researche nts self-
rs have to identify.
evaluate Convers
what they ely, if a
are truly research
interested er is
in intereste
measurin d in
g for social
their support
study, differenc
and then es
use that between
to inform people
 281

who women.
identify This
as lesbian same
versus research
women found
who 2.8% of
identify women
as aged 18
bisexual, to 44
then identifie
asking d as
about bisexual.
self- The rate
identifica of
tion bisexual
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pertinent. was
A study much
that higher
measured among
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definition 7.4% of
s found women
that when 18 to 19
measured years old
by sexual and
behavior, 3.5% of
approxim women
ately 3% 20 to 24
of years old
women identifyi
reported ng as
sexual bisexual.
contact As
with men there is a
and wide
women array of
in the issues to
past year; consider
however, when
13.1% of measurin
women g the
reported prevalen
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attraction bisexuali
to both ty, it is
men and no
282

surprise bisexuali
that ty was
reported measure
rates of d. Even
bisexualit so, most
y vary estimates
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studies. bisexuali
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suggest Because
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rates of ble
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identify bisexual
as gay or on a
lesbian. survey or
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Klein, a interview
bisexual even if
researche they
r and privately
activist, identify
estimated as
on the bisexual.
basis of Further,
previous some
research women
that the who
rates of identify
bisexualit under the
y varied bisexual
from 2 to umbrella
11 times but
that of typically
gay and use a
lesbian different
people, non-
dependin monosex
g on how ual
 283

identity emphasi
label may zes that
not individu
indicate als have
on a multiple
survey identities
that they that are
identify insepara
as ble from
bisexual. one
another,
we
Diversity cannot
in simply
consider
Bisexuali
one
ty
aspect of
Just as it identity
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important location
to of an
recognize individu
the al. All of
diversity the
within identities
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overall person
LGBTQ embodie
communi s interact
ty to with one
avoid another.
erasing In the
differenc context
es within of
the bisexual
communi women,
ty, it is we
important cannot
to just
recognize consider
the sexual
diversity and
within gender
bisexualit identity;
y as well. we must
From an also
intersecti consider
onal other
perspecti social
ve, which factors
284

such as to
socioeco consider
nomic how
status, experien
racial or ce
ethnic differs
identity within
and the
racializati bisexual
on, commun
ability, ity in
and age order to
as be able
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y salient appropri
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of address
identity. any
The lived resulting
experienc social
e of, for and
example, health
a Black, inequitie
cisgender s.
, bisexual
woman Sexual
will Identity
likely and
differ
Fluidity
from the
experienc In
e of a consideri
White, ng
transgend diversity
er, among
bisexual bisexual
woman. women,
Because sexual
lived identity
experienc and
e has a sexual
direct fluidity
influence are
on importan
important t aspects
outcomes of that
such as diversity.
health, it Just as
is the
important labels
 285

people although
use to whether
describe that
their differenc
sexual e is
orientatio based on
n identity social
may vary, construct
sexuality ion of
can also sexuality
in itself or on
vary over biologica
time. l
Research determin
ers such ants is
as Lisa debated.
Diamond Thus,
and Roy women
Baumeist who do
er have not
investigat experien
ed sexual ce sexual
fluidity, desire or
or the attraction
notion to more
that than one
sexual gender at
desire, one point
attraction in life
, and may
behavior begin to
change do so
over later, and
time, in vice
the versa. As
context such,
of female lived
sexuality. experien
It appears ces may
that a be quite
greater different
proportio for a
n of woman
women who
experienc identifie
e sexual d as
fluidity in heterose
comparis xual or
on with lesbian
men— and then
286

later genderqu
bisexual, eer or
compared genderfl
with a uid.
woman Embodyi
who has ng a
always cisgende
identified r identity
as often
bisexual. allows
people
Gender social
Identity privilege
, while
Anoth people
er point who
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among identity
bisexual can
women is experien
gender ce
identity. genderid
This can entity–
refer to based
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presentati and
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female ation.
identity Because
that does this
not discrimin
conform ation can
to social result in
gender differenc
norms of es in
femininit access to
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as n,
identifyin employm
g as ent,
cisgender safety,
, and
transgend health
er, or care
another services,
nonbinar it is
y gender importan
identity t to
such as recogniz
 287

e that gender
women and
who are sexual
bisexual identity.
and
cisgender Socioecon
will have omic
different Status
lived
experienc Socio
es from economi
women c status
who are disparitie
bisexual s within
and trans the
or bisexual
genderqu communi
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example, result in
whereas a variety
cisgender of
bisexual outcome
women s such as
may insecure
housing Female
Bisexuality,
and even
one’s
deal with feeling
discrimin of safety
ation in
based on coming
their out at
sexual work.
identity, While
transgend this
er research
bisexual has not
women been
face what conducte
is d for
sometime bisexual
s women
described specifica
as double lly,
discrimin researche
ation, or rs have
discrimin found
ation among
based on lesbian
their women
288

that care may

socioecon have a
omic particula
status rly
influence negative
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they felt some
about bisexual
coming women,
out at as
work. research
Namely, has
having a found
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socioecon bisexual
omic women
status on
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associate report
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feeling overall
more able health
to combat compare
discrimin d with
ation in lesbians
the and
workplac heterose
e. xual
Socioeco women.
nomic
status is Racializa
also tion
important
to Racia
consider, lization
as it is is the act
strongly of
linked to applying
the racial
ability to stereotyp
access es to
resources other
such as people or
quality groups
health that do
care. not
Disparitie identify
s in with
access to those
health stereotyp
 289

es. This support

can result from
in racial such
discrimin communi
ation, or ties.
racism. Thus,
Racializat they may
ion also receive
can be fewer of
linked to the
socioecon mental
omic health
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women such, it
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ation, lived
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to fewer bisexual
job women
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ed in the who are
broader not
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ty, so experien
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women privilege
who are as a
racialized result.
may find Bi
less se
social x
290

ua as
lit dominant
y, stereotyp
Fe
es of
m
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e are that
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hypersex
Ability ual and
Althou that one
gh there must
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research sex with
consideri people of
ng ability more
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sexuality, gender in
generally order to
it is be
found bisexual.
that With this
people confluen
who ce of
experienc prejudice
e , it may
disability be even
are more
assumed difficult
to not for
have people
sexual with
desire or disabiliti
attraction es to be
, much visible as
less bisexual.
identify Further,
as a bisexual
sexual women
minority. with
In the disabiliti
context es may
of also have
bisexualit restricted
y, this access to
may have LGBTQ
other spaces
implicati and
ons communi
inasmuch ties that
fail to
 291

accommo in what
date their environ
disability, ments
thus they
again come out
resulting in. This
in less may be
social in part
support because
from the of the
broader stigma
LGBTQ that
communi bisexuali
ty. ty is just
a phase
Age rather
than a
Bisexu legitimat
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women’s identity.
experienc For
es change young
over the bisexual
course of women,
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in added
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young assumed
bisexual experime
women ntation,
may face or the
different idea that
prejudice young
s than do bisexual
older women
bisexual are not
women. actually
Bisexual bisexual
people on but are
average just
come out performi
later than ng as
gay and bisexual
lesbian for the
people, sexual
and are gratificat
often ion of
more men.
selective
292

Prejudic ation
e and bisexual
Discrimi people
face
nation
overall.
As we Biphobia
have , or
seen, bisexual
different prejudice
intersecti , also
ons of includes
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how one nation
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es one’s specific
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identity, others
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the Robyn
context Ochs, a
of bisexual
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and er and
discrimin activist,
ation. has also
While pointed
bisexual out that
women bisexual
experienc people
e some face
aspects double
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homopho nation,
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heterosex experien
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these discrimi
terms do nation
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encapsula in the
te the heterose
experienc xual
e of commun
prejudice ity but
and within
discrimin the
 293

LGBTQ relations
communi hips; (d)
ty as bisexual
well. people
Some are
of the promiscu
dominant ous; and
stereotyp (e)
es about bisexual
bisexual people
people are
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y does transmitt
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people s. For
who say bisexual
they are women,
bisexual there is
are really also the
gay men eroticizat
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who are sexuality
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or engaging
alternativ in sexual
ely are behavior
heterosex with
ual other
people women
wanting is
to take portraye
space d as
away “hot” or
from gay “sexy”
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lesbian mainstre
people; am
(c) pornogra
bisexual phy and
people even
are nonporn
incapable ographic
of film and
monogam televisio
ous n.
294

Research and
on invisibili
attitudes ty are
toward promine
bisexual nt issues
people for
has found bisexual
that women.
negative For one
attitudes thing,
toward bisexual
bisexual erasure
people can
are more make it
prevalent difficult
than for
negative bisexual
attitudes women
toward to find
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lesbian another
people, and form
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demonstr ty. There
ating the is no
distinctio agreed-
n upon
between “symbol
homopho ” of
bia and bisexuali
biphobia. ty, and
Bisexu thus
al there are
erasure is no
a term visible
used to social
describe markers
stereotyp for
es and bisexual
behaviors people to
that make be able
bisexualit to
y publicly
invisible, identify
and themselv
researche es and
rs have each
indicated other.
that Research
erasure ers have
 295

found prejudice
that the and
lack of discrimin
supportiv ation in
e both
communi heterose
ty xual and
potentiall LGBTQ
y communi
contribut ties, and
es to the further
higher have
rates of difficulty
physical locating
and other
mental bisexual
health people to
disparitie form
s communi
experienc ty
ed by
bisexual
women in
comparis
on with
heterosex
ual and
lesbian
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In
particular
, social
support
has been
found to
be a
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minority
stress
among
marginali
zed
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However,
if
bisexual
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experienc
e
296
with, then they may not have the same opportunities to Berkeley, CA: Seal Press.
receive social support in relation to their sexual identity Fredriksen-Goldsen, K. I., Kim, H.-J., Barkan, S. E., Balsam, K.
that other sexual-minority people enjoy. F., & Mincer, S. L. (2010). Disparities in health-related
quality of life: A comparison of lesbians and bisexual
women. American Journal of Public Health, 100(11), 2255–
Health 2261.
Mosher, W. D., Chandra, A., & Jones, J. (2005). Sexual
Recent research has found that bisexual people, and in behavior and selected health measures: Men and women
particular bisexual women, experience health disparities 15–44 years of age, United States, 2002. Advance Data
compared with heterosexual, gay, and lesbian people. From Vital and Health Statistics, 362, 1–56.
For example, research has found that bisexual women Ross, L. E., Bauer, G. R., MacLeod, M. A., Robinson, M.,
report higher rates of generalized anxiety disorder than MacKay, J., & Dobinson, C. (2014). Mental health and
heterosexual and lesbian women, have higher rates of substance use among bisexual youth and nonyouth in
Ontario, Canada. PLOS One. doi:10.1371/
lifetime suicidality, and have higher diagnoses of 7 out
journal.pone.0101604
of 10 mood and anxiety disorders listed in the
Ross, L. E., Dobinson, C., & Eady, A. (2010). Perceived
American Psychiatric Association’s Diagnostic and
determinants of mental health for bisexual people: A
Statistical Manual of Mental Disorders. Bisexual
qualitative examination. American Journal of Public Health,
women have also been found to be more likely than
100(3), 496–502.
heterosexual and lesbian women to report mental
distress and poor functional health, and have a higher
likelihood of reporting lower overall physical health
than heterosexual women. Bisexual women also report BISEXUALITY, MALE
higher levels of diagnoses for sexually transmitted
infections, and higher rates of tobacco and alcohol use,
than heterosexual women. Further, bisexual women
Research on behaviorally and self-identified bisexual
have been found to report higher rates of intimate
individuals has been largely absent from previous social
partner victimization and sexual coercion in comparison
and behavioral science, including studies that examine
with heterosexual and lesbian women.
relationships of sexual orientation and identity with
As evidenced by recent research, bisexual women on
health. Most previous research on health among
average experience differences in their health status in
“lesbian, gay, and bisexual” and “same-sex”
comparison with heterosexual and lesbian women.
populations has not distinguished bisexual individuals
Moreover, some bisexual women may be at greater or
from lesbians and gay men. The aims of this entry are
lesser risk for negative health outcomes based on the
to provide an overview of male bisexuality in terms of
additional stressors added by the experience of
both behavior and identities, to examine the diversity of
discrimination in other identities. While little is
expressions of male bisexuality across cultures, and to
currently known about what social factors are driving
offer a brief review of research that has examined
this health disparity, it is likely that experience of
bisexual men separately from and compared with
discrimination and lack of social support play a role.
homosexual and heterosexual men in regard to health.
Corey Flanders This research indicates a pattern whereby
Bisexuality, Male
See also Biphobia; Bisexual People and Community;
Bisexualities; Bisexuality, Male; Monosexism; Sexual
Fluidity; Sexual-Identity Labels bisexuals tend to report higher rates of health concerns
Further Readings when compared with both homosexuals and
heterosexuals. Considering this, the entry offers insights
Diamond, L. M. (2009). Sexual fluidity: Understanding on new directions for public health research and
women’s love and desire. Cambridge, MA: Harvard
practice specifically with bisexual individuals, in order
University Press.
to better understand and address their health needs.
Ebin, J. (2012). Why bisexual health? Journal of Bisexuality,
12(2), 168–177.
Eisner, S. (2013). Bi: Notes for a bisexual revolution.

Male Bisexual Behaviors and Identities
Because definitions of heterosexual, homosexual, and
bisexual may vary substantially depending on culture
and context, some basic conceptual definitions are
necessary for framing our exploration of health among
bisexual individuals.
Self-identified bisexual: Individuals who use the word
bisexual in referring to their own sexual orientation,
preference, and/or identity.
Behavioral bisexual: Individuals who engage in sexual
activity with male and female (and sometimes
transgender) partners, usually within a time period
specified by the respective researchers.
Alfred Kinsey’s pioneering sexuality research at
Indiana University has shown that, in addition to
exclusively heterosexual and exclusively homosexual
individuals, substantial numbers of men and women in
North American samples have historically reported
sexual attraction and involvement with both men and
women. In addition, bisexual has only existed as a
sexual orientation and identity label since the latter half
of the 20th century, having originally denoted an
individual who possessed both male and female sex
characteristics; the development and meaning of our
contemporary usage of bisexual have received notably
less scientific attention than homosexual identity.
Bisexuality is certainly not rare. Indeed, in some
samples (including population-based samples), bisexual
individuals outnumber exclusively homosexual
individuals. However, interpretation of data on the
general prevalence of bisexuality is complex. Regarding
behavioral bisexuality, several large empirical studies
from the United States show that differences exist
across studies in terms of the time frame in which the
sexual behavior was measured. One study using
nationally representative data found that behavioral
bisexuality among men was between 0.7% and 5.8% (in
the previous year and since puberty, respectively) in the
general population of the United States. Another study
estimated that 1.0% (approximately 1.2 million) of the
U.S. adolescent and adult male population had behaved
bisexually in the past year. In terms of self-identified
bisexuality, Indiana University researcher Debby
Herbenick and her team conducted a refined assessment
of sexual behavior and identity in a large probability
sample of adolescents and adults in the United States,
with the National Survey of Sexual Health and
Bisexuality, Male 297
Behavior. They found that self-identified bisexuality
among men was between 1.5% and 2.6% (among
adolescents, ages 14 to 17, and adults, respectively).
The Chicago group estimated that the percentage of
individuals who self-identify as bisexual in the general
population of the United States is around 0.8% for men.
Although these percentages may seem relatively small,
they reflect a large number of individuals when the total
size of the population is considered. Within more
specialized samples, such as those composed of gay and
bisexual men and men who have sex with men (MSM),
the prevalence of bisexuality has varied widely
depending on the recruitment venue and the
demographics of the participants, particularly in terms
of ethnicity. Reported rates of behavioral and self-
identified bisexuality have been consistently found to
be higher among African American men and Latinos
than among White men.
The relationship between sexual behavior and
identity is complex, and fluctuations in self-identity
have been found to occur often. However, longitudinal
studies of bisexual individuals show that bisexual
identity remains stable for many self-identified bisexual
men and women. Self-identified bisexual individuals
also report high rates of bisexual behaviors. Focusing
on sexual identity among men who engaged in recent
bisexual activity in the midwestern United States, Brian
Dodge and colleagues at Indiana University found that
over 60% of those men classified themselves as
bisexual, with a further 16% not identifying with any
label whatsoever. Overall, men were heterogeneous in
terms of sexual self-identification; they were diverse in
how, when, where, and to whom they identify, and how
and why they arrived at their identities. The authors
noted the dynamic and fluid nature of sexual identities
and behaviors, even as bisexuality can be considered a
stable foundation for this to occur.
Diverse Experiences and Expressions of Male
Bisexuality
Numerous patterns of bisexual behaviors and identities
have been documented demonstrating that bisexual men
are exceedingly diverse across cultures and societies.
The cultural and social context in which bisexuality
occurs has proven to be an important factor in
understanding bisexual behaviors, identities, and related
factors. For example, a substantial body of
ethnographic research has shown that Latin American
298
and Caribbean bisexual men are unique in the ways
they construct, express, and experience their sexualities,
often basing identity in relation to the assumed
behavioral role in sexual activity (i.e., activo for
partners who penetrate and pasivo for partners who are
penetrated). Such research reminds us that familiar
Anglo-American conceptualizations of sexual
orientation are culturally specific and that their
imposition on Latinos and other groups may be
problematic.
Although research on diverse expressions of
bisexuality is critically important, a disproportionate
number of studies published in Englishlanguage, peer-
reviewed journals continue to focus on men in North
American, European, and Australian contexts. Studies
on bisexual men in other contexts are relatively fewer.
Both behavioral and self-identified bisexuals constitute
exceedingly diverse populations. Because of this,
caution must be used in extrapolating the results of
studies based on varying sampling frames and
recruitment methods in a global context.
Male Bisexuality and Health
The World Health Organization has conceptualized
health as “a state of complete physical, mental and
social well-being and not merely the absence of disease
or infirmity.” Health is determined by socioeconomic
and environmental factors, is linked to behavior
(including sexual risk behavior), and may be positively
influenced by effective public health interventions.
With the emergence of gay and lesbian identity theory
in the early 1960s and 1970s, a relatively polarized
debate arose between North American mental health
professionals who held antigay versus gay-affirmative
perspectives on sexual orientation. While
homosexuality was ultimately declassified as a mental
disorder by the American Psychiatric Association in the
Diagnostic and Statistical Manual of Mental Disorders
in 1973, bisexuality per se has never been officially
classified or declassified as a mental disorder. The
concept of bisexuality has been either implicitly
subsumed under the label of homosexuality or
altogether left out of the debate between those who
sought to affirm the lives and lifestyles of homosexual
individuals and those who sought to pathologize them.
While a debate still continues as to the “pathology” of
nonheterosexual orientations in some mental health and
religious circles, current best clinical practice,
according to the American Psychological Association,
characterizes bisexual, homosexual, and heterosexual
orientations and identities as healthy and valid.
A substantial amount of recent research has explored
relationships between sexual orientation and identity
and mental health, an important component of overall
health and well-being. In discussing the limitations of a
comprehensive review of mental health research
focusing on lesbian, gay, and bisexual (LGB)
populations, UCLA scholar Ilan Meyer agrees that
recent evidence shows that such intracommunity
distinctions are significant, and that bisexual men and
women may be exposed to more stressors and may have
greater mental health problems than lesbians or gay
men. Indeed, the personal and social circumstances of
bisexual women and men may be markedly different
from lesbians and gay men, including both mental
health stressors and supports. The inability to
distinguish bisexual individuals from homosexual
individuals has been cited as a significant limitation of
previous research if the intention of such inquiry is to
understand relationships between sexual
identity/behavior and mental health.
Bisexuality, Male
A growing number of studies have examined mental
health concerns among bisexual individuals separately
from homosexual and heterosexual individuals. For
example, Antony Jorm and colleagues recruited
participants for a large-scale 20-year longitudinal study
of mental health using sampling frames established
through Australian electoral rolls. They compared mean
scores of several standard mental health measures,
adjusted for age and gender, among bisexual,
homosexual, and heterosexual participants. The
researchers found significant differences between the
sexual orientation groups such that the bisexual group
was highest on all measures of depression, anxiety,
alcohol misuse, and negative affect. Based on these
findings, the researchers concluded that bisexual
orientation is associated with more psychological
distress and higher rates of mental health problems in
comparison with homosexual and heterosexual
orientations and hypothesized that the social pressures
faced by bisexual individuals are unique.
It is significant that bisexual and homosexual
participants have been combined together in the
majority of behavioral science research studies on
HIV/AIDS despite the emergence of a voluminous body

of
literature that has explicitly associated bisexual
behavior and identity with significant psychosocial risk
factors for HIV infection, particularly among men.
Researchers have found that bisexual men report higher
rates of sex work and injection drug use than
exclusively homosexual men. A recent meta-analysis
demonstrated that while bisexually behaving men were
less likely to have HIV than men who had sex only with
men, they were 5 times more likely to have HIV than
men who had sex only with women. Unfortunately,
very few intervention efforts have been designed that
consider the patterns, meanings, and implications of
bisexual men’s sexual behavior with both male and
female partners. Research on substance use and its
relationship with sexual risk behavior also experienced
a rapid increase with the emergence of HIV/AIDS as a
public health issue. Bisexual men have been largely
ignored in early and influential studies on injecting drug
use (IDU) even though they constituted a sizable subset
of individuals in IDU samples. Despite well-
documented differences between bisexual and
homosexual substance users, most studies on the
relationship between sexual orientation and substance
use still collapse bisexual and homosexual individuals
together during analyses and discussions.
Final Thoughts and Future Considerations
There is a lack of behavioral and social science research
that has focused on the lived experiences of bisexual
men, compared with research on the experiences of
homosexual and heterosexual men. While substantial
numbers of men and women in individual studies of
health in GLB populations identify as bisexual or report
sex with both men and women, researchers have
traditionally used a dichotomized (homosexual–
heterosexual) framework in terms of sexual orientation.
The relative invisibility and social denial of bisexuality
in contemporary society, including among academia
and funding agencies, may contribute to the lack of
scholarly research on male bisexuality.
Attempting to interpret differences in health
disparities among bisexual, homosexual, and
heterosexual individuals is complex. Given the diversity
of bisexual individuals, and the ways in which they
experience and express their sexualities, it is difficult to
isolate global factors that may be related to increased
risk of mental health problems observed in previous
studies. Bisexual individuals share with lesbians and
Bisexuality, Male 299
gay men similar burdens on the basis of their sexual
orientation and identity, particularly in regard to their
same-sex practices and desires. Similar to lesbians and
gay men, bisexual individuals face hostility,
discrimination, and violence on the basis of their sexual
orientation. The psychological and social effects of
stigma, discrimination, and minority stress have been
repeatedly documented in LGB samples. However, the
prevalence of such experiences specifically among
bisexuals is difficult to estimate because of the
invisibility of bisexual individuals in previous studies,
as well as their being collapsed into samples of gay men
and lesbians.
Another potential explanation for elevated rates of
health problems among bisexuals is that, along with the
burdens shared with lesbians and gay men, bisexual
individuals may also face additional stressors
specifically on the basis of their bisexual behaviors
and/or identity. These unique factors might also explain
the higher rates of mental health problems among
bisexual individuals when compared with homosexual
and heterosexual individuals in previous mental health
research. The existence of biphobia, or the stigma and
discrimination experienced by bisexual individuals
from both heterosexual and homosexual individuals on
the basis of their bisexual orientation and/or identity,
has been extensively illuminated in community-based
and, more recently, scientific literature. In another
probability sample, University of California, Davis,
researcher Gregory Herek found that heterosexual
individuals expressed negative feelings toward bisexual
men and women at higher rates than all other religious,
racial, ethnic, and political minority groups assessed
(including lesbians and gay men), save for injecting
drug users.
Consequently, bisexual individuals are at risk of
social isolation since they may often lack social support
from any ongoing and visible community, including the
“gay” community. Elizabeth Saewyc and colleagues at
the University of British Columbia highlight that
bisexual adolescents report significantly fewer health
protective factors, such as family and school
attachments, than their straight or gay counterparts.
Even with the emergence of lesbian, gay, bisexual, and
transgender (LGBT) services and organizations that are
inclusive at face value and intended to assist and
provide support to LGBT individuals, some gay men
and lesbians continue to reject and ostracize bisexual
and transgender individuals. Particularly in the context
of the move toward heteronormative “marriage
300
equality,” some may disavow these more “radical” Further Readings
forms of sexuality in an attempt to accommodate to the Baldwin, A., Dodge, B., Schick, V., Hubach, R. D.,
larger society. Researchers have just begun to Bowling, J., Malebranche, D., … Fortenberry, J. D. (2015).
investigate how bisexual individuals may experience Sexual self-identification among behaviorally bisexual
such double discrimination from both heterosexuals and men in the midwestern United States. Archives of Sexual
homosexuals and how biphobia may impact the lives Behavior, 44(7), 2015–2026.
and, in particular, the mental health of bisexual doi:10.1007/s10508-014-0376-1
individuals. Experiences of social adversity and
discrimination can be theoretically linked to future
psychosocial and behavioral disparities that may, in
turn, affect physical health. For example, profound and
persistent substance use and mental health disparities
among HIV-positive behaviorally bisexual men have
been found to coincide with relatively poorer viral load
suppression compared with exclusively homosexual
men in longitudinal cohort studies in the United States.
Overall, it is critical that future research on health be
based on more diverse populations of bisexual,
homosexual, and transgender individuals. Generalizing
to all nonheterosexual individuals from previous
samples of primarily White, welleducated, upper-
middle-class self-identified lesbians and gay men is
dangerous because results may be misleading and
simplistic. For example, research has suggested that
many bisexual individuals have little or no interaction
in “gay” social spaces, including gay bars, clubs,
parades, and community centers. Few researchers have
made attempts to specifically recruit bisexual
individuals outside of “gay” spaces from which LGB
samples are often drawn. Future research would benefit
from the development of innovative strategies to locate,
recruit, and examine bisexual individuals who may not
frequent “gayidentified” venues. More research on
bisexual men is also required outside of the context of
HIV/AIDS risk and drug use. While these are important
topics, these studies reveal only a limited amount of
information about a very small segment of the bisexual
population. Research is needed that explores the lived
experiences of bisexual men beyond sexual and other
health-risk behaviors in more representative samples
across a variety of global contexts.
Brian Dodge, M. Reuel Friedman, and
Vanessa Schick

See also Bisexuality, Female; Sexual Fluidity; Sexual-

Identity Labels

Dodge, B., Jeffries, W. L., & Sandfort, T. G. M. (2008).
Beyond the down low: Sexual risk, protection, and
disclosure among at-risk Black men who have sex with
men and women (MSMW). Archives of Sexual Behavior,
37(5), 683–696.
Dodge, B., Schnarrs, P. W., Goncalves, G., Reece, M.,
Martinez, O., Malebranche, D., … Fortenberry, J. D. (2012).
The significance of privacy, trust, and comfort in providing
health-related services to behaviorally bisexual men. AIDS
Education and Prevention, 24(3), 242–256.
Friedman, M. R., Dodge, B., Schick, V., Herbenick, D.,
Hubach, R. D., Bowling, J., … Reece, M. (2014). From
BIAS to bisexual health disparities: Attitudes toward
bisexual men and women in the United States. LGBT Health,
1(4), 309–318.
Friedman, M. R., Wei, C., Klem, M. L., Silvestre, A. J.,
Markovic, N., & Stall, R. (2014). HIV infection and
sexual risk among men who have sex with men and
women (MSMW): A systematic review and metaanalysis.
PLOS One, 9(1), e87139. doi:10.1371/
journal.pone.0087139
Herek, G. M. (2002). Heterosexuals’ attitudes toward bisexual
men and women in the United States. Journal of Sex
Research, 39(4), 264–274.
Jorm, A. F., Korten, A. E., Rodgers, B., Jacomb, P. A., &
Christensen, H. (2002). Sexual orientation and mental health:
Results from a community survey of young and middle-aged
adults. British Journal of Psychiatry, 188, 423–427.
Kinsey, A. C., Pomeroy, W., & Martin, C. (1948). Sexual
behavior in the human male. Philadelphia, PA: W. B.
Saunders.
Klein, F. (1978). The bisexual option: A concept of one hundred eating disorders in lesbian, gay, bisexual, trans, and
percent intimacy. New York, NY: Arbor House.
Laumann, E. O., Gagnon, J. H., Michael, R. T., &
Michaels, S. (1994). The social organization of
sexuality: Sexual practices in the United States.
Chicago, IL: University of Chicago Press.
Meyer, I. H. (2003). Prejudice, social stress, and mental health with their body. Body image concerns dramatically
in lesbian, gay, and bisexual populations: Conceptual issues impact a person’s quality of life, significantly
and research evidence. Psychological Bulletin, 129(5), 674–
697.
Muñoz-Laboy, M. A., & Dodge, B. (2007). Bisexual Latino men
and HIV and sexually transmitted infections risk: An
exploratory analysis. American Journal of Public Health,
Body Image Disturbance and Eating Disorders in LGBTQ People
97(6), 1102–1106.
Rust, P. C. R. (2000). Bisexuality in the United States: A
social science reader. New York, NY: Columbia
University Press.
Saewyc, E. M., Homma, Y., Skay, C. L., Bearinger, L. H.,
Resnick, M. D., & Reis, E. (2009). Protective factors in the
lives of bisexual adolescents in North America.
American Journal of Public Health, 99(1), 110.
301
Schick, V., & Dodge, B. (2012). Introduction to the special
issue: Bisexual health: Unpacking the paradox.
Journal of Bisexuality, 12(2), 161–167.
Weinberg, M. S., Williams, C. J., & Pryor, D. W. (1994). Dual
attraction: Understanding bisexuality. New York, NY:
Oxford University Press.
World Health Organization. (1946). Preamble to the
Constitution of the World Health Organization as adopted
by the International Health Conference, New York, NY, 19–
22 June, 1946 (Official Records of the World Health
Organization, No. 2, p. 100). Geneva, Switzerland: Author.
BLACK COLLEGES
See Historically Black Colleges and Universities,
LGBTQ Students at
BODY IMAGE DISTURBANCE AND
EATING DISORDERS IN LGBTQ PEOPLE
This entry focuses on body image disturbance and
queer people. The term body image refers to people’s
perceptions, feelings, and thoughts about their body.
Other terms synonymous with body image include
body (dis)satisfaction, body esteem, and weight
satisfaction, which all focus on people’s satisfaction
influencing self-esteem as well as psychological and
physical health. It is well known that body
dissatisfaction is linked to problematic eating behaviors
at both clinical (i.e., requiring medical or psychological
intervention) and nonclinical levels.
For many
people, body dissatisfaction is a key contributor to the
development of clinical problems such as anorexia
nervosa (where people maintain a low body weight by
restricting their food intake, making themselves vomit,
and exercising excessively) and bulimia nervosa (where
people try to control their weight by restricting their
food intake, then binge eating and purging the food
302 Body Image Disturbance and Eating Disorders in LGBTQ People
from their body by making themselves vomit or using
laxatives). Binge-eating disorder (where people eat
large amounts of food in a short period of time and feel
a lack of control while doing so) is linked to depression
and feelings of inadequacy, which may also result from
body dissatisfaction. Nonclinically, body image
concerns are related to dietary restriction and unhealthy
weight control practices. Dietary restriction and
disordered eating are often considered behavioral
indicators of an individual’s body dissatisfaction and
desires to alter his or her body shape. Therefore,
although body image concerns and disordered eating
behaviors are separate issues, many researchers
simultaneously examine the two.
People’s body image and eating behaviors are often
shaped by the appearance ideals of the society in which
they live. For women in Western cultures, current
mainstream (heteronormative) body shape ideals
include long legs, large breasts, a slim waist, and, most
significantly, a very thin body. For men, body shape
ideals include a tall, slender, and muscular physique,
with a flat, toned stomach. While men and women
currently experience social pressures to conform to
these ideals, historically women’s appearance has been
society’s focus. It is well known that women experience
more body dissatisfaction and disordered eating
behaviors than men; up to 80% of all women will
experience body dissatisfaction, and around 90% of
people with an eating disorder are female.
Historically, research exploring body image and
disordered eating behaviors has focused on
heterosexual women. Recently, a small but growing
body of research has begun to include LGBTQ people.
This entry provides a brief overview of some of this
research, examining any differences between
heterosexual and LGBTQ people’s body image and
eating behaviors, and discussing possible reasons for
these differences. There is a distinct lack of research on
trans- and queer-identified people, and therefore this
discussion necessarily focuses on lesbians, gay men,
and bisexual people. The term LGB is used where
appropriate in this entry to reflect this bias in research.
The omission of trans- and queer-identified people is a
significant gap in knowledge about body image
concerns and eating behaviors.
LGB and Heterosexual People’s Body Image
Concerns and Eating Behaviors
There has been some exploration of similarities and
differences in the level of body image concerns and
disordered eating behaviors reported by LGB and
heterosexual people. The focus of such research studies
has tended to be comparisons between lesbian and
heterosexual women, and gay and heterosexual men.
Bisexual people are sometimes excluded from these
studies.
There is a lack of clarity in the findings of
comparisons of body image between lesbian and
heterosexual women. Early researchers often found that
lesbian women reported less body dissatisfaction than
heterosexual women. In contrast, other (generally more
recent) studies have concluded that there are no
differences between lesbian and heterosexual women.
The lack of differences found recently could indicate
that lesbian women face increasing pressure to be thin,
and/or are increasingly sensitive to dominant
heteronormative body ideals, resulting in more body
dissatisfaction. Only a small number of comparisons
have included bisexual women; no differences were
found between their body image compared with that of
lesbian and heterosexual women. A problem for much
of this research is that lesbian and bisexual participants
were typically recruited from LGB communities,
whereas heterosexual women were recruited from
universities. This has resulted in significant differences
in age and weight between the groups; heterosexual
women were being compared with lesbian and bisexual
women who were older and heavier, and this was not
always considered in analysis.
In contrast to women, research has consistently
found that gay men have reported higher levels of body
dissatisfaction than heterosexual men. Problematically,
many of the body satisfaction scales used in such
research were originally developed with women and not
necessarily appropriate for use with men. Comparisons
that have used scales specifically designed to assess
men’s body satisfaction have also found that gay and
bisexual men reported more body dissatisfaction and
greater drives for muscularity and thinness than
heterosexual men. Collectively, this evidence suggests
that gay and bisexual men experience more body size
anxiety than heterosexual men. It has been theorized,
however, that body dissatisfaction is actually similar for
all men; differences might have been found because gay
and bisexual men are more willing to admit to holding
body-related concerns than are heterosexual men.

In terms of eating behaviors, heterosexual women,
and gay and bisexual men, were traditionally thought to
engage in more disordered eating behaviors than
lesbian or bisexual women and heterosexual men.
Recent research, however, has found no differences
between lesbian, bisexual, and heterosexual women in
clinical or subclinical levels of anorexia, bulimia, or
binge-eating disorder and no differences in weight-
control motives for engaging in exercise. Some
evidence has even found that lesbian and bisexual girls
were more than twice as likely to engage in some
disordered eating behaviors (purging or using diet pills)
as were heterosexual girls. In contrast, gay and bisexual
men still represent a disproportionate number of men
seeking help for eating disorders. Researchers have
estimated that 42% of men seeking help for eating
disorders are gay or bisexual. It is difficult to estimate
the prevalence of clinically diagnosed eating disorders
within LGB populations, because estimates are
dependent on the sample of the population studied: For
example, one study identified prevalence estimates of
clinical anorexia for both heterosexual women and
Body Image Disturbance and Eating Disorders in LGBTQ People
lesbian and bisexual women at 0%, because no women
in the sample had been diagnosed with this condition.
More accurate (though still problematic) tend to be
estimates of disordered eating behaviors. One
population-based study separately compared male and
female adolescents who identified as “heterosexual” or
“lesbian/gay/bisexual.” They found the following
prevalence rates for heterosexual and
lesbian/gay/bisexual women (respectively): dieting
21.8%, 15.2%; vomiting/taking laxatives 4.6%, 5.1%;
taking diet pills 4.1%, 8.5%; and binge eating 2.2%,
5.1%. Prevalence rates for heterosexual and
gay/bisexual men were dieting 7.2%, 13.2%;
vomiting/taking laxatives 0.6%, 0%; taking diet pills
0.5%, 2.6%; and binge eating 0.3%, 5.3%.
LGB Subculture
The influence of LGB communities or subculture on
people’s body image and eating behaviors differs for
men and women. For men, the impact of LGB
subculture is fairly clear. LGB communities tend to
place significant emphasis on men’s appearance and
value particular body shapes/sizes. Slim, toned, and
muscular body shapes are highly valued, and gay and
bisexual men often feel that they are being judged on
303
whether they conform to these ideals. Such pressures
are linked to desires for thinness and muscularity in gay
and bisexual men, and affiliation to LGB communities
has been found to be a significant predictor of men’s
body dissatisfaction and disordered eating behaviors.
Gay and bisexual men have reported feeling that LGB
subcultures are highly competitive in terms of
appearance and body shape. Such competition is
pronounced for single men, who experience pressure to
look attractive in order to meet a partner. Such
pressures from within the LGB community have been
used to explain the disproportionately high number of
gay and bisexual men with eating disorders.
Conflicting Ideas: Women and LGB Subculture
Two conflicting theories as to the influence of LGB
subculture on lesbian and bisexual women were
proposed in the 1980s. In contrast to the pressure that
men experience, Laura Brown theorized that LGB
subculture is protective of lesbian and bisexual
women’s body image concerns and eating behaviors,
because such
communities (although diverse in nature and values)
reject the mainstream heteronormative emphasis on
women’s weight, and are more accepting of diverse
female bodies. Consequently, lesbian and bisexual
women should experience fewer sociocultural pressures
to be thin than heterosexual women, resulting in less
body dissatisfaction and fewer disordered eating
behaviors. In contrast, Sari Dworkin argued that LGB
subculture cannot protect women from experiencing
body dissatisfaction or disordered eating behaviors, as
all women grow up and live in mainstream society and
are consequently subjected to the same pressures to
conform to an idealized female appearance. According
to this theory, all women, regardless of their sexuality,
are taught that they must be thin to conform to the
culturally defined standard of “beauty,” and those who
do not conform are stigmatized, rejected, and pressured
to alter their appearance.
Research exploring these two conflicting theories
has found that LGB communities have their own
appearance norms, which often value a
“healthier” range of body sizes/shapes than
heterosexual ideals, and promote messages that reject
mainstream beauty norms. Research findings that
lesbians have described less weight concern after
coming out and becoming part of an LGB community
support this argument. Recently, however, it has been
304 Body Image Disturbance and Eating Disorders in LGBTQ People
determined that appearance norms within LGB
communities are becoming more mainstream and there
is an increasing focus on slenderness (although a toned
and athletic body, rather than extreme thinness, is
ideal). Therefore, lesbian and bisexual women can
experience pressures to have a slender body from
within LGB subculture. This indicates that while the
source of pressures to be slim may, at times, be
different from those of heterosexual women, LGB
women still experience demands to conform to
particular body sizes.
Intimate Relationships
Body shape ideals are often transmitted through
relationships with family, friends, and intimate partners.
One major difference between LGB and heterosexual
people is their choice of partners for romantic/sexual
relationships. Therefore, this has been explored as one
possible explanation for differences in body satisfaction
and disordered eating.
The Value of Physical Appearance to Men
It has been argued that physical appearance and body
size are particularly important for heterosexual women
and gay men in terms of their attractiveness to men. As
lesbian women may not be concerned with being seen
as desirable by men, they may feel able to resist social
pressures to conform to the “ideal” thin body size. It is
claimed that because lesbians are often sexually
independent from men and are encouraged to appreciate
women’s bodies, societal appearance-related pressures
may be less salient for them and may have less of an
impact on their body satisfaction and eating behaviors.
A partner’s physical appearance and body size does
seem to be particularly important for men. Studies of
personal ads comparing lesbians, gay men, and
heterosexual men and women have found that men—
both gay and heterosexual— described desired partners
in terms of their body shape more often than women,
and this was often the first descriptor of a preferred
partner. Similarly, when lesbian and heterosexual
women’s and gay and heterosexual men’s preferences
for thinness in a partner were compared, both groups of
male participants reported higher preferences for
thinness and attractiveness in a partner than did either
group of women. In qualitative research, bisexual
women have described experiencing more pressure to
be
thin from male partners than female partners. It seems,
then, that men are more concerned about their partner’s
body size than women seem to be, regardless of the
gender of their potential partner. Therefore, it is likely
that desires to be attractive to men (e.g., for gay men,
heterosexual women, and possibly bisexual people)
create pressures to be thin and look attractive, which are
linked to the consequent problems of body image
concerns and disordered eating. Single gay and bisexual
men may particularly feel these pressures, and are
known to report more drive for thinness, bulimic
behavior, and dietary restriction than gay and bisexual
men in relationships, or single heterosexual men.
Once again, bisexual people have been overlooked in
much of this research. It is important to explore how
desires to attract a partner influence bisexual people, in
order to fill this gap in knowledge. Additionally,
bisexual people may be in the unique position of being
able to compare pressures from male partners with
pressures from female partners.
Women’s Same-Sex Relationships
Lesbian and bisexual women have reported fewer
appearance pressures within same-sex relationships
than within different-sex relationships. Attraction to
women who do not necessarily embody the thin ideal
has encouraged lesbian and bisexual women to question
mainstream ideals of “beauty,” and fostered positive
feelings about their own body size. Female partners
may also understand the social pressures that women
experience, providing empathy and support for women
experiencing body image concerns and disordered
eating behaviors. Women’s same-sex relationships,
however, can also be a cause of certain concerns. Some
women may make comparisons between their partner’s
body size and their own; if they feel unhappy with the
result, they engage in healthy or unhealthy eating
behaviors to change their body shape. It has also been
suggested that female partners can be just as critical of
a woman’s body size as male partners.
Lesbian and bisexual women may be influenced by
butch/femme stereotypes and societal assumptions
about the gender expression of partners in same-sex
relationships. Stereotypically, butch lesbians are
associated with masculinity, which, in terms of
appearance, includes wearing masculine clothes and
shoes, having short hair, and being muscular. In
contrast, femme lesbians are associated with femininity

and are often only acknowledged within the boundaries
of a same-sex relationship (alone they are often either
invisible as lesbians or misread as heterosexual). Some
women in same-sex relationships have received
comments about their gender expression, particularly
the assumption that one of them was “butch,” based on
their appearance and body size. This can be a cause of
concern for women who do not identify as butch or
femme, and consequently such women can become
anxious as to how they are perceived when in public
with their partner.
Other Causes of Difference
There are many other possible causes of difference
between LGB and heterosexual people. Three well-
known concepts that have been linked to LGB people’s
body image and disordered eating behaviors are
feminism, discrimination, and internalized
homonegativity.
Feminist ideology is known to be somewhat
protective of women’s body image concerns and
disordered eating behaviors. Women who identify as
feminist tend to be more critical of mainstream body
shape ideals for women, considering them to be
unrealistic and a tool of patriarchal oppression.
Feminist identity can be important for many lesbian and
bisexual women, as they reject heteronormative
patriarchy when they “come out” and embrace a sense
of unity with other women. Therefore, lesbian and
bisexual women may be more likely to be critical of
mainstream heterosexist ideals and pressures, and be
less susceptible to associated body image concerns and
disordered eating behaviors.
Social discrimination and experiences of violence
and rejection by family, friends, and the wider public
has been posited as a cause of the high levels of
disordered eating among LGB people. This is known as
minority stress theory. This theory states that stressors
related to possessing a marginalized identity have direct
health consequences through the psychological distress
they cause, and the (often unhealthy) health behaviors
used to cope with them. These stressors also have
consequences in terms of willingness to access health
care services. According to this theory, disordered
eating behavior may be one way in which LGB people
cope with the sexuality-related discrimination they
experience.
Internalized homonegativity, a controversial concept
whereby a lesbian, gay, or bisexual person accepts
305
heteronormativity and negative societal attitudes toward
LGB people, has been tentatively linked to gay men’s
body image and disordered eating behaviors. It is
known that internalized homonegativity is linked to low
self-esteem, and low self-esteem in turn is linked to
body dissatisfaction and unhealthy body-shaping
behaviors. There is, however, a lack of indication as to
whether and how internalized homonegativity
influences men’s body image concerns and eating
behaviors. Further research is needed on this topic
before any conclusions can be made.
Caroline J. Huxley
See also Body Modification; Body Size and Weight;
Butch–Femme; Embodiment; Internalized
Homophobia; Masculinities; Masculinity Stereotypes;
Romantic Friendships
Further Readings
Brown, L. S. (1987). Lesbians, weight, and eating:
New analyses and perspectives. In Boston Lesbian
Psychologies Collective (Ed.), Lesbian psychologies:
Explorations and challenges (pp. 294–309).
Urbana-Champaign: University of Illinois Press.
Bryn Austin, S., Ziyadeh, N., Kahn, J. A., Camargo, C. A., Jr.,
Colditz, G. A., & Field, A. E. (2004). Sexual orientation,
weight concerns, and eating-disordered behaviors in
adolescent girls and boys. Journal of the American Academy
of Child & Adolescent Psychiatry, 43(9), 1115–1123.
Dworkin, S. H. (1988). Not in man’s image: Lesbians and the
cultural oppression of body image. Women & Therapy, 8(1–
2), 27–39.
Feldman, M. B., & Meyer, I. H. (2007). Eating disorders in
diverse lesbian, gay, and bisexual populations.
International Journal of Eating Disorders, 40(3), 218–226.
Filiault, S. M., Drummond, M. J., & Anderson, E. (2012).
Bisexual men and body image. Psychology & Sexuality, 5(3),
191–200.
Huxley, C. J., Clarke, V., & Halliwell, E. (2011). “It’s a
comparison thing isn’t it?” Lesbian and bisexual women talk
about their body image and relationships. Psychology of
Women Quarterly, 35(3), 415–427.
Body Modification
Legenbauer, T., Vocks, S., Schafer, C., Schutt-Stromel, S.,
Hiller, W., Wagner, C., & Vogele, C. (2009). Preference for
attractiveness and thinness in a partner: Influence of
internalization of the thin ideal and shape/weight
306 Body Image Disturbance and Eating Disorders in LGBTQ People
dissatisfaction in heterosexual women, heterosexual men, motivations observed in the LGBTQ community. The
lesbians, and gay men. Body Image, 6(3), 228–234. following section focuses on the
Morgan, J. F., & Arcelus, J. (2009). Body image in gay and
straight men: A qualitative study. European Journal of
Eating Disorders, 17(6), 435–443.
Morrison, M. A., Morrison, T. G., & Sager, C. L. (2004). Does
body satisfaction differ between gay men and lesbian
women and heterosexual men and women? A meta-analytic
review. Body Image, 1(2), 127–138.

BODY MODIFICATION
Body modification refers to the range of practices that
individuals undertake to alter the physical appearance
of the body. Often used to reference tattooing and
piercing, it also includes practices such as branding,
cutting, and scarring, as well as cosmetic surgical
procedures that vary from breast augmentation to calf
implants. Broader conceptualizations of the term also
include exercising, dieting, and weight lifting, as well
as adornment practices such as tanning, makeup use,
and nail coloring.
Historical and cross-cultural accounts of body
modification reveal its universality. For example, in the
late 1700s, Captain James Cook, a British explorer, and
his navy crewmen were introduced to tattooing by
native Tahitians. Earrings have been found on
mummified remains more than 5,000 years old. And, in
the 1500s, Gaspare Tagliacozzi, now considered the
father of plastic surgery, wrote the first textbook on
plastic and reconstructive surgery.
Today, body modification has become prevalent in
the United States. This entry discusses the rise in body
modification rates in the United States and continues
with an examination of various motivations for
undergoing body modification, including specific

Body Modification
debate about body modification: Is body modification
empowering or oppressive? Finally, this debate is
situated in a discussion about the health risks associated
with body modification—risks that are compounded by
the laxity of government regulation of the body
modification industry.
The Rise in Body Modification in the
United States
Rates of tattooing, body piercing, and cosmetic surgery
are all rising in the United States. Tattoos and piercings
have now expanded to include a range of
socioeconomic classes, suggesting that these practices
are no longer confined to specific subcultures. This
increase is noteworthy given that some workplaces
regulate “body art” such as tattoos and piercings. While
critics argue that such regulation is outdated and
conservative, it is nevertheless legal. So long as this
regulation does not discriminate against a protected
legal category such as race, sex, religion, age, or
nationality, employers are within their rights. Today,
nationally representative surveys estimate that about
24% of adult Americans have a tattoo and that 14%
have piercings. While tattooing is equally common in
both sexes, women are more likely to pierce their
bodies. Unlike with tattooing and piercing, only a small
portion of adult Americans undergo cosmetic surgical
procedures. Board-certified surgeons perform about 1.6
million procedures each year, with breast augmentation
(about 290,000 surgeries) and nose reshaping (about
220,000 surgeries) topping the list. Surgeons perform
the majority (87%) of procedures on women and
individuals who identify as White (up to about 80% of
all procedures, depending on the type of procedure),
followed by Hispanics, African Americans, and
Asian/Pacific Islanders.
Motivations for Body Modification
While motivations range by type of body modification,
researchers studying tattoos and piercings have
identified several motivational categories. For example,
they have found that individuals use piercings as
fashion accessories to embellish the body, and that
those who have tattoos emphasize their aesthetic
qualities, even referring to them as pieces of art.
307
However, they have also found that body art can hold
deeper psychological meaning. Specifically, tattoos and
piercings can serve as an avenue for “identity work”
insofar as individuals view the body as an outgrowth of
the self and perform “body projects” to express their
unique personalities. Indeed, individuality is one of the
most commonly recurring themes in the tattooing and
piercing literature.
Researchers have also observed that sexual pleasure
is a motivating factor for body modification. For
example, research has found that some individuals
report direct sexual stimulation from nipple and genital
piercings. Meanwhile, other individuals turn to body
modification as a testament to their high pain threshold
and tolerance. The pain associated with these
procedures can demonstrate not only toughness, but
also the courage to engage in these practices.
Interestingly, the stimulation of pain correlates with the
release of endorphins—neurotransmitters that send
electrochemical signals within the central nervous
system. The release of endorphins can lead to positive
emotions, as well as an anesthetizing effect on the body,
thus reducing the perception of pain. For this reason,
some researchers maintain that the experience of
undergoing tattooing and piercing can have an addictive
quality.
Body Modification and the LGBTQ Community
Some individuals are motivated to obtain tattoos and
piercings to demonstrate affiliation with others or a
group. Body adornment can thus serve as a permanent
sign of commitment to a friendship, love connection, or
subcultural group. This group identification can
implicitly or explicitly signify the rejection of, or
resistance to, mainstream culture. In this way, this
motivational theme relates to the theme of identity
work. That is, individuals may use body modification to
express their unique sense of self, as well as how this
unique self is connected to a community. Notably,
researchers have observed that body modifiers in the
LGBTQ community, particularly because of their
structurally oppressed social position, report that they
see their bodies as a canvas to inscribe affirmation and
belonging to a community and to express their LGBTQ
identity. In this way, body modification can represent
an affiliation with an oppressed other.
Research on body modification in the LGBTQ
community, as well as other oppressed groups such as
women, racial/ethnic minorities, and individuals with
308
disabilities, further reveals that some individuals turn to
body modification as a personal catharsis. For example,
some women who have survived sexual and physical
abuse deliberately mark their bodies, painfully and
permanently, in order to reclaim them. Through a
conscious effort to inscribe the body with personal
meanings, body modification is a direct confrontation of
past pains; it is an intentional rewriting of the body’s
history. Modification can thus have a self-healing
effect, and even deter behaviors that might be
considered more harmful.
Researchers studying the LGBTQ community have
also found that more extreme forms of modification
such as branding, scarring, and cutting serve a similar
bonding and transformative function. That is, these
forms of body modification allow individuals to signify
group membership, as well as to cope with life stressors
and oppression based on race, gender, class, and/or
sexuality. As such, body modification in these
communities is far from a perverse and grotesque form
of selfmutilation, but rather a mechanism to connect
with like others, and to reclaim and reaffirm an
authentic self.
At the same time these various forms of body
modification serve empowering functions for
members of the LGBTQ community, scholars
acknowledge that there are limitations to this type of
body rebellion. First, whether they are tattoos, scars, or
piercings, body inscriptions are often hidden under
clothing and often only revealed in certain circles,
thereby suggesting a limit to their political
subversiveness. But even when revealed,
Body Modification
their subversiveness depends on an observer’s gaze. So
it is possible that instead of being read as a form of
reclamation or an ironic distortion of the body,
outsiders interpret body modification as a form of
individual perversion, particularly among sexual
minorities. Consequently, mainstream discourses about
pathology and sexual deviation are not challenged, but
rather reinforced in the eyes of observers. Furthermore,
as body modification practices become more
mainstream and popular—as they statistically are—they
lose their marginal and subversive character.
Body Modification as Empowerment or
Oppression?
Some feminist scholars have thus argued that body art
and other forms of body modification are not
empowering reinscriptions that transgress body
boundaries. Instead, they are a form of self- mutilation
that appeals to oppressed social groups such as young
lesbians and gay men largely because they are framed
in the language of choice and political resistance. This
perspective maintains that body modification is not
resistance to hegemonic structures, but rather a direct
result of sexual oppression and a disempowered social
position that results in self-loathing, body hatred, and
lowered self-esteem. Accordingly, those holding this
perspective view body modification as part of a larger
continuum of harmful bodily cultural practices.
The discussion about whether practices such as
tattoos and piercings are subversive forms of
empowerment or signs of oppression mirrors larger
debates in the cosmetic surgery literature. On the one
hand, some feminists emphasize that cosmetic surgery
—particularly if it results in a body that aligns with
hegemonic beauty norms—is oppressive. They label
those who have it “cultural dopes.” That is, they posit
that those who have cosmetic surgery buy into a larger
beauty culture that says that they need to look a certain
way to feel good and be accepted in society. This
perspective assumes that individuals, particularly
women, are cultural objects somewhat devoid of
agency.
Body Modification
They engage in these surgeries because they are swayed
by cultural discourses, including media depictions of
idealized beauty.
On the other hand, some feminists argue that
individuals who engage in aesthetic body modification
are “savvy cultural negotiators” who undergo these
practices to empower themselves. This second
theoretical perspective emphasizes agency and portrays
individuals who undergo surgery as empowered actors.
They obtain these surgeries to reap psychological,
social, and material benefits—that is, to increase body
esteem, their appeal to potential mates, and job
opportunities. However, some scholars have recognized
the limits of this type of individual empowerment. For
example, while these practices may benefit an
individual woman, they simultaneously reify a beauty
culture that is oppressive to women as a collective.
Thus scholars have recognized that aligning with one
theoretical camp over the other is to miss the big picture

when it comes to an individual’s relationship to
aesthetic culture. Individuals can be both passive
objects and subjective actors. In other words,
individuals who elect body modification potentially
exercise agency, but do so within social and cultural
structural constraints.
Body Modification and Health Risks
Theoretical debates about whether body modification is
empowering or oppressive must be situated in a
discussion about the medical risks associated with body
modification practices. The Mayo Clinic, a nonprofit
medical practice and research group, identifies specific
risks with tattooing. For example, tattoos can cause skin
problems such as keloids (raised areas caused by an
overgrowth of scar tissue), skin infections, and allergic
reactions caused by dyes. These allergic reactions can
occur even years after a tattoo is imprinted. Other
serious medical risks include the possibility of
contracting a blood-borne disease if the equipment used
is contaminated with infected blood. These diseases
include tetanus, hepatitis B, and hepatitis C. Rates of
contraction, however, are unknown.
Body piercings carry similar risks. Blood-borne
diseases, including tetanus and HIV, can be contracted
from contaminated equipment. Moreover, the Mayo
Clinic cautions that piercings can cause tearing or
trauma when accidently caught and torn out, and that
piercings on the tongue can chip teeth or even damage
the gums. An initial piercing on the tongue can even
interfere with chewing, swallowing, and breathing due
to swelling.
Finally, cosmetic surgery risks include loss of
sensation, scarring, infection, loss of mobility, and even
death. It is for these reasons that medical authorities
encourage patients to undergo these procedures only
when performed by board-
certified surgeons. However, there is little regulation of
the tattooing and piercing industry. Some medical
professionals (who often have to deal with the
complications associated with body art) have demanded
the regulation of tattoo artists, as well as regulations
regarding the sterilization of instruments. They have
also pressed for federal regulation of tattoo inks—
substances that are currently not subject to Food and
Drug Administration approval. There is also little
screening of customers. No federal age requirement
exists, but most states require that a person obtaining a
309
tattoo must be legally considered an adult—defined in
most states as 18 years of age.
In sum, rates of body modification are on the rise.
Although individuals modify their bodies for many
reasons, body modification holds special meaning for
LGBTQ individuals, particularly in the form of self-
expression and community affirmation. Debates about
body modification center on whether it is a form of
empowerment or subjugation, with some scholars
arguing that it is a form of self-mutilation that appeals
to young lesbians and gay men because of its affiliation
with the rhetoric of political resistance. These debates
must be considered in light of the health risks
associated with body modifications, particularly given
the lack of industry regulation.
Samantha Kwan
See also Body Size and Weight; Butch–Femme; Drag;
Embodiment; HIV and Treatment; Sexual Attraction,
Behavior, and Identity
Further Readings
American Society of Plastic Surgeons. (2014). 2013 plastic
surgery statistics report. Arlington Heights, IL: ASPS
National Clearinghouse of Plastic Surgery Procedural
Statistics.
Davis, K. (1995). Reshaping the female body: The dilemma of
cosmetic surgery. New York, NY:
Routledge.
DeMello, M. (2000). Bodies of inscription: A cultural
history of the modern tattoo community. Durham, NC:
Duke University Press.
Featherstone, M. (Ed.). (2000). Body modification.
Thousand Oaks, CA: Sage.
Heyes, C. J., & Jones, M. (Eds.). (2009). Cosmetic surgery: A
feminist primer. Burlington, VT: Ashgate.
Jeffreys, S. (2000). “Body art” and social status: Cutting,
tattooing and piercing from a feminist perspective.
Feminism & Psychology, 10, 409–429.
Laumann, A. E., & Derick, A. J. (2006). Tattoos and body
piercings in the United States: A national data set. Journal of
the American Academy of Dermatology, 55, 413–421.
Pitts, V. (2003). In the flesh: The cultural politics of body
modification. New York, NY: Palgrave Macmillan.
Wohlrab, S., Stahl, J., & Kappeler, P. M. (2007). Modifying
the body: Motivations for getting tattooed and pierced.
Body Image, 4, 87–95.
310
BODY SIZE AND WEIGHT
Body size and weight are affected by various norms and
expectations—both those within the larger society and
those within the LGBTQ community. Although eating
disorders such as anorexia and bulimia impact LGBTQ
people, and will be referred to briefly in this entry, the
major topics will be the influences of gender,
environment, LGBTQ cultures, and history on the body
size and weight of LGBTQ people. The controversy
surrounding body size and weight—not only as a
cultural identifier, but as an indicator of physical and
mental health—is presented.
Disparities
It is well documented that lesbians, as a group, have
larger bodies than heterosexual women, and
Body Size and Weight
that gay men have higher rates of eating disorders than
heterosexual men; the rates of eating disorders among
gay men are more in line with the rates of heterosexual
women. Eating disorders are sometimes seen as a way
to achieve or maintain a particular body size or weight.
There is little evidence to support any differences in
body size and weight in bisexual men compared with
heterosexual men; however, there is some literature that
indicates that bisexual women, on average, weigh more
than heterosexual women. Transgender people have not
been part of the discourse on body size or weight in the
same way, although there is anecdotal evidence that
transgender women feel pressure to lose weight to fit in
as women, and transgender men may try to “bulk up” to
pass more easily as men.
It must be emphasized that no two people view the
topics of body size and weight in exactly the same way.
It is also impossible to write about body size and weight
without including some explanation of differences in
gender, culture, era, and environment, as all have a
major impact on how body size and weight are
perceived and experienced. Body size and weight are
often affected by the individual’s not conforming to
societal and cultural expectations, and may have
consequences for health and well-being. Ideal body size
and weight are, for the most part, prescribed by culture;
in turn, norms about ideal body size and weight are
perpetuated and enforced by cultural discourses (e.g.,
media, education, medicine/health care, societal
attitudes). Notably, LGBTQ people have a history of
nonconformity to cultural norms (which in some cases
is quite adaptive, enabling them to form supportive
relationships and communities, thereby conferring
survival). This nonconformity may extend to the
physical body.
Gender
An important distinction needs to be made between sex
and gender. Sex is determined at birth (or before) and
assigned according to specific genetic markers.
Biologically, sex differences serve several functions.
Related to body size and weight, females need more
body fat than males to accommodate reproduction. It is
also expected that men need
Body Size and Weight
larger muscle mass to carry out societal expectations
related to physical labor. The biological determination
of sex predisposes many cultures to develop and accept
stereotypical expectations of femininity and
masculinity.
Gender is not as easy to understand as sex. Whereas
sex is assigned at or before birth, gender is an
expression of maleness and femaleness that is highly
individual and can vary between the extremes of male
and female. Throughout history, girls who behaved or
dressed in ways not typically female have been labeled
tomboys and boys who behaved or dressed in ways not
typically masculine have been labeled sissies. Thus,
historically and across many cultures, it was not widely
accepted that individuals could display or enjoy cross-
gender characteristics. This is beginning to change. A
small and seemingly insignificant example of this is that
before the 1940s, women and girls did not wear pants
(unless they were working on a farm). Pants, or
trousers, were considered clothing for men only. When
a woman wore pants, she was considered masculine and
publicly ostracized for this choice. Likewise, men who
dressed as women were, and still are in many cases,
castigated for being feminine or queer. As science gains
a better understanding of the real differences between
men and women, the lines are being blurred, and, just as
sexuality is commonly identified on a continuum as
opposed to a binary, gender is experiencing the same
evolution today.
Historically, many cultures have depicted
masculinity and femininity as synonymous with large

and small bodies, respectively. Particularly in the past
50 years, to be feminine has meant to be willowy, thin,
and weak, and masculinity implies physical bulk, being
powerful and strong. Therefore, when a woman is large
and strong, she is perceived as more masculine than
feminine, which may or may not affect her sense of
identity. Since power is inextricably linked to
masculinity in many cultures, the allure of power and
strength to some women is a fair trade for their
identification with the feminine. The advantage of
viewing gender as a continuum, then, is that individuals
are allowed more expression of body sizes and shapes
than if there is only a binary male or female option.
LGBTQ Culture/Community
LGBTQ culture is extremely diverse. Just as specific
ethnic groups have distinct and similar traditions as
other ethnic groups who live in the same geographic
region, LGBTQ people exhibit similarities and
differences. Culture is a compilation of language,
traditions, religion, art, music, knowledge, morals,
laws, customs, and habits that are rooted in, and
acquired through, belonging. It is important to
appreciate (especially in the United States) that
individuals’ overall identity may reflect the influence of
several cultures. LGBTQ people also experience these
influences, and are also shaped by the gay community.
The collective gay community also has its own
language, traditions, religion, art, music, knowledge,
morals, laws, customs, and habits that may shape
individuals. In turn, differences within distinct L, G, B,
T, and Q groups contribute many dynamic aspects to
gay culture as well.
For example, many lesbian and bisexual women are
involved in feminist organizations and activities that
critique heterosexist beauty standards, and therefore
may not be inclined to engage in weight-loss activities.
Gay men, on the other hand, are confronted with an
emphasis on physical appearance in the bar/club scene
as well as online dating and sex hookup sites. There are
many examples of gay cultural influences for each
separate group within the gay community. Thus, when
attempting to understand weight and body size in
LGBTQ populations, it is important to understand the
variability in the norms and expectations to which
LGBTQ people are exposed. Another example is the
finding that lesbians and bisexual women are heavier
than heterosexual women. There are many possible
reasons for this. For example, their heavier weights may
311
represent and reflect a backlash to unrealistic standards
of beauty forced on women from the male-dominated
fashion industry; it also may reflect greater athleticism
and muscle mass among a subset of lesbian women, as
compared with heterosexual women. In addition, norms
in lesbian communities are typically more accepting of
diverse body sizes, shapes, and ability levels. There is
also evidence that higher rates of alcohol consumption
and bar food may contribute to higher weight among
lesbians. From a cultural and historical perspective, this
may be explained by LGBTQ people frequently
socializing in bars and absorbing influences from a bar
culture because of not being accepted in other social
venues. What it does not explain is why women’s
weight seems to be more affected than the weight of
men.
These arguments have some support in the literature,
but none alone is likely a total explanation. Gay men
have higher rates of eating disorders than heterosexual
men or lesbians, and evidence suggests this may be due
to gay men wanting to be attractive to other men, which
supports the same prescriptive standards of beauty
applied to men as to women. Some research finds the
same degree of body surveillance and scrutiny among
gay men as among heterosexual women.
There is not much information on bisexual men or
women or transgender men or women, but their
attitudes about body size and weight might be shaped
by the communities and relationships to which they
belong. For example, bisexual or transgender women in
same-sex relationships may adopt lesbian community
norms; transgender men in relationships with
heterosexual women may try to appear more like
heterosexual men.
Era/Historical Period
Body size and weight acceptance are illustrated in
fashion and in common health trends during every
historical period. Indeed, it is not coincidental that
when tuberculosis was rampant in Europe and
throughout the United States (1820s through 1940s), it
became fashionable to be extremely thin. In countries
and eras where wealth was demonstrated by having
enough or more than enough to eat, larger bodies were
desired as an indicator of prestige. Recently, there has
been a shift in discourses in the United States, from
viewing larger
Body Size and Weight
312
bodies as “unattractive” to labeling them as “unhealthy”
and a potential burden on society. This trend
disproportionately impacts lesbian and bisexual women,
but adds pressure to all populations and may add
additional guilt and shame about the body for those
who are larger. Weight stigma may create health
problems independent of weight. Finally, LGBTQ
communities have been impacted by feminism. For 50
years, there has been feminist pressure to stop
objectifying women’s (and men’s) bodies, but it has yet
to make any serious impact on U.S. cultural norms.
Environment
LGBTQ communities may also have diverse
opportunities for physical activity and varying access to
adequate nutrition. Some studies find that female same-
sex couples are more likely to live in poverty than other
couples, forcing them into lowerincome neighborhoods
that may be less safe in general, and less safe
specifically for LGBTQ people. This also creates less
access to healthy food, and fewer options for recreation.
All these conditions increase stress and are associated
with weight gain. Larger, more integrated LGBTQ
communities may have not only sports leagues and
opportunities for recreation that may promote health,
but also health clinics and health education programs
that are culturally appropriate and tailored to subsets of
L, G, B, T, and Q communities.
The “Weight Paradox”
Recently, there is some discussion and exploration into
the phenomenon of a weight paradox, especially among
lesbians. The weight paradox is explained as a
discrepancy between the assumption that increased
body size and weight equate with higher risk for certain
chronic diseases (e.g., type 2 diabetes, heart disease,
hypertension, some cancers, asthma) and from research
findings that do not bear the expected results. To date,
there has been little research designed to explore this
observation, particularly in LGBTQ populations. With
the recent change in demographic questions being
Body Size and Weight
asked on national health surveys, it may be possible to
either further define and support, or dispel, the weight
paradox in LGBTQ populations.
The Health at Every Size (HAES) movement,
popular on the West Coast, is an example of a different
way of looking at body size and weight. The weight
paradox is in line with the assertions of HAES in that it
supports the possibility of maximizing health regardless
of how a body looks, or how much it weighs. It shifts
the focus from needing to lose weight to be healthy to
getting healthier regardless of a person’s weight or size.
There is growing evidence that this focus in LGBTQ
populations can (and does) benefit many people,
especially those with no genetic predisposition to
chronic diseases.
Minority Stress
Being LGBQ places an individual in a sexualminority
group—nonheterosexual. LGBQ people are also
members of other minority groups (e.g., racial, ethnic,
religious, gender, economic) and as stresses from each
identification layer upon one another, physical and
emotional problems may develop. For some,
internalized minority stress is manifest as guilt and
shame about the physical body. Overeating and eating
disorders are coping mechanisms that are frequently
used to temper, soothe, or exaggerate feelings that
result from minority stress. As alluded to earlier in the
entry, lesbians tend toward overeating as a means of
coping with stressors, and gay men tend toward weight
restriction (e.g., anorexia and/or bulimia). Recovery
programs for eating disorders are difficult to find for
men, and since it is also necessary to address stigma
from living with a minority sexual orientation, the
difficulties are compounded. For lesbians, overeating
may be more acceptable inasmuch as many lesbian
women are less likely to impose heterosexist
stereotyping of body size, shape, and weight on other
women. This seeming acceptance of bigger bodies does
not preclude stigma from general society or even from
other lesbians. There is a faction of lesbian women who
are very body-conscious and do not subscribe to the
acceptance of larger bodies. Also, as mentioned earlier,
there are conflicting fears among academics and health
care providers that acceptance of larger bodies will
perpetuate the epidemic of obesity among lesbians or
other women who partner with women and that the
emphasis on weight will, itself, become a new layer of
stigma.
If examined from an ecological perspective, change
to support better health must happen at all levels,
including the outermost layer, which is policy. Policies

that are supportive of healthpromoting environments
can permeate into institutions (such as health care),
communities (such as LGBTQ communities), families,
and social circles, and finally to the individual.
Consideration of
multiple minority-related stressors must be infused into
new ecological models that will lessen health-related
disparities for LGBTQ people.
Conclusion
With the pandemic spread of obesity, there has been
little research that suggests whether the L, G, B, T, and
Q populations are at an increased risk for obesity-
related health conditions in the same way that
heterosexual people are. Chronic illnesses thought to
result from obesity may actually stem from minority
stress, poor food choices, or other factors besides
weight. Several characteristics of national health policy, Morrison, M., Morrison, T., & Sager, C. (2004). Does body
health institutions, the environment, genetics, culture,
and individuals compound the risks, for both obesity
and elevated health risks. Further, labels used by
LGBTQ communities identify, celebrate, and
stigmatize their members at the same time. The same is
true for labels that are used to identify body size and
weight: stick-thin, skinny, emaciated, bony, skeletal,
fat, morbidly obese, super obese, and even obese are
interpreted by many as extremely stigmatizing. Others
embrace the words as honoring who they are and how
they identify, including the words queer and fat. For
many, neither is acceptable; for others, they are badges
of honor and embraced. This constitutes reclamation of
the true meaning of the words, which convey honesty
and acceptance of being different or unique.
Bondage, Dominance/Submission, Sadism/Masochism (BDSM)
Building different interventions and solutions from
an ecological perspective is likely the best way to shift
the emphasis from body size and weight to better health
and tailored plans for LGBTQ communities. Infusing
the ecological model with attention to minority stress
will strengthen both planning and health outcomes for
LGBTQ people.
Sarah C. Fogel and Michele J. Eliason
See also Body Image Disturbance and Eating Disorders in
LGBTQ People; Health Disparities; Minority Stress;
Physical Disabilities
313
Further Readings
Austin, S. B., Nelson, L. A., Birkett, M., Calzo, J. P., &
Everett, B. (2013). Eating disorder symptoms and obesity at
the intersections of gender, ethnicity, and sexual orientation
in US high school students. American Journal of Public
Health, 103, e16–e22.
Balsam, K., Molina, Y., Beadnell, B., Simoni, J., &
Walters, K. (2011). Measuring minority stress: The LGBT
People of Color B Scale. Cultural Diversity and Ethnic
Minority Psychology, 17(2), 163–174.
Eliason, M. J., Ingraham, N., Fogel, S., McElroy, J., Lorvick, J.,
Mauery, R., & Haynes, S. (2015). The paradox of weight in
sexual minority women: A systematic review.
Women’s Health Issues, 25(2), 162–175.
Fogel, S. (2010). But I have big bones! Obesity in the lesbian
community. In S. L. Dibble & P. A. Robertson
(Eds.), Lesbian health 101: A clinician’s guide
(pp. 165–181). San Francisco, CA: UCSF Nursing Press.
satisfaction differ between gay men and lesbian women
and heterosexual men and women? A metaanalytic review.
Body Image, 1(2), 127–138.
Siever, M. (1994). Sexual orientation and gender as factors in
socioculturally acquired vulnerability to body dissatisfaction
and eating disorders. Journal of Consulting and Clinical
Psychology, 62, 252–260.
Ward, B. W., Dahlhamer, J. M., Galinsky, A. M., & Joestl, S. S.
(2014, July 15). Sexual orientation and health among U.S.
adults: National Health Interview Survey, 2013. National
Health Statistics Reports, 77. Retrieved from
http://www.cdc.gov/nchs/data/nhsr/
nhsr077.pdf
Wen, M., & Kowaleski-Jones, L. (2012). The built
environment and risk of obesity in the U.S.: Racialethnic
disparities. Health and Place, 18, 1314–1322.
Wichstrom, L.
(2006).
Sexual orientation as a risk factor for bulimic symptoms.
International Journal of Eating Disorders, 39, 448–453.
Yean, C., Benau, E. M., Dakanalis, A., Hormes, J. M., Perone,
J., & Timko, C. A. (2013). The relationship of sex and
sexual orientation to self-esteem, body shape satisfaction,
and eating disorder symptomatology.
Frontiers in Psychology, 4. doi:10.3389/fpsyg
.2013.00887
BONDAGE, DOMINANCE/SUBMISSION,
SADISM/MASOCHISM (BDSM)
314
The acronym BDSM stands for bondage, dominance/
submission (DS), and sadism/masochism (SM). It is an
umbrella term for a variety of practices in a sexual
context that involve intense stimulations of body and
mind. It is a community term that has replaced the older
term sadomasochism (SM) for at least two reasons.
First, BDSM introduces a broader range of practices
than the emphasis on sensation or pain in SM alone.
The boundaries of the term BDSM remain fuzzy,
though, as it remains contested whether fetishes (such
as leather, rubber, worshipping of certain body parts)
and other related practices (e.g., nonmainstream
practices such as fisting and urination) that are
widespread in BDSM communities are considered
BDSM proper or not (see the entry on Kink).
Second, the term sadomasochism is associated with
mental illness and with nonconsensual criminal acts
historically, scientifically, and in everyday usage. In
contrast, BDSM refers to consensual sexual and erotic
practices. Practitioners of BDSM are considered a
marginalized sexual minority analogous to gays,
lesbians, and bisexuals with a coming-out process of
their own, although it remains contested whether
BDSM is best understood as a variety of non-normative
practices or as a sexual identity.
Bondage, Dominance/Submission, Sadism/Masochism (BDSM)
This entry continues with a short introduction to
BDSM communities, proceeds with an explanation of
basic concepts of BDSM, and finally introduces some
common practices.
The Lesbian, Gay, Bisexual, Trans, and Queer
BDSM Communities
The BDSM community is largely organized as separate
heterosexual, gay male, lesbian, and queer subsets. The
heterosexual and gay male ones are much larger in
numbers and resources than the lesbian and queer ones.
The BDSM community is also mostly inclusive of
transwomen and transmen. Recently, mixed queer
spaces—that is, spaces that create opportunities for gay
men, bisexual men and women, lesbians, and trans
people to play together—have also emerged.
Today’s BDSM communities have their roots in gay
male biker clubs that emerged in the United States after
World War II, establishing a (hyper) masculine, gay
leatherman style. These secretive circles passed on
BDSM techniques and ethics via personal mentorship
and are referred to as the “Old Guard.” Beginning in the
1970s, with growing numbers and in the aftermath of
the “sexual revolution,” the community became more
accessible. Today, novices tend to be introduced to
BDSM through formal organizations that offer
workshops, through how-to manuals, and increasingly
through the Internet.
The lesbian BDSM community started off small in
the 1970s and was strongly affected by antiBDSM
strands of feminism, which hold that women cannot
consent to BDSM activities, because their socialization
as submissive makes them reenact patriarchal relations.
These debates continue today.
Defining BDSM: Roles and Consent
In BDSM terminology, playing refers to BDSM
activities, and a session or scene denotes a BDSM
encounter, which is usually of limited duration and has
a clear, sometimes ritualistic, beginning and ending. For
instance, the collaring of a “slave” may mark the entry
into roles and the removal of the collar the closure. The
persons who take on the role of being in charge of
running the action are referred to as top, and the ones
who offer themselves to be acted upon are called
bottom. About a third of BDSM practitioners do not
prefer one
role, but
“switch” between them. Generally, the roles that one
performs in BDSM are distinct from one’s everyday
personalities, such as roles in the workplace or social
identities. One can choose to play as top or bottom
independently of gender, race, age, level of BDSM
experience, and so on. Some practitioners seek to
remain in their respective roles constantly within a
particular relationship, which is referred to as 24/7 (24
hours a day, 7 days a week).
To date, there is no agreed-upon definition of
BDSM. It is even contested whether BDSM should be
considered sex or rather, for instance, leisure, because it
does not necessarily involve genital sex and because
research has identified a number of motivations for
participating in BDSM, such as realizing erotic
fantasies, seeking out spiritual experiences, pushing
personal boundaries and social taboos, and experiencing
personal growth and healing.
It is commonly accepted today that BDSM is
distinguishable from violence and rape because of its
ethical standards, which rule out nonconsensual
activities and permanent damage. If a nonconsensual
incident occurs during BDSM activities, it is viewed as
an act of (sexual) violence and not

BDSM.
Since BDSM, with its intense physical and
psychological stimulations, is considered voluntary
risk-taking, there are two competing concepts in BDSM
communities as to how to approach BDSM in a
responsible manner: safe, sane, and consensual (SSC)
and risk-aware consensual kink (RACK). In SSC, to
play safe expresses the need to ensure physical safety,
for instance through utilizing technical and medical
knowledge such as not hitting the area of the kidneys,
or using the right kind of candle wax to prevent serious
burns. Sane is often interpreted as being capable of
distinguishing fantasy from reality, for instance,
refraining from actions that are considered not
consentable, such as permanently damaging the body.
In contrast, RACK stresses that absolute safety is
Bondage, Dominance/Submission, Sadism/Masochism (BDSM)
illusionary, that sanity is hard to define, and that it is
rather important that all parties are aware of the risks
they are taking with certain practices and apply risk-
management techniques accordingly. Both concepts
agree on the significance of consent for an activity to
count as BDSM. Practitioners attempt to establish
consent consciously and explicitly through
prenegotiations and through installing a veto-right
during a BDSM encounter, usually in the form of a safe
word. If a participant utters this code, the action is
supposed to stop immediately. This is why bottoms
often report feeling empowered rather than powerless
on an underlying level, as they remain in control
through their veto-right.
BDSM Practices: Bondage, Sensation, Power,
Role-Play
The most common practices in BDSM involve either
playing with a performed difference in positions of
power or with intense stimulations and manipulations
of body and mind, or both. While one can differentiate
between power play, sensation play, and bondage, most
BDSM encounters involve combinations of these
elements.
Bondage is a term used for a wide variety of
practices in which the bottom is immobilized. This can
be achieved through the use of wrist and ankle restraints on). Such a set of rules for behavior for a submissive is
(often made of leather or other soft but durable
materials), ropes (made of cotton or hemp),
mummification (with kitchen foil and tape), cages,
specific bondage equipment such as bondage sleeping
315
bags, vacuum beds, and so on. Often the psychological
dynamic involved is about giving up control, being at
the mercy of the top, being the sex toy/object for
someone, and so forth. But practices like suspension
bondage can also be about achieving a state of total
abandonment, literally “flying” in the air, or attaining a
sense of peace of mind akin to meditation in long-term
bondage sessions, with little or no power dynamic
between top and bottom.
The same holds true for the giving and receiving of
intense stimulations or pain, referred to as sensation
play, because it is different from the everyday
experience of pain through the presence of consent and
the erotic framework. The motivation to participate in
practices such as flagellation (hitting someone with an
implement such as a whip or flogger); spanking; placing
clamps or
dripping hot
wax on the body; and piercing, cutting, or branding the
skin, differs. Those individuals who enjoy inflicting
pain are referred to as sadists, while those who enjoy
and are capable of eroticizing the reception of pain are
called masochists. But not every practitioner is directly
aroused by pain itself; often it is about the symbolic
meaning behind it, the challenge to endure it for
someone, or the entering of a different state of
consciousness, akin to spiritual body stress rituals.
Therefore, very particular sensations are sought out, not
pain per se.
Practices focusing on power dynamics are referred to
as dominance/submission (DS), with the top being
called a dominant and the bottom a submissive. More
specifically, players may also identify as
“Mistress/Master” and “slave” or “boy/girl” and so on,
depending on the kind of role-play. In DS, participants
consciously and collaboratively construct a power
differential, for instance through symbolic, sometimes
ritualized acts and use of artifacts (such as submissives
wearing a collar around their neck, kneeling in front of
dominants, polishing their boots) and through
establishing different rules for dominant and submissive
(such as when the submissive is not allowed to use
furniture, has to ask for permission to speak, relieve
themselves, touch themselves or the dominant, and so
referred to as protocol. In DS, exercising or giving up
power is eroticized. Sometimes references to reallife
historical slavery, the service work industry, or human–
animal relations may serve to reinforce this power
dynamic, though mostly it is an erotic fantasy, rather
316
than a realistic version, of these social power relations
that is the basis for BDSM scenarios. DS often involves
role-playing, although some practitioners prefer to
interact with their everyday personalities, making it as
“real” as possible.
Role-play can take many different forms and refer to
real-life institutions as well as fantasy worlds. Within
gay/bi male communities, master– slave, daddy–boy,
puppy play, and military scenarios
Breast Care for Transgender People
are most common. In the les/bi/trans/queer
communities, a variety of other scenarios such as
vampire– human, teacher–student, secret police, and so
on are engaged in as well. Furthermore, playing with
gender (for instance embodying a gender other than
one’s everyday gender) is very popular, while in gay
men’s spaces it seems to be limited to performances of
(hyper)masculinity. Some of these practices are
considered edge play, if they push a personal boundary
of a participant or a cultural taboo, such as incest or
historical slavery play. This highlights the fact that risk
management in BDSM is not limited to technical
aspects and physical safety, but needs to consider
emotional care as well.
Collective BDSM Spaces: Play Parties
BDSM activities are not limited to private encounters
and monogamous relationships. Rather, the BDSM
communities have developed a sexual culture with
myriad opportunities to play outside couple structures
and the bedroom. Practitioners organize so-called play
parties privately, collectively in a nonprofit setting, or
commercially, providing a space to gather, socialize,
and engage in BDSM activities in one-on-one sessions,
or in small or sometimes large groups. In the gay/bi
men’s community, these spaces tend to be more
commercial, while in the les/bi/trans/queer
communities, the use of nonprofit spaces for these
activities is more common, owing in part to a lack of
resources. In the gay/bi men’s community, play parties
tend to operate with a “dress code,” making certain
fetish outfits mandatory. Gay/bi men’s play parties also
tend to have a theme, fragmenting the whole of BDSM
into specialties (leather, rubber, skin, bondage night,
etc.). In the les/bi/trans/queer communities, play parties
tend to include all possible practices and any outfits that
practitioners associate with their fantasies and roles. For
example, street clothing of a particular gender may be
appropriate for gender play. Usually rules exist to
ensure that people are not harassed or disturbed while
playing, sometimes also regulating safer sex. The rules
tend to be different in gay/bi male versus
les/bi/trans/queer spaces, with more regulation in the
latter.
Robin Bauer
See also Hypermasculinity; Kink; Monogamy and Non-
Monogamy; Sex Positive Movement; Sexual Consent;
Sexual Risk-Taking
Further Readings
Barker, M., & Langdridge, D. (Eds.). (2005).
Contemporary perspectives on sadomasochism (S/M)
[Special issue]. Lesbian & Gay Psychology Review, 6(3).
Bauer, R. (2014). Queer BDSM intimacies: Critical consent and
pushing boundaries. Houndmills, England: Palgrave.
Hart, L. (1998). Between the body and the flesh:
Performing sadomasochism. New York, NY:
Routledge.
Kaldera, R. (2009). Double edge: The intersections of
transgender and BDSM. Hubbardston, England:
Alfred Press.
Kleinplatz, P. J., & Moser, C. (Eds.). (2006).
Sadomasochism: Powerful pleasures. New York, NY:
Harrington Park Press.
Langdridge, D., & Barker, M. (Eds.). (2007). Safe, sane and
consensual: Contemporary perspectives on
sadomasochism. Houndmills, England: Palgrave.
Newmahr, S. (2011). Playing on the edge:
Sadomasochism, risk, and intimacy. Bloomington:
Indiana University Press.
Weiss, M. (2011). Techniques of pleasure: BDSM and the
circuit of sexuality. Durham, NC: Duke University Press.
BONDAGE AND DISCIPLINE/ DOMINATION
AND SUBMISSION
(BDSM)
See Bondage, Dominance/Submission,
Sadism/Masochism (BDSM)

BREAST CARE FOR TRANSGENDER
PEOPLE
Transgender individuals are born with a biologic sex
that does not match their gender identity and
expression. They have the same health concerns as non-
transgender people, in addition to a unique set of
considerations due to their medical and gendered
histories. Transgender individuals require care tailored
to their specific situation and choices. This requires
medical providers to be caring, be nonjudgmental, and
have an accurate understanding of their needs.
Although the term transgender can be applied to a
broad spectrum of people and groups, for the purposes
of this entry it is defined as those persons actively
engaged in anatomically and/or physiologically
transitioning from their biologic sex to their actual sex.
Many undergo hormone therapy and/ or alter their
breasts or genitals to facilitate this transition from male
to female (MtF) or female to male (FtM). This entry
focuses on changes in breast tissue due to hormone
therapy, breast binding, mastectomy, or breast
augmentation.
Relevant Anatomy and Physiology
Individuals in the transgender population often change
their breast anatomy and physiology to achieve an
aesthetic more congruent with their gender identity. A
description of breast tissue development and
maintenance is important to provide a basis for
understanding their choices.
The mature human breast sits between a layer of fat
and muscles. Between the breast and the muscles is a
network of small veins and arteries; it is here that
tissues are separated during a mastectomy. Nerves that
supply sensation to the chest and upper arms are
immediately next to the breast tissue, which consists
mainly of glands, supporting tissue, and fat. There are
10 to 15 tiny openings in each nipple, which in genetic
females are attached to the glands of the breast that
produce milk. Breast tissue changes throughout a
woman’s life, reflecting pregnancy, lactation,
menopause, and general aging. The male breast is
predominantly fat and supporting tissue, with very little
glandular tissue.
317
Male-to-Female Transgender Individuals
An individual who is born male and transitions to
female may undergo a combination of feminizing
procedures related to her breasts, including
Breast Care for Transgender People
hormone supplementation, implantation, and
augmentation by injection.
Hormone Supplementation
Estrogen is primarily used to create female
characteristics in the transgender woman, although
other medications are sometimes given as well. The
speed and degree of changes in breast tissue depend on
the individual person, as well as the combination of
agents being used. Breast and nipple development are
rarely as complete in MtF individuals on hormone
supplementation as it is in genetic females. Maximum
development is usually achieved after 18 to 24 months
of hormone therapy and is permanent, so MtF
individuals may choose to consider augmentation after
2 years if they are unsatisfied with their breast growth.
Weight gain in thin transgender women may also add to
breast volume.
General side effects of hormone therapy may include
weight gain, galactorrhea (nipple discharge), decreased
red cell mass, and decreased sex drive, and in non-
transgender women, infertility. No large studies have
been conducted to evaluate the adverse effects of
hormone therapy on the breast tissue specifically of
transgender individuals. However, many studies have
been done on nontransgender women who are receiving
hormones for a variety of reasons. The results have
been varied and difficult to interpret, so more research
is required. There are seven instances of breast cancers
in MtF individuals noted in the medical literature, and
some researchers hypothesize that MtF people receiving
these hormones may have a higher cancer risk. This is
because many cancers are fed and perpetuated by
estrogen. Cancers may be underreported in the small
transgender population, or the incidence may rise as the
new and growing generation of MtF individuals age.
Despite the complex and incomplete evidence related
to breast screening of MtF individuals on estrogen
therapy, guidelines are widely agreed upon. The
Endocrine Society’s recommendation is representative
of the consensus, in that MtF transgender individuals
318
should follow the same breast cancer screening
guidelines as non-transgender women.
Breast Care for Transgender People
Breast Implantation
Breast implants are typically made from saline or
silicone, encased in elastic shells made from silicone or
plastic. The body usually forms a dense capsule of scar
tissue around each implant. Early procedures entailed
inserting the implant just under the skin; now they are
more often placed beneath the chest muscles. This new
method does not visibly ripple the skin, and there is less
chance of unattractive or unhealthy results.
Although the practice of breast implantation is
common, in the general and MtF populations, there are
safety concerns for all. Many women experience
adverse events after surgery, some of which include
bleeding, wound infection, or chronic pain. Implant
rupture is a common complication. Silicone can leak
out and migrate to other parts of the body, leading to
pain and requiring surgical removal.
Unfortunately, there is little agreement about the
preferred method of screening the MtF person with
breast implants: mammography, ultrasonography, or
magnetic resonance imaging (MRI). Different
researchers have come to varying conclusions, although
transgender women have deemed all of the procedures
nearly painless and of high personal importance.
Injection for Augmentation
Various substances for injection into the face,
breasts, hips, buttocks, and calves are marketed as
minor or relatively inexpensive procedures for MtF
individuals to feminize their bodies. The material most
often used is silicone oil, but mineral oil and olive oil
are also sometimes injected. Improper use can lead to
numerous complications, sometimes years later. These
may include various infections, loss of vision, hepatitis,
migration and disfigurement, chronic ulcers, and
swelling of lymph nodes.
Treatment for these issues can be complex and
painful. Suction of silicone from the breast has been
used, but complete surgical removal of the oil is
generally considered impossible. Individuals who have
had these injections in the breast should receive
subsequent annual mammography and follow-up MRI.
Education should address possible adverse events and
the avoidance of breast trauma.
Female-to-Male Transgender Individuals
People seeking to transition from a female to a male
body may pursue a number of procedures that affect
their breasts, including hormone therapy, breast
binding, and mastectomy.
Hormone Supplementation
Testosterone is typically the only hormone
prescribed to produce masculinizing effects. Sometimes
various methods of birth control may be used to
suppress menstruation. Medical research has found no
increased risk of serious adverse effects on breast health
while taking such regimens.
If a mastectomy has not been performed, the
Endocrine Society recommends continued
mammography screening for individuals on testosterone
therapy, a position also supported by the American
Cancer Society.
Breast Binding
Breasts are perceived by many FtM transgender
individuals as a constant reminder of their biologic sex.
Binding of the breasts tightly to the torso allows them to
be more easily hidden beneath clothing, making it
easier to pass as male. Many FtM individuals perceive
their breasts and how they choose to hide them as
crucial to their gender presentation.
There is little specific evidence on the health effects
of breast binding, and mention of the practice is usually
only one part of broader research studies. There has
been an increase in the hormone prolactin observed in
those who bind, which is in turn linked to tumor
growth.
As noted, the Endocrine Society recommends
continued annual breast cancer screening, as dictated by
the American Cancer Society, for individuals on
testosterone therapy. This also applies to FtM people
who bind their breasts.
Mastectomy
Mastectomy for an FtM person is typically referred
to as chest reconstruction, and often involves an initial
procedure, followed by scar revisions. There are a
number of techniques employed for mastectomy in FtM
individuals, depending on a person’s breast volume,
skin elasticity, and the position of the nipples. The
performance of a mastectomy is made more complex by
poor skin quality caused by years of breast binding.

Skin elasticity is an important factor in choosing the
most appropriate surgical technique.
Chronic pain following mastectomy has been
reported frequently in multiple studies, some even
finding that more than half of women will experience it.
Other complications can occur, such as nipple tissue
death, contour irregularities, and substantial scarring.
The possibility of experiencing pain following a chest
reconstruction procedure is a risk that many MtF
individuals may be willing to accept; however, the
potential for this complication must be discussed.
There is no consensus in the literature on how, when,
or whether FtM individuals should be screened for
breast cancer following mastectomy, but most evidence
suggests that pathologic findings in residual tissue are
rare. The American Cancer Society recommends that
women who have had mastectomies undergo a clinical
breast exam annually, which includes examination of
the chest wall, skin, and incision. The guideline does
not mention the need for radiologic examination, or
specific recommendations for transgender people.
Conclusion
Health care providers have a responsibility to treat all
clients with respect, which includes having a thorough
understanding of their unique needs and desires.
Transgender individuals are particularly in need of this
consideration, reflecting their anatomical and
physiological choices and social vulnerability.
Transgender individuals perceive their breasts as being
an important part of their gender identity. As a result,
transitioning often entails a great deal of focus on breast
changes through
Bullying, Legal Protections Against
hormone therapy, implantation, augmentation
injections, binding, or mastectomy. All of these choices
have risks that warrant careful discussion and
monitoring by health care providers. Overall, the
acceptability of risks associated with these choices must
be determined by the individual and not by the
provider. In a society that has yet to fully accept
transgendered individuals, one of the most valuable
things a provider can offer is compassion and
acceptance to help this vulnerable population maintain
optimal health in the context of their choices.
Laura Maycock
319
See also Body Modification; Health Disparities;
Hormones and Surgery During Gender Transition;
Transgender Health Care; Transgender People and
Binding, Tucking, and Packing; Transgender Youth and
Cross-Sex Hormones; Transgender Youth and Puberty
Suppression
Further Readings
Coleman, E. (2012). Standards of care for the health of
transsexual, transgender and gender nonconforming people.
Retrieved October 16, 2014, from http://www
.wpath.org/site_home.cfm
Lawrence, A. A. (2007). Transgender health concerns. In I. H.
Meyer & M. E. Northridge (Eds.), The health of sexual
minorities: Public health perspectives on lesbian, gay,
bisexual and transgender populations (pp. 437–505). New
York, NY: Springer.
Maycock, L. B., & Kennedy, H. P. (2014). Breast care in the
transgender individual. Journal of Midwifery and Women’s
Health, 59(1), 74–81.
BULLYING, LEGAL PROTECTIONS
AGAINST
Over the past several decades, increased attention has
been paid to bullying and harassment in schools in
general, and bullying of LGBTQ students in particular.
Legal protections are some of the most discussed
avenues for addressing bullying in school. Although
there are a variety of legal
Bullying, Legal Protections Against
proscriptions and remedies in place to address school
bullying, they still fall short of sufficiently protecting
LGBTQ students. This entry reviews the current
landscape of both state and federal legal protections
against bullying for LGBTQ students in the United
States. Although the focus here is on statutory laws,
various administrative rules and procedures may also
provide a level of protection for LGBTQ students
against school bullying, such as school bullying codes
enacted by state departments of education.
Public education resides primarily in the purview of
state and local jurisdictions, and states have been at the
forefront in addressing bullying through specific state
statutes. Currently, all 50 states and the District of
320
Columbia have passed laws addressing bullying in
schools. By and large, these state laws require schools
and school districts to develop explicit anti-bullying
policies and mandate the content of the policies. The
U.S. Department of Education issued a report in 2011
documenting the prevalence and content of state anti-
bullying laws and the growth of this legislation over the
past decade.
These state laws are not uniform across the nation.
Their effectiveness in specifically protecting LGBTQ
students from bullying depends upon the explicit
inclusion of sexual orientation and gender
identity/expression among other enumerated categories
of protection, such as race/ethnicity, gender, or religion.
For example, a study conducted by the Gay, Lesbian &
Straight Education Network (GLSEN) of LGBTQ
secondary school students found that students living in
states with antibullying laws that included an explicit
enumeration of sexual orientation and gender
identity/expression reported lower levels of peer
victimization in school and higher levels of
effectiveness of staff response to victimization than
LGBTQ students in states that have anti-bullying laws
without such enumeration. The enumeration of
protected categories is generally set forth in the statutes
as an illustrative, but not exhaustive, list of protected
categories. The majority of anti-bullying statutes do not
include such enumeration. Currently, only 18 states and
the District of Columbia include the express
enumeration of protected categories, although all of
these include sexual orientation and gender
identity/expression. In addition to the District of
Columbia, the states that include protections based on
sexual orientation and gender identity/ expression are
Arkansas, California, Colorado, Connecticut, Illinois,
Iowa, Maine, Maryland, Massachusetts, Minnesota,
Nevada, New Jersey, New York, North Carolina,
Oregon, Rhode Island, Vermont, and Washington.
At the federal level, the U.S. Constitution and civil
rights law can provide legal remedies for LGBTQ
students who face bullying and harassment. The Equal
Protection Clause of the Fourteenth Amendment of the
U.S. Constitution guarantees all citizens the same
protection under the law. It has been successfully used
to hold public school districts accountable for failing to
protect LGBTQ students from harassment and bullying
and thereby depriving them of equal access to an
education.
In addition to the Equal Protection Clause, Title IX
of the Education Amendments of 1972 has been used to
protect LGBTQ students subject to bullying and
harassment. Title IX explicitly prohibits sex
discrimination in schools that receive federal funding
and applies to virtually all public schools and some
private schools. Title IX has traditionally applied to
providing equal access to girls in school sports and
protection from sexual harassment. Recently, the U.S.
Department of Education clarified that Title IX applies
to discrimination based on sex stereotypes (i.e.,
discrimination based on failure to conform to traditional
notions of masculinity or femininity) and gender
identity (i.e., discrimination against transgender
students). LGBTQ students who experience bullying
and harassment on account of sex stereotypes or gender
identity can file Title IX complaints through the Office
of Civil Rights of the U.S. Department of Education.
Although there are federal legal remedies for school
bullying, there is no existing federal legislation
explicitly addressing bullying in schools. The Safe
Schools Improvement Act is designed to ensure that all
students, including LGBTQ students, in every state are
statutorily protected from bullying and harassment. A
bipartisan bill,
the Safe Schools Improvement Act, has been introduced
in multiple Congressional sessions, and— while never
brought up for a vote—had the support of nearly half
the House and Senate at the end of the 113th Congress.
The Safe Schools Improvement Act would require all
primary and secondary schools receiving federal
funding to enact an anti-bullying policy that includes
specific prohibitions on bullying based on sexual
orientation and gender identity/expression. The policy
would also have to include other categories, such as
race and religion. A similar bill that applies to
institutions of higher education, known as the Tyler
Clementi Higher Education Anti-Harassment Act,
requires colleges and universities to prohibit harassment
and establishes within the Department of Education a
grant program to support campus antiharassment
programs.
Emily A. Greytak
See also Bullying, Rates and Effects of; Bullying, School-
Based Interventions for; Education; School Climate;
Transgender and Gender-Nonconforming Youth and the
Legal System; Violence and Victimization of Youth

Further Readings
Gay, Lesbian & Straight Education Network (GLSEN), &
National Center for Lesbian Rights (NCLR). (n.d.).
Expensive reasons why safe schools laws and policies are in
your district’s best interest. Washington, DC:
Author.
Kosciw, J., Greytak, E. A., Palmer, N. A., Bartkiewicz, M.
J., & Boesen, M. J. (2012). The 2011 National School
Climate Survey: The experiences of lesbian, gay, bisexual,
and transgender youth in our nation’s schools. New York,
NY: Gay, Lesbian & Straight Education Network.
Limber, S. P., & Small, M. A. (2003). State laws and
policies to address bullying in schools. School
Psychology Review, 32(3), 445–455.
Stuart-Cassel, V., Bell, A., & Springer, J. F. (2011).
Analysis of state bullying laws and policies. Washington,
DC: U.S. Department of Education, Office of Planning,
Evaluation and Policy Development.
Bullying, Rates and Effects of
BULLYING, RATES AND EFFECTS OF
This entry describes findings from research on the
bullying of LGBTQ youths. It offers a historical
overview of those studies that identify bullying as a
significant factor in the well-being of LGBTQ
individuals, and provides a summary of the findings
from larger, more recent, population-based surveys.
The entry then discusses the prevalence of LGBTQ
bullying, including the bullying of those who are
perceived to be LGBTQ, before turning to a discussion
of the long-term implications of those experiences for
victims. Finally, this entry offers an overview of current
debates about the use of language and whether the use
of epithets such as “gay” and “fag” are homophobic.
Rates of Bullying
Bullying perpetrated against LGBTQ youths remains a
significant education and public health issue. For more
than 30 years, LGBTQ support groups and researchers
have undertaken studies to understand its nature,
prevalence, and long-term effects. Those groups and
researchers have encountered hostility from local and
national politicians, and the leaders of faith
communities, as a result of their attempts to raise the
321
profile of and offer support to LGBTQ young people in
school.
The very first study to provide data on what we now
call homophobic bullying was conducted in the United
Kingdom on behalf of the Inner London Education
Authority in 1984. Four hundred and sixteen lesbian,
gay, and bisexual (LGB) youths were asked about the
pressures they faced in school and the ways in which
they were discriminated against in the classroom. The
results from this pioneering study suggested that 39% of
youths had experienced “problems at school,” which
included bullying. Of those who experienced problems
at school, 25% reported feeling isolated, 21% had been
called names or verbally abused, 13% had been teased,
12% had been physically assaulted, 7% had been
ostracized by peers, and 7% said they had been
pressured to
Bullying, Rates and Effects of
change their behavior. By comparison, in 1988,
researchers in the United States collected data from 461
gay men and 260 lesbians, which showed that 50% of
the men surveyed and 12% of women reported having
experienced victimization in junior high schools, rising
to 59% and 21%, respectively, in high school.
Subsequently, an analysis of the data gathered from
various studies conducted by LGB task forces and
coalitions across the United States in the late 1980s and
early 1990s suggested that, nationally, reports of
school-based victimization ranged anywhere from 33%
to 49%.
By the mid-1990s, community-based studies using
samples of LGB youths were beginning to be published.
One study of 194 youths attending community groups
across the United States suggested that as many as 30%
of young men and 25% of young women experienced
harassment or abuse in school. In the United Kingdom
(UK), a survey of hate crimes perpetrated against
British LGBs indicated that around 40% of those under
the age of 18 had been attacked at school. By the late
1990s, it was estimated that approximately 1 in 3 LGB
youths experienced victimization at school because of
their actual or perceived sexual orientation.
Since 2000, two large-scale surveys sponsored by a
UK charity have demonstrated a shift in the experiences
of young LGBs in secondary/high schools and colleges.
Data collected in 2012 (from 1,614 youths) was
compared with that collected in 2007 (1,145 youths)
and showed that reports of bullying decreased from
322
65% to 55%. However, of those who reported being Prevalence
bullied in the 2012 survey, 58% said they were victims
Most of the early studies that focused on LGBTQ
of verbal abuse, 46% were the subject of gossip, and
bullying relied on self-selecting samples of youths and
33% reported receiving intimidating looks. Other forms
young adults who were “out” and attending community
of victimization included being ignored by peers (31%),
groups; or who were drawn to the projects because of
cyberbullying (23%), physical abuse (16%), destruction
subject matter and their own experiences of violence
of property (11%), phone/text abuse (9%), death threats
and harassment. It has therefore been very difficult to
(6%), threats with a weapon (3%), and sexual assault
establish a prevalence rate for LGBTQ bullying in
(3%). LGB youths attending faithbased schools were
schools.
more likely to report being bullied than those attending
Two surveys run by a UK national charity have
public or secular schools.
asked young people in schools and colleges about all
In the United States, the Gay, Lesbian and Straight
forms of bullying. The first survey, published in 2013,
Education Network’s (GLSEN) biannual surveys of
included 1,843 young people attending colleges across
bullying and victimization, which began in 1999,
the United Kingdom. Among those youths who had
illustrate how reports of victimization have changed
experienced bullying before their 18th birthday, 11.1%
over time. There has been a noticeable decline in verbal
said that the bullying they experienced related to
harassment since 2007; however, rates of physical
“attitudes toward sexuality” with 3.4% reporting that it
assault have remained relatively stable. Among those
was the result of “attitudes toward gender identity.” The
who are bullied on the grounds of gender expression,
second survey, published in 2014, which included
while there has been a concomitant decline in verbal
responses from 3,616 young people, indicated that
harassment, physical assault has also remained
approximately 7% experienced what was described as
relatively unchanged.
“homophobic bullying” at school and 2% had
In its 2011 survey of 8,584 youths (ages 13 to 20),
experienced “transphobic bullying.”
GLSEN found that 63.5% said that they felt unsafe at
Between 2001 and 2002, the California Safe School
school because of their sexual orientation and 43.9%
Coalition, together with researchers from the University
because of their gender expression. Of those who felt
of California, Davis, surveyed 237,544 students
unsafe at school, 81.9% said they had been called
attending schools statewide (Grades 7 to 11; ages 12 to
names or threatened in the last year because of their
17 years) who were asked about their experiences of
sexual orientation, and 63.9% because of their gender
bullying, including incidents of homophobic bullying.
expression. Additionally, 38.3% reported having been
Overall, 7.5% of students said that they had been
physically harassed (pushed or shoved) and 18.3% said
victims of homophobic bullying, with two thirds of
they had been physically assaulted because of their
those students who identified as lesbian, gay, bisexual,
sexual orientation. Among those bullied because of
and transsexual reporting that they were victimized
their gender expression, 27.1% said that they had been
because of their actual or perceived sexual orientation.
physically harassed with 12.4% reporting having been
Additionally, those students who were bullied because
physically assaulted. Over half (55.2%) had also been
of their actual or perceived sexual orientation were
the victims of cyberbullying.
more likely to report receiving lower grades for
Although a great deal of data have been collected on
academic work (grade “C” or below) when compared
the experiences of LGBTQ people when they were at
with nonbullied peers (24% versus 17%). They were
school, these data have tended to be retrospective and
also more likely to report missing school in the past
questions have been raised about the ability of adults—
month because they felt it was not safe (27% versus
even young adults—to remember incidents in detail or
7%). They were twice as likely to report engaging in
provide accurate estimates of the frequency of their
healthrisk behaviors such as substance abuse, driving
bullying. While there is encouraging evidence to
under the influence of alcohol, or being a passenger in a
suggest that name-calling has diminished over time, it
car where the driver had consumed alcohol. They were
remains a concern that over 50% of LGBTQ youths
significantly more likely to report being threatened or
continue to report being harassed at school.
hurt by someone carrying a weapon (28% versus 5%),
and much more likely to report carrying a weapon to
school (19% versus 5%).

Bullying, Rates and Effects of
Data from these three surveys provide some index of
the prevalence of bullying on the grounds of actual or
perceived sexual orientation and gender expression.
Approximately 7% of young people experience some
form of bullying related to actual or perceived sexual
orientation. This figure includes not only LGBTQ
youths but also those heterosexual youths who, for
whatever reasons, are perceived to be different and thus
not members of the heterosexual in-group. Much more
research is needed on the health-risk behaviors
associated with LGBTQ bullying, and it is particularly
worrying that significantly more LGBTQ youths feel
the need to carry a weapon to school when compared
with their heterosexual peers who experience bullying.
Effects of Bullying
The issue of whether homophobic bullying is a
significant contributor to the mental health issues found
among sexual-minority groups is contested. Some
researchers and activists argue that there are
methodological flaws in the design of many of the early
studies examining LGB mental health where the focus
is on negative rather than positive experiences growing
up. Those early studies rarely included participants who
were transgender or queer/questioning. Some scholars
and activists argue that researchers continue to
perpetuate a myth of ongoing discrimination and poor
mental health among LGBTQ people when
homophobia is in fact in decline. However, there is now
an emerging body of longitudinal research that suggests
that there are indeed long-term and debilitating effects
arising from bullying at school, not just for LGBTQ
youths but also for those youths who are bullied for
other reasons.
The long-term correlates of homophobic bullying
range from reports of depression, anxiety, and non-
expressed aggression through to multiple
suicide attempts. In one study conducted in the United
Kingdom, it was found that 53% of LGB participants
who had experienced bullying at school because of their
actual or perceived sexual orientation had contemplated
suicide. The
Bullying, Rates and Effects of
majority (40%) had made at least one attempt and three
quarters of those had made two or more attempts. In the
323
United States, among a community sample of 194 LGB
youths, 42% reported having attempted suicide. While
researchers have been careful not to link suicide to
experiences of peer, family, and community
intolerance, increasingly there is evidence that suggests
good mental health is intrinsically linked to self-
acceptance, which is itself linked to societal acceptance.
This finding is corroborated by large-scale
populationbased studies, which show that external
environmental factors such as the political and social
acceptance of sexual minorities plays a significant role
in the general well-being and survival rates of LGBTQ
people. For example, using pooled data from the 2005
and 2007 Youth Risk Behavior Surveillance surveys (N
= 55,559, ages 13 to 18 years), one U.S. study found
that rates of suicide ideation among LGB young people
were lower in states and cities where sexual-minority
students reported feeling protected (e.g., they had safe
spaces to go to or their schools had a gay–straight
alliance).
In GLSEN’s 2011 survey, high rates of depression
and low self-esteem were found among those who
reported being victimized at school. Additionally, data
collected in California from 237,544 students suggests
that 55% of those bullied because of their actual or
perceived sexual orientation had experienced
depression for at least 2 weeks in the last 12 months
(compared with 23% among nonharassed students).
Furthermore, 45% had seriously considered suicide
(compared with 14% among nonharassed students) and
35% had made a suicide plan (compared with 9%
among nonharassed students). However, one UK study
found that there is very little difference in scores for
depression, anxiety, and non-expressed anger for those
who were bullied because of their sexual orientation at
school when compared with those who were bullied for
other reasons. Overall, both groups were found to have
poorer mental health when their scores were compared
with those of heterosexual and LGB participants who
had not been bullied at school.
Finally, data taken from the Longitudinal Study of
Young People in England suggest that, among those
who identified as LGB at age 16, while victimization
declined with age, young LGB people, particularly
young men, are nearly 4 times more likely to experience
some form of harassment or victimization after they
leave school when compared with young heterosexuals.
Depression, anxiety, non-expressed anger, and self-
loathing have all been identified as issues common
among LGBTQ youths and adults who experienced
324
bullying at school. Rates of suicide ideation have been
found to be particularly high among this group,
averaging at around 40%; however, some researchers
argue that the suicide “script” associated with bullying
is so well known among LGBTQ youths that taking
one’s own life may be seen as the only solution when
bullying occurs. If this is the case, it becomes
imperative that alternative scripts encouraging help-
seeking behaviors are promoted among those who
support LGBTQ youths.

Contemporary Debates on Language Use

Criticism of those early studies that explored LGBTQ
mental health has been followed most recently with a
discussion about the current use of epithets such as
“gay,” “fag,” “dyke,” and “tranny” by young people.
Cross-nationally, researchers and theorists from the
disciplines of sociology and education have suggested
that comments such as “that’s so gay” or labels such as
“fag” are not homophobic but rather represent new
language conventions among young people’s friendship
networks. Here, such labels are not associated with
sexual orientation; rather, they represent a form of
banter or “homosexually themed language” that can be
used without causing offense. It is argued that these
groups of friends would not consider themselves
homophobic or transphobic; rather, they have accepted
a much more relaxed attitude toward sexuality and
gender expression, which in turn allows them to use
those names or labels in a nondiscriminatory way. The
use of language and the way outsiders interpret it is an
important area of inquiry, and it is one that is ongoing.
Ian Rivers

See also Bullying, School-Based Interventions for;
Community Climate; Gay, Lesbian & Straight
Education Network (GLSEN); Homophobia;
Homophobic Language in the Peer Group; School
Climate; Suicide, Risk Factors for and Prevention of;
Transphobia
Further Readings
Gay, Lesbian and Straight Education Network. (2011). The
2011 National School Climate Survey: The experiences of
lesbian, gay, bisexual and transgender youth in our
nation’s schools. New York, NY: Author.
Guasp, A. (2012). The school report: The experiences of gay
young people in Britain’s schools in 2012.
London, England: Stonewall.
Hatzenbuehler, M. L. (2011). The social environment and
suicide attempts in lesbian, gay, and bisexual youth.
Pediatrics, 127, 896–903.
McCormack, M. (2013). Mapping the boundaries of
homophobic language in bullying. In I. Rivers & N.
Duncan (Eds.), Bullying: Experiences and discourses of
sexuality and gender (pp. 91–104). London, England:
Routledge.
Pascoe, C. J. (2005). “Dude, you’re a fag”: Adolescent
masculinity and the fag discourse. Sexualities, 8, 329–
346.
Rivers, I. (2011). Homophobic bullying: Research and
theoretical perspectives. New York, NY: Oxford
University Press.
Robinson, J. P., Espelage, D. L., & Rivers, I. (2013).
Developmental trends in peer victimization and
emotional distress in LGB and heterosexual youth.
Pediatrics, 131, 423–430.
Savin-Williams, R. C. (2005). The new gay teenager.
Cambridge, MA: Harvard University Press.
BULLYING, SCHOOL-BASED
INTERVENTIONS FOR
Bullying has recently been recognized as a
significant social problem, particularly in schools,
where young people spend the majority of their
waking hours. The school community has deemed
unacceptable a range of peer-to-peer antisocial
conduct used to intimidate and control others.
Bullying, School-Based Interventions for 325
Unacceptable bullying behaviors range from social
exclusion, name-calling, and spreading rumors to
harassment, threats, and physical assault. Bullying
may occur in person or online. Some behaviors
labeled as “bullying” by schools may rise to civilly
or criminally sanctioned behavior. According to the
American Educational Research Association’s
(AERA) recent report on bullying, LGBTQ students,
along with students with disabilities and African
American students, are the targets of a
disproportionate level of bullying in U.S. schools.
Because researchers, educators, and parents are
beginning to understand how bullying interferes with
a student’s ability to learn and negatively affects
their well-being, conduct that was formerly
minimized and accepted as just a normal part of
growing up is now the subject of school-based
intervention policies and practices.
Anti-LGBTQ bullying, however, is not often
integrated explicitly into a school’s prevention or
intervention policies or practices. This is likely due
to a combination of a school’s lack of awareness and
resources, which are maintained by institutionalized
forms of anti-LGBTQ discrimination in K–12
schools. Because of this enduring reality, some
scholars who research anti-LGBTQ bullying argue
against adopting an overly narrow conceptualization
of the term bullying because doing so obscures how
anti-LGBTQ bullying stems in part from and
contributes to an overall hostile school climate for
sexual-minority and gendernonconforming youth
and adults. They caution that generic anti-bullying
interventions will likely not protect LGBTQ youth,
and that LGBTQinclusive anti-bullying interventions
may ignore the structural inequalities experienced by
the LGBTQ
community.
School-based interventions for bullying differ
according to how bullying is defined and measured,
the intended scope and goal of the intervention, and
the level of educational resources invested. Some
interventions are directed at the individual, such as
incident-based counseling or disciplinebased
approaches often modeled on federal antiharassment
law or zero-tolerance antiviolence or
Bullying, School-Based Interventions for
antidrug policies. Other interventions involve a
group of students such as a therapeutic support or
326
skill-building group, student clubs such as gay–
straight alliances, and conflict-resolution/peer
mediation programs or other restorative justice
techniques. Still others engage the whole school to
prevent bullying (e.g., character education, positive
behavior intervention). The following sections
provide an overview of individual, group, and
wholeschool approaches to school-based
interventions for bullying. Highlighted throughout
are ways in which schools have used these tools to
create inclusive learning environments for all of
their students, regardless of sexual orientation or
gender identity.
Individual-Based Interventions
Classroom Management
One of the first sites for school-based
interventions for bullying is classroom management.
Educators are responsible for maintaining an
environment that is conducive to learning for all of
their students. Instilling and maintaining
expectations for student comportment in the
classroom (or bathroom, locker room, cafeteria, or
hallway) incorporates interrupting and stopping
inappropriate behavior, including anti-LGBTQ
bullying. Still, according to the Gay, Lesbian and
Straight Education Network’s (GLSEN) biennial
National School Climate Survey released in October
2014, students aged 13 to 21 who were in Grades 6
through 12 reported that over 40% of school
employees never intervene when they hear
homophobic remarks; the percentage rises to nearly
60% for negative remarks about gender expression.
More than half of the students surveyed also reported
that their teachers uttered homophobic and negative
remarks about gender expression. These findings are
not unexpected given the mix of affirming and
negative attitudes toward LGBTQ people found
across the United States, and the lack of discussion
of LGBTQ issues in preservice training for teachers
and other school staff. Supplementary efforts for
postgraduates include discretionary participation in
professional development to help classroom
teachers, counselors, coaches, school bus drivers,
and other “frontline” staff feel confident and
prepared to recognize and intervene in any kind of
bullying on school grounds or in the digital world.
Student Discipline
Over the last decade, statewide anti-bullying laws
have been passed in 49 out of 50 states. As a result,
most school codes of conduct now incorporate anti-
bullying policies, and student discipline constitutes
the most common school-based antibullying
intervention. Schools enforce these codes, policies,
and laws primarily through disciplinary action. The
discipline model is built around student and staff
awareness of policies related to school-appropriate
behavior, and relies on a student (or school
employee) to report misconduct via an established
procedure. Administrators then evaluate the
complaint and determine a suitable response to the
individuals involved. When punitive sanctions or
other steps are taken against antiLGBTQ bullying, it
sends a message to those who perpetrate the
behavior, and the student body as a whole, that the
school considers it unacceptable. Traditionally,
schools have failed to protect LGBTQ students and
those labeled as sexual minorities or gender
nonconforming. Lacking such protection, students
have turned to the courts. Jamie Nabozny, for
example, sued his middle school for failing to
protect him from persistent antigay peer harassment
and violence, even after he repeatedly reported the
behavior to school officials; his lawsuit resulted in
the landmark decision in 1996 by the 7th Circuit
Court of Appeals, which determined that schools
must intervene into antigay behavior in order to
ensure all students access to education.
Nevertheless, no national consensus exists as to
the definition of bullying, and Congress has yet to
pass a proposed federal anti-bullying bill, such as the
Safe Schools Improvement Act. However, the U.S.
Department of Education (DOE) has issued “Dear
Colleague” letters to schools receiving public funds
to guide how they must manage bullying and
harassment. In an instructive October 26, 2010,
“Dear Colleague” letter, the DOE’s Office of Civil
Rights reminded schools that regardless of whether
particular conduct is included within a school’s anti-
bullying policy, they are obligated under federal civil
rights law to intervene and protect all students from
discriminatory harassment that creates a hostile
environment based on a set of protected classes:
race, color, national origin, sex, disability, and
religion. For the first time, they emphasized that
schools must prohibit sexual and gender-based

harassment, “regardless of the actual or perceived
sexual orientation or gender identity of the harasser
or target.” The DOE’s StopBullying .gov website
includes additional resources such as a review of
state anti-bullying laws and policies, and 11 key
components to consider when developing or
reforming anti-bullying and antiharassment laws,
policies, and procedures. GLSEN has found that
enumerated anti-bullying laws and policies— that is,
policies that name frequently targeted and vulnerable
status characteristics, including actual or perceived
sexual orientation and gender identity/expression—
are more effective than generic policies.
Scholars and advocates alike have raised concerns
about the proliferation of anti-bullying laws, punitive
school policies, and overreliance on school resource
officers and other security measures. Similar to other
law-based interventions, student discipline is a
reactive, incident-driven, and often blunt approach to
a complex and dynamic social problem. Disciplinary
interventions can cause unintended consequences,
such as outing a student as a member of the LGBTQ
community, or discourage students from reporting
bullying. Such individual-based interventions
assume that antiLGBTQ bullying is a series of
isolated events rather than part of what education
scholars refer to as the “hidden curriculum” or the
overall school climate. That is, the discipline
approach blames a few “bad apples” rather than the
normative antiLGBTQ school climate. The punitive
nature of the discipline approach also has attracted
critics due to the intensification of surveillance and
policing in the name of school safety. Such critics
argue that zero-tolerance and other overly harsh or
disparately implemented school safety measures
have escalated the severity of sanctions, and
disproportionately “push out” school students of
color, students with disabilities, and LGBTQ
students through suspension, expulsion, and referral
to juvenile justice. In light of what has been referred
to as the “school-to-prison pipeline,” the DOE
recommended in its recent Guiding Principles that
schools strive to retain students in school, and reduce
referrals to law enforcement as part of their efforts to
create positive, supportive, and safe schools for all
students.
Counseling
Bullying, School-Based Interventions for 327
Students involved in reported incidents of
bullying also may be offered individual counseling.
When professionals such as counselors, social
workers, psychologists, or prevention specialists are
part of a school’s staff, and are prepared to advocate
for all students, they may provide support, resources,
and referrals to students identified as offenders,
targets (or victims), or bystanders (witnesses). This
counseling work could include risk or threat
assessment, identification of shortterm coping
mechanisms such as changing a class schedule to
avoid contact with the bully, development of long-
term modes of resilience, and referrals to
community-based resources such as an LGBTQ
youth services organization. Notably, the American
School Counselor Association’s ethical standards
require its members to understand how systemic
oppression affects students. This includes knowing
the critical difference between LGBTQ students
“coming out” on their own terms versus “outing” a
student without their consent when intervening into
bullying. School staff can signal their support or
“allyship” to the LGBTQ community and those
targeted with anti-LGBTQ bullying by displaying a
safe space sticker, poster, and other relevant
resources in their office. This helps students find
someone with whom they feel comfortable reporting
anti-LGBTQ bullying.
Group-Based Interventions
Peer Mediation
Considered an alternative to discipline, restorative
justice techniques such as peer mediation are found
in schools across the country. Peer
Bullying, School-Based Interventions for
mediation programs offer students an opportunity to
work out disputes with the help of a student cadre
trained to be neutral third parties, rather than rely on
school personnel to sort out or solve what are
understood as low-level conflicts. The goal is to
quickly de-escalate incidents before they become
disruptive to the learning process, enable students to
develop conflict-resolution skills and solve their own
problems, and, in the long term, contribute to a
culture of mutual responsibility and school
belonging. However, similar to the problems
328
associated with the adult use of mediation, when an
unequal balance of power is present, such as with
domestic violence, critics argue against the use of
peer mediation and related conflict-resolution
programs as a school-based bullying intervention.
Bullying is different from conflict because it has
been deemed as unacceptable behavior used to
intimidate and control others, and students should
not have to bargain or compromise in order to stop
such behavior as a means to secure their safety.
Furthermore, because peer-mediator skills vary, as
does their understanding of LGBTQ issues, this
intervention may be harmful when applied to anti-
LGBTQ bullying. Finally, peer mediation also has
not been fully evaluated to determine its
effectiveness as an intervention for bullying more
generally.
Group Therapy
Schools with the resources to do so may offer a
range of therapy groups for students requiring
additional support. Group therapy offered as a
resource to students who bully their peers typically
focuses on anger management and selfesteem.
Developmental psychologist Sue Linder argues,
however, that such an approach is counterproductive.
Students who bully, she contends, are not primarily
motivated by anger, nor do they necessarily suffer
from a lack of self-esteem. Additionally, the group-
based nature of this intervention enables students to
learn from and reinforce each other’s antisocial
behavior, which may exacerbate anti-LGBTQ
bullying in particular.
Student Clubs
School-based interventions for bullying are not
limited to those initiated by school staff. Students
have organized a variety of school clubs with
bullying awareness or anti-bullying activities at the
center of their mission. Gay–straight alliances
(GSAs) are student clubs developed in response to
the pervasive anti-LGBTQ school climate as a
mechanism to provide a safe space or haven for
LGBTQ-identified students and their allies who
encounter bullying and harassment on a regular basis
throughout the school day. GSAs also engage in
activities such as GLSEN’s National Day of Silence,
developed by students to build schoolwide
awareness about anti-LGBTQ bullying and
harassment. Another type of student-centered school
intervention, especially for bias-based bullying, is
the Anti-Defamation League’s A World of
Difference Peer Trainers antibias education program.
Peer Trainers are a group of high school students
who learn how to facilitate interactive classroom
activities with first-year students about bias and
discrimination, the value of diversity, and how to be
an ally to all of their peers. Student clubs tap into the
power of peer influence among youth. However,
student clubs organized around an antibullying
mission have been more successful when they are
one part of a more comprehensive set of school-
based interventions.
Whole-School Interventions
Research unquestionably demonstrates that students
who do not feel safe at school are not able to learn
effectively and experience educational and health
disparities. Thus, education scholars and reformers
are turning to the notion of “whole child” or “whole
school” to improve student learning in U.S. schools.
Whole-school advocates argue for nurturing students
beyond their academic skills by incorporating
opportunities for social and emotional development
throughout the school day. This would create what
the Center for Social and Emotional Education
(CSEE) calls a positive school climate, where
students feel safe not only physically but also
socially and emotionally.
A whole-school approach to bullying draws on this
integrated approach to a positive school climate. No
one anti-bullying intervention directed at one sector
of a school community at one interval can result in
meaningful improvement; annual school assemblies
may inspire a student audience but are an
insufficient approach to transforming a school’s
culture. The entire school community must be
responsible for and engaged in multiple ways at all
times to prevent and intervene in unacceptable
antisocial behaviors, including those labeled as
bullying, to promote a sense of belonging to the
school. Beginning in 2010, the Safe and Supportive
Schools (S3) federal grant program offered 11 states
the chance over 4 years to experiment with and
evaluate the effectiveness of evidence-based
comprehensive frameworks such as Positive
Behavior Intervention and Support (PBIS) that

ultimately intend to enhance student learning and
health.
Notwithstanding the demonstrated effectiveness
of comprehensive interventions, such as the Olweus
Bullying Prevention Program (OBPP), rarely do they
explicitly or consistently address the unique
challenges presented by anti-LGBTQ bullying
within their purview. Nor do they focus on
recommendations drawn from GLSEN’s school
climate research, and affirmed by small-scale case
studies, such as supportive educators, inclusive
curricula, student clubs, and enumerated policies.
From this broader perspective, Elizabeth Meyer is
joined by other scholars and advocates who suggest
that schools systematically address interlocking
forms of sexism and heterosexism, along with
ableism, xenophobia, White supremacy, and racism,
in order to make anti-LGBTQ bullying and
discrimination unacceptable in school as part of their
efforts to create a positive school climate for all
students.
Conclusion: Needs Improvement
Teachers frequently tell students that their academic
work or behavior “needs improvement.” School-
based interventions for anti-LGBTQ bullying might
receive similar feedback. Despite the variety and
recent growth of anti-bullying efforts across the
United States, inclusive interventions for anti-
LGBTQ bullying remain at a low level and have yet
to be institutionalized across the decentralized
education system. Unique to antiLGBTQ bullying
interventions are several needs. The school
community would benefit from education about
terminology related to sexual orientation and gender
identity/expression, and an opportunity to address
myths and stereotypes attributed to LGBTQ people.
Educators, parents, and students alike lack an
understanding of the effects of bias-based bullying
on education and well-being, and the efficacy of
research-based tactics for improving the school
climate. Schoolbased interventions for bullying take
place within a context where community members
may be personally conflicted or outwardly against
the acceptance of LGBTQ people, and where laws
and policies may not protect against
sexualorientation or gender-identity/expression-
based discrimination. Discussion of LGBTQ-related
Bullying, School-Based Interventions for 329
education issues may be constrained due to limited
community-based resources, including parents who
may not be aware of or affirming of their child’s
actual or perceived sexual orientation or gender
identity/expression, and a lack of culturally
responsive social services. Because antiLGBTQ
bullying is part of the larger sociolegal context
where discrimination and violence persist against
LGBTQ people, it would profit from a
multidisciplinary and collaborative approach
informed centrally by students’ experiences to
identify core etiologies and the most effective
configuration of individual, group, and wholeschool-
based interventions.
Madelaine Adelman
See also Bullying, Legal Protections Against; Bullying,
Rates and Effects of; Education; Gay, Lesbian &
Straight Education Network (GLSEN); No Promo
Homo Policies; School Climate; School Professionals’
Responses to LGBTQ Training; Schools as
Heteronormative Spaces; School-to-Prison Pipeline;
Sexualities at School; Transgender and
GenderNonconforming Individuals and Bathrooms;
Violence and Victimization of Youth
Business
Further Readings
American Educational Research Association (AERA).
(2013). Prevention of bullying in schools, colleges, and
universities: Research report and recommendations.
Washington, DC: Author. Retrieved October 22, 2014,
from http://www.aera.net/Portals/38/docs/News%20
Release/Prevention%20of%20Bullying%20in%20
Schools,%20Colleges%20and%20Universities.pdf
Brown, J. K., Trone, J., Fratello, J., & Daftary-Kapur, T.
(2013). A generation later: What we’ve learned about
zero-tolerance in schools. New York, NY: Vera
Institute of Justice.
Greytak, E., Kosciw, J., & Bossen, M. (2013). Educating the
educator: Creating supportive school personnel through
professional development. Journal of School Violence,
12, 80–97.
Kosciw, J. G., Greytak, E. A., Palmer, N. A., & Boesen,
M. J. (2014). The 2013 National School Climate Survey:
The experiences of lesbian, gay, bisexual and transgender
youth in our nation’s schools. New York, NY: Gay, Lesbian
& Straight Education Network. Retrieved October 22, 2014,
from http://glsen.org/nscs Limber, S. (2003). Efforts to
330
address bullying in U.S. schools. American Journal of policies that specifically protect LGBTQ employees,
Health Education, 34, S23–S29. to the slow pace of cultural change in some
Meyer, E. J. (2009). Gender, bullying, and harassment: organizations. At best, LGBTQ employees
Strategies to end sexism and homophobia in schools. experience supportive workplaces, led by
New York, NY: Teachers College Press. progressive, inclusive management. At worst,
Mitchum, P., & Moodie-Mills, A. C. (2014). Beyond LGBTQ employees face hostility and homophobia
bullying: How hostile school climate perpetuates the while on the job, from colleagues, supervisors, and
school-to-prison pipeline for LGBT youth. Washington, business partners. This entry examines how the
DC: Center for American Progress. cultural shift in the acceptance of LGBTQ people
Retrieved November 2, 2014, from http://cdn has impacted their visibility in business; addresses
.americanprogress.org/wp-content/uploads/2014/02/ the real and perceived challenges of being publicly
BeyondBullying.pdf “out” in the workplace; and provides perspective on
Movement Advancement Project. (2014). Safe schools laws. the evolution of corporate inclusion and diversity
Retrieved October 22, 2014, from http://www policies and how those policies may or may not
.lgbtmap.org/equality-maps/safe_school_laws work in practice to create favorable work
Payne, E., & Smith, M. (2012). Rethinking safe schools environments for LGBTQ employees.
approaches for LGBTQ students: Changing the
questions we ask. Multicultural Perspectives, 14, 187–
193.
Cultural Shifts and Growing Acceptance of
U.S. Department of Education (DOE). (2010). Dear
colleague [Sample letter]. Washington, DC: Author.
LGBTQ People
Retrieved October 22, 2014, from http://www2.ed.gov/ In recent years, the LGBTQ community has seen
about/offices/list/ocr/letters/colleague-201010.pdf important gains in the fight toward equality,
U.S. Department of Education (DOE). (2011). Analysis of particularly in the United States. Such gains include
state bullying laws and policies. Washington DC: Author.
Retrieved October 22, 2014, from http://www2
.ed.gov/rschstat/eval/bullying/state-bullying-laws/ state-
bullying-laws.pdf
U.S. Department of Education (DOE). (2014). Guiding
principles: A resource guide for improving school
climate and discipline. Washington, DC: Author.
Retrieved October 22, 2014, from
http://www2 .ed.gov/policy/gen/guid/school-
discipline/guidingprinciples.pdf

BUSINESS

Despite meaningful progress and increasing social

acceptance of LGBTQ people in media,
entertainment, and culture over the past two decades,
openly LGBTQ people continue to be significantly
underrepresented in business, especially in the upper
echelons of corporate executive suites. There are
myriad reasons why this marginalization persists,
ranging from personally or externally imposed rules
to “cover” or remain closeted while on the job, to the
absence of corporate and federal nondiscrimination

the 2013 repeal of the Defense of Marriage Act,
increased positive representation in media, and an
ever-growing awareness and acceptance of LGBTQ
people, especially among younger generations.
According to a 2013 survey conducted by Pew
Research that asked people in 39 countries whether
or not society should “accept homosexuality,” an
overwhelming majority of respondents in North
America, the European Union, and much of Latin
America said homosexuality should be accepted.
While the Pew Research study found that attitudes
toward LGBTQ people varied based on nationality,
education, religious beliefs, gender, and age of
respondents, the findings indicated a marked shift
toward greater acceptance of LGBTQ people,
particularly among younger, more educated, and less
religious populations. In 2013, 60% of Americans
said society should accept homosexuality, compared
with 49% of Americans in 2007.
The shifting of this cultural tide, however, has
been slower to move some corporations and
governments toward action. These changing societal
views exist within a patchwork of varying corporate
policies and have yet to result in a federal
antidiscrimination law in the United States that
would include the protection of employees based on
sexual orientation or gender identity. Although the
Employment Non-Discrimination Act (ENDA)—
which would prohibit discrimination in hiring and
employment on the basis of sexual orientation or
gender identity by employers with at least 15
employees— has been introduced during every
Congressional session (except for the 109th session)
since 1994, the proposed legislation continues to
stall.
The Pink Ceiling and The Glass Closet
Increasingly, LGBTQ employees have greater access
to a wider range of resources to help them on the job.
Despite a lack of consistent and uniform policies
across corporate America, many companies have
recognized the importance and value of providing
supportive work environments for LGBTQ
employees. Over the past 12 years, the Human
Rights Campaign (HRC) has issued a corporate
equality index (CEI) that benchmarks LGBTQ-
related policies and practices for major
Business
331
corporations. In 2014, 82% of employers surveyed
for the HRC corporate equality index claimed to
have LGBTQ employee resource groups or diversity
councils, more than double the amount reported in
the HRC’s 2002 index. In addition, 99% of CEI-rated
employers include the protection of sexual
orientation in their nondiscrimination policies, an
increase from 61% in 2002. Meanwhile, 86% of CEI-
rated employers provide employment protections on
the basis of gender identity, a dramatic increase from
just 5% in 2002. Furthermore, 46% of CEI-rated
businesses provide transgender-inclusive health-care
coverage options, including short-term leave,
counseling by mentalhealth professionals, hormone
therapy, medical visits to monitor hormone therapy,
and surgical procedures.
Despite many positive changes in the corporate
world, however, a majority (53%) of LGBTQ
employees said they are closeted at work, either by
choice or by need, according to the HRC. Among
many LGBTQ professionals, there is a belief that
keeping their sexuality a secret can help to protect
their career goals, even if their workplaces have
policies in place that ensure protection against
discrimination based on sexual orientation. In the
United States, companies in 29 states can still legally
fire an employee for being gay. The fear of hitting
the so-called “pink ceiling” is even more acute for
LGBTQ professionals in executive ranks. Until
Apple CEO Tim Cook publicly came out as gay in an
October 30, 2014, editorial in Bloomberg
Businessweek, there wasn’t a single publicly and
openly LGBTQ chief executive officer currently
working at a Fortune 1000 company.
In 2007, John Browne was forced to resign as
CEO of BP after he was outed as being gay by a
London tabloid newspaper. Browne, who remained
in the closet during his entire 30-plus-year tenure
with the British oil company, subsequently wrote a
book about his experiences, titled The Glass Closet:
Why Coming Out Is Good Business. Browne has
since said that coming out sooner would have been
better for himself and for business, and representing
himself more openly and honestly in the workplace
would have been better for his employees as well.
Although there are chief
Business
executives who are rumored to be LGBTQ or who
are privately open about their sexual orientation,
332
Browne’s public admission of his sexual orientation
made him the first current or former chief executive
of a major publicly traded corporation to publicly
acknowledge that he is gay.
In an op-ed for Fortune magazine in 2014,
Browne wrote, “The assumption of heterosexuality is
one of the reasons that many people in business and
in other sectors continue to lead hidden lives.”
Browne said the bias toward heterosexuality in
business leads LGBTQ workers to selfcensor and
bring less than their full selves to the workplace.
Studies have shown that remaining (or going
back) in the closet has detrimental effects on LGBTQ
employees, including decreased job satisfaction,
increased anxiety, and poorer performance.
Ultimately, studies have shown that being closeted
can lead to negative impacts on LGBTQ workers’
chances for professional advancement, including
lower retention and decreased visibility. In turn, the
dearth of LGBTQ professionals in the executive
ranks means there is a grave lack of mentors for early
and mid-career LGBTQ professionals to look up to.
Evolving Corporate Inclusion and
Diversity Policies
In some ways, the experience of LGBTQ
professionals mirrors the early experiences of women
and minorities in corporate America. Fifty years after
the start of the women’s and civil rights movements,
there has been some progress to advance the interests
and exposure of historically underrepresented groups
in business. Today, virtually all corporate
nondiscrimination policies have explicit language
that protects against gender, racial, or ethnic
discrimination. While women and minorities have
become more visible in corporate America, they still
deal with many of the same struggles for visibility
that LGBTQ workers face: Among the 1,000 largest
companies in the world, only 48 companies—less
than 5%—are led by a woman. Among the Fortune
500, there are 6 Black chief executives, 9 Asian chief
executives, and 10 Latino chief executives.
Inclusion and diversity programs and policies that
support LGBTQ workers may be on the rise,
including the establishment of LGBTQ-related
employee resource groups at many companies, and
providing the same company health-care benefits for
same-sex couples that heterosexual couples receive.
However, a full one third of Fortune 500 companies
fail to provide comparable health-care benefits to
LGBTQ employees.
Unlike gender and race, which ordinarily can’t be
“covered” in the workplace, LGBTQ employees can
sometimes disguise their sexual orientation to be
more heteronormative. A 2013 report published by
Deloitte University Leadership Center for Inclusion,
and authored by Christie Smith and Kenji Yoshino,
found that 83% of gay, lesbian, and bisexual workers
said they hide aspects of their identities at work,
often due to pressure—whether implied or explicit—
from their superiors. By contrast, 45% of straight
White men reported covering at least one aspect of
their identities in the workplace. Notably, this type of
“covering” behavior was widespread across the 10
different industries that were studied, resulting in a
misalignment of, and inconsistency with, the values
of inclusion that many of these companies espoused.
There were 3,129 respondents to the survey, which
included a diversity of age, gender, race, and sexual
orientation across different levels within an
organization.
A critical finding of the paper was the importance
and interconnectedness of fostering inclusive work
environments and talent retention. The authors
offered a new model for inclusion whereby
historically underrepresented groups can work
through the myriad challenges that they face together
with the support of everyone within an organization,
including straight White men, who sometimes have
felt marginalized from conversations about corporate
inclusion and diversity. The key is to implement
programs and apply policies uniformly and
consistently that stamp out micro-inequities across
all groups.
A Turning Tide in Corporate America
When he rang the bell at the New York Stock
Exchange to kick off the public offering of shares in
C1 Financial in August 2014, Trevor Burgess
became the first openly gay CEO of a publicly traded
bank in the United States. As chief executive of the
newly public regional bank, which has 29 locations
in Florida, Burgess was required by law to disclose
that his husband, Gary Hess, owns shares in the
company in its IPO filing to the Securities and
Exchange Commission, despite the fact that the
couple’s home state didn’t recognize same-sex
marriage.

While a surprising number of early career LGBTQ
professionals said they have chosen to remain (or go
back) in the closet in order to “fit in” or to advance in
their careers, a growing number of corporate
executives are stepping out of the closet, if somewhat
tentatively. As BP’s former CEO John Browne and
C1 Financial CEO Trevor Burgess have discovered,
being publicly and openly out as gay professionals
has provided them a platform to help the next
generation of LGBTQ business leaders find their
own voices—as well as serve as mentors. According
to the HRC’s 2014 corporate equality index, 304
businesses achieved a top score of 100% in support
of LGBTQ employees. Law firms and banking and
financial services companies led the pack, with 81
and 36 companies, respectively, earning top ratings
in that year’s corporate equality index.
For years, many Wall Street firms have actively
promoted workplace inclusion of LGBTQ
employees. They have done this by creating LGBTQ
networks, connecting LGBTQ employees with
mentors within the firm, sponsoring LGBTQ pride
events, and encouraging straight employees to join
LGBTQ networks to serve as straight allies. In
addition, Wall Street firms also are actively
recruiting LGBTQ employees and publicly
supporting same-sex marriage, and most recently,
more than 100 businesses joined a coalition calling
on Congress to pass the Employment Non-
Discrimination Act (ENDA). Indeed, Wall Street
firms now have some of the most LGBTQ-friendly
policies in corporate America.
Corporate Policy Versus Corporate Culture
As many LGBTQ employees can attest, corporate
nondiscrimination policies do not always translate to
positive office cultures. While it’s important to have
policies in place that protect and support all
Business
workers, nurturing and sustaining a corporate culture
that reflect an organization’s core values requires
vigilance and consistency, led and patterned by
management. Policies at Wall Street companies may
be among the most progressive in business when it
comes to the acceptance of LGBTQ workers and
ensuring that they feel at ease with colleagues, but
these policies are only successful because of
333
endorsements by the firms’ predominantly White,
middle-aged, male CEOs.
Lloyd Blankfein, CEO of Goldman Sachs Group
Inc., has said that the bank’s LGBTQ-friendly
policies are critical for talent retention, although he
added that the firm’s public support of
LGBTQrelated issues, including its support of gay
marriage, has resulted in the loss of at least one
client. Supporting LGBTQ workers and causes
“doesn’t
come without a price,” Blankfein said, “but
I couldn’t care less.”
Other CEOs of Wall Street firms, including John
Mack, former CEO of Morgan Stanley; Paul Singer,
CEO of Elliott Management Corp.; and Dan
O’Connell, CEO of Vestar Capital Partners, have
come out publicly in support of LGBTQrelated
rights, in large part to support their children who
came out as gay. According to a 2012 survey
conducted by the Center for Work Life Policy, 41%
of LGBTQ employees nationwide remain closeted at
work. Furthermore, only 7% of LGBTQ employees
ages 18 to 24 are open at work, compared with 32%
of LGBTQ employees ages 35 to 44, according to the
HRC. This disconnect may be a result of companies
having great policies on paper, but also having
suboptimal cultures that aren’t conducive to being
out.
Whether the success or failure of integrating and
raising the visibility of LGBTQ workers in
companies is measured by outside organizations such
as the HRC or through internal human resources
metrics, it is clear that LGBTQ people and straight
allies must work together to ensure that progress
continues.
“It is the responsibility of the LGBT minority to
overcome their fears,” said BP’s John Browne in his
Fortune editorial. “Only they can decide to live a
unified private and public life.”
Kipp Jarecke-Cheng
Butch–Femme
See also Closet, The; Education; Internalized
Homophobia; Leadership; Work Environments;
Workplace Policies
334
Further Readings
Browne, J. (2014, June 16). Confessions of a gay ex-CEO:
How corporate America can unlock the closet.
Fortune. Retrieved from http://bit.ly/XpAYNF
Browne, J. (2014). The glass closet: Why coming out is good
business. New York, NY: Harper Business.
Cook, T. D. (2014, October 30). Tim Cook speaks up.
Bloomberg Businessweek. Retrieved from http://
bloom.bg/1ExFVGB
Cooper, L., & Fidas, D. (2014). Corporate equality index
2014. Washington, DC: Human Rights Campaign
Foundation.
Ellis, B. (2014, May 19). Wall Street CEOs open up about
their gay sons. CNN Money. Retrieved from http://
cnnmon.ie/ZpVwH2
Feintzeig, R. (2014, May 6). Why gay workers decide to stay
in the closet. Wall Street Journal. Retrieved from
http://on.wsj.com/1wwE0Pc
Kwoh, L. (2012, July 25). A silence hangs over gay CEOs.
Wall Street Journal. Retrieved from http://on.wsj
.com/1qFapAB
Smith, C., & Yoshino, K. (2013). Uncovering talent: A new
model for inclusion. Westlake, TX: Deloitte University
Leadership Center for Inclusion. Retrieved from
http://www2.deloitte.com/content/dam/Deloitte/
us/Documents/about-deloitte/us-inclusion-
uncoveringtalent-paper.pdf
Stewart, J. B. (2014, June 27). Among gay CEOs, the
pressure to conform. New York Times. Retrieved from
http://nyti.ms/1uALQ7Y
BUTCH–FEMME
Butch and femme (also spelled fem) are terms that
refer to particular gender identities and/or
expressions among lesbian, bisexual, queer, and
other sexual-minority women. Butch is typically used
to describe sexual-minority women with a more
masculine presentation, whereas femme generally
describes sexual-minority women with a more
feminine presentation. These identities play an
important role in the history of sexual-minority
women’s identities and social structures, and
continue to have relevance within contemporary
sexual-minority women’s communities, although
meanings and usage have changed over time. This
entry provides a brief review of the terms from their
development in the mid-20th century through
contemporary usage, focusing on the United States.
Evolution of Butch–Femme
Emergence of Butch–Femme
Although masculine and feminine pairings of
same-sex couples were described as early as the
1890s, formal butch–femme gender roles came to
prominence in the 1940s and 1950s among working-
class sexual-minority women in the United States.
Lesbian and bisexual women’s workingclass
communities were organized around butch– femme
identities; an individual who did not identify within
either role was referred to somewhat pejoratively as a
“kiki.” Butch–femme identities served as social roles
that instructed community norms and dating
expectations, as well as making sexualminority
women visible to each other in a society that was
hostile to their existence. Due to rigid gender norms
at a time when it still was unconventional for women
to wear pants, both butch and femme women often
were forced to adhere to traditional female gender
expectations to maintain employment, but adopted
butch–femme gender expressions when attending
bars, house parties, and other community settings. It
should be noted that some butch women did not (or
could not) limit their masculine presentation to
community settings; some would pass as men at
work or find work for which their masculine dress
was tolerated, whereas others had difficulty attaining
work and relied on femme partners for financial
support.
Within sexual-minority environments, butch
women wore pants and masculine dress and
generally were expected to initiate romantic advances
with femmes and play a protective role in threatening
situations. Femmes dressed in traditional or
exaggerated feminine attire and typically were
expected to take care of the home. With regard to
sexual roles, butches were expected to take the lead,
but reversed heterosexual gender norms by focusing
on sexually pleasing their femme partners. Butch
women who preferred not to be touched sexually,
and were identified as “stone butches,” were
accorded higher status in the community. Butch–
femme communities were somewhat racially mixed,
with women dating across color lines more
commonly than among heterosexual pairings at the
time, although women of color were more likely to
socialize at house parties and White women at bars.
Given the gender policing of the times, both literally
and figuratively, butches and femmes took great risks
in enacting their identities even if only in the bar

scene, as bars were often raided. While femmes’
style of dress rendered them less visible to
community outsiders when out on their own, they
were clearly identified as sexual-minority women
when paired with butches. In fact, butch–femme
identities often have been credited with making
lesbian and bisexual women’s sexuality visible
outside of sexual- minority communities.
A Retreat From Butch–Femme
During the late 1960s and into the 1970s, there
was a shift in the cultural understanding of
sexualminority women’s gender; as the second wave
of feminism developed, gender differences were
viewed as the site of sexism, and lesbian feminism
emerged. Lesbian feminists typically viewed butch–
femme roles and relationships as derivative of
problematic heterosexual gender roles and
relationships. Butches were seen as replicating
patriarchy and femmes as having internalized
traditionally oppressive female gender roles. In
contrast, unisex or androgynous presentations
became de rigueur among lesbian feminist
communities, marginalizing lesbians with butch–
femme identities or gender expressions, who often
conformed or went underground. During this period,
lesbianism on the whole was disparaged within many
parts of this predominantly university-based White
feminist movement, and lesbians were referred to as
the “lavender menace,” resulting in a separate lesbian
feminist movement offshoot.
Butch–Femme
During these times, butch–femme identities still
proliferated in many working-class, rural, and racial-
minority communities—particularly among Black
women and Latinas, as well as within women’s
prisons. Working-class and/or racial-minority lesbian
and bisexual women often had especially complex
relationships with the liberation movements of the
day due to racism and classism within many feminist
and lesbian, gay, and bisexual groups, as well as
sexism and homophobia within many civil rights and
labor groups; the 1980s were characterized by these
heightening criticisms. As a result, many sexual-
minority women who also held working-class and
racial-minority identities were less likely to be
impacted by the predominantly White middle- to
upper-class-led feminist rhetoric against butch–
335
femme. Other lesbians of color developed their own
feminist groups, such as the Black lesbian feminist
Combahee River Collective, which focused on
organizing lesbian feminists of color and articulating
and responding to issues related to intersections of
race, gender, and sexual orientation.
Reemergence of Butch–Femme and a
Multiplicity of Terms
During the 1990s, a third wave of feminists began to
expand their focus on intersections of gender with
race, class, and sexual orientation, and the emphasis
on dismantling gender differences to combat sexism
became less prominent. In addition, recognition of
there being a difference between sex and gender and
the potential to view gender as a performance that
people enact, rather than a natural product of sex,
opened up new possibilities for gender play. Within
this context, butch–femme began to reemerge, only
with a greater emphasis on gender fluidity. Sexual
roles became less strict, with increased acceptance of
pairings between similarly gendered women and both
butches and femmes potentially initiating sexual
encounters. Butch–femme relationships were further
recognized as a unique form of erotic gender play
that can exist between two women. New terms
developed, such as “soft butch,” referring to a
somewhat masculine sexual-minority woman, and
“high
Butch–Femme
femme,” describing a very stylized woman who
employs exaggerated feminine dress and makeup and
thereby recognizes her own gender performativity.
More recently, the term boi has developed among a
younger generation, referring to a range of gender
identities, including masculine sexualminority
women, transmen, and genderqueer folks.
While the terms butch and femme have been used
in various racial communities, other gender identities
have also emerged and sometimes been preferred
among racial-minority groups. For instance, the
labels stud, aggressive (sometimes shorted to AG),
and tomboy are most often used by masculine sexual-
minority women of color. Aggressive femme refers to
a feminine sexualminority woman who is sexually
dominant. These fluid terms may be defined
differently across communities, and new terms
continue to emerge. Many organizations have popped
336
up to recognize butch– femme culture, such as
Femme Collective, a group that emerged in 2005 and
has held conferences for several years celebrating
femme culture. A significant feature of this group is
its emphasis on exploring femme identity and
strength, as the role of femmes has historically been
undervalued and invisible relative to butch women.
Alternatively, DapperQ is a project aimed at
increasing visibility for masculine sexual-minority
women as well as genderqueer and transmasculine
individuals, with a particular emphasis on masculine
fashion.
Popular Portrayals: Representations/
Presentations of Butch–Femme Roles
Butch–femme roles and relationships also have been
portrayed in literature and film, often centering on
masculine characters while reflecting the evolving
understandings of gender. In 1928, prior to the rise of
butch–femme culture, Radclyffe Hall’s The Well of
Loneliness centered on the masculine upper-class
White Englishwoman character of Stephen Gordon,
who was conceived within the model of sexual
inversion. In the late 1950s and early 1960s, Ann
Bannon published the lesbian pulp series that was
later titled as The Beebo Brinkler Chronicles, with
Beebo’s unabashed masculinity and appeal to
femmes making her a memorable butch icon.
Published in 1993, Stone Butch Blues was set in the
late 1960s and introduced the character of Jess
Goldberg, of a White working-class Jewish
background, whose gender struggle has inspired
countless butch women and transgender people. The
2011 film Pariah explored the coming out of a 17-
year-old Black lesbian named Alike and has been
described as a portrayal of aggressive culture.
Controversies and Complexities
As noted above, butch–femme identities have been
either critiqued as replicating binary gender norms in
heterosexual relationships, or seen as subverting
gender norms by revealing the performative aspects
of gender, specifically by showing that any gender
identity can be mapped onto any body. This latter
perspective on butch–femme genders has become
more accepted in recent years.
At times, tensions have arisen regarding overlaps
and distinctions between transgender male identities
and butch identities, with butch women sometimes
being included under the transgender umbrella term
and other times not. There have been specific
conflicts in which transmen have been accused of
betraying feminist ideals and gaining male privilege
when adopting male identities and butch women
have been accused of not fully embracing their
masculinity. While these tensions remain, it has been
suggested that these identity conflicts appear to be
resolving in younger generations.
Research on sexual-minority women in the United
States has suggested that particular dangers for butch
women include the high levels of heterosexist
discrimination and harassment that they face as well
as challenges in finding affirming medical and
gynecological care. Finally, many sexual-minority
women’s communities outside of the United States
include gender roles that share similarities with butch
and femme, though in looking at these similarities,
care must be taken not to minimize local contextual
meanings nor to assume that one system predated or
influenced the other.
Alternate Meanings of Butch–Femme
Butch and femme have been described thus far in
relation to butch–femme lesbian and bisexual
women’s culture, but these terms can have alternate
uses. For instance, in sexual-minority men’s
communities, butch has also been used to describe
especially masculine men. In Black ballroom culture,
terms such as butch and butch queen have context-
specific meanings. Femme, while primarily a
reference to a sexual-minority woman, also can refer
to any feminine woman.
Cara Herbitter and Heidi M. Levitt
See also Bisexuality, Female; Dating, Sexual-Minority
Women; Homosexuality, Female; Intersections
Between Sex, Gender, and Sexual Identity; Nonbinary
Genders; Policing Masculinities and Femininities;
Sexual-Identity Labels; Tomboy Experience;
Transgender Identities
Further Readings
Faderman, L. (1991). Odd girls and twilight lovers: A history
of lesbian life in twentieth-century America.
New York, NY: Columbia University Press.
Halberstam, J. J. (2012). Gaga feminism: Pregnant men,
heteroflexible women and the end of normal. Boston,
MA: Beacon Press.
 337
Hale, C. J. (1998). Consuming the living, dis(re)membering
the dead in the butch/FTM borderlands. GLQ: A Journal
of Lesbian and Gay Studies, 4, 311–348.
Butch–Femme

Hiestand, K. R., Horne, S. G., & Levitt, H. M. (2008). Effects

of gender identity on experiences of healthcare for sexual
minority women. Journal of LGBT Health Research, 3(4),
15–27.
Kennedy, E. L., & Davis, M. D. (1993). Boots of leather,
slippers of gold: The history of a lesbian community.
New York, NY: Penguin.
Kraus, N. (1996). Desire work, performativity, and the
structuring of a community: Butch/fem relations of the
1940s and 1950s. Frontier, 17(1), 30–56.
Levitt, H. M., Gerrish, E. A., & Hiestand, K. R. (2003). The
misunderstood gender: A model of modern femme
identity. Sex Roles, 48, 99–113.
Levitt, H. M., & Hiestand, K. R. (2004). A quest for
authenticity: Contemporary butch gender. Sex Roles, 50,
605–621.
Levitt, H. M., Puckett, J. A., Ippolito, M. R., & Horne, S. G.
(2012). Sexual minority women’s gender identity and
expression: Challenges and supports. Journal of Lesbian
Studies, 16, 153–176.
Moore, M. R. (2006). Lipstick or Timberlands? Meanings of
gender presentation in Black lesbian communities. Signs:
Journal of Women in Culture and Society, 32, 113–139.
Munt, S. R. (Ed.). (1998). Butch/femme: Inside lesbian
gender. Herndon, VA: Cassell Wellington House.
Nestle, J. (1992). The persistent desire: A femme-butch
reader. Boston, MA: Alyson Publications.
Weiss, J. T. (2007). The lesbian community and FTMs:
Détente in the butch/FTM borderlands. Journal of
Lesbian Studies, 11, 203–211.
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 347

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348

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350

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 351

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352

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 353

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transgend sexual-
er minority
concerns subgroup
along s.
with those Transgen
of other der,
sexual- genderqu
minority eer, and
groups, genderva
the riant
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of campus nts also
climate report
work that
generally name-
354

change to
policies, separate
gender- the
identificat experienc
ion es of
records sexual
policies, minoritie
and s of color
bathroom from
accessibili those of
ty are White
issues of students.
concern. Similarly,
There studies of
are campus
subgroups climate
in the based on
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perception analyzing
s of differenc
campus es
climate between
are heterosex
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ed. Thus LGBTQ
far, little persons
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e any that does
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ts and focus
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groups. populatio
Neither ns, noting
has much that
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 355

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This led of color,
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for fear of campus
being climate.
ostracized
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communit
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sexual- ent and
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lack of nce;
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to racial Athlete
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work is
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examine cally
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l
356

F bi
u ns
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r g,
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e 0
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.
i
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n
ss
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s si
Beemyn, n
B. g
(2003). th
Serving e
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transge us
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s. at
Journa e
l of fo
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Lesbia y,
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Educat n,
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 357

g a stru
mult ctin
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pers me
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ves ng
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. ca
Jour mp
nal us
of LG
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Stud Jou
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ment mo
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8– ual
26. ity,
Campus 58,
Pride. 521
(2014). –
LGBT- 546
friendly .
campus Patton, L.
climate D.
index. (2011).
Retrieve Perspec
d tives on
August identity
5, 2014, ,
from disclos
http://w ure,
ww and the
.campus campus
prideind environ
ex.org ment
Fine, L. among
E. African
(201 Americ
1). an gay
Min and
imiz bisexua
ing l men
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hom Journa
oph l of
obia Colleg
: e
Con Student
358

Develop r
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Rankin, S.
n
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r (2006).
it LGBT
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s s on
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campus
N
e : Is
w higher
educati
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i making
 359

the in
grade? higher
Journal educati
of Gay on: The
state
and
and
Lesbian status
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in field.
Educati Educati
on, 3, onal
111– Resear
117. cher,
Rankin, 39,
S. R., 132–
&
141.
Reaso
n, R. Sanlo,
(2008 R.
). (2
Trans 00
forma 4).
tional Le
tapest sbi
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: A y,
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ve bis
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ach to ua
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Journ :
al of Ri
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sity in res
Highe ili
r en
Educ cy,
ation, an
1, d
262– ret
274. en
tio
Renn, K. A.
n.
(2010).
Jo
LGBT
ur
and
na
queer
l
research
of
360

Co 3).
lle Perc
ge epti
Stu ons
de of
nt cam
Ret pus
ent clim
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, 6, by
97 sexu
– al
11 min
0. oriti
Sanlo, R., es.
Rankin, Jou
rnal
S., &
of
Schoenb Ho
erg, R. mos
(Eds.). exu
(2002). ality
Our , 60,
947
place on
–
campus: 964.
Lesbian, Vacc
gay, ar
bisexual o,
, A.
transge (2
01
nder
2).
services C
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progra m
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mi
educatio
cr
n. oc
Westpor li
t, CT: m
Greenw at
ood. es
Tetreaul fo
t, P. r
A., L
Fette G
, R., B
Meid T
linge fa
r, P. cu
C., & lty
Hope ,
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(201 af
 361

f, 44
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362

13 and
54. improve
ments in
treatment
. Persons
CANCER with
cancer
AND
often
SOCIAL need
assistanc
SUPPOR e with
T activities
of daily
living,
Cancer is family
a group of and
more than communi
100 ty
diseases responsib
characteri ilities,
zed by the and
uncontroll illness
ed growth managem
and ent tasks.
spread of The
abnormal prevalenc
cells. It is e and
the conseque
second nces of
most cancer
common and the
cause of need for
death in support
the for
United LGBTQ
States; persons
however, with
survival cancer
rates for have
all received
cancers limited
have attention
increased in the
substantia research
lly due to and
progress clinical
in earlier practice
diagnosis literature.
of certain However,
cancers several
 363

trends are chosen

leading to kin
an relations
increase hips, and
in increasin
recognitio g
n of and research
knowledg on the
e about cancer
cancer in experienc
LGBTQ e of
adults and LGBTQ
the individua
importanc ls.
e of The
informal next
and section of
formal this entry
social provides
support in informati
their on about
survivors the
hip incidence
experienc and
e. These prevalenc
trends e of
include cancer in
more adulthoo
LGBTQ d. Next,
individual cancer
s within
disclosing the
their context
sexual of
orientatio survivors
n to hip and
profession the
als in the importan
health ce of
care social
system, support is
growing discussed
public . The
awareness entry
of conclude
LGBTQ s with a
individual discussio
s and their n of the
family role of
and informal
364

and three
formal fourths of
social all
support cancers
for are
LGBTQ diagnose
individual d in
s who are persons
living aged 55
with and
cancer. older.
Accordin
g to the
The America
Demogra n Cancer
phics of Society,
Cancer the most
common
Cancer is cancer
a major types
public among
health women
concern include
in the breast,
United uterine
States corpus,
with colon and
approxim rectum,
ately 1 in melanom
3 women a, and
and 1 in 2 thyroid.
men Among
receiving men, the
a most
diagnosis prevalent
of cancer cancer
during types are
their prostate,
lifetime. colon and
Incidence rectum,
and melanom
prevalenc a, and
e rates of urinary
cancer bladder.
vary by Although
age, a small
gender, proportio
and type n of
of cancer. cancers
About are
 365

hereditary and
, many bisexual
geneticall women
y have
susceptibl higher
e cancers rates of
arise from breast
the cancer
interplay than
between heterosex
common ual
gene women.
variations One
and potential
lifestyle risk
(e.g., factor for
tobacco breast
use, cancer, as
obesity, well as
physical uterine
inactivity, cancer, is
excessive not
sun having
exposure) given
and birth,
environm which is
ental the case
(e.g., for
carcinoge almost
ns) risk two
factors. thirds of
Less is lesbian,
known bisexual,
about the and
specific transgend
prevalenc er adults
e of who have
cancer identified
among as LBT
LGBTQ througho
individual ut their
s. There is lives. In
some addition,
evidence greater
from obesity
general and risky
populatio health-
n studies related
that behaviors
lesbians (e.g.,
366

smoking, higher
drinking) among
among gay men,
lesbian has been
and linked to
bisexual non-
women AIDS
also may cancers,
contribute including
to higher anal,
risks for lung, and
breast, testicular
ovarian, cancer.
and colon Cancer and
cancer. Social
Findings Support
from the
California Cancer
Health
Survivor
Interview
Survey ship
indicated The
that gay National
and Coalition
bisexual for
men had Cancer
lower Survivors
rates of hip
prostate introduce
cancer d the
than concept
heterosex of
ual men, “cancer
whereas survivor”
the rate in the
for other mid-
cancers, 1990s to
particularl replace
y anal the
cancer, concept
was of cancer
higher. as a
The “death
human sentence.
immunod ”
eficiency Although
virus definition
(HIV) s of
infection, survivors
which is hip vary
 367

with cancer
respect to survivors
when a . Almost
person is two
first thirds of
considere cancer
d a survivors
survivor received
(e.g., time their
of initial diagnosis
diagnosis, 5 or more
posttreat years
ment), all previousl
definition y; about
s focus on 15%
the health were
and diagnose
quality of d 20 or
life of the more
person years
until the ago.
end of Although
life. This none of
includes the large
attention national
to follow- cancer
up registries
medical and
care; the surveys
physical, of cancer
psychosoc incidence
ial, and collect
economic data
issues about
surroundi sexual
ng cancer; orientatio
the late n or
effects of gender
treatment; identity,
and it is
second estimated
cancers. that there
As of are more
January 1, than a
2014, million
almost lesbian,
14.5 gay,
million bisexual,
persons and
were transsexu
368

al allows
(LGBT) LGBTQ
cancer individua
survivors ls to
living in acknowle
the dge and
United cope with
States. cancer.
The For
more example,
limited compared
research with their
about heterosex
LGBTQ ual
cancer counterpa
survivors rts,
has shown lesbian
that there breast
are both cancer
positive survivors
and demonstr
negative ate a
correlates heightene
of cancer d
and resilience
sexual , or
orientatio “lesbian
n. On the advantag
one hand, e,” when
years of it comes
dealing to
with fighting
chronic breast
minority cancer.
stress Regardin
around g age
heterosexi differenc
sm and es, older
homopho LGBTQ
bia in individua
their ls have
everyday grown up
lives has in an
led to environm
greater ent where
resilience sexual
and a orientatio
“fighting n
spirit” disclosur
that e was a
 369

greater networks
taboo. for help
Thus, and
younger support
LGBTQ during
individual their
s are less cancer
likely to journey.
deny that Informal
they have social
cancer support
and be includes
more the
proactive instrume
when it ntal,
comes to emotiona
getting l, and
treatment informati
and onal
support support
than their provided
older by family
counterpa members,
rts. friends,
and
Social neighbor
s. Formal
Support
support
Like most for
cancer cancer
survivors, survivors
LGBTQ comes
people from
turn to physician
members s and
of their other
informal professio
and nal health
formal care
social providers
Ca as well as
nc communi
er
ty
an
d
organizat
So ions that
cia may
l provide
Su education
pp , support
ort groups,
370

and other treatment

social appointm
services ents; help
during with meal
and after preparati
treatment. on,
househol
Informal d chores,
Support and
transport
The ation; and
type, provide
frequency informati
, and on and
amount of emotiona
informal l
support reassuran
cancer ce. Social
survivors and
receive cultural
varies norms
depending also
on a strongly
variety of influence
factors the extent
including and type
individual of
needs and support
abilities, and care
the type provided
of by family
relationshi members.
p, and LGBTQ
personal people
resources. who have
For been
example, shunned
family by their
and family of
friends origin
may make because
hospital of their
visits; sexual
accompan orientatio
y the n or
person gender
with identity
cancer to may lean
physician more
or heavily
 371

on their it is
partner, easier to
chosen deal with
family loss of
members, erectile
or friends functioni
for ng that
support. often
Having accompa
a nies
supportive treatment
life if one is
partner is working
a key through
source of the
resilience illness
in coping with a
with partner.
cancer, Resear
and the ch has
quality of linked
that social
relationshi support
p matters to
just as improved
much as adjustme
its nt to
presence. chronic
Lesbians or serious
with illnesses,
cancer including
report cancer.
feeling The
more perceived
loved and availabili
cared for ty of
by their social
same- support is
gender related to
partners better
than physical
heterosex and
ual psycholo
women gical
report. functioni
Gay men ng among
with cancer
prostate survivors
cancer whereas
report that inadequat
372

e social cancer
support that there
increases are other
isolation members
and of their
emotional communi
distress. ty who
Receiving are
support dealing
from with this
family condition
and .
friends
also has Formal
been Support
positively
associated Durin
with g
perceived diagnosis
quality of and
life. The treatment
larger of cancer,
LGBTQ interactio
communit ns with
y can also staff,
play an including
important doctors,
role in clinic
providing nurses,
informal and
support. specialist
Communi s, and the
ty social
awareness world of
programs cancer
help to clinics
reduce the play a
fear of valuable
cancer role in
and the the
prejudice provision
against of
those who support.
have it. A For
supportive LGBTQ
LGBTQ cancer
communit survivors,
y can fear of
reassure discrimin
those with ation
 373

coupled individua
with a ls is that
history of formal
negative education
experienc about
es often sexual
make orientatio
them n is not
wary of typically
formal included
care in
systems. medical
LGBTQ school
adults and the
have allied
reported a health
range of professio
negative ns.
reactions Doctors,
from nurses,
health and staff
communit members,
y service office
providers managers
including ,
rejection, volunteer
hostility, s, and
harassmen other
t, health
excessive care
curiosity, personnel
avoidance may not
of be
physical knowledg
contact, eable
and about the
breach of social
confidenti and legal
ality. issues
One of facing
the major sexual
problems minoritie
influencin s. They
g the may also
lower have
quality of certain
care from prejudice
profession d beliefs
als to about the
LGBTQ morality
374

and networks
normalcy —as they
of having define
an them—
LGBTQ health
identity. and
These communi
problems ty care
can be systems
reduced if must
accurate become
knowledg aware
e about that
sexual “family
orientatio support”
n is is far
included more
as part of extensive
education than the
and best nuclear
practices. family
Formal arrangem
care ent of
providers married
often spouses
overlook and their
the children.
importanc In
e of addition
addressin to
g sexual learning
orientatio about the
n, thus legal and
further nonlegal
marginali partnersh
zing ips and
LGBTQ chosen
individual kin ties
s and their establishe
families. d by
In order to LGBTQ
help individua
marshal ls, there
resources are many
from changes
cancer that
survivors’ formal
informal care
social providers
support can make
 375

to e
improve referrals
the to
experienc communi
e of ty
working agencies
with in order
profession to deal
als. These with
include issues of
being depressio
open and n and
inclusive anxiety
when that may
talking to arise in
patients the face
by of
directly dealing
asking if with
they are in cancer
an and its
intimate aftermath
relationshi .
p with a Anoth
same- er
gender important
partner. It formal
also resource
includes for
revising cancer
intake survivors
forms so is support
that the groups.
only They
choices provide
are not informati
between on,
male/fema education
le and , and
married/ emotiona
single. l support
Another for both
effective cancer
strategy is survivors
for health and their
care caregiver
profession s. Many
als to communi
make ties,
appropriat particular
376

ly those in ual men

large and
urban women.
areas, Yet, in
now offer smaller
LGBT or rural
cancer communi
support ties,
groups cancer
where support
LGBT groups
cancer for
survivors specific
and their cancers
caregivers (e.g.,
can come breast
together cancer
to share survivors
their ’ group;
experienc prostate
es, cancer
knowledg survivors
e, ’ group)
concerns, may not
fears, and be
hopes in a available,
supportive making it
and all the
respectful more
environm important
ent. It is for health
especially care
helpful to providers
be in a to receive
support sensitivit
group y training
addressin about
g the how
particular sexual
kind of orientatio
cancer n
one has diversity
experienc comes
ed as well into play
as one with
that does cancer
not survivors
exclusivel hip and
y cater to family
heterosex care. A
 377

positive Conclusi
developm on
ent is the
rise of With the
Internet- aging of
based the
support general
groups, populatio
such as n and the
the LGBT growing
Cancer visibility
Support of the
Group LGBTQ
sponsored populatio
by the n, an
Cancer and
National
Social
LGBT Support
Cancer
Project—
Out with increasin
Cancer. g number
Grassroot of
s online sexual-
cancer minority
support individua
groups are ls will
especially experienc
important e cancer
for and long-
individual term
s who survivors
wish to hip. The
meet stigma
other and
cancer discrimin
survivors, ation
participate they face
in online in the
chat health
groups, care
and learn system is
from often
others mitigated
who are with the
dealing support
with of a
cancer. caring
partner, a
caring
communi
378

ty, and Death,

knowledg and
eable and Bereav
sensitive ement;
health Health
care Care
profession Provide
als. Both rs,
kinds of Disclos
social ure of
support— Sexual
informal Identity
and to;
formal— Health
are Care
needed to System
help ;
LGBTQ Health
individual Dispari
s cope ties
with
cancer
and F
continue u
to have a r
high t
quality of h
life. e
r
Katherine
R. Allen R
and e
Karen A. a
Roberto d
i
See also n
Aging, g
Social s
Relation
American
ships,
Cancer
and
Society
Support
.
; Cancer
Cancer
in the
facts &
LGBTQ
figures
Commu
2014.
nity;
Retriev
Caregiv
ed from
ing;
http://w
Dying,
ww.can
 379

cer.org/r Bow
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orientati doi:
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gay, and L
bisexual G
elders. B
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01
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LGBT
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patients. COMM
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older
ions, but
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risk factor multiple
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lead to lingering
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 383

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informatio in the
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this cancer
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e risk for
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 385

bia, increasin
transphob g the risk
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o use is for which
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most readily
preventabl available.
e cause of There are
disease, three
disability, main
and death explanati
in the ons for
United this
States. disparity.
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to the lesbian,
most gay, and
recent bisexual
surgeon youth
general’s who
report, reported
LGBTQ higher
people levels of
smoke rejection
cigarettes and
at rates hostility
that are were
68% significan
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rest of the engage in
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386

health alcohol a
behaviors, person
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use. particular
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s have person
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y. of
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, gay bars g an
have been alcohol-
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places Based on
where data from
many 2009, an
LGBTQ estimated
people 3.5% of
have all cancer
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communit the
y and United
social States
acceptanc were
e, but this alcohol
also related.
contribute Alcohol
s to the increases
increased the risk
risk of for
smoking breast,
as well as colorectal
alcohol , liver,
use and and
abuse in esophage
this al
populatio cancers,
n. among
Research others.
suggests In
that the addition
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 387

increased and
alcohol discrimin
and ation.
tobacco Taking
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biological factors
child for breast
before the cancer.
age of 30. Excess
The weight
reasons and a
for the high-fat
weight diet also
difference increase
in the risk
lesbians for
and cancers
bisexual in other
women body
are only parts,
partially including
understoo the colon,
d, but thyroid,
probably gallbladd
include er, and
less of a esophagu
reliance s.
on Gay
heterosex and
ual bisexual
standards men are
of beauty, more
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unhealthy heterosex
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patterns to have
that arise HPV, the
from human
stigma papillom
388

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pose no case with
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however, are
that have inconsist
been ent in
implicated their
in an findings,
increasing most
number of report
cancer that
types, LGBTQ
such as people
anal have
cancer lower
and rates of
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l cancer. Preventiv
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coupled Services
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 389

nded the
screening lowest
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competent experienc
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coverage, women
with neglect
transgend prostate
er people cancer
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390

and trans s for

men diagnosin
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for do not
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ams or
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Pap orientatio
smears. n and/or
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some status. A
parts of cancer
the diagnosis
country, is clearly
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There are many
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medical about
school treatment
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and most and
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Diagnosi concerns
s about
Although social
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science The all-
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procedure question
 391

of “Will I and
be survival.
healthy?” All
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additional reported
chain of to cancer
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questions largest
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to my SEER
doctor?” (Surveilla
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family be program).
welcome? Since
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offered national
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informati registries
on I need collect
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to take on about
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relationsh n or
ip, my gender
sexuality, identity,
my valuable
fertility, informati
and my on about
family?” cancer in
become the
as LGBTQ
important, communi
if ties is
unasked, lost. For
as example,
questions while it is
about clear that
treatment lesbians
have
392

increased to refer
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and moment
Ca of
nc diagnosis
er , while
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BT organizat
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Co reserve
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people
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mammogr cancer
am rates, treatment
there is ,
virtually including
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on about rapy,
prevalenc and/or
e, radiation.
incidence, However
and the survivors
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when people
detected experienc
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populatio additiona
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challenge
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Treatme encounte
nt and rs with
health
Survivors
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survivors LGBTQ
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 393

can be “what
especially matters”
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g. It can patients.
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dramatical measure
ly more ments of
so, and patient
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long-term on prove
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recent health
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care Those
movement patients
” has who are
shifted the the most
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ents of healthier.
illness LGBTQ
and cure patient
(e.g., satisfacti
blood on is
work and comprom
imaging ised by
scans) to multiple
patients’ factors,
assessmen some of
ts of the which are
quality of detailed
their own in what
health follows.
care. This As
represents stated
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the people
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with history of
patients to avoiding
394

the health system,

care coupled
system. with a
Once simultane
diagnosed ous
with dependen
cancer, ce on
they are high-
thrust into quality
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system, care, is a
whether source of
they are constant
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e is no cancer
longer an patients.
option In an
and online
compound survey
s the conducte
stress d in 2012
level of by the
many National
LGBTQ LGBT
patients. Cancer
They Network,
must one
engage survivor
with the reported,
system in Alth
order to oug
survive, h
even as my
the doct
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worries all
about abo
acceptanc ut
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pressure eac
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 395

new health
peop care
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d Most
draw people
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brea near their
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ray, and their
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had e is
the dependen
basic t upon
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ety unique
of staff they
the meet
proc there and
edur the social
e policies
and of that
layer city and
ed
state. In
on to
nonurban
that,
regions,
the
there are
possi
limited
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options
y of
for where
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to receive
opho
cancer
bia
care and,
and
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when
ng to
multiple
watc
cancer
h out
treatment
for
facilities
mys
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elf.
health
Despit insurance
e national may be a
trends, all barrier in
selection.
396

Sometime facility
s, the only also plays
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at a hip. For
hospital example,
with LGBTQ
religious discrimin
affiliation ation is
s. In banned in
localities less than
with half the
multiple states of
hospitals, this
LGBTQ country.
people In the
may have previousl
to make y
an mentione
unfortunat d online
e choice survey,
between one
providers, cancer
selecting patient
either the wrote,
more “My
esteemed partner
doctor did not
who is come to
well the
known for hospital
his because
homopho the only
bia or the good
young hospital
oncologist around
with was a
better Catholic
cultural hospital
competen and I
ce but less didn’t
cancer want my
experienc treatment
e. The comprom
political ised by
landscape them
surroundi finding
ng the out about
cancer my
treatment
 397

‘sinful Because
lifestyle.’ cancer
” treatment
Patient involves
s have multiple
better health
outcomes care
when they providers
can be ,
their technicia
authentic ns, and
selves in clerical
treatment. staff, the
Disclosur decision
e of to
identity disclose
and the (or not) is
medical repeatedl
care y
team’s reconside
acceptanc red and
e of this made.
disclosure Those
are linked patients
to better who are
patient out to
health their
outcomes, oncologis
as t and
described radiologi
in the st,
patient- providers
centered with
care whom
model. they have
LGBTQ repeated
patients interactio
must ns during
repeatedly cancer
weigh the treatment
desire to , may
disclose choose
against not to
their fears come out
of to
substanda phleboto
rd mists,
treatment housekee
as a ping
result. staff, and
398

social this
workers disc
who they ussi
may on
interact toda
with only y,
once or with
infrequent this
ly. Their pers
experienc on,
e is about doe
perceived s it
safety. As matt
one er??
cancer ? I
patient in brin
the study g it
wrote, up
whe
I am n it
comf see
ortab ms
le to
bein matt
g out er to
as a the
lesbi situ
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Yet n
there and
are the
setti opp
ngs ortu
in nity
whic is
h avai
there labl
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that So
situa meti
tion mes
of the
aski proc
ng ess
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elf, com
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want out
to over
have and
 399

over visits,
is and/or
tires help with
ome. chores,
Che children,
mo and pets
Trea at home.
tmen Compare
t and d with
reco other
very survivors,
from LGBTQ
surg people
ery often
is a have
full some
time striking
job . differenc
. . it es in
is a those
matt they turn
er of to for
cost/ support
bene during
fit cancer
anal treatment
ysis. . For
many
Most people in
cancer this
patients communi
and ty, the
survivors most
create important
informal relationsh
teams of ips exist
people for outside of
support legal
through definition
the s; that is,
treatment they are
process. legal
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people Tradition
may al intake
accompan forms
y them to that ask
appointme only
nts, make about
hospital marital
400

status online
may miss survey
these said, “It
bonds of is
responsibi important
lity and to know
support. where it
Also, it is is safe to
not bring a
uncommo partner,
n for because
LGBTQ my
people to family
be hates me
rejected and even
by their my
biological mother
family told me
because right
of their before
sexual surgery
orientatio that she
n and/or hoped I
gender would die
identity, in
and this surgery
rift is not and that
necessaril she
y healed wished I
following had never
a cancer been
diagnosis. born.”
Treatment Cance
centers r
that do treatment
not is not
welcome only
and physical;
respect an it is also
LGBTQ embedde
person’s d in the
support culture in
team are which the
subtly care is
conveying given.
discrimina Cancer
tion. As care is
one rife with
survivor unexamin
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 401

messages people
about fall
appropriat outside
e gender these
expressio expectati
ns and ons, they
concerns. can be
For isolated
lesbian or
survivors, stressed
many of or even
whom are experienc
gender e
nonconfor substand
ming, the ard care.
education Many
al lesbians
materials, have had
pink to
ribbons, repeatedl
and y defend
expectatio their
ns of decision
breast to not
reconstruc have
tive breast
surgeries reconstru
are ction
particularl following
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alienating. mastecto
When my. The
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402

common fertility,
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and of family,
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their these
cancer survivors
can be with
particularl unanswer
y off- ed
putting. questions
As a . Support
lesbian groups
cancer for
survivor patients
from the and
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survey s are not
stated, always
“Being a places
lesbian LGBTQ
facing survivors
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are often caregiver
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cancer’s example,
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 403

survivor intercour
may not se. To
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support gay male
group survivors,
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treatment on these
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404

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There is have
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406

upended on about
with sexual
extensive orientatio
cultural n and
competen gender
ce identity.
training Finally,
of all cancer
health treatment
care , both
providers physical
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administr psychoso
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 407

rs, nity.
Disclos Retriev
ure of ed from
Sexual http://w
Identit ww.lun
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g.org/a
Health
Care ssets/d
System ocume
; nts/
Health researc
Dispari h/lgbt-
ties; report.p
Health df
Disparit Durso, L.,
ies, &
Transge Meyer,
nder I.
People; (2013).
Smokin Pattern
g s and
predict
ors of
F disclos
u ure of
r sexual
t orientat
h ion to
healthc
e
are
r
provide
rs
R among
e lesbian
a s, gay
d men,
i and
n bisexua
ls.
g
Sexuali
s
ty
American Resear
Lung ch and
Social
Institute
Policy,
. (n.d.).
10, 35–
Smokin 42.
g out a doi:10.
deadly 1007/
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Tobacc -012-
o use in 0105-2
the Eliason,
M. J.,
LGBT
Dibble
commu
, S., &
408

DeJose alth/
ph, J. 2014
(2010). /02/1
Nursin 6/stu
g’s dy-
silence antig
on ay-
lesbian, com
gay, muni
bisexua ties-
l, and lead-
transge early
nder -lgb-
issues: death
The Margolies,
need L.
for (2013).
emanci
Issues
patory
efforts. the
Advanc LGBT
es in popula
Nursing tion
Science, faces
33, when it
206– comes
218.
to
doi:10.1
cancer
097/AN
S.0b013 [Audio
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3e49 ].
Garcia, Retriev
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Retrie s, L.,
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patie alcohol
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outco
National
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Cancer
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surviv e.
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National
TRAJECT
Cancer ORIES
Institute
. (n.d.).
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and navigatin
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risk. careers,
Retrieve LGBTQ
d from people
http://w must
ww.can address
cer.gov/ concerns
about- related to
cancer/ visibility
causes- and
preventi stigma.
on/risk/ Understa
alcohol/ nding the
410

issues and nce or

challenge acceptan
s that ce and
LGBTQ support
individual at work)
s navigate or
as they economic
progress (e.g.,
through having a
their secure
careers is and
important stable
because it employm
helps both ent
persons situation)
and . This
organizati entry
ons to discusses
make the career
decisions develop
that will ment and
help them trajectori
maximize es of
career LGBTQ
satisfactio workers
n and as they
success. manage
One way the
of impact of
achieving the
career decision
success whether
and to
satisfactio disclose
n is to their
have a sexual
career identity
that meets as they
one’s seek to
needs. achieve
These career
needs can success.
be
psycholog
ical (e.g., I
experienci d
ng e
autonomy n
and ti
independe
 411

twhether
ythey
Dchoose to
imake
stheir
cidentity
publicly
l
known.
o
Unlike
srace and
usex,
rwhich are
enormally
avisual
nclues to a
dperson’s
Eidentity,
mfew
ppeople
lare
odirectly
identified
y
as being
m
LGBTQ,
ein part
ndue to
tsocietal
Pheterosex
rism
o(which
ttreats
eheterosex
cuality as
tinormativ
oe and
ntherefore
assumed)
s
.
The Consequ
careers of ently,
LGBTQ selfidenti
workers fication
are as
significan LGBTQ
tly is
affected necessary
by their ,
sexual particular
identity ly in the
and employm
412

ent g others
context. of the
Individual assumpti
s who ons of
choose to heterosex
be visible ism).
are Therefor
considere e, the
d to be first
out, critical
whereas career
those who decision
choose to to be
remain made is
invisible whether
are one
referred wishes to
to as be visibly
closeted and
(i.e., in openly
the closet, LGBTQ
which is a in one’s
metaphor work life.
for The
hiding). decision
To to
maintain disclose
this is
closeted conseque
status, a ntial,
person particular
engages ly in
in employm
passing, ent, given
either the
actively stigma
(i.e., often
engages associate
in d with
behaviors being
to make LGBTQ
people and the
believe lack of
that they legal
are not protectio
LGBTQ) ns for
or LGBTQ
passively individua
(i.e., not ls. Being
dissuadin LGBTQ
 413

is n, of
considere which 18
d by some (plus
to be D.C.) are
deviant, inclusive
and, of
depending individua
on the ls who
source, are
immoral transgend
and/or er. While
dangerous legislatio
. Business n may
owners provide
who hold recourse,
these it does
beliefs not
can feel necessaril
justified y prevent
in harassme
denying nt or
employme discrimin
nt ation.
opportunit Therefore
ies to , some
LGBTQ LGBTQ
people, people
and in the will
majority pursue
of states the
such strategy
employer of
actions C
are legal. a
Currently, r
e
in the
e
United r
States, D
only 21 e
states v
(plus e
Washingt l
on, D.C.) o
p
provide
m
employme e
nt n
protection t
s based on a
sexual n
orientatio d
414

Tcloseted,
rhe or she
acan have
j
a
e
csuccessfu
tl career,
obut there
rare
idifferenc
ees in how
sone is
likely to
passing in manage
hopes of and
avoiding experienc
detection e that
and career.
becoming This
potential occurs
targets. because
By of
contrast, different
others outcomes
will that
engage in result
the from the
strategy disclosur
of e
disclosure decision.
in hopes Individua
of finding ls who
a safe remain
work closeted
context need to
where be more
they will self-
have reliant in
access to managin
support. g and
directing
their
Types of careers
because
Careers
being
Regardles closeted
s of inhibits
whether the
an ability to
individual create
is out or develop
 415

mental careers
relationsh and
ips within organizat
an ions
organizati where it
on while is safe to
also be
making LGBTQ.
the This
individual promotes
vulnerabl a better
e to work–life
discrimin balance
ation if as well as
discovere increasin
d. Of g the
course, ability of
the the out
potential individua
for l to rely
discrimin on an
ation is a employer
major for career
career develop
concern ment and
for stability.
someone Career
who is s have
visibly both
LGBTQ; anchors
however, and
LGBTQ paths.
workers Career
manage anchors
this represent
potential the
differentl foundatio
y. n or basis
Individual that
s who are forms an
out of the individua
closet are l’s career.
expected It
to represent
actively s a
seek out person’s
and career
embed identity
themselve and
s in motivatio
416

n. Careers workers;
also have however,
paths the
based on ability of
the goals organizat
and ions to do
decisions this will
that be
people greatest
make. for those
Greater who are
consistenc out
y among because
these managers
career will have
anchors greater
and paths knowledg
with an e and
individual understan
’s ding of
psycholog the needs
ical and of those
economic workers.
priorities C
should ar
promote ee
r
career
D
satisfactio ev
n and el
success. op
Therefore, m
recognizin en
g one’s t
own an
d
priorities
Tr
will aj
facilitate ec
making to
wiser ri
career es
decisions.
This is
Three
also true
categorie
for
s of
employers
needs
seeking to
that have
advance
been
the
identified
careers of
as
their
 417

anchors/fo individua
undations ls who
from are out of
which the closet
careers will also
emanate manage
are their own
autonomy careers,
and they are
independe expected,
nce, as noted
lifestyle, earlier, to
and seek
security organizat
and ions
stability. where it
Of these is safe to
career be
anchors, LGBTQ,
autonomy thus
and allowing
independe them to
nce best experienc
meet the e greater
needs of support
individual and a
s who are healthier
closeted. work–
Autonom life
y and balance,
independe which is
nce reflect consisten
the needs t with a
of lifestyle
closeted anchor.
workers The third
to manage option for
their own a need-
careers as based
they are career is
less able security
to depend and
on a stability.
specific This
organizati alternativ
on for e is found
career most
security. among
While workers
many who are
418

out of the Tradition

closet but al careers
who place are based
greater on the
emphasis social
on contract
economic where
s than on employee
identity s provide
integratio their
n and effort and
career loyalty in
self- return for
managem job
ent. security.
From Another
these attribute
career of
anchors, traditiona
individual l careers
s is that
experienc they are
e different based
career more on
trajectorie extrinsic
s. Further, than
certain intrinsic
trajectorie factors.
s are more Understa
consistent nding
with these
specific characteri
career stics is
anchors particular
than ly
others. important
For for
example, organizat
traditional ions,
careers since
are most workers
suitable depend
for on their
individual employer
s who s for
have a career
security guidance
and and
stability developm
anchor. ent.
 419

Reflect distinctio
ing n,
changes individua
in the ls who
social follow a
contract boundary
between less path
workers focus on
and career
employers opportuni
, two ties and
theories are not
that have tethered
been to a
developed specific
as organizat
alternative ion,
s to whereas
traditional those on
careers a protean
are those career
of protean trajectory
and are more
boundaryl values-
ess driven.
careers. With
For both regard to
of these disclosur
theories, e status
how and
individual career
s take anchor, a
responsibi protean
lity for path is
their own most
career congruen
developm t for
ent is “out”
important individua
because, ls with a
increasing lifestyle
ly, anchor.
organizati The
ons are intrinsic
rewarding focus of a
employabi lifestyle
lity over anchor is
simple more
loyalty. consisten
By way of t with the
420

emphasis create
on a developm
values- ental
driven opportuni
career ties and
than the rewards
focus of for these
those with workers.
security As for
and pursuing
stability a
anchors. boundary
Similarly, less
the career
decision path, this
to trajectory
disclose is most
one’s congruen
LGBTQ t for
status is individua
more ls with
consistent autonom
with a y and
values- independ
driven ence
approach anchors
than the who have
choice to chosen to
remain remain
closeted. closeted.
Self- Boundary
awareness less
of one’s individua
anchor ls are
facilitates psycholo
making gically
appropriat the most
e career open to
decisions. changes
Further, it in
is employm
valuable ent.
for Because
employers closeted
to individua
recognize ls are
this expected
intrinsic to have
focus to weaker
properly social ties
 421

to an knowledg
organizati e of, and
on, influence
mobility on, the
for them career
is easier developm
and ent of
potentiall these
y more employee
necessary s.
(in the
event of
discovery) Develop
; they are mental
therefore Network
expected s
to be
Because
more
being
boundaryl
protean
ess in
or
their
boundary
career
less
orientatio
involves
n. These
actively
factors
directing
emphasize
one’s
remaining
career, it
autonomo
is useful
us and
to seek
independe
the
nt, which
advice of
explains
others
why that
and
anchor is
develop
the most
mentorin
congruent
g
. A further
relations
consequen
hips.
ce of this
Individua
combinati
ls who
on of
have
disclosure
mentors
, anchor,
tend to
and
experienc
trajectory
e greater
is that
career
employers
success
are likely
and
to have
satisfacti
the least
422

on. This relations

success hips with
and more
satisfactio than one
n results mentor.
from a Having
variety of multiple
psychosoc mentors
ial and is
career- particular
planning ly
functions beneficia
that l for
mentors those
provide, individua
not the ls who
least of might
which is want to
becoming be paired
part of a with
mentor’s different
network. people
Although for the
traditional career
ly planning
mentoring and
has been psychoso
discussed cial
as a functions
simple of
dyadic mentorin
relationsh g.
ip There
between a are
more several
senior reasons
individual for
and a wanting
protégé, to
research separate
has these
shown functions,
that particular
people ly if the
tend to person
have has a
these formal
types of (organiza
developm tionally
ental assigned)
 423

mentor. example,
Protégés serving
are paired as a role
with model is
formal one of
organizati the
onal important
mentors functions
for a that
variety of mentors
reasons, fulfill.
but sexual Having
identity is an
not likely LGBTQ
to be mentor
among who can
them. model
Therefore, such
an behaviors
LGBTQ as how to
person handle
may want social
an situations
additional and
developm personal
ental needs is
relationshi important
p with . If
someone closeted,
who is a mentor
also can help
LGBTQ a protégé
and who get the
can support
provide that he or
understan she needs
ding and without
guidance requiring
for how the
one’s individua
sexual l to
identity disclose
intersects his or her
with his LGBTQ
or her status.
organizati Even if
onal and someone
career is out of
experienc the
es. For closet,
424

the mentors
decision who can
whether speak to
to bring a those
partner/ facets of
spouse to their
a social identity.
function Even
when new when just
to an focusing
organizati on
on or professio
early in nal
one’s issues,
career can having
be stress additiona
inducing. l
Inform mentors,
al mentors both
do not within
need to be and
in the outside
same one’s
organizati organizat
on, which ion,
may be provides
particularl benefits
y to a
important protégé
for beyond
closeted what can
workers. be found
Also, in a
individual traditiona
s who l dyadic
have mentorin
other g
salient relations
identity hip.
issues
(e.g.,
race, sex, Conclusi
or on
religion) The
in social
addition and legal
to being environm
LGBTQ ent in
may want which
additional LGBTQ
 425

individual r
s live and i
work e
s
continues
to evolve.
Distinct Eventuall
progress y, these
has been will exist
made in at the
terms of federal
the laws level.
recognizi Does that
ng same- mean that
sex all stigma
relationsh and
ips and discrimin
protecting ation will
LGBTQ be
workers eliminate
from d?
discrimin Unfortun
ation. ately,
Cthere is
a
ample
r
evidence
e
efrom
rother
groups
Dwho
ecurrently
venjoy full
emarriage
lrecogniti
o
on and
p
memploym
eent
nprotectio
tns that
this will
anot be
nthe case.
dTherefor
e, the
T
needs
r
a
discussed
jin this
eentry are
clikely to
tcontinue
oto exist
426

and drive LGBQ

the career Parents
;
developm
Workpl
ent and ace
trajectorie Discri
s of minatio
LGBTQ n
individual
s.
Understan F
ding these u
will help r
LGBTQ t
workers h
and their e
employers r
make
R
decisions
e
that foster
a
career
d
satisfactio
i
n and
n
success.
g
David M. s
Kaplan Briscoe, J.
P., &
See also
Hall,
Coming
Out, D. T.
Disclosure, (2006).
and The
Passing; interpla
Domestic y of
Partners bounda
hip; ryless
Employ and
ment
protean
Non-
Discrim careers:
ination Combi
Act nations
(ENDA) and
; implica
Mentori tions.
ng; Journa
Work
l of
Environ
Vocati
ments;
onal
Work–
Family Behavi
Interfac or, 69,
e, 4–18.
 427

doi:10.1 Kapla
016/j.jv n,
b.2005. D.
09.002 M.
(2
Higgins, M.
01
C., &
4).
Kram,
Ca
K. E.
ree
(2001).
r
Reconce
an
ptualizi
ch
ng
ors
mentori
an
ng at
d
work: A
pat
develop
hs:
mental
Th
network
e
perspect
ca
ive.
se
Academ
of
y of
ga
Manage
y,
ment
les
Review,
bia
26,
n,
264– &
288. bis
doi:10.5 ex
465/AM ual
R.2001. wo
437802 rk
3 ers
Human .
Rights H
Campai u
gn. m
(n.d.). an
Re
Maps of
so
state ur
laws & ce
policies M
. an
Retrieve ag
d from e
http://w m
en
ww.hrc.
t
org/reso Re
urces/ vi
entry/m ew
aps-of- ,
state- 24
laws- ,
11
policies
428

9– 71–
130 79.
. doi:
doi 10.1
:10. 002/
101 j.15
6/j. 56-
hr 667
mr. 8.20
201 10.t
3.1 b00
0.0 153.
02 x
O’Ryan, Pichler, S.,
L. &
W., Ruggs,
& E.
McF (2015).
arlan LGBT
d, worker
W. s. In A.
P. Collela
(201 & E.
0). A King
phen (Eds.),
ome The
nolo Oxford
gical handbo
expl ok of
orati workpl
on of ace
the discrim
expe ination
rienc [Online
es of ].
dual- Retriev
caree ed from
r http://w
lesbi ww.oxf
an ordhan
and dbooks.
gay com/vi
coup ew/10.1
les. 093/
Jour oxfordh
nal b/9780
of 199363
Cou 643.00
nseli 1.0001/
ng oxfordh
& b-
Dev 978019
elop 936364
ment 3-e-13
, C
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), eg
 429

ivi L
ng .
,
&
Schein, E.
H. A
(1990). u
Career g
anchors u
: s
Discove t
ring ,
your R
real .
values. A
San .
Diego, (
CA: 2
Pfeiffer 0
& 0
Compan 6
y. )
Trau, R. N. .
C., & W
Härtel, o
C. E. J. r
(2004). k
One -
career, f
two a
identitie m
s: An i
assessm l
ent of y
gay
men’s c
career o
trajector n
y. f
Career l
Develop i
ment c
Internat t
ional, 9, :
627– A
637.
http://dx
s
.doi.org/
t
10.1108
u
/136204
d
304105
y
70338
Tute
o
n
f
,
l
T
e
.
430

s i
b .
i o
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/ lesbian,
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o
 431

queer Caregiv
(LGBTQ) ing for
persons Adults,
have long Childre
been n, and
involved
Elders
in
providing Caregivi
care to ng is the
partners practice
and loved of
ones in providing
need. This assistanc
entry e to
provides another
basic individua
informati l as well
on on as
caregivin finding
g, and
including managin
definition g
s of suppleme
caregivin ntal care
g roles in the
and duties communi
and ty.
descriptio Caregivi
ns of the ng roles
positive can be
and either
negative formal or
outcomes informal.
of care Formal
provision. caregiver
It also s include
offers paid
much- professio
needed nals,
insight such as
into the home
unique health
experienc aides and
es of visiting
LGBTQ nurses.
caregivers Informal
. caregiver
s are
often
parents,
432

spouses, of
partners, caregivin
family, g tasks,
and and this
friends, person is
who considere
provide d the
care to primary
individual caregiver
s who are .
ill or Secondar
disabled y
or cannot caregiver
perform s are also
activities common
of daily and
living typically
(ADL). assist the
Among primary
LGBTQ caregiver
persons, (s).
families Spouses
of choice and adult
consist of children
persons or have
groups of traditiona
people lly been
who may called to
be from become
their primary
family of caregiver
origin, s for
extended aging
family, or loved
significan ones.
t Research
members continues
of their to
social identify
network females
who are as the
not primary
biological caregiver
ly related. s across
Often, groups
one and
person througho
assumes ut the life
the span. The
majority majority
 433

of care living,
recipients including
are given bathing,
care in dressing,
their and
home or toileting
in the a care
home of a receiver.
loved one. They
As our may also
global pay bills,
populatio prepare
n ages meals,
and lives dispense
longer, medicati
demograp ons, and
hers provide
acknowle transport
dge that ation for
there will these
be fewer individua
adult ls.
children Providin
to care for g
our elder emotiona
populatio l support
n, placing for and
a heavy sharing
burden on social
both activities
informal with their
and friend or
formal loved one
care is also
providers. part of
the
caregivin
Outcome g role.
s of Caregive
Providin rs may
g Care also
coordinat
Caregiver
e external
s are
care
called
providers
upon to
and
assist in a
health
variety of
professio
activities
nals,
of daily
manage
434

schedules, result of
and caregivin
arrange g
for responsib
service ilities can
provision, also
including occur
respite because
care, providing
therapy, care can
and other be costly
social and time
services. intensive.
Several Because
negative caregivin
outcomes g can
have been involve
identified long
as a result hours
of the over long
caregiving periods
experienc of time, it
e. These can also
may cause
include strain
physical with an
strain, individua
including l’s other
injury or responsib
illness, ilities and
from relationsh
providing ips. For
hands-on example,
care for an
extended individua
periods of l
time. providing
Many care to an
caregivers older
also parent
experienc may be
e unable to
emotional spend as
stress and much
even time as
depressio usual
n. with a
Financial spouse,
difficultie partner,
s as a or child.
 435

Caregivin the
g may caregiver
also cause (s). Care
conflicts recipients
with are
employme frequentl
nt, as a y aware
caregiver of their
may need disabilitie
to take s and/or
time off declining
from capacity
work to to
provide perform
assistance their
to a loved ADLs
one. and may
These become
negative emotiona
outcomes lly
of distressed
providing ,
care have frustrated
been , and/or
described angry.
variously These
as reactions
caregiver may
stress, prevent
caregiver or hinder
burden, their
and ability to
caregiver access
strain. necessary
Although support.
not as Despit
well e such
researche negative
d, care outcomes
recipients ,
also caregivin
experienc g also has
e negative positive
outcomes, aspects,
including and
feelings providing
of guilt care to
and fears friends
of being a and
burden on family
436

members about
has been themselv
identified es and
as a their
rewarding capacity
experienc to give
e. and be
Caregiver strong
s often while
benefit caregivin
because g.
they feel Caregiver
good s and
about care
themselve recipients
s and the may also
care that have the
they benefit of
provide. increased
They may closeness
also enjoy ,
the connectio
satisfactio n, and
n of commitm
returning ent to
care to a each
loved one other.
who once Care
provided recipients
care to also
them or acknowle
fulfilling dge
a changes
responsibi in
lity to a important
partner or interpers
family onal
member. connectio
Many ns when
individual receiving
s also care from
experienc loved
e personal ones,
growth deepenin
during the g
caregiving relationsh
process, ips and
reporting forging
that they stronger
learned
 437

attachmen transgend
ts. er
persons
are
Caregivin almost
g Among nonexiste
LGBTQ nt in the
Individua caregivin
ls g
literature.
Overall, The
the studies
caregivin that have
g been
literature conducte
has grown d have
since the focused
1970s, on
although providing
the care to
majority spouses/p
of these artners
studies and other
are based loved
on the ones/
experienc friends in
es of need, and
heterosex have
ual shown
persons that
and LGBTQ
couples. caregiver
Far fewer s
studies experienc
exist on e many
the of the
unique same
caregivin stressors
g as those
experienc identified
es of in the
lesbian, traditiona
gay, l
bisexual, caregivin
transgend g
ered, and literature.
queer These
persons. similariti
The es
voices of include
438

financial institutio
strains, nal and
physical social
and discrimin
emotional ation,
problems, and cope
employm with
ent- social
related policies
stressors, that
and prevent
relationsh access
ip strains. and
Recent negativel
studies of y impact
LGBTQ their care
persons experienc
have also e.
identified The
unique historic
issues and discrimin
challenge ation and
s oppressio
experienc n of
ed by LGBTQ
persons
Caregiving
has
implicati
both the
ons in the
LGBTQ
caregivin
caregiver
g
and
experienc
LGBTQ
e of both
care
care
recipient.
providers
LGBTQ
and
persons
recipients
are more
.
likely to
Although
live alone,
advance
have
ments in
fewer
marriage
children,
equality
be ill-
legislatio
informed
n have
of
been
supportiv
made in
e
the
resources,
United
face
States
 439

and choice
abroad, networks
the lack of or non-
legal kin
recognitio relationsh
n of same- ips, and
sex the
couples omission
has of non-
historicall kin
y been caregivin
(and g in
remains, social
in many policies
areas of such as
the world) the
a Family
challenge, Medical
and has Leave
profound Act of
consequen 1993.
ces for Contextu
both ally,
caregivers LGBTQ
and care persons
recipients. have
Formally, varied
care experienc
provision es with
for the
LGBTQ “coming
persons out”
has been process,
compromi and many
sed due to do not
the lack of share
understan their
ding of sexual
the needs orientatio
of n with
LGBTQ family
persons, members,
profession friends,
al places of
constraint employm
s that do ent, and
not health
recognize care
informal providers
family-of- . This
440

may be formal
the result and
of fear of informal
discrimina awarenes
tion, fear s,
of the recogniti
denial of on, or
services, legal
and/or the rights.
lack of Transgen
acceptanc der
e of their caregiver
sexual s and
orientatio receivers
n by are
friends thought
and to
family experienc
members. e even
Studies greater
consistent difficultie
ly s, often
demonstra being
te that estranged
informal from
care is family
preferred and faced
over with
formal insensitiv
care and e
the professio
hierarchy nals.
of care It is
frequently equally
falls to important
families to note
of choice that there
within the are
LGBTQ ingroup
communit differenc
y. es among
LGBTQ LGBTQ
family-of- persons
choice that also
caregivers impact
may carry the
a heavier caregivin
burden g and
due to this care-
lack of receiving
 441

experienc continue
e. For d
example, discrimin
the ation and
experienc stigma.
e of Addition
females as ally, the
predomin pervasive
ant lack of
caregivers understan
, with ding or
fewer acceptan
financial ce of
supports, transgend
suggests a er/
heavier transsexu
burden is al people
carried. among
Ca health
reg care
ivi providers
ng
and
family
Lesbians members,
may be as
impacted reflected
by having in
a small discrimin
family-of- atory
choice institutio
network. nal
Further, mechanis
gay men’s ms and
higher policies,
incidence has the
of health potential
issues of
related to limiting
HIV can access to
impact informal
the supports.
availabilit Resear
y of ch studies
informal continue
care to
networks, highlight
which the lack
may be of
compoun knowledg
ded by e among
442

health required
care to “out”
providers themselv
about es or
meeting their
the needs loved
of ones in
LGBTQ an effort
persons. to receive
The lack care and
of training make
for health decisions.
care Finally,
providers research
and the studies
discrimina continue
tory to
language demonstr
of ate the
medical strong
records aversion
and intake to
forms are institutio
examples nalized
of this care, and
common this
problem. finding is
Faced also true
with the for
Health LGBTQ
Insurance persons.
Portabilit Disagree
y and ments
Accounta between
bility Act families
of 1996 of choice
(HIPAA) and
that often biologica
does not l families
recognize privilege
non-kin biologica
relationshi l family
ps, members,
LGBTQ creating
care the
recipients potential
and for
providers additiona
are l negative
frequently care
 443

experienc ation,
es. lack of
knowled
ge of the
Conclusi particular
on needs of
Caregivin LGBTQ
g has individua
complex ls, and
features the
for the omission
provider of
and alternativ
receiver, e care
particularl networks
y among in formal
LGBTQ care
persons. provision
The are just a
rewards few of
and the
challenge unique
s of issues
caregivin affecting
g are LGBTQ
similar care.
across Continue
groups; d
however, research,
the policy
unique and
experienc program
es and develop
challenge ment,
s facing and
LGBTQ education
persons in of health
need of care
care and providers
those are
providing important
care to activities
LGBTQ for the
persons improve
must be ment of
recognize LGBTQ-
d and care
addressed provision
. Fear of . Access
discrimin to and
444

knowledg Depres
e of legal sion;
Discri
and other
minatio
supportiv n on
e the
resources Basis
for of
LGBTQ HIV/
care AIDS
providers in
Health
and
Care;
recipients Familie
are s of
fundamen Choice;
tal to Familie
enhancing s of
the Origin,
overall Relatio
nships
quality of
With;
care for Health
this Care
populatio Plans;
n. Health
Care
Kristina Provide
M. Hash rs,
and Disclos
Marianne ure of
Sexual
Mankows
Identity
ki
to;
Health
See also
Care
Advance
System
Health
;
Care
Health
Planning;
Insuran
Aging,
ce
Social
Covera
Relation
ge for
ships,
Transg
and
ender
Support
People,
; Cancer
Access
and
to; HIV
Social
and
Support;
Treatm
Coming
ent;
Out,
HIV/AI
Disclos
DS and
ure, and
Aging;
Passing;
HIV/AI
Dementi
DS
a;
 445

Treatme D., . . .
nt and Richar
Care, d, B.
Psychos (2007).
ocial
Comin
and
Structur g out to
al care:
Barriers Caregi
to; vers of
Hospital gay and
Visitati lesbian
on; seniors
LGBQ
in
Parents
Canada
and the
.
Health
Care Geront
System; ologist,
Transge 47,
nder 490–
Health 503.
Care Cohen
, H.
L.,
F &
u Mu
r rra
t y,
h Y.
e (20
06)
r
.
Ol
R der
e les
a bia
d n
i and
n gay
car
g
egi
s
ver
s:
Brotman,
Car
S.,
ing
Ryan, for
B., fa
Collins, mil
S., ies
Chambe of
rland, cho
ice
L.,
and
Cormier car
, R., ing
Julien,
446

for s.
fam Jou
ilies rnal
of of
orig Gay
in. &
Jou Les
rnal bia
of n
Hu Soc
ma ial
n Ser
Beh vice
avi s,
or 18(
in 3/4)
the ,
Soc 109
ial –
Env 128.
iron doi:
men 10.1
t, 300
14, /J04
275 1v1
– 8n0
298. 3_0
doi: 7
10.1 Fredriksen
300 -Goldsen,
/J13 K. I., Kim,
7v1 H.-J.,
4n0 Emlet, C.
1_.1 A.,
4 Muraco
Coon, , A.,
D.
Eroshe
W.
(200 va, E.
5). A.,
Expl Hoy-
orin Ellis,
g C.
inter
P., . . .
venti
ons Petry,
for H.
LGB (2011).
T The
care aging
give
and
rs:
Issu health
es report:
and Dispari
exa ties
mple and
 447

resilien Jour
ce nal
among of
lesbian, Gay &
Lesbia
gay,
n
bisexual Social
, and Service
transge s,
nder 18(3/4)
older , 15–
38.
adults.
doi:10.
Seattle, 1300/J
WA: 041v18
Institute n03_02
for Hash, K.
Multige M.
neration (2006).
al Caregiv
Health. ing and
doi:10.2 post-
105/AJ caregiv
PH.201 ing
2 experie
.301110 nces of
midlife
Grossma
and
n, A.
older
H.,
gay
D’A
men
ugell
and
i, A.
lesbian
R., &
s.
Drag
owsk Journal
i, E. of
A. Geront
(200 ologica
5). l Social
Care
Work,
givin
g and 47(3/4)
care ,
recei 121–
ving 138.
amon doi:10.
g 1300/J
older 083v47
lesbi n03_08
an, Metlife
gay, Matur
and
e
bisex
ual Marke
adult t
s. Institu
448

te. 080/01
(2010) 634372
. Still .201
out, 3.8606
52
still
Williams
aging:
, M.
The E., &
Metlif Free
e study man,
of P. A.
lesbia (2005
).
n, gay,
Trans
bisexu gende
al, and r
transg health
endere :
d baby Impli
cation
boome
s for
rs. aging
Westp and
ort, caregi
CT: ving.
Author Journ
al of
.
Gay
Muraco, A., &
& Lesbi
Fredriks an
en- Socia
Goldsen l
, K. I. Servi
(2014). ces,
The 18(3/
highs 4),
and 93–
lows of 108.
caregivi doi:1
ng for 0.130
chronica 0/J04
lly ill 1v18
lesbian, n03_
gay, and 06
bisexual
elders.
Journal
of
Geronto C ATHOL
logical
Social IC
Work,
57, LGBT
251–
272.
doi:10.1
 449

faith may
Q lead to a
PEOPLE conflict
between
those
identities.
This entry
examines The main
the psycholo
official gical
position effects of
of this
the
Roman conflict,
Catholic as well as
Church the ways
regardingidentity
homosexu contradic
ality andtions are
transgendmanaged
erism, asand/or
resolved,
well as its
potentialare also
examined
effects on
the . Finally,
the
relationsh
ip influence
between of the
the wider
gender sociocult
and/or ural
sexual context
and
identities of
of the
Catholic specific
LGBTQ character
people istics of
and theirthe
confessioCatholic
nal confessio
or
religiousn on that
process is
identities.
Next, it highlight
shows ed.
how the
relationsh The
ip of Posi
Catholic tion
LGBTQ of
people
the
with their
Rom
450

an procreati
Cath ve
olic potential
Churc within a
h on monoga
mous and
Hom
stable
osexu
relations
ality
hip.
and Against
Trans this
gend backdrop
erism , a
The number
official of rights
position claimed
of the by the
Roman modern
Catholic LGBTQ
Church moveme
on human nt (same-
sexuality sex
stems marriage,
from a adoption
dichotom rights,
ous and identity
essentialis recogniti
t notion of on of
gender. transgend
Men and er people
women and
are seen transsexu
as als,
fundamen among
tally others)
different, have
but also been the
compleme subject of
ntary in clear and
regard to public
sexuality, oppositio
which n from
the
Catholic
Catholic
LGBTQ
Church.
People
As such,
on a
is valued
personal
essentiall
level, the
y for its
relations
 451

hip of in 1975,
Catholic and more
LGBTQ explicitly
people in the
with their 1986
faith can Letter to
be highly the
problemat bishops
ic. of the
The Catholic
position Church
of the on the
Catholic pastoral
Church on care of
homosexu homosex
ality rests ual
on six persons.
passages Homosex
of the Old uality is
and New classified
Testament in the
s (Genesis Letter as
19:1–28; an
Leviticus “objectiv
18:22, e
20:13; disorder”
Romans and
1:26–27; same-sex
1 acts as
Corinthia contrary
ns 6:9; 1 to
Timothy “natural
1:10). The law” and
Church’s “morally
position disordere
was first d.”
vaguely Although
articulated homosex
in the uality
encyclical itself is
Persona not
Humana: considere
Declarati d a sin,
on on involvem
certain ent in
questions homosex
concernin ual
g sexual practices
ethics, is
released because it
452

represents prohibite
a d.
transgress Transsex
ion of the uality is
divine labeled as
order. a psychic
Even disorder,
though and the
transgend Church
erism has asserts
not been that a
the focus person’s
of gender
identical cannot be
considerat changed
ion, in an through
internal surgery.
letter
released
in 2000 C
that was o
meant to n
be f
confidenti e
al, the s
Catholic s
Church i
instructed o
its n
bishops to a
refuse any
l
requests
I
for sex-
change d
registratio e
n in parish n
records. t
This i
means t
that the y
administra ,
tion of the R
sacrament e
s of l
matrimon i
y and
g
ordination
i
to
transsexua o
ls is also u
 453

s well as
on some
I western
d European
e,
n societies.
t Overall,
scientific
i
literature
t
highlight
y s the
, C
at
a ho
n lic
L
d
G
B
I T
d Q
e Pe
n op
le
t
i
t conflict
y between
the
C system of
o beliefs
n and
f values of
l Catholic
LGBTQ
i
people
c
and their
t feelings
Research and
on practices.
Catholic Such
LGBTQ conflict
people’s is usually
relationsh equated
ip with with
their faith cognitive
is scarce, dissonan
and ce (a
focuses concept
mainly on originally
Anglo- proposed
Saxon, as by Leon
454

Festinger) shame,
between self-
one’s invalidati
confessio on,
nal/religio depressio
us n,
identity internaliz
and one’s ed
gender homopho
identity bia
and/or and/or
sexual transphob
orientatio ia, self-
n. The hatred,
person is and
torn suicidal
between ideation,
the among
possibility others.
of self- The
fulfillmen conflict
t and the also tends
need to to be
abide by heightene
religious d when
precepts the
and of person’s
being immediat
socially e context
integrated (family,
in the friends,
religious and
communit communi
y he or ty) is
she is part highly
of. religious
Difficu and
lties in conforms
reconcilin to
g the two confessio
identities nal
lead to precepts.
variable It is,
degrees of neverthel
psycholog ess,
ical important
tension to notice
linked to that not
feelings all
of guilt, Catholic
 455

LGBTQ identifica
people tion with
feel that the
their specific
confessio precepts
nal/ of a
religious religious
identity denomina
and their tion.
gender Religious
identity identity
and/or refers to
sexual a form of
orientatio understan
n are ding and
conflictin living the
g. One principles
explanatio of a
n for this given
seems to religious
be the denomina
way tion in a
people relative
live and way; that
see their is,
relationshi identifica
p with tion with
their faith. the latter
There is, is only
in fact, a partial
difference and often
between rests on
confessio the
nal acceptanc
identity e of some
and precepts
religious and the
identity. rejection
Confessio of others.
nal In other
identity words,
refers to religious
understan feeling
ding and can be
living a partially,
religious or even
faith in completel
full y,
conformit autonom
y and ous from
456

particular LGBTQ
religious identity
confessio through
ns. sexual
abstinenc
e or
Conflict heterosex
Resolutio ual
n and marriage.
the Confessi
Sociocult onal
ural identity
could be
Context
rejected
There are by
several abandoni
ways to ng one’s
minimize faith.
—or even Both
eliminate identities
—the may also
dissonanc be
e between preserved
a person’s ,
confessio however,
nal/religio through
us compart
identity mentaliza
and his or tion. For
her example,
transgend one could
er identity avoid
and/or contexts
homosexu or
ality or situations
bisexualit that bring
y. One to light
possible dissonanc
solution is e
to reject between
one both (for
identity example,
and not
preserve attending
the other. religious
For services),
example, or by
one could concealin
reject g one of
one’s them (for
 457

example, “spiritual
hiding ity”).
one’s The
LGBTQ same
identity person
from can go
one’s through
religious more
communit than one
y and of these
leading a situations
double , and
life). conflict
Finally tends to
, it is also be solved
possible as he or
to she ages.
integrate Among
both the
identities, variables
for that
example interfere
by in this
becoming process
a member are the
of an search for
inclusive informati
congregati on
on, or by regarding
turning to different
individual religious
ized confessio
forms of ns and
religion philosoph
(for ies, and
example, the
refusing reading
the of holy
Catholic texts and
exegesis the
of biblical sharing
texts of doubts
and/or with
creating a other
personal persons,
religion, be these
often members
referred to of the
in terms same
of religious
458

denominat hand,
ion or not. unlike the
There United
are, States,
however, one
some cannot
fundamen find a
tal “religious
difference market”
s between in
Anglo- Europe.
Saxon Particular
societies, ly in
especially Catholic
the United western
States and European
western countries,
European in spite
countries, of the
that constituti
mediate onal
the separatio
process of n
conflict between
resolution church
. On one and state,
hand, the the
religiosity presence
of North of other
American confessio
society ns and
contrasts churches
with that tends to
of many be
European residual.
societies, Addition
especially ally, the
regarding Catholic
the faith is
centrality organized
and around a
relevancy central
ascribed institutio
by North n—the
American Catholic
s to Church
religion as itself—
a guide to with its
life. On diverse
the other organs
 459

and its suggests

exegesis, that the
which, most
unlike common
Protestant solution
ism, to the
prevents conflict
the between
recognitio religious/
n of other confessio
churches nal
within the identity
Catholic and
confessio sexual
n. This and/or
means transgend
that not er
only identity,
departing when it
from the exists, is
Catholic the
Church to individua
enter the lization
so-called of
“inclusive religious
congregati practice.
ons” is In fact,
not this is in
equally keeping
possible with a
for broad
European trend
Catholic toward
LGBTQ seculariz
people, ation and
but also the
that this decline of
would be institutio
objectivel nalized
y religious
equivalent practice
to a among
religious economic
conversio ally
n that develope
most of d western
them European
refuse. societies.
Resear This does
ch not
460

necessaril conflict
y mean between
rejecting their
the practices
Catholic and/or
faith. identities
What is and their
usually confessio
rejected is n.
the Remainin
Catholic g in the
Church’s Church
reading of and
homosexu actively
ality and taking
transgend part in its
erism, not activities
the are
Church considere
itself. In d
fact, the necessary
Catholic to their
Church personal
can be well-
differently being and
understoo are often
d—for associate
example, d with
as the the will
communit to change
y of the
believers, Catholic
not as the Church
formal from the
organizati inside.
on itself. An
Also, example
many of this
Catholic kind of
LGBTQ mission
people are was the
active creation,
members in
of their October
parishes, 2014, of
even the
though World
they Organizat
acknowle ion of the
dge the Homosex
 461

ual Religio
Catholic us
Identity
Associatio
and
ns Sexuali
(WOHCA ty,
). Reconc
WOHCA iliation
joins of;
Catholic Religio
LGBTQ us
LGBT
associatio
Q
ns from Youth;
Argentina Transg
, Brazil, ender
France, People
Italy, and
Mexico, Religio
Peru, n/
Spiritu
Poland,
ality
Portugal,
the
United F
Kingdom, u
and the r
United t
States. h
Ana e
r
Maria
Brandão
R
See also e
Christian a
LGBTQ d
People; i
Jewish n
LGBTQ g
People; s
Muslim
LGB Festinger,
People; L.
Religio (1957).
n and A
Spiritua theory
lity, of
Youth; cogniti
Religio ve
n/Spirit dissona
uality nce.
and Stanfor
LGBTQ d, CA:
People; Stanfor
d
462

Universi identity
ty Press. and
Child faith.
Support Journa
After l of
LGBQ
Religio
Divorce/S
n&
eparation
Spiritu
ality in
Gross, M. Social
(2008). Work:
Etre Social
chrétien Thought,
et 32, 60–83.
homose Pérez-
xuel en Agote, A.
France (2014).
[Being a The notion
Christia of
n and a secularizati
homose on:
xual in Drawing
France]. the
Sociétés boundaries
Contem of its
contempor
poraine
ary
s, 71, scientific
67–93. validity.
Levy, D. Current
L., & Sociology
Lo, J. R. Review,
62(6),
(2013).
886–904.
Transge
Sacred
nder, Congregati
transsex on for the
ual, and Doctrine
gender of the
queer Faith.
individu (1975).
Persona
als with
humana:
a Declaratio
Christia n on
n certain
upbringi questions
ng: The concernin
process g sexual
of ethics.
Retrieved
resolvin
October
g 25, 2014,
conflict from
between http://www
gender .vatican.va
 463

/roman faith_
curia/ doc_19
congregatio 861001
ns/cfaith/do _homo
cuments/rc
sexual-
_con_cfaith
_doc_ persons
197512 _en.ht
29_pers mlv
ona- Yip, A. K.
humana T.
_en.htm (1997).
l Dare to
Sacred differ:
Congre Gay
gation and
for the lesbian
Doctrin Catholi
e of the cs’
Faith. assess
(1986). ment of
Letter official
to the Catholi
bishops c
of the positio
Catholi ns on
c sexualit
Church y.
on the Sociolo
pastoral gy of
care of Religio
the n,
homose 58(2),
xual 165–
persons 180.
. Yip, A. K.
Retrieve T. (2003).
d The self as
October the basis
25, of
2014, religious
faith:
from
Spiritua
http://w
lity of
ww.vati
gay,
can.va/r lesbian
oman_ and
curia/co bisexua
ngregati l
ons/cfai Christi
th/docu ans.
ments/r In
G.
c_con_c
464

Davi st
e, P.
Heel
Debat
as, & e on
L. the
Woo
dhea
Origin
d s of
(Eds. Sexual
),
Orient
Pred
ictin ation
g
relig
ion:
Chri CHILD
stian
, SUPPOR
secul
ar T AFTER
and
alter LGBQ
nativ
e DIVORC
futur
es E/
(pp.
135– SEPARA
146). TION
Alde
rshot
,
Engl Child
and: support is
Ashg the
ate. financial
sum
provided
by
CAUSES noncusto
dial
OF parents in
SEXUAL the
aftermath
ORIENT of a
ATION divorce.
This
financial
award,
See
typically
Essenti court
alist– mandated
Constr , covers
uctioni basic
 465

living last 20
costs such years it
as food, has
clothing, become
Ch an
ild emerging
Su legal
pp
issue tied
ort
Aft
to same-
er sex
L marriage.
G The
B courts
Q continue
Di to rely on
vo
biologica
rce
/Se
l
pa relatedne
rat ss in
ion acknowle
dging
parental
health, rights
and and
education obligatio
while the ns, and
child is LGBQ
under the divorce
age of 18. highlight
In cases s the
of lesbian, ways in
gay, which
bisexual, diverse
and queer family
(LGBQ) forms
divorce or complica
separation te
, child divorce
support proceedi
has often ngs. This
been entry
decided discusses
through child
informal support,
discussion paying
s, outside particular
of a attention
courtroom to the
, although court’s
over the distinct
466

definition child
s of support is
parenthoo not
d. always
The tied to
average custody
amount of or
child contact,
support is and these
determine terms are
d on a considere
case-by- d
case basis separate
and issues in
considers divorce
the proceedin
noncustod gs (i.e.,
ial noncusto
parent’s dial
income, parents
the child’s who do
needs, and not wish
the to have
quality of contact
life the with the
child child are
would still
have required
experienc to
ed had the provide
two child
parents support).
stayed In the
together. United
For many States,
families, establishi
child ng
support is parent–
a lifeline child
— connectio
ensuring ns is
the complex.
economic Most
safety and children
well- raised in
being of same-sex
children. couple
Different househol
from child ds come
custody, from a
 467

previous used
heterosex creative
ual means,
relationshi such as
p and are establishi
biological ng legal
ly tied to guardians
only one hip and
parent. adopting
Moreover, the
in most nonbiolo
cases of in gical
vitro parent’s
fertilizatio last
n or name.
surrogacy, Despit
only one e many
parent has potential
a direct difficultie
biological s, same-
connectio sex
n to the couples
child. In have
these complete
families, d private
establishi and
ng a legal public
parent– adoptions
child tie of
for the children
nonbiolog of all
ical parent ages.
depends With no
on access biologica
to same- l parent–
sex child ties,
marriage, both
civil parents
unions, must rely
and on access
secondpar to legal
ent ties. Joint
adoption. adoption,
In the in which
absence both
of legal parents
ties, have
samesex legal
couples claim to
have often the child,
468

is ideal to parent)
but not rights. In
available de facto
in all or
states. psycholo
Often, one gical
partner parent
will adopt cases, the
the child court
in order to recognize
circumven s that the
t state noncusto
laws or dial and
adoption nonbiolo
policies gical
that bar parent
same-sex performe
couples d and
from continues
jointly to
adopting perform
children. parental
In duties at
families a similar
where (and
parent– sometime
child ties s higher)
cannot be level as
or are not the
accessed, custodial
same-sex or
couples biologica
have few l parent
alternative and
s. A few grants
states him or
recognize her
“de parental
facto,” rights and
“psycholo obligatio
gical ns. These
parent” de facto
(i.e., parents
acting in a become
parental responsib
role), or le for
equitable child
estoppel support,
(i.e., and in a
intention few
 469

cases, the (equitabl

court e
awards estoppel)
custody or
and presumpt
visitation. ion of
The parentage
burden of for a
proof for sufficient
de facto amount
parenthoo of time
d is the (“holding
responsibi out”).
lity of the There is,
nonbiolog however,
ical no
parent, universal
and, if standard
this parent for
does not holding
want to out or
assume intention
parental to parent,
rights, he and
or she therefore
often does courts
not. There often
are cases vary in
in which child
biological support
parents obligatio
have filed ns for
for nonbiolo
retroactiv gical
e child parents.
support In
and have cases of
won. unmarrie
Courts d, same-
required sex
child relationsh
support ip
from dissolutio
nonbiolog n, where
ical one
parents on parent
the basis has no
of legal or
intention biologica
to parent l ties to

Children With LGBQ Parents, Academic Outcomes

470

the in order
child(ren), to
the continue
nonbiolog their
ical or parental
nonlegal tie. In
parent has instances
no legal where the
obligation biologica
under the l or legal
law to parent
provide has
child sought
support. out child
As support,
discussed the courts
above, have
courts rarely
vary in awarded
requiring it but are
child increasin
support gly
for consideri
nonbiolog ng the
ical obligatio
parents, ns of
but often nonbiolo
de facto gical or
or nonlegal
psycholog parents,
ical especiall
parents y where
petition they were
the courts intended
in order to parents.
maintain a Instead,
connectio custodial
n to the parents
child(ren) have
and in relied on
hopes of the
gaining goodwill
visitation of
or noncusto
custody. dial
They are parents,
willing to and child
take on support
child has
support, largely
 471

been the more

result of custodial
informal parents
agreement are able
s between to
ex- demand
partners child
outside of support
a court of after a
law. divorce,
In fulfilling
marriage the
and most original
civil intent of
unions, child
both support.
spouses or Access to
partners divorce,
have however,
parental can be
rights restricted,
when the as the
child is ability to
born divorce
during the depends
relationshi on the
p. state of
Subseque residence
ntly, in and, in
same-sex some
divorce, instances,
the courts the state
can in which
obligate the
the couple’s
nonbiolog union
ical, was
nonadopti celebrate
ve, or d.
noncustod Child
ial parent support
to provide not only
child provides
support. economic
Since the benefit to
introducti families
on of but also
same-sex improves
marriage quality of
in 2003, life. With
472

child Nonma
support, rital
Same-
children
Sex
of Relatio
divorced nships;
same-sex Legal
parents Rights
experienc of
e more Nonbio
financial logical
Parents
stability
;
and Living
sometime Arrang
s more ements
positive of
family Childre
relationshi n After
ps. Child LGBQ
Divorc
support
e/Separ
does not ation;
guarantee Marria
parent– ge,
child Reason
contact or s for
visitation and
but does Against
;
help
Relatio
ensure the nships
child(ren) With
’s well- Former
being. Spouse
s
Emma C.
Potter
and
Katherine
R. Allen

See also
Coparentin
g; Custody
and
Litigation,
LGBQ
Parents;
Divorce
, Legal
Issues
in;
Legal
Recogni
tion of
 473

F Child
u custody
r /
t visitati
h on and
e child
r support
for
R lesbian
e couples
a under
d “comp
i
anion”
n
cases
g
Debra
s
H. and
Allen, K. In Re
R. H.M.
(2007).
(Paper
Ambig
No.
uous
27).
loss
Retriev
after
ed
lesbian
from
couple
http://s
s with
cholars
childre
hip.law
n break
up: A .cornell
case .edu/
for lps_pap
same- ers/27
gender Gartrell,
divorc N., Bos,
e. H., Peyser,
Family H., Deck,
Relatio A., &
ns, 56, Rodas, C.
174– (2011).
182. Family
doi:10. charact
1111/j. eristics,
1741- custody
3729.2 arrange
007.00 ments,
450.x and
Beekman, J. adolesc
C. ent
psychol
(2011).
ogical
In well-
search being
of after
parity: lesbian
mother
474

s break
up. S,
Family
Relatio
ACADE
ns, 60,
572–
MIC
585.
Goldberg,
OUTCO
A. E., MES
&
Allen,
K. R.In
(2013)
describin
.
Same-g the
sex academic
outcomes
relatio
nshipof
dissol
children
utionwith
and
lesbian,
LGB
gay,
stepfa
mily bisexual,
and queer
format
ion: (LGBQ)
Perspe
parents,
ctives
this entry
of
provides
young
an
adults
with overview
LGB of studies
on
parent
s. lesbian
Familmothers
y
and, to a
Relati
ons, lesser
62, extent,
529– gay
544. fathers;
doi:10.
very little
1111/research
fare.12
has been
024
conducte
d on
bisexual
CHILDRE parents.
First,
N WITH research
is
LGBQ described
PARENT that
summari
 475

zes sometime
LGBQ s other
parents’ adults),
involvem which
ent in can
school, contribut
which has e to
been school
establishe disengag
d (in prior ement
work with and
heterosex poorer
ual-parent academic
families) outcomes
as an . Then,
important having
predictor described
of several
academic factors
outcomes that
for affect
children, academic
whereby outcomes
greater of
parental children,
school the entry
involvem presents
ent is evidence
linked to on
better children’
academic s
outcomes. academic
Next, the achievem
entry ent,
reviews looking
evidence at both
about the the
amount acquisitio
and types n of
of academic
bullying skills and
that school
children performa
with nce, as
LGBQ well as
parents normal
face at grade
school progressi
from their on
peers (and through
476

the outcomes
education . One
system. parenting
The entry practice
ends with that has
a brief gained
discussion considera
of ble
limitation attention
s faced by is
studies on parents’
this involvem
subject, ent
and Children
suggestio With
ns for LGBQ
future Parents,
research. Academic
Outcomes
Factors
Shaping
with
the their
Academi children
c ’s
Outco schools.
mes of Having
Childre parents
n With that are
LGBQ involve
Parent d with
their
s
children
Parental ’s
School schooli
Involveme ng (e.g.,
nt doing
Resear such
chers things
have long as
studied volunte
the ering in
contributi the
on that classroo
parents m,
make to being
their an
children’s active
academic member
of
 477

parent– on is no
teacher differen
organiza t for
tions LGBQ
and parents;
associati howeve
ons, and r, the
developi reaction
ng lines s
of received
commun by
ication lesbian
with mothers
teachers or gay
and fathers
school when
administ interacti
rators) is ng with
typically schools
associate can vary
d with dramati
better cally.
academi School
c attitudes
outcome toward
s for LGBQ
children. parents
The can be
reasons broadly
for this classifie
associati d into
on are three
many, categori
but es:
evidence accepta
continue nce,
s to toleranc
support e, or
the ignoran
importan ce.
ce of Accepta
parents’ nce is
school characte
involve rized by
ment for schools
children’ that
s strive to
learning. create
This an
associati awarene
478

ss of openly
diversity particip
within ate and
their engage
building in their
(s), often children
includin ’s
g a schoolin
multitud g
e of experie
family nces,
structure but the
s in their type of
public proactiv
displays e efforts
(e.g., toward
bulletin diversit
boards), y
standard describe
curriculu d above
m (e.g., (e.g.,
types of differen
families t family
present structur
in es
classroo depicted
m in
books), public
and displays
classroo ) are
m generall
presentat y
ions lacking.
(e.g., Ignoran
discussi ce is
ons of characte
what rized by
families schools
can look that
like). actively
Toleran discoura
ce is ge or
characte prohibit
rized by LGBQ
schools parents
in which from
both being
parents involve
are able d in
to their
 479

children’ may
s contribu
schoolin te to a
g. In general
some sense of
cases, hostility
this to that
includes parent’s
schools presenc
prohibiti e at
ng one meeting
parent s or
from assembl
participa ies.
ting in Parental
school school
activities involve
or events ment is
(e.g., in importa
states nt for
that do children
not ’s
allow academi
same- c
sex outcom
parent es, and
adoption when
, parents
disallow are
ing the discoura
nonbiolo ged
gical from
parent particip
from ating,
being an this
active takes
member away
of from
parent– children
teacher ’s
associati opportu
ons or nities
being for
able to academi
serve as c
a legal success.
guardian Experienc
of the es With
child), Bullying
which
480

As as taking
children place
get older, between
one of the similarag
leading ed
contributo individua
rs to ls, in the
student form of
disengage student-
ment from to-
school is student
the interactio
experienc ns, but it
e of can also
bullying. take the
When form of
students student-
are to-adult
bullied at interactio
school, ns,
they are involving
less likely teachers,
to want to school
be there, officials,
they are and other
more parents.
likely to Much
associate of the
school early
with research
negative on the
experienc experienc
es and es of
emotions, bullying
and the for
end result children
is with
increased LGBQ
risk for parents
dropping sought to
out and determin
poorer e whether
academic these
performan children
ce in experienc
general. ed more
Bullying bullying
is than their
typically peers.
thought of Some
 481

smaller- tend to be
scale bullied
studies with
suggested similar
that, frequenc
indeed, y as their
children peers
with with
lesbian heterosex
mothers ual
or gay parents,
fathers but while
were other
more children
likely to are
be bullied, bullied
but this for
finding varying
has more reasons,
recently children
been with
challenge LGBQ
d. parents
Increasing often are
ly, it is repeatedl
believed y targeted
that because
children of their
with family
LGBQ structure.
parents do The
not persistent
experienc focus on
e more the
bullying family
than their structure
peers, but, has led
rather, some
that the researche
bullying rs to
they conclude
experienc that the
e is often bullying
more of
targeted. children
That is, with
children LGBQ
with parents
LGBQ may not
parents be more
482

frequent, and
but it is pressure
more to keep
intense. their
In family
addition, structure
the secret,
bullying and they
faced at are
school by chastised
children when
with they
LGBQ attempt
parents is to talk
not about
simply their
Children With LGBQ Parents, Academic Outcomes
limited to families
actions by in public
their spaces.
similar- Many
aged studies
peers; have
instead, document
these ed young
children children
sometime with
s face LGBQ
similar parents
albeit describin
more g their
covert family
victimizat structure
ion from to a class,
adults. only to
Related to have the
the extent teacher
to which dismiss
schools them as
encourage being
LGBQ confused
parents to about
be their
involved, family
their structure,
children actively
sometime rejecting
s face the
ridicule at possibilit
school y of their
 483

family themselv
structure, es use
or, when derogator
learning y
of the speech).
family Together,
situation, these
asking the types of
children experienc
to refrain es at
from school
discussing can
it in class. remove a
Older child’s
students sense of
are often safety
less open and
about security,
their which are
family essential
structure for
because learning
of earlier and
experienc healthy
es with developm
peer or ent.
teacher
disapprov
al, but are Researc
still faced h
with
Findings
bullying
from Over the
adults last half
(e.g., century,
when they studies
hear have
derogator repeatedl
y gay y
slang used demonstr
by other ated the
students central
go role that
uncorrecte academic
d by performa
teachers, nce and
and on education
occasion al
hear attainme
teachers nt play in
484

explainin many
g social unique
inequality challenge
. s and
Individual difficultie
s who do s related
better in to their
school schooling
tend to experienc
stay in es, which
school could be
longer, expected
attend to
better contribut
colleges e to
and poorer
universiti academic
es, attain outcomes
more for these
advanced children.
degrees, Despite
and work such
in more expectati
prestigiou ons, most
s jobs. studies
The have
importanc found no
e of evidence
education of
for differenc
getting e in the
ahead is performa
why nce and
understan progressi
ding on
difference through
s in school of
academic these
outcomes children
is so relative
essential. to their
As peers
described from
above, two-
children biologica
with l-parent
LGBQ (mother
parents and
are faced father)
with househol
 485

ds. In fact, family

children forms. In
with addition
LGBQ to
parents evidence
tend to of no
score as differenc
well as e
their peers between
on children
standardiz with
ed tests, LGBQ
get parents
similar and
grades as children
their living in
peers, and other
remain as family
academica forms
lly (e.g.,
engaged two-
and biologica
motivated l-parent,
as their stepparen
peers. t, and
Recent single-
findings parent
also forms),
indicate there is
that some
children evidence
with to
LGBQ suggest
parents that
are no children
more adopted
likely to into
be LGBQ-
retained parented
in a grade families
than their do better
peers, academic
suggestin ally than
g that their
normal peers
grade remainin
progressio g in
n is not group-
different home or
across foster-
486

care out that

settings. many
Where LGBQ-
as most parented
studies families
have are the
found that by-
no product
difference of
exists in dissolved
the different-
academic sex-
outcomes parent
of families
children (compare
with d with
LGBQ LGBQ-
parents, parented
authors families
often in which
reported the child
different was
reasons adopted
for at birth),
arriving at and that
this differenc
conclusio es may
n. Some exist in
authors the
have academic
suggested outcomes
that living of
with children
LGBQ with
parents is LGBQ
simply parents,
not but these
related to differenc
academic es are not
outcomes a
(i.e., there reflection
is not of the
even a family
baseline structure
difference but the
between changes
families). and
Others fluctuatio
have ns in
pointed family
 487

form from
often researche
involved rs
in the interested
creation in
of the understan
family. ding the
Regardles implicati
s of the ons of
explanatio this
n, most family
authors structure
generally on
agree that children’
children s
with outcomes
LGBQ . Despite
parents the
have interest
relatively in and
similar increasin
academic g number
outcomes of
to their LGBQ-
peers parented
from families,
other the body
family of
types. research
on these
househol
Limitatio ds
ns to continues
to be
Current
largely
Research
plagued
The by
LGBQ- relatively
parented small,
family is typically
a novel unreprese
family ntative
form in samples
recent that
history, severely
and as hinder
such has the
received a opportuni
lot of ty for
attention inference
488

and interview
generaliza s that
bility. offer
Studies very
on detailed
LGBQ- insight
parent into the
school hardships
involvem —some
ent have of which
often are
relied on extreme
in-depth —that
interviews children
of parents face at
describing school,
their but
experienc cannot
e with definitive
their ly say
children’s whether
schools, these are
so it the
remains experienc
unclear es of all
whether children
these with
patterns LGBQ
are true parents.
for this Research
populatio on the
n more actual
generally. academic
Children With LGBQ Parents, Female/Male Role Models
Similarly, outcomes
evidence of
of children
children’s with
experienc LGBQ
e with parents
bullying has
often historical
comes ly faced
from similar
retrospect criticism
ive related to
accounts small
or sample
qualitativ sizes and
e problems
 489

with househol
generaliza ds based
bility, on the
though family
recently structure
evidence (i.e., two
has unrelated
emerged adult
based on women
larger and or two
increasing unrelated
ly adult men
representa in the
tive househol
samples. d), and
Still, not
definitive necessaril
evidence y on the
remains self-
elusive, reported
while sexuality
studies in of the
the field parent.
continue As a
to result,
improve very little
in quality is known
and rigor. about the
Finally academic
, more outcomes
work is of
needed to children
highlight living in
the singlepar
experienc ent
es of househol
children ds in
growing which the
up in parent is
single- gay or
LGBQpar lesbian.
ent Similarly,
household as
s. Studies mentione
often d earlier,
identify research
gayfather on
or children
lesbian- whose
mother parents
490

identify as Childre
bisexual n With
LGBQ
is
Parents
severely
,
limited. Psycho
As asking social
about Outco
sexual mes;
orientatio Educati
n on;
Home–
becomes
School
less taboo,
Partner
more will ships in
be learned LGBT
about the Q-
importanc Parent
e (or lack Familie
thereof) s;
of LGBT
Q-
parents’
Parent
sexual Involve
orientatio ment
n for and
shaping Advoca
and cy in
influencin School
s;
g the
School
academic
Choice
outcomes in
of their LGBT
children. Q-
Parent
Daniel Familie
Potter s

See also
Adults
With
LGBQ
Parents;
Bullying,
Rates and
Effects
of;
Childre
n With
LGBQ
Parents,
Gender
Develop
ment
and
Identity;
 491

F d:
u The
r exper
t ience
h of
e lesbia
r n,
gay,
R bisex
e ual,
a
and
d
trans
i
gende
n
r
g
paren
s
ts and
Biblarz, their
T. J.,
childr
&
Stace en in
y, J. our
(2010 natio
). n’s
How K–12
does
schoo
the
ls.
gende
r of New
paren York,
ts NY:
matte Gay,
r?
Lesbi
Jour
an &
nal of
Marr Straig
iage ht
and Educa
Fami tion
ly,
Netw
72,
ork.
3–22.
Kosciw, MacCallu
m, F.,
J. G.,
&
& Golo
Diaz, mbok,
E. M. S.
(2008) (2004)
. .
Childr
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492

familie d,
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infanc .
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follow- (
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and ).
single N
heteros o
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logy il
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Psychi s
atry, a
45, n
1407– d
1419. c
Powell, B., hi
Bolzendahl ld
, C., Geist, h
C., & o
Steelman, o
L. C. d
(2010). p
r
Counte
o
d out:
g
Same- re
sex ss
relation th
s and r
o
Americ
u
ans’
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definitio h
n of s
family. c
New h
o
York,
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NY:
.
Russell D
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Rose m
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el g
 493

ra roma
p ntic
hy relati
, onshi
4 ps of
7( adole
3) scent
, s
75 with
5– same
77 -sex
5. paren
Tasker, F. ts.
(2005) Child
. Deve
Lesbia lopm
n ent,
mother 75(6)
s, gay ,
fathers 1886
, and –
their 1898.
childre
n: A
review
.
Devel CHILDRE
opmen
tal N WITH
and
Behav LGBQ
ioral
Pediat PARENT
rics,
26(3), S,
224–
240. FEMALE
Wainrigh
t, J.
/MALE
L.,
Russe
ROLE
ll, S.
T., &
MODEL
Patter S
son,
C. J.
(2004
This
).
Psych entry
osocia describes
l the
adjust female
ment, and male
school role
outco
models
mes,
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Children With LGBQ Parents, Female/Male Role Models

494

children children
with with
parents LGBQ
who are parents.
not Suggesti
heterosex ng that
ual. children
Beginning with
with a same-sex
review of parents
the need a
processes model of
by which the other
role gender is
models a
influence reflection
children’s of the
social and heterosex
identity ual
developm family as
ent, the the
entry standard
continues that other
with a families
descriptio must
n of the emulate.
role Under
models this
that exist model,
in the nonheter
lives of osexual
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with are
LGBQ expected
parents. to find
Finally, ways to
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addresses ate for
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possibilit es in
y that family
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sm is at The entry
the root of also
concern discusses
about an
male/fem alternativ
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models namely,
for that
 495

LGBQ they
parents observe
can the
construct behaviors
families of others
free of the in their
expectatio environm
ns and ent,
social known as
roles models.
embedded Children
in the often use
heterosex their
ual family parents
model. as
models,
but may
Role also
Models model
Social other
learning important
theory adults,
and later, siblings,
social peers, or
cognitive even
theory, television
both or
developed storyboo
by Albert k
Bandura, character
argue that s.
children Children
imitate, or can
model, observe
people in models
their showing
environm novel
ent. behaviors
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g to social children
learning have not
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passive Later,
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learn as behaviors
496

themselve tasks
s. increases
Observing children’
a model s interest
can also in and
serve to experienc
increase es with
or such
decrease objects or
children’s tasks.
inhibition Under
s social
surroundi cognitive
ng such theory,
behaviors. children
If a child are seen
was as more
nervous active in
about a their
task, developm
observing ent as
a model they
succeed at carefully
the task select
may from
prompt people in
the child their
to try it. environm
Models ent whom
also work they want
to draw to model.
children’s When
attention children
to certain observe a
objects model
and complete
increase a task,
children’s they
use of build
these feelings
objects or of
tools. efficacy
Finally, for that
observing task.
models’ With
positive efficacy
emotional children
reactions are more
to objects likely to
or during report
 497

interest in, accordin

as well as g to their
to persist gender.
in and As
seek out, children
activities model
that primarily
involve people of
such their own
tasks. One gender,
key they
componen become
t in more
children’s interested
selections in
of models activities
is the and
model’s objects
gender; associate
children d with
are more that
likely to gender.
choose a Children
model of build
their own efficacy
gender. for
gendered
tasks as
Role
they
Models watch
and models
Gender perform
Develop such
ment tasks.
With
According
increased
to Kay
efficacy,
Bussey
children
and
begin to
Albert
choose to
Bandura’s
participat
social
e in and
cognitive
practice
theory of
tasks that
gender
are seen
developm
as typical
ent,
for their
children
gender.
choose
Addition
models
ally,
498

children differenti
will not al
have the abilities
opportunit in
y to build gendered
efficacy tasks. If
in this
domains process
that are continues
not througho
performed ut
by their develop
models. ment,
For boys will
example, build
a boy may efficacy
choose to and
model capabiliti
men who es in
never masculin
perform e skills,
feminine and girls
tasks. will
Later, he increase
will be their
less likely efficacy
to choose and skills
activities in
that feminine
involve domains.
feminine Therefor
tasks and e,
less likely accordin
to persist g to the
if such social
tasks learning
seem theory,
frustrating children
. It is this need
process of models
model of their
selection, gender in
efficacy- order to
building, perform
and the
activity gender-
choices based
that social
explain roles
children’s expected
 499

by v
society. e
Howev s
er, when o
children f
select C
models
h
who
il
behave in
less d
gendered r
ways, e
they can n
build W
efficacy it
for tasks h
regardless L
of the G
stereotypi B
cality of Q
such
behaviors. P
Indeed,
a
when
r
children
e
observe
more n
egalitarian t
division s
of labor Early
between public
their and legal
parents, concerns
they about
report lesbian
more and gay
efficacy parents
for focused
nontraditi on the
onal tasks. role
models
Role available
M to their
o children.
It was
d
suggeste
el
d that
s these
in children
Li would
500

not have sons

exposure would
to or not be
relationsh able to
ips with perform
adult masculin
models of e tasks
each and
gender. would be
Concerns overly
were feminize
Children With LGBQ Parents, Female/Male Role Models
often d.
raised As a
about result of
children such
whose concerns,
gender research
was on
different families
from their headed
same-sex by
parents lesbian
(daughter and gay
s of gay parents
parents has been
and sons focused
of lesbian on
parents). available
In role
particular, models
judges in for
early children.
court In a study
decisions of
voiced planned
concerns lesbian
for sons families
being by Abbie
raised by Goldberg
lesbian and
mothers. Katherine
People Allen,
were more
concerned than two
that thirds of
without a mothers
male reported
parent in concerns
the home, about the
 501

impact finds that

that sons of
having no lesbian
male role parents
model are often
might in regular
have on contact
their with
children. grandfath
These ers and
women uncles.
had Similarly,
actively daughters
searched of gay
for men fathers
who could have
serve as important
models and
for their regular
children. contact
A with
significan grandmot
t body of hers and
research aunts.
indicates Both gay
that these and
concerns lesbian
were parents
unwarrant report
ed; having
children wide
with networks
parents of friends
who are of diverse
not genders
heterosex and
ual are sexual
likely to orientatio
have ns who
contact serve as
and models
relationsh for
ips with children
close in the
relatives family.
from their Parents
extended also
family. report
This that
research children
502

have research
neighbors, demonstr
coaches, ates that
teachers, gay and
and lesbian
parents of parents
the and their
children’s children
friends are
who may embedde
serve as d in a
same-sex large
models communi
for the ty of
children. family,
It friends,
seems that educators
the , and
concern peers
that who
children serve as
of gay or important
lesbian role
parents models
would not for
have children.
exposure
to
Are
samesex
models is Male/F
based on emale
the Role
heterosexi Model
st s
assumptio Necess
n that ary?
parents
It is also
who are
important
not
to reflect
heterosex
on the
ual isolate
premise
themselve
of the
s from the
question
wider
itself. Do
network
children
of adult
need a
supporters
model of
of
their
children.
same sex
Instead,
 503

to replicate
develop a
into traditiona
happy, l family
healthy, model,
and an
competent opportuni
adults? ty to
The rethink
question our
arises notions
because of
the families
culture’s is
definition missed.
of family If instead
has new
historicall family
y models
included were
both a investigat
man and a ed
woman. If without
lesbian- heteronor
and gay- mative
parented standards
families ,
are evidence
compared for
with this important
heteronor family
mative processes
family may
model it begin to
will emerge.
appear as
if these
families Other-
need to Sex
compensa Paren
te for the ts as
missing Model
father or s for
mother. Childr
When en
nonhetero
It has
sexual
been
parents
assumed
are asked
that,
to
504

insomuch able to
as model for
heterosex children
ual all of the
parents important
are character
presumed istics of
to healthy
specialize adulthoo
their d,
family regardles
roles and s of their
labor by gender.
gender, it Men can
is and do
therefore perform
important nurturing
to and
children’s expressiv
adjustmen e tasks
t to have a typically
parent of performe
each d by
gender. A mothers
close look in
at the heterosex
literature ualparent
on single ed
mothers families.
and Similarly
fathers, , women
primary can
caregivin model
g fathers instrume
and ntal
working behaviors
mothers, in the
and gay domains
and stereotyp
lesbian ically
parents attributed
reveals to men
that men (e.g., the
and work
women domain).
are both In an
capable of investigat
parenting ion of
children children
and are with
 505

lesbian mothers’
parents, reports.
Henny This
Bos and study is
her just one
colleagues of many
studied a that
sample of suggests
78 that
adolescent children
s in which do not
half need
reported significan
having t
male role interactio
models n with a
and half model of
reported a
not particular
having gender to
male role display
models. gendered
There was behaviors
no and to
difference show
in these healthy
children’s developm
masculinit ent.
y or
femininity
scores as Gen
a function d
of having er
a male R
role ol
model. e
Additiona A
lly, there d
was no h
difference er
in e
children’s
n
psycholog
c
ical
e,
adjustmen
t P
according sy
to their c
own and h
their ol
506

og adjustme
ic nt.
al However,
A research
dj indicates
that
us
children
t
and
m
adults
en who
t, show
an competen
d ce in
Ch both
ild stereotyp
W ically
ell masculin
- e and
Be feminine
in domains
are well-
g
adjusted
The and
concern healthy.
Children With LGBQ Parents, Gender Development and Identity
for Gender
children’s role
exposure flexibilit
to same- y allows
gender men to
models is create
also and
premised sustain
on the warm
assumptio connec-
n that tions with
building children,
skills in family,
gender- and
typical friends.
domains Such
is flexibilit
associated y also
with allows
children’s women
well- to
being and succeed
psycholog in
ical leadershi
 507

p and Less
career traditiona
domains l family
traditional organizat
ly ions, like
reserved those of
for men. gay and
Thus, lesbian
research parents,
suggests have
that parents
children who can
do not serve as
need to models
develop for more
gender- flexible
specific roles and
skills for a wider
well- range of
being and behaviors
adjustmen for
t. children
Under to model.
the When
heteronor children
mative use more
family gender-
model, flexible
men and models,
women they
are build
responsibl efficacy
e for for skills
different and tasks
tasks that are
inside and less tied
outside to
the home gender.
and Models
children are an
require important
same-sex compone
models in nt of
order to child
learn the developm
skills to ent, and
fulfill men and
these women
gendered can serve
roles. as
508

influential F
models to u
either r
boys or t
girls. h
e
Megan r
Fulcher
R
See also
e
Childre
a
n With
d
LGBQ i
Parents, n
Gender g
Develop s
ment
and Bos, H.,
Goldberg,
Identity;
N., Van
Childre
Gelderen,
n With L., &
LGBQ Gartrell,
Parents, N.
Psychos (2012).
ocial Adoles
Outcom cents of
es; the
Divisio U.S.
n of Nationa
Labor in l
LGBTQ Longitu
-Parent dinal
Familie Family
s; Study:
Heteron Male
ormativi gender
ty; role
Heteros traits
exism
and
psychol
ogical
adjustm
ent.
Gender
&
Society
, 26,
603–
638.
Clarke, V.,
&
 509

Kitinger, C. s of
(2005). male
“We’re not invo
living on lvem
planet ent
lesbian”: duri
Constructio ng
ns of male the
role models trans
in debates ition
about to
lesbian pare
families. ntho
Sexualities, od.
8, 137–152. Jour
Fulcher, nal
M., Chan, of
R. W., Mar
Raboy, B., riag
& e
Patterson, and
C. J. Fam
(2002). ily,
Contact 69,
with 352–
grandparent 365.
s among
children
conceived
via donor
inseminatio CHILDRE
n by
lesbian and N WITH
heterosexua
l mothers.
LGBQ
Parenting:
Science
PARENT
and
S,
Practice, 2,
61–76. GENDER
Goldber
g, A. DEVELO
E., &
Allen PMENT
, K.
AND
R.
(200
7).
IDENTIT
Imag Y
ining
men:
Lesbi Does
an
parental
moth
ers’ sexual
perce orientatio
ption n affect
510

children’s and gay”

gender parents
developm because
ent? And comparat
if so, how ively
and to little
what research
degree? has been
These conducte
questions d on self-
have been identified
widely bisexual
discussed or queer
in legal parents.
and Gende
policy r
debates, developm
such as ent is
those often
focused considere
on d to have
marriage, three
child aspects.
custody, The first
and is gender
adoption identity, a
by LGBQ person’s
adults. internal
They sense of
have also being
been the male or
subject of female.
considera This is
ble social generally
science discussed
research. in binary
This entry terms—
provides male or
an female—
overview but
of gender
research identity
findings can also
that fall
address outside of
these or
questions, between
focusing the
chiefly on typical
“lesbian binary
 511

categories ent are

. The discussed
second .
aspect of
gender
developm Gender
ent is Identity
gender Gender
role identity
behavior has been
and studied
attitudes: using
namely, both
Children With LGBQ Parents, Gender Development and Identity
the extent direct
to which a and
person’s indirect
activities assessme
and nt
preference technique
s conform s. Early
to studies
conventio employe
nal gender d indirect
norms. or
The third projectiv
aspect is e
sexual technique
orientatio s, such as
n, which the
concerns Rorschac
the sex of h test,
those to and
whom a reported
person that
feels children’
sexually s gender
attracted. identities
In the were not
discussion associate
below, d in any
results of systemati
research c way
relevant with
to each of parental
these sexual
three orientatio
aspects of n. More
gender recent
developm studies
512

using children
direct of lesbian
assessmen and gay
ts, such as parents
questionn has
aire explored
methods, develop
have ment of
come to gender
the same role
conclusio behavior
n. In and
short, and attitudes.
regardless Many
of studies
assessmen have
t reported
technique that the
s, results gender
of role
research behavior
have of
revealed children
that with
developm lesbian
ent of and gay
gender parents is
identity is similar to
not that of
related to children
parental with
sexual heterosex
orientatio ual
n. parents.
For
instance,
Gender one study
Role examined
Behavior children’
and s toy
Attitudes preferenc
es,
The activities,
greatest interests,
amount of and
research occupatio
on gender nal
developm choices,
ent and
among found no
 513

difference children
s between who had
children been
of lesbian naturally
versus conceive
heterosex d by
ual heterosex
mothers. ual
More couples.
recently, They
Anne used the
Brewaeys Preschool
and her Activities
colleagues Inventory
assessed , a
gender maternal
role report
behavior instrume
among 4- nt
to 8-year- designed
old to
children differenti
who had ate
been between
conceived masculin
via donor e and
inseminati feminine
on by behavior
lesbian among
couples, unselecte
and d samples
compared of
it with children
that of in
same- schools.
aged They
children found no
who had significan
been t
conceived differenc
via donor es
inseminati between
on by children
heterosex of lesbian
ual mothers
couples, and
and with children
that of of
same- heterosex
aged ual
514

parents on revealing
preference no
s for differenc
gendered es in
toys, gender
games, role
and behavior
activities. as a
Similar function
findings of
were parental
reported sexual
by a orientatio
number of n.
other One
investigat early
ors. Two study by
subsequen Richard
t studies Green
also and his
reported colleague
no s reported
significant some
difference isolated
s in differenc
gender es in
role gender
preference role
s or developm
activities ent as a
between function
children of
of gay parental
fathers sexual
and orientatio
children n. In
of interview
heterosex s with
ual children,
parents. the
Thus, researche
results of rs
studies reported
using the no
Preschool differenc
Activities es
Inventory between
have been children
consistent of lesbian
in mothers
 515

and those mothers

of were also
heterosex more
ual likely
parents than
with heterosex
respect to ual
favorite mothers
television to report
programs, that their
favorite daughters
television often
characters participat
, favorite ed in
games, or rough-
favorite and-
toys. tumble
There was play or
some occasiona
indication lly played
in with
interviews conventio
with nally
children masculin
themselve e toys
s that such as
those with trucks or
lesbian guns, but
mothers they
had less reported
conventio no
nally differenc
sextyped es in
preference these
s for areas for
activities sons.
at school Lesbian
and in mothers
their were
neighborh found to
oods than be no
did those more and
with no less
heterosex likely
ual than
mothers. heterosex
Consisten ual
t with that mothers
result, to report
lesbian that their
516

children of lesbian
often and
played heterosex
with ual
conventio mothers.
nally These
feminine researche
toys such rs found
as dolls. that boys
Thus, of lesbian
while mothers
there were reported
some more
difference feminine
s among (but not
girls as a less
function masculin
of e) gender
parental role
sexual preferenc
orientatio es
n, these compared
investigat with boys
ors found of
no heterosex
difference ual
s among mothers.
boys. They
In a reported
more no
recent differenc
study by es as a
Fiona function
MacCallu of
m and parental
Susan sexual
Golombo orientatio
k, the n among
Children’s girls.
Sex Role Thus,
Inventory while one
was used earlier
to study study
gender reported
role some
developm differenc
ent among es among
young girls but
adolescent not
offspring among
 517

boys, this gender

one found stereotyp
some es, and
difference also
s among unrelated
boys, but to
not children’
among s stated
girls. preferenc
Studies es among
by Megan current
Fulcher activities
and her or future
colleague adult
s and Erin occupatio
Sutfin and ns. On
her the other
colleague hand, the
s both researche
Children With LGBQ Parents, Gender Development and Identity
examined rs also
4- to 6- reported
year-old that
children lesbian
of lesbian mothers
or had more
heterosex liberal
ual attitudes
couples, about
using the gender
Sex Role role
Learning behavior
Index and and that
also a lesbian
Gender mothers
Transgres also
sion provided
questionn more
aire. They egalitaria
reported n models
that with
parental regard to
sexual division
orientatio of labor
n was in their
unrelated househol
to ds than
children’s did
knowledg heterosex
e of ual
518

parents. boy
Results wearing
also brightly
showed colored
that fingernail
lesbian polish).
mothers Henny
even Bos and
decorated Theo
their Sandfort
children’s recently
bedrooms reported
in less a study of
gender gender
stereotypi role
c ways developm
than did ent
heterosex among 8-
ual to 12-
mothers. year-old
Thus, it Dutch
was not children
surprising with
that lesbian or
children heterosex
reported ual
feeling parents.
less These
pressure investigat
from their ors
parents to studied
conform children’
to s
conventio conceptio
nal gender ns of
roles and their own
that they gender
also typicality
reported (i.e., the
feeling sense that
less one is a
concerned “typical
about girl” or a
other “typical
children’s boy”).
violations They also
of studied
gendered gender
norms contented
(e.g., a ness,
 519

which however,
was the report
degree to feeling
which less
children pressure
reported from
feeling their
happy or parents to
contented conform
in their to gender
gender norms,
identities. and more
These inclinatio
investigat n to
ors found question
no their own
significant heterosex
difference ual
s as a attraction
function s than did
of children
parental of
sexual heterosex
orientatio ual
n for parents.
children’s Consi
reports of dered
their own together,
gender the
typicality, results of
for research
children’s on gender
gender role
contented attitudes
ness, or and
for behavior
children’s suggest
reports of that,
pressure although
from children
peers to with
conform lesbian
to and gay
conventio parents
nal gender may
norms. receive
Children different
of lesbian input
mothers (such as
did, parental
520

division gender-
of labor related
and attitudes
parental may be
decoration more
of their liberal
homes), among
and hence children
that they of lesbian
may and gay
develop parents
more than
liberal among
attitudes, children
their of
gender- heterosex
relevant ual
behavior parents,
is the
neverthele research
ss very suggests
similar to that
that of gender-
children role
with behavior
heterosex is
ual remarkab
parents. ly similar
There is in the
more two
research- groups.
based
informatio
n about Sexual
younger Orienta
than older tion
children The third
and more compone
on nt of
children gender
with develop
lesbian ment,
mothers sexual
than on orientatio
children n, has
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 521

observers. a small
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studies interpret.
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proportio es as
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522

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 523

data are that

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regard to conventi
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identity; liberal
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role studies
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There are to be
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524

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clearest Parents
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Psycho
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research Childre
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that LGBQ
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children’s Relatio
attitudes nships
about
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topics, but u
not with r
children’s t
gender h
identities e
or gender- r
role
behavior. R
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Charlotte a
J. d
Patterson i
and n
Jason g
Sumontha s
Bos, H.,
See also &
Adults Sand
With fort,
LGBQ T. G.
Parents; M.
Children (201
With 0).
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Parents, dren’
Academ s
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Outcom er
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Childre ity in
n With lesbi
an
 525

and .
heter (201
osexu 0).
al Ado
two- ption
paren by
t lesbi
famili ans
es. and
Sex gay
Roles men:
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Brewaeys nsio
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Ponjae famil
rt, I., y
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E. V., New
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bok, NY:
S. Oxfo
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Donor ersit
insemi y
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develo Fulcher,
pment M., Sutfin,
and E. L., &
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functi C. J.
oning (2008).
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lesbia ual
n differen
mothe
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r
famili gender
es. develop
Human ment:
Reprod Associa
uction, tions
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1349– parenta
1359. l sexual
orientat
Brodzins
ky, ion,
D., & attitude
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an, A. divisio
(Eds.) n of
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Sex er.
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(2010). father
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M.
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Lamb
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their role
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n Green, R.,
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e. New s and
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raised i
in l
fatherl d
ess r
familie e
s from
528

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o Sutfin, E.
l L.,
o Fulcher
g , M.,
y Bowles
, , R. P.,
l &
a Patters
w on, C.
, J.
a (2008).
n How
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p heteros
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 529

n: The debates
role of in the
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United
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States
ments. and
Sex abroad,
Roles, particular
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concerni
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marriage
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CHILDRE sex
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SOCIAL These
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530

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This entry on
provides gender
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overview ent and
of social academic
science outcomes
research among
findings children
that with
address lesbian
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Children With LGBQ Parents, Psychosocial Outcomes
The but it is
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sections. are
Considera themselv
 531

es diverse in the
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type of existing
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involves in these
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In some called
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children lesbian-
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parent (or divorce.
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s both differenc
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as lesbian families,
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cases, the experienc
children es in
may be them may
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a lesbian significan
or gay t ways.
parent As in
after a other
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In other many
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lesbian or l kinds of
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children es
532

attributabl among
e to children
variations of
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religion, parents?
education, Many
etc.) also investigat
exist, but ors have
we focus studied
here this
mainly on question,
possible both in
difference the
s among United
children States
growing and in
up in Europe,
divorced over
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lesbian- and the
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parented findings
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remarkab
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Behavior consisten
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ent lesbian or
gay
Is the
parents
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behavior
overall
 533

adjustmen heterosex
t and ual
behavior. mothers.
In a In reports
well- of
known children’
early s
study behavior
published from
more than mothers
30 years and also
ago, from the
Susan children’
Golombo s
k and her teachers,
colleagues no
studied a significan
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10-year- differenc
old es
English between
children the
with behavior
divorced of
lesbian children
versus with
divorced lesbian
heterosex and
ual heterosex
mothers. ual
Using mothers
standardiz were
ed identified
measures . Similar
of results
adjustmen have
t and been
behavior reported
problems, by other
Golombo researche
k and her rs
colleagues working
compared in Europe
results for and in the
children United
with States.
lesbian Early
mothers data were
and those collected
with from
534

samples who were

of same-sex
volunteers couples
that were and
not compared
necessaril them
y with a
representa matched
tive of the group of
populatio youth
ns from living
which with
they were parents
drawn. who were
Later other-sex
studies in couples.
the United Using
States and standardi
in zed
England survey
were instrume
based on nts to
more assess
representa behavior,
tive the
samples. researche
For rs found
example, that the
Jennifer adjustme
Wainright nt of
and her those
colleagues living
, using with
data that same-
had been and
collected different-
for a sex
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representa was not
tive study reliably
of different.
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health in represent
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s living convenie
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parents samples,
 535

the parents
overall had
adjustmen conceive
t and d them
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patterns assuming
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children gay
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revealed coming
any out).
systematic Again,
variability studies
as a on both
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of the
parental Atlantic
sexual led to
orientatio similar
n. conclusio
Many ns.
of the Raymond
early Chan and
studies his
compared colleague
behavior s studied
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families United
that States,
Children With LGBQ Parents, Psychosocial Outcomes
conceived comparin
children g
in the developm
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heterosex among
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marriages. who were
This conceive
raised a d by
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whether heterosex
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children of a
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536

sperm conclusio
bank. ns.
Whether An
considerin area of
g parent behaviora
or teacher l
reports, adjustme
Chan and nt that
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colleagues received
reported particular
that there study is
were no that of
difference the use of
s in substance
overall s such as
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t or alcohol,
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as a drugs. In
function the
of Netherlan
parental ds,
sexual Henny
orientatio Bos and
n. Studies her
conducted colleague
in Europe s
and by compared
other self-
American reported
scholars substance
yielded use
similar among
findings. adolescen
More ts of
recently, lesbian
studies of mothers
gay versus
fathers those of
and their heterosex
children ual
have parents.
reported They
similar reported
findings no
and have significan
come to t
the same differenc
es
 537

between ts may
reports of vary as a
any type function
of of
substance parental
use in sexual
these two orientatio
groups. n. Using
Similar a six-
results item
have been scale that
reported required
in other adolesce
parts of nts to
Europe respond
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United such as
States. “feeling
Overall, loved and
there is no wanted”
evidence or
of “feeling
difference socially
s in accepted,
adjustmen ” Jennifer
t or Wainrigh
behavior t and her
as a colleague
function s
of compare
parental d self-
sexual esteem
orientatio among
n. adolesce
nts
(drawn
Self- from a
Concept national
Researche sample in
rs have the
also United
studied States)
the extent living
to which with
self- parents
concepts who were
of same-sex
children versus
and different-
adolescen sex
538

couples. between
Their youth
results reared by
revealed lesbian or
no gay
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s between and those
youth reared by
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with ual
same-sex couples
versus have
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sex identified
parents. .
In studies Social
of lesbian Relation
mothers ships
and their
children, Many
similar observers
findings have
have been predicted
reported differenc
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American social
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scholars. children
More and
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similar nts
findings growing
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been lesbian or
reported gay
with versus
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children parents.
of gay If only
fathers. In because
short, of the
after 30 existence
years of of stigma
research, and
no discrimin
difference ation,
s in self- some
concepts observers
 539

have relationsh
anticipate ips
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of lesbian children.
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parents might
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s in their children
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In the same-sex
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English and
children predomin
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divorced The
heterosex quality of
ual children’
mothers s
by Susan relationsh
Golombo ips with
k and her peers was
colleagues described
, the in
authors positive
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relationshi mothers,
ps in regardles
middle s of
childhood maternal
. sexual
Regardles orientatio
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reported investigat
typical ors in the
patterns United
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540

A 2008 the same

study by number
Jennifer of friends
Wainright and the
and same
Charlotte overall
Patterson relationsh
compared ip quality
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relations friends as
among did youth
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s (drawn different-
from a sex
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States) of friends
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ts were parents
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s, and parents in
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from their networks
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school. overall
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with y among
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parents Like
reported friendshi

Children With LGBQ Parents, Psychosocial Outcomes

 541

ps, the ually

romantic parented
relationsh peers. In
ip addition,
experienc in two
es of studies
children that
with assessed
same-sex this, the
parents likelihoo
have been d of
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interest to ts
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Several were
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States, was
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quality of A
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ips as do have
their examined
heterosex the extent
542

to which experienc
children e. A
and number
adolescent of studies
s with have
nonhetero revealed,
sexual however,
parents that
are teased offspring
or bullied of lesbian
by peers. and gay
Many parents
researcher are not
s have more
reported likely
that, than
especially other
in early children
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ce, youth teased or
with bullied. If
lesbian or a child of
gay lesbian or
parents gay
report parents is
hearing teased or
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comments is more
about likely
their than it is
families, for other
about children
lesbian/ga to focus
y people, in some
and/or way on
about their
lesbian/ga parents’
y sexual
parenting. identity.
Those The
who evidence
report does not,
having however,
heard suggest
such that
comments children
agree that or
it was an adolescen
unpleasan ts with
t lesbian or
 543

gay parental
parents sexual
are orientatio
overwhel n. Early
med or studies
traumatize on both
d by sides of
whatever the
teasing or Atlantic
bullying showed
they may that
experienc lesbian
e. On the and
contrary, heterosex
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the United mothers
States and described
in Europe their
have children’
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uncover with
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lasting outside
impact on the
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overall Relations
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Resear regardles
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qualities orientatio
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children’s studies of
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adults, as relationsh
a function ips with
of grandpar
544

ents, bothamong
conducted children
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of lesbian
United and gay
States, parents?
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reported predictor
that theses of
relationshi
healthy
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possibility
able
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Individua ment of
l children
Differenc with
es heterosex
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What
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 545

developm In
ent addition
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546

relationshi research
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researcher reported
s have from
found that other
overall parts of
outcomes the
among world, as
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Conclusi concept,
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ly,
 547

en Charlotte J.
Wi Patterson
th and
L
Bernadette
G
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See also
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Adults
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With
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Parents
children ,
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associated Identity
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parental Parent–
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nships
n.
548

F Goldberg,
u A. E.
r (2010).
t Lesbian
h and gay
e parents
r and
their
R childre
e n:
a
Resear
d
ch on
i
the
n
family
g
life
s
cycle.
Farr, R. Washin
H.,
gton,
Forss
ell, S. DC:
L., & Americ
Patter an
son, Psychol
C. J. ogical
(2010
Associa
).
tion.
Paren
ting Goldb
and erg
child ,
devel A.
opme
E.,
nt in
adopti &
ve All
famili en,
es: K.
Does R.
parent
(Ed
al
sexua s.).
l (20
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550

e 9, 230–
l 253.
o Palewski,
p J. G.,
m Perrin, E.
e C., Foy, J.
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t. C. E.,
H
Cr
o
a
b
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n
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M
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est r
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par n
tne
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y mporar
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Walker
 553

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Wainrigh
t, J. One of
L., the
Russe primary
ll, S.functions
T., &
of family
Patter
son, is the
C. J. socializat
(2004 ion of its
). members,
Psych including
osociasocializat
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ment, sexuality.
schoolSexuality
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554

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 555

developm children
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often Until
have done studies
so in the utilizing
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determini represent
ng ative
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individual conducte
s are more d, the
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as whether
nonhetero children
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than parents
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ual as LGBQ
parents. than
This line children
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suggest ual
that it is parents
“bad” if will
556

remain 1990s,
unanswer found
ed. That that
said, most young
studies on adults
this topic with
have lesbian
reported mothers
that the were
vast more
majority open than
of youth young
and adults adults
with with
LGBQ heterosex
parents ual
identify mothers
as to the
heterosex idea of
ual and entering
are into
similar to same-sex
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offspring ips. A
of 2010
heterosex study by
ual Henny
parents in Bos, a
regard to social
same-sex and
attraction. behaviora
Some l
studies, scientist,
however, and Theo
have Sandfort,
revealed a social
nuanced psycholo
findings: gist,
Groundbr reported
eaking that
work by school-
psycholog age
ists Fiona children
Tasker of lesbian
and Susan mothers
Golombo were
k, more
published likely to
in the question
mid- their
 557

future lesbian-
heterosex parent
ual families
romantic that the
involveme teenage
nt than daughters
children of lesbian
of mothers
heterosex were
ual more
parents. likely
Similarly, than
a 2007 daughters
qualitative of
study of heterosex
adults ual
with parents to
lesbian, identify
gay, and as
bisexual bisexual
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parents by have
psycholog engaged
ist Abbie in same-
Goldberg sex
relayed sexual
that some behavior.
participan Scholars
ts felt that have
growing posited
up with a that
nonhetero growing
sexual up in a
parent led familial
them to environm
develop ent where
less rigid same-sex
ideas relationsh
about ips and
sexuality. LGBQ
In 2011, identities
psychiatri are
st Nanette modeled
Gartrell and,
and her perhaps,
colleagues not
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longitudin lead
al study of children
558

to be parents
more might
open to influence
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possibility s sexual
of such identity
relationshi and
ps and behavior
identities could
for fuel
themselve heterosex
s. ist
Relativ criticisms
ely little of
research LGBQ-
exists on parent
the sexual families.
socializati For
on of example,
youth in findings
LGBQ- that some
parent LGBQ
families, parents
likely intention
because ally aim
the topic to teach
is their
politically children
sensitive. that there
Researche are
rs may options
worry that beyond
findings heterosex
from uality
studies may be
Childre interprete
n With d as
LGBQ LGBQ
Parents,
parents
Sexual
Identity
trying to
pressure
their
that children
explore toward
how samesex
being sexual
raised behaviors
with and
nonhetero relations
sexual hips.
 559

However, st
by failing perspecti
to move ve that
forward assumes
with such all LGBQ
studies, parents
researcher raise their
s not only children
succumb in the
to same
heterosexi way, a
st handful
pressures of studies
but also have
miss an explored
opportunit what
y to learn LGB
more parents
about teach
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identity children
developm about
ent in sexual
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There n and
may be found
important that many
lessons to lesbian
be learned mothers
from purposef
examinin ully teach
g sexual diverse
socializati notions
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ent beyond
families, just
such that heterosex
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families Notably,
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knowledg be
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to avoid a heterosex
reductioni ual
560

parents. way,
Although devoid of
any parent shame
could and
teach their stigma.
children A few
diverse studies
notions of have
sexuality, investigat
LGBQ ed LGBQ
parents’ parents’
experienc expectati
es of ons and
having a preferenc
nonhetero es for
sexual their
sexual children’
identity s sexual
could orientatio
influence ns and
their found
intentions. that these
LGBQ parents
parents hold
may have diverse
experienc perspecti
ed ves. In a
stigmatiza study
tion tied conducte
to their d by
nonhetero psychiatri
sexual st
identity; Ghazala
as a Javaid in
result, the early
some 1990s, 7
LGBQ out of 13
parents lesbian
might mothers
want their expressed
children an
to learn acceptanc
about e of, but
sexual not
orientatio preferenc
n in a e for,
more their
positive children
and to be
accepting LGBQ,
 561

while 3 children
reported to be
homosexu heterosex
ality to be ual,
more while
acceptable four were
for their unsure,
daughters and one
than for expected
their sons, his child
and 3 to be
preferred bisexual;
that their all said
children they
be would
heterosex accept
ual. A their
study children’
published s
in 1997 eventual
by sexual
sociologis orientatio
t Cary n
Costello regardles
reported s, “while
that 13 of four went
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Ch state a
ild preferenc
re e for
n
their
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th
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Study
xu participa
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Ide preferred
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ty uality for
their
children
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referred
expected
to the
their
homopho
562

bia that ual to

LGBQ avoid
individual struggles
s face as with
the reason homopho
for their bia.
preferenc Those
e. Early mothers
reports who did
(1999 and hope that
2000) their
from children
Nanette would be
Gartrell lesbian or
and gay “did
colleague not see
s’ homopho
longitudin bia as a
al study deterrent
document to
ed happines
changes s.” By
in 150 the time
lesbian the
mothers’ children
hopes were 5
over time. years old,
When 65% did
their not report
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were 2 preferenc
years old, e, while
50% of 21%
the hoped
mothers their
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report a would be
preferenc heterosex
e for their ual.
children’s When
future these
sexual same
orientatio children
n, while were 10
28% years old,
wanted over half
their of the
children mothers
to be said they
heterosex could not
 563

predict lesbian
their mother,
children’s Dan
sexual Cherubin
orientatio created
ns, while an
more than organizat
one third ion for
anticipate LGBTQ
d their youth
children and
being adults
heterosex with
ual, and LGBTQ
10% parents
predicted and
their named it
children “Second
would Generati
identify on.”
as LGBQ. Soon
afterward
, he
“Second- partnered
Generati with
on” COLAG
Youth E, a
national
Few organizat
studies ion run
have by and
explored for
the individua
experienc ls with at
es of least one
sexual- LGBTQ
minority parent.
youth Cherubin
with ’s and
LGBQ others’
parents. experienc
In the es as
early second-
1990s, as generatio
a result of n
his LGBTQ
experienc individua
es as a ls are
gay man shared in
with a the
564

groundbre experienc
aking es among
book by this
writer and group:
queer
family Alth
activist oug
Abigail h
Garner, “sec
titled ond
Families gen
Like erati
Mine: on”
Children is
of Gay an
Parents umb
Tell It rella
Like It Is ter
(2004). m
For her for
book, all
Garner LG
BT
interview
kids
ed more
with
than 50
LG
young
BT
adults
pare
with
nts,
LGBTQ
ther
parents,
e is
some of
no
whom
defi
also
niti
identified
ve
as
seco
LGBTQ.
nd
In her
gen
chapter
erati
called
on
“Second
fam
Generatio
ily
n: Queer exp
Kids of erie
LGBT nce
Parents,” that
Garner repr
highlights esen
the ts
diversity the
of
 565

m generatio
all. . n refers
. . A to all
lesbi nonheter
an osexual
daug and/or
hter gender-
of nonconfo
polit rming
icall individua
y ls with a
activ nonheter
e osexual
lesbi and/or
an genderno
moth nconform
ers, ing
for parent.
exa Followin
mple g
, will Garner’s
have work, in
a 2009,
diffe Katherine
rent Kuvalank
seco a and
nd Abbie
gene Goldberg
ratio
, two
n
scholars
expe
who
rienc
study
e
LGBQ-
than
parent
a
families,
daug
conducte
hter
d the first
raise
in-depth
d by
study of
a
second-
close
generatio
ted
n
gay
individua
dad.
ls
(p.
document
179)
ed in the
social
Thus,
science
the term
literature:
second
Namely,
566

they identifies
examined as
the LGBTQ
experienc may be
es of 18 experienc
LGBTQ ed as
young potentiall
adults y
with beneficial
lesbian , in that
and some
bisexual participa
mothers. nts felt
Many of that the
Kuvalank coming-
a and out
Goldberg’ process
s findings was less
echoed arduous
and than it
extended might
those of have
Garner, been with
lending heterosex
credence ual
to her parents.
pioneerin Some of
g Kuvalank
discussion a and
of the Goldberg
diverse ’s
experienc participa
es of the nts said
second that
generation having a
. nonheter
Both osexual
Garner’s parent
and allowed
Kuvalank them to
a and explore
Goldberg’ and
s research question
revealed their
that sexual/ge
having nder
nonhetero identities
sexual at a
parents younger
when one age than
 567

other e may
youth. As neutralize
such, society’s
participan powerful
ts homoneg
believed ative
that messages
having and foster
LGBTQ greater
parents self-
allowed acceptanc
them to e and
conceptua self-
lize esteem.
broader Indeed,
notions of for some
acceptable participa
sexual nts, their
and uniquely
gender supportiv
identity e familial
options environm
for ents led
themselve them to
s. construct
Furthermo their own
re, many emergent
participan identities
ts did not as normal
worry and
about acceptabl
rejection e.
upon Further,
disclosure having a
of their strong
identities connectio
to their n to the
LGBTQ LGBTQ
parents. communi
For some ty from a
second- young
generation age may
individual deepen
s, their understan
parents’ ding of
identificat LGBTQ
ion, history
support, and
and culture.
acceptanc Garner
568

posited parents to
that it is be
beneficial heterosex
for ual and
second- gender
generation conformi
individual ng, and
s to grow some
up with delayed
“out” and coming
“proud” out as
parents, LGBTQ
who can due to
serve as fears of
positive fulfilling
role critics’
models, assertions
thus that “gay
lessening parents
the raise gay
developm kids.”
ent of Some
internalize participa
d nts also
homopho expressed
bia among annoyanc
these e and
youth. feelings
Several of
participan disempo
ts in both werment
Garner’s as a
and result of
Kuvalank the
a and assumpti
Goldberg’ on that
s research their
discussed sexual/ge
unique nder
challenges identities
they faced were
as second- caused by
generation their
youth. parents.
Some Other
participan participa
ts felt nts
pressure reported
from their concerns
LGBTQ related to
 569

being not
LGBTQ, guarantee
including d
initially protectio
not n against
wanting the
to be influence
LGBTQ of
after societal
witnessin heteronor
g the mativity.
prejudice Interes
and tingly,
discrimina Kuvalank
tion that a and
their Goldberg
parents found
endured. that some
Second- participa
generation nts did
youth are not turn
inevitably to their
confronte lesbian/
d with the bisexual
heterosexi mothers
sm their for
parents support
have during
faced and their
understan sexual
d they and
may face gender
similar identity
struggles, formation
which . In
may cause particular
ambivalen , sons of
ce or fear lesbian/bi
about sexual
coming mothers
out as tended to
LGBTQ. look
These elsewher
experienc e for
es reveal support.
that In
having a addition
nonhetero to the
sexual obvious
parent is gender
570

difference es
between between
mothers the first
and sons, and
sons may second
also be generatio
hesitant to ns—also
discuss seemed
their to play a
emerging role.
Childre Some of
n With the
LGBQ youth/yo
Parents,
ung
Sexual
Identity
adults
and their
parents
sexualities disagreed
with their about
mothers how
because “out” to
of their be in
perceptio their
n that communi
aspects of ties and
gay male also
culture utilized
(e.g., different
pornograp language
hy) may (e.g.,
clash with queer as
their opposed
mothers’ to
political/ lesbian
lesbian/fe or gay) to
minist describe
ideologies their own
. identities.
Additiona Last,
lly, a some
“queer participa
generatio nts in
n gap”— Garner’s
stemming and
from Kuvalank
difference a and
s in social Goldberg
norms ’s
and research
experienc discussed
 571

disappoint sexual-
ment identity
upon developm
disclosing ent of all
their youth—
LGBTQ heterosex
identities ual and
to their LGBTQ
LGBQ —with
parents, heterosex
especially ual and
when nonheter
parents osexual
remained parents.
closeted Research
about findings
their own from the
identities. Family
Accordin Acceptan
g to these ce Project
participan have
ts, their begun to
LGBQ reveal the
parents powerful
had fears influence
about of
heterosexi familial
st acceptanc
discrimin e and
ation that rejection
their of
children youth’s
might sexual
face or identities
worried on young
that people’s
others well-
would being.
“blame” Indeed,
them for there is
their still much
children’s to learn
LGBTQ about all
identity. individua
More ls’ sexual
research socializat
is needed ion
that across the
investigat life span.
es the
572

Katherine F
A. u
Kuvalank r
a and t
Katie M. h
Barrow e
r
See also
Adults R
With e
LGBQ a
Parents; d
Children
i
With
n
LGBQ
g
Parents,
Female/ s
Male Cohen, R.,
Role &
Models; Kuvala
Childre nka, K.
n A.
With (2011).
LGBQ Sexual
Parents, socializ
Gender ation in
Develop lesbian-
ment parent
and familie
Identity; s: An
Childre explora
n With tory
LGBQ analysi
Parents, s.
Psychos Americ
ocial an
Outcom Journa
es; l of
Childre Orthop
n With sychiat
LGBQ ry, 81,
Parents, 293–
Stigmati 305.
zation; doi:10.
COLA 1111/j.
GE 1939-
0025.2
011.01
098.x
Childr
en
With
LGBQ
Parent
s,
 573

Stigmat resear
ization ch
and
implic
Family ations
Acceptance for
Project. practi
familyproje ce (pp.
ct/sfsu.edu 163–
Gabb, J. 175).
(2004). New
Sexualit York,
y NY:
educatio Spring
n: How er.
children doi:10
of .1007/
lesbian 978-1-
mothers 4614-
“learn” 4556-
about 2_11
sex/ualit Mitchell,
y. Sex V.
Educati (1998).
on, The
4, 19– birds,
34. the
doi:10.1 bees . .
080/146 . and
818104 the
200017 sperm
6515 banks:
Kuvalanka, How
K. A. lesbian
(2013). The mother
“second s talk
generation” with
: their
LGBTQ childre
children n about
of sex and
LGBTQ reprodu
parents. ction.
In A. E. Americ
an
Goldbe
Journa
rg &
l of
K. R.
Orthop
Allen
sychiat
(Eds.),
ry, 68,
LGBT-
400–
parent
409.
familie
doi:10.
s:
1037/h
Innova
008034
tions
9
in
574

parents’
sexual
CHILDRE orientatio
N WITH n. It
defines
LGBQ stigmatiz
ation,
PARENT explains
S, who is
stigmatiz
STIGMA ed, and
TIZATION when and
where
stigmatiz
ation is
Children
more
with
likely to
LGBQ
occur.
parents
The entry
may
discusses
encounter
children’
stigmatiza
s
tion
responses
related to
to
their
stigmatiz
parents’
ation,
sexual
and
orientatio
conclude
n. Such
s with
experienc
ways to
es have
limit
implicatio
stigmatiz
ns for
ation and
their
its
psycholog
negative
ical
effects.
adjustmen
t. This
entry
What Is
describes
stigmatiza
Stigmati
tion that zation?
children Stigmatiz
with ation is
LGBQ the
parents experienc
experienc e of
e as a being
result of teased,
their harassed,
 575

bullied, Bullying
excluded, tends to
disapprov be
ed of, compose
devalued, d of a
ostracized large
, or number
discrimin of
ated seemingl
against. y trivial
The instances
degree of that
stigmatiza occur
tion can over a
vary: long
Teasing, period of
for time. In
instance, contrast
occurs to
when bullying,
someone harassme
makes fun nt is
of or systemati
attempts c or
to unwanted
provoke aggressiv
another e
person, pressure
while or
bullying intimidati
refers to a on,
pattern of whereby
behavior an
that has a unpleasa
negative nt or
impact on hostile
the situation
victim, is created
where the through
victims verbal or
feel physical
threatened conduct.
and LGBQ-
unable to parent
protect families
themselve are
s because formed in
of the the
imbalance context
of power. of a
576

society (a) those

that who bear
favors the
opposite- stigma
sex and (b)
sexuality those
and who do
relationsh not bear
ips, and the
as a stigma
result, are but risk
more being
likely to affiliated
experienc with the
e stigmatiz
stigmatiza ed (i.e.,
tion. children
Erving of LGBQ
Goffman’ parents).
s theory Children
of social of LGBQ
stigma parents
defines both bear
stigma as stigmas
an and are
attitude, affiliated
behavior, with the
or stigmatiz
reputation ed.
that is Because
socially of their
discreditin parents’
g in a sexual
particular orientatio
way. An n, they
individual are at risk
is of facing
mentally discrimin
classified ation and
by others harassme
as an nt.
undesirabl
e, rejected
stereotype Who Are
. Goffman the
describes Stigmati
several zed?
categories
In spite
of stigma,
of
including
 577

changing parents
laws will
protecting experienc
LGBQ e
rights, a adjustme
substantia nt
l number difficulti
of people es and
still hold exhibit
negative behavior
views al
about problems
homosexu . Gay
ality and fathers in
bisexualit particular
y. Many are
people evaluated
still view more
LGBQ negativel
parents as y as
unfit parents
parents than
despite heterosex
the lack uals
of because
empirical of gender
evidence and
to support sexual
this orientatio
belief. n biases:
Other Men in
people general
worry that are not
the expected
developm to be
ent of adequate
sexual parents,
and and if
gender they are
identity in gay, they
children are not
of LGBQ expected
parents to be
will be suited for
impaired. parentho
Still od. In
others contrast,
fear that lesbian
children women
of LGBQ face only
578

sexual Europe,
orientatio for
n bias: instance,
They are people
thought to are less
be poor likely to
parents support
because equal
of their parenting
sexual rights,
orientatio while in
n, not the
because United
they are States,
women. people
Those are less
who are likely to
prejudiced support
vary by equal
age and marriage
by range rights.
of support These
(or lack prejudice
thereof) s are
for LGBQ often
parents. justified
Older through
adults, for explanati
instance, ons of
tend to concern
have for
stronger children’
prejudice s welfare.
against For
LGBQ example,
parents parental
than sexual
younger orientatio
adults. n is
The range frequentl
of support y
for equal considere
marriage d by
rights and judges
equal when
parenting deciding
rights child
varies by custody
geography outcomes
. In . LGBQ
 579

parents their
therefore intention
are to have
directly children.
affected Nonbiolo
by gical
stigmatiza parents in
tion. By particular
extension, tend to
children receive
may face less
discrimina support
tion, from
harassmen family
t, and members
bullying when
because they
of their decide to
parents’ have
sexual children,
orientatio particular
n. ly when
Family coparent
members adoptions
can also are not
be the available,
source of because
stigmatiza family
tion for members
many are
LGBQ- concerne
parent d that
families. contact
Some with the
LGBQ nonbiolo
parents gical
report children
receiving is not
less legally
support protected
from in the
family event that
members, the same-
such as sex
their couple’s
parents relationsh
and ip ends.
siblings, In states
when they where
announce same-sex,
580

second- difficult
parent for the
adoption LGBQ
is parents
available, and their
family children.
members The
tend to be disappro
more val of
supportive family
. members
Family is another
members way that
may react LGBQ-
negatively parent
for a families
variety of are
reasons. stigmatiz
For ed. Thus,
instance, from the
they may very
have beginnin
religious g,
or moral children
oppositio of LGBQ
ns to the parents
idea of may feel
LGBQ devalued
parents by their
having own
children. extended
The family
process of members.
adoption
may be
something W
family h
members e
do not n
support, a
particularl n
y if it is a d
transracial W
adoption. h
Family er
members e
might be
D
concerned
o
that life
will be es
 581

S Stigma
ti tizatio
n
g
m
adevelopm
tient and
zthat
aprotect
tiagainst
othe
effects of
n
bullying,
H
such as
ahaving a
pstrong
prelations
ehip with
none’s
?parents,
Children having
raised by parents
LGBQ with a
parents strong
tend to be sense of
remarkabl competen
y ce, and
resilient, being in
both a family
socially that has
and social
psycholog and
ically, economic
even in support.
the face These
of factors
stigmatiza can
tion. outweigh
There are the
many effects of
other stigmatiz
factors ation.
that Childr
bolster en with
healthy LGBQ
Childre parents
n With may have
LGBQ strong
Parents social
, skills and
582

good stigmatiz
relationshi ation.
ps with Howe
friends, ver, even
but at the if the
same time rates of
may also stigmatiz
experienc ation are
e bullying the same,
because the
of their content
family likely
structure. differs
Studies for
that children
compare of LGBQ
the parents
experienc versus
es of heterosex
stigmatiza ual
tion with parents.
children For
of LGBQ instance,
parents children
and of LGBQ
children parents
of are more
different- likely to
sex be teased
parents for
are mixed. having
Some two
suggest mothers,
that for not
children having a
of LGBQ father, or
parents for
are having a
stigmatize lesbian
d more, mother.
while Boys in
other particular
studies are likely
suggest to be
that there teased
is no about
difference being gay
in the themselv
amount of es,
whether
 583

true or excluded
not. more
Although than girls
the because
frequency of their
of teasing family
may be structure
the same and to be
for more
children hyperacti
of ve, while
heterosex girls tend
ual to
parents experienc
and e more
children gossip
of LGBQ about
parents, them and
the to have
content of lower
the self-
teasing is esteem.
likely to As
be children
different of LGBQ
between parents
these grow
groups, older,
with they may
children be more
of LGBQ likely to
parents experienc
experienci e teasing
ng teasing at certain
around developm
their ental
parents’ stages.
sexual For
orientatio instance,
n. preschool
Additiona -aged
lly, there children
are are
difference unlikely
s in to
reaction experienc
by e teasing
gender: related to
Boys tend their
to be parents’
584

sexual G
orientatio B
n, but as Q
Pa
children
re
grow nt
older and s,
move into St
formal ig
schooling, m
such ati
teasing za
tio
becomes
n
more
frequent.
Middle The
school in intensity
particular of
is where stigmatiz
many ation
children depends
experienc on the
e geograph
stigmatiza ic region
tion more and
intensely. neighbor
If children hood in
of LGBQ which
parents LGBQ-
feel parent
unsafe families
due to live. For
perceived instance,
stigmatiza families
tion, they that live
may be in more
more liberal
likely to areas
skip may not
school in experienc
an attempt e as
to avoid much
potential stigmatiz
harassmen ation as
t. families
Ch who live
ild in
re
conservat
n
ive
Wi
th locations.
L Children
 585

in and
families bullying
who are because
able to of their
attend parents’
progressiv sexual
e or orientatio
private n,
schools children
may not of LGBQ
face as parents
much peer tend to
discrimina respond
tion as in several
children ways.
of LGBQ- First,
parent children
families may
in public directly
schools. address
However, the
not all teasing
families through
are able to confronti
afford to ng the
send their perpetrat
children or. They
to private may tell
schools, the
and not all perpetrat
families or that
are able to their
move to comment
more s are
progressiv unaccept
e able or
neighborh unwanted
oods. ,
asserting
themselv
Children’ es
s through
Respons confronti
es to ng the
Stigmatiz bully.
ation Second,
they may
Confronte also
d with solicit
teasing help from
586

teachers, such as
peers, or “parents”
other instead of
supportiv “fathers,”
e people most
in an children
effort to are direct
stop the and
teasing. honest
Third, about the
they may structure
try to of their
defend family.
their They
parents often opt
against to
bullies, disclose
which can the fact
lead to that they
further have two
conflict. moms or
In spite two dads
of the fact to
that they whoever
may be asks.
teased Howe
because ver, some
of their children
parents’ try to
sexual control
orientatio how
n, much
children informati
of LGBQ on they
parents give to
are their
unlikely friends
to hide and peers
their concernin
family’s g their
status. family,
While it particular
might be ly as they
easier to get older.
mask their Some
family children
status might be
through more
using open with
terms close
 587

friends aged,
about some
their have
families, found
and might that their
avoid parents’
discussing sexual
that part orientatio
of their n is met
lives with with
acquainta more
nces and positive
peers. By reactions.
regulating Their
how much peers, for
informatio example,
n is given may
to peers think that
and it is
controllin “cool”
g how that they
“out” they have two
are about mothers
their or two
family fathers.
structure, As
children children
of LGBQ mature
parents into
are adulthoo
sometime d, they
s able to become
limit more
teasing accepting
related to of
their diversity,
parents’ including
sexual diversity
orientatio associate
n. d with
Interest sexual
ingly, as orientatio
children n and
and family
adolescent structure.
s with This
LGBQ acceptanc
parents e of
become sexual
college- orientatio
588

n and others
family might
structure think
as about
children their
grow partner’s
older has family
limitation and may
s. As be
children unwilling
of LGBQ to risk
parents facing
grow stigmatiz
older and ation
romantic through
relationshi associatio
ps n with
become the
important, LGBQ
they family.
sometime As a
s find that result of
potential stigmatiz
partners ation,
are not children
interested of LGBQ
in being parents
in a may have
relationshi a
p with heightene
someone d
who has sensitivit
two moms y to
or two homopho
dads. Men bia that
are less they see
accepting in
of being friends,
in peers,
relationshi and
ps with strangers.
children These
of children
lesbians. may have
The more
potential difficulty
partners trusting
may be others,
afraid of feeling
what the need
 589

to be protected
guarded from the
and effects of
cautious, bullying,
especially as their
when parents
forming would
new have
relationshi more
ps. financial
resources
. Having
Protec more
tive financial
Factor resources
s means
Agains that
t parents
Stigma have
tizatio more
n flexibilit
y in what
The
neighbor
broader
hoods
school
they
context
choose to
and
live in,
family
what
processes
support
may help
groups
to offset
they are
some of
able to
the
access,
negative
and what
effects of
schools
stigmatiza
they can
tion.
afford to
Additiona
Children With Transgender Parents, Psychosocial
Outcomes
lly, send their
children children
from to, all of
middlean which
d upper- can
middle- protect
class the child
families from
may be teasing.
more White
590

LGBQ stigmatiz
families ation
tend to be children
more of LGBQ
protected parents
by class may
privilege experienc
than e because
LGBQ of their
families parents’
of color. sexual
Other orientatio
protective n, these
factors children
against are
stigmatiza remarkab
tion ly
include resilient.
having They
friends tend to be
with socially
LGBQ competen
parents, t and
attending have
a school high-
that uses quality
LGBTQ- relationsh
friendly ips with
curricula, their
and friends.
having Academi
strong cally,
parent– they
child perform
relationsh as well as
ips. These children
protective of non-
factors LGBQ
can help parents.
to limit They also
the tend to be
negative more
impact empatheti
that c toward
stigma groups
has on that are
well- marginali
being. zed,
In spite likely as
of the a result
 591

of having Nonhet
experienc erosexu
ed al
stigmatiza Childre
tion n of
LGBT
themselve
Q
s. Even in Parents
the face of ;
stigmatiza Resilie
tion, with nce and
the right Protecti
support, ve
children Factors
, Youth
of LGBQ
parents
can thrive.
F
Kaitlin A. u
Black and r
Abbie E. t
Goldberg h
e
See also r
Adults
With R
LGBQ e
Parents; a
Childre d
n With i
LGBQ n
Parents, g
Psychos s
ocial
Gartrell,
Outcom N. K.,
es; & Bos,
Childre H. M.
n With W.
Transge (2010).
nder US
Nationa
Parents,
l
Psychos Longitu
ocial dinal
Outcom Lesbian
es; Family
Divisio Study:
n of Psychol
ogical
Labor in
adjustm
LGBTQ
ent of
-Parent 17-
Familie year-
s;
592

old family
adolesce life
nts. cycle.
Pediatri
Washin
cs, 126,
gton, DC:
28–36. American
doi:10.1 Psychologi
542/ped cal
s.2009- Associatio
3153 n.
Goldberg, Goldberg,
A. E. A. E.,
(2007). Gartrell,
(How) N. K., &
does it Gates, G.
(2014).
make a
differen Resear
ch
ce?
Perspect report
on
ives of
adults LGB-
parent
with
lesbian, familie
s. Los
gay, and
bisexual Angele
s, CA:
parents.
Americ Willia
ms
an
Journal Institut
e.
of
Orthops Retriev
ed from
ychiatry
, 77, http://
william
550–
562. sinstitut
doi:10.1 e.law.u
037/000 cla.edu/
2- wp-
9432.77 content
.4.550 /upload
Goldberg, s/ lgb-
A. E. parent-
(2010). familie
Lesbian s-july-
and gay 2014.p
parents df
and Golombok,
their S., Perry,
children B.,
: Burston,
Researc
h on the
 593

A., Murray,
C., OUTCO
Moo MES
ney-
Some
rs, J.,
Between
Steve
ns, one
M., quarter
& and one
Goldi half of
ng, J. transgend
(200 er people
3).
Child
identify
ren as
with parents
lesbi among
an studies of
paren various
ts: A
transgend
com
muni
er
ty populatio
study ns. Based
. on
Deve current
lopm populatio
ental
n
Psyc
holo
estimates
gy, , this
39, finding
20– indicates
33. that there
doi:10.1 are
037/001 roughly
2-
175,000
1649.39
.1.20
to
350,000
transgend
CHILDRE er people
parenting
N WITH children
in the
TRANSG United
ENDER States.
This
PARENT entry
S, describes
current
PSYCHO research
on
SOCIAL
transgend
594

er parents, e of trans
the women
process of report
disclosing being
transgend parents
er identity as
to compare
children, d with
and the trans
document men.
ed Other
developm gender-
ental, nonconfo
social, rming
and people,
identity such as
developm people
ent of who
children cross-
with dress or
transgend people
er parents. who
identify
as
Parentin
androgyn
g
ous or
Characte gender
ristics blended,
Parenting have
rates demonstr
among ated
transgend greater
er people variation
may be in
related to responses
a variety to
of questions
characteri about
stics, parenting
including , making
gender, estimates
cohort, of
and parenting
race/ethni rates by
city. In trans
the people a
majority challenge
of studies, . Older
a higher transgend
percentag er people
 595

are more report

likely to being
report parents
being also
parents report
than parenting
younger similar
transgend numbers
er people. of
This is children
often due as
to having compared
children with
with lesbian,
different- gay, or
sex bisexual
partners people,
prior to or non-
coming transgend
out as er
transgend siblings.
er. The
However, number
with the of
increased transgend
opportunit er people
y to use who
fertilityrel report
ated living
medical with
technolog children
ies, there is lower
is than the
evidence number
that more of those
recent who
cohorts of report
self- being
identified parents.
transgend This is
er people due in
are opting part to
to become having
parents at adult
younger children,
ages. but
Transg evidence
ender also
people suggests
who that

Children With Transgender Parents, Psychosocial

Outcomes
596

discrimina emphasiz
tion in ed that
custody transgend
decisions er parents
or frequentl
partners y teach
informally their
attemptin children
g to from
control early
access to ages
children about the
may be fluidity
contributi of
ng to gender,
transgend and
er people attempt
not living to break
with their down the
children. gender
In binary for
regard to their
parenting children.
styles, How this
qualitative parenting
research approach
suggests may
that many impact
transgend children’
er parents s
emphasize conceptu
the alization
strengths of gender
they bring in the
as parents long term
without has yet to
focusing be
on studied.
gendered Transgen
expectatio der
ns around parents
the have also
behaviors described
of preparing
“mothers” their
or children
“fathers.” for the
Qualitativ challenge
e studies s their
have also transgend
 597

er status research
may pose, has
such as
focused
being on
bullied, or
transgend
seeing er parents
people who
treating disclose
their to their
transgend partners
er parent and
disrespectchildren
fully. later in
Similar tolife. The
other majority
vulnerableof
groups, transgend
transgend er people
er parentsreport
report that they
having became
explicit parents
strategieswith a
to preparecurrent or
their past
children heterosex
for ual
encounteripartner.
ng stigma Often,
and to
this
help theiroccurs
children before
cope with transgend
negative er parents
experienc have
es relateddisclosed
to having their
a gender
transgend identity
er parent.to others.
Little is
known
Parental about
Disclosur transgend
e er people
The who
majority choose to
of become
existing parents
after
598

their e), when

identificat parents
ion as come out
transgend to their
er and/or children
following as
transition. transgend
In er, a
particular, period of
more challengi
research ng family
is needed dynamics
on those is
people introduce
who d as the
identify children
as try to
androgyn process
ous or this
gender change.
blended Frequent
and/or questions
choose raised by
not to children
transition in
at all qualitativ
while e studies
occupying include
a more what they
liminal should
space call their
between parent
genders. (e.g.,
Curren does
t theories “mom”
suggest become
that, “dad”)
similar to and how
other their
types of relationsh
stress ip with
brought that
on by parent
changes might
in a change.
family Followin
(e.g., a g a
relocation period of
, a transition
remarriag for the
 599

entire report
family, as maintaini
family ng
dynamics positive
are relationsh
renegotiat ips with
ed and one
reconfigur another.
ed, the Many
majority transgend
of er parents
transgend report
er parents waiting
and to reveal
children their
report transgend
relationshi er
ps are as identity
strong as, or to
if not begin any
stronger transition
than, prior process
to the until their
parent’s children
disclosure are older,
. Some due to
parents do fears
report about
being harming
rejected them or
by causing
children, them
particularl difficultie
y when s in
they school or
disclosed public.
to those However,
children most
when they research
were suggests
teenagers that
or adults. younger
However, children
the cope
majority better
of with a
transgend parent’s
er parents disclosur
and their e than
children older
600

children children
or adult of
children. transgend
Younger er people
children than the
have been parent’s
found to transgend
be more er status
accepting itself. In
of the particular
disclosure , some
and more transgend
easily er people
adapt to report
changes that ex-
in partners
pronoun have tried
and name to
usage. formally
The exclude
majority the
of transgend
transgend er parent
er parents from
who custody
report rights or
difficultie have
s with informall
their y blocked
children the
also transgend
report that er parent
this from
difficulty seeing
was with their
teenagers children.
or adult This
children. finding
Relations suggests
hip that
dissolutio addressin
n after g
disclosing discrimin
transgend ation in
er identity custody
has been decisions
found to and
be a larger assisting
problem both
for the parents to
 601

come to parents.
fair For
custody example,
arrangeme there is
nts will no
further evidence
help that the
transgend children
er people of
maintain transgend
relationshi er parents
ps with are more
their or less
children. likely
than
children
Outcome with
s for cisgender
Children parents to
of identify
Transgen as
der lesbian,
gay,
Parents
bisexual,
The few or
studies transgend
that have er. Most
examined studies
psychosoc that have
ial asked
characteri about
stics of children’
the s
children experienc
of es of
transgend bullying
er parents found
have that one
found third or
them to less
be no reported
different having
from these
those of types of
children experienc
of es
cisgender because
(non- of their
transgend parent’s
er)
602

transgend were
er status. claiming
As that the
stated, the transgend
children er
of parent’s
transgend gender
er people identity
can was
experienc harmful
e family to their
and child(ren)
relationshi .
p stress Although
that is high
related to levels of
tension family
between tension
transgend brought
er and these
cisgender children
parents to mental
and issues health
in their professio
relationshi nals, they
p. In have not
multiple been
samples document
of ed to
children have
referred to experienc
clinics, ed any
assessmen long-term
ts of child conseque
well- nces to
being and their
mental overall
health wellbeing
were due to
often part having a
of court transgend
proceedin er parent.
gs trying Specifica
to lly, they
establish have not
custody been
orders found to
because be at
cisgender elevated
partners risk for
 603

depressio any signs

n, gender of
identity difficultie
concerns, s with
unhappine either
ss, or their
abnormal transgend
psychosoc er
ial parent’s
developm transition
ent; or the
further, relationsh
only ip stress
short-term between
impacts their
on parents
academic have
performan been
ce as shown to
children be
process effective
this in
change resolving
have been any of
reported. these
Instead, difficultie
terminatio s. Short-
n of term
contact interventi
with a on helped
transgend children
er parent process
has been the
proposed changes
to have in their
the most families.
significant In
negative addition,
impacts protectiv
upon e factors
children. that allow
Short- transgend
term er parents
therapeuti to
c transition
interventi more
on for smoothly
children in their
who relationsh
showed ip with
604

their impacts
child(ren) on their
have been children
found, in terms
including of
having a valuing
strong diversity
parent– and being
child open-
relationshi minded
p before about
transition, differenc
taking e. Studies
care with of the
how the adult
transition children
is framed of
for the transgend
child, er parents
having a have
cisgender found
parent that the
experienc
Christian
LGBTQ
e of
People
having a
transgend
who is not er parent
opposed has
to the helped
transition, them to
and be less
having judgment
parents al about
who others.
cooperate Also,
with one some
another children
effectivel of
y. transgend
A few er parents
studies have said
have that
suggested seeing
that their
transgend parent
er parents braving a
may have world
unique where
positive they face
discrimin
 605

ation F
based on u
their r
gender t
identity h
has e
helped r
them to be
more true R
to e
themselve a
s and d
authentic i
n
with
g
others.
s
Rebecca Pyne, J.
L. Stotzer (201
2).
See also Tran
Childre sfor
n With ming
LGBQ fami
Parents, ly:
Gender Tran
s
Develop
pare
ment nts
and and
Identity; their
Parent stru
Gender ggle
Transiti s,
strat
on and
egie
Intimate
s,
Relation and
ship stre
Change ngth
s; s.
Parent– Toro
Child nto,
Onta
Relation
rio,
ships;
Cana
Transge
da:
nder
LGB
Parents
TQ
and
Pare
Well-
nting
Being
Net
work
,
Sher
bour
606

ne Institut
Healt e.
h Veldo
Clini ral
c. e-
Ryan, M. Gr
(2009). iffi
Beyon n,
d A.
Thoma (2
s 01
Beatie: 4).
Trans Tr
men an
and the sg
new en
parenth der
ood. In par
R. ent
Epstein s
(Ed.), an
Who’s d
your the
daddy ir
? And ad
other ult
writing chi
on ldr
queer en’
parenti s
ng ex
(pp. 139– per
150). ien
Toronto, ces
Ontario, of
Canada: dis
Sumach clo
Press. sur
Stotzer, R. e
L., an
Herman, J., d
& tra
Hasenbush, nsi
A. (2014). tio
n.
Transgen
Jo
der
ur
parentin
na
g: A
l
review of
of
existing
G
research.
LB
Los T
Angeles Fa
, CA: mi
William ly
s St
 607

udi political
es, viewpoin
10(
t, there
5),
C
475
hr
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ist
501
ia
.
n
doi:
L
10.
G
108
B
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550 T
428 Q
X.2 Pe
013 op
.86 le
606
3
are
certain
consisten
CHRISTI t,
foundatio
AN nal
LGBTQ character
istics of
PEOPLE Christian
ity that
distinguis
h it from
According
other
to the
monothei
Pew
stic
Research
religions
Center,
such as
Christiani
Islam and
ty is one
Judaism.
of the
Christian
most
s believe
common
in Jesus
religions
Christ as
on Earth,
the only
with
son of
31.5% of
God,
all people
who was
identifyin
born of
g as
the
Christian.
Virgin
Regardles
Mary and
s of
who
denomina
taught,
tional or
suffered
608

on the gender
cross, minoritie
died, and s as
was then sinners
resurrecte who will
d. be
Christians punished
believe by God.
that Jesus, This
who was attitude is
Jewish, one of
died to the
save all driving
humans forces
from their behind
sins. many of
This topic the 21st
is relevant century’s
to cultural
LGBTQ battles in
lives the West,
because including
Christians debates
from over
more LGBTQ
conservati civil
ve rights,
denomina same-sex
tions have marriage,
used six and
specific adoption
passages across
from the Europe
Bible and
(Genesis North
19:1–28; America.
Leviticus While
18:22 and many
20:13; LBGTQ
Romans individua
1:26–27; ls flee
1 from
Corinthia establishe
ns 6:9– d
10; and 1 Christian
Timothy denomina
1:10) to tions
condemn because
sexual of
and prejudice
 609

and and
discrimina spiritual
tion, beings in
many their own
others still right.
adhere to How do
their sexual
Christian and
faith and gender
do not minoritie
believe s thus
that being manage
a sexual to
or gender reconcile
minority their
goes sexual
against orientatio
the n while
teachings participat
of Jesus. ing in a
In the religion
social that
sciences, contains
there is a such
recent strong
paradigm anti-
shift LGBTQ
(within sentiment
the last 15 s? This
to 20 entry
years) that addresses
views such
LGBTQ questions
individual by
s not just illustratin
as g how
nonreligio religiousl
us/nonspir y active
itual LGBTQ
beings Christian
needing to s leave
be more
compared politicall
and y
contrasted conservat
with ive
religious denomina
others, but tions for
instead as more
religious liberal
610

ones, psycholo
reinterpret gist Eric
scripture, Rodrigue
argue z makes
against two
perceived relevant
Christian points
hypocrisy, regarding
and do bisexual
their best and
to live by transgend
the simple er
message Christian
of Jesus s: (1)
Christ. Christian
ity is
more
Bisexual concerne
and d with
Transgen same-sex
der sexual
Christian behavior
s than with
sexual
Historicall orientatio
y, social n; thus
scientific bisexualit
studies of y tends to
LGBTQ get
Christians subsume
have d by
focused conservat
predomin ive
antly on Christian
gay men aversion
and to men
lesbians, having
with little sex with
research men
conducted alongside
from Western
bisexual society’s
or tendency
transgend to
er eroticize
perspectiv women
es. Social having
and sex with
personalit women;
y and (2)
 611

spiritual sexual
journeys and
of gender
transgend minoritie
er s in how
individual such
s can be individua
viewed as ls,
variations regardles
on gay s of
male or sexual
lesbian identity
female or
experienc nonbinar
e—those y gender
who view status,
themselve manage
s as to
outsiders integrate
(in this their
case Christian
because beliefs
of the into their
discrimin LGBTQ
atory lives.
male/fem
ale gender
binary The
predomin Political
ant in the Spectru
Bible and m of
Christian Christian
culture) ity
trying to
understan Christian
d how attitudes
both their toward
gender sexual
identity and
and their gender
sexual minoritie
orientatio s are
n fit with generally
their determin
religious ed by the
beliefs. political
There is slant of
solidarity the
among denomin
Christian ation,
612

with many of
conservati the large
ve- Christian
leaning denomin
churches ations
holding worldwid
more e,
negative including
and the
exclusion Anglican,
ary Episcopa
attitudes lian,
and Lutheran,
doctrines, and
while Methodis
more t
liberal- churches.
leaning Politic
churches ally
hold more conservat
positive ive
and Christian
inclusive denomina
views. tions that
This issue continue
of how to
Christians condemn
should homosex
engage uality as
with the
sexual gravest of
and sins
gender include
minorities Baptists
(to (and
condemn Southern
them as Baptists),
sinful Evangeli
“others,” cals,
or to love Fundame
and ntalists,
accept Jehovah’
them fully s
into the Witnesse
life of the s,
church) Pentecost
has als, and
created Seventh-
schisms Day
within Adventist
 613

s. Most of Anglican
these s/
churches Episcopal
do not ians,
allow Methodis
gender- or ts, and
sexual- Mormons
minority . Many of
members, those
will not closer to
ordain the
LGBTQ political
clergy, do middle
not permit make the
LGBTQ argument
individual that a
s to serve distinctio
in n needs
congregati to be
onal made
leadership between
roles, do LGBTQ
not identity/o
support rientation
same-sex versus
relationshi samesex
ps, and sexual
will not behavior.
recognize Within
or this
perform standpoin
same-sex t the sin
weddings. is in the
Politic behavior,
ally not the
moderate identity,
Christian thus the
denominat creation
ions of the
include idea
Missouri “love the
and sinner,
Wisconsin hate the
Synod sin” as a
Lutherans driving
and factor in
Roman how to
Catholics, approach
as well as sexual
some and
614

gender LGBTQ
minorities clergy,
. Within do not
this support
perspectiv same-sex
e, relationsh
LGBTQ ips, and
individual do not
s are to be recognize
shown or
Christian perform
love and same-sex
compassio weddings
n as .
individual Altern
s, while at atively,
the same liberal
time Christian
encourage denomina
d to tions that
repent and welcome
turn away LGBTQ
from their people as
sinful equals
sexual include
lifestyle. the
Many of Evangeli
these cal
churches Lutheran
also Church
encourage of
active America
LGBTQ (ELCA),
participati the
on in the United
church to Church
give such of Christ,
individual the
s an United
opportunit Federatio
y to n of
repent the Metropol
sin of itan
homosexu Commun
ality. ity
However, Churches
such (UFMCC
churches ), and the
do not United
ordain Universal
 615

ists, as ual
well as religious
many denomina
Anglicans tion that
/Episcopal is
ians, inclusive
Methodist of
s, and LGBTQ
Presbyteri individua
ans. The ls—
liberal welcomin
perspectiv g them as
e can be full and
further active
broken members
down into of the
“gay- church
positive” communi
versus ty. Gay-
“gay- positive
friendly” and gay-
congregati friendly
ons. A churches
“gay- allow
positive” gender-
church or sexual-
(e.g., the minority
UFMCC) members,
is a ordain
denominat LGBTQ
ion that clergy,
was either support
founded samesex
by, and/or relationsh
ministers ips, and
specificall recognize
y to, the and
LGBTQ perform
communit same-sex
y. A “gay- marriages
friendly” .
church Christian
(e.g., the LGBTQ
ELCA), People
however,
represents
a
predomin
antly
heterosex
616

Scriptura God and

l everythin
Interpret g written
there
ation
should be
One of the taken at
critical face
issues value
relating to without
how question
sexual or
and reservati
gender on.
minorities Through
practice the
their fundame
Christiani ntalist
ty without lens, the
conflict Bible
between clearly
their states in
sexual/ge the
nder previousl
identity y
and mentione
religious d six
beliefs is passages
the that
interpretat same-sex
ion of attraction
scripture. and
There are behavior
two basic is an
ways of egregious
interpretin sin and is
g the thus
Bible: unnatural
fundamen and an
talist or abominat
historical ion in the
critical. eyes of
From a God.
fundamen In
talist contrast,
perspectiv the
e, the historical
Bible is critical
the (i.e.,
inerrant historical
word of contextua
 617

l) method
interpretat of
ion of interpreta
scripture tion
argues argue that
that the the most
Bible was important
inspired parts of
by God the Bible
but are the
written by four
fallible Gospels
human from the
beings. New
Within Testamen
this t
perspectiv (Matthew
e, the , Mark,
Bible Luke,
should be and John)
viewed in detailing
light of the life,
the teachings
historical , death,
and and
cultural resurrecti
context in on of
which it Jesus
was Christ.
written. Emphasiz
Thus, ing these
rules and passages
regulation means
s meant to that
guide individua
individual ls are
s in the encourag
1st ed to
century view
are not scripture
necessaril through
y germane the lens
to 21st- of God’s
century grace; the
life. idea that
Furthermo we are
re, those saved not
using the because
historical of our
critical actions or
618

identities, gender
but rather variations
because were
Jesus created
Christ by God,
was they are
crucified, all
died, and blessed
was by God.
resurrecte
d for the
sins of all. Sodom
This
and
message
Gomorr
is
particularl ah
y The story
compellin of the
g for destructi
LGBTQ on of the
Christians cities of
who point Sodom
out that and
Jesus Gomorra
never h in the
explicitly Old
spoke for Testamen
or against t book of
same-sex C
sexual hr
behavior ist
or gender ia
n
variations.
L
A major G
offshoot B
of this T
line of Q
thought is Pe
what op
sociologis le
t Andrew
Yip has Genesis
labeled provides
the an
ontogener excellent
ic illustratio
argument n of the
—since differenc
all sexual es
and
 619

between original
these two Greek
contrastin and
g methods Hebrew
of writings
interpretin have
g been
scripture. mistransl
One key ated and
disparity that the
centers on sin in
the question
origins, was
and actually
underlyin that of
g showing
meaning, a lack of
of the hospitalit
term y toward
sodomite. guests—
Fundame hospitalit
ntalists y being a
argue that cultural
in this more, or
story, norm,
God that was
clearly strong in
demolishe the
d these Middle
two cities East
because during
of the sin that time.
of Thus,
homosexu from the
ality and historical
thus a critical
sodomite perspecti
is a man ve, a
who sodomite
engages is
in sexual actually
behavior someone
with who
another refuses to
man. show
Historical hospitalit
contextual y toward
ists argue, a guest in
however, his home.
that the Relying
620

on the that
historical rejects
critical any type
approach, of
LGBTQ discrimin
Christians ation
argue that toward
the other
concept people
of sexual for any
orientatio reason.
n, as we This
understan inherent
d it today, inconsist
did not ency
exist over drives the
2,000 theologic
years ago, al battles
and thus between
prohibitio LGBTQ
ns against people
homosexu and
ality do conservat
not ive
pertain to Christian
same-sex s.
couples in Fundame
loving, ntalist
committe Christian
d s argue
relationsh that the
ips. Bible is
clear that
homosex
Charges uality is
of an
Christian unnatural
Hypocris abominat
y ion and a
sin, while
One of the
LGBTQ
key tenets
Christian
of
s
Christiani
counterar
ty is to
gue that
love your
singling
neighbor
out
as
sexual
yourself,
and
an idea
gender
 621

minorities many
as view as
somehow no longer
being applicabl
more e in 21st-
sinful century
than Christian
everyone society
else goes (e.g., not
against— eating
indeed pork and
outright shellfish,
contradict menstrua
s— ting
Jesus’s women
actual being
teachings forbidden
of peace to attend
and worship
tolerance services).
toward This
others. juxtaposit
LGBTQ ion of
Christians clashing
further religious
contend ideals is
that those one of
who use the main
the Bible reasons
against why
them are many
guilty of Christian
selective denomina
morality tions
or struggle
“cherry- in their
picking” interactio
Bible ns with
verses to the
support LGBTQ
the case communi
against ty. This is
LGBTQ where
individual “love the
s while sinner,
ignoring hate the
other sin” came
Biblical from as a
prohibitio form of
ns that comprom
622

ise thou shall

between not kill,
these two etc.) is
competing the height
Christian of
viewpoint hypocrisy
s. One because
conservati Jesus
ve actually
Christian’ had very
s harsh
compromi words to
se, say about
however, anyone
is often an who
LGBTQ would
Christian’ presume
s to sit in
hypocrisy judgment
(and vice against
versa). anyone
Many else
LGBTQ (Matthew
Christians 7:1–5):
argue that
singling Do
out same- not
sex sexual judg
behavior e,
as so
somehow that
being a you
greater sin may
than many not
of the be
others judg
mentioned ed.
in both For
the Old with
and New the
Testament judg
s of the men
Bible t
(adultery, you
bearing mak
false e
witness, you
divorce, will
greed, be
pride, judg
 623

ed, then
and you
the will
meas see
ure clea
you rly
give to
will take
be the
the spec
meas k
ure out
you of
get. you
Why r
do neig
you hbo
see r’s
the eye.
spec
k in
your Jesus’s
neig Simple
hbor
Message
’s
eye, Theologi
but ans have
do argued
not that
notic while
e the Jesus
log never
in spoke
your directly
own for or
eye? against
. . . sexual or
You gender
hypo minoritie
crite, s, he did
first speak
take explicitly
the regarding
log his two
out greatest
of comman
your dments—
own love your
eye, God with
and all of
624

your heart violates

and soul his
and love central
your teachings
neighbor for all
as Christian
yourself s to care
(Matthew for all
22:36– human
40). beings.
Perhaps Rather,
the most Jesus
powerful conducte
and d his
persuasiv ministry
e by
argument focusing
that on the
LGBTQ plight of
Christians the
use to downtrod
reconcile den and
their disposses
sexual, sed— his
and/or message
nonbinary was not
gender one of
identities exclusion
with their and
religious bigotry
beliefs is but
that Jesus instead
would not one of
approve love and
of the support
way for all
fundamen people. It
talist and should
Christian come as
conservati no
ves treat surprise,
sexual therefore,
and that
gender many
minorities who
, as such identity
prejudice as both
and LGBTQ
discrimin and
ation Christian
 625

find F
spiritual u
shelter r
beneath t
such ah
simple yet e
powerful, r
and all-
inclusive, R
message. e
a
Eric M. d
Rodrigue i
z and n
Chana g
Etengoff s
Barton, B.
See also
(2010).
Religion/Sp
“Abom
irituality
ination
and
”—Life
LGBTQ
as a
People;
Bible
Religiou Belt
s gay.
Identity Journa
and l of
Sexualit Homos
y, exualit
Reconci y,
liation 57(4),
of; 465–
Sexual 484.
Orientat Gay
ion Christian
Convers Network.
ion https://ww
Therapy w.gaychris
; tian.net/
Transge
Meeks, W.
nder
A.
People
and (Ed.).
Religio (1989).
n/Spirit The
uality Harper
Collins
study
Bible:
New
revised
standar
d
626

version. way?
New Expand
York, ing
psychol
NY:
ogical
HarperC researc
ollins. h on
Pew queer
Researc religios
h ity and
Center, spiritua
Religion lity to
and include
Public intersex
Life and
Project. transge
http://w nder
ww.pew individ
forum.o uals.
rg/ Psycho
Rodriguez, logy &
E. M. Sexuali
(2010). ty, 3(3),
At the 214–
interse 225.
ction Rodri
of gu
church ez,
and E.
gay: A M.
review ,
of the Ly
psycho tle,
logical M.
researc C.,
h on &
gay Va
and ug
lesbian ha
Christi n,
ans. M.
Journa D.
l of (20
Homos 13)
exualit .
y, Ex
57(1), plo
39–53. rin
Rodriguez, g
E. M., the
& int
Follins, ers
L. D. ect
(2012). ion
Did God alit
make y
me this of
 627

bise se
xua xu
l, al
reli
m
gio
us/s y
piri ne
tual ig
, hb
and or
poli
?
tica
l A
ide po
ntiti sit
es iv
fro e
m a
C
fem
inis hr
t ist
per ia
spe n
ctiv re
e.
sp
Jou
rna on
l of se,
Bis re
exu vi
alit se
y,
d
13,
285 an
– d
309 up
. da
Scanz te
oni d.
, L. Sa
D., n
& Fr
Mo an
lle cis
nk co,
ott, C
V. A:
R. Harper
(19 One.
94) Transgend
. Is er
the Christians.
http://ww
ho
w.transchri
mo stians.org/
628

Yip, differ
A. : Gay
K. and
T. lesbi
(1
an
99
7). Cath
At olics’
ta asses
ck smen
in t of
g offici
th
al
e
Cath
att
ac olic
ke positi
r: ons
G on
ay sexu
C ality.
hri
Soci
sti
an olog
s y of
tal Relig
k ion,
ba 58(2)
ck ,
.
165–
Br
180.
iti
sh Chronic Illness
Jo
ur
na
l CHRONI
of
So C
ci
ol ILLNESS
og
y,
48 Chronic
(1
illness
),
11 refers to
3– long-
12 term
7. condition
Yip, A. s that are
K. T. rarely
(1997 complete
). ly cured
Dare and are
to often
 629

characteri intersects
zed by with
uncertain LGBTQ
outcomes, lives
unpredict more
able specifical
episodes ly.
of Over
intrusive the
symptoms course of
, and the 20th
intermitte century,
nt or there was
progressiv a
e physical dramatic
and/or shift from
mental acute to
impairme chronic
nt. diseases
Examples as the
include leading
cardiovas cause of
cular mortality
disease, in
arthritis, industrial
respirator ized
y nations.
problems, Improved
diabetes, sanitation
epilepsy, , public
and health
cancer. surveillan
This entry ce,
provides a routine
brief immuniz
overview ations,
of how and
chronic improve
illness ments in
may health
impact care more
people’s broadly
lives have led
generally; to aging
it then populatio
goes on to ns and a
consider rise in the
how number
chronic of people
illness living
630

with physical
chronic and/or
health mental
conditions functioni
. ng and
Advances may
in result in
medicine reduced
have also life
seen a expectan
number of cy and
diseases poorer
transform quality of
ed from life.
terminal Although
to chronic the term
conditions illness is
; for often
example, preferred
with the in the
developm social
ent of sciences
antiviral over the
therapies, more
human medical
immunod term
eficiency disease,
virus/acqu in many
ired cases
immune those
deficiency with
syndrome chronic
(HIV/AID condition
S) has s may not
become a feel, nor
chronic consider
rather themselv
than an es to be,
acutely “ill” most
fatal of the
condition time and,
in many in some
parts of circumsta
the world. nces,
Chroni those
c living
conditions with
may lead well-
to a loss managed
of chronic
 631

conditions for-
(e.g., type granted
1 C
diabetes) hr
may lead on
ic
a long and
Ill
relatively ne
healthy ss
life.
For
those who assumpti
were ons about
neither life and
born with an
a medical associate
condition d crisis
nor of one’s
developed sense of
the self. Life
condition with
in early many
childhood chronic
, receiving condition
a s is
diagnosis character
of a life- ized by
changing uncertain
illness can ty and
come as a involves
shock and a process
be of
difficult considera
to accept. ble
A key psycholo
concept gical
within the adjustme
social nt. Many
scientific chronic
literature illnesses
on require
chronic lifelong
illness is treatment
that of or self-
“biograph managem
ical ent,
disruption sometime
”: the s in the
disruption form of
of taken- complex
medical
632

regimens deformiti
that may es, scars),
call for are
lifestyle transmitt
adjustmen able
ts (dietary (e.g.,
adjustmen HIV), or
t, are
monitorin viewed
g of blood as the
glucose result of
levels, unhealth
etc.). y
There is lifestyles
often a (e.g.,
negative type 2
impact on diabetes,
a person’s lung
quality of cancer)
life; for are often
instance, particular
people ly
with stigmatiz
chronic ing.
illness are
more
likely to Th
experienc e
e stress,
depressio L
n, sexual e
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 633

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While the not
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many as a experienc
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634

unclear academic
what the work and
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the health
HIV/AID policy.
S AIDS
epidemic and the
has been queer
for politics
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recognize Chronic
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on the
other Gay and
hand, bisexual
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made gay HIV/AID
men’s S are
health and more
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legitimate condition
focus of s as
 635

comorbidi among
ties in the some
form of sexual
diabetes minoritie
and some s. For
forms of example,
cancer. populatio
However, nbased
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exception have
of rates of consisten
HIV/AID tly found
S among that
gay men, nonheter
there is osexuals
currently are more
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data about smoke
the tobacco
prevalenc than
e of heterosex
chronic uals,
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ns as data of
on sexual developi
and ng a wide
cis/transg range of
ender chronic
identity condition
are rarely s such as
collected cardiovas
in cular
epidemiol disease,
ogical chronic
studies. obstructi
There is ve
some pulmonar
evidence y disease,
that risk stroke,
factors emphyse
associated ma, and
with various
certain forms of
chronic cancer.
conditions There is
are higher also
636

some breastfee
evidence ding is
to suggest thought
that to offer
lesbians some
are more protectio
likely to n against.
be To date,
overweig only a
ht or handful
obese of
than populatio
heterosex nbased
ual surveys
women, have
which directly
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increases differing
the risk of rates of
chronic chronic
conditions condition
such as s in
type 2 relation
diabetes. to sexual
The fact orientatio
that n. There
lesbians have
are less been
likely to some
have findings
children to
and more suggest
likely to that
delay lesbians
childbirth report
beyond higher
the age of rates of
30 may breast
also cancer,
increase and
their risk higher
of some rates of
conditions asthma
such as have
breast been
cancer found
and consisten
endometri tly
al cancer, among
which sexual-
 637

minority gay men.

women; Much of
however, the
there is literature
little on
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e experienc
evidence es of
that chronic
LGBTQ illness
people are has
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affected such
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other s disrupt
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For the ips and
most part, also on
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illnesses es of
that the homopho
literature bia and
has transphob
focused ia within
on in health
relation to care.
lesbians Studies
and gay have
men have found
been that
gendered mainstrea
illnesses m health
that affect care
sexualized organizat
(and ions are
gendered) often
parts of poorly
the equipped
anatomy, to
such as provide
breast support
cancer that is
among sensitive
lesbians to
and LGBTQ
prostate individua
cancer ls.
among Although
638

the als than

importanc in other
e of spheres
cultural of their
competen lives, for
ce within fear that
health it might
care is affect
well their
recognize ongoing
d in care. This
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e of the
training condition
that raises may
awareness affect
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encourage example,
s erectile
practition dysfuncti
ers to on may
carefully be the
reflect on first
their own symptom
attitudes of a
toward chronic
gender condition
and (e.g.,
sexual diabetes),
minorities while for
is yet to those
be fully already
recognize diagnose
d. d it may
LGBTQ be a sign
people of a
have been progressi
reported on or
to be less complicat
likely to ions of
be “out” their
to their condition
health , such as
profession heart
 639

disease. It with
is multiple
therefore forms of
critically stigmatiz
important ation
that based on
LGBTQ both their
people sexual/ge
feel nder
comfortab identity
le enough and their
to freely illness. In
discuss addition
their to
sexual passing
functionin as
g and heterosex
practices ual or
with their cisgender
health ed to
practition avoid
er. stigma in
LGBTQ certain
people situations
may also , LGBTQ
receive people
less social may also
support conceal
from their their
families chronic
of origin illness to
due to avoid
family being
members’ stigmatiz
failure to ed by
accept others,
their including
sexual or within
gender LGBTQ
identity. communi
LGBT ties.
Q people Studies
living have
with found
chronic that gay
illness male
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considere in
d to be particular
living are often
640

perceived stigma of
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sexualized chronic
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emphasize condition
bodily may also
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, idolizing the
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Although ed by
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ss Illness
influence
In
Chronic Illness
addition
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with chronic
chronic illness
illness more
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s and their documen
bodies. ting their
The narrative
 641

s, heteronor
LGBTQ mative
scholars concerns.
have also Audre
drawn on Lorde’s
queer book
theory to Cancer
provide a Journals
critical is a
examinati notable
on of how exception
gender is not only
inscribed because
in the it was
culture written
surroundi by a
ng lesbian,
medical but also
conditions because
and how it is
chronic written
illness explicitly
and its from a
treatment Black
relate to lesbian
the feminist
politics of position
gender that
and examines
sexuality. the
Culturally intersecti
available ons of
illness illness,
narratives race,
, for gender,
instance and
those sexuality
available within a
in political
published context.
autobiogr Lorde
aphies, writes,
are for
predomin instance,
antly about a
heterosex distressin
ual g
narratives experienc
that often e while
display visiting
642

her illness by
surgeon’s examinin
office g the way
postmaste in which
ctomy, gender
when she and
was sexual
chastised identity
in front of are
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for not cultural
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pink chronic
prosthesis condition
she had s such as
been breast
given. For cancer
Lorde, and
this was a HIV/AID
direct S. Some
assault on scholars,
her right for
to own instance,
and have
embrace examined
her body the way
despite its that the
not language
conformin and
g to imagery
normative used
standards within
of female self-help
appearanc and
e. Queer health
scholars care
have also literature
sought to s
forge heterosex
theoretica ualize
l links health
between condition
queer s in ways
theory that can
and be
cultural experienc
studies of ed as
health and marginali
 643

zing for chronic

LGBTQ illness
people. has
For tended to
example, reflect
sources of heterosex
informati ual,
on for the cisgender
partners narratives
of men of illness,
with while
prostate LGBTQ
cancer studies
often has yet to
assume fully
that such explore
partners the
are intersecti
women. ons that
Cis exist in
ge the lives
nd of sexual
eri
and
sm
gender
minoritie
The s living
scholarly with a
literature, wide
both on range of
chronic chronic
illness illnesses.
and on As
LGBTQ intersecti
studies, onal
has forms of
tended to analysis
reflect the continue
dominant to
narratives develop
of in
privileged LGBTQ
social studies, it
groups is likely
(e.g., that a
White, wider
middle range of
class). health
The condition
literature s will be
on examined
644

and that to;

additional Health
insights Care
from System
;
queer
Health
theory Dispari
will be ties;
applied to Intellec
the study tual
of health Disabili
and ties;
illness. Physica
l
Adam Disabil
Jowett ities

See also
Advance F
Health u
Care r
Planning; t
Cancer and
h
Social e
Support; r
Cancer
in the R
LGBTQ e
Commu a
nity; d
Disabilit i
ies n
Among g
LGBTQ s
Elders;
Axtell, S.
Discrim
(1999).
ination
Disabil
on the
ity and
Basis of
chronic
HIV/AI
illness
DS in
identity
Health
:
Care;
Intervie
Health
ws with
Care
lesbian
Provider
s and
s,
bisexua
Disclos
l
ure of
women
Sexual
and
Identity
their
partner
 645

s. 22,
Journal 501–
of Gay, 538.
Lesbian doi:10.
1525/c
, and
an.200
Bisexua 7.22.4.
l 501
Ide Jowett,
ntity, A.,
4, 53– &
72. Peel
doi:10. , E.
1023/A (20
:10232 09).
544080 Chr
84 onic
Dibble, illn
S., ess
Eliason in
, M., & non
Christi hete
ansen, rose
M. xual
(2007). cont
Chroni exts
c : An
illness onli
care ne
for surv
lesbian ey
, gay, of
& exp
bisexua erie
l nce
individ s.
uals. Fe
Nursin min
g ism
Clinics &
of Psy
North cho
Americ log
a, 42, y,
655– 19,
674. 454
doi:10.1 –
016/j.cn 474.
ur.2007. doi:
08.002 10.1
Jain, S. L. 177
(2007). /09
Cancer 593
butch. 535
Cultural 093
Anthropolo 427
gy, 70
646

Lipton, B. 080/00
(Ed.). 918360
(2004). 903005
Gay 220
men Wilker
living son, A.
with (2003).
chronic Memoi
illnesses rs of
and the sick
disabilit and the
ies: queer:
Genre
From
and the
crisis to
possibil
crossro
ity of
ads.
opposit
Bingha
ional
mton,
NY: subjecti
Harringt vity. In
on Park R. N.
Press. Fiore &
Lorde, A. H. L.
(1980). The Nelson
cancer (Eds.),
journals.
Recogn
Argyle,
NY: ition,
Spinster respon
s Ink. sibility,
Walden, E. and
L. rights:
(2009). Femini
An st
explorat ethics
ion of and
the social
experie theory
nce of (pp.
lesbians 105–
with 117).
chronic Lanha
illness. m,
Journal MD:
of Rowma
Homose n&
xuality, Littlefi
56, eld.
548–
574.
doi:10.1
 647

CISGEND es
associate
ERISM d with
their
genders
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to the disordere
ideology d, e.g.,
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The term misgende
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648

people C
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 649

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652

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 653

ks such as all people

transphob who
ia have experienc
focused e gender
on or body
negative delegitim
individual ization as
attitudes being a
and distinct
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acts. In people,
contrast, nor does
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describe people
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654

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 655

studies. context
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fields absence
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external n.
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Cisgender ons that
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applicable that all
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656

single as
gender as women);
either that the
women or visual
men; that appearan
a person’s ce of a
gender person’s
can be external
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d reliably at birth is
by their a reliable
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e and/or gender;
their that all
voice; that people’s
gender genders
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physical static
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the same span; that
way (e.g., “trans”
all people people
who “change
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necessaril exist
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 657

the binary to have a

options of gay,
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ns can and
motivate assumed
expressio to share
ns of the same
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with their having
current coined
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n of their misgende
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coercive and
queering Hegarty
(in which modified
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heterosex to
ual people transcend
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“trans” cis/trans
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es or develop
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658

misgender d
ing for i
research e
applicatio s
ns.
The first
empirical
Rresearch
on
cisgender
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consisted
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quantitati
ve
content
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assessed
claims
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views
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children’
s genders
were
becomin
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accepting
and less
cisgender
ist over
time.
Journal
articles
on
children’
s genders
or gender
expressio
n were
evaluated
as to
whether
they
reflected
or
contraste
d with
the stated
 659

aims of increasin
the g
American professio
Psycholog nal
ical influence
Associati over
on’s time, and
nondiscri language
mination used by
statement mental
on health
“transgen professio
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variant” cisgender
people ist (in
through degree)
an than that
analysis used by
of authors
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zing and other
misgender professio
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empirical This
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Pathologi that the
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Although s genders
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sm expressio
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660

around explored
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More provided
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authors research
associated and
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figures in d the
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tory es.
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More ed
recent cisgender
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the field developin
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cisgenderi cisgender
sm studies ism
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 661

checklist needs and

for experienc
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therapeuti people
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Other Australia
work has n
evaluated research
the most describes
widely as “trans”
cited or
Englishla “gender
nguage diverse.”
papers in
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for e
cisgenderi s
sm and
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guidelines o
aimed to r
reduce
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sm in e
psycholog d
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research.
c
Still other
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model
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research
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mental
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662

n and
professio
R nal
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s Ansara
e and
a Hegarty
produced
r
guideline
c
s in 2013
h that
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n develop
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research
D practices
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t reduce
a misgende
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o advise
ll researche
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c refrain
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assuming
i
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n based on
In people’s
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exploring and
everyday visual
cisgenderi appearan
sm in ce, in
diverse recogniti
cultural on that
contexts, these are
a primary culturally
goal of variable
cisgenderi “clues”
sm that can
studies is be
to reduce misleadin
cisgenderi g. They
sm in also
research recomme
 663

nd that stics that

researcher can be
s associate
distinguis d with
h between the same
the gender
administr self-
ative designati
“sex” on and
categories the
to which absence
people of a
have been universal
assigned template
and those to define
people’s which
physical gender
attributes; selfdesig
when nation is
researcher associate
s make d with
assumptio particular
ns about physical
people’s character
bodies istics.
and their They
related recomme
medical nd that
needs, those
this involved
practice in
can lead research
to design
unintentio consider
nal the
exclusion potential
s and distinctio
access n
barriers to between
health assigned
services. administr
The ative
guidelines “sex”
stress the category
need to and self-
consider designate
the d gender,
myriad the
physical existence
characteri of people
664

with described
multiple using
and/or only
nonbinary nonbinar
genders, y
and the pronouns
cultural and
variations descripto
in the rs; and to
number of ensure
recognize that
d gender research
categories anticipate
. The s the
guidelines possible
highlight range of
the need gender
for diversity
authors to among
document participa
clearly nts, so
how that
participan discrimin
t gender atory
was research
determine practices
d; to such as
consider excludin
methodol g all
ogical people
concerns who do
regarding not
the identify
coding of clearly as
gender as women
a single or men as
dichotom “outliers”
ous will be
variable; unnecess
to avoid ary.
misgender Although
ing these
people, guideline
particularl s focused
y those primarily
with on
nonbinary research
genders practices,
who may their
wish to be approach
 665

contains use of
elements “evidenc
that can e-based
also help medicine.
to reduce ” Ansara
cisgenderi asserted
sm in that
other feedback
forms of forms
profession typically
al focus on
communi questions
cation and related to
practice. individua
In his l staff
work on behavior
cisgenderi and
sm in overlook
medical important
contexts, structural
Ansara Cisgenderism
explored
how
and
technique
policy
s used to
compone
support
nts of
communit
health
y
care
engageme
experienc
nt and
es. His
inclusive
work also
practice
explored
can
the extent
perpetuate
to which
marginali
people
zation and
with
exclusion.
negative
This work
evaluatio
focused
ns of
on three
their
widely
health
used
care
methods:
experienc
feedback
es will
forms,
disclose
consultati
their
on with
evaluatio
communit
ns on
y leaders,
these
and the
666

forms. y.
The Definitio
widesprea ns of
d “evidenc
preferenc e” are not
e for neutral or
Likert- objective,
type but
scales determin
over e whose
narrative input and
responses experienc
on es will be
feedback used to
forms create
may also knowled
limit open ge,
disclosure evaluate
on existing
feedback views,
forms. and
This work determin
document e policy.
ed that Critical
“commun feedback
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consultati systemic
on” is gaps and
often structural
limited to barriers
contact needs to
with be
designate incorpora
d ted into
communit existing
y leaders definition
who s of
cannot evidence
adequatel to enable
y reflect improve
the needs ment in
of the health
most care
marginali contexts.
zed
Y.
individual
s within Gavriel
that Ansara
particular and
communit
 667

Israel Mental
Berger Health
Consid
See also eration
Gender s;
Binaries; Transg
Gender ender
Clinics; Identiti
Gender es;
Noncon Transg
formity, ender
Youth; Sexuali
Gender ties;
queer; Transp
Health hobia
Disparit
ies;
History F
of u
Transge r
nder t
Medicin h
e in the e
United r
States;
Intersec
R
tions
e
Betwee
n Sex, a
Gender, d
and i
Sexual n
Identity; g
Naming s
Practice
s; Ansara,
Nonbin Y.
ary G.
Genders (201
; 0).
Sexual- Beyo
Identity nd
Labels;
cisge
Sexual
Orientat nderi
ion sm:
Among Coun
Transge sellin
nder g
People; peop
Therapy le
With
with
Transge
non-
nder
assig
Individu
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668

gende the
r ordinar
identi y:
ties. LGBT
lives
In L.
(pp.
Moon 102–
(Ed.), 122).
Coun Cambri
selin dge,
g Englan
ideol d:
Cambri
ogies
dge
:
Scholar
Quee s
r Publish
chall ing.
enges Ansara,
to Y.
heter G., &
onor Hega
rty,
mativ
P.
ity (2012
(pp. ).
167– Cisge
200). nderi
Farnha sm in
m, psych
England ology
: :
Ashgate Patho
. logisi
Ansara, Y. ng
G. and
(2012). misg
Cisgend ender
erism in ing
medical childr
settings: en
How from
collabor 1999
ative to
partners 2008.
hips can Psyc
challeng holo
e gy &
structur Sexu
al ality,
violence 3(2),
. In I. 137–
Rivers 160.
& R. Cl
Ward os
(Eds.), et,
Out of
 669

Th ing:
e Rec
om
men
Ansara, Y. dati
G., & ons
Hegart for
y, P. redu
(2013). cing
Misge cisg
nderin ende
g in rism
Englis in
h psyc
langua holo
ge gical
context rese
s: arch
Applyi .
ng Fem
non- inis
cisgen m&
derist Psy
metho chol
ds to ogy,
femini 24(2
st ),
researc 259
h. –
Intern 270.
ational Blumer,
Journa M. L.,
l of Gavriel
Multip Ansara,
le Y., &
Resear Watson
ch , C. M.
Appro (2013).
aches, Cisgen
7(2), derism
160– in
177. family
Ansara, therapy
Y. : How
G., everyda
& y
Hega clinical
rty, practice
P. s can
(201 delegiti
4). mize
Meth people’
odol s
ogies gender
of selfdesi
misg gnation
ender s.
670

Journal
of
Family CLOSET,
Psychot
herapy, THE
24(4),
267–
285.
Davy, Z.
In order
(2013).
to
The
understan
construc d the “the
tion of closet” in
gender relation
dysphor to sexual
ia at orientatio
“Classif n, it is
ying necessary
Sex: to first
Debatin define
g DSM- the term.
5.” In
Psychol general
ogy of use, the
Women closet
Section refers to
Review, a space
15(2), for
63–67. hiding
Pyne, J. private
(2014). objects
The from
governa public
nce of view.
gender Accordin
nonconf g to the
orming Oxford
children English
:A Dictiona
dangero ry
us (OED), a
enclosur closet
e. can be a
Annual “room
Review for
of privacy,”
Critical an “inner
Psychol chamber,
ogy, 11, ” a
79–96. “private
repositor
 671

y of to expose
valuables, the living
” or the quarters
“den or of a
lair of a “wild
wild beast” or
beast.” A a
person conceale
may also d,
have a troubling
“skeleton “skeleton
in the ”; and/or
closet”— to “admit
a “private (somethi
or ng)
concealed openly,
trouble in to cease
one’s to
circumsta conceal”
nces, ever informati
present, on,
and ever especiall
liable to y same-
come into sex
view.” attraction
These (“homose
definition xuality”).
s of the The
closet person
make the who does
act of not
“coming disclose
out of the same-sex
closet” attraction
possible. may risk
To come being
out means considere
to make d a
hidden, “closet
private, queen” (a
and person
possibly who only
valuable comes
informatio out to
n public; other
to reveal queer
one’s people
“inner yet
chamber” avoids
to others; frequent
672

associatio out is
n with necessary
these in,
people out contexts
of a fear in which
of a
stigmatiza person’s
tion) or a same-sex
“closet attraction
case” (a is hidden
slang term and not
for “a known—
homosexu heteronor
al who mative
conceals contexts
or denies that, by
his or her default,
sexuality” frame a
; see person as
“closet” heterosex
[OED]). ual. In
While these
these contexts,
definition a person
s offer a must
sense of disclose
the closet her or his
and same-sex
coming attraction
out, there or engage
are five in a
additional nonheter
characteri osexual
stics of act (e.g.,
the closet being
and its intimate
relationshi with a
p to same- person of
sex the same
attraction sex) in
that are order to
worth disrupt
addressin ascription
g. s of
First, heterosex
the closet uality.
is Persons
applicable who
to, and identify
coming as
 673

bisexual which
or may then
pansexual make her
would “closeted
experienc ” in
e this relation
characteri to him.
stic of the Or an
closet if employee
they may
worry assume
about that his
revealing boss does
same-sex not know
attraction about his
or about same-sex
revealing attraction
their , and may
bisexualit thus feel
y or closeted
pansexual in
ity. relation
Second to her. Or
, the a woman
closet is a may be
relational out (of
construct; the
it exists closet) to
primarily her
in relation cousin,
to other but not
people, out to her
specificall mother;
y what out to co-
others do workers,
and do not but not
know out to the
about a server at
person’s a
same-sex restaurant
attraction. ; and out
For to her
example, therapist
a brother but not to
may not her
know dentist.
about his In these
sister’s situations
same-sex , the
attraction, closet
674

exists is
based on considere
(assumpti d to be
ons about) important
informatio informati
n that has on for a
not been relationsh
revealed ip. For
in example,
particular a mother
relationshi may ask
ps. The her son if
closet he finds a
could also particular
exist woman
when (intimatel
other y,
people relational
deny or ly)
pretend attractive.
not to The
know mother
about a may even
person’s try to get
same-sex this son
attraction, to marry
even this
though woman
the person and
has told encourag
these e the
others (heterose
about xual)
her/his couple to
attraction (biologic
numerous ally)
times. reproduc
Third, e in order
the to, by
relevance way of
of same- patriarch
sex al
attraction custom,
and the “carry on
closet the
depends family
on name.”
whether But if the
this son does
attraction not find
 675

women Fourth
attractive , coming
or does out can
not want be risky
to marry a and
woman, dangerou
and s, as a
instead person
finds men might
attractive reveal
and may informati
even want on that
to marry a others
man, then will
his private condemn.
and There are
concealed many
(closeted) accounts
same-sex of parents
attraction reacting
would be negativel
relevant y to their
informatio children’
n for his s coming
mother/th out, and
eir some
relationshi colleges
p. If the and
son could employer
disclose s can
(come dismiss a
out) to his student or
mother, employee
she might for
no longer disclosin
have such g same-
expectatio sex
ns about attraction
her son . In some
and might places
not (e.g.,
pressure Russia,
him into a Uganda),
relationshi a person
p that he can be
does not fined,
find to be imprison
satisfying ed, or
or even
important. killed
676

because be risky
of same- and
sex dangerou
attraction. s, not
As such, a coming
person out—
who staying in
comes out the closet
can lose —can
access to perpetuat
important e the
resources assumpti
and may on that
experienc same-sex
e attraction
emotional is
stress and unimport
physical ant,
harm; a inappropr
person iate,
who stays and/or
closeted abnormal
—that is, .
who does Fifth,
not come for a
out—may person
maintain with
safety and same-sex
protection attraction
, at least , the
in relation closet can
to others. be an
However, enduring
as many construct,
queer as
activists coming
have out can
argued, become a
coming perpetual,
out is lifelong
important process.
for If coming
recognitio out
n, pride, means to
and reveal
honesty; private or
even conceale
though d
coming informati
out may on to
 677

others, to
then a understan
person d
may be disclosur
closeted es of
when same-sex
immersed attraction
in new , these
(heteronor construct
mative) s can also
contexts be used
with to
unfamiliar understan
others. d any
Every disclosur
new work e that
environm reveals
ent, every hidden
trip to the and
grocery possibly
store, taboo
every new informati
venture on. For
into social example,
life—the dependin
closet g on
does not context
disappear and
with one audience,
act or a person
utterance; may need
new to come
audiences out as
make for someone
new times who
to struggles
disclose. with
genderThe
Closet,
identity
or as
While
transgend
“the
er, as
closet”
pregnant,
and
as an
“coming
undocum
out (of the
ented
closet)”
citizen,
are
as a
constructs
military
often used
veteran,
678

as a blance
particular (of
African
religious
Americ
identity ans);
(e.g., Don’t
Muslim, Ask,
atheist, Don’t
Jewish), Tell
or as and
having a Public
Opinio
(nonvisibl
n;
e) medical Down
condition Low;
(e.g., Gaydar
cancer, ;
diabetes, Hetero
colorblind normati
vity;
ness). The
Homon
need to ormativ
and the ity;
importanc Minorit
e of y
understan Stress;
ding the Queer
closet will Politics
;
thus exist
Stealth
as long as (Transg
the ender
revelation Passing
of hidden );
informatio Strategi
n to others c
is Disclos
ure
perceived
to be an
important
yet
dangerous
act.
Tony E.
Adams

See also
Coming
Out,
Disclos
ure, and
Passing;
Cultural
Dissem
 679

F A
u n
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l
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680

t July 20,
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r from
http://w
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ww.oe
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k Cowell,
, A.
C (2014,
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24).
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o antiga
y bill.
a
New
s York
t Times
P .
r Retrie
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Octob
s
er 1,
s 2014,
. from
Barton, B. http://
(2012). www.
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es.co
the gay
m/201
away: 4/02/2
The 5/
extraor world/
dinary africa/
lives of ugand
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Bible
presid
Belt
ent-to-
gays. sign-
New antiga
York, y-law
NY: .html
New Kramer, A.
York E. (2013,
June 11).
Universi
Russia
ty Press.
passes bill
Closet. targeting
(n.d.). In some
Oxford discussion
English s of
dictionary. homosexu
Retrieved ality. New
 681

York individua
Times. ls with at
Retrieved
least one
October 1,
2014, from
lesbian,
http://www gay,
.nytimes.co bisexual,
m/2013/06/ transgend
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urope/russi queer
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some- Accordin
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homosexua E
lity.html website,
Sedgwick,
the
E. K.
(1990).
organizat
Epistemolo ion’s
gy of the mission
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Berkeley: unite
University people
of
with
California
Press.
LGBTQ
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parents
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COLAGE in their
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national ties.
nonprofit COLAG
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682

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for States led
Children by youth
of and
Lesbians young
and Gays adults
Everywhe with
re, LGBTQ
expanded parents
its and
mission in provides
1996 to online
explicitly forums
include and
children communi
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 683

notably, e and
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Council of social
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COLAGE with
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684

majority y to
of connect
LGBTQ with
parents at other
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birth of nces. In
their 1979, at
children the first
but National
remained March on
largely Washingt
closeted. on for
Many of Gay and
these Lesbian
parents Rights,
kept their several
sexual local gay
and fathers’
gender groups
identities formed a
secret for national
fear of network
losing called the
custody of Gay
their Fathers
children. Coalition
Some of . In 1986,
these the Gay
parents Fathers
(primarily Coalition
middle- was
class, renamed
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fathers in and
major Lesbian
metropolit Parents
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began to Internatio
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social COLA
activities GE grew
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 685

several opportuni
parents in ty to
attendanc connect
e with one
organized another
activities in this
for their way. In
children 1990,
who had under the
come to name Just
the for Us,
conferenc this small
e with group of
them. young
These people
youth began
quickly putting
recognize out a
d that they periodic
—rather newslette
than their r and
parents— running
were the local
experts on chapters.
growing In 1993,
up in the group
lesbian- adopted
and gay- the name
parent Children
families of
and, as Lesbians
such, and Gays
should be Everywh
organizin ere
g their (COLAG
own E). In
supportive 1995,
and COLAG
education E opened
al a
activities. volunteer
They also -run
wanted national
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children San
with Francisco
lesbian . The
and gay organizat
parents to ion hired
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686

paid previous
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1997 and ns of
became COLAG
an Ers, they
independe also
nt 501(c) experienc
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1999. different
During benefits
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early s.
2000s, COLAG
COLAGE E has
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generation programs
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rs: the
Children shifting
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whose members
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Although youth of
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 687

racism, and
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adoption, er people
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intersectio own and
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external rs have
heteronor begun to
mativity investigat
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Thus, it support
took for youth
COLAGE with
time and LGBTQ
work to parents.
accept Social
bisexual support
688

from provide
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 691

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692

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 693

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694

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696

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 697

on without
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698

ne- Colleg
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 699

transitioni
ng
because
of the
unknown
response.
One of
the
challenges
in the
collegiate
setting is
the
generation
al
difference
s between
coaches
and
players.
Younger
individual
s—like
student-
athletes—
are
typically
more
accepting
of
nonhetero
sexual
and non-
cisgender
people
than their
coaches,
who are
700
often from an earlier generation and have been
enmeshed in an athletic culture that is not supportive
of nonheterosexual and non-cisgender people. The
power differential in the relationship between
student-athletes and coaches seldom allows for the
education to flow in a direction from studentathlete
to coach. For progress to be made in the collegiate
athletic setting, the involvement of coaches and,
similarly, athletic directors will be essential. To that
end, in 2012 a subcommittee within the NCAA
commissioned a best-practices document—
Champions of Respect: Inclusion of LGBTQ Student-
Athletes and Staff in NCAA Programs—that provides
guidelines for coaches, athletic departments, and
athletic directors. While directed toward NCAA-
affiliated programs, the recommendations are
applicable to any college athletic environment.
Sara B. Oswalt
See also Campus Climate; College Students; LGBTQ
(In)Visibility Within College Contexts; Sports,
SexualMinority Men in; Sports, Sexual-Minority Women
in
Further Readings
Anderson, E. (2011). Updating the outcome: Gay athletes,
straight teams, and coming out in educationally based
sport teams. Gender & Society, 25, 250–268.
doi:10.1177/0891243210396872
Griffin, P., & Carroll, H. (2011). NCAA inclusion of
transgender student-athletes. Retrieved August 20,
2014, from http://www.ncaa.org/sites/default/files/
Transgender_Handbook_2011_Final.pdf
Rankin, S., & Merson, D. (2012). Campus Pride 2012
LGBTQ national college athlete report. Charlotte,
NC: Campus Pride.
COLLEGE STUDENTS
LGBTQ students exist on every college campus
regardless of institutional type (2- or 4-year, public
or private, religiously affiliated or secular), region, or
size. LGBTQ students are diverse across several
dimensions, including demographics and identity
(e.g., race, ethnicity, social class, age, faith tradition,
nationality), academic majors and interests, and
academic experiences (e.g., transfer students, part-
time and full-time status, student veterans). They
also differ within the LGBTQ category by sexual
orientation and gender identity; a growing number of
students identify outside the categories represented
in the LGBTQ acronym as, for example, pansexual,
asexual, or genderqueer. Despite increased visibility
of LGBTQ college students, only a handful of
institutions ask students for their sexual orientation
and gender identity in a way that makes it possible to
determine with accuracy their number in
postsecondary education. Estimates of the number of
LGBTQ students range from 3% to 10% of the
overall student population. This entry addresses (a)
the history of LGBTQ students in U.S. higher
education, (b) identities of LGBTQ college students,
(c) campus climate for LGBTQ students, and (d)
multiple identities of LGBTQ students.
History of LGBTQ College Students
From the late 1800s through the mid-1900s,
postsecondary approaches to LGBTQ students took a
“deviance and disease” approach, which kept these
students largely out of sight. The disease model was
especially salient through the 1950s, when students
with same-sex desire were seen as having a serious
personality, medical, or psychological problem and
same-sex sexuality was cast as “not normal.”
Through the mid-20th century, students suspected of
same-sex sexual activity were expelled from many
campuses, individually or in larger “purges” of
suspected homosexual social groups.
The foundation of the college counseling and
student affairs professions in the mid-1900s
promoted a shift from this punishment orientation to
one of “treating” students who expressed
homosexual or unexpected gender tendencies. From
the mid-1900s to 1974, when the American
Psychiatric Association stopped classifying
homosexuality as a mental disorder, campus officials
and medical providers believed it was a treatable
condition and could be cured or controlled
College Students
through psychological and/or religious interventions.
Expulsions continued, but treatment approaches
overtook them as the primary means of dealing with

students suspected of being sexual or gender
minorities. There was also an increase in research
about sexuality during this time, including same-sex
sexualities, which made possible shifts in
understanding, from same-sex desire as deviant
toward conceiving of variations in sexuality as a part
of human diversity.
In addition to the landmark 1974 decision to
remove homosexuality from the list of psychological
diseases, social movements off campus in the late
1960s and early 1970s broke the silence and
invisibility of LGBTQ students. The 1969 Stonewall
riots, which represented interests of both sexual and
gender minorities and catalyzed the gay and lesbian
movement, occurred at the same time as early efforts
to organize gay (then also lesbian, bisexual, queer,
and transgender) students in higher education.
Movements with names like the Student Homophile
League and Gay Liberation Front spread to dozens of
campuses in the early 1970s. These movements
raised visibility of gay and lesbian students, and
university administrators and educators noticed them.
After 1974, a consensus emerged among student
affairs professionals in higher education that sexual-
minority students were not a threat to themselves or
campus safety. Gay and lesbian (then also bisexual)
activist movements on and off campus continued to
bring attention and visibility to issues of sexual
orientation. Among the earliest tasks of nascent
student organizations was to press for permission to
meet on campus and hold events. A number of
lawsuits at public universities in the 1970s paved the
way for the growth of student organizations and
increased visibility for LGBTQ students in higher
education. Unlike in the gay and lesbian rights
movement (e.g., Queer Nation, ACT UP, Gay
Liberation Front), the transsexual (later, transgender)
rights movements (e.g., Transsexual Menace) outside
higher education did not lead to the formation of
campus groups (e.g., Student Homophile League).
The first transgender student groups formed on
campuses in the 1990s, often but not always aligned
with student organizations for sexual-orientation
minorities. Around the same time, campus policies
and local, state, and federal laws related to
nondiscrimination on the basis of sexual orientation
and gender identity provided further support for
equitable treatment of LGBTQ students. Today more
than 2,000 LGBTQ student organizations exist on
College Students 701
college campuses, providing social, support,
educational, and activist outlets.
LGBTQ Identities in College Students
Some students enter higher education knowing that
they are LGBTQ; other students become aware of
their sexual orientation and/or gender identity while
in college. Research about LGBTQ identity
development represented an early step in empirical
investigations about queer and trans college students.
For lesbian, gay, bisexual, and queer (LGBQ) college
students, stage-based models developed with
nonstudent samples dominated the literature through
the 1990s. These models focused on resolving
internal conflict about one’s sexuality through the
process of coming out to self and others. Movement
through stages depended on interactions of the
individual with family, friends, and other LGBQ
individuals. Positive responses from others were
believed to lead to further disclosure; negative
responses could delay or halt identity development.
Contemporary scholars take a different, nonlinear
approach, presenting models of identity processes or
of patterns among similarly identified individuals.
Some of these models share the “coming out” focus
of the stage models, with an emphasis on the
contexts in which individuals disclose their sexual
orientation identity. Other models describe the ways
that the environment influences situational
identification as LGBQ. Emerging research points to
the complexity of the concept of “sexual orientation
identity” in the 21st century, when self-identification,
ascribed identity, emotions, and behaviors may point
to different definitions of sexuality. An asexual
college student, for example, may also identify as
heterosexual or as LGBQ, based on emotional
attraction, yet not engage in behaviors that some
people would consider essential to understanding
one’s sexual identity.
Given the historical classification of gender
identity disorder as a mental illness, a medical/
psychiatric lens is often the base for considering
transgender identity development. Relying solely on
diagnostic criteria with respect to transgender
students ignores identity processes and patterns of
this population, as well as the interaction of the
college experience with gender identity. While
gender dysphoria (formerly gender identity disorder),
702
listed in the American Psychiatric Association’s
Diagnostic and Statistical Manual (5th edition;
DSM-5), remains a psychological condition in need
of treatment, the propensity for higher education
professionals to see trans students exclusively
through a lens of deviance and disease is slowly
abating. However, even with trans identities
remaining classified within a disease model, access
to competent medical and psychological services
remains a challenge for many trans students.
There are a number of nonclinical models of
transgender identity development, most describing
identity across the life span and not limited to the
college experience. Some reflect the stagebased
approach to sexual orientation identity development,
in which the individual moves from self-discovery as
not cisgender (parallel to selfdiscovery as not
heterosexual) to disclosure of trans identity to an
increasingly wide circle of family, friends, peers,
coworkers, and transgender communities. Other
models focus on key milestones that many
transgender individuals reach, though not necessarily
in a set order. For example, a milestone for
transsexual individuals might be gender-
reassignment surgery. Given the wide range of
identities and experiences that fall under the umbrella
of transgender identities, existing models may lack
the ability to account for the complex processes that
making sense of one’s gender identity often entails.
There is some evidence that the postsecondary
context provides opportunities to explore gender
identity and expression; there is also evidence that
postsecondary institutions are locations for the
reinforcement of genderist assumptions related to
fixed, binary gender categories that place masculinity
and femininity at opposite poles that do not intersect.
Campus Climate for LGBTQ Students
Studies of campus climate are performed on
individual campuses and, occasionally, on the basis
of a national sample. LGBTQ students report being
harassed, threatened, and/or physically harmed,
though evidence demonstrates that postsecondary
campus climate is generally better than the secondary
school climates from which students come.
Transgender students report more negative incidents
than do cisgender students of any sexual orientation.
Campus climates are shifting in the 21st century as
public policy relating to, and societal opinions about,
LGBTQ people continue to evolve in a positive
direction. Overt hostility, such as vandalism of
LGBTQ student organization property or threats and
violence against individuals, has declined, although
anti-LGBTQ microaggressions continue to shape
campus climates.
While support has grown for same-sex marriage
and for bans on sexual orientation and genderidentity
discrimination in employment, and while anti-
LGBTQ violence, harassment, and discrimination
have decreased in frequency over time, less obvious
forms of anti-LGBTQ bias persist in the lives of
college students. Microaggressions are the everyday,
sometimes unintentional, words and actions that
invalidate, silence, and make invisible LGBTQ
identities and experiences; examples include the use
of the phrase “That’s so gay” as a universal put-
down, the lack of gender-inclusive language on
campus surveys, and refusal to use students’ chosen
names and pronouns. Exposure to microaggressions
in the college environment has a negative effect on
LGBTQ students’ psychosocial, physical, and
academic well-being. Recent research indicates,
however, that LGBTQ students are resilient in the
face of adversity.
LGBTQ climate varies across institutions and
institutional types. For example, many religiously
affiliated institutions remain unwelcoming to
LGBTQ college students; some continue to expel
transgender students from campus housing and
compel gay and lesbian students to take additional
College Students
pledges of purity beyond those required of
presumably heterosexual students. A few Catholic
and other Christian institutions (e.g., Calvin College,
Loyola University of Chicago) have made intentional
and specific efforts to more fully support LGBTQ
students on their campuses.
Progressive public and private institutions provide
gender-inclusive housing and public facilities (e.g.,
restrooms, locker rooms), straightforward processes
to change one’s name in campus records, LGBTQ
curriculum, an array of student organizations, and
well-trained professionals across campus who
implement LGBTQ-positive policies and programs.
Some campuses (currently fewer than 200, but with
more opening each year) have LGBTQ campus

resource centers (CRCs) or provide part- or full-time
staff responsible for supporting the LGBTQ
community.
Multiple Identities of LGBTQ College
Students
Although much of the existing research on LGBTQ
college student experiences and identities ignores
other identities—such as race, faith tradition, ability,
and social class—that may be salient to those
students, scholars are beginning to examine multiple
and intersecting identities in college students.
Research indicates that people of color who identify
as LGBTQ, or other more culturally specific terms
like same-gender-loving or two-spirit, may
experience the negative effects of heterosexism and
genderism as well as racism or combinations of these
oppressive forces. They may face antiLGBTQ
sentiment among peers of their racial or ethnic
background and racism among mostly White groups
of LGBTQ peers at predominantly White institutions
(PWIs). However, research that takes an appreciative
stance indicates that some LGBTQ students of color
demonstrate resilience in the face of multiple and
overlapping systems of oppression. For example,
some biracial, bisexual students indicated that they
developed their racial and sexual identities on
parallel, but related, tracks and that the college
environment provided unique opportunities for
identity development in these domains.
A small body of evidence addresses intersections
of LGBTQ and religious (sometimes called spiritual
or faith) identities among college students, mainly
addressing students with Judeo-Christian faith
identities and experiences. A strong faith identity,
particularly if that identity is rooted in a conservative
tradition, may lead to feelings of guilt, shame, or
confusion about an LGBTQ identity. Conversely, a
strong LGBTQ identity may lead some students
away from a religious tradition that they find
constraining. An increasing body of research finds
that some college students are able to reconcile and
integrate their sexual, gender, and religious selves.
Other LGBTQ students may leave organized
religious traditions to explore dimensions of
spirituality and faith outside formal religion. Studies
suggest that creating spaces for LGBTQ students of
faith to discuss their identities is particularly
College Students 703
important in the development and maintenance of a
positive self-concept.
In another area of multiple identities, LGBTQ
college students with disabilities may find
communities among supportive peers, staff, and
faculty. LGBTQ deaf students network on their own
campuses and through national organizations that are
facilitated primarily through online communities and
regular in-person conferences. The academic areas of
disability studies and queer studies share some
theoretical assumptions about embodied identities
and the medicalization of the so-called abnormal in
society. LGBTQ college students and faculty with
disabilities have been leaders in both academic areas.
Social class remains an understudied area of
higher education in general and of LGBTQ student
experiences and identities in particular. The ways
that social class identities interact with and mutually
cocreate sexual orientation and gender identities are
understudied. It is also not clear how a
socioeconomic analysis of LGBTQ college student
outcome (such as graduation rates, selection of
majors, sense of belonging on campus) might reveal
differences across economic quartiles. Presumably
LGBTQ students are distributed evenly across the
quartiles and their outcomes would mirror those of
their socioeconomic peers. But studies of LGBTQ
youth show that they are more likely than
heterosexual and cisgender youth to be homeless or
in foster care; how their overrepresentation in the
lower-income quartiles might appear in college data
is unclear.
LGBTQ Students at Colleges and Universities
With Specialized Missions
The majority of U.S. colleges and universities have
missions that are not specific to religion, race, or
gender. Several hundred, however, are affiliated with
religious denominations (mainly Catholic and
Christian, with a few Jewish, Muslim, and Hindu)
and have missions to promote the values and/or
practice of those denominations; 106 public and
private institutions were designated in 1964 as
historically Black colleges and universities (HBCUs)
and maintain strong commitments to educating
African American and Black students; and there are
about four dozen private women’s colleges
remaining (down from a high of more than 200 in the
704
mid-1900s). There are LGBTQ students at all of
these institutional types, and sometimes the mission
of the institution creates different conditions for
identities, experiences, and climate from those that
exist at public and secular private PWIs and at
coeducational institutions of all types.
The history of U.S. higher education is
inextricably bound to the establishment and spread of
(mostly Christian) religious denominations across the
North American continent. Hundreds of colleges
founded by religious denominations persisted to
become private colleges and universities of varying
degrees of religiosity in the 21st century; many
dropped their denominational ties entirely, while
others retain strong affiliations with religious
traditions and require students, faculty, and other
employees to sign a document that defines codes of
beliefs and behavior. Some students may identify as
LGBTQ before entering these faith-based
institutions, but others may come to understand
themselves as LGBTQ after beginning college. In
both cases, LGBTQ students are in a position that
may compromise their continued enrollment if their
identities become known. Navigating institutional
enactment of doctrinal teachings about
homosexuality (hate the sin, love the sinner) may
become part of their college lives. Catholic
institutions are unlikely to compel students to sign a
faith-statement, and LGBTQ students are a visible
presence on many Catholic campuses, though they
may not be allowed to create formally recognized
student organizations.
HBCUs on the whole lack institutionalized
support for LGBTQ students. Few HBCUs have
professionally staffed LGBTQ resource centers, their
library holdings have limited LGBTQ materials, and
the area of queer studies is not visible in their
curricula. About two dozen HBCUs, one quarter of
the institutions in this sector, have LGBTQ student
organizations. Paul Quinn College and Morehouse
College have articulated dress-code policies that
strictly forbid gender nonconformity; students at all-
male Morehouse, for example, are not to dress in
women’s clothing. Research demonstrates that while
there are a number of openly LGBTQ students at
HBCUs, they typically experience conflicting
messages about embracing racial pride in themselves
while carefully monitoring their gender and sexual
orientation expression to avoid violating stated and
tacit norms about what it means to be an educated
Black man or woman. Although a number of
prominent Black queer intellectuals do work in the
intellectual area of gender and sexuality within
African American communities, HBCUs generally
have not reflected progressive views on LGBTQ
issues or embraced progressive approaches to their
queer students.
Women’s colleges are in a unique situation among
these special mission institutions, in that gender
identity has been built into them from their
beginnings in the early 1800s when they were the
only option for female students aspiring to education
past secondary school. Evidence indicates that
women’s colleges have, from their early days, been
the location of romantic friendships and sexual
activity between students. Concern that they would
be considered “hotbeds” of lesbian activity led some
women’s colleges to react with extremely vigorous
campaigns to eradicate any signs of “particular
friendships” on their campuses; other colleges
became sanctuaries of a sort for women who found
themselves attracted to other women. By the 1990s,
most secular women’s colleges
Colorado Designated Beneficiary
settled into their reputations as tolerant—but not
promoting—of lesbian and bisexual identities on
campus.
In the 21st century, an influx of trans students has
challenged women’s colleges to clarify their
admissions and continuing enrollment standards.
Most women’s colleges admit students who are
legally female at the time of application, regardless
of their gender identity; the result is a visible
population of trans masculine spectrum students and
transgender men on some women’s college
campuses. Trans feminine spectrum individuals and
transgender women who are legally male, however,
are not welcome to apply to most women’s colleges.
Given the low likelihood that students in the
traditional applicant pool for women’s colleges—
first-time, first-year students just out of high school
—have had the opportunity to attain hormone
therapy and/or surgery necessary to change their
legal sex (or gender in some states), the number of
transgender women attending women’s colleges is
likely to remain low until institutional policies or
civil statutes regarding gender assignment change. In

2014, two women’s colleges (Mills and Mount
Holyoke) articulated admissions policies that are
inclusive of transgender students; Mount Holyoke
will consider applications from qualified applicants
who are biologically female and any gender identity,
or who are biologically male and any gender identity
other than cisgender male.
Kristen A. Renn and Erich N. Pitcher
See also Activists in College; Campus Climate; College
Athletes; Education; Historically Black Colleges and
Universities, LGBTQ Students at; Transgender
Inclusion on College Campuses
Further Readings
Dugan, J. P., Kusel, M. L., & Simounet, D. M. (2012).
Transgender college students: An exploratory study of
perceptions, engagement, and educational outcomes.
Journal of College Student Development, 53(5),
719–736. doi:10.1353/csd.2012.0067
Dugan, J. P., & Yurman, L. (2011). Commonalities and
differences among lesbian, gay, and bisexual college
students: Considerations for research and practice.
Journal of College Student Development, 52(2),
201–216. doi:10.1353/csd.2011.0027
Marine, S. (2011). Stonewall’s legacy—bisexual, gay,
lesbian, and transgender students in higher education
[Special issue]. ASHE Higher Education Report, 37(4).
Spade, D. (2011). Some very basic tips for making higher
education more accessible to trans students and rethinking
how we talk about gendered bodies. Radical Teacher, 92,
57–62.
College Students 705
beneficiaries was the first Colorado law that did
extend a limited set of legal rights to samesex
couples.
Both parties to a DBA must be 18 years or older,
competent to contract, unmarried, and not already a
party to a DBA. The parties must sign the agreement
voluntarily. There are 16 possible legal rights that the
parties to a DBA may select. The parties need not
select all 16. In addition, the parties may select
different legal consequences for each other. The
agreement must be signed and notarized and must be
filed with the county clerk and recorder in a county
in which one party resides.
Some of the most important rights and protections
that two people may choose in their DBA are the
right to visit in a hospital, nursing home, hospice, or
similar facility; to make complaints about the
patient’s treatment at a nursing home facility; to
make health care decisions when the patient cannot
make his or her own decisions; to inherit if the other
party dies and has not written a will; to obtain
survivor’s benefits if the other party dies on the job,
or to sue for wrongful death; and to determine the
disposition of the other party’s remains

COLORADO DESIGNATED BENEFICIARY

A designated beneficiary agreement (DBA) is a legal

document available only in Colorado that allows any
two unmarried individuals to designate each other for
one or more important purposes, such as medical
decision making and inheritance. The two people do
not need to live together or be in an intimate
relationship. Although it is not limited to same-sex
couples, the 2009 act creating designated
706
upon death. These go into effect immediately upon
signing the DBA and filing it in the office of the
county clerk and recorder where one of the
designated beneficiaries lives.
Either party can revoke the DBA by filing a
notarized revocation with the county clerk’s office
where the DBA was recorded. The subsequent
marriage of one of the parties also automatically
revokes the DBA. In addition, either party can
execute other documents, including a will, medical
power of attorney, or advance directive concerning
medical treatment and disposition of remains, and
those documents supersede a DBA.
The law creating DBAs was enacted in 2009 at the
urging of Equal Rights Colorado, the state’s LGBT-
rights legislative advocacy organization. In 2006,
Coloradans had voted to define marriage as between
a man and a woman in the state constitution and had
defeated a proposal to create a statewide domestic
partnership status. In 2009, unable to get the
legislature to pass either civil unions or marriage for
same-sex couples, LGBT-rights advocates and their
allies saw enactment of the statute authorizing DBAs
as a stepping-stone toward greater rights in the
future. Opponents of greater recognition for same-
sex couples also understood this legislation as an
incremental step toward same-sex marriage and
resisted it for that reason.
In 2010, One Colorado Education Fund, an
education and research organization dedicated to
LGBT equality, conducted a survey of 4,600 LGBT
Coloradans. Over 30% of the respondents were
unaware of the law that had created DBAs. Over half
of all respondents were in committed relationships,
and, of those, 34% had a DBA.
The Colorado LGBT community had additional
legislative success in 2013, when a vote of the
legislature created civil unions, available to both
same-sex and different-sex couples. That law
provided that “a party to a civil union has the rights,
benefits, protections, duties, obligations,
responsibilities, and other incidents under law as are
granted to or imposed upon spouses.” In October
2014, as a result of a ruling, binding in Colorado, by
the U.S. Court of Appeals for the 10th Circuit, the
state began allowing same-sex couples to marry.
Colorado Designated Beneficiary
Colorado’s designated beneficiary status is
unique. It most closely resembles the status of
reciprocal beneficiaries created in Hawaii in 1997,
the first U.S. law with the explicit purpose of
providing some legal rights to same-sex couples.
Colorado’s DBA differs from that status in two
important ways, however. Hawaii made its status
available only to two people who could not marry
each other, thereby excluding heterosexual couples.
The Hawaii status also confers identical, enumerated
rights on the two parties. In Colorado, the parties to a
DBA select for themselves which of the 16 legal
consequences they wish, and they need not select the
same ones. This flexibility allows the two parties to
tailor their DBA to their individual circumstances.
The DBA legislation remains in effect. Because
LGBT advocates saw DBAs as a stepping-stone to
greater rights, some might question the purpose of
retaining the DBA option. The value of this
alternative, however, is its availability to couples
who do not choose to marry and to any two
unmarried individuals who wish a way to give an
unrelated person a status that resembles that of next
of kin.
For example, when an unmarried person who has
not drafted power of attorney documents is
incapacitated and cannot make health care decisions
or manage his or her affairs, the law generally gives
decision-making power to relatives such as parents,
adult children, siblings, or more distant relatives.
When an unmarried person dies without a will, the
law names some of those same relatives to inherit the
deceased’s estate. When a person marries, any rights
those relatives would have automatically become
secondary to the spouse, who becomes the legal next
of kin. A DBA allows a person who is unmarried to
name someone who would become his or her next of
kin for the specific purposes identified in the DBA.
This is an especially important option for unmarried
LGBT individuals who have chosen family and may
be estranged from their relatives.
The marriage-equality movement has faced
criticism from some within the LGBT community for
assimilating to a heterosexual norm. A DBA is an
example of a mechanism that can be used creatively
to confer limited legal consequences on
Coming Out, Disclosure, and Passing
relationships that do not mirror marriage. In the wake
of nationwide marriage equality, LGBT advocates
may use Colorado’s DBA statute as a starting point

for developing similar legal structures in other
states.
Nancy D. Polikoff
See also Hospital Visitation; Legal Recognition of
Nonmarital Same-Sex Relationships; Marriage,
Reasons for and Against; Powers of Attorney; Wills
and Trusts
Further Readings
Berg, N. C. (2011). Designated beneficiary agreements: A
step in the right direction for unmarried couples.
University of Illinois Law Review, 2011(1), 267–307.
Colorado Bar Association. (2012). Colorado’s
Designated Beneficiary Agreement Act. Retrieved
from https://www.cobar.org/index.cfm/ID/21614
Feinberg, J. R. (2013). Avoiding marriage tunnel vision.
Tulane Law Review, 88, 257–315.
Trageser, C. (2009, July 1). Designated beneficiary rules
grant unmarried pairs decision-making power: Partners in
life, by law. Denver Post, p. B-01. Retrieved from
http://www.denverpost.com/ci_12727790
COMING OUT, DISCLOSURE,
AND PASSING
Coming out is a commonly used trope in LGBTQ
life, literature, media, and research. Coming out is
behind the scenes, often assumed by scholars as a
process occurring but seldom defined. Colloquially,
coming out refers to the disclosure of sexual
identity, but the metaphor has grown to encompass
the disclosure of any LGBTQ identity to others, or
even the claiming of nonqueer identities to further a
social movement, such as “coming out as fat.”
Coming out can refer to the internal claim to an
identity—“coming out to myself”—as well as the
disclosure of that identity to others. Conversely,
people are passing when others assume them to be
heterosexual or straight in a given situation. Because
of the history of the concept, coming out is often
seen as a one-time event: “When did you come out?”
However, scholars today see coming out as an
ongoing process of managing one’s identity, which
can involve disclosing to some people and passing
with others.
707
In the context of research, the concept of coming
out has had a tangled and convoluted history,
emerging from folk meanings about the public
embrace of a gay identity to the ongoing struggle of
regulating knowledge of one’s LGBTQ identity
within a society that assumes heterosexuality. This
entry first covers the development of the concept of
coming out and continues with a discussion of
research on the strategies, motivations, and future of
coming out.
The History of Coming Out
The metaphor “coming out of the closet,” although
common today, was not the original use of the term.
Rather, the term referred to coming out into queer
society, meaning that people were revealing
themselves to be gay to other gay people, in a
manner akin to the “coming out” of debutantes at a
high-society ball. Later, however, the term was
combined with the metaphor of the closet, implying
the oppressive, shameful existence of “living a
lie.” Coming out in this metaphor, then, is not about
the acceptance of a gay identity but the disclosure of
that identity to straight people.
Researchers began discussing coming out in
earnest as psychologists attempted to understand
patients who were struggling with integrating their
homosexual identity, often within communities that
stigmatized homosexuality. Building on Erik
Erikson’s stage model of psychological development
over the life course, Vivienne Cass’s stage model of
homosexual identity development is perhaps the
single most influential study on coming out from this
period, given that these stages influenced a
generation of research on gay people and her
assumptions about the nature of coming out linger to
this day.
In Cass’s model, coming out was a feature of the
“identity tolerance stage” in which gay men, having
realized and accepted their attraction to other men,
begin to live a double life. With other gay people,
they were publicly gay, whereas with straight people,
like their families, they continued to pass as straight.
Coming out, then, was the disclosure of their identity
such that they no longer had to live a double life, but
were beginning to synthesize the two identities into a
single, integrated identity in the next stage.
Later theorists continued to rely on Cass’s model,
but began to see the stages as too rigid to aptly
708
describe real life. Instead, researchers adapted these
stages into a more fluid “coming out process.” In this
definition, coming out was a process of disclosing
identity to more people over time, thus indicating a
commitment to a gay identity. Milestone events in
the process were coming out to family members or
friends. Conceptions of coming out as a process,
though, still retain a stagelike linearity, as though one
simply accumulates disclosures until one is “out.”
During the social constructionist turn in LGBTQ
studies, scholars began to move away from
essentialist notions that gay identity developed in the
same way for everyone; in turn, there was an
explosion of new research into coming out. However,
while many researchers between 1990 and 2004
introduced new definitions of coming out, these
definitions did not engage with one another, leading
to more confusion. Largely, coming out was seen as
an individual matter, with different researchers
emphasizing different aspects, such as emotional
connection, the family life cycle, or using their own
lives as models to define coming out. Coming out in
this era was seen as an act of disclosure to specific
people at specific times, rather than part of an
overarching process.
Although coming-out researchers proposed these
changes, other scholars applying the concept in
studies continued to refer to coming out as a one-
time event, primarily involving an emotionally
charged verbal disclosure of identity. Most research
was within a psychology frame, focusing on the
mental health outcomes of gay people, and so viewed
these disclosures, or instances of passing, as
reflecting internal states of identity, rather than
contextual social interaction in the long-term
Coming Out, Disclosure, and Passing
management of identity. One way to think of the
difference between these two perspectives is to think
about “coming out to oneself” versus
“coming out to others.”
Scholars today see coming out as an ongoing
process of identity management, focused on how and
why people come out to others, not just their identity
development. LGBTQ people make decisions about
which contexts and people warrant disclosure versus
passing. Of course, it is impossible for truly everyone
to know about someone’s gay identity within a
society that assumes heterosexuality. There will
always be strangers that do not know about one’s
LGBTQ identity. Therefore, the possibility of
coming out is always there.
Different scholars use different metaphors to
describe this situation, but they are similar in
describing an ongoing contextual social process of
managing identity. Some use the metaphor of “being
out,” although this has grown out of favor since it
implies an essential situation in which everyone
knows one’s sexual identity. Other scholars discuss
coming out as a “revolving door,” in which people
are constantly coming in and out of the closet as they
move through different situations. Others use the
metaphor of a “career.” This metaphor also
emphasizes that coming out is always happening in
one’s life. Others consider LGBTQ people to have a
“strategic outness.” This perspective views coming
out as continual and contextual. People can never
completely disclose their identity to everyone.
Rather, LGBTQ people continually make strategic
decisions about what identity they will disclose to
others and the methods they will use.
Methods of Coming Out and Staying In:
Disclosure and Passing
Although coming out is often discussed as though it
is a moment of revelation, a public disclosure, and/or
an emotional announcement, there are many ways
that people come out, or manage who knows about
their LGBTQ identity. This stereotypical coming out
is the “direct disclosure” strategy. This is the “Mom,
Dad, I’m gay” of coming out strategies.
Coming Out, Disclosure, and Passing
However, people can come out more subtly,
without explicitly referencing their identity, by
presenting clues. Often people use stereotypes of the
group to indicate membership in it. The other person
in the interaction, the person being come out to,
infers group membership on the basis of such clues.
Of course, the person has to understand the clue! If
the other person doesn’t get the reference, or doesn’t
associate it with the group, then that person might
not receive the message because coming out is
contextual. A woman who puts on a plaid flannel
shirt might be giving a clue to indicate her lesbian
identity, but it might not work as a clue in a
midwestern rural town, where such clothing is more
common among women. Clues depend on the social

contexts the other person moves through, and the
groups to which the person belongs.
Coming out with an affinity is closely related to
this category. In this case, the person comes out with
a statement, such as “likes guys,” that the other
person takes to mean that the person coming out is
queer. Essentially, the person is coming out as “not
straight,” or as LGBTQ, but it’s harder to pin down
the exact identity term.
Tailoring involves coming out using a different
identity than the one that a person identifies with, but
one that is also stigmatized. For instance, a bisexual
man might tell someone that he is gay, such that this
will be less remarkable to the person, or otherwise
minimize questions or interaction in the coming-out
encounter. In this way, tailoring takes us into the
types of coming out that involve preventing someone
from knowing a person’s identity.
Passing is one such method: coming out by
“staying in,” so to speak. It is coming out in the sense
discussed throughout this entry, as an ongoing
management of identity. Passing involves using the
heterosexual assumption to stay under the radar, to
pass as straight in the situation despite identifying
otherwise. Concealment, on the other hand, refers to
explicitly preventing others from finding out.
Covering is also similar in that it is about minimizing
clues to identity. However, in covering, people
consider themselves to be “out” in the situation, but
are merely trying to make their identity less salient
by monitoring their behavior for stereotypical clues
or other things that people might use to “clock” them
as LGBTQ.
Last, speculating is the strategic abdication of a
decision, a nonmethod method of coming out. If
people leave observers to “speculate” about their
identity, they are essentially saying that they don’t
want to make a choice. They want other people to
figure it out and ask them if necessary.
Overall, coming out is accomplished in multiple
ways, sometimes with multiple methods with the
same person or context. LGBTQ people use different
methods of coming out not only to manage
knowledge of their identity, but also to regulate their
distance from others in their life.
Motivations to Disclose or Pass
The reasons for coming out are as diverse as the
methods people use to accomplish it. Some people
709
come out because they feel the need to be “true to
themselves” or that they are “living a lie.” That is
coming out as viewed as essential and mandatory.
People must tell others because there will be
negative impacts in their own lives if they do not.
The reasoning is that honest people will disclose to
others, since passing often involves covering or
concealing aspects of their lives that would be clues
to their LGBTQ identity.
This motivation, however, cannot be divorced
from the political context, in which coming out has
been used as a tool of social change. The gay
liberation movement encouraged coming out as a
political strategy, because public visibility of
LGBTQ people was thought to erode discrimination
and secure rights. Harvey Milk, the slain gay civil
rights leader, for instance, commanded in a speech:
“Gay brothers and sisters, you must come out!”
Research shows that LGBTQ people sometimes
intentionally come out to people who they believe
will react negatively so that they might educate these
people, perhaps correcting stereotypes or stigma
before others can be discriminated against.
Coming out can also be dangerous. Some LGBTQ
people refer to it as “explosive knowledge,” in that it
could blow up in their faces if revealed to the wrong
people. Even if it doesn’t provoke discrimination or
violence, coming out can damage social relationships
in which people thought they deserved to be told
earlier or in a different manner.
Thus, coming out can be exhausting emotional
work. Unknowing people might ask personal
questions or begin to apply stereotypes to someone
who has come out to them. Since coming out is
ongoing and never-ending, some LGBTQ people find
it draining, preferring to minimize instances in which
they will have to come out to new people.
These different motivations for coming out (e.g.,
desire to live fully out, open lives; desire to educate
others; desire to decrease stigma through visibility)
work in concert. Research shows that people
consider various factors, including the closeness of
their relationships with individuals, to determine
whether coming out is worth the risk and reward.
Differences in Coming Out Between
Groups
Scholars disagree about whether there are
meaningful differences between groups in how and
710
why people come out. Some researchers contend that
the coming out process looks different for gay men
than it does for lesbian, bisexual, transgender, and
queer people. They argue that gay men have an
easier time coming out than members of other
groups, because the social privilege attached to being
men often enables them to be financially independent
from their families or stigmatizing communities. In
this line of thinking, because women are subject to
sexism, which lowers their economic potential, their
ability to form lives separate from heterosexual
marriage is hampered.
Other researchers disagree, arguing that although
the contexts in which gay men and lesbians might
come out and have difficulty are different, they use
similar methods and are motivated by similar reasons
to come out.
Coming out for bisexuals has an added dimension
in that their relationships with the other sex fit
societal expectations of heterosexuality. If a bisexual
man introduces his wife to someone, that person—
because of the heterosexual presumption— will
assume that he is straight. In this case, is he passing,
covering, speculating, or concealing? As discussed in
the previous section, the interpretation depends on
one’s political stance, with those
Coming Out, Disclosure, and Passing
advocating for bisexual visibility likely arguing that
this man would have a “disclosure imperative” to
reveal his sexuality to prevent others from assuming
heterosexuality.
There has been little research on whether the
methods of coming out, the motivations for doing so,
or how one would define coming out are different
across racial groups. Initial indications from some
research suggest that, again, the methods and
motivations are similar, but the contextual
considerations change. Much of the research in this
area has focused on a case of passing within the
Black community known as the “down low,” which
has its own identity and social politics and is
addressed in its own entry in this volume.
Similarly, passing within the transgender
community is sometimes called “going stealth,”
which also has its own dynamics, identity, and
political motivations, and is also addressed in a
separate entry.
Other factors influence the context that people use
to manage who knows about their identity or if others
accept that identity as legitimate. For example,
research has shown that people who are perceived as
conventionally attractive are more likely to receive
feedback when coming out to the effect that their
identity is not real, or that they are not truly LGBTQ.
As an ongoing social process, coming out develops
in concert with other social dynamics.
The Continuing Relevance of Coming Out
When people come out, what are they coming out
with? The identity that they reveal when they come
out is just as important a factor as the methods and
motivations for coming out. The diversity of identity
labels today means that people can come out with
identity labels beyond the traditional gay, lesbian,
bisexual, and transgender. Coming out with a
different label (i.e., one that most people are less
familiar with) may mean that people will have more
questions, and, in turn, create more emotional work
for the person coming out.
Furthermore, a number of scholars consider
LGBTQ people today to be “beyond the closet” or
“post-gay.” They believe that, with the growing
acceptance of LGBTQ people in society, LGBTQ
Commitment Ceremonies
people no longer go through a “coming out
experience.” Coming out is seen as an older model in
which people identify with the gay social group and
then disclose this to others. Today, it is thought in
this movement that young people do not need to
come out, because their sexual identity is public as
they are discovering it. They believe young people
tend not to identify as sexual minorities, but see
themselves as “normal people.”
Other scholars dispute the validity of this “post-
gay” model for several reasons. First, this model
relies on a definition of coming out that is linear,
developmental, and stagelike, rather than an ongoing
social process. Second, today’s young people
continue to use traditional sexual identity labels,
although perhaps concurrently with unique labels or
affinity labeling. Third, people might have to come
out multiple times over the course of their lives,
since sexuality is fluid, and people’s identifier might
change as they develop. Thus, coming out continues
to be an important metaphor and process to
understand how LGBTQ people manage their
identities.

Jason Orne
See also Developmental Aspects of Sexuality; Down Low;
Sexual-Identity Labels; Stealth (Transgender Passing);
Strategic Disclosure
Further Readings
Cass, V. (1979). Homosexuality identity formation.
Journal of Homosexuality, 4, 219–235.
Cox, S., & Gallois, C. (1996). Gay and lesbian identity
development. Journal of Homosexuality, 30, 1–30.
Evans, N., & Broido, E. (1999). Coming out in college
residence halls: Negotiation, meaning making, challenges,
supports. Journal of College Student Development, 40,
658–668.
Guittar, N. (2013). Coming out: The new dynamics.
Boulder, CO: FirstForumPress.
Kaufman, J. M., & Johnson, C. (2004). Stigmatized
individuals and the process of identity. The
Sociological Quarterly, 45, 807–833.
Mclean, K. (2007). Hiding in the closet? Bisexuals, coming
out and the disclosure imperative. Journal of Sociology,
43, 151–166.
Mosher, C. M. (2001). The social implications of sexual
identity formation and the coming-out process:
A review of the theoretical and empirical literature.
The Family Journal, 9, 164–173.
Orne, J. (2011). “You will always have to ‘out’ yourself”:
Reconsidering coming out through strategic outness.
Sexualities, 14, 681–703.
Orne, J. (2013). Queers in the line of fire: Goffman’s stigma
revisited. The Sociological Quarterly, 54, 229–253.
Oswald, R. F. (2000). Family and friendship relationships
after young women come out as bisexual or lesbian.
Journal of Homosexuality, 38, 65–83.
Troiden, R. (1989). The formation of homosexual identities.
Journal of Homosexuality, 17, 43–73.
COMMITMENT CEREMONIES
Commitment ceremonies are rituals that celebrate
romantic relationships. They may be held to
recognize and celebrate the romantic relationship (or
relationships) between individuals in same-sex,
different-sex, and gender-complicated couples or
polyamorous groups. Commitment ceremonies do
not provide legal recognition of the relationship
711
being celebrated and thus should not be equated with
weddings or marriage. This entry describes
commitment ceremonies, summarizes the benefits of
having one, and suggests that these rituals hold
continued relevance even as same-sex marriage
becomes more common.
In the United States, marriage is a contract written
by individual states. Those who enter into marriage
are beholden to its legal rules. These rules vary by
each individual state, but all marriage statutes require
the “solemnization” of a marriage license. Weddings
are rituals that provide the solemnization that
validates a marriage license. Weddings may be
secular or religious, but they must be officiated by
someone who is sanctioned by the state to perform
the ritual (e.g., a clergyperson or judge). Also, only
two spouses are allowed; all states currently ban
polygamy. Although there is room for
personalization in wedding ceremonies, certain
elements must be included (e.g., vows, witnesses,
signing the license). Upon filing a solemnized
marriage license, spouses may have the option to
change their last name with no fee or application.
Once obtained, the marriage license entitles spouses
to more than a thousand state and federal benefits.
By contrast, commitment ceremonies are scripted
by those involved and provide no legal standing.
Commitment ceremonies may look exactly like
traditional weddings, but they may also be
completely different and contain no recognizable
“wedding” elements. Commitment ceremonies may
be officiated by anyone who is chosen by those
getting committed. Any number of people may be
joined in a commitment ceremony—there is no
requirement that it be limited to couples. Although
people who have a commitment ceremony may apply
to change their legal names, they must do so as
individuals and always pay the required fee for name
changes. Having a commitment ceremony does not
establish any legal rights or obligations between
partners.
Commitment ceremonies are nonetheless seen as
important rituals. Rituals are meaningful events used
to mark important social transitions. Their meaning
may be drawn from deeply personal sources, and/or
from social norms and institutional expectations.
Rituals move people from one status to another by
creating boundaries around the ritual that distinguish
it from everyday life, by employing multiple symbols
that invoke the core meaning of the event, by
712
including people who conform to the expectations of
the event, and by scripting closure that marks a
transition back into everyday life but with a new
status.
Commitment ceremonies are events by which
couples or groups declare their intention to remain in
the relationship. They mark the change from a casual
or dating relationship to one that recognizes
obligations between partners. The partners involved
may consider it extremely important that they
replicate the symbols and customs of a traditional
wedding; although their ceremony does not provide
any legal standing, the enactment of a traditional
wedding ritual may provide social legitimacy in the
eyes of family or friends. If the ceremony has
religious
Commitment Ceremonies
content, then it may provide important religious
validation even if other religious sources are
rejecting.
Unlike weddings, commitment ceremonies may
be completely idiosyncratic to the partners involved.
Because there is no legal mandate for witnesses, the
ceremony may be private or even secret. The vows,
or statements of commitment, may take any form.
Rings may be used to symbolize commitment, but
other symbols may be instead of, or in addition to,
rings. What is essential is that those involved believe
that the event has solidified their commitment to
each other.
As some observers have pointed out, the
commitment ceremony is a valuable ritual form that
should not be overlooked despite the increasing
availability of same-sex legal marriage. Quite
simply, not all couples wish to be legally married,
and polyamorous groups do not have access to legal
marriage. Polyamorous relationships are those that
involve three or more partners; all partners may be
involved with one another, or they may be structured
such that one person is in multiple relationships.
Commitment ceremonies for these relationships
would involve rites of commitment between each set
of partners, and possibly among the entire group.
Reasons for avoiding legal marriage include a
belief that the state should not regulate personal
relationships, as well as the avoidance of tax or
social security penalties that may accrue if one is
divorced and then remarries. Furthermore,
commitment ceremonies demonstrate the creativity,
beauty, and tenacity that may arise when people are
marginalized and excluded from social norms, or
consciously choose to reject those norms. Indeed, the
LGBTQ community has always involved tensions
between normativity and “queering”—between the
stance that gender and sexual minorities want to be
“just like everyone else,” and the stance that
marginalization from social conventionality allows
for the creation of alternative models for love and
commitment.
Prior to legal same-sex marriage, commitment
ceremonies were the only option for same-sex
couples. Now that legal same-sex marriage is
increasingly possible, it is easy to overlook the fact
Community Climate
that not everyone desires it. Commitment ceremonies
can continue to provide deeply meaningful
recognition of relationships.
Ramona Faith Oswald
See also Domestic Partnership; Families of Choice; Long-
Term Same-Sex Couples; Marriage, Reasons for and
Against; Polyamory; Romantic Friendships; Same-Sex
Weddings
Further Readings
Lewin, E. (1998). Recognizing ourselves: Ceremonies of
lesbian and gay commitment. New York, NY: Columbia
University Press.
Reczek, C., Sinikka, E., & Umberson, D. (2009).
Commitment without marriage: Union formation among
long-term same-sex couples. Journal of Family Issues,
30, 738–756. doi:10.1177/0192513X09331574
Unmarried Equality. http://www.unmarried.org
COMMUNITY CLIMATE
This entry describes the concept of residential
community climate—what it is, how it is measured,
and how it affects LGBTQ people. Although
community can be defined in various ways, for the
purposes of understanding community climate, a
community refers to a geographical region—a town,
city, or municipality—bounded by shared local laws,
government offices, and political representatives.

The community represents the contextual piece of an
LGBTQ person’s experiences in a residential district.
The sections that follow explore ways to think
about community climate for LGBTQ people and the
importance of considering community climate as an
indicator of context. After defining and illustrating
the idea of community climate, the entry highlights
the ways that community climate has been measured
in LGBTQ research and summarizes the literature
connecting community climate and LGBTQ
individuals’ well-being. The entry concludes with
additional points of consideration when thinking
about community climate for LGBTQ people.
What Is Community Climate?
Community climate is the overall level of support or
hostility toward LGBTQ people that is present in a
geographical region (e.g., a municipality, city, town,
suburb, county). It describes the societallevel
conditions of support for LGBTQ issues, rather than
the individual experiences or interpersonal
interactions that occur at the micro level. Thus,
community climate refers to a macro-level
understanding of the social environment. It addresses
this question: “Is the general attitude of a region one
of acceptance or stigma?” Community climate is also
pervasive in that it is constantly present and
reinforces the beliefs about what types of individuals
and interpersonal interactions are acceptable. For
example, a singular act of antiLGBTQ victimization
or harassment may be a symptom of a larger hostile
community climate in an area. This community-level
support, or lack thereof, is reflected in local
institutions, laws, and political stances, as well as the
social norms and attitudes of the community’s
residents.
How Has Community Climate Been
Studied?
Since the concept of community climate describes
the general attitudes of a region, scholars have used
both subjective and objective measures to capture the
presence of supportive or hostile attitudes.
Subjectively, researchers have asked LGBTQ people
specifically as well as the general population of an
area, “How gay friendly is your neighborhood?” or
“Do you consider this community to be supportive,
tolerant, or hostile toward LGBTQ people?” These
713
perceptions can offer insight into what it feels like to
be a sexual-minority or transgender person in this
community, regardless of what resources are or are
not available. To an outsider, a municipal region may
appear to provide adequate resources to support this
marginalized group, but insiders within the
community may still report an overarching sense of
stigmatization in their day-to-day lived experiences.
These types of climate measures provide valuable
information regarding salient aspects of support or
hostility in the community.
Some scholars, however, have suggested that
asking LGBTQ individuals to rate both the
community climate (a predictor variable) and their
own well-being (often the outcome variable) leads to
inherent biases in the data. In order to reduce this
“same source” bias, scholars have turned to also
measuring community climate with objective
indicators, by calculating scores based on the
presence or absence of LGBTQ-supportive policies
and resources. The Human Rights Campaign, for
example, created an itemized “scorecard” known as
the Municipal Equality Index (MEI) in order to rank
the community climate of hundreds of U.S. cities.
The MEI evaluates a city’s laws and policies based
on the protection of and support for LGBTQ rights
and inclusiveness of local LGBTQ leaders. A city
scores higher—arguably a more supportive
community climate—for the presence of
nondiscrimination laws, having same-sex
relationship recognition in the form of marriage or
civil unions, providing same-sex partner benefits to
municipal employees, and having an LGBTQ liaison
in the mayor’s office or police department. Bonus
points are awarded to cities that elect openly LGBTQ
officials or provide services to vulnerable LGBTQ
subpopulations (e.g., LGBTQ homeless youth). All
of these indicators show the city’s commitment to
providing a safe and affirming climate for LGBTQ
people. A failure to enact such policies and
procedures can indicate a more hostile atmosphere,
where an LGBTQ person does not feel recognized,
valued, or even protected.
Other characteristics of the municipality may also
contribute to this sense of acceptance or disregard for
LGBTQ people. Ramona Oswald and her colleagues
suggest that in addition to an examination of the legal
climate, the political and religious climates of a
region can also serve as indicators of community
climate. Data are publicly available reporting the
714
number of Republican versus Democratic votes in about them. The internalization of negative messages
presidential elections, or the number about a part of someone’s identity can truly be
Community Climate damaging to their emotional and psychological
health.
Mark Hatzenbuehler has done extensive research
of religious adherents per denomination. Again, both
on structural discrimination and the social factors
of these measures are taken to represent the general
leading to mental health disparities for LGBTQ
tone of a geographical region toward LGBTQ
people. He and his colleagues have found that a
people. For instance, a community with an
hostile community climate, aside from direct
overrepresentation of a politically conservative
experiences with discrimination, has a negative
opinion or a theological stance that homosexuality is
impact on LGBTQ individuals’ wellbeing.
a sin may be interpreted as a less supportive
Individuals living in a hostile community climate
community climate. These factors contribute to the
show higher rates of depression and anxiety, as well
overall social attitudes toward LGBTQ issues, but
as increased mortality risks (e.g., homicide, suicide,
also interact with and influence the laws and policies
and cardiovascular disease). These effects do not
of a municipality. Taken together, these items can be
hold true for heterosexual people living in the same
seen as an objective summation of community
community, indicating that LGBTQ people are
climate.
uniquely impacted by the negative climate.

How Does Community Climate Affect

Additional Points of Considerations
LGBTQ People?
Community climate is an important contextual factor
Community climate, as the backdrop of support or
to consider when looking at LGBTQ people’s
hostility, sets the stage for LGBTQ people to feel
experiences. The messages present at the societal
valued or further stigmatized in a particular city. A
level can have great implications not only for how
hostile community climate, one where the majority
individuals are viewed by their neighbors, but also
of the population holds a general attitude or tone that
for how those individuals view and understand
LGBTQ people are not tolerated, allows
themselves. Some additional aspects of the concept
opportunities for discriminatory interpersonal
of community climate that are worth considering
interactions to occur. For instance, if a city lacks a
include the changeable nature of climate, the non-
punitive law against LGBTQ discrimination, and the
insular nature of communities, and how the
majority of residents support laws that remove rights
perceptions of community climate can vary by
from LGBTQ individuals and believe homosexuality
individual identity characteristics.
is a sin, residents may feel it is more acceptable to
Community climate is a sociohistorical
shout derogatory comments at presumed LGBTQ
phenomenon. That is, scholars cannot assign
people or shun someone based on sexual orientation.
rankings to a community and assume that the climate
A hostile community climate essentially reinforces
will remain static across time. Laws are amended and
individuals’ decisions to discriminate; the
society’s attitudes shift, yet the interplay between
community climate can guide what interpersonal
changing legal and social climate in a community is
behaviors are or are not deemed acceptable.
not always immediately apparent. Often, social
In addition to acting as the moral compass for
attitudes shift and subsequent legal change feels long
beliefs about LGBTQ people and therefore
overdue; alternatively, legal amendments may occur
individuals’ behavior, community climate can
before the overall community climate has swung in
directly impact LGBTQ individuals’ sense of worth
the direction of support for that law. Although laws,
and well-being. LGBTQ people in the community
in theory, reflect the beliefs and desires of the
receive the societal messages, cultural beliefs and
constituents in that jurisdiction, legal changes do not
expectations, and attitudes of others just as everyone
inherently shift social attitudes or vice versa.
else in the town does. In fact, they may be more
Therefore, it is important to recognize the unique
attuned to assessing these attitudes and the
contributions of subjective and objective measures to
community climate because these messages are
Community Climate

the understanding of community climate for a given
place in a given historical period.
Additionally, community climate and the residents
of those communities are not wholly insulated by the
geographical boundaries of the region. Rather,
individuals are mobile and may experience multiple
community climates depending on where they work
and live. For example, an LGBTQ person may live in
a less-than-tolerant community but work and
socialize in a neighboring, relatively more-supportive
town. Having access to other types of climates could
potentially change residents’ perspectives of their
own community or buffer the effects of their own
residential climate. Further, individuals may live in a
state with an overall hostile climate toward LGBTQ
people, but feel supported by the local community
climate of their particular town. Thus, consideration
should be given not only to the geographical bounds
of individuals’ communities, but additionally reach
the many climates that those individuals may also
experience.
Finally, it is not enough simply to study the
community climate as a context for LGBTQ people’s
experiences. Scholars should also aim to understand
the interaction between the individual person and the
contextual climate. For example, Abbie Goldberg
and JuliAnna Smith found that LGBTQ people with
high levels of internalized homophobia showed
significantly greater negative effects in a hostile
community climate than individuals who were more
comfortable with their sexual orientation. Moreover,
consideration must be given to an individual’s
multiple and intersecting identities. That is,
subpopulations within the LGBTQ demographic may
be affected by a regional community climate
differently than others. Scholars need to consider
how the climate for transgender individuals differs
from that of other sexual minorities, or how the local
climate is different for LGBTQ people of color.
Feeling extremely attached to one’s residential
community may make one more perceptive of, and
perhaps more vulnerable to, the messages embedded
in the community climate. Parents who interact with
local school policies may recognize different aspects
of the community climate that LGBTQ people
without children do not directly experience.
Therefore, understanding the ways that diverse
individuals interact with and understand their
environment
715
can lead to a more comprehensive understanding of
the effects of community climate for LGBTQ people.
Elizabeth G. Holman
See also Antigay Ballot Initiatives (and LGBTQ Activism);
Discrimination Against LGBTQ People in the Public
Sector; Nondiscrimination Protections, State and
Local; Rural and Urban Communities; School
Climate; Work Environments
Further Readings
Goldberg, A. E., & Smith, J. (2011). Stigma, social context,
and mental health: Lesbian and gay couples across the
transition to adoptive parenthood. Journal of Counseling
Psychology, 58, 139–150. doi:10.1037/ a0021684
Hatzenbuehler, M. L. (2011). The social environment
and suicide attempts in lesbian, gay, and bisexual
youth. Pediatrics, 127, 896–903. doi:10.1542/
peds.2010-3020
Hatzenbuehler, M. L., Keyes, K. M., & Hasin, D. S. (2009).
State-level policies and psychiatric morbidity in lesbian,
gay, and bisexual populations. American Journal of
Public Health, 99, 2275–2281.
doi:10.2105/AJPH.2008.153510
Human Rights Campaign. (2013). Municipal equality index:
A nationwide evaluation of municipal law. Retrieved from
http://www.hrc.org/mei
Lick, D. J., Tornello, S. L., Riskind, R. G., Schmidt, K. M., &
Patterson, C. J. (2012). Social climate for sexual
minorities predicts well-being among heterosexual
offspring of lesbian and gay parents. Sexuality Research
and Social Policy, 9, 99–112. doi:10.1007/ s13178-012-
0081-6
Oswald, R. F., Cuthbertson, C., Lazarevic, V., &
Goldberg, A. E. (2010). New developments in the
field: Measuring community climate. Journal of
GLBT Family Studies, 6, 214–228. doi:10.1080/
15504281003709230
Coparenting
Oswald, R. F., & Holman, E. G. (2013). Place matters: LGB
families in community context. In A. E. Goldberg & K.
R. Allen (Eds.), LGBT-parent families (pp. 193–208).
New York, NY: Springer. doi:10.1007/978-1-4614-
4556-2_13
COPARENTING
716
Regardless of sexual orientation, two adults who
parent together must manage the many tasks
associated with rearing children. Thus, coparenting
involves coordination between the two adults in
order to complete such tasks. Coparenting involves
how couples divide child care labor (and whether
there are discrepancies in involvement) and any
parental behaviors (overt or covert) that are
supportive or undermining of each other. In addition,
coparenting has been found to be more strongly tied
to child adjustment than other aspects of the couple
relationship or individual parent–child relationships.
Indeed, linkages between coparenting and child
development are well established in heterosexual-
parent families with biological children, particularly
young children. Coparenting has been more
commonly studied among heterosexual couples and
their biological children than among lesbian and gay
parents, yet increasing numbers of families in the
United States are not composed of a heterosexual
mother and father rearing biological children, and
thus it is imperative to understand parenting and
child development in the context of other family
systems. This entry centers on coparenting, or the
dynamics of two adults working together to raise a
child, among sexual-minority couples. It attends to
the extent to which coparenting dynamics are
influenced by parent gender and sexual orientation,
and on the relationship between coparenting
behaviors and child outcomes among families with
lesbian and gay parents.
Traditional and Gendered Divisions of
Family Labor
Research on coparenting among lesbian and gay
couples has largely focused on divisions of family
Coparenting
labor, often comparing patterns of how same-sex and
heterosexual couples make decisions about sharing
and specializing in housework and child care.
Traditional patterns of dividing labor denote that the
father specializes in paid employment (usually
outside the home) and the mother specializes in
unpaid employment at home (such as household
chores and child care tasks). This gendered
specialization of division of labor, while well
established, has become less common in recent
years. Specialization appears to be most pronounced
among families in which the mother does not work in
paid employment, and it is least pronounced in
families where both mother and father work full
time. Even so, most heterosexual couples adhere to
specialized divisions of family labor. Many
observers seem to expect that even same-sex couples
will show these traditional, gendered patterns. Same-
sex parenting couples often report being asked
questions such as “Which of you is the mother?” or
“Which one of you is the husband?” Such questions
are based on traditional notions about division of
labor, and assume that same-sex couples must also
specialize, with one partner in the “husband/father
role” and the other in the “wife/mother role.”
Shared Versus Specialized Patterns of
Dividing Family Labor
Findings from numerous studies, however,
demonstrate that divisions of labor among lesbian
and gay couples often differ from those among
heterosexual couples. Rather than specializing, same-
sex couples are more likely than heterosexual
couples to share the labor involved in parenting and
in maintaining other aspects of their household and
life together via a relatively equal distribution of
tasks. In studies of families formed through a variety
of pathways (e.g., donor insemination, adoption),
results have consistently demonstrated that same-sex
couples tend to report shared or egalitarian divisions
of labor, and heterosexual couples tend to report
specialized divisions, with mothers often doing more
child care (e.g., bathing, feeding, dressing the child)
than fathers in these families. Thus, divisions of
family labor are often characterized by shared
patterns among lesbian and gay couples and
specialized patterns among heterosexual couples,
particularly with regard to child care tasks.
When the actual number of hours spent in paid
employment per week is considered, research
suggests that lesbian and heterosexual couples spend
the same overall time in paid work each week. The
difference, however, lies in how the hours of paid
work are allocated between the two members of the
couple. In heterosexual couples, fathers work more
hours in paid employment than mothers, but in
lesbian couples, both mothers tend to work
approximately equal numbers of hours per week.
Similarly, discrepancies in occupational prestige

(which describes the relative worth or social class
associated with a particular job) between partners in
heterosexual couples are generally greater than
among those in same-sex couples, a further
indication of greater specialization among
heterosexual couples compared with same-sex
couples.
Consequences of Specialized Child
Care Divisions
In studies focusing specifically on lesbian couples in
which one parent is the biological mother (e.g.,
families formed via donor insemination, or DI), it is
sometimes the case that biological mothers report
doing more child care than nonbiological (or
“social”) mothers. Perhaps this is related to
biological mothers having the experience of
pregnancy and then breastfeeding when the child is
an infant, setting in motion a pattern of completing
more child care tasks. Indeed, lesbian couples who
adopt children (where there is no discrepancy in
biological connectedness between the mothers) tend
to report more shared divisions of labor than lesbian
couples with biological children. Some studies
suggest that lesbian couples who use DI (and one
mother is known to be the biological mother) may
experience more maternal jealousy than lesbian
couples who use in vitro fertilization in a way such
that one partner contributes the egg(s) to be fertilized
and the other partner is inseminated and carries out
the pregnancy. In these ways, discrepancies in
biological relatedness to the child can sometimes
facilitate tensions among the parenting couple and/or
differences in divisions of family labor. It should be
noted, however, that comparisons with heterosexual
couples reveal that different types of lesbian-headed
families (e.g., adoptive, DI) still show less-
specialized patterns of labor than do heterosexual
couples. Moreover, lesbian social mothers in couples
who pursue DI often report qualitatively different
experiences than heterosexual fathers, such as greater
feelings of satisfaction with their partner as a
coparent, need to justify their role as a parent, and
parental concern toward their child, as well as lesser
feelings of need to use power-assertive methods of
discipline and control with their child.
Perceived Parenting Competence and Child
Care Labor Divisions
717
Research has also investigated parents’ feelings of
competence in performing tasks associated with
child care, which has revealed no differences among
heterosexual and same-sex couples. Rather, when
comparing individual parent groups, heterosexual
fathers have been found to feel significantly less
competent as compared with gay fathers, lesbian
mothers, and heterosexual mothers. This finding
could be explained by the fact that heterosexual
fathers tend to do the least amount of child care
relative to these other parent groups. Regardless,
most parents describe themselves as very competent
in completing tasks related to child care.
Satisfaction With Divisions of Family Labor
Data from these studies of division of labor indicate
that same-sex couples not only report dividing child
care and household chores relatively evenly but are
also likely to prefer these arrangements; lesbian
mothers in particular report that they ideally want an
equal distribution of child care with each couple
member doing about half. In contrast, heterosexual
mothers typically report that, ideally, they would like
to do somewhat more than half of the child care,
while heterosexual fathers report that, ideally, they
would like to do somewhat less than half of the child
care. Indeed, many same-sex
Coparenting
couples particularly emphasize egalitarian values and
the purposeful, conscious decisions surrounding
sharing labor.
Contrary to actual patterns of dividing labor, how
satisfied couples are with their particular
arrangements is linked to children’s behavior
problems. Lesbian and gay parents who report being
more satisfied with their divisions of labor and with
their partner as a coparent also report that their
children enjoy better overall behavioral adjustment.
Interestingly, regardless of parental sexual
orientation, there is some indication that greater
specialization is related to less overall satisfaction
with division-of-labor arrangements. Thus, it is
possible that sharing family labor offers some
advantages to parents and children alike across
different family types.
718
Observations of Coparenting Dynamics
Some research on coparenting among lesbian and
gay couples has focused on the emotional and
relational dynamics of coparental interactions and
how these are related to child outcomes. Findings
suggest that lesbian, gay, and heterosexual parenting
couples may have different styles of coparenting
during observed family interactions. Lesbian couples
appear to be the most warm, interactive, and
supportive, as compared with heterosexual and gay
male couples. On the other hand, heterosexual
couples are more likely to exhibit competitive
behavior and undermining behavior than are lesbian
and gay male couples. Across all family types,
couples that show supportive behaviors toward each
other have children with fewer behavior problems.
When couples are undermining of each other,
children are especially at risk for externalizing
problems (e.g., aggression, acting out, etc.).
Importantly, across all families, parents are more
likely to act in a supportive rather than in an
undermining way in coparenting behaviors.
Directions for Future Study
Future research could expand much more on the
dynamics of relational and emotional interaction
between same-sex parenting couples, and how
Corrective Rape
these are relevant to their child’s development over
time. Further research would benefit from the
inclusion of more diverse samples (e.g., increased
attention to bisexual and transgender parents). The
roles of biological relatedness, legal parenting and
couple relationship status, and decisions surrounding
routes to family formation would be important to
consider in future studies about coparenting among
lesbian and gay couples.
In conclusion, same-sex and heterosexual couples
show both similarities and differences in coparenting
styles. While couples differ in reports of dividing
family labor and even in observations of coparenting
behaviors, it appears that satisfaction with
arrangements and supportive interactions are
consistently linked with better child outcomes across
all families. Thus, aligned with broader literature
about lesbian- and gay-parent family systems, it
seems that parental sexual orientation is connected
more with qualitative differences in family
experiences than with differences in outcomes for
children.
Rachel H. Farr
See also Couples Therapy; Division of Labor in LGBTQ-
Parent Families; LGB Parenting Styles and Values;
Long-Term Same-Sex Couples; Parent Relationship
Quality; Therapy With LGBTQ Parents; Transition to
Parenthood and Parental Roles; Transition to
Parenthood for LGBTQ People
Further Readings
Bos, H. M., van Balen, F., & van den Boom, D. C. (2007).
Child adjustment and parenting in planned lesbianparent
families. American Journal of Orthopsychiatry, 77(1), 38–
48.
Carrington, C. (1999). No place like home: Relationships and
family life among lesbians and gay men. Chicago, IL:
University of Chicago Press.
Chan, R., Brooks, R., Raboy, B., & Patterson, C. (1998).
Division of labor among lesbian and heterosexual
parents: Associations with children’s adjustment.
Journal of Family Psychology, 12, 402–409.
Farr, R. H., & Patterson, C. J. (2013). Coparenting among
lesbian, gay, and heterosexual couples: Associations with
adopted children’s outcomes. Child Development, 84,
1226–1240.
Goldberg, A. E. (2010). Lesbian and gay parents and their
children: Research on the family life cycle. Washington,
DC: American Psychological Association.
Goldberg, A. E., & Perry-Jenkins, M. (2007). The division of
labor and perceptions of parental roles: Lesbian couples
across the transition to parenthood. Journal of Social and
Personal Relationships, 24(2), 297–318.
Johnson, S. M., & O’Connor, E. (2002). The gay baby boom:
The psychology of gay parenthood. New York:
New York University Press.
Patterson, C. J., & Farr, R. H. (2011). Coparenting among
lesbian and gay couples. In J. McHale & K. Lindahl
(Eds.), Coparenting: Theory, research, and clinical
applications. Washington, DC: American Psychological
Association.
Patterson, C. J., Sutfin, E. L., & Fulcher, M. (2004).
Division of labor among lesbian and heterosexual
parenting couples: Correlates of specialized versus
shared patterns. Journal of Adult Development, 11(3),
179–189.
Pelka, S. (2009). Sharing motherhood: Maternal jealousy
among lesbian co-mothers. Journal of Homosexuality,
56(2), 195–217.

Schacher, S. J., Auerbach, C. F., & Silverstein, L. B.
(2005). Gay fathers expanding the possibilities for us
all. Journal of GLBT Family Studies, 1(3), 31–52.
CORRECTIVE RAPE
In many cultures across the globe, individuals
believe that being heterosexual and cisgender (i.e.,
the assigned sex at birth aligns with an individual’s
gender identity) are the only normal and acceptable
expressions of sexual orientation and gender identity.
Often these heterosexist and cisgenderist cultural
mores are strengthened by gender role expectations,
especially in patriarchal societies, where men hold
more power than women. For instance, feminine
gender role expectations may include having long
hair, wearing feminine clothing, and behaving in a
certain manner (e.g., submissive, caretakers) whereas
masculine gender role expectations tend to be
equated with strength, financial responsibility, and
being the primary decision maker. Moreover,
heterosexism is often coupled with homonegativity
(i.e., bias and prejudice toward lesbian, gay, and
bisexual individuals) and transnegativity (i.e.,
negative attitudes and feelings toward transgender
individuals); therefore, lesbian, gay, bisexual,
transgender, and queer (LGBTQ) individuals may be
perceived to be threating since they challenge
traditional cultural expectations about family,
religion, and legal policies. In some cultures, this
discrimination is fueled by the belief that LGBTQ
individuals are a Western issue or a White
phenomenon.
Increasingly, policies that used to enable legalized
discrimination against LGBTQ individuals are being
overturned. In some countries, LGBTQ individuals
are legally protected from discrimination in terms of
marriage, housing, and employment. However, in
some parts of the world, social stigma remains strong
and LGBTQ individuals are often the targets of hate
crimes. Specifically, verbal harassment and sexual
assault are among the different types of victimization
used in hate crimes.
The term corrective rape is frequently used to
describe when girls and women who identify as or
are perceived as lesbians are raped by one or more
heterosexual men under the faulty assumption that
719
this will change their sexual orientation, punish them,
or turn them into “real women.” Often the assailants
tell the individual during the attack that they are
doing this to “cure” them or “teach them a lesson.”
Despite the fact that corrective rape is a global issue
and reports of this crime have been made in Jamaica,
Thailand, the United Sates, and Zimbabwe, the
majority of research and literature about this topic
comes from South Africa (the country with the
highest prevalence of rape). Aside from not trusting
the police and fear of additional discrimination,
many LGBTQ individuals do not report incidents of
corrective rape because the perpetrators are often
family members, friends, and/or acquaintances.
In 2008, the issue of corrective rape became
widely known about when Eudy Simelane, a South
African soccer player, was raped and murdered for
being open about her sexual orientation. Although
multiple perpetrators attacked her, only one
conviction was obtained during the original trial. In
fact, between 1998 and 2008, out of the 31 reports of
lesbian women who were murdered in South
Corrective Rape
Africa, the conviction in the Simelane case was the
first of its kind. By the same token, less than 5% of
the men accused of rape in South Africa are
sentenced, with more than 95% being acquitted or
never charged for their crime(s).
Evidence suggests that Black lesbian women are
more likely to be targets of this hate crime than
White lesbian women. However, this discrepancy
may be due to the remnants of apartheid since White
women in South Africa are more likely to live in
better-protected neighborhoods while there tends to
be a lack of police presence in Black neighborhoods.
Regardless of race, ethnicity, gender, gender identity,
or sexual orientation, the issue of rape, in general, is
a significant problem across the globe that often goes
unreported due to barriers that prevent individuals
from seeking justice (e.g., police harassment, limited
support systems, and flawed legal systems that place
the victim on trial). Although rape is usually believed
to be a crime against women, victims of rape can be
of any gender. Research conducted by Out LGBT
WellBeing (a South African organization that
specializes in LGBT health care, research, and
advocacy) suggests that at least among lesbian
women and gay men, the prevalence of sexual assault
was almost identical. Therefore, the issue of
720
corrective rape impacts the broader LGBTQ
community and has many individuals living in fear.
It should also be noted that the term corrective
rape, like much other nomenclature, should be used
with caution, if at all. Some authors have cautioned
that when language is sensationalized by media or
misinterpreted by the reader, it could minimize the
experience of the victims, promote stereotypes, and
take away from the broader issue at hand. For
instance, this term not only ignores the progress that
has been made toward depathologizing the
experiences of LGBTQ individuals but also
erroneously suggests that diverse sexual orientations
and gender identities can be cured. Thus, the aim of
this entry is to increase awareness that rape, like
many other forms of victimization, can be used in
hate crimes, especially when individuals are targeted
because of their gender identity and/or sexual
orientation. In addition to raising awareness of this
global problem, readers are encouraged
Couples Therapy
to be mindful of how this term is used and that, over
time, the language used to discuss this specific type
of hate crime may evolve. Regardless of how this
offense is labeled, additional research about this type
of hate crime is needed from within South Africa, as
well as across the globe, to better understand this
issue and facilitate preventive efforts.
Megan C. Lytle
See also Criminal Legal System and LGBTQ People;
Discrimination Against LGBTQ People by Law
Enforcement; LGBTQ Health in Non-Western
Contexts
Further Readings
Di Silvio, L. (2010). Correcting corrective rape: Carmichele
and developing South Africa’s affirmative obligations to
prevent violence against women. The Georgetown Law
Journal, 99, 1469–1515.
Hames, M. (2011). Violence against Black lesbians:
Minding our language. Agenda, 25(4), 87–91.
Mieses, A. (2009, December). Gender inequality and
corrective rape of women who have sex with women.
GMHC Treatment Issues, 1–5. Retrieved from http://
www.gmhc.org/files/editor/file/ti-1209.pdf
Wells, H., & Polders, L. (2006). Anti-gay hate crimes in
South Africa: Prevalence, reporting practices, and
experiences of the police. Agenda, 20(67), 20–28.
COUPLES THERAPY
Couples therapy is a format of psychotherapy aimed
at assisting individuals in addressing problems they
feel unable to solve on their own. Couples in which
one or both partners hold a minority sexual or gender
identity or who are seeking to address issues related
to sexuality or gender identity may seek LGBTQ
couples therapy. Since the removal of homosexuality
from the list of psychiatric disorders in 1974,
scholarly articles and mainstream psychotherapy
texts focusing on LGBTQ couples in therapy have
steadily increased in visibility. Informed by this
literature, this entry will describe some of the most
common concerns that LGBTQ couples address in
therapy, as well as provide information about
accessing LGBTQ couples therapy.
What Brings LGBTQ Couples Into Therapy?
LGBTQ couples seek therapy for many of the same
reasons as heterosexual couples, such as issues
related to communication, conflict, feeling
appreciated or loved, division of labor, parenting,
sex, or the effects of one or both partners living with
mental illness or substance use. Furthermore, the
literature suggests that LGBTQ couples are more
likely to seek therapy for these reasons than issues
that are directly related to their sexual orientation or
gender identity.
Unfortunately, societal heteronomativity,
cisgenderism, and experiences as a result of
homophobia and transphobia play a role in issues
faced by LGBTQ couples. Heteronormativity refers
to an ideology that upholds the monogamous,
heterosexual couple as the only legitimate intimate
partnership. Cisgenderism refers to prejudice that
denies, ignores, denigrates, or stigmatizes nonbinary
(i.e., male/female) forms of gender identity or
expression. Homophobia involves a range of
negative attitudes and feelings toward individuals
who are perceived to be lesbian, gay, bisexual, or
otherwise not heterosexual. Transphobia involves a
 721
range of negative attitudes and feelings toward The social, political, and legal context has an
individuals who are perceived to be transgender or enormous impact on LGBTQ couples and the kinds
gender-nonconforming. These concepts help us to of issues that they bring to therapy. There is much
understand the often far-reaching effects of variation within the United States and internationally
discrimination and prejudice for LGBTQ individuals regarding rights and affirmative policies for LGBTQ
and couples. individuals, couples, and families. Stress related to a
Recent research has explored the concept of lack of legal protection can complicate issues faced
LGBTQ minority stress and how daily experiences of by LGBTQ couples. For example, if a couple is
microaggressions (i.e., when a member of a trying to decide if and when they want to have
dominant group sends a message to a member of a children, the absence of laws explicitly allowing
marginalized group, often unintentionally, that second-parent adoption by same-sex partners in their
denigrates their experience) can impact emotional area could make their decision even more difficult.
and physical health. In fact, individuals who identify Similarly, in some businesses and jurisdictions,
as LGBTQ often have higher rates of anxiety, sexual orientation
depression, suicide ideation, and substance use, as Couples Therapy
compared with those who identify as heterosexual.
When individuals hold an additional minority status,
and gender identity are not protected statuses,
such as an identity as a racial or ethnic minority, they
thereby leaving sexual-minority and transgender
may experience even more minority stress. Because
individuals vulnerable to unfair treatment (e.g., being
LGBTQ couples often have these experiences in
fired for being gay). The lack of legal protections for
common, it can strengthen the couple relationship,
sexual and gender minorities could become an
resulting in resilience. Conversely, these experiences
important factor that couples bring to therapy.
often create additional strain on the couple system,
When partners have differing levels of “outness”
complicating existing problems or generating more
to family, friends, and others, it often creates strain
stress than the couple can handle without appropriate
on the LGBTQ couple relationship, prompting the
social support or professional assistance.
couple to seek therapy. Differences in the degree to
LGBTQ couples may also present to therapy with
which each partner is out can also be an invisible
issues that are specific to their minority sexual or
factor in many relationship conflicts that result from
gender identity and relationship status. As a direct
seemingly mundane disagreements, such as whether
result of a heteronormative society, there are few
both partners will attend one partner’s work or
relationship scripts for LGBTQ couples. A lack of
community event or whether both partners will
relationship scripts can result in ambiguity around
attend a family gathering. Differences in the degree
relationship formation, family rituals (e.g., marriage
to which each partner is out can also be an
ceremonies or baby showers), relationship
overlooked factor in larger relationships issues, such
maintenance, and even relationship dissolution. The
as deciding whether to legalize their partnership or
lack of LGBTQ relationship scripts also may have
hold a relationship ceremony. Discrepancies in
implications for the extent of social support that is
outness or visibility can be even more complicated
available to LGBTQ couples from their families,
for couples in which one or both partners identify as
friends, and communities.
bisexual or transgender, particularly if one partner
Limited social support is one of the most difficult
disclosed his/her identity after the relationship
issues for LGBTQ couples. Often, LGBTQ couples
formed or if the identity of one partner results in a
are not fully accepted or embraced by one or both of
perceived change of the identity of the other partner
the partners’ families of origin. Many LGBTQ
(e.g., in a same-sex female partnership and one
couples create families of choice, composed of close
partner discloses her transgender identity, transitions
friends who are supportive of the couple relationship.
to a male identity, and then his female partner is now
Most scholarly articles geared to increasing
perceived as heterosexual but still identifies as
competence of therapists working with LGBTQ
lesbian).
couples emphasize expanding the sources of social
The least amount of scholarship on LGBTQ
support that are available to the LGBTQ couple.
couples therapy exists for couples in which one or
both partners identify as bisexual or transgender.
722
These couples also experience stigma and isolation better fit. Seeking recommendations from other
from both the mainstream heterosexual community LGBTQ-identified individuals in their community,
and also the lesbian/gay community. The literature local LGBTQ-serving organizations, friends, primary
that does exist suggests that as individuals depart care physicians, local community assistance or
from a binary understanding of gender and sexuality, referral services, or online directories such as
they are more likely to experience discrimination, www.therapistlocator.net are common methods for
negative internalized perceptions of self (e.g., finding a therapist. In many geographic locations, the
biphobia or transphobia), and high levels of minority local LGBTQ community has put together a list of
stress, which can burden the couple relationship, thus affirmative resources, such as affirmative churches,
increasing the likelihood that such couples may seek health care practitioners, lawyers, and
therapy. Unpacking the psychotherapists. LGBTQ couples may find it useful
Couples Therapy to ask a prospective therapist in a phone consultation
or during the initial session one or more of the
following questions in order to gauge goodness of fit:
complex ways their relationship is affected by gender
(1) Describe your view of lesbian, gay, bisexual, and
and sexuality would likely be an important task for
transgender people and their relationships. (2) How
couples therapy.
do you generally work with LGBTQ couples? (3)
What kind of training have you had in working with
What Should LGBTQ Couples Look for the LGBTQ population? It should be noted that
in a Therapist? couples in rural areas or small towns may have
limited access to any couples therapist, let alone one
There is a growing body of scholarship regarding
with specific training or experience working with
therapy with LGBTQ couples. Mainstream couples
LGBTQ couples. It is not uncommon for couples in
therapy texts are increasingly including sections and
these areas to travel to larger cities or metropolitan
examples of working with LGBTQ couples. While
areas to obtain services.
there are no known empirically validated LGBTQ
Consensus in the clinical literature emphasizes the
couples therapy treatment approaches to date, there is
necessity for clinicians to understand the
a substantial literature describing how various couple
implications of heteronormativity, homophobia, and
or family therapy models can be used to work with
more recently, cisgenderism and transphobia, in their
LGBTQ couples. Moreover, there are a number of
work with LGBTQ couples. It is important for
publications focused on building clinical competency
therapists to be actively aware of their own biases
working with LGBTQ couples. Given that most
and to avoid inadvertently pathologizing the LGBTQ
clinicians who work with couples will likely work
couple relationship. In addition, therapists should be
with at least one LGBTQ couple over the course of
cautious not to overemphasize the couple’s minority
their career, it is important for therapists to be
sexual or gender identity. As mentioned previously,
competent in working with LGBTQ couples. There
it is more common for LGBTQ couples to seek
is some indication that individuals who identify as
therapy for reasons not directly related to their sexual
LGBTQ believe therapist competence is more
orientation or gender identity. A therapist should be
important than the sexual orientation of the therapist.
able to work appropriately with these couples and
Unfortunately, research suggests that many therapists
acknowledge their identities without making these
do not feel clinically competent to work with
identities a part of the presenting problem.
LGBTQ individuals, couples, and families and report
a lack of training in this area. As a result, LGBTQ
couples should be encouraged to seek out a couples’ LGBTQ Affirmative Therapy
therapist who has had specific training or experience
LGBTQ affirmative therapy is an approach for
working with LGBTQ couples.
working with LGBTQ individuals, couples, and
LGBTQ couples seeking a therapist should feel
families that embraces a positive view of individuals
empowered to “shop around” for a therapist who can
who express gender and sexual diversity and their
best meet their needs. It is not uncommon for couples
relationships, while also addressing the adverse
to start therapy with a therapist, stop going or
influences of heterosexism, cisgenderism,
terminate, and then find another therapist who is a
homophobia, and transphobia. Communicating an
 723
LGBTQ affirmative stance to all clients, regardless
of their sexual orientation or gender identity, is
important to the LGBTQ affirmative therapist. The
literature on LGBTQ affirmative therapy provides
several recommendations for creating a more
724
inclusive therapy practice. For example, LGBTQ Bigner & J. L. Wetchler (Eds.), Handbook of LGBTQ-
affirmative couples therapists should include affirmative couple and family therapy (pp. 1–22). New
York, NY: Taylor & Francis.
affirming language on clinical paperwork and avoid
Green, R. J. (2008). Gay and lesbian couples: Successful
heteronomative or cisgender assumptions (e.g., they
coping with minority stress. In M. McGoldrick & K. V.
should use the term partner instead of husband or
Hardy (Eds.), Re-visioning family therapy: Race,
wife for all couples, and ask clients their preferred
culture, and gender in clinical practice (pp. 300–310).
gender pronouns).
New York, NY: Guilford Press.
Many clinicians, but not all, who practice LGBTQ
Lev, A. I. (2004). Transgender emergence: Therapeutic
affirmative therapy draw heavily from feminist-
guidelines for working with gender variant people and
informed therapy approaches, as well as narrative
their families. Binghamton, NY: Haworth Press.
therapy and solution-focused therapy. In addition,
McGeorge, C., & Stone Carlson, T. (2011). Deconstructing
emerging research with LGBTQ couples in therapy
heterosexism: Becoming an LGB affirmative
suggests that focusing on the emotional connection, heterosexual couple and family therapist. Journal of
such as the focus of Susan Johnson’s emotionally Marital and Family Therapy, 37, 14–26.
focused therapy (EFT), can be particularly beneficial
to LGBTQ couples. However, much more empirical
research is needed in order to provide
recommendations for specific kinds of therapeutic
approaches with LGBTQ couples. CRIMINAL LEGAL SYSTEM AND
Individuals who study or work with LGBTQ LGBTQ PEOPLE
couples should remain open and curious about how
LGBTQ couples do family, as this has important
implications for LGBTQ couples therapy. As our
From its inception, the U.S. criminal legal system has
understanding of LGBTQ couples grows, scholars
been a site of discrimination and violence for
and clinicians will be able to better serve these
LGBTQ people, particularly those of color, who are
remarkable families and utilize their strengths and
disproportionately policed, prosecuted, and punished
accomplishments to create additional strategies,
on the basis of their real or perceived sexual
opportunities for change, and stories of hope and
orientation and/or gender identity. It is also a system
resilience for other LGBTQ couples seeking therapy.
that many LGBTQ people have turned to in order to
Erika L. Grafsky seek safety from violence motivated by homophobia
and transphobia, only to be abandoned or further
See also Affirmative Therapy; Mixed-Orientation violated and traumatized by the very actors they
Marriages; Therapists, Training of; Therapists’ Biases believe are there to serve and protect them. This
Regarding LGBTQ People; Therapy With LGBTQ
entry describes how LGBTQ people have been
Parents; Therapy With Transgender, Transsexual, and
historically criminalized, and highlights the ways and
Gender-Nonconforming People
contexts in which they continue to be targeted by
police and punished in the courts on the basis of their
Further Readings
sexual and gender nonconformity.

Bepko, C., & Johnson, T. (2000). Gay and lesbian couples in

therapy: Perspectives for the contemporary family
therapist. Journal of Marital and Family Therapy, 26,
409–419.
Bigner, J. J., & Wetchler, J. L. (Eds.). (2012). Handbook
of LGBTQ-affirmative couple and family therapy. New
York, NY: Routledge.
Bigner, J. J., & Wetchler, J. L. (2014). Relationship therapy
with same-sex couples. New York, NY: Routledge.
Giammattei, S. V., & Green, R.-J. (2012). GLBTQ couple
and family therapy: History and future directions. In J. J.
The Criminal Legal System
The criminal legal system is composed of the laws
enacted by federal, state, and municipal governments
that proscribe actions deemed to be criminal
Criminal Legal System and LGBTQ People
or illegal, the law enforcement agents responsible for
enforcing them (e.g., police officers, sheriffs, FBI

agents, state and federal prosecutors), and the judges
and penal officials who are responsible for
adjudicating the law and meting out punishment.
What conduct is deemed to be a crime and who is
deemed to be criminal is largely socially constructed,
and is influenced by enforcement of racial, class,
gender, and sexual norms. For example, historically,
criminal laws have explicitly criminalized certain
conduct by Indigenous people, African-descended
people, and immigrants, while exempting the same
exact conduct when committed by White people
(e.g., the slave codes and later the Black codes
enacted after the Civil War). Similarly, whereas
sodomy laws, which were enacted in colonial times,
were originally designed to criminalize all acts of
nonprocreative sex, they were later amended or
enforced in ways to punish only people who engaged
in same-sex sexual activity, a practice legitimized by
the U.S. Supreme Court in the 1986 Bowers v.
Hardwick decision. Although in the 21st century the
vast majority of laws are now neutral on their face,
they continue to be discriminatorily enforced, leading
to the disproportionate criminalization of people of
color, including LGBTQ people of color.
The History of Policing and Punishment of
Sexual and Gender Nonconformity
The policing and punishment of sexual and gender
nonconformity was a central feature of the
colonization of the Americas and enslavement of
African-descended people in the United States.
Native American scholar Andrea Smith and historian
Brian Fone have documented that branding
Indigenous people as “sodomites” and “perverts”
served as justification for the genocide of Indigenous
people and seizure of their land by European
colonizers. Similarly, as legal scholar Dorothy
Roberts points out, casting enslaved Africans as
“hypersexual,” as well as “uncivilized,” “violent,”
and “immoral,” served as a necessary pretext to
countenance colonization of African people and the
imposition of chattel slavery. Immigrants to the
United States from Asian, Latin American, and
Middle Eastern countries were also framed as
sexually deviant and promiscuous in order to justify
sexual violence and laws used to exclude and control
them.
Criminal Legal System and LGBTQ People 725
Laws punishing sodomy—defined as oral or anal
sex—were enacted as capital offenses during the
colonial era, without regard to the race, gender, or
sexuality of the individuals involved. However,
sodomy crimes were selectively enforced. According
to historian Robert Oaks, those charged, convicted,
and executed were often Black men, while wealthy
White men were generally charged with lesser crimes
of lewd behavior, if prosecuted at all.
Sodomy laws were not always necessary or the
sole means of criminalizing and punishing perceived
sexual “deviance.” Legal scholar Ruthann Robson
notes that some women alleged to have been sexually
deviant were persecuted as witches, while others
accused of same-sex activity faced charges of
“unseemly practices” and lewd behavior. Crimes of
fornication, prostitution, and vagrancy were also used
to prosecute free women of color, immigrant women,
and poor White women, sending many to prison or
mental institutions.
In the 1850s, criminalization of gender
nonconformity was achieved through sumptuary laws
requiring individuals to wear at least three pieces of
clothing associated with their gender as defined by
their genitalia. These laws, along with vagrancy laws,
were designed to root out the alleged deception of
appearing in a manner that did not strictly adhere to
the norms of the gender binary. Law enforcement
agencies used these laws to target and harass
transgender and gender-nonconforming people,
including many butch lesbians, in the early 20th
century, prior to those laws being struck down as
unconstitutional or rewritten in the late 1970s and
early 1980s. During the Cold War era of the 1950s
and 1960s, laws were passed outlawing the existence
of gay bars, leading to the harassment, extortion,
arrest, and brutalization of countless LGBTQ people,
who not only faced criminal charges but were subject
to public shame and humiliation when their names
and photographs were published in newspapers upon
their arrest.
Present-Day Criminalization of
LGBTQ People
LGBTQ people, particularly LGBTQ people of color,
continue to face discrimination in the criminal legal
system in the 21st century. According to a national
survey conducted by Lambda Legal, 73% of all
LGBT people and people living with HIV have had
face-to-face contact with police, and 5% reported
726
having spent time in jail or prison, a rate markedly
higher than the nearly 3% of the U.S. adult
population who are under some form of penal
control.
Policing of LGBTQ People
LGBTQ people and communities report ongoing
profiling, false arrests, physical violence, sexual
harassment and assaults, and illegal searches by
police officers, particularly in the context of
enforcement of “quality-of-life” offenses, “stopand-
frisk” practices, selective enforcement of sexrelated
charges, and continual raids of LGBTQ
establishments. Existing data show that LGBTQ
people of color, transgender and gender-
nonconforming people, and homeless and low-
income LGBTQ people bear the brunt of police
misconduct against LGBTQ people in the 21st
century.
Several reports tracking identity-based violence
nationwide have documented that police officers are
responsible for a significant amount of the
homophobic and transphobic violence experienced
by LGBTQ individuals. Lambda Legal found that
21% of survey respondents who had face-to-face
contact with law enforcement officers experienced
hostile attitudes from police officers, and LGBTQ
people of color, transgender and gender-
nonconforming people, LGBTQ youth, and low-
income LGBTQ people all reported experiencing
hostility at higher rates. Further, Black, Latina/o, and
Native American respondents were also more likely
to be searched during their encounters with the
police. LGBTQ people of color, low-income LGBTQ
people, and transgender or gender-nonconforming
people also reported higher rates of false arrests.
Similar trends were revealed by a 2011 study
published by the National Gay and Lesbian Task
Force and National Center for Transgender Law and
Equality. One fifth of all transgender respondents
who interacted with the police reported they were
harassed, with Black, multiracial, and Asian
transgender people reporting higher rates of
harassment, physical assault, and sexual assault by
police.
The role played by the policing of “quality-oflife”
offenses in the ongoing criminalization of
LGBTQ people was documented by Amnesty
International in a 2005 report. “Quality-of-life”
regulations criminalize everyday activities, including
standing or congregating in public spaces; eating,
sleeping, drinking, urinating, or engaging in “lewd
conduct” in public; being “disorderly”; or smoking
too close to buildings. Of course, countless people
engage in these behaviors on a daily basis, but
“quality-of-life” laws are selectively enforced against
certain populations. Police officers are given almost
total discretion to decide when, where, and whom to
charge and whether they will issue a warning, write a
ticket, or arrest the person for these minor offenses.
Enforcement of “quality-of-life” offenses often
targets homeless people and youth of color,
disproportionately affecting LGBTQ youth, who
constitute 40% of all homeless youth.
LGBTQ people are also targeted for selective and
discriminatory enforcement of sex-related crimes
(e.g., solicitation, prostitution, lewd conduct, or
public indecency). Gay men and transgender women
are frequently presumed to be engaged in such
criminal activity simply by virtue of their presence in
public spaces, leading to preemptive arrests. The
profiling of transgender women of color for
prostitution-related offenses occurs so often it has
become a well-known phenomenon dubbed “walking
while trans.” Transgender women, and particularly
transgender women of color, report that regardless of
whether they are hailing a cab, greeting a friend,
going to the store, or simply traveling to and from
home, school, or work, they are profiled by police
and arrested for solicitation or prostitution without
any concrete evidence indicating an intent to trade
sex for money. Research by organizations such as
Amnesty International and Human Rights Watch
shows
Criminal Legal System and LGBTQ People
that police often engage in transphobic and
homophobic verbal harassment, physical violence,
sexual assault, and extortion of sexual acts in
exchange for leniency during such encounters, and
frequently use mere possession of one or more
condoms as evidence of intent to engage in
prostitution-related offenses.
“Stop-and-frisk” and other discriminatory policing
practices targeting communities of color have also
disproportionately impacted young LGBTQ people
of color. While the U.S. Supreme Court has

authorized police officers to stop individuals whom
they have reasonable suspicion to believe have
committed or are about to commit a crime, and to
conduct a brief pat-down if they have a reasonable
belief the person is armed, in many cities “stop and
frisk” is being used to stop people solely on the basis
of their skin color. For example, in New York City
from 2012 to 2013, almost 9 out of 10 stops were of
African American or Latina/o people, and half were
aged 14 to 21. Police failed to find a basis to even
issue a summons in almost 90% of stops, indicating
that the stops were motivated by profiling rather than
concrete evidence of criminal activity. Research
conducted by the City University of New York
during the same time frame found that LGB youth
experienced more negative police encounters than
their heterosexual peers, and reported twice as many
instances of sexual harassment and assault.
Gay men also continue to be targeted by police in
entrapment schemes seeking to root out alleged
public sex activity in locations such as parks and
public restrooms. These schemes often result in the
arrests of large numbers of gay and heterosexual
men, regardless of whether or not they are engaging
in or about to engage in sex. Fabricated boilerplate
assertions are then used to justify these schemes in
criminal court complaints and reports. Shame and
embarrassment cause many to simply plead guilty to
the charge rather than face ongoing court
proceedings.
Raids of LGBTQ establishments also continue to
take place with alarming frequency. For instance, in
2003, the Power Plant, a private club in Detroit
frequented by Black LGBTQ people, was raided by
local sheriffs claiming to be investigating complaints
by neighbors. Approximately 350 people were cuffed
and forced to lie on the floor for hours without access
to bathroom facilities while being brutalized and
called homophobic epithets and subsequently
charged with “loitering inside a building.” In 2009,
the Rainbow Lounge, a gay bar in Fort Worth, Texas,
was raided by local law enforcement officials for
alleged liquor violations, during which several
patrons were physically brutalized, with one person
suffering a brain injury. A few were subsequently
arrested for “public intoxication.” In November
2009, officers from the “Red Dog” unit of the Atlanta
Police Department raided the Eagle Bar, forcing all
those present to lie down on the ground, some lying
Criminal Legal System and LGBTQ People 727
in beer and broken glass, as police conducted
background checks while subjecting many to antigay
slurs.
Transgender and gender-nonconforming people
also frequently report that they are addressed using
the wrong names and pronouns and subjected to
routine harassment during stops, as well as
humiliating and unlawful searches during which
officers physically grope or demand to view their
chest area and/or genitalia, often accompanied by
ridicule and transphobic abuse. They are also held in
dangerous conditions in police custody when housed
with people who do not share their gender identity,
and humiliated by being forced to remove their wigs
and items of clothing consistent with their gender
identity such as bras and binding.
Criminal Courts and LGBTQ People in the
21st Century
Once a person is arrested and charged, prosecutors,
like police, have virtually unfettered discretion to
decide what charges to bring against the accused,
whether the accused will get a favorable or stiff plea
deal, and what sentences they will seek.
Discriminatory bias against LGBTQ people
continues to seep into charging decisions, and such
notions continue to influence the perceptions and
decisions of judges and jurors regarding innocence,
guilt, credibility, and the necessary punishment of
LGBTQ people.
Present-day civil and criminal courts remain
hostile environments for many LGBTQ people. A
2013 study by Lambda Legal found that one fifth of
respondents who appeared in court heard a judge,
attorney, or court employee make a negative
comment about a person’s sexual orientation or
gender identity or expression. Sixteen percent of
respondents reported that their LGBTQ identity was
raised in court when it was irrelevant to the
proceedings, and 11% reported the release of this
information was against their will, with LGBTQ
people of color or those with mental or physical
disabilities reporting nonconsensual disclosure at
higher rates. LGBTQ defendants, as well as attorneys
representing them, report that LGBTQ people are
routinely ridiculed, harassed, dehumanized, and
treated with a lack of respect and dignity by court
personnel, sheriff’s deputies, lawyers, and judges.
728
Many report that transgender people continue to face
overt bigotry and are referred to as “it” by judges.
LGBTQ people who stand accused of crimes,
particularly sex-related crimes, continue to face often
unconscious perceptions that they are inherently not
credible or deceptive and predisposed to engage in
“sexually deviant” behavior. Prosecutors often take
advantage of such prejudice against LGBTQ people,
arguing, for instance, that transgender people cannot
be believed because they tell the world they are one
gender, but they are really another. In light of these
circumstances, LGBTQ people often plead guilty to
avoid suffering the humiliation of defending
themselves against such charges and the harsher
punishments they risk if convicted after a trial.
LGBTQ people also receive disproportionate or
excessive sentences. For instance, as documented by
a 2009 study by the National Center for Lesbian
Rights (NCLR), the National Juvenile Defender
Center, and Legal Services for Children, LGBTQ
youth are disproportionately charged with sex
offenses, and are often sentenced to sex-offender
programs, even in cases that do not involve sex-
related charges.
In a number of capital cases, prosecutors
improperly injected irrelevant evidence of a person’s
sexual orientation or gender identity into the
proceedings, arguing on the basis of stereotypical and
pathologizing perceptions of LGBTQ people that
they are guilty of the crime or were worthy of greater
punishment, successfully prejudicing juries to both
convict and deliver death sentences. Examples of this
pattern of prosecutorial misconduct include the cases
of Calvin Burdine, sentenced to die in Texas in 1994;
Bernina Mata, sentenced to die in Illinois in 1998;
Stanley Lingar, executed in Missouri in 2001; Wanda
Gene Allen, executed in Oklahoma in 2001; Jay
Wesley Neill, executed in Oklahoma in 2002; and
Eddie Hartman, executed in North Carolina in 2003.
Finally, LGBTQ people are often denied
competent, effective, and professional legal services
by attorneys who represent them. Too often, publicly
funded or private counsel lack information and
knowledge about their client’s lived realities
necessary to effectively represent them in criminal
proceedings. Frequently, attorneys fail to refer to
their clients by their preferred name or pronouns, and
are unaware or lack the courage to ask judges and
prosecutors to do the same. Attorneys also fail to
advocate for appropriate enrollment in diversionary
programs such as drug treatment facilities, which are
often sex segregated, and they may fail to ask
necessary questions of potential jurors or elicit
mitigating evidence.
Anti-LGBTQ Hate Crimes and Alternatives to
the Criminal Legal System
LGBTQ people also encounter the criminal legal
system as victims of crimes, including victims of
bias-motivated violence and harassment. In 2013,
more than 2,000 instances of anti-LGBTQ hate
violence were reported to the National Coalition of
Anti-Violence Programs (NCAVP). A
disproportionate number of victims of homophobic
and transphobic violence are LGBTQ people of
color, and of those who were murdered, over half
were transgender women of color.
Many LGBTQ victims assert that when they
report hate violence to the police, the police do not
take their claims seriously and fail to classify these
incidents as hate crimes. LGBTQ victims also report
that they are often blamed for the violence they
experience, or are further harmed and traumatized by
homophobia or transphobia
Cross-Category Friendships
on the part of law enforcement officials when
seeking safety and protection.
In response to this violence and police
misconduct, many mainstream LGBTQ organizations
have demanded that politicians and players in the
criminal legal system take violence against LGBTQ
people seriously, seeking the passage of hate-crime
legislation in Congress and in state legislatures. Such
legislation generally requires that law enforcement
agencies track and document incidents involving
bias-motivated violence and enact enhanced
sentences for those convicted of a hatemotivated
crime. Mainstream LGBTQ organizations have also
demanded that law enforcement officers and judges
receive sensitivity training regarding LGBTQ issues,
and that law enforcement agencies hire more
LGBTQ officers and community liaisons.
Other LGBTQ organizations and advocates,
however, oppose hate-crime penalty enhancements
and the use of the criminal legal system as a vehicle
to address violence altogether, believing the system
 Criminal Legal System and LGBTQ People 729
is fatally and inextricably flawed and violent, Richie, B. (2012). Arrested justice: Black women, violence,
inherently biased against LGBTQ people, and America’s prison nation. New York, NY:
particularly those of color, and incapable of New York University Press.
providing protection, safety, and justice to Robson, R. (1992). Lesbian (out)law: Survival under the rule
marginalized communities. Some of these of law. Ithaca, NY: Firebrand.
organizations are investigating and creating new Smith, A. (2005). Conquest: Sexual violence and American
ways to address the violence faced by LGBTQ and Indian genocide. Cambridge, MA: South End Press.
other marginalized individuals. Looking to Stanley, E., & Smith, N. (2011). Captive genders: Trans
restorative and transformative justice frameworks, embodiment and the prison industrial complex.
they are developing community-based programs to Oakland, CA: AK Press.
provide safety to individuals while holding
perpetrators of violence accountable in ways that are
independent of the criminal legal system. The Audre
Lorde Project in New York City, Project NIA in
Chicago, and Creative Interventions, based in CROSS-CATEGORY FRIENDSHIPS
California, are just a few of the organizations
investing in these alternatives to the criminal legal Friendships are widely believed to be organized
system, and the trend in seeking such solutions is around the principle of homophily—the idea that
growing nationwide. relationships form between individuals who are
similar. Under this principle, individuals are most
Joey L. Mogul likely to form friendships with others who are similar
to themselves in terms of age, gender, race,
See also Bias in the Criminal Justice System;
socioeconomic status, or identity. Friendships
Discrimination Against LGBT People by Law
between individuals with different social identities
Enforcement; Gender Binaries; Incarceration; Sex
Work and Criminalization
Further Readings
Alexander, M. (2012). The new Jim Crow: Mass
incarceration in the age of colorblindness. New York,
NY: New Press.
Bronski, M. (2011). A queer history of the United States.
Boston, MA: Beacon Press.
Capers, B. (2008). Cross dressing and the criminal. Yale
Journal of Law and the Humanities, 20, 1–30.
Davis, A. (2003). Are prisons obsolete? New York, NY:
Seven Stories Press.
Hanssens, C., Moodie-Mills, A., Ritchie, A., Spade, D., &
Vaid, U. (2014). A roadmap for change: Federal policy
recommendations for addressing the criminalization of
LGBT people and people living with HIV. Retrieved
November 10, 2015, from https://web.law.columbia
.edu/sites/default/files/microsites/gender-sexuality/files/
roadmap_for_change_full_report.pdf
Mogul, J., Richie, A., & Whitlock, K. (2011). Queer (in)
justice: The criminalization of LGBT people in the
United States. Boston, MA: Beacon Press.
Oaks, R. (1978). “Things fearful to name”: Sodomy and
buggery in seventeenth-century New England. Journal of
Social History, 12(2), 268–281.
730
are considered cross-category friendships. By
definition, cross-category friendships form across
social identities in which one identity is privileged
and the other disadvantaged. Thus, in order to
maintain cross-category friendships, friends are
required to negotiate their own identities across
social inequalities. Cross-category friendships are
considered the exception rather than the rule in the
general population. Within minority communities,
however, cross-category friendships are more
common.
Friendships are understood as unique
interpersonal relationships that are voluntary,
reciprocal, and equitable in nature. The study of
cross-category friendships illuminates how identity
differences impact friendship patterns and dynamics.
Understanding the unique experience of minority
individuals in cross-category friendships provides
insight into how members of these communities
negotiate their minority status within an interpersonal
context. For lesbian, gay, bisexual, transgender, and
queer (LGBTQ) individuals in cross-category
friendships, such negotiation occurs across sexual-
and gender-minority status. This entry explores
patterns and characteristics of cross-category
friendships within the LGBTQ community across
sexual orientation, sex/gender, and race.
Patterns of Cross-Category Friendship Within
the LGBTQ Community
By and large, individuals in the LGBTQ community
conform to the principle of homophily; they are more
likely to report friendship dyads of similar identities.
Namely, LGBTQ individuals report more same-sex
and same-race friendships than friendships with
individuals of different sex and race. However, these
patterns differ across racial identity. LGBTQ people
of color are more likely than their White counterparts
to report cross-race friendships. Although LGBTQ
individuals primarily form samesex and same-race
friendships, cross-orientation friendships are fairly
common, occurring more often than same-orientation
friendships. Patterns of these cross-orientation
friendships differ across sexual-orientation identity;
bisexual men and
Cross-Category Friendships
women are more likely than lesbians and gay men to
report cross-orientation friendships. These patterns
suggest that, overall, those individuals with the most
marginalized identities are the most likely to form
cross-category friendships.
Cross-orientation friendship patterns may be
unsurprising, as there are far more heterosexual
individuals than there are sexual and gender
minorities. These patterns of friendships, however,
are not simply reflections of population
demographics. They are shaped by larger
sociopolitical attitudes. For LGBTQ individuals, the
acquisition and maintenance of cross-category
friendships is complicated by their minority status.
More specifically, dominant attitudes toward sexual
and gender minorities impact cross-orientation and
cross-gender identity friendship choices.
Examination of the characteristics of these
friendships reveals prevailing heterosexist, biphobic,
and transphobic ideology.
Characteristics of Friendships Across
Orientation and Gender Identity
For LGBTQ individuals, the importance of
friendships is contextualized by the relative lack of
social support for sexual and gender minorities in the
larger culture. LGBTQ individuals often rely on
friendships within the LGBTQ community to provide
support (both emotional and material) that is less
available in their natal homes and peer groups.
However, friendships across sexual orientation and
gender identity can also provide LGBTQ individuals
with a supportive personal relationship independent
of their connection to the LGBTQ community. The
literature on cross-orientation and cross-gender
identity friendships has largely focused on the
barriers and benefits of such friendships.
Friendships Across Sexual Orientation
Barriers to cross-orientation friendships are often
cited by heterosexual and LGBQ individuals alike.
Both heterosexual and LGBQ individuals may feel
discomfort discussing differences in
Cross-Category Friendships
sexual orientation, may perceive their lives to be
different as a function of sexual orientation, and/ or

may worry about potential sexual tension within their
friendships. Heterosexual individuals in particular
may avoid friendships with LGBQ individuals
because of the associated stigma and because of their
discomfort with, or lack of familiarity with, LGBQ
individuals or culture.
When cross-orientation friendships do form, how
friends negotiate the difference in sexual orientation
may present additional barriers to closeness. For
example, the difference in sexual orientation may
become a focal point where sexual-minority identity
becomes tokenized or overemphasized. Alternatively,
sexual-minority individuals may feel that their sexual
orientation is not acknowledged in the friendship or
that their friend does not understand their
experiences of being a sexual minority. Many sexual-
minority individuals in cross-orientation friendships
report feeling as if they cannot fully express their
sexual identity in such friendships. Still others report
that tolerating unintentional discrimination,
judgment, and/or invalidation of their sexual identity
is required to maintain such friendships. Bisexual
women in cross-orientation friendships with
heterosexual women, for example, report that their
bisexual identity may be invalidated as their
friendship focuses on the friends’ shared interest in
men. In their friendships with heterosexual men, gay
and bisexual men often need to negotiate the
traditional link between masculinity and
homophobia.
Despite these barriers, sexual-minority individuals
report several benefits to cross-orientation
friendships. Cross-orientation friendships may allow
LGBQ individuals to find acceptance from
heterosexuals that is otherwise unavailable from
friendships in other contexts. Friendships with
heterosexual individuals can potentially serve to
increase a sense of self-acceptance and self-esteem
among sexual minorities, challenge stereotypes about
heterosexuals, and allow an understanding that
acceptance outside the LGBTQ community is
possible.
There are also benefits to cross-orientation
friendships that are experienced by both individuals
in the friendship. Both sexual-minority and
heterosexual individuals experience closer and more
trusting cross-orientation relationships predicated
upon the disclosure of sexual-minority identity.
Furthermore, such friendships allow sexual-minority
731
and heterosexual individuals to cultivate an
appreciation for similarities between themselves and
their cross-orientation friend while also allowing for
an objective perspective in their lives. Heterosexual
individuals uniquely report experiencing increased
sensitivity to sexual-minority experience and an
increased reflection and understanding of their own
sexual-orientation identity as a result of friendships
with LGBTQ individuals.
Friendships Across Gender Identity
The friendship experiences of transgender
individuals have received far less attention in the
research literature than those of other sexual
minorities. To date, research has described the
important role of friendships formed among
transgender individuals. In addition to fulfilling a
familial role, friendships with other transgender
individuals often provide mentoring and support
specific to the transgender experience that is
perceived as unavailable from counseling and health
care professionals. Barriers to friendship across
gender identity exist both outside and within the
larger LGBTQ community. Although sexual (LGBQ)
and gender (T) minorities are often considered a
unified community, transgender individuals
experience increased stigma and a unique type of
discrimination or transphobia. Transphobia can come
from heterosexual or LGBQ individuals and can
impact friendship development and support.
Transgender individuals also report benefits of
friendship with cisgender (non-transgender)
individuals, including feeling supported in their
gender identity and experience. Specifically,
friendships across gender identity may contribute to a
feeling of normality for the transgender friend while
also allowing them to be perceived by others as their
identified gender. Transgender individuals report that
friendships with cisgender individuals may allow for
diverse perspectives and opinions, potentially serving
as a platform for educating others about their
experiences as a transgender person.
Cross-Category Friendships: Reflections on
Dominant Sociopolitical Attitudes
As previously discussed, lesbians and gay men are
more likely to develop same-orientation than cross-
732
orientation friendships. These same-orientation
friendships buffer sexual minorities from the social
isolation and stigma experienced in society at large.
It is the predominant culture of heterosexism that
functions to marginalize sexual-minority identity,
which in turn necessitates the use of sameorientation
friendships as a refuge from alienation within the
larger culture. However, lesbians and gay men are
still likely to report some cross-orientation
friendships in which their sexual identity may be
viewed as a barrier that must be addressed to further
develop the friendship. It is again because of
heterosexist attitudes that sexualminority identity
becomes something to be “dealt with” in the context
of cross-orientation friendships. Thus, heterosexism
impacts the experience of friendship for sexual-
minority individuals as well as heterosexual
individuals who maintain cross-orientation
friendships.
Cross-orientation friendships are more common
for bisexual individuals than for their lesbian and gay
peers. Thus, bisexual individuals may be less likely
than other sexual minorities to experience the type of
buffer from societal heterosexism that
sameorientation friendships offer. These friendships
may also be influenced by biphobia, a unique form of
sexual prejudice toward bisexual individuals that can
be experienced from both heterosexual and
sexualminority (LGBQ) individuals. Cross-
orientation friendships between bisexual and
heterosexual individuals may develop without an
explicit acknowledgment of the bisexual individual’s
sexual orientation. Among bisexual women in
particular, friendships with lesbian women may be
marred by biphobic attitudes that bisexual women are
untrustworthy or some other misunderstanding of
bisexuality. Similar research regarding friendships
between bisexual and gay men is underdeveloped.
Cross-Category Friendships
Although research on friendships across gender
identity is in its infancy, there is evidence that these
friendships are also subject to dominant
sociopolitical attitudes regarding transgender
identity. Specifically, friendships for transgender
individuals function not only in the context of
heterosexism toward the LGBTQ community in
general, but transphobic prejudice toward
transgender individuals in particular. Like
heterosexism for communities of sexual minorities,
transphobia also leads to a sense of social isolation
and rejection among transgender individuals.
Transphobia has the added harm, however, of
creating a general lack of professional support and
services for transgender individuals. Thus,
transphobia plays a significant role in the experience
of friendships for transgender individuals. While
friendships between transgender individuals may fill
the gap in support services experienced in society at
large, friendships across gender identity may
improve feelings of connectedness to mainstream
society. Thus both same- and cross-gender identity
friendships may buffer the isolation experienced by
transgender individuals as a result of dominant
discourses of transphobia and heterosexism.
Changing Attitudes: Friends as Allies
Cross-orientation and cross-gender identity
friendships within the LGBTQ community have the
added benefit of working to change dominant
discourses surrounding normative (i.e., heterosexual
and cisgender) and non-normative (i.e., LGBTQ)
identities. Friendships with LGBTQ individuals have
long been associated with more positive attitudes
toward the LGBTQ community. In fact, both sexual
and gender minorities report an added benefit of
cross-category friendships is their use as an
educational platform for issues related to sex, gender,
and privilege. Furthermore, cross-category
friendships are generally associated with increased
cognitive flexibility and self-reported breaking down
of stereotypes.
Friendships with LGBTQ individuals have more
recently been implicated in the development of allies
to the LGBTQ community. Thus, LGBTQ
individuals are not wrong when they associate
Cultural Dissemblance (of African Americans)
cross-category friendships as educational
opportunities. The aforementioned benefits of cross-
category friendships may be instrumental in fostering
the support of LGBTQ individuals, both at the
individual and at the cultural level.

Conclusion
Cross-category friendships by their nature occur
across identities of varying levels of social power
and marginalization. Patterns of cross-category
friendships among LGBTQ individuals suggest that
those who are more marginalized in the dominant
culture are less likely to form friendships with others
who share their marginalized identity. Further
qualitative research has revealed significant benefits
and barriers to LGBTQ cross-category friendships
stemming from dominant sociopolitical discourses of
heterosexism, biphobia, and transphobia. It is these
discourses that shape crosscategory friendships by
creating a context of social isolation and rejection for
members of the LGBTQ community. Thus, benefits
of cross-category friendships for LGBTQ individuals
are intimately linked
to the marginalization of LGBTQ individuals within
society at large. Furthermore, such benefits are
experienced only after overcoming barriers related to
the negotiation of sexual- and genderminority
identity within a broader culture of stigma, prejudice,
and discrimination against the LGBTQ community.
Renae C. Mitchell and M. Paz Galupo
See also Ally Experience; Families of Choice; Friendships;
Romantic Friendships; Workplace Friendships
Further Readings
Galupo, M. P. (2009). Cross-category friendship patterns:
Comparison of heterosexual and sexual minority adults.
Journal of Social and Personal Relationships, 26(6–7),
811–831.
Galupo, M. P., Bauerband, L. A., Gonzalez, K. A., Hagen, D.
B., Hether, S. D., & Krum, T. E. (2014). Transgender
friendship experiences: Benefits and barriers of
friendships across gender identity and sexual orientation.
Feminism & Psychology, 24(2), 193–215.
Galupo, M. P., & Gonzalez, K. A. (2013). Friendship values
and cross-category friendships: Understanding adult
friendship patterns across gender, sexual orientation, and
race. Sex Roles, 68(11–12), 779–790.
Galupo, M. P., & St. John, S. (2001). Benefits of
crosssexual orientation friendships among adolescent
females. Journal of Adolescence, 24(1), 83–93.
Hall, R., & Rose, S. (1996). Friendships between
African-American and White lesbians. In J. S.
Weinstock & E. D. Rothblum (Eds.), Lesbian
friendships (pp. 165–191). New York, NY: New York
University Press.
733
Muraco, A. (2012). Odd couples: Friendships at the
intersection of gender and sexual orientation. Durham,
NC: Duke University Press.
Price, J. (1999). Navigating differences: Friendships between
gay and straight men. New York, NY:
Harrington Park Press.
Ueno, K., Wright, E. R., Gayman, M. D., & McCabe, J. M.
(2012). Segregation in gay, lesbian and bisexual youth’s
personal networks: Testing structural constraint, choice
homophily and compartmentalization hypotheses. Social
Forces, 90, 971–991.
CULTURAL DISSEMBLANCE (OF
AFRICAN AMERICANS)
Cultural dissemblance occurs when a person takes on
characteristics they believe to be opposite of those
expected of their cultural or social group. In essence,
cultural dissemblance is a coping strategy used to
actively reject negative, offensive, or stereotypical
characteristics. The cultural dissemblance of African
Americans speaks rather heavily to their experiences
in the United States. Historian Darlene Clark Hine
theorized that cultural dissemblance served as a
survival strategy to help protect African Americans,
and in particular, African American women, from the
onslaught of Whites and the threat of sexual
exploitation. At its root, cultural dissemblance can
serve as a response to institutional racism, or a
systematic disadvantage based on race-specific
discrimination. In the United States, this form of
institutional racism was brought about by forces such
as slavery and the continued socioeconomic
subordination of African Americans, which
permeates various aspects of African American
social life. One arena where cultural dissemblance
can be seen as a coping strategy for African
Americans is in response to stereotypes concerning
African American sexuality.
Slavery Setting the Cultural Stage
Various sexually based African American archetypes
emerged during slavery. For African American
women, these archetypes are rooted in the
sexualization of the Black body. The two most
734
prominent sexualized African American female
archetypes are the “Jezebel” and the “Hottentot
Venus.” During slavery, sexual relations between
Whites and African Americans were illegal and seen
as morally reprehensible. Nonetheless, this did not
prevent White male slave owners and employers
from sexually assaulting African American women.
To shift the blame for these sexual assaults from
White men to African American women, the
stereotypical image of African American women as
lustful and oversexed, or the Jezebel, emerged. In
addition to the Jezebel, depictions of the late 19th-
century South African sideshow performer Saartjie
Baartman, otherwise known as the Hottentot Venus,
further sexualized the Black female body. At the
time, Whites often displayed Baartman in the nude
(often with “jungle” paraphernalia) and highlighted
areas of her body, such as her breasts and buttocks.
Although Baartman primarily traveled throughout
Europe, her notoriety and images of her naked body
reached the Americas and helped influence the
perception of the “wild” Black female body. Both the
Jezebel and Hottentot Venus images partially
developed in reaction to depictions of White
femininity, whereby White women were portrayed as
civilized, frail, docile, and submissive beings. Under
similar historical and cultural conditions, African
American men were also categorized under gender-
specific stereotypes. Given a similar underpinning of
illegal sexual relations between Whites and African
Americans, African American men were also
hypersexualized. Treated as “bucks,” African
American men were stereotyped as having large
genitalia, and therefore were portrayed as lustful
predators.
Cultural Dissemblance (of African Americans)
Consequently, many individual African Americans
and, most notably, African American cultural
stereotypes have reacted against negative depictions
of African American sexuality by taking a
conservative stance on issues pertaining to “deviant”
forms of sexuality. This is most often found within
African American religious institutions.
Political and Social Consequences of Cultural
Dissemblance
Given African Americans’ conservative stance on
alternative sexualities, African American
communities often denounce sexual relations that fall
outside the purview of procreative monogamy and
heterosexual matrimony. This view is closely linked
to the values espoused by the “Black Church.” The
Black Church (a religious institution made up of
Protestant churches with predominantly African
American congregations and leadership) served as a
major cultural institution in African American
communities. The Black Church is not only a
religious institution but a social one as well, which
has given comfort and support to African Americans
since slavery. Current estimates indicate that African
Americans are the most religious racial/ethnic group
in the United States, and most African Americans
belong to Black churches. Research also notes the
important role that religion and spirituality have in
the lives of African Americans. In response to
negative depictions of African American sexuality,
Black church leaders and members, many of them
middle class, worked to separate themselves as much
as possible from deviant forms of sexuality. As
within White communities, African American
religious institutions, often made up of the middle
class, emphasized support for “conventional”
heteronormative relationships that support
“traditional” family norms, such as a mother and
father giving birth to a child in wedlock. This has
resulted in the marginalization of LGBTQ members
of African American communities and has impacted
issues such as responses to HIV/AIDS within
African American communities and support for
same-sex marriage.
Cultural dissemblance can also be used to
examine responses to same-sex marriage among
Custody and Litigation, LGBQ Parents
African American religious and community
leadership. Although African Americans are more
likely to support laws that maintain equal treatment
for same-sex couples and are even more likely than
other racial or ethnic groups to acknowledge the
discrimination LGBTQ community members
experience, they are less likely to support same-sex
marriage. For many African Americans within the
Black Church, support of same-sex marriage would
equate to acceptance of deviant forms of sexuality.
This has resulted in politically and socially

conservative and predominantly White organizations
targeting African American religious institutions and
leadership in an effort to support homophobic and
anti-LGBT laws, such as bans against samesex
marriage.
Similar to how African Americans engage in
cultural dissemblance, the broader LGBT community
also shifts in reaction against negative stereo-
types. Using the Bible as their directive,
conservatives have painted the LGBT community as
wanton and lustful. This includes sanctioning
heterosexuality as representing monogamy and
morality, while demonizing relationships that involve
same-sex sexuality. The institution of marriage
solidifies the tie between heterosexuality and
monogamy. Additionally, as a result of the
HIV/AIDS crisis in the 1980s, members of the
LGBT community were further stigmatized as
deviant and wanton. As a reaction to Christian
conservatives and the AIDS crisis, many LGBT
political organizations began to focus on
assimilationist political strategies. These strategies
involved creating campaigns that attempted to
reverse negative stereotypes. This included
developing campaigns that involved portraying the
LGBT community as family and marriage oriented.
During the 1990s and early 2000s, gay marriage
became a mainstream political goal and continues to
redefine how members of the LGBT community
negotiate their sexualities.
Angelique Harris and Omar Mushtaq
See also HIV/AIDS and Racial/Ethnic Disparities;
Homophobia; Intersections Between Sex, Gender, and
Sexual Identity; LGBTQ People of Color; Religious
Identity and Sexuality, Reconciliation of
Further Readings
Harris, A. C. (2010). AIDS, sexuality, and the Black
Church: Making the wounded whole. New York, NY:
Peter Lang.
Harris, A. C. (2010). Sex, stigma, and the Holy Ghost:
The Black Church and the construction of AIDS in
New York City. Journal of African American Studies,
14(1), 21–43.
Harris, L. M. (2004). In the shadow of slavery: African
Americans in New York City, 1626–1863. Chicago, IL:
University of Chicago Press.
Hine, D. C. (1995). Rape and the inner lives of Black
women in the Middle West: Preliminary thoughts on
735
the culture of dissemblance. In B. Guy-Shetfall (Ed.),
Unequal sisters: A multi-cultural reader in US
women’s history (pp. 380–388). New York, NY:
Routledge.
CUSTODY AND LITIGATION,
LGBQ PARENTS
When legal parents of minor children separate,
whether they were married or not, provision must be
made for continuing care of those children. From a
legal point of view, there are two separate aspects of
the child’s life that must be considered: Decision-
making authority (also known as “legal custody”)
must be allocated between the separating parents,
and there must be a plan for where the child will live
and how much time the child will spend with each
parent—for “physical custody.” (The modern trend is
toward use of the terms decision-making authority
and residential provisions in place of “legal custody”
and “physical custody,” respectively.) In addition,
provision must be made for the financial support of
the children.
Ideally, allocation of decision-making authority
and the determination of residential provisions can be
made through agreement of the parties. (Because the
state takes an interest in minor children, any
agreement must be reviewed by a court, but most
agreements are approved.) Agreement, however, is
not always possible. If the parties cannot reach
agreement, then they must resort to the court system
and to litigation. While most family court systems
encourage mediation, if all else fails, a trial will be
held and a judge will determine the allocation of
decision-making responsibility and the residential
arrangements for the child.
Details of custody procedures vary from state to
state, but some generalizations can be made. Custody
proceedings are adversary proceedings in which each
of the opposing parties advocates for her or his own
preferred outcome, ideally with the assistance of a
lawyer. The opposing parties in a custody case are
the parents. The child is not a formal party to the
proceedings. While this may seem curious, the
general understanding is that parents are the best
representatives for their children’s interests and since
736
each parent is entitled to present arguments, the
child’s interests should be presented through them.
Indeed, contested custody proceedings typically turn
on competing visions of the child’s interests.
The judge ultimately resolves the issues in a
custody case. In virtually all cases, the law directs the
judge to consider the “best interests of the child” in
reaching her or his conclusion. As is readily
apparent, the “best interests” test is hardly a clear-cut
one. It allows the judge to consider all of the
circumstances as well as the particular needs of the
child. This can be seen as both a strength—in that it
directs the judge to make an individualized
determination particular to the facts of each case—
and a weakness—in that it opens the door to
consideration of an enormous range of factors, some
of which may not be properly before the court.
Historically, lesbian, gay, and bisexual parents
separating from heterosexual coparents as part of a
coming-out process often suffered severe
discrimination in custody cases. Some jurisdictions
held that being LGBQ automatically disqualified a
parent as custodian. Many judges imposed strict
conditions on visitation, limiting the LGBQ parent’s
activities while the child was in their care. With time
the formal law has largely evolved. Generally, states
require that a nexus—a causal link—between
sexuality and harm to the child be shown before
sexuality can be taken into account
Custody and Litigation, LGBQ Parents
in a custody case. However, the indeterminacy of a
“best interests of the child” analysis can still allow
particular judges to discriminate, so long as they do
not explicitly take sexuality into account.
With the rise of LGBQ families where both
parents are lesbian or gay, a new category of custody
case has arisen; namely, cases where each of the
contesting parties is LGBQ. While there are certainly
individual jurisdictions where anti-LGBQ
discrimination may be found, it is less predictable
how this might play out in a situation in which both
parents identify as LGBQ.
As is noted above, in a custody case the judge
determines what is in the best interests of the child,
guided by the arguments from the parties. Depending
on the jurisdiction, the court may appoint some sort
of representative for the child, either to make an
independent evaluation or to consult with the child
directly. If the child is of appropriate age and
maturity, the judge may meet directly with the child
to discuss the child’s wishes and perceived needs.
Ultimately the ruling of the court will specify both
allocation of decision-making responsibility and
residential provisions for the child. With regard to
allocation of decision-making, there is a general
preference for both parents remaining involved in the
major decisions in a child’s life— decisions
regarding nonemergency medical care, education,
and religion, for example. Minor decisions are
typically entrusted to the parent with whom the child
is residing at the moment the decision arises. Often
some procedure for dispute resolution is identified.
With regard to residential provisions, much will
depend on the particular circumstances. The age of a
child and the geographical distance between the
parents’ new homes will figure into the division of
the child’s time. There is a significant presumption
that both parents will have residential time with the
child.
Julie Shapiro
See also Custody Issues in Transgender Parenting; Joint
Adoption; Legal Rights of Nonbiological Parents;
Second-Parent Adoption; Surrogacy, Legal
Considerations of
Custody Issues in Transgender Parenting
Further Readings
Joslin, C. G., Minter, S. P., & Sakimura, C. (2014).
Lesbian, gay, bisexual and transgender family law. Eagen,
MN: Thomson Reuters.
CUSTODY ISSUES IN TRANSGENDER
PARENTING
In child custody cases, judges make decisions based
on several factors relating to the practical, emotional,
and psychological needs of the child(ren) in question,
as well as the ability of the parents to meet those
needs; often a subjective interpretation of a parent’s
morality is part of the criteria in making this
decision. The abstract nature of what is in the “best
interest of the child” allows judges expansive

discretionary freedom, allowing potential biases to
be part of their ruling. Further, the ruling is one of
rather high stakes because custody decisions are
rarely reviewed, and are not overturned unless there
is considerable evidence of court error.
There is a rulings precedent that a parent’s race or
religion is beyond the scope of the court’s opinion as
it relates to child custody. Case studies suggest,
however, that courts are currently divided on the
bearing of a parent’s sexual orientation in custody
cases. While some courts operate under a “nexus
test,” where a parent’s homosexuality would be used
as negative evidence only if it is found to have
specific unfavorable consequences for the child,
other courts still operate under a “per se ban,” where
homosexuality is seen as intrinsically harmful to
children. Although the latter was more frequently
used against gay and lesbian parents in the past than
it is today, transgender individuals are still likely to
experience their gender identity being used as
evidence that they are fundamentally unfit as parents.
Although there are some defining judicial
moments in the arena of transgender custody,
precedents rulings are relatively absent from family
law jurisprudence, partially because most transgender
custody decisions are settled outside of court.
However, case studies do suggest that judges are
more hostile to parents who transition from male to
female, whereas parents who transition from female
to male, and individuals who do not plan to transition
publicly, hold more favor with the courts. This is
likely due to two interrelated social issues. First,
transmisogyny describes the intersection of
discrimination against gendernonconforming
individuals with the cultural hatred of femininity in a
male-dominated society. In other words, trans
women may hold less favor with the courts because
transitioning to female is perceived as more deviant
than transitioning to male. Second, this may be a
form of cis-sexism, where non-transgender people
still perceive trans individuals as their assigned birth
sex rather than their current gender identity. In this
case, courts may perceive trans men as “mothers” to
their children, rather than fathers, and follow patterns
of awarding primary custody to mothers.
Generally speaking, if there is a custody case
between a biological parent and a nonbiological
parent, the court will award custody to the biological
parent unless he or she is proven to be unfit.
737
However, judicial decisions in this area have shifted
due to the rising patterns of surrogacy and same–
same parenting, sometimes granting custody to
nonbiological parents who expressly planned for and
intended the birth of the child. However, relating to
transgender custody cases, courts have denied
biological and legal parents custody of, as well as
visitation rights to, their children specifically due to a
parent being transgender. At least one court, in the
1981 Nevada Supreme Court case of Daly v. Daly,
has terminated the parent–child relationship due to
the parent’s gender identity.
In the 1993 Missouri case of J.L.S. v. D.K.S., a
custody case ensued after a wife (J.L.S.) sought
divorce from her spouse of nine years (D.K.S.)
because of the spouse’s decision to transition from
male to female. D.K.S. requested that she be granted
custody of her children as “Aunt Sharon,” rather than
as her children’s father, but was denied custody
under the guise of “best interest of the
child.”
The first high-profile custody case involving a
transgender parent occurred in 2003, surrounding the
custodial rights of a female-to-male transgender man,
Michael Kantaras. This case was also a “case of first
impression” in Florida, a case with no binding
precedent that would set guidelines for similar cases
in the future. Michael and Linda Forsythe had legally
married as a heterosexual couple in the state of
Florida in 1988, with Linda’s knowledge that he was
a transsexual man. They were married for nine years,
raising two children together: Linda’s biological son
conceived with a former partner who never acted as a
parent to the child, and Linda’s biological daughter
conceived with a sperm donation from Michael’s
brother. Although Michael was not the biological
father of his children, he had been their social father
since their births (marrying Linda six weeks after the
birth of their first child), and he had legally adopted
them. However, when the couple divorced, Linda
asked that their marriage be invalidated and
Michael’s parental rights rescinded, solely based on
his transgender status. The court relied on a court-
appointed psychologist as well as an independent
court-appointed therapist who were tasked with
assessing the parenting abilities of Michael and
Linda, and making a recommendation about the best
interest of their two children. In the therapist’s report
to the court, Michael’s transgenderism is not noted,
738
and he is recommended as the preferable choice for
custody. It is noteworthy that Linda’s mental health
issues and attempts to manipulate their children’s
opinion of Michael were part of the decision against
her custodial rights. The two were granted a divorce,
and Michael was granted full custody of the children.
In 2004, the Second District Court of Appeal of
Florida invalidated their marriage on the grounds that
Michael was not “male” by their definition, and that
same-sex marriage was banned in the state; it had no
effect on the custody decision.
There have been subsequent court decisions on
gay- or lesbian-parent custody that are positive signs
for future transgender-parent custody cases,
particularly as they pertain to the court’s
responsibility to provide evidence of harm to a child,
rather than a presumption of harm. For example, in
2006 a Georgia court (Moses v. King) found “a
parent’s cohabitation with someone, regardless of
that person’s gender, is not a basis for denying
custody
Custody Issues in Transgender Parenting
or visitation absent evidence that the child was
harmed or exposed to inappropriate conduct.”
Similarly, in 2007 a Tennessee court (Marlow v.
Parkinson) found that “a parent should not have
restrictions imposed on how she interacts or spends
time with her child unless those restrictions are
necessary to protect against a demonstrated harm.”
Although both of these cases were about a parent’s
right to have a same-sex partner involved in their
child(ren)’s lives, legal scholars believe it can be
extrapolated to include a transgender parent’s right to
express their gender around their child(ren).
Although most studies that have investigated the
outcomes of children raised by LGBTQ parents have
focused on lesbian and gay parents, studies that have
included transgender parents similarly report that
there are no significant negative differences between
them and non-transgender parents that would impact
the wellness of children. As with gay and lesbian
parents, the greatest detriment to transgender parents’
ability to adequately parent their children is their lack
of legal protection as parents, and widespread
institutional and social discrimination. One of the
oldest recognized court interpretations
constitutional liberty, protected by the due process
clause, is the right to parent one’s children. Many
legal scholars point out that when courts impose their
own moral interpretation of a parent’s worth, related
to issues like gender identity or gender expression, it
is not only a matter of transgender discrimination,
but one of denying basic constitutional rights.
Maura Ryan
See also Transgender and Gender-Nonconforming Youth and
the Legal System; Transgender Parents and Well-Being;
Transition to Parenthood and Parental Roles; Transphobia
Further Readings
Carter, K. J. (2006). Best interest test and child custody: Why
transgender should not be a factor in custody
determinations. Health Matrix, 16(1), 209–236.
Chang, H. Y. (2002). My father is a woman, oh no: The
failure of the courts to uphold individual substantive
Custody Issues in Transgender Parenting
due process rights for transgender parents under the guise
of the best interest of the child. Santa Clara Law Review,
43(3), 649–698.
Cooper, L., & American Civil Liberties Union. (2013).
Protecting the rights of transgender parents and their
children: A guide for parents and lawyers. New York,
NY: American Civil Liberties Union and National Center
for Transgender Equality.
Perez, S. S. (2009). Is it a boy or a girl—not the baby, the
parent: Transgender parties in custody battles and the
benefit of promoting a truer understanding of gender.
Whittier Journal of Child and Family Advocacy, 9(2),
367–403.
Tye, M. C. (2003). Lesbian, gay, bisexual, and
transgender parents. Family Court Review, 41(1), 92–
103.
of
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746

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 747

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748

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 749

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 753

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754

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 755

abuse. physical
The risks
mental also
harm of linked
dating to
violenc intimate
e for partner
minorit violenc
y men e (e.g.,
— physical
exacerb harm or
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the abuse).
effects The
of extent
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zation dating
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only e
may among
increase sexual-
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unhealt men,
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756

that Men
sexualm (MSM);
inority Transg
males ender
Youth
may
and
also Well-
experie Being;
nce Youth
dating and
violenc Dating
e issues
unique
to them, F
such as u
r
undesir
t
ed
h
“outing
e
” of
r
their
sexualit
R
y, and
e
difficult a
y d
coping i
or n
finding g
support s
for lack
of Adam, B.
D.
social
(2006
scripts ).
or fear Relati
of onshi
stigmati p
zation. innov
ation
Peter J. in
D. male
coupl
Ceglare
es.
k and Sexua
José A. lities,
Bauerm 9(1),
eister 5–26.
Bauerme
See also ister, J.
Men A.,
Who Leslie-
Have Santana,
Sex With M.,
 757

Johns, A.,
M. M., Cha
Pin krav
gel, arty,
E., D.,
& Neil
Eise ands
nber , T.
g, B.,
A. Beo
(20 ughe
11). r, S.
Mr. C.,
Rig &
ht Hoff
and , C.
Mr. C.
Rig (201
ht 4).
No Sexu
w: al
Ro risk
man for
tic HIV
and amo
casu ng
al gay
part male
ner- coup
seek les:
ing A
onli long
ne itudi
amo nal
ng stud
you y of
ng the
men Dati
who ng,
hav Sex
e ual-
sex Min
with orit
men y
. Wo
AIDS men
and
Beha impac
vior, t of
15(2), relati
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272. p
dyna
Darbes,
mics.
L.
758

Archi stud
ves of y
Sexu with
al LG
Beha BT
vior, yout
43(1), h.
47– Journ
60. al of
DeHaan Sex
, S.,
Rese
Kup
er, arch,
L. 50(5),
E., 421–
Mag 434.
ee, Gottma
J. n, J.
C., M.,
Bige Leve
low, nson
L., , R.
& W.,
Mus Gros
tans s, J.,
ki, Fred
B. S. erick
(201 son,
3). B.
The L.,
inter McC
play oy,
betw K.,
een Rose
onli nthal
ne , L.,
and et al.
offli (200
ne 3).
expl Corr
orati elate
ons s of
of gay
iden and
tity, lesbi
relat an
ions coup
hips, les’
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A hip
mix satis
ed- facti
met on
hods and
 759

relat ment
ions type
hip and
diss coupl
oluti e
on. serost
Jour atus.
nal AIDS
of Care,
Ho 22(7),
mos 827–
exua 835.
lity, LaSala,
45(1 M. C.
), (2004
23– ).
43. Mono
Hoff, C. gamy
C., of the
Beou heart:
gher, Extra
S. C., dyadi
Chakr c sex
avart and
y, D., gay
Darbe male
s, L. coupl
A., & es.
Neila Journ
nds, al of
T. Gay
(2010 &
). Lesbi
Relati an
onshi Socia
p l
chara Servi
cterist ces,
ics 17(3),
and 1–24.
motiv Mit
ations c
behin h
d e
agree l
ments l
amon ,
g gay J
male .
coupl W
es: .
Differ (
ences 2
by 0
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760

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 761

8 to know
. one
another
to
explore
each
DATIN other’s
G, romanti
c
SEXUA potentia
l but
L-
with no
MINO specific
goal. A
RITY series
of dates
WOM is often
EN the first
step to
Dating
a
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serious
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commit
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ment.
commo
The
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individ
entry is
uals to
to
develop
describ
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e same-
romanti
sex
c
dating
relation
among
ship in
sexual-
the
minorit
United
y
States,
women,
as well
includin
as many
g
other
lesbians
countrie
and
s. It
bisexua
typicall
l and
y refers
transge
to a
ndered
trial
women,
phase
and to
of
summar
getting
762

ize and
popular supporti
alternati ve and
ves to have a
dating. sense of
The humor.
majorit In
y of persona
researc l ads
h on and
dating, online
howeve dating,
r, has sexual-
been minorit
done y
with women
lesbians frequent
; at ly
present, emphasi
compar ze
atively hobbies
little is and
known interests
about more
the than
same- their
sex own or
dating the
experie prospec
nces of tive
bisexua partner’
l and s
transge physical
ndered or
women. sexual
Sexu attribute
al- s. Some
minorit online
y dating
women services
tend to cater
prefer specific
dating ally to
partners lesbians
that are (e.g.,
fun, Pinkwin
intellige k.com);
nt, kind, others
 763

are mutual
open to friends,
all or
couple recreati
types onal
(e.g., activitie
Match.c s. These
om). venues
Online provide
dating a pool
has of
become dating
very partners
popular; that are
it is likely to
easier to be of
find similar
partners social
without status,
having race/eth
to guess nicity,
the and age.
person’ The
s sexual ambigui
orientati ty about
on, whether
identity, interacti
or ons
interest with
in a another
friendsh woman
ip are
versus a steps
romanti toward
c a
relation friendsh
ship. ip
Sexual versus a
minorit romanti
y c
women relation
also are ship
likely to appears
meet to be
partners one of
through the
school, difficult
work, ies that
764

sexual- importa
minorit nt in
y this
women context.
have Some
when commo
seeking n
partners signals
. of
Sexual- romanti
minorit c
y interest
women among
may sexual-
also be minorit
tentativ y
e about women
approac include
hing nonverb
another al cues
woman (e.g.,
if they touchin
are g,
uncertai smiling,
n about eye
her contact)
sexual ;
orientati attentiv
on or eness
are (e.g.,
fearful listenin
that she g to the
will partner,
respond sexual
with energy);
prejudic direct
e or stateme
rejectio nts of
n if they interest;
come or
out to outright
her. asking
Nonver for a
bal date.
commu Direct
nication physical
become behavio
s very rs that
 765

lesbians clearer
say they sense of
use to their
signal attractio
attractio n and
n relation
include ship
briefly potentia
holding l at the
hands early
when stage of
talking, acquain
hugging tance.
tightly Appear
when ance
greeting also
, and may be
sustaine used to
d eye send a
contact. sexual
Researc signal.
h on For
online instance
dating , many
suggest young
s that it lesbians
works make
more some
effectiv changes
ely if in their
individu appeara
als nce
move after
fairly coming
quickly out,
from an includin
online g
to a getting
face-to- a
face shorter
interacti haircut,
on or wearing
date, more
where casual
the two or
women androgy
can get nous
a clothes,
766

no roles,
longer particul
wearing arly for
makeup a first
, getting date,
a tattoo with the
or body man
piercing being
, or expecte
wearing d to ask
comfort for the
able date,
shoes. pay
These expense
changes s, and
signal initiate
their sexual
group contact.
member For
ship, sexual-
make minorit
them y
more women,
visible these
to roles
potentia typicall
l y are
partners shared.
, and In
differen addition
tiate , unlike
them heterose
from xual
the women,
domina sexual-
nt minorit
culture. y
The women
cultural do not
script have to
for establis
heterose h or
xual guard a
dating “good
is well girl”
defined reputati
along on by
gender limiting
 767

or describe
rejectin d their
g sexual first-
involve date
ment. experie
As a nces,
result, most
most indicate
sexualm d being
inority anxious
women before
report the date
initiatin about
g some their
form of appeara
physical nce or
contact physical
on a attractiv
first eness.
date. Even at
Most this
individu early
als, stage,
includin many
g also
sexual- viewed
minorit the first
y date as
women, a
experie chance
nce to
some evaluate
anxiety a date’s
before potentia
or l as a
during a committ
first ed
date due relation
to the ship
desire partner.
to You
create a ng
good bisexual
impress women
ion. who are
Among dating
lesbians women
who have
768

been g
found to cultural
follow a events,
pattern or
similar engagin
to g in
lesbians outdoor
. Most activitie
were s such
involve as
d in hiking
same- or
sex swimmi
dating ng. Of
and note is
engaged that
in adolesc
typical ent
adolesc bisexual
ent women
dating who
activitie were
s steadily
includin dating a
g going woman
to the were at
movies, heighte
“hangin ned risk
g out” for
with verbal
each harassm
other or ent
with from
friends, others if
and they
going were
out to still in
eat. high
Other school.
activitie Kno
s wledge
include about
d going the
for same-
coffee, sex
shoppin dating
g, practice
attendin s of
 769

transge adult
nder transge
women nder
is women,
scarce dating
and is may be
based especial
primaril ly
y on stressful
first- during
person the
account transitio
s. n phase,
Dating when
is likely the
to be person
very is
challen changin
ging for g
transge physical
nder ly and
teens, Dating,
who Sexual-
face Minori
ty
much
Wome
higher n
levels
of
harassm seeking
ent and to
violenc develop
e than comfort
lesbian, with a
gay, female
and public
bisexual persona
teens . In
and addition
often ,
feel lesbian
isolated transge
and not nder
part of women
the face a
school constrai
commu ned
nity. dating
Among pool
770

because are a
many number
lesbians of
will not online
date a transge
transge nder
nder dating
woman. sites
Transge availabl
nder e.
women Emot
may ional
choose intimac
to come y is
out highly
immedi valued
ately to by
any sexualm
potentia inority
l women,
partners and
to avoid most
being seek to
rejected convey
if they a
reveal positive
their emotion
identity al tone
at a when
later dating.
stage of As
dating. dating
Some progres
bisexua ses,
l research
women, indicate
or other s that
transge lesbians
ndered engage
women, in long,
may be intimate
more convers
open to ations
dating a with
transge dating
nder partners
lesbian; , partly
there to get
 771

acquain both
ted but sexually
also to and
set the emotion
stage ally
for a involve
friendsh d. They
ip. expecte
Sharing d their
coming- partner
out to be
stories monoga
is a mous
commo and
n viewed
convers the
ational relation
topic. ship as
Getting moving
to know toward
a a
partner’ serious
s sexual commit
history ment.
also is Little
used as research
a way has
to been
evaluate done to
concern assess
s about sexual
HIV/AI satisfact
DS and ion
other during
sexually the
transmit dating
ted phase of
diseases relation
. When ships
asked to for any
describe couple
a fifth type.
date, Howeve
lesbians r,
typicall sexual
y satisfact
reported ion
being tends to
772

be high be more
among purposi
establis ve than
hed younger
lesbian lesbians
couples; in terms
presum of
ably, evaluati
this ng a
may dating
also be partner’
the case s
for potentia
dating l for a
couples. long-
Expe term
rience relation
and age ship and
also therefor
may e tend
affect to value
dating. warmth,
The respect,
percent and
age of reciproc
midlife al liking
sexual- from
minorit prospec
y tive
women partners
who are more
single is than
unknow physical
n. attractio
Those n and
who are sexual
single gratifica
may be tion.
dating Midlife
one and
woman, older
more sexual-
than minorit
one, or y
none. women
Midlife may
lesbians have an
tend to advanta
 773

ge over partners
heterose in their
xual age-
women groups.
in terms In
of addition
finding ,
new lesbians
romanti tend to
c orbe
sexual attracte
partners d to
because women
the pool their
of own
women age;
partners this
is means
greater midlife
than the lesbians
D may
a have a
t better
i
chance
n
g
of
, finding
S a new
e partner
x than
u their
a heteros
l
exual
-
M
counter
i parts.
n Gend
o er roles
r have
i been
t studied
y
primaril
y using
W
o
lesbian
m samples
e .
n Althoug
h most
lesbians
pool of appear
male
774

to reject power
gender and
roles subordi
when nation
dating, are not
a part of
minorit the
y roles
subscrib among
e to White
butch– or
femme African
roles as Americ
a form an
of butch–
gender femme
expressi lesbians
on. A . The
major roles do
function not
of parallel
butch– heterose
femme xual
roles is masculi
as a nity and
sexual feminin
signalin ity. For
g instance
system , butch
that is women
used to are not
commu the
nicate primary
attractio initiator
n to of
others physical
and to contact.
provide Instead,
mutual either
validati woman
on of may
identitie initiate
s. it.
Traditio Further
nal more,
gender butch
patterns lesbians
of often
 775

place ry to
the conceal
femme’ their
s sexual attractio
satisfact n when
ion in
above public,
their at work,
own. or
The interacti
quality ng with
of family.
dating Transge
relation nder
ships women
for have the
sexualm added
inority stress of
women coming
may be out as
affected transge
by ndered
factors to their
such as prospec
minorit tive
y stress, partners
defined .
as the Sexual-
chronic minorit
experie y
nce, women
expectat often do
ion, or not
percepti introduc
on of e their
prejudic dating
e or partner
discrimi to
nation. parents
Couples until the
experie relation
nce ship is
minorit fairly
y stress well
when establis
they hed.
feel it Public
necessa displays
776

of affectin
affectio g the
n are dating
less relation
commo ships of
n than some
among sexual-
heterose minorit
xuals. y
Many women.
same- Sexual-
sex minorit
couples y youth
are are
reluctan signific
t to antly
show more
affectio likely
n in than
public their
due to heterose
fear of xual
harassm counter
ent or parts to
violenc experie
e. nce
Dati dating
ng violenc
violenc e (35%
e, vs. 8%).
includin Howeve
g r,
psychol findings
ogical, about
physical prevale
, sexual, nce in
and women’
cyber s same-
(e.g., sex
outing dating
someon relation
e ships
online), are
has inconcl
been usive.
identifie Some
d as an research
issue reports
 777

that experie
young ncing
lesbians verbal
and gay or
men controll
experie ing
nce interper
interper sonal
sonal violenc
violenc e from a
e at male
about partner.
the Alth
same ough
rate many
(e.g., lesbians
44% and
and bisexual
45%, women
respecti engage
vely); in
other same-
findings sex
indicate dating,
that gay others
men are have
more never
likely dated;
than instead,
lesbians they
to describe
experie becomi
nce all ng
forms friends
of with
interper someon
sonal e,
violenc falling
e except in love,
sexual and
violenc then
e. making
Bisexua a
l commit
women ment to
most their
often relation
reported ship.
778

This is Othe
particul r more
arly true casual
for arrange
lesbians ments
who such as
came hookup
out in s,
the pre- hangout
Stonew s, and
all era friends
and with
among benefits
those have
who been
came propose
out in d as
midlife. being
Bisexua more
l commo
women n than
also dating,
frequent particul
ly arly
describe among
d emergin
becomi g
ng adults.
friends A
with a hookup
woman refers to
and brief,
then uncom
getting mitted
sexually sexual
involve encount
d ers
without among
formall individu
y dating als who
or are not
identify romanti
ing as c
being partners
more or
than dating
friends. each
other;
 779

the relation
degree ship or
of any
sexual kind of
interacti commit
on may ment.
range Little is
from known
kissing about
to the
intercou extent
rse. to
Hangin which
g out sexual-
refers to minorit
occasio y
ns when women
two prefer
people or
spend engage
loosely in
organiz dating
ed, compar
undefin ed with
ed time these
together alternati
without ves.
making Many
their lesbians
interest have
in one had
another casual
explicit. sex or a
Friends one-
with night
benefits stand on
refers to at least
two one
good occasio
friends n, and
who most
have were
casual positive
sex about
without the
a experie
monoga nce;
mous howeve
780

r, most hing
preferre another
d a woman
slower, directly
more to ask
romanti for a
c date, as
progres well as
sion to to be
a seen as
relation a dating
ship. couple
The with
dating family,
practice at work,
s of and in
sexual- public
minorit settings.
y
Suzann
women
a M.
may
change Rose
as See also
same- Butch–
sex Femme;
marriag Intimate
e and Partner
other Violence
,
societal
Fema
rights
le;
and Roma
recognit ntic
ions Frien
become dship
more s;
prevale Sexu
al
nt. In
Norm
the s and
future, Practi
sexual- ces
minorit
y
women
may be
more
comfort
able
approac
 781

F and
u sexu
r al
orie
t
ntati
h
on
e (pp.
r 165–
178)
R .
e New
a Yor
d k,
NY:
i
Oxf
n
ord
g Univ
s ersit
Fingerh y
ut, Pres
A. s.
W., Garcia
& , J.
Pepl R.,
au, Rei
L. ber
A. ,
(201 C.,
3). Ma
Sam sse
e- y,
sex S.
rom G.,
antic &
relat Me
ions rri
hips. we
In C. the
J. r,
Patte A.
rson M.
& A. (20
R. 12)
D’A .
ugell Se
i xu
(Eds al
.), ho
Han ok
dbo up
ok cul
of tur
psyc e:
holo A
gy rev
782

ie s
w. :
Re S
vie a
w m
of e
Ge -
ner s
al e
Ps x
yc
hol i
og n
y, t
16( i
2), m
16 a
1– t
17 e
6.
Mes p
s a
i r
n t
g n
e e
r r
, v
A i
. o
M l
. e
( n
2 c
0 e
1
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) n
.
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t
n
h
v
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i
s
N
i
a
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t
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V
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l
 783

e n
n c
c e
e ,
2
A 6
g (
a 1
i 1
n )
s ,
t 2
W 2
o 2
m 8
e –
n 2
2
S 4
u 3
r .
v Moore,
e M. R.
y (2006
. ).
J Lipsti
o ck or
u Timb
r erlan
n ds?
a Mean
l ings
of
o gende
f r
prese
ntatio
I
n in
n
black
t
lesbia
e
n
r
com
p
munit
e
ies.
r
Signs
s
:
o
Journ
n
al of
a
Wom
l
en in
Cultu
V
re
i
and
o
Socie
l
ty,
e
784

32,
113– DECIDI
139.
NG
Rose, S.
M., &
Eaton
WHET
, A. HER TO
A.
(2012 PAREN
).
Lesbi T
an
love,
Most
sex, researc
and h
relati examini
onshi ng
ps. In LGBT
D.
Q
Casta
neda
parents
& M. studies
Palud them
i after
(Eds.) they
. An have
essen
children
tial
hand
. This
book entry
of looks at
wome the
n’s major
sexua factors
lity:
embedd
Vol.
2.
ed in
Diver the
sity, process
healt that
h and LGBT
viole Q
nce
people
(pp.
3– go
28). through
New when
York, decidin
NY: g
Praeg whether
er.
or not
to
parent.
These
 785

include structur
persona es of
l race,
factors, class,
support gender,
network and
s, work- sexualit
related y that
issues, shape
and the
intimate decisio
partner nmakin
relation g
ships. process
The about
sections whether
that or not
follow to
examin parent.
e how The
these emphas
factors, is here,
while therefor
experie e, is on
nced by the
LGBT persona
Q l,
people cultural,
on an and
individ structur
ual al
level, reasons
are that
LGBT
Deciding
Whether
Q to
Parent
people
decide
socially whether
constru to
cted; parent.
that is,
they
Person
develop
out of al
and are Factors
embedd The
ed in first
social type of
786

factors (i.e.,
that come
shape out) in
LGBT order to
Q negotiat
people’ e
s multipl
parentin e
g identitie
decisio s.
ns (i.e.,
their
The
decisio
Desire
ns to
become to
parents Parent
or Whe
remain n
child- LGBTQ
free) people
are want to
persona become
l. parents,
Persona they
l factors often
are work to
those turn
that their
include desire
the into
desire reality.
to People’
become s
a desires
parent, to
internal parent
ized tend to
homoph fall on a
obia, continu
and the um,
ability with
and those
need to who
make really
public want to
one’s parent
sexual on one
identity end,
 787

and people’
those s
who parentin
want to g
remain decision
child- s
free on regardle
the ss of
other. their
LGBTQ parentin
people g
who are desires.
White As
and discusse
middle d
class below,
tend to these
follow barriers
their come in
desires the
such form of
that a lack
those of
who family
desire support;
parenth a lack
ood of
become access
parents to
and LGBTQ
those parent
who do network
not s;
remain inflexib
child- le jobs;
free. financia
Howeve l
r, for instabili
those ty; and
less a lack
privileg of
ed by access
race and to
social fertility
class, speciali
barriers sts (e.g.,
can reprodu
alter ctive
788

endocri various
nologist factors
s) who discusse
adminis d as
ter follows.
reprodu D
ctive e
technol c
i
ogies,
d
adoptio i
n n
agencie g
s, and
surroga W
cy h
options. e
Som t
h
e
e
LGBTQ r
people t
fall in o
between
the two P
extreme a
s of the r
parentin e
n
g
t
continu
um and
are Internali
therefor zed
e Homoph
undecid obia
ed as to
whether A
or not second
they persona
want to l factor
become that
parents. shapes
Ambiva LGBTQ
lent people’
LGBTQ s
people decision
are s about
often whether
swayed to
by the parent
is
 789

internali of
zed internali
homoph zed
obia. homoph
Because obia,
of some
heterose LGBTQ
xism people
and may
homoph questio
obia, n their
which own
are right
pervasi and
ve ability
through to
out parent.
society, In
many addition
LGBTQ ,
people LGBTQ
internali people
ze who are
negativ conside
e social ring
and parenth
cultural ood
messag may
es. Such also be
messag conside
es ring
portray how
LGBTQ their
people sexual
as being identity
immora may
l, negativ
making ely
unfit impact
parents, their
and children
raising ’s
emotion experie
ally nces
scarred and
children opportu
. nities.
Because Such
790

questio heterose
ning xual
can lead people
to to
persona demean
l doubt men
that who
presents relinqui
a real sh their
barrier sexual
to power
becomi over
ng a women,
parent. internali
Owi zed
ng to homoph
intersec obia is
tions of often
gender particul
and arly
sexualit strong
y, among
internali male
zed sexual
homoph minoriti
obia es. In
affects addition
gay and , gender
bisexual norms
men discour
differen age men
tly from from
lesbian believin
and g they
bisexual can be
women. good
For nurturer
exampl s.
e, Therefo
because re, male
definiti sexual
ons of minoriti
hegemo es are
nic often
masculi more
nity concern
encoura ed than
ge their
 791

female The
counter Ability
parts and
about Need to
how Come
heterose Out
xual
Inter
people
nalized
might
homoph
view
obia
and
often
treat
affects
them
LGBTQ
and
people’
their
s ability
children
to
.
safely
Regardl
and
ess of
comfort
the
ably
reason
reveal
for
their
internali
identity
zed
to
homoph
others
obia, if
(i.e.,
LGBTQ
come
people
out),
are
and
ambival
how
ent
comfort
about
able one
becomi
is to
ng
come
parents,
out is
it can
shaped
present
by
a big
larger
enough
structur
barrier
es of
to
race and
prevent
social
them
class.
from
choosin Rega
g rding
parenth race,
ood. historic
ally,
792

White and
people homoph
have obic
stigmati sexual
zed practice
Black s and
people beliefs
by so that
creating White
a myth people
of the will see
oversex them as
ualized being
Black sexually
man “normal
whom .”
Whites Further
need to more,
fear, because
and a Black
myth of families
the are
Black often
woman connect
whose ed to
sexualit religiou
y needs s
to be commu
controll nities
ed lest that can
she be
have homoph
too obic,
many coming
children out to
. family
Because and
of such commu
racializ nity is
ed often
sexualit difficult
y, Black for
people Black
have LGBTQ
often people.
tried to Simil
follow arly, in
puritan commu
 793

nities tightkni
with t family
heighte in both
ned Latino
sexism, and
coming Black
out can commu
also be nities,
difficult there is
. For often a
exampl “don’t
e, in ask,
many don’t
upper- tell”
class toleranc
Latino e for
commu people
nities, who are
the willing
honor to be in
of the LGBTQ
family relation
rests in ships
part on without
the openly
sexual revealin
purity g or
of their discussi
women, ng those
which relation
means ships.
high Soci
levels al class
of also
homoph matters
obia in how
against likely
lesbians people
or are to
bisexual come
women. out. For
Howeve exampl
r, e,
because because
of the working
value class
placed White
on the families
794

experie gender
nce mean
greater strict
econom rules
ic about
hardshi sexualit
p than y for
middle- women
class and
families men.
, they Howeve
rely on r,
family families
relation with
ships to tight
help emotion
them al ties
through are also
difficult disincli
econom ned to
ic expel
times. their
Such children
reliance . Thus,
has led similar
to the to
develop families
ment of of
a strong color,
belief in White
traditio working
nal class
notions families
of may
family adopt a
that “don’t
support ask,
a clear don’t
gender tell”
division practice
of as well.
labor. Midd
As in le-class
Latino White
families LGBTQ
, strong people
ideas do not
about necessa
 795

rily face come

the out.
same Such
problem race and
s in class
coming privileg
out. For e allows
exampl middle-
e, class
because White
White LGBTQ
middle- people
class to come
LGBTQ out to
people their
tend to families
come more
from often
families and
that are more
less easily
connect than
ed to other
larger racial/et
religiou hnic
s and
commu class
nities groups.
than are Whethe
people r or not
of LGBTQ
color, people
they are can
less come
likely out to
than their
other families
groups is
to risk importa
losing nt
connect because
ion to the
commu more
nities acceptin
outside g
their families
families are of
if they their
796

member to
s’ becomi
sexual ng a
identitie mother,
s, the particul
easier it arly if
is for they are
member plannin
s to turn g on
their getting
parentin pregnan
g t.
desires Howeve
into r, for
parentin gay
g men,
realities because
. of
Alth heighte
ough ned
there internali
are zed
many homoph
similarit obia as
ies discusse
among d
LGBTQ above,
people coming
in terms out may
of close
coming the door
out, on
there becomi
are ng a
some father.
variatio Therefo
ns by re, for
gender. some
For gay
exampl men,
e, for coming
many out
lesbians means
, that
coming they are
out is a giving
necessa up the
ry step chance
 797

to be n
fathers. d

R
A
e
c
s
c
o
e
u
s
r
s
c
e
t
s
o
In
S addition
u to
p persona
p l issues,
a
o
second
r
main
t
factor
that
N shapes
e LGBT
t Q
w people’
o s
r decisio
k ns to
s become
, parents
is
I access
n to
f support
o network
s,
r
informa
m
tion,
a and
t resourc
i es.
o Support
n generall
, y comes
from
a two
798

major than
sources: those
LGBT who are
Q- more
parent isolated
network from
s, and LGBTQ
legal -parent
and network
medical s. This
informa is
tion and because
services LGBTQ
. -parent
network
s help
LGBTQ
potentia
Parent
l
Network parents
s find
Supp reprodu
ort from ctive
other speciali
LGBTQ sts,
people adoptio
influenc n
es services
parentin ,
g surroga
decision cy
s. agencie
LGBTQ s, and
people other
who parents
live who
physical will
ly near support
to and their
know decision
other s to
LGBTQ parent
parents and
have an help
easier turn
time desires
decidin into
g to realities
parent .
 799

Particul nce and

arly in knowle
less dge
urban they
areas, need to
White help
middle- them
class choose
LGBTQ parenth
people ood
tend to over
have remaini
more ng
access child-
to other free.
LGBTQ
parents
and Access
support to Legal
network and
s than Medical
do those Informa
less tion and
Services
Deciding
Whether to
As
Parent
stated
earlier,
privileg finding
ed by LGBTQ
race parent
and network
class. In s is
short, importa
meeting nt
and because
interacti they
ng with provide
other potentia
LGBT l
Q LGBTQ
parents parents
can with
give vital
potentia informa
l tion
parents about
the how to
confide achieve
800

that ogies
goal. such as
While donor
some (i.e.,
LGBTQ alternati
people ve)
have insemin
become ation. If
parents LGBTQ
in people
previou want to
s use
heterose donor
xual insemin
relation ation or
ships, other
LGBTQ medical
people techniq
who are ues
conside such as
ring in vitro
parenth fertiliza
ood tion,
within they
their may
current need to
sexual access
and sperm
gender through
identitie a sperm
s can do bank,
so which
through usually
adoptio requires
n, foster help
care, from a
pregnan physicia
cy, or n. Some
surroga LGBTQ
cy. people
Pregnan use
cy often adoptio
requires n or
the use surroga
of cy
reprodu services
ctive in order
technol to
 801

become adoptio
parents. n
Such agency
services willing
often to work
require with
that them.
LGBTQ For
people exampl
be able e, some
to physicia
access ns or
medical adoptio
and/or n
legal agencie
services s may
to only
become work
parents. with
Beca married
use couples.
LGBTQ It
relation remains
ships to be
challen seen if
ge some physicia
people’ ns and
s adoptio
definiti n
on of agencie
family, s will
LGBTQ change
people their
who practice
want to s, now
become that
parents same-
may sex
experie couples
nce can
difficult marry
y in (as of
finding June
a 2015).
reprodu In
ctive addition
speciali , some
st or physicia
802

ns will terminat
work e their
only plans to
with the become
LGBTQ parents.
person In
who is addition
being to
insemin insemin
ated, ation
and will and
ignore adoptio
that n,
person’ D
s e
partner. c
i
When
d
LGBTQ i
people n
receive g
insultin
g W
treatme h
nt from e
physicia t
h
ns or
e
adoptio r
n t
agencie o
s, or
when P
they a
fear a r
general e
n
lack of
t
legal
protecti
on for surroga
themsel cy is an
ves and option
their for
children parenth
, they ood, but
may it is
decide expensi
to ve,
postpon complic
e or ated,
 803

and not s, a
legal in third
all major
states. factor
Therefo that
re, shapes
knowin parentin
g which g
physici decisio
ans, n-
adoptio making
n process
agencie es
s, involve
lawyers s issues
, or related
surroga to
cy work.
agencie Work is
s to importa
access nt to
is key how
to LGBT
helping Q
LGBT people
Q decide
people whether
become to
parents parent
if they for a
so variety
desire. of
reasons.
First,
Work- unless
Relate LGBT
d Q
Issues people
are
In
using a
addition
known
to
donor
persona
or have
l issues
children
and
from a
LGBT
previou
Q
s
parent
relation
network
804

ship, who
they want to
must be become
able to parents
pay for an
reprodu advanta
ctive ge over
technol workin
ogies, g-class
adoptio or poor
n, or LGBT
surroga Q
cy. Jobs people
primaril whose
y work
occupie does
d by not
middle- afford
class them
people such
often benefits
come .
with a Therefo
stable re,
salary; workin
flexible g-class
schedul LGBT
es; and Q
compre people
hensive are
benefits often
such as more
sick concern
leave, ed than
vacatio middle-
n time, class
and LGBT
health Q
insuran people
ce. about
Such how
benefits their
give work
middle- might
class hinder
LGBT their
Q opportu
people nities to
 805

become ce, can

parents. create
Indeed, real
the jobs barriers
that for
workin LGBT
g-class Q
LGBT people
Q who
people want to
of color parent.
in Simil
particul arly,
ar hold when
often do LGBTQ
not people
offer who
the desire
same econom
benefits ic and
as those persona
occupie l
d by freedom
middle- hold
class— jobs
and with
particul good
arly salaries,
White flexible
middle- schedul
class— es, and
LGBT good
Q benefits
people. , they
Thus, might
jobs not
with want to
limited give up
flexibili their
ty or freedom
career to
satisfact become
ion, as parents.
well as The
inadequ result is
ate that,
health regardle
insuran ss of
806

whether someon
LGBTQ e has an
people intimate
desire partner,
children and if
or not, so, the
work nature
can of that
serve as relation
a ship. As
powerfu with the
l barrier previou
or s three
incentiv factors,
e to the
parentin influenc
g, e of
dependi intimate
ng on relation
one’s ships is
race or shaped
class by
position structur
. es of
Relatio race,
nships class,
With and
gender.
Intimat
When
e LGBT
Partne Q
rs people
A want to
fourth become
major parents
factor and also
that have a
influenc willing
es and
LGBT supporti
Q ve
people’ partner,
s the
parentin decisio
g n of
decisio whether
ns is to
whether parent
 807

become whether
s easier. or not
On the the
other couple
hand, become
having parents,
a and
partner what
whose constitu
parentin tes the
g desire right
differs partner
from or time
one’s varies
own by
desire, social
or not class.
having “Right”
a for
partner working
at all, -class
can lesbians
make means
the that
decisio their
n- partner
making has to
process be both
more financia
challen lly
ging. stable
Rese and
arch has emotion
found ally
that, in ready to
the case have
of children
lesbians .
, “Right”
finding for
the middle-
“right” class
partner lesbians
at the , on the
“right” other
time is hand,
critical means
to that the
808

partner their
only has access
to be to
emotion social
ally network
ready. s, the
Gay, quality
bisexual of their
, work,
transge and
nder, their
and involve
queer ment or
(GBTQ noninvo
) people lvement
might in an
also intimate
face this partner
same relation
experie ship.
nce. Much
Howeve of the
r, researc
similar h
research conduct
regardin ed to
g date has
GBTQ examin
people ed
has yet parentin
to be g
conduct decisio
ed. ns
among
lesbians
Conclu and gay
sion men.
LGBTQ Few
people studies
make have
decisio looked
ns on specific
parentin ally at
g based transge
on nder- or
persona bisexua
l l-parent
factors, families
 809

, and in;
therefor Assist
ed
e more
Repro
researc ducti
h is ve
needed Tech
in these nolog
areas. ies
Howev (ART
s);
er, what
Comi
is clear ng
is that Out,
persona Discl
l, osure,
cultural, and
and Passi
social ng;
Healt
structur
h
al Care
factors Syste
along m;
lines of Masc
race, ulinit
class, y and
and Pregn
ancy;
gender
Partn
shape ers in
LGBT (Gen
Q der)
people’ Trans
s ition;
decisio Trans
ns to gende
r
parent
Healt
or h
remain Care;
child- Work
free. place
Discri
Nancy minat
J. ion
Mezey

See also
Adop
tion,
Legal
Consi
derati
ons
810

F 111–
u 141.
r Eady, A.,
t Ross,
h L. E.,
e Epste
in, R.,
r
&
Ande
R rson,
e S.
a (2009
d ). To
i bi or
n not to
g bi:
Bisex
s
uality
Bergman and
, K., disclo
Rubio, sure
R. J., in the
Green, adopt
R.-J., & ion
Padron, syste
E. m. In
(2010 R.
). Epste
in
Gay
(Ed.),
men Who’
who s
beco your
me dadd
father y?
s via And
surro other
writin
gacy:
gs on
The queer
transi paren
tion ting
to (pp.
paren 124–
thood 132).
Toron
.
to,
Journ
ON,
al of Cana
GLB da:
T Suma
Famil ch
y Press.
Studi Goldberg
es, 6, , A.
 811

E., gay
Dow men
ning, as
J. D., foster
& carers
Moye and
r, A. adopt
M. ers.
(2012 Journ
). al of
Why GLB
paren T
thood Fami
, and ly
why Studi
now? es, 2,
Gay 93–
men’ 114.
s Hines, S.
motiv (2006
ations ).
for Intim
ate
pursu
transi
ing tions:
paren Trans
thood gende
. r
Fami practi
ly ces of
partn
Relat
ering
ions,
and
61, paren
157– ting.
174. Socio
Hicks, S. logy,
(2006 40(2),
). 353–
Mater 371.
doi:1
nal
0.117
men: 7/003
Perve 8038
rts 5060
and 6203
devia 7
nts? Mallon,
Maki G. P.
ng (2004).
sense Gay men
of choosing
812

parentho paren
od. thood
New and
York, the
NY: declin
Colu e of
mbia pater
Univ nity
ersity as we
Press. knew
it.
Mezey,
Sexua
N. J. lities,
(2008 9,
). 27–
New 55.
choic
es,
new
famili DEFEN
es:
How SE OF
lesbia
ns
MARR
decid IAGE
e
A
about
mothe
C
rhood T
.
Balti
more,
(
MD: D
Johns
Hopk O
ins
Univ M
ersity
Press.
A
Mezey,
N. J.
)
(2015).
LGBT
families. The
Thousan Defense
d Oaks, of
CA:
Marriag
Sage.
e Act
Stacey, J.
(DOM
(2006
). A) is a
Gay United
 813

States v.
statute Windso
enacted r,
in 1996 invalida
that ted the
prohibit section
ed the of
recognit DOMA
ion of that
same- establis
sex hed a
marriag federal
e for all definiti
federal on of
Defemarriag
nse e and
of paved
Marr
the way
iage
Act
for the
(DOfederal
MA)recognit
ion of
same-
purpose sex
s and marriag
authoriz e. This
ed entry
states to outlines
refuse the
to history
recogni of
ze DOMA
same- and the
sex circums
marriag tances
es surroun
perform ding its
ed in passage
other . It
jurisdict explain
ions. s the
The range of
landmar disabilit
k 2013 ies
Suprem DOMA
e Court impose
case, d on
United married
States
814

same- traditio
sex nally
couples governe
and d by
conclud state
es with law.
a Prior to
discussi DOMA,
on of there
the was no
rules federal
governi definiti
ng the on of
recognit marriag
ion of e. In
same- questio
sex ns
marriag involvin
e at the g
federal federal
level law,
that such as
were in taxes or
place federal
until the benefits
2015 , the
U.S. validity
Suprem of a
e Court marriag
case e was
Oberge determi
fell v. ned by
Hodges referenc
mandat e to the
ed definiti
nationw on of
ide marriag
marriag e in the
e state
equality where
. the
In couple
the lived.
United DO
States, MA
marriag was
e had enacted
been to stop
 815

the signaled
spread the
of possibil
same- ity that
sex individu
marriag al states
e after could
the be
Hawai’i required
State to
Suprem recogni
e Court ze
issued same-
its 1993 sex
ruling marriag
in e under
Baehr the
v. protecti
Lewin, ons
in afforde
which d by
the their
court state
said that constitu
the tions.
prohibit Without
ion on DOMA,
samese the
x federal
marriag govern
e was ment
discrimi would
natory. have
Althoug been
h it took required
almost to
20 years recogni
for ze all
Hawai’i samese
to then x
recogni marriag
ze es that
same- were
sex valid
marriag under
e, the state
1993 law.
decision Moreov
816

er, the s, and it

Full authoriz
Faith ed
and states to
Credit refuse
Clause to
of the recogni
U.S. ze out-
Constit of-state
ution same-
could sex
have marriag
required es.
states to Section
recogni 3 of
ze DOMA
same- amende
sex d the
marriag seldom-
es used
perform federal
ed in D
other e
jurisdict f
e
ions.
n
DO s
MA e
address o
ed both f
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eventua a
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r
through
i
two a
substant g
ive e
provisio A
ns: It c
adopted t
a (
D
restricti
O
ve M
definiti A
on of )
marriag
e for all
federal Diction
purpose ary Act
with the
 817

followi ve
ng bu
definiti re
on of au
marriag s
e: an
d
In ag
deter en
minin ci
g the es
meani of
ng of
th
any
e
Act of
U
Co
nit
ng
ed
re
St
ss,
at
or
es,
of
th
an
e
y
w
rul
or
in
d
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re
m
gu
arr
lat
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io
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n,
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or
m
int
ea
er
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pr
on
et
ly
ati
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th
l
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io
rio
n
us
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ad
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mi
ee
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n
str
on
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e
818

m w
an ho
an is
d a
on hu
e sb
w an
o d
m or
an a
as wi
hu fe.
sb
an Secti
d on 2 of
an DOMA
d spoke
wi directly
fe, to Full
an Faith
d and
th Credit
e concern
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or
d N
“s o
po St
us at
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s or
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ly or
to po
a ss
pe es
rs si
on on
of of
th th
e e
op U
po nit
sit ed
e St
se at
x es,
 819

or e,
In ter
di rit
an or
tri y,
be po
, ss
sh es
all si
be on
re ,
qu or
ire tri
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to re
gi sp
ve ec
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y on
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c be
ac tw
t, ee
re n
co pe
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pr sa
oc m
ee e
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ng x
of th
an at
y is
ot tre
he at
r ed
St as
at a
820

m ch
arr rel
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ge on
un sh
de ip.
r
th DO
e MA
la was
ws enacted
of with
su overwh
ch elming
ot bipartis
he an
r support.
St Introdu
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ter in the
rit months
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po the
ss 1996
es preside
si ntial
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or preside
tri ntial
be candida
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or support
a ed the
rig legislati
ht on.
or Republi
cl can
ai preside
m ntial
ari candida
si te
ng Senator
fr Bob
o
Dole
m
introduc
su
 821

ed The
DOMA Report
in the of the
U.S. U.S.
Senate, House
where it of
passed Represe
by a ntatives
vote of Judiciar
85 to y
14. Commit
DOMA tee
passed explain
the ed that
House the
of legislati
Represe on
ntatives furthere
by a d four
vote of govern
342 to ment
67. interests
With : (1)
veto- defendi
proof ng and
majoriti nurturin
es in g the
both instituti
houses on of
of traditio
Congres nal
s, marriag
Preside e, (2)
nt defendi
Clinton, ng
who traditio
was nal
running notions
for of
reelecti moralit
on, y, (3)
signed protecti
DOMA ng
into law states’
in soverei
Septem gnty
ber and
1996. democr
822

atic dispara
self- ging
governa terms.
nce, and After
(4) DOMA
preservi was
ng enacted,
scarce it was 8
govern years
ment before
resourc Massac
es. husetts
Focusin became
g the first
primaril state to
y on recogni
moralit ze
y, the same-
testimo sex
ny in marriag
the e. Once
Congres same-
sional sex
Record couples
reflects could
the legally
heated marry
rhetoric under
of the state
time. law,
Membe DOMA
rs of mandat
Congres ed that
s they
invoked were
images still
of the conside
fall of red
ancient unmarri
Rome ed for
and all
discusse federal
d same- purpose
sex s. For
marriag exampl
e in e, a
alarmist same-
and sex
 823

couple benefits
who , rights,
was and
legally privileg
married es.
and These
lived in provisio
Massac ns
husetts include
could favorabl
file e joint
their tax
state rates,
income Social
taxes Security
jointly, spousal
but had benefits
to file , and
their pension
federal rights.
taxes as As
if they more
were states
unmarri adopted
ed. The marriag
United e
States equality
General , the
Accoun inequiti
tability es
Office impose
identifie d by
d 1,138 Section
federal 3 of
statutor DOMA
y came
provisio increasi
ns ngly
under under
which fire
marital because
status is legally
a factor married
in same-
determi sex
ning or couples
receivin were
g being
824

denied Advisor
importa y Group
nt (BLAG
federal ), and
benefits BLAG
. In took the
2011, place of
U.S. the DOJ
Attorne in the
y pending
General federal
Eric lawsuits
Holder that
announ were
ced that challen
the U.S. ging the
Depart validity
ment of of
Justice DOMA.
(DOJ) One
would of the
no lawsuits
longer was
defend United
Section States
3 of v.
DOMA Windso
because r, which
it was
violated brought
the U.S. by Edie
Constit Windso
ution. r, an 83-
The year-old
House widow
of who
Represe had to
ntatives pay
elected over
to $363,00
defend 0 in
the federal
statute estate
through taxes on
its the
Bipartis death of
an her
Legal same-
 825

sex not
spouse challen
because ge
the Section
federal 2 of
govern DOMA,
ment it was
did not later
recogni invalida
ze her ted by
marriag Oberge
e. After fell v.
lower Hodges.
courts The
ruled in invalida
favor of tion of
Windso Section
r, the 3 of
U.S. DOMA
Suprem by
e Court Windso
ruled in r
a 5-to-4 allowed
decision legally
that married
Section same-
3 sex
violated couples
the Due to be
Process conside
Clause red
and married
Equal for all
Protecti federal
on purpose
guarant s,
ees of includin
the g
Fifth federal
Amend spousal
ment of benefits
the U.S. .
Constit Because
ution. samese
Althoug x
h marriag
Windso e was
r did not
826

recogni marriag
zed in es,
all provide
states at d they
the time were
of the valid in
decision the state
, a where
complic they
ation were
arose perform
when a ed.
same- Howev
sex er, this
couple expansi
was ve rule
legally did not
married apply in
in one all
state, instance
but s
lived in because
a state the laws
that did authoriz
not ing
recogni certain
ze benefit
same- progra
sex ms,
marriag such as
e. To Social
reach Securit
these y,
marriag specific
es, the ally
federal impose
govern d a
ment require
adopted ment
a “state that a
of marriag
celebrat e must
ion” be valid
rule that in the
recogni couple’
zed s state
same- of
sex residen
 827

ce. In the
these Suprem
cases, a e Court
legally decided
married Oberge
same- fell v.
sex Hodges
couple in
who 2015
lived in and
a state mandat
where ed
their nationw
marriag ide
e was marriag
not e
recogni equality
zed .
would
not be Nancy
conside J.
red Knauer
married
See also
for
Domesti
federal c
purpose Partnersh
s. The ip; Legal
resultin Recognit
g ion of
confusi Non
marit
on
al
further Same
complic -Sex
ated the Relati
recognit onshi
ion of ps;
same- Marri
age
sex
Equal
marriag
ity,
e at the Land
federal mark
level. Court
The Decis
confusi ions
on was
not
resolve
d until
828

F age?
u The
r histor
t y
h shapi
e ng
r today
’s
R debat
e e over
a gay
d equali
i ty.
n
New
g
York,
s
NY:
Baehr Basic
v. Books
Lewin
.
, 852
P.2d Cott, N.
44, 53 (2002). A
(Haw. history of
1993). marriage
Baehr and the
v.
nation.
Miike,
No. Camb
91- ridge,
1394, MA:
1996 Harv
WL ard
69423 Univ
5, at ersity
*21 Press.
(Haw. Defense
Cir. of
Ct. Marriage
1996), Act, Pub.
aff’d L. No.
950 104-199,
P.2d 110 Stat.
1234 2419
(Haw. (1996
1997) ).
. Knauer,
Chaunce N.
y, G. (2006
(2004 ). The
). recog
Why nition
marri of
 829

same-
sex
DEME
relati NTIA
onshi
ps:
Com Dement
parati ia has
ve been
instit referred
ution to as a
al contem
analy porary
sis, epidemi
conte c, and,
sted while
social there
goals, has
and been a
strate great
gic deal of
instit attentio
ution n paid
al to the
choic ways in
e. which
Haw cognitiv
ai’i e
Law proble
Revie ms can
w, affect
28, those
23– diagnos
83. ed (and
Obergefe the
ll v.
caregiv
Hodges,
135 S. ers who
Ct. 2584 support
(2015). them),
United there
States v. remain
Windsor, a
133 S. number
Ct. 2675
of
(2013).
margina
Dementia
lized
groups
whose
experie
830

nce of and
cognitiv decisio
e loss n
remains making.
little For
researc LGBT
hed or Q
underst people,
ood. these
The issues
onset can be
and particul
effects arly
of profoun
dementi d,
a can presenti
have a ng
profoun addition
d and al
lasting obstacle
impact s and
on a challen
person’ ges that
s sense a non-
of LGBT
identity. Q
They person
can would
underm be
ine a unlikely
person’ to face.
s It is
carefull these
y issues
constru that are
cted the
coping focus of
mechan this
isms entry.
and can The
prove to reasons
be a for the
barrier invisibil
to ity of
effectiv LGBTQ
e people
commu in the
nication context
 831

of difficult
dementi ies in
a are later
not life, to
clear make
but may themsel
relate to ves
the known.
historic In
al addition
silencin , within
g of the
LGBTQ study of
voices dementi
in a itself,
mainstr difficult
eam issues
health are
and often
social margina
care lized,
research and the
and experie
practice nce of
. dementi
Further, a tends
the fact to be
is that governe
LGBTQ d by a
people, biomedi
who cal
may approac
have h to
spent a both
lifetime theory
conceali and
ng their practice
sexual . A
and biomedi
gender cal
orientati perspect
on from ive
service tends to
provide merge
rs, are issues
unlikely of
, in the sexualit
event of y into
832

the experie
more nce of
obvious cognitiv
presenti e loss
ng effectiv
needs of ely
a person subsum
with es one’s
dementi other
a (again persona
offsettin l and
g a need social
to identitie
address s. That
those is, one’s
issues sexualit
that y is
practitio seen as
ners largely
may irreleva
find nt to the
particul experie
arly nce of
challen cognitiv
ging). e loss.
Ther On the
e are, of other
course, hand, it
a could
number be
of ways argued
of that
concept issues
ualizing of
dementi D
a in an e
LGBTQ m
e
context.
n
The t
first i
would a
suggest
that
“demen sexualit
tia is y
dementi (which
a” and constitu
that the te part
of the
 833

core of person’
a s
person’ sexualit
s y.
identity There
) is,
inevitab howeve
ly r, little
affect, researc
influenc h that
e, and has
infuse focused
all of a specific
person’ ally on
s other LGBT
persona Q
l and people’
social s
dimensi experie
ons. nces of
That is, dementi
while a, so it
the is
physiol difficult
ogical to
effects determi
of ne
dementi which
a may side of
be this
broadly concept
similar ual coin
for all is most
those persuasi
who are ve. It is
diagnos likely,
ed, the howeve
experie r, that,
nce will as a
depend result of
upon a the lack
range of of
intersec knowle
ting dge
factors, about
one of how
which dementi
is a a might
834

be importa
experie nt to be
nced by cogniza
LGBT nt of
Q the
people, potentia
service l
provide difficult
rs may ies
not feel associat
confide ed with
nt in living
respons with
e to dementi
their a as
needs. part of
Noneth a sexual
eless, minorit
researc y.
h in Dem
dementi entia is
a more a
broadly conditio
would n that
suggest has the
that potentia
people l to
living highligh
with t and
dementi exacerb
a (and ate
their existing
caregiv social
ers) fare difficult
best ies.
when LGBTQ
they are people,
able to all of
continu whom,
e their by
lives as virtue
they did of their
prior to vulnera
the bility to
diagnos ongoing
is. discrimi
Thus, it nation
is and
 835

margina LGBTQ
lization, person.
continu One
e to live of the
in critical
uncertai challen
n social ges
circums these
tances, intersec
may tions of
face the experie
fears nce
associat bring
ed with about
dementi focuses
a more on the
intensiv ways in
ely. which
Discrim private
ination matters
and can
prejudic become
e more
remain public
potent when
forces dementi
and, for a
LGBTQ become
people s part of
with a
dementi person’
a, the s
associat everyda
ed y
stigma experie
can nce. As
serve to dementi
accomp a
any and progres
magnify ses, it
the may be
challen necessa
ges ry to
associat invite
ed with service
life as provide
an rs into
one’s
836

home— ormativ
ordinari e
ly a expectat
place of ions
sanctuar and, in
y but, this
for context,
those LGBTQ
who people
may not may
be have to
comfort decide
able whether
with or not
public to
knowle reveal
dge of their
their sexualit
sexualit y to the
y, this service
sanctuar provide
y can be rs who
easily may be
undermi called
ned and upon to
threaten support
ed when them.
the The
outside decision
world, to come
by out (or
necessit not) to
y, formal
enters care
in. provide
The rs can
experie generat
nce of e
dementi anxietie
a, like s that
other they
critical may be
life homoph
experie obic or
nces, is unwillin
undersc g to
ored by respect
heteron a
 837

person’ supporti
s life ng
choices. them,
Indeed, which
the little may
existing result in
research inappro
into the priate
experie (or at
nces of least
LGBTQ insensiti
people ve)
living service
with provisio
dementi n. The
a or anxiety
caring this
for a may
person generat
with e can
dementi only
a further
suggest exacerb
s that ate the
these difficult
anxietie ies
s are associat
well ed with
founded living
. In with
respons dementi
e, a and,
LGBTQ as
people cognitiv
with e losses
dementi accrue,
a may the
feel it ability
necessa to
ry to effectiv
conceal ely
their manage
sexual one’s
identity public
to those persona
people can be
charged compro
with mised.
838

For people
service may
provide experie
rs, a nce
recognit addition
ion and al
appreci difficult
ation of ies if
these their
issues is dementi
essentia a
l to become
support s so
LGBTQ challen
people ging
with that
dementi they
a require
effectiv long-
ely. In term
addition care.
, it is For
necessa exampl
ry to e, they
underst may
and the need
particul support
ar ways and
in assistan
which ce to
LGBTQ identify
people and
may access
constru LGBTQ
ct their -
own friendly
support services
systems . In this
to context,
purpose a
fully person’
include s
the dementi
family a may
of also be
choice. a barrier
LGB to
TQ making
 839

choices This, in
about turn,
whom might
to come generat
out to e
and anxietie
where it s for
is safe service
to be provide
open rs, who
about could
issues be
of uncertai
sexualit n as to
y. Trans how
people, best to
in respond
particul .
ar, may Dem
face entia
addition presents
al numero
challen us, and
ges that someti
relate to mes
the insurmo
ways in untable,
which challen
dementi ges to
a, and those
its diagnos
latent ed and
forgetti their
ng, has caregiv
the ers. As
potentia this
l to entry
undermi has
ne the demons
transitio trated,
n these
process challen
and ges can
obfusca be
te the particul
person’ arly
s true acute
identity. for
840

people Cultures;
who are Aging,
Sex, and
already
Sexua
margina
lity;
lized. Agin
Noneth g,
eless, Socia
there is l
a cohort Relati
of onshi
ps,
LGBTQ
and
people Supp
now ort;
aging Agin
with the g and
benefit Gay
of Men;
supporti Agin
g and
ve
Lesbi
legislati an
on and Wom
social en;
endorse Agin
ment. g and
They Trans
can gende
r
reasona
Peopl
bly e;
expect Discr
dementi imina
a care tion
service Agai
provide nst
rs to LGB
TQ
have an
Elder
informe s;
d Heter
underst osexi
anding sm
of their
needs.
Elizabe
th Price

See also
Ageisms
in
LGBTQ
 841

F care:
u Gay
r and
t lesbia
h n
e carers
r ’
exper
R ience
e s of
a deme
d ntia.
i Healt
n h and
g Socia
s l
Care
Price, E.
(2008 in the
). Com
Pride munit
or y, 18,
preju 160–
dice? 168.
Gay
doi:1
men,
lesbia 0.111
ns 1/j.13
and 65–
deme 2524.
ntia. 2009.
Britis 0088
h
4.x
Journ
Price, E.
al of
Socia (2011
l a).
Work Carin
, 38, g for
1337 mum
– and
1352. dad:
doi:1
Lesbi
0.109
3/bjs an
w/bc wom
m027 en:
Price, E. Nego
(2010 tiatin
). g
Comi famil
ng y and
out to navig
842

ating (2012
care. ).
Britis Lesbi
h an,
Journ gay,
al of bisex
Socia ual
l and
Work trans
. gende
doi:1 r
0.109 agein
3/bjs g:
w/ Biogr
bcr01 aphic
5 al
Price, E. appro
(2011
aches
b).
Gay for
and inclus
lesbia ive
n care
carers and
:
suppo
Agein
g in rt.
the Lond
shado on,
w of Engla
deme nd:
ntia.
Jessic
Agein
a
g and
Socie Kings
ty. ley.
doi:1
0.101
7
/
S014 DEMO
4686
X110
GRAPH
0056 ICS
0 AND
Ward, R.,
THE
River
s, I., LGBT
&
Suthe Q
rland,
M.
 843

the
POPUL L
ATION G
BT
Q
Po
Demogr pul
aphy ati
involve on
s the
study of
populati dozen
on subfield
patterns s,
and includin
process g areas
es, such as
traditio race
nally and
concent ethnicit
rated on y and
the gender.
fields of Over
fertility, the past
mortalit decade,
y, and populati
migrati on
on. The researc
discipli h has
ne has increasi
expand ngly
ed well incorpo
beyond rated
these the
core demogr
fields, aphy of
howeve sexualit
r, and y,
encomp includin
asses at g a
least focus
two on the
De demogr
mo aphics
gr of the
ap LGBT
hic Q
s
populati
an
d
on. This
entry
844

discuss same-
es the sex
importa sexual
nce of behavio
studyin rs, as
g the well as
demogr how
aphics these
of the sexual
LGBT identitie
Q s or
populati practice
on and s affect
provide their
s an life
overvie outcom
w of es. This
related type of
key informa
findings tion
. serves
at least
three
The purpose
Import s. First,
ance of as
Demog persons
raphy who fall
outside
Populati of the
on heteron
studies ormativ
provide e
an mainstr
opportu eam,
nity to LGBT
learn Q
more individ
about uals are
how often
many seeking
individ informa
uals tion
identify regardi
as ng the
LGBT commo
Q or nality
engage of their
in
 845

identitie sense of
s, commu
desires, nity.
and Seco
behavio nd,
rs. This knowle
informa dge
tion can about
provide the
a sense demogr
of aphics
validati of the
on, as LGBTQ
well as populati
connect on has
edness importa
to other nt
LGBT policy
Q implicat
individ ions.
uals. Most
Demogr commo
aphic nly,
researc informa
h on the tion
prevale gleaned
nce of from
the demogr
LGBT aphic
Q analyse
populati s of
on, sexual
therefor identity
e, has and
been behavio
frequen r has
tly cited been
by notable
individ in terms
uals and of its
LGBT relevan
Q ce for
organiz populati
ations on
to health
bolster and
visibilit reprodu
y and a ction.
846

LGBTQ s to
individu serve as
als face support
differen for
t health policy
needs initiativ
and es for
risks the
than do LGBTQ
heterose populati
xual on. For
individu exampl
als; e, data
accordi on the
ngly, geograp
gaining hic
an distribut
underst ion of
anding the
of the LGBTQ
prevale populati
nce of on have
the been
populati used in
on and policyre
its lated
particul work
ar that
health explore
require s the
ments econom
is ic
importa impact
nt for of
health same-
policy. sex
In a marriag
data- e for
driven states.
society, Studies
there on
has also econom
been a ic
demand outcom
for es for
demogr lesbian,
aphic gay,
analyse bisexual
 847

, and for
transge those
nder arguing
Demog both for
raphic and
s and against
the same-
LGBT
sex
marriag
Q
e or gay
Popula
adoptio
tion n.
Thir
(LGBT) d and
persons finally,
have demogr
also aphic
been studies
used to of the
analyze LGBTQ
the populati
merit of on have
the contribu
propose ted
d toward
Employ unwrap
ment ping the
Non- concept
Discrim of
ination sexual
Act orientati
(ENDA on as an
). In identity
addition and a
, studies behavio
on the r. By
charact studyin
eristics g the
of differen
same- ces in
sex prevale
couples nce
as between
parents same-
have sex
served sexual
as behavio
fodder r and
848

LGBTQ nation
identity, as
we are someon
able to e who
better identifie
underst s.
and
whether
behavio Overvi
rs
ew of
versus
Key
identitie
s have Finding
implicat s
ions for The
other Lesbian
demogr and Gay
aphic Male
outcom Populati
es. For on
exampl
e, a Rese
demogr arch on
apher LGBTQ
might demogr
assess aphics
whether has
an been
individu largely
al who driven
engages by an
in interest
same- in
sex quantify
sexual ing the
behavio size of
r, but the
does not LGBTQ
identify populati
as on. One
LGBTQ of the
, would first
be estimate
exposed s of the
to the prevale
same nce of
risk of gay
discrimi individu
 849

als in constru
the ction of
populati heterose
on came xual or
from nonhete
Alfred rosexua
Kinsey. l. Thus,
A when he
biologis presente
t with a d
doctorat estimate
e in s from
entomol his
ogy, research
Kinsey of the
gained prevale
notoriet nce of
y by gay
encoura men in
ging the the
develop populati
ment of on, he
a provide
methodi d
cal estimate
analysis s of the
of percent
typical age of
sexual men
behavio who
r within might
the fall
populati along a
on. He continu
conceiv um of
ed of same-
sexual sex
orientati desires
on as and
existing behavio
on a rs.
continu Despite
um, this
rather attempt
than in to
a provide
simpler more
binary nuanced
850

prevale inclusio
nce n of
estimate student
s for and
gay prison
men, a populati
single ons
estimate within
has his
been study,
most questio
cited ns arose
from regardin
Kinsey’ g the
s work represe
—that ntativen
10% of ess of
men in Kinsey’
the U.S. s
populati sample.
on are With
gay. the
This rising
figure populari
became ty of
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 851

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852

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 853

aphics relation
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854

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 855

Bureau al.
data Same-
indicate sex
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856

determi t-sex
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 857

women, s
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858

why exual
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 859

Ther prevale
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limited men is
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demogr 0.4% to
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populati on, and
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860

of Populati
straight on
or gay,
Little
with
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any
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same-
examin
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sexual
prevale
desire
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transge
Greater
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ation of
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.

The
Transge
nder

population is problematic. Some individuals identify
as transgendered, whereas others identify as their
lived gender; in other words, an individual who was
born female but lives as a male might identify as
either transgendered or as male. These measurement
challenges make collecting data about the prevalence
of the transgendered population difficult. In addition,
most of the information that has been collected about
the population is derived from medical or
psychological studies where individuals are recruited
from the portion of the transgendered population that
is seeking surgical or hormonal changes or
psychological counseling. It is unknown, therefore,
how prevalent the transgendered population might be
if individuals outside of these groups were to be
included.
With these limitations in mind, the best estimates
of the prevalence of the transgendered population are
approximately 0.0077% to 0.034% for male- to-
female transgendered individuals, and 0.0029% to
0.012% for female-to-male. Due to measurement
challenges and limited sample sizes, little is known
about other demographic characteristics of the
transgendered population.
Conclusion
Demographic analyses of the LGBTQ population
have proven important within the LGBTQ
community and for public policy. Many questions,
however, remain unanswered about this population.
Few surveys incorporate questions designed to
capture sexual behaviors or identities, and there is a
virtual absence of questions on gender identity in
representative population surveys. For those surveys
that do contain questions regarding sexual behavior
or identity, many were not designed with the purpose
of sexuality research in mind. For example, the U.S.
Census data on same-sex unmarried partners are
derived as a by-product of a variable that was
developed to measure cohabitation. Gaining
additional insight into LGBTQ demographics—
particularly those for the bisexual and transgendered
populations—thus requires future investments in
survey design and data collection.
Amanda K. Baumle
See also Methodological Decisions by Researchers of
LGBTQ Populations; Population-Based Surveys,
861
Collection of Data on Sexual Orientation and Gender
Identity; Quantitative Research; Sampling; Sexual
Attraction, Behavior, and Identity
Further Readings
Baumle, A. K. (Ed.). (2013). International handbook on
the demography of sexuality. Dordrecht, the
Netherlands: Springer.
Baumle, A. K., Compton, D. R., & Poston, D. L. (2009).
Same-sex partners: The social demography of sexual
orientation. Albany: State University of New York
Press.
Black, D., Gates, G. J., Sanders, S., & Taylor, L. (2000).
Demographics of the gay and lesbian population in
the United States: Evidence from available systematic
data sources. Demography, 37, 139–154.
Gates, G. J., & Ost, J. (2004). The gay and lesbian atlas.
Washington, DC: Urban Institute Press.
Kinsey, A. C., Pomeroy, W. B., & Martin, C. E. (1948).
Sexual behavior in the human male. Philadelphia, PA: W.
B. Saunders.
Laumann, E. O., Gagnon, J. H., Michael, R. T., & Michaels,
S. (1994). The social organization of sexuality: Sexual
practices in the United States. Chicago, IL: University of
Chicago Press.
DEPRESSION
Elevated rates of clinical depression have been
documented among LGBTQ populations when
compared with cisgender and heterosexual peers.
Depression is a mental health disorder with
cognitive, physical, and affective symptoms marked
by loss of interest and pleasure in activities. This
entry discusses depression in the LGBTQ community
using the minority stress theory model as an
explanatory framework. Variations in prevalence (the
percentage of the population affected at any one
time) and symptom expression are described, as well
as resilience and risk factors.
Prevalence
Lifetime depression rates in LGBTQ populations are
consistently higher than those in heterosexual and
cisgender samples. LGBTQ populations are up to 4
times more likely to meet the criteria for major
862 Depression
depressive disorder than peers. Rates of symptoms Psychosocial Risk Correlates
extreme enough to merit a diagnosis of major
The behavioral consequences of depression among
depression, also known as clinically significant
LGBTQ populations are varied. The documented
symptoms, have ranged from 13% to 71%,
relationship between LGBTQ identity and suicidal
underscoring the diversity of the LGBTQ population
thoughts and attempts seems to implicate a link
and the variations of risk within this group. Within
between LGBTQ depression and suicide. The
lesbian, gay, and bisexual (LGB) samples, bisexuals
evidence for a causal relationship between
often report the highest depression rates. However,
depression and attempted or committed suicide is
this finding is not always substantiated. Competing
unclear— no direct link has been found between
research has found depression rates in bisexuals to be
suicide attempts and clinically significant depression
comparable with those of lesbians and gay men,
among LGBTQ people. The uncertain relationship
indicating no elevated risk. While the reason for this
between depression and suicide, however, does not
disparity in findings is unclear, it is possible that
mean that LGBTQ people are not at risk for injury;
bisexuals experience stigma in both LGBTQ and
self-harm, as distinct from attempted suicide, is still
straight communities, increasing isolation and
a concern. Research has found a link between
distress.
depression and self-harm, with one study of LGBTQ
Compared with LGB people, however,
youth finding that those exhibiting depressive
transgender-identified people are twice as likely to
symptoms were up to 3 times more likely to engage
develop depression. Estimated prevalence rates for
in cutting behavior. Furthermore, depression appears
this group are consistently higher than rates reported
to predict high-risk sexual activity.
for cisgender LGB samples; an estimated 44% to
The relationship between mental and physical
60% of the transgender population have reported
health, especially as influenced by discrimination,
clinically significant depressive symptoms at some
may be particularly salient for LGBTQ individuals.
point in their life. Little research has been conducted
LGBTQ individuals with depressive symptoms are at
concerning nonbinary or genderqueer transgender
a greater risk for alcohol and drug abuse.
people. However, one study estimates major
Furthermore, LGBTQ older adults report engaging in
depression prevalence rates in this group to be 53%,
unhealthy behaviors such as missing doctor
comparable to findings in the larger transgender
appointments out of fear of discrimination by health
population. Depression rates may be particularly high
care providers. This suggests a link between
for transgender-identified women, who are almost
depression and poor physical health among LGBTQ
twice as likely as transgender men to meet the
populations.
criteria for major depressive disorder. This reflects
For youth, depression particularly impacts home
studies of general populations, where women are
and school life. Bullying, assault, and otherwise
commonly found to have higher rates of depression
hostile school environments may be particularly
than men. Similarly, studies of wide samples of the
difficult for LGBTQ students with clinical
LGBTQ community often find lesbians to be at an
depression, increasing their risk for absenteeism. One
elevated risk for depression compared with gay men.
study of youth with depressive symptoms found that
However, this relationship is complicated by the
those who identified as a sexual minority had a
higher risk of violence for gay men, as discussed in
significantly larger number of unexcused school
the following section. In studies that have shown
absences than straight peers, implying that the
elevated depression rates for
Depression
relationship between depression and absenteeism is
particularly strong for LGBTQ students.
Furthermore, studies of homeless youth have found
bisexuals, bisexual women tend to report higher elevated rates of depression among those who
levels of depressive symptoms than bisexual men. identify as LGBTQ.

Minority Stress and Stigma
A central framework used to understand elevated
rates of depression in LGBTQ populations is the
minority stress model, which has been adapted for
transgender populations as the gender minority stress
model. This theory proposes a model of stress unique
to LGBTQ individuals as a result of their stigmatized
social category. Discriminatory social institutions
uniquely and constantly place the burden of stigma
on LGBTQ people. The stressors associated with this
stigma exceed those stressors encountered in
everyday life and thus explain differences in distress,
including depression, between LGBTQ and non-
LGBTQ populations. Members of minority groups
respond to these stressors with both individual
resiliency and group-level coping skills. This model
commonly identifies three types of minority stress:
stressful events, anticipation of prejudice, and
internalized homophobia and transphobia.
All three types of stressors have been linked with
depression, providing strong evidence for the utility
of this model. Incidences of physical attack,
especially when related to gender or sexual-minority
status such as hate crimes, have been found to
significantly increase depressive symptoms in
LGBTQ people. In youth, victimization and bullying
in school are correlated with higher rates of
depression. Furthermore, nonviolent incidents such
as workplace discrimination have also been found to
correlate with increased depressive symptoms. It is
important to note that minority stressors impact
individuals differently. Gay men and
transgenderidentified people experience the highest
rates of violence, and thus are particularly impacted
by this type of minority stressor.
The effects of anticipation of prejudice and stigma
are more difficult to measure. Nonetheless, evidence
suggests that the stress of constant vigilance against
potential stigma, also known as anticipatory stigma,
is related to depressive symptoms. Studies with
samples of gay men have found that the anticipation
of stigma may be an even better predictor of
psychological distress in general than actual
instances of victimization. Furthermore, some tests
of the minority stress model have found expectation
of rejection or prejudice to have the largest impact on
depression levels compared with the other two stress
processes discussed. Anticipation of stigma
particularly impacts the well-being of LGBTQ
863
elders. Studies have shown that LGBTQ elders are
more concerned about discrimination from health
care providers than straight elders. Thus, long-term
health care, such as nursing homes or hospice, is
especially stressful for this population.
The internalization of societal views about
LGBTQ people has been related to depression. In a
study looking at many different measures of
internalized homophobia, the presence of
internalized homophobia was significantly related to
an increase in depression scores. For transgender
people specifically, internalized transphobia has been
linked with increased general psychological distress
and suicide attempts, implying a similar impact.
Thus, internalized homophobia and transphobia have
a demonstrated impact on the development of
depression in LGBTQ people.
Protective Factors and Resilience
LGBTQ people demonstrate unique resilience and
coping in the face of minority stress at both the
individual and group levels, ameliorating the effects
of stigma on depression. Group-level coping
mechanisms are utilized through access to the wider
LGBTQ community, garnering social support from
peers and the formation of a positive LGBTQ
identity. For example, studies of transgender samples
have found that support from other transgender-
identified people is associated with lower levels of
depression. These resources might include Gay–
Straight Alliances (GSAs), social media, LGBTQ
support groups, and involvement in LGBTQ
activism.
Connection with a group identity increases
resiliency and protects against LGBTQ-related
depression. Through these connections with peers,
LGBTQ people have access to the development of an
in-group identity. The development of an affirmative
LGBTQ identity acts as a further buffer against
minority stress. Those who endorse a strong level of
identity pride have been found to exhibit lower levels
of psychological distress. In addition, LGBTQ-
identified people who report a sense of belonging to
the wider LGBTQ community report fewer
depressive symptoms than those who do not feel
connected to the LGBTQ community.
Resilience is sustained through the use of specific
coping strategies. There is modest evidence to
864 Depression
suggest that some types of coping strategies are more
effective than others. Active coping skills that focus
on problem solving are modestly beneficial. For
transgender people, the use of coping strategies has
been seen to change throughout the process of
transition, with more active skills being used during
and after transition. These changes in coping
behavior may account for differences in
psychological distress during various stages of
transition; more psychological distress is generally
reported in the early stages of transition. LGBTQ
people with active coping styles have lower rates of
depression, and behaviors associated with active
coping predict lower levels of depressive symptoms.
Increased social support has also been associated
with a decrease in depression among LGBTQ
individuals. Some studies have found that LGBTQ
adolescents’ depression is most strongly impacted by
familial social support. Among gay and lesbian
adults, social support from gay friends has been
found to be most impactful. In general, relationships
providing support for an individual’s LGBTQ status
can act as a protective factor against the development
of depressive symptoms.
There is only limited research into the personality
characteristics that may boost resiliency in the face
of minority stress. Some researchers have found the
trait of optimism in particular to be negatively
associated with depression among gay and bisexual
men. High levels of optimism have been found to
minimize or eliminate the negative impact of
discrimination and victimization on mental health
especially. Research has also explored the resilience
factor of self-esteem in LGBTQ
Depression
samples. In two studies of LGBTQ youth, selfesteem
levels predicted depression levels among gay,
lesbian, and transgender participants. Thus, high
baseline levels of self-esteem may act as a buffer
against the development of depression.
Despite representations of religious institutions as
homophobic and transphobic, religious or spiritual
beliefs have been found to increase resiliency for
LGBTQ people. Notably, many LGBTQ individuals
experience stigma in their religious communities,
which adds stress, while at other times religious
communities may offer social support that enhances
resilience. In some studies, religious and spiritually
based coping has been mildly linked to lower levels
of depression in lesbians and gay men. Religious
coping behaviors are also highly associated with
active styles of coping, indicating that religiosity is
protective only insofar as it enables other coping
behaviors such as social support.
Risk Factors
While the use of adaptive coping strategies can boost
resiliency, some coping strategies can pose risk
factors to depression. Avoidant coping is an emotion-
based coping strategy that involves evading
emotional pain, rather than actively dealing with
problems. The use of avoidant coping has been
linked to negative mental health outcomes such as
anxiety and depression. In fact, evidence suggests
that facilitative or problem-based coping is helpful
mainly in that it replaces avoidant coping. The
absence of avoidant coping behavior is likely more
important for positive mental health outcomes than
the use of facilitative coping. Furthermore, the use of
emotion-based coping as a primary coping skill may
prevent LGBTQ individuals from accessing other
sources of resiliency. For example, high levels of
avoidant coping are associated with decreased social
support, especially from LGBTQ peers. Concealment
of LGBTQ identity, a risk factor implicated in
minority stress, is also strongly associated with
avoidant coping; individuals who engage in high
levels of concealment also tend to rely on avoidant
coping strategies.
Identity concealment, or being “in the closet,” has
also been associated with increased rates of
depression. One study found that concealment of
sexual identity among gay men predicted higher
levels of depressive symptoms. Conversely,
disclosure of one’s sexual identity has been linked to
a decrease in depressive symptoms. This
phenomenon is sometimes described as a type of
hypervigilance involving anticipatory stigma. Social
support can at least partially explain the relationship
between concealment and increased depression;
those who are more highly concealed may receive
less support. In social contexts that are unsupportive
or hostile to LGBTQ people, the beneficial effects of
coming out are demonstrably weakened, and
concealment might be necessary for safety.

LGBTQ-identified youths are at increased risk for
depression. Adolescents and youths who come out
publicly have particularly high rates of depression.
However, risk of LGBTQ depression appears to
decline with age. In studies of adult gay men and
lesbians, older age is associated with lower incidence
of depression. Furthermore, studies have shown that
the risk associated with LGBTQrelated physical and
verbal abuse declines as age increases.
While LGBTQ status disclosure has
overwhelmingly positive effects on LGBTQ mental
health, increased identifiability as LGBTQ raises the
risk of minority stress. The hostility or acceptance of
one’s social context can drastically curtail the
positive effects of coming out; evidence suggests that
the benefits of coming out in unsupportive families,
schools, or workplaces are negligible. In youth, the
number of years one is publicly “out” have been
found to correlate with increased level of depression
by increasing experiences of school victimization.
This suggests that coming out earlier increases rates
of depression in some contexts. The number of
people one has disclosed to is similarly related to
depression; being out to an entire school increases
depressive symptoms more drastically than being out
to one or two friends, underscoring the importance of
considering social context when examining
depression.
Similarly, gender nonconformity may act to identify
LGBTQ individuals, even when they have not come
out. Although gender nonconformity and LGBTQ
identity are separate constructs, gender
nonconformity is more often seen in LGBTQ people.
Both self-reported and observer-rated gender
nonconformity in lesbians and gay men have a
relationship to depression, although this relationship
is stronger for gay men. Furthermore, while negative
effects of “outness” are tempered by the benefits of
disclosure, this is not true for gender nonconformity.
Both forms of identifiability and gender
nonconformity increase depression through minority
stress victimization.
The high rates of HIV infection within the
LGBTQ population, particularly for gay and bisexual
men, are a concern for mental as well as physical
health. Studies of HIV-positive gay and bisexual men
have routinely found that HIV symptoms are
associated with depression as related to increases in
symptom numbers and severity. However, HIV
865
status appears to have no relation to depression
except as mediated through physical symptoms.
Conclusion
The high rate of depression among LGBTQ
populations is impacted by such factors as
victimization, internalized homophobia and
transphobia, and anticipatory stigma. Minority stress
largely accounts for the elevated rates of depression
among LGBTQ individuals. Minority stress does not
affect all individuals equally, as this experience
disproportionately impacts transgender-identified
people and women. Furthermore, other risk factors
may interact with LGBTQ minority stress, such as
age or health. While LGBTQ identity poses a risk for
minority stress, this identification also creates
opportunity for accessing group-level coping
mechanisms that enhance resiliency and life
meaning. These coping resources and resilience
factors further enhance the ability to cope with
minority stress. Research on LGBTQ individuals
with depression should focus on expanding the
accessibility of group coping and encouraging active
coping styles. Political and social change is also
needed to reduce overall minority stigmatization in
order to eliminate the source of minority stress and
reduce depression rates.
Mallory Merryman and Lauren Mizock
See also Homophobia; Resilience and Protective Factors,
Youth; Suicide, Risk Factors for and Prevention of;
Transphobia; Violence and Victimization of Youth
Further Readings
Budge, S. L., Adelson, J. L., & Howard, K. A. S. (2013).
Anxiety and depression in transgender individuals: The
roles of transition status, loss, social support, and coping.
Journal of Consulting and Clinical Psychology, 81(3),
545–557.
Budge, S. L., Rossman, H. K., & Howard, K. A. S. (2014).
Coping and psychological distress among genderqueer
individuals: The moderating effect of social support.
Journal of LGBT Issues in Counseling, 8(1), 95–117.
Cochran, S. D., Sullivan, J. G., & Mays, V. M. (2003).
Prevalence of mental disorders, psychological distress, and
mental health services use among lesbian, gay, and bisexual
adults in the United States. Journal of
Consulting and Clinical Psychology, 71(1), 53–61.
866 Depression
Fergusson, D. M., Horwood, L., & Beautrais, A. L. (1999). Is
sexual orientation related to mental health problems and
suicidality in young people? Archives of General
Psychiatry, 56(10), 876–880.
Hendricks, M. L., & Testa, R. J. (2012). A conceptual
framework for clinical work with transgender and
gender nonconforming clients: An adaptation of the
minority stress model. Professional Psychology:
Research and Practice, 43(5), 460–467.
McLaren, S., Gibbs, P. M., & Watts, E. (2013). The
interrelations between age, sense of belonging, and
depressive symptoms among Australian gay men and
lesbians. Journal of Homosexuality, 60(1), 1–15.
Meyer, I. H. (2003). Prejudice, social stress, and mental
health in lesbian, gay, and bisexual populations:
Conceptual issues and research evidence. Psychological
Bulletin, 129(5), 674–697.
Wright, A. J., & Wegner, R. T. (2012). Homonegative
microaggressions and their impact on LGB individuals: A
measure validity study. Journal of LGBT Issues in
Counseling, 6(1), 34–54.
Developmental Aspects of Sexuality
includes their genitals. Infants and toddlers also have
no knowledge of the social norms that determine
when nudity is appropriate or inappropriate.
Sexuality in Toddlers/Preschool
Children (Ages 2–5)
As children grow, they find new ways to explore
their own and others’ bodies. During the ages of 2 to
5, most children become aware of their gender and
how it is similar to and different from others’. They
also may begin to pay more attention to societal
gender roles. In addition, they begin to play games
with other children (e.g., doctor) that may involve
showing their genitalia or touching each other’s
bodies, motivated by curiosity. Some children
explore their genitalia via masturbation at this stage,
which may occur in public or in private, because they
may not yet be aware of social norms and
expectations regarding public nudity or masturbation.
Masturbation is conducted primarily

DEVELOPMENTAL ASPECTS
OF SEXUALITY

Sexuality, defined as physical, emotional, and

cognitive aspects of sexual development, undergoes
many changes during the life cycle. Understanding
these changes in the context of lesbian, gay, bisexual,
and queer (LGBQ) individuals is of interest because
the dominant understanding of sexuality has tended
to be heteronormative. This entry describes the
developmental aspects of sexuality, beginning with
infancy and closing with old age. Sexuality in
general will be discussed, with emphasis on the
sexuality and sexual orientation of individuals who
identify as LGBQ.

Sexuality: Infancy Through Adulthood

Sexuality in Infancy (Ages 0–2)
Many people find it difficult to imagine that the
development of sexuality begins as early as infancy.
However, children at this age are curious about their
bodies. They explore their bodies through touch; this
 867
Developmental Aspects of Sexuality also become more emotionally attached to their intimate
and/or sexual partners than in younger years.
out of curiosity about their bodies, but children may
also experience physical pleasure associated with Sexuality in Early Adulthood (Ages 18–25)
masturbation. Most young adults are sexually active. In addition,
many in early adulthood have romantic relationships
Sexuality in Middle Childhood (Ages 5–8) that continue to become increasingly emotionally
involved, and some begin to consider marriage or
Knowledge of gender roles becomes more solidified
starting a family. Now capable of reproduction, some
during middle childhood. For example, children may
young adults engage in sexual intercourse that leads to
express desire to conform to such gender roles through
decisions regarding pregnancy, childbirth, and
clothing, friendships, and extracurricular activities.
parenthood.
Masturbation becomes more private at this age, as
children begin to understand the societal view of
masturbation as a private activity. At this stage, children Sexuality in Adulthood (Ages 25 and older)
also may begin to ask more questions regarding gender As adults age, they continue to engage in sexual
and sexuality, displaying their continued curiosity. activity. Around the age of 50, most women experience
menopause and are no longer capable of birthing
Sexuality in Late Childhood (Ages 9–12) children, though most continue to have sex with others.
Men do not experience as abrupt a change in their
During the preadolescent/early adolescent stage,
sexual development, since they are capable of fathering
children’s experiences with puberty begin to impact
children for most of their lives. However, over time, it
their developing sexuality. Children at this age
becomes more difficult for men to sustain an erection,
experience physical changes in their bodies, including
and both men and women may experience age-related
changes in genitalia and reproductive organs as well as
health problems that interfere with sexual motivation
secondary sexual characteristics (i.e., changes that are
and activity. Adults with children begin to experience
not directly related to reproduction, such as breast
the responsibility of educating their children about
development and hair growth). They may be more self-
sexual development and answering their questions
conscious of their bodies and become more private with
about sexuality. They may also experience
nudity. Masturbation at this age is likely entirely
grandparenthood. In addition, adults who are
private, and their curiosity about sexuality may lead
married/committed to another (or others) may
children to explore media with sexual content (e.g.,
experience the death of their emotional and sexual
television, Internet, film). Children at this age also may
partner(s).
show desires to have more intimate relationships with
peers (e.g., socializing outside of school, exploring
kissing, talking about sexuality), and most begin to Sexuality Development for LGBQ Youth
think more about sexual orientation than during their Sexual orientation can be described as an emotional,
younger years. cognitive, and sexual attraction that an individual feels
toward another person and that exists on a continuum.
Sexuality in Adolescence (Ages 13–18) Individuals can experience
attractions to another gender, the same gender, some
Although puberty may begin prior to age 13 and may
genders, all genders, or no gender. Initial identification
not always conclude by age 18, most adolescents
with a sexual orientation occurs at various
experience puberty between these ages. During this
developmental stages. It has been shown to occur as
period, their bodies become physically capable of
early as young childhood and can fluctuate over time.
reproduction. Adolescents typically continue their
The developmental stages of sexuality have not been
explorations of sexuality via intimate and increasingly
shown to significantly depend on sexual orientation.
sexual encounters with others. They also continue to
However, LGBQ youth face distinct challenges, given
engage in masturbation, sexual orientation exploration,
that they experience the development of their sexuality
and exploration of gender and gender roles. Adolescents
868
within a society that assumes the value and universality
of heterosexuality. For example, as LGBQ youth
develop and explore their sexuality, they may confront
misunderstanding of their sexuality from family
members, peers, and schools, and especially if they
engage in heterosexual experiences, which is common.
Due to the stigmatization of same-sex sexuality, LGBQ
youth face an increased risk of bullying and are more at
risk for suicide than their heterosexual peers. It is
important for schools, families, and the community at
large to support the LGBQ youth who likely struggle
with society’s assumptions that only heterosexuality is
healthy and normative.
April M. Moyer and Abbie E. Goldberg
See also Aging, Sex, and Sexuality; Asexuality; Sexual Fluidity;
Youth and Dating
Further Readings
Diamond, L. M. (2000). Sexual identity, attractions, and
behavior among young sexual-minority women over a 2-year
period. Developmental Psychology, 36, 241–250.
Diamond, L. M. (2003). What does sexual orientation orient? A
biobehavioral model distinguishing love and sexual desire.
Psychological Review, 110, 173–192.
Ryan, C., Russell, S. T., Huebner, D., Diaz, R., & Sanchez, J.
(2010). Family acceptance in adolescence and the health
of LGBT young adults. Journal of Child and Adolescent
Psychiatric Nursing, 47, 205–213.
Disabilities Among LGBTQ Elders
DEVELOPMENTAL DISABILITIES
See Intellectual Disabilities
DISABILITIES AMONG
LGBTQ ELDERS
LGBTQ elders with disabilities represent a growing
number of persons among the elderly and include those
with physical, psychological, and sensory disorders.
These disorders may be due to the developmental stages
of the aging process, may be acquired as a result of an
accident, or may be congenital and the person is
growing older with the disability. In any case, LGBTQ
elders are among the most stigmatized groups because
of their sexual orientation and gender identity and one
of the most marginalized because of age and disability.
In general, a disability is a recognized condition that
imposes limitations on a person’s ability to adequately
perform major life activities. To perform such activities,
persons with disabilities typically need some type of
modification. Although far from homogeneous, older
adults are often categorized as old (ages 65–74),
middle-old (ages 75–84), and oldest-old (ages 85 and
over). Understanding disability-related issues that have
implications for LGBTQ elders is increasingly
important for several reasons. First, people are living
longer. Second, older individuals are staying in the
workforce longer out of necessity, and LGBTQ elders,
especially women, are among the poorest of the poor.
Third, quality of life is compounded by the intersection
of age, sexual orientation or gender identity, and
disability. Fourth, many LGBTQ elders have a lack of
access to health care services or culturally sensitive and
appropriate services, and LGBTQ elders have higher
rates of health disparities. Fifth, LGBTQ elders are at
high risk of victimization. Finally, until recently, older
LGBTQ adults have been essentially ignored in
gerontological and multidisciplinary research.
Disabilities Among LGBTQ Elders
The following section presents an overview of
research on LGBTQ elders and describes a range of
disabilities common to this population. The entry then
explores the experience of aging and living with a
disability and concludes with a discussion of
implications for service providers.
LGBTQ Elders
LGBTQ elders are diverse and heterogeneous. Today’s
LGBTQ elders grew up in the pre–gay pride era,
initiated in the 1970s. Their lives were marked by
secrecy because of the potential for violence and
imprisonment and a lack of legal protection from
legislation. Today, the often “closeted” (that is,
nondisclosure of sexual orientation or gender identity)
nature of older LGBTQ adults means that service
providers are unaware that they are serving LGBTQ
seniors, which further relegates them to a status of
invisibility. In the past, much of the existence of

LGBTQ elders was characterized by an extremely
phobic culture in which homosexuality or gender
variance was overtly and profoundly admonished. The
Diagnostic and Statistical Manual of Mental Disorders
classified homosexuality as a mental disorder until
1973 and first mentioned gender identity disorder in
1980, a diagnosis that remains to date. Often, bisexual
persons find themselves not fitting into either the gay or
heterosexual community. Transgender persons face
unique challenges apart from lesbian, gay, or bisexual
persons, especially if transitioning is done later in life,
because of widespread transphobia in the medical and
health care communities. In addition, LGBTQ elders
face discrimination and, in some instances, safety
concerns in nursing homes and residential facilities. In
the aging process, LGBTQ elders are confronted with
the typical challenges and concerns related to health
status, disability, financial stability, loss of a spouse or
partner, and a host of issues because of ageism.
Many LGBTQ elders face isolation as a result of not
having built social networks, as well as poor health,
mental health concerns, substance abuse, insufficient
income, transportation and mobility challenges, and
being more likely to live alone.
Although negative experiences can lead to a host of
problems for LGBTQ elders, researchers have found
that despite the barriers and risks, these elders have
developed unique skill sets, strengths, and resiliency
that their non-LGBTQ counterparts do not necessarily
benefit from as they age. Older lesbians tend to have
more social networks composed of lesbians across the
age spectrum, and LGBTQ elders of color demonstrate
a high level of resiliency resulting from coping
strategies developed to deal with racism. Many LGBTQ
elders are well adjusted and do not present with mental
health problems or psychological dysfunction. As with
anyone, numerous factors must be considered in
determining psychosocial adjustment of older LGBTQ
adults including preexisting conditions, propensity for
certain types of illness, family history, where they are
along the development continuum, and issues related to
self-identity.
The Presence of Disability
The rate of disability is higher in the elderly population
compared with that of the general population and
disproportionately higher in LGBTQ elders than non-
LGBTQ elders. For LGBTQ elders, one adverse effect
of stigma, discrimination, and homo/trans/biphobia is a
869
delay in seeking care, including social and health-
related services. In addition, these elders have high
levels of mistrust of health care providers and are less
likely to reveal their sexual orientation for fear of being
denied services or receiving inferior services. A lack of
disclosure prevents discussion about risk factors for
certain kinds of health conditions and increases the risk
of acquiring chronic conditions or disabilities. The
occurrence of mental health issues in LGBTQ
populations is the result of dealing with stress related to
stigma, discrimination, multiple minority statuses (e.g.,
being gay, a person of color, female), lower educational
level, and lower socioeconomic status. Mental health
plays a key role in physical health, and poor mental
health can increase the risk of developing chronic
health conditions or aggravate existing conditions. For
LGBTQ elders, a lifetime of victimization and
internalized stigma seem to increase the risk for
depression in addition to increasing the risk of poor
general health and disability. In addition, LGBTQ
elders who are closeted live with the constant stress of
fear that their sexual orientation or gender identity will
be discovered.
Older adults may have certain age-related disabilities
such as chronic conditions (e.g., cardiovascular
diseases, hypertension, arthritis, osteoporosis), obesity,
injuries (e.g., falls), malnutrition, and mental health
conditions (e.g., dementia, depression). Certain chronic
conditions are particularly related to disability,
including visual impairment, diabetes, stroke, and
cognitive impairment. Other disabilities that are
prevalent in LGBTQ elders are (a) alcohol and drug
addictions, which occur disproportionately because of
isolation and societal attitudes and bias; (b) pulmonary
disease, usually resulting from smoking, which is
disproportionately high among LGBTQ persons; and (c)
HIV/ AIDS because people are living longer with
improvement in the management of the condition.
Vulnerability to disease and disability is associated with
health-related behaviors earlier in life. Among all
populations living with HIV, older LGBTQ adults are at
heightened risk of hepatitis, anxiety, visual impairment,
some cancers, and suicidal ideation. The prevalence of
disability is higher among LGBTQ ethnic-minority
populations than in their White counterparts, which is
attributed to decades of disparity in health care services,
poverty, and discrimination. For non-English-speaking
LGBTQ elders, a language or communication barrier is
another obstacle to effectively addressing chronic
conditions and disability.
870
The rates of disability among LGBTQ elders are also
distinguishable by gender, with women’s physical
health being significantly lower than men’s. A study of
aging and health of LGBTQ elders found that women
have higher rates of disability, arthritis, asthma, obesity,
and osteoporosis, and men have higher rates of HIV
disease, high blood pressure, high serum cholesterol,
Disciplinary Tensions in Studying LGBTQ Populations
cardiovascular disease, diabetes, cancer, and hearing
impairments. The presence of disabilities among
LGBTQ elders is usually different from that of their
Disabilities Among LGBTQ Elders
non-LGBTQ counterparts because many older LGBTQ
adults live alone and lack social networks to assist
them, adversely impacting their quality of life. It is
unknown if the rate of Alzheimer’s disease among
LGBTQ elders differs from that of the general elderly
population.
Aging and Living With a Disability
Depending on the age of onset, over the course of a
lifetime, LGBTQ elders who have a disability might
experience substantial decline in health, mobility, self-
care, and independence. The way in which LGBTQ
elders must face living with a disability is challenging
because they must deal with heterosexism on the part of
service providers, and in many segments of society.
LGBTQ elders may experience pain and fatigue
secondary to their disability, which may worsen over
time resulting in secondary functional limitations and
disabilities. For many LGBTQ elders, the question of
where they will live as their disability becomes worse is
of great concern, as are end-of-life issues. Living itself
becomes stressful. Individuals with developmental
disabilities experience differences in the onset and
progression of aging because of genetic, environmental,
and lifestyle factors. These factors in tandem with
LGBTQ status add to the complexity of aging and the
continuous adaptation to changes across the lifespan.
Implications for Service Providers
Professionals who work with LGBTQ elders with
disabilities need to consider ways to provide
comprehensive and integrated services with
interdisciplinary intervention protocols. LGBTQ elders
may need to have multiple facets of their lives
addressed (e.g., housing, multiple medical conditions,
financial and safety issues) at any given time. Because
of the high likelihood that older LGBTQ adults are
living alone, it is critically important that services are
targeted for those without appropriate services or
adequate support. Older LGBTQ adults will also have
distinctive needs depending on their geographic
location
(urban vs. rural).
Today, there is consensus within the professional
literature that service providers need to be trained in
understanding and addressing the needs of LGBTQ
elders. Furthermore, as research on aging with
disability continues to emerge, a focus on LGBTQ
elders is becoming increasingly important.
Debra A. Harley
See also Ageisms in LGBTQ Cultures; Aging and
Bisexuality; Aging and Gay Men; Aging and Lesbian
Women; Aging and Transgender People; Intellectual
Disabilities; Physical Disabilities
Further Readings
American Psychiatric Association. (2013). Diagnostic and
statistical manual of mental disorders (5th ed.).
Arlington, VA: Author.
Crisp, C., Wayland, S., & Gordon, T. (2008). Older gay,
lesbian, and bisexual adults: Tools for age-competent and
gay affirmative practice. Journal of Gay & Lesbian Social
Services, 20(1–2), 5–29. doi:10.1080/10538720802178890
Dibble, S. L., Eliason, M. J., & Crawford, B. (2012).
Correlates of wellbeing among African American
lesbians. Journal of Homosexuality, 59, 820–838.
doi:10.1080/00918369.2012.694
Fredriksen-Goldsen, K. I., Kim, H. J., & Barkan, S. E. (2011).
Disability among lesbians, gay men, and bisexuals:
Disparities in prevalence and risk. American
Journal of Public Health, 102, 616–621. doi:10.2105/
AJPH.2011.300379
Fredriksen-Goldsen, K. I., Kim, H. J., Emlet, C. A.,
Muraco, A., Erosheva, E. A., Hoy-Ellis, C. P., et al.
(2011). The aging and health report: Disparities and
resilience among lesbian, gay, bisexual, and transgender
older adults. Seattle, WA: Institute for Multigenerational
Health.
Hash, K. M., & Rogers, A. (2013). Clinical practice with older
LGBT clients: Overcoming lifelong stigma through strength
and resilience. Clinical Social Work
Journal, 41, 249–257. doi:10.1007/s10615-0130437-2

Hunter, S. (2005). Midlife and older LGBT adults: Knowledge
and affirmative practice for the social services. Binghamton,
New York, NY: Haworth Press.
Kimmel, D., Rose, T., & David, S. (Eds.). (2006). Lesbian, gay,
bisexual, and transgender aging: Research and clinical
perspectives. New York, NY: Columbia University Press.
Muraco, A., & Fredriksen-Goldsen, K. (2011). “That’s what
friends do”: Informal caregiving for chronically ill lesbian,
gay, and bisexual elders. Journal of Social and Personal
Relationships, 28, 1073–1092.
doi:10.1177/0265407511402418
Services & Advocacy for GLBT Elders (SAGE) and
Movement Advancement Project (MAP). (2010, March).
Improving the lives of LGBT older adults. New York,
NY: Author.
Szymanski, D. M., & Gupta, A. (2009). Examining the
relationship between multiple internalized oppression and
African American lesbian, gay, bisexual, and questioning
persons’ self-esteem and psychological distress. Journal of
Counseling Psychology, 56,
110–118. doi:10.1037/a0013317
DISCIPLINARY TENSIONS IN STUDYING
LGBTQ POPULATIONS
In many ways, questions of how best to do research
about LGBTQ people mirror broader questions about
research: What counts as evidence? Is value-neutral
research possible or even desirable given social
inequities? What role does advocacy play in research?
In addition to these common concerns, researchers must
also address unique issues in a homophobic,
transphobic, and erotophobic (i.e., sex-phobic) culture.
Sexuality is generally considered a private matter that
should not be discussed publicly. In addition, despite
improved legal rights and recognition in recent years,
LGBTQ people still experience discrimination in many
public and private settings, and people who transgress
widely accepted gender norms experience particularly
oppressive treatment. Moreover, as intersectional
analysis has demonstrated, gender and sexuality don’t
exist in isolation. Rather, they interact in dynamic ways
with race, class, disability, and other social identities.
These realities not only make research about LGBTQ
people all the more pressing, but also raise crucial
ethical questions that researchers working in and
between different disciplines (e.g., sociology,
Disciplinary Tensions in Studying LGBTQ Populations
871
psychology, criminology, anthropology) and
interdisciplinary fields (e.g., women’s and gender
studies, queer studies, ethnic studies, disability studies,
cultural studies) respond to in divergent ways.
Following an overview of overarching ethical concerns,
this entry briefly explores social scientific, humanistic,
creative, and interpretive approaches to LGBTQ
scholarship.
Epistemological Concerns Regarding
Research
Feminist and antiracist researchers have long
questioned positivist approaches to research that
assume that facts exist free from social context. Some
have sought ways to be objective that are free from
patriarchal and racist assumptions and ways to use
quantitative data that don’t replicate masculinist and
racist assumptions in older research. Others have
posited that particular standpoints, generally of people
most affected by various forms of discrimination,
provide the best perspectives from which to view social
issues. For example, a poor woman of color working as
a live-in domestic worker must understand her
employer’s perspective as well as her own, while her
employer doesn’t need to think about her experience.
Researchers writing about LGBTQ people,
communities, and cultures have built on these
explorations, addressing related yet unique concerns
about heterosexist and transphobic biases within
society; the unique perspectives of LGBTQ people
navigating heterosexist and transphobic institutions;
and the role that research can play, and has played, in
dominant attitudes toward LGBTQ people. In
particular, researchers have had to confront stigma
about sexual and gender transgressions within society
and research institutions, and to address the role that
academic research has played in justifying
discrimination against LGBTQ people. Such concerns
exist across disciplines, although the legacy of
particular sites of knowledge production may be
particularly fraught. Two examples of such tensions are
psychology’s role in institutionalizing LGBTQ people,
and criminology’s role in criminalizing LGBTQ people.
These legacies may make finding support for
LGBTQaffirming research among colleagues difficult
as well as increase distrust of these researchers among
LGBTQ community members. Nonetheless, policy
makers remain
872
more likely to take seriously quantitative data from
these disciplines rather than explorations of queer life
and resistance documented using qualitative data or
theoretical analysis.
Approaches to Research: Foci and
Audience
How researchers approach the process of documenting
LGBTQ lives differs dramatically. Descriptions of
research foci reflect not only disciplinary norms, but
also relationships between researchers and subjects. For
example, research with or about LGBTQ people or
populations is quite different from research about
LGBTQ communities or culture. While a shared
investment in expanding knowledge about sexual
communities informs all these foci, who the experts are
and how and where knowledge is produced are quite
different. These concerns affect what kind of
knowledge is produced, who is likely to encounter it,
and the kinds of influence research is likely to have.
Another, related difference among disciplinary
approaches is audience. Some research focuses on
changing dominant attitudes toward LGBTQ people.
The goal for these researchers is for the general public
and policy makers to have accurate information about
LGBTQ people. Ideally, this will provide
documentation of discrimination and its effects that can
be used to create policies that do not reflect heterosexist
and cisgendered bias, as well as policies that can
address existing biases. While such documentation is
very important, the focus on dominant attitudes can,
generally unwittingly, affirm dominant value systems
and institutions rather than challenge them. Since
dominant values rarely affirm and frequently denigrate
gender and sexual-minority perspectives, addressing
research findings to populations that hold these values
requires framing research in ways that will be well
Disciplinary Tensions in Studying LGBTQ Populations
received, which, intentionally or not, affirms rather than
questions these discriminatory values. Similarly,
research invested in reaching people within
conservative institutions cannot challenge the
legitimacy of those institutions. If, for example,
research seeks to document law-abiding LGBTQ
people, it is unlikely to address why some LGBTQ
people earn their livelihood through illegal activities
such as sex work because of homophobic and
transphobic biases in familial, educational, and
workplace settings. Moreover, research that
demonstrates that current institutions cannot meet
LGBTQ people’s needs is unlikely to be supported by
those institutions. Similarly, queer humor that parodies
dominant values is unlikely to be deemed valuable
within such research despite its role as a community-
building and coping mechanism.
In contrast, other researchers document LGBTQ
lives across time and space in order to demonstrate the
existence of, and unique contributions of, LGBTQ
people in ways that may change dominant attitudes but,
more importantly, provide examples for LGBTQ people
and their allies. Such research has explored organized
resistance to legal repression, alliances between
LGBTQ communities and other marginalized groups,
the creation of cultural institutions, and a variety of
forms of cultural production. These kinds of studies are
less likely to provide data for policy makers but are also
less likely to uphold dominant value systems.
Research Methods
Social science researchers working with LGBTQ
populations use a variety of methods. Psychologists,
political scientists, and sociologists have,
unsurprisingly, been particularly likely to document the
existence and behavior of LGBTQ people using
statistical analysis drawn from survey data. Such data
has provided documentation of voting behavior,
violence against LGBTQ people, longterm
psychological stress due to homophobia and
transphobia, discrimination in hiring, how welladjusted
many LGBTQ people are despite discrimination, and
other macro-level social and psychological processes.
Such documentation has proved helpful for policy
makers and legal analysts, even while it has been less
able to address the effects of stigma and the creation of
communities of resistance.
In
addition,
some social scientists, particularly sociologists,
anthropologists, and historians, as well as researchers
working in interdisciplinary fields such as women’s and
gender studies, ethnic studies, disability studies, and
LGBTQ studies, utilize qualitative methods in order to
demonstrate the effects of the patterns identified by
quantitative methods. Qualitative interviews, participant
observation, focus groups, and archival research,
sometimes in combination with quantitative data, have
provided important documentation of

LGBTQ organizing strategies, the creation of
communities and alternative value systems, and coping
strategies.
Interpretive research—that is, research that focuses
primarily on analysis of difficult-todocument social and
cultural dynamics—has helped analyze the effects of
social stigma, explored the limitations of existing
organizing models, and provided road maps for change.
Some of this work is explicitly theoretical in nature,
analyzing cultural values and advocating particular
methods for change. Political theorists, for example,
may use legal cases and celebrity controversies as
examples that demonstrate widespread understandings
of LGBTQ people and build on existing political
theories to advocate for change. Cultural theorists
employ similar methods with different examples,
focusing instead on popular cultural or subcultural art
and performance. Critical historians use archival data
and close readings of published documents, including
novels, to demonstrate dominant, often discriminatory
social values and resistance to these values.
Methods such as critical-interpretive ethnographies,
autoethnographies, and performance ethnographies
remain grounded in participants’ understandings of
their lived experiences, while simultaneously exploring
the cultural and sociopolitical contexts they occur
within. This blending of empirical and interpretive
Disciplinary Tensions in Studying LGBTQ Populations
approaches enables researchers to address how people
navigate different social realities and make meaning
within them. In such research, evidence is drawn from a
variety of sources such as interviews; participant
observations; and analysis of cultural objects including
legal documents, fiction, news reports, mass media,
performances, and ephemera.
Arts-based researchers explore the ways that artistic
practices including writing, performance, and visual art
provide embodied methods to express emotional
responses and build communities of support. Some such
research works with therapeutic models designed to
explicitly address trauma resulting from oppression and
violence. Other approaches emphasize the
communitybuilding experience, focusing less on
specific outcomes and more on providing opportunities
for engagement and expression.
Increasingly, researchers using quantitative,
qualitative, interpretive, and arts-based methods are
approaching their research intersectionally. Sexuality
and gender identity interact in dynamic ways with race,
class, disability, immigration status, and other forms of
873
social hierarchy. The best research, regardless of
discipline, explores how LGBTQ lives are informed by
a variety of forms of privilege and oppression as well as
by creative and resilient responses to ongoing
homophobia and transphobia.
Given this diversity of approaches both within and
among traditional disciplines and interdisciplinary
fields, disciplinary tensions are not surprising, but
neither are they insurmountable. Audience influences
the type of research done and the methods of presenting
findings. In a broad sense, a scholar’s location within
the humanities or social sciences dictates both audience
and methodology; however, scholars working on the
edges of their respective disciplines frequently draw
from methods and theoretical models not traditionally
considered part of those disciplines. It is at these edges
and within new institutional locations that disciplinary
tensions are the least salient. Nonetheless, assumptions
about what counts as data, who produces knowledge
and under what conditions, and what an audience
expects affect how and why people do their research
and the degree to which they are willing to question
disciplinary norms.
Elizabeth Currans
See also Ethical Research With Sexual and Gender Minorities;
Heterosexist
Bias in
Research;
Intersections Between Sex, Gender, and Sexual
Identity; Qualitative Research; Quantitative Research
Further Readings
Bailey, M. M. (2013). Butch queens up in pumps: Gender,
performance, and ballroom culture in Detroit.
Ann Arbor: University of Michigan Press.
Browne, K., & Nash, C. J. (2010). Queer methods and
methodologies: Intersecting queer theories and social
science research. Burlington, VT: Ashgate.
Doan, P. (2010). The tyranny of gendered spaces— reflections
from beyond the gender dichotomy.
Gender, Place & Culture, 17, 635–654.
Ferguson, R. A. (2004). Aberrations in black: Toward a
queer of color critique. Minneapolis: University of
Minnesota Press.
Halberstam, J. (2005). In a queer time and place:
Transgender bodies, subcultural lives. New York, NY:
NYU Press.
874
Meezan, W., & Martin, J. (Eds.). (2009). Handbook of
research with lesbian, gay, bisexual, and transgender
populations. New York, NY: Routledge. Muñoz, J. E. (1996).
Ephemera as evidence. Women & Performance, 16, 5–18.
Parent, M. C., DeBlaere, C., & Moradi, B. (2013). Approaches
to research on intersectionality: Perspectives on gender,
LGBT, and racial/ethnic identities. Sex Roles, 68, 639–645.
Pelton-Sweet, L. M., & Sherry, A. (2008). Coming out
through art: A review of art therapy with LGBT clients.
Art Therapy, 25, 170–176.
Phelan, S. (2001). Sexual strangers: Gays, lesbians, and
dilemmas of citizenship. Philadelphia, PA: Temple
University Press.
Shuttleworth, R. (2012). Bridging theory and experience: A
critical-interpretive ethnography of sexuality and disability.
In R. McRuer & A. Mollow (Eds.), Sex and disability (pp.
54–68). Durham, NC: Duke University Press.
Discrimination Against LGBTQ Elders
DISCRIMINATION AGAINST
LGBTQ ELDERS
Discrimination is generally understood to be the
practice of treating a person or group of people unfairly
or differently than other people are treated, in this
instance on the basis of their sexual orientation. The
entry will provide an overview of the discrimination
that LGBTQ elders can face generally as a group and
then will discuss the specific discriminations and
potential oppression that each subgroup within the
larger LGBTQ community can encounter as a result of
their specific identity. Although only estimates are
available, it has been suggested that there are anywhere
between 1 million and 4 million Americans over the
age of 60 who identify as LGBTQ. As well, it has been
documented that the number of older Americans will
increase and that by 2030, one in five Americans will
be 65 or older. This means an increasing number of
LGBTQ individuals will be among the older population
as they are estimated to comprise 2% to 3% of that
population.
Ageism, Homophobia, and Heterosexism
Despite the fact that American society has seen
continual increases in the older population, we are
considered an ageist society that prefers and promotes
youth over older ages. Ageism has been defined as
negative attitudes toward older people, including
stereotyping and discrimination against people simply
because they are old. Ageism has been noted as
prevalent in the media, health care, advertising, and
employment practices (e.g., hiring, training, and
promotion). Ageism is also demonstrated in personal
interactions and everyday language. For example,
although intended as a compliment, to say, “Wow, you
don’t look 75!” demonstrates that there is a belief that
75-yearolds are not attractive. It also implies that
looking younger means looking better, while looking
older equates with looking worse. Parallel to the youth
culture found in general society, several researchers
have reported that older lesbian, gay, bisexual, and
transgender (LGBT) individuals experience ageism not
only in the general culture but also specifically within
the LGBTQ community.
There is a lack of recognition of LGBTQ elders’
needs, which is linked to institutionalized homophobia
and heterosexism through institutions that do not
recognize LGBTQ persons. In some cases, these
institutions may even actively work to deny services
and benefits to older LGBTQ persons. Despite a large
and growing number of LGBTQ elders, the National
Resource Center on LGBT Aging states that there are
no known current federal programs that explicitly
recognize or provide supports for LGBTQ elders. Yet,
in 2001, the U.S. Office of Aging stated that LGBTQ
elders are underserved. Research has also reported that
older LGBTQ individuals experience discrimination in
a host of areas such as housing, health and wellness,
economic disparities, supportive services, employment,
and social stigma. Supports and programs are needed
for older LGBTQ individuals to address these problems.
The lack of recognition of LGBTQ elders’ needs can
be seen as a result of institutionalized homophobia and
heterosexism that is seen in our culture through various
institutions that do not recognize LGBTQ persons or
that even actively work to deny services and benefits to
them. For example, many states do not have laws that
protect LGBTQ individuals in their employment. As a
result, individuals can be fired from their jobs simply on
the basis of their sexual orientation. This has resulted in
many LGBTQ elders having spent a lifetime fearful for
the loss of their income, in unstable and even hostile
work settings, and unable to live authentically within
their workplace environments. As well, there is
documented bias of mainstream health care providers
against LGBTQ individuals, where providers are, at

best, unaware of the sexual identity of their patients.
These policies and practices are issues that can be
relevant for all members of the LGBTQ community, but
are often especially pertinent for LGBTQ elders, as they
are most likely to need and seek all of the above
services as a part of the aging experience. They are
often more economically vulnerable, and these financial
discriminations and health care barriers can increase
and aggravate health issues.
As a result of this difficulty, some LGBTQ elders go
back in the closet or attempt to pass as heterosexual as a
survival strategy when seeking longterm care, entering
nursing homes, and using the services of health care
providers. This also results in LGBTQ elders not
accessing the very programs that they need or could
benefit from. However, research has also demonstrated
that LGBTQ elders have high levels of resiliency. As a
result of a lifetime of facing oppression and
discrimination, and overcoming these barriers and
obstacles, LGBTQ elders are more likely to adjust and
adapt emotionally to aging than their heterosexual
counterparts.
Differences Among Sexual Identities
While there is much discrimination that LGBT elders
have in common, there are also differences in
experience based on their unique sexual identities. The
following discusses the differences found, specific to
each subgroup.
Lesbian Elder Discrimination
In addition to facing ageism, homophobia, and
heterosexism, lesbian elders also can face the
discrimination that comes from being female in a male-
dominated society. It is well documented that women
continue to earn lower income than men, are less likely
to be in positions of power and responsibility, and are
often stereotyped in their gender role expectations as
weaker and less capable than men both physically and
emotionally. Women are often viewed as sexual objects
and prized for their attractiveness, and as a result of
ageism, the focus on attractiveness decreases for
women as they age. Although they can emotionally
benefit from no longer being sexually objectified,
women often find as they age that they are then
invisible and not noticed at all. This sense of loss is
documented as especially true for elder lesbians, as they
have been defined by American society for their
875
sexuality and sexual behaviors and now are seen as
asexual due to their age. This invisibility impacts the
ability to access resources, recognition of their needs,
and their social supports.
Discrimination Against LGBTQ Elders
Gay Elder Discrimination
In addition to facing ageism, homophobia, and
heterosexism in general society, older gay males report
greater experiences of ageism within the gay male
community, when compared with the other subgroups
within the LGBTQ community. Their unique
experience with ageism is a result of an even greater
emphasis on youth culture in the gay male community.
Both the LGBTQ community and members of the
broader society often stereotype gay elders as “old drag
queens,” and thus the experiences outside of that
stereotype are discounted. Elder gay men have reported
less family and social support than elder lesbians and
thus often face aging alone or only within their
partnerships. It is also important to note that the
HIV/AIDS epidemic of the 1980s and its connection to
the gay community, in terms of rates and contracting
the disease, has had lasting discriminatory outcomes for
aging gay men. Health care providers and researchers
continue to put a great deal of focus on the HIV/AIDS
experience, mental health, and sexually transmitted
disease rates of gay males, often to the neglect of other
potential health concerns. However, it should be noted
that older gay men are less likely to go back into the
closet than are members of other LGBTQ subgroups,
thus demonstrating potentially less fear about aging and
a desire for a more authentic life.
Bisexual Elder Discrimination
Bisexual elders are discussed in the literature as the
“invisible of the invisible,” as bisexual people are often
invisible both in the general society and within the
LGBTQ community. As a result of this, there is almost
no research literature on the aging experience of
bisexual persons. Even though it is routine for bisexual
individuals to be included in discussions of sexual
minorities in general (i.e., “LGBTQ”), their specific
experience is assumed to be one and the same with
other subgroups. However, much more research is
needed to increase awareness of the bisexual aging
experience and how it differs from the other LGBTQ
876
subgroups. In terms of discrimination experiences of
bisexual
Discrimination Against LGBTQ Elders
elders, much of it depends on their visibility and how
“out” they are. In the few existing studies of bisexual
aging, some of the participants felt an intense pressure
to choose one sexual orientation or the other
(heterosexual or homosexual) as they aged, and the
majority chose heterosexuality for the ease and security
found in that sexual identity. As well, participants
shared that they felt more intensely sure of their
bisexuality as they aged but did not live according to it,
again for ease and security in a homophobic culture.
Elder bisexual individuals have reported discrimination
within the LGBTQ community as a result of their
sexual identity not being accepted or recognized, in
addition to now facing ageism and discrimination in
general.
Transgender Elder Discrimination
Transgender elders face additional stigma and
discrimination based on their identity when compared
with all the other subgroups. In addition to the issues
discussed earlier, older transgender individuals also
face increased violence; greater employment and
housing discrimination; more privacy and
documentation issues in health care; and specific health
issues that are not acknowledged, such as the impact of
long-term use of hormones. In the rare studies that
address elder transgender individuals, the most
frequently reported concern is negative attitudes among
their health care providers. Transgender elders report
the least amount of social support of all groups, thus
making them most vulnerable to discrimination and
oppression.
Conclusion
Members of the older LGBTQ community face general
homophobic-based discriminations, such as federal,
state, and agency laws and policies that do not provide
the same benefits for LGBTQ individuals as for
heterosexual individuals. Many older LGBTQ
individuals return to the closet in order to avoid
discrimination, which creates additional stressors. Older
LGBTQ community members also face the same
ageism as all older adults within U.S. society. Older
LGBTQ individuals may find that the support they
formerly counted on within the LGBTQ community is
no longer necessarily present, given the priority of
youth culture and its promotion in the LGBTQ
community. As well, it is important to note that there
are differences among each subgroup within the older
LGBTQ community; what an older lesbian faces in
terms of discrimination can differ greatly from that of
an older gay male, and so on. There is need for
acknowledgment, practices, policies, and services that
are holistic yet also tailored to specific needs of each
subgroup within the older LGBTQ community in order
to provide greater financial, emotional, and physical
security for LGBTQ individuals as they age.
Paige Averett
See also Ageisms in LGBTQ Cultures; Aging and Gay Men;
Aging and Lesbian Women; Aging and
Transgender People; Discrimination Against LGBTQ
People in the Public Sector; Heterosexism;
Homophobia
Further Readings
Averett, P., Yoon, I., & Jenkins, C. (2013). Older lesbian
experiences of homophobia and ageism. Journal of Social
Service Research, 39, 3–15.
Cahill, S., South, K., & Spade, J. (2000). Outing age: Public
policy issues facing gay, lesbian, bisexual, and transgender
elders. Washington, DC: National Gay and Lesbian Task
Force Policy Institute.
Dworkin, S. (2006). The aging bisexual: The invisible of the
invisible minority. In D. Kimmel, T. Rose, & S. David
(Eds.), Lesbian, gay, bisexual, and transgender aging:
Research and clinical perspective (pp. 36–52).
New York, NY: Columbia University Press.
Funders for Lesbian and Gay Issues. (2004). Aging in equity:
LGBT elders in America. New York, NY:
Author.
Knauer, N. (2009). LGBT elder law: Toward equity in aging.
Harvard Journal of Law and Gender, 32, 302–358.
National Resource Center on LGBT Aging. http://
lgbtagingcenter.org
Services & Advocacy for GLBT Elders (SAGE). http://
www.sageusa.org/index.cfm
DISCRIMINATION AGAINST LGBTQ
PEOPLE, COST OF

Discrimination can be understood as the denial of social
participation based on prejudices. This includes
negative treatment of and attitudes toward an individual
or group based on their actual or perceived membership
in a certain group or social category. Throughout
history, discrimination has found a home wherever
there is opportunity to highlight our differences such as
sex, age, race, ethnicity, place of origin, social class,
religious affiliation, employment, and level of
education, among others. Sexual diversity is one such
aspect of human diversity that has historically been
fraught with prejudice and discrimination mainly
grounded in religious and cultural values and beliefs. In
this entry, using a social-determinantsof-health
framework, the impact of discrimination based on
sexual orientation and sexual identity is discussed from
two perspectives: first, the cost of discrimination
against LGBTQ people and second, the cost to the
broader communities to which LGBTQ people belong.
Social determinants of health are the conditions in
which people are born, grow, live, work, and age.
Money, power, and resources at the global, national,
and local levels in great part shape these circumstances.
This framework facilitates understanding how key
factors—such as income, education, and community
support—may have an impact on the health and well-
being of different populations. The impact of
discrimination, as a socially defined exercise of power,
can be understood using this framework and assessed at
the population level.
Around the globe, the costs associated with
discrimination for LGBTQ people have been severe.
Discrimination is pervasive and has been exercised
within a wide cross-section of social structures— from
archaic laws prohibiting entry to countries based on
sexual identity to more subtle discriminatory practices
that restrict opportunities for LGBTQ people in the
workplace. Discriminatory actions are not always
illegal. In fact, laws from
Discrimination Against LGBTQ People, Cost of
multiple countries around the globe support
discrimination against LGBTQ individuals. Some laws,
for example, even punish with the ultimate penalty—
death—for those found “guilty” of engaging in
homosexual acts. Other laws and policies officially
exclude LGBTQ people from access to basic social
services such as education, employment/working
conditions, food and sanitation, and health care
877
services, among others. The mere existence and
implementation of these policies perpetuate
burdensome socioeconomic costs to the lives, health,
and well-being of many LGBTQ people who, de facto,
are second-class citizens in their respective countries.
Researchers have documented that LGBTQ people,
due to the discrimination they face, are more likely to
experience violence, higher rates of school dropout,
substance misuse, homelessness, and poorer health
status, and they have lower income (even when they
have the same level of education) than their
counterparts. The negative economic footprint of
discrimination is undeniable. These negative outcomes
associated with discrimination are often layered,
complicated, and far-reaching. For example, coming out
as LGBTQ to their parents or legal guardians may cause
young people to face the difficult decision of living
under oppressive and sometimes violent circumstances,
or leaving their households. Being a young LGBTQ
person living on the streets increases the risk of
violence, disconnection from structured education,
malnutrition, and physical and mental diseases.
At the same time, some research suggests that
discrimination has ultimately resulted in some positive
consequences for LGBTQ groups. Some social
scientists agree that it was in fact the accumulation of
experiences of discrimination and its negative
consequences that led to community organization,
mobilization, and advocacy in countries in which
LGBTQ visibility and rights have improved in recent
decades. Also, among some members of the LGBTQ
groups, such as gay men, experiences of discrimination
related to their sexual orientation, sexual identity, and
sexual practices have been found to help them cope and
develop resilience to
Discrimination Against LGBTQ People, Cost of
deal with health issues, such as HIV infection and the
HIV epidemic in general. Furthermore, these
experiences may speak in general to human resilience
and ability to overcome obstacles.
Discrimination against LGBTQ people impacts their
interpersonal relationships, their family and social
networks, and the communities in which they live. This
can be defined as the social cost associated with
discrimination against LGBQ people. It has been
documented that discrimination toward LGBTQ
individuals affects the interactions that they develop
with friends, peers, and romantic partners. Their
878
experiences of discrimination may be integrated into
their beliefs and practices in ways that lead LGBTQ
individuals to experience social isolation. Self-
identified queer men, for example, may struggle with
developing meaningful relationships with lesbian, gay,
bisexual, and transgender (LGBT) people based on their
understanding of the fluidity and social nonconformity
of sexual orientation and gender identity. Further, there
is social exclusion within LGBTQ communities. Within
groups of LGBTQ people, sometimes, members can
feel excluded when their experiences or needs are not
addressed in social efforts for equality made by their
own group/community. This could be the case of
transgender people, whose experiences of
discrimination may vary. In fact, their experience might
be worse than those of lesbian, gay, bisexual, and queer
(LGBQ) individuals, since their transgression of the
social norms clearly challenges fundamental structures
of power and hegemony associated with gender-based
differences.
It can be argued that discrimination against LGBTQ
people not only has a detrimental effect on them but is
further reaching, significantly impacting their
communities as well. This is plausible if we understand
Discrimination Against LGBTQ People by Law Enforcement
our communities as environments in which all members
should have the same opportunity to contribute to social
wellbeing. In microeconomic theory, opportunity cost
may be defined as the value of the best alternative
forgone. Imagine the added value to a community of
their LGBTQ members contributing at optimal capacity
—one where the burden of discrimination has been
lifted and they have been afforded access to the same
opportunities as their straight counterparts. From that
perspective, discrimination against LGBTQ people has
a cost, a clear negative impact to the communities and
social groups in which discrimination is enacted.
Exclusion of LGBTQ people via discrimination affects
general social capital and consequently the opportunity
for a productive and healthy society. In places where
any other expression but heterosexuality is
criminalized, LGBTQ individuals are socially forced to
conceal their personal lives just to survive, and their
potential productivity and contributions to their
communities are made all the more challenging.
Correspondingly, even in places where LGBT rights—
such as same-sex marriage—have been won, the
exclusion of protection from discrimination at work
based on real or perceived sexual orientation or identity
may continue to perpetuate negative consequences.
These disjointed legal environments challenge not only
LGBTQ people and their families but also business and
government, by increasing health care costs and
diminishing economic returns and productivity.
The cost of discrimination against LGBTQ people is
high and may result in dangerously irreparable negative
outcomes to most. In general, discrimination against
LGBTQ people produces social exclusion and
subsequently an economic burden. The evidence of the
negative impact of discrimination toward these groups
suggests the need to reduce the disenfranchisement
resulting from social exclusion in order to improve their
ability to have and enjoy better, healthier, and more
fulfilling lives.
Carlos Rodríguez-Díaz
See also Business; Criminal Legal System and LGBTQ People;
Discrimination Against LGBTQ People by
Law Enforcement; Don’t Ask, Don’t Tell and Public
Opinion
Further Readings
Clark, F. (2014). Discrimination against LGBT people triggers
health
concerns. Lancet, 383(9916), 500–502.
Logie, C. (2012). The case for the World Health
Organization’s Commission on the Social
Determinants of Health to address sexual orientation.
American Journal of Public Health, 102(7), 1243–1246.
Ozeren, E. (2014). Sexual orientation discrimination in the
workplace: A systematic review of the literature.
Social and Behavioral Sciences, 109, 1203–1215.
Williams Institute. (2015). The business impact of opening
marriage to same-sex couples. Los Angeles, CA: Author.
Retrieved December 2, 2015, from http://
williamsinstitute.law.ucla.edu/interactive-economic- impact/
DISCRIMINATION AGAINST LGBTQ
PEOPLE BY LAW ENFORCEMENT
Historically, police forces targeted the LGBTQ
community through the use of sodomy laws, bar raids,
entrapment, selective arrests, and excessive physical
violence and harassment, especially toward particularly
vulnerable groups within the LGBTQ community.
These historical problems continue to manifest in some

form in the present day despite changes in laws and
policies to become more protective of LGBTQ people.
The evidence of ongoing mistreatment of the LGBTQ
community by police indicates the need for additional
interventions to further protect LGBTQ people in the
law enforcement context.
Sodomy Laws
Prior to 1961, every U.S. state had criminalized certain
types of sexual behavior through sodomy laws. Sodomy
laws resulted in numerous arrests and convictions of
Discrimination Against LGBTQ People by Law Enforcement
LGBTQ people, as well as other secondary
consequences including job loss, denial of state licenses
for certain professions, and loss of children in custody
cases. In many states, the laws were broadly written and
could apply equally to same-sex and different-sex
partners, but they were selectively enforced against
same-sex partners. In 1961, states began to repeal these
laws. In 2003, the U.S. Supreme Court found them
unconstitutional in the case of Lawrence v. Texas.
Although sodomy laws have been unenforceable
since Lawrence, they are still used by law enforcement
to arrest and harass LGBTQ people in some states
where they remain on the books. For example, in 2013,
a gay man was arrested in East Baton Rouge Parish,
Louisiana, for accepting an invitation to go to an
undercover officer’s home for “some drinks and some
fun.” The incident was one among several in Louisiana
in recent years. Other recent examples of enforcement
have been documented in Michigan, North Carolina,
and Virginia.
Bar Raids
In the 1950s and 1960s, police began raiding gay bars
under the guise of enforcing various state and local
laws that targeted LGBTQ people. Such laws included
those that prohibited LGBTQ people from gathering
publicly, business licensing restrictions that applied
only to gay bars, and sodomy laws. Often the raids
became violent and resulted in arrests. Bars throughout
the country were raided during this period, but the most
famous examples occurred at the Stonewall Inn in New
York City and the Black Cat Tavern in Los Angeles.
Today, there are no longer explicitly antigay laws to
encourage or justify police raids of gay bars or other
establishments. However, even in the last decade,
routine inspections by local vice or liquor licensing
879
agencies have turned into violent raids at gay bars,
particularly in the South. For example, in 2009, police
raided gay bars in Atlanta, Georgia; Dallas–Fort Worth,
Texas; and Memphis, Tennessee.
Entrapment
A 1965 study found that police departments in Los
Angeles County regularly used techniques designed to
lure gay men into attempting “homosexual acts.”
Similar practices were implemented in other
jurisdictions around the country, including in large
cities such
as New York, Chicago, Detroit, San Francisco, and
others. These incidents led to arrests under laws that
were either expressly directed at LGBTQ people, such
as sodomy laws, or laws that were broadly written but
selectively enforced against LGBTQ people, such as
solicitation laws.
Several recently documented examples show that
some police departments are continuing to entrap
LGBTQ people in order to arrest them under laws
against solicitation, public indecency, and similar
statutes. For example, in 2010, a total of 33 gay men
were arrested in Kent County, Michigan, under the
state’s solicitation statute after undercover officers
approached them in public parks. Recent large-scale
stings have also been documented in Washington, D.C.;
Houston, Texas; New York City; Milwaukee,
Wisconsin; Palm
Beach, Florida; and other cities.
Selective Arrests
For decades, LGBTQ people have been selectively
targeted under general, broadly written laws that could
apply to anyone, regardless of LGBTQ status.
Examples discussed above include sodomy laws that
could apply to both same-sex and differentsex sexual
conduct, solicitation laws, and lewd conduct laws.
Recent reports show that the trend of selective
enforcement against lesbian, gay, and bisexual (LGB)
people and particularly against transgender people
continues today. For example, recent studies by
governments and nongovernmental organizations
(NGOs) have documented discriminatory enforcement
against LGBTQ people in New Orleans and New York.
Other studies have found that particularly vulnerable
groups within the LGBTQ community, including
transgender people, people of color, and youth, have
880
experienced even higher rates of selective enforcement
than the LGBTQ population overall.
Discrimination Against LGBTQ People in the Public Sector
Excessive Physical Violence and
Harassment
The use of excessive physical violence and harassment
by law enforcement against the LGBTQ population has
been extensively documented. Historical examples
include cases of severe physical beatings during bar
raids and incidents of rape and sexual assault by law
enforcement, particularly against transgender women,
among many others.
Recent research indicates that law enforcement’s use
of excessive physical violence and harassment is still
common today. Surveys have found high rates of
physical violence and harassment against LGBTQ
people by law enforcement. Five surveys conducted
since 2011 found that of LGBTQ people who had
interacted with police, 14% to 66% reported being
verbally harassed or assaulted, 2% to 21% reported
being physically harassed or assaulted, 3% to 24%
reported being sexually harassed or assaulted, and 6%
reported being entrapped by the police. The percentages
were highest among particularly vulnerable groups
within the LGBTQ community, including transgender
people and people of color. In addition, numerous
anecdotal reports of excessive physical violence and
harassment against lesbian, gay, bisexual, and
transgender (LGBT) people by law enforcement have
been documented in court cases, in complaints to legal
organizations and NGOs, and by media outlets.
Christy Mallory and Amira Hasenbush
See also Bias in the Criminal Justice System; Criminal Legal
System and LGBTQ People; Juvenile Justice
System; Laws Banning Homosexuality and Sodomy;
Police Officers/Law Enforcement Officials;
Stonewall
Further Readings
Amnesty International. (2011). Stonewalled: Police abuse and
misconduct against lesbian, gay, bisexual and transgender
people in the U.S. Retrieved October 30, 2014, from
http://www.streetwiseandsafe
.org/wp-content/uploads/2011/01/StonewalledAI
.pdf
D’Emilio, J. (1983). Sexual politics, sexual communities: The
making of a homosexual minority in the United States.
Chicago,
IL: University of Chicago Press.
Project Report. (1966). The consensual adult homosexual and
the law: An empirical study of enforcement and
administration in Los Angeles County. UCLA Law Review,
13, 643–797.
DISCRIMINATION AGAINST LGBTQ
PEOPLE IN THE PUBLIC SECTOR
LGBTQ people have faced a long history of
discrimination in public sector employment, which
continues to the present day. The legacy of
discrimination can be traced back to purges of
thousands of LGBTQ employees from U.S. public
sector employment that began in the 1940s. Despite
changes in laws and policies to be more protective of
LGBTQ employees over the past 70 years, recent
evidence of discrimination has been documented in a
variety of sources. This evidence indicates that public
sector employment discrimination against LGBTQ
people continues to be widespread and pervasive.
History of Discrimination
Purges of LGBTQ government employees began with
the federal government in 1947 and were soon copied
by state and municipal employers. From 1947 to 1960,
LGBTQ people were labeled a security threat, due to
the impression that they could be blackmailed by those
who knew of their LGBTQ identity, and thus were
driven out of federal government employment. During
this period, which came to be known as the “Lavender
Scare,” more than 5,000 allegedly LGBTQ federal civil
servants lost their jobs for no reason other than their
sexual orientation, and thousands of applicants were
rejected for the same reason.
By the mid-1950s, state and local governments had
implemented similar purges of LGBTQ employees.
Statewide purges were conducted in at least eight states,
including California, Florida, Iowa, Massachusetts,
Texas, Oklahoma, Idaho, and North Carolina, and
impacted thousands of employees.

A distinct but related basis for denying public sector
jobs to LGBTQ people historically was the existence of
state antisodomy laws. Such laws were used to deny
LGBTQ people jobs in education and law enforcement,
in particular, on the belief that someone who engaged in
criminal behavior could
not be around children or enforce the law. Antisodomy
laws were held to be unconstitutional by the U.S.
Supreme Court in 2003.
Recent Evidence of Discrimination
Recent evidence of discrimination against LGBTQ
public sector employees has been documented in
surveys; wage studies; reports by federal, state, and
local governments; findings by courts; court opinions;
complaints filed with administrative agencies; and the
media. This evidence indicates that discrimination
against LGBTQ people in public sector employment
continues to be widespread and pervasive.
Surveys of LGBTQ Employees
More than 80 surveys of LGBTQ people, in which
either all or some of the respondents worked in the
public sector, have found that significant percentages of
LGBTQ public sector employees report experiencing
employment discrimination. For example, the 2008
General Social Survey found that 1 in 5 lesbian, gay, or
bisexual (LGB) employees reported experiencing at
least one form of employment discrimination based on
their sexual orientation at some point in their career.
More specifically, 17% reported being fired, 13%
reported being denied a promotion or receiving a
negative job evaluation, and 20% reported being
harassed verbally or in writing on the job.
Surveys of transgender workers have shown higher
rates of discrimination. For example, a 2009 survey
conducted by the Transgender Law Center found that
70% of transgender respondents reported experiencing
employment discrimination based on their gender
identity. More than 11% of the survey respondents were
public sector employees. The findings from these two
surveys are consistent with the findings of other surveys
Discrimination Against LGBTQ People in the Public Sector
of LGBTQ public sector workers, as well as those in the
private sector.
Wage Studies
881
Studies have shown wage gaps between LGB
government employees and their heterosexual
counterparts, controlling for factors expected to
influence wages. Together, two recent studies have
shown that LGB government employees earn 8% to
29% less than heterosexual government employees.
Reports by Federal, State, and Local
Governments
A number of state and local elected officials,
legislative bodies, and special commissions have issued
findings of widespread discrimination against lesbian,
gay, bisexual, and transgender (LGBT) people in their
jurisdictions, including in public sector employment. A
2009 study identified 29 such examples from 17
different states.
Findings by Courts
Several courts and legal scholars have acknowledged
a history and pattern of discrimination against LGBTQ
people by governments in the United States. Every
court that has substantively considered whether sexual
orientation classifications should be presumed suspect
for purposes of equal protection analysis has recognized
that LGBTQ people have faced a long history of
discrimination. In making this determination, many
courts expressly considered examples of discrimination,
including employment discrimination, by federal, state,
and local governments.
Administrative Complaints
A 2011 study found that LGBTQ state and local
government employees file complaints of
discrimination with administrative enforcement
agencies at slightly lower, but similar, rates compared
with LGBTQ workers in the private sector. Using data
gathered from 13 states, the study determined that
complaints of sexual orientation and gender identity
discrimination are filed by state and local government
workers at a rate of 3 complaints per 10,000 LGBTQ
employees. Among private sector employees, the rate of
discrimination was 4 complaints per 10,000 LGBTQ
employees.
Examples of Discrimination From
882
Court Opinions, Administrative
Complaints, and the Media
A 2009 study gathered a record of 380 anecdotal
examples of employment discrimination against
LGBTQ government employees that had occurred from
1990 through 2009. The examples were collected from
court opinions, administrative complaints, academic
journals, books, newspapers, and community-based
organizations.
The findings and examples of discrimination
summarized here provide insight into the existence and
nature of discrimination against LGBTQ public sector
employees, but are by no means a complete record of
such discrimination.
Christy Mallory and Brad Sears
See also Employment Non-Discrimination Act (ENDA);
Gender Identity Discrimination as Sex Discrimination;
Nondiscrimination Protections, State and Local;
Sexual Orientation Discrimination as Sex
Discrimination; Workplace Discrimination
Further Readings
Johnson, D. K. (2000). The Lavender Scare: The Cold War
persecution of gays and lesbians in the federal government.
Chicago, IL: University of Chicago Press. Sears, B., Hunter, N.
D., & Mallory, C. (2009, September). Documenting
discrimination on the basis of sexual orientation and gender
identity in state employment. Los Angeles, CA: Williams
Institute. Retrieved December 2, 2015, from http://
williamsinstitute.law.ucla.edu/research/workplace/
documenting-discrimination-on-the-basis-of-sexualorientation-
and-gender-identity-in-state-employment/
Sears, B., & Mallory, C. (2011, July). Evidence of employment
discrimination on the basis of sexual orientation in state
and local government: Complaints filed with state
Discrimination on the Basis of HIV/AIDS in Health Care
enforcement agencies 2003–2007. Los Angeles, CA:
Williams Institute. Retrieved December 2, 2015, from
http://williamsinstitute.law.ucla.edu/
wp-content/uploads/Sears-
MalloryDiscriminationComplaintsReport-July-2011.pdf
DISCRIMINATION ON THE BASIS OF
HIV/AIDS IN HEALTH CARE
An initial lack of understanding about HIV/AIDS
contributed to the birth of HIV-related stigma, and
laws, policies, and practices based on irrational fears
and misconceptions about the disease. This has given
rise to targeted discrimination against people living
with HIV (PLWH), such as discrimination on the basis
of HIV/AIDS in health care. This entry reviews such
discrimination, particularly discrimination in dental
care, and summarizes legal and ethical rules prohibiting
discrimination.
Studies have found that health care providers have
denied service to HIV-positive patients due to fear,
homophobia and prejudice, and a mistaken belief or
understanding of scientific facts or the law.
Discrimination against PLWH is often masked by
providers’ justifications such as lack of proper training
and expertise, or lack of proper equipment. This leads
to policies and practices that result in differential
treatment and care of HIVpositive patients, including
categorical refusals to treat HIV-positive patients and
blanket referrals of all HIV-positive patients to
“specialists.” Not only have these justifications been
found to be scientifically unwarranted, but courts have
also found such practices and policies to constitute
unlawful discrimination against PLWH.
Discrimination in Dental Care
Dental care is vital to PLWH because oral
manifestations may be the first sign of infection and
may also indicate progression of HIV. The impact of
discrimination in dental care is especially harsh, as
PLWH are also uniquely at risk for painful and
compromising oral health conditions. For these reasons,
researchers have sought to document and understand
this form of discrimination through surveying dentists,
dental school faculty, and dental students.
Between
1986 and 1995, studies found that 33% to 80% of
dentists surveyed did not want to serve patients that are
HIV-positive or at risk of becoming HIV-positive.
Other studies during this
period found that 25% to 50% of dental students did not
want to provide care to PLWH. Reasons cited for not
wanting to serve HIV-positive patients
were fear of infection, homophobia, and the belief that
PLWH are responsible for their illness. A more recent
study in 2012 found that only 34.1% of dental and
19.7% of dental hygiene students were able to
accurately identify the risk of HIV transmission from

occupational exposure, and over 8% of dental students
surveyed admitted an unwillingness to serve HIV-
positive patients.
In 2007–2008, testing studies focused on dental
providers in Los Angeles County found that 5% of
dental offices contacted had an unlawful blanket policy
of refusing to provide dental services to any PLWH.
Another 5% indicated they would treat PLWH
differently from HIV-negative patients. These rates
were almost double for providers affiliated with a
public dental benefit program for low-income
Californians, Denti-Cal.
Legal and Ethical Rules Prohibiting
Discrimination
All health care providers have legal and ethical duties to
serve PLWH. Because state laws vary greatly, they will
not be discussed here. Federal laws prohibit
discrimination based on HIV/AIDS status. In the 1998
case Bragdon v. Abbot, the U.S. Supreme Court ruled
that all PLWH are protected from discrimination under
the Americans with Disabilities Act of 1990 (ADA).
Health care providers cannot refuse services to PLWH,
with few exceptions. In order to make an exception,
they must make an individualized inquiry about the
specific circumstances of the patient’s condition and the
services requested and carry the legal burden to prove
that threats to the health of the provider or patient
cannot be substantially eliminated by making a
reasonable change to practices or
Division of Labor in LGBTQ-Parent Families
procedures. Most important, considerations must be
based on reasonable judgments informed by current
medical knowledge and not on stereotypes or irrational
fears.
In addition to the ADA, some health care providers
fall under the jurisdiction of Section 504 of the
Rehabilitation Act of 1973. Recipients of federal
funding, including hospitals affiliated with academic
institutions receiving federal funding or service
providers accepting payment from Medicaid or
Medicare, must also comply with disability
nondiscrimination provisions. This law applies to HIV
status. Federal agencies such as the U.S.
Department of Justice and the U.S. Department of
Health and Human Services have authority to
investigate administrative complaints based on these
laws. Both agencies have pursued action against health
883
care providers as a result of unlawful discrimination
against PLWH.
Finally, ethical codes of conduct apply to most, if not
all, health care providers. An American Medical
Association Opinion states that a physician may not
ethically refuse to treat an HIV-positive patient solely
because of the person’s HIV status. Three major dental
associations have incorporated specific duties for
dentists to provide care to PLWH, and failing to follow
these standards can result in censure, suspension, or
expulsion from these associations. Ethical codes for
other health care providers such as nurses and
pharmacists similarly demand providers treat patients
respectfully, regardless of their health problem.
Conclusion
Although one might assume that health care workers are
informed and educated about HIV, research indicates
that continuing education is needed. Protective laws
that demand nondiscrimination against PLWH in health
care and ethical duties to encourage such are necessary.
Enforcing nondiscrimination laws will allow society to
monitor this trend in discrimination on the basis of
HIV/AIDS in health care and to motivate health care
providers to deliver health care in an equitable manner.
Ayako Miyashita and Brad Sears
See also Disabilities Among LGBTQ Elders; Health Care
System; HIV and Treatment
Further Readings
Myers, J. E., Myers, R., Wheat, M. E., & Yin, M. T.
(2012). Dental students and bloodborne pathogens:
Occupational exposures, knowledge, and attitudes.
Journal of Dental Education, 76(4), 479–486.
Sears, B., Cooper, C., Younai, F., & Donohoe, T. (2012). HIV
discrimination in dental care: Results of a testing study in
Los Angeles County. Loyola of Los Angeles Law Review,
45, 909–956.
U.S. Department of Health and Human Services. (2014). Civil
rights enforcement success stories involving HIV/
AIDS. Retrieved December 2, 2015, from
http://www
.hhs.gov/ocr/civilrights/activities/examples/AIDS/hiv/
aidscivilrightscases.html
U.S. Department of Justice, Civil Rights Division. (2014). DOJ
HIV/AIDS enforcement. Retrieved December 2, 2015, from
http://www.ada.gov/aids/ada_aids_ enforcement.htm
884
DIVISION OF LABOR IN LGBTQ-PARENT
FAMILIES
Examination of the ways in which same-sex couples
organize their households provides insight into the lives
of LGBTQ-parented families. But, more broadly, it also
reveals new information about the operation of gender
in society. Household labor has traditionally been
organized along gendered lines with women being
primarily responsible for domestic labor, such as
cooking, cleaning, and caring for children, while men
have been responsible for earning income—that is, they
have occupied the role of the breadwinner.
Understanding processes by which same-sex couples
organize their work and family life demonstrates
possibilities for reshaping household practices along
nontraditional lines. But also, perhaps conversely, the
experiences of LGBTQ-parented families can show the
ways in which an individual’s gender shapes his or her
experience of parenting, domestic life, and the
workplace, irrespective of the person’s sexuality or the
gender of the partner.
Division of Labor Among LGBTQ Parents
The division of household labor refers to the ways in
which couples organize domestic tasks such as cooking,
cleaning, and general home maintenance. For couples
that are parents, household labor also includes caring
for children. Along with household and child care tasks,
research on the division of household labor includes
consideration of the ways in which couples manage the
need to earn an income with the demands of raising
children. Decisions about whether one or both members
of a couple will take on paid work, and the amount of
time they spend at work versus time spent at home, are
central to the organization of households.
Studies have suggested that same-sex couples are
likely to divide housework and child care tasks more
equally than heterosexual couples. There are a number
of reasons why this might be the case. First, many
LGBTQ parents have a strong ideological commitment
to achieving equality in their relationships, particularly
when it comes to parenting. Research has suggested that
this ideological commitment is one of the strongest
predictors of whether a couple will achieve equality in
their division of household labor. This also applies in
heterosexual couples; when both members of a couple
overtly express their commitment to equality, they are
less likely to divide tasks according to gender norms
and more likely to achieve an equal division of labor.
Furthermore, being of the same gender means same-
sex partners do not have the option of falling back on
traditional gendered expectations regarding household
tasks. In a household with two mothers, for instance, the
task of taking out the garbage cannot be allocated based
on the assumption of it being a “man’s job.” Similarly,
tasks traditionally considered “women’s work,” such as
cooking or ironing, could be assumed to be the
responsibility of either member of the couple.
Allocation of tasks therefore has to be actively
negotiated within same-sex couples. The division of
household labor may be organized according to each
member of the couple’s strengths, preferences, or
available time rather than gendered assumptions or
norms.
In some female same-sex couples, the division of
household labor may be organized to accommodate
Division of Labor in LGBTQ-Parent Families
a mother carrying and breastfeeding a child or children.
One mother may take on the role of primary caregiver
for a period while she cares for and breastfeeds a baby.
Over time, she may move back into the workforce to
enable her partner to take on the primary care role.
Often this will occur when the other partner becomes
pregnant and takes time off work to care for the baby.
Sharing the roles of primary caregiver and breadwinner,
by moving in and out of each role, enables the couple to
negotiate an equal division of labor over time.
There is, however, a growing body of research that
challenges the finding that most LGBTQ parents
achieve, or desire, equality in housework or child care.
Some researchers argue that most studies of LGBTQ
parents have predominantly focused on affluent, well-
educated, White lesbian couples. Affluence and high
levels of education are associated with an ideological
commitment to genderbased equality among both
LGBTQ and heterosexual adults. Research with a
greater diversity of participants has included lesbian
couples who follow more traditional patterns of
household organization—with one partner working full-
time while the other takes primary responsibility for
domestic tasks. This may be due to the couple’s choice
and values or because one partner has greater earning
power or more prestigious employment than the other.
In some studies, female samesex couples report being

aware of, and at times uncomfortable with, the fact that
their division of labor mimics traditional heterosexual
patterns. However, they often find it difficult to
overcome this—either due to the values or attitudes of
one or both members of the couple, or due to the
couple’s reluctance to relinquish financial rewards that
come with the arrangement.
The Influence of Gender
Some researchers argue that the effect of gender is
“neutralized” in families parented by same-sex couples.
That is, given the couple are of the same gender, they
will make decisions about paid work and the allocation
of household tasks on a neutral basis—one that is not
influenced by gender-based assumptions and norms.
Division of Labor in LGBTQ-Parent Families
However, the view that gender does not influence the
households of same-sex couples in any way has been
widely critiqued. Indeed, some researchers have pointed
out that female same-sex couples may be successful at
achieving an egalitarian division of labor because they
are both women. Despite the wide influence of
feminism on contemporary attitudes toward gender,
women still tend to be socialized to take on the majority
share of household and child care tasks. Indeed, recent
research has shown that in heterosexual couples, many
women still take on the bulk of housework and child
care even if they and their male partner spend an
equivalent number of hours in paid work. Female same-
sex couples in effect are two parents who have been
raised to assume primary household and child care
responsibilities. Negotiating these tasks on an equal
basis therefore may come more easily for two women
than for heterosexual couples.
In this context, women in a same-sex relationship
enact gendered social scripts regarding motherhood in
the same way that heterosexual women do. In fact, the
importance of undertaking tasks traditionally assigned
to mothers may be particularly salient for nonbiological
mothers. Given that nonbiological mothers cannot make
a claim to motherhood on a genetic/biological basis,
these mothers are often acutely aware of the need to
construct their motherhood identity through actions
associated with “mothering” their children.
Maintaining an equal division of household labor
may also be more achievable for a female same-sex
couple due to structural reasons, such as the position of
885
women in the workforce. There is some research that
suggests female same-sex couples are more likely than
heterosexual couples to manage work commitments and
child care by limiting the number of hours spent in the
paid workforce—either by both working part-time or by
taking turns moving in and out of the workforce.
Heterosexual couples, by contrast, are more likely to
manage work and home by having one member of the
couple (usually, but not always, the man) working full-
time while the other partner is home full-time or in part-
time paid work. Shifting out of the traditional
“breadwinner/homemaker” model may be easier for a
female same-sex couple than a heterosexual couple in
part because it is considered acceptable in many
industries for women to negotiate part-time work,
flexible work practices, or time out of the workforce to
care for children. By contrast, men who are seeking
part-time work or time off for family reasons are often
viewed as professionally uncommitted or unreliable.
This potentially affords less flexibility for men in
heterosexual or male same-sex couples to take on
primary child care responsibilities.
Unfortunately, there is limited research on the ways
in which fathers in same-sex couples negotiate the
demands of paid work and child care. Some studies
have suggested that the higher earning capacity of men
potentially affords male same-sex couples more options
than female same-sex or heterosexual couples to
purchase child care and household services, paying for
nannies, babysitters, and house cleaners. This would
enable fathers in same-sex relationships to adopt
fatherhood roles without compromising their
investment in a masculine identity associated with paid
work. To date, however, there are no studies that have
tested this theory, so it is not clear whether male same-
sex couples are more likely to purchase domestic labor
than heterosexual or female same-sex couples.
Bisexual and Transgender Parents
Most research on LGBTQ-parented families focuses on
same-sex couples. This may include some people who
identify as bisexual or transgender and who are in a
same-sex relationship, but in general the majority of
research participants in these studies identify as gay or
lesbian (or they are simply labeled that way by the
researcher because of their membership in a male same-
sex or female same-sex relationship, respectively). This
means that bisexual and transgender identities and
issues are often hidden or not acknowledged.
886
Many people who identify as bisexual have a
different-sex partner with whom they live and parent.
Yet there is very little research on the

parenting or relationship experiences of people who
identify as bisexual. As such, it is not possible to know
if people who identify as bisexual differ from
heterosexual, lesbian, or gay parents in their attitudes or
practices relating to division of household labor.
Transgender people may be in different-sex or same-
sex relationships. In some cases, transgender people
may have undergone a gender transition while in an
intimate relationship. Thus, they may have entered into
a different-sex relationship that became a same-sex
relationship, or vice versa. However, many transgender
people do not identify their gender in dichotomous
male/female terms and so may not identify their
relationship as either different- or same-sex. There is
some research on the division of household labor in
different-sex couples where one member of the couple
is a transgender man. This research suggests that these
couples often have a nonegalitarian division of
household labor, with the woman taking on the majority
of caring tasks. Notably, many of these couples explain
their division of labor as resulting from the free choices
of each member of the couple, rejecting the notion that
they are following traditional, heteronormative patterns.
Researchers have pointed to the significance of this
work in terms of explaining gender roles and inequality
in division of household labor as a social, rather than
biological, phenomenon.
Jennifer Power
See also Gender Binaries; Nonbiological, Nongestational
Mother; Work–Family Interface, LGBQ Parents
Further Readings
Coltrane, S., Miller, E. C., DeHaan, T., & Stewart, L. (2013).
Fathers and the flexibility stigma. Journal of Social
Issues, 69(2), 279–302.
Goldberg, A. E. (2013). “Doing” and “undoing” gender: The
meaning and division of housework in same-sex couples.
Journal of Family Theory & Review, 5(2), 85–104.
Goldberg, A. E., Smith, J. Z., & Perry-Jenkins, M. (2012).
The division of labor in lesbian, gay, and heterosexual
new adoptive parents. Journal of Marriage and Family,
74(4), 812–828.
Kurdek, L. A. (2007). The allocation of household labor by
partners in gay and lesbian couples. Journal of Family
Issues, 28, 132–148.
Lachance-Grzela, M., & Bouchard, G. (2010). Why do women
do the lion’s share of housework? A decade of research. Sex
Roles, 63, 767–780.
Divorce, Legal Issues in 887
Patterson, C., Sutfin, E., & Fulcher, M. (2004). Division of
labor among lesbian and heterosexual parenting couples:
Correlates of specialized versus shared patterns. Journal
of Adult Development, 11(3), 179–189.
Perlesz, A., Power, J., Brown, R., McNair, R., Schofield, M.,
Pitts, M., et al. (2010). Organising work and home in same-
sex parented families: Findings from the Work, Love, Play
Study. Australian and New Zealand Journal of Family
Therapy, 31(4), 374–391.
Pfeffer, C. (2010). “Women’s work”? Women partners of
transgender men doing housework and emotion work.
Journal of Marriage and Family, 72(1), 165–183.
DIVORCE, LEGAL ISSUES IN
The second decade of the 21st century has witnessed
extensive changes on the marriage equality front. As of
July 2015, same-sex marriage is available nationwide.
By contrast, just over 2 years earlier, in January 2013,
only 10 states and the District of Columbia permitted
same-sex couples to marry. A handful of states also
allow same-sex couples (and sometimes some or all
different-sex couples) to enter into other legally
recognized relationships, such as domestic partnerships
and civil unions.
This entry addresses the legal issues that arise for
same-sex couples in connection with divorce or
dissolution, including jurisdictional issues that
previously restricted access to divorce for some
samesex couples and issues related to dissolution of
civil unions and domestic partnerships that may
continue to exist.
Studies find that the relationships of LGBTQ people
are similar to those of heterosexual people. Thus, like
many heterosexual people, many
Divorce, Legal Issues in
LGBTQ adults are in long-standing, committed
relationships, and many same-sex couples are choosing
to formalize their commitments to each other by
marrying. Indeed, in 2011, the Williams Institute
reported that 47% of same-sex couples who lived in
states that permitted same-sex marriage or alternative
legal statuses entered into one or more such
relationships.
As is true with different-sex married couples, some
of these married same-sex couples will break up and
888
will want to end their legal relationships by getting
divorced. According to the Williams Institute, same-sex
couples currently have annual divorce rates that are a
bit lower on average (1.1%) than that of different-sex
couples (2%). These findings confirm that a significant
number of same-sex couples seek to formally dissolve
their legal relationships each year.
Although it is less celebrated than access to the right
to marry, the right to the formal, orderly divorce
process is also an important development for same-sex
couples. In the past, same-sex couples ending their
relationships often had few legal protections. Because
same-sex couples were unable to enter into formally
recognized legal relationships, they were treated as
unmarried cohabitants. Even today, in the
overwhelming majority of states, an unmarried
cohabitant has no automatic right to share property
acquired during the relationship. Moreover, even in
states that do extend some property rights to unmarried
cohabitants, the protections are usually very limited.
With the newly available right to divorce comes a more
established set of rules and procedures, as well as a host
of automatic protections.
In many respects, divorce proceedings for samesex
couples are similar to those involving differentsex
couples. But some divorcing same-sex couples could
encounter hurdles not faced by divorcing different-sex
couples.
First, before marriage was available nationwide,
some same-sex couples had a hard time finding a court
that had the authority, or jurisdiction, to grant them a
divorce. Being unable to get a divorce can be difficult
both emotionally and legally. Obtaining a divorce is
often an important step toward achieving some sense of
closure. In addition, spouses who want to end their legal
relationship, but who are unable to do so, may face a
host of legal and practical challenges. Such couples
might continue to accrue rights and responsibilities with
respect to each other, even if they no longer want to be
in a relationship.
Adding another layer of complications, many same-
sex couples are in multiple legal relationships. For
example, many same-sex married couples in California
are also registered as domestic partners. If such a
couple end their relationship, it is important for them to
terminate both their marriage and their domestic
partnership.
Today, most if not all same-sex married couples will
have access to a court that can terminate their marriage
as well as decide all of the ancillary issues related to a
divorce proceeding, such as property division, spousal
support, and child support. When that is the case, the
rules applicable to different-sex married couples
generally will apply equally to same-sex couples.
Because the right to marry has only been available to
same-sex couples for a relatively short time, however,
there may be some important protections that former
same-sex spouses are unable to access.
Jurisdictional Issues
In the past, some same-sex married couples were unable
to get divorced. No state requires a person to be a
resident of the state to marry there. By contrast, it is
generally understood that a divorce action must be
brought in the home state, or “state of domicile,” of at
least one of the spouses. Indeed, most states have
statutes requiring a person to be a resident of the state
for a certain length of time before he or she can either
file or obtain a divorce judgment. In the past, this
“domicile” requirement created problems for same-sex
spouses who validly married in one state, but who, at
the time of the divorce proceeding, lived in a state that
did not recognize marriages between same-sex couples.
This was the case for a gay male couple in Texas. J.
B. and H. B. legally married in Massachusetts in 2006.
Shortly after moving to Texas in 2008, the couple’s
relationship ended, and J. B. filed a divorce action in a
Texas court. Even though both spouses wanted a
divorce, a Texas appellate court held it lacked
jurisdiction or the power to grant the divorce. To grant a
divorce, the court held, would require the court to
recognize the parties’ same-sex marriage, something
Texas law prohibited. Moreover, due to the domicile
requirement, in order to get divorced in Massachusetts
—the state in which they married—one of them would
have to move back to Massachusetts. To use the phrase
coined by Mary Patricia Byrn and Morgan Holcomb, J.
B. and H. B. were left “wedlocked.” Unfortunately,
many other same-sex spouses found themselves in a
similar position.
These wedlocked same-sex couples faced a host of
legal complications. Even if their home state did not
recognize their marriage at that time, their marriage was
valid and recognized in many other states. The fact that
the parties remained in a valid marriage despite their
desire to end it could matter a great deal. Hundreds of
rights and obligations are automatically extended to

spouses because they are married. Depending on the
state, many of these rights and obligations continue to
accrue so long as a couple remains married (even if
they no longer want to be married).
For example, property acquired by either spouse
during the marriage is generally presumed to be the
marital or community property of the couple. Thus, if
the parties remained married, one spouse may have a
claim to property acquired by the other, even if the
property was acquired after their relationship was over.
On the other side, one spouse may be responsible for
debt acquired by the other during their marriage, even if
the debt was acquired after the breakdown of the
relationship. If one spouse had a child while the couple
was still validly married, the other spouse may be
presumed to be the legal parent of that child, even if the
couple had long since broken up. In addition, if one
spouse attempted to marry someone else—either of the
same sex or of a different sex—that conduct may
constitute bigamy and could result in criminal penalties.
These are just some of the reasons why it can be
important to obtain a divorce when the relationship is
over.
Fortunately, now that marriage is available
nationwide for same-sex couples, few if any married
couples will face this hurdle; divorce is also available
nationwide for same-sex couples. As discussed below,
however, couples in other legal statuses, like civil
unions or registered domestic partnerships, may
continue to face these jurisdictional difficulties going
forward.
Rules Applicable to a Same-Sex Divorce
If the court has jurisdiction over all of the relevant
issues, including child custody, child support, property
division, and spousal support, most of the rules
applicable to divorcing different-sex couples will apply
equally to same-sex couples. So, for example, unless
the spouses entered into a valid pre- or postmarital
agreement, all states distribute the available property
either equally or equitably upon divorce. In most states,
the property available for distribution is only property
acquired during the marital relationship. (Typically, a
few types of property acquired during the marriage are
excluded, including property inherited by one of the
spouses.) A minority of states allow courts to distribute
any property owned by either spouse, “however and
whenever acquired.” Whatever the relevant rules are,
Divorce, Legal Issues in 889
they will apply equally regardless of the respective
sexes of the spouses.
Further, as is true for different-sex spouses, the court
can order one spouse to support the other, either
indefinitely, or (more commonly) for some set period of
time. When considering a spousal support request,
courts typically take a variety of factors into account,
including the education, skills, and earning potential of
both spouses, as well as the health of both spouses.
The rules regarding children of the marriage apply
equally as well. All states presume that a child born
during a marriage is the child of both spouses. Many
states also have specific rules governing the parentage
of children born through assisted reproduction.
Typically, if a spouse— male or female—consents to
his or her wife’s
Divorce, Legal Issues in
insemination, the law will treat the spouse as the child’s
legal parent.
If both spouses are legal parents, the court will apply
the usual rules regarding child custody and child
support in a divorce proceeding. All states apply the
“best interests of the child” standard to determine child
custody and visitation between two legal parents. Under
this standard, courts typically consider a number of
factors, including the child’s relationships with both
parents, the age of the child, the child’s current living
situation, any history of domestic violence, and/or
(depending on the child’s age) the child’s wishes. The
court will determine the amount of child support using
the state’s child support guidelines.
Until recently, the federal tax consequences of a
divorce for a same-sex couple were very different from
those for a different-sex couple. That was the result of
Section 3 of the Defense of Marriage Act (DOMA).
Section 3 prevented the federal government from
recognizing or giving effect to any marriages between
same-sex couples. Under Section 3, the more favorable
tax rules that apply to divorcing different-sex couples
did not apply to divorcing same-sex couples. In 2013,
however, the Supreme Court held Section 3
unconstitutional in United States v. Windsor. As a
result, the federal tax rules that apply to divorcing
different-sex couples now apply equally to divorcing
same-sex couples.
While many aspects of a divorce proceeding for a
same-sex couple will be similar to those for a different-
sex couple, there may be some important differences.
890
As noted, in the absence of a valid preor postmarital
agreement, all states distribute available property
equally or equitably at divorce, and, in most states, the
property available for distribution only includes
property acquired during marriage. This may create
inequities or unfairness for some same-sex couples.
Marriage has only recently become available for same-
sex couples. Thus, there are many married same-sex
couples who were together for years, if not decades,
prior to their date of marriage. In such circumstances,
distributing only the property acquired during the
marriage, but not any of the property acquired prior to
their marriage, may produce unfair results. This may be
particularly true if one party was the primary wage
earner, while the other party was the primary caregiver
to the couple’s child(ren). In some states, there may be
other rules that enable the court to distribute property
acquired during the relationship but prior to the
marriage. This may be true, for example, in Washington
State under what is known as the committed intimate
relationship doctrine, which says that a court can
equitably distribute property acquired during a
committed but nonmarital relationship. In other states,
however, the court may be powerless to distribute
property acquired during the relationship but prior to
the marriage.
There are other problems or inequities that may arise
for same-sex married couples who were together for a
long time and who would have married long ago if they
could have. Former spouses who were married for at
least 10 years and who are otherwise qualified can get
Social Security benefits based on their former spouse’s
entitlement. At the present time, however, there are
very few former same-sex spouses who were married
for 10 or more years. For those long-term same-sex
couples who would have married years ago if they
could have, denying one of them the Social Security
benefits available to long-term former spouses may be
harsh and unfair.
There are other benefits that are available to former
spouses only if the couple was married for a relatively
long period of time. To retain full military benefits and
privileges as a former spouse, for example, the person
must have been married to the service member for 20
years. Currently, no samesex former spouse can fulfill
that requirement.
Issues for Couples Dissolving Other Forms of Legal
Relationships
There are some same-sex couples who are in domestic
partnerships or civil unions rather than marriages. To
end a registered domestic partnership or a civil union,
couples typically have to follow the same rules and
procedures that apply to divorce actions. If the action is
filed with a court that has full authority over it, the
general rules, including the rules regarding division of
property, spousal support, child custody, and child
support, should apply the same as to divorces.
That said, couples seeking to terminate a domestic
partnership or civil union may face some unique
challenges. First, if the parties live in a state that does
not permit same-sex couples to enter into a registered
domestic partnership or a civil union, the parties may
have difficulty obtaining a divorce/ dissolution. In the
past, some courts in such states held they lacked
jurisdiction to dissolve these alternative statuses. Now
that all states recognize samesex marriage, however,
courts may be less likely to conclude they lack
jurisdiction to dissolve these statuses between same-sex
couples. Also, in many states, the usual divorce
jurisdiction requirements apply, including the domicile
requirement. Thus, unless one or both parties moves to
the state in which they entered the relationship, the
courts of that state may lack the power to consider a
dissolution petition.
In recognition of this possibility, however, some
states have enacted special divorce jurisdiction statutes
to address this challenge faced by samesex couples.
California is one such state. When parties register as
domestic partners in California, they must consent to
allow a California court to dissolve their domestic
partnership later should one or both parties request a
dissolution. California courts have the authority to
dissolve a California domestic partnership, even if
neither party is or ever was a California resident. A
number of other states have passed similar provisions
allowing courts in that state to terminate alternative
legal statuses entered into in that jurisdiction.
Even if the court can terminate the nonresident
spouses’ civil union or domestic partnership (i.e., issue
them a divorce decree) under one of these types of
provisions, the court may not have the power (i.e.,
jurisdiction) to decide other issues related to the divorce
proceeding. For example, the court may not have
authority to address child custody or visitation issues,
and the court may also lack the power to divide the

parties’ property or to make a spousal or child support
award.
Divorce and Relationship Dissolution, Psychological Experience of
In addition, at the moment, the federal government is
not extending federal marital rights and obligations to
couples who are in a domestic partnership or a civil
union and not a marriage. Thus, the federal tax rules
applicable to divorcing spouses may not apply equally
to couples who are seeking to terminate a domestic
partnership or a civil union. As a result, the federal
government may tax a property division award from
one domestic partner to the other.
In addition, a federal law known as the Employee
Retirement Income Security Act (ERISA) limits a
court’s ability to transfer most types of retirement
accounts to people other than spouses. Because a
domestic partner or civil union spouse is not considered
a spouse for purposes of this federal law, the court may
be unable to divide the couple’s retirement accounts.
This can be particularly problematic when the couple’s
only or primary asset is a retirement account.
Looking Ahead
Now that same-sex marriage (and divorce) is permitted
nationwide, the jurisdictional challenges discussed
above have been eliminated for married couples. But
other challenges, including the lack, or lesser amount,
of protection for the premarriage portion of the couple’s
relationship, will persist into at least the near future.
Courtney G. Joslin
See also Child Support After LGBQ Divorce/Separation;
Divorce and Relationship Dissolution, Psychological
Experience of; Divorce and Separation, Historical
Perspective on
Further Readings
Badgett, M. V. L., & Herman, J. L. (2011). Patterns of
relationship recognition by same-sex couples in the
United States. Los Angeles, CA: Williams Institute.
Retrieved December 7, 2015, from http://
williamsinstitute.law.ucla.edu/wp-content/uploads/
Badgett-Herman-Marriage-Dissolution-Nov-2011.pdf Byrn,
M. P., & Holcomb, M. (2012). Wedlocked.
University of Miami Law Review, 67, 1–40.
Cal. Fam. Code §2320.
Estin, A. L. (2001). Ordinary cohabitation. Notre Dame Law
Review, 76, 1381–1408.
Divorce, Legal Issues in 891
Joslin, C. G. (2011). Modernizing divorce jurisdiction:
Same-sex couples and minimum contacts. Boston
University Law Review, 91, 1669–1721.
Joslin, C. G.,
Minter, S. P.,
& Sakimura, C. (2014).
Lesbian, gay, bisexual, and transgender family law.
Eagan, MN: Thomson West.
National Center for Lesbian Rights. (2013). Divorce for same-
sex couples who live in non-recognition states: A guide for
attorneys. San Francisco, CA: Author.
Retrieved December 3, 2015, from
http://www
.nclrights.org/wp-content/uploads/2013/07/Divorce_
in_DOMA_States_Attorney_Guide.pdf
Vt. Stat. Ann. tit. 15, §592.
DIVORCE AND RELATIONSHIP DISSOLUTION,
PSYCHOLOGICAL
EXPERIENCE OF
The ending of any relationship is complex and difficult
at best, and much research on different-sex couples
suggests that the experience of separating and divorcing
often comes with many psychological consequences.
Such consequences can include increased depression,
anxiety, loneliness, and drinking and substance use, as
well as stress surrounding child custody (when children
are involved) and the division of property, to name a
few. Much less is known about the experiences of
same-sex couples that seek to end their relationships
(i.e., dissolution) or marriages (i.e., divorce), or about
how their children fare in the wake of same-sex
parental relationship dissolution or divorce. This entry
focuses on these experiences, and, for ease, uses the
term dissolution to refer to the ending of any long-term,
committed relationship regardless of legal status except
in cases where divorce was examined specifically. In
doing so, the entry discusses (a) some of the biases of
dissolution research, (b) the psychological experiences
leading to dissolution, (c) the psychological experiences
of the transition to dissolution and after, and (d) the
experiences of children.
892
Biases of Dissolution Research
The lack of attention to the separation and dissolution
experiences of gays and lesbians has limited our
understanding of the needs of these groups. Marriage
traditionally has been considered the only form of a
real relationship in the United States, thereby reducing
any other type of committed, long-term partnership to a
trial for marriage or other form of a “less than”
relationship (e.g., dating). Initial research on LGBTQ
individuals and couples often labeled gays and lesbians
as mentally ill or incapable of forming long-term
committed relationships. Until more recently, public
opinion has not supported the recognition of same-sex
couples. Further, producing research about dissolution
among same-sex couples might have been seen as
counterproductive to the marriage equality movement.
As such, the lack of research on samesex dissolution is
understandable when considered with the social context
in mind.

Psychological Experiences Leading to

Dissolution
Same-sex couples who perceive their relationships (or
marriages) as more rewarding and with fewer costs
experience greater relationship satisfaction and, in turn,
a greater desire to maintain their relationships.
Generally, relationship satisfaction appears to gradually
decrease over time, with some evidence suggesting it
begins to increase slightly much later in a relationship,
but never reaches the same levels compared with the
early years. As relationship satisfaction decreases, the
likelihood of dissolution increases. Accordingly, higher
levels of conflict and negative affect may enter the
relationship, resulting in more costs and lowered
rewards. Some of the sharpest declines in satisfaction
among different-sex couples coincide with bringing
children into a relationship. However, the opposite has
been found among some same-sex couples, likely due
to the intentional efforts and planning (e.g., adoption,
surrogacy) needed to add a child to the family.
Alternatively, the couples who choose to adopt may be
characterized as having higher initial relationship
stability, resilience, and emotional resources, offsetting
the difficulty of bringing children into the family.
Couples should expect, and can navigate, some levels
of relational conflict.
 893
Divorce and Relationship Dissolution, Psychological Experience of
Couples tend to weather extremely high accuracy.
relational conflict as long as Contempt refers to the
perceived investments are devaluing of a partner,
higher (couples have been disrespect, mocking, eye-
together longer or have rolling, and so forth, and
children), barriers to leaving leads to stonewalling, or the
the relationship exist (such psychological withdrawal
as lack of financial and absence of the partner
independence), fairness is from the relationship. As
perceived, and there are these processes persist, the
fewer perceived alternatives overall climate of the
(such as a better potential relationship becomes toxic
partner). Stated another and leads to depressed
way, when a partner mood, anxiety, and stress,
experiences high levels of and can have a detrimental
conflict and negative affect, effect on the health of all
has few investments, has family members that are part
few barriers to leaving, does of this climate.
not perceive fairness, and
sees attractive alternatives,
she or he is likely to Psychological
dissolve the relationship. Experiences Among
Some research examines Those Who Separate
ways in which negativity and Dissolve
begins to take over the Relationships
emotional climate of a It is common among those
relationship, especially as who experience the
conflict becomes processes just described to
increasingly common consider dissolution, and
between partners. Research those who experience
by John Gottman has been contempt and stonewalling
especially important in most likely will. In fact,
highlighting the research finds that couples
psychological and who dissolve their
physiological experiences of relationships do so because
conflict that lead to divorce of partner
or dissolution. His work nonresponsiveness (a
with different-sex and same- potential indicator of
sex couples suggests that as stonewalling), no or
partners begin to criticize negative communication,
each other more and more, mental cruelty (a potential
partners become defensive indicator of contempt), and
(in response to feelings of incompatibility. These
being attacked), and this can interpersonal patterns can
lead to contempt. When this combine with external
pattern becomes a regular factors (e.g., social network
occurrence in the influences, financial
relationship, it predicts difficulties, perceived
divorce/dissolution with
alternatives) to increase the
perceived stress of staying
in the relationship—or can
result in reduced stress. For
example, some separated
individuals report relief
after leaving high-conflict
relationships. Others report
an opportunity to start over
and grow personally,
whereas still others report
loneliness and difficulty in
establishing new routines
and identities. Expecting
dissolution to occur is
related to a higher chance of
positive adjustment and
other beneficial short-term
outcomes such as personal
growth. Among same-sex
couples, many encounter
added stress as they
contemplate what separation
will mean for their lives and
go on to actually dissolve
their relationship. This is
especially true when it is a
partner in a different-sex
marriage who comes out to
her/himself as gay and goes
Divorce and Relationship Dissolution, Psychological Experience of
through a divorce at the
same time. Also unique to
some in this group are
worries about legal issues
surrounding their divorce,
especially those related to
custody when children are
involved.
The one somewhat
consistent factor for married
different-sex couples is that
courts overseeing divorce
proceedings are family
courts and base decisions on
previous case precedent.
Although it is not
necessarily the case that
court involvement will
alleviate the psychological
experiences of divorce for
any couple, it can be argued
that it provides some
stability in that decisions are
made more fairly and
equitably when based on
case precedent. This is not
always true for same-sex
couples. These couples do
not always have their
relationships recognized
legally or socially, leading
to the reduced availability of
social and family support,
chronic social stress, worry
about anticipated rejection,
and internalized
homophobia. These factors
can result in both reduced
well-being for the individual
and greater stress on their
relationship. The lack of
legal recognition and
associated benefits further
increases difficulty,
although, with recent legal
decisions regarding same-
sex marriage, this landscape
is likely to change
drastically in the future.
Until recently, most
same-sex couples lacked
legal recognition and had to
decide the terms of their
dissolution independently,
with a therapist or other
family practitioner, or
through a civil court.
Importantly, there is no case
precedent for dissolution or
divorce in civil court, and a
judge can make any decision
without consulting family
laws governing divorce. For
example, the precedent of
equitable division of assets
only applies to divorces
heard in family courts and

not to dissolutions heard in
civil courts. So, it is possible
a civil court judge
overseeing a dissolution
could render a decision that
awards all resources to one
partner, even if both
partners jointly accumulated
most of their assets. In this
way, the experiences of
many same-sex couples are
unique, thereby potentially
adding and intensifying
some of the psychological
consequences. Alternatively,
some research does exist
that demonstrates same-sex
couples’ abilities to navigate
independent dissolution
fairly successfully. This
likely represents what other
research has found: strong
levels of flexibility and
adaptability.
In addition to
encountering added stress
over dividing resources
given the lack of legal
intervention during the
course of dissolution, many
samesex couples also may
negotiate parental custody
rights. Indeed, recent
estimates suggest that about
31% of cohabiting same-sex
couples have children. For
these same-sex parents, the
nature of their relationship
(i.e., cohabiting, married)
can influence the outcome
of custody decisions. For
couples who are not legally
married or in which both
partners do not share
custody, there are no legal
rights or obligations (i.e.,
visitation, child support)
enforced for both parents.
Typically, the law may view
895
only one as the real parent.
In these cases, coparents can
lose all access to children,
especially if the separation
is less than amicable. This
can result in increased
financial and psychological
strain on both parents and
children. Even with
carefully constructed
agreements, coparents can
often end up feeling
marginalized, invisible, and
vulnerable, and some have
referred to this experience as
one of ambiguous loss.
Again, this demonstrates
potential psychological
consequences in the absence
of legal protections afforded
by marriage equality, as an
example.
Social networks can also
exert an influence on the
way same-sex couples
experience separation and
dissolution. The powerful
influence of social norms
and commonly held beliefs
can alter the way individuals
conduct their relationships
and the expectations for
their relationships. For
example, tightly woven
LGBTQ communities may
exert pressure for amicable
separations so as to keep the
cohesion of the community
intact. This is likely related
to the tendency for same-sex
ex-partners to remain in
each other’s friendship or
family networks after a
separation. This network
cohesion may be a function
of the bonding that occurs in
groups that experience
discrimination and prejudice
(i.e., collective identity), as
a method of protection from
sources external to the group
that may be harmful to its
members, and an influence
of smaller social networks
and communities.
Importantly, social networks
are sources of social
support, and this is
necessary to aid in the
psychological adjustment to
dissolving a relationship.
Children’s Experiences
With Parental
Relationship Dissolution
Children with same-sex
parents experience loss and
grief related to the ending of
their parents’ relationship.
As is the case with adults,
children generally adjust
well over time. The ability
to establish new routines,
parents being cordial toward
one another, and having
other supportive adults in
their lives help with
adjustment. Implicit is that
children do need to process
their experiences in order to
better adjust, and this can be
more challenging for
children with same-sex
parents. For example,
research indicates that these
children may find it more
difficult to discuss their
parents’ separation or
relationship dissolution,
given that most people may
assume that the child has
different-sex parents. This is
another negative influence
of LGBTQ-related stigma
and discrimination. Children
also experience more worry
about their parents being
stigmatized and often
increase their protectiveness
toward parents. When
parents had entered a
coparent adoption before the
dissolution, children
experienced more closeness
and less loss
postdissolution. It is well
known that (a) maintaining
contact with all parents and
(b) the ability of ex-partners
to be cordial following
dissolution are critical to
children’s adjustment. It
appears same-sex couples
may be particularly adept at
providing such a context for
their children, and this
seems to somewhat mitigate
the negative psychological
experiences of dissolution.
At the same time, the
experience is challenging
and difficult for all of these
children.
Conclusion
The period prior to divorce
or dissolution often is
characterized by conflict
and the buildup of
psychological stress.
Outcomes for all family
members appear to be
somewhat negative in the
short term, with positive
adjustment over the long
term. However, some have
experienced dissolution
more positively and have
even reported personal
growth. It is clear that
societal discrimination and
lack of access to legal
means of divorcing can
exacerbate adjustment
difficulties, although these
 897
circumstances appear to be and adolescent psychological
improving. More research is well-being after lesbian
mothers break up. Family
needed to fully understand
Relations, 60(5), 572–585.
these experiences and
Goldberg, A. E., & Allen, K.
impacts on same-sex R. (2013). Same-sex
couples who end their relationship dissolution
relationships, as well as on and LGB stepfamily
the children who experience formation: Perspectives of
the separation, dissolution, adults with LGB parents.
and/or divorce of their Family Relations, 62, 529–
parents. 544.
Gottman, J. M., Levenson, R.
Brad van Eeden-Moorefield W., Gross, J., Frederickson,
B. L., McCoy, K.,
See also Child Support After Rosenthal, L., et al. (2003).
LGBQ Divorce/Separation; Correlates of gay and
Coming Out, Disclosure, and lesbian couples’ relationship
Passing; Custody and satisfaction and relationship
Litigation, LGBQ Parents; dissolution. Journal of
Custody Issues in Homosexuality, 45, 23–43.
Transgender Parenting; Kurdek, L. A. (1991). The
Discrimination Against dissolution of gay and lesbian
LGBTQ People, Cost of; couples. Personal
Divorce, Legal Issues in; Relationships, 8, 265–278.
Divorce and Separation, Oswald, R. (2006). Same-sex
Historical Perspective on relationships and their
dissolution. In M. Fine & J.
Harvel (Eds.), Handbook of
F divorce and relationship
u dissolution (pp. 499–513).
r New York, NY: Taylor &
t Francis.
h
e
r

R DIVORCE AND
e
a SEPARATION,
d
i HISTORICAL
n
g
PERSPECTIVE ON
s
Gartrell, N., Bos, H., Peyser, H., The processes of separation
Deck, A., & Rodas, C.
and divorce have affected
(2011). Family
the lives of LGBTQ people
characteristics, custody
arrangements, Divorce and
since the first wave of
Separation, Historical LGBTQ liberation in the
Perspective on 1960s and 1970s. Initial
research and commentaries
on divorce and separation
considered LGBTQ people
leaving heterosexual
marriages and relationships.
Subsequently, though,
attention has turned to
same-sex relationship
separation. As legislation
surrounding same-sex
marriage becomes more
favorable in many different
countries and legislatures,
consideration is now turning
to same-sex divorce. The
children of LGBTQ parents
and how they fare after
parental divorce has been
one of the central research
areas influencing public
debate.
This entry reviews the
legal, social, and
psychological aspects of
divorce and separation
involving LGBTQ adults
and their children since the
first wave of LGBTQ
liberation. Historical
developments and landmark
legal judgments related to
divorce and separation are
contextualized in relation to
contemporary issues faced
by LGBTQ people and their
families.
Divorce and Separation,
Historical Perspective on
Leaving Different-
Sex
Marriages
and
Relationsh
ips
With the first wave of
LGBTQ liberation, many
lesbians, bisexuals, and gay
men began to be more open
about their sexual identity.
For many, this process of
coming out also meant the
end of a different-sex
marriage that was no longer
compatible or satisfying.
Men leaving heterosexual
marriages often had
experienced same-sex
attractions during
adolescence and young
adulthood but tended to
have dismissed or repressed
any thoughts of a
nonheterosexual future. In
contrast, lesbians leaving
heterosexual marriages
sometimes reported that
they had no earlier
awareness of same-sex
attractions whatsoever.
Many lesbians, bisexuals,
and gay men reported
having felt genuine feelings
of love for their spouse and
had seen their marriage as
the only socially acceptable
route to a “family lifestyle”
that included children.
Many newly identified
LGBTQ people delighted in
liberation but also struggled
with leaving behind a
heterosexual past. The
redefinition of self and
establishment of new
relationships and social
networks after coming out
may take a year or longer to
achieve. For example, a man
who previously had
prioritized the traditional
goals of heterosexual
marriage and children might
contend with his own
internalized homophobia or
biphobia as he gradually
begins the process of
assembling a new sexual

identity. Released from
marriage, he could
experience the excitement of
satisfying sexual encounters
with another man without
the previous feelings of
anxiety and guilt associated
with living a dual life.
Nevertheless, he might miss
the companionship and
emotional intimacy he had
previously enjoyed with his
wife and grieve the loss of
this attachment and the
pulling apart of family and
home. Further, the man’s
previous heterosexual
identity might well mean
that he is older, on average,
when coming out as a gay
man. Thus, developing a gay
identity, or finding a partner,
could be a challenge within
gay social spaces that prized
youthful body images and
freedom from
responsibilities to others.
Depending on one’s
relationship with an
expartner and one’s
particular social
circumstances, separation
and divorce could be not
only emotionally distressing
with the ending of an
intimate attachment, but also
financially difficult,
disruptive of domestic
routines, and socially
embarrassing. Compounding
the usual realignment of
relationships with extended
family and friends as a
marriage ends are the
reactions of others to the
disclosure of a stigmatized
identity (i.e., as LGBTQ)
and the accompanying
experience of social
899
isolation. Under legislative
systems that sought to
apportion joint assets by
establishing culpability,
LGBTQ individuals were
particularly vulnerable to
prejudice when seeking to
legally end a marriage that
was no longer viable. In
many jurisdictions, the
introduction of no-fault
divorce laws has helped to
end incompatible marriages
without the additional
aggravation of a contested
divorce.
Many of the high-profile
divorce cases that involved
lesbian mothers also
involved making custody
and access arrangements for
their children who had been
conceived or adopted during
the marriage. Until the turn
of the 21st century,
contested divorces often
meant that a lesbian mother
would lose custody and
possibly face severe
restrictions on the
circumstances under which
she could visit her child. For
example, in Bottoms v.
Bottoms (1993), Sharon
Bottoms’s mother was
granted custody of her
grandson because Bottoms
was deemed unfit to parent
due to her lesbian
relationship. Sharon
Bottoms was allowed to
visit her son, but he was not
allowed to visit her home or
to see her same-sex partner.
Some of the most
difficult legal cases have
involved transgender
parents. For instance, in
Kantaras v. Kantaras
(2004), Michael Kantaras
fought a drawn-out custody
battle with his ex-wife with
whom he parented two
children (his ex-wife’s child
from an earlier relationship
whom Kantaras had
adopted, and the child the
couple had together through
donor insemination).
Initially, the Florida county
judge had ruled that
Kantaras was the children’s
legal father and had awarded
him custody. This was then
overturned by the Florida
Supreme Court ruling that
Kantaras was born and
remained female, rendering
the marriage null and void
because same-sex marriages
were not legal in that state,
thus undermining his claims
to custody.
Nonetheless, with
increasing pressure from
equal rights groups, LGBTQ
parents gradually began to
win custody and access
battles for their children.
Often the nexus test is
applied in cases where
custody or visitation is
disputed. In the nexus test,
parental behavior (including
aspects connected with
parental sexual identity)
cannot be used as legal
evidence unless a direct
connection is recognized
between the behavior and a
negative effect on children’s
well-being.
By the early 1990s, equal
rights advocacy groups were
able to point to research on
the wellbeing of children
brought up in lesbian-
mother families, which
played a critical role in
helping to change public and
professional perceptions in
custody and visitation cases.
Research on children
brought up by their lesbian
mother after she and the
child’s father had divorced
has shown that children with
lesbian mothers generally do
not differ from children with
heterosexual mothers in
their relationships with their
parents or their peers, their
psychological well-being, or
their psychosexual
development.
Far less research has
looked at children of
divorced gay fathers, or at
bisexual, queer, and
transgender parents. One
reason for the lack of
research on children of
divorced gay fathers and
divorced transgender parents
may be that many are
nonresidential parents to
their children. Nevertheless,
reports from gay fathers
have indicated that their
relationships with their
children are generally warm
and positive. Gay fathers
also may be better than
nonresidential heterosexual
fathers at providing a
structured routine to their
child’s visit and setting
appropriate limits on their
child’s behavior. For those
gay fathers who did have
resident children, a key
factor in satisfaction with
family has been the extent to
which the father’s new
partner was integrated into
family life. Likewise,
research with small samples

of children of divorced
transgender parents indicate
that children are more likely
to be troubled by parental
conflict but otherwise show
no general difficulties in
psychological development.
Currently, many LGBTQ
parents have children from
previous different-sex
relationships, and this
Divorce and Separation,
Historical Perspective on
may be more likely for
LGBTQ parents from Black
and ethnic-minority groups.
Data from the U.S. Census
has indicated that same-sex
couples who reported a prior
heterosexual marriage were
nearly twice as likely to
have children compared
with same-sex couples who
recorded no prior history of
heterosexual marriage.
Parenting by lesbian couples
when one mother has
children living with her
from a previous
heterosexual relationship
may be organized
differently than parenting in
planned two-mother
families. One study of
African American lesbian
stepfamilies found that the
biological mother took on
major responsibility,
compared with her new
partner, not only for her
children but also for
household chores and
decision making.
Same-Sex
Couple
s middleclass,
901
Separa
ting
and
Divorci
ng
When same-sex couples
who lack legal recognition
of their same-sex
partnerships end these
relationships, they are often
vulnerable to disputation in
a number of ways, since no
legal redress can be sought
and the couple themselves
must arrange the
redistribution of joint assets.
Further, if the relationship
ends, then ex-partners might
not have extended family
and friends to rally around
them. Within some feminist
lesbian communities, there
may be particular pressures
for an amicable and
equitable separation—yet
this may drive underground
feelings of resentment,
leaving tensions between
ex-partners unresolved.
Reviews of research on
committed same-sex
relationships generally have
concluded that same-sex
couples experience similar
levels of relationship
happiness and satisfaction as
compared with different-sex
couples. Couples also seem
to have similar conflict
resolution patterns, although
lesbian couples tend to
indicate more positive
feelings about conflict
resolution than do women in
heterosexual relationships.
Longitudinal research on
White, American,
same-sex
cohabiting couples in the
1980s and 1990s indicated
that same-sex couples were
less likely to break up if
they had been together for
more than 10 years and were
more vulnerable
Divorce and Separation,
Historical Perspective on
to separating if the
cohabitation was more
recent. Emotional
nonresponsiveness,
experiencing individual
problems (e.g., drugs),
arguing about money or
work, and feeling sexually
dissatisfied were all cited as
reasons for relationship
breakdown by both same-
sex and different-sex
couples. Nevertheless, it
seems that when compared
with different-sex couples,
same-sex couples might
perceive fewer barriers to
leaving a relationship that
no longer brings them
happiness.
Some research has also
attended to the potential
impact that same-sex
parents’ relationship
dissolution may have on
children brought up within
that union. When the child is
biologically related to, or
adopted by, only one parent,
then the nonbiological/
nonlegal LGBTQ coparent
is in a weak legal position if
the couple separates.
Subsequently, the coparent
may be tempted to withdraw
financial support for the
child if the ex-partners are
not able to find a solution to
custody disputes. Children
of separated LGBTQ
parents may experience a
complex set of emotions in
the wake of parental
relationship dissolutions,
such as feeling isolated
because their grief at the end
of their parents’ relationship
is not appreciated or
recognized by others.
Data from the U.S.
National Longitudinal
Lesbian Family Study
(NLLFS) has indicated that
17-year-old adolescents in
the sample had experienced
higher rates of parental
separation than recorded in
comparable national U.S.
surveys. Nevertheless, over
time, adolescents and their
mothers also reported higher
rates of cooperation between
ex-partners over parenting
than are recorded in
heterosexual samples; these
adolescents generally
reported high levels of well-
being and life satisfaction.
Around two thirds of
expartners in the NLLFS
shared custody of their
children, although whether
or not mothers shared
custody was not associated
with adolescent
psychological adjustment.
Shared custody
arrangements were typically
negotiated between the
separating mothers
themselves, but were more
likely to be in place if a
comother had legally
adopted the child
previously.
The field now awaits the
results of further studies on
the impact of separation and
divorce on the well-being of
 903
LGBTQ parents and their Gartrell, N., Bos, H., Peyser,
children in light of the U.S. H., Deck, A., & Rodas, C.
(2011). Family
Supreme Court ruling in
characteristics, custody
June 2015 legalizing same- arrangements, and
sex marriage across state adolescent psychological
legislatures. well-being after lesbian
mothers break up. Family
Fiona Tasker Relations, 60, 572–585.
doi:10.1111/j.1741-
See also Child Support After 3729.2011.00667.x
LGBQ Divorce/Separation; Gates, G. (2008). Diversity
Custody and Litigation, among same-sex couples and
LGBQ Parents; Custody their children. In S. Coontz
Issues in Transgender (Ed.), American families: A
Parenting; Divorce, Legal multicultural reader (pp.
Issues in; Divorce and 394–399). New York, NY:
Relationship Dissolution, Routledge.
Psychological Experience of; Green, R. (1978). Sexual identity
Legal Rights of of 37 children raised by
Nonbiological Parents; homosexual or transsexual
Living Arrangements of parents. American Journal of
Children After LGBQ Psychiatry, 135, 692–697.
Divorce/Separation; Lau, C. Q. (2012). The stability
Relationships With Former of same-sex cohabitation,
Spouses different-sex cohabitation,
and marriage. Journal of
Marriage and Family, 74,
F 973–988.
u doi:10.1111/j.1741-
r 3737.2012.01000.x
t Logue, P. M. (2002). The rights
h of lesbian and gay parents
e and their children. Journal of
r the American Academy of
Matrimonial Lawyers, 18,
R 95–129.
e Morton, S. B. (1998). Lesbian
a divorce. American Journal of
d Orthopsychiatry, 68, 410–
i 419.
n Oswald, R. F., & Clausell, E.
g (2006). Same-sex
s relationships and their
dissolution. In M. A. Fine &
Bigner, J. J. (1996). Working J. H. Harvey (Eds.),
with gay fathers: Handbook of divorce and
Developmental, postdivorce relationship dissolution (pp.
parenting and therapeutic 499–514). Mahwah, NJ:
issues. In J. Laird & R.-J. Erlbaum.
Green (Eds.), Lesbians and Tasker, F. (2005). Lesbian
gays in couples and families mothers, gay fathers and their
(pp. 370–403). San
children: A review. Journal
Francisco, CA: Jossey-Bass.
 of Developmental &
Behavioral Pediatrics, 26,
224–240.
doi:10.1097/00004703-
200506000-00012
Tasker, F. (2013). Lesbian and
gay parenting
postheterosexual divorce and
separation. In A. E. Goldberg
& K. R. Allen (Eds.), LGBT-
parent families: Possibilities
for new research and
implications for practice (pp.
3–20). New York, NY:
Springer. doi:10.1007/978-1-
4614-4556-2
DOMA
See Defense of Marriage
Act
DOMESTIC
PARTNERSHIP
A domestic partnership is a
relationship between
individuals who share the
same household, may
combine tangible assets, and
are financially
interdependent. The criteria
for a legal or quasi-legal
recognition of a domestic
partnership vary widely.
Domestic partnership is a
concept advanced as an
alternative to marriage.
Beginning in the late 1970s,
LGBTQ activists sought
legal recognition for
individuals in same-sex
relationships because of
frustrations with restrictive
U.S. marriage laws. Other
activists sought and
continue to seek an
alternative to the institution
of marriage due to its
history of patriarchal power
relations and exclusion.
Some activists advocate for
recognition and openness to
relationships that include
opposite-sex couples who
rejected marriage, same-sex
couples, and those in
relationships that include
more than two individuals.
Others are simply not
interested in marriage due to
a history of divorce, fear of
divorce, or lack of interest in
marriage. The 2010 U.S.
Census recorded 7.5 million
opposite-sex couples
cohabiting, with 514,735
same-sex couples
cohabiting.
Domestic Partnership
Forms
Domestic partnership takes
several forms. The first
form is a legally binding
contract between two or
more individuals who
express a mutual
Do
me
stic
Pa
rtn
ers
hip
commitment, with
provisions for hospital
visitation rights and the
right to represent an
incapacitated partner. The
second form of partnership

is sanctioned through
municipal, county, or state
“registries,” in which two
partners proclaim to a
government agency that
they share a common
commitment. The third form
originated from employers
requiring demonstration of
domestic partnership to
establish a partner’s
entitlement to employment
benefits. Such
demonstration can take the
form of proclaiming
exclusive commitment to
each other, demonstrating
joint dependence, and/
or proving a shared
residence exists.
Emergence
of
Domesti
c other major companies
Partner
Benefits
In the early 1980s, LGBTQ
activists, frustrated by the
lack of equitable
employment benefits, began
working to attain spousal
benefits for their partners. In
many cases, health
insurance became the
rallying point for employees
due to the lucrative health
benefits offered by some
employers and the cost and
challenges of attaining
coverage on the private
market in the United States.
Prior to the implementation
of the Patient Protection and
Affordable Care Act in the
mid-2010s, individuals with
preexisting health
conditions had difficulty
905
attaining coverage.
Beginning in the late 1980s,
health care expenses in the
United States began
escalating rapidly, making
health care coverage a
valuable employee benefit.
These economic concerns
became a central argument
for securing domestic
partner benefits (DPBs).
Requests for DPBs began
with gay and lesbian
employees requesting that
their employers begin
extending spousal benefits
to same-sex partners. In
1982, the New York
newspaper The Village
Voice became the first
employer to offer DPBs, and
in 1991, Lotus Development
Corporation became the first
major company to offer
them. Following Lotus,
began offering DPBs.
Emergence of this
phenomenon is due to three
forces: competitive forces in
companies’ quest to attract
and retain employees,
pressure to be seen as
embracing diversity, and
formal and informal
employee groups lobbying
their
Domestic Partnership
employers. The offering of
DPBs has become widely
prominent among large
corporations but is less
common in the public
sector. In some
organizations, benefits have
been extended for both
opposite-sex and same-sex
partnerships. This broader
approach to DPBs was more Additional challenges
typical when trade unions or arose due to constitutional
women’s employee groups amendments enacted in
were also advocating for the some states to ban same-sex
offering of DPBs. marriage and any “marriage-
Government-sanctioned like benefits” offered by any
domestic partnerships rarely state institutions. This
require that employers resulted in some entities
provide DPBs. Historically, (e.g., state universities)
in states where marriage was revoking DPBs, while others
unavailable to same-sex attempted to work around
couples, employer-based the law by offering benefits
DPBs were typically the that were separate from state
primary means of attaining benefits plans or enacting
benefits for same-sex broader and more inclusive
partners. benefits policies. For
example, in some cases,
employers changed policies
Challenges to allow “qualifying adults”
With to be added to employee
Domestic benefits. Such individuals
Partner were not defined as having a
Benefits romantic relationship with
the employee, opening up
Employers and employees
the benefits to a larger
have faced various
population beyond those
challenges in offering
previously included.
DPBs. First, U.S. tax law
A third set of challenges
allows health insurance
has arisen due to employer
contributions by employers
policies. Some employers
and employees to not be
require periodic (e.g.,
subject to federal income
annual) updating that asks
taxes. However, this
employees to affirm that
exemption from taxes
their domestic partnership
applies only to benefits for
continues to exist. Such
the employee, the
periodic updating has been
employee’s spouse, and
controversial because
legal dependents. Most
legally married couples are
domestic partners do not
rarely required to regularly
meet this definition,
affirm continuation of a
typically resulting in
marriage. In addition, some
hundreds of dollars in
organizations do not allow
additional taxes incurred by
an employee’s stepchildren
employees with DPBs each
to be covered under DPBs,
year. Both the employee
while allowing such
contribution and the
coverage for legally married
employer subsidy of
couples.
benefits are included in
calculating an employee’s
income taxes.
 907
Evolution of Domestic F
Partnership u
r
In the face of rapid social t
transformation in the h
acceptance and availability e
of same-sex marriage, some r
have questioned the
continuing need for the R
concept of domestic e
partnership. Some a
employers are eliminating d
or phasing out domestic i
partner benefits, and some n
state and local governments g
are phasing out domestic s
partner registries. Other Badgett, M. V. L. (2001).
individuals and activists Money, myths, and change:
have responded negatively The economic lives of
to such changes, noting that lesbians and gay men.
some individuals have no
Chicago, IL:
desire to pursue marriage,
University of Chicago Press.
including some opposite-sex
Badgett, M. V. L. (2007).
couples who have utilized
Unequal taxes on equal benefits:
domestic partnership.
The taxation of domestic
Rod Patrick Githens and partner benefits. Washington,
Tonette S. Rocco DC: Center for American
Progress and Williams
See also Long-Term Same-Sex Institute.
Couples; Work Githens, R. P. (2009).
Environments; Workplace Capitalism, identity politics,
Policies and queerness converge:
LGBT employee resource
groups. New Horizons in
Adult Education and
Human Resource
Development, 23(3), 18–31.
Githens, R. P. (2012).
Organization change and
social organizing strategies:
Employee-initiated
organization development.
Human Resource
Development Quarterly,
23(4), 487–518.
Hornsby, E. E. (2006). Using
policy to drive
organizational change. New
Directions for Adult and
Continuing Education, 112,
73–83.
Raeburn, N. C. (2004).
Changing corporate
America from inside out:
Lesbian and gay
workplace rights.
Minneapolis: University
of Minnesota Press.
DOMESTIC VIOLENCE,
FEMALE
See Intimate Partner
Violence, Female
DOMESTIC VIOLENCE,
MALE
See Intimate Partner
Violence, Male
DON’T ASK, DON’T
TELL
AND PUBLIC OPINION
The policy of Don’t Ask,
Don’t Tell (DADT) was
instituted by the U.S.
military in 1993 and
removed in 2011. To
understand the policy, it is
necessary to understand the
history of bans on
homosexuality in the
military and the specific
policy known as DADT.
Further, an examination of
DADT must also address
the impact of public opinion
as it shifted over the years,
what affected this public
opinion, and how public
opinion affected public
policies.
History
Homosexuals
implicitly banned from
were
serving in the U.S. military
since its inception during
the Revolutionary War
(1775–1783). However, not
until a policy went into
effect in 1921 was sodomy
explicitly added as a crime
in the Articles of War.
Twenty years later,
homosexuality itself was
added as a disqualifying
characteristic to joining the
Don’t Ask, Don’t Tell and
Public Opinion
military. Before 1950, “blue
discharges,” which were
neither honorable nor
dishonorable, were given to
homosexual personnel. It
was President Harry S.
Truman who signed the
Uniform Code of Military
Justice into law in 1950,
formalizing the procedures
for discharging homosexual
servicemen and
servicewomen and making
homosexuality a crime
resulting in dishonorable
discharge and loss of
benefits. In 1982, President
Ronald Reagan signed
Defense Directive 1332.14,
which specifi-
cally stated that
homosexuals were not
 909
allowed to serve in the serve in the military would
military and were to be affect recruitment and
discharged. However, retention of military
enforcement of these rules personnel. In addition, based
varied depending on on public opinion, the
whether there was a military feared that allowing
shortage of soldiers, homosexuals to serve
whether it was wartime, or openly would damage the
whether individuals could military’s reputation. Some
be identified as homosexual. military leaders went on
Although the military record suggesting that
publicly claimed that having homosexuals in the
policies banning and military would result in
discharging homosexuals physical risk to other
from serving in the military soldiers due to AIDS and
were in the interest of psychological damage to
national security or unit heterosexual soldiers’ well-
cohesion, there was being from having to be in
evidence to the contrary. close quarters with
The Crittenden Report homosexuals. Thus, the
(1957) found no evidence homophobic
that homosexuals posed a Don’t Ask, Don’t Tell and
security risk but still Public Opinion
supported a ban on
homosexuality based on
perceived public norms of fears of the general public
morality. Various studies and morality norms of the
conducted by the military 1950s through the 1980s
continued to indicate that were reflected and
homosexuals did not influenced the views and
perform any differently policies of the military
from nonhomosexuals, did regarding homosexuality.
not have different
personalities than DADT and Changing Public
nonhomosexuals, did not
Opinion
constitute a security risk,
and did not negatively affect William Jefferson Clinton
missions. However, many of campaigned for president in
these studies were not 1992 on a platform that
released to the public until included a promise to
many years after they had eradicate the ban on
been completed. homosexuality in the
Instead of being based on military. However, after his
security concerns, the election, lingering
military’s ban on disapproval from the general
homosexuals was mostly public resulted in a
based on public opinion. It compromise on policy.
was founded on fear of how Clinton issued Defense
allowing homosexuals to Directive 1304.26 in 1993,
which stated that the
military could not ask its
personnel about their sexual
orientation, but if they were
found to be homosexual,
they could still be
discharged. This policy was
informally referred to as
“Don’t Ask, Don’t Tell”
(DADT), but the full name
was “Don’t Ask, Don’t Tell,
Don’t Pursue,” and later,
“Don’t Harass” was added.
DADT was a compromise
between divided public
opinions of acceptance and
rejection of homosexuality
in the military. The stance
of the military was that
DADT, by allowing
homosexuals to serve,
would result in lower unit
cohesion, lost productivity,
lower morale, and poorer
order and discipline.
In 1993, when this policy
was instituted, the majority
of U.S. citizens did not fully
support equal rights for
homosexuals, but
subsequently negative
attitudes have decreased,
and acceptance of equal
rights for sexual minorities
has become the majority
opinion in the United States.
Part of this is due to
campaigning by gay
activists who encouraged
gays and lesbians to come
out of the closet. Coming
out helped make the
discrimination that was
occurring toward gays and
lesbians more visible and
concrete in the eyes of
Americans, since they now
knew exactly whom these
policies were affecting. An
indication of the success of
such campaigns was
increases in acceptance for
homosexual civil rights.
Today, a majority of people
support public policies that
protect sexual minorities
against hate crimes and
discrimination in
employment, and guarantee
health benefits for same-sex
partners. However, not as
many people support public
policies that allow sexual
minorities to get married or
adopt children, although
these policies are also
rapidly gaining support.
Demogr
aph
ic
Diff
ere
nce
s in
Pub
lic
Opi
nio
n
Members of different
demographic groups support
policies favoring sexual
minorities in varying
numbers. For example,
heterosexual men and
people who consistently
attend church are more
likely to have negative
attitudes toward LGBTQ
people than heterosexual
women and nonreligious
individuals, respectively. In
addition, people who are
older, and people who are
less educated, are more
likely to have negative
attitudes than younger and
 911
more highly educated The Repeal of DADT
individuals, respectively.
Because the policies in the
One of the reasons for the
U.S. military are set by an
trend toward increasing
elected government, as the
support is generational
views of the public changed
differences. Millennials
regarding homosexuality,
(people born after 1980)
military policies also
support equal rights for
changed. Like Clinton
sexual minorities more than
before him, Barack Obama
any other generation, and
campaigned for president in
Gen X (people born
2008 on a platform that
between 1965 and 1980)
included a promise to end
support sexual minorities’
the ban on homosexuality
rights more than the baby
and DADT in the military.
boomer generation (people
Once elected, President
born between 1946 and
Obama chose not to use an
1964). So, as the number of
executive order to
millennials increases and
unilaterally repeal DADT
the number of baby boomers
but charged Congress to
decreases, public support of
repeal it. After many
homosexuality has also
obstacles, such as court
increased.
injunctions and
Public support for sexual
filibustering, Congress
minorities can also vary
finally passed the Military
depending on how the
Readiness Enhancement Act
question is asked (wording
(MREA) in 2010, which
effects), such as using the
went into effect in 2011,
term homosexuals versus
thus effectively repealing
gays and lesbians. When
DADT and the ban on
surveying the public, using
homosexuality, and allowed
the terms gays and lesbians
gays and lesbians to serve
may elicit more
openly in the military.
support/positive attitudes
than the term homosexuals. Joel T. Nadler and Tiffany
Order and format effects, G. Maglasang
social desirability, title of
the survey, the researchers’ See also Antigay Ballot
affiliation, and answer Initiatives (and LGBTQ
Activism);
choices (yes/no vs. a
Freedom to Marry (and Other
continuous “disagree” to
Marriage Equality
“agree” scale) can also Organizations); Gay
affect survey results, so it is Exclusion in the U.S.
important to keep these in Military:
mind when examining Evolution and Demise of
public opinion polls. Don’t Ask, Don’t Tell;
Homophobia
F describes things in the Black
u community that were “kept
r very quiet
t Down
h Low
e
r
and secretive; also
R something done on the sly”
e (p. 109). These acts of
a discretion took place on
d several fronts: political,
i social, criminal, sexual, and
n so on.
g In 1995, rhythm and
s blues artist R. Kelly took the
term into the public with his
Belkin, A., & Bateman, G.
hit song titled “Down Low
(Eds.). (2003). Don’t Ask,
(Nobody Has to Know).”
Don’t Tell: Debating the gay
This song was all about
ban in the military.
secrecy, but Kelly
Boulder, CO: Lynne Rienner.
specifically linked the DL to
Frank, N. (2009). Unfriendly
discreet heterosexual acts of
fire: How the gay ban
infidelity. The term shifted
undermines the military and
from its social and often
weakens America. New York,
nonsexual usage to having a
NY: Macmillan.
meaning within the social
Nadler, J. T., Will, K., Lowery, and sexual realm. This was
M. R., & Smith, K. (2012).
the first incarnation of the
Don’t Ask, Don’t Tell and
other LGB civil rights issues: DL as a term exclusively for
Effects of terminology on sexual stigma. Following
public opinion. Journal of Kelly’s musical moves,
Gay & Lesbian Social artists such as TLC and
Services, 24, 331–345. Brian McKnight also
incorporated the DL into
their lyrics.
Until 2001, men who had
DOWN LOW sex with men who
considered themselves “on
the down low” went
unrecognized by media and
Down low, or DL, is a term largely Black heterosexual
originally used within communities. The term kept
African American its conventional uses for
vernacular tradition to socially discreet doings and
connote actions performed was sparingly used to
with discretion, or outside discuss those acts of male–
the realm of surveillance. female sex outside of
The DL, according to committed relationships.
Geneva Smitherman (2000), After the first article on the

DL as a “bisexual
phenomenon” in the Los
Angeles Times (February
2001), several other articles
followed. In the course of
just 2 years, the DL moved
from being the common,
colloquial phrase to
signifying an ironic,
contradictory, and
paradoxical hip-hop “homo-
thug” (who was presumably
responsible for the fact that,
as of 2001, Black women
were identified as
comprising 64% of all new
HIV/AIDS cases among
U.S. women). As the media
spun one story after the
other, and Black magazines
and newspapers
disseminated information,
the idea that individuals who
engaged in DL behaviors
were “dangerous bisexuals”
gained traction within the
Black community between
2001 and 2003. Yet the U.S.
Centers for Disease Control
and Prevention—the major
distributor of information on
disease and its impact—had
made no statement affirming
such assertions about these
sexual connections.
In 2003, when French
journalist Benoit Denizet-
Lewis published his New
York Times article, “Double
Lives on the Down Low,”
the term gained greater
currency among the larger
American
Drag
public. This article took an
ethnographic approach to
“understanding” DL men
and their lives within and
913
outside traditionally gay
communities. This
perceived threat to Black
women—and particularly
the Black heterosexual,
often middle-class family—
issued an alarm that would
spark articles in major news
sources throughout the
United States (including
USA Today, The
Washington Post, the St.
Louis Post-Dispatch), and
Black magazines (Essence,
Ebony, Jet), as well as
mainstream television (ER,
Law and Order,
Girlfriends), and The Oprah
Winfrey Show (2004).
Indeed, these stories were
reproduced in more local
newspapers and received
attention within local and
national news stories for
television. As discursive
interests spread throughout
the country, so did the
amount of investment in the
DL as the blame for the
increase in HIV/AIDS in
America.
The term has evolved
into a global descriptor of
Black men who have sex
with other men, while
having wives/girlfriends.
Yet the DL still operates
within Black communities
as social/political/sexual
acts done secretly, with
some trepidation. The DL is
often used by men of color
who only have sex with
men, as an alternative to
such terms as gay, same-
gender loving, queer, and so
on. The DL, as a term, has
provided men of color a way
to describe their experiences
of sexuality, as well as a to as the specter behind the
desired gender performance. high rates of Black HIV/
Most recently, AIDS infection in the
scholarship has offered new United States. At the same
ways of interpreting its time, it continues to be
manifestation in discourse deployed as a label for
and everyday life. C. Riley anything done outside the
Snorton reach of surveillance.
(2004) offers the “glass
Jeffrey Q. McCune, Jr.
closet” as “an analytic to
work through multiple axes See also Bisexuality, Female;
of oppression . . . [which] Bisexuality, Male;
demonstrate(s) how HIV/AIDS and Gay
blackness transforms the Masculinity; HIV/AIDS and
closet from a space of Racial/Ethnic Disparities;
concealment— however Men Who Have Sex With
partial or contingent—to a Men (MSM);
site of Racialized Masculinity;
confinement and display” Sexual Risk-Taking
(p. 23). In contrast, Jeffrey
McCune, Jr. (2014)
disavows the closet as a F
space of Black containment, u
arguing that it reproduces r
“carceral logic” in Black t
life, in a time when society h
is stricken with the material e
and social realities of Black r
men’s actual incarceration.
Instead, he offers “sexual R
e
discretion” as a way to
a
better characterize how the
d
DL acts as a “complex
i
presence that has historical
n
and cultural significance in
g
the survival of people of
s
color, in the face of
surveillance” (p. 173). Boykin, K. (2005). Beyond
Today, the term serves the down low: Sex, lies,
both commercial and and denial in Black
colloquial usages. On one America. New York, NY:
hand, it has marketability in Caroll & Graf.
commercial advertisements McCune, J. Q., Jr. (2014).
such as for the clothing store Sexual discretion: Black
Old Navy, where their masculinity and the
politics of passing.
“sales are on the down low.”
Chicago, IL: University of
On the other hand, its use as Chicago Press.
sexual nomenclature still Smitherman, G. (2000). Black
remains and is often referred talk: Words and phrases from

the hood to the Amen Corner.
New York, NY:
Houghton Mifflin.
Snorton, C. R. (2014). Nobody is
supposed to know:
Black sexuality on the down
low. Minneapolis: University
of Minnesota Press.
DRAG
Drag, most simply defined,
is the act of performing a
gender identity other than
one’s own. At its core,
doing drag involves the
manipulation of bodies and
identities through
performance. Drag has been
a fixture in gay and lesbian
subcultures since the
mid20th century. Drag has
provided a safe space for
gender creativity; has
offered an outlet for protest
against homophobia and
heteronormativity; and has
been used to raise money
and attention for LGBTQ
causes and communities,
specifically during the
AIDS pandemic. This entry
discusses the existing
research on drag
performance, details the
major theoretical debates
about drag, considers how
drag is racialized, and
concludes with a description
of drag in a global world.
Historically, although as
recently as World War II
drag was performed by
presumably straight men as
substitutes for female actors,
by the mid-20th century,
915
lesbians and gay men began
to adopt drag performance
as a method to safely enter
public homophobic spaces.
Historians have records of
effeminate gay men and
butch lesbians crossdressing
in public as an attempt to
avoid violence when with
their partners.
Whereas in the 1960s
drag provided a safe public
space for sexual minorities,
today many drag performers
are queer public figures. The
two most common types of
drag are drag queens and
drag kings. Drag queens are
gay men who dress and
perform as women but do
not want to become women
or have a woman’s body.
Drag queens publicly
perform femininity for an
audience that knows they
are male bodied, regardless
of how convincingly female
they might otherwise
appear. Drag kings,
somewhat newer in terms of
popularity than queens, are
women or sometimes trans
men who perform
masculinities. Drag kings
are often more focused on
the deconstruction of gender
and sexuality than on the
impersonation or illusion of
presenting as a man. There
are some critical gender
distinctions in drag
performance. Drag queens
typically rely on camp,
vulgarity, and shock value,
while drag kings tend to
keep a strong focus on artful
protest. Although drag kings
and queens are the most
popular, drag is exceedingly
diverse in that multiple
genres of drag have recently
gained popularity, such as
women performing
hyperfemininity,
transwoman queens, or
bearded drag queens.
Some scholars of gender
and sexuality argue that
contemporary drag can be
seen as a political and social
protest that coincides with
many of the other goals of
gay and lesbian social
movements. Drag can
potentially disrupt gender
and sexual
Drag
dichotomies because drag
performances illuminate the
fluidity of gender and
sexuality. Femininity,
masculinity, and queerness
often circulate freely in drag
performance settings, and
through a parody of gender,
drag performance can
expose the artificiality of
both femininity and
masculinity. Thus, when
viewed through this lens,
drag can be both
transgressive and
subversive.
Others, however, assert
that drag reproduces gender
norms by reinscribing
traditional hierarchies of
gender and sexuality and
reifying the dichotomous
gender system rather than
dismantling or critiquing it.
Much of this criticism has
been directed at drag queens
more than drag kings. As
drag queens embody
femininity, they further
encourage the pursuit of a
hyperfemininity rather than
multiple femininities. Others
critique drag queens for
their ability to rely on their
male privilege. Drag queens
are in a unique position in
that, even as they perform as
women, they can still claim
a male body and identity,
and use their male and
cisgender privilege to
disassociate from
transwomen.
Some argue that drag
kinging, more so than
queening, contests the idea
of a heteronormative gender
system through subversive
protest. Whereas drag
queens are almost always
gay men (with the exception
of a small, emerging
transwomen queen circuit),
drag kings are straight
women, queer women, cis
women, trans men, and
masculinegendered women.
Some argue that because of
the wider range of gender
diversity, drag kings utilize
drag performance as a way
to critique gender more than
drag queens do. In addition,
drag kings lack the male
privilege of the queens,
creating a power dynamic of
female bodies disrupting
gender rather than male
bodies appropriating
femininity.
Some scholars have
identified patterns within
drag and race, suggesting
that White drag focuses on
camp, Latina drag focuses
on the impersonation of
artists, and Black drag
focuses on dance. Drag
performances are also
 917
racialized to the extent that
White performers frequently
adopt and perform
Blackness. Some scholars
suggest this desire to
identify with and rely upon
the imagery of blackness is
to position oneself as defiant
to
918 Dying, Death, and Bereavement
mainstream culture. However, the practices of racial
drag are far less disruptive than the performances of
gender and sexuality because White performers most
often do these performances. It is far less common
for performers of color to be rewarded for pursuing
Whiteness. White drag performers may embody
Blackness for a desired number, but they can always
reclaim their White privilege once off the stage.
Local queer communities across the globe use
drag performance for protest and entertainment.
Western-style drag has a complex relationship with
types of local and traditional drag in that it enforces
Western queer identities, fashion, and dance styles
while also allowing the local queer communities to
affirm their identities within the larger, international
gay rights movement. Although Western-influenced
drag enables communities to disrupt gender, it has
been criticized for identifying
with colonial ideas of racial and ethnic oppression.
Dana Berkowitz and Ray Siebenkittel
See also Gender Spectrum; Genderqueer; Transgender
Identities
Further Readings
Moreman, S., & McIntosh, D. (2010). Brown scriptings
and rescriptings: A critical performance ethnography of
Latina drag queens. Communication and Critical/
Cultural Studies, 7(2), 115–135.
Rupp, L. J., & Taylor, V. (2003). Drag queens at the 801
Cabaret. Chicago, IL: University of Chicago Press.
Shapiro, E. (2007). Drag kinging and the transformation of
gender identities. Gender and Society, 21(2), 250–271.
DYING, DEATH, AND BEREAVEMENT
Dying, death, and bereavement are experiences that
will touch everyone’s lives. Comprehensive care that
addresses the social, psychological, emotional,
physical, and spiritual needs of the individual, often
referred to as “holistic care,” is a central tenet of care
for the dying, and in particular, palliative care.
Current thinking about bereavement is also shaped
by acknowledging individual difference and variety
in ways of grieving, characterized by fluidity rather
than stages people move through. Available evidence
shows that socially excluded groups have poorer
access to end-of-life care, and it is increasingly
acknowledged that more attention is required to
address issues of cultural sensitivity. However, with
some exceptions, acknowledging and researching
diversity among dying and bereaved people is a
neglected area in the literature. This diversity of
experience should include the differing aspects of
people’s identities based on sexual orientation and
gender identity as well as variations within and
between LGBTQ populations and the ways in which
sexual orientation and gender identity may intersect
with ability, age, class, gender, and so on.
While there will be commonalities between
LGBTQ individuals’ experiences of dying, death,
and bereavement and those of their heterosexual
counterparts, there are also a range of significant
factors that are different. This entry considers these
distinctions in more detail, including influences that
can affect life expectancy for LGBTQ people as well
as issues that affect LGBTQ experiences of dying,
death, and bereavement. There is an increasing body
of research addressing broader health and social care
needs and concerns for LGBTQ individuals, but, to
date, less research has been undertaken with a
specific focus on dying, death, and bereavement.
Influences That Can Affect Life
Expectancy for LGBTQ People
The prevalence of ongoing discrimination and
marginalization on the basis of sexual orientation and
gender identity directly affects the health and well-
being of many LGBTQ people. Evidence suggests
that the mental and physical health of LGBTQ
people is poorer than that of their heterosexual
counterparts with associated consequences for the
lifespan. LGBTQ individuals are likely to have a
higher incidence of life-limiting and lifethreatening
disease, attributed to risk behaviors such as smoking
or alcohol abuse, which in turn are linked to minority
stress. Minority stress is a term used to define
chronically high levels of stress faced by members of
stigmatized minority groups. This stress may include

experiences of stigma, marginalization, or
discrimination, acknowledged as social determinants
of health, which may have a significant impact on the
health and well-being of LGBTQ people. Chronic
levels of stress can contribute to higher rates of risk
behaviors and poorer health outcomes, including
increased risks for some cancers, high blood
pressure, stroke, heart attack, and depression.
Minority stress may also contribute to reduced social
participation and engagement within society, and
delaying or not seeking care because of past
experiences of or anticipation of discrimination.
As LGBTQ people grow older, there is evidence
that they are more at risk of life-threatening
conditions for which incidence increases with age.
Over their lifetime, LGBTQ people might avoid
preventive health care because of concerns related to
both discrimination and insensitivity by health care
providers. Lesbian and bisexual women have a
higher lifetime risk than heterosexual women of
breast and endometrial cancer. In addition to being
linked to the increased prevalence of risk behaviors
as outlined, these cancers can be associated with
nulliparity (i.e., not having been pregnant and given
birth). Gay and bisexual men have a greater risk than
heterosexual men of anal cancer, especially those
who are HIV-positive. Little is known about the
long-term impact on transgender men and women of
using hormone therapies, but it is known that there
are risks of congestive heart failure linked to
testosterone use (used by female-tomale trans
individuals) and that estrogen therapy (used by male-
to-female trans individuals) increases the risk of deep
vein thrombosis (DVT) and other thrombosis. Given
evidence of an increased prevalence of risk behaviors
(such as smoking) in LGBTQ populations, it should
also be noted that there are higher health risks
associated with a combination of hormone
replacement therapies and smoking. Transgender
people have complex bodies, depending on the extent
of gender reassignment surgery they may have
undergone and when (reassignment surgeries have
progressed over time). More research is needed into
the specific health risks facing transgender men and
women.
There is a legacy of AIDS-related deaths that had
a particularly heavy impact on gay communities.
Dying, Death, and Bereavement 919
While HIV/AIDS is now acknowledged to date
further back, the outbreak in the 1980s was strongly
associated with gay men (starting in America), such
that it was initially termed GRID (gay-related
immune deficiency). For many years, HIV and AIDS
provided a dominant focus of research relating to
LGBTQ communities; this research addressed the
subject of dying, death, and bereavement, although
with primary attention being on younger gay men’s
experiences. HIV and AIDS carried a particular
social stigma (which still exists to some extent) and
involved experiences for the bereaved of multiple
losses and survivor guilt. Survivor guilt is a term
often used to include feelings of survivors about not
doing enough to try to help others who died or
feelings of being unworthy compared with those who
died. In relation to HIV and AIDS, survivors may
feel guilty about being HIV-negative in light of the
suffering of their peers, or if HIV-positive, they may
worry about their own health status factors, which
may confound bereavement. Much of this literature
originates from a period when an HIV/AIDS
diagnosis was accompanied by a short prognosis.
More recently, as a result of improvements in life-
extending treatments, HIV has come to be considered
a long-term condition, albeit potentially life-limiting
and not without complications. Further, HIV-positive
gay men may suffer from disrupted careers, with
associated impacts on income, reliance on benefits,
and possibly reduced support networks.
Issues That Affect LGBTQ Experiences of
Dying, Death, and Bereavement
There is a small but growing corpus of research
identifying the issues that may affect LGBTQ
experiences of dying, death, and bereavement.
As noted, while some of the issues facing LGBTQ
individuals are similar to those facing the wider
population, there are also a number of separate issues
that need to be addressed related to the wider social
influences that shape LGBTQ experience. These
include experiences of stigma, discrimination, and
legal inequality, which are discussed in more detail
in the following sections.
920 Dying, Death, and Bereavement

End-of-Life Care Needs and Concerns impact on the present lives and future plans of older
LGBTQ people. Even in parts of the world where
Consultation undertaken for the UK End of Life
social attitudes and acceptance of LGBTQ people
Care Strategy Equality Impact Assessment, published
have improved significantly, and laws have been
in 2008, suggests that there is a scarcity of available
implemented that secure more legal rights and
evidence addressing LGBTQ individuals’ concerns
recognition for LGBTQ people, these changes do not
and needs at end of life. The report also concluded
eradicate experiences of the past.
that in relation to quality of end-oflife care provision,
The sociolegal position for LGBTQ people varies
LGBTQ people were most likely to be at risk of
internationally. Many LGBTQ people in different
discrimination. A systematic review of peer-
parts of the world are still criminalized rather than
reviewed research published between 1990 and 2010
protected by laws such as those that now exist in the
regarding palliative and end-of-life care in LGBTQ
United States, Canada, Australia, the United
populations seems to confirm the scant evidence
Kingdom, and other parts of Europe. In such
base. This review identified only 12 relevant papers
contexts, LGBTQ individuals facing lifelimiting or
(the criteria excluded papers not published in
life-threatening disease may need to hide their sexual
English). The majority of papers resulted from
orientation, same-sex relationships, and other aspects
studies in the United States, and the primary focus of
of their lifestyle and culture. Where same-sex
the research was identified to be end-of-life care
relationships are not legally recognized, this may
relating to cancer in populations of lesbians and gay
mean that one’s partner is not involved in one’s care
men. Very little evidence alluded to bisexual
or that dying wishes may not be recognized by
experience. No papers were found that reported on
families of origin, who may override decisions.
transgender people’s experiences. However, this is a
To be living with a life-limiting condition, dying,
burgeoning field of research, and since this
or bereaved can be a socially excluding experience.
systematic review of papers published up to 2010,
Further, there are additional layers of exclusion that
there have been a number of other papers published,
LGBTQ people may face at these times. This may
primarily from the United States, the United
include feeling unable to disclose their sexual
Kingdom, and Australia, specifically addressing
orientation, gender identity, or other aspects of their
LGBTQ experiences and concerns relating to dying,
lifestyle and culture because of previous experiences
death, and bereavement.
or concerns about discrimination from the wider
While there are commonalities between LGBTQ
society; bisexual and transgender people may also
and heterosexual individuals in relation to
face discrimination from within lesbian and gay
experiences of dying, death, and bereavement, there
communities. Other issues include a potential lack of
are additional issues that need to be addressed for
support networks, and one’s loss and grief not being
LGBTQ people. Research that addresses broader
fully acknowledged.
health and social care issues suggests that older
It is often assumed that many existing concerns
LGBTQ people may receive care that is not of the
about access and provision of care when dying as
highest standard or quality, due to assumed
well as support for the bereaved shared by the oldest
heterosexuality and negative attitudes and behavior
generations of LGBTQ people would not apply to
toward people who are identified or perceived as
younger LGBTQ generations. It is argued that
being lesbian, gay, bisexual, or transgender. Because
because in many parts of the world there have been
of a general lack of awareness and gaps in
improvements in social attitudes and tolerance
knowledge, the experience of end-of-life care may be
toward LGBTQ people, and there is an increasing
similarly inadequate.
range of protective legislative rights, younger
Older LGBTQ individuals may be particularly
LGBTQ generations will feel more confident in
reluctant to challenge poor service provision or
requesting needed services. However, little is known
hesitant to approach services. There is growing
about points of transition in older age or ill health
evidence that a legacy of past stigma, hostility,
and the consequences of these. For example, levels
discrimination, and marginalization has an ongoing
 Dying, Death, and Bereavement 921

of confidence and assertiveness may be affected in Advance Care Planning

transitions from active and independent lives through
It can be particularly important for LGBTQ
to frailty or conditions that require care and support.
people to consider advance care planning for a
Evidence from the United States and the United
number of reasons including the need to counter
Kingdom suggests that older LGBTQ people are
discrimination and die with dignity. Advance care
more likely to live alone and to age without partners
planning may include identifying who they wish to
and children; they are more likely to rely on friends
nominate to be involved in their care and in decisions
for support of all forms. Given the issues outlined
about their care. This may require same-sex
above, they may be in more need of support but feel
relationships and other important relationships to be
less able to access it. Often service providers do not
communicated to and validated by families of origin
consider that some service recipients may be
and health care professionals. LGBTQ people have
LGBTQ. Further issues for transgender people
concerns that if they become ill, or if it becomes
include concerns about being placed in inappropriate
necessary for others to make decisions about their
hospital wards or having inadequate access to
care in the event that they lose capacity, the most
services. Feelings of exclusion may be exacerbated
important people in their lives might be excluded
for LGBTQ people in a range of settings such as
from being informed or from making decisions about
nursing homes or communal areas of supported
their care. A number of barriers to advance care
living. This may be due to negative attitudes
planning have been identified within existing
expressed by other residents who grew up in times
research. Some of these issues in common with the
when there were significant prejudicial attitudes
general population are not wanting to think about the
toward LGBTQ people. There may be more subtle
end of life, giving the issue low priority, or lack of
forms of exclusion such as feeling they do not have
knowledge about options. However, there are also
common experiences to talk about with their peer
some specific issues relating to LGBTQ people about
group. Together, these factors complicate
not knowing whom to appoint to significant decision-
preparations for and discussions about the end of life.
making roles, as in the case of those whose networks
Many LGBTQ people do, however, have strong
tend to consist of people within the same generation
supportive networks—although these may appear
or who are estranged from families of origin. It has
different from those of heterosexual individuals.
also been noted that ageism within gay communities
Some who have lost touch with families of origin
in particular means for some that there is a denial of
may build and rely on alternative networks of
the realities of aging and death.
support and people who are important to them—
Many people express a preference to die at home,
often termed “chosen families” in the literature.
which can necessitate the need to have a range of
However, these networks may lack full recognition
health and social care professionals coming into
and legal protection. For example, the term “next of
one’s home. This can be daunting for LGBTQ people
kin” is used widely in health and social care, but
who have spent a lifetime carefully managing their
there is a misunderstanding that it refers to and needs
social networks in order to minimize any exposure to
to be a person related by blood or marriage. LGBTQ
discriminatory behavior or attitudes. Having care
people may be concerned that someone close to them
workers coming into their homes may lead LGBTQ
will be denied visiting rights and information
people to alter their home, for example by putting
because he or she is not seen as the next of kin.
away items or photographs that might be associated
Members of a chosen family are often of the same
with their sexual orientation or gender identity. Some
generation, aging and dying through the same period
may live in households with more than one partner or
of years without an intergenerational support system.
have a number of people close to them with whom
This experience could lead to further social isolation
health and care professionals will need to interact.
for older LGBTQ people.
LGBTQ people may feel too vulnerable or dependent
on care services to be able to challenge any
discrimination encountered. Transgender people can
922 Dying, Death, and Bereavement
face further dilemmas. Service providers often have
even less knowledge about the issues relating to
transgender people than those that affect lesbian, gay,
bisexual, and queer (LGBQ) individuals.
Transgender people can face particular challenges if
they have to negotiate intimate care with care
workers who may not be aware of their particular
needs. It is important to be aware of the diversity
among transgender people; some will have spent
most of their lives with a gender identity and body
other than the one assigned at birth, while for others
this may be a relatively recent transition. Others
might not have undergone any form of gender
reassignment surgery. Some who fall under the
definition of transgender may not necessarily see
themselves as transgender. They may instead refer to
“transgender” as an aspect of their status or history,
but not their current identity.
Bereavement and Loss
The experience of bereavement may be different in
some ways for LGBTQ people, compared with the
heterosexual population. Surviving LGBTQ people
may have particular support needs following loss of a
partner. They may experience “disenfranchised
grief,” a phrase used to describe a situation where the
full extent of a person’s grief and loss may not be
acknowledged by those around them. When a
heterosexual spouse dies, the surviving partner has a
recognized social role of widow/widower that carries
a certain social status and a permissible range of
emotional expression. These kinds of privileges may
be denied a same-sex partner. Transgender people
may have particular concerns that the gender they
have lived in be respected after death.
Conclusion
In the last years of life, individuals and those
important to them may need access to a number of
services across different settings. It is important that
LGBTQ people and those close to them feel safe in
approaching services for assistance; if they are not
confident about services or staff, they may not seek
support. The care of the dying is said to be a good
indicator of the care for all sick and vulnerable
people. It is a crucial time to deliver good-quality
care to enable individuals to die in comfort and with
dignity because, to paraphrase Dame Cicely
Saunders (recognized as the founder of the modern
hospice movement), how someone dies remains a
lasting memory for the individual’s friends, family,
and staff involved. All individuals should be afforded
the same care, compassion, and dignity through life
and at the end of life, but inequalities in terms of
access to services, lack of confidence to access
services, and discriminatory attitudes still exist.
Addressing the distinctly complex and multiple
needs of LGBTQ people holds the potential to
develop nondiscriminatory services that will benefit
all.
Kathryn Almack
See also Caregiving; Chronic Illness; Health Care Plans;
Health Care System; Health Disparities; Health
Disparities, Transgender People
Further Readings
Almack, K., Moss, B., & Smith, T. (2014). Research and
policy about end of life care for LGBT people:
Identifying implications for social work services.
In J. Fish & K. Karban (Eds.), Social work and lesbian,
gay, bisexual and trans health inequalities: International
perspectives (pp. 173–186). Bristol, England: Policy
Press.
Almack, K., Seymour, J., & Bellamy, G. (2010). Exploring
the impact of sexual orientation on experiences and
concerns about end of life care and on bereavement for
lesbian, gay and bisexual elders. Sociology, 44, 908–
924. doi:10.1177/
0038038510375739
Cartwright, C., Hughes, M., & Lienert T. (2012). End-of-
life care for gay, lesbian, bisexual and transgender
people. Culture, Health and Sexuality,
14, 537–548. doi:10.1080/13691058.2012
.673639
Cox, K. (2011). Sexual orientation. In D. Oliviere, B.
Monroe, & S. Payne (Eds.), Death, dying and social
difference (2nd ed., pp. 191–199). Oxford, England:
Oxford University Press.
Fenge, L. A., & Fannin, A. (2009). Sexuality and
bereavement: Implications for practice with older
lesbians and gay men. Practice: Social
 Dying, Death, and Bereavement 923

Work in Action, 21, 35–46. doi:10.1080/

09503150902745997
Harding, R., Epiphaniou, E., & Chidgey-Clark, J. (2012).
Needs, experiences, and preferences of sexual minorities
for end-of-life care and palliative care: A systematic
review. Journal of Palliative
Medicine, 15, 602–611. doi:10.1089/jpm.2011.0279
Higgins, A., & Glacken, M. (2009). Sculpting the distress:
Easing or exacerbating the grief experience of same-sex
couples. International Journal of Palliative Nursing, 15,
170–176. doi:http://dx.doi.org/10.12968/
ijpn.2009.15.4.41963
National Council of Palliative Care. (2011). Open to all?
Meeting the needs of lesbian, gay, bisexual and trans
people nearing the end of life. London, England:
National Council for Palliative Care.
National End of Life Care Programme. (2012). The route to
success in end of life care: Achieving quality for lesbian,
gay, bisexual and transgender people. London, England:
Author.
Stein, G., & Almack, K. (2012). Care near the end of life:
The concerns, needs and experiences of LGBT elders. In
R. Ward, I. Rivers, & M. Sutherland (Eds.), Lesbian, gay,
bisexual and transgender ageing: Biographical
approaches for inclusive care and support (pp. 114–134).
London, England: Jessica Kingsley.
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comp ring
ariso back
n to
withi Euro
n an -
East– Ame
West rican
binar expe
y rienc
oppo es
sition and
, has ideas
left as
theor the
etical nor
Euro m or
centri stan
sm dard
largel of
y meas
intact urem
. ent
(Here for a
, field
Euro of
centr stud
ism y;
refers and
to the desc
 927

ribin empi
g ricall
Euro- y
Amer rich
ican field
sexua —
lity contr
studi ibuti
es as, ng
simpl new
y, kno
“sexu wled
ality ge
studi abou
es” t
witho non-
ut nor
denot mati
ing ve
its gend
regio ers
nal and
speci sexu
ficity alitie
, s in
while the
the regio
speci n—
ficity but
of also
other a
regio sour
ns is ce of
consi new
stentl theor
y y
highl and
ighte inno
d.) vativ
Ea e
st appr
Asia oach
n es
sexua for
lity the
studi broa
es is der
not stud
only y of
an sexu
928

alitie s
s. (how
This
entry 349
briefl geograp
y hic and
delin social
eates spaces
theor [includi
etical ng the
devel interpla
opme y
nts in between
the on- and
field off-line
acros spaces]
s five organiz
them e
atic sexualiti
areas es);
: family,
trans intimac
natio y, and
nal normati
sexua vity
lities (how
(how queer
sexua people
l navigat
practi e the
ces, powerfu
mean l norms
ings, associat
and ed with
subje marriag
cts e and
circul family);
ate critical
and approac
take hes to
shape globaliz
acros ation
s (how
natio globaliz
nal ing
borde forces
rs); impact
sexua queer
l sexualit
space ies in
 929

the another
region, burgeon
beyond ing
a field,
simplisti which
c focus overlap
on s with
Western but also
ization diverge
or s
America meanin
nization) gfully
; and the from
turn this
toward entry on
inter- sexualit
Asia ies,
organizi with its
ng and own
scholars key
hip. The texts
entry and
focuses questio
on ns.
sexualiti Works
es in the related
21st to East
century. Asian
Readers transge
who nder
desire a subjecti
more vities
compreh and
ensive embodi
survey ment
of the are also
field are provide
advised d under
to Further
consult Reading
the list s for
of readers
Further who
Reading wish to
s. delve
Transge into this
nder related
studies area of
in East inquiry.
Asia is
930

Definin are
g and “natural
Studyin ” and
unchan
g “East
ging,
Asia”
and that
Defining all
East people
Asia is within a
itself a cultural
political group
task. experie
The nce and
binary enact
construc that
ts “East” culture
and in the
“West” E
are a
products s
t
of what
A
literary s
critic i
Edward a
Said has n
called
“imagin S
ative e
geograp x
u
hy,”
a
arising l
from i
Europea t
n i
coloniali e
sm and s
imperial
ism, and
same
often
ways).
used in
While
ways
this
that
entry
perpetua
provisio
te
nally
cultural
defines
essentia
East
lism (the
Asia to
assumpti
include
on that
mainlan
cultures
 931

d China, diversit
Mongoli y not
a, Hong only
Kong, between
Japan, the
North societie
and s named
South above,
Korea, but also
and within
Taiwan, each of
this is these
not a societie
static s,
regional includin
boundar g
y; for linguisti
example c- and
, labor ethnic-
and minorit
marriage y
migratio populati
n and ons, and
other occupie
forms of d and
transnati nonurba
onal n areas
moveme that
nt have
increasi traditio
ngly nally
complic receive
ate the d less
distincti attentio
on n in the
between field of
East sexualit
Asia and y
Southea studies.
st Asia. While
In this
addition, entry
it is identifie
crucial s
to analytic
recogniz threads
e the stretchi
political ng
and across
cultural borders
932

through Toward
out the this
region, end,
these commit
connecti ments
ve ideas to
are not situated
intended knowle
to dge
flatten (recogni
the tion that
variation knowle
that also dge is
exists. not
Inasmuc objectiv
h as e or
ideas univers
about al, but
sexualit is
y have shaped
been by
central historic
to al and
Orientali social
sm, the influenc
field of es) and
sexualit deep
y studies engage
has a ment
particula with
rly local
importa languag
nt role es and
to play contexts
in have
critiquin been
g these fundam
ideas ental to
and the
dismantl growth
ing of the
controlli field.
ng
images
of East
Asia as
culturall
y
monolit
hic.
 933

Transna exampl
tional e,
Sexuali several
scholars
ties
have
The explore
“transna d the
tional populari
turn” zation
within of
sexualit Japanes
y studies e enjo
has kosai,
roots or
and teenage
branches sex
through work,
out East outside
Asian of
sexualiti Japan,
es and
scholars what
hip. this
Researc process
hers of
have transmi
especiall ssion
y noted reveals
the about
regional teen
influenc girls’
es of sexual
China agency
and under
Japan, diverse
through political
mechani and
sms moral
ranging regimes
from . More
military recently
occupati ,
on to scholars
diffusio have
n of begun
cultural to
norms docume
and nt how
practices K-pop
. For (a
934

popular a
musical motivat
genre) e the
and discipli
Korean ning of
construc two
tions of kinds of
feminini sexual
ty are subjects
hybridiz : gay
ed and men,
incorpor and
ated into Mongol
gay ian
subcultu women
res who
through have
out sex
Asia. with
National Chinese
and men
ethnic (and
boundar may
y- bear
making Chinese
have children
also , since
figured ethnicit
promine y in
ntly in Mongol
the ia is
literatur determi
e on ned
East patriline
Asian ally).
sexualiti As
es. For these
example exampl
, es
anthropo demons
logist trate,
Franck transnat
Billé ional
shows influenc
how es on
nationali East
stic Asian
ideologi sexualit
es in ies are
Mongoli not
 935

always East
or Asian
predomi queer
nantly organizi
“Wester ng both
n” or political
connecte ly and
d to socially
“Americ . Media,
anizatio and the
n.” Internet
Inter- in
Asia particul
transnati ar,
onal serves
flows as a
are crucial
centrally site of
importa queer
nt and cultural
represen formati
t some on and
of the represe
most ntation,
flourishi as well
ng sites as a
of first
research meeting
. place
for
many
Sexual individu
Spaces als who
The are
creation explorin
of g their
virtual own
and sexual
cultural desires,
sexual and
spaces forming
(also affinitie
often s
spannin around
g these
national aspects
borders) of their
has been lives. In
importa their
nt for 2003
936

edited gies are

volume embedd
Mobile ed in
Cultures queer
: New people’
Media s
in everyda
Queer y lives,
Asia, from
Chris use of
Berry, the
Fran Internet
Martin, to
and arrange
Audrey sexual
Yue encount
examine ers and
how the share
exponen sexual
tial content,
growth to the
of new display
media of
has phone
transfor charms
med to
lives signal
and sexual
lifestyle orientati
s in on in
diverse Japan,
Asian to
contexts online
. The collecti
authors on of
intention signatur
ally blur es for
the petition
boundari s to the
es govern
between ment
the about
“virtual” sexualit
and the y-
“real” related
by issues
showing in
how Taiwan
digital and
technolo Korea.
 937

Other and
research bisexual
ers have bar and
emphasi business
zed how owners
online from
commun accessin
ities and g prime
physical real
spaces estate,
intersect and as a
to shape result,
possibili many
ties for establis
queer hments
lives and for
relations lesbian
hips. For and
example bisexual
, women
sociolog are
ist located
Denise on the
Tang upper
notes floors
that of
state- highrise
imposed s. In
policies this
to context,
maintain online
land network
scarcity ing has
and keep been
rental especial
prices ly
high, critical
combine in
d with enablin
women’ g queer
s women
economi to find
c one
disadvan another,
tages, and to
have learn
prevente about
d Hong local
Kong events
lesbian and
938

resource s
s. In relation
another ship
example strategie
of how s and
physical goals,
space from
matters, finding
a ways to
majority sneak a
of girlfrien
Tang’s d into
lesbian the
and room
bisexual where
subjects multiple
shared family
close member
living s were
quarters sleeping
with , to
their achievin
family g
member financia
s (a l
common stability
characte and
ristic of indepen
daily life dence
for with a
queer goal of
people moving
in many out.
East These
Asian process
societies es of
). This balancin
living g family
arrange and
ment intimac
created y
practical represen
obstacle t
s to another
intimacy importa
, which nt
in turn theme
shaped within
the East
women’ Asian
 939

sexualiti ing
es private
scholars same-
hip, sex
discusse relation
d next. ships
while
also
Family, carrying
Intimac out
y, and other
Norma family
tivity roles
and
Gender-
obligati
and
ons.
sexually
Marriag
nonconf
es of
orming
lesbians
people
to gay
in East
men—
Asia are
someti
navigati
mes
ng
referred
normati
to as
ve
“contra
institutio
ct
ns of
marriag
marriage
es” or
, family,
“cooper
and
ative
patriline
marriag
al
es” in
kinship
English
in
-
multiple
languag
and
e
creative
literatur
ways.
e—are
Some
increasi
integrate
ng in
same-
Korea,
sex
Taiwan,
intimacy
and
with
mainlan
heterose
d China
xual
(and
marriage
possibly
s,
in other
maintain
places
940

as well). respects
Arrange ,
ments howeve
within r,
these lesbians
marriage who
s vary, marry
but gay
usually men
involve face
a public similar
display pressure
of s to
coupled lesbians
om for who
the marry
families, straight
while men,
husband particul
and wife arly
are surroun
released ding
from family
expectat work
ions for and
heterose pressure
xual from in-
consum laws.
mation For
and, exampl
ostensibl e,
y, enjoy East Asian
freedom Sexualities
to
cultivate
coopera
their
tively
primary
married
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lesbians
sex
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live
hips
with or
under
near to
the
their
protectiv
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parents,
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. In
shoulde
many
r the
other
 941

bulk of rtionatel
the elder y
care as allocate
well as d to
child sons). A
care and particul
other arly
housewo thought
rk. The ful
challeng analysis
es of of
such gender
marriage within
s, contract
particula marriag
rly for es is
women, provide
undersc d by
ore the anthrop
extent to ologist
which John
family (Song
pressure Pae)
s for Cho,
lesbians who
are not writes
only or about
even the
primaril decision
y moral -making
and process
ideologi es and
cal, but living
also arrange
material ments
(embodi of such
ed couples
through in
reproduc South
tive Korea.
labor) In
and addition
economi to the
c (as arrange
family ments
resource describe
s d above,
continue East
to be Asian
dispropo scholars
942

have relation
identifie ships to
d many normati
historica vity, as
l and explicat
contemp ed in
orary Yau
forms of Ching’s
resistanc 2010
e to edited
heterose collecti
xual on, As
marriage Normal
, and as
increasin Possibl
g e:
numbers Negotia
of young ting
people Gender
in East and
Asia Sexualit
report y in
that they Mainla
do not nd
plan to China
marry and
despite Hong
strong Kong.
normativ Contrib
e utors to
pressure the
s to do volume
so. foregro
Across und the
these context-
varying specifici
family ty of
arrange what is
ments consider
and ed
strategie normati
s, ve in a
gender- given
and place
sexually and
nonconf time,
orming and of
people queer
have “love-
complex and-
 943

hate y
relations studies
hips in East
with Asia
normativ has
ity” as a been a
site of thoroug
both h and
desire critical
and respons
impossib e to the
ility. assumpt
This ion that
strand of there is
research a
within “global
East gay”
Asian culture
studies exporte
promises d from
to the
advance West,
broader which
understa serves
ndings as a
of how primary
normativ referent
ity is for East
construc Asian
ted, queers.
negotiat It is
ed, and here
challeng that
ed by challen
diverse ges to
sexual the
subjects. East–
West
binary
Queer(i oppositi
ng) on,
Globaliz mention
ation ed
Among earlier
the most in this
central entry,
themes have
within been
sexualit vigorou
sly
944

deconstr “comin
ucted. g
E home,”
a as an
st alternati
A
ve to a
si
a
Western
n,
S individu
e alist
x sexual
u self-
a concept
li
that is
ti
e
separate
s and
distinct
from
An cultural-
illustrati familial
ve roles
debate and
on this relation
topic ships.
was For
carried Chou,
out the
between “comin
sociolog g
ists home”
Wah- lexicon
Shan is
Chou deeply
and Day embedd
Wong, ed in
concerni the
ng the culturall
relevanc y
e of unique
“coming categor
out” to y of the
family jiā
in a (home,
Chinese family,
context. househo
Chou ld),
propose which
d the denotes
term huí both a
jiā, physical
 945

location without
and a discussi
mental/s ng the
piritual sexual
one in nature
Chinese of these
cosmolo relation
gy. ships
Chou with
uses this their
notion parents.
of In
coming contrast
home to , Day
describe Wong
the (re)inter
behavior prets
s of his silent
Hong toleranc
Kong e of
study homose
subjects, xuality
many of as a
whom localize
integrate d form
d their of
same- homoph
sex obia,
partners and
into the critique
family s Chou
through for
everyda reinscri
y rituals bing a
like binary
sharing oppositi
meals on
and between
playing the
mahjong (individ
, and ualist)
through West
the use and
of quasi- (collecti
kin vist)
categori non-
es like West.
half- Wong
sister/br challeng
other, es
946

readers scholars
to have
abandon shown
the how
East– transnat
West ionally
binary circulati
altogeth ng
er, and discours
to es of
consider anti-
instead trafficki
how ng and
coming child
home is protecti
insepara on have
ble from led to
and increase
indispen d
sable to surveill
coming ance
out in and
the discipli
narrative ning of
s of sexual
many subjects
Chinese through
bisexual out East
s, Asia. In
lesbians, an
and article
gays. pointedl
Anot y titled
her site “Is
of Global
critical Govern
engagem ance
ent with Bad for
globaliz East
ation Asian
theories Queers?
can be ”,
found in Josephi
work on ne Ho,
global cultural
governa critic
nce and and
civil director
society. of the
Several Center
 947

for the Kong,

Study of Singapo
Sexualiti re, and
es at South
National Korea.
Central Thus,
Universi while
ty in some
Taiwan, LGBTQ
highlight groups
s the have
role of optimist
conserva ically
tive looked
nongove to
rnmental expandi
organiza ng civil
tions, or society
NGOs for
(whose leverage
scope of in social
influenc activism
e has , they
rapidly have
expande also
d under encount
global ered
governa new
nce), in challeng
blocking es
anti- through
discrimi what
nation Ho calls
legislati “the
on and new
gender state-
diversity NGO
in power
educatio bloc.”
n, and As Ho
advancin acknowl
g other edges
antisex and as
and other
antiquee research
r ers also
agendas show,
in East
Taiwan, Asian
Hong queers
948

have inter-
risen to Asia
this scholars
challeng hip and
e organizi
through ng
determin around
ed and gender
creative and
organizi sexualit
ng, and ies.
through This
the inter-
creation Asia
of turn is
alliances illustrat
with ed by,
other for
marginal exampl
ized e, the
groups AsiaPac
within ifiQueer
and Networ
across k and
their other
respectiv regional
e scholarl
societies y
. network
s and
confere
Inter- nces,
Asia the
Focus Queer
One of Asia
the book
major series
projects launche
of the d by
field in Hong
the early Kong
21st Univers
century ity
has been Press in
the 2008,
cultivati and a
on and new
institutio internati
nalizatio onal
n of master’
 949

s importa
program nt next
in Inter- step in
Asia this
Cultural project
Studies is a
(with a heighte
gender/s ned
exuality attentio
concentr n to
ation underst
option) udied
offered areas
by a within
consorti the
um of region,
top includin
research g (but
universit not
ies in limited
Taiwan. to)
These Mongol
efforts ia,
highligh Tibet,
t Asia and
not North
merely Korea,
as an as well
anthropo as
logical attentio
field n to
site, but rural,
as an poor,
epicente and
r of working
knowled -class
ge queer
producti populati
on about ons that
non- are
normati often
ve underre
genders presente
and d in
sexualiti queer
es. As organizi
noted ng
earlier locally
in the
entry, an
950

and F
globally. u
r
Amy t
Brainer h
e
See also
r
Intersecti
ons
Between R
Sex, e
Gender, a
and d
Sexual i
Identit n
y; g
LGBT
s
Health
in Berry,
Non- C.,
Weste Ma
rn rtin
Conte , F.,
xts; &
LGBT Yu
Q e,
Peopl A.
e of (20
Color; 03).
Queer Mo
Ethno bile
graphi cult
es/ ure
Autoet s:
hnogr Ne
aphies w
; me
Trans dia
gende in
r que
Geogr er
aphies Asi
a.
Dur
ha
m,
NC
:
Du
ke
Uni
ver
sity
Pre
ss.
Chalmers
, S.
 951

(2002) Hong
. Kong
Emerg Unive
ing
rsity
lesbia
n Press.
voices Cho
from ,
Japan J
. New .
York, S
NY: .
Routle P
dge. .
Chiang, (
H. 2
(Ed.). 0
(2012) 0
. 9
Trans )
gende .
r T
China h
. New e
York, w
NY: e
Palgra d
ve d
Macm i
illan. n
g
Ching, Y.
b
(Ed.). a
(2010) n
. As q
norma u
l as e
possib t
r
le:
e
Negoti v
ating i
sexual s
ity i
and t
e
gende
d
r in :
mainl “
and C
China o
and n
t
Hong
r
Kong.
a
Hong c
Kong: t
952

m 2
a ,
rr 4
ia 0
g 1
e –
s 4
” 2
b 2
et .
w Ho, J.
e (2008
e ). Is
n
globa
K
o l
r gover
e nance
a bad
n for
g East
a
Asian
y
queer
s
a s?
n GLQ:
d A
le Journ
s al of
b Lesbi
ia
an
n
s. and
A Gay
n Studi
t es,
h 14,
r 457–
o
479.
p
Hua
o
n
l
g,
o
H
g
.
i
T
c
.-
a
M
l
.
Q
(
u
2
a
0
rt
1
e
1
rl
).
y
Q
,
u
8
 953

ee ies,
r resist
p ance.
ol New
iti York,
cs NY:
a Routl
n edge.
d (First
se publis
x hed
u as a
al 2006
m speci
o al
d issue
er of the
ni Journ
ty al of
in Lesbi
T an
ai Studi
w es)
a McLellan
n. d, M.,
H &
on Dasg
g upta,
K R.
on (Eds.)
g: .
H (2005
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g Gend
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ni and
ve sexua
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). sity
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dge Sang, T.-
handb L. D.
ook of
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sexual
ity ). The
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s in ing
East lesbia
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ender
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an Asia
des Cultu
ire ral
s Studi
an es, 8,
d 600–
eve 616.
ryd
ay
life
.
EDUCA
Ho TION
ng
Ko
ng: This
Ho entry
ng traces
Ko the
ng history
Uni of the
ver LGBTQ
sity civil
Pre rights
ss. movem
Wong, D. ent in
(2007) terms of
. educati
Rethin on and,
king as such,
the employ
comin s the
g terms
home used to
alterna refer to
tive: the
Hybri Education
dizatio
n and
LGBTQ
comin
commu
g out
nity
politic
during
s in
the time
Hong
period
Kong’
in
s anti-
discussi
homo
on. It
phobia
begins
parade
by
s.
situatin
Inter-
956

g cultural
homose contesta
xuality tion. In
within addition
the ,
context children
of the are
societal often
aims of viewed
educatio as being
n and “innoce
then nt” and
describe in need
s the of
impact protecti
of on.
various Public
moveme educatio
nts on n in
LGBTQ particul
teachers ar
and comes
students. under
It ends scrutiny
by because
describi it is
ng the support
current ed by
climate taxpaye
in r
today’s money.
schools. Combin
Beca ed with
use a
schoolin conflati
g has on of
been homose
seen as a xuality
way of and
preservi pedophi
ng and lia,
passing these
on various
tradition factors
, created
educatio heighte
n has ned
long attentio
been a n to
site of schools
 957

as uality
potential largely
“breedin took
g place in
grounds terms of
” of policing
homosex teacher
uality, behavio
which r,
manifest includin
ed itself g
in behavio
various rs
ways outside
througho of
ut recent school,
history. and
Unfound policing
ed fears curricul
led to um, that
“witch is, what
hunts,” teachers
where taught
attempts in
were school.
made to The
identify younger
and the
eradicate students
homosex , the
uals and more
homosex scrutiny
uality was
because involve
they d.
were
seen as
potential The
“threats” “Ho
to mos
family exua
and l
heterose Men
xuality. ace”
This of
effort to the
purge 1950
schools
s
of
homosex
958

In the suppose
1950s, d
there commu
was nists,
increase but also
d of
awarene “sexual
ss and perverts
fear of ,”
the leading
“homose to what
xual became
menace, known
” a as the
phrase “Laven
that der
arose Scare.”
followin During
g World this
War II, period,
during a people
period associat
of ed
heighten homose
ed xuality
tension with
between pedophi
the lia, and
United local
States police
and the stations
Soviet would
Union. someti
U.S. mes
Senator team up
Joseph with
McCarth their
y and local
his school
follower districts
s to
attempte create
d to public
purge service
governm announ
ent and cements
other warning
institutio youth to
ns not beware
only of of
 959

homose homose
xuals, xuality
who to
were heterose
depicted xuals, it
as also
preying made
on homose
innocent xuals
children more
and aware
teenager of each
s. other.
Althoug Gay
h groups
McCarth started
yism forming
died out across
toward the
E country.
d For
u example
c
, the
a
ti
Mattach
o ine
n Society,
one of
the
the end earliest
of the gay
1950s, rights
concerns groups
about in the
homose United
xuality, States,
particula started
rly in 1950,
homose and the
xuality Daughte
in public rs of
schools, Bilitis,
did not. the first
Whil lesbian
e the civil
1950s rights
brought group in
increasin the
g United
awarene States,
ss of started
960

in 1955. did little

The to reach
burgeoni out to
ng gay youth or
rights schools.
moveme
nt
The “Save
during
the O
sixties u
culminat r
ed with C
the h
Stonewa i
ll Riots l
in 1969, d
when r
drag
e
queens
n
and
”
other
gender C
and a
sexual m
minoriti p
es took a
to the i
streets g
of New n
York to
protest o
police f
brutality t
in the h
gay bar
e
called
the
1
Stonewa
9
ll Inn.
Due to 7
fears of 0
being s
charged This
with newfou
pedophil nd
ia, these awarene
early ss of
gay discrimi
rights nation
groups against
 961

homose 1977.
xuals Bryant
led to claimed
Dade that
County, because
Florida, homose
passing xuals
nondiscr could
iminatio not
n have
legislati children
on that on their
included own,
sexual they
orientati became
on in the teachers
1970s. in order
In to
response “recruit
, Anita ” new
Bryant, member
an s. The
America gay
n singer commu
and nity’s
spokesp boycott
erson of
for the orange
Florida juice in
Citrus reaction
Commis to her
sion, campai
successf gn
ully resulted
lobbied in Anita
to have Bryant’
sexual s
orientati contract
on as
removed spokesp
from the erson
legislati for the
on with Florida
her Citrus
“Save Commi
Our ssion
Children not
” being
campaig renewe
n in
962

d in g
1979. Oklaho
Anita ma, did
Bryant’s pass,
self- laying
termed the
“crusade ground
” spread work
to for “no
Californi promo
a where homo”
the far- laws—
reaching laws
Briggs that
Initiative prohibit
, which teachers
would from
ban any portrayi
school ng
employe homose
e from xuality
even in a
talking positive
about light. It
homosex was
uality, under
was one of
propose these
d. It was laws
defeated that
as straight
celebriti teacher
es, Penny
includin Culliton
g of New
Ronald Ipswich
Reagan, , New
voiced Hampsh
their ire, was
oppositi fired for
on. teaching
Howeve Mauric
r, similar e, a
initiative novel
s in by E.
other M.
parts of Forster
the with a
country, gay
includin main
 963

characte how
r, in people
1995. should
(She act.
fought Despite
back and Morriso
was n v.
reinstate State
d in Board
1996.) of
Mean Educati
while, on
“moralit (1969)
y narrowi
clauses” ng the
— scope of
clauses morality
in clauses
teachers’ to just
contracts those
stating actions
that they shown
could be to affect
fired a
over any teacher’
immoral s ability
conduct, to teach,
regardle an
ss of unknow
whether n
or not it number
took of
place on LGBTQ
school teachers
grounds were
—lived fired
on and because
served they
as a were
wide net found to
to catch be in
teachers violatio
whose n of the
behavior morality
s did not clause
comport in their
with contract
local . Some
views of these
about instance
964

s d v.
resulted Mad
in court River.
cases, These
includin cases
g cases represen
about t the tip
LGBTQ of the
teachers iceberg,
who as many
were LGBTQ
fired teachers
after who
being were
“found fired
out” either
(Gaylor directly
d v. for
Tacoma being
School gay or
District indirectl
[1977]; y by
Acanfor being
a v. targeted
Board for
of being
Educati gay did
on of not
Montgo choose
mery to fight
County back
[1974]). through
In 1985, the
a court court
upheld system,
the or often
firing of did not
a fight
bisexual back at
teacher all.
for Moralit
disclosin y
g her clauses
sexual were,
orientati and
on to a possibly
staff still are,
member used as
in a legal
Rowlan means
 965

to “save e
our
children 1
” by 9
those 8
who
0
deem
s
LGBTQ
teachersIn 1988,
to Kevin
be
morally Jenning
corrupt.s, a
high
school
The Birth history
o teacher
f in a
G private
a school
y in
– Concor
S d,
t Massac
husetts,
r
started
a
the
i nation’s
g first
h Gay–
t Straight
A Allianc
l e
l (GSA),
i a group
a of
n teachers
c and
e students
dedicate
s
d to
i
making
n school a
safe
t space
h for gay
e students
.
l Currentl
a y, there
t are
966

GSAs in later
every found
state in to be in
the violatio
United n of the
States. Equal
Howeve Access
r, that Act in
accompl Utah, in
ishment East
did not High
come Gay/Str
about aight
without Allianc
a fight. e v.
Because Board
the of
Equal Educati
Access on of
Act Salt
requires Lake
that if a City
school School
allows District
one (1999).
extracur In
ricular 1990,
club, it Jenning
must s started
allow all a group
extracur that
ricular would
clubs, in later
1996 a become
Salt the Gay,
Lake Lesbian
City &
school Straight
board Educati
voted to on
ban all Networ
extracur k
ricular (GLSE
clubs to N), an
prevent organiz
a GSA ation
from that
forming. seeks to
This end
was homoph
 967

obia in discrimi
schools. nation
Jennings against
also students
authored on the
the first basis of
state- sexual
commiss orientati
ioned on.
survey Currentl
on gay y,
and GLSEN
lesbian ’s
youth. Nationa
Titled l
“Making Climate
Schools Survey
Safe for is used
Gay and by
Lesbian scholars
Youth,” and
findings politicia
about ns alike
the to
amount gauge
of experie
harassm nces of
ent gay LGBTQ
and youth in
lesbian our
students schools.
faced in In
school, Weaver
includin v. Nebo
g School
harassm District
ent by (1998),
teachers the
and court
other found
school that a
staff, led school
Massach district
usetts to violated
become a
the first lesbian
state in teacher’
the s
nation to freedom
outlaw of
968

speech closeted
when for fear
they of
prohibite losing
d her their
from jobs.
disclosin This
g her fear was
sexual furthere
orientati d when,
on. during
While argume
this may nts
have against
legally the
ended Employ
any ee Non-
school Discrim
districts’ ination
“Don’t Act
Ask, (ENDA
Don’t ) in the
Tell” 1990s,
(DADT) U.S.
policies senators
—a term objected
borrowe to this
d from federal
Presiden legislati
t Bill on that
Clinton’ would
s 1994 protect
policy workers
allowing from
gay being
service fired for
member being
s in the gay
military because
as long it would
as they include
did not teachers
disclose .
their Despite,
sexual or
identity perhaps
— because
teachers of,
remaine GSAs
d increasi
 969

ng the 1
awarene 9
ss of the 9
presence 0
of s
LGBTQ
a
students
n
and
d
faculty
in 2
schools, 0
many 0
teachers 0
followed s
the code In 1996,
of a
DADT. student
named
No Jamie
Nabozn
Pr
y won a
o
near-
m million-
o dollar
H settleme
o nt in a
m suit
o: against
St his
u Education
de
nt school
s, district
Te for
ac failing
he to
rs, protect
an him
d from
C his
ur antigay
ric torment
ors. The
ul
publicit
u
y
m surroun
in ding
th Nabozn
e y v.
970

Podlesn Larry
y et al. King
(1996) was
led to shot in
several the
school back
districts and
adding killed
sexual by a
orientati school
on to mate on
their school
nondiscr grounds
iminatio . The
n shootin
policies. g
Howeve occurre
r, a d after
number Larry
of King
incident had
s since publicly
then asked
demonst the
rate the shooter
need for to be
proactiv his
e tactics valentin
as well e.
as Even
enforce when
ment of educatio
these n is not
policies. directly
One of involve
the more d in the
widely fight for
publiciz LGBTQ
ed of rights,
these concern
incident s over
s teachers
occurred ’
in 2008, influenc
when a e on
middle students
school are
student often
by the used to
name of inflame
 971

prejudic become
e. For the first
example state in
, in the the
fight nation
over to pass
same- “pro
sex homo”
marriage legislati
in on—
Californi legislati
a, on
advertise requirin
ments g that
for curricul
Propositi a
on 8—a include
ballot promine
propositi nt
on for a LGBTQ
state people,
constitut milesto
ional nes in
amendm the fight
ent to for
prohibit LGBTQ
same- rights,
sex and
marriage contribu
— tions by
largely LGBTQ
centered people
around to all
false fields,
claims but this
that occurre
same- d before
sex same-
marriage sex
leads to marriag
schools e was
teaching made
about legal in
homosex Californ
uality ia.
and gay In
marriage contrast
. to
Californi Californ
a did ia’s
972

forward at least
thinking, one
there are filtering
eight site
states allowed
that students
have “no to see
promo antigay
homo” sites,
laws and includin
one state g giving
that has them
a pro- access
heterose to the
xuality Bowers
law, as v.
of 2014. Hardwi
Various ck
other (1986)
forms of decision
censorsh allowin
ip have g states
also to keep
been antisodo
used to my laws
try to on the
erase books,
homosex while
uality preventi
from our ng
schools. access
This has to gay-
ranged positive
from sites,
banning includin
books to g the
using Lawren
Internet ce v.
filters to Texas
try to (2003)
prevent decision
students that
from overrule
accessin d
g gay- Bowers.
positive In
websites Parents
. The ,
Web Familie
filter for s, and
 973

Friends studies
of in the
Lesbian late
s and eighties
Gays presume
(PFLAG d
) v. teachers
Camden were in
ton R-III the
School closet,
District describi
(2012), ng their
the “double
E lives”
d and
u “coping
c
mechani
a
ti
sms”
o such as
n avoidin
g gay
events
judge like
ordered pride
that the celebrat
school ions and
district conform
replace ing to
its gender
Internet norms.
filtering Howeve
system r, author
with one and
that activist
does not Eric
discrimi Rofes in
nate. 1999
Sever intervie
al wed his
studies former
have students
docume 20 years
nted after
LGBTQ their
teachers’ having
experien studied
ces in with
schools. him as
The first an
few openly
974

gay taught
teacher or by
and the
found teacher’
that s race/
students ethnicit
attribute y to
d their discuss
open- how
mindedn those
ess to particul
his ar
opennes aspects
s. Janna impacte
Jackson d their
publishe experie
d a study nces.
in 2007
that
detailed Current
the Climat
processe e
s that While
nine sentime
LGBTQ nt in the
teachers United
had States
experien has
ced in recently
their swung
various toward
stages of being
coming more
out to supporti
their ve of
students. LGBTQ
More people
recent and
studies their
have rights,
explored and the
various right of
subcateg same-
ories of sex
LGBTQ couples
teachers to
such as marry
by the in all 50
subject states
they
 975

has been nation

declared against
by the gay
U.S. students
Supreme , in
Court, 2009 an
the 11-
experien year-old
ces of student
LGBTQ named
students Carl
in our Walker
schools committ
still ed
remains suicide
spotty. after
Harassm sufferin
ent of g from
LGBTQ antigay
youth bullying
outside . While
of there is
school, some
includin controv
g in ersy
their over the
own exact
homes number
by their s of
own LGBTQ
parents, youth
also who
impacts commit
their suicide,
school there is
experien general
ces, agreem
leading ent that
to lower suicide
grades rates
and are
droppin higher
g out. compar
Even in ed to
Massach the
usetts, general
the first populati
state to on. A
outlaw number
discrimi of
976

organiza youth to
tions advocat
includin e for
g The themsel
Trevor ves.
Project While
have attentio
formed n to
to try to bullying
combat has
LGBTQ increase
suicide. d,
The It propose
Gets d anti-
Better bullying
Project, and
founded nondisc
by riminati
columni on
st Dan policies
Savage in
and his schools
partner that
Terry explicitl
Miller, y name
sparked sexual
a orientati
number on and
of gender
YouTub identity
e videos have
aimed at come
helping under
LGBTQ pressure
youth .
who are Even
being though
bullied. an
The LGBTQ
GSA teacher,
Network adminis
’s Make trator,
It Better staff, or
Project student’
provides s
material experie
s and nce in
supports school
for can
LGBTQ vary in
 977

the Aires,
United Argenti
States, na, to
by and discuss
large, conditio
conditio ns for
ns are LGBTQ
improvi people
ng. in
Howeve schools
r, around around
the the
globe, world.
LGBTQ While
youth, awarene
teachers, ss is
administ increasi
rators, ng
and staff across
can still the
experien globe,
ce steps
extreme need to
homoph be taken
obia. In locally
2013, and
GLSEN globally
met with to
the ensure
United that all
Nations LGBTQ
Educatio students
nal, ,
Scientifi teachers
c and ,
Cultural adminis
Organiz trators,
ation and
(UNESC staff
O) feel
during welcom
the e in
World school.
Compar
Janna
ative
Educatio Kelling
n er
Confere
See also
nce in
Bullying,
Buenos
978

Legal C
Protectio li
ns m
Against; a
Bullying, t
Rates e
and ;
Effect S
s of; c
Bullyi h
ng, o
Schoo o
l- l
Based s
Interv a
ention s
s for; H
Camp e
us t
Clima e
te; r
Gay, o
Lesbia n
n& o
Straig r
ht m
Educa a
tion ti
Netwo v
rk e
(GLS S
EN); p
Gay– a
Straig c
ht e
s
Allian
;
ces
S
(GSA
e
s);
x
Gende
u
r
a
Nonco
li
nform
ti
ity,
e
Youth
s
; It
a
Gets t
Better S
; No c
Promo h
Homo o
Polici o
es; l;
Schoo T
l r
e
 979

v sex
or desire
Pr ,
oj
gende
ec
t, r, and
T schoo
h l work
e; in the
V twenti
io
eth
le
n centu
ce ry.
a Alban
n y:
d State
V Unive
ic rsity
ti of
m New
iz York
at Press.
io
Graves,
n
of K.
Y (2009).
o And they
ut were
h wonderfu
l
teachers:
F Flori
u da’s
r purge
t of
h gay
e
and
r
lesbia
n
R
teach
e
ers.
a
d Cham
paign
i
:
n Unive
g rsity
s of
Illinoi
Blount, J.
s
(2005)
Press.
. Fit to Harbeck,
teach: K.
Same- (1992).
980

Coming Jennings,
out of the K.
classroo (1994
m closet: ).
Gay One
and teach
lesbia er in
n ten:
studen Gay
ts, and
teache lesbia
rs, n
and teach
curric ers
ula. tell
New their
York, storie
NY: s. Los
Harrin Angel
gton es,
Park CA:
Press. Alyso
Jackson, n
J. Public
(2007) ations
. .
Unma Kissen,
sking R.
identit (1996
ies: ). The
An last
explor closet
ation : The
of the real
lives lives
of gay of
and lesbia
lesbia n and
n gay
teache teach
rs. ers.
Lanha Ports
m, mouth
MD: , NH:
Lexin Heine
gton mann.
Books Kum
. a
s
 981

hi p
ro e
, d
K a
. g
(2 o
0 g
0 y
2) .
. N
T e
r w
o
u Y
bl o
in r
g k
e ,
d N
u Y
c :
at R
io o
n u
: tl
Q e
u d
e g
e e
r F
a a
ct l
iv m
is e
m r.
a Meyer, E.
n (2009).
d Gender,
a bullying,
nt and
i- harassme
o nt:
p Strate
p gies to
r end
e sexism
and
ss
homop
iv
hobia
e in
982

school
s.
Ne EFFEMI
w
York,
NACY
NY:
Teach
ers Effemin
Colleg acy
e describe
Press.
s a
Pinar,
W. man’s
(1998) perform
. ance of
Queer traits or
theory manneri
in sms that
educa
are
tion.
Mahw usually
ah, associat
NJ: ed with
Erlbau feminin
m. ity. This
Talburt, may
S., & encomp
Steinberg,
ass a
S. (2000).
Thinking broad
queer: range of
Sexual activitie
ity, s
cultur extendi
e, and ng from
educa a man
tion. merely
New displayi
York, ng
NY: emotion
Peter ality
Lang. through
Woog, D. to
(1995) displays
. that are
Schoo more
l’s distinctl
out.
y
Bosto
n, marked
MA: as
Alyso feminin
n e—such
Public as
ations. wearing
 983

obvious of
makeup. homose
When a xuality.
male This
body wasn’t
perform always
s the
feminini case,
ty with howeve
the r.
purpose Throug
of hout
identifyi history,
ng as the there
opposite have
gender, been
then this example
body s of
would cultures
not be that
identifie have
d as accepte
effemina d (and
te but as even
transgen celebrat
der. ed)
One perform
of the ances
reasons that
why would,
effemina by
cy has contem
been porary
central standard
to s, be
LGBTQ deemed
politics effemin
is that, ate.
in Howeve
contemp r, after
orary the
Western public
culture, disgrace
effemina of the
cy is writer
read as Oscar
the Wilde
dominan in 1895,
t effemin
signifier acy
984

became angloph
interpret one
ed in culture
angloph — was
one also one
culture of the
as the first
signifier publicly
of identifie
homosex d
uality. homose
Prior to xuals.
Wilde’s Althoug
public h Wilde
may
Effeminacy
have
entered
downfall
the
,
courtroo
effemina
m
cy was
charged
merely
with
consider
committ
ed the
ing acts
signifier
of
of
sodomy
upper–
, he left
middle-
the
class
court
laxity
identifie
and not
d as a
of
sodomit
homose
e.
xuality.
Therefo
The
re, after
reason
Wilde’s
for the
disgrace
conflatio
, the
n of
sexual
effemina
acts
cy and
were
homosex
perceive
uality
d as an
was that
identity,
Wilde—
and the
arguably
signifier
one of
of this
the first
identific
celebriti
ation
es in
was the
 985

Wildean characte
trait of rs on
“dandyis the
m” or, screen
as through
contemp gender
orary transitiv
culture ity so
would that
label it, lesbians
effemina were
cy. represen
More ted as
than a butch
century and gay
after men as
Wilde’s effemin
public ate.
disgrace, How
effemina ever,
cy is still althoug
regarded h
as the effemin
main acy has
identific caused
ation of anxiety
homosex because
uality. it is
This viewed
conflatio as the
n of signifier
homosex of
uality homose
and xuality,
effemina it can
cy has also be
been a source
supporte of
d by the unease
media in itself.
(especial Indeed,
ly critics
Hollywo have
od coined
cinema) the term
which, effemin
until ophobia
recently, to
identifie describe
d queer the fear
986

of sexually
effemina active,
cy. but
Effemin rather
ophobia that he
is not is not
simply a conform
fear of ing to
effemina tradition
cy as al
suggesti perform
ve of ances of
homosex masculi
uality, nity.
but is Argu
also an ably,
anxiety effemin
about acy is
the way troublin
effemina g to
cy many
disturbs people
the on a
hierarchi number
cal of
gender levels.
binary. First,
School the
playgrou effemin
nds are ate man
often is an
rife with upsettin
effemino g sight
phobic for
abuse, many
given effemin
that ophobes
when a because
10-year- he is
old boy openly
calls renounc
another ing
10-year- masculi
old boy ne
a “fag,” privileg
he is not e by
suggesti adoptin
ng that g traits
his peer usually
is associat
 987

ed with gender
feminini inequali
ty. ty.
Therefor Seco
e nd, the
effemino effemin
phobic ate man
terms of is
abuse— drawing
pussy- attentio
boy, n to the
nelly, construc
and ted and
sissy perform
(the ative
abbrevia nature
tion of of
sister- gender.
boy)— He is
are showing
grounde that a
d inmale
misogyn body
y can do
because feminini
they are ty and is
suggesti therefor
ng that e
the man challeng
in ing
E essentia
l list
d beliefs
e
that
r
A ascribe
b masculi
u nity to
s male
e bodies
and
feminini
question
ty to
is like a
female
woman,
bodies.
and this
To use
is only
contem
an insult
porary
in a
slang,
society
the
of
effemin
988

ate man s (homo

“gender =
fucks.” same),
Third and the
, the samenes
effemina s or
te man is differen
not ce that
simply is
challeng suppose
ing dly
gender eroticiz
politics ed is
but can gender.
be seen For
to example
trouble , when
the Aretha
matrix Franklin
of sings
sexuality “You
. The make
gender me feel
binary is like a
common natural
ly woman,
regarded ” she is
as the telling
scaffold her
of masculi
sexuality ne, male
. lover
Heterose that his
xuality masculi
translate nity
s as the stands
sexualiz in
ation of oppositi
differenc on to
e her
(hetero feminini
= ty and
differenc that the
e), while binary
homosex not only
uality is feels
the “natural
sexualiz ” but is
ation of also
samenes erotic.
 989

If her the
male represen
lover tation of
were the
effemina effemin
te, then ate man
her or sissy
sense of to thrive
feminini on the
ty would screen.
be Not
shaken only
and the was the
erotic sissy
binary unthreat
challeng ening,
ed. In because
this he had
respect, abandon
the ed
effemina masculi
te man is ne
thought privileg
to e to
trouble descend
the the
scheme gender
of hierarch
eroticis y, but
m (both he also
heterose did not
xual and seem to
homosex have a
ual) by sexualit
falling y
between because
the he fell
genders between
and the
failing genders
to and
appeal failed to
to be
anyone. either
For this masculi
reason, ne or
mainstre feminin
am e. For
media this
allowed reason,
990

much of cursory
gay glance
liberatio at any
n gay
politics dating
of the site will
1970s show a
and large
1980s number
was of
concern personal
ed with ads
challeng expressi
ing the ng
effemina distaste
te for
stereoty meeting
pe and anyone
asserting effemin
that ate. “No
gays effemin
were ates,
exactly please”
like is a
their standard
heterose request.
xual It could
counterp be
arts in argued
everythi that for
ng apart many of
from us,
sexual despite
object the
choice. advance
Argu ments
ably, in
this LGBTQ
prejudic politics,
e against the
effemina situatio
cy still n is not
continue very
s both in differen
heterose t from
xual and the
gay school
culture. playgro
Indeed, und, as
a nonconf
 991

ormity s and
to Femi
niniti
masculin
es;
ity is
Sissy
still boy
being Exper
policed ience
with
cruel
taunts. It F
may u
well be r
that, in t
future h
years, e
LGBTQ r
politics
R
may not
e
be
a
fighting
d
against
i
homoph
n
obia but
g
against s
effemino
phobia. Baker, P.
(2003
Niall ). No
Richard effem
son inates
pleas
See also e: A
Gender
corpu
Binaries;
Gender s-
Nonconfo based
rmity, analy
Youth; sis of
Gende masc
rqueer ulinit
; y via
Mascu
perso
linity
nal
Stereo
types; adver
Nonbi ts in
nary Gay
Gende News
rs; /Time
Polici s
ng 1973
Mascu
–
linitie
992

2000. .
Sociol Fashi
ogical onabl
Revie e
w, 51, “fags
243– ” and
260. stylis
Richar h
dso “sissi
n, es”:
N. The
(20
repres
09).
Eff entati
emi on of
nop Stanf
hob ord in
ia, Sex
mis and
ogy
the
ny
City
and
que and
er Nigel
frie in
nds The
hip: Devil
The Wear
cult
s
ural
the Prad
mes a.
of Film,
Cha Fashi
nne on &
l Cons
4’s umpti
Pla
on,
yin
g It 2(9),
Str 137–
aig 157.
ht. Sinfield,
Sex A.
uali
(199
ties
4).
,
12( The
4), Wild
525 e
– centu
544 ry:
.
Osca
Richardso
r
n, N.
Wild
(2012)
 993

e, can
effem include
inacy, emotion
and al or
the psychol
queer ogical
mome abuse
nt. (the
Lond inflictio
on, n of
Engla anguish
nd: , pain,
Casse or
ll. distress
through
verbal
or
ELDER nonverb
al acts)
ABUSE and
sexual
abuse
In the (noncon
United sensual
States, sexual
elder contact
abuse is of any
defined kind or
by state sexual
law. All contact
states with a
have person
laws conside
that red
address incapab
physical le of
abuse, giving
such as consent
hitting ). Due
or to poor
slapping physical
; most or
also mental
cover health
much or
more. frailty,
Other some
types of elders
elder require
abuse help
994

with assets)
basic is also
needs usually
such as conside
food and red
personal elder
safety. If abuse.
someone With
has the
agreed excepti
to on of
provide self-
such neglect,
care and all of
fails to these
do so, it forms
is of elder
consider abuse
ed may
neglect. also
It is occur in
called congreg
self- ate
neglect living
when settings,
the elder where
is they are
unable typicall
or y
refuses labeled
to obtain instituti
services onal
necessar abuse.
y for Because
health or only a
safety. small
Financia percent
l or age of
material elders
exploitat ever
ion (the live in
illegal such
or facilitie
imprope s, this
r use of entry
an focuses
elder’s on
funds, abuse
property of
, or elders
 995

who do abuse
not live are
in consider
institutio ed
ns. crimes
Althoug and are
h any address
elder, ed by
regardle law
ss of enforce
sexual ment,
orientati more
on or often
gender cases
identity, are
can be reported
the to
victim govern
of ment
abuse, agencie
this s called
entry Adult
focuses Protecti
on the ve
addition Services
al tactics (APS).
abusers Reports
can use are first
against assessed
elders to
who are ensure
LGBTQ the
and the alleged
addition victim
al falls
barriers under
LGBTQ the APS
victims law.
face in Some
recogniz states
ing cover
abuse everyon
and e over a
getting particul
help. ar age
Altho (typicall
ugh y 60 or
some 65),
types of while
elder others
996

cover tries to
only make
elders the
who are victim
also safe by
consider providin
ed g
“vulnera addition
ble” or al
unable services
to or
protect making
themselv agreeme
es due to nts with
physical caregive
or rs.
cognitiv Someti
e mes
limitatio APS
ns. Once provide
APS s
accepts services
a report, to the
a victim
casewor or
ker moves
visits the
and victim
intervie into a
ws the nursing
victim home or
and assisted
other living
witnesse while
s and prosecut
tries to ion of
determin the
e abuser
whether proceed
the s.
alleged Most
abuse elder
occurred abusers
. If APS are
determin spouses,
es abuse adult
occurred children
, the or
agency grandch
usually ildren,
 997

or other their
people loved
(such as one
neighbor being
s, jailed.
religious Moreov
leaders, er,
or in- victims
home may put
aides) up with
whom abuse if
the elder the
cares abuser
about also
and provide
relies s
upon. assistan
Because ce such
of the as
emotion grocery
al ties shoppin
victims g or
may Elder Abuse
have to
abusers,
some
elder
rent
abuse is
money,
consider
fearing
ed a
that
“betraya
they
l” crime
will be
with
unable
particula
to stay
rly
in their
devastati
home if
ng
the
emotion
abuser
al
no
aftermat
longer
hs.
helps
Victims
them.
are often
Abusers
unwillin
often
g to
manipul
report
ate their
abuse
victims
out of
by first
fear it
isolatin
may
g them
lead to
998

from e
contact LGBTQ
with victims.
other If there
people is
and then someon
convinci e in the
ng the LGBTQ
victim elder’s
that only life who
the does not
abuser know
cares the
about elder is
him or LGBTQ
her. This , the
makes abuser
the may
victim control
even the
more elder by
depende threaten
nt on the ing to
abuser. “out”
Beca the
use of person.
the An
history abuser
in the may
United take
States of advanta
prejudic ge of
e against social
and stigma
stigma by
around telling
LGBTQ an
people, LGBTQ
elder victim
abusers that if
have he or
addition she tries
al to
techniqu report
es they the
can use abuse,
to officials
isolate would
and never
intimidat believe
 999

the people
person like
or would them
mistreat will
him or probabl
her y “grow
because old
of being alone”;
LGBTQ. fear of
Some this can
same- lead an
sex LGBTQ
couples, elder to
to lower prefer
chances an
of being abusive
“outed,” partner
put to no
finances partner
and/or at all.
assets in Isolatin
only one g an
person’s LGBTQ
name; if elder
the may be
owning easier
partner than
later isolatin
liquidate g a non-
s the LGBTQ
account, elder
and the because
couple family
never member
married, s may
the other already
partner be
will estrange
have d, and
little the
recourse LGBTQ
. elder
Through may
out their already
lifetime, be
LGBTQ reluctan
individu t to
als access
typically health
hear that care
1000

provider normal
s and in
mainstre LGBTQ
am relation
aging ships. In
services a
out of similar
fear of vein,
encounte they
ring may
prejudic have
e there. become
Because convinc
there has ed by
tradition popular
ally stereoty
been pes that
little being
accurate LGBTQ
mainstre is
am inherent
discussi ly bad
on of or
LGBTQ harder
life, than
LGBTQ being
people non-
who LGBTQ
come , and so
out later they
in life or settle
who are for
relativel abusive
y relation
isolated ships
from simply
other because
LGBTQ they do
people not
may be think
convince healthy
d by LGBTQ
their relation
abusers ships
that are
whateve possible
r they .
are Even
experien when an
cing is LGBTQ
 1001

elder loved
abuse ones’
victim privacy.
recogniz It has
es the been
abuse especial
and ly
wants it importa
to end, nt for
the many
person LGBTQ
E elders
m to stay
b away
o
from
d
i
govern
m ment
e officials
n , since
t they
know
such
may be
officials
reluctant
have
to seek
confine
help.
d
LGBTQ
LGBTQ
elders
people
have
in
experien
mental
ced
hospital
decades
s,
of
arrested
discrimi
them, or
nation
worse.
and
Because
stigma.
of this
Typicall
history,
y,
many
survival
LGBTQ
meant
elders
keeping
take
silent,
pride in
staying
being
hidden,
self-
and
sufficie
protectin
nt and
g their
are very
own and
reluctan
their
t to ask
1002

authoritiLGBTQ
es Cultures;
for
Aging,
help.
Social
Althoug
Relati
h there onshi
are a ps,
growing and
number Supp
of ort;
LGBTQ Disab
ilities
organiza
Amo
tions ng
that are LGB
developi TQ
ng Elder
expertis s;
e and Discri
program minat
ion
ming
Again
around st
aging LGB
issues, TQ
few are Elder
talking s;
about Intim
elder ate
Partn
abuse
er
and Viole
encoura nce,
ging Fema
LGBTQ le;
elders to Intim
come ate
forward Partn
er
and seek
Viole
assistanc nce,
e if they Male;
are Senio
being r
mistreat Livin
ed or g
Progr
exploite
ams
d. and
Polici
Loree
es
Cook-
Daniels

See also
Ageisms
in
 1003

F center
u oneld
r erabu
t se.org
h /docs/
e Resea
r rchBr
ief_L
R GBT
e _Elde
a rs_50
d 8web.
i pdf
n National
g Reso
s urce
Cent
National er on
Center LGB
on T
Elder Agin
Abuse g
. and
FOR
(n.d.).
GE
Mistre
Tran
atmen sgen
t of der
lesbia Agin
n, g
gay, Net
bisexu work
.
al,
(201
and 3).
transg Ident
ender ifyin
(LGB g
T) and
elders assis
ting
:
LGB
Resea
T
rch elder
brief. abus
Retrie e
ved clien
Dece ts: A
mber guid
e for
4,
abus
2015,
e
from prof
http:// essio
www. nals.
1004

Retri nting,
eved recog
Dece nizin
mber g,
4, and
2015, addre
from ssing
http:// elder
www abuse
.lgbta .
gingc Retrie
enter. ved
org/re Dece
sourc mber
es/pd 4,
fs/ 2015,
Assis from
ting_ http://
LGB www.
T_El lgbtag
der_ ingce
Abus nter.o
e_clie rg/res
nts.p ource
df s/pdfs
National /SEL
Resou F-
rce HELP
Center _
on elder
LGBT Abus
Aging e_Gui
and de.pdf
FORG
E
Transg EMBO
ender
Aging DIMEN
Netwo T
rk.
(2013)
. A
self-
Embodi
help ment is
guide a term
for used to
LGBT describe
older the
adults
experie
and
their
nce of
caregi living
vers in and
and as one’s
loved body,
ones: and
Preve
 1005

negotiati private
ng its and
psychol public
ogical, is
physical necessa
, and ry for
social underst
identity anding
and the and
power, analyzi
pleasure ng
s, and embodi
limitatio ed
ns that LGBTQ
shape life,
bodily since
experien LGBTQ
ce. identitie
Those s are
who experie
study nced as
LGBTQ both
embodi persona
ment lly real
understa and
nd the socially
body as consequ
equally ential.
and Ther
simultan e is no
eously singular
the LGBTQ
home of mode of
individu embodi
al ment.
personh LGBTQ
ood and embodi
a site of ment,
shared like
political, LGBTQ
cultural, identity
and and all
social identity,
meaning is
. thoroug
Underst hly
anding intersect
embodi ional.
ment as This
both means
1006

that the specifici

particula ty of
r time
embodie and
d place,
experien and its
ces an domina
LGBTQ nt
person ideologi
has over es and
a social
lifetime and
will be political
inflected structur
by other es. This
socially entry
relevant summar
markers izes
of theories
identity; of
such as embodi
race; ment
ethnicity with
; class; particul
national ar
identity; relevanc
age; e to
health LGBTQ
and/or experie
disabilit nce and
y; and highligh
the ts some
cultural, of the
historica most
l, and salient
political topics
contexts related
in which to
embodie contem
d life is porary
lived. LGBTQ
Therefor embodi
e, ment in
LGBTQ Western
embodi culture.
ment
will
always
reflect
the
 1007

The identity.
Body LGBTQ
and the theorist
s, often
Self
informe
Contem d by
porary feminist
theorists , queer,
of and
embodi disabilit
ment y
from theory,
LGBTQ claim
perspect that the
ives body
typically plays an
reject enormo
descripti us role
ons of in
embodi determi
ment ning a
that person’
assume s
a firm identity,
and ability,
hierarchi and
cal social
division status.
between As a
mind nexus
and of
body, in nature
which and
the mind culture,
is a
associat person’
ed with s body
the self signals
and the member
body is ship in
seen as social
separate categori
from the es, such
self and as
therefor gender,
e a sexualit
nonesse y, and
ntial race,
aspect and
of those
1008

social misreco
categori gnized;
es patholo
assign gized;
varying and
degrees targeted
of for
power moral,
and legal,
vulnerab medical
ility to , and
individu social
als. regulati
Member on and
s of interven
socially tion.
denigrat Perhaps
ed and because
historica of these
lly challen
disenfra ges,
nchised LGBTQ
groups embodi
(LGBT ment
Q may
individu also
als, involve
women, creative
people and
of color, innovati
the ve
disabled efforts
) at
experien embodi
ce ed self-
restrictio determi
ns and nation,
oppressi as well
ons as
linked approac
directly hes to
to their embodi
bodily ed
status. pleasure
LGBTQ that
bodies defy
may socially
become sanction
stigmati ed
zed, views
 1009

of may
embodie include
d varied
pleasure and
typical multiple
of experie
societies nces of
that danger
favor and
cisgende violenc
red e as
heterose well as
xuality. empow
(Cisgen erment
der and
refers to pleasure
individu .
als
whose
gender Gender
identity Identit
conform y
s to the Gender
gender identity
they is a
were social
assigned and
at birth; psychol
cisgend ogical
ered underst
heterose anding
xuality of
refers to oneself
the as
culture belongi
of ng to
heterose one of
xual the
identity, availabl
norms, e
and gender
practices options
of in any
cisgende given
red culture
people.) —
Thus, usually
LGBTQ “male”
embodi and
ment “female
1010

.” with
Gender male
identity sex
is traits
assigned are
at birth assigne
but is d a
also male
maintain gender.
ed and In this
manage way,
d over a sex and
lifetime gender
through are
numerou correlat
s social ed at
institutio the site
ns (such of the
as body,
religion, and
school, often
modern assume
medicin d to be
e) that causally
teach linked,
and such
regulate that
gender male
identity. body
Bodies traits
are are
assigned thought
gender to
identitie cause
s based male
on gender
genital identity,
traits: and
Babies female
born body
with traits
female are
sex thought
traits are to
assigned cause
a female female
gender, gender
and identity.
babies Central
born to
 1011

gender typicall
identity y
is an correlat
assumpti ed to
on of that
opposite gender,
-sex or if
desire, they do
in that not
those exhibit
exclusiv
Embodiment
e
opposite
designat
-sex
ed
attractio
“male”
n
are
assume
thought
d to be
to
part of
exclusiv
gender
ely
identity,
desire
itself
those
thought
designat
to be
ed
built
“female,
into the
” and
body.
vice
Under
versa.
these
LGB
norms
TQ
of
individu
embodi
als are
ment,
understo
LGBTQ
od as
embodi
deviatin
ment
g from
may be
normativ
perceive
e gender
d and
identity
experie
if they
nced as
claim a
gender
gender
nonconf
identity
orming,
that does
or as
not
failing
conform
to
to the
express
body
correct
traits
gender
1012

identity and
properly psychol
. ogical
concern
, with
Sexual some
Regula sexual
tion acts (for
and instance
Pleasur ,
e heterose
xual
Bodies, intercou
and rse
what we between
can do married
with ,
them, cisgend
are er
heavily adults)
regulate encoura
d in ged and
different rewarde
ways d, and
across others
cultures. (such as
This is sex
especiall among
y true of lesbian,
sexual gay,
activity. bisexual
How, ,
when, transge
where, nder,
and with and
whom queer
one may folks)
engage discour
in aged
embodie and
d sexual punishe
behavior d.
is a Sexual
matter regulati
of on may
consider take
able official,
legal, legal
moral, form
medical, such as
 1013

“decenc such as
y” laws cultural
prohibiti taboos
ng that
sexual prohibit
activity sex
in public outside
(which of
have marriag
historica e.
lly Gender,
tended too, is
to target regulate
gay d in
men). cultures
Indeed, that rely
until a heavily
2003 on
Supreme traditio
Court nal
decision gender
ruled a ideologi
Texas es.
sodomy LGBTQ
law and individu
all als
similar whose
laws embodi
unconsti ed life
tutional, violates
more rules of
than a sexual
dozen conduct
U.S. , or
states whose
had embodi
official ment
laws does
criminal not
izing confor
same- m to
sex normati
sexual ve
activity. gender
Sexual roles,
regulatio may
n may face
also take bullying
unoffici ,
al form, gender-
1014

and sex- Emb

based odiment
harassm is often
ent, idealize
gender- d as a
and sex- state of
based feeling
hate “at
crimes, home”
and in one’s
other body.
embodie Such a
d feeling
dangers of
such as wholene
sexual ss and
assault security
and may
violation elude
. Such LGBTQ
trauma individu
can als who
register live in
in theeras and
body for places
a of
lifetime, sexual
significa and
ntly gender
diminish regulati
ing an on that
individu heavily
al’s favor
sense of cisgend
freedom ered
in, and heterose
sovereig xuality.
nty over, In those
his orsettings,
her own LGBTQ
body. people
E are
mlikely to
b experie
o
nce
d
i
their
msexual
e desires
n and
t actions
 1015

as sinful, their
unsafe, sexual
or or
patholog gender
ical, and identity
as a puts
result, them at
they risk of
may feel bodily
their punish
bodies ment
to be and
under violence
constant .
surveilla Conseq
nce and uently,
in embodi
perpetua ment
l danger. for
Even for LGBTQ
those people
who may be
have not experie
directly nced as
suffered conflict
such ed,
sex- or insecure
gender- , and
based alienate
violence d.
, the fear LGBTQ
of individu
potential als may
violence respond
function to a
s to keep culture
all of
LGBTQ sexual
individu regulati
als on by
vigilant internali
and zing
unsure those
of their external
bodily regulato
safety, ry
based on forces,
the so as to
knowled discipli
ge that ne their
1016

own red
bodies heterose
to xual
conform embodi
to ment,
dominan sexual
t norms pleasure
of for
sexual LGBTQ
behavior individu
. als will
Embo vary as
died life well.
includes Without
embodie a desire,
d or
pleasure, mandate
especiall , to
y sexual reprodu
pleasure. ce,
Under LGBTQ
regulator sexual
y behavio
conditio r may
ns such allow
as those for
describe embodi
d above, ed
LGBTQ pleasure
people s that do
still not
pursue exclusiv
sexual ely
pleasure center
even if on
their penetrat
freedom ive
to do so intercou
is not rse.
universa Such
lly alternati
protecte ve
d. sexual
Because practice
LGBTQ s can
embodi endow
ment bodies,
varies body
from parts,
cisgende and
 1017

embodie elsewhe
d sexual re,
scenario sexual
s with minoriti
erotic es may
meaning undergo
not (volunta
typically rily or
acknowl involunt
edged in arily)
cultures “conver
of sion
cisgende therapy
red ”
heterose designe
xuality. d to
transfor
m their
Bodily sexual
Interve orientati
ntion on from
In nonhete
cultures rosexua
that l to
favor heterose
cisgende xual.
r Convers
heterose ion
xuality, therapy
embodi includes
ment for a range
LGBTQ of
individu practice
als may s, many
also be of them
marked involvin
by g
intervent treatme
ion, or nts to
efforts the
at body,
intervent includin
ion, by g
outside behavio
forces. r
In the modific
United ation
States therapy
and and, at
times,
1018

painful s are
genital being
manipul increasi
ation. ngly
Physical discredi
and ted as
psychol both
ogical unethic
trauma al and
may ineffecti
result ve,
from suggesti
being ng that
subjecte sexual
d to orientati
physical on is
pain in not so
order to malleab
“cure” le a
one’s trait.
sexualit Whil
y, and e some
such interven
abuse tions to
can, like manage
other LGBTQ
forms of embodi
violence ment
, make have
for been
anguishe abusive
d and
embodi surely
ment unwelco
wherein me,
one’s medical
bodily, (and
sexual political
self may )
be interven
experien tion to
ced as a manage
liability. the
In the devastat
early ing
21st impact
century, of
conversi HIV/AI
on DS on
therapie LGBTQ
 1019

embodi of
ment bodily
would failure
have as well
been as
most social
welcome rejectio
. The n.
notoriou Activist
sly slow organiz
political ations
and that
cultural sprang
response up in
s to the respons
HIV/AI e to the
DS HIV/AI
crisis in DS
its early crisis,
years, such as
when ACT
gay men UP and
were the the Gay
most Men’s
visible Health
victims, Crisis,
had put
profoun LGBTQ
d effects health
on the concern
cultural s on the
designati national
on of agenda,
certain and
bodies made
as both clear
unhealth that
y and LGBTQ
unsafe. embodi
Embodi ment is
ment for a
LGBTQ political
individu issue.
als who Medi
are HIV- cal
positive interven
has thus tion into
been LGBTQ
marked embodi
by a fear ment
1020

may be on their
understo own
od in behalf
other, to
positive achieve
terms. the
Hormon anatomi
al and/or cal
surgical features
intervent of their
ion to chosen
“cure” gender,
or this is
“correct more
” commo
someone nly
consider underst
ed ood as
gender medical
nonconf interven
orming tion
or motivat
sexually ed by
deviant embodi
is ed self-
clearly determi
abusive nation.
in its The
violation same
of may be
individu said for
al bodily the use
sovereig of
nty. assisted
Howeve reprodu
r, when ctive
LGBTQ technol
individu ogies
als, (ARTs)
especiall for
y LGBTQ
transgen individu
der als
individu pursuin
als, g
pursue biologic
hormona al
l and/or parenth
surgical ood.
therapies Thus,
 1021

the role to
of express
modern a
medicin particul
e in ar
LGBTQ gender
embodi or
ment is sexual
complex identity,
, and its and
ethical someti
value mes
depends fashion
entirely is a
on why, resourc
how, e for
and by not
whom it calling
is used. attentio
n to
one’s
Styles sexual
of and
Embodi gender
ment identity.
Howeve
How r, for
individu others,
als style persona
their l and
bodies, collecti
and how ve style
those can be a
styles crucial
are dimensi
socially on of
understo persona
od, has l and
particula social
r identity
relevanc related
e to to
LGBTQ LGBTQ
embodi embodi
ment. ment.
Many More
people than
may not merely
turn to a matter
fashion of
1022

clothing, g
style eroticall
includes y
body charged
modifica body
tion, parts;
body and
habits, referenc
patterns ing,
of through
speech both
and clothing
moveme and
nt, and body
other comport
deliberat ment,
e uses of historie
the body s of
to LGBTQ
signify aestheti
one’s cs of
member embodi
ship in ment,
categori includin
es and g
cultures butch/fe
of mme,
gender androgy
and ny,
sexualit camp,
y. and boi
Embodi aestheti
ed, cs,
stylistic among
choices countles
for s others.
LGBTQ Androg
individu yny is a
als may style of
include embodi
breast- ment
binding; that
hiding refuses
one’s a single
penis; gender
wearing associat
dildos; ion and
conceali instead
ng or referenc
revealin es
 1023

both favored
masculi by
nity and queer
feminini women
ty. and
Camp is trans
a men
deliberat that
ely features
“over- preppy,
the-top” youthfu
style l, and/or
that has dandy
a strong style.
self- As this
consciou brief
sness to catalog
it, ue of
emphasi LGBTQ
zing styles
perform of
ance, embodi
irony, ment
and shows,
parody, creative
which self-
can be fashioni
powerfu ng can
l modes be a
of powerfu
signalin l mode
g for
awarene using
ss of the the
cultural body to
and enact
historica sexual
l, rather and
than gender
natural, identitie
basis of s that
gender gesture
identity. to
Boi is an differen
aesthetic ce from
of normati
LGBTQ ve
masculi heterose
nity xuality.
often
1024

Marjori F
e Jolles u
r
Emplo t
yment h
Non- e
Discri
r
minati
on Act
(ENDA R
) e
a
d
See also i
Body n
Image
g
Disturban
ce and s
Eating Bloodsw
Disorders orth-
in Lugo,
LGBT M.
Q (2007
Peopl ). In-
e; betwe
Body en
Modif bodie
icatio s:
n; Sexua
Body l
Size differ
and ence,
Weigh race,
t; and
Cisge sexua
nderis lity.
m; Alban
Inters y:
exuali State
ty Unive
rsity
of
New
York
Press.
Bornstein
, K.
(1995
).
Gend
er
outla
w: On
men,
wome
 1025

n, and Grosz, E.
the (1994
rest of ).
Volat
us.
ile
New bodie
York, s:
NY: Towa
Vintag rd a
e. corpo
real
Butler, J.
femin
(1993) ism.
. Bloo
Bodies mingt
that on:
matter India
na
: On
Unive
the rsity
discur Press.
sive Heyes,
limits C.
of (20
“sex.” 07).
New Sel
York, f-
NY: tra
Routle nsf
dge. or
Foucault, ma
M. tio
(1985)
ns:
. The
histor Fo
y of uca
sexual ult,
ity, eth
Vol. ics,
2: The
an
uses
of d
pleasu nor
re (R. ma
Hurley lize
, d
Trans.
bo
). New
die
York,
NY: s.
Rando Ne
m w
House Yor
. k,
NY
1026

:
Oxf
ord EMPLO
Uni
YMENT
vers
ity NON-
Pres
s. DISCRI
Pitts, V. MINATI
(2000) ON
.
Visibl ACT
y
queer: (END
Body
techno A)
logies
and
sexual
politic The
s. Employ
Sociol ment
ogical Non-
Quart Discrim
erly,
ination
41(3),
443– Act
463. (ENDA
Serano, J. ) refers
(2007) to
. propose
Whipp d
ing federal
girl: A legislati
transs on in
exual the
woma United
n on States
sexism that
and would
the prohibit
scape discrimi
goatin nation
g of based
femini upon
nity.
sexual
Emery
orientati
ville,
on and
CA:
gender
identity/
Seal
expressi
Press.
on by
 1027

employe that
rs with LGBTQ
at least workers
15 would
employe become
es. a
Propone protecte
nts of d group
ENDA alongsi
recogniz de other
e that protecte
LGBTQ d
people categori
have es, such
been as race,
historica color,
lly religion
marginal , sex,
ized in national
the origin,
workpla disabilit
ce, and y, and
passage age.
of E
ENDA m
would p
l
prohibit
o
employe y
rs from m
firing, e
denying n
job t
opportu N
nities to, o
n
or
-
otherwis D
e i
discrimi s
nating c
against r
LGBTQ i
workers. m
i
ENDA
n
becomin a
g law in t
the i
United o
States n
would
mean A
1028

c protecti
t ng
( LGBTQ
E
workers
N
D . Even
A though
) LGBTQ
workers
are not
END explicitl
A is y
modeled protecte
after d under
other Title
importan VII,
t civil certain
rights harassm
legislati ent
on of the impacti
past ng
century. LGBTQ
For workers
example has
, Title been
VII of recogni
the Civil zed
Rights under
Act of Title
1964 VII. For
prohibits example
discrimi , the
nation at Suprem
work e Court
based on ruled in
race, Oncale
color, v.
religion, Sundow
sex, or ner that
national workpla
origin, ce
and discrimi
provides nation
a strong based
foundati on sex
on for a also
compreh applied
ensive to
civil harassm
rights ent
bill between
 1029

individu Abzug
als of and
the same Edward
sex. Koch.
Howeve The
r, absent Equality
explicit Act of
protectio 1974
ns, would
propone have
nts say, outlawe
LGBTQ d
workers discrimi
are at nation
risk for based
adverse upon
workpla sexual
ce orientati
actions. on,
END relation
A, in its ship
various status,
forms, and
has been gender
propose in
d, public
defeated accomm
, and odation,
stalled at housing
the , and
federal employ
level for ment.
the past Represe
40 years. ntative
The Abzug
Equality and
Act of others
1974 introduc
was a ed
much various
broader forms
predeces of
sor of employ
ENDA ment
that was protecti
introduc ons
ed by during
Represe the
ntatives years
Bella followin
1030

g, but many
those local
measure jurisdict
s failed ions
to offer
become protecti
law. ons
ENDA based
has been upon
propose sexual
d in orientati
nearly on and
every gender
Congres identity.
s since Three
the mid- states
1990s provide
yet has protecti
failed to ons
gain the only
moment based
um upon
needed sexual
to orientati
become on.
law. Over
Empl 450
oyment Fortune
nondiscr 500
iminatio compan
n ies have
policies policies
and that
legislati expressl
on have y
been prohibit
more discrimi
successf nation
ul in the based
United upon
States at sexual
the state, orientati
local, on, and
and over
organiza 300
tional prohibit
level. discrimi
Eighteen nation
states based
and upon
 1031

gender certain
identity. protecti
Some ons to
employe its own
rs workers
actively and
recruit contract
LGBTQ ors.
workers Federal
as part civil
of their service
policies employ
to ees
promote have
workpla enjoyed
ce nondisc
diversity riminati
. Many on
cities policies
and prohibit
states ing
offer discrimi
compreh nation
ensive based
anti- on
discrimi sexual
nation orientati
protectio on since
n that 1995.
extends The
beyond military
employ ’s Don’t
ment Ask,
and Don’t
includes Tell
areas policy
such as was
housing repealed
and in 2010,
public and the
accomm armed
odations forces
. do not
In currentl
addition, y ban
the sexual
federal minoriti
governm es from
ent entering
offers military
1032

service, about
but LGBTQ
gender people,
identity/ these
expressi importa
on is nt
still not federal
protecte decision
d in the s set the
military. stage
In terms for
of passage
federal of a
employe compre
es, there hensive
have federal
been ENDA.
other Howeve
importan r,
t passage
decision of the
s bill has
impactin not
g occurre
LGBTQ d as of
workers, this
includin writing.
g the In
Supreme 2013,
Court’s ENDA
2015 was
ruling reintrod
that the uced in
U.S. both the
Constitu House
tion and
guarante Senate.
es the Althoug
right to h the
marry bill
for passed
samesex in the
couples. Senate,
Coupled major
with LGBTQ
significa rights
nt and
changes other
in public social
opinion justice
 1033

advocac ENDA’
y s
organiza current
tions religiou
have s
withdra exempti
wn their on
support could
for offer
ENDA any
because religiou
of its s
broad person,
exempti regardle
on for ss of
religious whether
organiza the
tions. In person
contrast, is in the
Title VII business
offers a of
very ministry
narrow , the
religious ability
exempti to
on that discrimi
allows nate
religious against
organiza LGBTQ
tions to workers
have .
some Othe
degree r
of oppone
latitude nts of
in hiring ENDA,
so that some
they can within
employ the
individu LGBTQ
als with equality
similar movem
religious ent,
convicti argue
ons. that
These ENDA
opponen itself is
ts note, fundam
however entally
, that flawed.
1034

Rather
than
amendin
g Title
VII to
include
sexual
orientati
on and
gender
identity/
expressi
on,
passage
of
ENDA
would
create a
separate
law,
further
perpetua
ting the
idea that
sexual
orientati
on and
gender
identity/
expressi
on
discrimi
nation
are
different
from
other
forms of
discrimi
nation.
States
that
have
 Essentialist–Constructionist Debate on the Origins of Sexual Orientation
been most successful at implementing protections based
upon sexual orientation and gender identity/ expression
have done so by expanding existing civil rights laws
rather than creating new laws. These opponents say the
solution is to amend Title VII to include sexual
orientation and gender identity or perhaps to amend the
entire Civil Rights Act of 1964.
In 2014, President Barack Obama, who has long
supported the passage of ENDA, signed an executive
order prohibiting discrimination based upon sexual
orientation and gender identity/ expression for federal
contractors. This executive order also formally
extended protections based upon gender
identity/expression to federal civil service employees.
Though President Obama’s executive order was narrow
in scope, it further expanded protections in the United
States for LGBTQ workers. There are an estimated
24,000 companies that are designated federal
contractors with over 28 million workers. President
Obama’s executive order was issued after years of
urging policy makers to pass a comprehensive federal
nondiscrimination act that would protect all LGBTQ
workers.
Trevor G. Gates
See also Defense of Marriage Act (DOMA); Don’t Ask,
Don’t Tell and Public Opinion; Gay Exclusion in the
U.S. Military: Evolution and Demise of Don’t Ask,
Don’t Tell; Workplace Discrimination
Further Readings
Badgett, M. V. L., Lau, H., Sears, B., & Ho, D. (2007). Bias
in the workplace: Consistent evidence of sexual
orientation and gender identity discrimination. Los
Angeles, CA: Williams Institute.
Gates, T. G., & Rodgers, C. G. (2014). Repeal of Don’t Ask,
Don’t Tell as “policy window”: A case for passage of the
Employment Non-Discrimination Act.
Journal of Discrimination and the Law, 14(1), 5–18.
Library of Congress. (2013). Employment NonDiscrimination
Act of 2013. Retrieved December 4, 2015, from
https://www.congress.gov/bill/113thcongress/house-bill/175
5
Essentialist–Constructionist Debate on the Origins of Sexual Orientation
1035
ESSENTIALIST–CONSTRUCTIONIST
DEBATE ON THE ORIGINS OF
SEXUAL ORIENTATION
Sexual identities, behaviors, and lifestyles have always
been a subject of much discussion and controversy. One
of the enduring questions posed by academics and the
general public alike is how and why some individuals
become gay, lesbian, or bisexual. Put more simply—but
not unproblematically— sometimes individuals ask
what “causes” someone to be bisexual, homosexual, or
queer. Questions about the origin or causation of sexual
orientation are often answered using one of two
frameworks: biological essentialism (nature) or social
constructionism (nurture).
This entry begins by providing definitions and
applications of biological essentialism and social
constructionism, both in general and then more
specifically in the context of LGBTQ identities and
behaviors. Next, a brief historical context of the
emergence of the essentialist–constructionist debate in
sexology is offered. This is followed by a description of
major concepts and implications of the biological-
essentialist and social-constructionist approaches. Then,
the either/or dichotomy/binary that this debate
continues to engender is explored. Finally, this entry
addresses the reasons this debate has been fought so
fiercely in LGBTQ studies and in the broader field of
sexuality studies.
Definitions and Applications of Biological
Essentialism and Social Constructionism
The origins of certain human behaviors and
characteristics are often explained through the lenses of
biological essentialism and social constructionism.
Biological essentialism suggests that biological factors
(e.g., genetics, hormones, and/or neuroanatomical
structures) are responsible for various human traits,
qualities, and characteristics. Social constructionism
maintains that sociocultural forces create, shape, and
maintain human behaviors, traits, and qualities. For
example, human intellect has been explained using
1036
biological-essentialist and social-constructionist
theories. If someone is perceived as smart, biological
essentialists would attribute this “brainpower” to
genetic giftedness: The person is seen as genetically
hardwired for brainpower, born with a biological
endowment for heightened intellectual capacity. Social
constructionists would claim that intellectual prowess
pertains to how someone has been nurtured and
encouraged to read, think critically, keep the company
of those who value ideas, and be intellectually engaged:
They maintain that intellect is not a product of
biological factors, but rather is created from social
circumstances that foster intellectual development and
capacity. The origins of criminality, alcoholism, athletic
ability, and a variety of other human traits have also
been argued along biological-essentialist and social-
constructionist lines. Perhaps the most fervent
discussion about the roles of biological factors and
social influences, however, centers on the origin of
nonheterosexual sexual identities and behaviors. Much
attention, and countless scholarly and popular-press
writings, has been devoted to the age-old question
about why individuals become LGBTQ-identified
and/or engage in nonheterosexual sexual activities.
Why do some people develop nonheterosexual,
“non-normative” sexualities? Is there a biological root
of their sexual behaviors and attractions? Are there
multiple biological factors at work? Or, completely out
of the biological arena, are there social or
environmental factors that form one’s sexuality? These
questions are at the basis of an ongoing debate known
as the essentialist–constructionist debate regarding
sexual orientation, sometimes simply referred to as the
biological essentialism (or determinism) versus social
constructionism debate (or “nature versus nurture”).
Arguments and strongly held positions about the origin
of heterosexuality and nonheterosexuality have been
prominently featured in the field for several decades.
Many scholars and researchers have devoted the bulk of
their academic careers— and in some cases, their entire
careers—espousing either the biological-essentialist or
the social- constructionist view. It is important to
understand the tenets of both positions.
Biological essentialists assert that biology alone
determines to whom a person is sexually attracted in
terms of same sex or opposite sex. Research in the areas
of behavioral genetics, endocrinology, and
neuroanatomy has attempted to pin down the origin of
same-sex attractions and behaviors. Genetics research
suggests that being gay or lesbian is more likely when
family members are gay or lesbian: A gay male is apt to
have other males in his family who are also gay; a
lesbian is likely to have other females in her family who
are lesbians. Studies of monozygotic (identical) and
dizygotic (fraternal) twins suggest inheritability of
sexual orientation. Chromosomal research and studies
have been done on hand-use preference, fingerprints,
and length of fingers and their connection with being
gay or lesbian. Several studies have been performed on
the effects of testosterone and estrogen on sexual
orientation. It has been hypothesized that gay men have
a deficient amount of testosterone and that lesbians are
short on estrogen. Researchers have concluded that
biology plays a major role in the formation of sexual
attractions and behaviors.
Social constructionists, however, assert that sexuality
is a product of social influences and that meanings
about sexuality are socially constructed through
language and discourse. Social constructionists
maintain that sexuality cannot be reduced to a physical
core or essences that emerge through biological
mechanisms. Rather, meanings, interpretations, and
values about sexuality are malleable—not biologically
fixed—and are created, for example, through
educational, legal, literary, medical, political, and
religious discourses, just to name a few. Language and
discourse are used by various institutions, such as
religion, law, medicine, education, and social welfare,
to control sexual and gender expression. These
institutions have enforced meanings that normalize
sexual and gender stereotypes and have marginalized
nonprocreative forms of sexuality, such as bisexuality,
homosexuality, masturbation, and other forms of
nonheterosexual sexual expression.
Nonheterosexual and heterosexual sexualities are not
immutably fixed, according to social constructionists.
As social conditions change, so do realities,
perceptions, and attitudes about various sexualities.
These shifts happen on a societal level and potentially
on an individual level as well. Homosexuality in the
United States is a good example. Before the 1970s,
homosexuality was viewed as a de facto mental illness.
Until recently, there were state laws (sodomy laws
targeting nonheterosexuals) that criminalized many
nonprocreative sexual acts and federal laws (e.g.,
Uniform Code of Military Justice) that outlawed gays
 Essentialist–Constructionist Debate on the Origins of Sexual Orientation
and lesbians serving openly in the U.S. military. The
medical (psychiatric) and legal discourses perpetuated
and reinforced the dim societal views and attitudes
about homosexuality. However, there was resistance to
counter such antigay and antilesbian sentiments in
various cities across the nation in the 1950s and 1960s,
including, but not limited to, the Compton’s Cafeteria
Riot in San Francisco in 1966 and the Stonewall Inn
Riot in New York City in 1969. Empirical
psychological research on gay men conducted by Dr.
Evelyn Hooker at UCLA in the late 1950s debunked the
long-held claim that gays and lesbians were
categorically mentally ill. Several significant changes
followed that disrupted the discourse of pathology
regarding homosexuality. For example, the American
Psychiatric Association removed homosexuality as a
mental disorder from the Diagnostic and Statistical
Manual of Mental Disorders (DSM) in 1973. In 2003,
the landmark U.S. Supreme Court decision in Lawrence
v. Texas struck down sodomy laws targeting gays and
lesbians nationwide. In 2013, the U.S. military’s Don’t
Ask, Don’t Tell policy was repealed, allowing gays and
lesbians to serve openly in the U.S. military. Finally, in
June 2015, the U.S. Supreme Court ruled that same-sex
marriage was legal in all 50 states. These are only some
examples of the events that have brought about change
in the discourses. The sociopolitical realities have
changed, creating more permissive and accepting
attitudes generally about nonheterosexuality in U.S.
Essentialist–Constructionist Debate on the Origins of Sexual Orientation
society.
Social constructionism not only influences societal
views about gays and lesbians and nonheterosexuals in
general, but affects individuals as well.
Social constructionists maintain that people “choose”
their sexualities insofar as sexual behaviors, identities,
and lifestyles are not biologically programmed or
predetermined. More specifically, according to social-
constructionist theory, sociocultural situations and
environments create individuals’ sexual realities:
Sexualities are products of social surroundings,
learnings, and experiences.
Brief Historical Overview of the
Essentialist–Constructionist Debate in
Sexology
1037
From the early 19th until the late 20th century, sexology
(the study of sexuality) in Europe and the United States
was dominated by biomedical researchers, including
psychiatrists. The popular notion was that sexuality was
“natural,” innate, and biologically driven. Perhaps one
of the most prominent European sexologists in the late
19th century was Dr. Richard von Krafft-Ebing, who
authored the widely known and celebrated sexological
book Psychopathia Sexualis. Among other ideas he
advanced—lodging sexuality in the realm of biology—
was that the sex instinct is an irrepressible impulse
meant to perpetuate the human race. Procreative
sexuality was seen as both natural and expected. In his
writings, Krafft-Ebing espoused a downright negative
view of nonheterosexuality. He postulated, for example,
that homosexuality was due to biodevelopmental
problems in utero that led to an inversion of the brain.
Another prominent thinker of the time, Sigmund
Freud, in his seminal 1905 work, Three Essays on the
Theory of Sexuality, suggested that a biological basis
for homosexuality likely would be discovered,
specifically regarding hormonal effects on the body and
mind. Scores of sex researchers from the 19th century
to the present not only have not questioned the
assumption of the primacy of biological factors in
determining sexuality, but have perpetuated this notion.
Behavioral geneticists such as J. Michael Bailey, Dean
Hamer, Brian Mustanski, Richard Pillard, and others
have indicated that homosexuality has a genetic basis.
Dick Swaab and Simon LeVay assert that certain
anatomical locations in the brain are indicators of
homosexuality. Endocrinological research by Melissa
Hines, Dick Swaab, and others has suggested a
hormonal basis for sexual orientation. Biological
theories of sexuality dominated—and went largely
unchallenged in—the sexological landscape until the
early 1970s.
The 1970s witnessed challenges to the notion that
sexuality was biologically determined. Many scholars
advanced the idea that historical and sociocultural
factors shape sexuality. In the early 1970s, U.S.
sociologists John Gagnon and William Simon proposed
that sexual scripts were generated from social and
psychological contexts. Later, acclaimed French
philosopher Michel Foucault theorized that discourses
shape sexualities. British historical sociologist Jeffrey
1038
Weeks suggested that sexuality is ultimately malleable
and deeply influenced by history. The prominent
academic Carole Vance wrote that the development of
sexualities is not rooted in biological functions, but
rather sexualities are created as products of human
actions and historical factors. Another influential
scholar, Leonore Tiefer, critiqued the notion that
sexuality is “natural” and inextricably linked to biology;
she has also been a leading critic of the
biomedicalization of sexuality. Numerous other
academics have joined the social-constructionist camp.
In many ways, the development of gay and lesbian
studies at U.S. universities in the 1970s provided an
academic home and genre in which to question
biologically deterministic views of homosexuality.
Scholars in queer studies have continued this effort
since the field’s inception in the academy in the 1990s.
Implications of the Biological-Essentialist and
Social-Constructionist Approaches
The essentialist–constructionist debate has largely
involved deep and contentious academic discussions
about the etiology of nonheterosexualities. That is,
lesbian, gay, bisexual, and queer (LGBQ) people have
been under the academic microscope about the origin of
their sexualities, but the cause of heterosexuality has
gone almost entirely unexamined. In many ways,
heterosexuality has been seen as unquestionably
“normal” and so socially expected and accepted that it
has remained invisible and off the proverbial table
regarding a discussion about the origin and impact of
heterosexuality on society.
The belief in a biological basis of homosexuality has
historically had very negative impacts on some LGBQ
people. For example, due in part to KrafftEbing’s
reputation as a sexologist and his stance on the
biological basis of sexual perversions, many people—
homosexuals and “other perverts”—were forcibly
sterilized between the late 19th and mid20th centuries.
As late as the early 1950s, lobotomies and
gonadectomies were performed on gays and lesbians
because homosexuality was considered a mental illness.
The idea of scientists finding a definitive biological
basis for nonheterosexualities and developing
“corrective measures” to “cure” or otherwise obliterate
them has been feared by some and infuriating to others.
Reparative psychotherapy, used to “correct”
homosexual attractions and behaviors, has also come
under fire.
In 1993, a stage play entitled The Twilight of the
Golds featured a hypothetical situation in which genetic
testing could determine the sexual orientation of
fetuses. One of the main characters, Suzanne, is
pregnant and decides to have her unborn baby
genetically tested. The baby is a boy, and genetic
analysis reveals that he is going to be gay. Suzanne
agonizes about whether to abort the fetus. She ends up
getting an abortion, and her decision devastates her gay
brother. This stage performance highlights the potential
dangers and ethical dimensions of such a laboratory
test, as well as the decisions that come from having it
available and the social upheaval and devastation that
can result because of such actions.
The motivations for researching the possible
biological roots of nonheterosexualities have been
varied and sometimes viewed as suspect. Some who
espouse the biological foundations of
nonheterosexualities claim that scientific support for the
biological origin of nonheterosexual sexualities would
be liberating. That is, there would be some comfort in
knowing that sexual orientation is deeply and
immutably lodged in one’s biology and there is no
choice in the matter, because there is unquestionable
legitimacy in one’s biology. Social constructionists find
it empowering to theorize that sexuality is the product
of social, political, and environmental forces.
Another implication of the essentialist–
constructionist debate concerns the notion of “opposite
sex.” Individuals often refer to the opposite sex as if
females and males are opposite of one another. This is a
prime example of a socially constructed concept
masquerading as a biologically based truism. However,
much research has challenged and even debunked the
veracity of opposite sex as a binary. In fact, according
to a body of literature, females and males have more in
common than they have differences. The concept of
opposite sex is a social construction, not rooted in
biological realities. The ideas surrounding opposite sex
also have the potential of reinforcing sexism, which is
based on the myth that females and males are
fundamentally different from one another. If the
perception of opposite sex is not challenged, it is likely
that commonly held assumptions about gender
stereotypes will continue along with sexist beliefs about
both females and males. However, if individuals have
 Essentialist–Constructionist Debate on the Origins of Sexual Orientation
an
understanding that opposite sex is a social construction
and that females and males are not completely different,
there is the potential for flexibility regarding how
females and males can be in the world. Another benefit
is that individuals might be open to exploring sexual
relationships with same-sex and other-sex partners. If
heterosexuality rests on the assumption that females and
males are opposite, then an understanding that
“opposite” is grossly overstated destabilizes part of the
foundation upon which heterosexuality has been built.
The implications of biological essentialism and social
constructionism can be profound.
1039
Many researchers maintain that sexual orientation is
either biologically determined or socially constructed.
This has been a bitterly fought debate. A plethora of
books and articles expose just how the issues
surrounding this debate have been divisive and have
even caused irreparable rifts in professional
relationships of some sexologists. It often comes down
to biological essentialists versus social constructionists.
While many individuals maintain that the origin of
sexual orientation is a matter of either biology or social
influences, other individuals argue that a combination
of biological and sociocultural influences is responsible.
One such approach is

The Dichotomous/Binary Aspects of the

Debate
The essentialist–constructionist debate has been
dichotomous. Often issues and questions are presented
in an “either/or” fashion. Using the example of
nonheterosexuality, the question is usually why certain
individuals become LGBQ. Is it nature or nurture?
Does it have to do with biological influences or social
factors? This dichotomization happens in both popular
culture and academic circles, reducing a complicated
and nuanced question about the origin of sexual
orientation to simplistic terms. The majority of
individuals hold firmly to the notion that it is either
biology or social influences. The majority of
individuals in the general population believe sexual
orientation is biologically determined. Perhaps this is
because biological studies receive a disproportionate
amount of attention in the popular press compared to
social conditions as the determining factor of sexual
orientation. Newspapers, magazines, and other popular-
press publications, as well as news programs on
television and radio, have historically featured the
results of biological studies and the causal relationship
of biology to sexual orientation. Scholarship focusing
on the social construction side of the debate rarely gets
the popular-press coverage that biological studies
receive. In fact, most social-constructionist scholarship
resides in academic journals and scholarly books that
are geared toward academicians, not the general reader.
The essentialist–constructionist debate has been
underway for approximately the past 40 years, and the
majority of the scholarship reveals that the question
about the origin of nonheterosexualities is polarized.
1040
Ethical Debates About Surrogacy
interactionist theory, which suggests that biological and
social aspects interact with one another to form an
individual’s sexual orientation. This has also been
called the multifactorial model or the interactive
biopsychosocial approach. These theories propose that
several forces interact to create various sexualities.
Another explanation for how sexual orientation
develops is the dialectical approach. This is a far more
nuanced and complicated theory than those mentioned
above. In this approach, both biological and
sociocultural realities are acknowledged as
“ingredients” that create sexualities. The dialectical
approach suggests that biological materials (e.g., genes,
hormones, etc.) are potentialities that get realized
through sociocultural and environmental aspects of life
and vice versa. It is not that the internal (biology)
interacts with the external (sociocultural), but rather
that they are mutually constitutive and penetrative, and
sexual orientation develops as a result of a unique and
complicated relationship between biological and
sociocultural factors. One does not take precedence
over the other. Neither biological nor sociocultural
aspects are primary in determining sexual orientation—
both are equally important and necessary. The
biological components cannot be separated or teased
apart from the sociocultural aspects, and together they
create sexualities.
Reasons This Debate Has Endured for
Decades in LGBTQ and Sexuality Studies
The essentialist–constructionist debate has continued
for numerous reasons; only a few will be explored here.
First and foremost, this debate has been highly political.
The question about whether being LGBQ is an inborn
reality (nature) or a creation of sociocultural
phenomena (nurture) has
raised the issue about whether sexual orientation is a
“choice.” Many individuals have argued that finding
sexual orientation to be a product of biology would be
“protective” against admonitions about the sinfulness of
choosing to be LGBQ. Some people feel if the notion of
choice is removed, then LGBQ individuals will be less
targeted and discriminated against. Others, however,
argue that the social-constructionist view is more
empowering for LGBQ individuals. In addition, social
constructionists have attempted to liberate LGBQ
individuals from the medicalization and pathologization
of nonheterosexuals. Giving agency to LGBQ people to
be active participants in their sociosexual lives has also
been part of the social-constructionist project.
Heterosexual orientation, however, has been
conspicuously absent from the essentialist–
constructionist debate. The focus has been on
nonnormative sexualities. Heterosexuality has gone
almost entirely unexamined and uncontested; however,
one of the main impulses of queer studies for the past
two decades has been to challenge heteronormativity. In
any event, the essentialist–constructionist debate has
hardly been settled and is likely to continue for the
foreseeable future.
John P. Elia
See also Heteronormativity; Heterosexism; Laws Banning
Homosexuality and Sodomy; Sexology
Further Readings
DeCecco, J. P., & Elia, J. P. (1993). A critique and synthesis of
biological essentialism and social constructionist views of
sexuality and gender. Journal of Homosexuality, 24(3–4), 1–
26.
DeLamater, J. D., & Hyde, J. S. (1998). Essentialism vs. social
constructionism in the study of human sexuality.
Journal of Sex Research, 35(1), 10–18.
Foucault, M. (1978). The history of sexuality, Volume 1:
An introduction. New York, NY: Vintage Books.
Tiefer, L. (1995). Sex is not a natural act and other essays.
Boulder, CO: Westview Press.
Weeks, J. (1991). Against nature: Essays on history, sexuality
and identity. London, England: Rivers Oram.
ETHICAL DEBATES ABOUT SURROGACY
Commercial surrogacy is one of the most hightech,
expensive, and controversial paths to parenthood. In
addition, surrogacy is often fraught with ethical
dilemmas and complicated by race, class, and gender
distinctions. The relatively high cost of surrogacy
means that people who create their families through this
route are typically White, affluent couples and
individuals who desire a biological tie to their child. In
this arrangement, a surrogate mother, often a non-White

female of lower socioeconomic status, agrees to bear a
child for a person or couple who is unable or, less
frequently, unwilling to do so without her assistance.
As the number and visibility of gay fathers constructing
families through surrogacy increases, it is important to
understand how sexuality is implicated in these
situations. This entry provides a brief background on
surrogacy practices and continues with a discussion of
the most prominent ethical debates about surrogacy.
These debates will include how surrogacy is
specifically related to sexual-minority families, as well
as ethics in international surrogacy.
Surrogacy: A Background
Surrogacy is an assisted reproductive technology (ART)
in which the prospective parents forge a contract with a
woman to carry and birth their child. Surrogate
motherhood has been traced back to prehistoric origins;
however, perhaps the earliest and most widely cited
case in Western culture is that of Hagar in the Old
Testament. Hagar was the handmaiden to Sarah, a wife
of Abraham in the Book of Genesis. When Sarah
became aware of her inability to conceive a child, she
offered Hagar to Abraham as a surrogate mother to
birth their children.
Women, both single and those in heterosexual
partnerships, who cannot carry or birth a child are the
majority of commercial surrogacy consumers. One
reason for the rise in surrogacy among single women
and heterosexual couples is the postponing of
childbearing to later years, which has impacted female
fertility by reducing the likelihood that a female will
have the physical ability or desire to use her own body
for reproduction. In addition to reduced female fertility
in today’s cultural environment, individuals or couples
seek surrogacy not only in the case of female infertility,
but also in circumstances of further physical barriers to
Ethical Debates About Surrogacy
procreation—among single men or gay male couples,
for example, who do not have a female partner with
whom to procreate.
There are two different types of surrogacy
arrangements: traditional genetic surrogacy and
gestational surrogacy. Traditional genetic surrogacy
features the fertilization of the surrogate mother’s egg,
which she then carries to term and gives birth to a child
to whom she is genetically related. Gestational
1041
surrogacy, also called in vitro fertilization (IVF)
surrogacy, occurs when a woman’s ovum is fertilized
with sperm using IVF, and the resulting embryo is
transplanted into another woman’s womb. In gestational
surrogacy, the surrogate who carries the fetus to term
and births the child is not genetically related to the
child.
Surrogacy arrangements can be made independently
or with the assistance of an agency. Arranging
surrogacy independently, however, without the
assistance of an agency, is risky and can create a host of
potential legal problems regarding custody of the child.
Since gay men and their families lack so many of the
legal protections of heterosexual families, these
problems can potentially be augmented. Prior to the
recent rise of agencies like Growing Generations, which
are willing to work with single gay men and gay
couples, gay men were forced to find surrogate mothers
through placing ads in newspapers or through other
informal channels like inviting friends or family
members to serve as surrogates. Today, however, in
order to minimize the possible legal complications,
many gay men, like heterosexuals, choose to work with
an agency. Working with an agency increases the cost
of surrogacy exponentially. Commercial surrogacy, as
mediated through an agency, can range anywhere from
$115,000 to $150,000 in the West.
Because of its high cost, surrogacy as a practice is
uncommon, in spite of its visibility and cultural
relevance. In the United States, slightly fewer than
1,000 babies are born each year through the assistance
of a surrogate mother.
Debates About Privileging Biology
The most frequently cited reason that people choose to
construct their families through surrogacy (rather
Ethical Debates About Surrogacy
than through adoption) is the desire for a genetic link to
their child. Some gay men may pursue surrogacy as
opposed to adoption because they believe that their
family members are more likely to accept a child who is
biologically related to them than one who is related to
them through adoption. Another reason gay men may
opt to have a child through surrogacy results from the
lack of ceremonial and legal recognition of their
families. For gay families, the presence of a genetic link
can be a meaningful symbol that validates their
1042
relationship to their child. Nonetheless, surrogacy
requires a female body to carry the fetus to term and
birth the child and only allows for one parent to be
genetically related to the child, thus introducing a
biological imbalance in genetic linkage of parents to
child.
The Ethical Dilemma of the Female Body
Research with heterosexual and gay and lesbian couples
has documented that parents who use ARTs, like
surrogacy, are often motivated by the high level of
control they have in choosing what their child will look
like by carefully evaluating the characteristics of the
surrogate mother and/or egg donor. Some gay
prospective fathers have reported that as they evaluate
their surrogates-to-be, they think about the importance
of racial and ethnic matching, speculating how adding
another dimension like racial differences to their family
might confuse their child or attract unwanted criticism.
Making separate choices about an egg donor and a
gestational surrogate allows intended parents to choose
among a wider pool of egg donors, and the ability to
select a donor who’s physical, cultural, and
biographical characteristics are more similar to
themselves or their partners.
Individuals or couples who construct families
through surrogacy have a unique opportunity to
consciously create what their families will look like.
Prospective parents can select desired physical traits in
gestational surrogates or egg donors with whom to
reproduce their own DNA. Because of this, commercial
surrogacy has been criticized for allowing White,
affluent people to purchase the means to reproduce
White infants in their own idealized image. Those with
the financial wherewithal literally have the purchasing
power to procure a womb and produce a genetically
engineered child.
However, for gay men, who have for so long had
little control over their reproductive options, this can
provide them the ability to regain control of their
reproductive choices. Onlookers tend to acknowledge a
family as such if they look like a family. Utilizing
biological connection or the semblance of it through
surrogacy is one method by which gay men can ensure
the most legitimacy possible for their families.
Choosing a surrogate mother who looks like one of the
gay fathers may be a preemptive measure, as they are
well aware that they have to prepare for questions about
their legitimacy as parent and child because they
occupy different racial or ethnic categories. Yet this
option is only available to a privileged minority of
affluent gay men.
Motivations of the Surrogate
While the motivations of an individual or couple
seeking to utilize a surrogate, as described above, may
seem rather straightforward, the motivation for a
surrogate’s participation in a process that is both
physically and emotionally taxing requires further
inspection. Research reveals how prospective parents
evaluate the surrogate mother’s age, race, physical
attractiveness, medical history, intelligence, athleticism,
and artistic ability. Alongside this, prospective parents
also evaluate her motives. Although surrogates in the
United States are reimbursed approximately $20,000,
the majority report that they are not motivated solely by
money, but rather by altruism, selflessness, and a desire
to help a family have a child. Some researchers and
social commentators assert that money is a substantial
factor in motivating surrogate mothers, even if an
altruistic motive is also present. People desiring
children through surrogacy often grapple with whether
the birth mother is motivated purely by financial
considerations or by an inclination to help people who
strongly desire to have children. Gay men, having few
other options for birthing children, may be especially
worried about this motivation.
However, research has found that surrogates actually
preferred to work with gay men because there was no
mother in the picture who might potentially be dealing
with emotions surrounding infertility (e.g., envy or
feelings of exclusion). Moreover, unlike heterosexual
couples, for which ART is usually a last resort, gay
fathers may turn to surrogacy joyfully as a pathway to
parenthood. Because such assisted technologies are
universally necessary for gay men who wish to create
their own biological offspring, they carry none of the
stigma or sense of failure of many infertile heterosexual
couples.
Some argue that while the basis of commercial
surrogacy is a financial arrangement, the realities are
such that this is often a relationship pervaded by
appreciation, mutual respect, and gratitude.
Specifically, the limited research on gay fathers who
have children via surrogacy reports that they forge deep
bonds with their surrogates. Even well after the

pregnancy and birth, many gay fathers choose to have
ongoing relationships with their surrogates, and in some
cases, with their egg donor.
International Surrogacy
Although surrogate mothers are often motivated by
financial or emotional compensation and enter willingly
into their role as a surrogate, many critics of
international surrogacy claim that the arrangement is
exploitive of the surrogates themselves. International
surrogacy is an arrangement in which the surrogate
mother is located in a different country from the
individual or couple who employ her reproductive
services. Some international human rights advocates
condemn commercial surrogacy, claiming that
surrogate mothers are involuntarily forced into the
commodification of their bodies and exploited by the
affluent class due to their social position as female,
ethnically brown, and located in a country where
poverty is endemic. However, citing their pay of $5,000
to $8,000 as 10 times what a working-class woman may
make after 1 year of labor in India, proponents of
international surrogacy claim that surrogacy can
financially empower women who would otherwise have
no other opportunities for such financial gain.
Ethical Debates About Surrogacy
1043
procreation norms. Surrogate mothers have reported
hiding their pregnancy by moving to a hostel facility to
prevent the discovery of their service as a surrogate,
because they are aware that their friends and family
would shun them for participating in what may be
considered an act of disrespect or infidelity.
Other concerns among critics of international
surrogacy relate to the lack of regulation of surrogacy in
many countries and pertain to the health and overall
care of surrogate mothers. Critics discuss the necessity
for all surrogate mothers of acceptable living
conditions, healthful food, proper medical care, and
trauma counseling after the pregnancy has ended.
Moreover, additional concerns for the well-being of
both the surrogate and the child have arisen in rare
cases where the intended parents abandon the child due
to a birth defect, illness, or capriciousness, thus leaving
the surrogate to care for the child but without the means
to do so. These issues in particular, along with
allegations of medical malpractice and general
reproductive exploitation, have gained the attention of
critics advocating for the global regulation of surrogacy
practices.

Surrogate mothers have claimed to use their

compensation to pay for health care for their husbands,
purchase a small home or a car, and send their children
to finer schools. In response, however, opponents of
surrogacy assert that not only is surrogacy
dehumanizing, reducing a woman’s value to only that
of her reproductive organs, but the amount of
compensation does not adequately cover the experience
of pregnancy and all it entails for 24 hours a day, 7 days
a week, for 9 months straight; nor, they argue, do the
fees adequately compensate the surrogate for the
physical and emotional toll of hormone treatments, or
in some cases multiple attempts at implementation, and
her postpartum recovery.
It has been speculated that the harsh criticism among
anti-surrogacy advocates originates in the
misappropriation of female gatekeeping of virtuous sex
and reproduction. Others may shame the surrogate and
reject the act as deviant and immoral on the grounds
that she has allowed her body to be used for
reproduction outside of the confines of social
1044 Ethical Research With Sexual and Gender Minorities
However, the decreased regulation of international
surrogacy may contribute to its appeal to same-sex
families. Many individuals and couples who utilize
surrogacy hail from countries that do not legally
recognize same-sex couples as eligible for
parenthood by adoption or child-rearing. Therefore,
even if surrogacy is legal in their country of origin, a
gay couple may not be eligible to participate in such
reproductive outsourcing. International surrogacy
provides an option for those individuals who seek a
genetic link to their child, but are not offered the
rights to pursue this in their home country. As most
international surrogacy locations are not regulated by
such legal restraints, gay couples can seek a
surrogate elsewhere. In this way, an increase in
regulation of surrogacy internationally may bring
with it barriers similar to those that gay couples may
find in their home countries.
Dana Berkowitz and Crystal Paul
See also Assisted Reproductive Technologies (ARTs);
International Surrogacy/Reproductive Outsourcing;
Surrogacy; Surrogacy, Legal Considerations of
Further Readings
Berkowitz, D. (2013). Gay men and surrogacy. In A. E.
Goldberg & K. R. Allen (Eds.), LGBT-parent
families: Innovations in research and implications
for practice (pp. 71–85). New York, NY: Springer.
Dillaway, H. E. (2008). Mothers for others: A race, class, and
gender analysis of surrogacy. International Journal of
Sociology of the Family, 34, 301–326.
McEwen, A. G. (1999). So you’re having another woman’s
baby: Economics and exploitation in gestational
surrogacy. Vanderbilt Journal of Transnational Law, 32,
271–304.
Mitchell, V., & Green, R. J. (2007). Different storks for
different folks: Gay and lesbian parents’ experiences with
alternative insemination and surrogacy. Journal of GLBT
Family Studies, 3, 81–104.
Tobin, J. (2014). To prohibit or permit: What is the (human)
rights response to the practice of international commercial
surrogacy? International Comparative Law Quarterly, 63,
317–352.
ETHICAL RESEARCH WITH SEXUAL
AND GENDER MINORITIES
The second half of the 20th century saw a dramatic
increase in the focus on ethical concerns related to
research with human subjects. This was in large part
due to the world’s becoming aware of severe ethical
transgressions in human research that had taken
place in the previous half-century, including the Nazi
regime’s torturous experiments on humans. By 1974,
all institutions in the United States receiving federal
funding for behavioral or biomedical research were
required to have an institutional review board (IRB)
to evaluate the ethical foundations of all research
conducted with human subjects.
This entry discusses the history of research ethics
as they apply to LGBTQ research; the debate
concerning whether or not LGBTQ individuals
should be considered a “vulnerable population”;
methods of best practice for conducting ethically
sound, inclusive LGBTQ research; and the ethics of
selecting research topics concerning LGBTQ
populations and experiences.
History of Ethics in LGBTQ Research
It is not necessary to travel very far back into history
to find professionals who have advocated for the
erasure of individuals with same-sex attractions or
transgender identities. In 1963, psychiatrist Karl
Menninger emphatically stated that same-sex
sexuality constituted abnormal behavior in need of
treatment, and, as recently as 1985, a prominent
Canadian psychologist noted that it was unlikely that
the goal of preventing individuals from becoming
transgender would ever gather systematic opposition.
In fact, the larger part of the 20th century was replete
with studies that pathologized all forms of same-sex
sexuality and gender diversity. Prior to 1970, two-
thirds of all research concerning gay men and
lesbians focused on topics related to sickness,
diagnosis, and causation. Researchers subjected
lesbian and gay participants to practices now deemed
unethical, such as involuntary castration, hormone
injections, shock treatment, institutionalization, and
behavioral therapies. Even when individuals
participated in these studies of their own free will,
 Ethical Research With Sexual and Gender Minorities
consideration was not given to the role that societal
devaluation, discrimination, or family pressures
might have played in coercing their decisions to
participate.
The ethical transgressions of past research led to
an intense focus on the protection of LGBTQ
populations in research once the topic began to grow
in popularity during the 1990s and early 2000s. Early
research focused predominantly on lesbians and gay
men, and emphasized the need to treat them as a
“vulnerable population” for the purposes of ensuring
their safety throughout the research process. Early
LGBTQ-affirming researchers were very concerned
about not causing harm to a population that they
considered to already be quite vulnerable. It was also
believed that LGBTQ individuals constituted a
vulnerable population due to the power imbalances
created by the lack of LGBTQ civil rights and the
social marginalization that lesbians and gay men
regularly experienced. LGBTQ research participants
were often closeted and consequently, the protection
of their privacy and confidentiality was of the utmost
concern. In one of the earliest “affirming” studies on
same-sex sexuality, Evelyn Hooker went to great
lengths to ensure that her participants’ identities
would be protected, even going so far as to conduct
interviews in her own home instead of bringing the
participants into her university office.
Current Status of Vulnerable Population
Designation
Although it made sense to view lesbians and gay men
as members of a vulnerable population during the
early years of affirmative LGBTQ research, when
participants were often closeted and societal views
were largely negative, researchers have since
questioned the current designation of LGBTQ
individuals as a vulnerable population. Because IRBs
often review research protocols with vulnerable
populations more closely and may even be less likely
to approve such protocols, current LGBTQ
researchers are concerned that continuing to treat
LGBTQ populations as vulnerable is actually
preventing the progress of LGBTQ research.
Although the precise definition of a vulnerable
population may vary between individual IRBs, for
the most part, the term is used to refer to groups of
1045
individuals who have a diminished capacity to make
decisions in their own interest, such as individuals
who are cognitively disabled or children, as well as
groups that may experience a power differential that
could make them susceptible to coercion (e.g.,
prisoners, students). Based on this definition, it is
only the latter portion that might apply to LGBTQ
participants, as there is no evidence to suggest that
LGBTQ individuals have a diminished capacity to
make informed decisions about participating in
research.
The concern related to potential power
differentials is relevant chiefly when considering the
historical treatment of LGBTQ individuals,
especially within the fields of psychology and
medicine. The past pathologizing of sexual and
gender minorities makes it important to take
additional steps to ensure that research does not
further perpetuate negative research experiences for
LGBTQ individuals. The danger, however, lies in
applying the vulnerable population status so broadly
that it ultimately further marginalizes LGBTQ people
by preventing research that might improve their
quality of life or contributes to additional experiences
of exclusion. It may be that some IRB members have
difficulty distinguishing between a population that is
vulnerable to negative outcomes (such as health
disparities) and a population that is vulnerable to
coercion by researchers. It may also be that IRBs
tend to be overprotective of LGBTQ populations
because of past ethical transgressions. This historical
sense of a failure to protect past LGBTQ research
participants may now, ironically, be contributing to
the continued stigmatization of LGBTQ populations
by creating unnecessary obstacles to LGBTQ-
inclusive research.
Ultimately, it is important that a balance be struck
between protecting the safety, dignity, and
confidentiality of LGBTQ participants while still
ensuring that they have equal access to participation
in research and that their lives and experiences are
not excluded from bodies of research under the guise
of paternalistic protection. There are still situations in
which it may be appropriate to apply the procedures
applicable to vulnerable populations to research with
sexual and gender minorities; however, these
procedures must be applied in a way that focuses
solely on protecting the individual research
1046 Ethical Research With Sexual and Gender Minorities
participants, rather than excluding them from
participation in research. In other words, the question
should not be whether or not a researcher could
conduct the same study without accessing a
“vulnerable population,” but rather, whether the
researcher has taken the steps necessary to ensure the
safety of the participants within this vulnerable
population.
The extent to which any given sample of LGBTQ
participants might be considered vulnerable will
fluctuate depending on time and place. The same
study conducted in two different locales may alter
the interpretation of a population’s vulnerability. A
study on same-sex relationships in Uganda (where
homosexuality is illegal and punishable with a jail
term) might produce very different power imbalances
between participants and researchers, along with
significant risks to participants should their
confidentiality be breached in any way, compared
with the same study conducted in, say, Toronto or
San Francisco.
In addition, trans* (trans* is a term that refers to
all identities within the gender identity spectrum)
individuals may frequently find themselves in
precarious situations where researchers are affiliated
with the institutions that govern access to
transitioning health care services, such as gender-
affirming surgeries or hormone treatments. In these
cases, the extreme power imbalance (either actual or
perceived) and the position of trans* individuals
seeking approval for their health care needs would
constitute their being treated as a vulnerable
population for research ethics purposes. However, it
should still be emphasized that this status should
only serve to ensure that research protocols respect
the dignity and autonomy of participants and should
not be used as a means of delaying or preventing
research using gender-minority populations.
A final area where researchers have debated
whether or not LGBTQ populations should be
considered vulnerable is in the study of LGBTQ
youth. In general, youth are considered vulnerable
populations by most IRBs and therefore require both
the consent of the youth to participate in research as
well as parental permission. For LGBTQ youth,
however, the requirement of parental permission
could place youth at additional risk, given that they
may not be out to their parents or that their parents
may not be supportive of their sexual or gender
identity. Research has found that youth as young as
14 years of age have proven as capable as adults of
making informed decisions about participating in
research and that they should not be viewed as
having a diminished capacity. In addition, research
has found that requiring parental permission to
participate in research on LGBTQ youth can
significantly alter the results of a study by
underrepresenting the experiences of participants
who are less likely to participate in research that
requires parental permission. Specifically, parental
permission in LGBTQ research leads to the
underrepresentation of racial and ethnic minorities,
bisexual youth, and youth who experience lower
levels of family support.
Regardless of whether a population is deemed
vulnerable or not, it is imperative that research with
LGBTQ populations place a strong emphasis on
issues related to confidentiality, privacy, and the
prevention of harm. Data should be stripped of any
identifying information as early as possible in the
collection process, and participants should be clearly
informed of how their identifying information will be
handled so that they can make informed decisions
about participating in research. It is also crucial that
steps be taken to ensure the psychological and
physical well-being of LGBTQ participants.
Resources must be made available to participants
should they experience any form of distress
associated with their participation in research, and it
is important that the resources provided be
LGBTQaffirming. This can be difficult in areas
where there are fewer LGBTQ resources available,
and consequently, the onus is on the researcher to
ensure that enough resources are collected and made
available prior to launching the study.
Methods for Best Practice in Ethical and
Inclusive LGBTQ Research
One of the most effective means of reducing the
likelihood of negative psychological experiences for
participants in LGBTQ research is the reduction (and
ideally, removal) of heterosexist bias. Heterosexist
bias is displayed in the implementation of the
conscious or unconscious assumption that there are
only two biologically determined sexes, each having
 Ethical Research With Sexual and Gender Minorities
its own unique set of behaviors and each naturally
inclined to desire the other.
The consideration of heterosexist bias in research
is relevant not only for those conducting LGBTQ
research, but also for researchers with no specific
interest in LGBTQ issues, given that LGBTQ
individuals are still likely to encounter their research.
For example, research that fails to ask about sexual
or gender identities, or research that automatically
excludes sexual and gender minorities, further
perpetuates experiences of marginalization and
stigmatization. In and of itself, the exclusion of
LGBTQ individuals from research represents
systemic heterosexism.
Heterosexist bias needs to be considered at nearly
every stage of the research process, from the theory
that generates the research questions to the
presentation and publication of results. If the theory
used to design a study is based in heteronormative
belief systems, then the entire study is likely to
demonstrate heterosexist bias (e.g., basing research
questions on the assumption that the cause for
homosexuality needs to be identified, but that no
cause or explanation is required for heterosexuality).
The phrasing of recruitment materials should also
be considered for evidence of bias, such as when a
study indicates that it is open to all women, only
trans women are rejected from the study. Similarly, it
is important to select measures that are free from
heterosexist bias and to use language that is
inclusive. For example, failing to provide more than
two gender options (male/female) informs
participants that the study is not inclusive of diverse
gender identities; not allowing individuals to identify
a sexual identity other than straight, gay, or lesbian
indicates that the study is not interested in the
experiences of bisexual, queer, questioning, two-
spirited, or asexual individuals. The failure to include
queer identities in recruitment materials or response
options has been shown to have implications for who
ultimately participates in the research, as well as the
research results. If participants are to be asked about
their parents, using terms like “mom” and “dad”
further reinforces the researcher’s assumption that
parents come in heterosexual pairings only; instead,
the researcher can ask about parent 1 and parent 2
(and possibly parent 3 and 4 as well) and ask
1047
participants to indicate each parent’s relation to
them, or parenting role.
Heterosexist bias can also be found in the specific
wording of questions within the survey that do not
directly relate to a participant’s identity. For
example, asking about sexual intercourse may
indicate that the researchers predominantly view
“sex” as involving penile–vaginal penetration, which
excludes many of the sexual activities engaged in by
same-sex couples. In presenting research results, it is
equally important to consider how terms are phrased
and whether or not any bias is being displayed. For
example, stating that a study examined the
experiences of newlyweds or new parents and then
failing to present information on the sexual identity
of participants may indicate an underlying
assumption that all newlyweds and new parents are
heterosexual.
Finally, even studies that have gone out of their
way to avoid bias may still encounter efforts to
incorporate bias into their study during the
peerreview process. It is important for individuals
reviewing research not to automatically assume that a
study inclusive of LGBTQ experiences should be
relegated to an LGBTQ-specific journal, and it is
rarely if ever appropriate to ask authors to remove
the LGBTQ participants from their sample in order
to make the manuscript more appealing to a
“mainstream” journal’s audience.
Just as it is important to include multiple identities
within an inclusive study, it is also important to
recognize the heterogeneity of LGBTQ identities.
While the LGBTQ acronym may provide a literary
short form in writing, it should not be taken to imply
that all identities included within this acronym share
the same experiences. Even within the LGBTQ
community, different identities experience various
forms of marginalization, exclusion, and
discrimination (e.g., the treatment of LGBTQ femme
identities by other LGBTQ people as inauthentic).
This spills over into research, such that the body of
research on lesbians and gay men is much greater
than the body of research on bisexuals, trans*
identities, and queer individuals. For example, the
exclusion of queer women from HIV research has
systemic implications for the health of queer women
living with HIV, demonstrating how, even within the
LGBTQ community, certain identities are seen as
1048 Ethical Research With Sexual and Gender Minorities
privileged (and in competition with one another)
within HIV research discourse. The erasure of
specific identities can also take place during the data
analysis phase, when specific identities may be
dropped altogether from the analysis or collapsed
into other categories (e.g., bisexuals not being
analyzed separately from lesbians and gay men).
Other areas where language can reinforce
heterosexist bias and exclusionary research practices
include the conflation of sex and gender or the use of
pathologizing language, such as gender identity
disorder, which places gender-independent kids
outside the realm of healthy lives and identities. The
mere perception of heterosexism or cis-sexism in the
research process will contribute to feelings of
discomfort and exclusion for LGBTQ participants,
which thereby fails to properly protect participants
from the experience of harm. One method for
avoiding heterosexist and cis-sexist bias in research
is the use of community research practices, in which
members of the LGBTQ community are asked to
participate in, and provide feedback on, each stage of
the research process, from research question
development to the publication and dissemination of
results.
The Ethics of Research Topic Choices in
LGBTQ Research
In addition to considering the language used in
LGBTQ research and publications stemming from
such research, it is also important to consider the
broader implications of research questions.
Researchers need to consider how their research
questions will impact the quality of life experienced
by LGBTQ individuals and whether or not the
research is of enough importance to justify any
potential harm that might befall the participants or
the community they represent. Given that views
about same-sex sexuality and gender diversity vary
greatly around the world, researchers must also adopt
a global perspective in evaluating how the results of
any given study might be misinterpreted and used to
cause harm. Given the past ethical transgressions in
research against LGBTQ individuals, it is important
to be vigilant about the potential uses of LGBTQ
research and to give careful thought and
consideration to how best to present results in ways
that are accurate and least susceptible to distortion.
One area of LGBTQ research that prompts ethical
debates is the question of whether researchers should
study the causes of same-sex sexuality or gender
diversity. Those opposed to causal lines of research
argue that any research that seeks the cause of same-
sex sexuality inherently reveals evidence of
homophobia and heterosexism. Those in favor argue
that there is nothing inherently unscientific or
unethical about seeking information on the origins of
sexual identities and erotic desires. Perhaps the
caveat to keep in mind is that, while it may not be
unethical to study the origins of sexuality in general
(i.e., what causes homosexuality and what causes
heterosexuality), to only study one side of this
equation (the causes of homosexuality) implies a
value judgment that defines samesex sexuality as a
developmental abnormality in need of research and
the other side (causes of heterosexuality) as the
normal course of human development.
Consequently, it is important to thoroughly
examine the motivations for specific research
questions as well as the potential implications of all
possible research outcomes. Concerns have been
raised in the past that genetic research on the origins
of same-sex sexuality will lead to the development of
prenatal tests to determine the sexual orientation of a
fetus or treatments aimed at eradicating same-sex
sexuality from the human condition. Although
current understandings related to the development of
same-sex sexuality make such tests unlikely, it is still
necessary to consider how future developments in
this area of research may lead to ethically
questionable practices that could be implemented in
jurisdictions that do not protect the rights and
freedoms of LGBTQ citizens.
Those in favor of causal lines of research have
often contended that if the biological origins of
same-sex sexuality can be proven, same-sex
sexuality will consequently be viewed as a “natural”
variation in human development, thereby
contributing to the advancement of LGBTQ rights. In
fact, many of the recent advancements in LGBTQ
rights in the United States have been predicated on
the immutability of sexual orientation, thus bringing
into play the Equal Protection Clause of the U.S.
Constitution. However, such arguments can be
 Ethical Research With Sexual and Gender Minorities 1049

dangerous in that they suggest that diverse sexual in their well-meaning attempts to protect LGBTQ
and gender identities are only “worthy” of civil rights research participants. It is recommended that
protections to the extent that they were not researchers always carefully consider the feedback
consciously chosen and were biologically from IRBs and that they attempt to challenge or
predetermined outcomes. In other words, were sexual educate their IRBs prior to revising a protocol if they
or gender identity proven to be a choice, then sexual feel that any of the IRB’s concerns may be rooted in
and gender minorities could be deemed blameworthy heterosexist or cis-sexist biases.
and no longer eligible for legal protections.
Karen L. Blair
Consequently, discourses on human rights strongly
oppose genetic research on the causes of same-sex See also Heteronormativity; Heterosexism; Heterosexist
sexuality, as human rights should be granted Bias in Research; Scientific Integrity, Debates About;
regardless of the biological underpinnings associated Sexual Orientation Conversion Therapy
with any given human identity.
Finally, it is important for researchers to consider
their own personal beliefs, biases, and motivations Further Readings
for pursuing specific lines of research. As is true for
Meezan, W., & Martin, J. (Eds.). (2009). Handbook of
many areas of research, those conducting LGBTQ
research with lesbian, gay, bisexual, and transgender
research are often personally motivated and invested,
populations. New York, NY: Routledge.
either because they care about the social justice
Murphy, T. F. (1997). Gay science: The ethics of sexual
issues associated with LGBTQ lives and experiences
orientation research. New York, NY: Columbia
or because they themselves are members of an University Press.
LGBTQ community. Although science often Mustanski, B. (2011). Ethical and regulatory issues with
purports to be objective and valueneutral, it is often conducting sexuality research with LGBT adolescents:
impossible to separate one’s own personal biases and A call to action for a scientifically informed approach.
values from one’s work when conducting social Archives of Sexual Behavior, 40, 673–686.
justice research. For this reason, it is important that
LGBTQ researchers be prepared to acknowledge
their own assumptions and values that influence the
questions they ask and the lenses through which they
interpret their findings. Ethical LGBTQ researchers
must be open to any possible results, even those that
might reflect poorly on the LGBTQ community.
Failure to be able to do so may place a researcher at
risk of engaging in unethical practices, such as data
fabrication or the selective reporting of results. At the
same time, it is also important that researchers seek
to study a broad array of LGBTQ experiences.
LGBTQ research has been criticized in the past for
placing too great of an emphasis on the negative
outcomes for LGBTQ individuals, rather than also
highlighting the resilience that is common within
LGBTQ populations.
As the field of LGBTQ studies grows, ethical
considerations will continue to fluctuate and change
with the time and place. At times, LGBTQ
researchers will find themselves educating and
challenging their IRBs, which may produce decisions
indicative of stereotypes and latent sexual prejudices
1050
Evolutionary Theory
Schüklenk, U., Stein, E., Kerin, J., & Byne, W. (1997). The
ethics of genetic research on sexual orientation.
Hastings Center Report, 27(4), 6–13.
Tufford, L., Newman, P. A., Brennan, D. J., Craig, S. L., &
Woodford, M. R. (2012). Conducting research with
lesbian, gay, and bisexual populations: Navigating
research ethics board reviews. Journal of Gay & Lesbian
Social Services, 24(3), 221–240.
EVOLUTIONARY THEORY
The study of evolutionary theory as it relates to
human psychology and behavior is called
evolutionary psychology. Evolutionary psychology
asks if a specific human behavior may have had
adaptive value for early human ancestors, that is,
whether it contributed directly to survival or
reproduction. Evolutionary psychology does not hold
that behavior is genetically driven; rather, it holds
that under certain conditions, humans have a
tendency to engage in some forms of behavior rather
than alternatives because those behaviors were
adaptive during evolution.
Same-sex attraction and sexual behavior have
been studied in evolutionary psychology, but there is
much disagreement about them from an evolutionary
perspective. This disagreement arises in part from the
fact that in the study of “homosexuality,” different
researchers have studied seemingly related but
actually different phenomena: samesex attraction,
same-sex sexual behavior, sexual identity, and
exclusive and nonexclusive forms of same-sex
attraction and sexual behavior. There is increasing
evidence for a genetic component to exclusive forms
of same-sex attraction and sexual behavior, but there
is also increasing evidence of nongenetic
contributions. The likelihood that some genes for
same-sex attraction and sexual behavior exist in
humans and are passed on makes evolutionary
explanations compelling, while the broad diversity in
expression and degree of samesex attraction and
sexual behavior suggest a significant influence of
environmental factors. This entry presents the basic
principles of the evolutionary perspective and some
of the major ways that same-sex attraction and sexual
behavior have been explained from this perspective.
The Four Products of Evolution
Scientists have argued that the process of evolution
can result in one of four products. The first product,
called an adaptation, is the best known, and it is the
easiest to understand. It is a physical or behavioral
characteristic that is passed along to the next
generation because it helped the individual to
reproduce more successfully, or to survive more
effectively, than would have been the case otherwise.
The assumption here is that a characteristic that
contributes directly to survival contributes indirectly
to reproduction because the individual who survives
has increased chances of ultimately finding a mate
and reproducing. A good example of an adaptation is
the umbilical cord. All humans have one during
prenatal development, and it is adaptive because it
increased the survival of humans before birth. The
second product of evolution is called noise. Noise is
a characteristic due to random events or
environmental factors, and it serves no role in
survival or reproduction. For example, the shape of
the belly button of any one person is due to noise:
random and environmental factors such as how the
umbilical cord was cut, the age of the person, and the
weight of the person. The third product of evolution
is called a by-product. It is a characteristic that is not
adaptive itself, but it is passed along with a
characteristic that is adaptive. The best example of
this is the navel, or belly button. All humans have
one, but it does not contribute to survival or
reproduction. It was passed along with the umbilical
cord.
The fourth product of evolution is more
controversial and more difficult to understand. It is
called an exaptation. This is a characteristic that
originally started out as either a by-product of an
adaptation, which itself contributed to reproduction
or survival and became adaptive, or as an adaptation
that was selected to serve another function. For
example, recently it has been observed that some
birds in urban areas line their nests with cigarette
butts. The cigarette butts have a significant pesticide
quality, killing parasites in the nest, and the result is
that more baby birds survive. It appears that picking
up butts for the nest is a by-product of picking up

aromatic plants for the nest that can kill parasites. In
theory, if there is a genetic aspect of this behavior
linked to some birds, and these birds reproduce more
successfully because of the behavior, future
generations of descendants of these birds may exhibit
a strong tendency to line their nests with cigarette
butts. In this example, lining the nest with cigarette
butts is a by-product, but the by-product could prove
to be adaptive.
Same-Sex Attraction and Sexual Behavior and
the Four Products of Evolution
Adaptation
Scientists generally agree that exclusive samesex
attraction and sexual behavior in humans are not
adaptations because they do not lead to reproduction.
Some theorists have argued that any same-sex sexual
behavior is maladaptive because it decreases the
likelihood of reproduction. However, research has
shown that some same-sex sexual behavior does not
decrease reproduction in those who exhibit it. Other
theorists have argued that nonreproductive sexual
behavior between both opposite-sex and same-sex
individuals played an important role in social
interactions, communication, and bonding for early
human ancestors, thus contributing to survival, just
as it does for closely related primate species of
monkeys and apes. In this light, some nonexclusive
same-sex attraction and sexual behavior could be
conceptualized as having had adaptive value during
the course of human evolution.
Noise
Some theorists have argued that same-sex
attraction and sexual behavior can be conceptualized
as noise. That is, some random environmental event
occurs, and same-sex attraction and sexual behavior
are best explained by that random event. For
example, people who are usually attracted to the
opposite sex are temporarily segregated from
opposite-sex partners for some reason and engage in
same-sex sexual behavior because it is the only
Evolutionary Theory
sexual opportunity available. Similarly, cultural
traditions generated by specific ecological conditions
may have encouraged some forms of samesex
1051
attraction and sexual behavior. Noise is likely to be a
factor in some cases, but certain universal patterns of
same-sex attraction and sexual behavior across
cultures and history also suggest a predictable
expression consistent with an adaptation.
Two theories that reflect the noise concept of
random environment factors influencing same-sex
attraction rely on research that shows that sex
hormones act on the brain during a fetus’s
development before it is born. They hold that same-
sex attraction is a by-product of this process, and it
can be influenced by many factors. Simply put,
depending on how the brain develops under the
influence of the hormones, a person will develop an
attraction to the opposite sex, the same sex, or both
sexes. One theory holds that many people who
consider themselves lesbian, gay, or bisexual have
brains, shaped by hormones, that give them a
package of same-sex and opposite-sex characteristics
including sexual attraction to the same sex. A second
theory goes a little further and speculates a
developmental mechanism for same-sex attraction.
At puberty, girls and boys act differently from each
other, and they see the opposite sex as very different
or exotic, and that difference is ultimately
experienced as erotic or attractive. In essence, the
exotic becomes erotic. The theory goes on to state
that some boys and girls who are gender
nonconforming in their behavior, due partly to
unique aspects of their brain development under the
influence of hormones, will find same-sex
individuals to be different or exotic and thus find
them erotic or sexually attractive.
By-Product
The most common explanation for same-sex
attraction and sexual behavior is that they are
byproducts of some other characteristic or process.
There are many by-product theories, all of which
have been criticized for a variety of reasons, and
none emerges as a convincing argument that
comprehensively explains same-sex attraction and
sexual behavior.
Evolutionary Theory
Human Plasticity. One theory that is most applicable
to nonexclusive same-sex attraction and sexual
behavior holds that they are the by-product of
1052
general plasticity or flexibility in human behavior
resulting from a highly evolved brain. Thus,
learning, thinking, and abstracting play a more
important role in generating behavior than do
biologically programed behavioral dispositions.
Consequently, people have the potential to learn that
same-sex sexual behavior is pleasurable, and they
can learn to overcome cultural taboos and restrictions
about it.
More Attractive Mates. A second theory holds that
exclusive same-sex attraction in males is a byproduct
of selection for more “feminized” male ancestors.
Specifically, it is theorized that male homosexuality
results from selection for a number of characteristics
that contribute to fitness. Male– male sexual
attraction results from a shift in male brain
organization to a more feminized direction, allowing
males to exhibit characteristics like kindness,
tenderness, and empathy that would have made
ancestral males better fathers and more attractive
mates. Due to random genetic distribution, a small
number of males would have more extreme
feminization of their characteristics than others,
resulting in sexual attraction to other males.
Birth Order. A third theory holds that exclusive male
same-sex attraction is influenced by birth order.
Some studies have shown that men who identify as
gay have a higher number of older brothers than their
heterosexual counterparts. It is speculated that this is
the by-product of maternal immune reactions to the
H-Y antigen produced by the male fetus. The
gestation of several male fetuses leads to changes in
the intrauterine environment that cause the
feminization of the brains of laterborn males
resulting in predominantly same-sex sexual
attraction.
Improved Female Fecundity. A fourth theory holds
that predominant same-sex attraction in males is the
by-product of a genetically based characteristic
linked to increased fertility in their female relatives.
Specifically, it is argued that genes on the X-
chromosome contribute to increased fecundity in
female carriers and to the development of same-sex
attraction in their male relatives. Thus, the genes for
male homosexuality remain in the population,
although these males show a significantly lower rate
of reproduction relative to heterosexual males. Some
studies have shown that men who identify as gay do
have larger families through the maternal line (and
not the paternal line) than their heterosexual
counterparts.
Female Sexual Plasticity. A fifth theory addressing
nonexclusive same-sex attraction in women is related
to the argument that female sexuality exhibits more
plasticity than male sexuality. Plasticity in this case
means greater responsivity to situational and
interpersonal factors. The theory notes that in species
where the females have a very specific period of
estrus, motivation to initiate sexual behavior and
receptivity to sexual advances are closely linked, and
they occur when females are most likely to conceive.
In higher primates, there is a trend for an uncoupling
of motivation and receptivity, which allows a
broader range of sexual strategies for females. This
trend culminates in human females for whom there is
a highly evolved independence between proceptivity,
or motivation to initiate sexual activity, and
arousability, or the capacity to become aroused by
sexual stimuli. This uncoupling of proceptivity and
arousability, and the greater presence of arousability
in women’s day-to-day desires, allows
environmental and situational factors to have greater
influence on female desire. The independent
arousability allows the development of desire to a
range of situationdependent stimuli including, in
some cases, samesex individuals.
Exaptation
The alliance theory focuses on same-sex attraction
and sexual behavior in males but has been applied to
females as well. It holds that the evolution of same-
sex sexual attraction and behavior is the result of an
exaptation. That is, same-sex sexual attraction and
behavior were originally by-products of the
sociosexual behavior exhibited by all primates and
used for a variety of social and communication
purposes. The sexual behavior between same-sex
individuals may have reinforced alliances between
them that contributed directly to their survival and
indirectly to their reproductive success. Individuals
in alliance with a partner would have been better able
to fight off predators and enemies and hold onto food
resources, all contributing to better survival and
ultimately to reproduction. The alliances may have
been particularly important to younger ancestral

males who, it is argued, were highly vulnerable to
aggression from older males and had to work their
way up the male hierarchy before gaining access to
female mates for reproduction. The theory holds that
all humans could experience same-sex attraction and
engage in same-sex sexual behavior under conditions
similar to those in which the behavior was adaptive
in the evolutionary past. This theory draws on cross-
species and cross-cultural evidence and can be
applied to some human group settings. However, the
theory has been criticized for the lack of empirical
evidence to support it.
Conclusion
Same-sex sexual attraction and behavior are not
unitary phenomena and may have multiple origins
that include evolutionary, genetic, and environmental
factors, and interactions between these. The
evolutionary model has generated a large number of
theories about the origins of same-sex sexual
attraction and behavior. All of the theories have been
criticized for a variety of reasons, and they are all
lacking strong evidence to support them. Despite
this, the evolutionary model can be seen as a useful
one because it generates so many ideas and theories.
More recent work on the evolution of human
sexuality has begun to look at the role of
nonreproductive sexual behavior in all humans,
whether between members of the opposite sex or the
same sex. This work suggests that nonreproductive
sexual behavior played a very important role as a
social adhesive in early human groups that may not
have been able to survive without it. The advent of
agriculture and the
Evolutionary Theory
cultural changes that this brought about resulted in
nonreproductive sexual behavior being discouraged
and prohibited. Thus, evolutionary processes may
very well be at the root of some same-sex attraction
and sexual behavior and provide us with useful
insights into their natural history.
Frank Muscarella
See also Bisexuality, Female; Bisexuality, Male; Exotic
Becomes Erotic: A Developmental Theory of Sexual
Orientation; Pansexuality; Theories of Sexual
Orientation
1053
Further Readings
Bem, D. J. (1996). Exotic becomes erotic: A developmental
theory of sexual orientation. Psychological Review, 103,
320–335.
Blanchard, R., & Klassen, P. (1997). H-Y antigen and
homosexuality in men. Journal of Theoretical Biology,
185, 373–378.
Buss, D. M., Haselton, M. G., Shackelford, T. K., Bleske,
A. L., & Wakefield, J. C. (1998). Adaptations,
exaptations, and spandrels. American Psychologist,
53(5), 533–548.
Diamond, L. M. (2006). The evolution of plasticity in
female–female desire. Journal of Psychology and Human
Sexuality, 18, 245–274.
Gallup, G. G., & Suarez, S. D. (1983). Homosexuality as a
by-product of selection for optimal heterosexual
strategies. Perspectives in Biology and Medicine, 26,
315–321.
Iemmola, F., & Camperio Ciani, A. (2009). New evidence of
genetic factors influencing sexual orientation in men:
Female fecundity increase in the maternal line.
Archives of Sexual Behavior, 38, 393–399.
Kirkpatrick, R. C. (2000). The evolution of human
homosexual behavior. Current Anthropology, 41, 385–
414.
LeVay, S. (2011). Gay, straight, and the reason why.
Oxford, England: Oxford University Press.
Miller, E. M. (2000). Homosexuality, birth order, and
evolution: Toward an equilibrium reproductive
economics of homosexuality. Archives of Sexual
Behavior, 29, 1–34.
Muscarella, F. (2000). The evolution of homoerotic behavior
in humans. Journal of Homosexuality, 40, 51–77.
Ex-Gay Movement
Muscarella, F. (2006). The evolution of male–male sexual
behavior in humans: The alliance theory. Journal of
Psychology and Human Sexuality, 18, 275–311. Ryan, C., &
Jethá, C. (2010). Sex at dawn. New York, NY: Harper.
EX-GAY MOVEMENT
The ex-gay movement has been an important cultural
influence and political force in reaction to efforts to
achieve LGBTQ social and political equality. This
entry describes the ex-gay movement, a social
movement founded on the belief that gays, lesbians,
and bisexuals can become heterosexual or otherwise
“leave homosexuality behind” through counseling,
1054
prayer, and other therapies. The entry explains the
origins of the movement, the events that led to its
appearance in the national spotlight, and the
consequences of that visibility including current
issues and controversies related to the movement.
Origins of the Ex-Gay Movement
Historically, the ex-gay movement has its primary
origins in the United States, and is ideologically
founded in conservative Christian Protestantism. The
first ex-gay ministry, Love in Action, was formed in
1973 in San Rafael, California (a suburb of San
Francisco), by Frank Worthen and John Evans, two
men struggling with reconciling their same-sex
attractions and their religious beliefs, along with
heterosexual minister Kent Philpott. In 1975,
cofounder Philpott published a book called The
Third Sex? that included interviews with six people
who sought to become heterosexual through
counseling and prayer. As a result, other ministries
started around the country. In 1976, an ex-gay
conference was held in Anaheim, California, and
resulted in formation of Exodus International—a
coalition organization for ex-gay ministries.
In the years that followed, affiliates of this newly
created organization were founded throughout the
country, and eventually overseas in Europe, East
Asia and the Pacific, and Latin America. Somewhat
counterintuitively, in the United States, new affiliates
were not likely to form in areas with a large presence
of conservative Protestants, but instead formed in
states with predominantly sexually libertarian
attitudes and states where Metropolitan Community
Churches were formed (the Metropolitan Community
Church is a pro-gay Protestant Christian
denomination formed specifically for ministry to the
LGBTQ community). This suggests that the
perception of sociocultural threat represented by
changing norms and values around sexuality,
especially in a religious context, were one of the
driving forces in the emergence and growth of these
ex-gay ministries.
Growth and Visibility of the Ex-Gay
Movement
Although ex-gay mobilization has spanned several
decades, the movement spent much of its early
existence in relative obscurity, slowly gaining
strength and support through low-visibility, local,
faith-based support groups. Exodus affiliates and
other ex-gay ministries primarily operated as selfhelp
and support groups, providing guidance for
individuals who wanted to “recover from
homosexuality” as well as support for their family
(parents, spouses, children, and relatives) and
friends. The movement first gained widespread
national attention in 1998 with the “Truth in Love”
ad campaign, which promoted “hope and healing for
homosexuals” through participation in ex-gay
ministries. This campaign was largely funded by
conservative faith-based organizations that oppose
LGBTQ rights laws (e.g., the Alliance for
Traditional Marriage, American Family Association,
Christian Coalition, Christian Family Network,
Citizens for Community Values, Concerned Women
for America, Family First, Family Research Council,
Focus on the Family, and National Legal
Foundation). Full-page ads about the ex-gay
movement ran in newspapers across the country,
including the New York Times, the Washington Post,
USA Today, the Los Angeles Times, the Chicago
Tribune, the Miami Herald, and the San Francisco
Examiner. The ads caused the media’s interest in the
subject to rise dramatically, peaking with a
Newsweek cover story featuring an ex-gay man and
ex-lesbian, John and Anne Paulk, who were leaders
within the movement and had become a married
couple.
With this newfound visibility, Exodus
International, as an umbrella organization for ex-gay
ministries, became more vocal and politicized. It
began to hold regular protests of the American
Psychiatric Association, which held the position that
efforts to change sexual orientation are unlikely to be
successful and involve some risk of harm. Exodus
International also increasingly organized lobbying on
public policy issues. A set of policy statements
argued for marriage as a sacred, legal, and social
union between one man and one woman, against
same-sex parenting and adoption as not in the best
interest of children, and for the repeal of “thought
crimes laws” (otherwise known as hate crime laws).
As a result, during the 2000s, Exodus’s directory
grew to list over 230 affiliated ministries, counselors,
and churches in the United States, as well as many
ministries outside the country, becoming by far the
largest organization in the ex-gay movement. By way

of comparison, during the same time period, the
second-largest network, Homosexuals Anonymous,
had fewer than 40 chapters, some of which were also
affiliated with Exodus. A few other local-level and
independent national membership groups also grew
in visibility during this period. These included the
National Association for Research & Therapy of
Homosexuality (NARTH), a professional
organization that makes secular arguments in support
of conversion therapies and other treatments to
change sexual orientation; and Parents and Friends of
Ex-Gays and Gays (PFOX), an analogue to the pro-
gay PFLAG organization.
Current Issues and Controversies Related to
the Ex-Gay Movement
The surge in visibility and growth resulted in some
more recent negative outcomes for the ex-gay
movement. Greater visibility invited public criticism
and pushback from groups supporting LGBTQ
rights. One damaging outcome for the movement
was research that questioned the efficacy of ex-gay
therapies. Several psychologists and
Ex-Gay Movement
other mental health professionals researched whether
or not ex-gay therapies were effective in changing
same-sex sexual attractions or behaviors, and they
found few studies that supported the effectiveness of
sexual orientation change therapies. Further, they
found methodological issues in those studies that did
support their effectiveness, and evidence that such
therapies might cause mental health harms. For
example, perhaps the bestknown research study seen
as supporting the effectiveness of conversion
therapies was published in 2003 by prominent
psychiatrist Robert Spitzer. However, at the time,
Spitzer noted that it had been difficult to find 100
participants, and they did not represent a random
sample but rather the strongest cases for conversion.
In 2012, he retracted the study because he felt the
results were misleading and the credibility of
participants’ reports of sexual orientation change was
questionable. As a result of these findings regarding
conversion therapy efficacy, most mainstream
medical and healthrelated professional organizations
made official statements that the practice of trying to
change sexual orientation is ineffective and harmful.
1055
These organizations included the American
Psychiatric Association (as noted above, protested by
Exodus), American Medical Association, American
Psychological Association, American Academy of
Pediatrics, American Counseling Association, and
the National Association of Social Workers. Beyond
these general concerns, ex-gay ministries have drawn
particular criticism for targeting youth, especially
those who may be under pressure from their families
to undergo conversion therapy. To date, California,
Oregon, Illinois, and New Jersey, as well as
Washington, D.C., have passed laws preventing the
use of therapies intended to change the sexual
orientation of LGB youth, and other states are
currently considering such legislation.
Furthermore, the actions of Exodus and other ex-
gay organizations, along with related controversies,
have caused fragmentation within the ex-gay
movement itself. One point of contention among
those affiliated with the movement is a disagreement
about the degree to which the movement should be
politicized. There is no consensus within or outside
of the movement about whether
Ex-Gay Movement
the ex-gay movement is a separate movement that
sometimes allies itself with the antigay movement or
whether it is a subgroup of that movement.
Prominent national LGBTQ rights organizations,
such as the Human Rights Campaign and National
Gay and Lesbian Task Force, call ex-gay groups an
integral part of the Christian right and label Exodus
International a notorious antigay group. Supporting
these claims, some ex-gay leaders have worked for
organizations known for their antigay lobbying (in
particular, there has been a close association with the
conservative Focus on the Family organization).
However, Tina Fetner’s social movement analysis
characterizes ex-gay conversion groups and antigay
social movement organizations as separate entities
working together. Suggesting an even stronger
distinction, Tanya Erzen, based on her in-depth
ethnographic work, identifies the ex-gay movement
as a political, cultural, and social movement that she
regards as a challenge to not just LGBTQ
movements but also traditional antigay politics. She
found that many of the ex-gay men and women she
talked to did not oppose LGBTQ rights. Supporting
this view, some ex-gay ministries did distance
1056
themselves from Exodus after it became a more
politicized organization.
Another set of divergent views relates to what is
seen as the ultimate goal of the ministries in terms of
personal transformation. As phrases such as
“conversion therapy” suggest, some participants in
the movement believe the goal or expectation should
be a change in sexual orientation—a shift in
attractions toward heterosexuality, or at least
attraction to a spouse of a different gender. However,
other participants focus on managing samesex
attractions and providing a supportive atmosphere for
See also Essentialist–Constructionist Debate on the
single celibacy. Indeed, some groups eschew the
term “ex-gay” and instead prefer alternatives such as
“struggler” as more accurate terminology. The most
prominent messaging during the period of the ex-gay
movement’s high visibility has been representative of
Exotic Becomes Erotic: A Developmental Theory of Sexual Orientation
the former view, which has been a source of
embarrassment for the movement. For example, John
Paulk, the ex-gay man featured in the Newsweek
cover story, as well as a former chair of the board of
Exodus International, was identified in a gay bar in
2000, which resulted in a public scandal, and in 2013
he announced that he was still gay, had ended his
relationship with his former wife, and renounced
conversion therapies as ineffective in changing
sexual orientation and as potentially harmful. Other
prominent figures within the movement have
likewise publicly announced they were leaving due
to lack of success in changing orientation.
These controversies likely contributed to the
eventual closure of the Exodus International
organization in 2013. At the time of its closure and in
the months leading up to the decision, Exodus’s
president, Alan Chambers, expressed a desire for a
more spiritual and less political focus, as well as
regret for focusing on the idea that only a change in
attractions constituted success. Chambers and some
other former Exodus leaders formed a new
organization, Speak Love, which is focused on
reconciliation between people with differing beliefs
about the morality of same-sex sexual behavior.
However, most of the Exodus affiliates reformed into
a new umbrella organization, Restored Hope
Network, which continues to advocate for conversion
therapy and orientation change.
To date, research on the ex-gay movement has
explored the claims of the movement, the social
dynamics within the movement, and the relationship
of the ex-gay movement with other groups. However,
considering the movement’s influence on national
politics in regard to LGBTQ issues, relatively little
research has been conducted that focuses on ex-gay
men and women. As the broader culture changes in
regard to gender and sexuality and the ex-gay
movement evolves in response to these changes, this
may open up future opportunities for research.
Jason Lee Crockett
Origins of Sexual Orientation; Heteronormativity;
Heterosexism; Internalized Homophobia; Mixed-
Orientation Marriages; Religious Identity and
Sexuality, Reconciliation of; Sexual Attraction,
Behavior, and Identity; Sexual Orientation Conversion
Therapy
Further Readings
American Psychological Association. (2009). Report of
the American Psychological Association Task Force
on Appropriate Therapeutic Responses to Sexual
Orientation. Retrieved September 1, 2014, from
http://www.apa.org/pi/lgbt/resources/therapeuticrespo
nse.pdf
Arthur, E., McGill, D., & Essary, E. H. (2014). Playing it
straight: Framing strategies among reparative therapists.
Sociological Inquiry, 84, 16–41.
Crockett, J. L., & Kane, M. D. (2012). Mobilizing in response
to threat: The case of the ex-gay movement. Research in
Social Movements, Conflicts, and Change, 33, 227–256.
Erzen, T. (2006). Straight to Jesus: Sexual and Christian
conversions in the ex-gay movement. Berkeley and Los
Angeles: University of California Press.
Fetner, T. (2008). How the religious right shaped lesbian and
gay activism. Minneapolis: University of Minnesota
Press.
Ponticelli, C. M. (1999). Crafting stories of sexual identity
reconstruction. Social Psychology Quarterly, 62, 157–
172.
Serovich, J. M., Craft, S. M., Toviessi, P., Gangamma, R.,
McDowell, T., & Grafsky, E. L. (2008). A systematic
review of the research base on sexual reorientation
therapies. Journal of Marital and Family Therapy, 34,
227–238.
Wolkomir, M. (2006). Be not deceived: The sacred and
sexual struggles of gay and ex-gay Christian men. New
Brunswick, NJ: Rutgers University Press.
 1057
sex fraternal twin pairs (dizygotic twins).
EXOTIC BECOMES EROTIC: A Monozygotic twin pairs share all of their heritable
DEVELOPMENTAL THEORY genes with one another, whereas dizygotic twin pairs
share only about half of their heritable genes with
OF SEXUAL ORIENTATION one another. So, if monozygotic twin pairs are more
alike on a trait than are samesex dizygotic twin pairs,
we can infer that the trait is partially heritable.
There is evidence that biological factors, including Studies have now established the heritability of
genes, are correlated with an individual’s sexual sexual orientation for both men and women. In a
orientation. But as we are often reminded, correlation study of gay men who had twin brothers,
is not necessarily causation. This entry describes a
developmental theory of sexual orientation that
proposes that biological factors do not, in fact,
directly influence an individual’s sexual orientation
but act indirectly by influencing the child’s
preferences for sex-typical or sex-atypical activities.
Children who prefer sex-typical activities and who
play primarily with same-sex playmates are called
gender conforming; children who prefer sex-atypical
activities and who play primarily with opposite-sex
playmates are called gender nonconforming. These
preferences lead children to feel different from either
opposite- or same-sex peers—to perceive them as
dissimilar or exotic. Gender-conforming children
will experience opposite-sex children as different
from themselves, and gender-nonconforming
children will experience same-sex children as
different from themselves. The theory further
proposes that this feeling of difference produces
heightened emotional arousal to members of the
dissimilar sex that subsequently becomes
transformed into erotic attraction to them.
Accordingly, the theory is called the exotic-becomes-
erotic (EBE) theory of sexual orientation.

Genes Are Correlated With Sexual

Orientation
To determine whether a physical or personality trait
is correlated with genetic factors, researchers look to
see whether individuals are more similar to close
relatives on that trait than they are to more distant
relatives. For example, individuals’ heights are more
closely related to the heights of their parents than to
the heights of their aunts and uncles. This implies
that the physical trait of height has a significant
genetic component, or is heritable. The best studies
are those that compare identical twin pairs (called
monozygotic twins) with a matched sample of same-
1058
Exotic Becomes Erotic: A Developmental Theory of Sexual Orientation
52% of monozygotic twin
brothers were also gay,
compared with only 22% of
dizygotic twin brothers. Some
men also had adopted brothers
in their families, men who did
not share any heritable genes
with their gay brothers: Only
11% of those adopted brothers
were also gay. A parallel
study of lesbians showed the
same pattern: In that study,
48% of monozygotic twin
sisters were also lesbian,
compared with only 16% of
dizygotic twin sisters and 6%
of the lesbians’ adopted
sisters. A subsequent study of
nearly 5,000 twins who had
been drawn from a twin
registry confirmed the
heritability of sexual
orientation.
Gender
Conformity/Nonconfo
rmity Is Correlated
With Sexual
Orientation
To date, there have been more
than 45 studies confirming a
correlation between childhood
gender
conformity/nonconformity and
an adult sexual orientation.
The largest of these compared
nearly 1,000 gay men and
lesbians with 500 heterosexual
men and women on many
aspects of their childhoods,
including family relationships
and early sexual experiences
with both sexes. None of these
aspects correlated with their
later sexual orientations. In
fact, there was only one
childhood variable that
correlated with adult sexual
orientation for both men and
women: gender conformity/
nonconformity. For example,
many more gay men than
heterosexual men reported that
as children, they had not
enjoyed typical boy activities
(such as sports), had enjoyed
typical girl activities, and had
had more childhood friends
who were girls. Similarly,
more lesbians than
heterosexual women reported
they had not enjoyed typical
girl activities, had enjoyed
typical boy activities
(especially sports), and had
had more childhood friends
who were boys.
Gender
Conformity/N
onconformity
and Feeling
Different
EBE theory proposes that
gender-conforming children
will feel different from their
opposite-sex peers, and
gender-nonconforming
children will feel different
from their same-sex peers.
The large study, cited above,
found that 71% of the gay
men and 70% of the lesbians
in the sample had felt different
from their same-sex peers
during childhood. When asked
in what ways they had felt
different, they
overwhelmingly cited
genderrelated reasons. Gay

men were most likely to reply
that they had not liked sports;
lesbians were most likely to
reply that they had liked sports
more and had been more
masculine than other girls. In
contrast, less than 8% of
heterosexual men and women
said that they had felt different
from same-sex childhood
peers. Those who did tended
to cite non–gender-related
reasons such as having been
poorer, more intelligent, or
more introverted than other
children.
EBE theory’s proposal that
individuals can become
erotically attracted to a class
of individuals from whom
they felt different during
childhood also applies to
erotic preferences based on
characteristics other than
biological sex. For example, a
light-skinned person could
come to eroticize darkskinned
persons through this same
exotic-becomeserotic process.
However, to produce a
differential homoerotic or
heteroerotic attraction requires
that the individual must feel
different for sex-based or
gender-related reasons. Simply
being poorer, more intelligent,
or more introverted than one’s
childhood peers does not
produce differential
homoerotic or heteroerotic
attraction.
How Does Exotic Become
Erotic?
In his 1st-century Roman
handbook, The Art of Love,
Ovid advised any man who
Exotic Becomes Erotic: A Developmental Theory of Sexual Orientation
1059
was interested in sexual
seduction to take the woman
in whom he was interested to
a gladiatorial tournament
because she would there be
more easily aroused to
passion. A contemporary
version of Ovid’s claim can be
understood to be a special case
of what psychologists call the
two-factor theory of emotion.
It states that the physiological
arousal of our nervous system
provides the cues that we feel
emotional, but the more subtle
judgment of which emotion
we are feeling often depends
on our interpretation of the
surrounding circumstances.
The experience of erotic
arousal thus arises from the
conjunction of physiological
arousal and circumstances that
permit it to be interpreted as
erotic arousal.
There is now experimental
evidence that an individual
who has been emotionally
aroused— whether that
arousal is neutral, pleasant, or
unpleasant—will show
heightened sexual
responsiveness to an
appropriate target person. In
one study, male participants
were physiologically aroused
by running in place, by
hearing an audiotape of a
comedy routine, or by hearing
an audiotape of a grisly
killing. No matter how they
had been aroused, these men
reported greater erotic interest
in a physically attractive
woman than did a control
group of men who had not
been aroused.
1060
This effect has also been Link Versus EBE
observed physiologically. Men Theory
and women were shown an
The discovery that genes are
erotic video while their
correlated with sexual
physiological sexual arousal
orientation has led some
was monitored (penile erection
people to believe that there
in men and vaginal blood flow
must be a “gay” gene or set of
in women). But before seeing
genes that directly influence
the erotic video, half the
or “code for” sexual
participants first saw a
orientation. In contrast, EBE
disturbing video of a grisly
theory proposes that the link
automobile accident; the
between genes and sexual
remaining participants saw a
orientation is only indirect:
video of peaceful landscapes.
The genes influence early
Participants who had seen the
personality traits that lead a
disturbing video subsequently
child to become gender
showed more sexual arousal in
conforming or gender
response to the erotic video
nonconforming, and it is
than did those who had seen
gender conformity or
the peaceful video.
nonconformity that provides
EBE theory thus proposes
the important intervening link
that an individual’s experience
between the genes and sexual
of feeling different from same-
orientation. Because the large
or opposite-sex peers in
study of twins, discussed
childhood produces a
above, assessed both sexual
physiological arousal that gets
orientation and gender
eroticized when the
conformity or nonconformity,
maturational, cognitive, and
those data provide for a
situational factors coalesce to
comparative test of the direct
provide the defining moment
and the indirect EBE paths
when it can be interpreted as
from genes to sexual
sexual arousal. The timing of
orientation.
this moment, however, is
First, the data confirm the
influenced by several factors,
first link proposed by EBE
including actual sexual
theory: Monozygotic twins are
experience with opposite- and
significantly more alike on
same-sex peers and the norms
gender conformity or
of the surrounding culture.
nonconformity than are same-
The recent heightened
sex dizygotic twins. This is
visibility of gay men and
equally true for both men and
lesbians in our society appears
women. Second, the data
to be leading individuals who
confirm the second link
experience same-sex arousal
proposed by EBE theory:
to recognize it, label it, and act
Childhood gender conformity
on it at earlier ages than in
or nonconformity is
previous years.
significantly correlated with
An Empirical Test of the
sexual orientation. When the
Direct Genetic direct and EBE paths were
 1061
statistically compared, it was Origins of Sexual Orientation;
found that the EBE path Homosexuality,
significantly accounts for the Female; Homosexuality, Male;
Sexual Fluidity;
correlation between genes and
Sissyboy Experience; Theories
sexual orientation, but the
of Sexual Orientation;
direct path does not.
Tomboy Experience
This one test does not, of
course, establish the validity
of EBE theory as a whole, F
which proposes several other u
links and processes (e.g., the r
link between feeling different t
in childhood and later erotic h
attractions), but it does e
demonstrate that the r
correlation between the genes
and sexual orientation should R
not be interpreted as a direct e
causal link. This general point a
Exotic Becomes Erotic: A Developmental Theory of Sexual Orientation

is nicely illustrated by the d

finding that there is a
correlation between genes and
getting divorced: If a g
monozygotic twin is divorced,
his or her twin is also more
likely to be divorced than if
they are dizygotic twins. Yet
nobody has proposed that
there must be a “divorce” gene
because it is obvious that there
must be some intervening
heritable personality traits
(e.g., irritability or clinical
depression) that account for
the link between genes and
divorce. EBE theory is an
example of that same
reasoning applied to sexual
orientation.
Daryl J. Bem
See also Bisexualities;
Developmental Aspects of
Sexuality; Essentialist–
Constructionist Debate on the
i
n
s
Bailey, J. M., Dunne, M. P., &
Martin, N. G. (2000). Genetic
and environmental influences
on sexual orientation and its
correlates in an Australian
twin sample. Journal of
Personality and Social
Psychology, 78, 524–536.
Bell, A. P., Weinberg, M. S., &
Hammersmith, S. K. (1981).
Sexual preference: Its
development in men and
women. Bloomington: Indiana
University Press.
Bem, D. J. (1996). Exotic becomes
erotic: A developmental theory
of sexual orientation.
Psychological Review, 103,
320–335.
Bem, D. J. (2000). Exotic becomes
erotic: Interpreting the
biological correlates of sexual
orientation. Archives of Sexual
Behavior, 29, 531–548.
1062
Diamond, L. M. (2003). What does
sexual orientation orient? A
biobehavioral model
distinguishing romantic love
and sexual desire.
Psychological Review, 110,
173–192.
Diamond, L. M. (2009). Sexual
fluidity: Understanding
women’s love and desire.
Cambridge, MA: Harvard
University Press.
Green, R. (1987). The “sissy boy
syndrome” and the development
of homosexuality. New Haven,
CT:
Yale University Press.
Hamer, D., & Copeland, P.
(1994). The science of desire:
The search for the gay gene
and the biology of behavior.
New York, NY: Simon &
Schuster.
Walster, E. (1971). Passionate love.
In B. I. Murstein (Ed.),
Theories of attraction and love
(pp. 85–99). New York, NY:
Springer.
White, G. L., Fishbein, S., &
Rutstein, J. (1981).
Passionate love and the
misattribution of arousal.
Journal of Personality and
Social Psychology, 41, 56–62.
F beca
use
FAMILI of
the
ES OF
host
CHOIC ility
they
E
may
enc
ount
The
er
conc
fro
ept
m
of
their
fami
fami
lies
lies
of
of
choi
orig
ce
in.
has
Wh
its
erea
roots
s
in
LG
the
BT
idea
Q
that
fami
LGB
lies
TQ-
hav
ident
e
ified
som
peop
etim
le
es
creat
bee
e
n
their
disc
own
usse
fami
d as
lies,
“frie
1064

ndsh ity
ip me
fami mbe
lies, rs,
” the and
conc so
ept on)
of can
fami be
lies incl
of ude
choi d as
ce fami
refer ly.
s to Som
the e
way argu
s in e
whic that
h all unli
man ke
ner hete
of rose
relat xual
ions fami
hips lies,
(incl whi
udin ch
g imp
coup ose
les, hete
ex- rono
part rmat
ners, ive
frien nor
ds, ms,
acce valu
ptin es,
g and
fami ineq
ly of ualit
origi ies,
n, LG
copa BT
rents Q
, fami
LGB lies
TQ of
com choi
mun ce
 1065

are ts,
unde mai
rpin nstr
ned eam
by a fami
frien lies
dshi are
p bec
ethic omi
that ng
pro mor
mote e
s like
auto LG
nom BT
y, Q
mut chos
ualit en
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and .
dem Sev
ocrat eral
ic criti
patte cis
rns ms
of hav
relat e
ing. bee
Som n
e mad
sugg e of
est thes
that e
beca prop
use ositi
heter ons,
osex not
uals least
are on
incre the
asin basi
gly s of
rejec the
ting limi
“trad ts of
ition choi
al” ce
fami in
ly ever
scrip yda
1066

y and
life. acti
vely
pro
Fami mot
ly e, a
and hete
the rose
Hete xual
rose assu
xual mpt
Assu ion.
mpti Mo
on st
peo
Des ple
pite are
the taug
incr ht
easi to
ng asso
soci ciat
al e
acce hete
ptan rose
ce xual
of ity
LG wit
BT h
Q
iden 391
tities natural
in desire,
som and
e heteros
cont exual
exts, family
it is relation
still s with
the normal
case adult
that relation
most al life.
fami In fact,
lies “the
oper family”
ate has
acco long
rdin posed a
g to, threat
 1067

to those Co
who do ming
not out as
identify LGBT
as Q
heteros implies
exual. disrega
In the rding
past, the
LGBT heteros
Q kin exual
often self
experie that
nced most
violenc people
e at the are
hands attribut
of ed
family from
membe birth.
rs, and This
even can be
today linked
such to a
violenc sense
e of
continu persona
es to be l crisis,
reporte or
d. More ontolog
commo ical
nly, disrupti
they on,
experie which
nced is
family exacerb
exclusi ated by
on and the risk
rejectio or fact
n of
because losing
of their access
refusal to
to go family,
along friends
with hip,
heteron commu
ormativ nity,
e order. and
other
1068

persona the
l person
support become
s that s, in a
are very
availabl real
e to sense, a
heteros “differe
exuals. nt
Becaus person.
e of ” Thus
this, it has
some been
have said
argued that
that coming
until out of
very heteros
recently exualit
coming y
out as entails
LGBT enterin
Q g into
necessa and/or
rily activel
involve y
d a formin
process g new
of friends
social hips,
relocati networ
on: ks, and
from commu
the nity
families support
, s that,
commu in turn,
nities, provide
friendsh the
ips, and context
locales for
that creatin
sustain g new
heteros familie
exual s.
selves,
to new
LGBT
Q ones
where
 1069

Friends emotio
hip nal
Familie support
s) more
s
commo
One of nly
the key associa
ways in ted
which with
LGBT familie
Q s of
families origin.
have On the
been one
discuss hand,
ed is as some
friends have
hip concep
families tualize
, where d
FLGBT
aQ
m
friends
i
l hip
i familie
es as
s substit
utes or
oreplace
f ments
Cfor
h
estrang
o
i
ed
c familie
es of
origin.
On the
friends other
provide hand,
the some
“goods argue
” that
(mutual friends
care hip
and familie
econom s
ic, provide
social, the
cultural love,
, and mutual
1070

recogni familie
tion, s, but
respect, are
and selfcon
uncondi sciousl
tional y
support choosin
commo g to
nly create
associat alternat
ed with ive
biologi family
cal or forms
legal that are
kin, but more
that the conduc
latter ive to
often translat
fail to ing
provide democr
in atic
practice relation
. al
In ideals
this of
context, mutuali
the ty,
termino equalit
logy of y, and
“electiv negotia
e” and tion
“chosen into
” practic
family e. It is
alludes argued
to the that
fact that becaus
LGBT e
Q LGBT
people Q
who familie
particip s are
ate in made
friendsh up of
ip adults
families (be
are not they
mimick friends,
ing partner
“real” s, ex-
 1071

partners ethic”
, that
coparen promot
ts, or es
LGBT creativi
Q ty,
commu equalit
nity y,
member mutuali
s) who ty, and
opt to autono
particip my.
ate in A
family number
practice of
s with studies
each have
other, focused
they are on the
not materia
simply l,
followi social,
ng cultural
mainstr , and
eam emotio
cultural nal
guidelin resourc
es and es that
scripts friends
that hip
support familie
unequal s and
(gender familie
ed) s of
roles, choice
obligati provide
ons, for
and their
respons membe
ibilities. rs. As
Rather, well as
they are the
more comfor
likely ts
to associa
operate ted
accordi with
ng to a “idealiz
“friends ed”
hip familie
1072

s, they emotio
can also nal
provide and/or
an sexual
anchor bonds
for self- as well
made as the
identitie care of
s, a childre
sense of n. They
belongi are
ng, and fluid in
a focus terms
for of their
persona membe
l/politic rship
al over
agency. time,
Friends and
hip they
families are
and especia
families lly
of associa
choice ted
can, but with
do not urban
necessa LGBT
rily, Q ways
include of
couples living,
; sexual althoug
partners h their
; ex- existen
partners ce in
; single nonurb
and an
couple areas
friends has
who are also
straight been
or docum
queer; ented.
and Some
asexual, argue
monoga that at
mous, the
or heart of
polyam the
orous friends
 1073

hip particip
ethic ating
underpi parties
nning can
friendsh dissolv
ip e the
families family
and relation
families ships
of when
choice they no
is the longer
idea provide
that the
they are “goods.
relation ”
ships
betwee
n adults Chose
that are n
not Famili
skewed es
by
Kath
unequal
Weston
power
’s 1991
relation
book,
s and
Famili
that
es We
their
Choos
boundar
e,
ies and
which
limits
was
are
based
open to
on a
negotiat
study
ion.
of
Ultimat
LGBT
ely, the
Q
limits
relation
to
s in
unequal
San
power
Francis
relation
co,
s are set
made a
by the
pivotal
fact that
contrib
one,
ution
some,
to the
or all of
literatu
the
1074

re on of how
families people
of defined
choice. their
First, it familie
highlig s, but
hted the also
ways in the
which family
LGBT practic
Q es they
families engage
were d in.
not Third,
“preten Weston
d” or ’s work
“substit extend
ute” ed
family underst
forms, anding
but s of
were a chosen
matter familie
of s by
LGBT showin
Q g that
agency. they
Second, could
through include
an membe
ethnogr rs of
aphic family
study it of
demons origin
trated who
the were
operati accepti
on of ng and
chosen support
families ive of
on the their
ground, LGBT
and Q kin’s
showed identity
that and
they way of
were living.
not A
only a decade
matter later,
 1075

in ot in
2001, mainstr
Jeffrey eam
Weeks, intimat
Brian e life.
Heaphy Drawin
, and g on
Catheri Weston
ne ’s
Donova ideas,
n feminis
publish t and
ed LGBT
Same Q
Sex deconst
Intimac ructive
ies, approa
based ches to
on the “the
finding family,
s of ” and
their Europe
study an
on work
British on
families transfo
of rming
choice. pattern
This s of
extende intimac
d y,
Weston Weeks
’s and
insights colleag
by ues
linking interpr
familial eted
develop LGBT
ments Q
in familie
nonhete s of
rosexua choice
l as an
cultures exempl
to ar of
develop broader
ments develo
that pments
were in
underfo Wester
1076

n ally
democr had
acies, good
where reason
the to
structur adopt
e and an
meanin antago
g of all nistic
family approa
and ch to
intimat the
e family
relation as a
ships social
were instituti
increasi on, and
ngly to the
becomi use of
ng family
subject termino
to self- logy to
definiti describ
on, e
self- LGBT
creation Q
, and relation
negotiat ships.
ion in Not
everyda least
y among
practice these
. reasons
Both was the
Weston central
and part
Weeks “the
and family”
colleag plays
ues not
acknow only in
ledged the
that reprodu
LGBT ction of
Q capitali
theory st,
and patriarc
politics hal,
have and
historic discipli
 1077

nary Criticis
social ms
orders,
but also There
in terms are
of now
violenc several
e, criticis
abuse, ms
and the made
impositi of the
on of concep
gendere t of
d and familie
sexual s of
inequali choice,
ties. not
Despite least
this, the on the
use of basis
the of
family questio
termino ning
logy by the
LGBT extent
Q to
people which
to LGBT
describ Q
e and friends
make hips,
sense of intimat
their e and
relation sexual
ships relation
has ships,
continu couples
ed to be ,
recorde parenti
d in ng, and
studies commu
of nity
LGBT relation
Q ships
relation are the
al lives. subject
of
“real”
and
“free”
1078

choices. more
The or less
termino wholly
logy of reinven
choice t
fits well themse
with the lves
pervasi and
ve their
discour relating
se of orientat
neolibe ions in
ral context
consum s of
er their
ideolog own
y, choosi
where ng.
increas This
ed serious
choice ly
is oversta
associat tes the
ed with extent
enhanc to
ed which
agency family
and as
citizens heteros
hip. It exual
rests on instituti
the idea on,
of based
individ on
ualized biologi
and cal and
reflexiv legally
e agents defined
who are kinship
more or , has
less been
wholly deconst
disemb ructed
edded in
from Wester
their n
biograp culture
hical s and
roots in
and can everyd
 1079

ay ons of
practice the
. It also possibil
underm ity of
ines the breakin
biograp g away
hical, from
social, “given”
cultural kin and
, and reinven
econom ting
ic new
factors forms
that of
limit family
choice relation
in ships.
relation While
ships. family
Pers connect
onal edness
relating and
orientat obligati
ions are ons
embedd may no
ed in longer
relation be
al simply
biograp given
hies, by
which biologi
in turn cal and
are legal
influenc related
ed by ness,
class, people
race, can
gender, still
ethnicit carry
y, with
religion them a
, sense
generati of
on, and respons
other ibility
factors, to
all of Families of Choice
which
shape
percepti
1080

biologic family
al and practic
legal es
kin. In relation
the case ships.
of It is
LGBT also
Q predica
people, ted on
this can the
still be assump
experie tion
nced as that
a people
pressur have
e to access
remain to
closete social
d, or to skills,
continu resourc
e to be es, and
involve confide
d with, nce to
and seek
even coparti
care cipants.
for, Econo
hostile mic,
kin. social,
The and
notion cultural
of resourc
being es
able to matter
choose in
family facilitat
is also ing
predicat LGBT
ed on Q
the choices
availabi , and
lity of the
like- availab
minded ility of
people such
who are resourc
willing es is
to linked
particip to
ate in econo
 1081

mic and as well

sociocu as the
ltural lack of
position resourc
ing in es
terms require
of class, d to
race, particip
gender, ate in
ethnicit the
y, persona
religion l
, reinven
generati tion of
on, family.
geograp
hical
location Transf
, and so ormin
on. g
Thus, Relati
while onship
the s?
creation
of Two
families further
of criticis
choice ms of
is a real LGBT
possibil Q
ity for familie
some s of
LGBT choice
Q are
people, worth
for conside
others ration.
such The
possibil first of
ities are these
limited concer
by the ns the
pull of notion
given that
families friends
, hip and
commu other
nities, kinds
and of
cultures electiv
1082

e underpi
families nned
are by a
more friends
democr hip
atic ethic is
than often
traditio centere
nal d on
heteros friends
exual hip as
ones the
and that ideal
they are type of
“power relation
- ship. A
neutral. proble
” Some m
studies arises
have when
demons this is
trated transpo
that rted
these into
notions claims
rest on made
an about
idealize friends
d hip and
version friends
of hip
friends familie
hip, and s as
a partial empiric
underst al
anding realitie
of s.
LGBT Resear
Q ch has
familial shown
life. that in
The practic
theoreti e
cal friends
argume hip
nt that familie
families s and
of familie
choice s of
are choice
 1083

are not LGBT

necessa Q
rily as F
democr a
atic and m
i
power-
l
neutral i
as some e
theorist s
s have
imagine o
d them f
to be.
Rather, O
they r
i
can
g
involve i
unequal n
domesti ,
c and
emotio R
nal e
labor, l
unequal a
t
decisio
i
nmakin
o
g power n
and, in s
the h
most i
extreme p
cases, s
emotio
nal and W
i
physica
t
l abuse. h
The
second
criticis familie
m s of
concern choice
s the are
extent politica
to lly
which partial
theoreti in the
cal sense
argume of the
nts ideolog
about ical
1084

work ships
they do, and
especial familie
ly s are
where empiric
LGBT ally
Q unsupp
families orted.
are Some
argued LGBT
to be Q
indices critics
of have
broader also
develop argued
ments that the
in the discour
individ se that
ualizati suggest
on and s
democr greater
atizing equalit
of all y
(includi within
ng heteros
heteros exual
exual) familie
family s and
and betwee
intimat n them
e and
relation LGBT
ships. Q
Several familie
critics s is an
have illusion
noted ary one
how that
argume works
nts to
about make
the invisibl
democr e
atic continu
transfor ing
mation gender
of inequal
heteros ities in
exual heteros
relation exual
 1085

relation marriag
ships, e
and nowada
masks ys
the involve
constru s a
ction of relation
new ship
hierarc betwee
hies n social
and and
new econo
inequali mic
ties in equals.
LGBT On the
Q life. other
Sam hand, it
e-sex can be
marriag argued
e is an that
importa becaus
nt issue e same-
in this sex
respect. marriag
On the e
one privileg
hand, it es the
can be couple
argued and
to legally
recogni recogni
ze and zed
support kin, it
LGBT impose
Q s a
relation heteron
ships as ormativ
equal to e
heteros structur
exual e on
ones same-
that, in sex
turn, is relation
indicati ships
ve of that
the neutrali
ways in zes the
which more
heteros radical
exual implica
1086

tions of ity;
families Hom
onor
of
mati
choice vity;
as they Marr
were iage,
perceiv Reas
ed to be ons
based for
on a and
Agai
friendsh
nst
ip ethic
and
informa F
l bonds u
with r
nonbiol t
ogically h
or e
legally r
related
kin as R
well e
and a
anchore d
d in i
diverse n
kinds of g
emotion s
al, Butler,
sexual, J.
and (20
caring 02)
commit . Is
kin
ments.
shi
Brian p
alw
Heaphy
ays
alr
See also
ead
Families
y
of
het
Origin,
ero
Relation
sex
ships
ual
With;
?
Frien
Dif
dship
fer
s;
en
Heter
ces
onor
: A
mativ
 1087

Jou mation
rna of
l of intimacy
Fe
.
min
ist Cam
Cul bridg
tur e,
al Engl
Stu and:
die Polit
s, y
13( Press
1), .
14– Heaphy,
44. B.,
Carringto Smar
n, C. t, C.,
(2002 &
). No Einar
place sdotti
like r, A.
home (201
: 3).
Relat Same
ionsh -sex
ips marr
and iages
famil :
y life New
amon gene
g ratio
lesbi ns,
ans new
and expe
gay rienc
men. es.
Chica Basi
go, ngst
IL: oke,
Univ Engl
and:
ersity
Palgr
of
ave
Chica Mac
go milla
Press. n.
Giddens, Week
A. s,
J.,
(1992).
He
The
ap
transfor hy
1088

, e
B., s
& w
Do e
no c
van h
, C. o
(20 o
01) s
. e
Sa :
me L
sex e
inti s
ma b
cie i
s: a
Fa n
mil s,
ies g
of a
ch y
oic s,
e a
an n
d d
oth k
er i
life n
ex s
per h
im i
ent p
s. .
Lo N
nd e
on, w
En Y
gla o
nd: r
Ro k,
utl N
edg Y
e. :
West C
o o
n, l
K. u
(1 m
9 b
9 ia
1) U
. n
F i
a v
m e
ili rs
 1089

it individ
y uals.
Pr
Thus,
es
s.
this
entry
discuss
es the
relation
FAMILI ship
ES OF dynami
cs of
ORIGI sexual-
minorit
N, y
RELATI individ
uals
ONSHI and
PS their
familie
WITH s of
origin,
as well
Family as their
relation influen
ships ce on
among physica
lesbian l and
and gay psycho
adults logical
and health.
their In
families particul
of ar,
origin researc
are h in
critical this
to area
conside has
r in focuse
underst d on
anding the
a disclos
variety ure of
of one’s
related sexual-
health minorit
outcom y
es for identity
lesbian , or the
and gay “comin
1090

g out” origin
process, is a rite
to of
parents. passag
e and
formati
Comin ve
g Out event
to in the
Familie lives of
sexual-
s of
minorit
Origin y
Sexual- individ
minorit uals
y and
individ one
uals that
have often
been sets
concept change
ualized s in
as motion
“family within
outlaws the
” even family
with system.
ongoin Despite
g trends growin
toward g
greater accepta
accepta nce of
nce of sexual
nonhete minorit
rosexua y lives
lity in in the
the United
United States,
States coming
as well out to
as in one’s
many family
places is still
around one of
the the
world. most
Coming difficul
out to t
families challen
of ges
 1091

that arent
lesbian closet”
and gay and
individ “family
uals closet”
must to
face. differe
Various ntiate
cultural betwee
, n
sociode situatio
mograp ns in
hic, and which
other family
context membe
ual rs fully
factors accept
influen and
ce how embrac
families e their
react to, child’s
manage coming
, and out
then from
embrac situatio
e or ns in
reject which
their family
child’s membe
sexual- rs
minorit know
y about
identity the
. For child’s
exampl sexual-
e, minorit
recent y
internat identity
ional but
researc refuse
h on to
gay accept
men in the
Sloveni child’s
a has coming
suggest out. On
ed use the
of the other
terms hand,
“transp membe
1092

rs of
The
families R
of o
origin l
who e
fully
embrac o
e and
f
accept
their
R
nonhete
e
rosexua
l l
relative i
often g
must go i
through o
a sort n
of
coming i
out n
process
of their I
own in n
which f
they l
decide
u
whether
e
they
n
will
disclose c
or i
discuss n
their g
family
membe F
r’s a
sexual- m
minorit i
y l
identity y
(or not)
within R
their
e
own
l
social
networ
a
ks and t
experie i
nces. o
 1093

n church
s es, play
h domina
i nt roles
p in
feeling
s
s of
Religio self-
us rejectio
values n, self-
have discrim
constitu ination,
ted one and a
pivotal lack of
set of self-
influen accepta
ces on nce.
family Simi
reaction larly,
s to a among
child’s parents
coming of gay
out men
process. and
Among lesbian
gay women
men in in Italy,
Chile, Catholi
family c
values religiou
of s
religios beliefs
ity, must
includi often
ng be
views reconci
of led
homose with
xuality attitude
as s about
unnatur sexual
al that orientat
have ion in
been order
shaped to
by accept
Catholi their
c and sexual-
evangel minorit
ical y
1094

children capacit
. y of
Interesti parents
ngly, to
these accept
parents their
frequen child
tly (and an
draw on alternat
differen ive to
t and rejectio
even n)
contradi while
ctory maintai
cultural ning a
norms grasp
in order of
to heteron
negotiat ormativ
e e
seemin cultural
gly values.
irreconc As a
ilable result
position of
s in conserv
public ative
discour religiou
se s or
(accept family
ance of beliefs,
sexual- sexual-
minorit minorit
y lives y
and adults
Catholi often
c endure
identity pervasi
). For ve
exampl internal
e, the struggl
idea es to
that the achieve
“homos their
exual is own
destine persona
d to l
suffer” accepta
allows nce and
for the perceiv
 1095

ed ws
normali with
zation heteros
of exual
being a biologi
sexual- cal
minorit sibling
y s of
person. lesbian
Famili and
es of gay
Origin individ
, uals
Relati
reveal
themes
onship
of
s With
varied
reactio
Disclos ns to
the
ure to
sexuali
Sibling dentity
s disclos
Some ure,
researc includi
h has ng
focused feeling
on the s that
reaction being
s of gay
siblings was
from “differ
families ent,” as
of well as
origin, feeling
in s that
additio were
n to much
parents, more
to the comfor
coming table
-out with
experie having
nces of a
sexual lesbian
minorit or gay
y sibling.
individ Comm
uals. only,
Intervie sibling
1096

s positiv
appear e and
to negativ
suspect e),
that referen
their ce the
brother/ challen
sister is ge of
gay/les dealing
bian with
before heteros
the exism,
disclos and
ure perceiv
occurs. e
Sibling positiv
s often e
feel change
protecti s in
ve themse
toward lves as
their a result
lesbian/ of their
gay sibling
sisters/ s’
brother coming
s and out.
express
anger if
their Disclos
parents ure to
react
Family
negativ
ely to and
the Social
disclos Suppo
ure. rt
Heteros Some
exual researc
brother h about
s and the
sisters implica
also tions of
note disclos
changes ure and
in their coming
sibling out to
relation familie
ship s of
(both
 1097

origin surroun
had its ding
roots in AIDS,
studies the
of HIV- inabilit
positive y of
gay family
men membe
and rs to
their commu
families nicate
. Early openly
researc or
h compet
showed ently
a about
notable nonhet
lack of erosex
social uality
support and/or
from AIDS,
the and
families overpr
of otectiv
origin eness
of gay or
men infantil
with izing
AIDS, behavi
which or by
was parents
tied to .
the Findin
family’ gs
s lack from
of these
accepta studies
nce of consist
nonhete ently
rosexua demon
lity strated
and/or a that, on
relation a more
ship positiv
with a e note,
male when
partner, gay
as well men do
as disclos
stigma e about
1098

their F
sexualit a
y (and m
i
potentia
l
l HIV i
status), e
higher s
levels
of o
social f
support
are O
experie r
i
nced
g
from all i
family n
membe ,
rs
(mother R
s, e
fathers, l
and a
t
siblings
i
) as o
well as n
lower s
levels h
of i
barriers p
to s
support
W
from
i
parents. t
Gay h
men
appear
most sisters),
likely as
to compar
disclose ed with
to and fathers.
receive When
support familie
from s do
mothers provide
and support
siblings , it is
(particu often
larly in the
form of
 1099

emotio receive
nal d
rather increasi
than ng
instrum public,
ental legislat
(or ive,
informa and
tional) scholar
support. ly
Beyo attentio
nd n in the
coming United
-out States.
and From
disclosu intervie
re ws
experie with
nces, gay
some male
more couples
recent who
researc legally
h has married
investig in the
ated the state of
reaction Iowa, it
s of is clear
member that
s of many
lesbian sexual
and gay minorit
individ y
uals’ persons
families may
of hold
origin high
to their expecta
announ tions
cement about
of the
same- “power
sex of
marriag marriag
e, e” to
particul facilitat
arly as e
this increas
topic ed
has recogni
1100

tion and of
support origin.
from Thus,
their the act
families of legal
of marriag
origin. e
Often, appears
howeve to hold
r, both
family the
reaction capacit
s are y to
more cultivat
varied e or
and limit
comple greater
x even support
with from,
same- and
sex status
marriag among,
e sexual-
frequen minorit
tly y
leading individ
to uals’
overall familie
positive s of
family origin.
outcom Atte
es. ndance
Some at
negativ family-
e of-
outcom origin
es are rituals
possible and
too, feeling
includin s of
g belongi
renewe ngness
d or have
potentia also
lly new been
experie examin
nces of ed
rejectio among
n by sexual-
families minorit
 1101

y (e.g.,
adults. family
Whethe reunion
r s,
lesbian holiday
women gatheri
and gay ngs,
men family
choose dinners
to ,
attend weddin
rituals gs).
with Often,
their sexual-
families minorit
of y
origin individ
and uals
how feel
much pressur
they e to
feel a “desex
sense of ualize”
belongi their
ngness current
(vs. samese
feeling x
like an relation
outsider ship in
) appear an
to effort
revolve to feel
around a sense
the of
quality belongi
and ng
perceiv based
ed on
closene family
ss of connect
relation ion (or
ships racial
with identity
their )
family during
member extende
s, as d
well as family
the type rituals.
of ritual Differe
1102

nt d
family T
rituals h
appear ei
to be r
linked
P
with
a
differen
r
t
strategi e
es n
among ts
sexual- ’
minorit F
y a
individ m
uals in ili
negotiat e
ing and s
redefini o
ng roles f
(e.g.,
O
their
ri
own
same- gi
sex n
weddin The
g degree
versus a to
family which
memori the
al childre
service) n of
. lesbian
Contac and
t gay
B parents
et are
w involve
e d with
parents
e
’
n
familie
C
s of
hi origin
ld has
re also
n been
a assesse
n d.
 1103

When Suppor
sexual- t from
minorit familie
y adults s of
have origin
childre may be
n, their particul
own arly
parents critical
(and at this
other time in
membe the life
rs of cycle,
the since
family sexual-
of minorit
origin) y
are parents
often often
called perceiv
upon to e
renegot signific
iate or antly
negotiat less
e new social
kin support
relation from
ships. friends
Indeed, overall
some (especi
families ally
of gay
origin and
are lesbian
reporte friends
d to ) after
have having
become childre
more n. In
accepti terms
ng of
when actual
their contact
sexual- among
minorit the
y childre
relative n of
s have sexual-
childre minorit
n. y
1104

parents with no
with differe
families nces
of found
origin, betwee
researc n
h with childre
lesbian n of
mothers heteros
who exual
created and
their lesbian
families parents
via .
donor Howev
insemin er,
ation when
debunk looking
s myths within
that lesbian
childre mother
n are familie
isolated s
from formed
their throug
parents’ h
families donor
of insemi
origin. nation,
Childre childre
n n tend
appear to have
to have more
regular frequen
contact t
with contact
grandpa with
rents, their
other biologi
relative cal
s, and mother
other ’s
adult relative
nonrela s,
tives particul
outside arly
their grandp
own arents,
househ than
olds, with
 1105

their support
nonbiol , and
ogical better
mother’ overall
s health
relative status.
s. Family
accepta
Benefit nce
s of appears
to be
Family
protecti
Accept
ve
ance against
In sympto
terms ms of
of depress
outcom ion,
es suicida
linked l
with ideatio
family n and
accepta behavi
nce of ors,
sexual- and
minorit substan
y ce
family abuse.
membe In
rs who contras
are t,
adolesc rejectio
ents, n from
those familie
enjoyin s of
g origin
greater or even
accepta percept
nce ions of
from rejectio
their n (and
families lack of
of disclos
origin ure)
have are
higher linked
selfeste with a
em, whole
greater cascad
social e of
1106

detrime t
ntal i
health o
effects n
for s
sexual-
minorit f
y
o
persons
r
.
Thus,
P
accepta
nce of r
sexual- a
minorit c
y t
relative i
s’ c
identity e
is key
The
to
aforem
positive
entione
mental
d
and
studies
physica
have
l health.
many
implica
Future tions
R for
e therapy
and
s
educati
e
on,
a particul
r arly
c with
h sexual-
minorit
a y
n individ
d uals
struggli
I ng to
m gain
p accepta
l nce
i from
c their
familie
a
 1107

s of persons
origin early in
and/or the life
those course,
living as
in support
predom from
inantly familie
conserv s of
ative origin
Christia is
n associa
cultures ted
’ with a
sociopo host of
litical positiv
context e
s. adjust
Interve ment
ntions outcom
that es.
promot Future
e researc
parental h could
and address
caregiv best
er practic
accepta es for
nce of workin
sexual- g with
minorit family
y membe
adolesc rs (and
ents not
may be only
particul parents
arly , but
crucial also
in sibling
reducin s and
g health other
disparit relative
ies s) of
among sexual-
heteros minorit
exual y
and individ
sexual- uals in
minorit terms
y of
1108

cultivat ng
ing their
accepta sexual
nce, orientat
especial ion, to
ly with underst
conside and the
ration positiv
of e
religiou change
s or s that
cultural family
factors system
that s often
might underg
conflict o in
with the respons
ability e to a
to child’s
embrac coming
e out,
nonhete and to
rosexua determi
l lives. ne the
Additio factors
nal that
studies can
could contrib
be ute to
framed these
from a adaptiv
more e
strength transfo
s-based rmatio
perspec ns
tive to within
highlig familie
ht the s.
positive Despite
charact prejudi
eristics ce and
of discrim
families ination
to faced
whom by
childre sexual
n feel minorit
comfort ies,
able lesbian
disclosi women
 1109

and gay minat

men ion
have Agai
nst
clearly
LGB
demons TQ
trated Peop
the le,
ability Cost
to of;
success Supp
fully ort
Grou
create ps
and and
maintai Reso
n urces
family Film
relation
ships
for F
themsel u
ves and r
t
their
childre h
e
n.
r
Rachel
H. Farr R
e
See also a
Catholic d
LGBTQ i
People;
n
Christian
g
LGBTQ
s
Peopl
e; Bertone,
Close C.,
t, &
The;
Fran
Comi
ng chi,
Out, M.
Discl (201
osure 4).
, and Suff
Passin ering
g; as
Com
the
munit
path
y
Clima to
te; acce
Discri ptan
1110

ce: Chile
Paren an
ts of youn
gay g gay
men.
and
Jour
lesbia nal
n of
youn GLB
g T
peopl Fam
e ily
Studi
negot
es,
iating
10(3)
Cath ,
olicis 269–
m in 297.
Italy. Fulcher,
Jour M.,
nal Chan
of , R.
GLB W.,
T Rabo
Fami y,
ly B.,
Studi &
es, Patte
10(1– rson,
2), C. J.
58– (200
78. 2).
Figueroa Cont
, V., act
& with
Taske gran
r, F.
dpar
(2014
). “I ents
alway amo
s ng
have child
the ren
idea conc
of sin
eive
in my
d via
mind.
. . .”: dono
Famil r
y of inse
origin mina
, tion
religi by
on,
lesbi
and
 1111

an N.,
and &
heter Szy
osexu man
ski,
al
D.
moth M.
ers. (20
Pare 11).
nting Fa
, mil
2(1), y
dyn
61–
ami
76.
cs
Glass, V. and
Q. cha
(2014 nge
). s in
“We sibli
are ng
of
with
orig
famil in
y”: rela
Black tion
lesbia ship
n afte
coupl r
lesb
es
ian
negot
and
iate gay
ritual sex
s ual
with orie
exten ntat
ded ion
disc
famil
losu
ies. re.
Jour Con
nal tem
of por
GLB ary
T Fa
mil
Fami
y
ly
The
Studi rap
es, y:
10(1– An
2), Inte
79– rnat
100. ion
al
Hilton,
Jou
A.
1112

rnal J.
, (201
33(3 0).
), Fami
291
ly
–
309. acce
Ocobock ptan
, A. ce in
(2013 adol
). esce
The nce
powe and
r and the
limits healt
of h of
marri LGB
age: T
Marri youn
ed g
gay adult
men’ s.
s Jour
famil nal
y of
relati Chil
onshi d
ps. and
Jour Adol
nal esce
of nt
Marr Psyc
iage hiatr
and ic
Fami Nurs
ly, ing,
75(1) 23(4
, ),
191– 205–
205. 213.
Ryan, C., Švab,
A.,
Russ
&
ell, S. Kuha
T., r, R.
Hueb (201
ner, 4).
D., The
Diaz, trans
R., & pare
nt
Sanc
and
hez, famil
 1113

y
closet FILM
s:
Gay
menThis
and
entry
lesbia
ns focuses
andon the
cinema
their
tic
famili
es of
represe
origin
ntation
.
s of
Jour
LGBT
nal of
GLBQ
T subject
s.
Fami It
ly explain
Studi
s the
es,
critical
10(1–
2),method
15–s used
35.to
identif
y such
represe
ntation
FERTILI s,
which
TY
F
TOURI i
l
SM m

See
Inter span
natio over a
century
nal
of
Surr filmma
ogac king,
y/Re from
prod experi
uctiv mental
shorts
e
to
Outs comme
ourci rcial
ng feature
s to
indepe
1114

ndently general
produce ly.
d
docume
ntaries Catego
and ries of
beyond.
LGBTQ
It
Film
describ
es the Cinema
history tic
of represe
global ntation
LGBT s of
Q film LGBT
from Q
1895 to subject
the s have
present, long
with been
attentio crucial
n to to
numero popular
us key and
works. scholar
The ly
entry efforts
conclud to
es with underst
an and
examin sexual
ation of minorit
how the ies.
critical Such
study of represe
LGBT ntation
Q film s are
has typicall
evolved y
, and defined
what it in three
can overlap
contrib ping
ute to ways:
the as
study of direct
human depicti
sexualit ons of
y more self-
identifi
 1115

ed ball
LGBT scene,
Q and
individ Robert
uals, as Wise’s
the The
product Haunti
s of ng
LGBT (1961),
Q a
authors horror
(usually film
screen that
writers feature
and s a
director lesbian
s), and charact
as er (a
particul chic
arly psychic
relevant played
to by
LGBT Claire
Q Bloom)
audienc . The
es. The second,
first, authors
subject- hip-
specific specifi
paradig c
m paradig
encomp m
asses include
works s films
as by
diverse lesbian
as directo
Jennie r
Livings Doroth
ton’s y
docume Arzner,
ntary such as
Paris Is Christ
Burnin opher
g Strong
(1990), (1933),
about about
New an
York’s aviator
drag- (Kather
1116

ine Q
Hepbur subject
n) in s, but
love that,
with a like the
politici comedi
an es of
(Colin Mae
Clive), West
and and
The many
Bride of the
Wore melodr
Red amas
(1937), of
about a Bette
cabaret Davis,
singer have
(Joan been
Crawfo demon
rd) who strably
masque popular
rades as among
a LGBT
woman Q
of great movieg
wealth. oers.
Finally, Rangin
the g from
third, the
spectat deeply
or- politica
specific lly
paradig commit
m ted to
describ the
es films seemin
that gly
neither trifling,
were LGBT
made Q films
by self- have
identifi made
ed tremen
LGBT dous
Q contrib
authors utions
nor to the
feature comple
LGBT xity of
 1117

global such
popular images
images .
of Produc
human ed at
sexualit the
y, in Thoma
some s
cases Edison
even estate
prompti in
ng new 1895, a
social short
movem film
ents, popular
cultural ly
theories known
, and as The
legislati Gay
ve Brothe
measur rs
es. consist
LGBTQ s of
Repres two
entatio young
men
n in
who
Early togethe
Cinem r
a perfor
Filmic m a
images particul
of arly
LGBT romant
Q ic
subjects waltz,
are and
traceabl while
e to specula
cinema’ tion
s abound
inventi s
on in surroun
the 19th ding
century, the
as are precise
critical goals
efforts of the
to make film’s
sense of makers
1118

, who constra
may or ints
may not both of
have social
intende conven
d to tion
depict and of
same- sexolo
sex gical
erotic classifi
attracti cation.
on, Similar
their ly
work romant
neverth icized
eless images
offers of
an same-
iconogr sex
aphic intimac
record y are
of a relative
pronou ly rare
nced in early
male cinema
intimac ,
y. howev
Arrivin er.
g at They
comme include
rcial the
cinema’ famous
s very same-
inaugur sex
ation, kiss—
The shared
Gay by the
Brother actors
s Buddy
seemed Rogers
to and
promise Richar
an d Arlen
explosi —that
on of arrives
similar toward
represe the end
ntations of
despite Willia
the m
 1119

Wellma the
n’s war latter is
film plainly
Wings a work
(1927), of
as well advoca
as the cy
loving predica
bond ted on
betwee the
n a basic
violinis human
t rights
(played of
by homos
Conrad exual
Veidt) citizen
and his subject
adoring s—
protégé those
(played deeme
by Fritz d
Schulz) “differ
in ent
Richard from
Oswald the
’s others,
German ” yet
film who
Differe are no
nt less
From deservi
the ng of
Others fair
(1919). treatme
The nt or of
former simple
film recogni
privileg tion.
es the Cowritt
respecti en by
ve Magnu
heteros s
exual Hirschf
encount eld,
ers of whose
its male Institut
protago e for
nists, Sexual
while Scienc
1120

e was Pabst’s
commit Pandor
ted to a’s
promoti Box
ng (1929),
toleranc whose
e for charact
sexual ers
minoriti include
es, a
Differe lesbian
nt -
From identifi
the ed
Others countes
vividly s, and
demons Maurit
trates z
that Stiller’
early s The
cinema Wings
in fact (1916),
accom a
modate Swedis
d the h film
sort of about a
represe young
ntationa man’s
l doome
strategi d love
es that for his
would bisexua
later be l male
associat compa
ed with nion—
the gay early
rights cinema
movem furnish
ent. ed a
Beyo remark
nd able
depictio represe
ns of ntation
same- of the
sex fluidity
erotic of
attractio gender
n— as and
in G. sexualit
W. y,
 1121

includin patholo
g gize
Sidney LGBT
Drew’s Q
A subject
Florida s
Enchan accordi
tment ng to
(1914), the
in popular
which biases
magical of their
seeds era.
precipit While
ate a designa
range of tions
transfor have
mations change
. The d
extent conside
to rably in
which the
these years
and since
other The
silent Gay
works Brothe
were, at rs was
the time release
of their d—
release, with
underst the
ood to term
be “gay”
LGBT becomi
Q films ng a
may be popular
gauged substitu
from te for
contem “homos
poraneo exual”
us print in the
reviews 1960s
, the and
vast 1970s,
majorit and
y of with
which “transg
sought ender”
to and
1122

“queer” Holl
emergin ywo
g even od’s
later—a “Gol
variety den
of
Age
idiomat
”
ic, now-
archaic In the
expressiHollyw
ons ood
(such ascontext
“invert”, one of
and the
“sodom most
ite”), promin
appeari ent
ng both obstacl
in filmses to
and in the
the develo
criticalpment
and of
publicitLGBT
y texts Q film
surroun was the
ding Produc
them, tion
functio Code
ned to Admini
establisstration
h , which
a
corpus in 1930
of drafted
LGBT a series
Q of
cinema regulat
long ory
before measur
the es for
acrony the
m was content
coined. of
comme
rcial
Cens motion
orshi picture
s.
p
Enforc
and
ed in
 1123

1934, ion
these Code
measur conspir
es ed to
promin limit
ently LGBT
include Q
d subject
injuncti s to
ons fleeting
against instanc
so- es of
called same-
“sex sex
perversi intimac
ons,” y (as in
effectiv Nichol
ely as
barring Ray’s
LGBT 1955
Q film
subjects Rebel
from Withou
direct t a
cinemat Cause,
ic with
depictio James
n, Dean
relegati and Sal
ng them Mineo
to a playing
regime particul
of arly
substitu devote
tion and d
connota friends
tion. ), or
The stolen
prevaili momen
ng ts of
mode gender-
of bendin
Hollyw g (as in
ood Cary
censors Grant’s
hip for cross-
over 30 dressin
years, g
the perfor
Product mance
1124

in Willia
Howard m
Hawks’ Wyler’
s 1938 s The
film Childr
Bringin en’s
g Up Hour
Baby (1961),
and adapte
Merced d from
es Lillian
McCam Hellma
bridge’ n’s
s role lesbian
as an -
“ethnic themed
tough” 1934
in stage
Orson play
Welles’ (and
s 1958 the
thriller second
Touch of
of Evil).Wyler’
In s
1961, efforts
the to
Product shape
ion this
Code source
was materia
amende l
d incinema
order to tically,
accom after
modate 1936’s
certain heteros
“tastefu exualiz
l” ed
represe These
ntations Three);
of Edwar
d
Film
Dmytr
yk’s
homose
Walk
xuality.
on the
These
Wild
include
Side
d
(1962),
 1125

about a for
Louisia Hollyw
na ood in
brothel the
headed early
by a 1960s,
lesbian suicide
madam was the
(played only
by viable
Barbara option
Stanwy for the
ck); and inevita
Otto bly
Premin self-
ger’s loathin
Advise g
and homos
Consen exual,
t suggest
(1962), ing that
which the
features Produc
a young tion
senator Code’s
haunted concep
—and tion of
eventua “tastef
lly ul”
driven represe
to ntation
suicide deman
—by ded
his punitiv
affair e
with measur
another es for
man. sexual
Both minorit
The ies.
Childre
n’s
Hour LGBT
and Q
Advise
and F
Consen i
t
l
illustrat
m
e that,
1126

range
i of film
n industri
es
E contrib
u uted
r represe
o ntation
s of
p
LGBT
e
Q
subject
a
s
n throug
d hout
the
A 1960s
f and
r well
i into the
c 1970s.
a In
Britain,
i a
n cultural
movem
t ent
h marked
e by
social
1 realism
saw the
9
product
6
ion of
0 such
s ground
breakin
a g films
n as
d Tony
Richar
1 dson’s
9A
7 Taste
0 of
s Honey
(1961),
Beyond
about a
Hollyw
gay
ood, a
student
 1127

who Q
attempt charact
s to ers
care for ranged
a from
pregnan the
t melodr
teenage amatic
r, and ally
Basil duplicit
Dearde ous
n’s lesbian
Victim of
(1961), Robert
about o
Britain’ Rossell
s ini’s
infamo Rome
us Open
“black City
mailer’ (1945)
s to the
charter” panopl
—the y of
longsta effete
nding gay
law that men in
crimina Rosa
lized von
homose Praunh
xuality eim’s
as a It Is
form of Not the
“gross Homos
indecen exual
cy,” Who Is
leading Perver
to the se, But
extortio the
n of Society
countle in
ss gay Which
men. He
Elsewh Lives
ere in (1971).
Europe, In
represe Africa,
ntations filmma
of kers
LGBT such as
1128

Ousma al of
ne the
Sembèn Senega
e and lese
Med social
Hondo spectru
offered m.
allusion
s to the
figure
LGBTQ
of the Film in
goor- Holly
jigeen wood
(Wolof After
for 1968
“man-
woman In
”), Hollyw
while ood,
Djibril the
Diop abolish
Mambé ment
ty, in of the
his Produc
1973 tion
film Code
Touki in
Bouki, 1968,
include couple
d a d with
wealthy the
, Stonew
unasha all riots
medly in
sexual 1969,
gay ushere
charact d in an
er, era of
Frelative
i ly open
l express
mions of
LGBT
Q
roundin subject
g out s.
his Some
path- exampl
breakin es of
g these
portray
 1129

are Word
John Is Out
Schlesi (1977)
nger’s and
Midnig Gay
ht USA
Cowbo (1978).
y In the
(1969), mid198
which 0s, the
covers perceiv
New ed
York commo
City’s dificati
“sexual on of
undergr LGBT
ound” Q
in a subject
melodr s—
amatic exempl
account ified
of the by a
friends series
hip of of
two high-
men; profile
Sidney 1982
Lumet’ release
s Dog s,
Day includi
Afterno ng
on Robert
(1975), Towne
about a ’s
botched lesbian
bank themed
robbery Person
motivat al
ed (in Best,
part) by Blake
the high Edwar
cost of ds’s
genderr gender
eassign bendin
ment g
surgery Victor/
; and Victori
the a, and
docume Arthur
ntaries Hiller’s
1130

gay inspire
romanc d what
e lesbian
Making critic
Love— B.
gave Ruby
way to Rich
tentativ labeled
e, the
explora New
tory Queer
represe Cinem
ntations a, an
of the explosi
HIV/AI on of
DS genre-
crisis, defying
such as ,
Arthur stylisti
Bressan cally
’s advent
Buddie urous
s films.
(1985) Exemp
and Bill lars of
Sherwo the
od’s New
Parting Queer
Glance Cinem
s a
(1986). include
d Todd
Haynes
The , who
New made
Queer the
Cinem widera
a nging
omnibu
By the s film
early and
1990s, AIDS
politica allegor
l y
neglect Poison
of the in
HIV/ 1991;
AIDS Marlon
crisis Riggs,
had directo
 1131

r of the nd
docume the
ntaries Unit
Tongues ed
Untied Stat
(1989) es
and
Black Is Coterm
. . . inous
Black with
Ain’t the
(1994); New
John Queer
Greyso Cinem
n, a were
whose a
Zero number
Patienc of
e equally
(1993) provoc
address ative
es filmic
HIV/AI develo
DS pments
through in
a range Asia,
of Latin
irrevere Americ
nt a, and
method the
s; and Middle
Rose East.
Troche, Tomás
who Gutiérr
directed ez
the Alea’s
lesbian Cuban
romanti film
c Strawb
comedy erries
Go and
Fish Chocol
(1994). ate
(1993)
address
Que es the
er Cuban
Cine Revolu
ma tion
Beyo from a
1132

queer norms
perspec in his
tive, films,
while which
Lucind include
a 1986’s
Broadb Man of
ent’s Ashes,
docume about
ntary the
Sex and effects
the of
Sandini childho
stas od
(1991) sexual
conside molest
rs the ation
social on two
conditi adult
ons for men,
sexual and
minoriti 1992’s
es Beznes
before s,
and about a
during male
the prostitu
Nicarag te
uan (played
Revolut by
ion. By Abdell
the atif
early Kechic
1990s, he)
the who
Tunisia pursues
n both
filmma female
ker and
Nouri male
Bouzid clients.
had In
develop 1993,
ed a Egypti
global an
reputati directo
on for r
critiqui Yousry
ng Nasrall
gender ah
 1133

made and, to
Merced date,
es, the
which only—
features Chines
gay and e film
lesbian to win
charact the
ers, and covete
which d
remains Palme
one of d’Or at
the few the
Middle Cannes
Eastern Film
films to Festiva
have l. In
been 1996,
screene Indian
d at directo
multipl r
e queer Deepa
film Mehta
festival comple
s ted
around Fire, a
the lesbian
world. romanc
In e that
China, didn’t
Chen open in
Kaige’s India
Farewe for
ll, My nearly
Concub three
ine years;
(1993) when it
tackled finally
the did, in
topics 1999, it
of male was to
homose conside
xuality rable
and controv
gender ersy.
perform By
ance, the late
becomi 1990s,
ng the the
first— New
1134

Queer range
Cinema of
had perspec
given tives:
rise to in
an 1997,
abunda Guinea
nce of n
big- director
budget, Moham
criticall ed
y Camara
acclaim made
ed, and the
award- ground
winning breakin
Hollyw g
ood Dakan,
films, a
from variatio
Sam n on
Mendes Romeo
’s and
Americ Juliet,
an in
Beauty which
(1999) two
to boys
Stephen come
Daldry’ to
s The terms
Hours with
(2002). their
At taboo
around love
the for one
same another
time, a , and in
number 2001,
of Senega
African lese
filmma director
kers Joseph
were Gaï
addressi Ramak
ng a made
LGBT Karme
Q n Geï,
subjects an
from a adaptat
 1135

ion of y
Prosper interdis
Mérimé ciplinar
e’s y
novella pursuit,
and general
George ly
s encom
Bizet’s passing
opera film
Carme and
n, media
starring studies,
Djeïnab gender
a Diop studies,
Gaï as feminis
the t and
bisexua queer
l title theory,
charact and
er. In sociolo
Israel, gy.
director Resting
Etyan on a
Fox rich
made history
Yossi & of
Jagger, subcult
which ural
follows criticis
the love m that
affair of include
two s the
men in pioneer
the ing
Israeli work
army. of
The Parker
Study Tyler,
of Kennet
h
LGBTQ
Anger,
Film and
The Vito
study of Russo,
LGBT the
Q film study
represe of
nts a LGBT
distinctl Q film
1136

is s
predom several
inantly salient
concern method
ed with s for
the analyzi
matters ng
of mainstr
authors eam
hip, Hollyw
represe ood
ntation, films
and beyond
receptio conven
n. tional,
While straight
Anger’s -
book identifi
Hollyw ed
ood interpr
Babylo etive
n, first framew
publish orks.
ed in First
France publish
in ed in
1959, is 1972,
largely Tyler’s
speciou Screen
s in its ing the
author’ Sexes:
s efforts Homos
to “out” exualit
such y in the
movie Movies
stars as was
Rudolp one of
h the
Valenti first
no, major
Randol books
ph to
Scott, borrow
and Anger’
Cary s
Grant, subvers
it ive
neverth approa
eless ch to
suggest cinema
 1137

, times,
revivin his
g detaile
Anger’s d, even
combin ecstatic
ation of appreci
politica ations
l of
resistan individ
ce and ual
libidino filmma
us kers,
engage from
ment. Sergei
Howev Eisenst
er, as ein to
its Françoi
subtitle s
suggest Truffau
s, t.
Screeni Tyler’s
ng the chapter
Sexes is -long
more analysi
directly s of
concern Mae
ed than West,
Hollyw in
ood which
Babylo he
n with makes
filmic a case
represe both
ntations for
of West’s
same- status
sex as a
eroticis camp
m, and icon
it and for
features her
not diverse
only contrib
Tyler’s utions
original to
critical various
taxono films,
mies, suggest
but s that,
also, at for
1138

him, s
“gay obviou
culture” s
extends affectio
well n for
beyond “positi
direct ve”
represe represe
ntations ntation
of gay s, and
men. In his
1981, unmist
Russo akable
publish disdain
ed The for
Cellulo “negati
id ve”
Closet, ones,
a has
compen been
dium of met
analyse with
s of conside
Hollyw rable
ood’s criticis
represe m in
ntations various
of academ
LGBT ic
Q publica
charact tions.
ers; The
updated study
in of
1987, LGBT
the Q film
book continu
continu es to
es to occupy
serve as a
a key central
referen positio
ce for n in
the scholar
study of ly
LGBT writing
Q film, s on
althoug human
h its sexuali
author’ ty,
 1139

reflecti Theo
ng the ry;
Sexu
breadth
al-
and Ident
depth ity
of Labe
represe ls;
ntationa Tran
l sgen
der
practice
Sexu
s that
alitie
date s
Focus Groups

back to F
the 19th u
r
century,
t
and that
h
only
e
stand to
r
prolifer
ate in
R
the e
years to a
come. d
Noah i
Tsika n
g
See also s
Bisex
Anger,
ualiti
K.
es;
(1975).
Hom
Hollywo
opho
od
bia;
Babylon
Hom
. New
osexu
York,
ality,
NY:
Fema
Dell.
le;
Hom Bens
osexu ho
ality, ff,
Male; H.
Quee M
r; .,
Quee &
r G
Politi rif
cs; fi
n,
Quee
S.
r
1140

(2 cine
00 ma.
6). In
Q M.
ue
Aaro
er
im n
ag (Ed.)
es ,
: New
A quee
hi r
st
cine
or
ma:
y
of A
ga criti
y cal
an read
d er
les (pp.
bi
155–
an
fil 170).
m New
in Brun
A swic
m k,
eri NJ:
ca
Rutg
.
ers
La
Univ
nh
ersit
am
y
,
Press
M
.
D:
Rich, B.
Ro
w R.
ma (2013).
n New
& queer
Lit cinema:
tle
The
fie
ld. director
Leung, ’s cut.
H. H. Durh
(2004 am,
NC:
).
Duk
New
e
queer Univ
cine ersit
ma y
and Press
third .
 1141

Russo,This
V. entry
(1987
describ
).
The
es the
use of
cellul
oidfocus
groups
close
t: as a
Homway in
osexu
which
ality
to
in the
conduc
movi
es t
researc
(Rev.
ed.).
h with
Newlesbian
York,
, gay,
NY:
bisexua
Harp
l,
er &
transge
Row.
nder,
Tyler, P.
and
(1972
). queer
Scree
(LGBT
ning
Q)
the
individ
sexes
: uals.
HomThis
entry
osexu
ality
begins
in the
with a
movi
brief
es.
New
overvie
w
York, of
NY:the
differe
Holt,
Rineh
nt
art &
types
Winst
of
on.
researc
h
method
FOCUS ology
that
GROU have
PS been
used
when
investi
gating
1142

the t
lives h
and o
experie d
nces of ol
LGBT
o
Q
g
people.
y
This
include W
s a it
general h
discussi L
on on G
the use B
of T
quantita Q
tive and In
qualitat di
ive vi
researc d
h
u
method
al
ology
with s
this Resear
populat ch that
ion; has
howeve specifi
r, the cally
primary focuse
focus isd on
on the LGBT
importa Q
nce of people
focus remain
group s
researc somew
h with hat
LGBT limited
Q . Early
individ researc
uals. h
primari
ly
Resear
focuse
c
d on
hresearc
Mhing
ethe
 1143

“pheno finding
menon” s were
Fpublish
oed. The
c collect
u
ed
s
publish
G
ed
r volume
os
ucontinu
pe to be
s referre
d to as
the
of
Kinsey
sexual
Report
orientat
s. The
ion.
Kinsey
Initial
Report
researc
s
h on
reveale
sexual
d that
orientat
there
ion was
was a
conduct
continu
ed in
um of
the late
sexual
1940s
behavi
and
or from
early
heteros
1950s
exual
by
to
Alfred
homos
Kinsey.
exual
Kinsey
and
was
individ
among
uals
the first
who
researc
were
hers to
identifi
study
ed as
male
being
and
bisexua
female
l were
sexual
somew
behavio
here in
r and in
the
1948,
middle.
the
The
1144

Kinsey conside
reports red
describ shocki
ed ng by
individ conser
ual and vative
group heteros
variatio exuals,
ns in but
sexual welco
behavio med by
r and the
reporte lesbian
d that and
37% of gay
males commu
and nity. In
13% of the late
females 1950s,
engage ground
d in at breakin
least g
one researc
same- h
sex reporte
experie d that
nce widely
during used
adolesc psycho
ence, logical
with tests
10% of could
men not
continu diagno
ing to se
engage homos
in exualit
homose y. This
xual finding
behavio was
rs after replicat
adolesc ed by
ence. many
The mental
finding health
s from profess
these ionals
early who
studies also
were found
 1145

that led to
homose empiric
xuality al
was not researc
a h
psycho focusin
patholo g on
gical discove
disorde ring the
r. This diversit
eventua y of the
lly led lesbian,
the gay,
Americ and
an bisexua
Psychia l
tric (LGB)
Associa populat
tion and ion and
the the
Americ ways in
an which
Psychol discrim
ogical ination
Associa and
tion, stigma
respecti have
vely, to affecte
remove d their
homose well-
xuality being.
from Key
their clinical
lists of writing
mental s at this
disorde time
rs in the focused
mid- on
1970s. LGB
The identity
removal develo
of pment,
homose disclos
xuality ure,
from self-
classific esteem,
ation as and
a relation
mental ship
disorder issues.
1146

Howev clinical
er, the researc
majorit h on
y of this gay
researc males
h was shifted
conduct from
ed with psychol
young ogical
adults issues
— to
primaril physica
y l/health
White, issues.
middle- Resear
class ch also
gay focuse
males. d on
Researc prevent
h that ing
focused HIV/A
on IDS,
transge coping
nder with
individ death,
uals and
was maintai
especial ning
ly physica
limited l health
prior to and
the social
1980s. well-
With being.
the The
1981 researc
reportin h on
g of HIV/A
numero IDS
us continu
deaths es and
among has
gay been
males broade
living ned to
in San focus
Francis on
co, health
Califor disparit
nia, ies
 1147

betwee ant
n finding
homose s on
xual older
and lesbian
heteros s and
exual gay
populat men
ions. were
The that
focus any
on negativ
physica e
l health outcom
among es
LGB discove
individ red
uals led were
to primari
includi ly due
ng to
middlea factors
ged and other
older than
LGB their
individ sexual
uals. It orientat
was ion.
during Proble
the late ms for
1970s older
and gay
early men
1980s and
that lesbian
scholar s were
s due
publish chiefly
ed their to
early instituti
studies onalize
on d
older heteros
gay exism.
men Resear
and chers
older reporte
lesbians d that it
. The was
signific not
1148

sexual ty in
orientat gender
ion per role
se that definiti
affected on, and
the adjuste
psychol d to
ogical aging
well- more
being success
of fully
middle- than
aged their
and heteros
older exual
LGB counter
individ parts.
uals, Des
but pite
rather these
the importa
social nt early
stigma studies,
that empiric
LGB al
people researc
faced h with
because LGBT
of their Q
sexual individ
minorit uals
y remain
status. s
General sparse
ly, and the
older majorit
LGB y of
individ researc
uals h
were finding
found s
to have continu
higher e to be
levels limited
of life to
satisfac White,
tion, socioec
greater onomic
flexibili ally
ty/fluidi secure,
 1149

educate not a
d homog
people. eneous
Additio group.
nally, As
most previou
researc sly
h that indicat
has ed, it is
focused evident
on that the
LGBT majorit
Q y of
issues publish
has not ed
adequat researc
ely h on
focused LGBT
on Q
transge individ
nder, uals
transsex primari
ual, ly used
intersex lesbian
ual, or s or
queer gay
populati men as
ons. subject
As s. The
the inclusi
body of on of
researc bisexua
h with l,
LGBT transge
Q nder, or
individ queer
uals individ
evolves uals as
, it is subject
essentia s
l for continu
researc es to be
hers to rare.
appreci Additio
ate that nally,
the the
LGBT theoreti
Q cal and
commu empiric
nity is al
1150

researc is on
h on the use
LGBT of
Q focus
individ groups.
uals has
neglect
ed Q
LGBT u
Q a
people n
of t
color. i
The t
designe a
rs of t
future i
researc
v
h
e
studies
need to
a
recogni
ze the n
diversit d
y that
exists Q
among u
LGBT a
Q l
individ i
uals t
and a
their t
multipl i
e v
identitie
e
s, and
this
R
requires
e
both
quantita s
tive and e
qualitati a
ve r
researc c
h h
method
s, with M
an e
emphas t
 1151

h cation
o of data
d with
o the
l goal of
underst
o
anding
g
how
y
prevale
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i proble
t m or
h issue is
L by
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S in an
u effort
b to
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j
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e
observ
c ed and
t then
s general
Researc izing
h can the
be results
broadly from a
categori large
zed as sample
consisti of
ng of respon
quantita dents
tive or to an
qualitat entire
ive populat
analysis ion of
. interest
Quantit . Data
ative in
researc quantit
h ative
analysis researc
involve h is
s the collect
quantifi ed
1152

through hers
questio also
nnaires observe
or what
surveys people
and the do. The
data is aim of
in the qualitat
form of ive
number researc
s and h is a
statistic comple
s. te and
Qual detaile
itative d
researc descrip
h tion of
provide a topic
s or issue
insights of
by interest
eliciting .
detail Becaus
from a e
typicall qualitat
y small ive
number researc
of h by
individ definiti
uals. on is
The explora
data in tory,
qualitati the
ve results
researc are not
h is general
most izable
commo to the
nly in general
the populat
form of ion.
words Rather,
(e.g., qualitat
what ive
people researc
say), h
but enables
qualitati a
ve deeper
researc and
 1153

richer interest
investig is
ation of inadeq
issues uate
of and
interest. new
The inform
commo ation is
n data needed
collecti before
on a large-
method scale
s used questio
in nnaire
qualitati can be
ve constru
researc cted.
h Theref
include ore,
in- LGBT
depth Q
intervie focus
ws, groups
particip have
ant been
observa suggest
tion, ed as a
and useful
focus starting
groups. point
for the
design
Focus of
Group survey
Metho questio
dology nnaires
for
Focus
quantit
groups
ative
are
researc
especial
h.
ly
Focus
useful
groups
when
provide
existing
a
knowle
means
dge of a
for
subject
facilitat
or topic
ing a
of
group
1154

discussi etc.)
on pertine
around nt to
a the
particul study
ar and are
issue, carefull
such as y
experie recruite
nces d to
with avoid
discrim system
ination atic
and biases
stigma, in the
selectio
Focus Groups
n
process
and
. The
identify
researc
ing
her is
questio
the
ns that
focus
subsequ
group
ently
modera
could
tor and
be
should
include
be a
d in
good
surveys
listener
.
, be
Parti
nonjud
cipants
gmenta
in
l, and
LGBT
ideally
Q focus
share
group
some
discussi
of the
ons
particip
share
ants’
key
charact
charact
eristics.
eristics
The
(sexual
researc
orientat
her/mo
ion,
derator
gender
develo
identity
ps a
, race,
questio
age,
n
 1155

guide/r questio
oute (a ns
series engage
of the
prepare particip
d ants,
questio allow
ns) that for the
are used explora
to guide tion of
the the
discussi topic at
on and hand,
elicit and
particip include
ants’ exit
percepti questio
ons, ns that
beliefs, enable
opinion the
s, and modera
attitude tor to
s about verify
the that
topic of nothing
interest. was
The missed
questio that
ns should
posed have
must be been
open- include
ended, d.
phrased Ideally,
clearly, the
and modera
should tor is
draw flexible
upon and
concret recepti
e ve to
exampl relevan
es to t issues
illustrat the
e a particip
topic. ants
General raise
ly, the that
sequenc were
ing of not
1156

anticipa ating.
ted in Such a
the neutral
intervie setting
w facilitat
guide. es an
The open,
desirabl frank,
e and
number unham
of pered
particip discuss
ants in ion.
a focus The
group is goal of
betwee all
n eight focus
and ten group
and the session
suggest s is
ed lively
duratio interact
n of the ion
focus betwee
group n
discussi particip
on ants,
(session with
) is the
approxi researc
mately her
90 to assumi
120 ng the
minutes role of
. The a
focus facilitat
group or/mod
session erator
takes and not
place in a part
a of the
neutral discuss
setting ion. A
that is good
accepta facilitat
ble and or/mod
nonthre erator
atening is open
to those and
particip caring,
 1157

but also remark

possess s
es the audiota
ability ped.
to The
redirect analysi
the s of
group focus
to the group
purpose data is
s of the an
researc ongoin
h g
and/or process
address that
potentia begins
l prior to
conflict the
s that focus
arise. group
The session
focus F
group o
sessions s
t
are
e
audiota r
ped.
Prior to C
the start a
of any r
discussi e
on, all
particip
and is
ants
based
must
on the
provide
questio
their
ns used
informe
and the
d
purpos
consent
e of the
to
focus
particip
group.
ate in
For
the
exampl
focus
e, if the
group
purpos
discussi
e is to
on and
develo
to have
p a
their
1158

questio percept
nnaire, ions,
the beliefs,
analysis attitude
may be s, and
differen opinion
t from s are
that analyze
require d using
d if the qualitat
purpose ive
is to data
develop analysi
an in- s
depth techniq
underst ues
anding (e.g.,
of a constan
particul t
ar compar
issue. ison,
All discour
focus se
groups analysi
are s,
audiota content
ped and analysi
transcri s) and
bed throug
verbati h this
m. The analysi
informa s
tion commo
from n
the themes
transcri are
pts is identifi
examin ed.
ed, The
categori focus
zed, group
tabulate researc
d, and h
coded method
by the with
researc LGBT
her. Q
The populat
express ions
ed can be
 1159

a method
valuabl always
e and depend
an s upon
instrum the
ental purpos
way to e and
increase goals
knowle of the
dge and study,
underst as well
anding as the
of a key availab
topic or ility of
area of resourc
interest. es.
A key Combi
conside ning
ration both
when qualitat
decidin ive and
g quantit
whether ative
or not researc
to h
conduct designs
focus is
group becomi
researc ng
h is the more
researc commo
h n, and
questio these
n. The mixed-
choice method
betwee s
n using studies
a focus can
group capitali
(a ze on
qualitati the
ve respecti
researc ve
h advanta
method ges of
) and a each
quantita approa
tive ch.
researc Often
h the
1160

results within
of a LGBT
qualitati Q
ve focus
approac group
h are researc
used to h has
inform include
a d a
quantita variety
tive of foci,
approac such as
h. This individ
was uals’
evident experie
in focus nces
group when
researc disclosi
h with ng their
LGB sexual
older orientat
adults ion or
that led gender
to the identity
develop and
ment of LGBT
an Q
instrum individ
ent, the uals’
LGB experie
Elder nces
Needs with
Assess discrim
ment, ination
that or
was stigma.
subsequ Other
ently topics
used in of
quantita interest
tive have
researc include
h. d
The familial
specific relation
“focus” ships,
underly health
ing the concer
discussi ns,
on minorit
 1161

y stress, F
and u
federal r
policy t
develop h
ment. e
r
Nancy
A. Orel R
e
See also
a
Heterose
d
xist Bias
in i
Research n
; g
Populati s
on-
Hooker,
Based
E.
Surveys,
(195
Collecti
7).
on of
The
Data on adjus
Sexual tmen
Orientati t of
on and the
Gen male
der overt
Iden hom
tity; osex
Qua ual.
litati Jour
ve nal
Res of
earc Proj
h; ectiv
Qua e
ntita Tech
tive niqu
Resea es,
rch 21(1)
,
18–
31.
doi:1
0.10
80/0
8853
126.
1957
.103
8074
2
Kinse
y,
1162

A., (5th
Po ed.).
me Thou
roy sand
, Oaks
W. , CA:
,& Sage.
Ma Liamputt
rti ong, P.
n,
(2011).
C.
(19 Focus
48) group
. methodo
Se logy:
xu Prin
al ciple
be and
ha prac
vio tice.
r Lond
in on,
the Engl
hu and:
ma Sage
n .
ma
Miles,
le.
M.,
Phi
&
lad
Hu
elp
ber
hia
ma
,
n,
PA
A.
:
(19
W.
94).
B.
An
Sa
exp
un
and
der
ed
s.
sou
Krueger, rce
R. boo
(2014 k:
). Qu
Focu alit
s ativ
grou e
ps: A dat
pract a
ical ana
guide lysi
for s
appli (2n
ed d
resea ed.)
rch .
 1163

Lon
don,
Engl
When
and:
Sag
childre
e. n and
youth
Orel, N.
A. experie
nce the
(2004).
Gay, loss of
lesbian,
parents
and
or
bisexual
guardia
elders:
ns and
Expre
have
ssed
no
needs
extend
and
conce
ed
rns
family
acros
to care
s
for
focus
them,
group
s.or
when
Journ
child
al of
welfare
Gero
service
ntolo
s
gical
remove
Socia
l them
from
Work
, familie
s due
43(2–
to
3),
abuse
57–
or
77.
neglect
doi:1
,
0.130
or
when
0/J08
they
3v43
have
n02_
run
05
away
or been
kicked
out by
FOSTE their
family
R but
CARE they
are still
1164

minors, researc
they h has
may be docum
placed ented
in that
govern LGBT
ment Q
care, or youth
foster report
care. higher
Foster rates of
care abuse,
include as well
s living as
with runnin
foster g away
families or
assigne being
d by kicked
child out of
welfare their
services homes,
, some
placem of
ent in a them
group will
home, inevita
or bly end
occasio up in
nally, foster
among care.
older This
adolesc entry
ents, summa
supervi rizes
sed what is
indepen known
dent about
living the
with proport
financia ion of
l LGBT
support Q
from youth
the in
govern foster
ment. care,
Since the
extensi reasons
ve they
 1165

may be o
disprop n
ortionat s
ely in
the o
child f
welfare Y
or
o
foster
u
care
system, t
and the h
limited
evidenc i
e about n
their
experie F
nces in o
foster s
care. t
The e
entry r
also C
describ a
es the r
policy
e
changes
and
W
strategi
h
es child
welfare o
systems
are A
develop r
ing to e
improv
e foster L
care for G
LGBT B
Q T
childre Q
n and
There
youth
has
in care.
been
Prop
limited
oresearc
rh
testimat
iing the
1166

proporti that
on of ask
LGBT about
Q youth sexual
in orientat
foster ion
care in seldom
North ask
Americ about
a. This foster
is care.
primaril Howev
y er, one
because school-
most based
child survey
welfare in
services wester
do not n
systema Canada
tically that
ask asked
about about
sexual being
orientat in
ion or govern
gender ment
identity care
, or and
include one
these longitu
demogr dinal
aphics study
in their of
trackin older
g or youth
reportin who
g were
systems transiti
. oning
Likewis out of
e, child
populat welfare
ion- service
based s in the
surveys midwe
of stern
youth United
in States
school found
 1167

similar n 2%
percent and 6%
ages of of
sexual- young
minorit people
y youth in the
who general
had populat
been in ion
foster identif
care: y as
namely, LGB,
about this
12% of would
youth suggest
who that
had LGBT
been in Q
foster youth
care are
identifi overrep
ed as resente
LGB, d in the
with a foster
greater care
percent system.
age of To
females date,
than there
males have
identify been
ing as no
LGB. publish
Since ed
most studies
populat estimat
ion ing the
studies percent
of age of
sexual transge
orientat nder
ion youth
among in
adolesc foster
ents care.
estimat
e that Reaso
somew
n
here
s
betwee
1168

f Americ
o a have
r consist
H ently
i found
that
g
LGBT
h
Q
e
youth
r are
R more
a likely
t to
e experie
s nce
o physica
f l and
F sexual
o abuse
s than
their
t
heteros
e
exual
r
counter
C parts.
a Indeed,
r the
e growin
A g
m number
o of
n studies
g has
L generat
G ed at
B least
one
T
metaan
Q
alysis,
Y which
o found
u that on
t averag
h e,
A sexual
number minorit
of y youth
studies were
across nearly
North 3 times
 1169

more do not
likely report
to abuse
report historie
sexual s, and,
abuse given
and the
30% much
more larger
likely populat
to ion of
report heteros
parental exual
physica adolesc
l abuse ents,
than most
heteros abused
exual youth
peers in Foster Care
the
same
identify
studies.
as
It is
heteros
importa
exual.
nt to
Howev
note
er, the
this
disprop
does
ortiona
not
te
mean
percent
that
age of
physica
sexual-
l or
minorit
sexual
y youth
abuse
who
leads to
have
LGB
been
orientat
physica
ion, as
lly or
older
sexuall
studies
y
have
abused
someti
means
mes
they
suggest
are
ed; the
also
majorit
disprop
y of
ortiona
LGB
tely
youth
1170

likely Y
to need o
child u
welfare t
services h
and
foster LGBT
care Q
placem youth
ents. may
not end
up with
Foste
foster
r care,
howev
Cer,
aeven
r when
ethey
cannot
alive
nwith
dtheir
family.
HSeveral
ostudies
mhave
edocum
l ented
ethat
LGBT
s
Q
s
youth
nare
emore
slikely
sto run
away
Afrom
mhome,
oor to be
nkicked
gout of
home,
Lthan
Gheteros
Bexual
Tadolesc
ents,
Q
often
 1171

due to homop
conflict hobia
with on the
family street
or even and in
abuse shelters
by . They
family are
membe more
rs. This likely
in part to be
explain targete
s the d for
disprop physica
ortionat l
e violenc
number e and
of for
LGBT sexual
Q youth exploit
who ation
become than
homele heteros
ss or exual
street street-
involve involve
d. Yet d
leaving youth.
home Some
may not homele
ultimat ss and
ely end street-
up involve
being d
safer: LGBT
Studies Q
of youth
homele have
ss and run
street- away
involve from
d youth homop
have hobic
found discrim
that ination
LGBT and
Q youth harass
also ment in
experie the
nce foster
1172

care as
setting evictio
as well. n,
Man utility
y youth, shutoff,
regardle or not
ss of having
orientat enough
ion, money
also to pay
struggle rent,
financia compar
lly after ed to
transitio their
ning heteros
out of exual
foster peers.
care, They
which also
places found
them at that 1
risk for in 5
homele had
ssness. been
One homele
study of ss once
econom or
ic more in
outcom the past
es after year,
foster althoug
care h that
found was not
that signific
LGBT antly
Q youth differe
reporte nt from
d lower heteros
hourly exual
wages, peers
greater who
food had
insecuri also
ty, and aged
one or out of
more foster
econom care.
ic Such
hardshi challen
ps, such ges can
 1173

affect C
the a
long- r
e
term
econom
ic well- whethe
being r in
of familie
LGBT s or
Q group
young homes,
adults as well
after as their
foster treatme
care. nt
within
Expe the
rienc child
es of welfare
LGB system.
TQ These
studies
Yout
have
h in
identifi
Fost ed
er pervasi
Care ve
A experie
number nces of
of stigma,
studies discrim
have ination,
docume rejectio
nted the n, and
experie outrigh
nces of t
LGBT violenc
Q youth e, as
in well as
foster failure
care to
settings protect
, LGBT
FQ
oyouth
s from
t violenc
e
e by
r
other
youth.
1174

While t
most of regions
these and
studies over
have time
been paint a
qualitat consist
ive ent
studies picture
with of how
relative many
ly small LGBT
number Q
s of youth
young in
people, foster
they care
have struggl
include e to be
d youth safe.
across Deci
North ding
Americ whethe
a, from r or not
diverse to
ethnic disclos
backgro e their
unds, sexual
gender orientat
identiti ion or
es, and gender
ages, identity
and in is an
various importa
child nt
welfare hurdle
jurisdic faced
tions, by
over LGBT
many Q
years. youth
The in
similar foster
experie care
nces settings
docume . Some
nted in studies
studies have
from found
differen that
 1175

when files,
LGBT disclos
Q youth ed to
in their
foster foster
care parents
disclose , shared
their with
orientat other
ion or youth
gender in a
identity group
, many home
of them setting,
experie and
nce even
rejectio disclos
n from ed
their publicl
child y
welfare during
workers court
as well hearing
as from s.
foster Being
parents. outed
They has
may carried
experie signific
nce ant
unwant risks
ed for
outing some
of their young
LGBT people,
Q includi
identity ng
by forced
social reparati
workers ve
; for therapy
exampl ,
e, it religiou
may be s
docume indoctri
nted in nation,
their violenc
child e from
welfare other
case youth
1176

in the for fear

foster of
care or further
group rejectio
home n or
setting, violenc
and e.
even You
expulsi ng
on from people
the in
home. foster
Youth care
in also
foster face
care challen
often ges in
have develo
trauma- ping
related healthy
difficult romanti
y in c
trusting relation
adults, ships
because becaus
of their e of
historie both
s of prior
abuse abuse
and history
neglect, and
and lack of
LGBT positiv
Q youth e role
who models
have for
experie loving
nced relation
prior ships.
rejectio For
n from LGBT
families Q
or child youth
welfare in
workers foster
may care,
choose there
to are
remain further
closeted compli
 1177

cations; care
they youth
may in their
face setting
stereoty have
pes and those
myths support
about s. They
their may
sexual even be
orientat segrega
ion or ted
gender from
identity samege
, and nder
unwarra peers
nted out of a
concern fear
s about they
their will
sexualit make
y or unwant
gender ed
expressi sexual
on from overtur
social es. In
workers most
and regions
foster , there
parents. may be
They few or
may not no
be LGBT
allowed Q
to date, foster
or may parents
not be availab
support le,
ed in either
develop becaus
ing e of
healthy instituti
romanti onal
c discrim
relation ination,
ships, or
even becaus
when e
other LGBT
foster Q
1178

foster make
parents healthy
are choices
directly around
forbidd sexual
en by intimac
law. y. They
Thus, may be
LGBT more
Q youth vulnera
in ble to
foster exploit
care are ative
seldom relation
placed ships,
with and at
LGBT higher
Q foster risk for
parents, uninten
and ded
may not pregna
have ncy,
LGBT sexuall
Q y
mentors transmi
. This tted
means infectio
they ns, and
may sexual
lack violenc
role e than
models heteros
in exual
caring youth
adults in
who foster
can care, or
support than
them as other
they LGBT
begin Q
dating, youth
and who
ensure are not
they in
have foster
the care.
relevant
knowle
dge to
 1179

Po rights
lic of
ie LGBT
s, Q
Pr youth
in the
ac
child
tic
welfare
es
system.
, Several
an organiz
d ations
G have
ui develo
de ped
lin trainin
es g
to progra
Su ms for
pp child
welfare
or
social
t
worker
LG
s,
BT foster
Q parents
Yo , group
ut home
h staff,
in guardia
Fo ns ad
st litem,
er attorne
Ca ys, and
re judges
in
In a family
growin court,
g to help
number them
of underst
jurisdic and the
tions, needs
there of
has LGBT
been Q
increas youth
ed and
attentio improv
n to the e their
1180

policies e
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permanency options in placements for LGBTQ
youth, training for child protection workers and
foster parents, and policies to prevent the use of
inappropriate segregation, punishment, or reparative
therapy to try to change adolescents’ sexual
orientation or gender identity.
Although there has been extensive evidence of the
stigma, discrimination, and rejection that LGBTQ
youth have experienced within child welfare systems,
there are also positive examples of programs to
support their needs. For example, there have been
some longstanding group homes, shelters, and
transitional housing programs for LGBTQ youth in
the foster care system. In the early 1980s, the first
LGBTQ-focused group home, Gay and Lesbian
Social Services (GLASS), was founded in Los
Angeles, and in 1987, a similar program was
established in New York City. Since then, a number
of cities in the United States and Canada have
licensed LGBTQ-focused group homes, and foster
care matching programs to place LGBTQ youth with
LGBTQ foster parents. Several jurisdictions have
enacted systemwide policies to support LGBTQ
youth in care in North America, as have regions of
the United Kingdom and some countries in
continental Europe. This progress in reducing stigma
and discrimination and creating supportive
environments is slow in some regions, however, and
in other regions changing political climates have
resulted in protective laws being rescinded and
further barriers to supporting LGBTQ youth in child
welfare systems care being enacted, including
banning LGBTQ adults from becoming foster
parents or mentors, as well as laws to prevent adults
from talking with young people about sexual
orientation in affirming ways. These reversals in
protective policies and laws may further endanger
LGBTQ youth who have the greatest need for
protection and support.
Elizabeth M. Saewyc
See also Adoption via the Child Welfare System; Families
of Origin, Relationships With; Foster Parenting;
Homelessness; Violence and Victimization of Youth
Foster Parenting 1181
Further Readings
Dworsky, A. (2013). The economic well-being of lesbian,
gay, and bisexual youth transitioning out of foster care
(OPRE Report No. 2012-41). Washington, DC: U.S.
Department of Health and Human Services,
Administration for Children and Families, Office of
Planning, Research and Evaluation.
Friedman, M. S., Marshal, M. P., Guadamuz, T. E., Wei,
C., Wong, C. F., Saewyc, E., & Stall, R. (2011). A
meta-analysis to examine disparities in childhood
sexual abuse, parental physical abuse, and peer
victimization among sexual minority and non-sexual
minority individuals. American Journal of Public
Health, 101(8), 1481–1494. doi:10.2105/
AJPH.2009.190009
Marksamer, J., Spade, D., & Arkles, G. (2011). A place of
respect: A guide for group care facilities serving
transgender and gender non-conforming youth. San
Francisco, CA: National Center for Lesbian Rights; New
York, NY: Sylvia Rivera Law Project.
Wilber, S., Ryan, C., & Marksamer, J. (2006). CWLA best
practice guidelines: Serving LGBT youth in out-ofhome
care. Washington, DC: Child Welfare League of
America. Retrieved from National Center for Lesbian
Rights website: http://www.NCLRights.org
FOSTER PARENTING
This entry describes the general phenomenon of
foster parenting, and specifically, foster parenting by
LGBTQ people. It explains the implications of foster
parenting by LGBTQ people for child welfare
practice. The entry also highlights the emerging
changes in policies and practices that have impacted
LGBTQ people’s experiences in becoming foster
parents.
Foster Parenting: An Introduction
Federal guidelines define foster care as 24-hour a day
substitute care for all children placed away from their
parents or guardians and for whom the state agency
has placement and care responsibility. Foster care
placement is intended to be a temporary rather than
long-term solution to family problems,
Foster Parenting
1182
with the intent of reunifying children as
expeditiously as possible with their families, when it
is safe to do so. Foster care is developed in
collaboration with the family and based on the needs
and best interest of the child.
Children come into foster care for a number of
reasons. In many cases, they have experienced
physical, emotional, or sexual abuse at home. A
small percentage of children are in foster care
because their parents are unable to control the
children’s behavior, and the children’s past behavior
may have led to delinquency or fear of harm to
others. Some children have been physically,
educationally, or medically neglected by their parents
or legal guardians, or have parents or legal guardians
who are unable to take care of them because of
substance abuse, incarceration, or mental health
problems. These children are placed into custodial
care while the parents or guardians receive treatment
or counseling.
Children separated from their birth parents are
placed in foster care in a variety of settings. They
may be placed in the care of relatives other than the
family members who have been involved in alleged
neglect or abuse (kin placement), with nonrelatives,
in therapeutic or treatment foster care, or in an
institution or group home. Placement with a relative
who expresses a willingness to provide a long-term
commitment to the child and to become an approved
resource parent is the preferred placement for most
children. If placement with a relative is not possible
or appropriate, the first alternative to consider should
be a nonrelative foster family home.
Foster parents must be licensed by the agency that
handles a specific state or locality’s foster care
system. The foster home must be assessed in a home
study process, in which prospective foster parents are
evaluated for appropriateness and their home is
inspected for safety. All potential foster parents must
attend training sessions covering a range of issues
that focus on caring for a child. When a child is
placed, the foster family takes responsibility for
feeding and clothing the child, getting the child to
school and to appointments, and doing any of the
usual things a child’s parents or legal guardians
might be called to do. The foster parents might also
need to meet with the foster child’s therapist, and
will typically meet regularly with the child’s
caseworker. The foster parent’s main goal is to help
the foster child develop normally in a safe family
environment.
Foster placements may last for a single day or
several weeks, and some continue for years; but the
ideal is to keep the placement as short as possible. If
the parents surrender their rights permanently, or if
the court terminates their rights to their child, the
foster family may adopt the foster child or the child
may be placed for adoption— which is deemed to be
a more permanent option. The goal of foster care is
the care of the child within the child welfare system,
but also is to place all appropriate and available
services at the disposal of the parents so that they can
create a safe home environment for their child when
they are reunified.
Moving Toward a Policy of Inclusiveness
Although policies increasingly have become more
affirming toward LGBTQ people who desire to
become foster parents, some jurisdictions maintain
restrictions. At the time of this writing, however,
only Utah enforces statewide restrictions on foster
care by LGBTQ people. In June 2013, the U.S.
Supreme Court ruled that the Defense of Marriage
Act (DOMA)—which since 1996 had not recognized
same-sex marriage as legal at a federal level—was
unconstitutional. In support of this change in law,
Justice Anthony Kennedy wrote that
[DOMA] places same-sex couples in an unstable
position of being in a second-tier marriage. The
differentiation demeans the couple, whose moral
and sexual choices the Constitution protects . . . and
whose relationship the State has sought to dignify.
And it humiliates tens of thousands of children now
being raised by same-sex couples. The law in
question makes it even more difficult for the
children to understand the integrity and closeness of
their own family and its concord with other families
in their community and in their daily lives.
This landmark ruling—and the subsequent 2015
U.S. Supreme Court decision rendering state
marriage bans against same-sex marriage
unconstitutional—will have significant positive
implications for LGBTQ people hoping to become
parents through foster care.

Similarly, policies have made it possible for a
broader range of adults to become foster parents,
including families of color, single individuals (both
male and female), older individuals, individuals with
disabilities, and families across a broad economic
range. At one time or another, many of these groups
were excluded from the foster care system. Inclusion
of some of these groups caused great controversy at
the start. Moreover, as policies have moved toward
greater inclusiveness, many professionals have
voiced concern about lowering the standards of foster
care and thereby damaging the field.
The trend toward inclusiveness, and a broader
understanding of who makes a suitable parent, has
had a major effect on the almost 400,000 children in
out-of-home care, some of whom have waited for
extended periods for permanent homes. Such
changes have allowed children and youth previously
considered “unplaceable,” or not suitable for family
foster care, to be provided with homes with caring
adults, some of whom are LGBTQ. According to a
study conducted in 2011 by the Williams Institute at
the University of California, Los Angeles, School of
Law, there are roughly 9 million gay, lesbian, and
bisexual adults in the United States. Excluding such a
significant population from becoming foster parents
solely on the basis of gender identity expression and
sexual orientation would seem unwise, considering
how many children and youth are in need of loving
families.
Trends in Foster Care: Dilemmas That Agencies
Face in Accepting LGBTQ Prospective Parents
Numerous child welfare agencies across the country
have broken through their own organizational biases
against LGBTQ people and are already placing
children with same-sex parents. A 2011 report
published by the Donaldson Adoption Institute,
which focused on adoption but can be extrapolated to
include foster parents as well, yielded a number of
important findings relevant to LGBTQ parents and
prospective parents. First, the survey found that more
than 50% of lesbian and gay adoptive parents had
adopted their children from the public child welfare
system; further, 60% of all lesbian and gay adoptive
parents had adopted transracially. Thus, these data
demonstrate that nonheterosexual individuals and
Foster Parenting 1183
couples are important resources for children who
linger in foster care. Further, the survey found that
“gay-affirmative” images and information in a foster
care agency’s “marketing” materials (website,
brochures, newsletters, and recruitment documents)
increased the comfort and confidence of
nonheterosexual applicants in working with the
agency and its staff. The survey also found that more
than 80% of lesbian and gay study respondents
reported that they voluntarily shared information
about their sexual orientation with their caseworkers,
and most caseworkers responded in a positive and
accepting manner. Notably, 75% of those surveyed
were generally satisfied with the professionalism and
competence of their caseworkers, but less than half
felt the same way about the caseworkers’ knowledge
and sensitivity regarding LGBTQ issues and family
life. Lesbian and gay parents reported feeling more
satisfied with their experience when they were
comfortable disclosing information about their
sexual orientation to agency staff, received positive
reactions, and obtained good preadoption preparation
and support. Also of note is that two thirds of lesbian
and gay survey respondents identified unmet training
needs, including those related to general parenting,
children’s developmental issues, helping children
cope with adoption and parental sexual orientation,
and race and culture issues.
How LGBTQ People Become Foster Parents
Although many child welfare agencies are struggling
to develop policies about LGBTQ parenting, there
are still some that are not as open to the benefits of
LGBTQ people becoming parents. Yet the reality is
that LGBTQ people represent an
Foster Parenting
untapped resource of potential foster parents for
some of the almost 400,000 children who need
substitute families through foster care. Importantly,
although lesbian, gay, bisexual, and trans people may
historically have been discouraged from becoming
foster parents, changes in legislation and policy in
many states over the past 10 years reflect a more
open attitude toward LGBTQ people as potential
parents.
1184
LGBTQ people become foster parents for some of
the same reasons that heterosexual people foster
children. Some pursue foster care as a single person;
some seek to create a family as a same-gender
couple. Regardless of whether they are single or
coupled, LGBTQ people must do their “homework”
about the foster care system in their locality. They
must learn as much as they can about foster care and
how to apply, be trained for, and become licensed as
foster parents. The basic flow of the foster parenting
process occurs as shown below. The steps are the
same for all potential foster parents, LGBTQ or
otherwise.
Step 1: Get the Basic Information
Prospective foster parents should contact the
foster parent agency in the local area where they live.
Step 2: Attend an Orientation
Prospective foster parents should schedule an
orientation. In many localities, it is possible to
register online. At the orientation, child welfare
professionals will provide an overview of foster care
and will answer questions.
Step 3: Complete the Foster
Parenting Application
At the end of the orientation, the individual or
couple will be given an application to fill out.
Potential foster parents must fully complete the
application and return it to the foster care agency.
Once social workers have reviewed it and are
satisfied that the basic elements are in place, they
will contact the potential foster parents to begin a
home study.
Step 4: Have a Home Study Prepared
The home study provides the child welfare agency
and the courts with comprehensive information about
potential foster parents. The individuals or couples
and their social worker will meet several times
during this process. Potential foster parents must
submit various documents, including copies of birth
certificates, marriage license (if applicable), income
tax returns, personal references, and medical reports
completed by physicians. All adults in the potential
foster parent’s home must be fingerprinted and
cleared through the State Central Registry for Abuse
and Neglect. A foster care home study can take up to
several months.
Step 5: Complete a Training Series
While the home study is under way, potential
foster parents will attend an 8-to-10-week Model
Approach to Partnerships in Parenting (MAPP) or
Parent Resources for Information, Development, and
Education (PRIDE) training course. Through these
training sessions, potential foster parents will
improve parenting skills and assess their own
strengths as foster parents. Potential foster parents
will learn how to work with birth parents and how to
help children adjust to their temporary home.
Potential foster parents will also learn about the
subsidies that they will receive for the care of the
child and will find out about their rights and
responsibilities as a foster caregiver.
Step 6: Become a Certified Foster Parent
Upon the successful completion of the home study
and training, potential foster parents become certified
foster parents. This means that that they can now care
for foster children in their home.
Step 7: A Child Is Placed With the
Family or Individual
Once a family is certified, foster parents will
begin receiving calls from the agency to discuss
placing children in their home. If the family is the
right family for the young person, the child will come
for a preplacement visit on either a short- or longer-
term basis. Before a child is placed in a foster home,
the caseworker will discuss visiting schedules with
birth parents and siblings, and will give foster parents
information that will help them provide the best care
for the child.
The Strengths of LGBTQ Parents
There are numerous positive aspects to establishing
policies and practices that welcome and support
LGBTQ foster families. Data from the National
Survey of Family Growth suggests that up to 2
million lesbian, gay, and bisexual (LGB) individuals

expressed an interest in foster care/ adoption as a
path to family-building. Other studies show that
children raised by LGB parents are highly successful
in all measures, from academic achievement to
interpersonal relationships. Research provides
evidence of myriad strengths and capacities that
LGBTQ individuals and same-sex couples bring as
prospective parents:
LGBTQ parents are highly motivated to create
families; for most, foster care/adoption is their first
choice in family-building. They tend to be highly
engaged and invested in the foster parenting process,
have a deep understanding of how it feels to be
“different,” and embrace a broader definition of
family, often as a result of facing rejection by their
family of origin and by establishing their “family of
choice.”
Many LGBTQ parents are able to advocate for
fairness and equality for their family as they have
experience overcoming oppression, discrimination,
and other obstacles in their own lives. LGBTQ
parents are able to support children who struggle
with peer relationships and identity issues. Since
there is vast regional, racial, and ethnic diversity
within the LGBTQ community, LGBTQ people who
choose to create families often have the advantage of
already having redefined and reinvented their own
meaning of family, precisely because they may exist
outside of the traditionally defined family. They have
the unique opportunity to break out of preconceived
gender roles and be a new kind of parent to a child.
Conclusion
The social work—and more specifically, the child
welfare—community’s response to lesbian, gay,
bisexual, trans, and questioning foster parent
applicants has been varied and sometimes
unpredictable. Although not all social workers are
heterocentric (i.e., subscribe to the concept that the
only legitimate norm is heterosexuality) in their
attitudes toward LGBTQ families, a major issue
seems to be the lack of policies to guide their
practice. Going out on a limb to approve or to work
with an LGBTQ parent, or quietly implementing a
home study, have been common themes in child
welfare. Inconsistencies and lack of state and agency
competency-based training for working with LGBTQ
families have also been noted.
Foster Parenting 1185
It is important that agencies and social workers
are prepared for issues that will arise, both
professionally and individually, in working with
prospective LGBTQ foster parents. Professionals
need to be aware of assumptions and stereotypes that
previously may have shaped policy and legislation
and may have informed practice, which was less than
competent. Social workers also need to examine their
own personal attitudes toward LGBTQ people. They
need to be careful not to assume automatic parenting
skills in heterosexual applicants, just as they need to
be careful not to assume unsuitability for parenting in
LGBTQ applicants. The gender identity expression
and sexual orientation of a potential parent does not,
in itself, indicate anything about his or her ability to
care for children who may have had difficult
experiences. Social workers need to explore openly
with each individual or couple their experience and
skills in relation to caring for and parenting a child or
adolescent.
Gerald Mallon
See also Adoption, Choices About; Adoption,
International; Adoption, Openness in; Adoption and
Foster Care Discrimination; Adoption via the Child
Welfare System; Foster Care; Joint Adoption; Second-
Parent Adoption; Single-Parent Adoption
Foster Parenting, Legal Considerations in
Further Readings
Brooks, D., & Goldberg, S. (2001). Gay and lesbian adoptive
and foster care placements: Can they meet
the needs of waiting children? Families in Society, 46,
147–157.
Donaldson Adoption Institute. (2003). Adoption by lesbians
and gays: A national survey of adoption agency policies,
practices, and attitudes. New York, NY: Author.
Downing, J., Richardson, H., Kinkler, L., & Goldberg, A.
(2009). Making the decision: Factors influencing gay
men’s choice of an adoption path. Adoption Quarterly,
12(3), 247–271.
Downs, C., & James, S. E. (2006). Gay, lesbian, and
bisexual foster parents: Strengths and challenges for the
child welfare system. Child Welfare, 85(2), 281–298.
Farr, R. H., Forssell, S. L., & Patterson, C. J. (2010).
Parenting and child development in adoptive families:
Does parental sexual orientation matter? Applied
Developmental Science, 14(3), 164–178.
1186
Farr, R. H., & Patterson, C. J. (2009). Transracial adoption by
lesbian, gay, and heterosexual couples: Who completes
transracial adoptions and with what results? Adoption
Quarterly, 12, 187–204.
Gates, G. J. (2011). How many people are lesbian, gay,
bisexual, or transgender? Retrieved from http://
williamsinstitute.law.ucla.edu/wp-content/uploads/
Gates-How-Many-People-LGBT-Apr-2011.pdf
Gates, G. J., Badgett, L. M., Macomber, J. E., &
Chambers, K. (2007). Adoption and foster care by
lesbian and gay parents in the United States.
Washington, DC: Urban Institute.
Mallon, G. P. (2007). Assessing lesbian and gay prospective
foster and adoptive families: A focus on the home study
process. Child Welfare, 86(1), 67–86.
Mallon, G. P. (2014). Issues in adoption practice. In
G. P. Mallon & P. Hess (Eds.), Child welfare for the
21st century: A handbook of practices, policies, and
programs (2nd ed., pp. 219–231). New York, NY:
Columbia University Press.
Mallon, G. P. (2014). Lesbian, gay, bisexual and trans foster
and adoptive parents: Recruiting, assessing, and
supporting an untapped resource for children and youth
(2nd ed.). Washington, DC: Child Welfare League of
America.
foster parents and the legal system (e.g., attorneys,
judges) are addressed.
Foster Parenting
Motivations for becoming a foster parent vary, and
may include altruism (i.e., wanting to do “good” or
give a child a home), desire for an additional source
of income, and desire to be parents (i.e., to be long-
term foster parents or to eventually adopt the
children in their care). A foster parent may be raising
one or more children at a time and the children may
or may not have a biological connection to one
another (i.e., as siblings) or the foster parents (i.e., as
aunt, uncle, grandparent). The amount of contact that
the child in care has with biological parents varies
from regular visits to no contact. The legal/placement
goal for the children also varies. Some children in
foster care remain in care for as little as a few days
and others remain in care for years, possibly until
they emancipate (i.e., “age out”) from the child
welfare system. It is the foster parents’ responsibility
to feed, clothe, and care for the child, which also
includes

FOSTER PARENTING, LEGAL

CONSIDERATIONS IN

Foster parenting refers to a situation in which an

individual or couple is raising a child who is in the
care and custody of the state. Foster parents must be
certified by the county in which they live and do not
have legal decision-making power regarding the
children in their care. The process of becoming a
foster parent varies from state to state and county to
county. LGBTQ individuals and couples experience
an added layer of complexity when they initiate the
foster care certification process, given that they face
heterosexist policies and individuals that may deter
the certification process. This entry describes the
legal considerations for LGBTQ individuals and
couples who are foster parents and who are pursuing
foster parenthood. First, foster parenting in general is
defined and described. Next, legal policies are
discussed. Finally, interactions between LGBTQ

bringing the child to school, medical appointments,
therapy appointments, and so on. Foster parents are
paid a stipend (which differs in each state and is
dependent on the needs of the child) to care for the
child.
Foster Parent Legal Policies
Foster care policies vary from state to state, as do the
criteria for becoming a foster parent. Most states, over
the past few decades, have acknowledged that in order
to find more families for children in care, their criteria
needed to become more inclusive. Common criteria for
foster parents among most states include a minimum
age of 18 years and a safe home with enough space and
resources to accommodate children; furthermore, foster
parents usually must attend a class to learn more about
the needs of children in care. In addition, the parent
must pass a background check.
Despite the notion that parent sexual orientation has
no impact on parenting ability, the sexual orientation of
the individual applying to be a foster parent is taken
into account in some states and by some agencies.
Although most states do not take a position on whether
LGBTQ individuals or couples can become foster
parents, some do. The positions vary from explicit
protection of the rights of LGBTQ foster parents to
explicit prevention of LGBTQ individuals and couples
from being certified foster parents. Moreover, most
states leave the decision of who has the right to become
a foster parent to local child welfare agencies. In
addition, some states explicitly prohibit unmarried
parents from adopting children; up until June 2015, this
effectively made it impossible for LGBTQ individuals
and couples to adopt when same-sex marriage was not
legally possible in their state. Therefore, in some states,
the only way LGBTQ couples could become parents
was to become foster parents, an option that leaves
parents with the responsibility to care for children, but
without the legal protections that are afforded through
adoption. That is, children can be removed from their
care at any time, at the discretion of the child welfare
agency. Research on LGBQ foster parents has found
that
Foster Parenting, Legal Considerations in
their awareness of this possibility can create significant
intrapersonal stress and tension, potentially interfering
1187
with their ability to completely “ease in” to the
placement, fully bond with the children in their care,
and ultimately relax into the role of parent.
Navigating the Legal Challenges
Because states and agencies are becoming more
inclusive in their criteria for selecting certified foster
parents, many LGBTQ individuals are taking the
opportunity to do so. However, as mentioned, many
states provide that local agencies and courts make the
decision about whether LGBTQ individuals and
couples can provide foster care. That is, the
determination of parenting rights is made on a case-by-
case basis and is often in the hands of an individual
social worker or judge. Research has demonstrated that
this causes feelings of frustration and disappointment
for the parents pursuing foster care certification,
especially given that the number of children waiting in
care is high and that some of these parents wish to
adopt the children in the long run. These parents often
“agency shop,” that is, they look for an agency known
to be friendly to the LGBTQ community, to improve
their chances of being certified. The argument exists
that fewer children would suffer the negative impact of
waiting in care for a family (e.g., emotional
disturbance, decline in school performance, behavioral
difficulties) if states and local jurisdictions would move
toward a position of equality for all individuals and
couples desiring to provide foster care. In addition,
scholars and policy makers have emphasized that states
would likely benefit financially if LGBTQ individuals
and couples had as much right to become foster parents
as do heterosexual couples. In addition, it is important
to note that little research has examined the foster
parenting experiences of transgender and bisexual
individuals. It is unknown whether these prospective
foster parents encounter unique discriminatory policies
by agencies or individual professionals related to their
gender or identification as bisexual. It is possible, for
example, that transgender
Fraternities and Sororities
individuals and couples may be perceived as “less fit”
than cisgender individuals and couples if an agency or
professional has little or no background working with
transgender parents. In addition, bisexual individuals
and couples may experience feeling “invisible” or
1188
“different” from heterosexual and same-sex couples
given that their sexual orientation may not be as easily
understood by agencies or professionals. Additional
research is necessary to gain understanding of the foster
parenting experiences of bisexual and transgender
parents.
April M. Moyer and Abbie E. Goldberg
See also Adoption, Legal Considerations in; Foster Care;
Foster Parenting
Further Readings
Goldberg, A. E., Moyer, A. M., & Kinkler, L. A. (2013).
Lesbian, gay, and heterosexual adoptive parents’
perceptions of parental bonding during early parenthood.
Couple and Family Psychology: Research and Practice, 2,
146–162.
Goldberg, A. E., Moyer, A. M., Kinkler, L. A., & Richardson, H.
B. (2012). “When you’re sitting on the fence, hope’s the
hardest part”: Experiences and challenges of lesbian, gay,
and heterosexual couples adopting through the child welfare
system. Adoption Quarterly, 15, 1–28.
Shapiro, J. (2013). The law governing LGBT-parent families. In
A. E. Goldberg & K. R. Allen (Eds.), LGBTparent families:
Innovations in research and implications for practice (pp.
291–304). New York, NY: Springer.
FRATERNITIES AND SORORITIES
Fraternities and sororities are typically single-sex social
organizations on college campuses. They are important
in the LGBTQ context because they serve as formally
organized sites where gender and sexuality are visible,
serve as membership markers, and are reproduced.
Traditional fraternities and sororities tend to both
reinforce the gender binary and expect heterosexuality
from their members. This entry discusses the critiques
of traditional fraternities and sororities, the
development and practices of a gay fraternity and
lesbian sororities, as well as the benefits and challenges
of LGBTQ membership in traditional fraternities and
sororities.
Critiques of Traditional Fraternities and
Sororities
College students who “rush” (a formal admission
process) fraternities or sororities cite a myriad of
benefits, such as access to a large group of friends, a
quasi-familial environment (brothers, sisters, “big” and
“little” brothers/sisters), a formalized relationship with
other-sex organizations (fraternities and sororities have
formal “mixers”), leadership opportunities, popularity
and status associated with their organization, a “home”
on the campus, access to parties, alumni contacts,
continuing their family of origin’s legacy, and much
more.
Yet despite their benefits, fraternities and sororities
have come under scrutiny. Scholars have described
traditional fraternities as heterosexist institutions that
reproduce gender, typically reinforcing hegemonic
masculinity, the cultural ideal of masculinity that men
are expected to achieve. Hegemonic masculinity is
always framed as superior to femininity and other more
feminine forms of masculinity. Fraternities also have a
history of physically and psychologically abusing their
pledges through hazing rituals, sometimes resulting in
injury and—although rarely—even death. Scholars have
also noted fraternities’ propensity to develop a culture
that is conducive to sexual abuse, with
disproportionately high rates of gang rape, for example.
Sororities tend to encourage particular types of
femininity and they frequently lack significant
diversity. They have been criticized for reinforcing
hegemonic femininity, defined as the cultural ideal of
femininity. A defining feature of hegemonic femininity
is that it always exists as a support or reinforcement of
hegemonic masculinity and maintains the dominant
position of men in the gender hierarchy. Additionally, a
focus on femininity and appearance may be linked to
distorted body image and possible eating disorders.
Despite the costs of membership, openly lesbian,
gay, and bisexual (LGB) college students have sought
entry into these organizations. In both fraternities and
sororities, the default assumption is that all members
are heterosexual. While sororities are generally less
homophobic than fraternities, homosexuality is a topic
that is simply not discussed in many sororities.
Although the rosters of these traditional fraternities and
sororities had included nonstraight members in the past,
the Gay Rights Movement encouraged LGB college
students to disclose their identities following
acceptance, rush traditional fraternities and sororities as
openly LGB, and form their own organizations that
were open to all sexual identities. Having openly LGB

members of fraternities and sororities, and fraternities
and sororities that do not make an assumption about the
heterosexuality of their members, challenges the
existing structure of fraternities and sororities in some
ways but reproduces them in others.
Gay Fraternities
Delta Lambda Phi (DLP) is a fraternity founded by gay
men in 1986 in Washington, D.C., to provide more
opportunities for gay men to make connections with
each other, as well as with other openminded men.
While founded by gay men, the organization is
inclusive of all men, including heterosexual and
bisexual men as well as transgender individuals. One of
the chief goals of the organization is to overturn the
assumption of heterosexuality in fraternities and
emphasize that gay men are fit for membership in
fraternities. Scholars note that the existence and
practices of this fraternity challenge the
heteronormativity and heterosexism of fraternities in
some ways but reaffirm it in others. Similarly, the
fraternity both challenges and reinforces the larger gay
culture.
Ethnographic research by Mindy Stombler and her
colleagues found that DLP challenged the typical model
of a fraternity in the following ways. The hazing of
pledges, a practice typically viewed as a test of
manhood in traditional fraternities, was strictly
prohibited in DLP. Similarly, performing
Fraternities and Sororities
femininity was not considered a punishment or
humiliation in DLP but was instead treated as an
expression of identity. However, these performances of
femininity were mostly limited to the private spaces of
the fraternity (although there were a few exceptions to
this rule, such as hosting a drag ball on campus).
Performing masculinity served as a way to change the
stereotype of gay men and for DLP to establish itself as
a legitimate fraternity in the eyes of the other
fraternities.
The members of DLP also engaged in other
contradictory strategies in order to legitimize their
organization. Though one of the primary organizing
categories of the fraternity is sexual orientation, the
brothers also typically downplayed this aspect of the
fraternity in public spaces. Additionally, the brothers
1189
went to considerable lengths to create an asexual image
for the fraternity in order to change the perception, or
presumption, that it was nothing more than a sex club.
Dating among the brothers was formally discouraged,
as was casual sex. The members emphasized that in the
fraternity they were brothers rather than potential
romantic partners. These practices, intended to give
credibility to the fraternity, reinforced the existing
heterosexism in fraternities.
The founders of DLP decided to create a fraternity,
as opposed to another type of social organization, as a
way of distinguishing themselves from other LGBTQ
organizations. They argued that both gay men and
straight men would benefit from being in an all-male
environment because men have a different social
experience than women. This reinforces the idea that
there are essential differences between men and women,
contributing to the perpetuation of existing gender
inequality.
In addition to providing a model of a fraternity that
was connected to but slightly different from traditional
fraternities, DLP also provided a model of community
that was connected to the larger gay community, yet
differed from it. Researchers argued that one of the
benefits of joining DLP was that it helped members
construct their identities as gay men. The fraternity
explicitly taught new members about gay culture in an
effort to bring out the cultural aspect of gay identity.
However,
Fraternities and Sororities
the fraternity was not completely accepting of gay
culture as a whole. Members of DLP were critical of
certain aspects of the larger gay community, reporting
that they found it oversexualized, overly political, and
that it encouraged destructive behavior. These members
joined DLP because they were interested in a different
kind of community and in creating different kinds of
bonds with other gay men.
Gay Men in Traditional Fraternities
DLP and other gay fraternities are not the only option
for gay and bisexual men who desire to join a fraternity.
Gay men also join traditional fraternities seeking
friendships, expanded opportunities for social life, and
for social support. Most fraternities do not have specific
rules that bar gay men from membership. Traditional
1190
fraternities are unlikely to accept a known gay man into
the organization, though members are generally
accepting of brothers who come out after they are
already members. Yet homophobic and heterosexist
behaviors and attitudes are very common among
members of traditional fraternities. Though there is
little research exploring the distinction between the
experiences of gay and bisexual men, the majority of
gay and bisexual men who joined more traditional
fraternities reported to researchers that they observed
these behaviors and attitudes among other men in the
fraternity. In many cases this homophobia and
heterosexism discouraged them from disclosing their
sexual orientation to their brothers in the fraternity.
Although they still have to deal with homophobia in
their organization, participating in a traditional
fraternity provides benefits to gay men similar to those
that straight men receive. While straight men tend to
acquire greater personal gains as a result of
membership, gay men and straight men report similar
levels of leadership experience and satisfaction with
their experience in their fraternities. Many gay men
obtain leadership roles within fraternities even when
they are out to other fraternity members. Gay men also
report that in addition to leadership skills and
experience, they improved their social and interpersonal
skills and cultivated long-term friendships as a result of
joining a traditional fraternity.
Lesbian Sororities
Though not as well studied as gay fraternities, there are
some lesbian sororities; most are relatively young
organizations with few chapters. Lambda Delta Lambda
(LDL) was a sorority founded around the same time as
DLP, but it did not expand in a similar manner and few
chapters remain in operation today. One of the reasons
for this may be the lack of an alumnae base that would
help support the group financially. This may be one
reason that lesbians might choose to join traditional
sororities over lesbian ones, which tend to be newer and
smaller. However, several new lesbian sororities have
formed recently with some success. One of the largest,
Gamma Rho Lambda (GRL), was founded in 2003 by
12 students at Arizona State University. They began
expanding nationally in 2005. GRL is a growing
organization with 15 chapters across the nation whose
mission is to provide scholastic and emotional support,
build community, and develop sisterhood among its
members. Though it is known as a lesbian sorority,
GRL tries to be inclusive of all members, including
lesbian, bisexual, transgender, and straight members.
Lesbians in Traditional Sororities
There has also been little research on the experiences of
lesbians or bisexual women in traditional sororities, and
the existing research tends to group these two
populations together, providing scant information on
how their experiences differ. However, research does
show that sororities tend to enforce hegemonic
femininity in the same way that fraternities enforce
hegemonic masculinity. Lesbians present a challenge to
hegemonic femininity, and many sorority members
have concerns that lesbians in the sorority may lead to
challenges to the femininity of the other members. Most
lesbians who join sororities are closeted when they rush
and many still identify as heterosexual when they
graduate. Like fraternities, sororities are less likely to
accept a known lesbian into their organization but tend
to be accepting if a member comes out after they have
already joined. Sororities also do not typically have
explicit rules barring lesbians from membership and
typically do not engage in explicitly homophobic
behavior to the extent that men in fraternities do.
However, if a woman’s lesbian identity is known, the
existing members may come to the conclusion that she
is not a “good fit” for the sorority and deny her group
membership on that basis. Women in sororities tend to
construct lesbianism as masculine and aggressive; they
believe that lesbians will have different interests, styles,
and social chemistry and will alter the sorority as a
result of their presence. Sororities that do regularly
accept openly lesbian pledges or otherwise have diverse
membership tend to have less status in the hierarchy of
other fraternities and sororities on campus. Failure to
conform to the traditional model of a sorority typically
damages a sorority’s reputation and the group is taken
less seriously as a legitimate sorority.
Kiersten Kummerow and Mindy Stombler
See also Campus Climate; College Students; Coming Out,
Disclosure, and Passing; Friendships; Heteronormativity;
Transgender Inclusion on College Campuses

Further Readings
Case, D. N., Hesp, G. A., & Eberly, C. G. (2005). An
exploratory study of the experiences of gay, lesbian and
bisexual fraternity and sorority members revisited. Oracle:
The Research Journal of the Association of Fraternity
Advisors, 1(1), 15–31.
Connell, R. W. (1995). Masculinities. Berkeley: University of
California Press.
Delta Lambda Phi Social Fraternity. (2013). About.
Retrieved August 6, 2014, from http://dlp.org/about/
Delta Lambda Phi Social Fraternity. (2013). FAQ: Joining a
chapter. Retrieved August 13, 2014, from http://dlp
.org/join/faq-joining-a-chapter/
Gamma Rho Lambda National Sorority. (2014). About.
Freedom to Marry (and Other Marriage Equality Organizations)
Retrieved August 12, 2014, from http://gammarholambda
.org/?page_id=7
Fraternities and Sororities
Gamma Rho Lambda National Sorority. http://gamma
rholambda.org/
Handler, L. (1995). In the fraternal sisterhood: Sororities as
gender strategy. Gender and Society, 9(2), 236–255. Literte, P.,
& Hodge, C. (2012). Sisterhood and sexuality: Attitudes about
homosexuality among members of historically Black sororities.
Journal of African American Studies, 16(4), 674–699.
Long, L. (2011). An exploration of the sexual orientation and
educational outcomes of undergraduate fraternity members.
Oracle: The Research Journal of the Association of
Fraternity/Sorority Advisors, 6(1), 23–38.
Moffatt, M. (1989). Coming of age in New Jersey:
College and American culture. New Brunswick, NJ:
Rutgers University Press.
Schippers, M. (2007). Recovering the feminine other:
Masculinity, femininity, and gender hegemony. Theory and
Society, 36(1), 85–102.
Schulken, E. D., Pinciaro, P. J., Sawyer, R. G., Jensen, J. G.,
& Hoban, M. T. (1997). Sorority women’s body size
perceptions and their weightrelated attitudes and behaviors.
Journal of American
College Health, 46(2), 69–74. doi:10.1080/
07448489709595590
Stombler, M. (1994). “Buddies” or “slutties”: The collective
sexual reputation of fraternity little sisters.
Gender & Society, 8(3), 297–323.
Stone, A. L., & Gorga, A. (2014). Containing pariah
femininities: Lesbians in the sorority rush process.
Sexualities, 17(3), 348–364. doi:10.1177/
1363460713516336
1191
Trump, J., & Wallace, J. A. (2006). Gay males in fraternities.
Oracle: The Research Journal of the Association of
Fraternity/Sorority Advisors, 2(1), 8–28.
Yeung, K.-T. (2009). Challenging the heterosexual model of
brotherhood: The gay fraternity’s dilemma. In C. L.
Torbenson & G. Parks (Eds.), Brothers and sisters: Diversity
in college fraternities and sororities (pp. 184–209).
Cranbury, NJ: Associated University Presses.
Yeung, K.-T., & Stombler, M. (2000). Gay and Greek: The
identity paradox of gay fraternities. Social Problems,
47(1), 134–152.
Yeung, K.-T., Stombler, M., & Wharton, R. (2006).
Making men in gay fraternities: Resisting and
reproducing multiple dimensions of hegemonic
masculinity. Gender & Society, 20(1), 5–31.
FREEDOM
TOMARRY (AND OTHER MARRIAGE
EQUALITY ORGANIZATIONS)
Marriage is at once a deeply personal commitment to a
person, a legal gateway to a crucial safety net of
tangible and intangible protections and responsibilities,
and a fundamental freedom guaranteed by the U.S.
Constitution. In 2014, a majority of Americans (63%)
believed that it was time to end marriage discrimination
nationwide. And, in 2015, the U.S. Supreme Court
ruled that it was unconstitutional to prevent same-sex
couples from marrying, thus affirming the freedom to
marry and equal protection under the law for all
Americans. The current entry reviews the birth of the
modern-day marriage movement and landmark
victories for the freedom to marry in the United States,
and the challenges that remain for the same freedom to
be implemented in all states nationwide.
1970–1990s: The Birth of the
Freedom-to-Marry Movement in America
Same-sex couples have sought the freedom to marry in
the United States since the dawn of the modern LGBTQ
movement, in the immediate aftermath of the Stonewall
riots in 1969. Same-sex couples filed early challenges
in Minnesota, Washington, and Kentucky; but in 1972,
the U.S.
Supreme Court upheld a Minnesota Supreme
Court ruling that the Constitution does not protect “a
fundamental right” for same-sex couples to get married.
1192
Although those first marriage cases were rubber-
stamped away, a second wave of marriage litigation in
the 1990s launched the ongoing global freedom-to-
marry movement. The Hawai’i
Supreme Court in 1993 was the first high court in
history to rule in favor of same-sex couples, finding that Republican-led chamber, the New York State Senate,
Freedom to Marry (and Other Marriage Equality Organizations)
exclusion from marriage is discrimination and
presumptively unconstitutional. But opponents
succeeded in enacting an anti–gay marriage state
constitutional amendment, undoing the court win. And
even as Hawai’ian courts were seeing the world’s first-
ever trial on the freedom to marry, resulting in the first ending the exclusion of same-sex couples from
ruling in favor, the U.S. Congress passed the so-called
Defense of Marriage Act (DOMA), which withheld
federal respect for the marriages that gay couples
seemed on the verge of winning.
Early 2000s: Marriage Legalization and Setbacks
With Hawai’i stymied, and a second freedom-tomarry
case in Vermont yielding civil union but not yet
marriage, the Netherlands in 2001 became the first
country in the world to allow same-sex couples to
marry. Shortly after, in 2003, a court win made
Massachusetts the first state in the United States where
same-sex couples could marry.
Following the win in Massachusetts, opponents
succeeded in passing a wave of discriminatory state
constitutional amendments to ban marriage for same-
sex couples. One of the most notable marriage bans was
Proposition 8, which stripped gay and lesbian couples
in California of the freedom to marry. It was a painful
blow, eased only slightly by freedom-to-marry victories
in Connecticut, and, after Prop 8, in Iowa, Vermont,
New Hampshire, and Washington, D.C.
Late 2000s: Majority Support for Marriage
With the election of Barack Obama to the presidency
and a new Congress, a new era began for marriage
advocates. Continued campaigning yielded, in 2010, a
majority of Americans embracing the freedom to marry
for same-sex couples. Soon after, the Obama
administration announced that it would no longer
defend the Defense of Marriage Act, deeming it
unconstitutional; and Congress introduced the Respect
for Marriage Act to repeal it.
Advocates also continued to build momentum at the
state level in New York and elsewhere. Winning the
right to marry in New York was transformative for
same-sex couples and widely seen as a triumph for love
and equality under the law. For the first time, a
joined a
Democrat-led chamber in passing marriage legislation.
The bipartisan bill was supported by some of America’s
most prominent businesses, corporate leaders,
Republican leaders, labor unions, and professional
athletes. The unprecedented support demonstrated how
marriage had become truly mainstream.
2012: Election Year Brings Unprecedented Wins
In May 2012, President Obama became the first sitting
president to support the freedom of samesex couples to
marry. His heartfelt message reflected a changed
emphasis in the movement: that samesex couples want
to marry for reasons of love, commitment, and family.
President Obama’s announcement encouraged millions
of Americans to think anew and move toward support.
In September 2012, the Democratic Party became the
first major political party in U.S. history to endorse the
freedom to marry.
On Election Day, following 30 consecutive losses in
previous years, same-sex marriage advocates won four
out of four ballot measures in Maine, Maryland,
Minnesota, and Washington—vindicating the tenacious
and hard work of learning how to persuade the public,
build campaigns, and convince a majority to vote
against discrimination. The victories were the result of
millions of conversations and years of work by local
campaigns and volunteers, supported by national and
local groups across the country.
2013: Supreme Court Strikes Down Core of So-
Called Defense of Marriage Act
In June 2013, the U.S. Supreme Court struck down the
core of DOMA as unconstitutional, thus ending the
exclusion of legally married same-sex couples from
more than 1,000 federal protections. The same day, the
Supreme Court also let stand a lower court ruling
restoring the freedom to marry in California, about four
and a half years after the passage of Proposition 8.
 1193
2013–2015: Continued Momentum for the
Freedom of Same-Sex Couples to Marry
Subsequent to the decision in U.S. v. Windsor, at least
65 federal and state judges concluded that excluding
same-sex couples from marriage was unconstitutional.
At the time of the June 26, 2015, decision by the
Supreme Court that made bans against same-sex
marriage unconstitutional, lawsuits were under way in
each of the states that continued to discriminate against
same-sex couples’ freedom to marry and equal respect
for samesex couples’ marriages. Polls also showed
support at an all-time high, with dwindling opposition
isolated in a few holdout demographics. Thus, with a
supermajority of supportive Americans and nearly three
fourths of Americans living in a freedom-to-marry
state, advocates of marriage equality were largely
optimistic as they awaited the Supreme Court ruling on
marriage, confident that they had built the critical mass
of states and support they set out to secure. The
Supreme Court decision was a great victory, as it served
to end the systematic injustice and indignity faced by
couples denied the freedom to marry.
Evan Wolfson

See also Defense of Marriage Act (DOMA); LGBT/Queer

Studies Programs; Long-Term Same-Sex Couples;
Marriage Equality, Landmark Court Decisions

Further Readings
Ball, M. (2012, December). The marriage plot: Inside this year’s
epic campaign for gay equality. The Atlantic. Retrieved
August 26, 2014, from http://www
.theatlantic.com/politics/archive/2012/12/the-marriageplot-
inside-this-years-epic-campaign-for-gay-equality/
265865/
Solomon, M. (2014). Winning marriage. Lebanon, NH:
University Press of New England.
Sullivan, A. (1989, August). Here comes the groom. The New
Republic. Retrieved August 26, 2014, from
http://www.newrepublic.com/article/79054/ here-comes-
the-groom
Wolfson, E. (2004). Why marriage matters. New York, NY:
Simon & Schuster.
1194 Friendships
FRIENDSHIPS
Friendships are close social relationships that are often
distinguished in the general literature from family
relationships or kinship ties. Because friendships are
entered into voluntarily, they emphasize reciprocity,
mutuality, and equality between friends. Friendship
experience may differ across level of closeness (casual,
close, or best friends) and size (dyadic, group, network,
or communities).
Research on the social and personal relationships of
lesbian, gay, bisexual, transgender, and queer
individuals (LGBTQ) has focused primarily on
romantic and sexual relationships. By comparison,
friendships have been de-emphasized. Friendships,
however, do play an important role in the lives of
LGBTQ individuals. In many ways, their friendship
experiences are similar to the friendships of their
heterosexual counterparts. LGBTQ and heterosexual
individuals report having a similar numbers of friends
and emphasize similar friendship needs, such as having
someone to talk to, emotional support, being there when
needed, and having fun. Despite similarities, sexual
orientation and gender identity do contribute to unique
friendship patterns and experiences for LGBTQ
individuals. Because the importance of friendship is
emphasized during periods of social and societal
change, particularly for individuals who are
experiencing times of transition or whose identities are
at odds with social norms, friendships are considered to
have increased importance for gender and sexual
minorities.
The importance of friendship is evidenced by the
fact that LGBTQ identity disclosure, or coming out,
often occurs first with a friend. Therefore, friendships
can serve as an important practice ground for LGBTQ
individuals learning to negotiate their identity in social
and relational contexts. Coming out to friends can be
met with negative reactions and outcomes leading to
friendship loss or the creation of emotional distance
within the relationship. Coming out may also lead to
positive outcomes, such as strengthening feelings of
trust and acceptance within the friendship. When this
occurs, LGBTQ individuals can experience friendship
as a means of social support, which may take
on
increased significance when traditional support from
family and community may not be reliably available.
Consistently, LGBTQ individuals report more
discrimination in their familial relationships than in
their friendships. Friendships, then, may also take on
additional importance by fulfilling a supportive role in
relation to minority stress and status.
The general literature emphasizes that friendships
largely develop between individuals with similar
characteristics, identities, or experiences. It is important
to understand intersections of identity when considering
the social and personal relationships of LGBTQ
individuals. Not all LGBTQ individuals have the same
experiences in friendship. Sexism, racism,
heterosexism, biphobia, and transphobia all
simultaneously impact friendship experience. In
addition, LGBTQ friendship experience can differ
greatly depending on whether it is experienced within
or outside of the larger LGBTQ community.
Friendships Within the LGBTQ Community
Friends as Family
LGBTQ friendship research has mostly focused on
understanding friendships that form between
individuals who identify within the LGBTQ
community. In the same way that we see homophily
(the idea that individuals connect with others who are
similar to themselves) in heterosexual relationships,
LGBTQ individuals also form relationships based on
similarities. Many lesbians report having a majority of
lesbian friends, and many gay men’s friends also
identify as gay. LGBTQ friendship is often
characterized as providing a unique familial type of
support in which friendships function as chosen
families and serve to buffer gender and sexual
minorities from social isolation or rejection associated
with homophobia, biphobia, and transphobia. That
LGBTQ individuals consider others within the
community in familial terms is evidenced by the
colloquial use of the term “family” to refer to other
individuals in the community.
Friendships within the LGBTQ community are often
characterized as social networks that not only make up
larger LGBTQ communities, but are also an outlet for
individuals in the community to positively experience
their identity in a culture that often either dismisses or

disapproves of them. These within-community
friendships are seen as having unique benefits as they
may provide a sense of shared experience and an
avenue for processing minority status. Within-
community friendships can provide a buffer against
being socially devalued as a sexual minority and can
provide an outlet for sharing daily aspects of life,
especially for individuals who are not able to be open
about their identity in larger society. LGBTQ friends
can also serve as role models in a culture where
LGBTQ experience is not widely visible. These
withincommunity friendships may be particularly
important because they represent a social relationship in
which LGBTQ individuals can experience relative
equality.
While lesbians and gay men may find a unique type
of support through same-orientation friendships,
bisexual women and men are less likely to do so. Not
only are they less likely to have sameorientation
friendships with individuals who also identify as
bisexual, but, in addition, bisexual individuals can
experience discrimination and isolation from both
within and outside the LGBTQ community. Bisexual
women and men report often experiencing an
invalidation of their bisexual identity within their
friendships with lesbian, gay, and heterosexual
individuals. LGBTQ individuals of
color also experience marginalization within the larger
LGBTQ community and are faced with simultaneously
negotiating sexual orientation and race in their
friendships. The pressure to choose one identity over
the other is likely to impact their experience of
friendship.
Friendships, Romance, and Sexuality
In the general research literature, friendships are
explicitly distinguished from romantic relationships and
sexual attraction. The platonic nature of friendships is
assumed to provide a unique type of
Friendships
freedom and support. Because close friendships
between same-sex heterosexual friends are emphasized
as the most typical and “model” friendship, friendships
have been assumed to be nonsexual in nature. In fact,
other-sex friendships have often been seen to be
problematic because of the potential for sexual
attraction or tension and a central research question has
1195
been whether (heterosexual) women and men can
“really” be friends.
The LGBTQ friendship literature has also stressed
the importance of same-sex friendships. Because the
potential for sexual attraction and tension exist among
LGBTQ same-sex individuals, the friendship literature
from the beginning has suggested that LGBTQ
definitions of friendships may differ from traditional
heterosexist definitions in important ways. For
example, friendships of LGBTQ individuals may
incorporate and acknowledge romantic feelings and/or
sexual attraction. In fact, for LGBTQ individuals,
romantic relationships most commonly develop out of
friendships, and many sexual-minority individuals
report being friends with their partner before becoming
romantically involved. Likewise, sexual-minority
individuals often report that lovers and ex-lovers are
among their closest friends.
Other-sex friendships for lesbian and gay
individuals, in contrast, are more likely viewed as
nonsexual, and a good deal of attention has focused on
gay men’s friendships, for example, with heterosexual
women as a friendship free from sexual tension and
pressure. Bisexual individuals’ friendships have been
uniquely considered for the ways both same- and other-
sex friendships could be complicated by the potential
for sexual attraction.
Intense emotional interactions that involve elements
of both friendship and romantic relationships have been
referred to as “passionate friendships.” Passionate
friendships most often develop out of close same-sex
friendships that have had an intense emotional
connection but lack a sexual component. Although
more likely to be studied among young sexual-minority
women, passionate friendships can develop for
sexualminority and heterosexual women or men. The
research on friendships of LGBTQ individuals
emphasizes that friendships can include elements
similar to romantic relationships, and may also include
sexual elements. In addition, casual friendships may
incorporate sexual behavior without a romantic
component and may also serve as an important site for
exploration of sexual identity and development.
Transgender Friendships: Friends as “Family” and
as “Community Resource”
In many ways within community, LGBTQ friendships
generally serve as a proxy to family relationships. They
1196 Friendships
can provide a sense of belongingness and shared culture
that may not be fulfilled by families of origin. Friends
can serve as “families of choice” by providing
emotional support not provided by lost or strained
familial relationships due to differences in sexual
orientation. Transgender friendships in the LGBTQ
community, likewise, fulfill a similar familial role.
However, the stigma and marginalization experienced
by transgender individuals can be even more
pronounced than for sexual minorities (lesbian, gay
men, bisexual, and queer individuals). Even though
LGBQ and transgender individuals are generally
conceptualized as a unified LGBTQ community, it is
important to acknowledge the distinction. Transgender
persons experience increased stigmatization and
discrimination, increased pathologization within the
medical community, and different (and often fewer)
legal protections than are afforded to sexual minorities.
Even within the LGBTQ community, transgender
individuals and issues related to gender identity have a
history of being overshadowed by the focus on sexual
orientation and LGBQ experience. Thus, transgender
individuals are more likely to be subject to social
isolation and invisibility.
Given the increased marginalization of transgender
experience, it makes sense that within the LGBTQ
community friendships take on an additional level of
significance for transgender individuals. Having friends
in the LGBTQ community is largely beneficial for
transgender individuals, as it allows transgender people
to feel comfortable being themselves and talking about
issues related to their gender identity. Friends within the
LGBTQ community are also generally characterized as
having an understanding of non-normative experience;
are knowledgeable on issues of gender, sex, and
privilege; and are relatively nonjudgmental and open-
minded. In short, these friendships provide transgender
individuals with a shared sense of belonging, family,
and community. Benefits of within–LGBTQ
community friendships for transgender individuals
focus on common understandings, shared experiences,
or knowledge in ways that made non-normative
experience primary.
Friendships between transgender individuals also
take on an added significance. Sharing a transgender
identity, these friendships not only offer support but
also provide an exchange of shared knowledge and
similar experiences. While providing support and
having similar experiences are regarded as
characteristics of friendship in general, friendships
between transgender individuals often allow an
exchange of knowledge surrounding transitioning
and/or other issues that are unique to transgender
individuals. Transgender friends are also seen as
providing needed counseling unavailable from the
traditional health care system. Benefits of friendships
with other transgender individuals were largely seen as
filling in the gaps of support and services not otherwise
provided by traditional family, friends, and institutions.
In particular, transgender–transgender friendships have
been shown to have unique benefits not experienced to
the same degree with sexual-minority individuals.
When compared to their friendships with LGBQ
individuals, transgender individuals find that with their
transgender friends they are more likely to have shared
experiences, be able to talk about transgender issues,
receive support via mentoring and shared resources, and
are more comfortable being themselves.
As important as within-community friendships may
be for some transgender individuals, it is important to
note that not all transgender individuals see themselves
as part of the LGBTQ community, or even as part of a
transgender community. There is great variation in how
individuals experience their transgender experience.
Some individuals view it less as an identity and more of
a status or history. For some, it is important that their
transgender identity is acknowledged within social
relationships whereas others do not see it as relevant.
All of these factors can greatly impact the type of
support transgender individuals may actually receive in
their friendships from both within and outside the
LGBTQ community. Similar to LGBQ individuals,
transgender persons socially navigate identity
disclosure and/or coming out. Transgender individuals
may also experience a transition in their gender
presentation and ask friends to address them with
different names and gender pronouns. These factors
may impact friendships dynamics and may even lead to
loss of friendships.
Friendships Outside the LGBTQ Community
Initial research on the topic suggested that friendships
outside the LGBTQ community are tenuously
constructed around a number of barriers. Barriers to
such friendships include the stigma surrounding having
a sexual- or gender-minority friend, sexual tension, or
even reduced comfort (for both the LGBTQ and

heterosexual individual). When friendships do occur
outside of the community, they often do so at the
expense of the LGBTQ individual’s identity, where
they cannot be fully open about their experiences or
where they experience microaggressions or
misunderstandings within the friendship.
Benefits of friendships outside the LGBTQ
community have also been considered. For example,
sexual-minority women report that through their
friendships with heterosexual women they gain an
understanding that acceptance from heterosexuals is
possible, gain an objective perspective in their lives, are
able to break down stereotypes, and experience
increased closeness and trust within the friendship
accompanying sexual orientation disclosure. The
literature on the friendships of transgender individuals
also details a variety of benefits to friendships outside
of the LGBTQ community. These include fostering a
feeling of normalcy, offering more diverse perspectives
and interactions, and helping transgender individuals to
Friendships
present as their identified gender as well as validating
transgender identity and experience. Additionally, these
friendships serve as an educational tool for transgender
individuals about their identity and experience.
Friends as Allies
Friendships outside the LGBTQ community provide
both sexual-minority and transgender individuals the
opportunity to educate individuals about LGBTQ
experience and discrimination. Friendships, then, may
be an important avenue for developing allies to the
LGBTQ community. The research literature has long
connected interpersonal contact—inclusive of
friendship—as being related to positive attitudes toward
LGBTQ individuals. More recently, friendships with
LGBTQ individuals have been shown to be important
in the development of heterosexual allies to the LGBTQ
community. LGBTQ allies can serve to both personally
support LGBTQ individuals and advocate for larger
acceptance and rights of LGBTQ individuals within the
larger culture.
Conclusion
Friendship experience of LGBTQ individuals
challenges the notion of friendship as being secondary
1197
to romantic relationships. The emphasis on friends as
“family” or as chosen family illustrates that for LGBTQ
individuals, friendships both within and outside the
LGBTQ community serve important roles. Research on
the experiences of individuals within transgender
communities indicate that friendship fulfills an even
broader role by providing support and services not
otherwise provided by traditional family, friends, and
institutions. Likewise, friendships with individuals
outside the LGBTQ community provide a sense of
acceptance and an opportunity for developing allies to
the LGBTQ community. Although the research
emphasizes a unique and potentially broader role of
friendship for LGBTQ individuals than for their
heterosexual counterparts, it is important to note that
this is, in part, due to the fact that friendships are
experienced within a larger system of discrimination
and inequality still present in family and other societal
institutions.
M. Paz Galupo and Shane B. Henise
See also Ally Experience; Cross-Category Friendships;
Families of Choice; Romantic Friendships; Workplace
Friendships
Further Readings
Baiocco, R., Laghi, F., Di Pomponio, I., & Nigito, C. S.
(2012). Self-disclosure to the best friend: Friendship
quality and internalized sexual stigma in Italian lesbian
and gay adolescents. Journal of Adolescence, 35, 381–
387.
Diamond, L. M. (2002). “Having a girlfriend without knowing
it”: Intimate friendships among adolescent sexual-minority
women. Lesbian Studies, 6(1), 5–16.
Galupo, M. P. (2009). Cross-category friendship patterns:
Comparison of heterosexual and sexual minority adults.
Journal of Social and Personal Relationships, 26, 811–831.
Galupo, M. P., Bauerband, L. A., Gonzalez, K. A.,
Hagen, D. B., Hether, S. D., & Krum, T. E. (2014).
Transgender friendship experiences: Benefits and
barriers of friendships across gender identity and sexual
orientation. Feminism & Psychology, 24(2), 193–215.
Hines, S. (2007). TransForming gender: Transgender
practices of identity, intimacy, and care. Bristol,
England: Policy Press.
Morgan, E. M., & Thompson, E. M. (2006). Young women’s
sexual experiences within same-sex friendships: Discovering
and defining bisexual and bi-curious identity. Journal of
Bisexuality, 6, 7–34.
1198 Friendships
Muraco, A. (2012). Odd couples: Friendships at the intersection
of gender and sexual orientation. Durham, NC: Duke
University Press.
Nardi, P. M. (1999). Gay men’s friendships: Invincible
communities. Chicago, IL: University of Chicago Press.
Stanley, J. L. (1996). The lesbian’s experience of friendship. In
J. S. Weinstock & E. D. Rothblum (Eds.), Lesbian
friendships (pp. 39–59). New York, NY: New York
University Press.
Ueno, K., Wright, E. R., Gayman, M. D., & McCabe, J. M.
(2012). Segregation in gay, lesbian and bisexual youth’s
personal networks: Testing structural constraint, choice
homophily and compartmentalization hypotheses.
Social Forces, 90, 971–991.
Weinstock, J. S. (1998). Lesbian, gay, bisexual and transgender
friendships in adulthood. In C. J. Patterson & A. R.
D’Augelli (Eds.), Lesbian, gay, and bisexual identities in
families: Psychological perspectives (pp. 122–155). Oxford,
England: Oxford University Press.
Weston, K. (1991). Families we choose: Lesbians, gay, kinship.
New York, NY: Columbia University Press.
G visual
stimuli
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1200

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1202

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attitudes
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people
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many
communit
characters
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thought
screen
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representa
or wanted
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to be a
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 1203

in the the
number of developm
positive ent
video company
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portrayals, This
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LGBTQ m gaming
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titles. This have the
representat option of
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many that lead
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games, in the
racing Mass
games, Effect and
and Dragon
adventure Age
games, to franchises
name a , which
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games is
1204

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inclusivity, preordere
BioWare d the
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named ultimately
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themes, noted that
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considered obscenity
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Dragon Scholar
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 1205

attracting research
the is likely
attention to emerge.
of Of note is
academics, the
particularl research
y in the program
fields of of
social Adrienne
psycholog Shaw,
y and who has
communic conducted
ation. extensive
However, work in
research this area.
exploring In a
games as seminal
they relate article
to LGBTQ titled
people is “Putting
sparse. the Gay in
This is Games:
perhaps Cultural
because Productio
video n and
game GLBT
scholars Content in
have Video
largely Games,”
focused Shaw
their analyzed
efforts on press
understand coverage
ing the and
downstrea interviews
m effects with game
of developer
gameplay s and
such as journalists
aggression in an
and attempt to
hostility. better
As understan
LGBTQ d this
themes group’s
become representa
increasingl tion in
y visible, video
more games.
relevant Shaw
1206

concluded developed
that by Lynn
important Miller and
factors her
include research
attitudes team,
toward this successful
group held ly reduced
by players’
members perception
of the s of
video stigma
game and
industry sexual
and the shame,
market and which in
institution turn led to
alized reductions
risks in risky
associated sexual
with behavior.
presenting
non-
normative
The
sexualities Future
on screen. of
A very LGBTQ
different Gamin
example of g and
LGBTQ Cultur
video e
game
Video
research
games
involves a
have the
health-
power to
oriented
affect the
“serious”
player’s
game
attitudes,
designed
feelings,
to reduce
and
HIV risk
behavior
behaviors
—for
among
better or
young men
worse.
who have
Consideri
sex with
ng the
men. This
potential
video
impact of
game,
characters
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 1207

, F
storylines, u
and r
dialogue t
content h
during the e
design r
process
benefits R
the e
LGBTQ a
communit d
y. It is i
clear that n
g
video
s
games and
gaming Christensen
culture are , J. L.,
becoming Miller,
L. C.,
increasingl
Appleby
y inclusive , P. R.,
and, if this Corsbie-
trend Massay,
endures, C.,
people Godoy,
identifying C. G.,
Marsella
as LGBTQ
, S. C.,
will et al.
continue to (2013).
be Reducin
positively g shame
affected by in a
gaming. game
that
John L. predicts
Christense HIV risk
reductio
n
n for
young
See also
adult
Film;
men
Leisure;
who
Media
have sex
Representati
with
ons of
men: A
LGBTQ
randomi
People; zed trial
Visual delivere
Arts d
nationall
y over
the web.
Journal
1208

of the M.
Internati Cody,
onal & P.
AIDS Vord
Society, erer
16(3 (Eds.)
Suppl. ,
2). Serio
Miller, L. us
C., game
Christ s:
ensen, Mech
J. L., anis
Godoy ms
, C. and
G., effect
Apple s (pp.
by, P. 429–
R., 447).
Corsbi New
e- York,
Massa NY:
y, C., Routl
& edge.
Read, Shaw, A.
S. J. (2009).
(2009) Putting
. the gay
Reduc
in
ing
risky games:
sexual Cultural
decisi producti
on- on and
makin GLBT
g in content
the
in video
virtual
games.
and in
the Games
real- and
world: Culture,
Seriou 4(3),
s 228–
games 253.
,
Shaw, A.
intelli
gent (2010).
agents What is
, and a video
SOLV game
E culture?
Appro Cultural
ach. In
studies
U.
and
Ritterf
eld, game
 1209

studies. display of
Games gang-like
and attributes,
Culture, such as
5(4), tattoos
403–424. and
Gangs
graffiti.
GANGS Although
there is a
large
This entry body of
explores research
both the in the
participati general
on of area of
LGBTQ gangs,
persons in there is
heterosexu scant
al street informatio
gangs and n on
the recent LGBTQ
emergence gang
of members.
exclusivel Existing
y gay and gang
lesbian preventio
gangs. n and
Street interventi
gangs are on
visible, programs
violent do not
groups that address
engage in the needs
regular of sexual
criminal minorities
activity. . For this
Members reason, it
represent is
their gangs important
through to identify
communic pathways
ation into and
rituals out of
such as gangs, as
complicate well as
d the roles
handshake and
s and the activities
public of
1210

LGBTQ peoples,
members. dominate
Street membersh
gangs have ip. While
some some
stability gangs
over time. have
They members
typically mainly
claim an from a
area, or single
turf, which group, an
they increasing
protect number of
from rival gangs
gangs. have a
This may multiracia
be a l and
housing multiethni
project, a c
school, or membersh
an area ip. Many
they claim gang
to be members,
exclusivel not just
y their LGBTQ
own for members,
drug talk about
distributio the
n. Street identity,
gangs rely sense of
on violent belonging,
entry and and
exit rituals acceptanc
—vicious e they get
beatings from their
for men, gangs.
beatings or They talk
gang rapes about
for women their
—to gangs as
protect “family.”
them from Althou
outsiders. gh rare,
Marginaliz there are
ed ethnic some
and racial document
minorities, ed
including examples
indigenous of lesbian
 1211

and gay who

gangs. require
Dykes special
Taking protection
Over ,
(DTO) including
was an gay men.
African Members
American of the
lesbian GBG are
youth gang typically
in a school former
in members
Philadelph of other,
ia, created mainly
by lesbian heterosex
students in ual gangs.
early Lesbia
2000s to n relations
retaliate among
against members
homophob of all-
ic peers female
and also to gangs
express have also
their been
gender. document
The DTO ed. The
bullied and 1960s
harassed Vice
those Queens of
female Chicago
students was the
who had African
victimized American
them. The female
Gay Boy auxiliary
Gangsters to the
(GBG) is a male-
prison dominated
gang in Vice
California Kings.
active in The Vice
“sensitive Queens
needs reported a
yards,” preference
which are for
designated samesex
for intimate
inmates relations
1212

as an minorities
avenue out .
of chronic Canadi
sexual an
violence researcher
and forced s have
prostitutio identified
n by the a number
Vice of
Kings. pathways
Other into gang
qualitative life:
research victimizat
suggests ion by
that there chronic
are and severe
LGBTQ violence
members at a young
of male- age,
dominated particularl
heterosexu y in
al gangs. families;
These multiple
members placement
seem to go s in child
to great welfare
lengths to and youth
hide their justice
identities facilities;
and fear being
that they born into
will be “super-
severely gang
harmed if families”;
discovered economic
by other and racial
gang marginali
members. zation;
Interesting experienci
ly, they ng brain
participate injuries
in violent and
victimizati serious
on and mental
sometimes health and
homicides behavioral
of persons disorders;
perceived addictions
to be ; and the
sexual formation
 1213

of violence,
hypermasc and
uline and harassmen
sexualized t. This
feminine victimizat
gender ion takes
identities. place at
Gang school, in
involveme the
nt is communit
typically y, and in
the result the
of a family.
multitude The
of risk impacts of
factors homopho
across bic
many bullying
domains described
(e.g., in almost
family, all studies
peer, include
school, suicide
communit and
y, and emotional
psychologi problems,
cal). addictions
LGBTQ , and
youth who school
are gang- failure,
involved among
typically others.
have Recent
experience studies
d many of suggest
these risk that
factors, LGBTQ
which youth are
predispose more
them to likely than
gang heterosex
behavior. ual youth
Further, to carry
there is the weapons,
added risk fight, and
of be
suffering involved
homophob in gangs.
ic Physic
bullying, al fighting

Gay, Lesbian & Straight Education Network (GLSEN)

1214

by where the
LGBTQ traditional
youth is male
likely a gender
response role is
to pursued to
homophob the
ic extreme.
victimizati There is
on. an
Fighting emphasis
serves to on
counter violence,
disrespect toughness,
and create independe
a violent nce, and
identity. sexuality.
Fighting The gang
also serves is a space
as a to
strategy to construct
construct nontraditi
and onal
express identities.
gender Lesbian
identity. gang
Displaying members
violent resist and
identities negotiate
in the gang gender
can thus roles
enhance outside of
personal traditional
safety and femininity
provide .
LGBTQ Many
members gang
with members
alternative —both
strategies those who
of “doing” are
gender. LGBTQ
Some and those
lesbian who are
gang heterosex
members ual—bash
display persons
hypermasc perceived
uline to be gay.
behavior, How can
 1215

we .
understand Heterosex
this ual
violence? members
Sexual could be
minority motivated
gang to
members victimize
are gays
concerned because of
about self- repressed
preservatio same-sex
n. They urges.
protect Bashing
their own may
self-image represent
and a strategy
personal to cover
safety by up sexual
publicly and
denying gender
any anxieties.
affiliation Thus,
with gay the gang
culture. provides a
They may social
also have space to
internalize construct
d and
homophob express
ia— that alternative
is, a hatred gender
for roles—a
themselves very
. Feelings complex
of guilt, matter
shame, and with many
self-hatred variations.
are rooted Theories
in must take
rejection into
by their account
families the
and distinct
experience difference
s of s in these
bullying gender
and other strategies
forms of displayed
intolerance by
1216

LGBTQ work to
gang resist
members. gang
Their recruitme
constructio nt and
n and safely
doing of support
gang gang exit.
identities This is
is likely inherently
distinct risky,
from their however,
relations given the
with others severity of
outside of violence
the gang engaged
context. in by
Their many
actions can gang
be seen as members.
a means of
Mark
resisting
gender Totten
See also
oppression Bullying,
within and Rates and
outside of Effects of;
gangs. Criminal
The Legal
dynamics System
of LGBTQ and
LGBTQ
involveme
People;
nt in Hyperm
hardcore asculinit
street y;
gangs need Internali
further zed
exploratio Homop
hobia;
n.
Violenc
Evidence- e and
based Victimi
counseling zation
approaches of
are Youth
needed.
Counselors
require
informatio
n on
strategies
known to
 1217

F invol
u ved
r men’
t s
h exper
e ience
r s
with
R homo
e phobi
a c
d bullyi
i ng
n and
g haras
s sment
Johnson, D. in
(2007). schoo
Taking ls.
over the Jour
school: nal of
Student Crim
gangs as e and
a Justi
strategy ce,
for 37,
dealing 79–
with 103.
homopho Totten, M.
bic (2012).
Gays in
bullying
the
in an gang.
urban Journal
public of Gang
school Researc
district. h, 19(2),
Journal 1–24.
of Gay Totten, M.
and (2012).
Lesbian Nasty,
Social brutish
Services, , and
19(3/4), short:
87–104. The
Panfil, V. lives of
(2014) gang
. Gay membe
gang- rs in
and Canad
crime- a.
1218

Toronto envisions
, ON, a world in
Canada: which
James every
Lorimer child
. learns to
value and
respect all
people,
GAY, regardless
of sexual
LESBIAN orientatio
n or
& gender
STRAIGH identity/e
xpression.
T
This entry
EDUCATI explores
GLSEN’s
ON major
NETWOR contributi
ons to
K advancing
LGBTQ
(GLSEN issues in
K–12
) education.
GLSE
N works
GLSEN, toward
the Gay, school
Lesbian & climates
Straight in which
Education difference
Network, s are
is the valued for
leading their
national contributi
education ons
organizati toward a
on focused more
on vibrant,
ensuring diverse
safe communit
schools for y, and
all strives to
students. assure that
Establishe each
d in 1990, member
GLSEN of every
 1219

school their
communit schools
Gay, Lesbian & Straight Education Network (GLSEN)

y is valued safer.
and Organiza
respected. tional
GLSEN History
works with
educators, GLSEN
policy formed in
makers, 1990 as
communit the Gay
y leaders, and
parents, Lesbian
and Independe
students nt School
on the Teachers
urgent Network
need to (GLISTN
address ). A group
anti- of
LGBTQ teachers
behavior from
and bias in Massachu
schools. setts
GLSEN independe
provides nt schools
public dedicated
education themselve
about s to
LGBTQ improving
experience an
s in K–12 education
schools, system
protects that
students frequently
from allowed
bullying its
and LGBTQ
harassment students
, advances to be
safe bullied,
schools discrimin
laws and ated
policies, against, or
and marginali
empowers zed at
educators school. At
to make that time,
1220

LGBTQ- establish
inclusive GLISTN
education chapters
resources all across
were rare: the
There country,
were only advocatin
two gay– g locally
straight for
alliances LGBTQ
(GSAs) in students.
the United In
States; 1995,
only one GLISTN
state with became a
legislation national
in place to organizati
protect on and
LGBTQ hired its
students; first full-
and few, if time staff
any, person,
LGBTQ- cofounder
related and
training executive
and director
curricula Kevin
available Jennings.
for To better
teachers. reflect the
The organizati
organizati on’s focus
on grew on safe
quickly schools
and for all
expanded students,
to include the
educators organizati
from all on
types of changed
private and its name
public K– to the
12 Gay,
schools. Lesbian &
Like- Straight
minded Education
educators Network,
and or
advocates GLSEN,
began to in 1997.
 1221

The s of
national LGBTQ
office secondary
currently students
supports nationally
local ,
chapters documenti
across the ng the
United occurrenc
States that e and
bring impact of
educator negative
training, aspects of
days of school
action, climate
resources, such as
events, and biased
expertise language,
to over 35 victimizat
regions of ion, and
the discrimina
country. tion, as
well as
the
Research availabilit
In 1999, y and
GLSEN effects of
responded supportive
to a school
paucity of resources
national such as
research GSAs and
on supportive
LGBTQ educators.
adolescent GLSEN’s
s by research
launching has
its first expanded
biennial the
National knowledg
School e base on
Climate LGBTQ
Survey. It issues in
remains education
one of the by
few examining
studies to the
examine attitudes,
the school beliefs,
experience and
1222

experience and
s of other recommen
education ded
communit interventi
y ons for
members, creating
including safer
general schools.
population Findings
s of are
elementary dissemina
and ted to the
secondary public via
students, freely
teachers, available
and reports,
principals; media
LGBTQ coverage,
parents and public
and their service
children; announce
and others. ments
GLSEN (PSAs),
also including
assesses a national,
the multiyear
effectivene partnershi
ss of the p with the
organizati AdCounci
on’s l: Think
programs. B4 You
Speak,
featuring
Public print,
Education radio,
GLSEN’s television,
research and web
and messages
evaluation discouragi
efforts ng the use
serve as a of anti-
foundation LGBTQ
for public language
education among
efforts young
about people.
LGBTQ
issues in
K–12
education
 1223

Student National
Activism Day of
Silence
GLSEN and No
supports Name-
student Calling
advocates Week.
and their
adult allies
organizing Curricula
in their r and
schools Training
and Resource
communiti s
es by
providing GLSEN is
free a
resources, preeminen
products, t provider
and events of
for educator
fostering training,
inclusive tools, and
school resources
environme to combat
nts for all, anti-
including LGBTQ
providing bias and
resources promote
and respect in
activities schools,
for GSAs, and it
initiating provides
activist profession
campaigns al
on social developm
media, ent for
supporting thousands
student-led of
initiatives educators
such as each year,
Transgend both
er Student directly
Rights, and in
and partnershi
sponsoring p with
national national
days of and local
action agencies.
such as the Offerings
1224

range from
curriculum
guides to
national
training
programs
and cover
a wide
variety of
topics
related to
developing
safe,
respectful,
and
inclusive
schools,
including
the Safe
Space Kit,
for
educators
supporting
LGBTQ
middle and
high
school
 1225
Gay Exclusion in the U.S. Military: Evolution and Demise of Don’t Ask, Don’t Tell

students, and Ready, Set, Respect!, See also Bullying, Legal Protections
a toolkit for fostering respect in Against; Bullying,
elementary schools. Rates and Effects of; Bullying,
School-Based
Interventions for; Education; Gay–
Public Policy Straight Alliances
(GSAs); No Promo Homo Policies;
GLSEN believes that a quality K–
School Climate;
12 education is a fundamental right
School Professionals’ Responses to
of every American. It works with LGBTQ Training
policy makers at the local, state,
and federal level to ensure that the
best and most inclusive safe schools F
u
policies are considered, passed, and
r
implemented, including
t
nondiscrimination and
h
antiharassment policies that contain
e
protections for LGBTQ students.
r
GLSEN’s National Safe Schools
Partnership includes more than 100
R
member organizations that support
e
and participate in GLSEN’s work to a
pass federal anti-bullying d
legislation, the Safe Schools i
Improvement Act. n
g
International Efforts s

GLSEN’s safe schools work in the Gay, Lesbian & Straight Education
United States has earned the Network. http://www
organization an international .glsen.org
reputation for its expertise on GLSEN. (2013). The Safe Space Kit:
LGBTQ issues. GLSEN has Guide to being an ally to LGBT
spearheaded the creation of an students. New York, NY: Author.
international network of Harris Interactive. (2012). Playgrounds
and prejudice:
nongovernmental organizations
Elementary school climate in the
(NGOs), scholars, and advocates to
United States. New York, NY:
make the world safer for
GLSEN.
LGBTQ youth. In 2013, GLSEN
Kosciw, J., Greytak, E. A., Palmer, N. A.,
convened a meeting in partnership
& Boesen, M. J.
with the United Nations
(2014). The 2013 National School
Educational, Scientific, and
Climate Survey: The experiences of
Cultural Organization (UNESCO)
lesbian, gay, bisexual, and
to discuss homophobic and
transgender youth in our nation’s
transphobic prejudice and violence
schools. New York, NY: GLSEN.
in schools worldwide.
Madelyn J. Boesen and Joseph
Kosciw
1226
GAY EXCLUSION IN THE U.S.
MILITARY: EVOLUTION AND
DEMISE
OF DON’T ASK, DON’T TELL
Gay Exclusion in the U.S. Military: Evolution and Demise of Don’t Ask, Don’t Tell
Title 10 of the U.S. Code, Section
654, entitled “Policy Concerning
Homosexuality in the Armed
Forces,” was passed into law in
1993 and became commonly known
as Don’t Ask, Don’t Tell (DADT).
DADT expressly forbade open
homosexuality in the U.S. military.
It required that a member of the
U.S. armed forces be separated
from military service if she or he
had (1) engaged in, attempted to
engage in, or solicited another to
engage in a homosexual act; (2) had
stated that she or he was
homosexual or bisexual; or (3) had
married or attempted to marry a
person known to be of the same
biological sex.
During the 17 years in which
DADT was in force, more than
13,000 gay, lesbian, and bisexual
service members were forcibly
separated under the policy. DADT
was not a spontaneous political
issue from the 1990s, but rather a
deep-seated cultural issue that
began to emerge after World War II
and continued to evolve over the
next six decades. In September
2012, after certification by the
commander in chief, secretary of
defense, and chairman of the Joint
Chiefs of Staff, DADT was finally
rendered obsolete, at which point it
became permissible to serve openly
in the U.S. military irrespective of
one’s sexual orientation. This entry
describes the historical context that
gave rise to the evolution and
decline of DADT and related
legislation from 1949 to 2011.
Early History
Active exclusion of gay, lesbian,
and bisexual service members
prominently emerged during the
middle of the 20th century at the
onset of the Cold War. With
manpower overages at a peak
following the conclusion of World
War II, the U.S. military became
increasingly selective about who
would be allowed to serve. In 1949,
the U.S. Navy implemented the first
regulation expressly prohibiting
homosexuality within its ranks.
Secretary of the Navy Directive
1620.1 stated that “homosexuals
were liabilities to the service, and
must be discharged.” Army
Regulation 635–443 (in 1950) and
Air Force Regulation 35–66 (in
1951) soon followed with similar
prohibitions. Although military
policy continued to prohibit gay
and lesbian military members from
serving openly, results from legal
challenges to the gay exclusion
policy in the decades to follow
would serve to establish a precedent
toward acceptance.
Legal Challenges
By the time the Vietnam War had
drawn to a close in 1975, legal
challenges to the military’s gay
exclusion policy began to assert that
homosexual service members were
worthy of the same legal safeguards
that heterosexual service members
enjoyed. At the same time, federal

court decisions began to identify
problems in how the Pentagon
enforced its gay ban. In one
landmark case, Leonard Matlovich,
a Vietnam veteran and Purple Heart
recipient, openly admitted that he
was gay. Despite his exemplary
record, he was immediately
discharged in 1975. However, in
1978, a U.S. Court of Appeals ruled
against the Pentagon that Matlovich
had, in fact, been wrongly
dismissed from the military due to
his sexual orientation. In a second
landmark case, Miriam Ben-Shalom
was discharged from the military in
1975 based on her admission to a
reporter that she was a lesbian.
Consistent with the previous
standard set by the
Matlovich case, the court ruled in
favor of BenShalom that
discharging her on her statements
alone was a violation of her right to
free speech.
Formalized Policy
In the wake of these landmark
cases, Pentagon leaders quickly
acknowledged that the current gay
exclusion policy was legally
unenforceable because it could not
be applied in a consistent fashion.
In a proactive move to strengthen
the policy, then– Deputy Secretary
of Defense Graham Claytor
announced a change, proclaiming
that “homosexuality is incompatible
with military service” and that
anyone who “engages in, has
attempted to engage in, or has
solicited another to engage in a
homosexual act” be immediately
discharged without exception. By
1982, the Pentagon formalized the
Gay Exclusion in the U.S. Military: Evolution and Demise of Don’t Ask, Don’t Tell
1227
gay ban using the following
rationale:
The presence of [homosexuals]
adversely affects the ability of
the Military Services to maintain
discipline, good order, and
morale; to foster mutual trust and
confidence among
servicemembers, to ensure the
integrity of the system of rank
and command; to facilitate
assignment and worldwide
deployment of servicemembers
who frequently must live and
work under close conditions
affording minimal privacy; to
recruit and retain members of the
Military Services; to maintain the
public acceptability of military
service; and to prevent breaches
of security. (DoD Directive
1332.14, January 28, 1982)
For the next several years, the
issue faded from the political
spotlight, as the revised policy
seemed to be congruent with public
sentiment.
Public Sentiment
Until the late 1980s, public attitudes
toward homosexuality in the
military were sufficiently subdued
as to exert very little pressure on
military leaders to change the
policies toward gays in the military.
It was generally assumed that
because military leaders deemed the
exclusion of gay men and women
from service as in the best interests
of the military, it was logical that
such a policy position was also
likely in the best interests of the
U.S. public. However, public
sentiment changed in 1989 with the
1228
release of the Crittenden Report.
Commissioned more than 30 years
prior, in 1957, and named for the
senior U.S. naval officer who
served as committee chairman, the
Crittenden Committee had been
charged to investigate potential
military-security risks posed by gay
sailors. In its final analysis, the
Crittenden Report concluded there
was no evidence to “support the
contention that homosexuals are a
greater risk than heterosexuals.”
Questions emerged as to why the
military had concealed the report
from public view until a federal
court ordered it to be released in
1989. The controversy rekindled
the discussion over the efficacy of
the current exclusionary policy
toward gay and lesbian military
members. This rekindled debate
quickly became part of the national
political dialogue once more.
The Rise of DADT
In 1992, Bill Clinton, then a
presidential candidate, announced
at a campaign stop that if he were to
be elected, he would ensure that all
men and women, regardless of
sexual orientation, would be
permitted to serve openly in the
U.S. military. This campaign pledge
became a rallying cry among
members of Congress who opposed
such a change in policy. Knowing
that a sitting president, as
commanderin-chief of the U.S.
military, could make good on such
a promise, opposition legislative
leaders preemptively began drafting
legislation to prevent such
unilateral action. Later that year,
Bill Clinton was elected president
and the issue of “gays in the
military” became a top priority—
for both major political parties.
As the national debate over the
efficacy of open homosexual
military service continued, two key
studies were released in 1993. The
first was a report by the
Government Accountability Office
(GAO), which reviewed
experiences of four Western allied
nations—Canada, Germany, Israel,
and Sweden—countries that had
previously banned open
homosexual service and had since
reverted to more inclusive policies.
The GAO report stated that
“military officials in all four
countries said that the presence of
homosexuals in the military is not
an issue and has not created
problems in the functioning of
military units.” Likewise, a study
conducted in the same year by the
RAND Corporation reviewed all
available data pertaining to unit
cohesion from six foreign
militaries. The RAND report
concluded that “none of the
militaries studied for the report
believed their effectiveness as an
organization has been impaired or
reduced as a result of the inclusion
of homosexuals.” Nevertheless,
despite the growing evidence to the
contrary, Congress passed, and the
president signed, legislation that
codified into law the gay exclusion
policy (10 USC 654 or Public Law
103–160, 1993) that became
commonly known as Don’t Ask,
Don’t Tell. This compromise policy
permitted military service, without
questioning the issue of sexual
orientation, for any person
otherwise deemed qualified to
serve, just so long as no admission
of being gay or evidence of
homosexual behavior was made
known. Gay and lesbian members
of the military would be allowed to
serve, but they would have to do so
 1229
in silence about their orientation, or
risk administrative separation.
Although unknowable at the time it
was passed in 1993, DADT would
persist as the governing policy for
the next 17 years.

Data-Driven Analysis
By the mid-1990s, researchers who
examined data gathered from allied
Western nations concluded there
were no negative impacts from
repeals of laws similar to DADT in
other countries such as Australia,
Canada, and Israel. When the
British government finally lifted its
ban on gays in the military in 2000,
both advocates and opponents of
DADT repeal in the United States
paid very close attention. Great
Britain provided a direct test of the
claims on which the U.S. policy had
been built, regarding the effects on
unit cohesion, morale, and military
effectiveness. Nine months after the
British repeal took effect, Britain’s
Ministry of Defence published a
report that found policy
implementation to be better than
anticipated and to have “fewer
problems than might have been
expected.” There were “no reported
difficulties of note concerning
homophobic behavior amongst
Service Personnel.” The report
concluded that “there has been a
marked lack of reaction” to the
change. In essence, the biggest
story regarding repeal of the ban
was no story at all.

The Demise of DADT

Despite the growing evidence
refuting claims that open
homosexuality would harm unit
cohesion,
1230
military effectiveness, and morale, societal attitudes
toward open homosexuality in the military began to
change. Trends among public opinion polls that had
originally showed a majority of American citizens
opposed to openly gay service in 1993 showed a
marked change by 2008, with a significant majority
of Americans supporting a move to repeal DADT. In
light of this changed attitude, Congress ordered the
Pentagon in 2010 to evaluate potential effects of
repealing DADT. During the next 9 months, in one
of the largest studies ever conducted by the military,
the 68- member committee, which formed the
Comprehensive Review Working Group (CRWG),
solicited the opinions of nearly 400,000 individuals.
In its final 266-page report submitted to Congress,
the Pentagon’s CRWG concluded that the risk to
repealing the law was “low.” Almost 70% of the
115,000 respondents believed that DADT repeal
would have a positive or neutral result. As a result, in
December 2011, Congress passed and President
Barack Obama signed the Don’t Ask, Don’t Tell
Repeal Act of 2010 (Pub.L. 111–321, 2011), making
the United States the 36th country in the world to
allow open homosexual service in the military, and
the 26th NATO nation (out of 28) to do so.
Conclusion
Since the full implementation of the DADT repeal in
September 2012, several studies have been
conducted to identify negative effects of open
homosexual service in the United States. To date, no
such negative effects have been found.
James E. Parco
See also Military and LGBTQ People; Military and
Transgender People
Further Readings
Belkin, A. (2011). How we won: Progressive lessons from the
repeal of “Don’t Ask, Don’t Tell.” New York, NY:
Huffington Post Media Group.
Don’t Ask, Don’t Tell Repeal Act of 2010. Pub. L. 111-321,
124 Stat. 3515 (2010).
Gay Gentrification
Frank, N. (2010). Unfriendly fire: How the gay ban
undermines the military and weakens America.
New York, NY: Thomas Dunne Books.
Ham, C., & Johnson, J. (2010). Comprehensive Working
Group report on the issues associated with a repeal of
Don’t Ask, Don’t Tell. Washington, DC: Government
Printing Office.
Parco, J. E., & Levy, D. A. (Eds.). (2011). Attitudes aren’t
free: Thinking deeply about diversity in the U.S. armed
forces. Montgomery, AL: Air University Press.
Parco, J. E., & Levy, D. A. (Eds.). (2014). Evolution of
government policy towards homosexuality in the U.S.
military: The rise and fall of DADT. London, England:
Routledge.
Policy Concerning Homosexuals in the Armed Services.
Pub. L. 103-160, Sec 654, Title 10 (1993).
Seefried, J. (2008). Our time: Breaking the silence of
“Don’t Ask, Don’t Tell.” New York, NY: Penguin
Books.
GAY GENTRIFICATION
Gentrification is a contentious dimension of urban
renewal. The term describes the process whereby
rundown, industrial, marginal, low-income, or
working-class neighborhoods are transformed into
middle-class, wealthy residential neighborhoods or
desirable entertainment or commercial precincts.
Economic, demographic, and lifestyle shifts are
bound up in the process. Gentrification entails
transformations in the material aesthetic of the
neighborhood, an increasing share of wealthier
residents and commercial premises, rising rent and
property prices, and the displacement of long-term
residents and businesses unable to afford the
increasing costs of local living. It is most commonly
associated with changes, which started in the 1960s
and are ongoing, in inner-city neighborhoods of large
cities in the Global North.
While gentrification is a broad urban renewal
process, since the early 1980s a diverse range of
commentators, planners, scholars, media outlets, and
public officials have circumscribed a reputedly
distinct gentrification trend associated with gay
communities and the formation of “gayborhoods”
(i.e., gay neighborhoods). This has been denoted as
Gay Gentrification

gay gentrification, and it is controversial within and
beyond academia. The relationship between gay
gentrification and broader gentrification trends is
complex, yet it is often reduced to a simple narrative
in mainstream discourse whereby gay men, in
particular, are narrowly perceived as pioneers of
gentrification and a bellwether of urban regeneration.
This logic suggests that when gay men move into a
neighborhood, gentrification follows. This notion has
become embedded in popular culture across a range
of countries, including the United States, the United
Kingdom, Canada, and Australia, and is propagated
by the discourse of estate agents, lifestyle media,
property developers, and scholars who are influential
in urban and regional planning (e.g., Richard
Florida).
Simultaneously, this rhetoric—if read within a
critical framework—nevertheless draws attention to
some catalysts, trends, and outcomes that can be
understood to generate a specific set of gentrification
experiences linked to LGBTQ people and
communities. The initial point to emphasize is that
while LGBTQ people in general are participants in
gentrification, there is an especially strong
association between gay men and urban renewal, as
highlighted in popular discourse. This mainstream
rhetoric stereotypes gay men as affluent, stylish, and
domestically inclined, and therefore centrally
concerned with the aesthetic-cum-economic
revaluation of inner-city neighborhoods and their
heritage housing stock. But those who have studied
the postwar history of gay men’s involvement in
gentrification find more sobering reasons for their
role in urban change.
Research on gay gentrification in the 1970s and
1980s in the United States, the United Kingdom,
Canada, and Australia finds that the involvement of
gay men in the renovation of housing and
commercial premises in marginal or rundown
innercity areas was not primarily a matter of
economic need. Rather, it was a crucial part of the
process of claiming a territorial base for subcultural
definition and political organization. Gay
territorialization (i.e., the territorial demarcation of
gayborhoods, albeit porous, through the
concentration of gay residents and institutions) and
regeneration of inner-city neighborhoods was as a
response to wider social oppression. Gay men were
prepared to pay a financial cost in order to create
urban neighborhoods over which they might have
1231
some control, and thus contest their marginalization.
These early gay gentrifiers included workingclass as
well as middle-class men, itinerant service workers
as well as professionals.
While most gay gentrification processes are
associated with gay men, there is also research on
lesbian involvement in gentrification and in the
creation of lesbian neighborhoods. Lesbian processes
of territorialization were, and remain, limited,
however, by generally lower incomes and more
restricted access to finance. Nevertheless,
neighborhoods such as Park Slope, Brooklyn (New
York), and Northampton (Massachusetts) attained
association with lesbian identities through women’s
participation in urban renewal.
Economic factors were thus important foundations
for enabling gay men to pursue place-making
through gentrification. Often free from
responsibilities of marriage and children, gay men
tended to have higher disposable incomes than
oppositesex couples or lesbians. This enabled them
to purchase cheap residential and commercial
premises. But they were not alone in doing so; artists
and bohemians have also been considered pioneer
gentrifiers, in search of low-cost work and living
spaces. What made these groups gentrifiers—gay
men, artists, bohemians—was their embodiment of
middle-class aesthetics of style and taste, or at least
the assumption that they embodied and conveyed
such aesthetics. These groups arguably changed the
material environment, social life, and ambience of
neighborhoods by bringing in new tastes and
lifestyles. This shift to middle-class aesthetics made
neighborhoods desirable to wealthier people,
triggering property price rises. The result was the
displacement of long-term working-class and low-
income residents. Gay gentrification has thus been
accompanied by negative impacts on existing
residents and businesses.
Gentrification, however, is a multifaceted and
ongoing process. Pioneer gentrifiers are often
followed by ever-wealthier gentrifiers as
neighborhood desirability and property costs
continue rising. This is called super-gentrification or
resurgent gentrification, and research has examined
its effects on gayborhoods, that is, on neighborhoods
regenerated through gay gentrification, which came
to be identified as gay neighborhoods. In these
contexts, middle-class gayborhoods take on a cultural
cache, a cutting-edge coolness, which attracts
1232
wealthy heterosexual residents. The influx of
heterosexual couples and “family values” again
changes the lifestyle and atmosphere of the
neighborhood and further exacerbates the rise of
property and living costs. Consequently, just as gay
gentrifiers initially displaced existing residents, they
too are often displaced by super-gentrification.
Resurgent gentrification has been identified as a
critical threat to gayborhood longevity, contributing
to “de-gaying” neighborhoods.
Andrew Gorman-Murray
See also Gayborhoods; Spatial/Social Location of LGBT
Persons
Further Readings
Brown, M. (2014). There goes the gayborhood. Progress in
Human Geography, 38, 457–465.
Collins, A. (2004). Sexual dissidence, enterprise and
assimilation: Bedfellows in urban regeneration. Urban
Studies, 41, 1789–1806.
Doan, P., & Higgins, H. (2011). The demise of queer space?
Resurgent gentrification and LGBT neighborhoods.
Journal of Planning Education and Research, 31, 6–25.
Forsyth, A. (1997). NoHo: Upscaling Main Street on the
metropolitan edge. Urban Geography, 18, 622–652.
Knopp, L. (1995). Sexuality and urban space: A
framework for reference. In D. Bell & G. Valentine
(Eds.), Mapping desire: Geographies of sexualities
(pp. 149–161). London, England: Routledge.
GAY SPERM DONORS
Since the 1970s, gay men have acted as sperm
donors, primarily for lesbian recipients. This entry
outlines the reasons for this history and the legal
complexities that arise from it for both donors and
recipients. Specifically, the entry suggests that the
Gay Sperm Donors
assumption that gay men may constitute ideal donors
for lesbian recipients overlooks the competing
motivations that may lead gay men to donate sperm.
The entry then examines some of the motivations
that lead gay men to act as sperm donors as
documented in empirical research, and the challenges
that may arise for some men (and the women to
whom they donate sperm) as a result of these
motivations. The entry ends by considering what the
future holds for the role of gay men as sperm donors.
As a whole, this entry highlights both the
vulnerabilities that gay men face as donors in wider
heteronormative contexts, and also the privileges
they hold as men living in patriarchal societies.
Historical and Legal Background
Until relatively recently, lesbian women in Western
societies (both single women and couples) were
unable to access donor sperm in clinics due to
legislation that prevented them. In many
jurisdictions, this has also been the case for single
heterosexual women. For these reasons, various
groups of people, including lesbians, have
historically sought options outside of clinics to
achieve a pregnancy. Although socially the
prohibitions placed on lesbian women outlined above
were also placed on gay men (in terms of donating
sperm to clinics), this has not prevented lesbian
women (and in some instances heterosexual women)
from negotiating with gay men to donate sperm to
them in private arrangements outside of clinics.
There are a number of reasons why gay men have
been seen as likely and supportive sperm donors to
lesbian women. The first is the assumption that,
given that both lesbians and gay men experience
homophobia, there would be unity or a sense of
community in the face of that homophobia, which
would lead gay men to support lesbian women’s
reproductive desires. The second reason is the
assumption by many gay men that identifying as gay
meant that they would not have children. For some
gay men, then, donating sperm offered the possibility
of fulfilling a desire to have children, or to at least
leave a genetic record of themselves in the world.
Gay Sperm Donors
The two reasons why some lesbian women have
considered gay men viable sperm donors are, it may
be suggested, to a degree contradictory. On the one
hand, gay men are often seen by lesbian women as
altruistic and politically motivated, while on the
other hand, they are potentially seen as fulfilling their
own desires (that is, wishing to have a child or leave
a genetic record of themselves in the world). These
contradictory motivations have in some cases led to

disputes between gay sperm donors and lesbian
recipients over the custody of children conceived of
the donation, specifically where lesbian recipients
have presumed that the gay man would have no
involvement in the child’s life, whereas after the
birth of the child the gay man has petitioned for
access to the child. In Australia, the United States,
and the United Kingdom, high-profile cases have
demonstrated that allegiances between gay sperm
donors and lesbian recipients are not always
successful, and that some courts may display an
investment in “finding a father” for children
conceived by lesbian women, leading them to rule
that gay men are entitled to access to children
conceived of their sperm.
Motivations and Challenges for Gay
Men Donating Sperm
Research on gay men’s motivations to donate sperm
has consistently highlighted the altruism– self-
motivated binary outlined above. That is, gay men
may be motivated to help others by donating sperm
but may also be motivated to fulfill their own desire
to have children or leave a genetic record of
themselves in the world. In terms of some gay men’s
desire to be involved with children conceived of their
sperm, empirical research suggests that this is a
positive aspect of gay men’s role as sperm donors,
given momentum across Western countries toward
the release of identifying information to donor-
conceived children. Yet at the same time, research
also suggests that gay men who agree to act as sperm
donors with the motivation that they would like to be
a parent (or at least have a relationship to a child)
may find themselves challenged when it comes to
respecting the agreement they have entered into with
recipients (which in most cases does not involve a
coparenting arrangement).
Further, it has been suggested that as sperm
donors gay men must negotiate forms of “emotion
work” specific to them as gay men. The first of these
is highlighted above, in terms of gay men who may
feel that identifying as gay prevents them from
having children. Donating sperm, then, may be
challenging in that it activates parental desires that
may potentially remain unfulfilled. For gay men who
donate in the context of clinics (which is now
possible in many countries), there is the possibility of
1233
heterosexism. Research has suggested that clinic staff
may discriminate against gay men in explicit ways,
or that gay men may experience more subtle forms of
marginalization (such as the lack of gay-specific
information or materials). Finally, in terms of
challenges, gay men may find that the regulation of
their sexuality and sexual activity when donating
sperm contributes to a broader sense of sexual
regulation that arises from living in heteronormative
societies. While it is often presumed that sperm
donation is simply a physical act, research has
consistently reported that there is emotion work
attached to sperm donation. Although this is true for
all men, it may be especially exacerbated for gay
men who may already feel like their sexuality and
sexual activity are not recognized or condoned.
The Future
Regarding the future of gay men as sperm donors, in
part this will continue to be mediated by changes to
legislation. In most Western countries, lesbians or
single women can now access donor sperm in clinics,
and to a degree this has lessened the demand upon
such women to identify and negotiate with donors in
private arrangements. Nonetheless, some women
continue to prefer private arrangements, and some
women cannot afford access to clinics. Beyond
legislation, and as has long been the case in terms of
lesbian and gay kinship formation, some lesbians and
gay men will likely continue to enthusiastically and
intentionally enter into coparenting arrangements.
Finally, and given legislative changes allowing gay
men to donate sperm to clinics, there has been a rise
of promotional materials by clinics targeting gay
men as donors. The role of gay men as sperm donors
is thus likely to continue, and it warrants ongoing
attention.
Damien W. Riggs
See also Coparenting; Heterosexism; Sperm Donor,
Choosing a; Sperm Donors, Known; Sperm Donors’
Involvement in Children’s Lives
Further Readings
Dempsey, D. (2012). More like a donor or more like a father?
Gay men’s concepts of relatedness to children.
Sexualities, 15, 156–174.
1234
Riggs, D. W. (2009). The health and well-being implications
of emotion work undertaken by gay sperm donors.
Feminism & Psychology, 19, 517–533.
Ripper, M. (2008). Australian sperm donors: Public image
and private motives of gay, bi-sexual and heterosexual
donors. Health Sociology Review, 17, 313–325.
Van Reyk, P. (2007). Baby love: Gay donor father narratives
of intimacy. Gay and Lesbian Issues and Psychology
Review, 3, 44–52.
GAYBORHOODS
Gayborhood is a term used to describe
neighborhoods, especially urban neighborhoods, that
are populated by and associated with LGBTQ people
and communities. Arguably, the term is most
commonly used in North America, and is equivalent
to descriptions deployed in other places, including
gay ghetto, gay village, or simply a gay and/or
lesbian neighborhood. A neighborhood can be
understood to be a gayborhood if it (a) contains a
cluster of LGBTQ institutions, both commercial
(bars, clubs, cafes, bookstores, shops) and service-
oriented (legal, health, and community
organizations); (b) houses a substantial residential
LGBTQ population; and (c) has conspicuous, locally
dominant
Gayborhoods
LGBTQ subculture(s). The LGBTQ presence is
sufficiently embedded and visible in society that
gayborhoods have mainstream recognition.
Owing to the spatial concentration of LGBTQ
populations, institutions, and subcultures,
gayborhoods have symbolic as well as physical
significance for LGBTQ people. They provide a
touchstone of LGBTQ community and place-
making, and are perceived as beacons of acceptance
and social connection for—at least some—LGBTQ
people. This symbolism is essential for the
development and consolidation of gayborhoods,
drawing LGBTQ migrants through gravitational
migration (i.e., attraction to like-minded others,
subculture(s), and support institutions). Indeed, most
internationally recognizable examples of
gayborhoods are located in inner-city areas in the
Global North, and this urban characteristic underpins
their material fabric, symbolism, and centrifugal
force; they include the Castro (San Francisco, USA),
Greenwich Village (New York,
USA), West Hollywood (Los Angeles, USA), Soho
(London, UK), The Village ( Manchester, UK),
Church-Wellesley Village (Toronto, Canada), and
Oxford Street, Darlinghurst (Sydney, Australia).
These gayborhoods began developing in the post–
World War II era, during the 1950s, 1960s, and
1970s. Catalysts varied from country to country and
between cities, depending on national and regional
circumstances. San Francisco, for instance, became
home to a gayborhood in the Castro partly due its
role as the demobilization site for dismissed
American armed services personnel. Sydney,
however, began to house a gayborhood around
Oxford Street in the 1960s due to low rent costs and
a reputed libertine culture vis-à-vis other Australian
cities. Both economic and social conditions
contribute, even if specific catalyzing circumstances
vary. This is noted in Alan Collins’s model of
gayborhood evolution in a 2004 article in Urban
Studies: from LGBTQ people and institutions
occupying cheap, marginal inner-city areas; to
consolidation and expansion; to possible mainstream
colonization and property price increases that may
force out LGBTQ people and institutions and lead to
gayborhood decline.
Gayborhoods
As well as socioeconomic models of gayborhood
development, researchers have examined their
political dimensions. Work conducted across the
Global North documents the consolidation of
gayborhoods as a form of social and political
territorialization (i.e., territorial demarcation, albeit
porous, through concentration of gay residents and
institutions) based on economic capacity. The
materialization of a gayborhood provides a site of
social inclusion vis-à-vis the heteronormative
mainstream, and a concentrated voting bloc. In this
sense, social and political territorialization is a way
of creating a geographical base for rights claims at
various levels of government, from local to national.
These same LGBTQ social and political territories
are also sites of exclusion. Commentators have
pointed out that most gayborhoods have been created
by and for gay men—largely White, middleclass gay
men who are able to afford residential and/or

commercial property, with surplus income to spend
in local businesses. Both subtle and overt exclusions
operate along lines of gender, race, and class, as well
as age and ability, and many gayborhoods are seen as
places primarily for the comfort and privilege of
White, middle-class gay men.
The gender, race, and class exclusions of
gayborhoods have impelled the development of
alternative neighborhoods for fractions of LGBTQ
communities. For instance, scholars have
documented the development of lesbian
neighborhoods in the Global North, including Park
Ridge, Brooklyn (New York); Northampton
(Massachusetts); Hebden Bridge (West Yorkshire,
UK); West End (Vancouver, Canada); Leichhardt
(Sydney, Australia); and Alice Springs (Northern
Territory, Australia). Lesbian neighborhoods are less
visible in terms of commercial venues, but
nevertheless demonstrate a residential concentration.
The fewer commercial premises are attributed to
women’s lesser economic resources and different
modes of social interaction.
A range of studies in the Global North also find
race- and age-based exclusions operable in gay
(male) neighborhoods and institutions. Forms of
socialization and subculture in gay commercial
venues often favor White, youthful bodies. In some
gayborhoods, this has led to the development of
community organizations with services specifically
for older men and men from diverse racial, ethnic,
and linguistic backgrounds.
The early 21st century has seen media and
community concern over the “de-gaying”—the
decline and “death”—of notable gayborhoods,
including the Castro, Greenwich Village (New
York), and Oxford Street (London). In his
evolutionary model, Collins forecasts the possible
decline of gayborhoods when mainstream popularity
pushes property costs beyond the means of most
LGBTQ people and businesses. The community and
subculture cannot be sustained under such economic
conditions. Other factors also impel decline.
Mainstream acceptance renders gayborhoods
unnecessary for territorial protection. The uptake of
online social media (the Internet, mobile apps) makes
it possible for LGBTQ people to meet and socialize
without need for physical gathering spaces.
In this context, scholars are now researching new
forms that gayborhoods are beginning to take, as
post-gay or queer-friendly neighborhoods, where
1235
LGBTQ people and communities are present and
visible as part of a broader social mix. Places such as
Newtown (Sydney, Australia); London’s East End
(UK); and Parkdale (Toronto, Canada) might be
emblematic of new materializations. A range of
possibilities remains open, however, including
gayborhood revival, queer-friendly alternatives, and
mainstream assimilation.
Andrew Gorman-Murray
See also Gay Gentrification; Spatial/Social Location of
LGBT Persons
Further Readings
Brown, M. (2014). There goes the gayborhood. Progress in
Human Geography, 38, 457–465.
Collins, A. (2004). Sexual dissidence, enterprise and
assimilation: Bedfellows in urban regeneration. Urban
Studies, 41, 1789–1806.
Nash, C. J., & Gorman-Murray, A. (2014). LGBT
neighborhoods and “new mobilities”: Towards
understanding transformations in sexual and gendered
urban landscapes. International Journal of Urban and
Regional Research, 38, 356–372.
Nash, C. J., & Gorman-Murray, A. (2015). Lesbians in the
city: Mobilities and relational geographies. Journal of
Lesbian Studies, 19, 173–191.
GAYDAR
Gaydar, in its most general sense, refers to the ability
(or inability) to sense whether someone is
homosexual based on observation or intuition.
Gaydar judgments can be made explicitly and
deliberately, or unintentionally and outside of
conscious awareness. Gaydar is deeply relevant in
contemporary society because many arguments
against legal nondiscrimination protections for
homosexual people center on the premise that a
homosexual person cannot be discriminated against
if the person does not explicitly state his or her
sexual orientation. Gaydar is also part of the daily
lives of many people, regardless of sexual
orientation, who are seeking to identify friends,
mates, sexual competitors, sexual noncompetitors,
and so on. Gaydar may be even more relevant to the
1236
daily lives of the targets of gaydar perceptions, who
may or may not want their sexual orientation to be
readily perceived, or who may be concerned that
people will make incorrect gaydar judgments about
them. Gaydar is a term of international significance,
with presence as “gaydar” in languages including
Spanish, French, Dutch, German, and Portuguese,
and a transliterated presence in languages with non-
Roman alphabets such as Hebrew, Russian, and
Korean.
Gaydar—a portmanteau comprising gay and
radar that many dictionaries claim was first observed
in the English language in the 1980s— can be
informed by nearly any behavioral cue, verbal or
nonverbal. However, basing a perception of a target’s
sexual orientation on a target’s explicit declaration of
sexual identity or on observed or recounted sexual
behaviors violates the spirit of gaydar and does not
constitute a gaydar judgment. For a perception to
qualify as gaydar, it should be based only on cues
that do not generally define sexual orientation. That
is, a style of dress or manner of speaking may be
associated with a certain
Gaydar
gender or sexual orientation, but these cues are not
accepted as defining sexual orientation. A person’s
self-identification or sexual behaviors generally
define his or her sexual orientation.
Although the word gay is sometimes strictly
defined as referring to gay men (and not as referring
to gay men or lesbians), gaydar can refer to
perceptions of men’s or women’s sexual orientation.
Gaydar, like many informal or slang words, has been
defined in many ways, both in scientific literature
and in popular media, due to lack of consensus or
historical basis. Some definitions of gaydar are so
limited that they refer only to the ability of gay men
to gauge other men’s sexual orientation. Other
definitions are more generous about the perceivers
(i.e., men or women of any sexual orientation) but
still limit the definition of gaydar to apply only to
perceptions of male targets. Going forward, ideally,
the definition of gaydar should include perceivers of
any gender or sexual orientation and any
heterosexual or homosexual perceptual targets.
Perceptions of people who do not identify as straight
or gay/lesbian (such as those who identify as
bisexual or pansexual) are not generally accepted as
gaydar judgments. To date, there is no specific term
for judgments of a person’s sexual orientation if that
target person cannot be categorized as straight or
gay. (Throughout this entry, gay refers to gay men
and lesbians unless otherwise noted.)
Published experimental research from the
behavioral sciences has confirmed that gaydar exists,
and that a perceiver’s gaydar can be fed by a variety
of cues from the target person. These cues range
from completely uncontrollable (e.g., distance
between facial features) to completely controllable
and subject to the target’s self-presentation
preferences (e.g., clothing, hairstyle), or even the
target’s environment and surroundings. Experiments
have found gaydar abilities in both male and female
perceivers, and for both male and female perceptual
targets. Studies generally have not found consistent
gender differences in gaydar abilities (neither in
perceiver gender nor in target gender). However, it is
important to note the limitations of most extant
research. Current research has primarily or
exclusively used heterosexual
Gay–Straight Alliances (GSAs)
participants in the 18- to 25-year-old age range to
make judgments, and has primarily used people of
the same age range as perceptual targets. It is not yet
known if people of other age groups can make
gaydar judgments with above-chance accuracy, or if
people can do so when the perceptual targets are of a
different age group than the perceivers. It is likewise
not currently known if gay perceivers’ gaydar
accuracy is superior to the accuracy of their straight
counterparts; researchers have faced challenges
addressing this question owing to difficulty in
recruiting gay people to participate in studies without
causing them to suspect they were selected due to
their sexual orientation.
Gaydar judgments have been found to rely
substantially on stereotypes of sexual orientation.
The predominant stereotype of gay men is that they
are relatively feminine, and the predominant
stereotype of lesbians is that they are relatively
masculine. These stereotypes are so prevalent in
perceivers’ judgment processes that some
experiments have shown that virtually any relatively
feminine man’s face and virtually any relatively
masculine woman’s face will be labeled as gay,
regardless of the target person’s actual sexual

orientation. Gaydar judgments do not, however,
require stereotyped cues for them to be made with
above-chance accuracy. For example, studies in
which perceivers were shown only small portions of
targets’ faces—with some facial portions small
enough (e.g., the eye area) and controlled enough
(e.g., no makeup, neutral facial expression) that they
could not reasonably be believed to contain
stereotyped content—still do yield gaydar judgments
with above-chance accuracy.
Joshua A. Tabak
See also Coming Out, Disclosure, and Passing; Gay
Exclusion in the U.S. Military: Evolution and Demise of
Don’t Ask, Don’t Tell; Masculinity Stereotypes;
Nondiscrimination Protections, State and Local;
Sexual-Identity Labels; Strategic Disclosure
Further Readings
Ambady, N., Hallahan, M., & Conner, B. (1999).
Accuracy of judgments of sexual orientation from thin
slices of behavior. Journal of Personality and Social
Psychology, 77, 538–547. doi:10.1037/0022-3514
.77.3.538
Freeman, J. B., Johnson, K. L., Ambady, N., & Rule, N.
O. (2010). Sexual orientation perception involves
gendered facial cues. Personality and Social
Psychology Bulletin, 36, 1318–1331. doi:10.1177/
0146167210378755
Johnson, K. L., Gill, S., Reichman, V., & Tassinary, L. G.
(2007). Swagger, sway, and sexuality: Judging sexual
orientation from body motion and morphology. Journal
of Personality and Social Psychology, 93,
321–334. doi:10.1037/00223514.93.3.321
Rule, N. O., Ambady, N., Adams, R. B., Jr., & Macrae,
C. N. (2008). Accuracy and awareness in the
perception and categorization of male sexual
orientation. Journal of Personality and Social
Psychology, 95, 1019–1028. doi:10.1037/a0013194
Tabak, J. A., & Zayas, V. (2012). The roles of featural and
configural face processing in snap judgments of sexual
orientation. PLoS ONE, 7, e36671. doi:10.1371/
journal.pone.0036671
GAY–STRAIGHT ALLIANCES (GSAS)
1237
Gay–Straight Alliances (GSAs) are school-based
student clubs that aim to make schools safer for
lesbian, gay, bisexual, transgender, queer, and
questioning (LGBTQ) youth. This entry discusses
the historical context and growth of GSAs in North
America, in addition to describing the characteristics
of schools and communities where GSAs are
typically located as well as their members. Next, the
entry discusses the various roles that GSAs play in
schools and for students, and it ends with a summary
of how GSAs contribute to youth development and
well-being.
GSA History and School and Member
Characteristics
The sections below provide a brief history of
GSAs, including their beginnings on the East and
West Coasts of the United States, and the legal
challenges encountered when students were blocked
from forming or continuing GSAs in their schools. In
addition, sociodemographic characteristics of the
schools and communities where GSAs are located
are described. Finally, a description of the types of
students that typically join GSAs is provided. These
descriptions provide insight for readers specific to
when, where, and why students may face challenges
in forming or joining a GSA, and opportunities for
future research on how to ensure that GSAs are
accessible to all students who would benefit from
membership.
History
GSAs and similar clubs, such as Project 10, were
first organized in the late 1980s in Massachusetts
(GSAs) and California (Project 10) by educators and
community-based organizations. Today, there are
more than 4,000 GSAs in middle schools and high
schools in all 50 U.S. states and Puerto Rico; in
addition, GSAs have been formed in Canada and
Mexico, although there are fewer of them.
Nonetheless, while GSAs are now present in schools
across the United States, students and adult
advocates (e.g., the club’s advisor, community and
parent advocates) have encountered several barriers
that have impeded or slowed the formation of GSAs
in particular schools or school districts. In 1998, the
American Civil Liberties
1238
Union (ACLU) and the National Center for Lesbian
Rights (NCLR) filed a groundbreaking court case
against the Salt Lake City (Utah) School District
Board of Education after it prohibited students from
forming a GSA. The ruling on this case—in addition
to others that have followed— found that the U.S.
Federal Equal Access Act of 1984 guarantees the
right of students to form GSAs if their school
receives federal funding and has at least one
additional school-based extracurricular activity,
thereby prohibiting exclusionary resistance by school
administrators and school boards or districts.
Notably, even though these initial court cases were
settled in the late 1990s and early 2000s, LGBTQ
students still encounter barriers that prohibit the
formation of GSAs. For instance, other efforts to ban
the formation of GSAs in schools have included
allowing parents to decline permission for their
children to
Gay–Straight Alliances (GSAs)
participate in certain school clubs (e.g., Georgia state
law), requiring parental permission forms to
participate in all school-based extracurricular
activities (e.g., Utah state law), or threatening to
remove all school-based activities (e.g., Municipal
School Board of Education in Farmington, New
Mexico).
In addition to efforts by the ACLU and NCLR to
ensure the rights of LGBTQ students to form a GSA,
three additional organizations have been critical to
the GSA movement, including Lambda Legal, which
has filed several legal cases against school districts
that have attempted to ban the formation or
continuation of GSAs; the Gay, Lesbian & Straight
Education Network (GLSEN); and the GSA
Network. Neither GLSEN nor the GSA Network
officially organize or direct the dayto-day functions
of GSAs, but both organizations do provide support
and help to build capacity for students to form and
sustain GSAs in their schools and to advocate for
safer schools via various campaigns/actions
(GLSEN’s Day of Silence), programs (GLSEN’s
Changing the Game), and events (GSA Network’s
Queer Youth Advocacy Day). Finally, several
statewide coalitions have formed that provide
support and advocacy for LGBTQ students and
GSAs (e.g., New Mexico GSA Network).
School and Community Characteristics
U.S.-based research has identified several unique
characteristics of schools and communities that have
GSAs, as compared with those that do not.
Specifically, in the United States, GSAs are more
likely to be formed in suburban or urban areas than
in rural areas, and are predominantly located in the
northeastern United States and on the West Coast.
GSA formation has also been linked to schools’
financial capital (i.e., greater economic resources)
and social capital (i.e., larger student enrollment).
Finally, GSAs in the United States are more likely to
be present in schools that have adopted
nondiscrimination policies that include sexual
orientation and in states that have organized
coalitions that advocate for LGBTQ youth.
Gay–Straight Alliances (GSAs)
GSA Member Characteristics
As with any other voluntary school-based
extracurricular activity, GSAs include students and
an adult advisor (typically a teacher or a school
counselor). Given limited sampling frames (e.g.,
studies using convenience samples of a single GSA,
or retrospective reports of young adults), the
demographic makeup of GSAs is relatively
unknown, although research does suggest that GSAs
typically include large numbers of straight
(heterosexual) students. Additional research suggests
that LGBTQ youth who have already disclosed their
sexual orientation or gender identity to others, youth
who do not conform to societal gender norms, and
White youth are more likely to be members of GSAs.
The following paragraphs describe these
characteristics in greater depth.
Given that expectations of heterosexuality and
conformity to binary gender roles and expressions
are still enforced in schools and other societal
institutions via bias-based bullying and harassment,
the probability of a student joining a GSA may
depend on the level of disclosure of his or her sexual
orientation or preferred gender identity to other
students, school personnel, and parents, guardians, or
other family members (e.g., siblings). Thus, it may
be “less risky” for students who have disclosed their
orientation to others at school and home to be
involved in GSAs, whereas those who have not
disclosed this information to others may fear being

“outed” if they attend a GSA meeting or event.
Similarly, youth who are perceived to be LGBTQ
because of their gender expression may already be
the target of sexual orientation– or gender
expression–based bullying or harassment, and
therefore, membership in the GSA is less risky than
for youth who conform to gender norms and are not
read by others as a sexual or gender minority.
Finally, research suggests that youth of color are
less likely to join a GSA compared to their White,
non-Latino counterparts. Several potential
explanations for this disparity in involvement exist,
including that youth of color need to perceive that
they are represented in school-based clubs and other
activities in order to feel like they belong. Thus,
students of color may witness the lack of racial and
ethnic diversity within GSAs and be less likely to
join. In addition, given that the focus of GSAs has
traditionally been on promoting school safety and
well-being for LGBTQ students, LGBTQ youth of
color may need to seek out different clubs and
activities that focus on their salient developmental
needs, such as contexts that foster a sense of ethnic
identity or ethnic pride. A third explanation for this
disparity is the belief that communities of color
conflate LGBTQ sexual and gender identities with
“acting White,” and because the need for peer
belonging and acceptance is particularly salient
during adolescence, LGBTQ youth of color may
avoid GSAs in order to be accepted by their peer
group. Finally, and perhaps most importantly, if
GSAs are predominately White, there may be actual
or perceived barriers that exclude participation by
youth of color in GSAs. Much more research is
needed that examines how the intersection of sexual
orientation and gender expression with race or
ethnicity informs youths’ participation in GSAs, in
addition to factors such as socioeconomic status.
Roles of GSAs
GSAs serve several different roles for students and
their schools, such as providing a safe place for
LGBTQ youth and their straight allies in school
environments that enforce compulsory
heterosexuality and hegemonic masculinity. Because
LGBTQ youth experience relatively high levels of
biasbased bullying, victimization, and harassment at
school, GSAs can and do serve as a place for
1239
LGBTQ youth to gather, have fun, provide support,
and engage in advocacy efforts to increase safety and
decrease bias-based incidents in the school context.
The actual roles and functions of a particular GSA
likely shift over time, depending on the needs of its
members at any given time; for example, support
may be more salient when a student member has
recently disclosed his or her sexual orientation or
gender identity to others and was met with resistance
or rejection. Alternatively, advocacy efforts may be
needed when school policies exclude members of the
LGBTQ student community from student events
(e.g., prom). Lastly, education efforts may be needed
when students or school personnel have little
understanding of sexual orientation or gender
identity and expression. Notably, little research has
been conducted on the variability of how GSAs
spend their resources and time, and the implications
of those roles for student well-being and school
climate.
GSA Contributions to Student and
School Outcomes
Most of the scholarship on GSAs has focused on
understanding whether GSAs promote well-being
among LGBTQ students, and whether the presence
of a GSA or GSA participation protects LGBTQ
students against the harmful contribution of bias-
based bullying, victimization, and harassment to
poor academic and health outcomes. Research on the
benefits of GSA presence in a school and GSA
participation for students is discussed next, with the
caveat that most research in this area is retrospective
or cross-sectional and has not examined the
prospective influence of GSAs on student well-being
or school climate.
Compelling evidence suggests that the presence of
a GSA is associated with more positive student
outcomes, such as greater academic achievement and
fewer psychosocial and behavioral problems (e.g.,
lower suicide ideation and attempts). Further, the
presence of a GSA has also been linked to more
positive school climates for LGBTQ youth (e.g., less
sexual orientation– or gender identity/ expression–
based bullying, victimization, and harassment;
greater school safety). This evidence suggests that
GSAs may positively contribute to the school
environment via efforts to increase education and
1240
awareness of issues related to sexual orientation and
gender identity and expression. At the individual
student level, the presence of a GSA may be
associated with more positive academic and
psychosocial well-being because the mere presence
conveys a message of belonging and acceptance by
the school. Finally, the presence of a GSA may
confirm that there are supportive adults in the school
environment for LGBTQ students, which is a
Gay–Straight Alliances (GSAs)
known promotive and protective factor for all youth,
regardless of their sexual orientation or gender
identity and expression. Although the promotive
nature of GSAs has been well established, findings
pertaining to whether the presence of a GSA protects
against LGBTQ minority stress, such as school-
based bullying, have been mixed: Some findings
suggest that the presence of a GSA does buffer
LGBTQ-related bullying, victimization, or
harassment, whereas others have not found evidence
for such protection.
Relatedly, findings specific to GSA participation
and youth outcomes have been somewhat mixed.
Most of the research focused on GSA participation
has not found that it is related to student academic or
psychosocial well-being or that it protects against
LGBTQ-related bullying, victimization, or
harassment. Many of these studies utilized a
dichotomized report of participation (any
participation versus no participation). Thus, given the
variability that likely exists in membership and actual
levels of participation, it will be important for future
research to capture how varying levels of
participation, ranging from occasional participant to
GSA leader, contribute to youth academic and
psychosocial outcomes.
Russell B. Toomey
See also Bullying, Rates and Effects of; Gay, Lesbian &
Straight Education Network (GLSEN); Resilience and
Protective Factors, Youth; School Climate; Sexualities at
School
Further Readings
Fetner, T., & Kush, K. (2008). Gay–straight alliances in high
school: Social predictors of early adoption. Youth &
Society, 40, 114–130.
Goodenow, C., Szalacha, L., & Westheimer, K. (2006).
School support groups, other school factors, and the
safety of sexual minority adolescents. Psychology in the
Schools, 43, 573–589.
Griffin, P., Lee, C., Waugh, J., & Beyer, C. (2004).
Describing roles that gay–straight alliances play in
schools: From individual support to school change.
Journal of Gay & Lesbian Issues in Education, 1, 7–
22.
Gender Binaries
Kosciw, J. G., Greytak, E. A., Bartkiewicz, M. J., Boesen,
M. J., & Palmer, N. A. (2012). The 2011 National School
Climate Survey: The experiences of lesbian, gay, bisexual
and transgender youth in our nation’s schools. New York,
NY: GLSEN.
Poteat, V. P., Sinclair, K. O., DiGiovanni, C. D., Koenig,
B. W., & Russell, S. T. (2012). Gay–straight alliances
are associated with student health: A multischool
comparison of LGBTQ and heterosexual youth.
Journal of Research on Adolescence, 23, 319–330.
Russell, S. T., Muraco, A., Subramaniam, A., & Laub, C.
(2009). Youth empowerment and high school gay–
straight alliances. Journal of Youth and Adolescence, 38,
891–903.
Toomey, R. B., Ryan, C., Diaz, R. M., & Russell, S. T.
(2011). High school gay–straight alliances (GSAs) and
young adult well-being: An examination of GSA
presence, participation, and perceived effectiveness.
Applied Developmental Science, 15(4), 175–185.
GENDER BINARIES
This entry explores gender binaries, the division of
gender into two discrete and apparently separate
categories of male–female. Unlike the term
dichotomy, the term binary does not attribute a value
to each side of the division. Thus, a gendered
dichotomy is often a way of discussing the
hierarchies that pertain to male–female, although
binaries do assume that there are opposite sides.
Therefore, a gendered binary presumes that men and
women are opposite to each other, but does not
necessarily suggest that one side of the binary is
inferior or superior to the other. This entry will first
outline normative gender binaries before moving on

to explore how these binaries are destabilized. Then,
it will look at how gendered binaries are recreated.
Normative Gender Binaries
Gender binaries are pervasive in our contemporary
society, through what is called the heterosexual
matrix. The heterosexual matrix is used to name the
ways that men and women are made to be opposite
to each other and are meant to come together within
heterosexual relationships, in order to “complete”
themselves.
People often understand themselves and make life
choices on the basis of gender binaries. This can
include embodied aspects of gender such as how
individuals stylize their bodies both to fit into the
gender they understand themselves to be, and also to
be attractive to the “opposite” sex. Gender binaries
can also influence individuals’ academic interests
(including the selection of subjects to be studied),
careers, and household divisions of labor and child
care. This is all based on what women and men
“should” do as complementary opposites.
As the heterosexual matrix makes clear, gender
binaries are the key ways in which not only gender
and sex come into being, but also sexualities.
Without gender binaries, the categories heterosexual,
lesbian, gay, and bisexual would not exist, and
neither would trans identities. For this reason, gender
binaries are central to the contemporary
configurations of our worlds and also the reason that
they have been subject to much political and
scholarly critique and deconstruction.
Challenging Gender Binaries
Once the binary of male–female, man–woman is
seen to be constructed and produced, we can look at
how this is occurring, by whom, and for what ends.
Not only that, but it is also possible to identify how
worlds might be created differently, in ways that
create genders that are less constricted and associated
with normative heterosexualities.
Some scholars and activists have contended that
there are more than two genders (including studies of
third and multiple genders that exist often outside of
dominant groups in the Global North); that
intersexed individuals are often forced into gender
binaries, despite contesting the binaries themselves;
1241
and that trans individuals question the necessary
links between sexed bodies and gendered identities
and lives. Some people are nonbinary, an umbrella
term for those who don’t conform to gender binaries.
These, and other contestations of gender binaries,
have shown gender to be fluid and socially created.
From this, the gender scholar Judith Butler has
argued that we should see gender as performative.
If gender binaries are fluid, then how they are
created is not “natural” or pre-given; instead, they are
produced through actions and power relations. This
conceptualization frees us from having to be either
male or female, and also disrupts sexualities that can
be contained within heterosexual/homosexual
binaries. Bi (bisexual) activists and theorists have
been key in developing critiques of this binary,
insomuch as bi desires, identities, and practices query
the ways that sexual binaries polarize sexual
identities into either heterosexual or homosexual,
and challenge the ways in which gender binaries are
seen to dictate sexual desires.
Recuperating Gender Binaries
Despite the theorization of gender binaries as fluid
and subject to disruption, gender binaries continue to
be pervasive and normalized. The majority of people
conform to, rather than disrupt, gendered binaries.
Indeed, crossing gendered binaries is still
understood as transgression, and those who do not
conform to normative gender roles can be subject to
discrimination, marginalization, and abuse. This
comes in multiple forms including gender bashing
(where people are subject to violence because of
their gendered presentation/enactment) and
genderism (where people are subject to multiple
forms of discrimination and marginalization because
they do not fit into normative gender binaries). Trans
people are often the focus of these discussions, but
gender-nonconforming people also include those
who choose not to define themselves by gender, to
live between genders or as genders other than male–
female. Even where individuals do understand
themselves within particular genders, if these are not
displayed and enacted in the ways that are socially
recognizable and approved, those who do not
conform can also be subject to genderism and gender
bashing. This includes women who are mistaken for
men and effeminate men.
Gender Binaries
1242
By making those who do not conform different,
“other,” and unusual, the gendered binaries of male–
female are recuperated and the norm reestablished.
Although some see transgressions of gender binaries
as “playing” with gender, these recuperations remind
us of how dangerous and physically/emotionally
painful it can be to contest dominant gendered
norms.
However, gender is not only recuperated through
violence, discrimination, and abuse. Trans activists
and theorists have challenged those who see trans
people as contesting gender binaries and rendering
them fluid. They have argued that for many trans
people, gender is not fluid. Rather, their gender is
fixed; it was simply wrongly ascribed at birth (with
some believing that they were born into the “wrong
body”). Thus, trans people can see themselves within
gender binaries as male or female and in this way
recuperate gendered binaries.
Kath Browne
See also Bisexualities; Heteronormativity; Intersexuality;
Nonbinary Genders; Queer; Transgender Identities
Further Readings
Bowes-Catton, H. (2007). Resisting the binary:
Discourses of identity and diversity in bisexual
politics 1988–1996. Lesbian and Gay Psychology
Review, 8(1), 58–71.
Browne, K. (2004). Genderism and the bathroom problem:
(Re)materialising sexed sites, (re)creating sexed bodies.
Gender, Place & Culture, 11(3), 331–346.
Butler, J. (1990). Gender trouble: Feminism and the
subversion of identity. New York, NY: Routledge.
Doan, P. L. (2010). The tyranny of gendered spaces—
Reflections from beyond the gender dichotomy. Gender,
Place & Culture, 17(5), 635–654.
doi:10.1080/0966369X.2010.503121
Namaste, V. K. (2000). Invisible lives: The erasure of
transsexual and transgendered people. Chicago, IL:
University of Chicago Press.
Nestle, J., Howell, C., & Wilchins, R. (2002). Gender
queer: Voices from beyond the sexual binary. New
York, NY: Alyson Books.
Gender Clinics
GENDER CLINICS
Gender-variant persons—that is, persons whose
gender expression does not match the sex that was
assigned at birth—may require or feel more
comfortable with specialized health, social, and legal
services that are tailored to their unique gender
needs. In some countries and some U.S. states, a
variety of services are offered together, such as in an
integrated gender clinic. In other locations, services
are separated by type, or are offered within other
existing frameworks such as by a primary care
provider or housing authority. This entry summarizes
briefly the history of service provision for trans
persons and describes the existing service structures
internationally, as well as specifically within the
United States.
History of Gender Clinics
In the early 1900s, medical experimentation for
gender reassignment surgeries (GRSs) began first on
animals. There are some concurrent reports of
individuals (then labeled “inverts”) in the United
States and Europe requesting and receiving surgeries
such as removal of testicles, breasts, or uteri, but the
surgeries were not labeled as GRS. Until 1933, GRS
was developed and practiced on humans mostly
based in the Institute of Sexual Science in Berlin,
until the institute was looted in May 1933 by the
National Socialist Party police and Nazi student
groups. There are a few reports of continuing
surgeries in Europe (Norway and Denmark) during
WWII, but more commonly gender-variant persons
were prosecuted and subjected to experimentation
under Nazi rule. After the war, clinics outside of
Germany moved to prominence in providing GRS. In
the 1940s, treatments began to include hormones;
legal alterations of name or sex; and an
understanding that sex transition was an element of
one’s identity, or sense of self, rather than simply a
feature of sexuality. Throughout the 1940s and
1950s, U.S. treatments were more focused on
hormonal approaches. During this time, grassroots
organizations to support trans persons in the United
States began to develop. In the 1960s, U.S. surgical
centers began
to provide GRS. Over time, a number of
nonEuropean countries have also served historically
important roles in providing GRS, including a

French-run clinic in Casablanca, Morocco, and
programs in Thailand. Clinics across Europe and in
Australia and Canada have continued to develop as
integrated programs with team-centered systems of
care, and these have in many ways defined treatment
protocols for adults, adolescents, and children.
Notably, clinics in the Netherlands, United Kingdom,
Canada, and Belgium have played active roles in
developing standards of care for trans persons
worldwide.
International Clinics
Given the divergent evolution of services between
international and U.S. contexts, it is not surprising
that structural differences exist today in the ways that
services are provided. In contexts where medical and
psychological care is covered through nationalized
insurance programs, as in much of Western Europe,
Australia, Canada, and some Asian countries, clinics
have developed that provide assessment and
diagnosis, and hormonal, psychological, and surgical
care all in one integrated system. In most of these
countries, as well as many others throughout the
world, treatment for gender dysphoria—that is, the
condition of feeling one’s emotional and
psychological identity as male or female to be
opposite to one’s biological sex—is covered by
medical insurance, and treatment decisions are made
collaboratively with an individual and a team of
treatment providers. At the time of this writing, there
are at least 40 clinics worldwide (not in the United
States) that provide different constellations of
gender-related care. Some clinics provide services
that are only accessible for those living in that
country, and as such may have a low profile
internationally, such as those in Cuba and Iran. Other
clinics are more surgically specific and cater to
international “medical tourists,” like the multiple
clinics in Thailand. The European, Canadian, and
Australian clinics offer far more comprehensive
Gender Identity Discrimination as Sex Discrimination
services including psychological support, hormone
therapy, individual and group therapy, and HIV
support, and some even provide speech and language
therapy and body hair removal.
1243
United States Clinics
In the United States, care systems vary considerably
by locality, and individual medical care is often
funded by the individual gender-variant person and
occasionally by third-party insurers or government
systems. Some clinics function in an integrated
manner, but most individuals also have the
possibility of non-clinic-based providers for things
like hormonal and psychological care. Services like
name change support, housing support, and other
anti-discrimination support may be provided in the
same context where HIV testing
and hormonal care are provided. Currently, at least
45 unique treatment centers advertise varying
constellations of medical transgender support
services for children, adolescents, and adults.
Services provided include things like trans-positive
primary care, behavioral health support,
gynecological services, hormones, HIV support, and
family planning, and in some cases other services
such as support for victims of violence, a name
change clinic, acupuncture, and hair removal. Most
do not provide GRS services, but may refer
individuals and provide preoperative and
postoperative care. In countries with limited or
expensive GRS options, such as the United States,
individuals may opt to travel for surgical care to a
country that allows nonresidents to seek surgery at a
price cheaper than the home country. Thailand and
Belgium are both countries that currently accept
nonresidents for surgical gender-reassignment
procedures.
Jenifer K. McGuire
See also Therapy With Transgender, Transsexual, and
Gender-Nonconforming People; Transgender Health
Care; Transgender Identities; Transgender Youth and
Cross-Sex Hormones; Transgender Youth and Puberty
Suppression
Further Readings
Cohen-
Kettenis,
P. T., Delemarre-van de Waal, H. A., & Gooren, L. J.
(2008). The treatment of adolescent transsexuals:
Changing insights. Journal of Sexual Medicine, 5(8),
1892–1897.
Pleak, R. R. (2011). Gender-variant children and
transgender adolescents. Child and Adolescent
Psychiatric Clinics of North America, 20(4), xv–xx.
1244
Stryker, S. (2009). Transgender history. Berkeley, CA: Seal
Press.
University of California, San Francisco. Center of
Excellence for Transgender Health. http://transhealth
.ucsf.edu/
World Professional Association for Transgender Health.
http://www.wpath.org/
GENDER IDENTITY AND PREGNANCY
See Masculinity and Pregnancy
GENDER IDENTITY DISCRIMINATION AS
SEX DISCRIMINATION
Federal and state law in the United States prohibit
sex discrimination in employment, education,
housing, places of public accommodation, and other
settings. Sex discrimination is discrimination
motivated by a person’s sex or gender. This entry
discusses the idea that courts and governmental
entities charged with enforcing anti-discrimination
laws in the United States are increasingly concluding
that prohibitions on sex discrimination prohibit
discrimination motivated by an individual’s gender
identity or expression. Before describing this trend,
this entry discusses some background concepts, the
prevalence of discrimination against transgender and
gender-nonconforming individuals, and the status of
laws explicitly prohibiting discrimination on the
basis of gender identity or expression.
Generally in the context of anti-discrimination
Gender Identity Discrimination as Sex Discrimination
law, “sex” refers to a person’s biological status and is
typically categorized as male or female. “Gender”
refers to the behaviors and characteristics that society
delineates as masculine or feminine and typically
associates with one sex but not the other. “Gender
identity” refers to a person’s innate psychological
identification as male, female, transgender, or other
gender. “Gender expression” refers to the ways in
which people express or represent their gender
identity, such as mannerisms, clothing, and
grooming. Broadly speaking, “transgender”
individuals’ gender identity or expression is different
from those typically associated with the sex assigned
to them at birth. Each of these concepts is distinct
from sexual orientation, which refers to sexual and
romantic attraction.
The best available data indicate pervasive and
persistent discrimination against individuals who are
transgender or do not conform to gender norms. For
example, in the U.S. National Transgender
Discrimination Survey, 78% of respondents reported
harassment, mistreatment, or discrimination on the
job; 47% reported an adverse employment outcome,
such as being fired, not hired, or not promoted; 19%
reported being refused a home or apartment; 11%
reported eviction; and 53% reported verbal
harassment and disrespect at public accommodations,
such as hotels, restaurants, buses, airports, and
government agencies. Analyses of complaints filed
with administrative agencies charged with enforcing
anti-discrimination laws also indicate widespread
discrimination based on gender identity and
expression, as do compilations of specific instances
of such discrimination.
As of 2015, a total of 19 states, the District of
Colombia, and numerous localities explicitly
prohibit, by statute, discrimination on the basis of
one’s gender identity or expression in private and
public employment. The federal government and 31
states do not. A similar number of jurisdictions
prohibit/do not prohibit these types of discrimination
in other settings such as housing and public
accommodations. For many years, Congress has
considered, but not enacted, federal legislation to
prohibit gender identity discrimination in
employment (recently known as the Employment
Non-Discrimination Act). In 2015, a bill was
introduced in Congress—the Equality Act—that
would prohibit gender identity discrimination in not
only
employment but also the other settings reached by
existing anti-discrimination laws. At the federal level
and in five states without explicit statutes, executive
orders or other nonstatutory laws prohibit gender
identity discrimination in public (but not private)
employment. In addition, in 2014, President Barack
Obama issued an executive order prohibiting federal
contractors from discriminating on the basis of
gender identity.

While federal and many state statutes do not
explicitly enumerate gender identity or expression as
prohibited forms of discrimination, federal and state
law do prohibit sex discrimination in a variety of
settings. Unlawful sex discrimination includes, for
example, denying someone a promotion, an
apartment, or schooling because she is a woman or
he is a man. Courts—including the U.S. Supreme
Court in Price Waterhouse v. Hopkins (1989)—have
clarified that sex discrimination includes gender
discrimination, such as penalizing or harassing
someone for not conforming to gender stereotypes.
In other words, in the employment context, for
example, gender must be irrelevant to employment
decisions (except in narrow exceptions), and
employers cannot consider gender-based norms,
stereotypes, expectations, or preferences in making
employment decisions. Even before Price
Waterhouse, the Supreme Court invalidated laws
resting on or perpetuating sex or gender stereotypes.
Nonetheless, for many years courts consistently
rejected sex discrimination claims brought by
transgender or gender-nonconforming individuals,
concluding that they had been discriminated against
because they were transgender or gay and that those
forms of discrimination were not prohibited. These
courts often conflated gender identity and expression
with sexual orientation. However, following Price
Waterhouse and as our understanding of gender and
transgender people has increased, a growing number
of courts, administrative bodies, and government
agencies are concluding, in both constitutional and
statutory contexts, that sex discrimination includes
discrimination based on an individual’s gender
identity or expression, including transition from one
gender to another, identification as transgender, or
nonconformity with gender norms. As the court in
Glenn v. Brumby (2011) reasoned, “the very acts that
define transgender people as transgender are those
that contradict stereotypes of gender- appropriate
appearance and behavior.”
Most courts and governmental entities that have
interpreted existing sex discrimination protections to
cover discrimination based on gender identity or
expression have relied on a gender stereotyping
theory—that transgender and gendernonconforming
individuals are protected from discrimination based
on their deviation, or perceived deviation, from
gender stereotypes. However, in Macy v. Holder
(2012), the U.S. Equal Employment Opportunity
1245
Commission clarified that a person facing gender
identity or expression discrimination may—but need
not—rely on evidence of gender stereotyping. The
ultimate question is whether sex or gender was a
motivating factor in the discrimination. Thus, for
example, a transgender job applicant may prove sex
discrimination with evidence that her prospective
employer was willing to hire her when the employer
thought she was a man, but was unwilling to hire her
once discovering she was now a woman, regardless
of whether the employer acted upon gender
stereotypes.
Adam P. Romero and Brad Sears
See also Employment Non-Discrimination Act (ENDA);
Gender Transition at Work; Housing, Protection
Against Discrimination in; Nondiscrimination
Protections, State and Local; Sexual Orientation
Discrimination as Sex Discrimination; Workplace
Discrimination
Further Readings
Pizer, J. C., Sears, B., Mallory, C., & Hunter, N. D. (2012).
Evidence of persistent and pervasive workplace
discrimination against LGBT people: The need for
federal legislation prohibiting discrimination and
providing for equal employment benefits. Loyola of Los
Angeles Law Review, 45, 715–779.
Rao, D. (2013). Gender identity discrimination is sex
discrimination: Protecting transgender students from
Gender Nonconformity, Youth
bullying and harassment using Title IX. Wisconsin
Journal of Law, Gender & Society, 28, 245–269. Sears, B.,
Hunter, N. D., & Mallory, C. (2009). Documenting
discrimination based on sexual orientation and gender
identity in state employment. Los Angeles, CA: Williams
Institute. Retrieved October 22, 2015, from
http://williamsinstitute.law.ucla.edu/
research/workplace/documenting-discrimination-on-thebasis-
of-sexual-orientation-and-gender-identity-instate-
employment/
Turner, I. M. (2007). Sex stereotyping per se: Transgender
employees and Title VII. California Law Review, 95,
561–596.
GENDER NONCONFORMITY, YOUTH
1246
There are many terms for referring to
gendernonconforming youth, that is, young people
whose gender identity or gender expression falls
outside of a heteronormative man–woman gender
binary. These include terms that are more or less
politicized, such as agendered, dual gender, gender
fluid, intergender, genderqueer, and transgender; as
well as psychomedical terms such as gender
dysphoric and gender disordered; and terms that
perhaps seek a more neutral position such as gender
diverse, gender variant, and gender nonconforming.
Many of these terms are also used by, or about,
adults. A key advantage of the term gender
nonconformity, in relation to children and young
people, is its relative neutrality and nonjudgmental
tone: This term allows us to avoid the politicized and
medicalizing connotations of terms like trans youth.
This entry will address issues of emotional distress,
psychiatric diagnosis, and therapeutic interventions,
as well as young people’s own experiences and ways
of identifying.
Gender Nonconformity and Mental Illness
Gender nonconformity among youth has become a
research topic and a politicized issue largely in
relation to the psychiatric classification of gender
identity disorder in 1994 in the fourth edition of the
Diagnostic and Statistical Manual of Mental
Disorders (DSM). This has now been relabeled as
Gender Nonconformity, Youth
gender dysphoria in the fifth edition of the DSM,
which was published in 2013. The move, in 1994, to
establish the diagnostic category Gender Identity
Disorder in Childhood prompted critical responses
from researchers who saw this as a move to
pathologize diversity. Critics mindful of such
categorizations are wary of pathologizing diversity in
general, and particularly concerned about
pathologizing the gender diversity that is expressed
by children and young people. Critiques have been
specifically directed to therapeutic approaches that
aim to guide children and young people toward
heteronormative, binary gender expression.
Particular concern has been raised about the extent to
which this normalizing kind of therapeutic work
effectively polices the gendered behavior and
identity of boys who could possibly later emerge as
gay or bisexual. It is not uncommon for gay and
bisexual people to recall gender-nonconforming
childhoods.
Historically, the focus of gender normalizing
therapeutic efforts has been on boys who prefer
feminine ways of being, although the diagnostic
category applies to both boys and girls, and
contemporary treatment approaches work with both.
In previous decades, research with
gendernonconforming boys focused on what
proportion of them later came to identify as
transsexual, gay, or bisexual. Parallel studies were
not done on girls, and girls’ gender nonconformity
has tended not to cause the same degree of cultural
anxiety as that of boys.
Pivotal psychological publications authored by
Richard Green, Kenneth Zucker, and Susan Bradley,
among others, are examples of research that has been
critiqued for being pathologizing toward gender-
nonconforming children and youth. Such work
focused primarily on boys’ gender expression and
identity. Key critiques have included work by Karl
Bryant, who provides an incisive historical analysis
of the production of gender identity, and by Susan
Langer and James Martin, whose tonguein-cheek title
“How Dresses Can Make You
Mentally Ill” captures the simultaneous incredulity
and seriousness with which the psychiatric diagnosis
of gender-nonconforming children and youth has
been met by critics.
Early Gender Reassignment
While the earlier impetus was for psychological
“correction” of gender nonconformity, more recent
years have seen the development of attempts to
facilitate early transition (i.e., gender reassignment)
for a selected group of gender-nonconforming youth.
This is physical transition that can begin in early
puberty (e.g., around the age of 11) with hormonal
blockers to halt the progress of pubertal
development, then transition can proceed with cross-
sex hormones from the age of 16 and surgical
reassignment from the age of 18 years. The process
of selecting which gender-nonconforming youth may
access these interventions is guided by DSM criteria
but has been developed within specialist centers. The
clinic led by Peggy Cohen-Kettenis in Amsterdam,
the Netherlands, has been the most prolific at

publishing information about early reassignment and
the outcomes of this kind of intervention. While this
is the very kind of health care that some trans adults
have been arguing for (i.e., health care by
professionals who acknowledge the psychological
pain that pubertal changes can bring when one feels
completely at odds with one’s assigned sex), this
kind of care necessarily only reaches a select few,
and the way it is presented has raised some concerns.
Most likely, it only reaches those who happen to live
in geographic regions where such intervention is
available, who happen to have parents willing to
support them in seeking intervention, and who are
sufficiently articulate and convincing to pass through
diagnostic and screening processes. Other gender-
nonconforming youth are less likely to find tailored
support available to them as they navigate their way
through the years of their lives when their family’s
and peers’ tolerance for their gender nonconformity
may become dramatically reduced.
Youth Experiences and Identities
Gender nonconformity among children is relatively
popularly accepted as a phase that will be passed
through, and there are terms such as sissy boy and
tomboy pointing to the wider societal
acknowledgment that this exists as a childhood
phenomenon. Gender-nonconforming youth,
however, repeatedly report that any tolerance they
experienced from others during childhood lessens
dramatically as they enter their teens and are
expected to begin performing explicitly
heteronormative roles, in terms of gender expression,
gendered interests, and romantic attractions.
Among some contemporary youth, the use of
concepts such as genderqueer and trans* currently
opens an array of identificatory possibilities that
would make it foolhardy to try and measure
percentagewise what proportion of gender-
nonconforming children later come to identify within
any fixed sexuality or gender identity. Rather, what
we now see (in some urban centers and Internet-
based groups) is a movement to create a fluid and
diverse range of gendered possibilities that challenge
both the binary man–woman system as well as the
very assumption that one must ultimately identify
within any category at all. The term genderqueer
suggests a critical perspective on identification
within the man–woman binary. The term trans*
1247
allows for diverse identifications that do not presume
to fit within categories such as man, woman, or
transsexual, but that do suggest a fluid or
transgressive approach to gender categories. While
some young people respond to the
psychomedicalization of their gender nonconformity
and their feeling of being at odds with their sexed
development by embracing the opportunity of early
transition, other young people respond with an
articulate, politicized rejection of the very
frameworks of meaning that surround gendered
expectations and gender identity.
Alternative Therapeutic Approaches
Almost in step with these more recent developments,
some health professionals have been speaking out,
offering alternative approaches to working with
gender-nonconforming youth. Some scholars, such
as Bernadette Wren, bring feminist poststructuralist
thinking about gender to working with gender-
nonconforming youth, highlighting the importance of
not foreclosing questions of identity. Some health
professionals, such as Edgardo Menvielle, take an
inclusive
Gender Nonconformity, Youth
approach to supporting a diverse range of children,
youth, and families, using face-to-face and online
support groups, and allowing for a celebration and
acceptance of gender nonconformity, rather than
seeking solutions that involve fixing gender (or
fixing the body). Other explicitly nonpathologizing
approaches to gender nonconformity have been
written about by therapists; for example, Diane
Ehrensaft, who has proposed an alternative
taxonomy of gender among children, including terms
like transgender children, gender-fluid children,
gender Priuses, gender Tauruses, protogay children,
and prototransgender youth.
Another interesting contribution of Diane
Ehrensaft has been to point to the severe difficulties
faced by gender-nonconforming children and youth
whose parents are passionately and determinedly
against gender nonconformity. She raises the topic of
emotional abuse by parents to point to the
seriousness of the situation faced by some gender-
nonconforming youth in unsupportive families, and
this would seem to be an important topic to be
1248
explored further. It seems likely that existing
research has focused heavily on youth whose
families are sufficiently resourced and invested in
their well-being to at least seek psychological
support, whereas the larger pool of
gendernonconforming youth are undoubtedly not
living in such families, do not have access to such
support, and may be facing situations of severe
emotional abuse.
Ongoing debates about how to understand gender
nonconformity among youth, and how to best work
with gender-nonconforming youth, have been
explored in two recent special issues of journals. The
first of these is edited by Richard Pleak, who
explains that the articles in the special issue work
with the terms cross-gender, gender variant, gender
atypical, and gender nonconformity, which may be
viewed as equivalent in that context. The second
special issue, edited by Jack Drescher and William
Byne, is published by the Journal of Homosexuality
and includes papers by some of the key
commentators in this field, as well as an analysis of
their underpinning conceptual frameworks.
Gender Spectrum
Distress and Resourcefulness
The fact that a proportion of gender-nonconforming
children and youth face substantial psychological
distress has been used as an argument for
maintaining Gender Dysphoria in the DSM as a
classification used specifically for children and
adolescents. Yet psychological research suggests that
the distress tends not to be caused by the gender
nonconformity itself. Instead, it has been shown that
psychological distress stems from the social
pressures that children and young people are under to
conform to gender norms. Children who are
supported and encouraged to express themselves
freely, including expressing gender-nonconforming
interests, are less likely to manifest the levels of
distress that would warrant a psychiatric diagnosis.
This point is relevant for children, but in instances
where gender nonconformity persists beyond
childhood, and includes distress about the sexually
developing body, the situation is quite different. This
is where early physical interventions come into play
for some gender-nonconforming youth.
Research on trans* or gender-nonconforming
youth points clearly to the alarming emotional
consequences of refusing or failing to fit in with
gender norms: Studies on bullying, abuse, self-harm,
and suicidality paint a consistent picture of
gendernonconforming youth being much more likely
to suffer in these ways than their gender-normative
and heteronormative peers. At the same time, it is
important to avoid a stigmatizing, risk-oriented
approach. It is worth recognizing the substantial
(face-to-face and online) community building that is
being done among gender-nonconforming youth,
as well as their creativity and resourcefulness.
Katrina Roen
See also Gender Binaries; Genderqueer; Therapy With
Transgender, Transsexual, and Gender-Nonconforming
People; Transgender and Gender-Nonconforming
Individuals and Bathrooms; Transgender and
Gender-Nonconforming Youth and the Legal System;
Transgender and Gender-Nonconforming Youth of
Color; Transgender Identities; Transgender Youth and
Cross-Sex Hormones; Transgender Youth and Family
Relationships; Transgender Youth and Well-Being
Further Readings
Bryant, K. (2006). Making gender identity disorder of
childhood: Historical lessons for contemporary debates.
Sexuality Research & Social Policy, 3(3), 23–39.
Drescher, J., & Byne, W. (2012). Introduction to the
special issue on “The treatment of gender dysphoric/
gender variant children and adolescents.” Journal of
Homosexuality, 59(3), 295–300.
Ehrensaft, D. (2011). Boys will be girls, girls will be boys:
Children affect parents as parents affect children in
gender nonconformity. Psychoanalytic Psychology, 28(4),
528–548.
Green, R. (1987). The “sissy boy syndrome” and the
development of homosexuality. New Haven, CT:
Yale University Press.
Lev, A. I. (2004). Transgender emergence: Therapeutic
guidelines for working with gender-variant people and
their families. New York, NY: Haworth.
Menvielle, E. (2012). A comprehensive program for children
with gender variant behaviors and gender identity
disorders. Journal of Homosexuality, 59(3), 357–368.
Pepper, R. (Ed.). (2012). Transitions of the heart: Stories of
love, struggle and acceptance by mothers of transgender
and gender variant children. Berkeley, CA:
Cleis Press.
Pleak, R. R. (2011). Gender-variant children and
transgender adolescents. Child and Adolescent
Psychiatric Clinics of North America, 20(4), xv–xx.

Zucker, K., & Bradley, S. (1995). Gender identity disorder
and psychosexual problems in children and adolescents.
New York, NY: Guilford.
GENDER SPECTRUM
This entry examines the complex nature of gender.
Rather than a rigid, binary concept grounded in
biology, it presents a model for understanding gender
that incorporates a spectrum of characteristics,
including an individual’s sex, gender expression, and
gender identity. In the process, a more nuanced
understanding of this core aspect of self emerges,
accounting for each person’s unique gender
experiences.
Beyond Biology
When someone has a baby, the question most
frequently asked is “Is it a boy or a girl?” This
seemingly innocent query reinforces the ubiquitous
notion of the binary gender system, which rests on
two deeply held, but nonetheless flawed
assumptions: that gender is binary, and that this core
aspect of self is biologically determined. Rarely
challenged, this notion has a significant and costly
consequence. Not only are individuals who fail to
meet narrowly defined criteria frequently
marginalized, but society as a whole risks losing
access to the potential contributions of many of its
members as they choose or are needlessly forced to
cast off aspects of themselves to fit narrowly
prescribed expectations.
The binary gender system typically conflates
“gender” and “sex.” One’s sex includes physical
attributes such as external genitalia, sex
chromosomes, gonads, sex hormones, and internal
reproductive structures. At birth, this “biology of
gender” is used to answer the “boy or girl?” question.
For many, this is cause for little or no dissonance. By
default, most environments are designed around this
simplistic model. However, beyond typically “male”
or “female” bodies, there are naturally occurring
conditions (often referred to as “intersex”) that occur
in all species, including humans. Rather than just two
distinct boxes, sex exists across a continuum of
anatomical variation that by itself should be enough
1249
to discredit the simplistic notions of a binary gender
system.
Yet gender is neither inherently nor solely
connected to one’s physical anatomy. Gender
biology (sex) and gender are not one and the same.
Beyond anatomy, there are multiple dimensions
influencing gender. Put simply, gender is the
complex interrelationship between an individual’s
sex (gender biology); one’s internal sense of self as
male, female, or something else (gender identity);
and one’s outward presentation and behavior (gender
expression) related to that perception. In turn, each of
these can be independently characterized across a
range of possibilities.
Gender Spectrum
Gender Identity:
Can You See the Real Me?
Beyond biology, another dimension of gender is
gender identity, which can be defined as an
individual’s deeply held sense of self as male,
female, or another gender altogether. Most people
have an early sense of their gender identity, and if it
is not congruous with their anatomical sex, they may
begin voicing this between the ages of 2 and 4. If
you ask individuals when and how they recognized
themselves as male or female (or perhaps something
else), most will reply that they have simply always
known. This core aspect of one’s identity is
internally driven. Gender identity is believed to be an
inherent aspect of a person’s makeup, most likely
formed in the brain. A variety of factors, such as
prenatal hormonal exposure, neurogenital
development, and environmental influences, may
play a part in its formation, but most agree that one’s
gender identity is determined prior to birth.
Individuals do not choose their gender identity;
rather, gender identity emerges from within.
Gender Expression
The third dimension of gender is gender expression,
which can be defined as the way we show our gender
to the world around us. Given the prevalence of the
binary gender system, children face great pressure to
conform to narrow definitions of “boy” or “girl.”
Expectations around gender expression are taught to
us from the moment we are born. Social constructs
of gender are communicated through every aspect of
1250
our lives, including family, culture, peers, schools,
community, media, and religion.
Like other social constructs, gender expression is
closely monitored and reinforced by society.
Practically everything is assigned a gender—toys,
colors, clothes, and activities are some of the more
obvious examples. Through a combination of social
conditioning and personal preference, by age 3, most
children prefer activities and exhibit behaviors
typically associated with their sex. Accepted social
gender roles and expectations are so entrenched in
our culture that most people
Gender Spectrum
cannot imagine any other way. As a result,
individuals fitting neatly into these expectations
rarely if ever question what gender really means.
They have never had to, because the system has
worked for them.
But children who express gender in ways that
transgress these social norms often have a very
different experience. Boys seen as feminine at any
age, and girls thought to be too masculine (especially
as they move into their teens), face a variety of
challenges. Pressures to conform at home,
mistreatment by peers in school, and condemnation
by religious or other institutions are just some of the
difficulties facing a child whose expression does not
fall into line with the binary gender system. For
many young people, whether typical in their
presentation or not, gender expression is the most
immediately experienced aspect of gender, impacting
them in most if not all of their interactions with
others.
Yet norms around gender expression change
across societies and over time. One need only
examine the history related to men wearing earrings
or women sporting tattoos to quickly see the
malleability of social expectations about gender.
Even the seemingly intractable “pink is for girls, blue
is for boys” notions are relatively new. It is well
documented that not until the mid–20th century were
notions of pink for girls and blue for boys so firmly
ensconced.
Gender Versus Sexual Orientation
One final distinction to make is the difference
between gender and sexual orientation, which are
often incorrectly conflated. When someone’s gender
expression or identity is perceived to be inconsistent
with others’ expectations, the person is frequently
assumed to be gay. But gender is about who we are,
and sexual orientation is about our physical,
emotional, or romantic attractions to others. Sexual
orientation is a distinct aspect of self. Why is it so
critical to distinguish these two notions?
First of all, they are simply different, and accuracy
of language is critical as we discuss issues of
identity. Further, it is not uncommon to “read” a
young person’s gender expression and assume it tells
us something about his or her sexual orientation. The
boy who loves to play princess is assumed to be gay,
and the adolescent girl who buys clothes in the boys’
section and favors a short haircut must be a lesbian.
These are faulty conclusions. What someone plays
with, or wears, or does is about gender expression,
not orientation. Finally, when we think about gender
identity as sexuality, we are attaching a meaning that
may well have nothing to do with the young person’s
authentic assertion of self. This error, however, can
have significant impact on the manner in which
others interpret the child’s gender identity or
expression.
Gender in 3-D
Alone, each dimension of gender challenges the
binary model so common in many cultures. But
when considered as a whole, the diversity of gender
truly unfolds. Just as three dimensions of space
provide a more detailed landscape for understanding
physical objects, the three dimensions of gender
provide a much richer model for exploring this
misunderstood concept. When thinking about gender,
it is the interaction of the three dimensions that really
captures gender’s complexity.
For many individuals, gender is “aligned.” That is,
gender biology (assigned gender), gender expression
(presentation of gender), and gender identity (internal
sense of self) line up. An adjective sometimes used
to capture this alignment is cisgender. The prefix cis-
comes from Latin and means “on the same side as”
or “on this side of.” While perhaps the most common
pattern, even within this arrangement there is
tremendous room for variation. Nonetheless, the term
cisgender is an important one in that it names the
dominant experience, rather than simply assuming it
to be the default or “normal” way to be.
 1251
However, being cisgender is not the only own identity and expression. Some individuals do
description available for capturing individual not identify with being either male or
experiences of gender. Another possibility is for Gender Spectrum
biology and identity to line up, but for expression to
be seen as inconsistent. A child assigned and
female; others identify as a blend of both; while still
identifying as female who is seen by those around
others identify with a gender, but express their
her to gravitate toward the masculine is often
gender in ways that differ from stereotypical
referred to as a “tomboy.” A child assigned and
expectations. A gender-expansive person’s
identifying as male who is seen by those around him
preferences and self-expression may fall outside
to gravitate toward the feminine has no comparable
commonly understood gender norms within his or
name.
her own culture; or the person may be aligned with
These two young people may well face drastically
them even as his or her internal gender identity
different experiences as they grow up. Particularly
doesn’t align with the sex assigned at birth.
when young, a tomboy is sometimes celebrated by
This diversity of gender is a normal part of the
the adults around her, and the term tomboy is not
human experience, across cultures and throughout
necessarily negative. However, there is no widely
history. Nonbinary gender diversity exists all over
used positive or neutral term for a child assigned
the world, documented by countless historians and
male who is perceived to be feminine in some way.
anthropologists. Examples of individuals living
Pejorative words that immediately come to mind in
comfortably outside of typical male–female
the form of schoolyard taunts are “faggot,” “sissy,”
expectations or identities are found in every region of
“homo,” or “gay.” Though the norms for expression
the globe. The calabai and calalai of Indonesia,
that are seen as “male” or “female” are artificially
twospirit Native Americans, and the hijra of India all
created, many are nonetheless deeply invested in
represent more complex understandings of gender
making sure they are adhered to.
than allowed for by a simplistic binary model. Put
Finally, some individuals are labeled as a
simply, gender expansiveness as a concept
particular sex based on biology while identifying as
recognizes that it is society’s narrow perceptions of
the “other” gender. Where cisgender refers to
gender and the consequent limitations it imposes that
someone whose identity is “on the same side as”
must be questioned, rather than the individuals who
their assigned sex, transgender refers to someone
don’t conform to them.
whose identity is “across from” their assigned sex.
Expression for transgender individuals can be
anywhere along the spectrum. There are transgender Gender Spectrum: The Organization
individuals who express gender in very stereotypical
These expanded notions about gender inform the
ways, and others who do not. In part, this may be
work of Gender Spectrum, an organization whose
about preferences, and in part this may be indicative
mission is the creation of gender-inclusive spaces for
of the context in which they find themselves. In other
all children and teens. Recognizing the limitations
words, a transgender boy may wear skirts and
and pressures that the binary gender system places
blouses because the people around him will not allow
on young people, its work takes place in four distinct
a more typically masculine style. However, he may
ways: (1) Through education and training, they work
also simply prefer to dress this way.
with schools and other organizations to build their
capacity to support the gender diversity of every
Beyond the Binary: child. (2) They provide direct services to parents and
About Gender Expansiveness caregivers through support groups, resources, and
consultations. (3) Each year, the Gender Spectrum
Gender expansive is an umbrella term used for Conference brings these two elements together for a
individuals who broaden commonly held definitions weekend of learning and engagement for families,
of gender, including its expression, associated professionals, and young people of all ages. (4)
identities, and other perceived gender norms, in one Finally, the organization seeks to lead a deeper
or more aspects of their life. These individuals
expand common definitions of gender through their
1252
conversation about the evolving understandings of
gender and how it affects young people.
Gender Transition at Work
Conclusion
The multidimensional model presented here provides
a far more dynamic way to think about the complex
subject of gender. Instead of the static, binary model
produced through a solely physical understanding of
gender, a far richer tapestry emerges with
recognition of gender as the intersection of biology,
expression, and identity. Quite simply, the gender
spectrum represents a more nuanced and accurate
model of the diversity of human gender, affirming
each person’s unique and authentic experience of this
core aspect of self.
Joel Baum
See also Cisgenderism; Gender Binaries; Gender
Nonconformity, Youth; Genderqueer; Intersexuality;
Masculinity Stereotypes; Nonbinary Genders;
Transgender Identities; Transgender Youth and
Well-Being
Further Readings
Ainsworth, C. (2015). Sex redefined. Nature, 518, 288–291.
Brill, S. A., & Pepper, R. (2008). The transgender child: A
handbook for families and professionals. San Francisco,
CA: Cleis Press.
Ehrensaft, D. (2011). Gender born, gender made: Raising
healthy gender-nonconforming children. New York, NY:
The Experiment.
Hidalgo, M. A., Ehrensaft, D., Tishelman, A. C., Clark, L. F.,
Garofalo, R., Rosenthal, S. M., et al. (2013). The gender
affirmative model: What we know and what we aim to
learn. Human Development, 56, 285–290.
Kennedy, N. (2012). Transgender children: More than a
theoretical challenge. Graduate Journal of Social
Science, 7(2).
Kosciw, J. G., Greytak, E. A., Palmer, N. A., & Boesen, M. J.
(2014). The 2013 National School Climate Survey: The
experiences of lesbian, gay, bisexual and transgender
youth in our nation’s schools. New York, NY: GLSEN.
Marksamer, J., Spade, D., & Arkles, G. (2011). A place of
respect: A guide for group care facilities serving
transgender and gender non-conforming youth. San
Francisco, CA: National Center for Lesbian Rights and
Sylvia Rivera Law Project.
Toomey, R. B., Ryan, C., Diaz, R. M., Card, N. A., &
Russell, S. T. (2010). Gender-nonconforming lesbian,
gay, bisexual, and transgender youth: School
victimization and young adult psychosocial adjustment.
Developmental Psychology, 46(6), 1580–1589.
GENDER TRANSITION AT WORK
This entry outlines the key issues that transgender
individuals may encounter when undergoing a
gender transition in their place of employment. It
explains motivations for starting a gender transition
at work and elucidates potential trajectories of this
experience, including reactions from coworkers and
institutional ramifications. The entry then discusses
identity management strategies that transgender
employees may use with their colleagues and some
logistical “nuts and bolts” related to the gender
transition process. The entry concludes with
strategies for employers to facilitate gender transition
at work.
Transgender Workplace Experiences
Transgender is an umbrella term used to capture a
range of gender identities, such as gender
nonconforming, transsexual, male-to-female (MtF),
female-to-male (FtM), cross-dresser, or genderqueer.
In contrast, people whose assigned birth sex matches
with their gender identity are described as cisgender.
Though most research on workplace climate has
focused on the experiences of cisgender lesbian, gay,
and bisexual people (LGB), a growing body of
literature is beginning to attend to the experiences of
transgender employees.
Parallel to studies with LGB participants, research
on workplace climates for transgender employees
find that jobs often feel “chilly,” as a result of
transphobia from coworkers. Only a few studies have
focused specifically on transgender employees, but
this available research has highlighted that
transgender individuals face a high prevalence of
prejudice, discrimination, and harassment at work,
and at the very least, almost all individuals who
come out as transgender are treated differently after
their disclosure. One largescale national study by

Jaime Grant and colleagues reported that 90% of
transgender and gendernonconforming respondents
experienced harassment or mistreatment on the job or
took action to avoid it. Further, 47% of these same
respondents indicated that they had experienced a
negative job outcome, including being fired, not
hired, or denied a promotion as a result of their
gender identity. In another study, Stephanie Budge
and colleagues found that about half of their
participants had been physically threatened or
emotionally abused by coworkers because of their
gender identities. These negative job outcomes must
be contextualized within the legal landscape of the
United States, where there is currently no federal
employment protection for transgender employees
and only 19 out of 50 states and the District of
Columbia provide legal protection at the state level.
Considering the bleak legal landscape for
transgender employees, it is not surprising that many
individuals may think twice before “coming out” as
transgender or undergoing a gender transition while
employed. Identities under the transgender umbrella
such as transsexual, MtF, and FtM suggest a
transition from one gender to another. Transgender
employees may undergo some form of gender
transition to more accurately live their identity or
express their experience of gender. The phrase
gender transition can be used to refer to medical and
physical transformations (e.g., sex hormone
treatments, gender affirmation surgery, and facial
feminization or masculinization surgeries) or to
encompass a larger variety of steps toward presenting
one’s authentic gender identity. As such, the broad
dimensions of gender transition may encompass
appearance-based changes (e.g., wearing different
clothing, weight-training to build muscle); social
changes (e.g., adopting different gender pronouns to
refer to oneself, creating a new e-mail handle to
reflect a different name); and legal changes (e.g.,
changing one’s gender or name on legal
documentation).
While parallels have been drawn between the
workplace coming-out processes of cisgender LGB
people and transgender employees, two important
Gender Transition at Work
differences should be noted. First, cisgender LGB
employees may choose to disclose or conceal their
sexual minority identities at work, whereas
1253
undergoing a gender transition essentially discloses
one’s transgender identity. Thus, if a transgender
individual opts to undergo a gender transition while
employed, the individual cannot easily control who
knows about his or her identity. Illustratively, data
from a national study by Jaime Grant and colleagues
found that 71% of transgender employees attempted
to hide their gender transition, and 57% delayed their
transition to avoid negative reactions from
coworkers. Second, cisgender LGB employees
typically do not face the same complications from
gendered work environments as transgender
employees. Specifically, many work environments
require gender-specific or stereotypic uniforms for
male and female employees and have spaces that are
segregated by gender such as bathrooms or locker
rooms. For some transgender employees whose
gender presentation is more fluid, ambiguous, or
androgynous, such genderspecific spaces often
become points of confusion, awkwardness, and
hostility for transphobic coworkers. As a result of
these factors, transgender employees often use
identity management strategies to navigate their
workplace environments.
Transgender Identity Management Strategies
To date, most literature regarding workplace identity
management strategies has focused on cisgender
LGB employees. Scott Button and other scholars
have discussed that opting to disclose or conceal
one’s LGB identity at work may manifest in the use
of different strategies—being explicitly or implicitly
out, passing, or covering one’s sexual orientation—
and is partially dependent on perceived climate of the
organization and personal comfort levels.
These LGB-specific identity management
strategies were recently tailored to the experiences of
transgender employees by Melanie Brewster and
colleagues. A transgender employee may be
explicitly out at work by displaying affirmative
symbols related to his or her identity (e.g., a trans-
pride logo)
Gender Transition at Work
or talking openly about the individual’s gender
transition. Another option may be to be implicitly out
by being open about one’s life experiences and past,
but not explicitly coming out as transgender— in
1254
other words, letting coworkers assume whatever they
like. Other identity management strategies may
include passing as cisgender (e.g., not disclosing that
one has undergone a gender transition) or covering
(e.g., deliberately censoring, withholding, or
fabricating information that would reveal that one is
transgender). These passing or covering strategies
have often been referred to as stealth (choosing to
only be known by one’s current gender presentation)
or deep stealth (severing all ties to the transgender
community to ensure that one is not outed) outside of
the vocational literature.
For transgender employees, being explicitly out is
positively related to job satisfaction and more
positive perceptions of workplace environment,
whereas having to cover one’s transgender identity is
related to perceiving more discrimination and having
lower levels of job satisfaction. However, it is
important to note that the aforementioned workplace
identity management strategies are limited by nature,
as they cannot capture the experiences of transgender
individuals who are early in their transition process,
those who have not yet transitioned, or people who
identify as gender nonconforming.
Key Issues in Gender Transitions at Work
As discussed by Melanie Brewster and colleagues,
several distinct topics to consider emerge within
workplace gender transitions including interpersonal
factors, intrapersonal factors, systemic and
organizational issues, and logistics and planning.
Interpersonal Factors
Unless they are self-employed, transgender
employees regularly interact with coworkers; thus,
interpersonal dynamics drastically shape a workplace
gender transition. Commonly, cisgender colleagues
may initially struggle with name and pronoun change
requests from transgender coworkers. Without on-
the-job education about gender transitions, cisgender
employees may be confused or feel awkward when
interacting with their transgender colleagues at work.
Hostilities or tension surrounding gender-specific
spaces (e.g., bathrooms) may also emerge.
Intrapersonal Factors
Psychological literature suggests that keeping
secrets can be detrimental to mental and physical
health. As such, being able to “come out” and live
genuinely as one’s preferred gender identity is a
critical component of health and job satisfaction for
transgender employees. Many transgender employees
find that after transitioning at work, they feel
liberated, free, and empowered to be themselves.
However, some individuals may also find the
prospect of transitioning genders at work very
overwhelming or frustrating because of the climate
of their workplace. As a result, experiencing anxiety
or depression is not uncommon during a transition.
Systemic and Organizational Issues
As mentioned previously, there is no federal
protection for transgender employees, and few states
offer legal protection. As a result of these sparse
protections, transgender employees are
disproportionately at risk for career crises—being
terminated, denied promotions, or unable to advance
further in their careers—if they transition at work.
Similarly, medical benefits for gender transitions are
highly variable and may be applied haphazardly.
Considering the significant cost of gender
affirmation procedures, without full or partial
medical coverage, many transgender employees may
accrue significant debt or be unable financially to
undergo such procedures. Further, many of the
surgeries that some transgender employees may elect
to undergo (e.g., mastectomies, phalloplasties) not
only are cost prohibitive but also yield a lengthy
recovery time. Without ample sick leave, disability
coverage, or paid medical leave, missing work to
recuperate from these invasive procedures may result
in termination.
Logistics and Planning
Considering the numerous uncertainties
surrounding job security and discrimination that one
may face if one undergoes a gender transition while
employed, preparation and forethought prior to
“coming out” are crucial. Steps to prepare may range
widely from researching legal protections and
knowing one’s rights to ironing out technical details
(e.g., changing one’s e-mail address, getting a new
name propagated through IT systems). One important
part of a successful workplace transition may be to
do a trial run, or selectively come out as transgender

to a couple of workplace friends or allies prior to
telling everyone. Relatedly, working closely with
human resources before coming out could help to
gauge organizational climate and safety with less risk
than coming out to a direct supervisor or someone in
an evaluative position. Most importantly, if possible,
transgender employees should be prepared to
weather—financially, emotionally, and logistically—
almost any reaction from employers and coworkers.
In this way, available literature on workplace gender
transitions points to a general theme of “plan for the
worst, hope for the best.”
Strategies for Employers
While gender transitions may be stressful at times,
research by Ellen Riggle and colleagues highlights
the many positive aspects of identifying as
transgender. When a gender transition is complete,
individuals often feel that they have grown
personally, are more resilient, have more empathy,
and are more self-aware. Employers should take note
of these benefits of a successful transition and work
to facilitate the process for their transgender
employees. One concrete way to facilitate this
process is by actively working to improve workplace
climate toward transgender individuals through
challenging negativity that emerges. Other more
logistical changes—such as implementing gender
neutral or single-stall restrooms and eliminating
gendered uniforms—would circumvent some of the
common points of interpersonal tension between
transgender and cisgender coworkers. At
Gender Transition at Work
the structural level, implementing workplace
nondiscrimination policies and providing
psychoeducation to employees could help to combat
harassment and hostility. Finally, working with
medical and health insurance providers to make sure
gender transition procedures are covered would help
to defray much of the financial stress that
transgender employees accrue when transitioning
without this support.
Melanie E. Brewster
See also Employment Non-Discrimination Act (ENDA);
Gender Identity Discrimination as Sex Discrimination;
Stealth (Transgender Passing); Transgender Identities;
1255
Transgender People and Division of Labor;
Transphobia; Work Environments; Workplace
Discrimination; Workplace Policies
Further Readings
Brewster, M. E., Velez, B., DeBlaere, C., & Moradi, B.
(2012). Transgender individuals’ workplace experiences:
The applicability of sexual minority measures and models.
Journal of Counseling Psychology, 59, 60–70. Brewster, M.
E., Velez, B. L., Mennicke, A., & Tebbe, E. (2014). Voices
from beyond: A thematic content analysis of transgender
employees’ workplace experiences. Psychology of Sexual
Orientation and Gender Diversity, 1, 159–169.
Budge, S. L., Tebbe, E. N., & Howard, K. A. S. (2010). The
work experiences of transgender individuals: Negotiating
the transition and career decision-making processes.
Journal of Counseling Psychology, 57, 377–393.
Button, S. B. (2004). Identity management strategies
utilized by lesbian and gay employees: A quantitative
investigation. Group & Organization Management,
29(4), 470–494.
Dispenza, F., Watson, L. B., Chung, Y. B., & Brack, G.
(2012). Experience of career-related discrimination for
female-to-male transgender persons: A qualitative study. The
Career Development Quarterly, 60, 65–81. Grant, J. M.,
Mottet, L. A., Tanis, J., Harrison, J., Herman, J. L., &
Keisling, M. (2011). Injustice at every turn: A report of the
National Transgender Discrimination Survey. Washington,
DC: National Center for Transgender Equality and National
Gay and Lesbian Task Force.
Genderqueer
Schilt, K., & Connell, C. (2007). Do workplace gender
transitions make gender trouble? Gender, Work &
Organization, 14, 596–618.
Waldo, C. R. (1999). Working in a majority context: A
structural model of heterosexism as minority stress in
the workplace. Journal of Counseling Psychology, 46,
218–232.
GENDERQUEER
This entry describes the experiences of individuals
who identify as genderqueer. First, the entry
discusses the concept of genderqueer, explaining
what it means to have a gender identity that is on a
spectrum of male and female, rather than a gender
identity that conforms to the male–female binary.
1256
The next section discusses the role of culture in
gender identity, and the distinctions between sexual
and gender identity are then addressed. Next, gender
identity development is examined, specifically
noting the lack of models to encompass genderqueer
identity. Finally, relationships with others are
reviewed by considering genderqueer individuals’
anticipated reactions from loved ones and other
individuals within their social networks.
The Concept of Genderqueer
The concept of being genderqueer is not currently
well understood within most Western cultures.
Genderqueer is a term that typically describes one of
three gender identity categories: (1) an individual
who feels their identity falls in between male and
female, (2) an individual who may feel male or
female at distinct times, or (3) an individual who
rejects gender completely. The following terms may
be used by individuals who feel that their gender
identity falls somewhere in between male and
female: gender variant, intergender, androgene,
genderfluid, and pangender (this list is constantly
growing and changing, so these are several examples
of a longer list). The term bi-gender is typically used
for individuals who may feel male or female at
distinct times, meaning that a person may feel male
on a specific day and will use male pronouns and
dress in masculine clothing, but on another day the
same person will feel female and use female
pronouns and dress in feminine clothing. There are
several terms that are used for individuals who reject
gender entirely, of which agender and neutrois are
the most common.
Other than bi-gender individuals, who will often
use male (he/him/his) or female pronouns
(she/her/hers), most genderqueer individuals will use
gender-neutral pronouns. Many genderqueer
individuals will use they/them/their as a singular
pronoun. Other common pronouns include zie/hir/
hirs, xe/xem/xyr, and ey/em/eir. It is common for
genderqueer individuals to use a name in lieu of
pronouns or to use the pronouns they were socialized
with. Typically, pronouns are chosen based on what
feels most comfortable and aligns with the gender
identity of the genderqueer person.
Genderqueer has been used as a term that broadly
describes individuals who have a wide range of
experiences of gender—often referred to as the
gender spectrum. In most Western cultures, both
gender and sex have been conceptualized as being
solely man–woman or male–female. These identities
are primarily considered to be the only two possible
options for humans and are portrayed as opposites to
one another; as such, they are referred to as binary
gender identities. The terms gender and sex are used
interchangeably, even though they are distinct
constructs. Sex refers to biological characteristics
(e.g., chromosomes, reproductive organs, secondary
sex characteristics, and hormones) that usually are
used to categorize an individual as male or female.
Gender refers to traits and identities that are usually
considered masculine or feminine based on social
and cultural stereotypes and norms. Even though the
concept of gender may be more easily considered to
be a spectrum of feelings and expressions, sex should
also be given the same consideration. There are many
variations of chromosomal makeups. Indeed, XY and
XX are the most common, but there are numerous
other combinations (for example, X, XXY, XXX)
that provide biological evidence that there is a range
of sex possibilities.
Except for rare situations, all infants are assigned
a male or female sex in utero or when they are born.
This assignment is most often based on perceptions
of the infant’s external genitalia, but it is also
sometimes based on chromosomal tests that are
conducted during pregnancy. When infants are
assigned male or female, societal expectations of
how they should act, be treated, and raised arise. For
genderqueer individuals, the assignment of one of
two sexes and the social implications of this
assignment can contribute to the difficulty of
understanding and coming to terms with their own
gender identity.
Gender Identity and Culture
Although the term genderqueer may not yet be one
that is well understood in broader Western cultures,
most non-Western cultures incorporate more than
two genders. Many groups that are indigenous to
what is now the United States describe a two-spirit
identity for individuals who feel both masculine and
feminine; there are many terms for a two-spirit
identity, based on the culture (e.g., nádleehí—
Navaho; niizh manidoowag—Ojibwe;
Bote/Bate/Bade—Apsáalooke [Crow]). Outside of
the United States, there are numerous examples of

individuals who may be considered to have a “third
gender” that often translates similarly to the concept
of Western genderqueer identity (e.g., the Chuckchi
in Siberia, Bakla in the Philippines, Hijra in India,
and Quariwarmi in Peru).
Gender Identity and Sexual Orientation
Sexual orientation and gender identity are often
conflated. Just as gender is portrayed as a binary
concept, so too is sexual orientation (e.g., gay/
straight). Gender identity is an internal sense of how
masculine, feminine, or nongendered an individual
feels. Sexual orientation includes a person’s
attractions, behaviors, and fantasies. Even though
these two concepts are not the same, they tend to be
related to how individuals are socialized. Most
cultures are considered to be heteronormative— that
is, most people will be raised and assumed to be
heterosexual. Adding to the complexity, assuming
that an individual will be heterosexual is also
assuming that the person will be cisgender (the
individual’s gender identity will be congruent with
Genderqueer
his or her sex assigned at birth). As an example, a
person is raised as a boy from birth due to the
presence of a penis when born. This person will be
socialized as a boy in all aspects, including specific
commentary about performing masculinity with
women, such as how to treat girlfriends and a future
wife.
For many genderqueer individuals, their gender
identity does not conform to whom they are attracted
or with whom they are romantically involved. Sexual
orientation is composed of romantic/ sexual
attractions, behaviors, and fantasies, whereas
genderqueer identity is rooted in feelings (or lack of
feelings) of masculinity/femininity. Sexual
orientation labels such as gay and lesbian often
reinforce a gender binary. For instance, labeling
someone a lesbian communicates that this person
identifies as a woman and is attracted to women; the
label gay can be used for any individual, but most
often is used for men; bisexual communicates the
person is attracted only to men and women; and
heterosexual communicates the person’s gender by
indicating that he or she is attracted to an individual
on the other end of the gender spectrum. While some
1257
genderqueer individuals will use these common
labels (lesbian, gay, bisexual, straight), many others
will use sexual orientation terms that allow for less
constricted communication of gender. For example,
most genderqueer individuals will identify their
sexual orientation as queer, pansexual, or
omnisexual, or they may not use a label at all. Even
if a genderqueer person is exclusively attracted to
women or exclusively attracted to men, they will
likely choose a sexual orientation label that will not
confine them to a binary gender identity.
Identity Development
To date, there is very little research on identity
development for genderqueer individuals. Most
identity development models indicate that there is a
beginning process that will lead to some endpoint.
For gender identity development, earlier models
focused on children understanding how to identify
men and women and the permanence of gender (also
called gender consistency) based on the sex assigned
at birth. Newer research has
Genderqueer
started to focus on transgender individuals’ identity
development. It typically follows a pattern of an
individual transitioning from male to female or
female to male and the social and medical procedures
involved in that process.
It is clear that the earlier models of gender identity
development were incorrect, in that they assumed
two genders. Not only are there more than two
genders, but gender is also not necessarily fixed.
Because there is a lack of popular culture
understanding of genderqueer identity, most
individuals who feel genderqueer do not have the
terminology or the understanding of what is going on
internally to communicate with others about how
they are feeling regarding their gender identity.
Individuals who do not conform to gender norms are
often dismissed or ignored; nonconformity is
considered shameful in most Western cultures. Even
though transgender men and women will experience
the same amount of internal shame as genderqueers,
there are systems that are set up in order to assist
them with their gender identity process (more
language in the media, therapeutic guidelines, etc.).
However, genderqueer identity is often misconstrued
1258
as the middle phase of transgender identity, whereby
the individual will eventually “choose” a more binary
identity. Because genderqueer identity is often not
talked about, individuals typically find out about the
identity label from the Internet. Genderqueer
individuals will usually assess whether or not they
feel they can come out to loved ones and at school or
work. Typically, individuals who are able to be fully
authentic about who they are with other people
usually feel more actualized in their identities, but for
reasons outlined in the next section, they may not
feel comfortable communicating their genderqueer
identity with others.
Relationships With Others
The assumption that everyone’s identity will align
with their sex assigned at birth (i.e., cisnormativity)
can influence genderqueer individuals’ fears of
coming out to others. This fear occurs for several
reasons, including worry about rejection by loved
ones, concern about being diagnosed with a mental
disorder, and feeling like one is deviating from
societal gender norms. The fear of a negative
response from family members is often the primary
worry for genderqueer individuals. If the
genderqueer individual is planning on
communicating their identity to their family, there is
typically a fear that the family member will respond
with grief (“I’m losing the
child/parent/sibling/partner I thought I had”) and
shame (“It is dysfunctional to have a genderqueer
identity”). Family members often have the most
difficulty with using a different name or gender-
neutral pronouns because they have typically known
this individual longer than anyone else. Being
rejected by family members after coming out as
genderqueer can be extremely painful and may lead
to fear and distrust about how others will respond.
Outside of family, genderqueer individuals will need
to navigate coming out at school/work and to friends.
Though this can be a difficult process for some
individuals, recent research suggests that
genderqueer individuals are positively surprised by
the affirming response they receive from others.
Stephanie Budge
See also Cisgenderism; Gender Spectrum; Queer;
Transgender Inclusion in the LGBTQ Rights
Movement; Transgender Inclusion on College
Campuses; Transphobia
Further Readings
Ault, A. (1996). Ambiguous identity in an unambiguous
sex/gender structure. Sociological Quarterly, 37, 449–
463.
Budge, S. L., Rossman, H. K., & Howard, K. A. S. (2014).
Coping and psychological distress among genderqueer
individuals: The moderating effect of coping and social
support. Journal of LGBT Issues in Counseling, 8, 95–
117.
Burdge, B. J. (2007). Bending gender, ending gender:
Theoretical foundations for social work practice with the
transgender community. Social Work, 52(3), 243–250.
Harrison J., Grant J., & Herman J. L. (2012). A gender not
listed here: Genderqueers, gender rebels, and otherwise in
the National Transgender Discrimination Survey. LGBTQ
Policy Journal at the Harvard Kennedy School, 2, 13–24.
McPhail, B. A. (2004). Questioning gender and sexuality
binaries: What queer theorists, transgendered individuals,
and sex researchers can teach social work. Journal of Gay
& Lesbian Social Services, 17(1), 3–21.
Shotwell, A., & Sangrey, T. (2009). Resisting definition:
Gendering through interaction and relational selfhood.
Hypatia, 24(3), 56–76.
GLAAD
This entry describes the formation, development, and
current configuration of GLAAD, a
nongovernmental media-monitoring organization
based in the United States. This entry covers the
history of GLAAD from 1985, when the
organization was founded, to the present. The entry
ends by examining the controversial significance of
GLAAD to the production, distribution, and
reception of mediated representations of LGBTQ
individuals, suggesting the organization’s industrial,
social, cultural, and even economic impact.
The Formation of GLAAD
By the mid-1980s, a number of mainstream
American publications were regularly reporting on
the HIV/AIDS crisis using derogatory language,
 1259
often appearing to support multiple forms of including The Associated Press Stylebook, which was
discrimination against those suffering from or revised in 2006 to reflect a terminological
assumed to be susceptible to sexually transmitted broadening among LGBTQ individuals.
diseases. Perhaps the most prominent and persistent Such revisionist impulses have extended to
culprit in such AIDS-themed journalistic alarmism GLAAD itself and include the organization’s racial,
was the New York Post, which frequently rankled ethnic, and transnational diversification (in terms
AIDS activists by employing a range of apparent both of critical purview and of active personnel), as
scare tactics, printing headlines suggesting the well as its 2013 decision to officially discard its
threats posed to straight families by gay men, and foundational designation as the Gay & Lesbian
generally reducing the global HIV/AIDS crisis to the Alliance Against Defamation.
contours of gay male “deviance.” GLAAD, then GLAAD
known as the Gay & Lesbian Alliance Against
GLAAD
GLAAD and American Television
Ten years after successfully lobbying the New York
Defamation, formed as a response to the Post’s
Times to adopt the word gay, GLAAD orchestrated a
coverage, aligning itself with the broad goals of
wide-ranging campaign centered on Ellen
AIDS activism while honing a commitment to
DeGeneres, the performer who publicly self-
monitoring popular media for signs of homophobic
identified as lesbian in 1997, shortly before her
biases. By 1987, GLAAD had successfully lobbied a
character on the network television sitcom Ellen
range of publications, including the New York Times,
similarly came out of the closet. GLAAD’s “Let
to end their reliance on the term homosexual, with its
Ellen Out” campaign, which commenced when
clinical connotations, and to replace it with the word
DeGeneres began negotiating with ABC/Disney
gay—a word whose affirmative, liberationist
regarding the sexuality of her television avatar, led to
associations had long since been advanced within
the creation of a webpage—part of GLAAD’s
activist communities. Later, in 2002, GLAAD would
broader organizational website—devoted to
help inspire the Times to include, for the first time,
information about DeGeneres’s process of emerging
same-sex couples on its “Weddings & Celebrations”
from the closet. Long before the explosion of online
page.
platforms for celebrity gossip, GLAAD’s
GLAAD’s first decade witnessed the
DeGeneres–themed webpage, titled “Ellen Watch,”
organization’s focus on print journalism as a source
provided frequent updates on DeGeneres’s path to
of misleading, obviously prejudiced portrayals of
prominence as a lesbian-identified cultural figure. In
nonheterosexual citizens and the medical, legal, and
April 1997, DeGeneres made the cover of Time
cultural crises believed to be derivative of their very
magazine, along with the notably colloquial,
identities. With a number of mainstream publications
nonchalant headline “Yep, I’m Gay”—a headline
casually referring to gay bars and clubs as “AIDS
whose language and tone were traceable to
dens,” and suggesting that any concentration of gay
GLAAD’s efforts to combat clinical and alarmist
men was inevitably generative of HIV infection,
designations. Since the cancellation of DeGeneres’s
GLAAD orchestrated a multipronged campaign to
sitcom in 1998, GLAAD has maintained a
combat such offensive, heterosexist reductionism, in
pronounced commitment not merely to scrutinizing
the process helping to popularize words and phrases
representations of LGBTQ characters on television,
that were free of antiquated or otherwise undesirable
but also to advocating for the expansion of such
connotations. The organization thus played a key role
representations.
in conditioning producers of print media to accept a
greater responsibility for protecting the rights of
sexual minorities not to be identified with disease GLAAD “On the Ground”
and destruction, as well as for employing an GLAAD has frequently attempted to preempt
affirmative or at least equitable parlance. As part of negative or erroneous media portrayals of LGBTQ
this process, GLAAD has contributed to the creation individuals through a range of interventionist
and maintenance of various reference standards, measures. In 1998, the organization dispatched
1260
experts to Laramie, Wyoming, where the gay youth ongoing commitment to terminological
Matthew Shepard had recently been murdered in an standardization.
evident hate crime, to survey the local conditions in
Noah Tsika
which television, print, and online journalists were
composing some of the first Shepard-themed news See also Bisexualities; Homophobia; Homosexuality,
stories. GLAAD’s active presence in Laramie Female; Homosexuality, Male; Media Representations of
contributed to the organization’s growing reputation LGBTQ People; Queer; Queer Politics; Queer Theory;
as the type of watchdog group whose members were Sexual-Identity Labels; Transgender Sexualities
willing to conduct far-flung fieldwork. Bolstering
Further Readings
this image, GLAAD has consistently expanded its
media-monitoring practices to include productions in GLAAD. http://www.glaad.org
Latin America and Asia, implementing specific James, A. (2014). The GLAAD board’s ‘tranny’ trouble: How
Spanish- and Chinese-language measures in 2004 its trans takeover is reshaping LGBT politics.
and 2007, respectively. Retrieved October 24, 2015, from
One of GLAAD’s most famous interventions http://www.queerty .com/the-glaad-boards-tranny-trouble-
occurred in 2001, when the organization accelerated how-its- trans-takeover-is-reshaping-lgbt-politics-
its efforts to curtail the trans-media spread of Dr. 20140724
Laura Schlesinger, a pop therapist whose radio Schiavi, M. (2011). Celluloid activist: The life and times
program had long provided a platform for her of Vito Russo. Madison: University of Wisconsin Press.
homophobic opinions and rhetoric. Thanks in large GLAAD
part to GLAAD’s efforts, production on
Schlesinger’s television talk show did not continue as Shilts, R. (1987). And the band played on: Politics, people,
planned, and Schlesinger herself soon faded into and the AIDS epidemic. New York, NY: St.
relative obscurity. More recently, rather than
Martin’s Press.
petitioning media producers to ban particular
Strub, S. (2014). Body counts: A memoir of politics, sex,
individuals, GLAAD has orchestrated campaigns to
AIDS, and survival. New York, NY: Scribner.
“educate” those celebrities, such as Kobe Bryant and
Tracy Morgan, who have publicly employed antigay
slurs or sought to advance antigay sentiments.
GLAAD’s operations have not been immune to GSAS
controversy, however, and the organization has
periodically been the object of criticism among those
who perceive considerable conservatism in its See Gay–Straight Alliances (GSAs)
methods, objectives, and leadership. Beyond the
heterosexist circles whose media productions
GLAAD had pledged to address, criticism has often
come from LGBTQ individuals who see certain
hierarchies among the organization’s personnel and
critical concerns, as well as an aversion to nuance.
For instance, GLAAD’s resistance to the television
series RuPaul’s Drag Race on the basis of its use of
allegedly transphobic slurs has drawn opposition
from several of the program’s participants, including
its eponymous host (and cocreator), who has
proclaimed an affirmative queer position from which
to speak, seeking to reclaim the term tranny in
particular. Others, including writers for the website
Queerty, have critiqued what they see as GLAAD’s
exclusionary practices, including the organization’s
The SAGE Encyclopedia of
LGBTQ Studies

Edited by
Abbie E. Goldberg
Clark University
1262

H Defining Hate Crimes

HATE CRIMES Hate crimes, also called “bias
crimes,” are a 20th-century legal
concept that has emerged primarily
in the United States,
LGBTQ people are frequent targets
Commonwealth countries, and
of biasmotivated crimes (i.e., hate
Europe. Despite variation in
crimes). This entry addresses the
definition, the Organization for
topic of hate crimes based on sexual
Security and Co-operation in
orientation and gender identity. First,
Europe and the Office for
the entry provides a legal definition
Democratic Institutions and
of hate crimes, maintaining a global
Human Rights outline two basic
perspective on how this legal
features of bias crimes: (1) There is
definition is constructed. Second, the
a base offense (e.g., vandalism,
entry presents data from official legal
assault), and (2) bias is a motive
sources that outline the
for the crime. In other words,
characteristics and prevalence of bias
perpetrators selected targets
crimes based on sexual orientation
because of their membership in a
and gender identity.
protected group or based on a
particular social characteristic, and
victims were selected because of
the group or characteristics they estimating bias crime prevalence
represent rather than their individual globally.
identity. Bias crimes are a legal
definition of one type of bias-
motivated behavior, and official
Hate Crimes Against LGBTQ People
Due to fears of being victimized again
467 by law enforcement and criminal
counts do not capture all the types of justice personnel, many LGBTQ
violence, discrimination, and harassment people choose not to report incidences
experienced by of bias, although cases in which the
vulnerable group members. Instead, bias victim sustained great injury and
crime laws have been implemented as a when the perpetrator was a stranger
means of recognizing the additional are more likely to be reported to law
harms that bias victimization imposes on enforcement. Therefore, official
individual victims, their families and reports of bias crimes are at best
communities, and society at large, and estimates, and they are in fact an
as a means to deter future bias crimes by Hate Crimes
clearly identifying them as a type of
crime worthy of attention.
undercount of the true number of bias
Great variation in tracking bias
crimes committed each year. Even
crimes across the globe can be attributed
given these limitations, there is still
in part to the differences in bias crime
evidence that LGBTQ people are
definitions. For example, many
frequent targets of bias-motivated
countries throughout Europe include
crimes. For example, over 1,000
some types of bias speech in their bias
sexual orientation–motivated bias
crime laws, while the United States
crimes are reported to the Federal
protects the freedom of speech,
Bureau of Investigation in the United
including bias speech, more broadly,
States each year. Both the United
making comparisons across countries
States and Canada have reported that
difficult. Many jurisdictions also do not
sexual orientation bias crimes are
include sexual orientation or gender
particularly violent, as compared to
identity/expression in their bias crime
other types of bias crimes, and more
definition, adding further challenges in
likely to result in physical injuries.
1264
Research also suggests that sexual-
minority men are more likely to be
targeted for bias-motivated violence
than are sexual-minority women. Bias
crimes based on gender identity or
expression tend to be more violent than
even crimes based on sexual orientation,
to occur in public places, to involve
perpetrators who are strangers, and to
have multiple perpetrators. In addition,
people who are transgender or gender
nonconforming in their identity or
expression have a high rate of becoming
victims of murder due to gender
identity– motivated violence.
Studies conducted in the United
States that examined relative risk of
victimization based on official reports of
bias crimes and estimates of overall
population have found that LGBTQ
people bear a disproportionate burden.
For example, in the United States, bias
crimes based on race/ ethnicity are the
most common numerically, but when
dividing the reported number of bias
crimes by the population estimates of
each victim group (e.g., dividing the
total number of reported crimes against
Latinos by the estimated number of
Latinos in the population, or the total
number of reported bias crimes against
gay men divided by the estimated
number of gay men in the population),
results suggest that sexual minorities
face a greater chance of being the
victims of bias crime than any other
group, and the victims of
biasmotivated physical violence in
particular. Because of variance in
cultural values, stereotypes, and
historical understanding of varying
sexualities and gender, this finding
may not be true in all jurisdictions and
societies. However, given the high
rates of violence reported globally
against sexual minorities and gender-
nonconforming people, these results
suggest that LGBTQ people are at
least as vulnerable as other historically
vulnerable groups, if not more
vulnerable to bias-motivated violence.
Bias crime perpetrators have been
identified as primarily young White
men, often those with a criminal
history who are crime “generalists”
rather than “specialists.” Although
there are many theories that attempt to
explain bias-motivated offending,
most theories take into account the
masculinized nature of bias crimes
against LBGTQ people, such as the
high degree of violence used in the
crimes, the presence of “overkill” in
many antigay and anti-transgender
murders, the high frequency of
multiple male perpetrators
“performing” their masculinity in front Peterson, D., & Panfil, V. R. (Eds.).
of other men by gay bashing in groups, (2014). Handbook of LGBT
communities, crime, and justice. New
and the reports that many perpetrators
York, NY: Springer.
experienced intense feelings of peer
Turner, L., Whittle, S., & Combs, R.
pressure to participate in biasmotivated (2009). Transphobic hate crime in the
crime to “prove” their masculinity. In European Union. ILGA-EUROPE and
addition, gay bashers have reported that Press for Change. Retrieved October
they believe society condones their 26, 2015, from
behavior, suggesting the importance of http://www.ucu.org.uk/media/pdf/r/6/
reducing societal stigma in order to transphobic_hate_crime_in_eu.pdf
reduce bias-motivated crimes against
LGBTQ people.
Rebecca L. Stotzer

See also Discrimination Against LGBTQ

People by Law
Enforcement; Sexual Minorities and
Violence;
Transgender People and Violence;
Violence and
Victimization of Youth

Fur
the
r
Rea
din
gs
Hall, N., Corb, A., Giannasi, P., &
Grieve, J. (Eds.). (2014). The
Routledge international handbook on
hate crime. New York, NY:
Routledge.

HEALTH CARE PLANS
A health care plan is the mechanism used to pay for and
deliver health care. Health care is unique when
compared with other goods and services because people
generally lack knowledge of what kind of health care
they need; health care prices are frequently unknown to
patients; and health care services are either medically
necessary or elective, so patients do not change their
health care consumption on the basis of price.
Consequently, health care plans are in place to help
strike a balance between keeping costs affordable and
making sure people receive enough care to stay as
healthy as possible. Historically, the LGBTQ
population has faced unique challenges in their health
coverage because of the earlier absence of universal
recognition of same-sex marriages affecting spousal
coverage under employee benefit plans. In addition, the
availability of health care coverage is especially
important for the LGBTQ population, because health
insurance can mean the difference between having or
not having access to HIV treatments if needed, HIV
prevention medicines, gender reassignment therapy,
and reproductive coverage.
The majority of Western countries outside of the
United States have government-provided health care.
While government-provided health care has been
debated in Congress since 1911, the United States has
never implemented it and instead has a complex system
of alternative health insurance models. The majority of
people in the United States rely on a health care plan to
subsidize the high cost of medical care.
There are four broad categories of U.S. health care
plans: direct capitation, government health care,
corporate self-insurance, and self-insurance. Each
model has its own mechanisms for controlling costs and
preventing overuse.
Insurance models are systems that pool money by
collecting payments from many members, and then
paying for the medical costs of members who require
care. Insurance models include health maintenance
organizations (HMOs), participating provider options
(PPOs), and consumer-directed
Health Care Plans
1266
health plans (CDHPs). The majority of Americans who
do not receive insurance through the govern-
ment are enrolled in an insurance plan. Insurance is
most often provided by an employer, but under the
sweeping health care reforms of the 2010 Affordable
Care Act (ACA, known colloquially as “Obamacare”),
more Americans are able to purchase individual
insurance coverage. Insurance plans control costs and
prevent overuse by charging co-pays or coinsurance,
capping coverage, and including deductibles. Many
insurance systems prevent overuse by using a
“gatekeeper,” meaning patients are required to get
referrals from their primary care providers before
seeing specialists. Insurance companies delineate
between essential services and inessential services, and
coverage often reflects social biases. For instance,
sexualminority men generally do not receive any
assistance in their reproductive expenses. Sexual-
minority women, however, often have medical
coverage for costs associated with intrauterine
insemination.
Purchasing insurance has been simplified and
regulated under the ACA. Private insurance plans can
be easily compared in terms of both price and services.
Importantly, insurers may no longer deny coverage for
preexisting conditions. Further, the insurance exchanges
use a person’s reported earnings to determine if he or
she is eligible for government subsidized health
insurance. The Affordable Care Act has partially
addressed the problem of having a significant uninsured
population in America.
Employers under the Affordable Care Act will be
required to provide insurance; however, as of this
writing, that provision has yet to take effect. Still, the
majority of Americans receive health insurance for
themselves and their families from their employers. For
many years, insurance coverage was not extended to
same-sex marriage partners in many states, due to the
influence of the Defense of Marriage Act (DOMA) and
state laws. The Supreme Court’s adjudication of
DOMA as unconstitutional and same-sex marriage
recognition have reversed this trend by creating a
federal mandate to treat same-sex marriages and
domestic partnerships identically to their opposite-sex
counterparts. The latter decision also invalidated state
and local laws
Health Care Plans
 Health Care Providers, Disclosure of Sexual Identity to
that had denied recognition to same-sex marriages.
Some cities, municipalities, and states also require
employers to extend family health care coverage to
unmarried long-term partners.
The direct capitation model is a membership system.
Members pay to have access to an established network
of providers and hospitals that exclusively serve
members. Unlike fee-for-service models, the direct
capitation model pays doctors a flat rate. Kaiser
Permanente is an example of this system. Kaiser
members always see Kaiser doctors and go to Kaiser
hospitals. Direct capitation systems control costs
because, unlike fee-for-service models, doctors do not
make more money from ordering more expensive care.
The Affordable Care Act has created a new form of
direct capitation systems called accountable care
organizations (ACOs) that are now spreading to the
private market. In an ACO, a collection of health care
facilities band together and agree to treat a patient pool
for a certain amount of money; consequently, they take
any surplus, reflective of efficient care, as profit.
Government insurance in the United States is
available to select groups only, although under the
ACA, the number of people eligible has been
significantly expanded. There are four major
government health care systems in the United States:
Medicare, which is available to all people over 65 and
disabled people, and is provided by the federal
government; Medicaid, which is available to people
who are low earners; the Veterans Administration,
which provides care to military veterans; and Tricare,
which provides care to people currently in the military.
Medicare covers HIV treatment when a person is
impoverished and under 65. Starting in 2014, Medicare
pays for gender reassignment therapies; because there is
a significant transgender, low-income, HIV-positive
population who are eligible for Medicare and under 65,
this means many more transgender people will be able
to receive gender reassignment therapies. Rarely do
state programs opt to cover gender reassignment
therapies. Many transgender rights groups are pushing
for an expansion of Medicaid coverage at the state
level. Medicaid, Medicare, and nearly all insurance
plans provide coverage for HIV transmission–
preventing drugs (PrEP and PEP).
Corporate self-insurance is offered by organizations
that are large enough to create an internal health care
structure. For example, Boeing selfinsures its
employees. A corporate self-insurer does not rely on an
1267
outside insurer. Instead, the corporation has its own
contracts with health care providers and determines its
own co-pays, deductibles, and caps. This system
operates similarly to group insurance, because the
corporation is able to use its large employee pool to
spread risk. It controls overuse and growing costs by
aggressively incentivizing healthy lifestyles and
providing easy-to-access primary care.
While the Affordable Care Act provides a more
affordable way for people to get insurance than
previously available in America, many people,
particularly those with unstable incomes who earn
above the subsidy threshold, may not find the health
care prices affordable and may instead opt to incur the
tax penalty for lack of insurance. People who have no
health care plan in place have “self-insurance,” because
the individual must pay all costs out of pocket directly
to the providers of their care. Under the best conditions,
a person who is self-insured has opted to use a
government-supported health savings account (HSA),
where a person can save for health care costs with
pretax income so that when confronted with an illness
or injury, he or she has the resources to cover it.
Unfortunately, most people who self-insure do not use
HSAs and have limited access to primary care.
Theoretically, costs should be controlled because a
rational consumer will request only necessary services
at the best prices. However, uninsured individuals are
likely to depend on emergency care for their medical
needs, letting their conditions worsen until they become
life threatening and then receiving care regardless of
their ability to pay. This trend is very costly, and the
expansion of Medicaid and individually purchased
insurance represents a calculated strategy to reverse this
paradigm.
Leslie C. Allen
See also Aging, Social Relationships, and Support;
Chronic Illness; Discrimination Against LGBTQ
People, Cost of; Discrimination on the Basis of HIV/
AIDS in Health Care; Domestic Partnership; Health Care
System; Health Disparities; HIV/AIDS Treatment and Care,
Psychosocial and Structural Barriers to
Further Readings
Blue Cross BlueShield of Illinois. (n.d.). Health plans and
provider networks. Retrieved September 2, 2014, from
http://www.bcbsil.com/getting_started/health_insurance/
types_plans
DeNavas, C., Proctor, B., & Smith, J. (2011, September).
1268
Income, poverty, and health insurance coverage in the
United States: 2010. Current Population Reports. U.S.
Department of Commerce. Retrieved September 2, 2014,
from https://www.census.gov/prod/2011pubs/p60-239.pdf
How private health coverage works: A primer—2008 update.
(2008, April 1). Henry J. Kaiser Family Foundation.
Retrieved September 2, 2014, from http:// kff.org/health-
costs/issue-brief/ how-private-health-coverage-works-a-
primer/
Kates, J., & Ranji, U. (2014, February 21). Health care access
and coverage for the lesbian, gay bisexual, and transgender
(LGBT) community in the United States: Opportunities and
challenges in a new era. Henry J.
Kaiser Family Foundation. Retrieved October 20, 2014, from
http://kff.org/disparities-policy/perspective/ health-care-
access-and-coverage-for-the-lesbian-gaybisexual-and-
transgender-lgbt-community-in-the-unitedstates-
opportunities-and-challenges-in-a-new-era/
Medicaid expansion: States’ implementation of the Patient
Protection and Affordable Care Act. (2012, August).
Washington, DC: U.S. Government Accountability
Office. Retrieved September 2, 2014, from http://www
.gao.gov/assets/600/593210.pdf
U.S. Department of Health and Human Services. (2012). Health,
United States, 2011. With special feature on socioeconomic
status and health. Hyattsville, MD: National Center for
Health Statistics. Retrieved September 2, 2014, from
http://www.cdc.gov/nchs/ data/hus/hus11.pdf
HEALTH CARE PROVIDERS, DISCLOSURE OF
SEXUAL IDENTITY TO
There is debate as to whether or not LGBTQ people
should reveal their sexual and gender identities to
health care providers, and whether revealing this
Health Care Providers, Disclosure of Sexual Identity to
information leads to better quality health care. This
entry explores this debate and examines the barriers and
facilitators to disclosure. But first, some definitions are
in order.
In general, LGBTQ people call the process of
exploring, accepting, and revealing one’s sexual or
gender identities (as LGBTQ or other similar labels)
“coming out.” This is an ongoing unfolding of one’s
own internal understanding of the meaning of these
identities, and making decisions about who should
know, how best to tell others, and how to manage the
reactions of others. It can be an extremely stressful
process because it is hard to predict who might react
negatively. The stakes can be very high, including
losing a job, being cut off from family, or losing
custody of a child. Being visibly LGBTQ or sometimes
just being physically within a neighborhood or business
identified as LGBTQ can increase the risk for violent
victimization. Within this larger context of coming out,
disclosure to health care providers is one specific form
of coming out that can have a set of possible negative,
positive, or mixed consequences and contributes to
LGBTQ health disparities. These are explored later in
the entry.
Disclosure is not a simple yes or no, “out or not out”
proposition. One study found that LGBTQ people
ranged along four distinct types of disclosure to health
care providers:
1. Active disclosure: This person directly revealed
information about sexuality and gender to the health
care provider.
2. Passive disclosure: This person wore a T-shirt with an
LGBTQ slogan, introduced a same-sex partner, or had
a visible marker of his or her sexuality/gender and
assumed that the provider accurately read the clue.
3. Passive nondisclosure: This is the classic “don’t ask,
don’t tell” scenario.
4. Active nondisclosure: Some LGBTQ people lied about
their sexuality or gender to avoid negative
consequences.
The Health Care Encounter
Any visit to a clinic, doctor’s office, hospital, or other
health care setting typically involves interactions with
many people, including receptionists, patient
navigators, nurses, nursing assistants, doctors,
physician
assistants, medical social workers, housekeepers,
students from health care training programs, dieticians,
chaplains, and a host of other workers, not to mention
other patients/clients. Most research has focused on
disclosure to doctors or nurses, ignoring the sheer
number of disclosure decisions that need to be made in
any health care visit. Most encounters are with
strangers, and therefore, the LGBTQ patient/client has
no prior knowledge of their attitudes. There is also the
stress of the underlying health problems or threats to
 Health Care Providers, Disclosure of Sexual Identity to
health and well-being that go along with health care
visits. It is a stressful situation under the best of
circumstances, and some think that disclosure adds
unnecessary stress, but there is research showing
benefits of disclosure.
Benefits of Disclosure
Some of the benefits of disclosure can arise from
coming out in general. Many people report a sense of
relief from no longer having to hide their true identity,
and not having that big secret overshadowing
everything. The person feels more authentic and
truthful. There is a sense of integrity, a wholeness, and
an improvement in the quality of relationships. Part of
the benefit of coming out stems from releasing the
shame and guilt that accompanies keeping secrets from
others. Letting go of that soul-sucking shame results in
better mental health and well-being.
Disclosure to health care providers can have
additional health benefits in at least five areas:
1. When a person comes out, his or her partner and family
may be more readily recognized and acknowledged,
increasing the support available for healing. This will
take the stress off and alleviate fears that partners may
not have access to information, may not be allowed to
visit, or may be treated with less respect than
significant others of opposite-sex relationships. If
health care providers know their patients’ sexual and
gender identities, they can inquire about whether the
patient has appropriate legal documents to protect his
or her relationships/families, and patients will be more
satisfied with their care.
2. Health care can be better tailored to one’s needs. For
example, a woman in an exclusive relationship with
another woman does not need a lecture about birth
control.
3. Honesty fosters more honesty. Sometimespatients need
to reveal information about unhealthy behaviors, fears,
or vulnerabilities to get the best possible care. Issues
not raised to health care providers can increase the
feelings of shame and guilt, and may contribute to an
avoidance of health care. Disclosing about one’s
sexuality or gender identity may pave the way for other
difficult sharing, such as experiences of child abuse,
intimate partner violence, or substance abuse.
4. When nonbiological or nonlegal LGBTQ parentsare
out to health care providers, the providers know who
1269
cares for the child in case of emergencies, ensuring that
all primary caregivers are involved in the child’s care.
5. Some research suggests that men who have sexwith
men may sometimes fragment their health care. They
go to sexual health clinics for anything related to their
sexual practices, and to primary care providers for
everything else. The result is that their primary care
providers do not have the whole picture, and this may
compromise the quality of their care. When primary
care providers have the full disclosure of patients, they
can provide more holistic and comprehensive care in
one location, benefiting the patient.
Dangers of Disclosure
There are potential risks with disclosure as well. Far
too many LGBTQ people have experienced denial of
care, rough treatment, verbal harassment, referrals to
psychiatry or religious groups for a “cure,” dismissal of
significant others, and “tolerance” rather than
acceptance. Tolerance is a form of microaggression, a
common experience of not being welcomed or included
that can increase the stress level of LGBTQ people
because it happens so often, and is dismissed as trivial
or not “real” discrimination. Another common problem
that can stem from disclosure is becoming the subject of
gossip or voyeuristic attention. Some fear that their
confidentiality may be breached.
Finally, the sexual or gender identity of the
individual might become the focus for the health care
provider. Many gay and bisexual men, in particular,
have reported that their primary care providers often
interpret every symptom they have as HIV/ AIDS or
other sexually transmitted infections.
Most of the time, the health problem that brings
LGBTQ patients to a health care visit is not related to
their sexuality or gender identity, but they are always
entering the system in the context of their LGBTQ
identities and relationships.
Issues That Might Differ for
Transgender Patients/Clients
Transgender people have some unique issues related
to disclosure. Imagine the potential for shock/surprise
on the part of health care providers doing a physical
exam when they are expecting one type of body and
find another. In addition, there are some circumstances
when the physical body is important. Transgender
1270
women still have a prostate; transgender men often still
have a cervix, uterus, vagina, and ovaries. They need
the appropriate cancer screenings. In addition,
hormones can interact with other drugs/treatments, so
health care providers need to know the type and dose of
hormones.
Gender differences seem to provoke even more
anxiety and discomfort among health care providers
than sexual identity differences, so transgender patients
report an even higher likelihood of being denied needed
services, being treated roughly, hearing negative
comments, and having providers who are
uncomfortable and inconsistent with their patients’
preferred names and pronoun choices. Some health care
providers insist that gender stems from one’s biology
and refuse to acknowledge the gender identity of the
patient.
The rest of this article combines LGBTQ people
together, but in reality, people who identify with each
letter in the alphabet soup of sexual and gender
identities may have somewhat different experiences.
Most of the research has focused on gay men and
lesbians, and much less is known about bisexual or
Health Care Providers, Disclosure of Sexual Identity to
transgender people’s experiences with disclosure to
health care providers. The section that follows
addresses general issues that may be true for many, but
not all, LGBTQ people.
Barriers to and Facilitators of Disclosure to
Health Care Providers
Often advice is given to LGBTQ people to come out,
but the decision is a complex one, and disclosure is not
always the safe option. In this section, four sets of
factors that might be related to the likelihood of
disclosure to a health care provider are considered: (1)
the individual patient/client level; (2) factors related to
the health care provider; (3) the health care institution
level (the agency, clinic, office, hospital, etc.); and (4)
the higher societal, legal, and health care systems level.
The Individual Patient/Client Level
We know the most about individual-level factors,
and there are many things that may play a role in
disclosure to health care providers. The following list is
certainly not exhaustive.
Factors Related to Identities. Every patient is a
combination of many identities, and some people of
color, people with disabilities, or immigrants may be
less likely to disclose. They may think that they already
have enough strikes against them for their visible
differences without disclosing the hidden identity
related to their sexuality or gender. People with higher
levels of education and income (more privilege) might
be more likely to come out. Youth who are dependent
on parents and family may be less likely to disclose for
fear of loss of that support, and older adults who grew
up in more restrictive times may be less likely to
disclose for fear of discrimination.
Factors Related to One’s Sexual or Gender Identity
Development. These may include the stage of overall
coming out (people who are still struggling near the
beginning of the process and have not fully accepted
their own identities may not be ready to disclose to
others), comfort level with one’s own sexuality and
gender, degree of internalized oppression, whether
partnered or not (there may be someone who needs to
be included in health care decisions), whether the
person has children (health care providers need to be
aware of the relationships of the parents), prior
experiences
with health
care in general and with disclosing to a health care
provider, and community norms and resources. Several
studies found that bisexual men and women were less
likely to disclose than gay men or lesbians.
Factors Related
to the Specific
Health Care
Visit. These might include the reason for the visit. If the
problem is acute, such as a sprained ankle or strep
throat, there may be less need to disclose than if the
visit is for a chronic health problem, such as heart
disease or cancer. Another factor is opportunity. If the
health care provider asks a question about sexual and
gender identities, or if the written forms have a place to
disclose, patients are much more likely to reveal their
sexuality or gender than if they must create the
opportunity themselves. In studies of both adults and
youth, about two thirds of respondents wished that the
provider would ask.
The Health Care Provider Level
Some LGBTQ patients will seek referrals from
friends and people in their communities, or use online
 Health Care Providers, Disclosure of Sexual Identity to
resources such as the GLMA (Gay and Lesbian Medical
Association) Provider Directory to find health care
providers who are known to be LGBTQ-sensitive.
Many do not have the luxury of choice and have to base
their decision about whether to disclose on at least two
types of health care provider characteristics. These
include the following:
Provider Demographic Characteristics. This includes
whether the provider is known to be LGBTQ or at least
has a reputation as LGBTQfriendly, and often includes
age and gender. Some LGBTQ people believe that
women and younger providers are more likely to be
accepting.
Provider Behaviors. These include both the language
and the nonverbal behavior of a provider.
All patients want providers who are good
communicators, but LGBTQ patients may be looking
for key words that indicate the provider has some
knowledge of LGBTQ issues and family structures—
for example, asking, “Are you sexually active with
men, women, both, or neither?” and using words like
partner instead of, or in addition to, spouse or
husband/wife. Nonverbal cues include personal space,
tone of voice, touch, and body language that send
messages about the provider’s level of comfort with the
situation. Most providers automatically assume that
their patients are heterosexual (a concept called
heteronormativity) and this assumption makes it harder
for the LGBTQ person to disclose because it renders
their sexuality or gender invisible. A parallel
assumption is that all people are clearly male or female
and have been that way since birth, a concept called
gender normativity.
If the patient does disclose, the individual will
carefully monitor the provider’s response. Sometimes
silence is the hardest reaction to interpret. It would be
beneficial if providers acknowledge the disclosure,
because it may have been an act of courage. A simple
statement such as, “Thank you for sharing that. Is it
okay if I mention it in your written records?” signals
both acceptance and an awareness that it still may not
feel safe to have sexual orientation and gender identity
information on formal paperwork.
The Local Health Care Agency/System Level
1271
At the local community level, the clinic, office,
hospital, or other health care setting (called the
“agency” for the rest of this section) is located in a
neighborhood, and sometimes physical locations have
reputations as LGBTQ-friendly or -hostile. The agency
may have a tie with a religious group that is not
generally welcoming of LGBTQ people. The agency
may have a bad reputation among the LGBTQ
community because of a negative experience only one
person had years ago. If the agency is not aware of the
bad reputation, they do nothing to change it.
Once patients enter the agency, they will scan the
environment for clues that this agency recognizes that it
serves LGBTQ people. Such clues include posters,
flyers, patient information brochures, magazines,
newsletters, the patient rights statements, and the forms
that the receptionist hands over, as well as many other
visual cues. Some agencies or individual providers will
have stickers that declare “safe zone,” “straight but not
narrow,” or have symbols like pink triangles or
rainbows that indicate some awareness of LGBTQ
communities. The patient will look to see if there are
any visible, openly LGBTQ employees.
Some patients may do research on the agency before
deciding whether to make an appointment, and may
search to find whether the agency has a human rights
policy that explicitly names sexual orientation and
gender identity; whether they have domestic partner
benefits, LGBTQ committees, and LGBTQ people on
the board of directors; whether they advertise their jobs
or services in the LGBTQ press; and so on. It is
important for agency websites to use inclusive and
welcoming language for all the communities they serve.
The Human Rights Campaign (HRC) collects
information from health care institutions about
LGBTQ-inclusive policies using a survey tool called
the Health Equality Index. The HRC website has a
database of inclusive agencies for individuals who have
choices in their health care systems and providers.
Societal Level
Local systems and individuals that work within these
systems are influenced by the broader context.
Although the U.S. Supreme Court ruled in June 2015
that same-sex couples have the same right to marry as
heterosexual couples throughout the country and that
these unions must be recognized nationwide, a given
locality may differ in other respects, including health
care policy. Does it have legal protections for LGBTQ
1272
people in employment, housing, and education? Is there Further Readings
agency oversight by a government regulatory body like Durso, L. E., & Meyer, I. H. (2012). Patterns and predictors of
the Joint Commission (the organization that accredits disclosure of sexual orientation to health care providers
and monitors hospitals) that now requires LGBTQ- among lesbians, gay men, and bisexuals. Sexuality Research
inclusive policies? What is the overall political climate and Social Policy.
of the region or state? These often invisible forces can doi.10.1007/s13178-012-0105-2
have profound influence over individual health and
well-being, but they are often not recognized or
acknowledged as sources of stress. It is easier to focus
on the individual’s behavior than to study the effects of
laws, policies, or political campaigns. However, state
and federal laws and policies related to health care are
profoundly important. A good example of widespread
impact was when President Obama issued an executive
order mandating that health care agencies that accept
federal money must grant visitation rights to same-sex
partners. These messages from the top down must be
balanced with bottom-up provider and agency-level
changes to make systems more hospitable to LGBTQ
people. This will shift the likelihood of disclosing in
major ways.

Conclusion
The decision to disclose sexual or gender identity to a
health care provider is complex and multilayered. Some
of the factors lie within individual patients’ personal
characteristics and experiences, but the bulk of them
come from higher-level influences. If the societal level
promoted policies that included LGBTQ people as full
citizens and valued the diversity of the population,
more education about LGBTQ issues would be found in
health care training programs (and elsewhere), partners
and families would be recognized, forms would be
inclusive, and disclosure would be simple and
straightforward. Although much progress has been
made in the past 10 years, there are still dangers
associated with disclosure that will keep some LGBTQ
people from getting the highest possible quality of
health care. LGBTQ political campaigns that urge
individuals to disclose to health care providers need to
also work on the higher-level factors that make
disclosure uncomfortable or even dangerous for
individuals.
Michele J. Eliason

See also Chronic Illness; Closet, The; Coming Out,

Disclosure, and Passing; Health Care System;
Heteronormativity; Physicians

Eliason, M. J., & Schope, R. (2001). Does “Don’t Ask, Don’t
Tell” apply to health care? Lesbian, gay, and bisexual
people’s disclosure to health care providers. Journal of the
Gay and Lesbian Medical Association, 5(4), 125–134.
Gay and Lesbian Medical Association (GLMA). Provider
directory. https://glmaimpak.networkats.com/
members_online_new/members/dir_provider.asp
Human Rights Campaign (HRC). (n.d.). Healthcare equality
index. Retrieved December 7, 2015, from
http://www.hrc.org/hei
McNair, R. P., Hegarty, K., & Taft, A. (2012). From silence to
sensitivity: A new identity disclosure model to facilitate
disclosure for same-sex attracted women in general
practice consultations. Social Science & Medicine, 75,
208–216.
Mosack, K. E., Brouwer, A. M., & Petroll, A. E. (2013).
Sexual identity, identity disclosure, and health care
experiences: Is there evidence for differential homophobia
in primary care practice? Women’s Health Issues, 23(6),
e341–e346.
Neville, S., & Henrickson, M. (2006). Perceptions of
lesbian, gay, and bisexual people of primary health care
services. Journal of Advanced Nursing, 55(4), 407–415.
HEALTH CARE SYSTEM
A health care system supplies health-related resources
corresponding to the health demands of a population.
Health care systems are made up of the complex
structures of hospitals, clinics, doctors, nurses, support
staff, pharmaceutical products, medical devices,
emergency response services, and payment systems that
come together to improve the health of a population.
Health care systems, as discussed here, are limited to
direct interventions aimed primarily at improving
health. This entry will first identify the components of a
health care system and then move on to model different
systems of health care delivery. Health care systems
that fail to provide universal health coverage, like the
system in the United States, generally underserve the
LGBTQ population. In part, this underservice is a direct
result of the ban on gay marriage that was still in effect
in many states until the Supreme Court ruled in June
2015 that samesex couples have a right to marry
anywhere in the United States. Until that ruling, many
people in same-sex relationships were unable to extend
their health insurance coverage to their partners. The
LGBTQ population also experiences a higher
1273
prevalence of HIV, substance use, and smoking, which
all require medical interventions.
Components of a Health Care System
Medical infrastructure such as hospitals, clinics,
doctors’ offices, long-term care facilities, and
ambulances are the skeleton of a health system. The
ability of the medical infrastructure to promote health in
an area depends on the access to, and quality of,
service.
Health care providers are a key part of the system.
Physicians, psychiatrists, psychologists, nurses,
advanced practice registered nurses, midwives,
pharmacists, physician’s assistants, nursing aides,
traditional healers, and medical support staff are all part
of the health care system at large.
Medical devices and pharmaceuticals play a crucial
role in a health system. Having stable access to
appropriately prescribed medicines is an essential
component to maintaining a high quality of health. For
example, for those with HIV, having access to a stable
source of antiretroviral medication can mean the
difference between life and death. Because developing
new medicines is an extremely long and costly process,
pharmaceutical drugs often carry high price tags. Drug
companies protect their developed medicine by filing a
patent, making it illegal for anyone else to produce the
same drug for a set period so they have an opportunity
to recoup their costs. In countries with a low average
income, governments may choose to produce their own
generic versions of lifesaving medicine, even when a
patent is still in effect.
Health Care System Models
In the modern world, governments play a very
important role in the health of their respective
populations. Economically and socially, illness has a
negative impact that is costly to society. An unhealthy
population is prone to missing days of work due to
illness and disability; consequently, public health issues
can reinforce poverty and make running a business,
school, and government more difficult. Having a
healthy population creates stability and social cohesion.
Further, health is an essential component of a happy,
well-balanced life. For these reasons, many countries
have come to consider access to health care a basic
right, and therefore believe the government should be
1274 Health Care System
its primary provider. Because of widespread
discrimination, when health care is not a universal right,
the LGBTQ population feels the impact
disproportionately. There are three models that various
countries use to deliver health care to all: the Beveridge
model, the Bismarck model, and the national health
insurance or single-payer model. Other countries, either
from lack of resources or for philosophical reasons,
treat health care more like a traditionally consumed
good where people have access to it only if they can
pay for it—known as the out-of-pocket model. Next, all
four of these models, plus the American model, are
explored.
The Beveridge Model
Under the Beveridge model, the government
finances and provides health care through taxation.
Philosophically, this model sees health care as a public
good and basic right for all. The Beveridge model is
named after its creator, William Beveridge, who
developed this model and oversaw its implementation
in the United Kingdom.
In the Beveridge model, the government owns the
majority of hospitals and clinics. For the private
facilities that do exist, payment is still rendered by the
government. There is no significant private health care
market supplementing the publicly available care.
Doctors may be government employees or may work
for a private group. Private groups are still paid by the
government. The Beveridge model is characterized by
the fact that only the government pays for health care.
Patients do not receive bills and do not cover any
percentage of their own health care. This model is in
practice throughout the world; for example, it has been
implemented in Great Britain, Hong
Health Care System
Kong, Taiwan, Australia, Cuba, New Zealand, and
Spain. In some of these countries, the government owns
the majority of hospitals and clinics; in others, hospitals
and clinics are mostly privately owned and the
government pays them for services rendered. Countries
where the government owns more of the hospitals and
clinics are more socialized systems than those that have
significant private sector contributions.
Countries using this model tend to have a low cost
per capita. This is because the model is successful at
controlling costs from both the supply side and the
demand side. The supply side is controlled because the
government is the sole purchaser of services and can
negotiate doctor fees, pharmaceutical prices, and
hospitalization costs very effectively. This ability to
bargain should be contrasted with a free market system
where patients, often facing death or suffering if they
go without care, are willing to pay any price, resulting
in skyrocketing care costs. Under the Beveridge model,
the demand for expensive health services is reduced
because everyone has access to health care absolutely;
therefore, price never prevents them from seeking care.
Consequently, people receive early interventions, which
results in enough preventive care to reduce the amount
of crisis care needed in the long run.
This model takes away consumer choice to a large
degree. Care delivery can be cold and impersonal;
because the government pays, consumer demand does
not shape the care experience. On the worst side of it,
there can be long waits to receive nonemergency care.
While these systems boast a rather good average quality
of care, receiving exceptional care is difficult because
one does not have the option to hire the best specialists
and innovators for a specific illness. Further, becoming
a physician or nurse is not a highly prestigious and
profitable career, and consequently these countries may
see their best and brightest choosing other fields where
they can generate greater financial returns. Countries
with this model are vulnerable to “brain drain,” where
the most innovative and cutting-edge doctors leave the
country to pursue careers where they can make more
money and devote more resources to research. Critics of
collective drug bargaining argue that governments buy
pharmaceuticals at negotiated prices; thus, they drive
down prices below what it costs to develop new drugs.
As a result, some believe that if all countries adopted
this system, the rate of medical innovation could slow
down.
The Beveridge model is mostly positive for the
LGBTQ population because it provides services
universally. In most Beveridge systems, many
treatments for gender dysphoria are covered entirely.
However, the system is not flawless; indeed, waiting
lists for gender reassignment surgery can be staggering.
LGBTQ people can also be frustrated by a lack of
choice in providers, making it more difficult to receive
culturally competent care.
The Bismarck Model

The Bismarck model is an insurance system whereby
all employers and employees contribute to health care
through payroll taxes, and the government fills in the
health insurance gap for the unemployed and retired.
Bismarck models are distinct from the American health
insurance system because contributions are not optional
and everyone is covered. Further, the government
prohibits insurance providers from seeking a profit. The
government still plays a heavy role in cost control, and
prices for services and pharmaceuticals are negotiated.
Countries using the Bismarck model have what is still
an example of a multi-payer system, and employers use
higher-end plans to attract
talent. In these systems, insurance is called sickness
plans. The Bismarck model has been adopted by
Germany, Switzerland, Belgium, and Japan. This is a
hybrid model where there is mandatory insurance with
public and private providers.
This model is a premium-funded, mandatory
insurance model. In general, it has been very effective
at keeping costs reasonable, though not quite as
effective as the Beveridge model. This model provides
health care for all citizens, and it treats health care as a
basic right, but it has many different payers, including a
safety net government payment system, all closely
regulated. By keeping hospitals almost entirely private
and competing for patients, the Bismarck model is
thought to do a better job than the Beveridge model at
creating a positive patient experience. Further, by
having many different insurance companies
participating, but preventing them from generating large
profits, the marketplace rewards competition without
exploiting inelastic consumer demand. The Bismarck
system has shorter waiting times to see providers than
the Beveridge system, as well as high-quality care and
overall low per-capita costs. Unlike the U.S. insurance
system, Bismarck model insurers rarely deny insurance
coverage for services rendered, they do not require a
copay, and the government independently heavily
subsidizes pharmaceuticals. This system is
overwhelmingly positive for LGBTQ patients, who
benefit from universal coverage and the ability to
choose their providers.
The Bismarck model, like the Beveridge model, may
not provide significant enough profit incentives to
attract the most talented minds to medicine or breed the
kind of pharmaceutical innovation that the highly
profitable U.S. system does. Other negatives of this
system are that costs and medical outcomes are, on
1275
average, worse than in countries with a Beveridge
model. The reason for this is rising costs, which tend to
be addressed by increasing premiums instead of
controlling costs, because the government does not
have control over the providers.
The National Health Insurance Model/
Single-Payer Health Care Model
This system relies on private sector health care
providers and is paid for by the government-created
insurance plan supported by taxes. It is a hybrid of the
Beveridge and Bismarck system because it uses a
single, government-run, health insurance provider, and
relies entirely on the private sector to give care.
However, it is distinct from these systems in that health
care can still be purchased beyond what the government
provides, outof-pocket. Care providers who offer elite
or innovative care may accept only out-of-pocket
payment. Consequently, the “brain drain” is less of a
risk under this system. Canada, South Korea, and
Argentina all have implemented this system.
This system provides universal care and keeps costs
contained because the government is a powerful
bargaining entity. In particular, this model is highly
effective at purchasing pharmaceutical drugs. There are
no incentives for the government to reject claims, and
there are no marketing costs associated with health care
because there is no competition.
There are negatives to this model due to budget
constraints. This system suffers from significant wait
times and coverage caps. Consequently, consumers may
have to settle for care that is not their preferred method
and may need to enroll in waitlists. LGBTQ populations
may be particularly likely to be affected by these
shortcomings because of biases existing within the
system toward LGBTQ individuals, especially those
who are HIV-positive or transgendered. For example, a
person with HIV may have to settle for an antiretroviral
therapy that has more side effects than other similar
drugs.
Out-of-Pocket Model
Only 40 of 200 countries have implemented a
national health care system. For those that have failed
to do so, their system is referred to as an outof-pocket
system. In these countries, those with money have
access to health care, and those without money do not.
1276 Health Care System
Limited government programs and charity programs fill
the gaps with crisis care.
Some countries with nominally socialized health
care have de facto out-of-pocket systems. In China, for
example, most nonrural citizens are uninsured, and the
major form of aid in receiving health care is a direct
subsidy. In Vietnam, government subsidies cover only
about 20% of care, with the remainder paid out of
pocket. This system results in many people, including
the LGBTQ population, being underserved in all areas
of health care. Because some of the countries with this
system are impoverished, lifesaving medicines,
including antiretrovirals, may be made by the
government under an international, need-based
suspension of pharmaceutical patents, which drives
down the prices
Health Care System
significantly. Even with this allowance under patent
law, countries with an out-of-pocket system still see too
few people receiving antiretroviral drugs, largely
because testing is not done before the illness progresses
to AIDS.
The American System
The United States has the ultimate hybrid model.
Americans may experience their health care similarly to
those living under a Bismarck system, national health
insurance model, Beveridge model, or an out-of-pocket
model.
Many Americans receive health care from their
employer. For them, American health care is a lot like
the Bismarck model, because both they and their
employer pay into a private insurance pool. Notably,
unlike Bismarck countries, not all employers provide
insurance, and insurance companies are profit seeking.
The Affordable Care Act, passed in 2010, reformed the
American insurance model to require organizations that
employ 50 full-time workers or more to provide
insurance to their employees or pay a penalty. To date,
the change in policy has not dramatically changed the
availability of employer-provided health insurance, and
unlike a Bismarck system, employees do not have to
buy insurance from their employer.
Employer-provided health insurance varies
tremendously in terms of quality and fee mechanisms.
Many employers offer traditional insurance, which
often requires partial payment for services rendered,
through copays, deductibles, and coverage capitations.
Employers also may choose to offer managed-care
health insurance, where doctors and hospitals join as a
collaborative entity that takes a single fee per patient
and provides care exclusively to patients in the system,
and that offers no coverage if employees choose to
leave the organization. In between these two examples
exist health management organizations (HMOs), where
a patient may get care from providers who have entered
into a contract with the insurance company. American
insurance plans are notoriously and intentionally
complex, and they have been criticized for using
bureaucracy and opaqueness to deny claims and drive
down their costs by placing them more squarely on the
patient. Proponents of the system say that Americans
with insurance are very satisfied with their health care
and enjoy the autonomy to choose their care. LGBTQ
families have been excluded in some jurisdictions under
this model because, until June 2015, not all states have
had marriage recognition or have created a proxy
institution (e.g., domestic partnership). Many employers
who were not bound by law to recognize same-sex
relationships as equivalent to marriage have opted to
extend spousal health insurance benefits as a
recruitment tactic.
An increasing number of Americans are receiving
their health care from the government through Medicare
and Medicaid. Americans who get coverage this way
experience health care the way that people who have
the national health insurance model do. Only
Americans who have disabilities or are over age 65 are
eligible for Medicare. The federal government
consistently administers Medicare all across the United
States. Medicaid is intended for people who have low
income; however, the income threshold varies
tremendously from state to state. Medicaid is
administered by each state independently, and the way
the care is structured varies. Under the Affordable Care
Act, the federal government has hoped to both expand
and converge state Medicaid plans by offering federal
dollars to states that agree to offer certain programs and
expand coverage. Typically, Medicare offers better
coverage and reimbursement for providers than
Medicaid, but both operate similarly. Neither Medicare
nor Medicaid operates its own facilities, and instead
they both simply provide insurance; patients can choose
their own providers. Unfortunately, some providers
limit the care they offer to those on federal government
plans, because state plans typically promise lower
reimbursement rates.
 1277
Impoverished LGBTQ populations living in areas is that fewer Americans will be uninsured in the future.
that, prior to the June 2015 Supreme Court decision, did Many of the previously uninsured are obtaining health
not recognize same-sex marriage, have received an insurance in a quasi-public fashion, because the
unintentional benefit from this discrimination. Because Affordable Care
spousal earnings are used to determine if an individual
is eligible for Medicaid, individuals in unrecognized
same-sex relationships were more likely to qualify for
Medicaid.
Medicare covers half of the HIV population in
America because HIV treatment receives special
coverage under Medicare. While Medicare is
traditionally available only to those over 65, it has a
specific expansion for patients who are found to be
disabled by the Social Security Administration.
For a very small percentage of Americans, health
insurance is delivered similarly to the Beveridge model.
The U.S. Department of Veterans Affairs (VA) and
TriCare both offer governmentpaid care at government-
owned facilities. The VA provides care to military
veterans, and the TriCare system provides care to those
who are active military. TriCare is known to provide
top-quality care, including covering treatment with
private specialists, while the VA is often accused of
providing subpar care. This contrast illustrates that the
quality of Beveridge coverage is highly dependent on
the resources supporting it.
Those in the United States who do not have any
insurance live in an out-of-pocket system. One notable
difference from this model in some other countries is
that, in the United States, emergency care must be
provided. Consequently, Americans without insurance
often leave routine illnesses untreated, getting treatment
only when the illness has progressed far enough to
require emergency hospital admission. Emergency care
is not free; the cost is still billed to the patient, so these
visits can leave visitors with high bills. Medical debt is
often crippling and is the leading cause of bankruptcy in
America. Before 2010, many Americans were
uninsured because buying private insurance was
exorbitantly expensive. Further, insurers refused to
provide coverage for those with preexisting conditions;
as a result, people with a chronic illness could not
purchase insurance that covered them. Because LGBTQ
people are more likely to live in poverty, the
community has been disproportionately affected by this
problem.
In 2010, the Affordable Care Act was passed,
changing the way insurance companies could exclude
buyers and charge for coverage. The anticipated effect
1278 Health Disparities
Act provides people who earn less, but not so little as
to make them eligible for Medicaid, with significant
sliding-scale subsidies that can be used to purchase
insurance of the consumer’s choosing. In theory, this
hybrid approach will address the number of
uninsured without destroying the advantages that the
American health care system has in terms of
innovation and consumer choice.
Leslie C. Allen
See also Aging, Social Relationships, and Support;
Chronic Illness; Discrimination Against, LGBTQ
People, Cost of; Discrimination on the Basis of HIV/
AIDS in Health Care; Domestic Partnership; Health Care
Plans; Health Disparities; HIV/AIDS Treatment and Care,
Psychosocial and Structural Barriers to
Further Readings
Bloomberg. (2014, August 25). Most efficient health care
2014: Countries. Retrieved September 2, 2014, from
http://www.bloomberg.com/visual-data/best-andworst/mo
st-efficient-health-care-countries
Centers for Medicare and Medicaid Services. (n.d.).
National health expenditures 2013 highlights.
Retrieved September 2, 2014, from https://www.cms
.gov/Research-Statistics-Data-and-Systems/
StatisticsTrends-and-Reports/NationalHealthExpendData/
downloads/highlights.pdf
DeNavas, C., Proctor, B., & Smith, J. (2011, September).
Income, poverty, and health insurance coverage in the
United States: 2010. Current Population Reports. U.S.
Department of Commerce. Retrieved September 2, 2014,
from http://www.census.gov/prod/2011pubs/ p60-239.pdf
Kates, J., & Ranji, U. (2014, February 21). Health care
access and coverage for the lesbian, gay bisexual, and
transgender (LGBT) community in the United States:
Opportunities and challenges in a new era. Henry J. Kaiser
Family Foundation. Retrieved October 20, 2014, from
http://kff.org/disparities-policy/perspective/ health-care-
access-and-coverage-for-the-lesbian-gaybisexual-and-
transgender-lgbt-community-in-the-unitedstates-
opportunities-and-challenges-in-a-new-era/ Lameire, N.,
Joffe, P., & Widmann, M. (1999). Healthcare systems—an
international review: An overview. Nephrology Transplant
Dialysis Journal, 14, 3–9.
Mills, A. (2014, February). Health care systems in lowand
middle-income countries. New England Journal of
Medicine, 370, 552–557.
Physicians for a National Health Program. (n.d.). Health care
systems—Four basic models. Retrieved September 2,
2014, from http://www.pnhp.org/single_payer_
resources/health_care_systems_four_basic_models.php
Starfield, B., Shi, L., & Macinko, J. (2005). Contribution of
primary care to health systems and health. Milbank
Quarterly, 83, 457–502.
Van Deusen, L., Holmes, S., Cohen, A., Restuccia, J.,
Crammer, I., Shwartz, M., et al. (2007, October/
December). Transformational change in health care
systems: An organizational model. Health Care
Management Review. Retrieved September 2, 2014, from
http://www.rwjf.org/en/research-publications/ find-rwjf-
research/2007/10/transformational-changein-health-care-
systems.html
World Health Organization. (2000). World health report:
Why do health systems matter? Retrieved September 2,
2014, from http://www.who.int/whr/2000/en/
whr00_ch1_en.pdf?ua=1
HEALTH DISPARITIES
Lesbian, gay, bisexual, transgender, and queer
(LGBTQ) individuals make up a population that is
heterogeneous and diverse in terms of a wide range
of demographic factors including age, race, ethnicity,
geographic location, socioeconomic status, gender
expression, and gender identity. Despite these
differences, LGBTQ individuals face some common
problems, including both minority stress and
psychosocial inequities that are unique to sexual and
gender minorities. These problems are implicated in
the health disparities experienced by these groups
when compared with heterosexual and cisgender
counterparts on both physical and mental health
indicators. This entry will first outline some
explanatory theories of health disparities including
individual factors, psychosocial components, and
other protective and risk factors. Next, mental and
physical health research with LGBTQ populations
will be reviewed, and issues related to access to
healthcare for LGBTQ individuals will be discussed.
Finally, some conclusions based on the review of the
literature will be provided.
To date, a majority of the research on LGBTQ
populations indicates that these groups experience

elevated levels of mental health symptoms, higher
rates of some psychiatric disorders, higher levels of
health-risk behaviors, and greater risk for some
physical health problems. The consensus in the field
is that it is not something inherent in diverse sexual
and gender identities that causes these disorders.
Indeed, despite elevated risk in the overall LGBTQ
population, most LGBTQ individuals are relatively
healthy and resilient. Still, the undeniable pattern of
disparities between LGBTQ and
heterosexual/cisgendered populations indicates that
something about these groups’ experiences
contributes to these results. If it is not something
inherent in nonheterosexual or gender-
nonconforming identity itself, then it must be
something in this population’s life experiences.
Theories Explaining Health Disparities
Health disparities for LGBTQ people are situated in a
long history of stigmatization and discrimination
toward this group. Recent medical and social science
literature has framed LGBTQ health disparities
within the context of this inequality, which underlies
society’s inattention to the unique experiences and
health needs of this population. To encourage and
facilitate understanding of how LGBTQ individuals’
identities and experiences interact with their health,
health care access, and health care outcomes, the
Institute of Medicine (IOM) reviewed four
conceptual frameworks: (1) the life-course
perspective, (2) the minority stress model, (3) the
intersectional perspective, and (4) the social ecology
model. The life-course perspective attends to
development between as well as within age cohorts,
considering relevant historical contexts. Sexual-
minority stress theory seeks to understand an
individual’s experiences with both internal and
external stressors within a social and community
context. Intersectionality focuses on the interaction
of multiple stigmatized identities, considering the
ways in which related experiences adversely affect
health. Finally, the social ecology perspective
considers the various influences in people’s lives,
emphasizing social connections, societal factors, and
how these may impact health. A full discussion of
these models is outside the scope of this entry.
However, each of these frameworks provides
Health Disparities 1279
perspective to improve understanding of health
needs, status, and disparities in LGBTQ populations.
The IOM report notes that these models complement
each other, enabling a comprehensive approach to
understanding LGBTQ individuals’ experiences and
the subsequent impact on health issues.
As the health disparities between LGBTQ and
heterosexual/cisgendered populations have emerged
in the literature, efforts have shifted to understanding
why these disparities exist. Several theories and
models seeking to explain these effects have been
posited. The most researched and widely recognized
of these models, Ilan Meyer’s minority stress model,
delineates a complex interaction of both proximal
and distal stressors as well as protective and
supportive factors that, together, contribute to the
mental health of the individual. To understand the
health disparities only with regard to prevalence rates
would be to only understand half the issue—the
effect without the cause. Recent reports from the
American Psychological Association and the IOM
have highlighted the importance of understanding the
role of these risk and protective factors in this
population.
With regard to LGBTQ youth, research has
consistently revealed higher levels of minority
stressors such as victimization, harassment, and other
forms of overt discrimination. These experiences are
predictive of increased rates of emotional and
behavioral issues. Research in this domain is
disproportionately focused on the experience of
sexual-minority adolescents rather than gender
minorities and younger children. However, results
have been remarkably consistent in revealing that
increased minority stressors are associated with
depression, anxiety, suicidal ideation and attempts,
self-image issues, interpersonal issues, and
behavioral problems including substance use. In
addition, research has consistently suggested that
prevalence of childhood abuse, including physical
and sexual abuse, may be higher among LGBTQ
youth, which may also be causally linked to health
disparities. A disproportionate number of homeless
youth identify as LGBTQ; in turn, their homelessness
may in part reflect family rejection. Both
homelessness and family rejection may exacerbate
already deleterious health consequences for these
youth. Recent research has suggested that young
1280 Health Disparities
transgender females may be most at risk for
becoming homeless, which can disrupt medical
services if they have already begun the transition
process.
Conversely, acceptance and support from peers,
school mentors, and especially family have been
revealed to be protective against mental health
problems. LGBTQ youth who experience family
acceptance, particularly during the coming-out
process, report significantly lower symptoms of
depression as well as suicidal ideation and attempts
than those who experience family rejection. While
few studies have directly examined the impact of
inclusionary and protective school policies and
organizations, it may be that these serve to
ameliorate the risk associated with an unsafe
environment and promote the protective effects of
safety and being supported. To this end, a limited
number of studies have revealed that students in
schools with such policies report feeling safer and
experiencing fewer incidents of harassment.
Among LGBTQ adults, the roles of
discrimination, violence, and victimization as they
relate to mental and physical health have also been
evaluated. For most LGBTQ people, living in a
society in which one’s sexual and gender identity
places them in the minority can create internalized
stigma and elicit day-to-day microaggressions that
have implications for health and well-being. LGBTQ
adults are more likely to be the victim of
discrimination, both overt and covert, over their
lifespan than are their heterosexual and cisgender
counterparts. These lifetime experiences are even
more prominent in the lives of older LGBTQ adults,
who came of age during a time when societal
attitudes toward LGBTQ people were even more
negative and restrictive. Negative events that are
perceived by the victim to be directly related to his or
her sexual or gender identity are even more
deleterious to mental health than those events that are
less clearly linked. Although policies and laws are
changing in the United States, LGBTQ adults still
face institutional discrimination in the workplace and
within the larger context of society. In particular,
those living in regions or cities with fewer
protections for LGBTQ people may experience
disproportionate minority stress and resulting health
problems. In sum, while all LGBTQ people are
subject to the negative health impact of minority
stress, there is research evidence that variations in
exposure to these stressors are related to variations in
depression, anxiety, suicidality, substance abuse, and
other health-related concerns.
The research on protective factors among adults is
more limited and is an area for future study. Social
support and connection to a supportive LGBTQ
community may be important protective factors
against certain negative problems. Another protective
factor is the development of a positive LGBTQ
identity. Self-acceptance and the formation of a
positive belief about oneself as an LGBTQ person
may protect against the negative mental health
sequelae of a poor self-image. Among transgender
individuals, developing this positive selfimage may
entail utilizing medical interventions to achieve
congruence between one’s physical body and gender
identity. Some limited research has suggested that
obtaining these interventions can play a role in
mental health.
Mental Health
For years, even after homosexuality was removed
from the Diagnostic and Statistical Manual of
Mental Disorders (DSM), research on this topic was
tainted by its former classification as a psychiatric
disorder. Over the past two decades, research on
mental health of LGBTQ populations has grown due
to greater societal acceptance of this topic as well as
methodological advances in the field. The inclusion
of questions about sexual and gender identity on
national, population-based health surveys has
allowed researchers to systematically examine
differences between populations without the bias
inherent in uneven sampling methods. Results have
indicated higher levels of psychological distress and
higher rates of several mental health disorders in
LGBTQ populations. Findings are at times
inconsistent and may vary based on sampling
methods and measurement issues. For example,
disparities tend to be greater among samples that are
recruited using probability methods than among
those recruited directly from LGBTQ communities,
indicating that perhaps those who are “out” and
connected to these communities are less vulnerable.
In addition, disparities tend to be greater when sexual

orientation is defined in terms of sexual behavior
rather than self-identification as LGBTQ. This may
indicate that there is something protective about self-
identification for those with same-sex behaviors.
Still, the overall picture is clear that LGBTQ
populations are at greater risk and warrant further
study.
Awareness of a minority sexual or gender identity
often develops in adolescence, and this is also the
period in which mental health disparities emerge. In
addition to the typical developmental tasks facing all
teenagers, LGBTQ youth are faced with the
challenge of developing an identity that does not
conform to societal expectations. To date, the
majority of research has focused on lesbian, gay, and
bisexual youth, and not on those who are
transgender-identified. Results indicate an increased
risk for depression, suicidal ideation, and suicide
attempts relative to heterosexual peers. These
disparities appear to transcend sex, age, race, and
ethnicity differences within LGBTQ populations.
Very recently, greater attention has been paid to the
unique issues for transgender and gender-
nonconforming youth, and similar disparities have
been found with respect to depression and suicidality.
In addition, some research has also suggested that
both sexual and gender minority youth may be at
greater risk for anxiety-related disorders, substance
use and abuse, as well as disordered eating and body
dysmorphic disorders.
Even as LGBTQ youth enter adulthood and gain
more control over their environments and mastery
over their lives, mental health disparities persist. A
considerable amount of research with population-
based samples has documented the elevated
prevalence of mental health disorders among lesbian,
gay, and bisexual adults, with a focus on depressive,
anxiety, and substance use disorders. Lesbian, gay,
and bisexual (LGB) adults are also significantly more
likely than heterosexual adults to have experienced
suicidal ideation or have attempted suicide in their
lifetime and in the past year, indicating that suicide is
a risk that persists into adulthood. Though the
empirical research with transgender and gender-
nonconforming adult samples is sparse, studies have
revealed that gender minority individuals, similar to
sexual-minority individuals, experience higher rates
of depressive symptoms as compared to cisgender
Health Disparities 1281
individuals. Suicidal ideation and attempts are a
particular risk among this highly stigmatized
population, with rates among transgender adults even
higher than those of LGB and cisgender people.
Demographic, environmental, and individual factors
all play a role in the risk and resilience of LGBTQ
people with respect to suicide. In particular, recent
research has elucidated the critical roles of social
support and acceptance as well as of the individual’s
own experiences of successful identity formation and
self-acceptance in supporting mental health and
reducing suicidal ideation.
Physical Health
The physical health of LGBTQ individuals has
received less attention than the mental health of this
population. Thus, the research in this domain is less
consistent and thorough. The preponderance of the
research has focused on sexual health outcomes
including HIV and other sexually transmitted
infections, which has disproportionately impacted
gay and bisexual men since the first cases were
discovered in the late 1970s and early 1980s.
Presently, it is estimated that approximately 20% of
gay and bisexual men in urban areas are living with
HIV. Though incidence rates of new infections have
notably decreased, men who have sex with men are
still at greater risk for contracting the disease,
particularly in early adulthood. HIV rates may also
be elevated among young, male-to-female
transgender individuals. Among older adult men who
have sex with men, HIV still continues to represent a
substantial medical concern. In addition to higher
prevalence in this population overall, older gay and
bisexual male adults are more likely to contract HIV
compared with their heterosexual counterparts. As
with youth, little research has been done with
transgender and female adults with regard to HIV;
however, some small studies suggest that transgender
and bisexual females may be at greater risk of
contracting the disease.
Other research on physical health of LGBTQ
people is limited, particularly among LGBTQ youth.
Most of the research focuses on health risk behaviors
rather than disease. For example, some research has
revealed that adolescent lesbian and bisexual girls are
more likely than their heterosexual peers to
1282 Health Disparities

experience a teen pregnancy, which in part may be Access to Care

due to greater risk behaviors overall and a higher
The onset and persistence of LGBTQ health
prevalence of childhood sexual abuse. Among adults,
disparities is closely tied to access to care. Access to
LGB individuals are 1.5 to 2 times more likely than
care is an important consideration in understanding
their heterosexual counterparts to use tobacco, which
health disparities among LGBTQ people. Access
is associated with a number of chronic and terminal
may be understood as the ability to obtain health care
diseases. Similarly, LGB adults and particularly
and may be impacted by personal as well as
lesbian and bisexual women are more likely to
institutional factors. The issue of access among
consume alcohol and to do so in larger quantities
LGBTQ people is a complex one, and the degree to
over the lifespan and, thus, may experience greater
which disparities in access are problematic may vary
risk for alcohol-related disease. Lesbian and bisexual
according to the type of care. For example, a number
women also tend to have higher body mass index
of studies have demonstrated that LGBTQ people are
(BMI) scores than their heterosexual counterparts,
more likely to seek mental health services over their
which can be associated with disease risk.
lifespan. This may be due in part to elevated rates of
Among the LGBTQ adult and older adult
mental health problems that necessitate care. In
populations, physical health concerns have received
addition, many LGBTQ people seek professional
slightly more attention from researchers, as health
help during the process of coming out and coming to
and disease become more salient with age. With
terms with their sexual or gender identity. Perhaps
respect to disparities in actual diseases, less is known
relatedly, there is generally a greater sense of peer
about sexual and gender identity–related disparities,
acceptance and “normalizing” of psychotherapy in
in part due to the historical lack of information about
LGBTQ communities, thereby reducing a barrier that
sexual orientation in national disease registries and
is present in other segments of the population.
health records. This makes population-based
Regarding physical health care, the picture is less
morbidity and mortality information difficult to
clear. Population-based studies of access to routine,
track. There is some evidence that gay and bisexual
preventive care indicate that gay and bisexual men
men have elevated risk for anal cancer, and lesbian
use such services with equal or greater frequency
and bisexual women may have elevated risk for
than their heterosexual counterparts. This is likely
breast cancer. In terms of sexual and reproductive
due in part to the HIV/AIDS epidemic and the
health, limited research indicates that gay men may
greater awareness of and need for preventive
experience higher rates of erectile dysfunction. Data
services. For lesbian and bisexual women, however,
regarding most of these physical health issues are
seeing a medical provider is less common. Fear of
relatively sparse and not yet conclusive, particularly
discrimination and traumarelated issues from a
with regard to the mechanisms causing or
sexual abuse history can serve as psychological
contributing to these health disparities.
barriers among this segment of the population.
It is important to note that the small body of
Cultural competency is a key factor in health care
literature on physical health focuses almost
access disparities. Although attention is increasingly
exclusively on lesbian, gay, and bisexual
being paid to LGBTQ health in medical, nursing,
populations, with little attention to transgender
psychological, and other training programs, many
people. Understanding the physical health of
professionals lack the knowledge and skills to
transgender people, who may undergo medical
adequately address the concerns of this unique
interventions in order to have their physical body
population. Cultural competency problems can arise
reflect their gender identity, is particularly important.
from negative attitudes about LGBTQ people,
Recently, evaluation of the long-term effects of
stereotypical beliefs, and unfamiliarity with the
hormone treatments indicates that this may have
actual lives and concerns of LGBTQ people over the
some physical health consequences. In addition,
lifespan. Broader, policy-based problems include
transgender individuals face significant barriers to
lack of availability of programs and services tailored
accessing culturally competent care.
to LGBTQ people’s needs.
 Health Disparities 1283

Another notable barrier to health care access for play a role. These problems may be further
some LGBTQ people is lack of health insurance. For exacerbated by a lack of access to competent care for
many people in the United States, health care LGBTQ individuals due to actual and perceived
benefits are available through a spouse’s stigma among providers and structural barriers such
employment. Although the recent change in samesex as lack of health insurance.
marriage laws has also increased access, it is still true The third conclusion is that protective factors can
that many companies and insurance providers do not make a difference. Family acceptance, community
recognize same-sex partners for the purposes of connectedness, and positive LGBTQ identity
health care coverage. Data from 2014 revealed that achievement all play a role in preventing and
LGBTQ Americans were more likely to be uninsured ameliorating the negative health consequences of
and less likely to have a personal doctor than non- living in a society in which one’s sexual and gender
LGBTQ people. Recent health care reform has identity is not the norm. It is important to note that
reduced these disparities slightly; however, while consistent and statistically significant health
observable discrepancies persist. disparities have been found, these disparities are
often relatively small. Indeed, we must not overlook
the fact that the majority of LGBTQ people are
Conclusion relatively mentally and physically healthy, even in
There are three primary conclusions that may be the context of such ongoing challenges. Thus, it will
drawn from this discussion of LGBTQ health be critical for future researchers to continue to
disparities. The first is that sexual and gender
minorities experience health disparities with their
heterosexual and cisgender counterparts across
health domains over the lifespan. Disparate rates of
mental and physical health problems are supported
by a rapidly growing body of empirical research in
the fields of psychology, medicine, and sociology.
With regard to mental health, LGBTQ individuals
are more likely to experience depression, suicidal
ideation and attempts, as well as substance use
problems. They may also be at increased risk for
anxiety, eating disorders, and body dysmorphic
disorders. With regard to physical health, more
research is needed in many areas; however, there is
some research to suggest that LGBTQ individuals
experience greater risk for certain types of cancers.
HIV is most prevalent among gay and bisexual men
as well as male-tofemale transgender individuals.
The second conclusion is that the source of these
disparities is linked to the social and cultural
oppression experienced by LGBTQ people. As
research has made the shift to understanding why
these health disparities exist, models for organizing
and understanding the roles of risk and protective
factors have been developed. Important risk factors
include experiences of violence, victimization,
harassment, and discrimination. Rejection by friends
and family, institutional discrimination, societal
stigma, and lack of community connectedness also
1284
ask questions about resilience and thriving in the face
of adversity in order to fully understand the health of
LGBTQ people.
Kimberly F. Balsam
See also Health Care System; Health Disparities,
Transgender People; HIV and Treatment; Minority Stress
Further Readings
Cochran, S. D., Sullivan, J. G., & Mays, V. M. (2003).
Prevalence of mental disorders, psychological distress,
and mental services use among lesbian, gay, and
bisexual adults in the United States. Journal of
Consulting and Clinical Psychology, 71(1), 53–61.
doi:10.1037/0022-006X.71.1.53
Hatzenbuehler, M. L. (2010). Social factors as
determinants of mental health disparities in LGB
populations: Implications for public policy. Social
Issues and Policy Review, 4(1), 31–62.
doi:10.1111/j.1751-2409.2010.01017.x
Institute of Medicine. (2011). The health of lesbian, gay,
bisexual, and transgender people: Building a foundation
for better understanding. Washington, DC:
National Academies Press.
King, M., Semlyen, J., Tai, S., Killaspy, H., Osborn, D.,
Popelyuk, D., et al. (2008). A systematic review of mental
disorder, suicide, and deliberate self harm in lesbian, gay
and bisexual people. BMC Psychiatry,
8(1), 70. doi:10.1186/1471-244X-8-70
Meyer, I. H. (2003). Prejudice, social stress, and mental
health in lesbian, gay, and bisexual populations:
Conceptual issues and research evidence. Psychological
Bulletin, 129(5), 674–697. doi:10.1037/0033-2909
.129.5.674
HEALTH DISPARITIES,
TRANSGENDER PEOPLE
Health disparities and inequities arise from
systematic exposure to social stressors that are a
result of being part of a socially marginalized group
(e.g., transgender). This entry describes health
disparities from a social epidemiologic
Health Disparities, Transgender People
perspective, reviews key health disparities facing
transgender people, identifies barriers to
documenting and understanding health disparities,
and reviews recommended measures to identify
transgender people in health surveys in order to
further future research in health disparities.
Definitions
In this entry, the term transgender refers to people
who have a current gender identity or expression that
is different from their sex assigned at birth.
Transgender comes from the Latin prefix trans—
which means “across” or “beyond” (gender and sex
different). The term cisgender refers to people who
have a gender identity or expression that is the same
as their assigned sex at birth (i.e., not transgender).
Cisgender comes from the Latin prefix cis—meaning
“on this side of” (gender and sex consistent).
A health disparity, also known as a health
inequity, refers to a difference in health in which
disadvantaged social groups—such as transgender
and gender-nonconforming people; racial/ethnic
minorities; poor people; and other groups who have
experienced and continue to experience systemic
social disadvantage and exclusion, marginalization,
or discrimination—systematically experience more
adverse health outcomes or health risks than do more
advantaged social groups. Health disparities and
inequities arise from systematic exposure to social
stressors that are a result of being part of a socially
marginalized group.
Not all differences in health represent health
disparities. Health inequities are avoidable,
remediable, unfair health inequalities between
populations. For example, on average in the
population,
males are taller in height than females. Is this
difference a health disparity? No. The difference in
height between males and females is not attributable
to unfair treatment, a social inequity, or a
disadvantaged social status. However, females tend
to suffer more disease and disability in their lifetime
than males, including a two- to threefold increased
risk of depression. Is this difference a health
disparity? Yes. Depression is predicted to be

Health Disparities, Transgender People
a leading cause of disability in females by 2020 due
largely to gender inequities, including differential
access to socioeconomic and health resources, status,
roles, options, and treatment in society. In addition,
the prevalence of depression varies markedly among
countries, suggesting that macro social factors and
social determinants (e.g., country-level gender
inequality) are important to consider when
examining health disparities.
Transgender Populations Are Burdened by
Health Disparities
Despite methodological limitations of existing
research, studies show that transgender populations
across the world are burdened by more health
disparities compared to cisgender (non-transgender)
people. Documented health disparities include the
health areas of HIV and other sexually transmitted
infections (STIs), particularly among transgender
women, who are at 49% increased odds of being
HIV-infected compared with all adults of
reproductive age, according to a recent meta-analysis
across 15 countries. Disparities are also present in
mental health distress, including suicidality,
depression, nonsuicidal self-injury, and anxiety; and
substance use and abuse, including alcohol, tobacco,
marijuana, and non-marijuana illicit drugs. Many
areas of health are underresearched in relation to
transgender health disparities, including chronic
diseases, cancer, general preventive health screening
and behaviors, and patterns of health care utilization.
A gender minority stress framework can be used
to conceptualize and understand health disparities
that burden transgender people compared to
nontransgender (cisgender) people. This framework
posits that experiences of social stress across the life
course disproportionately affect transgender people
relative to cisgender people due to their
disadvantaged social status and are largely
responsible for health inequities. This is shown in
Figure 1, where (a) there is an association between
transgender status and health disparities (top), and
(b) social stressors explain (i.e., mediate) the
association between transgender status and health
disparities.
(a)
1285
TransgenderHealth Disparity
X Y
(b)
Social Stress
M
Transgender Health Disparity
X Y
Figure 1 Gender-Minority Stress Model of Health
Disparities
Source: Sari L. Reisner.
Notes: (a) Transgender people experience health disparities. (b)
Social stressors related to transgender status explain these health
disparities.
Stressors such as experiences of discrimination,
stigma, violence and victimization, and social and
economic exclusion are all too common among
transgender people. Social stressors can include
family rejection, peer bullying victimization,
intimate partner violence, inability to access needed
medical care, and poverty and lack of economic
opportunity, leading many transgender women in
particular to engage in transactional sex (i.e., sex in
exchange for money, food, housing, or other goods
and services; also known as sex work);
discrimination in employment, housing, and health
care (i.e., experiences of enacted stigma); and gender
invalidation (i.e., being mispronouned or
misgendered). This framework can also be applied to
understand health-promoting, salutogenic (beneficial
to health and well-being), and resilience-related
factors that are protective for disparities in
transgender populations. For example, positive
growth-fostering coping processes may mitigate
health disparities.
Limits to What We Know About Health
Disparities in Transgender Populations
Very little population-level data exist to document
transgender health disparities worldwide. This is
because routine national health surveillance efforts in
the vast majority of countries do not typically include
questions to identify transgender survey respondents.
1286
This is a major gap in furthering an understanding of
the health inequities burdening transgender people.
Documenting and understanding transgender health
disparities at a population level necessitates having
adequate data by which to compare the health of
transgender and cisgender people. Such data allow
comparison of the health of transgender people with
cisgender people to document health disparities, and
provides the opportunity to unpack the mechanisms
and pathways (i.e., mediators and potential
intervention points) that cause poor health
differentially by gender identity, including social
stressors such as discrimination. Without
comparative data, we cannot state that “transgender
people are disproportionately burdened by or
experience a disparity or inequity in depression.”
This is important to consider and ensure accuracy of
inferences in health research. A study consisting of a
sample of exclusively transgender people allows us
to examine health outcomes and state that
“transgender people bear a high burden of
depression” or that “depression is highly prevalent
among transgender people.” Without a comparison
group, however, we cannot call this a health
disparity.
Measuring “Transgender” in Surveys to
Document and Understand Health
Disparities
Transgender health reminds us of the importance of
explicitly considering sex- and gender-specific
pathways in health outcomes and health disparities.
Sex and gender are robust social determinants of
health. In the broad, social scientific literature, sex
and gender are often used interchangeably, resulting
in a lack of clarity about sex and gender differences
in health. The recommended approach to identifying
transgender people in health surveys in order to
document health disparities is using the two-step
method. In this approach, Step 1 captures assigned
sex at birth, and Step 2 queries current gender
identity. Respondents are then cross- classified based
on their assigned sex at birth and their current
identity.
Health Disparities, Transgender People
An illustration of implementing a two-step
approach is shown in Figure 2 using survey items
from the Growing Up Today Study (GUTS). The top
of the figure shows the two questions: natal sex (two
response options: “male” and “female”) and current
gender identity (four response options: “male”;
“female”; “transgender”; and “do not identify as
male, female, or transgender”). Cross-tabulating
these questions gives a two-by-four (2 x 4)
contingency table with eight cells demonstrating
different sex and gender combinations. Column A
(left column) is people assigned a male sex at birth,
cross-tabbed with four genders. Column B (right
column) is people assigned a female sex at birth,
cross-tabbed with four genders.
How does this schema help us document health
disparities? That depends on the research question.
Here are three examples:
1. A researcher is interested in disparities indepression
by transgender status. The researcher can compare
people with concordant sex/gender responses (i.e.,
cisgender males and females) to those with
discordant sex/gender responses (i.e., assigned male
sex and identify as female, transgender, or do not
identify; assigned a female sex at birth and identify
as male, transgender or do not identify).
2. A researcher is interested in sex-linked processes in
depression and hypothesizes that people who have a
female sex assigned at birth have a higher
prevalence of depression compared to people
assigned a male sex at birth, regardless of current
gender identity. The researcher can compare all
natal sex females to natal sex males, ignoring
current gender identity; or the researcher could
compare by natal sex, and adjust for gender identity
in statistical analyses to isolate the effects of sex.
3. A researcher wants to conduct a health studyabout
preventive screening for prostate cancer. The
researcher would only include the people in column
A in the study. Why? Because only natal males
(e.g., those with male assigned sex at birth) have a
prostate gland; natal females (i.e., those with female
assigned sex at birth)—even those
 1287
Health Disparities, Transgender People
STEP 1: NATAL SEX
What sex were you assigned at birth, on your original birth certificate? (check one)
Male
Female
STEP 2: GENDER IDENTITY
How do you describe yourself? (check one)
Male
Female
Transgender
Do Not Identify as Male, Female, or Transgender
Assigned Sex*

Column A Column B
Male Female
(Male birth sex) (Female birth sex)

Current Gender Identity

Male Cisgender Male± Male Identity

(male birth sex, male (female birth sex,
gender identity) male gender identity)

Female Female Identity Cisgender Female

(male birth sex, female (female birth sex,
gender identity) female gender identity)

Transgender Transgender Identity Transgender Identity

(male birth sex, (female birth sex,
transgender identity) transgender identity)

Do Not Identify as Male, Female, or Do Not Identify Do Not Identify

Transgender (male birth sex, other diverse (female birth sex, other
gender identity) diverse gender identity)

Figure 2 Conceptual Overview of Natal Sex and Current Gender-Identity Measurement Using a Two-Step Method in
the Growing Up Today Study (GUTS) to Document Health Disparities
Source: Sari L. Reisner.
Note: *Infants born intersex are assigned either a female or male sex by a medical provider at birth.
who are transgender men or male-identified—do not have
a prostate.
1288
When we are thinking about health disparities—
and sex- or gender-linked differences—it is
important to be accurate about who is and is not in
the sample. The two-step approach to survey health
research can help us not only understand health
inequities facing transgender people but also better
understand sex and gender differences—and health
disparities that may be due to assigned sex, current
gender, both, or neither.
Sari L. Reisner
Health Insurance Coverage for Transgender People, Access
to
See also Substance Abuse/Dependence and Transgender
People; Therapy With Transgender, Transsexual, and
Gender-Nonconforming People; Transgender Health
Care; Transgender Identities; Transgender Sexualities
Further Readings
Baral, S. D., Poteat, T., Stromdahl, S., Wirtz, A. L.,
Guadamuz, T. E., & Beyrer, C. (2013). Worldwide
burden of HIV in transgender women: A systematic
review and meta-analysis. Lancet Infectious Diseases,
13(3), 214–222.
Braveman, P. (2006). Health disparities and health equity:
Concepts and measurement. Annual Review of Public
Health, 27, 167–194.
Conron, K. J., Scott, G., Stowell, G. S., & Landers, S. J.
(2012). Transgender health in Massachusetts: Results
from a household probability sample of adults. American
Journal of Public Health, 102(1), 118–122.
Hendricks, M. L., & Testa, R. J. (2012). A conceptual
framework for clinical work with transgender and gender
nonconforming clients: An adaptation of the minority
stress model. Professional Psychology:
Research and Practice, 43(5), 460–467.
Reisner, S. L., Conron, K. J., Tardiff, L. A., Jarvi, S.,
Gordon, A. R., & Austin, S. B. (2014). Monitoring the
health of transgender and other gender minority
populations: Validity of natal sex and gender identity
survey items in a U.S. national cohort of young adults.
BMC Public Health, 14, 1224.
Reisner, S. L., Greytak, A., Parsons, J. P., & Ybarra, M.
(2015). Gender minority social stress in adolescence:
Disparities in adolescent bullying and substance use by
gender identity. Journal of Sex Research 52(3), 243–256.
doi:10.1080/00224499.2014.886321
HEALTH INSURANCE COVERAGE FOR
TRANSGENDER PEOPLE, ACCESS TO
Transgender people sometimes need medical or
surgical care as part of a gender transition.
According to the Standards of Care described by the
World Professional Association for Transgender
Health (WPATH), medical and surgical care for
gender
transition
is
considered medically necessary when clinically
indicated for an individual. However, health
insurance plans in the United States often exclude
transition-related health care, meaning that services
related to a gender transition are not covered. The
costs associated with medical and surgical care for
gender transition, which can reach into the tens of
thousands of dollars, may prevent individuals from
getting the medically necessary care they need if they
are not covered by insurance. This entry describes
the current status of health insurance coverage for
gender transition, barriers to increasing coverage
available to transgender people, and the shifting
public policy environment that impacts the
availability of transition-inclusive health insurance
coverage.
Health insurance coverage for gender transition
has been very rare in the United States in both
private and public health insurance plans, but the
number of plans that cover gender transition is
increasing. Since 2009, the Human Rights Campaign
(HRC) has tracked the availability of transition-
inclusive health benefits plans for employees of
Fortune 1000 companies and AmLaw 100 law firms.
In 2009, a total of 49 of these employers reported
that they provide transition-related health care
coverage for employees. As of 2015, a total of 418 of
these employers reported providing this coverage,
representing an 850% increase over 6 years. In May
of 2014, the federal government removed the
exclusion for transition-related care from Medicare,
which is the U.S. public insurance program for
people 65 and older. State Medicaid programs, which
are state-run plans that provide health coverage for
people with low incomes and some other groups of
people, generally do not cover transition-related care.

However, several states, such as California,
Massachusetts, Vermont, Oregon, and the District of
Columbia, have removed exclusions for transition-
related care from their Medicaid plans. Overall, there
are an increasing number of employers and public
insurance plans that are providing transition-related
health care coverage.
A barrier to increasing the availability of
transition-related health care coverage is the
perception by employers and policy makers that the
cost to provide the coverage would be high.
Employers who have provided the coverage for
several years, including the city and county of San
Francisco and the University of California, have
reported that in
Heteronormativity
fact there has been little to no cost for providing the
coverage. One reason the costs are generally low is
that the number of people who will need transition-
related health care is small. The transgender
population is relatively small, and not all transgender
people will need transition-related health care. The
best available estimate of the transgender population
shows that 0.3% of the U.S. adult population, or
around 700,000 adults, identify as transgender.
Another barrier to the availability of
transitionrelated health care coverage is the type of
insurance products made available to employers to
purchase. Employers who purchase health insurance
plans for their employees from health insurance
providers (i.e., the employer is “fully insured”), such
as Aetna, Cigna, and others, are sometimes limited to
the products the provider offers them. For instance, if
an employer wants to add transition-related health
care to the employee health benefits plan, the health
insurance provider may or may not offer that type of
coverage for the employer to purchase. If an
employer pays for the full cost of the employees’
health care coverage (i.e., the employer is “self-
insured” and does not pay a premium to a health
insurance provider), the employer has much more
flexibility in the scope of the coverage that can be
offered to employees.
One way that state governments are currently
trying to increase the availability of transitionrelated
health care coverage is by requiring that health
insurance plans that are under the regulation of the
state, such as private plans sold by health insurance
1289
providers within the state, remove exclusions to
transition-related health care. States such as
California, Oregon, Vermont, and the District of
Columbia have put in place insurance regulations or
directives to remove transition-related health care
exclusions from health insurance plans that the states
regulate. These regulations do not apply to plans that
are regulated by the federal government. For
instance, an employer who is selfinsured would not
be subject to state regulations to remove transition-
related health care exclusions.
Though coverage for transition-related health care
is increasing in availability in the United States,
currently most plans do not provide this type of
coverage. Those plans that do provide some coverage
may not cover the entire scope of care that would be
considered medically necessary according to the
WPATH Standards of Care. Both the availability of
health insurance plans that cover transition and the
scope of coverage provided in plans will need to
increase to improve transgender people’s access to
transition-related health care.
Jody L. Herman
See also Health Care System; History of Transgender
Medicine in the United States; World Professional
Association for Transgender Health
Further Readings
Coleman, E., Bockting, W., Botzer, M., Cohen-Kettenis, P.,
DeCuypere, G., Feldman, J., et al. (2011). Standards of
care for the health of transsexual, transgender, and
gender-nonconforming people, version 7. International
Journal of Transgenderism, 13, 165–232.
Gates, G. J. (2011). How many people are lesbian, gay,
bisexual, and transgender? Los Angeles, CA: Williams
Institute.
Herman, J. L. (2013). Costs and benefits of providing
transition-related health care coverage in employee
health benefits plans: Findings from a survey of
employers. Los Angeles, CA: Williams Institute.
HETERONORMATIVITY
1290
Heteronormativity refers to the Western social norm,
or assumption, that the overwhelming majority of
sexual relationships in society are heterosexual.
Further, heteronormativity is the dominant sexual
model of social, cultural, political, and economic
organization, including the way it organizes
identities, experiences, regimes of truth and
knowledge, and ideologies of gender and sex.
History of Usage
According to the Oxford English Dictionary, the
term heteronormativity was first used by queer
theorist Michael Warner in 1991 in the introduction
to his book Fear of a Queer Planet, where he
suggested that embedded within most sociological
concepts is an unspoken set of heteronormative
assumptions. Direct precursors to the term
heteronormativity include compulsory
heterosexuality, coined by lesbian feminist poet and
theorist Adrienne Rich in 1980; the heterosexual
contract, coined by feminist Monique Wittig; and the
heterosexual matrix, used by gender theorist Judith
Butler, terms that all explain how individuals are
socially coerced into, and rewarded for, participating
in heterosexuality. Poststructuralist Michel Foucault
also challenged assumptions of heteronormativity, as
he wrote about discursive “regimes of truth” that
constructed and reinforced knowledge about
heterosexuality and homosexuality.
A related term is homophobia, which Eve
Sedgwick argued was the key social behavior that
needed to be challenged by Lesbian and Gay Studies.
However, this term has been critiqued for embedding
a justification of its own oppressive action within the
term itself, as it is framed from a heterosexual
perspective implicitly rationalizing a fear of
homosexuality, which has been used legally to justify
antigay violence. The term has thus been critiqued as
being itself heteronormative, leading queer activists
and scholars largely to reject it because it focuses on
the individual while ignoring systemic effects of the
heterosexual imperative. Moving beyond the focus of
early lesbian and gay movements on challenging
homophobia, queer theory and activism have as their
goals to challenge heteronormativity and
heterosexism.
Heterosexuality: Norm Versus Privilege
Implicit in the term heteronormativity is the notion
that we can define what is normal in terms of a
sexual practice, identity, or expression. This norm is
then called heterosexuality, which is routinely taken
for granted to be the form of sexual, emotional, or
intimate partnering that everyone in society will
partake in—a male partnering with a female (both
cisgender and cis-sex) in a lifelong, monogamous
married couple. This heteronormative view presumes
that sexual relations are deemed normal when they
take place between two people
Heteronormativity
of “opposite” sexes, men and women, and moreover,
that their sex can be determined definitively by an
analysis of chromosomes and genitalia.
Heteronormativity forms part of a worldview
promoting heterosexuality as the preferred sexuality,
in relation to homosexuality, which is deemed,
sometimes through a biological determinist lens, to
be abnormal. Nonheteronormative practices
including bisexuality are ignored, silenced, or
presumed not to exist.
The term heteronormativity presumes that
heterosexuality is the dominant or privileged subject
position or identity, and that homosexuality is the
dominated or inferior subject position. However, it
has also been noted that homosexuality only becomes
coherent or intelligible through heterosexuality. If
heterosexuality is the norm, then homosexuality is
automatically non-normative, as it is defined in
relation to heterosexuality.
Conversely, heterosexuality only becomes
coherent through homosexuality. If homosexuality is
the transgression, then heterosexuality is
automatically normative through its definition in
relation to homosexuality. However, heterosexuality
is privileged over homosexuality, so this mirror
relationship is inherently unequal, which is signaled
by the terms heterosexism and heterosexual
privilege. These terms signify different elements of
the same system of unequal power allocated to
people in society based on their real or perceived
sexual practices, expressions, or preferences.
Moreover, heteronormative discursive and
material practices organize categories of identity into
binary pairs that privilege and invest social, cultural,
 1291
political, and economic power in one of the system, media and culture, the government (through
categories over the other (e.g., male–female, ID cards, passports, marriage and birth laws, etc.),
masculine–feminine, heterosexual–homosexual). religion, and other institutions. Postcolonial feminist
Heterosexual privilege can be defined as the Gayatri Spivak notes that reproductive
invisible advantages that accrue to people, whether heterosexuality is in fact the main pillar of global
currently in a couple or not, who are—or profess to political and social structures, which are also
be—heterosexual. This privilege is guaranteed patriarchal or male-dominated, thus reproducing both
through most of society’s social and institutional heterosexism and heterosexual privilege.
structures and systems, which ensure that straight or
straight-acting people will have more status, power,
rights, and privileges, including accessing specific Heteronormativity in Law
economic benefits, than those with nonnormative or Heteronormativity is inscribed in the legal system of
nonheterosexual expressions of sex many countries. Denial of legal rights to same-sex or
Heteronormativity nonheterosexual partners is common. Prison
visitation rights are often denied. Prisons are divided
into male and female populations, and trans people
or gender or sexuality. These advantages are
are frequently placed in dangerous situations.
sometimes called the “heterosexual bribe,” whereby
International borders control for heteronormativity in
people gain cultural and social capital or rewards by
issuing family passports, demanding a stable gender
properly performing heterosexuality within a strict
identity inscribed in a passport, and using scanners
and narrow frame.
that reveal one’s body to the border guard. In some
countries, such as Saudi Arabia, Yemen, Mauritania,
Heteronormative Institutional Practices Sudan, and Iran, as well as parts of Somalia and
Nigeria, homosexuality is illegal and punishable by
Heterosexuality is in need of constant affirmation as
death.
the dominant category, through performance of
Legislation pertaining to same-sex rights has
normative heterosexual practices such as getting
emerged in the past two decades, with countries such
married, having a stable gender expression consistent
as Norway, Sweden, Iceland, South Africa, Portugal,
with one’s sexed body, and reproducing biological
Spain, Canada, and the United States offering both
children. It is further reinforced in middle-class
same-sex marriage and antidiscrimination laws. A
economic expressions of heterosexuality such as
range of legal positions along the spectrum between
buying a house together, having a joint bank account,
the death penalty and same-sex marriage exist in
accessing spousal benefits or insurance through
different countries, including imprisonment with a
employment, and the like.
variety of sentences from 14 years to life, the
Queer theorist Nikki Sullivan has suggested that
provision of inferior marriage-like alternatives, a lack
these dominant discourses and institutional practices
of explicit legislation, and legal gray areas.
tend to have the effect of ignoring or eradicating
sexual difference. Historically, those practicing queer
sexualities were medicalized, hospitalized, and Sociological Effects of Heteronormativity
subjected to various technologies to attempt to “cure”
Heteronormativity creates a social context in which
them of their non-normative sexual desires, a
nonheterosexual people are marginalized, which can
practice now widely acknowledged to have been
result in persecution, discrimination, or violence
barbaric and ineffectual. Eve Sedgwick, largely
toward those engaged in sexual diversities. It is
credited with being the first queer theorist, famously
inherently injurious as a limit on available
stated that sexually everyone is different, which is
expressions of sexuality, which can result in coerced
contrary to the implicit assumption of similar
closeting of sexuality. Heteronormativity is present
sexualities among all heterosexuals, and instead
in geographies of space marked heterosexual; in
emphasizes the naturalness of sexual diversities.
psychologies of internalized norms; in our social
Through institutional practices, heteronormativity practices, from familial to friendship and from
is actively created and perpetuated in the education
1292
intimacies to sexualities; in our cultural practices and
media representations; and in our epistemological or
knowledge systems that shape how we come to
understand sexualities.
Heteronormativity is also socially constructed
through media and culture, which repeatedly depict
the heterosexual imperative in film, news media,
dating websites, sexting, comics, radio, and the like
through both underrepresentation, and
representations of non-normative expressions of
sexuality as deviant, weird, criminal, or problematic.
These socalled transgressions may even be
discursively constructed as warranting death through
legal processes such as incarcerating a transwoman
in a male prison population, which often results in
her violent and brutal gang rape, serial rape, suicide,
or murder; and through extralegal processes such as
trans bashing. Heteronormativity can mean that basic
human rights are denied to those who do not conform
to the hetero norm, and these rights are differently
inscribed, legalized, and enacted across the globe.
In queer relationships, there is often a sense that
the relationship needs to be made legible to the
straight world in order for it to be considered
legitimate. Examples include the emphasis on gay
marriage, the question of who is the male/ dominant/
masculine and who is the female/submissive/
feminine person in a queer relationship, and the
binary notions of butch–femme or top–bottom.
Queer Challenges to Heteronormativity
Queer movements focus on disrupting
heteronormative thinking, assumptions, and
behaviors by revealing and challenging the
heterosexual imperative. An anti-heteronormative
politics interrupts the continued narrative of the
heterosexual category as a norm, attempts to remove
the heterosexual bribe, and assigns value to diverse
sexualities. Sexuality is reframed as a narrative, or a
fluid and dynamic expression that takes place in
relation to others, rather than a fixed and stable
category.
Heteronormativity is considered by queer theorists
to be one axis of a series of intersectional identities,
including gender, racialized and colonial identities,
social class, religion, immigration status, and
disability. Furthermore, everyone (not just those in
marginalized groups but also those in dominant
groups) has an identity based on these axes, which
they experience at all times, rather than experiencing
one axis of identity independent of the others in
specific situations. Strategies for dealing with this in
order to make positive change in people’s lives often
include organizing in nonmixed or caucus-based
groups, developing modes of self-representation to
correct media
Heteronormativity
misrepresentations, creating safe(r) spaces for
specific groups, and organizing spaces for advocacy
for specific rights for certain groups of people such
as same-sex marriage.
Some argue there is a need to move beyond
identity politics of the individual to also consider
systemic oppressions and privilege. Rather than
considering the identity of an individual, we can
examine systemic oppression caused by
heteronormativity in relation to other systems of
oppression and strategies for activism developed to
challenge root systems of oppression. For example,
activists have challenged gay pride for being
capitalist, a system that reinforces White middle-
class dominance of the queer scene, known as
homonormativity; others argue that gay marriage is
rooted in patriarchy, which reinforces sexism and the
gender binary; still others have recognized the
importance of gay marriage to queer migrants and
immigrants who might access citizenship or legal
status through marriage. Using an intersectional
approach may result in different political strategies,
depending on the interlocking systems being
addressed.
Critiques of the Term Heteronormativity
Some critics suggest that the term heteronormativity
is problematic because it relies on a binary
formulation of homosexual–heterosexual and may
inadvertently uphold this binary as an inequality,
privileging the heterosexual and ignoring the
possibility of bisexuality. This formulation needs to
be challenged, as it results in a static interpretation of
sexuality based on a gender binary system. For
example, for trans people, it is hard to define a
relationship as homosexual or heterosexual when it
cannot be easily determined whether the object of a
 1293
person’s desire has the “same” gender or sex, or the
“opposite” gender or sex.
Challenges to this binary by male-bodied women
and female-bodied men, as well as genderqueer,
pangender, transgender, transsexual, and other
diverse bodies, can interrupt not just the gender
binary but also the heterosexual matrix, thereby
disrupting the link between sex, and gender and
sexuality—that is, the assumptions that (a) men have
male bodies and women have female bodies,
1294 Heterosexism
that sex is equal to gender; and (b) therefore men
only have sex with women, and women only have
sex with men, that is, sex/gender determines
sexuality. These critiques suggest that queer theories
and practices must move beyond the term
heteronormativity to account for diverse genders,
sexes, and sexualities.
Sandra Jeppesen
See also Bisexualities; Cisgenderism; Gender Binaries;
Genderqueer; Heterosexism; Heterosexist Bias in
Research; Homonormativity; Homophobia; Intersections
Between Sex, Gender, and Sexual Identity; LGBTQ
Social Movements (Assimilation vs.
Liberation); Queer Politics; Schools as
Heteronormative Spaces; Transgender Sexualities
Further Readings
Butler, J. (1999). Gender trouble: Feminism and the
subversion of identity. New York, NY: Routledge. Foucault,
M. (1978). The history of sexuality. New York, NY: Vintage.
Rich, A. (1980). Compulsory heterosexuality and lesbian
existence. Signs, 5(4), 631–660.
Sedgwick, E. K. (1990). Epistemology of the closet.
Berkeley: University of California Press.
Sullivan, N. (2003). A critical introduction to queer theory.
New York, NY: New York University Press.
Warner, M. (Ed.). (1993). Fear of a queer planet.
Minneapolis: University of Minnesota Press.
Wittig, M. (1992). The straight mind. Boston, MA: Beacon.
HETEROSEXISM
Heterosexism refers to the cultural ideology that
reproduces the normative and privileged status of
heterosexuality in most aspects of people’s lives,
vilifying and stigmatizing nonheterosexual
(referred to in this entry as LGBTQ) behaviors,
identities, relationships, and communities.
Heterosexism includes institutionalized negative
attitudes and beliefs about LGBTQ sexualities as
inferior, unnatural, and deviant, thereby reproducing
sexual stigma. Heterosexism may also include sexual
prejudice, the harmful attitudes and beliefs
individuals hold about LGBTQ people. It is
manifested in a range of behaviors, the most extreme
being violent and murderous hate crimes against
LGBTQ people—that is, criminal acts perpetrated on
the basis of an individual’s perceived sexual
orientation. This entry discusses heterosexism in
conjunction with homophobia, a term with which it
is often used interchangeably, before examining
aspects of two types of heterosexism most frequently
discussed: cultural and psychological heterosexism.
Heterosexism and Homophobia
One of the most influential scholars associated with
the study of heterosexism is Gregory M. Herek, an
eminent and openly gay psychologist in the United
States. His research on heterosexism has been
motivated, in part, by the inadequacy of the term
homophobia for explaining the ideological
dimension of sexual prejudice. Homophobia has
often been conceptualized as an irrational fear and
hatred of gay men and lesbians; in turn, scholars
have criticized this concept for reducing the problem
of discrimination and prejudice against LGBTQ
people to a problem of individual-level panic and
fear of individuals who are attracted to those of the
same sex. When viewed in this way, homophobia has
been used to excuse attacks on LGBTQ people. For
example, a “gay panic defense” was deployed in the
murder trial of Matthew Shepard, a gay university
student who in 1998 was pistol-whipped and left to
die in Wyoming. The defendants claimed they had
acted in a state of homosexual panic, wherein they
had been panicked by Matthew’s homosexuality to
the point of murder. In this case, the judge rejected
the claim as a legitimate strategy for defense. The
gay panic defense is one instance of how
homophobia is constituted as an uncontrollable,
individual psychological disorder that requires
treatment, thereby shifting attention away from
analysis of the ideological origins and reproduction
of sexual prejudice against LGBTQ people. Scholars
have also argued that homophobia is a misleading
term, not least because there is no justification for the
-phobia suffix on any clinical grounds. Officially,
homophobia is neither a phobia nor something that is
inevitably irrational. While the irrational fear of
people who are attracted to others of the same sex
has produced problematic outcomes for LGBTQ
people and is a severe social problem, homophobia

cannot account for the nub of the problem: the
societal and cultural privileging of heterosexuality.
As such, homophobia is a problematic term in how it
individualizes the origins of sexual prejudice, while
heterosexism is regarded as a term with greater
explanatory power for accounting for the
institutionalized and informal beliefs that denigrate
LGBTQ identities, behavior, relationships, and
communities.
Despite the conceptual differences between
homophobia and heterosexism, these terms are often
used interchangeably. Recent scholarly interest in
both terms indicates that the relationship between
homophobia and heterosexism is not always clear-
cut. In principle, an individual may be homophobic
but not heterosexist, while someone else may be
heterosexist but not homophobic. The basis for this
argument rests on the premise that the two
phenomena are wholly independent from one
another, although this is disputed. Homophobia may
work alongside heterosexism to enforce beliefs and
practices within societies that institutionalize and
privilege heterosexuality. Heterosexism is generally
viewed as a sociological term that draws attention to
the ideological system that favors heterosexuality
over LGBTQ sexualities, thereby bringing
heterosexuality into the frame of analysis. On this
point, Gregory M. Herek’s research on heterosexism
has elaborated this focus of study in specific ways,
allowing us to speak of different types of
heterosexism: namely, cultural and psychological.
Cultural Heterosexism
Parallels are sometimes drawn between cultural
heterosexism and institutionalized racism and sexism
in the way that they originate from the same social,
cultural, and political foundations. Seen in
Heterosexism
this way, cultural heterosexism is embedded in and
pervades numerous societal norms, practices, and
institutions (e.g., in the fields of law, medicine,
psychology, education, and religion), making it
ubiquitous but invisible. In other words, cultural
heterosexism can be understood to be so ingrained
into the fabric of everyday life that heterosexuality is
routinely taken for granted and accepted as the norm.
1295
As such, cultural heterosexism is invisible because it
is so widely accepted that it is largely unquestioned.
Indeed, institutions have provided various
ideological rationales for stigmatizing LGBTQ
sexualities. For instance, scientific and medical
institutions have pathologized homosexuality as
deviant and abnormal. It took until 1973 for the
American Psychiatric Association to declassify
homosexuality as a mental disorder and the World
Health Organization until 1990 to follow suit. At the
same time, institutionalized forms of cultural
heterosexism have sought to render LGBTQ
sexualities invisible through societal customs and
practices that criminalize homosexuality. Cultural
heterosexism is a sophisticated means by which
societies can entrench cultural ideologies about the
relative status of LGBTQ persons as inferior to
heterosexuals and less deserving of social
recognition. This is evident in the widespread
difficulty that samesex couples have faced in
achieving formal recognition for their relationships
(e.g., in terms of marriage and civil partnerships). In
other instances, LGBTQ people are denied access to
fertility services on the basis of sexual orientation,
curbing the place and role of LGBTQ parenting
within society. In these cases, cultural heterosexism
is symbolically powerful, sending out a clear
message to LGBTQ people about their inferior status
relative to heterosexuals, and it shapes the material
circumstances under which LGBTQ people are able
to live meaningful lives. Moreover, when LGBTQ
sexualities are made visible in order to challenge
cultural heterosexism, such as when individuals
openly identify as LGBTQ, defy laws that prohibit
homosexuality, and create their own family
arrangements and partnerships, these individuals can
become public targets for persecution and
punishment. This reinforces the superiority of
heterosexuality, positioning heterosexuality and
homosexuality in a hierarchical binary opposition
(i.e., heterosexuality–homosexuality, with the former
term privileged over the latter) that refuses to
validate LGBTQ sexualities and genders.
Scholarly interest in the multiple manifestations of
cultural heterosexism in everyday life, and the
challenges this creates for LGBTQ people, has
produced highly illustrative research. Two examples
are provided.
1296 Heterosexism
LGBTQ Personnel in the Military Cultural heterosexism is evident in the absence of
legal employment protection for LGBTQ employees
The enduring prohibition of LGBTQ persons from
in many countries. In these contexts, employers can
openly serving in the military in many countries has
legally discriminate against LGBTQ people in hiring
been and continues to be a highly controversial issue.
and employment on the grounds of sexual
The enforcement of such bans reinforces a cultural
orientation. The absence of antidiscrimination
belief that homosexuality is not fit for purpose in the
employment legislation signals clearly to LGBTQ
theater of war, despite countless LGBTQ people who
people that they are abnormal, deviant, and second-
opt for nondisclosure (i.e., not sharing information
class citizens who are undeserving of a basic level of
about their sexuality) in order to gain employment
protection against discrimination in the labor market
serving their country as loyal and brave military
afforded to other groups of employees (e.g., on the
personnel. Indeed, some scholars have extended their
basis of class, race, ethnicity, disability). As such,
efforts to recover the lost and silenced voices of
many LGBTQ employees may choose nondisclosure
LGBTQ people who have fought and died in military
as a way to keep their jobs and evade discrimination
service, so their contributions within the theater of
in the workplace. Such disclosure decisions carry
war are duly acknowledged. Even when concessions
additional salience in regard to issues of personal
around the role of LGBTQ personnel in the military
safety within countries where homosexuality is
have been made, some policies continue to reflect
criminalized and carries severe penalties for those
dominant cultural ideologies about LGBTQ
who are prosecuted. Under these circumstances,
sexualities as morally suspect and potentially
cultural heterosexism serves to legitimate hostility
disruptive in the workplace.
toward LGBTQ people at and outside work,
One of the most infamous concessions of this type
constraining opportunities for LGBTQ people to
was introduced and later repealed in the United
flourish as human beings. Even in countries where
States. The Don’t Ask, Don’t Tell (DADT) policy,
legal employment protection has been enforced on
which from 1994 to 2011 outlined the position of the
the grounds of sexual orientation and gender identity,
United States government on gay, lesbian, and
cultural heterosexism still influences the disclosure
bisexual people in the military, conveyed a
decisions of LGBTQ employees in the workplace.
contradictory message about the role played by
This is partly due to the fact that employment
existing and potential LGBTQ service personnel. On
antidiscrimination legislation cannot function as a
the one hand, the DADT policy banned military
single strategy to combat how cultural heterosexism
personnel from discriminating against existing
variously manifests itself in the workplace. By itself,
closeted lesbian, gay, and bisexual (LGB) military
it cannot alter people’s negative attitudes toward
personnel while, on the other hand, it barred openly
LGBTQ people and thus eliminate sexual prejudice,
LGB people from military service. In so doing, it
the means by which cultural heterosexism is
reflected and reproduced cultural anxieties within the
articulated and sustained.
United States about the place of homosexuality in
The United States is a case in point. At the time of
military service, fueling further speculation about its
this writing, despite repeated attempts to pass the
supposedly negative influence on morale and
Employment Non-Discrimination Act (ENDA), no
discipline. Although President Barack Obama put an
federal antidiscrimination employment regulation has
end to the policy in 2011, some political leaders and
been successfully introduced and enforced across the
military members continue to argue that accepting
country. In many U.S. states, sexual minorities can
LGB people in the military will have a negative
be fired for disclosing their lesbian, gay, bisexual, or
impact on military discipline and morale, despite
trans (LGBT) status. Although an increasing number
scholarly evidence showing that ending the ban on
of states and a large number of cities have passed
service by openly LGB personnel is unlikely to
statutes that prohibit employment discrimination on
damage military effectiveness, recruitment, or unit
the grounds of sexual orientation and gender identity
cohesion.
expression, scholarly research continues to show that
many LGBTQ employees experience sexual
Heterosexism in the Workplace

prejudice in the workplace. The fight against cultural
heterosexism in and outside the workplace continues.
Psychological Heterosexism
Psychological heterosexism is a multifaceted
construct that incorporates personal feelings,
attitudes, and beliefs of disgust and hostility toward
LGBTQ people, as well as behaviors that are
motivated by and reflect these sorts of attitudes and
beliefs. Although psychological heterosexism is
manifested at the level of the individual, it is
intimately bound to cultural heterosexism. The types
of psychological needs and benefits some individuals
experience from expressing sexual prejudice toward
LGBTQ people can only function as such if they are
aligned with the cultural ideology that legitimates
this type of sexual prejudice. For instance,
psychologists have argued that if an individual feels
the need to belong to a social group or connect with
an individual such as a friend or family member, the
person may express specific attitudes known to be
endorsed by that group or individual. For example,
articulating the same anti-LGBTQ attitudes and
beliefs shared by a family member or a group of
friends can help to demonstrate alignment and
connection. In that regard, psychological
heterosexism can have a negative socially expressive
Heterosexism
function, only because it is legitimated by a wider
cultural ideology that denigrates and disempowers
LGBTQ people. The effects of psychological
heterosexism on the mental and physical health of
LGBTQ people can be devastating, as illustrated in
the next section. The study of psychological
heterosexism typically focuses on the following
components.
Attitudes and Beliefs
Attitudes are understood as positive and negative
evaluations that individuals make about other people,
issues, relationships, and so on. Beliefs represent
conceptualizations regarding the relationships among
phenomena in everyday life. As such, within the
study of psychological heterosexism, the expression
of attitudes and beliefs is an important focal point for
comprehending how LGBTQ people have come to be
1297
viewed negatively and stigmatized. The formation of
attitudes, the functions they serve, and the manner in
which they can be changed have occupied scholarly
interest for well over the last three decades. Recent
surveys in the United States and the United Kingdom
appear to show that heterosexuals’ attitudes toward
LGBTQ people have become more positive, showing
greater tolerance and acceptance of the roles LGBTQ
people play in society. Be that as it may, sexual
prejudice and sexual stigma persist even in “liberal”
countries and communities. This bears testimony to
the argument that changing attitudes is challenging,
and may be possible only when anti-LGBTQ
attitudes no longer yield benefits for the individuals
holding them.
Behavior
The investigation of negative behavior toward
LGBTQ people has routinely produced shocking
results. For example, in the UK, The Gay British
Crime Survey 2013, published by the LGB charity
organization Stonewall, found that hate crimes
against LGB people (criminal actions such as
physical assault, emotional suffering, and property
damage perpetrated on the basis of someone’s
perceived sexual orientation) are a serious social
problem. Of the 2,500 LGB survey respondents, 1 in
6 people reported having experienced a homophobic
hate crime over the last 3 years. The survey revealed
a wide range of hate crimes, from physical assaults
and threats of violence to harassment, verbal insults,
and damage to property. The survey showed that 1 in
10 respondents reported being physically assaulted,
while 1 in 8 respondents experienced unwanted
sexual conduct. Survey research carried out in
continental Europe and the United States reveals
similar findings, indicating the pervasiveness and
malicious dimensions to hate crimes against LGBTQ
individuals.
When psychological heterosexism is articulated
through hate crimes, explanations have been sought
as to how they benefit the perpetrators of these
crimes. One explanation, noted above, is that
individuals who carry out hate crimes against
LGBTQ people do so in order to connect with or
reinforce a sense of belonging with dominant groups
that hold negative attitudes about or enact similar
behaviors toward LGBTQ people. Another
1298 Heterosexism
explanation is that such hate crimes allow Conclusion
perpetrators to express values they hold dear such as
Heterosexism influences how LGBTQ individuals go
the superior status of heterosexuals within society,
about their everyday lives because they experience
which is used to justify the penalization of LGBTQ
sexual stigma in a way that heterosexuals do not, due
people. This appeal to moral authority, although
to the fact that nonheterosexuality is widely
potentially divorced from codified liberal moral
considered abnormal, deviant, and unnatural.
conventions within society, is used to rationalize the
Heterosexism’s negative effects on the material
constitution of LGBTQ people as valid targets for
circumstances of LGBTQ people’s lives as well as
punishment. One extreme example has been
on their mental and physical health are deep
documented within urban communities in Bogotá,
and far-reaching. Heterosexism creates interpersonal
Colombia, where reports emerged in 2013 of “social
dilemmas for LGBTQ people who must repeatedly
cleansing” practices targeted at LGBTQ people,
decide whether and to whom to disclose their
among others, by means of murder, death threats, and
LGBTQ status. As such, disclosure becomes a
disseminating anti-LGBTQ literature. Another
personal act with political consequences because it
explanation relates to what psychologists have
can bring LGBTQ people into direct opposition with
dubbed the “ego-defensive” motivation for hate
heterosexist ideologies that endorse and protect the
crimes against LGBTQ people, whereby perpetrators
normative status of heterosexuality. Yet
use violence as a way of reasserting their
heterosexism has negative effects on heterosexuals as
heterosexuality in light of an aspect of their own
well, evident in the fact that many heterosexuals
personality they find distasteful, such as effeminacy
(especially men) choreograph their behavior and
or sexual feelings toward individuals of the same sex.
interactions to specifically avoid being labeled
In these cases, the psychological motivations for
homosexual. This can have a profound effect on
perpetrating are sometimes unconscious and
experiences such as same-sex friendships, many of
unknown to the individual, but the use of violence
which have been plagued with anxieties about
helps the individual to negate anxiety and other
circumscribing emotional closeness to fend off
negative emotions associated with threats to self-
accusations of homosexuality. Crucially, the fight
identity.
against heterosexism is an ongoing, global endeavor
The study of psychological heterosexism also
that concerns both LGBTQ people and heterosexuals
focuses on who holds anti-LGBTQ beliefs. The
as allies committed to its eradication.
principal culprits are heterosexuals who may
internalize heterosexist attitudes. However, LGBTQ Nick Rumens
people may also hold heterosexist attitudes and
beliefs. This assertion is supported by evidence that See also Biphobia; Defense of Marriage Act (DOMA);
some LGBTQ people give credence to social beliefs Gay–Straight Alliances (GSAs); Gender Binaries; Hate
that their sexual or gender identity is unnatural, Crimes; Heterosexist Bias in Research; Homophobia;
abnormal, and problematic. One explanation for this Homosexuality, Female; Homosexuality, Male; Minority
seeming paradox is that LGBTQ live their lives Stress; No Promo Homo Policies; Transphobia
within communities that hold heterosexist attitudes,
beliefs, and values, so it is expected that they will
Further Readings
internalize some of these stigmatizing views. The toll
that internalized heterosexism can take on LGBTQ Frei, D. (2014). Challenging heterosexism from the other
individuals ranges from self-doubt and mild anxiety point of view: Representations of homosexuality in Queer
to self-hatred, self-harm, and suicidal ideation, as Folk and The L Word. Bern, Switzerland:
although psychologists maintain that internalized Peter Lang.
heterosexism can be unlearned. Of great concern is Herek, G. M. (1990). The context of anti-gay violence:
the personal toll internalized heterosexism exacts on Notes on cultural and psychological heterosexism.
LGBTQ individuals and how LGBTQ people may Journal of Interpersonal Violence, 5, 316–333.
act as unwitting and complicit agents in its Herek, G. M., Cogan, J. C., & Gillis, J. R. (2002). Victim
perpetuation. experiences in hate crimes based on sexual orientation.
Journal of Social Issues, 58, 319–339.

Herek, G. M., Gillis, J. R., & Cogan, J. C. (2009).
Internalized stigma among sexual minority adults:
Insights from a social psychological perspective.
Journal of Counseling Psychology, 56, 32–43.
Herek, G. M., & McLemore, K. (2013). Sexual
prejudice. Annual Review of Psychology, 64,
309–333.
Kuvalanka, K. A., Leslie, L. A., & Radina, R. (2014).
Coping with sexual stigma: Emerging adults with
lesbian parents reflect on the impact of heterosexism and
homophobia during their adolescence. Journal of
Adolescent Research, 29, 241–270.
Ragins, B. R., Cornwell, J. M., & Miller, J. S. (2003).
Heterosexism in the workplace: Do race and gender
matter? Group and Organization Management, 28(1), 45–
74.
Stonewall. (2013). Homophobic hate crime: The Gay
British Crime Survey 2013. London, England: Author.
Heterosexist Bias in Research
1299
individual’s personal beliefs, heterosexism derives
from implicit norms that are present in formal and
informal social institutions. Paired with bias,
heterosexism becomes a system of prejudicial
attitudes against nonheterosexual individuals,
behaviors, and relationships.
The concept of heterosexism is often compared
with or used in place of the concept of homophobia;
however, there are important differences between the
two concepts. Homophobia refers to a negative
attitude or fear regarding nonheterosexual people.
These negative attitudes and fears are held at an
individual or interpersonal level. An example of
homophobia would be using antigay slurs or calling
something “gay” as an intentional form of
denigration. Homophobia involves intentionally
prejudicial words, beliefs, and actions.

Szymanski, D. M., Kashubeck-West, S., & Meyer, J.

(2008). Internalized heterosexism: A historical and
theoretical overview. Counseling Psychologist, 36,
510–524.

HETEROSEXIST BIAS IN RESEARCH

Heterosexist bias systematically limits what we know

and imagine about the world as a result of
conceptualizing human experience in strictly
heterosexual terms. The term bias describes a
prejudice against or an inclination toward some ideas
or people over others, and as a result, bias creates
prejudices within social structures, policies, and
conventions. Heterosexism is a foundational system
that oppresses nonheterosexually identified
individuals. Heterosexism stems from the assumption
that heterosexuality is natural, universal, and
therefore inevitable. In turn, sexualities and
identities such as lesbian, gay, bisexual, transgender,
and queer (LGBTQ) are assumed to not be natural,
universal, or inevitable. As a result, heterosexism
ignores, rejects, and stigmatizes nonheterosexual
identities, behaviors, and relationships.
It is important to note that heterosexist bias does
not rely on whether an individual considers him- or
herself to be antigay or homophobic. Rather than an
1300
Heterosexist Bias in Research
Heterosexism, in contrast, involves a set of practices,
norms, and conventions that may not be seen or
intended to be prejudicial, but are prejudicial
nevertheless. For example, whereas homophobia might
be expressed through gay slurs, heterosexist bias might
be expressed through school policies that do not punish
gay slurs, thereby reinforcing homophobic attitudes in
the classroom, school, family, and community.
Heterosexist Biases and Assumptions in
Empirical Research
Research on sexual identities, attractions, and
relationships is important for developing public policies
and, in particular, evaluating whether policies
negatively impact some groups more than others. High-
quality research is necessary to evaluate the impact of
institutional practices and laws that regulate
individuals, including, for example, in the areas of
schooling, health care, and commerce. Heterosexist bias
in research can hinder the collection of such data.
One example of heterosexist bias in research can be
found in the U.S. Census definition of “household.”
When collecting data on all of the individuals living in
the country, the U.S. Census has recognized households
only as “married,” “widowed,” “divorced,” “separated,”
or “never married.” These categories demonstrate how
heterosexist forms of data collection can systematically
obscure alternative family structures, particularly
among families that have been historically denied
access to the institution of marriage. Under the U.S.
Census definition of “household,” many different forms
of family, including but not limited to same-sex
couples, have been made invisible. As a result of the
heterosexist bias embedded in this research design,
social policies and other forms of support have been
made less available to LGBTQ individuals and families
because they were not recognized through the available
categories in U.S. Census data.
Heterosexist bias must be examined in the process of
conducting research, although because such biases have
become well integrated into the systems, terminology,
and norms of research practices, they are sometimes
hard to discern. Several recommendations have been
developed for ways to observe and avoid heterosexist
bias in research. These are discussed in the following
sections.
Research Question Development
Heterosexist bias can affect any point in the research
process, beginning with the development of a research
question. For example, the consistent development of
research questions that focus on marriage, childbearing,
and monogamous romantic relationships assumes that
all individuals have the same values, the same relational
norms, and the same access to social and religious
institutions such as marriage. When researchers
describe marriage and childbearing as the primary goals
of adulthood, they systematically exclude those who are
legally banned, or even simply discouraged, from
participating in these and other activities. To avoid
heterosexist bias, researchers should, therefore,
consider and study a diverse set of relationships and
forms of intimacy in youth and adulthood and should
resist making assumptions about the normalcy and
universality of certain social and family practices.
Another way to reduce heterosexist bias is to resist
assuming that sexual identity represents a primary
source of group difference. This theoretical position
implies that being heterosexual or LGBTQ leads to
fundamentally different experiences or beliefs. While
there may, of course, be important differences between
those who do and do not have same-sex relationships,
desires, or fantasies, the development of research
questions that assume group difference based on sexual
identity, attraction, or behavior may be shortsighted. It
is essential to acknowledge that group differences may
be driven by factors outside of the individual, such as
exposure to discriminatory policies, media images that
focus on heterosexual relationships, or lack of family
support for samesex desires. Researchers are
encouraged to develop research questions that do not
assume that sexual identity creates group differences in
and of itself, and to develop a set of broader questions
that theorize a range of factors that shape how
heterosexual and nonheterosexual individuals behave,
relate, and develop.
Sampling
The process of developing a study sample often follows
from the development of a research question; it is the
way that a researcher decides who will be asked to
participate in a study. Heterosexist bias in sampling has
been an area of concern because bias at this stage of a
study systematically reduces the number of people and
the diversity of experiences that are represented in

research. Some researchers mistakenly conclude that
there are few or no LGBTQ individuals in a particular
neighborhood or community when LGBTQ participants
have been reluctant to participate in research studies.
There are, however, several reasons why LGBTQ
individuals might be reluctant to participate in research
studies. Some individuals may fear being publicly
identified as LGBTQ. Other individuals may find that
conventional sexual identity labels (which vary
significantly by region, race/ethnicity, generation, and
education level) do not adequately describe them.
Researchers must recognize the range of factors that
can impact how often, when, and under what conditions
LGBTQ individuals may participate in research.
Without such awareness, researchers risk incorporating
heterosexist bias into their sampling designs and
underrepresenting the experiences of nonheterosexual
individuals.
To avoid this, researchers should consider several
recruitment strategies when sampling nonheterosexual
populations, including using community informants to
understand local sexual identity and behavior
terminology and accessing samples through community
networks that enable participants to understand the risks
(and rewards) of participation. Researchers should also
consider the sampling biases that can be introduced
when LGBTQ individuals are sampled largely from
specific locations such as bars, hospitals, or clinics.
LGBTQ individuals sampled primarily from such
locations will have specific concerns, characteristics,
and behaviors that do not necessarily reflect the
diversity of all LGBTQ individuals. As a result,
Heterosexist Bias in Research
policies developed from these specialized samples
might reinforce prejudices (e.g., assumptions that all
nonheterosexual individuals use drugs or abuse alcohol)
and could potentially limit social support for LGBTQ
individuals and communities.
Research Design
Heterosexist bias can also be introduced into a study
through the questions a researcher asks, the way these
questions are posed, and the options for response
provided. For example, providing only the options of
“male” or “female” to describe one’s gender ignores
those who do not identify with either of these gender
choices. Researchers should also avoid using language
1301
that positions heterosexual individuals as the primary
group and LGBTQ people as “other.” Such positioning
suggests that heterosexuality is easily understood,
whereas only nonheterosexuality requires explanation.
Even simple language choices such as using the term
“other” to describe nonheterosexual gender or sexual
identities can communicate heterosexist bias, given that
the term suggests a non-normative and “strange” status.
A preferable approach is to allow participants to
endorse a less stigmatizing category, such as “a gender
not listed here,” “a sexual identity not listed here,” or
“none of these options describes me/ my experience”
rather than “other.”
Similarly, demographic questions that refer to a
person’s “spouse” or “husband/wife” have typically
assumed that all participants are heterosexual or have
the legal right to be married. Researchers are
encouraged to use the term “partnered” or “un-
partnered” instead of “married” or “single” and avoid
response options that do not provide same-sex couples
an option to indicate a partner status. It is also important
to avoid creating an implicit hierarchy among partner
statuses, with married as the prioritized status. Lastly,
researchers should consider whether their study
implicitly presumes that participants are heterosexual
and that all participants have equal access to or desire
for “traditional” partnering activities. For example, a
study that asks participants to imagine a scenario in
which they are on a romantic date at the movies
presumes that all participants can
Heterosexist Bias in Research
equally imagine such a date, occurring safely in public
with a partner of their choice.
Another strategy for avoiding heterosexist bias
involves the use of continuous dimensions rather than
dichotomous categories to measure characteristics such
as gender(s), sexual identity, sexual orientation, and
relationship status. Researchers should consider how
dichotomous categories systematically represent and
reinforce majority groups, while systematically
excluding or inaccurately representing sexual-minority
groups. Lastly, LGBTQ individuals should not be
described as a single homogenous group (“the gays”),
but rather in reference to a relevant characteristic (e.g.,
“individuals who identify as gay or lesbian” or
“individuals in a same-sex relationship”), to avoid
suggesting that an individual’s sexual identity or
1302
orientation is the person’s single most important and
defining characteristic.
Researchers that examine sexual health, sexual
function, and sexual relationships have additional
considerations to make in order to avoid heterosexist
bias. In addition to considering terminology for gender
and relational status, researchers should describe sexual
activities in such a way that penile– vaginal intercourse
is not presumed to be participants’ sole or primary form
of sexual activity. Researchers should use measures that
allow participants to describe a range of sexual
activities and avoid terminology that prioritizes
heterosexual intercourse or makes non-intercourse
behaviors secondary. In assessments of sexual function,
for example, researchers should consider how questions
focusing solely on experiences of penetration or vaginal
dryness might be more relevant to participants who
engage in vaginal intercourse and may exclude
participants who engage in other sexual activities.
Considering such factors can help reduce heterosexist
bias and can allow participants— regardless of sexual
identity—to imagine and share aspects of their sexual
lives in research settings.
Historically Black Colleges and Universities, LGBTQ Students at
Analysis
At the analysis stage in research, heterosexist bias
emerges in the process of forming explanations, making
interpretations, and deriving meanings from data.
Researchers are encouraged to resist the common
practice of comparing heterosexual and LGBTQ
groups, and positioning heterosexual experiences as the
implicit norm and LGBTQ experiences as “the effect to
be explained.” Instead, researchers are encouraged to
consider analytical strategies that position majority
groups (e.g., heterosexuals, Whites) as requiring just as
much explanation as minority groups. For example,
researchers should analyze the causes and prevalence of
gender conformity among heterosexual men and
women, rather than simply analyzing the causes and
prevalence of gender nonconformity among lesbians
and gay men. Such an approach provokes new and
valuable questions and interpretations. Researchers
should consider whether they have inadvertently
analyzed group differences in a manner that implicitly
privileges a heterosexual norm and presumes this norm
to be stable and to require no explanation.
Research Dissemination
Finally, there is the issue of how heterosexist bias can
influence the reception and support of research. For
example, journal editors and reviewers are encouraged
to recognize the legitimacy of research on issues
relevant to sexual identity, relationships, and
communities. Most importantly, this body of research
should not be dismissed as overly specialized or only
relevant to LGBTQ individuals. An especially
pernicious form of heterosexist bias is the assumption
that all individuals should find research about
heterosexuals relevant and useful, while research about
LGBTQ individuals or issues is only relevant to other
LGBTQ individuals.
There is a compelling and important history of
researchers working to reduce heterosexist bias. In
1985, the American Psychological Association (APA)
formed the Task Force on Non-Heterosexist Research;
this group developed a set of guidelines for
psychologists to avoid heterosexist bias in their research
and clinical practice. Specifically, the task force
recommended that researchers include more
nonheterosexual individuals in their studies; employ
research
methods that lead to a greater understanding of sexual
identities, relationships, and behaviors; and change
current attitudes and assumptions about gay people.
One of the most important statements of the task force
was that these efforts are not only the responsibility of
nonheterosexual psychologists or those studying
LGBTQ people but also the responsibility of the entire
research community.
Sara I. McClelland and Harley Dutcher
See also Defense of Marriage Act (DOMA); Gender
Binaries; Heteronormativity; Homonormativity;
Homophobia; Legal Recognition of Nonmarital Same-
Sex Relationships; Sampling
Further Readings
Ansara, Y. G., & Hegarty, P. (2012). Cisgenderism in
psychology: Pathologising and misgendering children from
1999 to 2008. Psychology & Sexuality, 3(2), 137–160.
Badgett, M. V. (2009). Best practices for asking questions about
sexual orientation on surveys. Los Angeles, CA:
Williams Institute.
Harrison, J., Grant, J., & Herman, J. L. (2012). A gender not
listed here: Genderqueers, gender rebels, and otherwise in
the National Transgender Discrimination Survey. LGBTQ

Public Policy Journal at the Harvard Kennedy School, 2(1),
13–24.
Hegarty, P. (2006). Undoing androcentric explanations of
gender differences: Explaining “the effect to be predicted.”
Sex Roles, 55(11–12), 861–867.
Herek, G. M., Kimmel, D. C., Amaro, H., & Melton, G. B.
(1991). Avoiding heterosexist bias in psychological research.
American Psychologist, 46(9), 957–963.
Meyer, I. H., & Wilson, P. A. (2009). Sampling lesbian, gay,
and bisexual populations. Journal of Counseling
Psychology, 56(1), 23–31.
Rothblum, E. D., Factor, R., & Aaron, D. J. (2002). How did you
hear about the study? Or, how to reach lesbian and bisexual
Historically Black Colleges and Universities, LGBTQ Students at
women of diverse ages, ethnicity, and educational attainment marginalized identities may at times be stressful.
for research projects. Journal of the Gay and Lesbian
Medical Association, 6(2), 53–59.
example, Fayetteville State University in North
U.S. Census Bureau. (2014). America’s family and living
Carolina is one example of an HBCU that has taken
arrangements: 2013. Retrieved October 14, 2014, from
steps to show visible support of LGBTQ students. The
http://www.census.gov/hhes/families/data/ cps2013.html
HISTORICALLY BLACK COLLEGES
AND UNIVERSITIES, LGBTQ
STUDENTS AT
There are 105 historically Black colleges and
universities (HBCUs) in the United States, as reported
by the U.S. Department of Education. HBCUs are
institutions chartered prior to 1964 with the principal
mission to educate and advance African Americans and
the communities surrounding HBCUs. African
American students who identify as lesbian, gay,
bisexual, transgender, or queer (LGBTQ) have
increasingly become a topic of discussion among
administrators at HBCUs, as these institutions address
diversity and inclusivity. Observers note, however, that
regarding formalized attention to the needs of LGBTQ
students who attend HBCUs, the development of major
campaigns, centers, and programs has been lacking.
The explanations for the lack of widespread and
visible institutionalized extracurricular programming,
curriculum development, and programs of advocacy
and visibility for LGBTQ students at HBCUs involve
the obvious issues of religiousbased prohibitions, and
the beliefs that HBCUs and African American
communities in general have other issues that are
perceived to be more urgent. For LGBTQ students who
are African American and attending an HBCU,
however, such beliefs about the significance of
1303
students’ identities and religious-based constraints fail
to consider intersectionality. Intersectionality theorists
have been most vocal about the developmental
significance of individuals’ acknowledged multiple
marginalized identities. In the case of LGBTQ students
who attend HBCUs, the students have the challenge of
integrating at least two core aspects of who they are
within the greater society, as well as within the “Black
spaces” where they bring not just their blackness, but
also their minority sexual identity, transgender identity,
and/or gender-nonconforming expression. For these
emerging adults, the negotiation of their multiple
Allies do exist within the HBCU context. For
university’s grand opening of a Safezone Office
occurred on National Coming Out Day, October 11,
2013. Yet LGBTQ college students may still experience
microaggressions from other students, faculty, and staff
within HBCU environments that remain socially
conservative spaces.
Finding Community
LGBTQ students attending HBCUs are likely to find
their sense of community via primarily informal
networks and leisure activities at their institution. As
examples, students who are athletes, members of
modeling troupes, or choir members often find
opportunities to connect with other students who are
LGBQ or gender nonconforming. This occurs even
though such organizations are not specifically in
existence for the purpose of LGBTQ student
networking and advocacy. Students develop romantic
attractions, dating opportunities, and friendships via
such outlets and social networking. Leisure activities
and social interactions that are often informal provide
opportunities for LGBTQ students, including those at
HBCUs, to find a sense of community, as well as aid
them in affirming their identities.
In addition, there is literature available that details
the resilience of African American LGBTQidentified
persons relative to their non-Black LGBTQ
counterparts. HBCU contexts, and collective
consciousness among Black students who have chosen
to attend HBCUs, may further foster resilience among
the LGBTQ students attending these institutions. This
1304
may occur for LGBTQ students despite a relative lack Philander Smith College, Morehouse College, and
of formal and widespread targeted programming to Morgan State University. Invited HBCUs represented a
address their needs. sample of schools having active LGBTQ student
organizations on their campuses at the time.
HBCUs Are Not Monolithic
The literature of higher education includes discussions
of educational environments, institutional issues, and
strategies for university personnel attempting to serve
the needs of LGBTQ students. In the context of these
ongoing discussions, HBCUs have sometimes been
viewed as monolithic; yet they are not. Commonality
lies in the history of HBCUs’ purpose, and their
relationship to historically socially conservative ideals
of Black churches; yet HBCUs’ relevant campus
incidents, their active LGBT student organizations, and
their responsiveness to the needs of LGBTQ students
may vary. For example, while Bowie State University,
Fayetteville State, and Alcorn State University have
created safe zones and resource centers for their gender
and sexual-minority students, some other HBCUs have
received negative media attention such as the
following:

• Tragedy: the hazing death of openly gay drum major

Robert Champion at Florida Agricultural and Technical
University
• Harassment: a Twitter-leaked photo of Aaron
McCorkle of Winston-Salem State University shown in
drag during his campaign for title of Mr. Winston-
Salem State
• Controversy: four male-identified gender-
nonconforming Morehouse men who wore makeup,
hair weaves, and dresses sparked the creation of a dress
code policy of prohibition at the college

Sometimes, even following negative publicity, there

may be no public forums or workshops on campus to
educate and advocate for social justice for LGBTQ
members of HBCU communities.
A major progressive move occurred in 2011 when
Spelman College hosted a first-of-its-kind conference,
titled Facilitating Campus Climates of Pluralism,
Inclusivity, and Progressive Change at HBCUs. The
focus was on LGBTQ communities and creating a more
open campus climate. HBCUs joining Spelman College
at the conference were Bennett College, Howard
University, Clark Atlanta University, Southern
University, North Carolina Central University,
 History of Transgender Medicine in the United States
Conclusion
At historically Black colleges and universities, there are
LGBTQ students who possess a strong sense of
themselves and expect acceptance. More than 200
HBCU students have gained lobbying and leadership
skills related to issues important to LGBTQ people of
color, through participation in the Human Rights
Campaign’s HBCU LGBT Leadership and Career
Summit. At the same time, other HBCU students are in
a nascent stage of embracing their identities.
Increasingly, HBCUs are recognizing the importance of
broadly examining aspects of students’ identities
beyond race. Accordingly, strategic planning at HBCUs
will likely move toward establishing multicultural,
institutionalized, full-time centers with directors or
coordinators to provide resources and support to their
LGBTQ students.
Michele K. Lewis
See also Campus Climate; College Students; Education;
LGBTQ People of Color
Further Readings
Lewis, M. K., & Marshall, I. (2012). LGBT psychology:
Research perspectives and people of African descent.
New York, NY: Springer.
Petrosino, F. J. (2003). HBCUs tackle homophobia with
diversity initiatives. Crisis, 110(4), 10.
Prichard, E. (2007). HBCUs have a responsibility to
LGBT students. Diverse Issues in Higher Education, 24(7).
Retrieved November 2, 2015, from http://
diverseeducation.com/article/7335/
HISTORY OF TRANSGENDER MEDICINE IN THE
UNITED STATES
Although transgender people have been described
throughout the world since early humans began keeping
History of Transgender Medicine in the United States
records, the history of medical intervention for
individuals with gender dysphoria (distress caused by a
discrepancy between assigned sex at birth and gender
identity) dates back just to the start of the 20th century.
Medical and mental health providers have spent the last
1305
hundred years developing an understanding of
transgenderism, as well as language that accurately
reflects patient experience and that can be used to guide
treatment. The history of transgender health in the
United States is tied to the history of medical research
and technology, the popular press, academic thought,
and various human rights movements. It is peppered
with accounts of extraordinary individuals whose
voices have shaped social change, often at great
personal risk. Despite evidence that transsexuality (the
process of medically changing oneself to the opposite
sex) occurs naturally across time, cultures, and
socioeconomic/ethnic groups, a constant theme has
been the struggle to legitimize medical care, and hence
legitimize the lives of transgender people themselves.
Patients have been and continue to be labeled mentally
ill, and the providers who treat them considered
suspect. This entry provides a brief history of
transgender medicine in the United States, and explores
how treatment for this population has moved from the
margins toward mainstream medical care.
Early Twentieth Century
The first medical descriptions of cross-gendered
individuals date to the early 1900s, when British and
German sexologists Havelock Ellis and Magnus
Hirschfield published texts describing various types of
sexual inversions, which they presented as ubiquitous,
natural, and inborn, including hermaphroditism
(medical term for individuals born with both ovarian
and testicular tissue), homosexuality, androgynism
(state of having both feminine and masculine
characteristics), and trans-
vestism. They described individuals who crossdressed
or demonstrated cross-gender identification, labeling
them transvestites or eonists. The idea that these
conditions were normal variations on human experience
was controversial, despite the fact that concepts of
universal bisexuality were prevalent among European
intellectuals at this time. Scholars, including Charles
Darwin, Sigmund Freud, and Otto Weininger, presented
evidence on the overlap of masculine and feminine
traits, and tended to view gender as a continuum rather
than a
binary.
Their theories led to more open cultural attitudes about
gender and sexuality, compared with those then
common in the United States. Hirschfield first coined
the word transsexual when he described seelischen
1306
Transsexualismus (psychic transsexualism, a form of
homosexuality), although the term was not used to
distinguish those who wished to physically transform
their bodies to align with their internal gender identity
until popularized by Drs. Harry Benjamin and David
Cauldwell in the 1940s and 1950s.
In the 1910s, Eugen Steinach, an Austrian
physiologist, conducted the first sex reassignment
experiments in animals. Steinach transplanted ovaries
into castrated male rodents, and testicles into neutered
females, to demonstrate that the surgically altered
animals developed secondary sex characteristics and
behaviors associated with the transplanted gonads.
Steinach concluded that secretions from the gonads
were responsible for sexuality, a claim that led to the
identification of estrogen and testosterone as the
feminizing and masculinizing hormones, and eventually
to their synthetic production and use for a number of
medical conditions.
Prior to the 1950s, experiments with human gender-
altering surgeries were largely confined to countries in
Europe, where physicians and sexologists began to
distinguish between those who cross-dressed and those
who desperately wished to physically change their sex.
Magnus Hirschfield became one of the first proponents
of gender reassignment surgeries, and many of the
original procedures took place in his Institute for Sexual
Science in Berlin in the 1920s and 1930s. In 1922,
Dorchen Richter started her male-to-female transition
with an orchiectomy (removal of testicles), completing
her surgical reassignment in 1931 when she underwent
penectomy (removal of the penis) and vaginoplasty
(reconstructive surgery to form a vagina). Lili Elbe, a
Danish male-to-female transsexual, also went through a
series of genderaltering surgeries at this time, including
transplantation of ovaries and a uterus, complications of
which ultimately led to her death. Her story was widely
published and captured the interest of the Western
world. Dr. Felix Abraham, a surgeon in Hirschfield’s
institute, published the first professional paper
describing the surgical technique for male-to-female
sexual reassignment. Gender surgeries were performed
in Berlin until 1933, when the Nazis destroyed
Hirschfield’s institute and burned the archives.
Stories from Europe reached the United States
through the popular press, garnering the fascination of
the American people, particularly transgender
individuals, who previously had no language to
describe their experiences or hope for relief. Dr. David
Oliver Cauldwell, an army contract surgeon and
neuropsychiatrist for the U.S. War Department, left
patient care in 1946 to become the editor of the Q & A
section of a trendy, quasi-scientific magazine called
Sexology. In the 1940s and 1950s, he published
extensively about sexual issues, breaking traditional
taboos and creating a more liberal climate for
discussion on gender diversity. Cauldwell wrote at
length about transsexuality, transvestism, and
hermaphroditism. His early work pathologized
transsexuality as mentally unhealthy, but as he matured,
he began to promote tolerance and understanding.
Though considered one of the pioneers of
transgenderism, Cauldwell opposed sex reassignment
surgery, stating that it fell short of effecting a true
change in sex and that it was unethical to remove
healthy tissue.
When Christine Jorgensen returned to the United
States from Denmark in 1952 after successful gender
reassignment under the care of Dr. Christian
Hamburger, the ensuing media blitz brought the
possibilities of gender transition to the forefront of
American culture. Christine had been born and raised in
the Bronx as a boy named George, but was driven to
seek gender-altering treatment abroad by her profound
cross-sex identification. Captured by accounts of the
ex-GI’s transformation into a “blonde bombshell,” and
fascinated by Christine’s refined matter and the sober,
dignified way in which she presented herself, the
American people continued to follow her story for
years. Patients with gender dysphoria began to seek
medical care in droves, and American doctors were
suddenly faced with requests for treatment for a
condition they knew nothing about. The press also
turned to the medical community, asking questions
about issues raised by Jorgenson’s story. As a result,
doctors and scientists in the United States began to
discuss and debate the etiology, biology, and
psychology of transsexualism, and were forced to
explore the available treatments and develop language
to reflect increasingly complex ideas about sexuality
and gender.
Dr. Harry Benjamin, considered the father of
transgender medicine, was the first U.S. medical
provider to bring gender-affirming medical treatment
into the spotlight. Benjamin, a Germantrained
endocrinologist, studied with Dr. Hirschfield at the
Berlin Institute for Sexual Science before coming to the
United States, and traveled to Europe during his
 History of Transgender Medicine in the United States
summers to continue this work. In the 1930s, he spent
time in Austria studying with Eugen Steinach. In the
1920s, Benjamin agreed to treat a dysphoric
“transvestite” who requested an experimental trial of
the recently developed feminine hormone medication
Progynon®. Benjamin agreed, and over a short period of
time, his patient developed gynecomastia (swelling of
breast tissue in males) and significant relief from her
gender dysphoria. Over the next 29 years, Benjamin
met several patients he later identified as transsexuals,
though he did not focus on medical care for this
population until he became Christine Jorgensen’s
physician in 1952. As American transsexuals began to
request treatment, Benjamin was inundated with
referrals. For many years, he was the only doctor in the
United States prescribing hormones. Benjamin was
known for his kindness to patients and his conviction
that transsexualism was not a mental illness, but a
concrete, psychopathological entity that caused intense
suffering and deserved care. He observed that cross-
gender identification wasn’t changed by psychotherapy,
and instead recommended hormone therapy and sexual-
reassignment surgery to change the body to match the
mind. In 1953, Benjamin presented a paper on
“Transvestism and Transsexualism” at the first medical
symposium in the field. This conference included
History of Transgender Medicine in the United States
lectures on hormonal, psychiatric, surgical, and legal
aspects of care, and sparked professional interest across
the nation. In 1966, Benjamin published The
Transsexual Phenomenon, the first major medical
publication on the subject, which he wrote with the
expressed hope that his work would promote scientific
objectivity, open-mindedness, and compassion.
Transsexuals who sought medical care in the 1950s
faced considerable barriers, many of which were related
to this socially conservative period in history.
Americans were struggling with the emerging Cold War
and a fear of communists and others who strayed from
traditional narratives. Most providers opposed treatment
on ethical, religious, and legal grounds. For many years,
gender surgeries were illegal due to the antiquated
“mayhem statutes,” which prohibited the intentional
mutilation of body parts that could handicap a soldier in
combat. These legal statutes codified a more profound
fear that ambiguity in biological sex (e.g., intersex) or
gender identity might potentially rupture social order.
Psychoanalysts agreed that psychotherapy could not
change someone’s gender identity, but concluded that
1307
transsexuals were mentally ill and warned against
complying with their deranged desire to mutilate
healthy tissue. There was no training or medical
literature to assist providers in the care of these patients,
medical insurance did not cover treatment, and
providers who did offer care were viewed with
suspicion. Only the very wealthy and determined found
appropriate care, often traveling overseas for treatment.
Most were forced to lead secretive double lives or exist
on the margins of society.
Mid- to Late Twentieth Century
In 1963, Reed Erickson, a wealthy transman, became a
patient of Dr. Benjamin’s and underwent masculinizing
hormone transition under his care. Their subsequent
collaboration led to radical changes in the field of
transgender health. Erickson, with his fortune and
vision for social change, established the Erickson
Educational Foundation (EEF) in 1964, a nonprofit
philanthropic organization with the mission “to provide
assistance and support in areas where human potential
was limited by adverse physical, mental or social
conditions, or where the scope of research was too new,
controversial or imaginative to receive traditionally
oriented support” (University of Victoria Libraries,
http://www.transgenderarchives.uvic.ca/ the-
collection/reed-erickson). For the next 20 years, the
EEF supported scores of programs on transsexuality,
specifically related to patient care resources, referrals,
advocacy, education, medical research, and the creation
of professional infrastructure. The EEF developed lists
of providers who served transgender patients; launched
campaigns to educate the general public through media
presentations; and sponsored a series of international
professional symposia, which ultimately lent credibility
to the field. The Harry Benjamin International Gender
Dysphoria Association, Inc. (HBIGDA), the first
professional organization devoted to the understanding
and treatment of transsexuals, was formed in 1979 in
London at a conference sponsored by the EEF. The
EEF financed the Harry Benjamin Foundation, a
professional organization devoted to case review and
research, as well as the first U.S. gender clinic, which
opened at Johns Hopkins University in 1966. The EEF
also supported many of the other university-affiliated
gender clinics, which opened shortly thereafter.
1308
Although providers for transsexuals were generally
felt to be practicing on the fringe, the creation of the
clinics and development of professional infrastructure
led to collaboration, research, and some grudging
respect in the medical community. The Harry Benjamin
Foundation held monthly meetings, attended by a
number of prominent sexologists, providers, and
researchers from across the country, including Dr. John
Money and Dr. Richard Green, who coedited the book
Transsexualism and Sex Reassignment (1969), the first
collection of scholarly articles dedicated to the
professional care of transsexual patients.
The goals of the Johns Hopkins gender clinic and the
other university clinics included provision of care for
transsexuals and the opportunity for research. However,
due to a general lack of knowledge, the professionals
who staffed the clinics had little or no training in gender
diversity, and the treatments offered were experimental.
Desperate patients applied to the clinics by the
thousands, but were often disappointed by the strict
criteria used to determine treatment eligibility. In some
clinics, surgical and hormonal treatment was only
offered as a last-ditch effort to assist those who had
failed all other interventions, while better adjusted,
more successful people were turned away. Others were
denied treatment because their providers decided they
would never pass well in their preferred gender. To
qualify for treatment, clinicians expected male-to-
female transsexuals to hate their male genitalia, be
sexually attracted to men, and present themselves in a
hyperfeminine manner. Patients quickly learned what
the clinics expected and coached one another on how
best to present, thus reinforcing a narrow,
heteronormative binary. Patients were required to leave
their jobs, divorce their spouses, and move to new
towns as part of the social transition process. As a
result, few patients received appropriate care, most did
not thrive, and providers were often disappointed by
outcomes.
In 1979, Dr. Jon Meyer and his secretary Donna
Reter, members of the Psychiatry Department at Johns
Hopkins, grew concerned about the lack of controversy
surrounding the surgical removal of healthy
reproductive organs in their institution, and published
an outcome study that demonstrated no long-term
improvement in adjustment between operative and
nonoperative transsexuals. Due to political pressure, the
Johns Hopkins gender clinic closed shortly afterward,
followed by the closing of most of the other U.S.
gender clinics. The psychoanalysts renewed their
attacks on the gender surgeons, warning of severe
consequences from acquiescing to the psychotic
delusions of transsexual patients.
In the 1970s, sociocultural academics who had been
influenced by the recent civil rights movement began to
challenge the beliefs and practices of the medical
community with their contributions to the field.
Sociologist Deborah Feinbloom contested the clichéd
view of transgender people promulgated by the gender
clinics, describing a wide range of gender identity and
expression in her subjects. Psychologists Suzanne
Kessler and Wendy McKenna questioned the binary
definition of gender and offered an interpretation of
gender as existing along a continuum, determined by
behavioral and expressive attributes. Anthropologist
Ann Bolin criticized the rigid eligibility criteria
imposed by the gender clinics, arguing that they forced
patients to lie to get treatment. She debunked the idea
that trans women were universally hyperfeminine,
attracted only to men, and demonstrated heterogeneous
clinical presentations; she also railed against literature
that stigmatized transsexuality as a mental illness.
Transgender people avidly read the studies of these and
other academics, resented the restrictions imposed by
the medical community, and began to demand systemic
change.
In 1979, HBIGDA published the first Standards of
Care for diagnosis and treatment, guidelines designed to
regulate and standardize psychological evaluation and
medical treatment. In 2007, HBIGDA changed its name
to the World Professional Association for Transgender
Health (WPATH), an organization whose mission
continues “to promote evidence-based care, education,
research, advocacy, public policy and respect in
transsexual and transgender health”
(http://www .wpath.org). In 2010, WPATH issued a
statement on the medical necessity of gender-
confirming surgeries, thus exerting pressure on
insurance companies to include these procedures as a
covered benefit. The seventh edition of the WPATH
Standards of Care, published in 2012, offers flexible
clinical guidelines that reflect further evolution of
treatment guidelines, particularly the move to
destigmatize, referring to gender nonconformity as a
form of diversity, not pathology.
 History of Transgender Medicine in the United States
Recent Developments
The classification of gender nonconformity as described
in successive editions of the American Psychiatric
Association’s Diagnostic and Statistical Manual (DSM)
reflects a persistent resistance to incorporate changing
views of transsexualism. In 1980, the diagnosis of
transsexualism was included for the first time in the
DSM-3, under the heading of gender identity disorders
(GID). Providers hoped that inclusion in the DSM
would legitimize transgender identities and facilitate
access to medical care, including insurance coverage.
This occurred to some extent, but diagnostic inclusion
also reinforced the popular notion of transsexualism as
a mental illness, which led to further marginalization
and discrimination. Ironically, in 1980, the diagnosis of
homosexuality was removed from the DSM3, on the
grounds that it was not a disorder. In 2014, GID was
removed from the DSM for similar reasons and replaced
with the term gender dysphoria. There is ongoing
discussion about the diagnostic and coding terms used
to describe variance—a constant battle to balance the
need for medical treatment against language that
implies pathology and leads to stigmatization.
The treatment of transgender youth with pubertal-
blocking medications is a relatively new historical
development. Medical providers have begun to use
GnRH analogues, medications previously used for the
treatment of precocious puberty, to halt puberty in trans
youth soon after it begins, thus preventing the
irreversible effects of passing through puberty in the
natal gender (assigned gender at birth). Treatment
protocols were developed by the Dutch in the early
2000s and were quickly adopted for use in the United
States. This powerful intervention allows individuals to
be less visibly transgendered, and prevents the need for
costly procedures such as facial feminization surgery,
electrolysis, and masculine chest reconstruction. There
has been public controversy over the use of pubertal
blockers in young patients, but medical research has
proven it to be safe and effective.
Since 2010, the popular media and professional
literature in the United States have frequently referred
to reaching a tipping point around acceptance of
transgenderism. Although civil rights abuses and
rampant discrimination persist, slow but noticeable
progress has been made with regard to media attention
to transgender issues, legal advocacy, social support,
and the provision of medical care. As research now
clearly demonstrates the efficacy of medical
1309
interventions, insurance companies have been
challenged to cover transgender health services. In
2014, Medicare removed its reflexive denial of
coverage for trans health, and it is expected that over
the coming years, other private and public insurance
will follow. Professional journals now devote space to
scholarly articles on transgender research and care.
Numerous professional associations
HIV and Treatment
have voiced support for access to health care, including
the American Medical Association, the American
Psychiatric Association, and the American Public
Health Association. Professional organizations are
holding conferences to train providers, and pressure is
mounting to include care of transgender people as part
of medical education curricula. There is still much work
to be done before transgender people in the Unites
States are able to easily access the health care that will
enable them to live authentic lives, but small steps have
been made away from marginalization and toward
incorporation into mainstream medical practice.
Concerted efforts are underway to build on those steps
to create a health care system that recognizes and
embraces our gender-diverse citizens.
Carolyn Wolf-Gould
See also Affirmative Therapy; Health Care System;
Health Disparities; Hormones and Surgery During
Gender Transition; Transgender Health Care; World
Professional Association for Transgender Health
Further Readings
Benjamin, H. (1966). The transsexual phenomenon. New York,
NY: Julian Press.
Bolin, A. (1988). In search of Eve: Transsexual rites of passage.
South Hadley, MA: Bergin & Garvey.
Denny, D. (1991). The politics of diagnosis and a diagnosis of
politics. Chrysalis Quarterly 1(3), 9–26. Retrieved
November 3, 2015, from http://dallasdenny
.com/Writing/2013/10/05/the-politics-of-diagnosisand-a-
diagnosis-of-politics-1991/
Devor, A., & Matte, N. (2007). Building a better world for
transpeople: Reed Erickson and the Erickson Educational
Foundation. International Journal of Transgenderism,
10(1), 47–68.
Ekins R., & King, D. (2001). Pioneers of transgendering:
The popular sexology of David O. Cauldwell.
1310
International Journal of Transgendering, 5(2). Retrieved own cellular mutations, resulting in cancers. A person is
November 3, 2015, from http://www.iiav.nl/ezines/web/ diagnosed with AIDS when he or she either has a very
ijt/97-03/numbers/symposion/cauldwell_01.htm
Feinbloom, D. (1976). Transvestites and transsexuals: Mixed
views. New York, NY: Delacorte Press/Seymore Lawrence.
Green, R., & Money, J. (1969). Transsexualism and sex
reassignment. Baltimore, MD: Johns Hopkins University
Press.
Jorgensen, C. (1967). Christine Jorgensen: A personal
autobiography. New York, NY: Paul S. Eriksson.
Kessler, S., & McKenna, W. (1978). Gender: An
ethnomethodological approach. New York, NY: Wiley.
Meyerowitz, J. (2002). How sex changed: A history of
transsexuality in the United States. Cambridge, MA:
Harvard University Press.
Stryker, S. (2008). Transgender history. Berkeley, CA: Seal
Press.

HIV AND TREATMENT

HIV and treatments for it have had a tremendous impact

on the LGBTQ population. This entry first examines
HIV and AIDS from a medical perspective, and then
looks at the evolution of treatment for the disease and
its effect on the LGBTQ community from the 1980s
until the present.

HIV and AIDS

Human immunodeficiency virus, or HIV, is the
retrovirus that causes acquired immune deficiency
syndrome (AIDS). As of 2011, there are 34 million
HIV-infected persons in the world. In the United States,
79% of all HIV diagnoses are of gay and bisexual men.
HIV enters the host’s body and attacks immune cells
known as T-helper cells. When a viral or bacterial
infection or cancer is present, these cells trigger the
body’s full immune response. Without T-helper cells,
there is no immune response.
Eventually, HIV causes the body to lose its cellular
response to infection, at which point the person has
AIDS. AIDS is a pandemic disease that has claimed 30
million lives since 1980 by making the HIV-infected
person’s body unable to fight external infections caused
by other bacteria and viruses. In addition, AIDS inhibits
the body from providing an adequate response to its

low immune response, one or more opportunistic
infections, or opportunistic cancers.
When HIV is untreated, it takes up to 10 years to
progress into AIDS, but current medicines can prevent
progression. HIV is transferred between people through
the exchange of breast milk, blood, semen, or vaginal
fluids. HIV exists in these fluids and is contagious, both
when inside of a host’s T-helper cells and when freely
distributed in the fluid.
History of HIV Treatment
1980s
In 1981, gay and bisexual men in California and
New York began to come into hospitals with
mysterious illnesses. The disease’s appearance varied,
but young healthy men were being admitted with rare
forms of cancers and pneumonias normally only seen in
the elderly with compromised immune systems. There
were no treatments when AIDS cases were first
diagnosed in the 1980s. For the first part of the decade,
AIDS was a mysterious disease that shook the medical
profession. In 1982, the disease was known as GRID
(gay-related immune deficiency), and colloquially as
“gay cancer” and “gay compromise syndrome” because
the people coming in with the illness were, in large part,
gay. It took until 1984 for HIV to be discovered as the
root cause of AIDS. As other groups began to suffer
from the disease, the Centers for Disease Control and
Prevention (CDC) identified the “Four H Club”—
homosexuals, hemophiliacs, Haitians, and heroin
addicts—as the groups most at risk for the disease. The
Gay Men’s Health Crisis organization was formed to
help raise money for research. They ended up forming a
group (now called the GMHC) providing everything
from social work services, to advocacy, to legal aid.
Because of prejudices and government inaction,
there was very little immediate research into the
disease. The LGBTQ population mobilized to press the
federal government to take action. The Reagan
administration was notably silent on HIV, and early
AIDS activists responded by adopting the slogan
“Silence Equals Death.” The advocacy
HIV and Treatment
organization ACT UP took the national stage,
advocating for public education about the spread of
AIDS, AIDS treatments, and an end to AIDSbased
discrimination.
1311
The Food and Drug Administration approved the
first HIV treatment in 1987, called zidovudine/
azidothymidine (AZT). AZT slows the progression of
HIV to AIDS, preventing the HIV from replicating at its
normal pace by inhibiting a key enzyme used to
replicate DNA. AZT is still prescribed today and has
provided the backbone to other treatments. AZT both
delayed HIV’s progression to AIDS and prevented the
transmission of HIV between mother and fetus.
Unfortunately, to be effective, AZT must be taken every
four hours indefinitely.
After AZT was released, ACT UP rallied for a
significant relaxation in FDA policies to accelerate
testing. This was followed by a wave of secondary HIV
treatments to address specific cancers and opportunistic
infections experienced by HIV patients. The first fast-
tracked therapy was an alternative treatment for
pneumonia for AIDS patients who could not tolerate
traditional treatments. Later came injections for the
treatment of Kaposi’s sarcoma (cause of the skin
lesions commonly associated with AIDS cases). A
treatment was also developed for AIDS-related
cytomegalovirus retinal infection, which causes sight-
threatening inflammation of the eye. Alternative
therapies to AZT, preliminary medicines for pediatric
patients with HIV, and treatment for AZT-caused
anemia also came out during this time. Over 100,000
cases had been reported in the United States by the end
of the 1980s.
1990s
HIV treatment continued to improve, but costs were
incredibly high. Patents for these novel medications
were still enforced, and insurance companies would
deny coverage, or deny insurance altogether, to people
with HIV. Medicaid filled the gap for some, but often
only took effect once patients had entirely depleted their
savings and were so sick they were regarded as having a
disability. ACT UP pushed heavily to stop profiteering
HIV and Treatment
at the expense of marginalized populations. The
therapies frequently cost over $7,000 a year, and many
of those infected did not have insurance.
In 1990, a young boy named Ryan White was
infected with HIV through a blood transfusion he had
received for his hemophilia. In response, the federal
government created the national Ryan White
Comprehensive AIDS Resources Emergency (CARE)
1312
Act. This had a huge impact on the gay community
because federal resources were finally available to
provide quality care for those who were uninsured or
underinsured.
During the 1990s, a new array of treatments for
opportunistic infections and cancers emerged. Each
specific treatment had to be targeted at the unique
profile of diseases experienced by people with AIDS.
One of the early 1990s treatments with the most far-
reaching benefits was Epogen, which provided relief
from the AZT-induced anemia that affected many HIV-
positive people and alleviated some of the weakness
caused by the treatment.
Throughout this period, AZT remained the best and
most used antiretroviral therapy. HIV management was
bolstered by the creation of additional antiretrovirals. In
1991, Didanosine was approved by the FDA. It was
followed by Salcitabine, which, like many HIV
medicines, was fast-tracked through approval, yet
ultimately proved ineffective. Stravudine had better
success, and provided an alternative to AZT.
During the 1990s, ACT UP continued to play a
major role in driving what would become national
trends to combat the spread of HIV. They started illegal
needle exchanges, which were highly controversial but
continue to be present today in most major cities.
In 1995, Epivir was approved for use alongside
AZT. Epivir was the first major support drug that, when
used in combination with AZT, created significantly
better HIV suppression therapy. The release of Epivir
was the start of what is known as the “AIDS cocktail,”
a combination of antiretroviral drugs that work together
to prevent HIV from transitioning into AIDS. At the
same time, the Gay Men’s Health Crisis began offering
its own HIV testing clinic.
Other antiretroviral medicines added to the AIDS
cocktail throughout the 1990s. Medicines released
include the first wave of protease inhibitors (such as
Invirase), which attack HIV’s protease enzyme that is
essential for its ability to reproduce. Invirase was so
promising that the FDA approved it only 97 days after
the application was submitted. The addition of protease
inhibitors to the AIDS cocktail transformed the
syndrome from a death sentence to a chronic condition.
With more developed medicines, HIV’s progression
could be delayed indefinitely, but the medicines often
carried many side effects.
In 1998, Sustiva was released. It is still one of the
preferred treatments among non-nucleoside reverse
transcriptase inhibitors (NNRTIs). While this drug is
not used alone, its importance in HIV suppression is so
great that it is included in the
World Health Organization’s list of essential drugs.
Another essential drug, Siagen, was granted approval in
1998. It successfully suppresses AZTresistant strains of
HIV.
During this time, many fraudulently labeled over-
the-counter medicines that promised either HIV
suppression or a cure were on the market. The FDA
aggressively brought suits against these medicines
because they endangered consumers by making them
believe that they were suppressing their HIV, allowing
the disease to progress into AIDS. Troublingly, some
FDA-approved medicines ultimately showed very low
efficacy because HIV medicines were being rapidly
fast-tracked.
Also during this time, despite the combination
therapies and lower doses available, HIV treatment still
wreaked havoc on the body. Many patients suffered
from end-stage liver disease induced by a combination
of HIV medicine and hepatitis, a frequent comorbidity
with HIV, making cirrhosis of the liver the leading
cause of death for those with HIV. Even people who
have a low viral load (i.e., a low level of HIV in the
blood) were frequently struggling to sustain a normal
quality of life. HIV medications also caused the
disappearance of fat from the extremities and face,
while depositing large quantities of fat to the
midsection. In the LGBTQ community, this pouch was
referred to as a “protease paunch,” because it is caused
by protease inhibitor medication. HIV still had a
striking visual profile even as the disease was
controlled.
2000s
The 2000s saw a further proliferation of therapies as
well as many tested therapies becoming more widely
available. The decade also brought a surge in the
number of once-a-day treatments, as coated drugs
became more reliable in emergency release and
extended-release form. The therapies work by placing
medicine in an isolated core that dissolves hours after
the drug is ingested. This way, people taking medicine
for HIV no longer have to take many pills throughout
the day. Further, common combinations of drugs used
in HIV therapy were combined into one pill. These
innovations made treatment easier. The most prominent
example of these extendedrelease combination therapy
pills is Trizivir (a fixeddose combination of AXT,
Epivir, and Retrovir).

During the early 2000s, new technology emerged,
allowing patients to monitor the effects of the medicine
by measuring plasma HIV-1 RNA. Viral load, or the
level of HIV in a patient’s blood, is tested every few
weeks until it stabilizes. When the viral load is high,
then the number of immune cells a person has is
typically low. Conversely, a low viral load signals a
healthy immune system. Importantly, this gives patients
more flexibility in when they take medicine. Someone
who is recently infected can delay taking large doses of
antiretroviral medicines, and a person who once had a
high viral load can monitor the success of the
medication in bringing that load down, and eventually
reduce the number of medications the person is taking.
The LGBTQ community brought state and federal suits
to ask the courts to consider HIV a disability under the
Americans with Disabilities Act. There was a
proliferation of cases challenging the legitimacy of
denying insurance coverage to someone because the
person was HIV-positive. In 2008, Congress explicitly
codified HIV as a disability under the Americans with
Disabilities Act.
2010–Present
A preexposure prophylactic (PreP), Truvada, gained
approval in 2012, changing the way people thought
about HIV therapy. Truvada is a combination of
antiretrovirals taken four times a week to prevent the
contraction of HIV. In multiple
HIV and Treatment
studies, it is shown to have a 100% success rate when
taken as prescribed. PreP has surged in popularity with
gay and bisexual men as well as transwomen. In major
cities, PreP is available on a sliding scale in lesbian,
gay, bisexual, and transgender (LGBT) wellness
centers. The drug is a breakthrough therapy in
decreasing the rate of HIV transmission.
Current HIV treatment breakthroughs have focused
on potential cures and vaccines. Recently, two people
were thought to be cured once they reached a zero viral
load after having received a bone marrow transplant.
Unfortunately, HIV returned in both cases. Similarly,
an aggressive antiretroviral therapy was used in a
newborn, and the child’s viral load hit zero. While the
viral load stayed at zero for a sustained period of time,
eventually HIV reappeared in the child’s system. HIV
continues to be a chronic condition with no cure.
1313
The Affordable Care Act compels insurance
companies to provide HIV treatment coverage. HIV
therapies have come a long way, and the treatments
have never been as readily available as they are now.
Still, HIV and AIDS cost more than a million lives
around the world every year. Gay and bisexual men are
still the group most affected in the United States by
HIV; however, the community’s strong outreach,
advocacy, and support networks have steadily driven
down the rate of transmission and increased the life
expectancy for those with the condition.
Leslie C. Allen
See also Aging, Social Relationships, and Support;
Chronic Illness; Discrimination Against LGBTQ
People, Cost of; Discrimination on the Basis of HIV/
AIDS in Health Care; Health Care System; Health
Disparities; HIV/AIDS and Aging; HIV/AIDS and Gay
Masculinity; HIV/AIDS and Racial/Ethnic Disparities;
HIV/AIDS and Social Support; HIV/AIDS in Prison;
HIV/AIDS Treatment and Care, Psychosocial and
Structural Barriers to
Further Readings
AIDS.gov. (n.d.). What is HIV/AIDS? Retrieved November 3,
2015, from https://www.aids.gov/hiv-aids-basics/ hiv-aids-
101/what-is-hiv-aids/World wide HIV
HIV/AIDS and Aging
AVERT. (2014). Global HIV and AIDS statistics.
Retrieved November 3, 2015, from http://www.avert
.org/worldwide-hiv-AIDS-statistics.htm
AVERT. (n.d.). History of HIV & AIDS overview.
Retrieved November 3, 2015, from http://www.avert
.org/history-hiv-aids-us.htm
Catz, S., Kelly, J., Bogart, L., Benotsch, E., & McAuliffe, T.
(2000, March). Patterns, correlates, and barriers to
medication adherence among persons prescribed new
treatments for HIV disease. Health Psychology.
Retrieved September 2, 2014, from http://psycnet.apa
.org/journals/hea/19/2/124/
Centers for Disease Control and Prevention. (n.d.). Living with
HIV. Retrieved November 3, 2015, from http://
www.cdc.gov/hiv/living/
Günthard, H., Aberg, J., Eron, J., Hoy, J., Telenti, A.,
Benson, C., et al. (2014). Antiretroviral treatment of adult
HIV infection: 2014 recommendations of the International
Antiviral Society-USA Panel. JAMA.
Retrieved September 2, 2014, from https://www
.iasusa.org/content/antiretroviral-treatment-adult-hiv-
1314
infection-2014-recommendations-internationalantiviral-
society-usa-panel
U.S. Food and Drug Administration. (2014). Timeline/
history. Retrieved November 3, 2015, from http://
www.fda.gov/ForPatients/Illness/HIVAIDS/History/
default.htm
HIV/AIDS AND AGING
According to the Centers for Disease Control and
Prevention (CDC), there are approximately 1.1 million
people in the United States with the human
immunodeficiency virus (HIV), the virus that causes
acquired immune deficiency syndrome (AIDS). AIDS
is defined by the collapse of the immune system (CD4
T-cell counts of 200 or less) or the presence of an
AIDS-defining illness, such as Kaposi’s sarcoma. HIV
is contracted through exposure to an infected
individual’s bodily fluids (most specifically blood,
semen, vaginal/cervical secretions, and breast milk),
most often through unprotected sexual intercourse,
intravenous drug use, or childbirth. The World Health
Organization (WHO) estimates that 35.3 million people
are infected worldwide. When first identified in the
early 1980s, HIV was equivalent to a death sentence,
and life expectancy was a few years at best. In the
United States, gay, bisexual, and other men who have
sex with men remain disproportionately affected by this
disease. Approximately 60% of new infections occur in
this group, yet these men account for only 2% to 3% of
the U.S. population.
In the mid-1990s, access to highly active
antiretroviral therapy (HAART) transformed
HIV/AIDS into a manageable although still serious
chronic disease. As a result, in the United States and
other parts of the world where there is access to
HAART, and adherence support, people with HIV are
growing older and challenging the lengths of normal
lifespans for people with this disease. In the United
States, the CDC estimates that half of those living with
HIV/AIDS will be age 50 or older by 2015. The same
pattern is occurring in the developing world as access to
HAART improves. In addition to long-term survivors,
this aging HIV population is growing because people
50 and older are sexually active and engage in other
behaviors that put them at risk for HIV; approximately
1 in 6 HIV infections are diagnosed in this age group.
Thus, the graying of the HIV epidemic poses challenges
with regard to how to care for a population aging with
the virus and how to reduce or prevent new infections.
The Challenges of Success
The aging of people with HIV is a success story, but
there remain significant challenges. People with HIV in
their 50s and 60s report health problems that are
typically observed in one’s 70s and 80s. Research finds
that older adults with HIV report, on average, five
comorbid health conditions in addition to HIV. These
conditions include cardiac disease, certain types of
cancers, bone and joint problems, kidney disease, and
depression. While not conclusive, existing research
suggests that these multiple comorbid conditions, or
multimorbidity, result from HIV itself rather than
toxicities from ART medications.
Some have attributed this phenomenon of
multimorbidity to accelerated aging, or the early onset
of age-related conditions. However, Amy Justice has
described this process as “accentuated” aging. Namely,
people with HIV are not developing these conditions at
younger ages compared to those without HIV, but they
are developing a greater number of diseases relative to
others the same age. Data suggest that starting a person
on ART as soon as possible after HIV infection reduces
the likelihood of multimorbidity by restoring immune
function. But because older adults and their health care
providers do not usually consider themselves to be at
risk for HIV, older adults tend to be tested later after
infection when significant damage to the immune
system has already occurred. Adults 50 and older are
significantly more likely than younger adults to receive
a concurrent HIV/AIDS diagnosis, meaning that they
receive an AIDS diagnosis within 1 year of testing
positive for HIV. This is further complicated because
the immune system tends to weaken naturally with
aging, a process known as immunosenesence. Many
symptoms of HIV, such as poor appetite or insomnia,
may be seen as signs of “normal” aging.
Behavioral Health Concerns
Depression ranks as one of the most commonly
reported comorbidities, and older adults with HIV have
been found to have rates of depression 5 times greater
than noninfected adults. The reasons for these high
rates of depression are not clear, but are likely related to
a history of depression prior to HIV diagnosis, the
impact of the HIV diagnosis and associated HIV
stigma, as well as ongoing stress and anxiety related to

coping with a serious illness. Depression in this
population is a concern because it is one of the most
reliable predictors of nonadherence to HIV treatments
and medications, as well as to medications for other
conditions. In addition to health problems and stigma,
depression among older adults with HIV has been
linked to low levels of social support and associated
loneliness. Alcohol and substance use are also a
concern for gay or bisexual men and transgender
HIV/AIDS and Aging
adults aging with HIV. Use of these substances may not
only lead to behaviors that increase the risk of HIV
transmission but also interfere with the effectiveness of
ART and impede the ability to control one’s HIV
infection. Lastly, many older adults with HIV continue
to use tobacco, with some studies reporting current
smoking rates at greater than 50%. Given the issues of
multimorbidity and associated cardiac and respiratory
problems, smoking cessation programs targeting this
population are warranted.
Social Care for Those Aging With HIV
These multiple comorbid conditions, or multimorbidity,
impose a significant burden of disease that suggests a
need for caregiving both now and in the future.
Generally speaking, older adults rely heavily on family
and sometimes friends to provide the care and support
they need as they age. But on closer examination, many
older adults with HIV lack the social support resources
necessary to address their caregiving needs. Andrew
Shippy and Stephen E. Karpiak characterized the social
networks of older HIV-positive adults as “fragile” and
truncated, with greater reliance on friends as compared
to biological family members. In addition, older gay
and bisexual men in this group are much less likely to
have a spouse/partner or children compared to
heterosexuals. In addition, many of these men have lost
partners and friends to HIV in the last decades, further
shrinking their social networks.
These types of friend-centered networks typify those
of older gay and bisexual men in general, but the
reliance on friends may be exacerbated in the context of
HIV. Older HIV-positive gay and bisexual men are
more likely to report that instrumental help with the
tasks of daily living (e.g., shopping, running errands)
and emotional support (e.g., getting advice, talking
about problems) is both unavailable and inadequate
compared with older adults in general. While many of
1315
these men say that they will rely on their friends in
times of need, many of these friends also have
HIV/AIDS and may not be in a position to provide
assistance due to their own health problems.
HIV/AIDS and Aging
Social care also includes government and
community-based agencies that provide services to
older adults that are necessary for independent
community living, and these often come into play when
the needs of the older adults exceed the capacity and
skills of their family and friends. Evidence suggests that
older adults with HIV use a high volume of non-HIV-
related services. There are concerns about the readiness
of these agencies to serve an aging population with
HIV. AIDS service providers have typically focused on
younger populations and may be unfamiliar with the
needs of an HIV-positive older adult. Senior service
providers typically lack training in HIV or experience
providing services to the lesbian, gay, bisexual, and
transgender (LGBT) community. Training, technical
assistance and capacity-building will be needed to
ensure that these agencies can effectively serve older
gay or bisexual men and transgender women with HIV.
Sexual Activity and Risk
Older adults remain sexually active well into their later
years given good health and the availability of a
partner. The same is true for older gay and bisexual
men and transgender adults, including those who have
HIV. According to published reports on community-
based samples, nearly two thirds of LGBT adults 50
and older were sexually active in the past year. Among
samples of older gay and bisexual men with HIV,
upwards of half report being sexually active in the
previous year, and 1 in 5 report unprotected anal or
vaginal intercourse. Higher rates of substance use are
reported among older HIV-positive adults who engage
in unprotected sex. Among older gay and bisexual men,
the use of erectile dysfunction medications along with
the legal and widely available stimulant amyl nitrate
(aka “poppers”) has been found to increase the odds of
unprotected intercourse by approximately 150%.
Considering that nearly 1 in 10 new HIV infections
occurs after the age of 50 and that some older HIV-
positive adults continue to engage in unprotected sex,
the need to develop primary and secondary prevention
programs is critical to address sexual risk in this
population.
1316
However, less than one fifth of older LGBT adults
report discussing sexual health matters with a health
care provider after the age of 50.
Coping, Adaptation, and Resilience
Resilience is an individual’s tendency and ability to
cope with stress and adversity and may be manifested
in a number of ways. An individual may “bounce back”
to a previous state of normal functioning, or the person
may simply not show negative effects. In some cases, a
person may undergo posttraumatic growth, in which the
experience of adversity leads to better functioning.
Resilience is best understood as a process and not a trait
of an individual. Resilience may be drawn from a
variety of personal and social resources. One important
personal resource is a person’s spirituality. Spirituality,
in contrast to religiousness, which involves prescribed
sets of beliefs, is defined as one’s sense of purpose and
meaning in life, the ability to transcend one’s
immediate situation, a feeling of connectedness with
others and the world, and feelings of inner strength or
resources. Spirituality has been found to be an
important buffer to the stigma still faced by many older
adults with HIV, and may help to optimize well-being
in this population, as it has been associated with lower
levels of depression and social isolation. Other
important resilience factors include social support from
family and friends. Thus, despite the myriad challenges
faced by LGBT adults aging with HIV, many
demonstrate considerable resilience in coping and
adapting to the challenges of growing older with the
virus.
Future Directions
While research on the biological and medical impact of
aging with HIV is burgeoning, more needs to be done
to provide an evidence base to address the psychosocial
needs of this population, including behavioral health
and social care needs. Such an evidence base is needed
to effectively craft policies and programs that will meet
the demands of aging with HIV. In addition, education
and outreach to health care providers and older adults
themselves concerning sexual and other risks for HIV
transmission in later life are imperative if we are to
reduce the number of new infections in this age group,
particularly among high-risk groups such as gay and
bisexual men and people of color. Public health expert
and gerontologist Linda Fried has posited that the
lessons we learn in caring for an older population with
HIV will be extremely beneficial in terms of informing
policies and programs designed for all adults as they
face the challenges of aging.
Mark Brennan-Ing
See also Depression; Disabilities Among LGBT Elders;
Health Disparities; HIV/AIDS and Racial/Ethnic Disparities;
HIV/AIDS and Social Support; Resilience and Protective
Factors, Youth; Sexual Risk-Taking; Substance Abuse and
LGBTQ People
Further Readings
Brennan, M., Karpiak, S. E., Shippy, A. R., & Cantor, M.
H. (Eds.). (2009). Older adults with HIV: An in-depth
examination of an emerging population.
New York, NY: Nova Science.
Brennan-Ing, M., Porter, K. E., Seidel, L, & Karpiak, S. E.
(2014). Substance use and sexual risk differences among
older bisexual and gay men with HIV.
Behavioral Medicine, 40(3), 108–115. doi:10.1080/08
964289.2014.889069
Brooks, J. T., Buchacz, K., Gebo, K. A., & Mermin, J. (2012).
HIV infection and older Americans: The public health
perspective. American Journal of Public Health, 102(8),
1516–1526.
Golub, S. A., Tomassilli, J. C., Pantalone, D. W., Brennan, M.,
Karpiak, S. E., & Parsons, J. T. (2010). Prevalence and
correlates of sexual behavior and risk management among
HIV-positive adults over 50.
Sexually Transmitted Diseases, 37(10), 615–620.
Halkitis, P. N. (2013). The AIDS generation: Stories of
survival and resilience. New York, NY: Oxford
University Press.
High, K. P., Brennan-Ing, M., Clifford, D. B., Cohen,
M. H., Currier, J., Deeks, S. G., et al., for the OAR Working
Group on HIV and Aging. (2012). Report on the Office of
AIDS Research (OAR) Working Group on HIV and Aging.
Journal of Acquired Immune
Deficiency Syndromes, 60(Supplement 1), S1–S18.
HIV/AIDS and Gay Masculinity
Justice, A., & Falutz, J. (2014). Aging and HIV: An evolving
understanding. Current Opinion in HIV and AIDS, 9, 291–
293.
Masten, J., & Schmidtberger, J. (2011). Aging with HIV: A gay
man’s guide. New York, NY: Oxford University Press.
Shippy, R. A., & Karpiak, S. E. (2005). The aging HIV/
AIDS population: Fragile social networks. Aging &
Mental Health, 9(3), 246–254.

HIV/AIDS AND GAY MASCULINITY
Gay, bisexual, and other men who have sex with men
(GBMSM) may access gay-specific norms of
masculinity via their social and sexual relationships
with other GBMSM. These alternative, or subordinate,
forms of masculinity may inform GBMSM’s romantic
and sexual relationships and thus shape the HIV
epidemic. This entry summarizes how gay masculinities
are situated in relation to hegemonic masculinity, and it
lays out what is known about the role of gay
masculinity with regard to the transmission of HIV,
living with HIV/ AIDS, and HIV interventions designed
to stop the spread of the virus among GBMSM.
Hegemonic and Gay Masculinities
Gender, or the social roles ascribed to men and women,
is one of the key organizing structures of society. A
shared understanding of the meanings of gender shapes
individuals, institutions, and society at large. The term
masculinity refers to the social roles and attributes
ascribed to the male sex. The counterpoint to
masculinity is conventionally thought to be femininity,
or the social roles and attributes ascribed to the female
sex.
Hegemonic masculinity is a term used to describe the
dominant or idealized way of being a man in society.
This term was developed to describe the relational
nature of gender, and it refers not only to the attributes
expected of men, but also to the social imbalance of
power between men and women and the structure of
power dynamics within groups of men. Although the
form or expression of hegemonic masculinity
HIV/AIDS and Gay Masculinity
changes across history and cultural context, its defining
feature is that it is the form of masculinity that offers
men the most social power.
Gender scholar Sandra Bem researched individuals’
perceptions of the ideal man and woman, and found
several characteristics to be aligned with idealized
masculinity. These characteristics included traits such
as “assertive,” “competitive,” “dominant,”
“independent,” and “self-sufficient”—attributes that can
be said to reflect hegemonic masculinity in
contemporary Western culture. Others have sought to
explain the characteristics of hegemonic masculinity by
pointing to examples of idealized manhood, such as
professional athletes or famous male actors. Of course,
1317
not all men can or desire to meet the parameters of
hegemonic masculinity, and some may express their
masculinity in alternate forms. Cultural forms of
masculinity that deviate from the idealized or dominant
form are referred to as subordinate masculinities. The
qualities of subordinate masculinities vary across other
salient social identities such as race, class, and
sexuality.
Current characterizations of gay masculinity are
rooted in a long history of the conflation of gender and
sexual orientation. Prior to the 20th century, same-sex
attractions were understood as a form of gender
inversion. A sexual attraction to the opposite sex was
believed to be a central part of what it meant to be a
man or woman, and thus any man who expressed same-
sex attractions was also presumed to be effeminate.
While contemporary understandings of gender and
sexual orientation define these as two distinct
conceptual categories, the history of their conflation
lingers in how gay masculinity gets understood both in
and outside of gay communities.
Raised as men in a culture that prizes hegemonic
masculinity, GBMSM identify what it means to be a
man in much the same way as heterosexual men. Yet
because hegemonic masculinity presumes
heterosexuality, as GBMSM explore same-sex
attractions, engage in sexual behavior with other men,
or claim a nonheterosexual identity, they may find that
their understanding of masculinity evolves. The
presence of the gay community offers up a conduit
through which GBMSM can and do find access to
alternate representations of gender and room to
construct a masculinity that allows for same-sex desire.
Sociologist Peter Nardi, a scholar of men’s studies,
refers to these as gay masculinities and notes that the
spectrum of available archetypes of masculinity for
GBMSM varies widely from very butch, “straight-
acting” men to drag queens and high femmes. For most
GBMSM, these forms of gay masculinity represent
extremes, and many GBMSM opt to blend
conventionally feminine and masculine characteristics
to create their own unique masculinity.
Gay Masculinities and HIV/AIDS
Transmission
In the global epidemic of heterosexually transmitted
HIV, power imbalances between men and women are
implicated. Women’s subordinate status to men due to
the sexual division of labor, the sexual division of
1318
power, and the sexual division in social norms puts
women at risk for conditions such as economic
dependence on and fear of violence from male partners.
These in turn place women at risk for HIV/AIDS
because women may not feel able to negotiate sexual
safety in terms of monogamy, partner selection, or
consistent condom use.
Departing from the heteronormative (i.e., the belief
that heterosexuality is the only natural form of
sexuality) framework, scholars have sought to
understand whether gay masculinities relate to power
imbalances among GBMSM that might play a role in
the transmission of HIV in this population. In
particular, there has been interest in how gay
masculinity may shape sexual positioning and condom
use among GBMSM.
This line of inquiry is important given that unprotected
anal intercourse is the primary route of transmission of
HIV among GBMSM. The receptive partner or
“bottom” has roughly 5 times the risk of contracting
HIV when engaging in condomless sex without
preexposure prophylaxis (PrEP) with an infected sexual
partner as the insertive partner or “top.” Addressing
how men decide whether to top or bottom during anal
sex may aid in the development of culturally relevant
HIV interventions.
Power and Sexual Positioning
Heteronormativity informs the way that GBMSM
think and talk about sexual positioning. Because anal
sex between men has two actors (top, bottom), and
heterosexual intercourse also has two actors (man/top,
woman/bottom), men engaging in anal sex frequently
are interpreted in terms of masculine and feminine
characteristics. Research with male couples finds that
GBMSM may use gendered language to refer to one
another, describing the partner who more frequently is
the bottom in terms of feminine characteristics and the
partner who more frequently is the top in terms of
masculine characteristics. In the context of casual sex,
perceived masculinity or femininity of a sexual partner
may be used by GBMSM in their sexual decision
making. Men who believe their partners possess more
masculine characteristics (e.g., taller, older, larger
penis, etc.) than they do may opt to bottom.
Because gender does appear to play a role in
GBMSM’s decision making around anal sex, scholars
have raised concerns about whether bottoms have the
power in sexual scenarios to negotiate condom use or
other HIV prevention strategies. Yet GBMSM indicate
that while perceived masculinity and femininity of a
partner can aid in decisions around sexual positioning,
the power dynamics found within heterosexual
intercourse (i.e., masculine/dominant,
feminine/submissive) do not necessarily transfer. Men
who bottom discuss their preferred sexual position
primarily as a choice related to pleasure—both theirs
and their partners’. For many, the decision to bottom
does not result from a more masculine partner’s
coercion. On the contrary, power bottom is a common
identity among GBMSM, describing those who enjoy
taking control of a sexual encounter as the receptive
partner. The existence of power bottoms poses a direct
challenge to using heterosexual gender dynamics to
understand anal sex between two men. Heteronormative
understandings of gender, power, and HIV transmission
may be inappropriate for
GBMSM.
HIV/AIDS and Gay Masculinity
Gay Masculinities and Living With HIV/AIDS
HIV and its burden among GBMSM have shaped gay
masculinities. Scholars who have discussed masculinity
with HIV-positive GBMSM note that many value
maintenance of their physique as a way in which to
showcase both their health and their manhood. Before
the advent of highly active antiretroviral therapy
(HAART), HIV/AIDS was associated with severe
physical wasting. As such, maintenance of strength and
size became indicators of health, well-being, and
masculinity among GBMSM, and a sculpted, muscular
body became prized in gay communities. While
HAART has transformed HIV into a manageable long-
term illness, this image of fitness has persisted in the
gay community and remains the aspirational standard
for masculine beauty for many.
HIV-Related Sexual Safety
The Centers for Disease Control and Prevention (CDC)
recommend limiting the number of sexual partners and
using condoms consistently as two key strategies to
protect oneself from HIV infection. Hegemonic
masculinity has been linked to health risk-taking among
men in general—for example, it has been associated
with high rates of substance use and unintentional
injury. Notably, a key attribute of hegemonic
masculinity is sexual prowess, and men who seek to

uphold such norms may engage in sexual behaviors that
place them at risk for HIV, such as forgoing condoms
or seeking out multiple sexual partners. Because gay
masculinities are multifaceted, their relationship to
condom use and seeking multiple partners is also
multifaceted.
For young GBMSM who may not yet be out in their
sexual identity or who may feel unsafe openly
identifying as gay or bisexual, acting in an overtly
masculine way can be an act of self-preservation, as
masculinity is presumed to be heterosexual. Given the
centrality of sexual performance in hegemonic
masculinity, young GBMSM attempting to maintain an
appearance of heterosexuality may engage in
condomless sex with multiple female and male partners
to prove their masculinity and keep
HIV/AIDS and Gay Masculinity
their nonheterosexual attractions or identity hidden.
These behaviors can put them at risk for HIV.
Barebacking, or the intentional act of engaging in
condomless anal sex, has also been a point of interest
for those seeking to understand the relationship between
gay masculinities and HIV risk. While the term
barebacking refers to a sexual act, some subcultures of
GBMSM define themselves as barebackers. For
barebackers, participation in condomless sex is a central
part of their social identity. Examinations into the
characteristics of this subculture find that members
prize characteristics in line with hegemonic masculinity
such as aggression, muscularity, and dominance.
Barebackers cite public health interventions aiming to
stop the spread of HIV through condom promotion and
communication of HIV status as emasculating,
believing that these acts sanitize and feminize gay
sexuality. In protest, those in the barebacking
subculture may celebrate silence and the willingness to
take on the risk of HIV as ways to reclaim their
manhood.
Despite the link between condomless sex and HIV
transmission, not all condomless sex contains the same
degree of risk. GBMSM engaging in intentional
condomless intercourse frequently employ alternative
harm-reduction strategies to prevent the spread of HIV.
Some studies suggest that HIV-positive men may be
more likely to bottom when barebacking than HIV-
negative men, and that many are sero-sorting (i.e.,
partnering with other men based upon shared HIV
status, negative or positive), thus containing the spread
of HIV. As such, the performance of masculinity
1319
portrayed by barebackers may not be a driving factor in
the transmission of HIV among GBMSM.
While forms of gay masculinity have been linked to
condomless sex and multiple partners among some
GBMSM, these patterns cannot be generalized to this
population broadly. For many, gay masculinities offer a
route to reject many of the qualities of hegemonic
masculinity. GBMSM may have room to construct
masculinity that prizes egalitarian qualities like open
communication and honesty. As such, gay masculinities
may invite the possibility of men valuing those
interpersonal attributes that actually stymie the
transmission of HIV.
Conclusion
Recently, scholars have called for more purposeful
inclusion of gay masculinities into HIV/AIDS
interventions targeting GBMSM. The inclusion of
candid discussions of masculinity may make HIV/
AIDS interventions more culturally relevant to
GBMSM and increase participant willingness to take
part in these interventions. Interventions that address
gay masculinities may also allow for men to integrate
their sexual identity and masculinity in a safe and
supportive environment. Future research on GBMSM
and masculinity should continue to explore both risk
and protective factors that align with the multiple forms
of gay masculinity, and seek to find novel ways to
include conversations about gender in interventions
addressing the burden of HIV among GBMSM.
Michelle Marie Johns
See also Body Image Disturbance and Eating Disorders in
LGBTQ People; Butch–Femme; Dating, Sexual-
Minority Men; Effeminacy; Hypermasculinity;
Intersections Between Sex, Gender, and Sexual
Identity; Racialized Masculinity; Sexual Risk-Taking
Further Readings
Carballo-Diéguez, A., & Bauermeister, J. (2004).
“Barebacking”: Intentional condomless anal sex in HIV-risk
contexts. Reasons for and against it. Journal of
Homosexuality, 47(1), 1–16.
Connell, R. W., & Messerschmidt, J. W. (2005).
Hegemonic masculinity: Rethinking the concept.
Gender & Society, 19(6), 829–859.
Davis, S. (2009). Bem sex role inventory. In J. O’Brien (Ed.),
Encyclopedia of gender and society (pp. 59–61).
Thousand Oaks, CA: Sage.
Dowsett, G. W., Williams, H., Ventuneac, A., &
1320
Carballo-Diéguez, A. (2008). Taking it “like a man”:
Masculinity and barebacking online. Sexualities, 11(1–2),
121–141.
Haig, T. (2006). Bareback sex: Masculinity, silence, and the
dilemmas of gay health. Canadian Journal of
Communication, 31(4).
Halkitis, P. N. (2001). An exploration of perceptions of
masculinity among gay men living with HIV. Journal of
Men’s Studies, 9(3), 413–429.
Halkitis, P. N., Parsons, J. T., & Wilton, L. (2003).
Barebacking among gay and bisexual men in New York
City: Explanations for the emergence of intentional
unsafe behavior. Archives of Sexual Behavior, 32(4),
351–357.
Harper, G. W. (2007). Sex isn’t that simple: Culture and context
in HIV prevention interventions for gay and bisexual male
adolescents. American Psychologist, 62(8), 806–819.
Hoppe, T. (2011). Circuits of power, circuits of pleasure:
Sexual scripting in gay men’s bottom narratives.
Sexualities, 14, 193–217.
Johns, M. M., Pingel, E., Eisenberg, A., Santana, M. L., &
Bauermeister, J. (2012). Butch tops and femme bottoms?
Sexual positioning, sexual decision making, and gender roles
among young gay men. American Journal of Men’s Health,
6(6), 505–518.
Kippax, S., & Smith, G. (2001). Anal intercourse and power in
sex between men. Sexualities, 4(4), 413–434. Lopata, H. Z.
(2006). Gender and social roles. In J. S. Chafetz (Ed.),
Handbook of the sociology of gender (pp. 229–246). New York,
NY: Springer. Nardi, P. (2000). Gay masculinities. Thousand
Oaks, CA: Sage.
Wingood, G. M., & DiClemente, R. J. (2000). Application of the
theory of gender and power to examine HIV-related
exposures, risk factors, and effective interventions for
women. Health Education & Behavior, 27(5), 539–565.
HIV/AIDS AND RACIAL/ETHNIC
DISPARITIES
This entry describes the racial/ethnic disparities in HIV
infection among gay, bisexual, and other men who have
sex with men (GBMSM). The entry begins with an
overview of epidemiological trends in HIV infection
across race/ethnicity. Next, it leads into a discussion on
factors contributing to the disproportionate rates of HIV
infection among Black and Latino GBMSM, with a
particular focus on Black GBMSM, as this population
suffers the heaviest burden of HIV. These factors will
be explored across multiple socioecological levels,
including individual, community, and sociostructural
levels. The entry concludes with a brief
HIV/AIDS and Racial/Ethnic Disparities
discussion on current avenues for culturally mediated
approaches to public health intervention.
Epidemiologic Trends
More than 30 years have passed since the emergence of
HIV, and GBMSM continue to be disproportionately
represented in the epidemic. Following decades of
aggressive HIV prevention campaigns, and with the
introduction of highly active antiretroviral therapy
(HAART), the overall prevalence and incidence of HIV
in the United States has undergone a steady decline. In
spite of these downward trends, GBMSM remain at the
highest risk for HIV infection, having accounted for
roughly 75% of new infections between 2008 and 2010,
according to reports from the Centers for Disease
Control and Prevention (CDC). These incidence rates
have been especially pronounced for GBMSM of color,
and most notably for Black and Latino GBMSM. Black
GBMSM accounted for half of new infections among
young GBMSM in 2010, and the rate of infection for
Black GBMSM was 7 times the rate of infection for
White GBMSM. For Latino GBMSM, the rate of
infection was 3 times greater than for White GBMSM.
Although Latinos only comprise 17.1% of the U.S.
population, Latino GBMSM accounted for 23% of new
infections in 2011, compared to White GBMSM, who
accounted for 34% of new infections. Black GBMSM,
however, have been the most affected group,
accounting for 39% of new infections in 2011, despite
only comprising 13.2% of the population. In addition,
the CDC notes that Blacks accounted for almost half of
HIV-related deaths in the United States in 2010, and
that Blacks experience the lowest survival rates of any
other racial/ ethnic group after receiving an AIDS
diagnosis.
Individual-Level Correlates of HIV Risk
Sexually Transmitted Infections
As has been well established, sexual intercourse
serves as the primary mode of individual-level
transmission of HIV and other sexually transmitted
infections (STIs). Having an STI makes it easier to
become infected with HIV, as sores around the

HIV/AIDS and Racial/Ethnic Disparities
genital region provide a gateway for HIV to enter the
body. Having an STI also makes an individual more
likely to transmit HIV, as coinfection increases the
likelihood of the virus being present in sexual fluids.
Black and Latino GBMSM have disproportionate rates
of STIs—including syphilis, gonorrhea, and chlamydia
—and are also more likely to be undiagnosed or
untreated for STIs relative to other racial/ethnic groups.
For these reasons, researchers have implicated
untreated STI infections as a factor contributing to
higher rates of HIV infection and transmission among
Black and Latino GBMSM.
Age of Partners
For younger Black GBMSM, researchers have found
an association between having older sexual partners and
being more susceptible to HIV infection. This may be
due in part to higher rates of HIV infection among older
Black men, and researchers also consider issues related
to power dynamics, sexual roles, and perceptions of
masculinity within an older–younger dyad that may
influence behavioral health risk. Researchers have
noted that some young Black GBMSM seek out older
partners for a wide variety of reasons, including
emotional security, financial/social support, and the
experience/wisdom that older men can provide about
living as a gay Black man.
Age at Sexual Debut
Researchers have noted that having an earlier age at
sexual debut is associated with sexual risk behavior and
greater susceptibility to infection with STIs and HIV.
This may be due in part to having been exposed to less
sex education at a young age, having less access to HIV
prevention options (e.g., condoms), and being less
informed about ways to negotiate safer sex. Black
GBMSM, as well as Black males as a whole,
experience the earliest ages of sexual debut when
compared to other groups, and are therefore considered
to be especially at risk for negative sexual health
outcomes associated with early-age debut.
Key Risk Behaviors
While individual-level factors are always important
to consider when discussing HIV risk, researchers have
provided strong evidence that Black GBMSM do not
1321
engage in key individual risk behaviors to any greater
degree or frequency than other racial/ethnic groups.
Such behaviors include having sex under the influence
of alcohol or other drugs, having sex without a condom,
and having multiple sexual partners. Other issues often
considered to be more prevalent among Black
GBMSM, such as choosing not to disclose sexual
behavior (i.e., being “in the closet” or being “on the
downlow”) and maintaining a nongay identity, also fail
to explain the disparate rates of infection among this
group. Furthermore, Black GBMSM have actually
reported less risky sexual behaviors at the individual
level than non-Black GBMSM in a number of recent
studies, and have endorsed more positive condom
attitudes than other racial/ethnic groups. For these
reasons, researchers have suggested that individual
behavior does not account for the racial disparities
observed in the incidence and prevalence of HIV.
Community Correlates of HIV Risk
Sexual Networks
Beyond individual-level risk behavior, researchers
have pointed to a number of social, cultural,
community, structural, and economic factors that may
be associated with disparate rates of HIV infection
among Black and Latino GBMSM. In particular,
discrimination and racism may facilitate the spread of
HIV in multiple ways. At the community level, sexual
network restrictions may serve as a key contributor to
the elevated rates of HIV among Black GBMSM. In
one study, researchers found that non-Black GBMSM
regarded Black GBMSM as their least preferred sexual
partners. Non-Black GBMSM also perceived Black
GBMSM to be less welcome to LGBT social venues
and were less likely to have Black GBMSM within their
friendship circles. These factors may serve to restrict
Black MSM’s sexual networks, such that Black
GBMSM have exclusive sexual contact with other
Black men. Given that there is already a higher
concentration of HIV within the Black community,
these sexual network restrictions may allow HIV to
spread at a considerably faster rate, even if individual
risk behavior is comparable to or lower than those
outside of the network. Sexual network restriction thus
serves to illustrate how the interplay of multilevel
factors can contribute to health disparities, with racism
(structural) and sexual networks (community)
interacting to produce a social context for Black
1322
GBMSM that places them at greater risk for HIV
infection.
Cultural Context
A number of in-group community dynamics may
also contribute to health risk for both Black and Latino
GBMSM. Stigma around HIV and homosexuality is a
shared concern within these communities, as fear of
disclosing sexual behavior with other men may prevent
Black and Latino GBMSM from seeking out HIV
testing and healthrelated resources for GBMSM.
Cultural norms and gender role expectations related to
machismo and Black masculinity may also contribute to
behavioral health risk in each of these communities.
Among Latino GBMSM in particular, researchers have
found that acculturation is significantly associated with
more risky sexual behaviors. Such findings point to the
unique experiences of Latinos within a U.S. cultural
context, and highlight the importance of developing
culturally appropriate health interventions that consider
the specific challenges across different racial/ethnic
groups.
Sociostructural Correlates of HIV Risk
Access to Health Services
Lack of access to health care, education, preventive
health services, and HIV testing are all important
structural barriers contributing to the disparate rates of
HIV among Black and Latino GBMSM. Researchers
have shown barriers to gaining access to a primary care
physician and receiving consistent, quality treatment for
Black and Latino
HIV/AIDS and Racial/Ethnic Disparities
GBMSM who are already infected with HIV.
Moreover, Black men infected with HIV tend to have
lower rates of medication adherences when compared
to Whites, with researchers citing conspiratorial beliefs
around HIV, medical mistrust due to an
institutionalized history of racism, and challenges
around initial linkage and retention in care as factors
contributing to lower adherence rates. Among Latino
GBMSM, some may avoid seeking health care services
due to cultural and language barriers, as well as fears
around immigration status and deportation.
Furthermore, both Black and Latino GBMSM
experience difficulty in accessing health care and health
insurance due to poverty and economic hardship.
Homelessness
Researchers have shown that homelessness is
associated with elevated risk for HIV infection.
Lesbian, gay, bisexual, and trans (LGBT) youth in
particular experience disparate rates of homelessness,
and this is especially true for LGBT youth of color.
Young Black and Latino GBMSM often experience
homelessness due to socioeconomic difficulties, as well
as being thrown out of the home by family members
who reject them on the basis of their sexual orientation.
In many cases, the social infrastructure to protect
homeless gay youth is considerably underdeveloped and
poorly resourced. As a result, a large number of
homeless Black and Latino young GBMSM may turn to
sex work as a means of survival. Many are unable to
fully dictate the terms of these sexual encounters,
therefore placing them at higher risk for HIV and STI
infection.
Fundamental Health Determinants
Overall, researchers have suggested that broad
fundamental determinants of health—including racism,
homophobia, and poverty—overlay many, if not all, of
the discussed socioecological factors contributing to
HIV. While examining these factors empirically is a
challenging task for sexual health investigators, the
current direction of research in HIV risk and
prevention, as well as the present
HIV/AIDS and Social Support
discourse surrounding race-based health disparities,
continues to be fueled by sociostructural frameworks of
health risk.
Avenues Toward Intervention
In recent years, a small number of researchers have
been pursuing innovative health promotion initiatives to
address the disparities in HIV risk experienced by
Black and Latino GBMSM. These pilot intervention
studies have utilized unique methodological
approaches, such as Internet and cell phone–based
methods—and innovative theoretical frameworks, such
as critical consciousness. They have also focused on a
wide range of health outcomes, such as linkage and
retention to health care services; HIV testing; safer sex
behaviors; and critical deconstruction of sociocultural
forces that contribute to oppression, stereotypes, and

discrimination. Initial results from these studies appear
promising, and may pave the way for innovative and
culturally tailored interventions to be employed on a
larger scale in the future.
Ryan M. Wade
See also African American Sexualities; Health Care System;
Health Disparities; HIV and Treatment;
Homelessness; Homophobia; Interracial Relationships;
LGBTQ People of Color
Further Readings
Centers for Disease Control and Prevention (CDC). (2011).
Rates of diagnoses of HIV infection among adults and
adolescents, by area of residence—United States. HIV
Surveillance Report, 23, 1–84.
Fuqua, V., Chen, Y., Parker, T., Dowling, T., Ick, T. O.,
Nguyen, B., et al. (2012). Using social networks to reach
Black MSM for testing and linkage to care.
AIDS and Behavior, 16(2), 256–265.
Garofalo, R., Mustanski, B., Johnson, A., & Emerson, E. (2010).
Exploring factors that underlie racial/ethnic disparities in
HIV risk among young men who have sex with men. Journal
of Urban Health: Bulletin of the New York Academy of
Medicine, 87(2), 121–131.
George, S., Phillips, R., McDavitt, B., Adam, W., & Mutchler,
M. G. (2012). The cellular generation and a new risk
environment: Implications for texting-based sexual health
promotion interventions among minority young men who
have sex with men. AMIA Annual Symposium Proceedings,
2012, 247–256.
Gindi, R. M., Erbelding, E. J., & Page, K. R. (2010). Sexually
transmitted infection prevalence and behavioral risk factors
among Latino and non-Latino patients attending the
Baltimore City STD clinics.
Sexually Transmitted Diseases, 37(3), 191–196.
Harawa, N. T., Greenland, S., Bingham, T. A., Johnson, D. F.,
Cochran, S. D., Cunningham, W. E., et al. (2004).
Associations of race/ethnicity with HIV prevalence and HIV-
related behaviors among young men who have sex with men
in 7 urban centers in the United States. Journal of Acquired
Immune Deficiency Syndromes, 35(5), 526–536.
Harper, G. W. (2007). Sex isn’t that simple: Culture and context
in HIV prevention interventions for gay and bisexual male
adolescents. American Psychologist, 62(8), 806–819.
Hightow-Weidman, L. B., Smith, J. C., Valera, E.,
Matthews, D. D., & Lyons, P. (2011, January). Keeping
them in “STYLE”: Finding, linking, and retaining young
HIV-positive Black and Latino men who have sex with
men in care. AIDS Patient Care and STDs, 25(1), 37–45.
Maulsby, C., Millett, G., Lindsey, K., Kelley, R., Johnson, K.,
Montoya, D., et al. (2013). HIV among black men who have
1323
sex with men (MSM) in the United States: A review of the
literature. AIDS and Behavior, 96(6), 1007–1019.
Newcomb, M. E., & Mustanski, B. (2013). Racial differences
in same-race partnering and the effects of sexual
partnership characteristics on HIV risk in MSM: A
prospective sexual diary study. Journal of Acquired
Immune Deficiency Syndromes, 62(3), 329–333.
Raymond, H. F., & McFarland, W. (2009). Racial mixing and
HIV risk among men who have sex with men. AIDS and
Behavior, 13(4), 630–637.
HIV/AIDS AND SOCIAL SUPPORT
This entry describes the role of social support in HIV
prevention and care primarily among gay, bisexual, and
other men who have sex with men (GBMSM), which
are among the populations most affected by the
HIV/AIDS epidemic in the United States. A brief
review of social network theory to explain the different
types and sources of social support is followed by a
discussion of how social support benefits physical and
mental health. The entry then describes the importance
of social support in relation to HIV prevention and
vulnerability to HIV infection. Next, there is a
discussion on the importance of social support in
relation to the health of people living with HIV/ AIDS
(PLWHA). Given the vast body of literature on the role
of social support in general physical and mental health,
the focus here is on the applicability of social support in
HIV/AIDS prevention efforts.
Social Networks, Social Support, and
Health
Social support has been linked to both physical and
psychological health, with both quantity and quality of
social relationships being linked to morbidity and
mortality. Social network theory provides a framework
to begin understanding the relationship between social
support and health. Social networks have structural,
interactional, and functional characteristics. Structural
characteristics indicate the size and density of a social
network, whereas interactional characteristics describe
the different ways in which people in a network interact
or relate to each other. Functional characteristics often
refer to the material and psychological resources passed
between people in a network. These resources represent
different kinds of social support including, but not
1324
limited to, emotional, informational, and instrumental
support. Examples of emotional support are expressions
of care and affection by another person. Informational
support may come in the form of advice or guidance
received around a particular issue. Material aid such as
money, shelter, or assistance with a task constitutes
instrumental support. Despite the abundance of
evidence, a major challenge in examining the social
support literature is the lack of consistency in definition
and measurement of social support across research
studies. Furthermore, social support may be measured
as perceived or received. This variability in
HIV/AIDS and Social Support
definition and measurement has hindered our ability to
understand the pathways through which social support
influences health.
Two major pathways, the stress-buffering hypothesis
and the direct effects model, have been used to explain
how social support impacts health. According to the
stress-buffering hypothesis, social support protects
health by reducing the presence or negative effects of a
stressor such as the death of a loved one, victimization,
or loss of employment. The direct effects model
suggests that social support is beneficial for health even
in the absence of stressors. The extent to which social
support is available and accessible, and thus influences
health, also depends on the structural and interactional
characteristics of a given network. For example,
researchers have recently begun to focus on how
relationship type (e.g., sibling, parent–child, romantic
partnership) influences the availability and effects of
certain types of social support. Furthermore, new
questions have emerged about the potential importance
of matching specific types of social support to
corresponding types of stressors in order to maximize
the benefits of social support.
Social Support and Vulnerability to
HIV/AIDS Among GBMSM
In the United States, the majority of HIV infections and
AIDS diagnoses occur among GBMSM.
According to the Centers for Disease Control and
Prevention (CDC), nearly 80% of new HIV infections
and 70% of AIDS diagnoses among men in 2011
occurred among men who have sex with men (MSM).
Racial, ethnic, and age disparities further characterize
the HIV/AIDS epidemic. For example, disparities were
greatest among 20- to 24-year-old MSM, with infection
rates being 12 times higher for Black (146.9 per
100,000) and 3 times higher for Latino (33.9) young
adults compared with White (12.3) young adults.
National and local HIV/AIDS surveillance reports also
indicate that the proportion of individuals with
unrecognized HIV infection is highest among younger
and nonWhite MSM populations of low socioeconomic
status (SES). These same populations are thus
HIV/AIDS and Social Support
more likely to have delayed treatment, have an AIDS
diagnosis at the time of initial HIV detection, and
subsequently experience higher rates of HIV/ AIDS-
related morbidity and mortality.
A convergence, or syndemic, of stressors and
psychosocial factors such as those related to sexuality
and race-based discrimination, poverty, substance
abuse, and psychological distress contribute to
increased risk of and vulnerability to HIV/AIDS among
GBMSM. Given its potential direct effect on health and
mitigating effect on stressors, social support becomes a
key resource in prevention of HIV infection and in
addressing the burden of infection carried by GBMSM
populations. Researchers now focus on examining how
different sources and types of social support matter in
addressing HIV/AIDS disparities. These sources
encompass family and friendship networks that may or
may not include other GBMSM, and may also include
current and former sexual and romantic partners.
Family Networks and Social Support
For LGBTQ individuals and youth in particular,
expression of their sexual or gender identity to parents
and family may result in the loss or gain of different
types of social support, which has implications for
healthy social and identity development. Compared to
those who report little or no rejection from family,
LGBTQ youth who experience rejection of their sexual
identity or gender expression are more likely to report
high levels of depression, use of illegal drugs, and sex
without condoms. In this case, the loss of family-based
emotional support may result in psychological distress
leading to poor long-term health outcomes. Conversely,
family acceptance was associated with greater self-
esteem and social support, and lower levels of
depression, substance abuse, and suicidal ideation.
Homelessness resulting from sexualitybased rejection is
also more common among LGBTQ youth. This loss of

instrumental support is associated with greater use of
addictive substances, higher rates of psychopathology,
and higher numbers of sexual partners.
Loss of instrumental and emotional support may
increase vulnerability to HIV infection in several ways,
particularly for younger GBMSM. When individuals
lack basic necessities, maintaining healthy behaviors
becomes very challenging, as the focus becomes
securing food and shelter. Concerns about HIV
infection and its long-term consequences become more
distal in this scenario, as may be the case for individuals
engaging in transactional sex. The stress and isolation
related to rejection itself may also lead to maladaptive
coping behaviors such as substance abuse, which is
associated with HIV-related sexual risk behavior. For
some GBMSM, condomless sex may provide a sense of
intimacy and security that serves to counter feelings of
isolation and loneliness. Collectively, these behaviors
translate into increased vulnerability to HIV infection
among GBMSM.
Friendship Networks and Social Support
Through adolescence and into adulthood, friendship
networks gradually become as important as family
networks. While friendships in general are important
for healthy social development, involvement with
LGBTQ networks or communities offers access to
many kinds of social support that help GBMSM protect
themselves from HIV and reduce or minimize
psychosocial factors that would otherwise increase
vulnerability to HIV infection. Emotional support from
other LGBTQ individuals helps GBMSM process
experiences of victimization and discrimination, thus
reducing the psychological distress resulting from these
experiences, which are also associated with HIV-related
sexual risk behavior. Informational support in the form
of knowledge about LGBTQ-friendly medical, HIV
counseling and testing, and other sexual health services
helps GBMSM obtain information about behavioral
practices (e.g., strategic positioning and serosorting)
and medical technologies (e.g., condoms, PreP
[preexposure prophylaxis], PEP [post-exposure
prophylaxis]) for reducing and preventing HIV
infection. Instrumental support in the form of monetary
aid and shelter also helps cover basic needs that in
general are necessary for individuals to then implement
and sustain healthy behaviors and to concern
themselves with the consequences of HIV infection.
Social support from friendship networks, however, may
1325
also be accompanied by exposure to environments that
increase vulnerability to HIV infection. Dance clubs
and bars, for example, often become an important and
even primary setting for seeing and meeting other
LGBTQ people, yet this setting also increases the
opportunity for sex while intoxicated.
Social Support and PLWHA
Similar to the losses and gains in social support
resulting from the sexual identity disclosure of LGBTQ
individuals, PLWHA face similar challenges as they
consider when and to whom they disclose their HIV-
positive status. The impact, however, may be more
pronounced if disclosing both an LGBTQ and HIV-
positive status. Having social support is associated with
better psychological and physical health outcomes
among PLWHA. Lack of social support might even
result in quicker progression to an AIDS diagnosis. In
some cases where disease progression occurs, PLWHA
report increases in social support over time. For
PLWHA, emotional support may provide the
psychological resources necessary for coping with the
diagnosis of a disease that is highly stigmatized.
Instrumental
support may be important for PLWHA with advanced
disease as physiological function begins to decrease.
Also, informational support may be exchanged between
LGBTQ and non-LGBTQ PLWHA regarding choices
for medical care and providers. Further exploration is
needed to examine the role of different types and
sources of social support for PLWHA, including
HIV/AIDS-specific support as HIV infection is
increasingly treated as a chronic disease.
Conclusion
Social support plays an important role for the general
health of GBMSM and particularly for their sexual
health in the context of HIV/AIDS prevention,
treatment, and care. Social support continues
HIV/AIDS and Social Support
to be defined and measured in a variety of ways,
however, thus underscoring the need for theoretical and
conceptual clarity. Understanding how specific types
and sources of social support influence GBMSM’s risk
and vulnerability to HIV infection contributes toward a
framework that situates HIV/AIDS prevention work in
a socioecological context.
1326
Jorge Soler and José A. Bauermeister
See also HIV/AIDS Treatment and Care, Psychosocial and
Structural Barriers to; Men Who Have Sex With Men
(MSM)
Further Readings
Centers for Disease Control and Prevention (CDC). (2013).
Rates of diagnoses of HIV infection among adults and
adolescents, by area of residence, 2011—United States and
6 dependent areas. HIV Surveillance Report, 23, 1–84.
Darbes, L. A., & Lewis, M. A. (2005). HIV-specific social
support predicts less sexual risk behavior in gay male
couples. Health Psychology: Official Journal of the
Division of Health Psychology, American
Psychological Association, 24(6), 617–622.
Doty, N. D., Willoughby, B. L. B., Lindahl, K. M., & Malik,
N. M. (2010). Sexuality related social support among
lesbian, gay, and bisexual youth. Journal of Youth and
Adolescence, 39(10), 1134–1147.
Edwards, M. R. (2011). Influence of social support on gay men
living with HIV. Marriage & Family Review, 47(5), 265–
288.
Johnson, B. T., Redding, C. A., DiClemente, R. J.,
Mustanski, B. S., Dodge, B., Sheeran, P., et al. (2010). A
network–individual–resource model for HIV prevention.
AIDS and Behavior, 14(2), 204–221.
Lauby, J. L., Marks, G., Bingham, T., Liu, K. L., Liau, A.,
Stueve, A., et al. (2012). Having supportive social
relationships is associated with reduced risk of
unrecognized HIV infection among Black and Latino men
who have sex with men. AIDS and Behavior, 16(3), 508–
515.
Mizuno, Y., Borkowf, C., Millett, G. A., Bingham, T., Ayala,
G., & Stueve, A. (2011). Homophobia and racism
experienced by Latino men who have sex with men in the
United States: Correlates of exposure and HIV/AIDS in
Prison
associations with HIV risk behaviors. AIDS and Behavior,
16(3), 724–735.
Mustanski, B. S., Newcomb, M. E., Du Bois, S. N., Garcia, S.
C., & Grov, C. (2011). HIV in young men who have sex
with men: A review of epidemiology, risk and protective
factors, and interventions. Journal of Sex Research, 48(2–
3), 218–253.
Nelson, M. K. (2013). Fictive kin, families we choose, and
voluntary kin: What does the discourse tell us? Journal of
Family Theory & Review, 5(4), 259–281.
Ramirez-Valles, J. (2002). The protective effects of community
involvement for HIV risk behavior: A conceptual
framework. Health Education Research, 17(4), 389–403.
Thoits, P. A. (2011). Mechanisms linking social ties and support
to physical and mental health. Journal of Health and Social
Behavior, 52(2), 145–161.
HIV/AIDS IN PRISON
Globally, 10 million people are held in penal
institutions at any given time. The United States has the
largest prison population by far, with 2.3 million people
incarcerated in its federal and state prisons. In fact,
nearly 25% of the world’s inmates are held in American
prisons, followed by Russia, Rwanda, several countries
in Eastern Europe, and the Caribbean. Individuals
detained in prisons have already stood trial and are
serving sentences of more than 1 year. Individuals
incarcerated in prisons across the United States and
globally are disproportionately affected by human
immunodeficiency virus (HIV). This entry describes
HIV in prisons, how HIV is transmitted, and HIV
prevention activities.
Background
In the United States, more than 2 million people are
incarcerated in state and federal prisons. Racial and
ethnic minorities are disproportionately represented in
the U.S. correctional system with more than 60% of
inmates belonging to racial and ethnic minorities. While
Black Americans comprise only 13% of the general
U.S. population, they constitute 40% of all inmates held
in prisons, and
41% of the population on death row. In addition, Black
men are imprisoned at a rate of 7 times that of White
men and almost 2.5 times that of Hispanic and Latino
men. In 2010, Black women were incarcerated at rates
nearly 3 times that of White women and twice that of
Hispanic women and Latinas. American Indians are
overrepresented in the federal prisons and are over
twice as likely to be incarcerated as Whites.
The majority of individuals incarcerated in U.S. state
and federal prisons regularly used drugs and alcohol
prior to incarceration, and most of their offenses were
committed under the influence of drugs and alcohol.
Incarcerated populations are also disproportionately
affected by viral infections such as HIV. Inmates are
more likely to have histories of HIV risk-taking
behaviors, including injection drug use, tattooing, and

unprotected sexual behaviors. These behaviors often
continue, even behind bars. Overcrowding contributes
to the spread of HIV, as stress, poor health, drug and
alcohol use, and sexual violence among inmates places
them at greater risk for the transmission of HIV.
HIV Prevalence and Transmission
The prevalence of HIV infection among inmates in
many countries is substantially higher than in the
general population. For example, the number of HIV
infections among sub-Saharan African inmates has been
estimated to be 2 to 50 times that of the general
population. In the United States, it has also been
estimated that 25% of individuals living with HIV pass
through the U.S. penal system. Outbreaks of HIV in
prisons have occurred and are often associated with
sharing contaminated injecting equipment when using
drugs, the use of homemade and nonsterile equipment
for tattooing, and unprotected sexual intercourse.
Injection Drug Use
Sharing contaminated injecting equipment when
using drugs is one of the primary routes of HIV
transmission in prisons. Injection drug users (IDUs) are
of particular concern, because sharing contaminated
injecting equipment has contributed to the HIV
epidemic in prisons and other bloodborne infections,
including the hepatitis C virus (HCV). Those who inject
drugs in prisons are more likely to share needles and
syringes or other injecting equipment. Outbreaks of
HIV associated with the use of nonsterile injecting
equipment in prison have been documented in
Australia, Lithuania, Russia, and Scotland.
Tattooing
Tattooing in prison is also a risk factor for blood-
borne viruses such as HIV and HCV, because it is
illicitly performed by nonprofessional inmates using
homemade, nonsterile shared equipment. Inmates with
a history of drug injection have been noted as being
tattooed in prison and sharing tattooing needles and ink,
placing inmates at risk for acquiring HIV through
tattooing.
Sex in Prison
1327
One of the primary transmission routes of HIV is
through unprotected sexual intercourse. In many
prisons, same-sex sexual behaviors are common among
inmates, although prohibited under prison rules. It is
difficult to determine the frequency of sexual activity
among inmates. Inmates who reported same-sex
encounters with other inmates stated that they had had
consensual sex, “exchange sex” (e.g., sex exchanged for
food, money, cigarettes, or protection), and/or had
raped other inmates. Nonconsensual sex, sexual
assaults, and rapes are common in penal facilities, and
an estimated 13% of U.S. inmates report being sexually
assaulted during their incarceration in prison; the Prison
Elimination Rape Act (PREA) was passed in 2003
(Public Law 108-793) to protect inmates from sexual
violence. One factor that contributes to HIV infection
through sexual intercourse in prisons is the
unavailability of condoms in that setting, which leads to
unprotected same-sex behaviors.
LGBTQ inmates are extremely vulnerable in prisons.
Lesbian, gay, bisexual, and queer (LGBQ) inmates who
were open about their sexual identity outside of prison
typically remain “closeted”
HIV/AIDS in Prison
during incarceration because they are at heightened risk
of torture, ill treatment, and sexual violence from other
inmates. In addition, transgender inmates are especially
vulnerable to sexual violence. Transgender inmates
who have not had genital surgery are housed according
to their birthassigned gender. This situation places them
at great risk of sexual assault. One correctional policy
that is used to protect transgender inmates who are at
high risk of sexual violence is to separate them from
other inmates. This procedure is referred to as
“administrative segregation” or “solitary confinement.”
The benefit of placing transgender inmates in
administrative segregation is to provide them with
greater protection than being housed in the general
population. The disadvantage, however, is that
transgender inmates housed in administrative
segregation are locked down in a small cell, sometimes
windowless, for 23 hours a day, and are excluded from
recreational activities, services, and other programs.
Prison officials can mitigate this issue by designing
appropriate housing classification systems for LGBTQ
inmates to prevent sexual victimization and abuse from
other inmates. In other words, separate housing units
should be provided to LGBTQ inmates.
1328
HIV Prevention Activities Moreover, the World Health Organization (WHO)
recommends that prison officials provide condoms to
The prison setting is often the first place that
inmates to prevent the sexual transmission of HIV.
incarcerated individuals are either diagnosed with HIV
Condoms and other HIV prevention strategies such as
or are able to start antiretroviral therapy. Given the
PreP must be provided to inmates to reduce the
documented benefits of early diagnosis and treatment
likelihood of HIV infection. Providing PreP, condoms,
for people infected with HIV, the Centers for Disease
clean syringes, drug substitution therapy, and bleach
Control and Prevention (CDC) in 2009 provided
provisions could reduce HIV infection among various
recommendations on HIV testing in correctional
high-risk populations, including LGBTQ inmates.
facilities. HIV testing, known as opt-out voluntary
Unfortunately, HIV prevention strategies and programs
testing, is offered to every inmate after his or her arrival
are rarely available to prison inmates.
to prison. Voluntary HIV testing is also provided when
Finally, the health, safety, security, and wellbeing of
an inmate requests it. Voluntary HIV testing is
LGBTQ inmates in prisons require an understanding of
available to all inmates, regardless of duration of stay.
certain broad areas. Particular areas worth considering
Mandatory HIV testing is performed when there is an
include intake protocols, housing classification and
indication of risk and when it is clinically indicated or
assignment, medical treatment and care, policy and
part of surveillance. Involuntary testing is performed
research, cultural competence, sexual health,
following an exposure incident; a written consent from
victimization and stigma, and discharge planning.
the inmate is required.
HIV/AIDS Treatment and Care, Psychosocial and Structural Barriers to Pamela
Correctional facilities are legally required to provide Valera
medical care to all inmates, including inmates living
with HIV. The goals of HIV therapy in prisons are the See also HIV and Treatment; Incarceration; Juvenile
following: Reduce or suppress viral load as much as Justice System; Prison Rape; Transgender Inmates
possible and support CD4 cell count, restore or preserve
the patient’s immune system, enhance the patient’s
Further Readings
quality of life, and reduce HIV-related illnesses and
deaths related to AIDS. Brewer, R. A., Magnus, M., Kuo, I., Wang, L., Liu, T. Y., &
Improvement of HIV treatment in prisons, as well as Mayer, K. H. (2014). The high prevalence of incarceration
access to antiretroviral therapy, has been shown to history among Black men who have sex with men in the
United States: Associations and implications. American
dramatically decrease AIDS-related deaths. Despite Journal of Public Health, 104, 448–454.
this, the management and treatment of HIV within Brown, G. R. (2014). Qualitative analysis of transgender
corrections vary by jurisdiction. In fact, few state inmates’ correspondence: Implications for departments of
prisons have developed comprehensive and coordinated correction. Journal of Correctional Health Care, 20, 334–
HIV prevention programs and treatment across all 342.
correctional facilities. Moreover, there are gaps in HIV Jürgens, R., Nowak, M., & Day, M. (2011). HIV and
treatment when an inmate is transferred to different incarceration: Prisons and detention. Journal of the
correctional facilities, when he or she is released from International AIDS Society, 14, 26. Okie, S. (2007). Sex,
drugs, prisons, and HIV. New England Journal of Medicine,
custody, and when prison staff confiscates an inmate’s
356, 105–108.
HIV medication.
Rich, J. D., Wohl, D. A., Beckwith, C. G., Spaulding, A. C.,
Lepp, N. E., Baillargeon, J., et al. (2011). HIV-related
research in correctional populations: Now is the time.
Conclusion Current HIV/AIDS Reports, 8, 288–296.
Prison facilities are prime settings for implementing
comprehensive HIV prevention, research, and treatment
efforts. Scientific knowledge concerning the best
practices for LGBTQ inmates garnered from high- HIV/AIDS TREATMENT AND CARE,
quality biomedical HIV research is critical to advance
the health of this population. To date, there are no PSYCHOSOCIAL AND STRUCTURAL
biomedical HIV research activities in prisons involving
LGBTQ inmates.
BARRIERS TO

HIV care and treatment are critical to maintaining the
physical health of people living with HIV and
preventing new infections. Although HIV-infected men
who have sex with men (MSM) have better health
outcomes than do other HIV transmissionrisk groups,
there are also lesbian, gay, bisexual, and transgender
subpopulations that may experience significant
psychosocial and structural barriers to HIV treatment
HIV/AIDS Treatment and Care, Psychosocial and Structural Barriers to
and care. Such barriers are disproportionately prevalent
among youth as well as gender and racial/ethnic
minorities.
The HIV care continuum is a model that is used by
federal, state, and local agencies to identify issues and
opportunities related to improving service delivery to
people living with HIV (PLWH). The continuum has
four steps, including HIV diagnosis, linkage and
retention in HIV medical care, the uptake of
antiretroviral therapy (ART), and achieving viral
suppression. The continuum is particularly critical in
the context of the “treatment as prevention” initiative
that focuses on providing ART to PLWH in order to
lower or suppress an individual’s viral load enough to
reduce the transmission of HIV infection. Efforts to link
PLWH to HIV medical care and encourage the
initiation of ART to achieve viral load suppression are
therefore essential in reducing new HIV infections,
particularly for high-risk populations.
Young men who have sex with men (YMSM) of
color and transgender women are disproportionately
impacted by HIV in the United States. Although HIV-
infected MSM typically have better health outcomes
compared to other transmissionrisk groups, there is
evidence that HIV-infected YMSM of color may
experience significant barriers to HIV care and
treatment. In a report by the U.S. Centers for Disease
Control and Prevention (CDC), younger MSM had
lower levels of care at each step of the HIV care
continuum compared with older MSM in 2010. Black
MSM had the lowest levels of care compared with
MSM of all races/ethnicities. Another group,
transgender women, has similar health challenges. In
metaanalyses, HIV prevalence rates for this population
have been estimated to be approximately 19.1%
worldwide and 27.7% within the United States. Based
on these estimates, transgender women have a 49 times
higher likelihood of being HIV-positive compared with
all adults of reproductive age.
1329
Understanding the multiple barriers to HIV/ AIDS
treatment and care for HIV-infected YMSM of color
and transgender persons is critical in terms of
improving health outcomes in these populations. The
aims of this entry are (1) to review the existing
literature for HIV-infected YMSM of color and
transgender persons on barriers to (a) linkage and
retention in HIV medical care, (b) ART utilization and
adherence, and (c) HIV medical care (e.g., viral
suppression); and (2) to provide recommendations for
future
research, practice, and policy based on these findings.
Linkage and Retention in HIV Medical Care
Service-level factors represent some of the barriers to
linkage and retention in care for HIV-infected YMSM
of color, including provider characteristics (e.g.,
consistency in provider contact across HIV diagnoses
and linkage to care activities, provider knowledge and
experience in treating HIV-infected youth); the
availability of services that specifically target youth;
and intervention length. HIV-infected YMSM of color
often experience stigma related to race, sexual
orientation, or HIV status, which may function as a
barrier to engaging in HIV care. The fear of the
negative consequences of disclosing a positive HIV
status or the organization’s (e.g., a medical clinic’s)
fear of being seen as HIV-identified may delay the
initiation of HIV care. There may also be psychosocial
and developmental factors that improve linkage to HIV
medical care, including stronger connection to the
individual’s ethnic identity/community, positive
attitudes toward homosexuality, and access to peers that
support health-promoting behaviors.
HIV-infected transgender persons may have
particular difficulty seeking and receiving care, in part
because they may be reluctant to disclose their gender
identity or HIV status to health care providers.
Insufficient provider knowledge/competency,
discrimination, and transphobia may also negatively
impact retention and linkage in HIV care for this
population. Indeed, HIV-infected transgender women
report significantly fewer positive interactions with
their health care providers compared to HIV-infected
non-transgender persons. HIV-infected transgender
persons also have unique issues that need to be
addressed in the context of HIV care, such as the
possibility of adverse interactions between ART and
hormone therapy.
1330
HIV/AIDS Treatment and Care, Psychosocial and Structural Barriers to
ART Utilization and Adherence
A range of psychological and contextual variables
may influence ART utilization and adherence among
HIV-infected YMSM of color. Risk behaviors (e.g.,
frequency and severity of substance use), negative
coping styles, and psychological distress may interfere
with an individual’s ability to initiate ART or maintain
ART adherence. ART adherence may also be impacted
by whether or not HIVinfected YMSM of color have
made a successful transition to adulthood, such as
having plans and concrete goals for the future (e.g.,
career plans). Those who have may more likely
understand the importance of ART adherence as a
necessary prerequisite to meeting developmental goals.
Research on ART utilization and adherence among
transgender persons is currently limited. There is,
however, some evidence to suggest that transgender
persons are less likely to be on ART compared to non-
transgender persons. In one study, transgender women
on ART were less likely than other HIV-infected
individuals on ART to report 90% ART adherence and
also were less confident in integrating ART into their
regular routines. In another study of HIV-infected
transgender women on ART, optimal ART adherence
was associated with the importance of gender
affirmation, or the desire for validation of one’s gender
identity/expression; lower stress appraisal of
transphobic experiences; and adherence to hormone
therapy. These findings suggest the potential value of
integrating HIV care and hormone therapy to increase
treatment engagement in this population.
HIV Medical Outcomes
HIV medical outcomes, including unsuppressed viral
load and low CD4 counts, are commonly used by
federal and local organizations to track the health of
PLWH. Existing data indicate that a relatively high
number of HIV-infected YMSM of color have poor
HIV medical outcomes, including unsuppressed viral
loads or low CD4 counts.
The existing data are mixed in terms of HIV medical
outcomes among transgender persons. Some studies
have found that there are no significant differences
between HIV-positive transgender people and HIV-
positive non-transgender people in terms of viral
suppression or CD4 counts. However, HIV surveillance
data from San Francisco and New York City (NYC)
suggest that transgender persons have poorer HIV
medical
outcomes compared with some other transmission-risk
groups. In San Francisco, transgender persons have a
threefold higher community viral load than MSM and
intravenous drug users, while in NYC, transgender
women were less likely than non-transgender MSM to
achieve viral suppression.
Conclusion
Although YMSM of color and transgender persons
continue to be disproportionately impacted by HIV in
the United States, there has been limited research to
date on HIV care and treatment outcomes among these
populations. There is some evidence that both HIV-
infected YMSM of color and transgender persons may
be more likely than other groups of HIV-infected
individuals to have poor HIV medical outcomes,
particularly in terms of achieving viral suppression.
More research is needed that focuses on understanding
the individual and system-level factors that impact HIV
care continuum indicators. For YMSM of color, there is
evidence that service utilization–related variables (e.g.,
provider experience) may have a particularly critical
role in engaging and maintaining this population in HIV
care.
Information about whether someone is transgender is
not currently required by the CDC as a part of
jurisdiction-level HIV surveillance; therefore, it is
difficult to estimate the number of transgender persons
living with HIV or to track HIV care continuum
indicators for this population. In 2012, the CDC
released guidance for HIV surveillance on capturing
gender identity for transgender people, which some
jurisdictions have integrated into routine surveillance
activities. Collecting this information can be
challenging, particularly because of inconsistencies
between sources of information on sex at birth or
gender identity. Future research on HIV treatment and
care interventions should also consider how system-
level factors, including service delivery and multiple
levels of stigma, could ultimately impact HIV medical
outcomes in these populations.
Matthew B. Feldman and Simon Andrade
See also Health Disparities; LGBTQ People of Color;
Transgender and Gender-Nonconforming Youth of
Color; Transgender Health Care

Further Readings
Baral, S. D., Poteat, T., Strömdahl, S., Wirtz, A. L., Guadamuz,
T. E., & Beyrer, C. (2013). Worldwide
burden of HIV in transgender women: A systematic
review and meta-analysis. The Lancet Infectious
Diseases, 13(3), 214–222.
Centers for Disease Control and Prevention (CDC). (2012).
Guidance for HIV surveillance programs: working with
transgender-specific data. Washington, DC: Author.
Centers for Disease Control and Prevention (CDC).
(2014a). HIV among gay and bisexual men. CDC Fact
Sheet. Retrieved November 5, 2015, from http://www
.cdc.gov/hiv/group/msm/
Centers for Disease Control and Prevention (CDC). (2014b).
Men living with diagnosed HIV who have sex with men:
Progress along the continuum of HIV care—United
States, 2010. Morbidity and Mortality Weekly Report,
63(28), 829–833.
Ellen, J. M., Kapogiannis, B., Fortenberry, J. D., Xu, J.,
Willard, N., Duval, A., et al. (2014). HIV viral load
levels and CD4+ cell counts of youth in 14 cities.
AIDS, 28(8), 1213–1219.
Herbst, J. H., Jacobs, E. D., Finlayson, T. J., McKleroy, V. S.,
Neumann, M. S., & Crepaz, N. (2008). Estimating HIV
prevalence and risk behaviors of transgender persons in
the United States: A systematic review.
AIDS and Behavior, 12(1), 1–17.
Hightow-Weidman, L. B., Jones, K., Phillips, G.,
Wohl, A., & Giordano, T. P., for the YMSM of Color SPNS
Initiative Study Group. (2011). Baseline clinical
characteristics, antiretroviral therapy use, and viral load
suppression among HIV-positive young men of color who
have sex with men. AIDS Patient Care and STDs, 25(S1),
S9–S14.
Melendez, R. M., Exner, T. A., Ehrhardt, A. A., Dodge, B.,
Remien, R. H., Rotheram-Borus, M. et al. (2006).
Health and health care among male-to-female Homelessness
transgender persons who are HIV positive. American
Journal of Public Health, 96(6), 1034.
Sevelius, J. M., Saberi, P., & Johnson, M. O. (2014).
Correlates of antiretroviral adherence and viral load
among transgender women living with HIV. AIDS Care,
26(8), 976–982.
Yehia, B. R., Fleishman, J. A., Moore, R. D., & Gebo, K. A.
(2013). Retention in care and health outcomes of
transgender persons living with HIV. Clinical Infectious
Diseases, 57(5), 774–776.
HOMELESSNESS
1331
Homelessness is a broad term that encompasses a
variety of situations in which an individual may have
unstable housing; this may range from brief periods or
nights in which an individual does not have a secure
place in which to sleep to months or years without a
stable residence. The prevalence rates of homelessness
among LGBTQ youth are of particular concern. Based
on data from several studies examining this issue
among LGBTQ youth, it is clear that these youth
disproportionately experience homelessness and its
associated mental and physical health risks, in
comparison to heterosexually identified cisgender (i.e.,
when one’s gender identity coincides with assigned
sex) youth. Although most of the research on LGBTQ
homelessness addresses youth specifically, it is likely
that many of the experiences of LGBTQ homeless
youth would also apply to adults; however, this essay
focuses primarily on youth, based on the available
research literature. Specifically, the entry first reviews
general information about LGBTQ youth homelessness,
then discusses the potential consequences of
homelessness in these populations, and concludes with
an overview of the unique experiences of homeless
transgender youth.
Just as the definition of homelessness includes a
broad variety of situations, the reasons that youth
experience homelessness may also vary tremendously
from individual to individual, from forcible rejection by
parents or caregivers to willing participation in a
homeless subculture. Because many LGBTQ homeless
youth may be fleeing situations where they were
marginalized on the basis of their
Homelessness
sexual orientation or gender identity, it makes sense that
they would relocate to urban “gayborhoods,” where the
visibility of LGBTQ individuals may hold the promise
of a more accepting environment. When considering the
specific circumstances surrounding homelessness for
LGBTQ youth, many assume a prototypical narrative in
which an LGBTQ individual comes out to family, is
kicked out of the home by rejecting parents, and then
lives on the margins. The reality is that although this
situation often exists for LGBTQ youth, homelessness
is also influenced by multiple individual and societal
factors. In turn, the experiences of these youth are
complex and multifaceted.
Estimating the number of LGBTQ homeless
individuals in a given area is a difficult task. Indeed,
getting an accurate count of the general homeless
1332
population is complicated by stigma (individuals not
wanting to identify as homeless), justified skepticism
on the part of homeless individuals toward authority
figures, difficulty locating homeless camps or networks,
and the frequent mobility of homeless individuals. Of
the studies that examine the homeless population in
general, very few ask about sexual orientation or gender
identity beyond the binary male–female options. Those
that do, however, estimate that anywhere from 30% to
43% of homeless youth are LGBTQ. This
extraordinarily high proportion of LGBTQ individuals
among the homeless population highlights a health
disparity that is only addressed by a few specialized
service programs, such as the Ali Forney Center in New
York City. Only a handful of similar shelters and
programs currently exist in the United States, and all
are concentrated in urban centers. Homeless shelters
that are not LGBTQ-specific often pose additional risks
for LGBTQ youth; these may be places where youth
experience further victimization and discrimination, and
housing quarters often are established on a binary
concept of gender, resulting in inadequate services for
trans-identified consumers of their services. Accurate
counts of the LGBTQ homeless population are
imperative for providing funding to assist in the
development and maintenance of specialized services.
In order to examine the experience of LGBTQ
homelessness, it is essential to invoke the concept of
intersectionality, which refers how the various identities
people hold interact in different ways that can result in
oppressive practices and systems. These identities can
include biologically and socially constructed identities
such as gender, race, class, and sexual orientation. By
definition, LGBTQ homeless youth face simultaneous
social pressure from being part of a stigmatized gender
or sexualminority group and the economic disadvantage
of being homeless. Of course, other intersecting
elements may confer additional risk or protective factors
that modify the person’s experience, including ethnicity,
ability status, national origin, and many others. These
intersecting characteristics impact LGBTQ homeless
youth’s well-being in a variety of ways that are specific
to each individual’s experience.
Consequences of Homelessness
Homelessness is associated with numerous mental
health risks, including posttraumatic stress disorder
(PTSD), substance misuse, depression, and suicidal
ideation. Homeless LGBTQ youth experience higher
rates of these mental health problems than do homeless
youth more generally, which is believed to be
associated with the experience of having multiple
stigmatized identities. Living on the street exposes
youth to many potential traumatic events (through both
witnessing these events as they happen to others and
directly experiencing them). For many LGBTQ youth,
shelters and social service programs designed for
homeless youth are often affiliated with organizations
that do not support their sexual or gender identities,
creating additional obstacles that block access to
needed resources. Increased discrimination also
contributes to homeless LGBTQ youth facing higher
rates of physical and sexual violence than do homeless
youth more generally.
Mental health conditions, including PTSD, may
develop after exposure to such trauma(s). Among other
symptoms, the criteria for PTSD include negative
alterations in one’s mood and thought patterns that
represent looking at the world in a fundamentally
different way once a trauma (or traumas) has happened.
People with PTSD often believe that the world around
them is unsafe, that they are powerless to change it, and
that they are highly vulnerable to future traumatic
experiences. It would be difficult to dispute these
thoughts for homeless individuals, who lack the safety
and security that is related, at least in part, to having a
stable and safe place to live. A diagnosis of PTSD may
further complicate the mental health of LGBTQ
homeless individuals, as it is associated with increased
depression, other anxiety disorders, and elevated
consumption of alcohol and substances that may be
used to self-medicate in the absence of treatment.
Indeed, much of the psychological research literature
related to homelessness highlights elevated rates of
substance misuse among homeless individuals.
Homeless youth generally are more likely than other
youth to have used illicit drugs, but rates of illicit
substance use are even higher for LGBTQ youth within
this group. It is important to note that many homeless
individuals are further stigmatized on the basis of their
substance use; in fact, others often assume that
substance use is the reason that individuals become
homeless. This simplistic explanation overlooks the
factors that may have led to the individual’s substance
use in the first place, which may include minority
stress, genetics, peer pressure, and a lack of alternative
coping skills. Substance use may also be a coping
response to homelessness or the risk factors associated
with it. In other words, the high rates of substance use

among homeless populations can both precede and
follow one’s homelessness, in addition to stemming
from a variety of complex origins.
Although it is impossible to separate mental health
risks from physical health conditions, as the two
constructs have a great deal of overlap, there are many
ways in which being homeless confers additional risk
for negative physical health outcomes. Homeless
individuals often experience higher rates of
unemployment, have less educational resources, and
have fewer sources of economic and social support.
This combination of limited personal and social
resources often makes adequate medical care
impossible for homeless youth, particularly homeless
LGBTQ youth, who tend to have even fewer social
supports. Higher rates of injection drug use and risky
sexual behavior also increase rates of HIV, hepatitis,
and other
Homelessness
medical conditions among homeless individuals. Other
potential sources of health problems for homeless
individuals relate to often unsanitary living conditions,
exposure to harsh weather, and difficulties obtaining
enough nutritious food. Consequently, physical health
problems and inadequate medical care often compound
psychological problems for homeless individuals.
Higher instances of survival sex, or engaging in sex
work in order to attain necessities such as food and
shelter, also increase the likelihood that homeless
LGBTQ youth experience both physical and
psychological difficulties. Engaging in survival sex
increases the odds of contracting sexually transmitted
diseases and infections, while also increasing the odds
of being exposed to physical, sexual, and emotional
victimization. Survival sex is also associated with
higher rates of suicidal ideation and attempts among
homeless youth, regardless of sexual orientation or
gender identity. The increased discrimination and
barriers to care that LGBTQ youth often face at shelters
and when seeking services contribute to the higher rates
at which LGBTQ homeless youth engage in survival
sex compared with cisgender heterosexual peers. In this
way, engaging in survival sex is a particularly relevant
risk scenario for homeless LGBTQ youth.
Homeless Transgender Youth
Transgender youth represent a population within the
LGBTQ umbrella group that encounters additional risks
Home–School Partnerships in LGBTQ-Parent Families
1333
if they are homeless. In addition to increased medical
needs due to risk-related scenarios, homeless
transgender youth may experience medical
complications that result from inadequate medical care.
Many transgender youth require hormone or silicone
injections, which can lead to health problems if
improperly administered, or if poorer quality
medications are obtained on the street. Factors that may
contribute to these issues include shelter policies and
practices that create particularly hostile or unsafe
environments for trans-identified youth, creating
additional barriers to the already limited services that
are available. In addition to relying on binary systems
that may exclude many trans youth, some shelters may
overtly discriminate or prevent transgender individuals
from accessing services that may be more available to
lesbian, gay, and bisexual (LGB) youth. In this way, not
only are unmet medical needs particularly relevant for
homeless transgender youth, but also the experiences of
these youth often vary substantially from those of
cisgender LGB youth.
Conclusion
While the exact prevalence rates of homelessness
among LGBTQ youth have been difficult to discern, it
is clear that homelessness disproportionately impacts
sexual- and gender-minority individuals. Researchers
have also identified several potential psychological and
physical health disparities that are only beginning to be
addressed in the literature. Further research is needed to
more accurately estimate the prevalence of
homelessness as it relates to these populations, as well
as clarify the nature and origins of these potential health
disparities.
Bryan N. Cochran and Kathryn M. Oost
See also Community Climate; Demographics and the
LGBTQ Population; Gayborhoods; Housing,
Protection Against Discrimination in; Minority Stress;
Parent–Child Relationships; Social Class
Further Readings
Cochran, B. N., Stewart, A. J., Ginzler, J. A., & Cauce, A. M.
(2002). Challenges faced by homeless sexual minorities:
Comparison of gay, lesbian, bisexual, and transgender
homeless adolescents with their heterosexual counterparts.
American Journal of Public Health, 92(5), 773–777.
Corliss, H. L., Goodenow, C. S., Nichols, L., & Austin, B.
(2011). High burden of homelessness among sexualminority
1334
adolescents: Findings from a representative Massachusetts
high school sample. American Journal of Public Health,
101(9), 1683–1689.
Gattis, M. N. (2011). An ecological systems comparison
between homeless sexual minority youths and homeless
heterosexual youths. Journal of Social Service
Research, 39(1), 38–49. doi:10.1080/01488376.2011
.63381
Spicer, S. S. (2010). Healthcare needs of the transgender
homeless population. Journal of Gay and Lesbian Mental
Health, 14, 320–339. doi:10.1080/19359705
.2010.505844
Walls, N. E., Potter, C., & Van Leeuwen, J. (2009). Where risks
and protective factors operate differently:
Homeless sexual minority youth and suicide attempts. Child
& Adolescent Social Work Journal, 26,
235–257. doi:10.1007/s10560-009-0172-2
Yu, V. (2010). Shelter and transitional housing for transgender
youth. Journal of Gay & Lesbian Mental
Health, 14, 340–345. doi:10.1080/19359705.2010
.504476
HOME–SCHOOL PARTNERSHIPS IN
LGBTQ-PARENT FAMILIES
The entry starts by defining home–school partnerships
and describing the factors in such partnerships that
promote academic, social, emotional, and psychological
well-being among students. Next, the entry highlights
the inequality in home– school partnerships among
diverse families, which creates systemic barriers that
prevent positive partnerships with LGBTQ-parent
families. Then, this entry provides an overview of the
positive and negative factors in home–school
partnerships with LGBTQ-parent families. The entry
concludes with recommendations for working with this
diverse and marginalized population and a description
of the limitations in research and practice when it
comes to fully understanding home–school partnerships
in LGBTQ-parent families.
Defining Home–School Partnerships
While research on home–school partnerships has been
explored for decades now, there are different
definitions for what this term encompasses. For
example, some studies have centered on the idea that
parents need to be more active in their child’s
Home–School Partnerships in LGBTQ-Parent Families
education, while other studies emphasize the
responsibility of schools in reaching out to parents. In
any case, there are key components that characterize
this type of relationship between families and schools.
As with most studies that explore the effects of home–
school partnerships on the success of students, the term
home–school partnership is used here to refer to a
shared responsibility for collaboration and outcome
between families and schools with the goal of
advancing students’ learning, development
(academically and emotionally), and long-term success
(in school and beyond).
The term family, as used in the definition of home–
school partnership, is intended to be used as an
encompassing term to describe all types of families,
including, but not limited to, differentsex–parent
families, same-sex–parent families, biological-parent
families, adoptive-parent families, racially and
ethnically diverse–parent families, singleparent
families, and multiracial-parent families, among others.
Factors That Contribute to Successful Home–
School Partnerships
It is clear that home–school partnerships are crucial in
promoting academic, social, emotional, and
psychological well-being among students. However,
much like the different definitions that exist for home–
school partnerships, there is a plethora of factors that
contribute to the success of such partnerships. These
factors seem to evolve with time, as research and
interventions advance to match a growing need for
understanding diversity in schools in an effort to create
a collaborative approach that includes all parties
involved in home–school partnerships (students,
families, and schools). These factors include
engagement, quality of the home–school partnership,
and building collaborative relationships between home
and school contexts. The specific roles of homes and
schools will be discussed further below.
Engagement refers to the ability of schools and
families to develop a two-way relationship in order to
make joint decisions about ways to support students and
implement strategies that increase successful academic
outcomes. Furthermore, while engagement is a basic
step in building home– school partnerships, engagement
alone does not necessarily yield positive outcomes.
There needs to be an element of intentionality in the
communication between families and schools. In other
words, communication needs to be engaged and goal-

oriented in order to allow students to be successful and
develop in a healthy environment. A collaborative
relationship is best achieved when both families and
schools are actively engaged and respect the
contributions and suggestions from all parties involved.
Regarding the specific role of home in home– school
partnerships, research and practice suggest that family
is significant to children’s academic, emotional, social,
and psychological development. Thus, families need to
be receptive to working with schools in advocating for
their children by implementing concepts and values
taught in school. This includes incorporating lessons
taught in the classroom at home. This collaborative
effort helps deliver a message of unity and consistency
to all students, regardless of the diverse group of which
they are a part. If done in an efficient and respectful
manner, collaborative relationships will lead to an
effective consultation process between families and
schools, contributing to students’ healthy academic,
social, and behavioral development.
Besides the responsibility of home, school personnel
(e.g., teachers, administrators, staff) are crucial in
developing and fostering home–school partnerships.
Under the supervision of caring adults away from
home, school personnel provide opportunities that
promote the academic, social, and emotional
development of students to reach their full potential.
Thus, school personnel need to be open to learning and
incorporating the values of diverse families in their
curriculum to create a welcoming environment, and to
ensure open channels of communication such that
diverse families feel comfortable expressing their
concerns and needs.
Inequality in Home–School Partnerships
As discussed, home–school partnerships require more
than both parties working individually to promote the
well-being of students. Most importantly, home–school
partnerships are effective when engaged and
collaborative relationships can be built. However,
Home–School Partnerships in LGBTQ-Parent Families
oppressive school factors affecting certain diverse
families can create systemic barriers to the development
of positive home–school partnerships.
In the last three decades, researchers and educators
have devoted much time and effort to understanding
and achieving effective home–school partnerships with
diverse students and their families (e.g., special
education and linguistically diverse students). However,
1335
attention to the development of strong home–school
partnerships with LGBTQparent families has been
lacking. The lack of research and interventions on how
schools can foster positive relationships with LGBTQ
parents and their children could lead LGBTQ parents to
doubt the intentions of schools toward them and their
children. A close analysis of home–school partnerships
among special education and linguistically diverse
students and their families reveals commonalities that,
if enacted effectively, could likely benefit other diverse
students and families, including LGBTQ-parent
families. The following sections provide an overview of
home–school partnerships in LGBTQ-parent families,
including positive and negative factors, suggested
courses of action for working with LGBTQ parents, and
limitations in the literature regarding creating equal
home–school partnerships with this understudied
population.
Positive Aspects of Home–School
Partnerships in LGBTQ Families
LGBTQ parents report a high level of involvement in
their child’s education, including doing homework
assignments with their child and discussing their child’s
school progress (e.g., going over school report cards
and material being taught in the classroom) as well as
frequent interactions with other students and school
personnel. However, it is important to note that the
available research suggests that LGBTQ parents
infrequently discuss with their children how their
school incorporates LGBTQ issues in the curriculum.
The research thus far has not provided an explanation
as to why LGBTQ parents are not actively inquiring
about what their children are learning in school
regarding LGBTQ issues. Thus, further research is
needed in order to find out why LGBTQ parents seem
to avoid talking to their children about how schools
integrate issues that directly affect their family unit.
In addition, according to the limited research,
LGBTQ parents report higher levels of communication
with
schools
than the national average (e.g., they are more likely to
inquire about a child’s school performance and to
volunteer at the school). In contrast to the negative
experiences that LGBTQ parents and their children
often experience in school (e.g., lack of inclusive
policies and procedures and microaggressions), research
shows that schools both initiate and reciprocate
1336
communication more frequently with LGBTQ parents
than with heterosexual parents, thus potentially creating
a more collaborative environment where the children of
LGBTQ parents can thrive academically and
emotionally in schools. While there is no concrete
research to explain this finding, perhaps it may be
related to the fact that, as discussed, LGBTQ parents
seem to report higher levels of communication with
schools. Thus, those schools that are open to and
accepting of LGBTQ families might be invested in
nurturing a relationship with LGBTQ parents.
Furthermore, most LGBTQ parents report being
comfortable discussing their family structure with
school personnel, specifically school principals and
teachers. However, it is noteworthy that, based on the
limited research available, public schools are more
receptive to having a discussion with LGBTQ parents
about their family structure than are private schools,
including religious private schools. A possible
explanation for this difference may be that public
schools are subject to state and federal regulations when
it comes to providing equal opportunities to students
and their families that private schools may not be
required to follow, and this may result in a higher
receptivity to working with families of diverse
backgrounds.
Negative Aspects of Home–School Partnerships in
LGBTQ-Parent Families
While schools and LGBTQ parents seem to be
Home–School Partnerships in LGBTQ-Parent Families
communicating effectively with one another,
suggesting a level of acceptance and respect from
schools toward diverse family structures, this may not
be representative of all LGBTQ family experiences. For
many LGBTQ parents and their children, schools
represent institutions that promote the traditional family
structure of one cisgender mother and one cisgender
father. This negative school climate creates a
disconnect between schools and LGBTQ parents,
making it challenging for schools and LGBTQ parents
to enact those factors that are crucial for a productive
home–school partnership to be established (e.g.,
engagement, collaborative relationships).
The limited research suggests that for a significant
percentage of LGBTQ parents, home–school
partnerships are hard to form due to schools’ lack of
recognition of their family structure and refusal to allow
LGBTQ parents to volunteer in school activities. As a
result, LGBTQ parents do not have an opportunity to
engage in as many school activities and are denied the
opportunity to make connections with other parents in
order to create support systems that could be beneficial
to their child—both in school and in their family
structure overall. This lack of respect and inclusiveness
affects the children of LGBTQ parents, as schools fail
to communicate with LGBTQ parents about their
child’s school progress.
Recommendations for Working With LGBTQ-
Parent Families
While research on home–school partnerships in
LGBTQ-parent families is scant, it is possible to make
tentative recommendations for schools when working
with this population based on the extensive research
base on home–school partnerships among special
education and linguistically diverse students. These
recommendations include professional development
opportunities for school personnel, creating first contact
with LGBTQ families, and examining collaborative
efforts.
Most school districts require teachers and school
personnel to attend professional development
workshops. Thus, implementing workshops to educate
school personnel about LGBTQ families and how to
best serve them in schools could be an effective strategy
for school personnel to become aware of the importance
of working with all diverse families. Professional
development workshops are also a great opportunity for
revisiting
school policies
and rules in an effort to make sure that LGBTQ families
are being included in all school functions in which
parents participate. In addition, creating first contact, or
initiating communication with LGBTQ families,
delivers the message to this oppressed population that
their family’s well-being is important to the school.
Building relationships with parents creates a sense of
respect and alliance between LGBTQ families and
schools. Creating first contact also facilitates ongoing
and meaningful communication and collaboration.
Furthermore, while home–school partnerships are the
responsibility of all parties involved, schools need to
take into consideration the oppressive factors that
LGBTQ families are exposed to on a daily basis and
need to make sure that parents have a voice in their
child’s education. Thus, schools need to be able to
examine if LGBTQ parents are being given the

opportunity to express concerns and make suggestions
for schools to implement.
Roberto L. Abreu and Alicia L. Fedewa
See also LGBTQ-Parent Involvement and Advocacy in Schools;
School Choice in LGBTQ-Parent Families
Further Readings
Cox, D. D. (2005). Evidence-based interventions using
home–school collaboration. School Psychology
Quarterly, 20(4), 473–497.
Esler, A. N., Godber, Y., & Christenson, S. L. (2002). Best
practices in supporting home–school collaboration. In A.
Thomas & J. Grimes (Eds.), Best practices in school
psychology IV (Vols. 1–2, pp. 389–411). Washington, DC:
National Association of School Psychologists.
Fedewa, A. L., & Clark, T. P. (2009). Parent practices and
home–school partnerships: A differential effect for children
with same-sex coupled parents? Journal of
GLBT Family Studies, 5, 312–339. doi:10.1080/
15504280903263736
Homonormativity
Glueck, C. L., & Reschly, A. L. (2014). Examining
congruence within school–family partnerships: Definition,
importance, and current measurement approaches.
Psychology in the Schools, 51, 296–315.
doi:10.1002/pits.21745
Kosciw, J. G., & Diaz, E. M. (2008). Involved, invisible,
ignored: The experiences of lesbian, gay, bisexual and
transgender parents and their children in our nation’s K–12
schools. New York, NY: Gay, Lesbian & Straight Education
Network.
Olivos, E. M., Gallagher, R. J., & Aguilar, J. (2010). Fostering
collaboration with culturally and linguistically diverse
families of children with moderate to severe disabilities.
Journal of Educational and Psychological Consultation, 20,
28–40. doi:10.1080/10474410903535372
HOMONORMATIVITY
Scholars and activists use the term homonormativity in
many ways. Transgender scholars and activists used it
to highlight the normalization of gays and lesbians
during the lesbian, gay, bisexual, and transgender
(LGBT) rights movement in the 1990s. A more
prevalent use of the term is associated with
1337
heteronormativity and queer theory. Homonormativity
has a distinctive relationship with heteronormativity.
Queer scholars and activists have examined sites of
homonormativity in queer politics and culture,
including representations of queer bodies in the media.
Critiquing homonormativity is an important component
of queer theory in LGBTQ studies and activism.
Variants of Homonormativity
Theorist and filmmaker Susan Stryker is often credited
with coining the term homonormativity. Stryker’s use of
the term is concerned with the way that gays and
lesbians became the primary identities represented in
the LGBT rights movements of the 1980s and 1990s.
The “T” in LGBT was too often an afterthought. In
Stryker’s variation, homonormativity drew attention to
the ways that queer activism focused almost exclusively
on homosexuality. With this focus, transgender was
juxtaposed against norms of homosexuality, which
were not the norms that transgender activists needed to
be fighting against. For example, organizations like
Queer Nation and ACT UP focused on programs and
politics that generally benefited gay men.
Lisa Duggan, a social and cultural analyst, initially
articulated the contemporary idea of homonormativity.
Duggan argued that homonormativity is a politic of
queer assimilation. Homonormativity is antiqueer in the
ways that it reifies heteronormativity, and it is further
understood as providing cultural norms for the right
way to be gay and lesbian. In this capacity,
homonormativity perpetuates gender, sexuality, and
racial stereotypes for gays and lesbians.
Homonormativity is best understood in relation to
heteronormativity, where queer politics and activism
arise.
Heteronormativity, Homonormativity, Queer
Politics, and Activism
Heteronormativity is the culturally constructed
assumption that everyone is heterosexual, or straight.
Because everyone is presumed straight, the world is
designed for straight people. All of our cultural
institutions and social structures privilege heterosexual
relational configurations. Queer, in the subversive
sense, threatens heteronormativity through doing
gender, sexuality, and relationships in ways that disrupt
what is understood and taken for granted. Although
queer is often used as an umbrella term for non-
1338
normative genders and sexualities, it is important to
note that not all gays and lesbians are queer in the
subversive sense of queer theory.
As the HIV/AIDS pandemic became clear in the
1980s, queer activism of difference—“We’re here,
we’re queer, get used to it”—gave way to a reformed
gay movement predicated on normalizing gays and
lesbians: “We are your sons and daughters, your
brothers and sisters. We are no different from you.” By
the 1990s, gay and lesbian activism had fixed on
equality in access to marriage and military service.
Homonormativity can be understood as gays and
lesbians embracing and embodying the norms of
heteronormativity. When gays and lesbians mimic
straight couples and perform the culturally expected
gender for their biological bodies, they may avoid
punishment and, at times, be socially rewarded.
The Human Rights Campaign (HRC), a prominent
LGBT civil rights organization, has been criticized as
steadfastly homonormative in its activism pursuits.
Openly gay, lesbian, and bisexual individuals have been
allowed to serve in the military since 2011, and in 2015
the Pentagon announced that it will allow transgender
members to serve as of 2016. In June 2015, the U.S.
Supreme Court held that states must allow same-sex
couples to marry and that they must recognize same-sex
marriages from other states. Queer critiques of the HRC
have denounced setting normative social goals, such as
marriage equality and military inclusion, which do not
represent the concerns of all LGBTQ people. Queer
activists emphasize the LGBTQ people whose best
interests are not served by activism founded in
homonormativity such as transgender discrimination;
homelessness among LGBTQ youth; job and housing
discrimination based on sexuality and gender; bisexual
erasure; and inequalities at the intersections of race,
gender, sexuality, socioeconomics, and nationalism.
Centralizing activism efforts on homonormative
political pursuits constructs normative stereotypes of
who LGBTQ people are, what they want, and how they
behave. These stereotypes are often examined in the
context of media representations.
Homonormativity and the Media
Early film portrayals of non-normative sexualities were
often villainous (e.g., Cruising). There was scarce
representation of LGBT identities in popular media
until the 1990s, and then it was often as comic relief
(e.g., My Best Friend’s Wedding), fodder for tragedy
(e.g., Philadelphia), or an oddity (e.g., The Crying
Game). In the late 1990s, Will and Grace became a
popular, award-winning comedy that featured gay male
characters balanced with (straight) female counterparts.
Will Truman, the titular character, was unlucky in love
and easily desexualized. Will and Grace was quickly
criticized for its heteronormativity—a gay television
show for straight people to watch.
Homonormativity
In 2000, Showtime’s Queer as Folk presented a
group of five friends who were all gay, male, White,
sexual beings. The portrayal of gay sexuality was both
praised and criticized. In accomplishing what Will and
Grace could not, gay sexuality in Queer as Folk could
be conceived of as normal and unremarkable—a form
of homonormativity. The comedy series Modern
Family premiered in 2009 with a gay couple, Cameron
and Mitchell, who eventually adopt a child and get
married. Their relationship arguably illustrates a second
variant of homonormativity in the media: gay people
who model their lives after straight people. Beyond the
heteronormativity reified through the homonormative
gay characters, Cameron and Mitchell present a model
of gays for consumption—male, White, successful, and
relationally gendered as complementary. This
perpetuates heteronormativity through modeling
homonormativity. Pervasive homonormativity in
popular media proliferates stereotypes of what it means
to be gay, how to be gay correctly, and that—in the end
—it is quite normal. This disadvantages LGBTQ people
who do not—because they are unable or do not want to
—conform to homonormative stereotypes.
Homonormativity and LGBTQ Studies
Homonormativity offers a useful critical perspective for
deconstructing embodied heteronormativity. Variations
of what homonormativity means may initially seem
disparate. However, each rendering of homonormativity
provides a more nuanced space from which to
interrogate the heteronormative world in which we live.
Scholars have long critiqued queer theory and its
ancillaries as too complex and limited. However, the
critical theoretical values of the discourse that queer
theory has offered, such as heteronormativity and
homonormativity, remain beneficial tools for thinking
about social constructions of culture and society in
LGBTQ studies activism and scholarship.
Derek M. Bolen

See also Closet, The; Coming out, Disclosure, and
Passing; Gender Binaries; Heteronormativity; Queer
Politics; Queer Theory; Sexual Norms and Practices;
Stealth (Transgender Passing)
Homophobia
Further Readings
Duggan, L. (2002). The new homonormativity: The sexual
politics of neoliberalism. In R. Castronovo & D. D. Nelson
(Eds.), Materializing democracy: Toward a revitalized
cultural politics (pp. 175–194). Durham, NC: Duke
University Press.
Duggan, L. (2003). The twilight of equality? Neoliberalism,
cultural politics, and the attack on democracy. Boston, MA:
Beacon Press.
Puar, J. K. (2006). Mapping U.S. homonormativities.
Gender, Place & Culture, 13(1), 67–88.
Stryker, S. (2008). Transgender history, homonormativity, and
disciplinarity. Radical History Review, 100(2008), 145–157.
doi:10.1215/01636545-2007-026
HOMOPHOBIA
Homophobia is a contemporary social scientific term
coined in the field of psychology to describe negative
attitudes toward nonheterosexuals and
nonheterosexuality. It has been characterized in a
multitude of ways including aversion, disgust, fear, or
hatred of homosexuals (gay men and lesbians) and
homosexuality, which may be accompanied by anti-
homosexual hostility. The term homophobia provided
language for a phenomenon that reversed the dominant
approach to homosexuality as psychopathological.
Research turned from treating homosexual people in
therapy to interrogating homophobia as a construct.
Homophobia is understood to operate at multiple levels
in society, from individuals to institutions. Although the
social and cultural significance of the construct of
homophobia is important, recent scholarship has called
for a reexamination of the term and construct.
The Pathology of Homosexuality and Naming
of Homophobia
From the first edition of the American Psychiatric
Association’s (APA’s) Diagnostic and Statistical
Manual of Mental Disorders (DSM) in 1952,
1339
homosexuality was listed as a diagnosable form of
psychopathology (i.e., mental illness). The result,
clinically, was that no matter the nature of a
homosexual patient’s issue or problem, homosexuality
as psychopathological was the focus of treatment.
Issues or problems that homosexual patients brought to
the psychoanalytic couches of the 1950s and 1960s
were subjugated to homosexuality itself; that is, any
issue or problem was regarded as stemming from the
person’s being homosexual. Instead of exploring issues
or problems that patients perceived to be primary,
psychologists were trained to focus on homosexuality
as the primary concern and pursued treatment as such.
Several years prior to the APA’s historic removal of
homosexuality from the DSM in 1974, George
Weinberg—a psychotherapist who was trained,
practicing, and doing research in the era of
homosexuality as pathology—coined the term
homophobia. Weinberg, a heterosexual man, conceived
of his homophobia construct after reflecting on the way
that many other psychotherapists would display intense
and personally negative responses to coming into
contact with homosexuals outside of their work. He
recognized their responses as fear, as a phobia, and
began calling them homophobes. The word
homophobia is the blending and compounding of
“homo,” from homosexual (the term homosexual has its
own distinctive morphology), with “phobia,” from the
Greek word for fear. In simplified terms, Weinberg’s
homophobia of the late 1960s characterized a fear of
homosexuals— likely born of religion—that was
predicated on social fears that homosexuality would
spread and destroy the procreative nuclear family, the
bedrock of society, thereby destroying society. In the
fields of psychology and sociology, the conception of
homophobia helped turn scrutiny away from
homosexuals (as mentally ill, abnormal, deviant) and
toward homophobia as a social issue, as well as toward
those who exhibited homophobic attitudes or behaviors
and the effect that homophobia had on the lives of
homosexual individuals. Researchers, in turn, began to
direct their attention to studying homophobia. As
Weinberg continued to articulate and advance his
conception of homophobia in the late 1960s and early
1970s at speaking events and in periodicals produced by
and for homosexual people, the construct of
homophobia offered new ways for gay men and
lesbians to conceive of their social locations in society
and provided new language that expanded the discourse
for activists of the gay rights movement.
1340
Weinberg’s 1972 book, Society and the Healthy
Homosexual, was written to be an accessible resource
that interrogated homophobia and psychotherapy.
Departing from the position of homosexuality as
psychopathology, Weinberg endeavored to reframe
homosexuality as normal and homophobia and
psychotherapy as problematic. Two years later, in 1974,
the APA removed homosexuality from the DSM. Many
scholars credit this change, in part, to the
conceptualization of homophobia. Removing
homosexuality from the DSM initiated a change of
perspective that affected the health fields (e.g.,
psychotherapy, medicine) and the social sciences (e.g.,
psychology, sociology).
Institutionalized Homophobia
Institutionalized homophobia refers to instances where
homophobic or anti-homosexual ideologies are
engrained in the social and cultural institutions of a
society. For example, when homosexuality was listed as
a pathology in the DSM, homosexuality was positioned
as a sickness, abnormal, and bad. It would not have
been advantageous to be seen as homosexual or socially
supportive of homosexuality. The mental health system,
like society in general, viewed homosexual individuals
and homosexuality as undesirable and in need of
treatment to overcome sickness and abnormality. It
follows that when homophobia is institutionalized,
large systems that comprise society are encoded with
ideologies that subjugate, oppress, and often punish
homosexuals and, at times, their allies and advocates.
Again, the removal of homosexuality from the DSM is
often noted as the deinstitutionalization of homophobia
from the field of mental health. That does not mean that
the institution of mental health is free of homophobia.
Instead, it means that an explicit and radical effort was
undertaken that reconfigured the way that the institution
of mental health privileged one group of people
(heterosexual) while discriminating against another
group of people (nonheterosexual).
Homophobia
Other examples of social and cultural institutions
that are regularly critiqued for forwarding homophobic
ideologies include religion, government, and education.
Because many of our contemporary laws, ethics, and
morals are shaped by religious teachings, religion is
regularly criticized for institutionalized homophobia.
For example, most gay men and lesbians who live in a
culture dominated by Christianity are familiar with
Leviticus 18:22, “Thou shalt not lie with mankind, as
with womankind: it is abomination.” The wording is a
bit different depending on which version of the Old
Testament it comes from, but the prominent
interpretation of this line remains the same in
mainstream Christianity and Judaism alike—
homosexuality is bad. Thus, a rule from a powerful
sociocultural institution can influence not just
individual attitudes and beliefs, but whole systems of
laws and governance. This is not to say that all religions
are homophobic or that all religious people are
homophobes. This biblical passage represents an
example of homophobic ideology institutionalized in a
way that makes it difficult to enact change. It also
works to illustrate the way that institutionalized
homophobia reaches from one institution to others.
Both legal and educational policies have been affected
by this instance of what many characterize as
institutionalized homophobia. Indeed, homosexuality is
often symbolically erased (i.e., not mentioned at all,
omitting it from reality) from textbooks in primary and
secondary education, and laws may limit the rights of
homosexuals so that they are rendered unequal to
heterosexuals—both actions serve as examples of
institutionalized homophobia. Those who critique
religion as a site of institutionalized homophobia may
point out that it privileges some relational
configurations (heterosexual) at the cost of
discriminating against others (homosexual). For
instance, religion has slowed the process of realizing
marriage equality in the United States.
Social Homophobia
While institutionalized homophobia is anti-homosexual
ideologies encoded into the social and cultural
institutions of society, social homophobia can
Homophobia
be considered the public or interactional manifestation
of institutionalized homophobia. It is the “doing” of
homophobia—the action of reifying homophobia. It can
be a direct or indirect speech act of name-calling to
ostracize or humiliate someone for being
nonheterosexual or not heterosexual enough. Social
homophobia may also be expressed through avoidance,
exclusion, and isolation. If individuals feel targeted,
they may feel compelled to affirm their heterosexuality.
Whether someone being targeted is nonheterosexual or

heterosexual, the message of homophobia is clear: It is
bad to be homosexual. Some masculinities scholars
have argued that homophobia is the cornerstone to
being a real, masculine man. Social homophobia has the
potential to incite fear of being perceived as
nonheterosexual. Individuals (whether nonheterosexual
or heterosexual) who are unable to negotiate social
homophobia may face depression and anxiety. Some
homosexuals internalize homophobia; this is referred to
as internalized homophobia, and it has been linked to a
wide range of negative intrapersonal outcomes,
including depression and anxiety.
Homophobia, Sexual Stigma, Heterosexism, and
Sexual Prejudice
Although the term homophobia has played an integral
role in much social and cultural change, recent
scholarship has identified limitations and questioned its
continued use for three reasons. First, the nature of
homophobia is not consistent with other phobias.
Phobia sufferers generally understand that their fears
are irrational, yet they still have a physiological
response (e.g., sweat, shivering). Whereas phobias are
typified by anxiety, empirical researchers argue that
negative emotional reactions to homosexuals and
homosexuality tend to be that of anger and disgust,
which is in line with similar findings on negative
emotional reactions associated with race. It follows that
hostility, violence, and brutality toward homosexuals
and homosexuality are more consistent with anger than
fear. Second, homophobia is an unproductive
framework for social change because it tends to
conceptually limit anti-homosexual attitudes or actions
to the homophobic individual—it does not encompass
the culture and society. Further, homophobia has been
extended to describe more phenomena (e.g.,
institutionalized homophobia, social homophobia,
internalized homophobia). Scholars argue that
broadening the use of the term is an indicator that we,
once again, need new language—just as we once
needed homophobia. Third and finally, homophobia has
been criticized as outdated because it is conceptually
built upon a false binary of heterosexual versus
homosexual. Fifty years ago, gay liberationists argued
that the binary should be destroyed because there was
no true heterosexuality—every heterosexual was
repressing his or her homosexuality. In this context,
homophobia made sense as one rejecting one’s own
homoerotic desires. However, we have moved beyond
1341
many of the limitations that rendered the binary
sensible, so homophobia no longer works because we
know that sexuality is much more complicated than the
labels heterosexual or homosexual suggest.
To continue understanding the anger, hostility,
discrimination, and oppression faced by
nonheterosexuals, scholars have taken up three
interrelated areas of research: sexual stigma,
heterosexism, and sexual prejudice. First, sexual stigma
refers to shared knowledge concerning sexuality within
a culture or society. No matter what individuals of a
culture may personally believe, they are aware of what
constitutes good and bad sexually in their culture.
Sexual stigmas have permanence. It is through people
that sexual stigmas have meaning, and that meaning is
widely understood as negative. Individuals with sexual
stigmas understand themselves through stigma because
it permeates their identity, and what differentiates them
from people who are not sexually stigmatized are power
and resources. There are exceptions, as sexual stigmas
are in constant negotiation. In some ways, sexual
stigma expands the space of institutionalized
homophobia. Second, heterosexism provides the
information and rules that keep sexual stigmas
negatively positioned. For instance, the roles and rules
of gender performances and expectations are bound in
heterosexism. In upholding the rules and expectations
that support sexual stigmas, the hierarchy is maintained,
and power remains with those who are not stigmatized.
The way that individuals enact heterosexism is through
their sexual prejudices. Third, sexual prejudice refers to
persistent negative attitudes that individuals have on the
basis of sexual orientation. Although sexual prejudice
may occur regarding any sexual orientation, including
heterosexual, it is usually directed toward
nonheterosexual individuals. Sexual prejudices are
attitudes that occur along binaries of good/bad,
right/wrong, and they are associated with people as they
are grouped. For example, men having sex with men is
bad because, categorically, being nonheterosexual is
bad.
The influential construct of homophobia, which
involves thinking about anti-homosexual attitudes and
behaviors as individual accomplishments, is limited.
Thinking about sexual stigma, heterosex-
ism, and sexual prejudices reveals a more complex
framework that allows us to better interrogate hostility
based on sexual orientation. Each of these concepts
allows for new ways to examine antihomosexual
attitudes and behaviors from various locations—from
1342
the individual’s actions to the cultural taken-for-granted
beliefs.
Derek M. Bolen and Dianah McGreehan
See also Affirmative Therapy; Biphobia; Bullying, Rates and
Effects of; Criminal Legal System and LGBTQ People;
Discrimination Against LGBTQ People, Cost of;
Employment Non-Discrimination Act (ENDA); Essentialist–
Constructionist Debate on the Origins of
Sexual Orientation; Heteronormativity; Internalized
Homophobia; It Gets Better; Nondiscrimination
Protections, State and Local
Further Readings
Adam, B. D. (1998). Theorizing homophobia. Sexualities, 1(4),
387–404.
Fone, B. (2001). Homophobia: A history. New York, NY:
Picador.
Haaga, D. A. F. (1991). “Homophobia”? Journal of Social
Behavior and Personality, 6(1), 171–174.
Herek, G. M. (2004). Beyond “homophobia”: Thinking about
sexual prejudice and stigma in the twenty-first century.
Sexuality Research & Social Policy, 1(2), 6–24.
Homophobic Language in the Peer Group
Herek, G. M. (2007). Confronting sexual stigma and
prejudice: Theory and practice. Journal of Social
Issues, 63(4), 905–925.
McCormack, M. (2013). The declining significance of
homophobia: How teenage boys are redefining masculinity
and heterosexuality. New York, NY:
Oxford University Press.
Smith, K. T. (1971). Homophobia: A tentative personality
profile. Psychological Reports, 29(3), 1091–1094.
Weinberg, G. (1972). Society and the healthy homosexual.
New York, NY: St. Martin’s Press.
Young-Bruehl, E. (1998). The anatomy of prejudices.
Cambridge, MA: Harvard University Press.
HOMOPHOBIC LANGUAGE
IN THE PEER GROUP
This entry focuses on the use of homophobic language
among adolescents, with attention to its expression
within peer groups and within schools. First, the entry
provides an overview of the prevalence of homophobic
language use, factors contributing to and explaining this
behavior, and how it is connected to other serious
behavioral concerns. Next, the entry considers
homophobic language use within a broader social
context, particularly as it is expressed among peers and
within friendship groups. Topics discussed include how
peers influence and shape this behavior, how group
norms contribute to such socialization processes, and
how homophobic language use affects individuals and
their interpersonal relationships. Finally, the entry notes
the implications of this knowledge for continued
research and interventions.
Prevalence and Correlates of Homophobic
Language Use
Homophobic language can comprise negative,
disparaging words or phrases connected to the sexual-
minority population (e.g., lesbian, gay, bisexual, queer,
or questioning; LGBQQ). This language often is
directed toward specific individuals (e.g., calling
someone a fag or dyke), or it can be used in a more
general manner, though with the same
Homophobic Language in the Peer Group
underlying intent to express a critical or derogatory
judgment (e.g., “that [shirt, activity] is so gay”). Over
the past two decades, there have been a number of
surveys from researchers and organizations attempting
to track the prevalence of homophobic language use
and harassment. Whether based on national or local
data sources across the United States, an overwhelming
majority of sexual-minority youth report hearing or
being the direct target of homophobic language, with
little evidence of decline during this period. Many
heterosexual youth also report being the target of
homophobic epithets and harassment, though to a lesser
extent than sexual-minority youth. In combination,
these findings continue to underscore the widespread
nature of this behavior in schools.
Use of homophobic language is strongly connected
to students’ engagement in various forms of bullying.
Students who report more frequent use of homophobic
language also engage in more frequent physical (e.g.,
pushing, hitting, threatening) and relational (e.g.,
spreading rumors, excluding others) aggression against
other peers at school. This association holds for both
male and female students, although the connection is
stronger for males. Homophobic language often is used

as part of bullying to intensify the severity of the
aggressive act. Adolescents report that homophobic
language is considered especially profane, and they
consider bullying that is homophobic in nature to be
particularly disturbing. Indeed, emerging studies have
shown that students who experience bias-based
harassment (e.g., homophobic bullying) report even
worse mental and physical health outcomes and poorer
academic outcomes than students who experience
harassment that is not based in bias (e.g., harassment
that students do not perceive to be based on a particular
social identity such as ability, gender, race, or sexual
orientation). Homophobic language can intensify
bullying because it symbolically places the targeted
student into a group that is highly stigmatized and
marginalized in society, and in the case of sexual-
minority youth, it denigrates the entire group of which
they are a member.
Homophobic language is also used among peers for
other interconnected reasons. Students may use this
language to express their negative attitudes toward
sexual minorities, to enforce gender-normative behavior,
to prove or emphasize their heterosexuality, or to
establish and enforce dominance hierarchies among
peers. Although some adolescents who use this language
at times minimize its seriousness (whereas others
emphasize its heightened severity), studies do show that
students who report stronger negative attitudes toward
sexual minorities also report greater use of this
language. Similarly, although some adolescents describe
this language as innocuous and harmless banter among
friends, findings nevertheless show that this banter is
more likely to occur within friendship groups whose
members express stronger prejudiced attitudes against
sexual minorities and that members of these groups
actually report poorer relationship dynamics.
Students also use homophobic language to enforce
traditional masculine or feminine behavior norms
among their peers. Whether an individual identifies as
LGBQQ or heterosexual, the person may still be the
target of homophobic epithets if he or she behaves in
ways that violate rigid expectations for gendered
behavior norms. Consequently, many heterosexual male
youth report feeling pressured to prove or emphasize
their masculinity to peers. Most research has focused on
this dynamic among males, given that traditional
masculine ideology tends to include a homophobic
component that denigrates gay or bisexual men. Still,
this same experience is reported by female adolescents,
and this should be considered more closely in research.
1343
Building on the issue that students feel pressured to
prove their masculinity or femininity to peers, students
also feel pressured to prove their heterosexuality and to
avoid being perceived as a sexual minority for fear of
peer stigmatization or rejection. In fact, students who
consider their heterosexual identity to be more salient
and central to their overall self-identity report more
frequent use of homophobic language. In this case,
students may use homophobic language as a deliberate
means to distance themselves from sexual minorities
and to avoid the potential of being perceived or
misclassified as a sexual minority. Some heterosexual
adolescents may feel especially pressured to prove their
heterosexuality, given that adolescence is a period
during which sexuality and sexual identity become
increasingly salient.
Finally, students use homophobic language in part to
establish and maintain dominance hierarchies over other
peers. Again, because sexual minorities are a
stigmatized group in society, directing homophobic
language toward another student symbolically places
that peer in a subordinate position. As such, some
students may rely on homophobic language as an
antagonistic means to establish a higher position over
their peers, and they may continue to use this language
to maintain their dominant position over time.
Homophobic Language in a Larger Social
Context
It is important to consider how homophobic language is
expressed within a broader social context. Homophobic
language and behavior often are highly visible and
widely observed among peers. Particularly when it is
tied to aggressive behavior, homophobic language use
often occurs as part of a larger group process that
involves multiple individuals. Indeed, the general
bullying literature has recognized that students are
involved in various roles beyond the immediate “bully”
or “victim” that include students who reinforce and
assist the primary instigator, those who support the
student being victimized, and other bystanders who
observe this behavior or who are largely uninvolved.
Notably, students who reinforce and assist primary
instigators of bullying also report frequently using
homophobic language. These findings have
underscored the need to look at homophobic language
use through a broader social lens that acknowledges the
role of peer groups and the broader school culture in
perpetuating this behavior.
1344
Peers become increasingly relevant and influential
during adolescence, and peer groups become a central
socializing context at this time. Adolescents look to
peers as a primary source for support and affirmation,
and peer groups provide a context for socializing,
learning, and individual development. Through their
repeated interactions, peers influence one another
across a range of attitudes and
Homophobic Language in the Peer Group
behaviors. Studies now show that peers influence one
another’s use of homophobic language. Studies
examining the social networks of adolescents find that
peer groups are distinct from one another in the
frequency with which homophobic language is
expressed among group members. Friends engage in
homophobic language use at similar rates. Further,
individuals within the same friendship group become
more similar to one another in their homophobic
language use over time. Students in peer groups using
this language may receive a degree of validation and
encouragement from their peers for using this language.
The desire to receive validation, attention, and status
may lead some youth in these groups who initially use
this language less than other members to increase their
use.
Some peer group norms also relate to students’ use
of homophobic language. Essentially, individuals’
engagement in this behavior is not simply a reflection
of their own attributes or characteristics (e.g.,
individuals’ own beliefs toward sexual minorities or
their own engagement in bullying); rather, the beliefs
and behaviors of individuals’ peers also contribute to
their use of homophobic language. Homophobic
language use is especially heightened among aggressive
students who are friends with highly aggressive peers.
Similarly, students who are members of peer groups
whose members espouse strong traditional masculinity
norms are particularly likely to direct homophobic
language toward other students. In addition, being
called a homophobic epithet is a much stronger
predictor of a student also directing homophobic
epithets toward others when that student is a member of
a more homophobic peer group.
Many studies have shown the serious negative
effects of homophobic harassment on youth toward
whom this behavior is directed. In contrast, there has
been less attention to how homophobic language or
behavior affects those who use or engage in it.
Emerging findings indicate that peer interactions in
friendship groups characterized by high levels of sexual
prejudice (i.e., groups whose members espoused
negative attitudes toward sexual minorities) are more
negative than in friendship groups characterized by low
Homophobic Language in the Peer Group
levels of prejudice. Moreover, these negative
interactions increase over time within these groups.
Given the significant association between sexual
prejudice and homophobic language use, the heightened
use of homophobic language and banter within these
groups may account for the distinctly negative
interactions that occur within them. Along these lines,
because homophobic language use is associated with
dominance and hierarchy promotion, and because youth
in these groups may feel especially pressured to prove
their heterosexuality to peers holding negative views of
sexual minorities, these dynamics could prompt
increasingly negative interactions. These negative
effects are important to acknowledge because they
highlight complexity and apparent tension in the intents
and outcomes of this behavior. In essence, although
students may use homophobic language and banter to
serve a self-promotional function (in the case of
establishing hierarchy and dominance over peers) or to
emphasize shared in-group identities and beliefs among
peers (e.g., in the case of expressing shared prejudiced
beliefs or common heterosexual identities), these
behaviors also carry negative implications for the
students who engage in them. Thus, these students may
experience positive interactions and some connection
with their peers that is also accompanied by heightened
and increasingly negative interactions.
Beyond adolescents’ primary or immediate peer
group, it is important to consider the overall network of
youth within the broader school ecology and how
homophobic language affects youth throughout this
network. At this more expansive level, hearing or being
the target of homophobic language contributes heavily
to negative and hostile school climates. Thus, even
though some students who use this language consider it
to be nonoffensive in its intent, its use has decidedly
negative effects for the youth around them. Even
students who are not direct targets of this language or
harassing behavior may feel unsafe because they may
fear being targeted in the future or may experience
secondary trauma from prior victimization experiences.
Further, this language and behavior often go
uncorrected and unchallenged by other students and
adults in schools. As such, students may perceive that
 1345
this behavior is passively condoned and acceptable, and
that sexual minorities are not welcomed or respected in
the school. Building on this issue, attention to
bystanders has received growing attention in the general
bullying literature, but this attention has been notably
absent in extant research on homophobic language use
and harassment. Much greater attention is needed to
understand what factors prompt other students and
adults in schools to be active, rather than passive,
bystanders and to intervene specifically during
instances of homophobic language use.

Ongoing Research and Intervention to Address

Homophobic Behavior
As research continues to document the continued
prevalence and seriousness of homophobic language
use and harassment within schools, ongoing study is
vital to aid in the development of more effective
interventions to reduce and prevent this behavior.
Continuing to identify the range of factors underlying
youth’s engagement in this behavior will highlight
areas that intervention efforts need to address and
challenge. For example, prevention and intervention
programs could work with children and adolescents to
identify prosocial ways to serve in leadership roles that
do not rely on attaining them through antagonistic
means such as homophobic language use or bullying.
Similarly, the fact that homophobic language use and
behavior are socialized by peers underscores the need
for interventions to address the groupbased nature of
this behavior as opposed to individual-based
interventions. Interventions that focus singularly on
correcting an individual’s homophobic behavior will
likely be ineffective because that individual most likely
will be resocialized by his or her peer group to reengage
in this behavior. Future research should identify the
specific norms and ways in which peers socialize this
behavior to help develop interventions to address and
counter these specific processes. Finally, emerging
research has showcased the value of school and district
anti-bullying and anti-discrimination policies that
enumerate and extend explicit protection
1346
to sexual-minority youth in addressing issues of school
safety and attenuating health and academic disparities
faced by this population. Continued research should
identify how these policies and other programs
effectively reduce homophobic language use and
promote respect for diverse populations. These ongoing
efforts have high potential for promoting the health and
academic success of both sexual-minority and
heterosexual youth.
V. Paul Poteat
See also Bullying, Rates and Effects of; Gay, Lesbian &
Straight Education Network (GLSEN); Gay–Straight
Alliances (GSAs); Homophobia; Masculinities;
Minority Stress; School Climate; Transphobia;
Violence and Victimization of Youth
Further Readings
Bigler, R. S., & Liben, L. S. (2006). A developmental intergroup
theory of social stereotypes and prejudice. In R. V. Kail
(Ed.), Advances in child development and behavior (Vol. 34,
pp. 39–89). San Diego, CA:
Elsevier.
Horn, S. S., Szalacha, L. A., & Drill, K. (2008). Schooling,
sexuality, and rights: An investigation of heterosexual
students’ social cognition regarding sexual orientation and
the rights of gay and lesbian peers in school.
Journal of Social Issues, 64, 791–813.
Pascoe, C. J. (2007). Dude, you’re a fag: Masculinity and
sexuality in high school. Los Angeles: University of
California Press.
Poteat, V. P. (2007). Peer group socialization of
homophobic attitudes and behavior during adolescence.
Child Development, 78, 1830–1842.
Poteat, V. P., DiGiovanni, C. D., & Scheer, J. R. (2013).
Predicting homophobic behavior among heterosexual youth:
Domain general and sexual orientation–specific factors at the
individual and contextual level. Journal of Youth and
Adolescence, 42, 351–362.
Rivers, I. (2011). Homophobic bullying: Research and
theoretical perspectives. New York, NY: Oxford University
Press.
Russell, S. T., Kosciw, J., Horn, S., & Saewyc, E. (2010).
Safe schools policy for LGBTQ students. Society for
Research in Child Development Social Policy Report,
24(4), 3–17.
Swearer, S. M., Turner, R. K., Givens, J. E., & Pollack, W. S.
(2008). “You’re so gay!” Do different forms of bullying
matter for adolescent males? School Psychology Review,
37, 160–173.
HOMOSEXUALITY, FEMALE
This entry begins with a brief historical review of
scientific perspectives on female versus male sexual
orientation, and then reviews what is currently known
about the ways in which female same-sex sexuality
differs from male same-sex sexuality, particularly
regarding its development, its nonexclusivity, and its
capacity for fluidity.
Sexual orientation has historically been
conceptualized as a trait-like predisposition to
experience sexual attractions for one sex or the other.
This predisposition is generally thought to have a
biological basis, to operate in a stable fashion, and to
channel all markers of erotic interest (sexual attractions,
fantasies, behaviors, and romantic affection) in the
same direction over the life course. Numerous studies
have supported this overall model by documenting a
consistent set of early developing behavioral and
cognitive markers among individuals with same-sex
orientations, such as childhood “feelings of
differentness,” gender atypicality, and same-sex
attractions and fantasies.
Much of the foundational research in support of this
model was conducted with predominantly or
exclusively male samples, and female and male sexual
orientation were generally presumed to be parallel
phenomena. In fact, during the first wave of rigorous
psychological research on sexual orientation in the
1970s and 1980s, it was common for researchers to
discuss “gay men and lesbians” as if they were a single,
coherent group, differentiated only by biological sex.
The traditional model of sexual orientation that initially
emerged from research on men was rigidly categorical,
yielding two fundamental types of people: homosexuals
and heterosexuals. Yet this model of sexual orientation
has proven less successful in describing women’s
experiences of same-sex sexuality than
Homosexuality, Female
men’s experiences, and over the years researchers have
increasingly documented pervasive differences in the
development, expression, and phenomenology of same-
sex sexuality in men and women. These differences are
reviewed in the sections that follow.
 Homosexuality, Female 1347
Developmental Trajectories magnitude of gender differences in identity milestones
varies from study to study, and subgroups of women
A considerable body of research has focused on
exhibit patterns that resemble that of their male
developing stage-sequential psychological models of
counterparts in some studies, it is more accurate to
the “coming out” process, through which individuals
conclude that women show greater variability in the
first become aware of their same-sex attractions; first
timing of sexual identity development than to conclude
explore same-sex contact; and eventually adopt a gay,
that they uniformly develop “later.” In addition to
lesbian, or bisexual identity. Most of these models mark
variability in timing, women show greater variability in
the onset of sexual identity development as the
the sequencing of different stages, the length of time
individual’s first awareness of same-sex attractions,
between successive stages, and the overall duration of
presumed to occur in late childhood or early
the process, with some women pausing and then
adolescence (although sometimes preceded by
revisiting identity questioning multiple times, rather
childhood “feelings of differentness” or gender-atypical
than moving inexorably toward the adoption of a
behaviors). The next stage involves a period of testing
lesbian or bisexual label.
and exploration, during which youths seek information
Perhaps most striking, however, are the many cases
about gay, lesbian, and bisexual individuals and
of women who report no adolescent awareness of same-
communities and may begin experimenting with same-
sex attractions at all, and instead begin experiencing
sex sexual contact. Succeeding stages of identity
these attractions in mid- to late adulthood. Historically,
development entail adopting a sexualminority label,
such long delays in awareness were attributed to
disclosing this sexual identity to others, becoming
repression and latency. Yet over the years, studies
involved in a same-sex romantic relationship, and
probing the antecedents and phenomenology of such
celebrating one’s sexual identity within a larger social
late-life transitions have suggested that the dormancy
context (e.g., the political arena).
model is not always accurate. In some cases, the context
Such models have been strongly criticized over the
for unexpected emergence of same-sex attraction is an
years for their overly prescriptive nature, their rigid
intimate emotional relationship with a specific woman,
(and often untested) assumptions regarding “healthy”
and this has been documented among younger women
development, their insensitivity to sources of
as well. This is consistent with other research showing
sociocultural variation, and their inapplicability to
that women place greater emphasis than do men on
bisexuals (reflecting the fact that bisexually identified
romantic and affectionate feelings in their overall
individuals were generally excluded from the research
sexual-questioning process, whereas men typically
samples on which the models were generally developed
emphasize explicit same-sex arousal or attraction. Some
and validated). Perhaps more importantly, the very
women report experiencing emotional attractions to
notion of “prototypical” pathways of sexual identity
women before ever experiencing physical attractions
development has become increasingly suspect, as
for women, or describe their sexual feelings as
researchers have collected increasingly rigorous data—
developing out of a singular emotional attachment.
from increasingly diverse samples—on variation in
Other women emphasize ideological factors and social
developmental trajectories. For example, although it
reference groups as triggering or supporting their
was once thought that all sexual minorities experienced
identity questioning.
the emergence of their same-sex attractions prior to
In summary, the notion that same-sex sexual orientations
adolescence, we now know that this is not always the
express themselves uniformly early in development, in the
case. Rather, sexual minorities show a wide range of
form of clear-cut same-sex desires, is inaccurate. Although
developmental histories, with different ages and
there is variability in both men and women regarding the
contexts for the classic “milestones” of first same-sex developmental unfolding of same-sex sexuality, this
attractions, first conscious sexual questioning, first variability appears to be particularly large among women.
same-sex contact, and first self-identification.
Some of the largest and most notable deviations
from conventional coming-out models have been Nonexclusive Sexual Attractions
documented among women. The most consistent gender
It has long been presumed that sexual orientation has
differences involve later ages of first awareness, same-
only two forms: exclusive homosexuality and exclusive
sex contact, or identification. Yet, because the
1348
heterosexuality. Reflecting this view, researchers
studying the nature of sexual orientation have
historically excluded individuals claiming nonexclusive
patterns of attraction, sometimes for the sake of
methodological clarity and sometimes because such
individuals were simply not considered to be the
“prototypical types” of homosexuals. Yet numerous
surveys using large, random, representative samples
have shown that the opposite is true when it comes to
women: The prototypical type of woman with same-sex
attractions also experiences other-sex attractions.
Largescale representative studies estimate that
approximately 5% of men and 12% of women report
experiencing both same-sex and other-sex attractions,
whereas about 1.5% of men and less than 1% of women
report experiencing exclusive same-sex attractions.
Hence, directly contrary to the conventional wisdom
that lesbians represent the prototypical “types” of
sexual minorities and bisexuals are unusual exceptions,
the data clearly show that bisexuals are the prototypical
type of sexual-minority women, and lesbians represent
the exceptions.
In every large-scale representative study, the single
largest group of women with same-sex attractions
reports predominant other-sex attractions (i.e., “mostly
but not completely heterosexual”).
Historically, such individuals have been treated with
skepticism by scientists studying sexual orientation, and
have often been deleted from research samples on the
basis of suspicion that they might not be “authentically”
gay. Yet recent research suggests that, although “mostly
heterosexual” women show diverse patterns of current
and prior attractions and behavior, they nonetheless
appear to represent a distinct subtype of
nonheterosexual women, with erotic profiles falling
midway between bisexuality and exclusive
heterosexuality. Without knowing exactly why their
sexual profiles develop in this fashion, there is no
scientific basis to consider that they are “less
authentically gay” than exclusively lesbian women, or
to exclude them from research on female sexual
orientation. Rather, a growing body of
psychophysiological research on female sexual arousal
suggests the critical importance of including such
women in studies of same-sex and other-sex sexual
arousal, as we review below.
Patterns of Sexual Arousal
Historically, research on sexual orientation has relied
on self-report questionnaire data, which of course has
known limitations when it comes to stigmatized topics
such as same-sex desire. Perhaps, for example, the
appearance of greater numbers of bisexual women than
men is due to the fact that men perceive greater stigma
attached to bisexuality than do women, and are
therefore less likely to report bisexual attractions. The
only way to rule out this possibility is to use measures
of sexual attraction that do not rely on self-reports.
Studies that have adopted this strategy have provided
robust evidence that women’s capacity for nonexclusive
patterns of attraction is also manifested in nonexclusive
patterns of genital arousal. These studies involve
continuous measurement of blood flow to the genitals
(a well-validated marker of sexual arousal) while
participants view erotic film clips of women having sex
with women, men having sex with men, and men
having sex with women. As one might expect, gay men
show the greatest physiological and subjective arousal
to male–male sexual contact, whereas heterosexual
Homosexuality, Female
men show the greatest physiological and subjective
arousal to female–female sexual contact. Lesbian and
heterosexual women, however, show roughly
equivalent genital responses to the male–male and the
female–female videos, and they also show less
correspondence than do men between their genital and
subjective responses altogether. Studies using other
psychophysiological measures of sexual arousal, such
as electroencephalograms, functional magnetic
resonance imaging, and viewing time have yielded
parallel findings of gender specificity in the sexual
arousal of men but not women. Of course, genital or
neurobiological measures do not necessarily provide
“truer” measures of sexual orientation than do
individuals’ own subjective reports, but such findings
dovetail with the evidence reviewed above regarding
women’s greater capacity for attractions to both sexes.
Change Over Time
Historically, researchers have presumed that sexual
orientation shows fundamental continuity in its
expression over time, but studies have consistently
found that a sizeable minority of individuals— more

often women than men—report notable shifts in same-
sex attractions, behaviors, and identities over time
(although changes in identity and behavior tend to be
larger and more common than changes in attraction).
These findings concur with the evidence for shifts in
same-sex and other-sex sexuality among individuals in
other cultures, suggesting that some degree of
flexibility in sexual desire and behavior may simply
represent a general property of human nature. Yet,
because studies consistently find larger and more
frequent changes in sexuality among women than
among men, researchers have argued that women’s
sexuality may be intrinsically more “plastic” or “fluid”
than men’s, meaning that women’s desires are
particularly sensitive to situational or interpersonal
factors, making it possible for a woman to develop
sexual desires and to enjoy sexual behavior that run
counter to her overall orientation. In essence, sexual
fluidity suggests that a woman’s orientation provides
less of a constraint on her lifetime pattern of desire and
behavior than is the case for men.
Female sexual fluidity provides a possible
explanation for the fact that women are more likely than
men to report that choice, circumstance, and chance
have played some role in their sexual orientation and
identity. In addition, women have frequently been
observed to pursue sexual behavior that would appear
to contradict their overall pattern of attraction and
identity—that is, women with predominantly
heterosexual attractions pursuing sex with women, and
women with nearly exclusive same-sex attractions
engaging in sex with men. In many such cases, the
impetus for these “atypical” encounters is an intense
emotional bond, and in fact numerous sexual-minority
women have reported that their feelings for women are
predominantly emotional, or that their sexual desires
are triggered or enhanced by feelings of emotional
connection. Other women report that their desires are
not so much directed toward women at all, but rather to
“the person and not their gender.” The degree to which
fluidity is a particularly distinctive feature of female
sexuality remains a topic of active debate. After all, the
appearance of a distinctively female capacity for
fluidity might simply be an artifact of female sexual
socialization. For example, the pervasive social and
cultural forces that have long controlled and suppressed
female sexuality may have left women with blunted
awareness of their own sexual feelings and identities,
and few opportunities to express and experiment with
Homosexuality, Female 1349
these feelings. These factors complicate the task of
understanding and modeling female sexual orientation,
and they must be taken into account as we embark on
the next generation of research on these questions.
Toward New Models of Female Sexual Orientation
In light of the unique dynamics of female same-sex
sexuality reviewed above, how might researchers begin
the task of building new models of female sexual
orientation? Some have provocatively suggested that
women may not even have sexual orientations (to the
degree that one defines sexual orientation as a gender-
specific pattern of sexual arousal). Yet this notion is not
consistent with the fact that there is extensive variation
among women regarding their specific degree of
nonexclusivity or nonspecificity, and some women
appear to show tightly “oriented” patterns of exclusive
same-sex attraction. Rather, an alternative approach is
to imagine that female sexual orientation is composed
of two orthogonal dimensions: One represents the
degree of “genderedness” of a woman’s desires (i.e.,
the degree to which a woman’s desires are targeted to
one gender over the other), and the other represents the
direction of this targeting (same-sex versus other-sex).
One of the ways in which this revised model deviates
from conventional conceptualizations of sexual
orientation is that it no longer takes for granted that
sexual desire is always “about” gender. Perhaps,
instead, some women’s sexuality might be
fundamentally “gender neutral,” in which case a host of
other factors (emotional intimacy, sex drive, mood,
personality similarity) might determine the partners she
finds most arousing. Some women’s same-sex sexuality
appears to be strongly influenced by the quality of a
single intimate relationship, rather than a uniform,
generalized preference for women versus men. Such
findings raise the inevitable question of why some
women experience their nonexclusive attractions as
fundamentally gender-neutral, whereas others do not. In
fact, researchers know remarkably little about the
gradual “gendering” of children’s erotic impulses more
generally. Although this process appears to occur
sometime during adolescence, its underlying
mechanisms are unknown. Hence, the early factors that
might steer some nonheterosexual women toward
exclusive lesbianism, others toward bisexuality, and
others toward “mostly” heterosexuality remain a topic
of active study.
1350
An additional complication is that arousal and Chivers, M. L., Seto, M. C., & Blanchard, R. (2007). Gender
desire (and for that matter, pleasure and attraction) are and sexual orientation differences in sexual response to
sexual activities versus gender of actors in sexual films.
not equivalent constructs, despite the fact that they are
Journal of Personality and Social Psychology, 93, 1108–
often used interchangeably in discussions of sexual 1121.
orientation. This means that when determining the
differences between “mostly” heterosexual, bisexual,
and lesbian women, we must first decide which aspect
of sexual orientation to focus on (sexual desire, sexual
arousal, physical attraction, emotional attraction,
romantic affection, etc.). At the present time, we have
little or no basis on which to make this judgment,
especially given that there is little research specifying
exactly how sexual arousal and subjective desire relate
to each other, and how each of them relates to other
fundamental components of sexuality, including
behavior, fantasy, attraction, and romantic affection.
In conclusion, scientists now have an increasingly
reliable body of data charting the diverse manifestations
and long-term developmental trajectories of same-sex
sexuality, in our own culture as well as others, and
these data consistently show that female and male
sexual orientation appear to represent distinct
phenomena. Women’s greater propensity for
nonexclusive, fluid patterns of attraction suggests the
possibility that the underlying determinants of female
same-sex sexuality may be starkly different from those
for men, requiring different explanatory models, and the
development of such models is a critical next step for
research on human sexuality more generally.
Lisa Diamond

See also Bisexuality, Female; Sexual Attraction, Behavior, and

Identity; Sexual Fluidity

Further Readings
Bailey, J. M. (2009). What is sexual orientation and do women
have one? In D. A. Hope (Ed.), Nebraska Symposium on
Motivation: Contemporary perspectives on lesbian, gay, and
bisexual identities (Vol. 54, pp. 43–63). Lincoln: University
of Nebraska Press.
Baumeister, R. F. (2000). Gender differences in erotic
plasticity: The female sex drive as socially flexible and
responsive. Psychological Bulletin, 126, 247–374.
Chandra, A., Mosher, W. D., Copen, C., & Sionean, C. (2011,
March 3). Sexual behavior, sexual attraction, and sexual
identity in the United States: Data from the 2006–2008
National Survey of Family Growth.
National Health Statistics Reports, 1–36.

Diamond, L. M. (1998). Development of sexual orientation
among adolescent and young adult women.
Developmental Psychology, 34, 1085–1095.
Diamond, L. M. (2003). What does sexual orientation orient?
A biobehavioral model distinguishing romantic love and
sexual desire. Psychological Review, 110, 173–192.
HOMOSEXUALITY, MALE
Male homosexuality has been used as a label to
describe a wide array of erotic relations, sexual
identities, emotional intimacy, and forms of desire
between men. Evidence of male homosexuality has
been found in earlier civilizations from around the
world, including China, Japan, Europe, South
America, and Asia. Research on the etiology (i.e.,
origins) of male homosexuality has revealed there is
no consensus about what causes it, with numerous
studies examining the influence of different social,
psychological, and biological factors. Historical
research highlights the differences in how male
homosexuality has been experienced and understood
within particular cultures at specific moments in
time. That being said, male homosexuality is often
deployed narrowly as a term for describing sexual
relations between men, which fails to account for the
cultural and historical variation in how male
homosexuality has been and is currently understood
and experienced. This entry outlines some of the
principal theories of male homosexuality before
discussing examples of how male homosexuality and
the figure of the male homosexual have been
expressed and treated in earlier civilizations. The
entry concludes by noting how histories of male
homosexuality are characterized by cultural
opposition and resistance to bodies of knowledge
that understand male homosexuality as a sin, an
abnormality, and a disease.
Theories of Male Homosexuality
Theorizing the causes of male homosexuality has
attracted much controversy among researchers who
differ on whether male homosexuality and the figure
of the male homosexual in Western societies can be
explained by psychological, biological,
1351
environmental, and social factors. In the sections that
follow, some of the most influential theories derived
from psychology, biology, and sociology are
considered.
Psychological Theories
Psychologists have provided some of the most
influential explanations for male homosexuality prior
to and throughout the 20th century. Early
psychological theories have, like biological theories,
often emphasized male homosexuality as innate.
Such approaches, which are sometimes described as
“essentialist,” treat the idea of male homosexuality as
a relatively fixed and immutable property of the
individual. They also play down, or dismiss
altogether, the influence of environmental and social
factors in male homosexuality.
Sigmund Freud was one of the first to theorize
homosexuality in psychological terms. He famously
reasoned that homosexual men could be accounted
for by how they can become “inverted” or “stuck” in
or “regress” to specific stages of psychosexual
development throughout childhood—namely, stages
that involve the direction of sexual desires toward
women at puberty. Freud was notable for his
psychoanalytical account of homosexuality, as he
was for suggesting that (male) homosexuality was
nothing to be ashamed of, explaining it as a result of
arrested psychosexual development. Freud did not
regard homosexuality as a vice, disease or illness, or
as a form of pathology— although these became the
dominant frames for understanding homosexuality
among later psychologists. Indeed, psychological
theories during much of the 20th century tended to
pathologize homosexuality as a mental illness,
promulgating a view that individuals could not be
blamed for their homosexuality. The pathologization
of homosexuality within the field of psychology has
encouraged many male (and female) homosexuals to
seek reparative (or corrective) therapy, the goal of
which is to return the individual to a “normal”
healthy state of heterosexuality.
The pathology of homosexuality as a mental
illness began to lose academic credibility as a result
of influential empirical investigations by
psychologists such as Evelyn Hooker in the late
1950s, which failed to return any reliable or concrete
evidence to confirm homosexuality as a mental
1352 Homosexuality, Male
disorder. This wave of research challenged the
official classification of homosexuality as a mental
disorder and the validity of reparative therapy as an
appropriate and ethical treatment, which ushered in a
new official consensus within Western psychology
that homosexuality is a normal variation of human
sexual orientation. This culminated in the American
Psychiatric Association’s declassifying
homosexuality as a mental disorder in 1973; the
American Psychological Association Council of
Representatives followed suit in 1975. Today, the
American Psychological Association conceptualizes
male homosexuality as a natural and healthy
variation of human sexuality that cannot and should
not be corrected by reparative therapy. Contemporary
psychology research exerts a powerful influence on
how sexual orientation is understood in general and
male homosexuality in particular. For example,
psychologists specializing in the psychology of
sexualities are committed to developing
nonheterosexist and gender-inclusive forms of
research, theory, and clinical practice. Some research
in this area has problematized essentialist theories of
male homosexuality and challenged the
stigmatization of male homosexuality, investigating
the impact of sexual stigma on the mental health of
male homosexuals.
Biological Theories
Biological accounts of male homosexuality also
endorse an essentialist view that can be traced back
as far as ancient Greece. However, it was not until
the late 18th and early 19th centuries that the idea of
male homosexuality having a biological basis began
to gain prominence. One pioneer of this view was
Havelock Ellis, a British physician whose research,
published in six volumes titled Studies in the
Psychology of Sex (1897–1928), suggested that most
cases of male homosexuality are innate or “inborn,”
and, therefore, not immoral.
Homosexuality, Male
Ellis popularized the view of male homosexuality as
a form of sexual inversion, whereby the male
homosexual (as a sexual invert) lacked the ability to
express “normal” emotional and sexual desires
toward the opposite sex. Viewed in this way, male
homosexuality is explained as a biological,
nonpathological gender anomaly.
Contemporary biological perspectives on male
homosexuality have come at the topic from a
different direction, some of them contending that
homosexual men share a “gay gene.” Research seems
to be inconclusive on this issue, with social scientists
criticizing biological theories for essentializing
human sexuality. For proponents of the genetic view,
male homosexuality is something that certain men
are born with and is not acquired from the social
environment. Some neurological research appears to
support this claim, by suggesting the brains of gay
men are more like those of heterosexual women in
terms of structure and function. Scientists interested
in the neurological differences between gay men and
heterosexual women claim to have found that gay
men exhibit more resemblance to heterosexual
women on male-typical tests such as those
concerning spatial perception and map reading.
Nevertheless, many scientists remain confused about
the genetic view of male homosexuality, but the
increasing number of published studies on the subject
have kept afloat the idea that male homosexuality is
much more genetically determined than previously
believed. Indeed, male homosexuality is regarded by
some scientists as another means of contributing to
the maintenance of the natural genetic variability of
humans.
Biological explanations of male and female
homosexuality have found favor among some
LGBTQ persons who assert that their homosexuality
is not a matter of choice but is inborn and, therefore,
something over which they have no control. This
argument maintains that because male homosexuality
may have a biological basis, male homosexuals
should be protected from discrimination. However,
social scientists have cautioned against using such a
view as a platform for advancing LGBTQ equality,
not least because some biological theories continue
to conceptualize male homosexuality as a state of
effeminate pathology. As such, scholars of LGBTQ
sexualities aver that it is neither possible nor
desirable to explain the diverse phenomena behind
the term male homosexuality as only the result of
DNA or a “gay gene.”
Sociological Theories

Sociological accounts of male homosexuality have
put forward a view that it is a social construction. In
contrast to biological and psychology theories, which
articulate an essentialist perspective, sociologists
assert that the identities, emotions, desires, and
relationships associated with male homosexuality are
shaped by society. What this means is that
sociological research has focused on the diverse
ways in which the organization of, and meanings
ascribed to, male homosexuality have been shaped by
different norms, values, and beliefs within societies
in certain ways at specific moments in time. As such,
the terms homosexual and heterosexual are revealed
to be relatively new labels for categorizing people
sexually. The social construction thesis of
homosexuality points out that the term homosexual
first appeared in public use in 1869 when German
psychologist Károly Maria
Benkert used it as a scientific term in a legal
argument, to assert that it was a natural and private
matter that should be beyond the interference of the
law. The idea of the (male) homosexual as a person
and a distinct identity gathered momentum from the
late 18th century onward, as social constructionists
argued that Western cultures are responsible for
creating the category of the homosexual (and
heterosexual) and ascribing it the cultural
disapproval it attracted around that time and still
does today.
Sociological work on male homosexuality accepts
the variability in sexual norms, beliefs, identities, and
relationships, placing a great deal of emphasis on the
contingency of these variations in how male
homosexuality is understood and experienced. As
such, sociological theories have served as a
counterpoint to pathologizing male homosexuality as
a mental “disorder,” which requires the intervention
of sex psychologists and psychiatrists.
Sociologist Mary McIntosh is credited as being one
of the first to highlight how male homosexuality had
become pathologized as a disorder as a result not of
scientific fact but of the emergence of a derogatory
and widespread European Christian interpretation of
same-sex behavior between men. Viewed in this
way, male homosexuality is something that society
produces in very complex ways. Indeed, sociological
theories of male homosexuality tend to embrace the
idea that there is no single history of male
homosexuality, but rather multiple histories that are
1353
intricately linked. This argument has generated a
vibrant academic literature on male homosexuality
that exposes the multifarious ways in which it has
been subject to social control and regulation, but also
how male homosexuality has shaped and continues
to shape the contemporary landscape of LGBTQ
identities, relationships, politics, and activism. Some
of these issues are discussed in the following
sections.
The Histories of Male Homosexuality
McIntosh’s approach has provided, in essence, the
basis of most contemporary sociological studies of
gay men, lesbians, and same-sex identities and
communities. This section discusses the contribution
of historical research on homosexuality to identifying
how the homosexual emerges as a distinct figure.
French philosopher Michel Foucault appears to be
credited more than most with examining how power
relations have been deployed within Western
societies to give rise to specific forms of knowledge
about sexuality. In a three-volume study titled The
History of Sexuality (1976–1984), Foucault observed
how scientific knowledge was used to categorize
people as either “homosexual” or “heterosexual,”
fueled by a cultural obsession in the West with
determining “normal” and “abnormal” sexualities
using the dualistic classification heterosexual and
homosexual. This argument has provoked debate
among social historians about how the existence,
nature, and role of male homosexuality was
understood and experienced in earlier civilizations.
Carrying out this type of research sensitively is
challenging because historians may be searching for
signs of male homosexuality in bygone ages and
periods of history where no terms of reference
existed for describing these types of relations
between men. One risk is that historians can import a
contemporary notion of male homosexuality into
interpretations of past forms of same-sex intimacies
that were not used as a basis for identifying male
relationships as “homosexual” or male individuals as
“homosexuals.” Some commentators have voiced
concerns about how historians have “sexed up” the
past by identifying prominent male historical figures
as homosexual (e.g., Alexander the Great, Leonardo
da Vinci, and Roman emperor Hadrian) and
searching for signs of male homosexuality in earlier
1354 Homosexuality, Male
civilizations based on a Western contemporary
understanding of the term that, for example, reduces
male homosexuality to a form of sexual intercourse
between men. Such endeavors have been criticized
for potentially excluding accounts of male
homosexuality that may be expressed in other ways.
Despite these pitfalls, historians of human sexuality
have excavated rich and illuminating evidence on the
way male homosexuality has been organized and
understood in numerous civilizations separated by
wide spans of time. Two examples are provided:
ancient Greece and 18th-century England.
The ancient Greeks had no word for a male or
female homosexual (or heterosexual) person. Some
historians have argued that the ancient Greeks
believed that individuals were capable of entering
into erotic relations with either men or women, as
both possess beauty that can provoke erotic
responses in a male (or female) onlooker.
Homosexuality was prevalent in ancient Greece,
particularly within Greek male culture. Although
male homosexuality was not stigmatized, how it was
organized was of paramount significance. Here, then,
the issue was less about the object of desire (i.e.,
another man), as tends to be the case in contemporary
Western societies, and more about how these
relations were organized in terms of status. Greek
male culture was acutely sensitive to the organization
of homosexual relations in terms of which men were
active or passive (for example, in
Homosexuality, Male
sexual intercourse between men) given its highly
competitive nature and fixation on status distinctions.
Idealized sexual relations between men involved an
adult lover (between the ages of 20 and 30) and a
prepubescent male whose youth ascribed him a low
status, the former gaining the latter’s admiration
through gift giving and demonstrating exemplary
conduct. Sexual relations between men of equal
social or political status were frowned upon because
a similarity in status was understood as a deprivation
of status. So, while the sexual subordination of
younger men in ancient Greek culture was culturally
acceptable, it was not entirely unproblematic in that
men had to engage very carefully with issues of
status in order to demonstrate devotion, sacrifice, and
honor within these relations.
Another example relates to the male homosexual
subcultures that developed in the molly houses of
18th-century London. The English molly houses, a
name given to the taverns and rooms where men
(often dressed as women and taking women’s names)
could gather to dance, sing, drink, and meet potential
same-sex (sexual) partners, have been understood as
a society nestled within a society. In other words, the
molly houses have been understood as a concrete
manifestation of a gestating male homosexual
culture. At this time, uncertainty about what
characteristics signaled (un) acceptable male
intimacy grew large in the public consciousness.
Because the molly houses represented a context in
which male homosexuality could be expressed, and
therefore recognized as such, they aroused suspicion.
Unlike in ancient Greece, the organization and
expression of male homosexuality in 18th-century
England was subject to severe hostility. The molly
houses became targets of organized raids, which led
to many of their patrons being prosecuted and some
executed, as was the case for three men in 1726. The
notorious molly house court trials articulated the
cultural anxieties of the time surrounding how to
distinguish the bonds between men deemed to be
“acceptable” (e.g., platonic forms of male friendship)
from those that were to be feared (sexual relations
between men). Of note is that writers on this subject
have cautioned against conflating male
homosexuality with practices associated with
sodomy. While contemporary definitions of sodomy
often refer to acts of sexual copulation between
members of the same sex, particularly men, sodomy
was understood differently in 18th-century England.
Sodomy was not specifically a male or female
homosexual crime but rather a capacious concept
denoting sexual as well as religious and political
crimes and acts of bestiality. All individuals were
thought to be susceptible to such vices and, thus,
vulnerable to charges of sodomy.
The Emergence of Gay Male Sexualities
In concluding this entry, it is imperative to
acknowledge research that has exposed numerous
homosexual subcultures among men that have
resisted moral codes about the nature of
homosexuality. As mentioned above, histories of
male homosexuality have revealed how individuals

have engaged in acts of resistance toward its strict
regulation. One important example relates to the
adoption of the term gay around the 1970s by the
homosexual community as a positive descriptor for
referring to male (and female) homosexuality.
Today, the term’s most widely held meaning refers
to male homosexuality in its coverage of different
types of gay sexualities and gay men. Researchers
have examined the conditions that have given birth to
and the subsequent role played by “gay” male
identities and subcultures (e.g., gay skins, radical
faeries, bears, clones) within Western societies from
the 20th century onward. These subcultures have
played a vital role in the development of a vast
efflorescence of contemporary gay male identities,
sexualities, and relationships that underscore the
fluidity in how male homosexuality is currently
understood and experienced.
Within the social sciences, researchers have
addressed wider cultural issues such as what role gay
men might play in society. Some commentators point
out that gay male sexuality has been understood as a
cultural resource that can help heterosexual men,
exemplified in Queer Eye for the Straight Guy, a
U.S. television show that aired on the Bravo cable
television network from 2003 to 2007. The show
promulgated the view that gay men are more skilled
consumers, are more fashion aware, and understand
women better than their heterosexual male
counterparts. Marshaled as a resource for
heterosexual men who fall short in all these areas,
Queer Eye for the Straight Guy brought gay men to
the rescue of their heterosexual counterparts in a
seemingly innovative depiction of male
homosexuality, although critics have argued that the
show negatively reinforced the association of gay
men with stereotypically feminine activities and
qualities.
Elsewhere, scholars of adult relationships have
seen in gay men the potential for rethinking men’s
relationships with other men and women on the basis
that gay men have, out of necessity, had to be
creative in reforming relationships with other men
against a backdrop of homophobia. Gay men might
provide perspectives that help heterosexual men (and
women) to transcend heteronormative ideals of how
human relations ought to be organized, contributing
to the ongoing exploration and maintenance of new
ways of identifying and relating to others in everyday
1355
life as gay. Such analyses bear testimony to the
importance of sustaining future avenues of research
that aim to undo the grip heteronormativity still holds
over how male homosexuality is understood and
experienced.
Nick Rumens
See also Effeminacy; Homosexuality, Female;
Hypermasculinity; Masculinity Stereotypes; Men Who
Have Sex With Men (MSM)
Further Readings
Bech, H. (1997). When men meet: Homosexuality and
modernity. Cambridge, England: Polity.
Bray, A. (1982). Homosexuality in Renaissance England.
London, England: Gay Men’s Press.
Foucault, M. (1979). The history of sexuality, volume 1:
An introduction. London, England: Allen Lane.
Greenberg, D. F. (1988). The construction of homosexuality.
Chicago, IL: University of Chicago Press.
Halperin, D. M. (2012). How to be gay. Cambridge, MA:
Harvard University Press.
Lewes, K. (2009). Psychoanalysis and male homosexuality:
Twentieth-anniversary edition. Lanham, MD: Jason
Aronson.
Vernon, M. (2000). “What are gay men for?” Theology and
Sexuality, 7, 63–76.
Weeks, J. (1985). Sexuality and its discontents: Meanings,
myths, and modern sexualities. New York, NY:
Routledge.
Wilson, G., & Rahman, Q. (2005). Born gay: The
psychology of sex orientation. London, England:
Peter Owen.
HORMONES AND SURGERY DURING
GENDER TRANSITION
Hormones and surgeries are sometimes used by
people who are not content to remain the gender they
were assigned at birth (often called trans or
nonbinary people) in order to effect a body that is
more congruent with their internal sense of self. This
entry briefly overviews these interventions and will
also consider when it is generally recommended that
they be used.
1356 Homosexuality, Male
People under the broad, umbrella term trans may
identify as trans men if they are assigned female at
birth and identify as men, or as trans women if they
were assigned male at birth and identify as women.
People under the broad term trans may also identify
as something outside of the gender binary of men or
women and so may identify as nonbinary,
genderqueer, or one of a number of other terms.
Further, those people who do not identify with any
gender form may identify as agender, neutrois, or
one of a number of other terms. All these groups of
people may seek to alter the outward appearance of
their body in order to be congruent with their internal
gender identity. For example, people may wish to
effect the outward appearance of genitalia and
secondary sex characteristics (breasts, chest or body
hair, etc.) of their identified sex.
Hormones
Those people who have a permanent identity as a
gender not assigned at birth and are also in a
Hormones and Surgery During Gender Transition
unnecessary in natal females where exogenous
(medicine-derived) testosterone is usually sufficient
to suppress endogenous estrogens. GnRH analogues
are expensive medicines, and in countries where this
cost is an issue, antiandrogens have been used as an
alternative. These medicines, however, have more
adverse side effects than the GnRH analogues.
It is important for trans men and women to have
their endogenous hormones suppressed to
postsurgical levels prior to surgeries such as removal
of the testicles (orchidectomy) or removal of the
ovaries (oophorectomy) so that they can experience
the postoperative hormonal milieu before permanent
removal of the capacity to produce hormones is
undertaken.
Cross-sex hormones will induce pubertal changes
in the person who takes them. For natal males, this
will include such things as the development of
breasts, softening of the skin, redistribution of body
fat to a female contour, finer body hair, loss of
erectile function, and loss of fertility. For natal
females, changes will include enlargement of the
clitoris,

position to effect a permanent change in this regard

may elect to utilize hormones and/or surgeries in
order to change their body to be in line with their
identity. Hormonal treatment consists of two main
types:
1. Medicines to reduce the production or effect of natal
hormones. These either inhibit the action of the
gonad to arrest puberty in children, stop the
production of endogenous (body-derived) hormones
in adults, or reduce the action of natal hormones by
preventing them binding to their receptor
(antiandrogens).
2. Medicines consisting of various forms of sexsteroids
—estrogen or testosterone—that are “cross-sex”
hormones that replace the endogenous hormones of
a trans person with those of their desired sex.

Most often, drugs to stop testosterone, such as

gonadotropin-releasing hormone (GnRH) analogues,
are used in natal males who have not had their
testicles removed, because estrogens alone are
usually inadequate to suppress endogenous
testosterone—whereas such medicines are usually

Hormones and Surgery During Gender Transition
deepening of the voice, redistribution of body fat to a
male contour, male-pattern body hair, baldness in those
with a genetic propensity for it, coarser skin, cessation
of menses, and loss of fertility. As both natal males and
females will lose fertility, gamete storage of sperm or
eggs prior to starting cross-sex hormones is an
important consideration.
Both GnRH analogues and cross-sex hormones may
be sourced from the Internet or other retail outlets in
countries where this is legal (and indeed, often in
countries where it is not), usually by people who wish
to forgo the processes associated with engaging with a
medical professional for a prescription. This can lead to
people taking unwise types and dosages, which can in
turn lead to medical complications and may also lead to
a poorer outcome in terms of the desired results.
As part of a medical or psychological assessment of
a social gender role change, it is the usual practice in
countries with nationalized health care for the person to
have shown psychosocial functioning in their desired
gender through proof of having made a formal change
to that gender— most usually through a change of
identity documentation and having some form of
occupation in that gender. The use of hormonal and
surgical therapies is usually undertaken in the context
of a multidisciplinary team, which may consist of
psychologists, endocrinologists, and psychiatrists— and
possibly others such as speech therapists, counselors
and psychotherapists, primary care physicians with a
special interest, specialist nurses, and others.
Surgeries
Usually, a period of time longer than 1 year living in
the identified gender role and psychological assessment
suggesting good psychological functioning in that
gender are necessary before genital surgeries may be
undertaken (although not all people will wish to have
surgeries). Breast surgery, called an augmentation
mammoplasty (enlargement for natal males) or bilateral
mastectomy and associated chest recontouring (removal
for natal females), will often be undertaken after any
hormonal manipulation (in order that the best outcome
may be achieved), but often before any genital
surgeries. Such surgeries are clustered under a number
of names including sex-reassignment surgery (SRS),
gender-confirmation surgery (GRS), gender-
1357
reconstruction surgery (GRS), and genital-
reconstruction surgery (GRS)—with most professionals
preferring the latter to refer to genital surgeries as a
group, and the specific name of the procedure to refer
to each procedure and to each of the chest surgeries.
Trans men also sometimes refer to top (chest) and
bottom (genital) surgeries.
For natal males who wish to have larger breasts, the
augmentation mammoplasty is an operative procedure
to insert a silicone- or saline-filled breast implant either
over or under the pectoral muscle of the trans person
such that a larger, female-shaped breast is created. This
is usually deferred until breast development is
complete, after 18 months to 2 years of hormonal
treatment. Augmentation mammoplasty can be required
more commonly for natal males, as a fully developed
female breast may appear smaller against the
proportionally larger and wider natal male chest.
The bilateral mastectomy and associated chest
recontouring for natal females involves the removal of
most of the breast tissue and the surgical creation of the
desired (male) chest contour. This can be made more
difficult if the person is overweight. If the breasts are
small, this can be achieved through an incision around
the edge of the areola. If the breasts are large, however,
submammary incisions (under the breast) are needed,
and repositioning of the nipple may also be required. It
can be further complicated if the person has engaged in
breast binding to flatten the breast through wearing an
elastic undershirt for a protracted period of time, as this
causes ptosis (flattening/drooping) of the breast tissue.
Genital surgeries consist of the removal of
reproductive capacity and possibly the creation of
genitalia of the desired gender. For natal males,
removal of reproductive capacity will involve removal
of the testicles. They may also have the penis removed
and the scrotum formed into labia, with the tip of the
glans used to create a clitoris and the urethra situated in
the usual place for a female. This procedure is called a
cosmesis or cosmetic vulvoplasty and does not form a
vagina. Alternatively, the above may be followed with
the skin of the penis, the penis and some of the scrotum,
or (very rarely) a piece of sigmoid colon used to create
a vagina—a procedure called a vaginoplasty. This
vagina must be kept open through regular dilation with
a phallus or acyclic dilator for the rest of the person’s
life or else contraction of the neovagina will result in a
loss of its function.
1358
For natal females, removal of reproductive capacity
will involve the removal of the ovaries and usually the
womb (uterus), too. Removal of the womb can be
necessary in those people who have been taking
testosterone, as endometrial hyperplasia (thickening of
the lining of the uterus) can be an unwanted effect.
With regards to the construction of genitals, for those
people who wish to have prosthetic testicles, the labia
may be fused to create a scrotum, and two standard
testicular implants can be added. To create a phallus,
some people who have been taking testosterone opt for
a metoidioplasty in which the enlarged clitoris is
released to sit further forward, often with the additional
removal of fat from the mons pubis such that the
phallus is yet more prominent. The urethra may be
routed through the phallus so that the person may stand
to urinate. The phallus is seldom large enough for
vaginally or anally penetrative sex and consequently,
for those for whom this is important and who have
evaluated the increased surgical risk, another option is
the phalloplasty. In this procedure, tissue from the
forearm, or less commonly the leg or abdomen, is used
to create a phallus (the latissimus dorsi muscle may be
used also, but this is rare). The phallus thus created
must have both blood supply and nerves surgically
attached for protective sensation, with erogenous
sensation being provided by the clitoris, which is left in
place. The urethra is routed through the phallus,
allowing the person to stand to urinate, and an implant
may be inserted, which allows the penis to become
erect. Due to the increased complexity of the
phalloplasty, the risks of complications including
incontinence and necrosis (tissue death) of the phallus
are significantly higher than for the metoidioplasty.
Hormones and Surgery During Gender Transition
It should be noted that many trans people opt to have
hormones and no surgeries, or neither hormones nor
surgeries, and these are entirely acceptable outcomes, as
one’s sense of self is not solely determined by one’s
body, though having a body congruent with one’s sense
of self is important to one’s mental health. Indeed, it
appears that for many trans people, there is a biological
cause for their gender identity—with the sex of their
brain matching their sex of identity rather than that of
birth assignation. For this reason, people who have been
supported to make well thought out, staged, and real
world–tested decisions with regard to hormones and
surgeries do far better.
Christina Richards and Leighton Seal
See also Embodiment; Gender Clinics; Stealth
(Transgender Passing); Therapy With Transgender,
Transsexual, and Gender-Nonconforming People;
Therapy With Transgender Individuals: Mental Health
Considerations; Transgender Health Care; Transgender
Identities; Transgender People and Binding, Tucking, and
Packing; Transgender Youth and Cross-Sex Hormones
Further Readings
Barker, M., & Richards, C. (in press). Further genders. In C.
Richards & M. Barker (Eds.), The Palgrave handbook of
the psychology of sexuality and gender.
London, England: Palgrave Macmillan.
Gijs, L., & Brewaeys, A. (2007). Surgical treatment of
gender dysphoria in adults and adolescents: Recent
developments, effectiveness, and challenges. Annual
Review of Sex Research, 18, 178–224.
Kruijver, F. P. M. (2004). Sex in the brain. Amsterdam:
Netherlands Institute of Brain Research.
Monstrey, S., Selvaggi, G., Ceulemans, P., Van Landuyt, K.,
Bowman, C., Blondeel, P., et al. (2008). Chest-wall
contouring surgery in female-to-male transsexuals: A new
algorithm. Plastic and Reconstructive Surgery, 121, 849–
859.
Richards, C., & Barker. M. (2013). Sexuality and gender for
mental health professionals: A practical guide.
London, England: Sage.
Richards, C., & Seal, L. (2014). Reproductive issues for trans
people. BMJ, Journal of Family Planning and
Reproductive Health Care, 40(4), 245–247.
Hospital Visitation
Seal, L. J., Franklin, S., Richards, C., Shishkareva, A., Sinclaire,
C., & Barrett, J. (2012). Predictive markers for breast
augmentation and a comparison of side effect profiles in
transwomen taking various hormonal regimens. Journal of
Clinical Endocrinology and Metabolism, 97(12), 4422–4428.
HOSPITAL VISITATION
Hospital visitation is of great concern to the LGBTQ
community. Being denied access to a same-sex partner
or spouse is one of the community’s greatest fears. This
entry provides an overview of the legal issues and
 1359
general impediments facing LGBTQ individuals and Regulations Parts 482 and 485. Providers that fail to
couples when trying to visit each other in a health care comply with the rule may be terminated from the
setting. Medicare and Medicaid program.
Traditional hospital policies have historically limited The rule requires health care providers to honor a
visitation to immediate family members and were not patient’s advance directive that authorizes another
inclusive of LGBTQ patients and their families. In person to make medical decisions when the patient is
2007, Lisa Marie Pond; her life partner, Janice K. unconscious or unable to make decisions. Advance
Langbehn; and their four children were scheduled to directives are essential for LGBTQ individuals,
take a cruise out of Miami, Florida. As they were couples, and their families because they can grant
boarding the ship, Lisa collapsed and was taken to decision-making authority in the absence of a
Jackson Memorial Hospital Ryder Trauma Center. The traditional family relationship.
admitting clerk refused to provide Janice with access or The hospital visitation rule does not include a
information regarding Lisa’s condition. A hospital conscience clause or religious exemption clause that
social worker told Janice that she was in an antigay city would allow hospital personnel to ignore a rule if they
and state, and Lisa’s power of attorney naming Janice assert the rule violates their religious convictions.
as her agent would not be recognized. Lisa died without Accordingly, a hospital cannot refuse to honor advance
her partner of 18 years and their children at her side. directives because the doctor or nurse does not like
Janice Langbehn sued Jackson Memorial Hospital in LGBTQ people. The absence of a conscience or
federal court, but her case was dismissed because the religious exemption clause is significant in light of the
court held that there was no relief available. Although 2014 U.S. Supreme Court decision in Burwell v. Hobby
the judge thought the hospital’s actions lacked Lobby. The Supreme Court decided that closely held
compassion and did not reflect well on the institution, for-profit corporations are exempt from a law if its
he agreed that medical personnel must be able to make owners have religious objections and there is a less
decisions regarding visitation. The publicity restrictive means of implementing the law. This is the
surrounding the Langbehn case caused Jackson first time the Court has recognized that for-profit
Memorial Hospital to make significant changes to its companies can have religious beliefs. This decision
hospital visitation policy as it applied to LGBTQ may
patients and their families. The case also garnered
attention at the federal level and changed the
accreditation standards applicable to hospitals.
In April 2010, President Barack Obama issued a
Presidential Memorandum on Hospital Visitation that
instructed the secretary of Health and Human Services
(HHS) to draft a new rule to require all hospitals to
honor advance directives. In his memorandum, the
president stated the new rule would make sure that
patients receive compassionate care and equal treatment
while in the hospital. The new rule applies to all
hospitals participating in the Medicare or Medicaid
programs.
The memorandum directed that the new rule must
specify that hospitals cannot deny visitation privileges
on any basis, including sexual orientation and gender
identity. The rule must also guarantee that a patient’s
advance directives, including living wills and health
care proxies, are respected. Under the new rule, a
patient’s designated representative has the right to make
informed decisions for the patient. HHS published the
final rule in January 2011 in the Code of Federal
1360
create problems for LGBTQ patients and their
families in the future, especially with providers
affiliated with religious institutions. If medical staff
in hospitals that are affiliated with a specific religion
claim the right to discriminate based on their
religious beliefs, many LGBTQ patients may find
themselves alone and without support in a medical
emergency.
Under the hospital visitation rule, a patient may
verbally designate an individual as a support person
who has the right to visit and make decisions for the
patient. Written documentation is only required if the
patient is unconscious or incapacitated and has never
designated a support person. The documentation that
meets the requirement can include evidence of a
shared residence, business ownership, financial
interdependence, or a legal relationship recognized in
another state.
The hospital visitation rule does not provide a
private cause of action against a hospital, including a
critical access hospital, although complaints may be
filed with the appropriate state agency. A critical
access hospital is certified under Medicare, has 25 or
fewer beds, and is designed to provide outpatient
care for common conditions. Accordingly, Janice
Langbehn’s lawsuit would have likely been
dismissed, even after HHS promulgated the new rule.
The hospital visitation rule is also no guarantee that
hospital staff or a patient’s biological family will
honor the patient’s wishes. LGBTQ patients continue
to experience discrimination by hospitals and their
employees.
The Joint Commission on Accreditation of
Healthcare Organizations publishes national hospital
accreditation standards. Its definition of family
extends to the people who play a significant role in
the patient’s life, including people who are not
legally related to the patient. In 2011, the Joint
Commission published a new version of its Hospital
Accreditation Program Visitation Rights Rule. The
revision includes spouses, same-sex domestic
partners, other family members, or a friend as people
a patient can authorize to visit. The rule specifically
gives the patient the right and authority to name
whoever he or she pleases to visit. Health care
facilities accredited by the Joint
Commission must accept and comply with its rules
or risk losing accreditation, and without
accreditation, the facility cannot operate. A
complaint can be filed with the Joint Commission if
a hospital violates the rule.
Joan M. Burda
See also Advance Health Care Planning; Domestic
Partnership; Legal Recognition of Nonmarital
Same-Sex Relationships; Legal Rights of Nonbiological
Parents; Long-Term Same-Sex Couples; Powers of
Attorney; Retirement; Second-Parent Adoption; Wills
and Trusts
Further Readings
Burda, J. M. (2012). Estate planning for same-sex
couples (2nd ed.). Chicago, IL: American Bar
Association.
Joint Commission. (2014). Advancing effective
communication, cultural competence, and patient- and
family-centered care for the lesbian, gay, bisexual, and
transgender (LGBT) community: A field guide. Oak
Terrace, IL: Author.
Obama, B. (2010, April 15). Presidential memorandum—
Hospital visitation. Washington, DC: White House,
Office of the Press Secretary. Retrieved November 8,
2015, from http://www.whitehouse.gov/the-
pressoffice/presidential-memorandum-
hospitalvisitation
Squillace, S. E. (2014). Whether to wed. Boston, MA:
Squillace & Associates, P.C.
HOUSING, PROTECTION AGAINST
DISCRIMINATION IN
This entry focuses on housing discrimination against
LGBTQ people and their families and efforts to
increase access to fair housing in the LGBTQ
community. While no federal law explicitly prohibits
housing discrimination against LGBTQ people, there
are significant federal policies and state and local
laws that provide crucial protections for lesbian, gay,
bisexual, and transgender (LGBT) people seeking
access to fair and affordable housing.
Housing, Protection Against Discrimination in
 Housing, Protection Against Discrimination in 1361
Overview of Homelessness and Housing different areas. Of the respondents in that survey,
Discrimination in the LGBT Community 19% reported being refused a home or apartment,
and 11% reported being evicted because of their
LGBTQ people and families face significant housing
gender identity or expression. Home ownership in the
discrimination and higher instances of homelessness
transgender community is only 32%, which is less
and housing insecurity than the general population. A
than half the national rate. Nineteen percent, or
2010 study by the Welfare Warriors Research
nearly 1 in 5 respondents, reported that they had
Collaborative shows that a majority of low-income
experienced homelessness as a result of
LGBTQ people have been or are currently homeless,
discrimination, or mistreatment because of their
finding that 70% have been homeless in the past
gender identity or expression. The survey
year, and 58% are currently homeless. Without
additionally found that discrimination was
explicit federal protections guarding against housing
particularly pronounced for transgender people of
discrimination, LGBTQ people must rely on a
color. As this survey confirmed, housing
patchwork of state and local protections, which are
discrimination and a lack of access to housing-related
insufficient to adequately protect them. As a result,
services and programs is extremely pervasive in the
LGBTQ people are at a much higher risk for adverse
LGBTQ community.
housing outcomes, including discrimination,
LGBTQ people of color and low-income LGBTQ
harassment, and eviction based on their sexual
people have been especially victimized with respect
orientation or gender identity.
to housing discrimination. Notably, transgender
In 2013, the U.S. Department of Housing and
people of color are particularly vulnerable. In the
Urban Development (HUD) conducted a first-ever
same transgender study discussed above, 37% of
study examining housing discrimination against
African Americans reported having been evicted
same-sex couples at the national level. This study
because of their gender identity. They were also 3
found that same-sex couples were significantly less
times as likely to have experienced homelessness.
likely to receive favorable responses to e-mail
Similar trends are seen for Latinos, Native
inquiries about rental housing than heterosexual
Americans, and multiracial respondents: All faced
couples. Different-sex couples were favored over gay
significantly higher rates of housing discrimination
male couples in 15.9% of the tests, and favored over
than their White transgender counterparts. In short,
lesbian couples in 15.6% of the tests. While this
transgender people of color face substantial housing
study was groundbreaking and clearly indicates a
discrimination and are likely to live in low- and very
statistically significant disparity in
low–income communities. Poverty is also more
access to fair housing, it still fails to capture several
likely among LGBTQ people and families,
types of anti-LGBTQ housing discrimination. For
particularly female same-sex relationships, same-sex
example, discrimination faced by single lesbian, gay,
relationships between people of color, and the
bisexual, and queer (LGBQ) people is widespread
transgender community.
and could not be measured by this study because the
LGBTQ people living in rural communities are
study used same-sex couples. Moreover, the study
also an especially vulnerable demographic. There is a
failed to measure any discrimination faced by
widely held belief that the LGBTQ community is
transgender and gendernonconforming people. This
isolated to urban areas of the United States. Contrary
is particularly troubling because discrimination based
to this popular assumption, studies paint a much
on gender identity represents some of the most
more accurate picture that includes rural LGBTQ
significant discrimination the LGBTQ community
people and families. Research shows that many
faces.
people in the LGBTQ community live, work, and
Indeed, research reveals that the transgender
raise families in rural communities across the United
community is especially vulnerable to housing
States. According to the Williams Institute at the
discrimination. According to a groundbreaking
UCLA School of Law, an analysis of the 2010 U.S.
survey prepared by the National Center for
Census data revealed that there are approximately
Transgender Equality and the National Gay and
64,000 cohabiting same-sex couples living in rural
Lesbian Task Force in 2011, transgender people face
America. This number represents almost 10% of all
devastating housing discrimination in a number of
1362
cohabiting same-sex couples in the country.
Thousands of these samesex couples are raising
children in rural areas as well; research by Gary
Gates of the Williams Institute shows that same-sex
parenting is more common in the South than in any
other region. LGBTQ people and families in these
areas often face an intersection of identities that
subjects them to an even greater degree of
marginalization. For instance, these couples are also
more likely to be of color, twice as likely to live in
poverty, and significantly more likely to receive
public assistance.
Accordingly, rural LGBTQ communities remain
extremely vulnerable to housing instability and
discrimination in accessing services. Research by
Randy Albelda of the Williams Institute shows that
LGBTQ adults who live outside of urban areas are
poorer than non-LGBTQ people, and more than
twice as likely to live in poverty as LGBTQ people in
urban areas. This research also shows that of those
LGBTQ people who sought assistance from a
government or community agency, about half
reported instances of discrimination, with about 40%
being denied services. The same research also found
that a significant number of LGBTQ people reported
instances of violence within social service agencies.
Namely, 57% reported that they had been threatened,
and 35% reported that they had been physically
assaulted.
The intersection of poverty and LGBTQ
discrimination can lead to greater marginalization of
LGBTQ people and families in rural areas. Research
shows that lesbian, gay, and bisexual (LGB) people
and families living in rural communities are more
likely than their nonrural LGB counterparts and their
straight rural counterparts to struggle financially.
Further, rural LGB people and families are almost
twice as likely to receive public assistance as their
nonrural LGB counterparts.
LGBTQ youth homelessness in the United
States is a particularly alarming and often overlooked
epidemic. The Center for American Progress
estimates that there are currently 1.6 million to 2.8
million homeless youth in the United States. LGBTQ
youth are disproportionately represented within this
population. Although only 5% to 10% percent of the
general youth population self-identify as LGBTQ,
20% to 40% percent of homeless youth identify as
LGBTQ. This percentage translates, conservatively,
to between 320,000 and 400,000 individual homeless
LGBTQ youth. The majority of this homelessness is
a direct result of discrimination, based solely on
LGBTQ identification (whether actual or perceived),
from family members, community members,
unresponsive school administrators, fellow students,
child welfare programs, and other federal programs.
LGBTQ youth are highly susceptible to familial
discrimination and rejection based on their sexual
orientation or gender identity. According to 2010
research by the Center for American Progress, 62%
of LGBTQ homeless youth have reported familial
conflict as the predominant reason they were
homeless. This percentage represents twice the
amount reported by their non-LGBTQ peers.
Recently, the age when LGBTQ people “come out”
to their family has decreased, averaging around 13–
15 years, compared to the previous estimate of 18–20
years. Due to this decrease in age, children are being
forced out of their homes and ending up on the
streets at a younger age, which has created a greater
demand for homeless youth services. Without a
safety net, LGBTQ homeless youth are resorting to
“survival crimes”—crimes necessary in order to meet
survival needs such as sex work, drug trade, or theft
—as a means to provide food, shelter, money, and
clothing.
Federal and State Housing Discrimination
Legislation and the LGBT Community
Title VIII of the Civil Rights Act of 1968 is the
original Fair Housing Act (FHA), which prohibited
discrimination based on race, color, religion, or
national origin for any sale, rental, or financing of
housing. In 1974, amendments to the FHA were
enacted to broaden its protections and prohibit
housing discrimination based on sex. Congress
Housing, Protection Against Discrimination in
later passed the Fair Housing Act Amendments
(FHAA) in 1988, which both again broadened the
scope and coverage of the original FHA, and
strengthened the remedies and enforcement measures
available to private litigants and federal agencies.
The FHAA also extended protections to prohibit
housing discrimination based on familial status and
disability. The FHA, however, has not been amended

to contain language explicitly protecting against
discrimination directed at LGBTQ people.
Recent guidance from HUD on the interpretation
of the FHA has provided crucial protections for
transgender and gender-nonconforming people. In
July 2010, HUD announced that it would interpret
the FHA’s prohibition against discrimination “based
on sex” to include discrimination based on gender
identity and sex stereotyping. As a result, the FHA
now prohibits the type of gender identity
discrimination most often faced by transgender
persons. This announcement opened the door to
enforcement actions under the FHA against
discrimination directed at transgender and
gendernonconforming people based on gender
identity and expression.
Since this guidance was announced, HUD has
pursued at least one case of discrimination based on
gender identity and sex stereotyping. In October
2013, the U.S. government filed a lawsuit against a
Texas recreational vehicle (RV) park and its
management on behalf of Roxanne Joganik, a
transgender woman, in the U.S. District Court for the
Eastern District of Texas. The complaint alleged that
Ms. Joganik and her partner Darlina Anthony had
lived in the RV park for over a year when the
defendant took over the management of the RV park.
According to Ms. Joganik, the defendant prohibited
her from wearing female clothes and otherwise
expressing her female gender identity in common
areas of the RV park. When she refused to comply,
the defendant allegedly began eviction proceedings
against her and her partner. After an initial
investigation, HUD filed a case on Ms. Joganik’s
behalf, alleging Ms. Joganik had experienced
unlawful sex discrimination based on her gender
identity. The case was subsequently settled in the
summer of 2014 before going to trial.
Under the terms of the settlement, Ms. Joganik was
awarded $4,000 in damages, and the defendant was
required to add a prohibition against gender
discrimination as a category in the park rules and
leases.
There have also been efforts to amend the FHA to
explicitly include discrimination against LGBT
people. The Housing Opportunities Made Equal Act
of 2013 (the HOME Act) is the latest iteration that
would expand existing prohibitions on housing
discrimination to recognize sexual orientation or
Housing, Protection Against Discrimination in 1363
gender identity as protected classes. The HOME Act
inserted the terms “sexual orientation” and “gender
identity” after “sex” each time that it appeared in the
FHA. Under the HOME Act, “sexual orientation”
was defined as “homosexuality, heterosexuality, or
bisexuality.” “Gender identity” was defined as
follows: “the gender-related identity, appearance, or
mannerisms or other gender-related characteristics of
an individual, with or without regard to the
individual’s designated sex
at birth.”
In addition to the FHA, states and municipalities
also have laws and ordinances that prohibit
discrimination in housing. Many states and
municipalities have specifically amended their
housing laws to prohibit discrimination based on
sexual orientation or gender identity. At the time of
this writing, 18 states and the District of Columbia
currently protect individuals from housing
discrimination based on sexual orientation and
gender identity. An additional three states protect
against housing discrimination on the basis of sexual
orientation alone. The Family Equality Council
estimates that across the United States, more than
100 towns, cities, counties, and municipalities
prohibit housing discrimination based on both sexual
orientation and gender identity.
Federal Regulations and Policy Efforts to
Target Housing Discrimination in the
LGBT Community
Without explicit protections at the federal level
against housing discrimination, LGBTQ people have
historically had to rely on the patchwork of state and
local laws that protect against housing
discrimination. In 2012, HUD promulgated a new
regulation known as the LGBT Equal Access Rule
that extended critically important protections for
LGBTQ people in housing services and programs
administered or funded by HUD. This
groundbreaking regulatory change provides the first
comprehensive protection for LGBTQ individuals
against discrimination in housing at the federal level.
The LGBT Equal Access Rule prohibits
discrimination based on sexual orientation, gender
identity, and marital status in public housing
programs and services. This rule impacts more than
5.5 million people across the county. HUD-assisted
1364
and HUD-insured housing accounts for a large
segment of all housing opportunities. The LGBT
Equal Access Rule also prohibits all lenders offering
FHA-insured mortgages from considering sexual
orientation or gender identity in determining a
borrower’s eligibility. FHA-insured mortgages
represent a very large share—between 40% and 50%
—of the mortgage market.
The LGBT Equal Access Rule further clarified the
definition of “family” to ensure that otherwise
eligible participants in any HUD programs will not
be excluded based on marital status, sexual
orientation, or gender identity. These programs,
including crucial public housing programs like the
Section 8 Housing Choice Voucher Program, will
now be accessible to all LGBT individuals and
families. Also, this rule does not provide a religious
exemption. It applies equally to all organizations that
operate HUD-assisted or HUD-insured housing
facilities, including religious organizations.
In 2014, the U.S. Department of Agriculture
(USDA) followed the lead of HUD and amended its
own existing nondiscrimination rule to add “gender
identity” as a prohibited basis for discrimination in
programs or activities it conducts, including low-
income housing and loan programs in rural areas.
The USDA nondiscrimination rule had already
included prohibitions against discrimination based on
sexual orientation and marital status. The rule covers
all USDA-conducted programs, which includes
crucial loan programs like those designed to help
low-income families buy and maintain homes in rural
communities.
The combined effect of the USDA rule and the
LGBT Equal Access Rule has been to prohibit
discrimination based on sexual orientation, gender
identity, and marital status in almost all public
housing services and programs in both metropolitan
and rural communities.
Advocates continue to work on federal protections
that explicitly prohibit anti-LGBT housing
discrimination because such protections are the only
way to ensure that discrimination against LGBTQ
individuals and their families is prohibited in all
housing situations. The recent changes in federal
regulations illustrate that it is sometimes possible to
target and address this type of discrimination without
legislative action. However, an amendment to the
FHA prohibiting discrimination based on sexual
orientation and gender identity would have a broader
and longer-lasting impact.
Maya Rupert
See also Nondiscrimination Protections, State and Local;
Senior Living Programs and Policies
Further Readings
Albelda, R., Badgett, M., Schneebaum, A., & Gates, G.
(2009, March). Poverty in the lesbian, gay, and bisexual
community. Los Angeles, CA: Williams Institute.
Retrieved November 8, 2015, from http://
williamsinstitute.law.ucla.edu/research/census-
lgbtdemographics-studies/poverty-in-the-lesbian-gay-
andbisexual-community/
Badgett, M., Lau, H., Sears, B., & Ho, D. (2007, June).
Bias in the workplace: Consistent evidence of sexual
orientation and gender identity discrimination. Los
Angeles, CA: Williams Institute. Retrieved November
8, 2015, from http://williamsinstitute.law.ucla.edu/
research/workplace/bias-in-the-workplace-consistent-
evidence-of-sexual-orientation-and-gender-
identitydiscrimination/
Center for American Progress. (2010, June 21). Gay and
transgender youth homelessness by the numbers.
Retrieved from http://americanprogress.org/issues/lgbt/
news/2010/06/21/7980/gay-and-transgender-
youthhomelessness-by-the-numbers/
Friedman, S., Reynolds, A., Scovill, S., Brassier, F.,
Campbell, R., & Ballou, M. (2013, May). An estimate
Human Rights Campaign (HRC)
of housing discrimination against same-sex couples.
Washington, DC: U.S. Department of Housing and Urban
Development, Office of Policy Development and
Research. Retrieved November 8, 2015, from
http://www.huduser.org/portal/publications/fairhsg/
discrim_samesex.html
Gates, G. (2012, Spring). Economic disadvantage in the
LGBT community. Management Information Exchange
Journal, 26(1). Retrieved from http:// baylegal.org/wp-
content/uploads/Providing-FamilyLaw-Services-to-
LGBT-clients.pdf
Grant, J., Mottet, L., & Tannis, J. (2011, January 1).
Injustice at every turn: A report of the National
Transgender Discrimination Survey. Retrieved March
4, 2015, from http://endtransdiscrimination.org/PDFs/
NTDS_Report.pdf
Quintana, N. (2009). Poverty in the LGBT community.
Washington, DC: Center for American Progress.
 Housing, Protection Against Discrimination in 1365
Retrieved November 8, 2015, from http://www fundraising dinners across the United States and in
.americanprogress.org/issues/lgbt/report/2009/ Washington, D.C.
07/01/6430/poverty-in-the-lgbt-community/ In 1985, the Human Rights Campaign Fund
Welfare Warriors Research Collaborative. (2010). A merged with the Gay Rights National Lobby.
fabulous attitude: Low-income lgbtgnc people Although outreach regarding political campaigns and
surviving and thriving in love, shelter and
candidates had always been a cornerstone of the
knowledge. Retrieved November 8, 2015, from
http://www.issuelab.org/resource/fabulous_ organization, its outreach efforts expanded in the
attitude_low_income_lgbtgnc_people_surviving_ mid-1980s to include a broader engagement of issues
and_thriving_on_love_shelter_and_knowledge_a that were of most interest to the LGBT community.
The spread of the AIDS epidemic ignited a critical
need for research and dissemination of news and
information to the broader community.
HRC The Human Rights Campaign Fund began
distributing a packet of information called a
MEDPAC, containing news reports and medical
See Human Rights Campaign (HRC) updates regarding HIV/AIDS, including clippings
from major newspapers, medical journals, and
magazines. MEDPACs laid the groundwork for the
future education and outreach efforts of the
HUMAN RIGHTS CAMPAIGN (HRC) organization involving health and aging, schools and
education, and family formation and protections.
In 1995, the Human Rights Campaign Fund
underwent significant changes. The name of the
The Human Rights Campaign (HRC) is the largest
organization was officially shortened to the Human
civil rights organization working to achieve equality
Rights Campaign, and the Human Rights Campaign
for lesbian, gay, bisexual, and transgender (LGBT)
Foundation was officially formed, reflecting then–
people in the United States. HRC represents more
Executive Director Elizabeth Birch’s sentiment that
than 1.5 million members and supporters nationwide.
“we are so much more than a fund.”
The mission of HRC is to create a world where
LGBT people are embraced as full members of
society at home, at work, and in every community.
HRC was originally founded as the Human Rights
Campaign Fund. Today, HRC is home to both a
political action arm and the Human Rights Campaign
Foundation, which operates as a taxexempt charitable
organization. Created in 1980, the Human Rights
Campaign Fund was the first political action
committee in the United States created specifically to
support pro-equality congressional candidates. The
Human Rights Campaign Fund raised money for and
contributed to the campaigns of candidates who were
likely to represent lesbian and gay civil rights in
congressional votes and among their colleagues in
Congress. It also engaged in education and outreach
to voters and to the LGBT community. The
organization held its first large fundraising dinner in
September 1982 in New York City. The dinner
featured former vice president, and presidential
hopeful, Walter Mondale. Today, HRC hosts annual
1366
In addition to these changes, the modern HRC logo—a
yellow equal sign on a blue background— was adopted.
In creating the new logo, HRC enlisted Stone
Yamashita, a design firm formerly associated with
Apple Computers. Of the 10 potential designs for the
logo, Elizabeth Birch was drawn to this simple, bold
design. The logo was an immediate success. The logo
has become an iconic symbol visible at pride
celebrations and other LGBT events. The HRC logo
can be spotted all over the world. It was also used as a
rallying cry around the March 2013 U.S. Supreme
Court hearing of arguments in two marriage equality
cases. HRC shared a red version of the logo on social
media, asking supporters to change their profile pictures
in a show of support. The campaign quickly went viral
among celebrities and everyday citizens who were
searching for a way to show their support for marriage
equality.
True to its original mission, HRC continues to
undertake significant federal advocacy work on issues
pertaining to the LGBT community and the federal
government. Working with every branch of the
government, HRC lobbies to ensure that LGBT issues
receive attention from federal officials. In this effort,
HRC lobbies for the passage of proequality legislation,
monitors the records of judicial nominees on LGBT
equality, and advocates for fair-minded regulatory
changes. Most recently, HRC worked in coalition to
lead the successful lobbying efforts surrounding the
passage of the Matthew Shepard and James L. Byrd
Hate Crimes Prevention Act and the repeal of the
discriminatory military policy known as Don’t Ask,
Don’t Tell. In addition to serving as the president of the
Matthew Shepard Foundation, Judy Shepard,
Matthew’s mother, worked closely with HRC
throughout the passage of the Hate Crimes Prevention
Act and continues to be an active volunteer and HRC
board member.
Today, the Human Rights Campaign Foundation
provides educational resources and publications
addressing issues impacting the daily lives of LGBT
people including health care and workplace equality.
During the 1999 restructuring, the Human Rights
Campaign Foundation also added two significant
programs—the Workplace Project and the
Human Rights Campaign (HRC)
Family Project, now known as the Children, Youth, and
Families Program.
The Workplace Project advances workplace equality
for LGBT employees. It provides not only advocacy but
also technical assistance and best practices on LGBT
workplace issues. The Workplace Project publishes the
Corporate Equality Index (CEI), an annual survey and
report benchmarking best practices in LGBT diversity
and inclusion among the nation’s largest corporations
and law firms. In addition to the CEI, the Workplace
Project publishes the HRC Buyer’s Guide, which is the
go-to resource for consumers looking to support top-
ranked CEI companies. The Buyer’s Guide is
distributed at gay pride celebrations and other events
nationwide every year.
The Children, Youth, and Families Program
recognizes the special challenges that LGBT youth and
same-sex parents may face. Specifically, the Children,
Youth, and Families Program operates the All Children
—All Families Project, which trains child welfare
professionals to improve agency policies and practices
around LGBT foster and adoptive families, as well as
LGBT children and youth. This program also operates
the Welcoming Schools Project, which offers
professional development and curricula for schools to
create learning environments that embrace family
diversity, avoid gender stereotyping, and end bullying.
Within the HRC Foundation, the Health and Aging
Program works to ensure that LGBT people receive fair
and equal treatment in hospitals, clinics, nursing homes,
and assisted living facilities. The program conducts
training for current and future care providers, and it
serves as a national advocate for LGBT health and
aging needs. The Health and Aging Program also
includes the Healthcare Equality Index (HEI), an annual
report detailing LGBT inclusion and equity in health
care facility policies across the country.
Robin Maril
See also Employment Non-Discrimination Act (ENDA);
Gay Exclusion in the U.S. Military: Evolution and
Demise of Don’t Ask Don’t Tell; Marriage Equality,
Landmark Court Decisions
Hypermasculinity
Further Readings
Chauncey, G. (2004). Why marriage? The history shaping
today’s debate over gay equality. New York, NY: Basic
Books.
Cornell University Library. (2006). 25 years of political
influence: The records of the Human Rights Campaign.

Retrieved February 28, 2015, from http://
rmc.library.cornell.edu/HRC/
Hirshman, L. (2012). Victory: the triumphant gay revolution.
New York, NY: HarperPerennial.
HYPERMASCULINITY
Hypermasculinity, a term used to describe the
exaggeration of behavior and identity elements
stereotypically associated with men, is both celebrated
and denigrated throughout Western culture. This entry
describes conformity to the more daring and dangerous
rules and roles associated with contemporary
masculinity. The entry identifies the important qualities
of hypermasculinity, discusses some of the factors that
influence this particular configuration of gender
practice and identity, and addresses some of the
associated consequences.
Masculinity as Enactment and Ideology
Although many people think of masculinity as
biologically determined (as, for instance, arising out of
our chromosomal, endocrinological, or brain
chemistry), there is actually a great deal more evidence
to suggest that masculinity is socially constructed.
When scholars say that masculinity is “socially
constructed,” they mean that masculinity is a concept
that is subject to great variation and that the form,
meaning, interpretation, and so forth are better
understood as consequences of the structure of the
societies in which they emerge than as a natural
outcome of the bodies with which they are enacted.
Masculinity is best understood as socially
constructed in part because of the enormous variation in
what different societies and cultures understand as
“masculine” in the first place. In some societies,
strength, dominance, authority, violence, and the like
are understood to be qualities associated with men. But
in others, whether or not men are strong, dominant,
authoritarian, or violent is not something people
understand as associated with their gender. Masculinity
has also varied over time. How people understand and
experience masculinity changes over the life course as
well. All of this helps illustrate that masculinity is not
the stable “thing” that we often suppose it to be.
1367
Scholars studying masculinity understand it to be
two things at once: a performance and an ideology. To
say that masculinity is a performance means that it is
enacted; we demonstrate masculinity by “doing”
masculinity. This perspective is at odds with a
biologically deterministic perspective
precisely because masculinity is not here seen as
something that men either “are” or “have,” but rather,
as something people must demonstrate by “doing” (or
failing to do). Beyond this, however, masculinity also
operates ideologically. An ideology refers to a set of
ideas that are widely shared by members of a society,
that shape identities and behaviors, and that become
embedded in social institutions. To call masculinity an
ideology is to say that it is part of a shared body of
gendered ideas and meanings societies collectively
construct. This means that masculinity can be
understood as simultaneously the product and the
producer of an ideology of masculinity.
Hypermasculinity refers to an exaggerated conformity
to behavior and identity rituals and practices
stereotypically associated with contemporary
masculinity.
From Masculinity to Masculinities
Aside from masculinity being socially constructed,
scholars of masculinity also recognize that it is better
understood when pluralized—masculinities. Most
people conjure up a fairly specific picture in their minds
when asked about masculinity. However, it is equally
true that most men fail to live up to this image in some
way, in part because the qualities that comprise our
culturally idealized “masculinity” would be difficult to
come across in a single individual: hardworking,
playboy, devoted father, professionally successful,
incredibly athletic, with a high tolerance for alcohol,
and so on. Living up to all of these things at the same
time is impossible. Yet, collectively, this constellation
of practices and traits works in ways that justify and
naturalize gender inequality. By virtue of being men, all
men have some claim to masculinity, but some are
more marginalized or subordinated than others.
Hypermasculinity is best understood as a strategy
associated with groups of men who easily approximate
masculine identities and ideals (e.g., tall, heavily
muscled, athletic, wealthy) as well as a compensatory
strategy for men who fail to live up to idealized
configurations of masculinity. Thus, some
hypermasculine displays are best understood as
1368
strategies undertaken by men who lack masculine status
associated with key facets of their gender identity.
Testosterone as Causal?
While testosterone is popularly understood as the
“masculine” hormone and blamed for all manner of
men’s misbehavior, research on whether testosterone
can be understood as causally linked to hypermasculine
displays challenges this perspective. For instance,
heightened levels of testosterone are often popularly
claimed to cause violent behavior. We know that
violence and testosterone are correlated with each other
(e.g., more violent men also often have higher levels of
testosterone). This fact has caused some to claim that
certain hypermasculine displays (such as violent
behavior) are the result of endocrinology. However,
there are really three ways of making sense of the
correlation we know exists: (1) It could be that
testosterone and aggression are not actually
meaningfully related to one another. (2) If they are
related, testosterone may play a crucial role in elevated
aggression. (3) It is also possible that aggressive
behavior might actually elevate levels of testosterone
secretion. While there is considerable cultural bias
toward number 2 (the notion that testosterone produces
aggression), scientific evidence overwhelmingly
supports number 3 (aggression produces higher levels
of testosterone in the body).
This is a significant finding for a variety of reasons,
but chief among them is that while hypermasculinity
may be manifested physiologically, the best science
understands hypermasculinity as a cultural phenomenon
with physiological consequences (rather than the other
way around). Just
Hypermasculinity
by way of example, it is also true that playing a central
role in the caretaking and nurturing of their children has
the effect of lowering levels of testosterone in men (and
in women). So this does not mean that men with lower
levels of testosterone are more likely to nurture. Rather,
the evidence suggests that it is the act of nurturing and
caring for others that decreases testosterone secretion.
These are significant findings because they support the
twin findings on hypermasculinity that it is a cultural
phenomenon and that, as such, it is subject to change
(i.e., hypermasculinity is not inevitable).
Hypermasculinity as Culturally Normative
Rather Than Deviant
It is important to understand hypermasculinity as an
exaggeration of behavior and identity elements
otherwise normatively assigned to boys and men.
Hypermasculinity is simultaneously culturally idealized
and denigrated. Thus, media portrayals of culturally
idealized forms of masculinity often depict men as
heavily muscled, violent, physically powerful, and
emotionally stoic. However, men are also popularly
teased for conforming too closely (or too much) with
any of these ideals. Terms like “workaholic,”
“meathead,” “hothead,” and the like are testament to the
fact that hypermasculinity is best understood as an
exaggeration of culturally normative behavior. We
expect men to work (but not too much)‚ we expect men
to be strong (but not too strong), and we expect men to
be capable of violence (but not to be violent too often).
It’s these sets of cultural contradictions surrounding
masculinity that create difficulty for some boys and
men. Hypermasculinity is one attempt to acquire status
as “masculine.”
Hypermasculinity Among LGBTQ Populations
Hypermasculinity is also often assumed to be a
heterosexual configuration of practice. However, these
sorts of gendered exaggerations exist among groups of
gay men and some rural configurations of lesbian
identities as well. Gay identities among men are
sometimes culturally situated as at odds with
Hypermasculinity
normative conceptualizations of masculinity. Thus, it is
logical that some gay men will rely on
hypermasculinity to acquire a status symbolically
denied to gay men as a result of sexual inequality.
Indeed, subcultures of gay men sometimes form around
hypermasculine stereotypes, such as the emergence of
the “gay clone” in the 1970s and 1980s, or, more
contemporarily, “bear culture.” Much has been made of
the meanings of the hyperconformity to gendered
norms associated with these groups. Research has
documented that the motivations to participate in
hypermasculine displays may be somewhat different for
gay men. For instance, hypermasculinity among gay
men may be simultaneously a strategy of gender
conformity as well as a strategy that might work to
ensure individual men’s safety. Thus, hypermasculinity

among gay men emerges as a result of a different set of
concerns.
Components and Consequences of
Hypermasculinity
Hypermasculinity has been studied as being composed
of three separate components: (1) insensitive sexual
attitudes and behavior toward women (and sometimes
men), (2) the belief that violence is masculine, and (3)
experiencing danger and daring behavior as exciting.
These beliefs and behaviors harm both men and women
—physically and psychologically. Men are harmed by
other men’s hypermasculine displays, as are women.
However, hypermasculinity also shapes understandings
and expectations of men. So both men and women
sometimes seek out protection from men who display
hypermasculine traits. In this way, people sometimes
favor some hypermasculine traits out of fear of others.
According to some researchers, hypermasculinity harms
men’s health, shortens men’s lives, causes them to
resist emotionally close relationships with others, and
more. These behaviors have been shown to be
responses to cultural pressures associated with gender
ideals.
Tristan Bridges
1369
Levine, M. (1998). Gay macho: The life and death of the
homosexual clone. New York, NY: New York University
Press.
Messerschmidt, J. W. (2000). Becoming “real men”:
Adolescent masculinity challenges and sexual violence.
Men and Masculinities, 2, 286–307.
Munsch, C. L., & Willer, R. (2012). The role of gender
identity threat in perceptions of date rape and sexual
coercion. Violence Against Women, 18, 1125–1146.
Sabo, D. (2001). Masculinities and men’s health: Moving
toward post-Superman era prevention. In M. S.
Kimmel & M. A. Messner (Eds.), Men’s lives (5th
ed., pp. 285–298). Needham Heights, MA: Allyn &
Bacon.
Sapolsky, R. M. (1997). Testosterone rules. In M. S. Kimmel
& A. Aronson (Eds.), The gendered society reader (3rd
ed., pp. 26–31). New York, NY: Oxford University Press.
Scheff, T. (2006). Hypermasculinity and violence as a social
system. Universitas, 2, 1–10.
Schrock, D., & Schwalbe, M. (2009). Men, masculinity, and
manhood acts. Annual Review of Sociology, 35, 277–295.
Willer, R., Rogalin, C., Conlon, B., & Wofnowicz, M.
(2013). Overdoing gender: A test of the masculine
overcompensation thesis. American Journal of
Sociology, 118, 980–1022.

See also Bullying, Rates and Effects of; Hate Crimes;

Masculinities; Masculinity Stereotypes; Policing
Masculinities and Femininities; Sissyboy Experience;
Violence and Victimization of Youth
Further Readings
Booth, A., Granger, D., Mazur, A., & Kivlighan, K. T.
(2006). Testosterone and social behavior. Social Forces,
85, 167–191.
Byrnes, J., Miller, D., & Shafer, W. (1999). Gender differences
in risk taking: A meta-analysis.
Psychological Bulletin, 125, 367–383.
Connell, R. (2008). A very straight gay? Masculinity,
homosexual experience, and the dynamics of gender.
American Sociological Review, 57, 735–751.
Courtenay, W. (2000). Constructions of masculinity and their
influence on men’s well-being: A theory of gender and
health. Social Science & Medicine, 50, 1385–1407.
Hennen, P. (2005). Bear bodies, bear masculinity:
Recuperation, resistance, or retreat? Gender &
Society, 19, 25–43.
Kimmel, M. S., & Mahler, M. (2003). Adolescent
masculinity, homophobia, and violence: Random school
shootings, 1982–2001. American Behavioral Scientist, 46,
1439–1458.
I v
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1380

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 1381

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1382

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 1383

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1384

l an
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 1385

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1386

mi e
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an ly
d re
be un
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 1387

in ati
sta on
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mi di
gr es
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co se
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ha e
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re po
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1388

am al
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 1389

a e
nu m
m po
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r y
of L
co G
un B
tri T
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ha im
ve mi
fac gr
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1390

l un
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 1391

tw lo
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im BT
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1392

ns
to
sp
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th
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th
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at
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re
an,
co
ga
gn
y,
iz
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e
ex
th
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an
mi
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rig
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 1393

m erl
e- an
se ds
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co N
up e
les w
ar Ze
e al
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ral N
ia, or
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m, Po
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Ca So
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nl S
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Fr en
an ,
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1394

m. up
To les
da ,
te, alt
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U h
nit th
ed e
St gr
ate o
s wi
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lic arr
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pl in
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e nu
th m
at be
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ize S.
th sta
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of m
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m th
e- e
se Su
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co e
 1395

m er
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Co fo
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m gr
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in H
Ju ist
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15 ly,
, w
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sa 32
m U.
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1396

clu le
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M ha
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set im
ts, pa
Ve ct
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for to
a th
nu e
m 19
be 96
r De
of fe
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ma M
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pe Ac
rfo t
rm (D
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wi M
thi A)
n .
the D
se O
sta M
tes A
fai de
 1397

fin di
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ma du
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ag sta
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for to
fe dis
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pu rd
rp sa
os m
es e-
as se
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leg un
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on ot
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ma r
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on As
e a
wo res
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as e
hu to
sb th
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d rel
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1398

usi d
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nt en
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 1399

es e
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do m
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1400

” m
for mi
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pu int
rp im
os at
es e
of rel
th ati
e on
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mi ip
gr wi
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on an
an ad
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Na U.
tio S.
na cit
lit iz
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(I ga
N l
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as rm
an an
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pe t
rs re
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18 de
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of w
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or bo
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de pa
r rti
w es
ho int
is en
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a a
co “li
 1401

fel us
on t
g be
co “fi
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U er
A de
F pe
A nd
als en
o t”
sti wi
pu th
lat hi
es s
th or
at he
th r
e pa
no rtn
n– er,
U. no
S. t
cit m
ize arr
n ie
in d
an or
y in
les a
bi pe
an rm
or an
ga en
y t
bi pa
na rtn
tio er
na sh
l ip
rel wi
ati th
on an
shi yo
p ne
m ot
1402

he A
r F
th A
an ha
th s
at sti
pe ll
rs no
on t
, be
an en
d si
un gn
ab ed
le int
to o
co la
ntr w,
act th
wi e
th Su
th pr
at e
pe m
rs e
on C
a ou
m rt’
arr s
ia le
ge ga
th liz
at ati
is on
re of
co sa
gn m
ize e-
d se
un x
de m
r arr
th ia
e ge
IN in
A. 20
W 15
hil m
e ea
U ns
 1403

th en
at cy
de ar
po e
rta be
tio in
n g
or m
de ad
rs e
ag on
ai a
nst ca
bi se
na -
tio by
na -
l ca
sa se
m ba
es sis
ex .
co I
up n
les th
in os
th e
e co
U un
nit tri
ed es
St th
ate at
s do
ha gr
ve an
be t
en im
ha mi
lte gr
d, ati
an on
d rig
pe hts
titi for
on bi
s na
for tio
res na
id l
1404

L to
G id
B eal
T ize
Q d
co no
up tio
les ns
, of
the he
qu ter
eer os
co ex
up ua
les l
in m
qu arr
est ia
io ge
n .
are Fo
fre r
qu ex
ent a
ly m
su pl
bje e,
cte th
d e
to Ga
sur y
vei an
lla d
nc Le
e sbi
on an
the Im
ba mi
sis gr
of an
ho t
w Ta
we sk
ll Fo
the rc
y e
co in
nf A
or ust
m ral
 1405

ia im
“s mi
cre gr
en ati
s” on
ap rig
pli hts
ca for
nts sa
for m
the e-
ir se
co x
m co
mi up
tm les
ent ar
to e
m si
on mi
og lar
am ly
y lin
an ke
d d
“lo to
ok a
- cla
ali ss-
ke an
” d
het ra
er ce
os -
ex ba
ual se
rel d
ati ec
on on
shi o
ps. mi
In c
the m
Un od
ite el
d of
Ki se
ng xu
do al
m, id
1406

ent bi
ity na
go tio
ve na
rn l
ed L
by G
ne B
oli T
be Q
ral co
ma up
rk les
et sti
pri ll
nci do
ple no
s. t
M off
or er
eo an
ve y
r, le
ma ga
ny l
of ad
the vi
im ce
mi to
gr tra
ant ns
rig ge
hts nd
or er
ga in
niz di
ati vi
on du
s als
tha in
t bi
ad na
vo tio
cat na
e l
on rel
be ati
hal on
f shi
of ps.
 1407

Tno
he t
ca co
m nf
pai or
gn m
s to
to ne
inc oli
lu be
de ral
sa ,
me ho
- m
se on
x or
co m
up ati
les ve
wi id
thi eal
n s
cu of
rre fa
nt mi
fa ly
mi an
ly d
re do
un m
ifi est
cat ici
io ty,
n ye
po t
lic ne
ies oli
dis be
av ral
ow gl
qu ob
eer al
im an
mi d
gr ec
ant on
s o
wh mi
o c
do po
1408

lic L
ies G
ar B
gu T
abl Q
y im
ma mi
ke gr
it ati
all on
bu po
t lic
im ies
po to
ssi ac
ble co
for un
po t
or for
or in
leg di
all vi
y du
vu als
lne w
ra ho
ble ar
qu e
eer un
mi ab
gr le
ant to
s pr
to ov
ass id
im e
ila ad
te eq
to ua
su te
ch fin
no an
rm cia
s. l
Th su
e pp
fai ort
lur for
e th
of eir
 1409

for Q
eig im
n mi
pa gr
rtn an
er ts
th in
us a
pe rel
rp ati
etu on
ate shi
s p
exi wi
sti th
ng a
ine cit
qu ize
ali n
tie of
s an
alo ot
ng he
the r
lin co
es un
of try
rac ar
e, e
cla for
ss, ce
ge d
nd to
er, re
an m
d ai
nat n
io un
n. do
As cu
a m
res en
ult te
, d.
ma U
ny p
L un
G til
B its
T re
1410

pe ve
al qu
in ee
20 r
08, mi
the gr
off an
ici ts
al w
ba ho
n de
on sir
ad ed
mi to
tti be
ng re
HI un
Vp ite
osi d
tiv wi
e th
im th
mi eir
gr A
ant m
s eri
to ca
the n
Un pa
ite rtn
d ers
St .
ate
s
led
to
sig
nif
ica
nt
ch
all
en
ge
s
for
HI
V-
po
siti
 1411

LG on
BT is
Q th
at
Re
of
fu
ref
ge ug
e ee
an an
d d
As as
yl yl
u
u
m
m
cl
Cl ai
ai m
m s.
s Si
nc
An
e
ot
th
he
e
r
U
ar
nit
ea
ed
in
N
w
ati
hi
on
ch
s
L
Re
G
fu
B
ge
T
e
Q
A
in
ge
di
nc
vi
y
du
pu
als
bli
ar
sh
e
ed
eli
its
gi
of
bl
fic
e
ial
for
gu
mi
id
gr
eli
ati
ne
1412

s ng
on m
cla an
im ua
s ls
rel fo
ati r
ng th
to e
se ad
xu ju
al di
ori ca
en tio
tat n
io of
n les
an bi
d an
ge ,
nd ga
er y,
id bi
en se
tit xu
y al,
in tra
20 ns
08 ge
, a nd
nu er,
m an
be d
r int
of er
co se
un x
tri as
es yl
ha u
ve m
int ca
ro se
du s.
ce H
d o
ne w
w ev
tra er,
ini alt
 1413

ho e
ug 19
h 90
se s,
xu no
al t
ori all
en co
tat urt
io s
n ac
an ce
d pt
ge se
nd xu
er ali
id ty
en or
tit ge
y nd
ha er
ve id
be en
en tit
re y
co as
gn m
ize ee
d tin
as g
gr th
ou e
nd qu
s ali
for fic
po ati
liti on
cal s
as of
yl m
u e
m m
sin be
ce rs
th hi
e p
mi in
d- a
to pa
lat rti
1414

cu liti
lar cal
so as
cia yl
l u
gr m
ou ap
p. pli
In ca
de nts
ed, ,
a L
nu G
m B
be T
r Q
of ref
ch ug
all ee
en s
ge m
s ust
to pr
L ov
G e
B bo
T th
Q th
ref at
ug th
ee ey
an ha
d ve
as a
yl “w
u ell
m fo
cla un
im de
s d
sti fe
ll ar
re of
m pe
ai rse
n. cu
Ltio
ike n”
all an
po d
 1415

tha on
t of
the a
y ref
are ug
me ee:
m
be A
rs n
of y
a
pa p
rti e
cul r
ar s
so o
cia n
l
gr w
ou h
p. o
Ar
tic .
le
1 .
of
the
.
19
51
o
Re
w
fu
i
ge
n
e
g
Co
nv
t
ent
o
io
n
w
pr
e
ov
l
ide
l
s
-
the
f
fol
o
lo
u
wi
n
ng
d
de
e
fin
d
iti
1416

i
f g
e i
a o
r n
,
o
f n
a
b t
e i
i o
n n
g a
l
p i
e t
r y
s ,
e
c m
u e
t m
e b
d e
r
f s
o h
r i
p
r
e o
a f
s
o a
n
s p
a
o r
f t
i
r c
a u
c l
e a
, r

r s
e o
l c
 1417

i n
a t
l r
y
g
r o
o f
u
p h
i
o s
r
n
p a
o t
l i
i o
t n
i a
c l
a i
l t
y
o
p a
i n
n d
i
o i
n s
,
u
i n
s a
b
o l
u e
t
s o
i r
d ,
e
o
t w
h i
e n
g
c
o t
u o
1418

r
s o
u t
c e
h c
t
f i
e o
a n
r
, o
f
i
s t
h
u a
n t
w
i c
l o
l u
i n
n t
g r
y
t ;
o
o
a r
v
a w
i h
l o
,
h
i n
m o
s t
e
l h
f a
v
o i
f n
g
t
h a
e
n
p a
 1419

t f
i o
o r
n m
a e
l r
i
t h
y a
b
Immigration
i
t
a u
n a
d l

b r
e e
i s
n i
g d
e
n
o
c
u
e
t
s
i a
d s
e
a
t
h r
e e
s
c u
o l
u t
n
t o
r f
y
s
o u
f c
h
h
i e
s v
e
n
1420

t
s t
, o

i r
s e
t
u u
n r
a n
b
l t
e o

o i
r t
, .

o [
w e
i m
n p
g h
a
t s
o i
s
s
u a
c d
h d
e
f d
e ]
a
r T
, he
pri
im
s ar
y
uch
nall
wen
i ge
l to
lL
iG
nB
g
 1421

T ou
Q s,
as an
yl d
u po
m liti
cla cal
im pe
s rse
lie cu
s tio
in n,
the an
fac d
t th
tha e
t cat
the eg
19 or
51 y
Re “p
fu art
ge ic
e ul
Co ar
nv so
ent cia
io l
n gr
wa ou
s p”
de in
sig cl
ne ud
d ed
to ne
pr ith
ote er
ct w
in o
di m
vi en
du no
als r
fro in
m di
rac vi
ial, du
rel als
igi pe
1422

rse eg
cut or
ed y
for “
the m
ir e
se m
xu be
al rs
ori hi
ent p
ati of
on a
or pa
ge rti
nd cu
er lar
ide so
nti cia
ty. l
Al gr
th ou
ou p”
gh sin
se ce
xu th
al e
ori mi
ent d-
ati to
on lat
an e
d 19
ge 90
nd s,
er it
ide is
nti sti
ty ll
ha th
ve e
be ca
en se
inc th
lu at
de th
d e
in cl
the os
cat er
 1423

on is
e’s to
ap be
pli ab
cat le
io to
n ob
co tai
nf n
or as
ms yl
to u
the m.
tra Th
dit is
io te
nal nd
m s
od to
el be
of ne
the fit
ma th
le os
act e
ivi qu
st ee
fle r
ein ref
g ug
an ee
op s
pr (m
ess ost
ive no
po ta
liti bl
cal y,
re ga
gi y
me m
, en
the )
m w
or ho
e se
lik ex
ely pe
on rie
e nc
1424

es on
fit e’s
pa id
rti en
cul tit
ar y
ge in
nd th
ere e
d pu
an bli
d c
cla sp
ss- he
ba re
se an
d d
un be
de in
rst g
an tar
di ge
ng te
s d
of by
wh sta
at te
it ag
me en
an ts
s for
to pu
be bli
a c
po dis
liti pl
cal ay
ref s
ug of
ee, th
su at
ch id
as en
bei tit
ng y.
“o L
ut” es
ab bi
ou an
t an
 1425

d th
bis os
ex e
ual of
wo ga
me y
n’s m
wa en
ys ,
of an
dis d
pla fre
yi qu
ng en
se tly
xu fai
ali l
ty to
an co
d nf
ot or
he m
r to
ex im
pe mi
rie gr
nc ati
es, on
inc off
lu ici
di als
ng ’
for pr
ms ec
of on
pe ce
rse pti
cut on
io s
n, an
are d
oft ex
en pe
qu cta
ite tio
dif ns.
fer As
ent a
tha res
n ult
1426

, les
wo bi
me an
n’s as
an yl
d u
les m
bia ca
ns’ se
cla s,
im co
s urt
for s
as ty
yl pi
u cal
m ly
are dis
oft re
en ga
dis rd
mi th
sse e
d int
as err
ins ela
uff tio
ici n
ent of
ly ge
me nd
eti er
ng an
the d
Re se
fu xu
ge al
e id
Co en
nv tit
ent y
io in
n na
re rra
qu tiv
ire es
me of
nts les
. bi
In an
 1427

pe st
rse les
cut bi
io an
n. s
M in
or co
eo un
ve try
r, -
co of-
urt ori
s gi
stil n
l re
ha po
ve rts
a wi
ten th
de an
nc ab
y se
to nc
eq e
uat of
e pe
the rse
lac cu
k tio
of n.
do Th
cu e
me res
nte ult
d is
evi th
de at
nc it
e is
of oft
hu en
ma dif
n fic
rig ult
hts for
ab les
us bi
es an
ag s
ain to
1428

pr th
od ey
uc ca
e n
su ret
cc ur
ess n
ful to
as th
yl eir
u co
m un
cla tri
im es
s of
wh ori
en gi
the n
ir an
ex d
pe be
rie “d
nc isc
es re
are et”
pe ab
rce ou
ive t
d th
by eir
ju se
dg xu
es al
to ori
be en
“to tat
o io
pri n.
vat W
e,” hil
the e
ass a
u nu
m m
pti be
on r
bei of
ng co
tha un
t tri
 1429

es rej
(fo ec
r te
ex d
a th
m e
pl “d
e, isc
th ret
e io
Un n”
ite re
d qu
Ki ire
ng m
do en
m, t,
th or
e th
Ne e
th no
erl tio
an n
ds, th
th at
e L
Cz G
ec B
h T
Q
Imm
as
igrat
ion
yl
u
Re m
pu ap
bli pli
c, ca
an nt
d s
A ca
ust n
ral ret
ia) ur
ha n
ve to
re th
ce eir
ntl co
y un
try
1430

of yl
ori u
gi m
n cl
an ai
d m
be s
“d ar
isc e
re no
et” w
ab be
ou in
t g
th ref
eir us
se ed
xu on
al th
ori e
en gr
tat ou
io nd
n s
or th
ge at
nd th
er e
id ap
en pli
tit ca
y, nt’
a s
gr cl
o ai
wi m
ng ed
nu se
m xu
be al
r ori
of en
les tat
bi io
an n
an is
d di
ga sb
y eli
as ev
 1431

ed. of
Th fic
is ial
is s
lar oft
ge en
ly rel
du y
e up
to on
th ste
e re
fa ot
ct yp
th ic
at al
in as
as su
se m
ssi pti
ng on
th s
e an
cr d
ed ex
ibi pe
lit ct
y ati
of on
a s.
po Fo
liti r
cal ex
as a
yl m
u pl
m e,
ap as
pli yl
ca u
nt’ m
s ad
cla ju
im di
, ca
im tor
mi s
gr te
ati nd
on to
1432

as m
su m
m on
e so
th ci
at al
all gr
les ou
bi p
an wi
s th
an sh
d ar
ga ed
y cu
m ltu
en ral
en tas
ga tes
ge an
in d
pr so
act ci
ice al
s sp
of ac
cr es,
os an
s- d
ge th
nd at
er th
id ey
en wi
tifi ll
cat all
io co
n, m
th e
at ou
th t
ey as
all ga
for y
m or
pa les
rt bi
of an
a im
co m
 1433

ed ibl
iat e
el id
y en
up tit
on y
arr in
iv th
al e
in co
th un
e try
re to
cei w
vi hi
ng ch
co th
un ey
try mi
. gr
U at
nli e,
ke les
ot bi
he an
r an
ref d
ug ga
ee y
cla as
im yl
an u
ts m
w ap
ho pli
ar ca
e nt
no s
t ar
co e
m ex
pe pe
lle ct
d ed
to to
pe co
rfo nf
rm or
a m
vis to
1434

W in
est th
er e
n pu
ste bli
re c
ot sp
yp he
es re
ab in
ou or
t de
m r
ale to
ho be
m co
os ns
ex id
ua er
l ed
be w
ha ort
vi hy
or ca
gr nd
ou id
nd at
ed es
in fo
vis r
ibi as
lit yl
y u
po m.
liti T
cs, he
co ki
ns nd
u s
m of
pti ra
on cia
, liz
an ed
d ,
an cla
id ss
en ed
tit ,
y an
 1435

d s
ge to
nd les
ere bi
d an
ste as
re yl
ot u
yp m
es ap
of pli
ma ca
le nts
ho .
m Al
os th
ex ou
ual gh
be th
ha e
vi dis
or cr
ty eti
pic on
all re
y qu
in ire
vo m
ke en
d t
by is
as no
yl lo
u ng
m er
adj ex
ud pli
ica cit
tor ly
s sta
po te
se d
sig in
nif m
ica ost
nt co
ch un
all tri
en es’
ge as
1436

yl f
u pl
m ac
po ed
lic on
ies les
, it bi
re an
ma as
ins yl
im u
pli m
cit ap
in pli
the ca
tre nts
at to
me m
nt ak
of e
les th
bia eir
n se
as xu
yl al
u ori
m en
ca tat
ses io
an n
d vis
is ibl
evi e.
de Th
nt e
in pr
ter ob
ms le
of ms
the of
inc cla
rea im
sin in
g g
bu as
rd yl
en u
of m
pr ar
oo e
 1437

oft qu
en en
co tly
m di
po sb
un eli
de ev
d ed
for ,
les es
bia pe
n ci
an all
d y
bis if
ex th
ual ey
wo ha
me ve
n, ch
wh ild
o re
ma n
y or
be ha
as ve
ke be
d en
to m
“p arr
ro ie
ve d.
” Fo
th r
eir w
se o
xu m
al en
ori w
en ho
tat pe
io rc
n ei
an ve
d th
w eir
ho se
ar xu
e ali
fre ty
1438

as u
a m
pri pr
va oc
te es
an s
d is
de an
ep in
ly cr
int ed
im ibl
ate y
as ch
pe all
ct en
of gi
th ng
eir ex
liv pe
es, rie
pr nc
ov e.
in R
g ec
th en
eir t
se w
xu or
al k
ori on
en L
tat G
io B
n T
in Q
th as
e yl
co u
nt m
ex cla
t im
of s
th in
e Eu
po ro
liti pe
cal an
as d
yl Ca
 1439

na on
da s
ha ab
s ou
sh t
ow ge
n nd
tha er
t an
bis d
ex se
ual xu
an ali
d ty
tra in
ns th
ge e
nd po
er liti
ide cal
nti as
tie yl
s u
ten m
d pr
to oc
be es
si s.
mi W
lar hil
ly e
ju tra
dg ns
ed ge
in nd
rel er
ati an
on d
to int
het ers
er ex
on id
or en
ma titi
tiv es
e ar
ass e
u co
m m
pti m
1440

on ed
ly to
mi be
su un
nd w
ers ort
to hy
od of
by pr
im ot
mi ect
gr io
ati n
on be
off ca
ici us
als e
an of
d th
co e
nfl he
ate ter
d on
wi or
th m
se ati
xu ve
al as
ori su
ent m
ati pti
on, on
bis th
ex at
ual it
as is
yl po
u ssi
m bl
ap e
pli for
ca th
nts e
are m
fre to
qu ret
ent ur
ly n
de to
em th
 1441

eir cla
co im
un s
try in
of th
ori e
gi sc
n ho
an lar
d shi
ass p
u on
me po
a liti
het cal
er as
os yl
ex u
ual m,
ori wi
ent th
ati th
on. e
Tex
he ce
re pti
ha on
s of
be lit
en er
a at
no ur
tab e
le fo
lac cu
k sin
of g
att on
ent th
io e
n U
to nit
tra ed
ns St
ge ate
nd s.
er H
ref o
ug we
ee ve
1442

r, ap
tra s
ns du
ge e
nd to
er th
as e
yl pri
u vil
m eg
cla in
im g
s of
are vis
rel ua
ati l
vel m
y ar
su ke
cc rs
ess of
ful dif
in fer
ter en
ms ce
of an
est d
abl ge
ish nd
in er
g pe
cre rfo
di rm
bil an
ity ce
re wi
ga thi
rdi n
ng th
ge e
nd po
er liti
ide cal
nti as
ty. yl
Th u
is m
is pr
pe oc
rh es
 1443

s, su
as cc
we es
ll sf
as ul
to in
the est
mi ab
no lis
rit hi
y ng
sta cr
tus ed
of ibi
tra lit
ns y
ge th
nd an
er ga
ap y
pli an
ca d
nts les
. bi
Ho an
we as
ve yl
r, u
wh m
ile se
tra ek
ns ers
ge ,
nd th
er e
as re
yl as
u on
m in
ap g
pli be
ca hi
nts nd
ten thi
d s
to su
be cc
m es
or s
e is
1444

oft er
en id
the en
res tit
ult y.
of Th
a is
mi fre
su qu
nd en
ers tly
tan res
di ult
ng s
on in
the tra
pa ns
rt ge
of nd
im er
mi cla
gr im
ati s
on be
off in
ici g
als tre
ab ate
ou d
t as
the a
dif “s
fer ub
en set
ce ”
s of
bet se
we xu
en al
se ori
xu en
al tat
ori io
ent n
ati cla
on im
an s,
d lea
ge di
nd ng
 1445

to cle
ina ar
pp ne
ro ed
pri to
ate est
ap ab
pli lis
cat h
io tra
ns ns
of ge
co nd
un er
try as
- yl
of- u
ori m
gi cla
n im
re s
po as
rts a
in se
do pa
cu rat
me e
nti id
ng en
tra tit
ns y
ge cat
nd eg
er or
pe y
rse fro
cut m
io se
n. xu
Fo al
r ori
thi en
s tat
rea io
so n–
n, ba
the se
re d
is as
a yl
1446

u on
m ch
cla all
im en
s ge
wi s
thi to
n fa
ref mi
ug ly
ee re
la un
w. ifi
ca
tio
So n
m fo
e r
A bi
dd na
iti tio
na
o
l
na L
l G
Po B
in T
ts Q
of co
Co up
les
ns
,
id
co
er m
a bi
ti ne
o d
n wi
th
Th th
e e
co ob
nti sta
nu cl
in es
g to
im su
mi cc
gr es
ati sf
 1447

ul or
L e
G w
B or
T k
Q is
as ne
yl ed
u ed
m th
cla at
im att
s, en
m ds
ea to
ns th
th e
at su
m bj
an ec
y t
qu of
ee un
r do
im cu
mi m
gr en
an te
ts d
ch qu
oo ee
se r
to im
re mi
m gr
ai an
n t
un po
do pu
cu lat
m io
en ns
te .
d. M
A or
gr e
eat re
de se
al ar
m ch
1448

is ns
als ,
o th
ne e
ed Gl
ed ob
th al
at So
ex ut
a h
mi is
ne ho
s st
th to
e th
ch e
all va
en st
ge m
s aj
to ori
L ty
G of
B th
T e
Q w
mi orl
gr d’
ati s
on qu
in ee
th r
e ref
Gl ug
ob ee
al s,
So m
ut an
h. y
As of
wi w
th ho
all m
ref do
ug no
ee t
po ha
pu ve
lat th
io e
 1449

res ref
ou ug
rc ee
es s
ne in
ed th
ed e
to Gl
se ob
ek al
or So
be ut
gr h
an co
te nti
d nu
po e
liti to
cal ex
as pe
yl rie
u nc
m e
an vi
d ol
ar en
e ce
co as
m a
pe re
lle sp
d on
to se
re to
m th
ai eir
n vi
un si
do bil
cu ity
m an
en d
te do
d. no
M t
an ha
y ve
qu th
ee e
r ne
1450

tw e
or cl
ks ai
th m
at to
w as
ou yl
ld u
est m.
ab In
lis ste
h ad
th of
eir ev
pa id
rti en
ci ce
pa of
tio th
n eir
in pu
a bli
“p c
art pe
ic rf
ul or
ar m
so an
cia ce
l s
gr of
ou th
p” eir
th se
at xu
is ali
ne ty,
ce th
ss ey
ar re
y po
for rt
pr th
od e
uc op
in po
ga sit
cr e,
ed eff
ibl ort
 1451

s oo
to se
co to
nc se
eal ek
th po
eir liti
se ca
xu l
ali as
ty yl
or u
ge m.
nd In
er de
id ed
en ,
tit th
y e
as ca
a te
m go
att rie
er s
of ar
saf e
et th
y. e
Th m
is sel
po ve
se s
s pr
ser ob
io le
us m
ch ati
all c
en fo
ge r
s m
if an
an y
d as
w yl
he u
n m
th se
ey ek
ch er
1452

s H
w o
ho w
se ev
ex er,
pe th
rie e
nc sc
es ho
as lar
se sh
xu ip
al on
an L
d G
ge B
nd T
er Q
mi mi
no gr
riti ati
es on
do ha
no s
t no
al t,
wa fo
ys r
m th
atc e
h m
th os
e t
pr pa
ec rt,
on sit
ce ua
pti te
on d
s th
of e
im ch
mi all
gr en
ati ge
on s
off to
ici L
als G
. B
 1453

T tiv
Q es.
im It
mi is
gr th
ati us
on es
in se
rel nti
ati al
on th
to at
hu fut
m ur
an e
rig re
hts se
an ar
d ch
th on
e L
ch G
all B
en T
ge Q
s im
of mi
tra gr
nsl ati
ati on
ng co
gl nti
ob nu
al es
se to
xu co
ali nn
tie ec
s t
int th
o e
po st
liti ud
cal y
as of
yl qu
u ee
m r
na mi
rra gr
1454

ati io
on nal
Sa
to
me
th -
e Se
qu x
est Co
io up
n les
an
of
d
w Fa
ha mi
t it lie
m s;
ea De
ns fe
to ns
thi e
of
nk
M
of arr
se ia
xu ge
ali Ac
ty t
gl (D
ob O
M
all
A)
y ;
an He
d ter
tra on
ns or
na m
tio ati
vit
na
y;
lly
H
. o
m
Ra
o
ch n
el o
Le r
wi m
s a
t
Se i
e v
als i
o t
Bi y
nat ;
 1455

F
Su
e r
xt
uh
a
e
l
r
M
R
i
ne
oa
r d
i i
t n
i g
e s
s
Berg,
a L.,
n&
d Mi
llb
V an
i k,
o J.
l
(2
e
01
n
c 3).
e De
; vel
opi
Tng
ra
ajur
nisp
sru
g
de
e
nnc
de
eof
r tra
ns
I ge
dnd
eer
n
par
t
i tic
t ula
ir
eso
scia
1456

l ,
gro
up. N
In Y
T. :
Spi
R
jke
o
rbo u
er t
(E l
d.), e
Fl d
eei g
e
ng
.
ho
Cha
mo
v
ph
e
obi
z
a:
,
Se
xu K
al .
ori (
ent 2
ati 0
on, 1
ge 3
nd )
er .
ide Q
nti u
ty, e
an e
d r
as
ylu m
m i
(pp g
. r
12
a
1–
t
15
i
3).
o
N
n
e
w
p
Yo
ol
ri
k
t
 1457

i b
c a
s n
: a
A :
c U
t n
i i
v v
i e
s r
t s
r i
h t
e y
t
o o
r f
i I
c l
s l
, i
c n
o o
a i
l s
i P
t r
i e
o s
n s
a .
l Incarceration
p
o
Lewis,
s
R.
s (2
i 01
b 3).
i De
l po
rta
i
ble
t su
i bje
e cts
s :
. Le
sbi
U
an
r s
1458

Lea
nw
di
s
p,
o
lR
i.
t,
i
c&
a
lN
a
ap
sl
ye
ls
u,
m
.N
.
F
e(
m2
i0
n1
i4
s)
t.

FI
on
rt
mr
ao
td
iu
oc
nt
si
,o
n
2:
5
,Q
u
1e
7e
4r
–
1m
9i
4g
.r
a
 1459

t 9
i .
oLuibh
n éid
, ,
E.
a (2
s 00
y 2).
l En
u try
m de
, nie
d:
a Co
n ntr
d oll
in
d g
i se
s xu
p ali
l ty
a at
c the
e bo
m rd
e er.
n Mi
t nn
. ea
pol
is:
S
Un
e
ive
x
rsit
u
y
a
of
l
Mi
i
nn
t
es
i
ota
e
Pr
s
ess
,
.
Luibh
1
éid
7
,
/
E.
(
(2
8
00
)
8).
,
Qu
eer
1 /M
– igr
ati
1460

obi
nan
: an
d
AGa
ny
St
uud
nies
r,
u14
l,
y16
9–
19
b
0.
o
Luib
d
yhé
id
,
o
E.
f
(2
0
s
0
c
8)
h
.
o
S
l
ex
a
ua
r
lit
s
y,
h
m
i
ig
p
ra
.
ti
o
Gn,
Lan
Qd
: th
e
Ash
ift
Jin
og
uli
r ne
ns
abe
lt
w
oee
fn
le
Lga
el
s an
 1461

d see
ill kin
eg g
al the
st
gra
at
us nt
. of
G as
L ylu
Q m
: an
A
d
Jo
pr
ur
n ote
al cti
of ng
L glo
es bal
bi se
a
xu
n
a al
n div
d ers
G ity.
ay In
St B.
u
Ep
di
ps,
es
, K.
1 Va
4, len
28 s,
9– &
31 B.
5.
Go
Miller,
nz
A.
ále
(20
z
05)
(E
.
ds.
Ga
),
y
Pa
en
ssi
ou
ng
gh:
lin
So
es:
me
Se
ten
xu
sio
ali
ns
ty
in
1462

anPeña,
d S.
im (2
mi 00
gr 7).
ati “O
on bvi
(pp ou
. s”
13 ga
7– ys
18 an
8). d
Cthe
asta
mte
bga
r
ze:
i
dCu
gba
en
, ga
y
Mvis
Aibi
:
lit
y
H
an
a
rd
vU.
aS.
r im
dmi
gra
Utio
n
n
i
pol
v
eicy
r du
srin
ig
t the
y19
80
P
M
r
eari
sel
sBo
. atli
ft.
 1463

Jo M
ur cG
nal ill
of La
the w
Hi Jo
sto ur
ry na
of l,
Se 53
xu ,
ali 59
ty, –
16, 10
48 2.
2–Simm
51 on
3. s,
Rehaa T.
g, (2
S. 00
(20 8).
09) Se
. xu
Pat alit
roll y
ing an
the d
bor im
der mi
s gra
of tio
sex n:
ual U
ori K
ent fa
ati mi
on: ly
Bis reu
ex nio
ual n
ref pol
ug icy
ee an
cla d
im the
s in reg
Ca ula
na tio
da. n
1464

of int
sex im
ual aci
citi es
zen an
s in d
the ter
Eu rit
rop ori
ean ali
Un ze
ion d
. bel
Po on
liti gin
cal gs.
Ge Int
og er
ra ve
ph nti
y, on
27, s:
21 Int
3– er
23 na
0. tio
White, na
M. l
(20 Jo
13) ur
. na
A l
mb of
iva Po
len stc
t ol
ho on
mo ial
nat St
ion ud
alis ies
ms ,
: 15
Tra ,
nsn 37
ati –
on 54.
alYu
qu e
eer ,
 1465

A d
. e
n
( c
2 y
0
0 t
8 o
)
. i
n
S t
a i
m m
e a
- c
s y
e .
x
G
m L
i Q
g :
r
a A
t
i J
o o
n u
r
A n
u a
s l
t
r o
a f
l
i
L
a
e
:
s
b
F i
r a
o n
m
a
i n
n d
t
e
G
r
a
d
y
e
p
S
e
t
n
u
1466

d B
i T
e
Q
s
,
pe
op
1 le
4 ar
, e
in
2 ca
3 rc
9
er
–
2
at
6 ed
2 in
. pe
na
l
fa
cil
IN iti
CA es
RC in
th
ER
e
AT U
IO nit
N ed
St
at
Th es.
is Pe
en na
try l
de fa
scr cil
ib iti
es es,
th w
e hi
m ch
an in
ne cl
r ud
in e
w de
hi te
ch nti
L on
G ce
 1467

nt ert
ers y,
, pri
jai va
ls, cy
an ,
d an
pri d
so ag
ns, en
ar cy
e .
pl B
ac y
es ex
w te
he ns
re io
ev n,
er su
y ch
pe cu
rs rta
on il
in m
ca en
rc t
er of
ate th
d es
is e
su ba
bj sic
ect rig
ed ht
to s
th Inca
e rcer
cu ation
rta
il is
m as
en so
t ci
of at
his ed
or wi
he th
r fe
lib
1468

eli Th
ng e
s m
of an
los ne
s r
of in
co w
ntr hi
ol; ch
los L
s G
of B
fa T
mi Q
lia pe
l op
an le
d su
pe ffe
rs r
on in
al pe
rel na
ati l
on fa
shi cil
ps; iti
an es
d, is
in bo
so th
m si
e mi
ca lar
se to
s, an
pr d
of dif
ou fer
nd en
se t
ns fr
or o
y m
de th
pri e
va m
tio an
n. ne
 1469

r es
in e
w in
hi sti
ch tut
he io
ter ns
os .
ex Th
ua is
l, en
cis try
ge id
nd en
er tif
(th ies
os th
e e
w pa
ho rti
id cu
en lar
tif w
y ay
as s
th in
e w
ge hi
nd ch
er L
th G
ey B
we T
re Q
as pe
sig op
ne le
d ex
at pe
bir rie
th) nc
pe e
op in
le ca
ex rc
pe er
rie ati
nc on
e ,
th ex
1470

pl try
ori als
ng o
th pr
e es
sp en
eci ts
fic a
ha bri
rd ef
shi ov
p er
th vi
ey e
en w
du of
re L
an G
d B
th T
e Q
wa co
y m
in m
w un
hi iti
ch es
th ’
eir re
se sp
xu on
al se
or s
ge to
nd in
er ca
no rc
nc er
on ati
for on
mi .
ty
is
pu
nis
he
d.
Th
e
en
 1471

In orl
ca d,
rc wi
th
er
5
ati
%
on of
in th
th e
e w
21 orl
st d’
s
Ce
po
nt
pu
ur lat
y io
In n
th bu
e t
21 25
st %
ce of
nt th
ur e
y, w
th orl
e d’
U s
nit pri
ed so
St ne
ate rs.
s As
is of
th 20
e 13
lar ,
ge th
st er
in e
ca w
rc er
er e
at 2.
or 4
in mi
th lli
e on
w pe
1472

op d
le ar
in e
U. pe
S. op
pri le
so of
ns co
or lor
jai ,
ls an
an d
d thi
5 s
mi in
lli cl
on ud
m es
or a
e di
on sp
pr ro
ob po
ati rti
on on
or at
pa e
rol nu
e. m
A be
dis r
pr of
op L
ort G
io B
na T
te Q
nu pe
m op
be le
r of
of co
th lor
os an
e d/
in or
ca th
rc os
er e
ate w
 1473

ho n
ar rel
e ati
po on
or. shi
ps
an
Isol
d
ati
su
on
pp
Aort
ll .
pri O
so nc
ne e
rs re
are m
for ov
cib ed
ly fro
re m
m th
ov eir
ed fa
fro mi
m lie
the s
ir an
fa d
mi co
lie m
s m
an un
d ity
co ,
m m
m an
un y
iti pri
es, so
iso ne
lat rs
in ha
g ve
the litt
m le
fro or
m no
hu co
ma nt
1474

act ps
wi to
th ot
an he
yo rs,
ne pa
on rti
the cu
ou lar
tsi ly
de. th
Th os
is e
is w
pa ho
rti ha
cul ve
arl be
y en
tru rej
e ect
for ed
L by
G th
B eir
T fa
Q mi
pe lie
op s
le, du
ma e
ny to
of ho
wh m
o op
m ho
ma bi
y a
alr an
ea d
dy tra
ha ns
ve ph
li ob
mi ia
ted (a
rel bo
ati ut
on 40
shi %
 1475

of an
ho d
me pe
les tty
s th
yo eft
ut ).
h W
ide ith
nti ou
fy t
as an
L y
G pe
B rs
T on
Q, al
ma or
ny fin
of an
wh cia
o l
m m
sur ea
vi ns
ve of
thr su
ou pp
gh ort
cri ,
mi m
nal an
ize y
d L
ec G
on B
o T
mi Q
es pe
su op
ch le
as ar
se e
x iso
wo lat
rk, ed
dr in
ug pri
tra so
de, n,
1476

inc s,
rea fo
sin ot
g we
the ar,
ir an
vu d
lne fo
ra od
bil to
ity su
to pp
vi le
ole m
nc en
e. t
Pth
ris e
on in
ers ad
are eq
re ua
qu te
ire m
d ate
to ria
bu ls
y pr
ba ov
sic id
ne ed
ce by
ssi th
tie e
s fa
fro cil
m ity
the .
co Th
m e
mi co
ssa m
ry, mi
inc ss
lu ar
di y
ng als
toi o
let sel
rie ls
 1477

po ot
sta he
ge r
sta ite
m ms
ps to
an m
d ak
ele e
ctr lif
on e
ics m
(ra or
di e
os be
an ar
d ab
tel le.
evi W
sio ith
ns) ou
tha t
t m
all on
ow ey
m to
o bu
me y
nts th
of es
dis e
tra ite
cti ms
on ,
fro pri
m so
the ne
rea rs
lit ar
y e
of vu
pri ln
so er
n ab
lif le
e, to
as ex
we pl
ll oit
as ati
1478

on an
by d,
th ev
os en
e m
wi or
th e
m so,
or tra
e ns
res ge
ou nd
rce er
s. pri
Aso
s ne
in rs,
dic ar
ate e
d vu
by ln
the er
Bu ab
rea le
u tar
of ge
Ju ts
sti for
ce ph
St ysi
ati cal
sti vi
cs, ol
les en
bia ce
n, or
ga ha
y, ras
an sm
d en
bis t
ex by
ual pri
(L so
G n
B) sta
pri ff
so an
ne d
rs, ot
 1479

he pri
r so
pri ne
so rs.
ne Th
rs. e
M as
an su
y m
pri pti
so on
ne is
r th
ad at
vo th
ca er
cy e
or wi
ga ll
niz be
ati fe
on w
s or
att no
rib co
ute ns
thi eq
s ue
rea nc
lit es
y, for
in ha
pa rm
rt, in
to g
lac so
k m
of eo
ou ne
tsi w
de ho
co is
nta no
ct t
for ca
L re
G d
B for
T or
Q wa
1480

tch tsi
ed de
by .
ot La
he ck
rs, of
an su
d pp
the ort
ma fro
nn m
er ot
in he
wh rs
ich on
ma th
il e
is ou
pu tsi
bli de
cly is
dis als
tri o
bu an
ted iss
on ue
a for
dai L
ly G
ba B
sis T
in Q
dic pe
ate op
s le
to w
all ho
ex ar
act e
ly de
wh tai
o ne
ha d
s in
su jai
pp ls,
ort att
on e
the m
ou pti
 1481

ng de
to ni
de ed
fe bo
nd nd
the or
ms ca
elv nn
es ot
ag aff
ain or
st d
the ex
ir ce
cri ssi
mi ve
nal bo
ch nd
ar a
ge m
s. ou
Of nts
ten to
wi ba
th il
ou th
t e
m ms
on el
ey ve
or s
a ou
sta t,
ble co
ho m
me pr
ad o
dr mi
ess sin
, g
L th
G eir
B ab
T ilit
Q y
pri to
so de
ne fe
rs nd
are th
1482

em ne
sel me
ve nt
s
P
an
ris
d
on
the
s
re
ar
by
e
inc
se
rea
x-
sin
se
g
gr
the
eg
lik
ate
eli
d
ho
ins
od
tit
the
uti
y
on
wi
s
ll
ba
be
se
co
d
nv
on
ict
th
ed
e
or
ge
ser
nd
ve
er
a
bi
lo
na
ng
ry
er
(th
se
e
nte
no
nc
rm
e.
ati
ve
Ho as
usi ser
ng tio
an n
d th
Sol at
itar th
y er
Co e
nfi ar
 1483

e pri
on so
ly ne
tw rs,
o th
po er
ssi ef
ble or
ge e,
nd ar
ers e
), de
an ni
d ed
pri th
so eir
ne ge
rs nd
are er
ho id
us en
ed tit
in y
ma by
le w
or he
fe re
ma th
le ey
ins ar
tit e
uti co
on nfi
s ne
ba d,
se an
d d
on th
the eir
ir m
ge er
nit e
ali ex
a. ist
Tr en
an ce
sg in
en va
de rio
r us
1484

ins ort
tit io
uti na
on tel
s y
ca pl
n ac
ele ed
vat in
e sol
the ita
ir ry
ris co
k nfi
for ne
vi m
ole en
nc t,
e an
an d
d thi
ha s
ras is
sm pa
ent rti
by cu
pri lar
so ly
n tru
sta e
ff for
an tra
d ns
ot ge
he nd
rs. er
Lw
G o
B m
T en
Q .
pe W
op he
le n
are im
als pri
o so
dis ne
pr d
op in
 1485

sol ur
ita sa
ry da
co y,
nfi 7
ne da
me ys
nt a
un we
its, ek
alt ,
er an
nat d
ive th
ly ey
cal ar
led e
“s de
pe ni
cia ed
l ph
ho ysi
usi cal
ng co
” nt
or act
“p or
rot co
ect m
ive m
cu un
sto al
dy, act
” ivi
pri tie
so s
ne wi
rs th
are ot
loc he
ke r
d pri
in so
the ne
ir rs,
cel in
ls cl
for ud
23 in
ho g
1486

eat th
in e
g, lib
ex rar
erc y.
isi Su
ng, ch
or co
rel nd
igi iti
ou on
s s
pr ca
act n
ice ca
. us
Th e
ey se
are ve
als re
o se
de ns
nie or
d y
ac de
ce pri
ss va
to tio
ed n,
uc lea
ati di
on ng
al to
pr pe
og rm
ra an
ms en
, t
vo ps
cat yc
io ho
nal lo
tra gi
ini cal
ng, tra
an u
d m
us a
e an
of d
 1487

the Sp
ex eci
ac al
er Ra
bat pp
io ort
n eu
of r
sy on
m To
pt rtu
o re
ms (a
for titl
th e
os gi
e ve
wh n
o to
alr an
ea in
dy di
suf vi
fer du
fro al
m ch
a os
me en
nta by
l th
ill e
ne U
ss. nit
Fo ed
r Na
ex tio
am ns
ple H
, u
in m
20 an
11, Ri
Ju gh
an ts
M Co
en un
de cil
z, w
U or
N ki
1488

ng L
on G
a B
sp T
eci Q
fic pri
ma so
nd ne
ate rs
), re
fo po
un rt
d th
tha at
t th
in ey
de ha
fin ve
ite be
an en
d co
pr nfi
ol ne
on d
ge in
d de
pe fin
rio ite
ds ly
of in
sol su
ita ch
ry un
co its
nfi for
ne m
me on
nt ths
ca ,
n ye
am ars
ou ,
nt an
to d
tor ev
tur en
e. de
M ca
an de
y s.
 1489

Pri oo
so se
n to
off be
ici de
als tai
cla ne
im d
thi in
s th
is es
the e
saf un
est its
ho .
usi
ng Sex
op ual
tio Vio
n len
for ce
L
G O
B ve
T rw
Q he
pe lm
op in
le, g
bu ev
t if id
gi en
ve ce
n de
the m
op on
tio str
n, ate
ma s
ny th
pri at
so L
ne G
rs B
wo T
ul Q
d pri
no so
t ne
ch rs
1490

are ss
m m
or ed
e ia
lik te
ely nd
to s
be to
su su
bje gg
cte est
d su
to ch
se vi
xu ol
al en
vi ce
ole is
nc on
e ly
tha co
n m
ot mi
he tte
rs d
in by
the ot
pri he
so r
n in
po m
pu ate
lat s;
io ho
n. we
A ve
po r,
pu a
lar pl
m et
yt ho
h ra
pr of
o stu
m di
ote es
d an
by d
the su
ma rv
 1491

ey by
s, pri
inc so
lu n
di sta
ng ff.
th Su
os ch
e vi
by ol
the en
fe ce
de in
ral cl
Bu ud
rea es
u se
of xu
Ju al
sti as
ce sa
St ult
ati ,
sti se
cs, xu
ha al
ve co
de er
m ci
on on
str ,
ate de
d hu
tha m
t an
se izi
xu ng
al str
vi ip
ole se
nc ar
e ch
is es,
oft an
en d
pe se
rp xu
etr al
ate ha
d ras
1492

sm ls
ent wi
. th
M pe
or op
eo le
ve w
r, ho
pri ar
so e
n kn
off o
ici w
als n
oft to
en be
int se
ent xu
io all
nal y
ly vi
ho ol
us en
e t
L or
G ref
B usi
T ng
Q to
pri re
so m
ne ov
rs e
in th
da e
ng m
er aft
ou er
s th
sit ey
uat re
io po
ns, rt
pla ha
cin vi
g ng
the be
m en
in as
cel sa
 1493

ult R
ed. E
PA)
ris in
on 20
ra 03
pe ,
ha as
s we
ga ll
rn as
ere re
d gu
m lat
uc io
h ns
att iss
ent ue
io d
n by
in th
rec e
ent U.
de S.
ca De
de pa
s rt
an m
d en
led t
to of
the Ju
pa sti
ssa ce
ge in
of 20
the 12
Pri th
so at
n ar
Ra e
pe ost
Eli en
mi sib
nat ly
io de
n sig
Ac ne
t d
(P to
1494

pr lat
ov io
ide ns
pr ,
ote ho
cti w
on ev
s er,
for ar
pri e
so no
ne t
rs un
at iv
ris er
k sal
of ly
se ce
xu le
al br
at
Incarceration
ed
by
vic
pri
ti
so
mi
ne
zat
rs
io
or
n,
th
es
eir
pe
ad
cia
vo
lly
ca
L
tes
G
,
B
w
T
ho
Q
qu
pri
est
so
io
ne
n
rs.
th
Th
eir
e
eff
P
ic
R
ac
E
y
A
an
re
d
gu
th
 1495

e al
fur vi
th ol
er en
er ce
osi be
on ca
of us
pri e
so it
ne do
rs’ es
pri no
va t
cy in
br cl
ou ud
gh e
t th
by e
th pe
es rf
e or
ref m
or an
ms ce
. of
M str
an ip
y se
ob ar
jec ch
t es,
to w
P hi
R ch
E ar
A’ e
s de
li gr
mi ad
te in
d g
de to
fin all
iti ,
on an
of d
se ar
xu e
1496

th o
e be
m en
ea us
ns ed
by by
w pri
hi so
ch n
sc of
or fic
es ial
of s
L to
G fu
B rth
T er
Q pu
pri ni
so sh
ne co
rs ns
ar en
e su
se al
xu se
all xu
y al
as ac
sa tiv
ult ity
ed .
an
d
Th
ha
e
ras
Ba
se
n
d.
on
P
Se
R
xu
E
A al
re Ac
gu tivi
lat ty
io A
ns ll
ha pri
ve so
als ns
 1497

ba d
n to
se be
xu L
al G
act B
ivi T
ty Q
bet ar
we e
en su
pri bj
so ect
ne ed
rs to
re m
ga or
rdl e
ess su
of rv
wh eil
eth la
er nc
the e
se an
xu d
al pu
act nis
ivi h
ty m
is en
co t
ns for
en th
su e
al. vi
Th ol
os ati
e on
wh of
o th
ide es
nti e
fy rul
as es,
or w
are he
pe th
rce er
ive or
1498

no ng
t or
su hu
ch gg
vi in
ola g
tio ot
ns he
oc r
cu pri
r so
in ne
fac rs
t. or
L th
G e
B re
T m
Q ov
pri al
so of
ne on
rs e’s
are cl
fre ot
qu hi
ent ng
ly in
pu ho
nis t
he we
d at
an he
d r;
se po
nt st-
to P
pu R
nit E
ive A,
se th
gr e
eg fre
ati qu
on en
for cy
ha an
nd d
ho pu
ldi nis
 1499

h off
me ici
nt als
for be
su lie
ch ve
vi th
ola eir
tio se
ns xu
ha al
ve pa
inc rtn
rea ers
se ar
d. e
Fu att
rth en
er, di
L ng
G th
B e
T sa
Q m
pri e
so ser
ne vi
rs ce
ha s.
ve T
be ho
en ug
de h
nie it
d is
ac we
ce ll
ss kn
to o
pr w
og n
ra th
m at
mi pri
ng so
wh ne
ere rs
pri en
so ga
n ge
1500

in nd
co o
ns ms
en pl
su ac
al es
se pri
xu so
al ne
act rs
ivi at
ty, ris
no k
saf for
er se
se xu
x all
ma y
ter tra
ial ns
s mi
are tte
ma d
de inf
av ect
ail io
abl ns
e (S
in TI
the s).
va Th
st is
ma is
jor pa
ity rti
of cu
pri lar
so ly
ns. da
Fo ng
rbi er
dd ou
in s
g for
ite HI
ms V-
su po
ch sit
as iv
co e
 1501

pri ge
so nd
ne er
rs, an
wh d
o ge
are nd
at er-
gr no
eat nc
er on
ris for
k mi
of ng
co pri
ntr so
act ne
in rs,
g pa
ST rti
Is, cu
pa lar
rti ly
cul tra
arl ns
y ge
he nd
pat er
itis w
. o
m
en
De
,
nia
ar
l of
e
Ge
su
nd
bj
er
ect
Ide
ed
ntit to
y ad
an dit
d io
Exp na
res l
sio for
n ms
Tof
ra vi
ns ol
1502

en ho
ce rm
an on
d e
the th
de er
nia ap
l y
of an
the d
ir ot
ge he
nd r
er ge
ide nd
nti er-
ty co
be nfi
yo rm
nd in
wh g
ere Inca
the rcer
y ation
are
ho ca
us re.
ed. Of
Tr te
an n,
sg ac
en ce
de ss
r to
pri ho
so rm
ne on
rs e
are th
ro er
uti ap
nel y
y is
de de
nie pe
d nd
ac en
ce t
ss on
to
 1503

w at
he m
th en
er t
pri pri
so or
ne to
rs th
ha eir
ve im
be pri
en so
di n
ag m
no en
se t.
d H
wi o
th w
ge ev
nd er,
er th
id er
en e
tit ar
y e
dis on
or go
de in
r g
(G ba
ID ttl
) es
or to
ge ge
nd t
er th
dy es
sp e
ho m
ria ed
an ic
d ati
re on
cei s
vi ad
ng mi
su ni
ch ste
tre re
1504

d (
co W
nsi P
ste A
ntl T
y H)
in sta
th nd
e ar
pr ds
op of
er ca
do re.
sa Ev
ge en
s th
in os
ac e
co w
rd ho
an w
ce er
wi e
th ta
th ki
e ng
W ho
orl rm
d on
Pr es
of pri
es or
sio to
na th
l eir
As in
so ca
cia rc
tio er
n ati
for on
Tr m
an ay
sg ha
en ve
de su
r ch
He m
alt ed
h ic
 1505

al no
ca nc
re on
dis fo
co rm
nti in
nu g
ed pri
if so
th ne
ey rs
di ar
d e
no als
t o
ha re
ve gu
a lar
le ly
ga de
l ni
pr ed
es ac
cri ce
pti ss
on to
an ge
da nd
do er
cu ap
m pr
en op
te ria
d te
di cl
ag ot
no hi
sis ng
. an
Tr d
an gr
sg oo
en mi
de ng
r ite
an m
d s,
ge in
nd cl
er- ud
1506

in ha
g ir
un or
de tri
rg m
ar th
m eir
en na
ts ils
an ac
d co
co rdi
sm ng
eti to
cs, tra
th dit
at io
cis na
ge l
nd ge
er nd
pe er
op rol
le es.
ar W
e he
all n
o tra
we ns
d ge
to nd
po er
ss pri
es so
s. ne
M rs
an ar
y e
ar ref
e us
als ed
o ac
for ce
ce ss
d to
to ge
cu nd
t er-
th aff
eir ir
 1507

mi gle
ng ct
ca
P
re
ris
an
on
d
ers
m
all
ate
ac
ria
ro
l
ss
ne
th
ed
e
s,
co
th
un
ey
try
ar
re
e
cei
at
ve
a
su
m
bst
uc
an
h
da
hi
rd
gh
m
er
ed
ris
ica
k
l
for
ca
de
re,
pr
re
es
ga
sio
rdl
n,
es
sel
s
f-
of
inj
th
ur
eir
y,
ge
an
nd
d
er
sui
id
ci
en
de.
tit
y
Me or
dic se
al xu
Ne al
ori
1508

ent cc
ati or
on, di
bu ng
t it to
ha th
s e
pa Ce
rti nt
cul er
arl for
y HI
da V
ma La
gi w
ng an
eff d
ect Po
s lic
on y,
pri 1
so in
ne 7
rs pe
liv op
in le
g liv
wi in
th g
HI wi
V/ th
AI HI
D V
S wi
wh ll
o be
are in
dis ca
pr rc
op er
ort ate
io d
nat at
ely so
inc m
arc e
era po
ted int
. in
(A th
 1509

eir pl
liv aci
es. ng
) pri
Pri so
so ne
ns rs
ha wi
ve th
a HI
his V/
tor AI
y D
of S
iso in
lat sol
in ita
g ry
HI co
Vp nfi
osi ne
tiv m
e en
pri t
so on
ne th
rs. e
Pri ba
or sis
to of
20 th
13, eir
all sta
50 tus
sta .
tes Pri
fai so
led ne
to rs
ha wi
ve th
po HI
lic V/
ies AI
tha D
t S
pr co
ecl nti
ud nu
ed e
1510

to iso
be lat
su io
bje n,
cte an
d d
to vi
dis ol
cri en
mi ce
nat fro
io m
n, ot
inc he
lu r
di pri
ng so
pr ne
act rs
ice an
s d
tha sta
t ff,
“o an
ut” d
the ac
ir ce
HI ss
V/ to
AI m
Ds ed
sta ica
tus tio
, ns
wh an
ich d
ma pr
ke op
s er
the do
m sa
at ge
ris s
k is
for int
ha err
ras up
sm te
ent d
, or
 1511

ar to
bit in
rar ca
ily rc
de er
nie ati
d on
on ,
an th
on er
go e
in ha
g ve
ba be
sis en
. gr
as
sr
Res oo
ist ts
anc co
e m
to m
Inc un
arc ity
era eff
tio ort
n s
Ares
s po
lo nd
ng in
as g
L to
G th
B e
T ha
Q rm
pe s
op ca
le us
ha ed
ve by
be im
en pri
su so
bje n
cte m
d en
t.
1512

In co
the nn
19 ect
70 in
s, g
ear th
ly e
ga str
y ug
pri gl
de e
ma for
rc ga
he y
s lib
in er
Ne ati
w on
Yo wi
rk th
Cit th
y e
ral an
lie tip
d ris
ou on
tsi m
de ov
a e
jai m
l en
in t.
M M
an an
hat y
tan ga
ch y
eer m
in ag
g azi
for ne
pri s
so an
ne d
rs’ ne
rel ws
ea pa
se pe
an rs,
d in
 1513

clu 70
di s
ng thr
Bo ou
sto gh
n’s th
G e
ay mi
C d-
o 19
m 90
m s,
un su
ity pp
Ne ort
ws ca
, m
ma pa
de ig
su ns
bs we
cri re
pti or
on ga
s ni
av ze
ail d
abl for
e ga
to y
pri m
so en
ne w
rs ho
for we
fre re
e in
or ca
dis rc
co er
un ate
ted d
pri on
ce th
s. e
In ba
the sis
lat of
e tru
19 m
1514

pe to
d- U
up nl
se ea
x- sh
rel Po
ate we
d r
ch (A
ar C
ge T
s, U
oft P)
en ch
ac all
cu en
sin ge
g d
the th
m e
of U.
pe S.
do G
ph ov
ili er
a. n
In m
the en
lat t’s
e fai
19 lur
80 e
s to
thr ad
ou dr
gh es
the s
ear th
ly e
19 HI
90 V/
s, AI
the Ds
AI ep
D id
S e
Co mi
ali c,
tio w
n hi
 1515

ch an
inc d
lu su
de pp
d ort
eff th
ort os
s e
to liv
ch in
all g
en wi
ge th
the th
cri e
mi dis
nal ea
iza se,
tio in
n cl
of ud
pe in
op g
le th
wi os
th e
HI w
V/ ho
AI we
D re
S in
(a ca
cri rc
mi er
nal ate
iza d.
tio By
n th
tac e
tic be
tha gi
t nn
co in
nti g
nu of
es 20
in 00
20 ,
15 th
) er
1516

e ni
we zi
re ng
m as
ult pa
ipl rt
e of
or a
ga lar
niz ge
ati r
on an
s tip
thr ris
ou on
gh m
ou ov
t e
the m
co en
un t,
try in
wo cl
rki ud
ng in
to g,
ad bu
dr t
ess no
the t
ne li
ed mi
s te
of d
L to,
G th
B e
T Tr
Q an
pe sg
op en
le de
in r,
pri Ge
so nd
n er
wh Va
ile ria
or nt,
ga an
 1517

d Pr
Int oj
ers ect
ex ,
Ju all
sti of
ce w
Pr hi
oje ch
ct; en
Bl ga
ac ge
k in
an pe
d n
Pi pa
nk l
; pr
Sy og
lvi ra
a ms
Ri an
ve d
ra w
La or
w k
Pr to
oje bu
ct; ild
He co
art nn
s ect
on io
a ns
Wi wi
re; th
an L
d G
the B
Tr T
an Q
sfo pri
rm so
ati ne
ve rs
Ju to
sti m
ce eet
La th
w eir
1518

ne on
ed of
s un
an its
d de
sta sig
ve ne
off d
iso sol
lat el
io y
n to
an ho
d us
vi e
ole tra
nc ns
e. ge
Snd
o er
me pri
ma so
ins ne
tre rs,
am op
L er
G ati
B ng
T un
Q de
or r
ga th
niz e
ati be
on lie
s f
ha th
ve at
pu su
bli ch
cly sp
su eci
pp ali
ort ze
ed d
the un
co its
nst w
ru ou
cti ld
 1519

be d
saf m
er ak
for e
tra th
ns e
ge m
nd m
er or
pe e
op vu
le. ln
Ot er
he ab
rs le
bel to
iev ab
e us
su e
ch an
un d
its ha
wi ras
ll sm
ser en
ve t
to fro
se m
gr pri
eg so
ate n
tra off
ns ici
ge als
nd in
er th
pri e
so ab
ne se
rs nc
fro e
m of
ot an
he y
r ot
pri he
so r
ne wi
rs tn
an es
1520

ses pri
. so
Pri ns
so to
ne pr
r- ot
sp ect
eci L
fic G
L B
G T
B Q
T pri
Q so
or ne
ga rs,
niz be
ati lie
on vi
s ng
an pri
d so
ma ns
ny ar
L e
G in
B he
T re
Q ntl
pri y
so an
ne d
rs in
op ex
po tri
se ca
bu bl
ild y
in vi
g ol
ne en
w t
or an
ex d
pa un
nd saf
in e
g pl
ol ac
d es.
 1521

Mer
oti al
vat ins
ed tit
by uti
su on
ch s
bel an
ief d
s, pr
ma act
ny ice
L s
G (in
B cl
T ud
Q in
ant g,
ipr bu
iso t
n no
or t
ga li
niz mi
ati te
on d
s to,
su po
bs lic
cri e,
be ju
to dg
an es,
ide pri
ol so
og ns,
y su
of rv
pri eil
so la
n nc
ab e
oli str
tio uc
n, tur
in es,
wh an
ich d
inc ra
arc cia
1522

liz ga
ed ni
cri zat
mi io
nal ns,
iza in
tio cl
n) ud
are in
ab g
oli Ge
sh ne
ed rat
an io
d n
re Fi
pla ve
ce ,
d Cr
wi eat
th iv
co e
m Int
m er
un ve
ity nti
- on
ba s,
se an
d d
sol th
uti e
on A
s. ud
A re
gr Lo
ow rd
in e
g Pr
nu oj
m ect
be ,
r ar
of e
L ex
G pl
B ori
T ng
Q tra
or ns
 1523

for nt
ma m
tiv ete
e d
wa ou
ys t
to in
ho th
ld e
pe cri
op mi
le na
ac l
co le
un ga
tab l
le sy
for ste
the m
ha an
rm d
the by
y in
ha ca
ve rc
ca er
us ati
ed on
wi .
th
Ja
ou
t so
res n
ort Ly
in do
g n
to an
ret d
rib Jo
uti ey
ve L.
jus M
tic og
e ul
an
d Se
e
pu
als
nis o
h Cr
me im
1524

ina S
l e
Le v
gal e
Sy n
ste
m S
an t
d o
LG r
BT i
Q e
Pe s
opl
e P
r
e
F s
u s
r .
t Ku
h n
e z
r e
l
R ,
e
a R
d
.
i
n
(
g
s 2
0
Da 0
vis
8
,
A. )
(20 .
03)
. C
Ar
r
e
pri i
so m
ns i
ob n
sol a
ete
l
?
Ne
w i
Yo n
rk, t
N
i
Y:
 1525

m e
a r
c i
y c
: a
n
P
r s
i e
s x
o u
n a
l
a i
n t
d y
.
t C
h
h
i
e c
a
u g
n o
,
e
v
I
e
L
n :

h U
i n
i
s
v
t
e
o r
r s
y i
t
y
o
f
o
f
m
o C
d h
e i
c
r
a
n g
o
A
m P
1526

rt
ei
sc
s
e
.
:
Mog
T
u
h
l,
e
J.
c
,
r
R
i
i
m
c
i
h
n
i
a
e
l
,
i
A
z
.,
a
&
t
i
W
o
h
n
it
l
o
o
f
c
L
k
G
,
B
K
T
.
(
2 p
0 e
1 o
1 p
). l
Q e
u i
e n
e
r t
( h
i e
n U
) n
j i
u t
s e
d
 1527

S N
t .
a
t (
e 2
s 0
. 1
B 1
o )
s .
t
o C
n a
, p
M t
A i
: v
B e
e
a
g
c
e
o
n
n
d
P
e
r
r
e
s
s
:
s.
Sta
T
n
r
l
a
e
n
y
s
,

e
E
m
.
b
,
o
d
&
i
m
S e
m n
i t
t
h
a
,
n
1528

d
P
t r
h e
e s
s
p .
r
i
s
o IN
n
FE
RT
i
n
ILI
d TY
u A
s N
t
r D
i
R
a
l
EP
R
c O
o D
m UC
p
TI
l
e VE
x
.
L
OS
O S
a
k
l Th
a is
n en
d try
, de
sc
C rib
A es
:
L
G
B
A
T
K
Q
 1529

ex mi
pe d
rie pr
nc eg
es na
of nc
inf y),
ert inf
ilit an
y t
an lo
d ss
re fol
pr lo
od wi
uc ng
tiv pr
e eg
los na
s, nc
in y,
cl fai
ud le
in d
g ad
pr op
eg tio
na n,
nc an
y d
los fai
s le
(of d
te su
n rr
ref og
err ac
ed y
to arr
as an
mi ge
sc m
arr en
ia ts.
ge Al
in th
ea ou
rly gh
- re
to pr
1530

od ilit
uc y
tiv is
e on
los th
s e
an ris
d e
inf in
ert m
ilit an
y y
are ar
co ea
m s
m of
on th
— e
est w
im orl
ate d
s —
su litt
gg le
est ha
th s
at be
ne en
arl wr
y itt
25 en
% ab
of ou
pr t
eg L
na G
nc B
ies T
en Q
d pe
in op
mi le’
sc s
arr ex
ia pe
ge, rie
an nc
d es
inf wi
ert th
 1531

th ild
e re
m. n
Si th
mi at
lar ar
ly, e
fe pl
w ac
stu ed
di wi
es th
ar an
e ad
av op
ail tiv
ab e
le L
on G
ca B
se T
s Q
of fa
ad mi
op ly
tio (o
n fte
to n
L fo
G r
B up
T to
Q 30
fa da
mi ys
lie ,
s Infertility
th and
at Reproductiv
e Loss
ar
e
no de
t pe
co nd
m in
pl g
ete on
d, lo
or ca
ch l
1532

la mi
ws lie
) s
be —
in su
g ch
“r as
ecl fin
ai an
m ci
ed al
” co
by nc
a er
bir ns
th rel
pa ati
re ng
nt. to
Be as
ca sis
us te
e d
of re
thi pr
s, od
co uc
nc tiv
er e
ns te
th ch
at no
ar lo
e gi
un es
iq or
ue ad
or op
he tio
ig n
ht pr
en oc
ed es
for se
L s,
G th
B e
T ex
Q pe
fa rie
 1533

nc is
es en
of try
no pr
ng es
est en
ati ts
on th
al es
pa e
re as
nts pe
, cts
an of
d L
ho G
m B
op T
ho Q
bi re
a pr
in od
he uc
alt tiv
h e
ca lo
re ss
su an
rro d
un inf
di ert
ng ilit
los y
s thr
an ou
d gh
inf a
ert re
ilit vi
y e
— w
ha of
ve th
be e
en ex
ne ist
gl in
ect g
ed. lit
Th er
1534

at D
ur ea
e fe
pu
ni
bli
ng
sh
ed H
by et
an er
thr o
op n
ol or
og
m
ist
a
s,
nu ti
rse vi
- ty
mi Al
d th
wi ou
ve gh
s, m
so uc
cia h
l ha
w s
or be
ke en
rs, wr
an itt
d en
ps ab
yc ou
ho t
lo th
gis e
ts. ho
m
op
ho
bi
a
an
d
he
ter
on
or
 1535

m ref
ati err
vit ed
y to
ex as
pe th
rie e
nc “d
ed ea
by fe
L ni
G ng
B he
T ter
Q on
pa or
re m
nts ati
, vit
fe y”
w th
res at
ea inf
rc us
he es
rs th
ha e
ve ex
ad pe
dr rie
es nc
se es
d of
w L
ha G
t B
Eli T
za Q
be pa
th re
Pe nt
el s
an w
d ho
Ru ha
th ve
Ca su
in ffe
ha re
ve d
1536

a ho
los ha
s. ve
It ex
is pe
im rie
po nc
rta ed
nt re
to pr
no od
te uc
th tiv
at e
th lo
e ss
us id
e en
of tif
th y
e th
w e
or m
d sel
“p ve
ar s
en as
ts” pa
in re
th nt
e s
lat of
ter th
ins e
ta ch
nc ild
e (re
is n)
str th
ate ey
gi ha
c, ve
sin lo
ce st,
m w
ost he
pe th
op er
le or
w no
 1537

t ca
th us
ey e
ha of
ve as
ot su
he m
r pti
ch on
ild s
re th
n. at
Si a
mi sa
lar m
ly, e-
th se
e x
ex pa
pe rtn
rie er
nc wi
e ll
of be
inf wi
ert lli
ilit ng
y an
a d
m ab
on le
g to
L do
G na
B te
T eg
Q gs
pe or
op sp
le er
is m
oft fo
en r
do su
w bs
np eq
la ue
ye nt
d att
be e
1538

m es
pts wi
at th
co mi
nc sc
ep arr
tio ia
n, ge
or, ha
in ve
th be
e en
ca ba
se se
of d
cis on
- sm
fe all
m sa
ale m
pa pl
rtn es
ers (6
, –
ca 20
rry pa
a rti
pr ci
eg pa
na nts
nc )
y. an
Md
ost ha
exi ve
sti fo
ng cu
stu se
die d
s al
of m
L ost
G ex
B cl
T usi
Q ve
ex ly
pe on
rie W
nc hit
 1539

e gis
wo t
me Eli
n’s za
ex be
pe th
rie Pe
nc el’
es. s
Th on
e lin
fir e
st su
ma rv
jor ey
em of
pir 60
ica les
l bi
stu an
dy ,
ad bis
dr ex
ess ua
in l,
g an
qu d
eer qu
wo ee
me r
n’s w
ex o
pe m
rie en
nc w
es ho
of ha
pr d
eg ex
na pe
nc rie
y nc
los ed
s mi
wa sc
s arr
ps ia
yc ge
ho .
lo N
1540

urs th
e- eir
mi un
dw bo
ife rn
Da ch
nu ild
ta ve
W ry
oj ea
na rly
r in
ha pr
s eg
pr na
op nc
os y.
ed Re
tha ga
t, rdl
un es
lik s
e of
so w
me he
het th
er er
os a
ex los
ual s
m oc
ot cu
he rre
rs, d
les ea
bia rly
n or
m lat
ot e
he in
rs th
fre e
qu pr
ent eg
ly na
bo nc
nd y,
ed th
wi es
th e
 1541

stu Infer
die tility
s and
Repr
re
oduc
po tive
rt Loss
tha
t it
ha re
da po
“si rt
gn th
ifi at
ca th
nt” ey
or gri
“v ev
er ed
y no
sig t
nif on
ica ly
nt” th
im e
pa lo
ct ss
on of
the th
liv eir
es ch
of ild
les (re
bia n)
n, bu
bis t
ex als
ual o
, th
an e
d lo
qu ss
eer of
wo th
me eir
n. ho
So pe
me s
pa an
re d
nts dr
1542

ea ch
ms ell
for e
th W
e al
fut ks
ur ’s
e. re
se
ar
Se ch
ek on
in inf
g ert
Su ilit
pp y
in
or
qu
t ee
Li r
ke fa
wi mi
se, lie
litt s
le ha
ha s
s cri
be tiq
en ue
wr d
itt th
en e
on fla
L w
G ed
B lo
T gi
Q c
ex of
pe pr
rie ev
nc io
es us
wi st
th ud
inf ies
ert ,
ilit w
y. hi
Mi ch
 1543

hi w
gh ap
lig .”
ht Sh
ed e
th als
e o
“f e
air m
ly ph
un asi
iq ze
ue d
ad th
va e
nt e
ag m
e” oti
for on
les al
bi ch
an all
w en
o ge
m s
en th
th at
at su
if ch
on an
e arr
pa an
rtn ge
er m
wa en
s t
un po
ab se
le d
to fo
co r
nc so
ei m
ve, e
th qu
ey ee
co r
ul co
d up
“s les
1544

, m
es e
pe tra
cia ns
lly id
for en
pe tif
op ie
le d
w in
ho di
do vi
no du
t als
e ,
m so
br m
ac e
ea of
ste w
re ho
ot m
yp re
ica po
l rte
“f d
e litt
mi le
ni int
ne er
” est
id in
en pr
tit eg
y, na
su nc
ch y
as th
bu e
tc m
he sel
s, ve
ge s
nd an
er d
qu w
ee er
rs, e
or di
so str
 1545

es y.
se It
d is
by als
he o
alt no
h ta
ca bl
re e
pr th
ov at
id re
ers ce
’ nt
su st
gg ud
est ies
io ha
ns ve
th su
at gg
th est
ey ed
sh pa
ou rti
ld cu
pu lar
rs co
ue nd
pr iti
eg on
na s
nc of
y inf
w ert
he ilit
n y
th ar
eir e
pa m
rtn or
ers e
ex co
pe m
rie m
nc on
ed or
inf m
ert or
ilit e
1546

se m
ve ay
re or
a m
m ay
on no
g t
so be
m ac
e kn
qu o
ee wl
r ed
w ge
o d
m by
en he
an alt
d h
tra ca
ns re
m pr
en ac
(i. titi
e., on
po er
ly s.
cy In
sti so
c m
ov e
ar ca
y se
sy s,
nd L
ro G
m B
e T
an Q
d in
en di
do vi
m du
etr als
ios ha
is) ve
, als
w o
hi w
ch el
 1547

co an
m d,
ed fo
a r
di th
ag os
no e
sis w
of ho
inf w
ert er
ilit e
y try
— in
as g
a to
va co
lid nc
ati ei
on ve
of ,
th as
e a
e re
m as
oti on
on fo
al r
or no
ph lo
ysi ng
cal er
pa ha
in vi
th ng
ey to
we w
re or
fe ry
eli ab
ng ou
du t
rin be
g co
th mi
e ng
pr pr
oc eg
es na
s nt
1548

th e
e an
ms d
el in-
ve pe
s. rs
Oon
the as
r sis
stu te
die d
s re
ha pr
ve od
sh uc
ow tio
n n
tha su
t pp
ma ort
ny gr
qu ou
eer ps,
wo bu
me t
n th
se at
ek ho
su m
pp op
ort ho
for bi
inf a
ert ca
ilit n
y, in
inf cr
ant ea
los se
s, th
an eir
d se
mi ns
sc e
arr of
iag iso
e lat
in io
on n.
lin Ot
 1549

he wi
rs lli
re ng
po to
rt do
av so
oi du
di rin
ng g
su su
pp ch
ort a
gr dif
ou fic
ps ult
for ti
fea m
r e
tha in
t th
the eir
y liv
wo es.
ul To
d da
ha te,
ve th
to er
jus e
tif is
y litt
or le
ex res
pla ea
in rc
the h
ir on
(q th
ue e
er) ex
rel pe
ati rie
on nc
shi es
p, —
an ho
d m
we op
re ho
un bi
1550

c of
or lar
ot ge
he r
rw stu
ise di
— es
of ab
ga ou
y t
an ga
d y
bis pa
ex re
ual nti
me ng
n ),
ex or
pe th
rie e
nci re
ng pr
inf od
ert uc
ilit tiv
y e
or ex
los pe
s rie
wh nc
ile es
pu of
rsu tra
in ns
g ge
sur nd
ro er
ga an
cy d
or ge
ad nd
op er
tio qu
n ee
(e r
xc pa
ept re
as nts
pa .
rt
 1551

Es,
ve m
n an
for y
L re
G po
B rt
T fe
Q ar
in in
di g
vi ne
du ga
als tiv
wh e
o res
di po
d ns
no es,
t an
ex d
pe se
rie ve
nc ral
e stu
ov di
ert es
ho ha
m ve
op un
ho de
bia rsc
in or
se ed
eki th
ng e
tre im
at po
me rta
nt nc
for e
inf of
ert ed
ilit uc
y ati
or ng
du he
rin alt
gah
los pr
1552

of ng
ess fai
io le
nal d
s ad
ab op
ou tio
t ns,
L so
G m
B e
T L
Q G
he B
alt T
h Q
an pr
d os
fa pe
mi cti
lie ve
s, pa
in re
pa nts
rti fe
cul el
ar th
to at
em be
ph ca
asi us
ze e
the ad
dif op
fic tio
ult n
y pr
of of
ac es
hie sio
vi na
ng ls
pr co
eg nsi
na de
nc r
y. th
Re e
ga m
rdi “u
 1553

nd t
esi fe
ra el
ble re
” ad
or y
“h to
ar co
d m
to mi
pla t
ce to
” ad
pa op
re tio
nts n.
, Al
the th
y ou
are gh
“p th
us er
he e
d” is
to no
ac sta
ce tis
pt tic
“ri al
ski da
er” ta
op on
en fai
ad le
op d
tio ad
ns op
wi tio
th ns
bir a
th m
m on
ot g
he L
rs G
wh B
o T
ma Q
y fa
no mi
1554

lie w
s ho
tha m
t th
are ey
for as
thc su
o m
mi e
ng to
fro be
m we
ad alt
op hi
tio er
n th
ag an
en he
cie ter
s os
(e. ex
g., ua
be l
ca ad
us op
e ter
the s),
y A
are bb
try ie
in E.
g G
to ol
ent db
ice er
les g’
bia s
n w
an or
d k
ga wi
y th
pr ga
os y
pe fat
cti he
ve rs
cli an
ent d
s, ad
 1555

op ga
tio cy
n or
ma co
ke nc
s it ei
cle ve
ar ch
tha ild
t re
the n
se vi
ex a
pe as
rie sis
nc te
es d
are re
no pr
t od
ent uc
ire tio
ly n)
un m
co ay
m eli
m cit
on. a
Fu co
rth nsi
er, de
the ra
de bl
cis e
io se
n ns
to e
ad of
op los
t s
(ra for
the pa
r re
tha nts
n w
pu ho
rsu ha
e d
sur ho
ro pe
1556

d n
to to
ha ad
ve dr
a es
bi s
ol L
og G
ica B
l T
co Q
nn ex
ect pe
io rie
n nc
wi es
th of
the inf
ir ert
chi ilit
ld. y
Pan
op d
ula los
r s
so for
ur br
ce oa
s de
— r
inc au
lu di
di en
ng ce
me s.
m Fo
oir r
s ins
an ta
d nc
bl e,
og Kr
s ist
— en
ha He
ve nd
als ers
o on
be an
gu d
 1557

Sa s
ra th
h eir
Ka si
te m
Ell ult
is’ an
s eo
20 us
11 pr
m eg
e na
m nc
oir ies
, ,
Ti as
m w
es ell
T as
w th
o: eir
T ex
w pe
o rie
W nc
o e
m of
en tw
in o
Lo lo
ve ss
an es:
d Sa
th ra
e h’
H s
ap mi
py sc
Fa arr
mi ia
ly ge
Th at
ey 11
M w
ad ee
e, ks
ch ,
ro an
ni d
cle lat
1558

er ve
he r,
r re
“d m
isa ai
pp n
ea rel
rin ati
g ve
tw ly
in, sp
” ar
th se.
e
los
s Pa
of rt
on n
e er
ch s
ild a
du
n
rin
ga
d
tw “S
in oc
pr ial
eg ”
na P
nc ar
y.
e
Ev
nt
en
th s
es A
e pa
pe rti
rs cu
on lar
al ly
na un
rra de
tiv rre
e se
ac ar
co ch
un ed
ts, ar
ho ea
we of
 1559

L e
G to
B ca
T ll
Q “s
inf oc
ert ial
ilit ”
y m
an ot
d he
los rs
s, in
as co
we ntr
ll ast
as to
L “b
G iol
B og
T ic
Q al
pa ”
re or
nti “g
ng est
, is ati
th on
e al
ex ”
pe m
rie ot
nc he
e rs,
of an
w d
ha ad
t op
m tiv
an e
y pa
res re
ea nt
rc s.
he So
rs m
ha e
ve sc
co ho
m lar
1560

s ee
ha n
ve a
go m
ne ot
so he
far r
as an
to d
de ch
scr ild
ib (re
e n),
les ne
bi ga
an tin
m g
ot th
he e
rh ex
oo pe
d rie
sol nc
el es
y of
in no
ter ng
ms est
of ati
a on
bi al
ol or
og “s
ica oc
l ial
or ”
le m
ga ot
lly he
ad rs
op w
tiv ho
e ar
rel e
ati no
on t
shi le
p ga
be lly
tw ab
 1561

le ge
to sta
ad tio
op na
t l
th m
eir ot
ch he
ild r’s
re ex
n. pe
Ev rie
en nc
w e.
he In
n H
“s en
oc de
ial rs
” on
m an
ot d
he El
rs lis
na ’s
rra m
te e
th m
eir oir
o m
w en
n tio
ac ne
co d
un ab
ts, ov
pri e,
m fo
ac r
y in
is sta
oft nc
en e,
pl alt
ac ho
ed ug
up h
on th
th e
e au
1562

th ssi
or on
s of
shi bo
ft th
ba lo
ck ss
an es
d th
for ey
th ex
be pe
tw rie
ee nc
n ed
th to
eir ge
o th
w er
n w
pe as
rs al
pe m
cti os
ve t
s en
thr tir
ou el
gh y
ou wr
t itt
th en
e in
bo th
ok e
(id ge
en sta
tifi tio
ed na
by l
th m
eir ot
na he
m r’s
es) (S
, ar
th ah
e ’s)
dis vo
cu ic
 1563

e, on
th no
ou ng
gh est
sh ati
e on
no al
tes pa
on re
se nts
ve ’
ral ex
oc pe
ca rie
sio nc
ns e
th of
at inf
Kr an
ist t
en los
wa s
s an
in d
ev mi
en sc
w arr
or ia
se ge
sh ,
ap al
e be
e it
m sp
oti ars
on e,
all sh
y o
th ws
an th
sh at
e. so
Tm
he e
exi no
sti ng
ng est
res ati
ear on
ch al
1564

m rt
ot ha
he vi
rs, ng
tra a
ns de
pa ep
re se
nts ns
, e
an of
d los
ga s
y aft
me er
n a
wh mi
o sc
ex arr
pe ia
rie ge
nc ,
e w
mi hil
sc e
arr ot
iag he
e rs
wi ex
th pr
a es
sur s
ro mi
gat ld
e er
or fe
du eli
rin ng
g s
ad of
op dis
tio ap
n po
arr int
an m
ge en
me t
nts (e.
re g.,
po so
 1565

me he
fee alt
l h
tha ca
t re
the w
y or
do ke
no rs,
t fri
ex en
pe ds,
rie an
nc d
e co
the w
lev or
el ke
of rs
dis —
tre bo
ss th
tha he
t a ter
ge os
sta ex
tio ua
nal l
pa an
re d
nt qu
do ee
es) r
. —
No fre
ng qu
est en
ati tly
on ex
al pr
pa es
re se
nts d
oft su
en rpr
re ise
po th
rt at
tha th
t ey
1566

di g
dn aft
’t er
“g th
et eir
ov los
er” s.
the Fo
los r
s so
fas m
ter e
. no
Ins ng
tea est
d, ati
fa on
mi al
ly pa
an re
d nts
fri ,
en th
ds eir
m se
or ns
e e
co of
nsi los
ste s
ntl go
y es
in str
qu uc
ire tur
d all
ab y
ou far
t de
ho ep
w er
the th
ir an
pa th
rtn e
er e
wa m
s oti
do on
in al
 1567

los pa
s re
of nt
the shi
ir fti
chi ng
ld. fro
Fo m
r th
ins e
tan ge
ce, sta
in tio
co na
un l
tri m
es ot
wh he
ere r
sa to
me th
- e
se no
x ng
se est
co ati
nd on
- al
pa m
re ot
nt he
ad r
op m
tio ea
n ns
is th
ill at,
eg in
al, ad
inf dit
ert io
ilit n
y to
tha no
t t
res ha
ult vi
s ng
in a
a bi
1568

ol co
og ad
ica op
l tio
rel n
ati is
on ill
shi eg
p al
to an
the d
ir on
chi ly
ld, on
the e
y pa
wi re
ll nt
als is
o Infertility
no and
t Reproductiv
e Loss
ha
ve
leg ab
al le
tie to
s le
to ga
hi lly
m ad
or op
he t.
r. As
Th A
e bb
sa ie
me G
is ol
tru db
e er
in g’
are s
as re
wh se
ere ar
sa ch
me de
se m
x on
 1569

str n
ate fa
s, mi
ne lie
go s
tia by
tio hi
ns gh
ov lig
er hti
w ng
ho un
wi co
ll mf
be ort
co ab
m le
e so
th ci
e oe
“o co
ffi no
cia mi
l” c
ad in
op eq
tiv uit
e ies
pa an
re d
nt po
in w
su er
ch dif
ins fer
ta en
nc tia
es ls
ca be
n tw
als ee
o n
ca pa
us rtn
e er
fri s.
cti Th
on es
wi e
thi le
1570

ga re
l nt
in w
eq ho
uit w
ies as
als un
o ab
lea le
ve to
th ad
e op
po t
te le
nti ga
al lly
for ret
fur ai
th ns
er no
los le
se ga
s l
in rel
th ati
e on
fut sh
ur ip
e, to
in th
th e
e ch
ev ild
en re
t n.
th R
at eg
a ar
rel di
ati ng
on ch
shi ild
p los
en s,
ds Ell
an en
d Le
th wi
e n’
pa s
 1571

stu aft
dy er
of a
ga ga
y y
fat (o
he r
rh les
oo bi
d an
no )
tes co
tha up
t le
wh ha
en s
an br
ad ou
op gh
tio t
n th
do e
es ch
no ild
t int
go o
thr th
ou eir
gh ho
for m
ga e,
y su
me ch
n, lo
or ss
a es
bir ar
th e
m ex
ot pe
he rie
r nc
“re ed
cla si
im mi
s” lar
th ly
e to
ch th
ild e
1572

wa he
y rs
th fel
e t
de th
at ey
h co
of ul
an d
alr gri
ea ev
dy e
ex op
ist en
in ly,
g so
ch ci
ild al
mi m
gh ot
t he
be rs
fel oft
t. en
Re ke
se pt
ar th
ch eir
ers sa
ha dn
ve es
als s
o m
sh or
o e
w hi
n dd
th en
at, wi
w th
he th
re e
as int
ge en
sta t
tio of
na “b
l ei
m ng
ot str
 1573

on k
g” or
for to
th th
eir eir
pa fa
rtn mi
ers ly.
. I
Su t
ch is
los als
se o
s im
ar po
e rta
co nt
m to
po no
un te
de th
d at
for th
ex e
pe ex
cta pe
nt rie
no nc
ng es
est of
ati inf
on ert
al ilit
pa y
re an
nts d
w re
ho pr
ha od
ve uc
no tiv
t e
co los
m s
e a
ou m
t on
at g
w L
or G
1574

B o
T mi
Q c
pe ca
op pit
le al,
are (di
ine s)a
vit bil
abl ity
y ,
me an
dia d
ted so
by on
int .
ers N
ect o
in cu
g rre
ax nt
es res
of ea
pri rc
vil h
eg ex
e ist
an s
d th
ma at
rgi is
nal ex
iza te
tio nsi
n ve
ba en
se ou
d gh
on to
eth att
nic en
ity d
, to
so th
cia es
l e
an dif
d fer
ec en
on ce
 1575

s. d
Th wi
ere thi
is n
als co
oa un
gr tri
eat es
de lik
al e
of th
va e
ria U
tio nit
n ed
re St
ga ate
rdi s,
ng w
the he
leg re
al le
sta ga
tus l
of rig
L hts
G va
B ry
T by
Q sta
rel te.
ati Th
on es
shi e
ps di
an ve
d rse
pa le
re ga
nts l
thr sta
ou tus
gh es
ou un
t do
the ub
wo te
rld dl
, y
an aff
1576

ect e
the de
ex cis
pe io
rie ns
nc for
es th
of eir
re pa
pr rtn
od er
uct or
ive th
los e
s au
for to
no ps
ng y
est or
ati fu
on ne
al ral
pa arr
re an
nts ge
, m
pa en
rti ts
cul aft
arl er
y a
re sti
ga llb
rdi irt
ng h.
wh
eth
er
the
y
are
abl
e
to
ma
ke
he
alt
h
car
 1577

Inf ve
er dur
tiliing
the
ty,
alr
Lo ea
ss, dy
an em
d oti
Fi on
na al
nc ex
per
ial
ien
Co ce
nc of
er inf
ns ant
los
Fin
s
anc
or
ial
Infer
co tility
nce and
rns Repr
are oduc
oft tive
en Loss
an
uns
pr
po
ol
ke
on
n
ge
an
d
xie
inf
ty
ert
tha
ilit
t
y.
LG
Fi
BT
na
Q
nc
ind
ial
ivi
co
du
nc
als
er
an
ns
d
m
fa
mil ay
ies be
ha es
1578

pe an
cia ge
lly m
he en
ig ts,
ht or
en ad
ed op
a tio
m n
on pr
g oc
th ee
os di
e ng
w s.
ho Ta
ha lki
ve ng
in op
ve en
ste ly
d ab
su ou
bst t
an th
tia e
lly ex
in pe
as ns
sis es
te as
d so
re ci
pr at
od ed
uc wi
tiv th
e a
tec ba
hn by
ol th
og ey
ies ha
, d
su lo
rro st,
ga ho
cy w
arr ev
 1579

er, es
m in
ay ve
be ste
av d
oi in
de ac
d hi
by ev
th in
e g
pa pr
re eg
nts na
, nc
as y
it (e
m m
ay oti
se on
e al,
m int
to er
tai pe
nt rs
th on
e al,
e fin
m an
oti ci
on al,
al an
ex d
pe ph
rie ys
nc ic
e al)
of sh
los ap
s. e,
Ul an
ti d
m oft
ate en
ly, int
th en
e sif
res y,
ou th
rc e
1580

ex T
pe Q
rie fa
nc mi
e lie
of s
re va
pr ry
od wi
uc de
tiv ly
e ac
los ro
s ss
an co
d un
inf tri
ert es
ilit an
y d
for jur
L isd
G ict
B io
T ns,
Q ba
fa se
mi d
lie on
s. w
I he
t is th
sig er
nif ac
ica ce
nt ss
tha to
t as
fin sis
an te
cia d
l re
co pr
nc od
er uc
ns tiv
for e
L tec
G hn
B ol
 1581

og L
ies G
is B
op T
en Q
to pa
L re
G nts
B ,
T ex
Q pe
pa rie
re nc
nts in
an g
d pr
wh ol
ich on
tec ge
hn d
ol inf
og ert
ies ilit
are y
av or
ail los
abl s
e in
for cr
fre ea
e, se
or s
pai th
d e
for ur
by ge
the nc
in y
di to
vi try
du to
al be
or co
fa m
mi e
ly. pr
Fo eg
r na
ma nt
ny or
1582

ad co
op nc
t ei
ag ve
ain or
. ad
So op
me t
re ag
po ai
rt n.
tak In
in ad
g dit
ou io
t n,
se th
co er
nd e
m ar
ort e
ga m
ge an
s, y
ma L
xi G
ng B
ou T
t Q
cre pe
dit op
car le
ds, w
or ho
bo w
rro ou
wi ld
ng lik
m e
on to
ey try
fro in
m vit
rel ro
ati fer
ve tili
s zat
to io
try n
to or
 1583

to a
ad sig
op nif
t, ica
bu nt
t iss
are ue
un th
abl at
e ha
be s
ca ye
us t
e to
of be
res dis
tri cu
cte ss
d ed
fin in
an m
cia ost
l ac
res ad
ou e
rce mi
s. c
Fi an
na d
nci po
al pu
co lar
nc lit
er er
ns at
in ur
L e.
G
B
T
Q
re
pr
od
uct
io
n
re
ma
in
1584

M E
e S
m Pr
oj
or
ec
ial
t
izi or
ng AI
Lo D
ss S
m
L
e
G
m
B
ori
T
al
Q
qu
co
ilt,
m
th
m
e
un
Tr
iti
an
es
sg
ha
en
ve
de
a
r
lo
D
ng
ay
his
of
tor
Re
y
m
of
e
m
m
e
br
m
an
ori
ce
ali
,
zi
an
ng
d
los
art
s,
an
su
d
ch
fic
as
tio
wi
n
th
m
th
e
e
m
N
ori
A
ali
M
zi
 1585

ng po
th w
e erf
St ul
on sp
ew ac
all e
rio fo
ts. r
Th m
e e
ex m
pe ori
rie ali
nc za
e tio
of n
re th
pr at
od ca
uc n
tiv ch
e all
los en
s ge
(a he
nd ter
, on
to or
a m
les ati
ser ve
ex as
te su
nt, m
inf pti
ert on
ilit s
y) ab
is ou
e t
m lo
er ss
gi an
ng d
as gri
an ef,
ot as
he w
r ell
1586

as ve
ex w
pe or
cta ke
tio d
ns wi
of th
be rel
lo igi
ng ou
in s
g, pr
co ac
m titi
m on
un er
ity s
, to
an cr
d ea
fa te
mi ne
ly w
for ce
m re
ati m
on on
. ies
Fo an
r d
ins ph
ta ys
nc ic
e, al
L m
G e
B m
T ori
Q als
fa to
mi m
lie ar
s k
of th
va e
rio de
us at
fai h
ths of
ha ch
 1587

ild by
re a
n, bir
th th
e pa
ex re
pe nt.
rie Ot
nc he
e rs
of ha
mi ve
sc “
arr m
ia ar
ge, ke
an d”
d th
th eir
e ex
ex pe
pe rie
rie nc
nc e
e wi
of th
ha co
vi m
ng m
an e
ad m
op or
te ati
d ve
ch tat
ild to
w os
ho —
wa so
s m
ult e
im in
ate di
ly vi
“r du
ecl al
ai an
m d
ed ot
” he
1588

rs im
as m
m ed
atc iat
hi el
ng y
art fol
w lo
or wi
k ng
sh th
ar eir
ed ex
by pe
pa rie
re nc
nts e,
. an
Th d
es pe
e rm
m an
e en
m t
ori m
als e
he m
lp ori
pa als
re lik
nts e
to tat
m to
ou os
rn ca
th n
eir be
los pa
s rt
wi of
thi th
n eir
th lo
eir ng
co -
m ter
m m
un he
iti ali
es ng
 1589

pr d
oc re
es pr
s od
an uc
d tiv
th e
eir lo
co ss
nn in
ect L
io G
n B
to T
wi Q
de co
r m
co m
m un
m iti
un es
iti is
es rel
of ati
su ve
pp ly
ort na
. sc
en
t,
Co st
nc ud
lu ies
si ar
on e
e
Al m
th er
ou gi
gh ng
res ac
ea ro
rc ss
h a
on va
inf rie
ert ty
ilit of
y ac
an ad
1590

e T
mi Q
c pe
dis op
ci le
pli ar
ne e
s m
an or
d e
he lik
alt el
h y
pr to
of ha
es ve
sio in
ns. vo
Si lv
nc ed
e le
th ng
er th
e y
is pl
gr an
o ni
wi ng
ng an
ev d
id re
en so
ce ur
th ce
at s,
pr pr
eg of
na es
nc si
ies on
an als
d sh
ad ou
op ld
tio be
ns pa
for rti
L cu
G lar
B ly
 1591

att inf
en ert
tiv ilit
e y
to fo
ho r
w L
th G
eir B
re T
pr Q
od in
uc di
tiv vi
e du
his als
tor an
ies d
m fa
ay mi
co lie
ntr s
ib ar
ut e
e lik
to el
an y
d to
a be
m a
pli m
fy pli
ex fie
pe d
rie by
nc in
es eq
of uit
los ab
s. le
Si la
mi ws
lar ,
ly, as
ex w
pe ell
rie as
nc ho
es m
of op
1592

ho es
bi is
c ce
or ntr
he al
ter to
os br
ex oa
ist de
res r
po he
ns alt
es h
by ca
pr re
of eff
es ort
sio s
na ai
ls, m
fa ed
mi at
ly, im
co pr
lle ov
ag in
ue g
s, th
an e
d he
fri alt
en h
ds. —
Be bo
tte th
r ph
un ys
de ic
rst al
an an
di d
ng e
of m
th oti
es on
e al
ex —
pe of
rie L
nc G
 1593

B i
T n
g
Q
po
W
pu h
lat e
io t
ns. h
e
C r
hr
ist t
a o
Cr
av P
a
en r
e
Se
n
e
t
als
;
o
Ad
opt D
ion y
an i
d n
Fo g
ste ,
r D
Ca e
re a
Di t
scr h
imi ,
nat
ion a
; n
C d
o
p B
a e
r r
e e
n a
t v
i e
n m
g e
; n
t
D ;
e
c F
i a
d m
1594

i u
l a
i l
e
s I
d
o e
f n
t
C i
h t
o y
i
c t
e o
; ;
H
H e
e a
a l
l t
t h
h
C D
a i
r s
e p
a
P r
r i
o t
v i
i e
d s
e ;
r
s L
, e
g
D a
i l
s
c R
l i
o g
s h
u t
r s
e
o
o f
f
N
S o
e n
x b
 1595

iF
ou
lr
o
t
g
h
i
ce
ar
l
PR
ae
ra
ed
ni
t
n
s
g
;
s
CaS
ec
cc
oi
na
dt
-o
Pr
ae
r,
e
nJ
t.
,
A
d&
o
pR
ta
if
of
no
,

Z
.

(
2
0
1
1
)
.

A
n
1596

e ,
x
p 5
l 6
o (
r 2
a )
t ,
i
o 1
n 6
9
o –
f 1
7
l 7
e .
s Cr
b av
i en,
a C.,
n &
Pe
m el,
a E.
t (2
e 01
r 4).
n St
a ori
l es
of
b gri
e ef
r an
e d
a ho
v pe:
e Q
m u
e e
n e
t
r
.

S e
o x
c p
i e
a r
l
i
e
W
n
o
r c
k e
 1597

s
m
o o
f t
h
p e
r r
e h
g o
n o
a d
n :
c
y N
a
l r
o r
s a
s t
. i
v
I e
n
a
M n
. d

G t
i h
b e
s o
o r
n e
t
i
(
c
E
a
d
l
.
)
, p
e
r
Q
s
u
p
e
e
e
c
r
t
i
i
n
v
g
e
1598

s
P
( r
p e
s
p
s
. .
Goldb
9erg
7,
–A.
1E.
(2
1
01
0
2).
) Ga
.y
da
Bds:
r Tr
an
a
siti
don
fs
oto
r ad
dop
, tiv
e
fat
Ohe
nrh
t oo
ad.
r Ne
iw
Yo
o
rk,
,N
Y:
CNe
aw
nYo
rk
a
Un
d
ive
arsit
:y
Pr
Dess
e.
mMi
esc
t arr
eiag
re
As
 1599

soc m
iati i
on. s
(20 c
14)
a
.
Pa r
rtn r
ers i
to a
o. g
Re e
trie
a
ve
s
d
s
N
o
o
c
v
i
e
a
m
t
b
i
e
o
r
n
.
1
o
0
r
,
g
.
2
u
0
k
1
/
5
w
,
p
/
f w
r p
o -
m c
o
h n
t t
t e
p n
: t
/ /
/
w u
w p
w l
o
. a
1600

dl
se
/s
2b
i
0
a
1n
1
/a
0n
4d
/
Pb
ai
s
r
e
t
x
nu
ea
rl
sw
-o
Tm
e
o
n
o:
.A
pn
d
fo
Peel n
, l
E i
. n
( e
2
0 s
1 u
0 r
) v
. e
P y
r
e o
g f
n e
a x
n p
c e
y r
l i
o e
s n
s c
i e
n s
 1601

. 4
H 1
uPeel,
m E.,
a &
n Ca
in,
R R.
e (2
p 01
r 2).
o “Si
d len
u t”
c mi
t sca
i rri
o ag
n e
, an
2 d
5 de
( afe
3 nin
) g
, het
7 ero
2 no
1 rm
– ati
7 vit
2 y:
7 A
. Bri
d tis
o h
i ex
: per
1 ien
0 tial
. an
1 d
0 cri
9 tic
3 al
/ fe
h mi
u nis
m t
r ac
e co
p unt
/ .
d In
e S.
p Ea
4 rle,
1602

Cve
. los
s
K(p
op.
m79
a–
r 92
o).
mFa
yrn
, ha
m,
&En
gla
nd:
L
As
.
hg
ate
L
.
a
Walks
y
n,
eM.
(2
( 00
E7).
dBr
s ea
.
kin
)
g
,
the
Usil
nen
dce:
eInf
r ert
s ilit
t
y,
a
nmo
dthe
i rh
noo
gd,
an
rd
e
qu
p
eer
r
ocul
dtur
ue.
cJo
t ur
i na
 1603

l of
the C
As u
so l
cia t
tio u
n r
for e
Re
,
se
ar
a
ch
n
on
d
M
oth
eri C
ng. l
Sp a
eci s
al s
Iss ,
ue:
M 9
o (
t 2
h )
e ,
r
i 1
n 3
g 0
, –
1
R 4
a 3
c .
e
Wojna
, r,
D.
(2
E
00
t 7).
hMi
nsca
i rri
cag
e
i
ex
t per
yien
, ces
of
1604

l 5
e 2
s (
b 5
i )
a ,
n
4
c 7
o 9
u –
p 4
l 8
e 5
s .
.
d
J o
o i
u :
r 1
n 0
a .
l 1
0
o 1
f 6
/
M j
i .
d j
w m
i w
f h
e .
r 2
y 0
0
7
&
.
0
W
3
o
.
m
0
e
1
n
5
’
Woj
s
n
ar
H
,
e
D
a
.,
l
&
t
S
h
w
,
a
n
 1605

s io
o n
n, ?
K J
. o
M u
. r
(2 n
0 a
0 l
6) o
. f
W G
h L
y B
s T
h F
o a
ul m
d il
n’ y
t S
le t
s u
bi d
a i
n e
w s,
o 2
m (
e 1
n ),
w 1
h –
o 1
m 2
is .
c
ar d
ry o
re i
c :
ei 1
v 0
e .
s 1
p 3
e 0
ci 0
al /
c J
o 4
n 6
si 1
d v
er 0
at 2
1606

nno
0rit
1
y
_
0
wi
1thi
n
a
se
IN xu
al
TE mi
LL no
EC rit
y.
TU
Pe
AL op
le
DI wi
SA th
BIL int
ITI ell
ec
ES tu
al
di
Th sa
is bil
en iti
try es
ad (I
dr D)
es ar
se e
s fre
th qu
e en
nu tly
an th
ce ou
d gh
co t
nc to
er be
ns se
of xu
a all
se y
xu in
al no
mi ce
 1607

nt, th
bu at
t se
m xu
an ali
y ty
ha tra
ve ve
th rs
e es
ab int
ilit ell
y ec
to tu
un al
de bo
rst un
an da
d rie
an s,
d th
act er
on e
se is
xu litt
al le
ori su
en pp
tat ort
io fo
n r
an its
d en
ge co
nd ur
er ag
id e
en m
tit en
y. t.
W Th
hil is
e en
it try
is als
re o
co ad
gn dr
ize es
d se
1608

s le
to wi
pi th
cs ID
th an
at d
he in
lp cl
us ud
to es
be th
tte e
r to
un pi
de cs
rst of
an co
d ns
ho en
w t,
se pr
xu ot
al ec
ori tio
en n
tat fr
io o
n m
an ab
d us
ge e,
nd de
er m
id og
en ra
tit ph
y ics
ar ,
e an
ex d
pr ed
es uc
se ati
d on
a .
m Intellectual Disabilities
on
g
pe
op
 1609

Ba e-
ck St
gr on
e
ou
w
nd
all
Pe m
op en
le tal
wi ity
th , a
int la
ell ck
ect of
ua ful
l l
dis ac
ab kn
ilit o
ies wl
ha ed
ve g
be m
en en
int t
eg an
rat d
ed ac
int ce
o pt
so an
cie ce
ty ,
in w
sig he
nif n
ica co
nt ns
wa id
ys, eri
bu ng
t th
th eir
er ne
e ed
is s
sti an
ll d
a de
pr sir
1610

es hu
for m
se an
xu ne
al ed
ex fo
pr r
es se
sio xu
n. al
Sti ex
ll pr
e es
m si
er on
gi as
ng th
is os
th e
e wi
re th
co ou
gn t
iti di
on sa
th bil
at iti
pe es.
op N
le ati
wi on
th al
an or
int ga
ell ni
ect za
ua tio
l ns
dis su
ab pp
ilit ort
y in
sh g
ar pe
e op
th le
e wi
sa th
m ID
e ,
 1611

su ID
ch do
as es
th no
e t
A pr
m ec
eri lu
ca de
n so
As m
so eo
cia ne
tio fr
n o
of m
Int be
ell in
ect g
ua ab
l le
an to
d ex
De pl
ve or
lo e
p an
m d
en en
tal jo
Di y
sa hi
bil s
iti or
es he
an r
d se
Th xu
e ali
Ar ty,
c, bu
ac t
kn th
o er
wl e
ed is
ge litt
th le
at ev
an id
1612

en ies
ce gu
th idi
at ng
se pr
xu of
ali es
ty si
is on
su als
pp w
ort ho
ed su
an pp
d ort
en pe
co op
ur le
ag wi
ed. th
Th ID
es s
e an
dif d
fic th
ult eir
ies im
res pl
ult e
in m
a en
sta tat
rk io
co n
ntr wi
ast th
be th
tw e
ee ve
n ry
th pe
e op
ov le
er th
ar e
ch po
in lic
g ies
po ar
lic e
 1613

de T
sig he
ne re
d is
to a
im we
pa ll-
ct. do
Pe cu
op m
le en
wi te
th d
ID his
ha tor
ve y
m of
an ho
y w
ob pe
sta op
cle le
s wi
to th
ov ID
er ha
co ve
m be
e en
in de
or ni
de ed
r op
to po
ha rtu
ve nit
op ies
po for
rtu se
nit xu
ies al
for ex
se pr
xu es
al sio
ex n.
pr M
es o
sio m
n. en
1614

ts c
of att
int itu
im de
ac s
y th
an at
d re
the ga
abi rd
lit th
y e
to m
de as
vel se
op xu
clo all
se y
pe in
rso no
nal ce
rel nt
ati an
on d
shi re
ps qu
are iri
fre ng
qu pr
ent ot
ly ect
res io
tri n
cte fro
d m
for ad
pe ult
op ex
le pe
wi rie
th nc
ID es.
, M
du an
e y
to pe
pat op
er le
nal wi
isti th
 1615

ID id
, en
es tia
pe l
cia an
lly d
th vo
os cat
e io
wh na
o l
rec ser
eiv vi
e ce
su s,
pp rel
ort y
thr on
ou su
gh pp
sta ort
te- sta
sp ff
on to
sor fa
ed cil
ser ita
vic te
es th
an e
d da
the ily
ir ro
net uti
wo ne
rk s
of of
pri lif
vat e.
e De
no ve
np lo
rof pi
it ng
pr a
ov rel
ide ati
rs on
for shi
res p
1616

tha wa
t rdr
ha ob
s e,
the an
po d
ten pri
tia va
l cy
to ,
lea a
d m
to on
int g
im m
ac an
y y
wi ot
th he
an r
ot co
he nsi
r de
pe rat
rso io
n ns.
oft M
en an
re eu
qu ve
ire rin
s g
ac wi
ce thi
ss n
to a
fin rel
an ati
cia on
l shi
res p
ou is
rce fur
s, th
tra er
ns co
po m
rta pli
tio cat
n, ed
 1617

for op
pe le
op wi
le th
wi ID
th do
ID no
, t
sin dri
ce ve
the ).
y Th
ca e
n ab
be ilit
de y
pe of
nd a
ent pe
on rs
su on
pp wi
ort th
sta ID
ff to
for ex
ac pl
ce or
ss e
to se
va xu
rio al
us ex
res pr
ou es
rce sio
s n
(e. en
g., ga
tra ge
ns sa
po pr
rta oc
tio es
n, s
sin th
ce at
ma fre
ny qu
pe en
1618

tly e
re fil
qu ter
ire ed
s thr
sta ou
ff gh
sta
Intel
lectu
ff
al
an
Disa
d
biliti
be
es
co
m
wh e
o in
ar co
e rp
co or
mf at
ort ed
ab int
le o
wi pr
th ac
pr tic
ov es,
idi pe
ng op
th le
at wi
su th
pp ID
ort ca
. n
W ex
he pe
n rie
se nc
xu e
al va
ex ryi
pr ng
es ou
sio tc
n o
to m
pi es
cs as
ar ref
 1619

lec th
te e
d su
al pp
on ort
ga pe
co rs
nti on
nu w
u he
m n
fro fa
m cil
lo ita
w tin
to g
hi se
gh xu
sta al
ff ex
su pr
pp es
ort si
. on
Th op
es po
e rtu
ou nit
tc ies
o fo
m r
es th
ar eir
e cli
oft en
en ts
co wi
nn th
ect ID
ed .
to P
th eo
e pl
co e
mf wi
ort th
le ID
ve oft
l en
of re
1620

qu go
ire es
ad be
dit yo
io nd
nal th
ass e
ist tra
an dit
ce io
to na
de l
vel se
op x
an ed
un uc
de ati
rst on
an pr
di og
ng ra
of ms
se to
xu on
ali e
ty. th
Th at
ey in
re vo
qu lv
ire es
a a
co pe
m rs
pr on
eh -
en ce
siv nt
e er
ap ed
pr su
oa pp
ch ort
to tea
se m
xu wi
ali th
ty in
tha di
t vi
 1621

du ve
ali rs
ze an
d d
ass pr
ess ov
me id
nt er
of ag
ne en
ed cie
s. s
Th to
e ad
pri eq
ma ua
ry tel
ba y
rri ad
er dr
to es
se s
xu se
al xu
ex ali
pr ty.
ess It
io wa
n s
by be
pe lie
op ve
le d
wi th
th at
ID by
ha de
s lib
be er
en ate
an ly
ins ke
uff ep
ici in
ent g
eff pe
ort op
by le
car wi
egi th
1622

ID res
un ult
inf in
or g
me ig
d no
ab ra
ou nc
t e
iss m
ue an
s ife
in sts
vo in
lvi hi
ng gh
se er
xu rat
ali es
ty, of
the se
y xu
co al
ul ab
d us
be e,
pr un
ote saf
cte e
d se
fro xu
m al
ex pr
pe act
rie ice
nci s,
ng un
a int
se en
xu de
al d
aw pr
ak eg
eni na
ng. nc
Ho ies
we ,
ve in
r, ap
the pr
 1623

op wi
ria th
te ID
so re
cia co
l gn
be ize
ha th
vi er
or, e
an is
d an
ult in
im he
ate re
ly nt
a se
di xu
mi al
nis rig
he ht
d for
qu pe
ali op
ty le
of wi
lif th
e. ID
E,
ve pe
n rsi
th ste
ou nt
gh co
ma ns
ny er
of va
the tiv
ag e
en so
cie cie
s tal
tha att
t itu
su de
pp s
ort res
pe tri
op ct
le th
1624

eir ns
rig er
ht va
to tiv
se e
xu vi
al ew
ex s
pr to
ess wa
io rd
n. all
M bu
an t
y th
pa e
re m
nts ost
, be
ser ni
vic gn
e ex
pr pr
ov es
ide sio
rs ns
of of
pe se
op xu
le ali
wi ty.
th Co
ID ns
, er
an va
d tiv
ev e
en an
pe d
op ne
le ga
wi tiv
th e
ID att
ho itu
ld de
m s
or res
e ult
co in
 1625

the res
ide se
nti d
fic ar
ati ea
on in
of th
pe e
op su
le pp
wi ort
th of
ID pe
as op
in le
no wi
ce th
nt ID
de .
pe Sp
nd eci
ent fic
s all
re y,
qu th
iri er
ng e
pr is
ote li
cti mi
on te
fro d
m ac
ad kn
ult o
ex wl
pe ed
rie g
nc m
es. en
Se t
xu th
ali at
ty pe
is op
an le
un wi
de th
ra ID
dd ca
1626

n ntr
un ac
de ep
rst tiv
an es.
d Pe
ma op
ny le
to wi
pic th
s ID
rel ar
ati e
ng fre
to qu
se en
xu tly
ali rel
ty ia
an nt
d on
se su
xu pp
al ort
ex sta
pr ff,
ess ye
io t
n th
inc er
lu e
di is
ng a
ge lac
nd k
er of
ide inf
nti or
ty, m
saf ati
e- on
se re
x ve
pr ali
act ng
ice ho
s, w
an ca
d re
co gi
 1627

ve id
r an
pr ce
act ref
ice le
s cti
im ng
pa ho
ct w
the ca
abi re
lit gi
y ve
of rs
pe ca
op n
le su
wi pp
th ort
ID pe
to op
ex le
pe wi
rie th
nc ID
e w
se he
xu n
al th
ex os
pr e
ess op
io po
n. rtu
W nit
ha ies
t is e
ne m
ed er
ed ge
in .
th
e
pr
of
es
sio
n
is
gu
1628

D tat
e io
m n
of
og
its
ra
di
ph ve
ics rsi
Re ty.
co As
gn a
izi m
ng ar
th gi
e na
de liz
m ed
og gr
ra ou
ph p,
ic pe
co op
nsi le
de wi
rat th
io ID
ns ha
of ve
a oft
cu en
ltu be
ral en
gr pr
ou es
p en
all te
o d
ws as
for m
a on
m oli
or thi
e c
in- an
de d
pt se
h xu
pr all
es y
en ob
 1629

sc wi
ur thi
e. n
Th th
er e
ef po
or pu
e, lat
th io
e n.
co A
nsi di
de ag
rat no
io sis
n of
of int
de ell
m ect
og ua
ra l
ph dis
ics ab
of ilit
pe y
op re
le qu
wi ire
th s
ID th
pr e
ov pr
id es
es en
a tat
pa io
th n
for of
re thr
co ee
gn cri
izi ter
ng ia.
se Th
xu es
al e
di in
ve cl
rsi ud
ty e
1630

(1) be
a for
su e
ba th
ve e
ra ag
ge e
ge of
ne 18
ral . It
int is
ell ge
ect ne
ual ral
fu ly
nct ac
io ce
ni pt
ng ed
wi th
th at
an up
IQ to
bel 3
ow %
70, of
(2) th
li e
mi U.
tat S.
io po
ns pu
in lat
ad io
apt n
ive ex
be pe
ha rie
vi nc
ors es
, an
an int
d ell
(3) ect
a ua
ma l
nif dis
est ab
ati ilit
on y,
 1631

an ve
d th
am e
on ca
g pa
the cit
se y
9 to
mi un
lli de
on rst
pe an
op d
le, saf
m e
ost se
ex xu
pe al
rie pr
nc act
e ice
on s.
ly M
a an
mi y
ld stu
int di
ell es
ect ha
ual ve
dis be
abi en
lit co
y. nd
Th uc
is te
me d
an to
s id
tha en
t tif
m y
ost th
pe e
op po
le pu
wi lat
th io
ID n
ha of
1632

L ify
G ,
B th
T e
Q W
pe illi
op a
le. ms
Th In
es sti
e tut
stu e’s
die 20
s 11
us stu
ual dy
ly re
rel po
y rte
on d
sel th
f- at
dis 3.
clo 5
sur %
e of
of th
se e
xu po
al pu
ide lat
nti io
ty, n
an id
d en
wh tifi
ile es
the as
co les
m bi
m an
un ,
ity ga
is y,
dif or
fic bis
ult ex
to ua
qu l
ant (L
 1633

G in
B), cl
an ud
d in
an g
ot int
he ell
r ect
0.3 ua
% l
ide bo
nti un
fie da
s rie
as s,
tra a
ns be
ge st
nd est
er. im
Si ate
nc w
e ou
se ld
xu be
al th
ori at
ent th
ati er
on e
an ar
d e
ge ap
nd pr
er ox
ide im
nti ate
ty ly
tra 35
ve 0,
rse 00
m 0
ult L
ipl G
e B
bo T
un Q
da pe
rie op
s, le
1634

wi en
th s
ID ov
in er
the ti
Un m
ite e.
d Se
St xu
ate al
s. kn
o
wl
O ed
n ge
Be is
co ob
mi tai
ne
ng
d
a by
Se en
xu ga
al gi
Pe ng
rs in
on pe
rs
De on
ve al
lo ex
pi pl
ng or
se ati
xu on
al ,
kn fo
o rm
wl al
ed se
ge x
for ed
an uc
yo ati
ne on
us ,
ua pe
lly er
ha int
pp er
 1635

act es.
io Fo
ns, r
an pe
d op
m le
ed wi
ia th
co ID
ns ,
u th
m e
pti pr
on oc
, es
a s
m ca
on n
g be
m ar
an du
y ou
ot s
he as
r th
wa ey
ys m
th us
at t
a fre
pe qu
rs en
on tly
dis na
co vi
ve ga
rs te
w m
ha aj
t or
he ob
or sta
sh cl
e es
lik du
es e
an to
d a
dis la
lik ck
1636

of l
for int
m er
al ac
ed tio
uc ns
ati .
on To
, o
lo oft
w en
ex ,
pe in
cta or
tio de
ns r
fro fo
m ra
fa pe
mi rs
ly on
an wi
d th
so ID
cie to
ty, be
su ab
pp le
ort to
sta ha
ff ve
in se
dif xu
fer al
en op
ce, po
an rtu
d nit
li ies
mi ,
te th
d e
op in
po di
rtu vi
nit du
ies al
for m
so us
cia t
 1637

be e
ab op
le po
to rtu
art nit
ic ies
ul oc
ate cu
or r.
de Th
m er
on e
str ar
ate e
his se
or ve
he ral
r co
de ns
sir id
es er
an ati
d on
int s
en th
tio at
ns ca
an n
d as
th sis
en t
ha pe
ve op
a le
ne wi
tw th
or ID
k to
of ex
su pr
pp es
ort s
to th
en eir
su se
re xu
th ali
at ty
th in
os cl
1638

ud ue
in s
g an
un d
de so
rst ci
an al
di no
ng rm
w s,
ha an
t it d
m m
ea ai
ns nt
to ai
gi ni
ve ng
co go
ns od
en w
t, or
pa ki
rti ng
ci rel
pa ati
tin on
g sh
in ip
ed s
uc wi
ati th
on su
al pp
op ort
po sta
rtu ff.
nit
ies
, On
lea Being
rni LGBT
ng Q
ab With
ou an
t Intell
le ectua
ga l
l
iss
 1639

e
co
m
Pe
m
op
un
le
iti
wi
es.
th
Ju
ID
st
an
as
d
pe
pe
op
op
le
le
wi
w
th
ho
ID
ar
ar
e
e
L
pa
G
rt
B
of
T
a
Q
m
ar
ar
e
gi
aw
na
ar
liz
e
ed
th
co
at
m
th
m
er
un
e
ity
is
,
bi
th
as
ey
an
als
d
o
dis
en
cri
co
mi
un
na
ter
tio
an
n
ad
dir
dit
ect
io
ed
na
at
l
th
bu
es
rd
1640

en pe
w op
he le
n wi
th th
ey ID
id fre
en qu
tif en
y tly
as en
L du
G re,
B su
T ch
Q. as
De th
spi e
te R-
se w
ve or
ral d
ini ca
tia m
tiv pa
es ig
th n
at to
ha eli
ve mi
de na
alt te
wi th
th e
th us
e e
dis of
cri th
mi e
na w
tio or
n d
an re
d ta
bu rd
lly ed
in in
g so
th ci
at al
 1641

ve yi
rn ng
ac as
ul a
ar se
an xu
d al-
po mi
pu no
lar rit
cu y
ltu pe
re, rs
ch on
an an
ge d
is be
dif in
fic g
ult pa
to rt
en of
act an
. ot
Si he
mi r
lar sti
ly, g
pe m
op ati
le ze
wi d
th co
ID m
ca m
n un
be ity
co .
nfl S
ict in
ed ce
ab m
ou ost
t pe
op op
en le
ly wi
id th
en ID
tif rel
1642

y ne
on d
ot by
he ho
rs w
to co
ass mf
ist ort
the ab
m le
wi th
th eir
the su
ir pp
dai ort
ly sta
lif ff
e, an
wh d
eth fa
er mi
or ly
no m
t e
the m
y be
are rs
abl ar
e e
to wi
ha th
ve th
op e
po m
rtu en
nit ga
ies gi
for ng
se in
xu th
al es
ex e
pr act
ess ivi
io tie
n s.
is Su
det pp
er ort
mi sta
 1643

ff w
wo he
rki n
ng a
wi pe
thi rs
n on
the se
dis ek
abi s
lit to
y en
co ga
m ge
m in
un an
ity y
ma se
y xu
ha al
ve act
co ivi
ns ty.
er I
vat t
ive ca
rul n
es be
an dif
d fic
val ult
ue for
s, pe
the op
re le
by wi
pr th
es ID
ent to
in fin
g d
ad a
dit pe
io er
nal gr
ch ou
all p
en w
ge he
s re
1644

the en
y ga
ca ge
n hi
fin s
da or
pa he
rtn r
er. se
So xu
ali
Intellectual Disabilities
ty
is
li
in
mi
a
te
su
d
pp
ar
ort
e
gr
th
ou
e
p
op
w
po
he
rtu
re
nit
th
ies
er
th
e
at
is
oft
on
en
ly
th
co
e
nv
on
er
ly
sat
wa
io
y
n
for
an
an
d
L
fe
G
w
B
op
T
po
Q
rtu
pe
nit
rs
ies
on
fo
wi
r
th
se
ID
xu
to
al
 1645

act on
ivi th
tie an
s. as
So a
m pe
e rs
pe on
op wi
le th
wi ID
th .
ID A
ha to
ve pi
sai c
d fo
th r
at re
th se
ey ar
fin ch
d w
gr ou
eat ld
er be
so to
cie co
tal ns
ac id
ce er
pt ho
an w
ce pe
of op
th le
eir wi
se th
xu ID
ali na
ty vi
as ga
an te
L th
G eir
B co
T nn
Q ec
pe tio
rs n
1646

be As
tw so
ee ci
n ati
th on
es of
e Int
tw ell
o ec
m tu
ar al
gi an
na d
liz D
ed ev
co el
m op
m m
un en
iti tal
es. Di
sa
bil
Co iti
ns es
en [A
t AI
D
Ag
D]
en
an
cie
d
s
Th
wi
e
thi
Ar
n
c)
th
pr
e
es
ID
u
pr
m
of
e
es
th
sio
at
n
pe
(e.
op
g.,
le
A
wi
m
th
eri
ID
ca
ar
n
e
 1647

ab di
le sa
to bil
m ity
ak , a
e pe
im rs
po on
rta wi
nt th
pe ID
rs m
on an
al y
de no
cis t
io ha
ns ve
th th
at e
all ca
o pa
w cit
th y
e to
m gi
to ve
lea va
d lid
sel co
f- ns
de en
ter t
mi to
ne en
d ga
liv ge
es. in
H se
o xu
we al
ve ac
r, tiv
be iti
ca es.
us W
e he
of n
th a
e pe
1648

rs s
on m
is ay
un be
ab im
le pa
to ct
gi ed
ve by
va th
lid e
co ab
ns ilit
en y
t, of
le th
ga e
l in
int di
er vi
ve du
nti al
on to
m gi
ay ve
be co
re ns
qu en
ire t.
d Pe
to op
de le
sig wi
na th
te ID
a ar
gu e
ar ge
di ne
an. ral
Di ly
ffe ab
re le
nt to
se pa
xu rti
al ci
act pa
ivi te
tie in
 1649

be es
ni pe
gn ci
act all
ivi y
tie th
s, os
su e
ch th
as at
de in
m vo
on lv
str e
ati sa
on m
s e-
of ge
aff nd
ect er
io se
n xu
or al
lea be
rni ha
ng vi
ab or
ou s,
t re
se qu
xu ire
al pr
he of
alt es
h, si
bu on
t al
m sc
or rut
e in
int y
im to
ate de
ph ter
ysi mi
cal ne
act w
ivi he
tie th
s, er
1650

th gi
e ve
in n
di an
vi d
du wi
al th
ca ou
n t
be co
saf er
e ci
an on
d .
is As
ab sis
le tin
to g
gi pe
ve op
co le
ns wi
en th
t ID
to to
th ha
e ve
act be
ivi tte
ty. r
Va ac
lid ce
co ss
ns to
en se
t xu
m al
ea ex
ns pr
th es
at si
it on
m re
ust qu
be ire
vo s
lu su
nt pp
ari ort
ly sta
 1651

ff fr
to o
un m
de ha
rst vi
an ng
d m
th or
at e
th in
e vo
ab lv
ilit ed
y op
to po
gi rtu
ve nit
co ies
ns .
en
t is
bu Pr
t ot
on ec
e ti
res o
ou n
rc
Fr
e
an
o
d m
do A
es b
no us
t e
au
to It
m is
ati wi
cal de
ly ly
res no
tri te
ct d
an th
in at
di pe
vi op
du le
al wi
1652

th l
ID ac
ex tio
pe ns
rie .
nc Su
ea pp
ve ort
ry sta
hi ff
gh oft
rat en
e re
of ce
se iv
xu e
al tra
ab ini
us ng
e. Inten
Vi tions
cti and
Moti
mi
vatio
zat ns to
io Pare
n nt
in
cl
ud ab
es ou
bo t
th ho
se w
xu to
all re
y co
in gn
ap iz
pr e,
op pr
ria ev
te en
an t,
d an
no d
nc re
on po
se rt
ns in
ua sta
 1653

nc al
es ab
of us
ab e.
us Ev
e. en
In th
pa ou
rt gh
be th
ca e
us L
e G
of B
thi T
s Q
dy co
na m
mi m
c, un
su ity
pp ha
ort s
sta m
ff ad
ca e
n tre
int m
er en
pr do
et us
an so
y ci
dis al
pl ad
ay va
s nc
of e
se m
xu en
ali ts
ty su
to ch
be as
a th
ris e
k de
for cri
se mi
xu na
1654

liz ab
ati ou
on t
of w
sa ha
m t
e- is
se le
x ga
act lly
ivi an
tie d
s m
an or
d all
th y
e pe
fre rm
ed iss
o ibl
m e
to fo
le r
ga pe
lly op
m le
arr wi
y, th
m ID
an to
y ex
in pe
di rie
vi nc
du e.
als
an
d
Ed
su uc
pp a
ort ti
sta o
ff n
ca
n A
be de
co sir
nfl e
ict fo
ed r
 1655

rel th
ati at
on ro
shi m
ps an
an tic
d rel
se ati
xu on
al sh
ex ip
pr s
es an
sio d
n se
is xu
a al
fu ac
nd tiv
a ity
m ar
en e
tal als
co o
m im
po po
ne rta
nt nt
of iss
th ue
e s
hu fo
m r
an pe
ex op
pe le
rie wi
nc th
e. ID
It .
is Fr
im ie
po nd
rta sh
nt ip
to s
re an
co d
gn int
ize er
1656

act s.
io Se
ns x
wi ed
th uc
su ati
pp on
ort m
sta us
ff, t
vo be
lu tai
nt lor
ee ed
rs, no
an t
d on
fa ly
mi fo
ly r
m pe
e op
m le
be wi
rs th
ca ID
nn ,
ot bu
su t
bst als
itu o
te fo
for r
pe th
rs os
on e
al w
fri ho
en m
ds us
an t
d pr
int ov
im id
ate e
co in
m di
pa vi
ni du
on ali
 1657

ze se
d xu
su al
pp ex
ort pr
an es
d si
ad on
vo of
ca pe
cy op
for le
th wi
eir th
cli ID
en .
ts. A
m
on
Co g
nc th
lu e
si m
on os
t
M
da
an
m
y
ag
en
in
du
g
rin
ha
g
s
as
be
su
en
m
th
pti
at
on
th
s
ey
ha
ar
ve
e
be
as
en
ex
m
ua
ad
l
e
or
ab
ch
ou
ild
t
lik
th
e
e
an
1658

d ed
de or
ser by
ve de
pr lib
ot er
ect at
io el
n y
fro wi
m th
su ho
ch ldi
ad ng
ult se
ex xu
pe al
rie ed
nc uc
es. ati
Ot on
he ,
rs th
ha ey
ve co
si ul
mi d
lar m
ly ai
be nt
lie ai
ve n
d a
th se
at xu
by al
ke in
ep no
in ce
g nc
th e.
os H
e o
wi w
th ev
ID er,
un th
inf er
or e
m is
 1659

a ss
gr to
o se
wi xu
ng al
aw pl
ar ea
en su
es re,
s an
th d
at fo
ha rm
vi fri
ng en
a ds
go hi
od ps
qu th
ali at
ty ca
of n
lif de
e ve
in lo
vo p
lv int
es o
be ro
in m
g an
ab tic
le rel
to ati
po on
ss -
es shi
s ps
se .
xu Th
al e
kn ab
o ilit
wl y
ed to
ge, pa
ha rti
ve ci
ac pa
ce te
1660

in to
lif be
e sa
as fe
a w
se he
xu n
al en
pe ga
rs gi
on ng
wi in
th se
a xu
ba al
sic ac
kn tiv
o iti
wl es
ed is
ge a
of fu
bi nd
ol a
og m
ica en
l tal
an rig
d ht
e of
m all
oti pe
on op
al le.
se A
xu ck
al no
fu wl
nc ed
tio gi
ni ng
ng an
an d
d pr
to ac
kn tic
o in
w g
ho thi
w s
 1661

rig g.
ht In
en or
ga de
ge r
sa fo
pr r
oc pe
es op
s le
th wi
at th
be ID
gi to
ns ha
wi ve
th gr
sel ea
f- ter
aw ac
ar ce
en pt
es an
s ce
an in
d so
lea ci
ds et
to y,
sel th
f- e
de ne
ter ed
mi fo
na r
tio ge
n nu
an in
d e
gr op
eat po
er rtu
in nit
de ies
pe fo
nd r
en se
t xu
liv al
in ex
1662

pr d
es th
sio e
n pr
is of
a es
fro si
nti on
er al
th ne
at tw
wi or
ll k
ha of
ve su
to pp
be ort
ac .
kn Jo
o hn
wl D.
ed Al
ge le
d n
no
See
t
als
on
o
ly
Ag
by
e
pe
of
op
Co
le
ns
wi
ent
th
;
ID
All
, y
bu Ex
t per
als ien
o ce;
by Bu
fa lly
mi ing
ly ,
m Ra
e tes
m an
be d
rs Eff
an ect
 1663

s (
of; 2
Ph 0
ysi 0
cal 3
Dis )
abi .
liti
es;
G
Su
a
pp
y
ort
,
Gr
ou
ps l
an e
d s
Re b
sou i
rce a
s n
,

F
b
u
i
r
t s
h e
e x
r u
a
R l
e ,
a
d a
i n
n d
g
s
t
All r
e a
n n
, s
g
J e
. n
d
D e
. r
1664

p l
e
o r
p e
l t
e a
r
w d
i a
t t
h i
o
d n
e :
v
e S
l t
o o
p r
m i
e e
n s
t
a o
l f

d t
i h
s e
a
b R
i a
l i
i n
t b
i o
e w
s
S
a u
n p
d p
o
m r
e t
n
t G
a r
 1665

o,
uM.
pS.
. (19
B93)
i.
nDe
g
vel
h
opi
a
mng
t sta
off
nco
, mp
ete
N
nci
Y
: es
for
Hsu
app
wort
oing
r
pe
t
hopl
.e
Ga wit
rh
dde
nvel
eop
r me
, nta
l
Jdis
. abi
liti
es:
F
An
.
ori
,
ent
ati
&
on
ha
Cnd
hbo
aok
p(2n
md
aed.
n
1666

) 9
. 2
)
B .
a
l U
t n
i d
m e
o r
r s
e t
, a
n
M d
D i
: n
g
B
r a
o n
o d
k
e e
s x
. p
Mo r
n e
a s
t s
- i
H n
a g
l
l s
e e
r x
, u
a
R l
. i
t
K y
. :

( R
1 e
9 s
 1667

p t
o a
n l
s
i d
b i
l s
e a
b
c i
h l
o i
i t
c i
e e
s s
.
f
o B
r a
l
i t
n i
d m
i o
v r
i e
d ,
u
a M
l D
s :

w B
i r
t o
h o
k
d e
e s
v .
e Sc
l hw
ier
o
,
p K.
mM.
e,
n&
Hi
1668

ng t
sb i
urg e
er, s
D. .
(20 B
00) a
. l
Se t
xu i
ali m
ty: o
Y r
o e
u ,
r
s M
o D
n :
s
a B
n r
d o
d o
a k
u e
g s
h .
t
Stav
e i
r s
s ,
wP
i .
t F
h .,
i &
n
t W
e a
l l
l k
e e
c r
t -
u H
a i
l r
d s
i c
s h
a ,
b L
i .
l W
i .
 1669

( O
1 ’
9 S
9 u
9 ll
). i
C v
o a
n n
s (
e E
n d
t s
t .
o )
s ,
e A
x
u g
a u
l i
a d
c e
ti t
v o
it
y c
. o
I n
n s
R e
. n
D t
. (
D p
i p
n .
e 5
r 7
st –
e 6
i 7
n )
, .
S W
. a
S s
. h
H i
e n
rr g
, t
& o
J n
. ,
L D
. C
1670

: (E
A d.).
m (20
e
07)
ri
c .
a Th
n e
A fac
s ts
s
of
o
life
c
i ...
a an
ti d
o mo
n re:
o
Se
n
M xu
e ali
n ty
t an
a d
l
int
R
e im
t ac
a y
r for
d pe
a opl
ti
e
o
n wit
. h
Wa int
l ell
kect
eual
r dis
- abi
Hliti
i es.
r Bal
stim
core
h,
,M
D:
LBr
. oo
 1671

k,
eC
sa
n
.
a
Wolf d
en a:
sb N
er at
ge io
r, n
W al
. In
(1 st
9 it
7 ut
2) e
. o
T n
h M
e e
p nt
ri al
n R
ci et
pl ar
e d
of at
n io
o n.
r
m
al
iz
at I
io N
n
in T
h E
u
N
m
a T
n I
se
rv
O
ic N
es S
.
T
or A
o N
nt
o,
D
O
nt
ar M
io O
1672

T all
I y
be
V
co
A m
T e
I pa
O re
nt
N
s.
S U
n
T w
O an
te
d
P pr
A eg
R na
nc
E
ies
N do
T oc
cu
r,
Ar bu
ou t
nd m
th os
e t
w un
orl pl
d an
an ne
d d
ac pr
ro eg
ss na
cu nc
ltu ies
res ar
, e
m m
ost er
pe el
op y
le mi
ev sti
en m
tu ed
 1673

; int
m en
ost tio
ch ns
ild an
les d
s m
pe oti
op va
le tio
ar ns
e fo
m r
oti pa
va re
te nt
d ho
to od
be ha
co ve
m ap
e pe
pa ar
re ed
nts in
an lit
d er
pl at
an ur
to e
be as
co ol
m d
e as
pa th
re e
nts H
at eb
so re
m w
e Bi
ti bl
m e,
e. an
De d
scr th
ipt ey
io pe
ns rsi
of st
1674

cr y,
os pe
s- op
cu le
ltu in
ral W
ly est
to er
da n
y. so
Ev ci
en eti
th es
e w
ph ho
en ex
o pe
m rie
en nc
a ed
of sa
no m
nh e-
ete se
ro x
se de
xu sir
al es
an an
d d
tra int
ns im
ge ac
nd ies
er oft
pa en
re m
nt arr
ho ie
od d
ar dif
e fer
no en
t t-
ne se
w: x
Hi pa
sto rtn
ric er
all s
 1675

an y.
d M
be os
ca t
m L
e G
pa B
re T
nts Q
, a pe
pr op
act le
ice to
th da
at y,
ha ho
s w
be ev
co er,
m fa
e ce
les un
s iq
co ue
m ba
m rri
on er
a s
m to
on pa
g re
se nt
xu ho
al- od
mi .
no Fa
rit mi
y ly
ad fo
ult rm
s, ati
bu on
t ou
sti tsi
ll de
oc of
cu he
rs ter
to os
da ex
1676

ua og
l ic
m al
arr ba
ia rri
ge er
ha s
s to
his pa
tor re
ica nt
lly ho
be od
en th
sti at
g ca
m n
ati re
ze nd
d er
in int
W en
est tio
er ns
n an
so d
cie m
tie oti
s, va
an tio
d ns
th fo
er r
e pa
ar re
e nt
le ho
ga od
l, a
so m
cia on
l, g
fin L
an G
cia B
l, T
an Q
d pe
bi op
ol le
 1677

m pe
or op
e le’
co s
m int
pl en
ex tio
th ns
an an
a d
m m
on oti
g va
cis tio
ge ns
nd for
er, pa
he re
ter nt
os ho
ex od
ua .
l Fu
pe rth
op er,
le. it
Twi
his ll
ent dis
ry cu
wi ss
ll res
de ea
scr rc
ibe h
res wi
ear th
ch les
fin bi
di an
ng ,
s ga
ab y,
ou bis
t ex
L ua
G l,
B tra
T ns
Q ge
1678

nd al
er, of
an di
d ve
qu rsi
eer ty
pe wi
op thi
le n
wi L
th G
att B
ent T
io Q
n co
to m
the m
wa un
ys iti
tha es.
t Th
ex is
pe is
rie pa
nc rti
es cu
wi lar
thi ly
n tru
thi e
s in
gr dis
ou cu
p ssi
ma on
y s
va of
ry, int
gi en
ve tio
n ns
tha for
t pa
the re
re nt
is ho
a od
gr .
eat Ci
de sg
 1679

en co
de m
r e
les bi
bia ol
n, og
bis ica
ex l
ual pa
, re
an nts
d wi
qu th
eer ou
wo t
me cis
n ge
an nd
d er
so fe
me m
tra ale
ns pa
ge rtn
nd ers
er m
pe ust
op pu
le rs
ca ue
n su
be rro
co ga
me cy
pr ,
eg w
na hi
nt, ch
wh is
ile m
ot uc
he h
rs m
wh or
o e
int fin
en an
d cia
to lly
be co
1680

stl pa
y re
tha nt
n ho
do od
no th
r an
ins ot
em he
ina rs,
tio de
n. pe
So nd
me in
me g
m on
be lo
rs cal
of le
L ga
G l
B an
T d
Q so
co cia
m l
m cli
un m
iti ate
es s
are as
lik we
ely ll
to as
fac th
e eir
gr o
eat w
er n
so id
cia en
l tit
an y,
d ge
leg nd
al er
ba ex
rri pr
ers es
to sio
 1681

n, en
an ,”
d w
ot as
he on
r ce
de a
m co
og m
ra m
ph on
ic pa
ch re
ara nt
cte al
ris ref
tic rai
s. n
w
he
In
n
te th
n eir
ti ad
on ol
s es
fo ce
r nt
ch
Pa
ild
re
ca
nt m
ho e
od ou
“N t
o as
w les
I’l bi
l an
ne ,
ve ga
r y,
ha or
ve tra
gr ns
an ge
dc nd
hil er.
dr To
m
1682

an be
y fo
les re
bi ha
an, vi
ga ng
y, ch
tra ild
ns re
ge n
nd Intentio
er, ns and
or Motivati
ons to
qu
Parent
ee
r
(L oft
G en
T im
Q) pli
in ed
di fo
vi rg
du oi
als ng
an pa
d re
th nt
eir ho
pa od
re .
nts Th
, is
co co
mi nfl
ng ati
ou on
t of
as pa
les re
bi nt
an, ho
ga od
y, an
or d
tra he
ns ter
ge os
nd ex
er ua
 1683

lit tsi
y de
ha of
s he
be ter
co os
m ex
e ua
les l
s rel
an ati
d on
les sh
s ip
co s.
m Th
m e
on in
in cr
re ea
ce si
nt ng
de vi
ca si
de bil
s. ity
To of
da op
y, en
m ly
an L
y G
L B
G T
B Q
T pa
Q re
pe nt
op s
le in
ar m
e ed
be ia
co an
mi d
ng da
pa ily
re lif
nts e
ou ha
1684

s ua
he l
lp se
ed x
ch ar
ild e
les no
s w
L av
G ail
B ab
T le,
Q su
pe ch
op as
le ad
to op
re tio
co n,
gn fo
ize ste
th r
at ca
thi re,
s do
is no
po r
ssi in
bl se
e. mi
M na
an tio
y n,
ro su
ut rr
es og
to ac
pa y,
re an
nt d
ho co
od pa
ou re
tsi nti
de ng
of .
he Fe
ter m
os al
ex eb
 1685

od r
ie in
d se
pe mi
op na
le tio
(s n,
uc in
h w
as hi
cis ch
ge a
nd la
er yp
w er
o so
m n
en or
an a
d m
so ed
m ic
e al
tra pr
ns of
ge es
nd si
er on
pe al
op in
le) se
ca mi
n na
be tes
co a
m w
e o
bi m
ol an
og wi
ica th
l fre
pa sh
re or
nts pr
thr ev
ou io
gh us
do ly
no fr
1686

oz l
en pa
do re
no nt
r s
sp thr
er ou
m. gh
M su
ale rr
- og
bo ac
di y,
ed in
pe w
op hi
le ch
(s a
uc w
h o
as m
cis an
ge ca
nd rri
er es
m an
en d
an gi
d ve
so s
m bir
e th
tra to
ns a
ge ch
nd ild
er fo
pe r
op so
le) m
ca eo
n ne
be els
co e.
m C
e op
bi ar
ol en
og tin
ica g
 1687

is a
a ro
va m
ria an
tio tic
n rel
on ati
th on
es sh
e ip.
m Fo
et r
ho ex
ds, a
in m
w pl
hi e,
ch a
tw ga
o y
or m
m al
or e
e co
pe up
op le
le mi
ag gh
re t
e de
to ci
co de
nc to
ei co
ve pa
an re
d nt
rai wi
se th
a a
ch si
ild ng
to le
ge fe
th m
er al
ou e
tsi fri
de en
of d.
1688

In st
ot of
he w
r ha
w t
or so
ds, m
int eo
en ne
tio pl
ns an
to s
en to
ga do
ge .
in N
he ot
ter ab
os ly,
ex thi
ua s
l is
se dis
x tin
ar ct
e fro
no m
lo de
ng sir
er es,
ne w
ce hi
ss ch
ar ar
y e
to w
be ha
co t
m so
eam
pa eo
re ne
nt. w
I an
nte ts
nti to
on do
s ,
co an
nsi d
 1689

m es
oti an
vat d
io int
ns, en
wh tio
ich ns,
are w
the hi
re ch
as a
on pe
s rs
tha on
t mi
so gh
me t
on ex
e pr
wa es
nts s
or by
pla sa
ns yi
to ng
do ,
so “I
me wa
thi nt
ng. to
So be
me co
ti m
me ea
s, pa
the re
re nt,
is bu
a t I
ga do
p n’t
bet thi
we nk
en it
pa wi
re ll
nti ha
ng pp
de en
sir .”
1690

Fo d,
r it
ex is
am to
ple o
, a dif
sin fic
gle ult
ga to
y ov
ma er
n co
in m
his e
40 le
s ga
wh l
o ba
wa rri
nts ers
to to
be ad
co op
me tio
a n
fat as
he a
r sin
mi gl
gh e
t fat
no he
t r,
int or
en be
d in
to g
do a
so sin
if gl
he e
fee pa
ls re
tha nt
t is
he to
is o
to e
o m
ol oti
 1691

on a
all m
y on
dif g
fic bi
ult se
. xu
al
pe
Transgender
op
Peo
le,
ple’
an
sd
Inte
litt
ntio
le
ns
re
for
se
Par
ar
ch
ent
ha
hoo
ds
ad
Un dr
for es
tu se
na d
tel thi
y, s
no to
res pi
ea c
rc sp
h ec
ha ifi
s ca
fo lly
cu a
se m
d on
on g
int Inten
en tions
tio and
ns Moti
for vatio
pa ns to
Pare
re
nt
nt
ho
od
1692

tra tra
ns ns
ge ge
nd nd
er er
pe ad
op ult
le. s
De w
cis ho
io ha
n- ve
m un
ak de
in rg
g on
ab e
ou or
t ar
bi e
ol co
og ns
ica id
l eri
pa ng
re un
nt de
ho rg
od oi
, ng
in ho
pa rm
rti on
cu al
lar th
, er
pr ap
es y
en or
ts se
ch x
all re
en as
ge si
s gn
for m
ch en
ild t
les su
s rg
 1693

er ldl
y. es
Th s
is tra
tra ns
nsi ge
tio nd
n er
m ad
ay ult
int s
erf wa
er nt
e an
wi d
th int
th en
e d
po to
te be
nti co
al m
for e
bi pa
ol re
og nts
ica .
l So
pa m
re e
nt tra
ho ns
od ge
. nd
Eer
xis ad
tin ult
g s
res fre
ear ez
ch e
su th
gg eir
est ge
s ne
tha tic
t m
ma ate
ny ria
chi l
1694

(i. alr
e., ea
sp dy
er pa
m, re
eg nts
gs) ,
pri to
or ha
to ve
un ad
de dit
rg io
oi na
ng l
bi ch
ol ild
og re
ica n
l aft
tra er
nsi tra
tio nsi
ns. tio
Th ni
is ng
ca .
n So
all m
ow e
the ch
m ild
to les
ful s
fill tra
int ns
ent ge
io nd
ns er
for m
pa en
re re
nt gr
ho et
od, th
or, at
if th
the ey
y di
are d
 1695

no m
t en
do we
thi re
s. un
In aw
so ar
me e
ca th
ses at
, th
the e
tec tec
hn hn
ol ol
og og
y y
wa wa
sn’ s
t av
av ail
ail ab
abl le.
e Th
at es
the e
ti fin
me di
the ng
y s
tra ha
nsi ve
tio im
ne pli
d, cat
an io
d ns
in for
ot m
he en
r tal
ca an
ses d
, ph
the ysi
tra cal
ns he
ge alt
nd h
er ca
1696

re. pa
Pr re
ov nt
ide ho
rs od
mi wi
gh th
t th
hel os
p e
tra w
ns ho
ge ar
nd e
er co
pe nsi
op de
le rin
ma g
ke ho
inf rm
or on
me e
d th
de er
cis ap
io y
ns or
ab se
ou x
t re
re as
pr sig
od n
uct m
io en
n t
by su
dis rg
cu er
ssi y.
ng
po
ssi
Lesbian
ble and
int Gay
ent People’
io s
ns Intenti
for ons for
 1697

ae
Parent
l
hood
(th
M
e
an
na
y
tio
ch
ns
ild
st
les
ud
s
ie
les
d)
bi
re
an
po
an
rt
d
th
ga
at
y
th
ad
ey
ult
do
s
w
(s
an
o
t
m
to
e
be
of
co
w
m
ho
e
m
pa
m
re
ay
nt
be
s
tra
at
ns
so
ge
m
nd
e
er)
ti
in
m
th
e.
e
M
U
os
nit
t
ed
ch
St
ild
ate
les
s,
s
Ita
les
ly,
bi
an
an
d
an
Isr
d
1698

ga to
y ful
ad fil
ult l
s th
w eir
ho de
re sir
po e
rt fo
th r
at pa
th re
ey nt
w ho
an od
t .
to H
be o
co w
m ev
e er,
pa ga
re y
nts m
als en
o se
int e
en m
d to
to be
be m
co or
m e
e lik
pa el
re y
nts th
; an
in he
ot ter
he os
r ex
w ua
or l
ds, pe
th er
ey s
pl to
an ha
 1699

rb to
or be
de co
sir m
es e
bu pa
t re
no nts
t bu
int t
en do
tio n’t
ns int
for en
pa d
re to
nt do
ho so
od ar
. e
Nm
ota or
bl e
y, lik
thi el
s y
res to
ear ex
ch pe
ha rie
s nc
me e
nta sy
l m
he pt
alt o
h ms
im of
pli de
cat pr
io es
ns. sio
Ga n
y an
me d
n ot
wh he
o rw
wa ise
nt lo
1700

we os
r pe
se cti
ns ve
e pa
of re
we nts
ll- ex
bei pe
ng. rie
M nc
ent in
al g
he inf
alt ert
h ilit
pr y;
ov th
ide at
rs is,
mi inf
gh ert
t ile
no he
te ter
tha os
t ex
thi ua
s l
fin co
di up
ng les
is oft
co en
nsi ex
ste pe
nt rie
wi nc
th e
lit de
era pr
tur es
e siv
on e
het sy
er m
os pt
ex o
ual ms
pr as
 1701

we ly
ll. pu
Th rs
us, ui
un ng
ful pa
fill re
ed nt
de ho
sir od
es .
for Be
pa ca
re us
nt e
ho ga
od y
ma m
y en
lea (a
d nd
to po
ne te
gat nti
ive all
me y
nta les
l bi
he an
alt w
h o
ou m
tco en
me )
s ar
re e
ga m
rdl or
ess e
of lik
wh el
eth y
er th
so an
me he
on ter
e os
is ex
act ua
ive l
1702

pe gh
ers er
to rat
ex es
pe of
rie de
nc pr
e es
de siv
sir e
es sy
for m
pa pt
re o
nt ms
ho a
od m
wi on
th g
ou les
t bi
int an
ent an
io d
ns ga
for y
pa ad
re ult
nt s
ho th
od, an
un a
ful m
fill on
ed g
pa th
re eir
nti he
ng ter
de os
sir ex
es ua
ma l
y co
co un
ntr ter
ib pa
ute rts
to .
hi
 1703

AG
s B)
ma ad
ll ult
bu s’
t so
gr cia
ow l
in cli
g m
bo ate
dy s.
of Fo
res r
ear ex
ch a
su m
gg pl
est e,
s a
tha m
t on
pla g
ns th
for os
pa e
re w
nt ho
ho liv
od e
als in
o U.
rel S.
ate sta
to tes
as wi
pe th
cts po
of lic
les ies
bia th
n, at
ga aff
y, ir
an m
d L
bis G
ex B-
ual pa
(L re
1704

nt an
fa d
mi bis
lie ex
s, ua
ga l
y m
an en
d w
bis ho
ex do
ual n’t
me ca
n re
wh as
o m
car uc
e h
m ab
or ou
e t
ab be
ou co
t mi
be ng
co fat
mi he
ng rs.
fat In
he co
rs ntr
in ast
the ,
fut ga
ur y
e an
re d
po bis
rt ex
gr ua
eat l
er m
we en
llb w
ein ho
g ca
tha re
n m
ga or
y e
 1705

ab w
ou he
t n
be th
co ey
mi liv
ng e
fat in
he sta
rs tes
in wi
the th
fut po
ur lic
e ies
re th
po at
rt dis
w all
or o
se w
we ful
ll- l
bei le
ng ga
tha l
n re
th co
os gn
e iti
wh on
o of
do L
n’t G
car B-
e pa
as re
m nt
uc fa
h mi
ab lie
ou s.
t Th
be es
co e
mi fin
ng di
fat ng
he s
rs m
1706

ay al
ref an
lec d
t so
dif cia
fer l
en co
ce nt
s ex
in t
leg in
al int
an en
d tio
so ns
cia for
l pa
ex re
pe nt
rie ho
nc od
es .
in
the
se
M
dis o
tin ti
ct va
co ti
m o
m ns
un
fo
iti
r
es,
an P
d ar
the e
y nt
hi h
gh o
lig
o
ht
d
the
im A
po lif
rta e
nc fre
e e
of of
leg ch
 1707

ild h
re su
n gg
ho est
lds s
a th
ce at
rta th
in e
ap tra
pe ns
al iti
for on
m to
an pa
y re
pe nt
op ho
le, od
re le
ga ad
rdl s
es to
s a
of de
th cli
eir ne
se in
xu rel
al ati
ori on
en sh
tat ip
io sat
n isf
or ac
ge tio
nd n
er fo
id r
en m
tit os
y. t
Af co
ter up
all les
, (L
res G
ea B
rc T
1708

Q m
an or
d e
ot fre
he ed
rw o
ise m
). to
Fu tra
rth ve
er, l
rai an
sin d
ga pu
ch rs
ild ue
to ho
ad bb
ult ies
ho .
od T
to he
da re
y ar
co e
sts ad
a dit
gr io
eat na
de l
al re
of as
m on
on s
ey, w
an hy
d L
ad G
ult B
s T
wi Q
th pe
ou op
t le
ch mi
ild gh
re t
n ch
ha oo
ve se
 1709

no tio
t n,
to as
be sis
co te
me d
pa re
re pr
nts od
. uc
M tiv
an e
y tec
L hn
G ol
B og
T y,
Q or
pe ot
op he
le r
fac m
e ea
ad ns.
dit So
io m
nal e
fin ro
an ut
cia es
l to
co pa
sts re
for nt
be ho
co od
mi als
ng o
pa re
re qu
nts ire
, pr
wh os
eth pe
er cti
thr ve
ou pa
gh re
ad nts
op to
1710

ov t
erc pr
o ev
me en
so t
cia tw
l o
ba w
rri o
ers m
, en
su fro
ch m
as be
so co
cia mi
l ng
wo le
rk ga
ers l
wh pa
o re
dis nts
ap to
pr th
ov e
e sa
of m
L e
G ch
B ild
T .
Q Pe
pa rh
re ap
nts s
, be
or ca
leg us
al e
ba of
rri th
ers es
, e
su ba
ch rri
as ers
la ,
ws L
tha G
 1711

B oti
T va
Q tin
pe g
op m
le or
are e
les an
s d
lik m
ely or
tha e
n L
het G
er B
os T
ex Q
ual pe
pe op
op le
le to
to pu
ex rs
pe ue
rie pa
nc re
e nt
so ho
cia od
l ?
pr L
ess ittl
ur e
e to
to no
be res
co ea
me rc
pa h
re ha
nts s
. ad
So dr
wh es
at se
is d
it thi
tha s
t is to
m pi
1712

c G
am B
on pa
g re
tra nts
ns an
ge d
nd pr
er os
pe pe
op cti
le, ve
bu pa
t re
the nts
re de
is scr
a ib
bo e
dy so
of m
res e
ear of
ch th
on e
L sa
G m
B e
pe m
op oti
le’ va
s tio
m ns
oti as
vat th
io eir
ns he
for ter
pa os
re ex
nt ua
ho l
od. pe
W ers
he .
n Th
as ey
ke als
d, o,
L ho
 1713

we ro
ve se
r, xu
de al
scr an
ibe d
so L
me G
m B
oti pe
vat op
io le
ns de
rel scr
ate ib
d e
to m
the an
ir y
ex si
pe mi
rie lar
nc m
es oti
as va
L tio
G ns
B for
pe pa
op re
le. nt
ho
od
Mo
.
tiv
Fo
ati r
ons ex
Un a
rel m
ate pl
d e,
to L
LG G
B B
Ide an
ntit d
y he
Hter
ete os
ex
1714

ual vi
pa ng
re lo
nts ve
an ,
d en
pr jo
os yi
pe ng
cti ti
ve m
pa e
re wi
nts th
ali ch
ke ild
ten re
d n,
to an
na d
me pa
pe ssi
rso ng
nal on
ful fa
fill mi
me ly
nt tra
as dit
a io
m ns.
oti Ga
vat y
in m
g en
fac w
tor ho
. ar
Pe e
rso pu
nal rs
ful ui
fill ng
me ad
nt op
inc tio
lu n,
de in
s pa
gi rti
 1715

cul t
ar, th
ha ey
ve ar
de e
scr m
ibe oti
d va
alt te
rui d
sti to
c e
m m
oti oti
vat on
io all
ns y
sh an
are d
d fin
by an
het cia
er lly
os su
ex pp
ual ort
pr ch
os ild
pe re
cti n
ve w
ad ho
op mi
tiv gh
e t
pa ha
re ve
nts ot
. he
In rw
pa ise
rti lac
cul ke
ar, d
the th
y at
re su
po pp
rt ort
tha .
1716

Opa
the re
r nts
m .
oti Fo
vat r
io ex
ns a
to m
pa pl
re e,
nt so
are m
les e
s he
alt ter
rui os
sti ex
c, ua
bu l
t an
are d
als L
o G
sh B
are pa
d re
by nts
ma an
ny d
L pr
G os
B pe
an cti
d ve
het pa
er re
os nts
ex no
ual te
pa th
re at
nts on
an e
d of
pr th
os eir
pe m
cti oti
ve va
 1717

tio t
ns th
for ey
pa ar
re e
nt m
ho oti
od va
is te
to d
ha to
ve ta
chi ke
ldr on
en a
to pa
car re
e nti
for ng
the rol
m e
in in
the pa
ir rt
eld be
er ca
ye us
ars e
. it
M is
an su
y ch
L a
G co
B m
an m
d on
het pa
er rt
os of
ex lif
ual e
pa for
re m
nts an
als y
o ad
no ult
te s.
tha
1718

Mo th
tiv eir
ati va
ons lu
Rel es
ate wi
d th
to a
LG ch
B ild
Ide co
ntit ntr
y ib
ut
W ed
hil to
e th
ma eir
ny pl
het an
er s
os for
ex pa
ual re
pa nt
re ho
nts od
an ,
d on
pr e
os stu
pe dy
cti su
ve gg
pa est
re s
nts th
re at
po L
rt G
tha B
t pa
m re
oti nts
vat an
io d
n pr
to os
sh pe
are cti
 1719

ve dy
pa ha
re ve
nts su
are gg
pa est
rti ed
cul th
arl at
y ex
m pe
oti rie
vat nc
ed es
wi
Intentio
ns
th and
Motivati
bi
ons to
as
Parent
an
d
by di
th sc
e ri
de mi
sir na
e tio
to n
tea m
ch ay
a be
sp on
eci e
fic re
va as
lu on
e: th
tol at
er L
an G
ce. B
Th pa
e re
au nt
th s
or an
s d
of pr
thi os
s pe
stu cti
1720

ve g
pa he
re ter
nts os
ar ex
e ua
m l
or th
e an
lik a
el m
y on
to g
fo L
cu G
s B
on pr
thi os
s pe
va cti
lu ve
e. pa
Nre
ota nts
bl .
y, Fo
so r
me ex
m a
oti m
vat pl
io e,
ns th
for e
pa de
re sir
nt e
ho to
od co
se nti
em nu
m e
or th
e e
co fa
m mi
m ly
on lin
am e
on is
 1721

les nts
s ar
co e
m les
m s
on lik
ly el
cit y
ed to
by pu
L rs
G ue
B bi
pa ol
re og
nts ica
an l
d pa
pr re
os nt
pe ho
cti od
ve .
pa
re
nts C
, o
pe nc
rh lu
ap si
s o
be
n
ca
us L
e G
L B
G T
B Q
pa pe
re op
nts le
an ca
d n
pr fa
os ce
pe un
cti iq
ve ue
pa ch
re all
1722

en pe
ge op
s le
as fa
th ce
ey m
pu or
rs e
ue pr
pa es
re su
nt re
ho to
od be
, co
bu m
t e
no pa
ta re
bl nt
y, s,
th L
er G
e B
ar T
e Q
un pe
iq op
ue le
str m
en ay
gt be
hs les
as s
we lik
ll. el
Be y
ca th
us an
e th
cis eir
ge pe
nd er
er, s
he to
ter ta
os ke
ex pa
ua re
l nt
 1723

ho ay
od be
for w
gr hy
an les
te bi
d, an
pu m
rs ot
ui he
ng rs
it ha
as ve
a re
de po
fa rte
ult d
rat str
he on
r ge
th r
an m
du oti
e va
to tio
str ns
on to
g be
de co
sir m
e. e
So pa
m re
e nt
res s
ea co
rc m
he pa
rs re
ha d
ve to
su th
gg eir
est he
ed ter
th os
at ex
thi ua
s l
m co
1724

un re
ter nt
pa s,
rts w
. hil
Co e
un m
sel an
or y
s ot
an he
d rs
th do
er no
ap t.
ist Th
s os
w e
ou L
ld G
do B
we T
ll Q
to pe
re op
co le
gn w
ize ho
th do
at int
m en
an d
y to
L be
G co
B m
T e
Q pa
pe re
op nt
le s
int m
en ay
d ex
to pe
be rie
co nc
m e
e si
pa mi
 1725

lar Ab
or ou
t;
dis
As
tin sis
ct ted
m Re
oti pr
va od
tio uct
ive
ns,
T
co
e
m c
pa h
re n
d o
wi l
th o
g
th
i
eir e
cis s
ge
nd (
er, A
he R
ter T
s
os
)
ex ;
ua
l D
pe e
ers c
. i
d
Ra i
ch n
el g
G.
W
Ri h
ski e
nd t
h
Se e
e r
als
o t
Ad o
opt
ion
P
,
a
Ch
r
oic
e
es
1726

nF
tu
;r
It
nh
f
e
e
rr
t
iR
le
ia
td
yi
n
ag
n
s
d
D’Au
Rgel
eli,
pA.,
r
Gr
o
doss
uma
cn,
t A.,
i Si
vncl
eair,
K.,
L
&
o
sRe
sndi
; na,
J.
S(2
u00
r 7).
r
Le
o
sbi
g
aan
can
yd
ga
y
yo
uth
s’
as
pir
ati
 1727

ons W
for hy
ma par
rria ent
ge ho
an od,
d an
rai d
sin wh
g y
chi no
ldr w?
en. Ga
Jo y
ur me
nal n’s
of mo
LG tiv
BT ati
Iss on
ue s
s for
in pu
Co rsu
un ing
sel par
ing ent
, 1, ho
77 od.
– Fa
98. mi
Goldb ly
erg Re
, lat
A. io
E., ns,
Do 61
wn ,
ing 15
, J. 7–
B., 17
& 4.
Mo Inter
yer naliz
, ed
A. Hom
opho
M.
bia
(20
12)
. Ra
b
1728

u t
n h
, e

C n
. o
, r
m
& a
l
O
s f
w a
a m
l i
d l
, y
:
R
. F
u
F t
. u
r
e
(
2
0 f
0 a
9 t
) h
. e
r
h
U
o
p
o
h
d
o
l
d t
i h
n r
g o
u
g
a
h
n
d
t
h
e
e
x
p
a e
n y
d e
i s
n
g o
f
 1729

y
g ,
a
y R
e
m s
a e
l a
e r
c
e h
m ,
e
r a
g n
i d
n
g P
r
a a
d c
u t
l i
t c
s e
.
A
F b
a o
t u
h t
e
r M
i e
n n
g
: a
s
A
F
J a
o t
u h
r e
n r
a s
l ,

o 7
f ,

T 2
h 6
e 9
o –
r 2
1730

8 t
5 e
. n
Ris t
k i
i o
n n
d s
,
a
R n
. d

G d
. e
, s
i
& r
e
s
P
a
t a
t m
e o
r n
s g
o
n c
, h
i
C l
. d
l
e
J
s
.
s
(
l
2
e
0
s
1
b
0
i
)
a
.
n
,
P
a
g
r
a
e
y
n
,
t
i
n a
g n
d
i
n h
 1731

e 4
t ,
e
r 7
o 8
s –
e 8
x 1
u .
aShenk
l
ma
n,
i
G.
n
d (2
i 01
v 2).
i Th
d e
u ga
a
p
l
bet
s
. we
en
J fat
o her
u ho
r od
n an
a
d
l
co
o upl
f eh
oo
F d
a de
m sir
i es
l am
y
on
g
P
s Isr
y ael
c i
h ga
o y
l me
o
n
g
an
y
, d
est
2 im
1732

ati Va
ons n
of de
the Pe
ir er,
lik F.,
eli et
ho al.
od. (2
Jo 01
ur 2).
nal Re
of pr
Fa od
mil uct
y ive
Ps wi
yc sh
hol in
og tra
y, nss
26( ex
5), ual
82 me
8– n.
83 Hu
2. ma
Wierc n
kx, Re
K., pr
Va od
n uct
Ca io
ene n,
ge 27
m, ,
E., 48
Pe 3–
nni 48
ngs 7.
,
G.,
Ela
ut,
E., IN
De TE
dec R
ker
N
,
D., AL
 1733

IZE en
a
D by
H w
hi
O ch
M les
OP bi
H an
OB ,
ga
IA y,
bi
se
Int xu
er al,
na an
liz d
ed qu
ho ee
m r
op (L
ho G
bi B
a Q)
is pe
a rs
ter on
m s
us dir
ed ec
by t
so ne
cia ga
l tiv
sci e
en so
tis ci
ts et
to al
de att
scr itu
ib de
e s
th re
e ga
ph rdi
en ng
o ho
m m
1734

os h
ex an
ua d
lit w
y ell
to -
wa be
rd in
th g
e of
ms L
el G
ve B
s. Q
Int pe
er rs
na on
liz s
ed by
ho di
m mi
op ni
ho sh
bi in
a g
is sel
ge f-
ne re
ral ga
ly rd,
as in
su hi
m bit
ed in
to g
ha pr
ve ot
de ec
let tiv
eri e
ou fa
s ct
eff or
ect s
s as
on so
th ci
e at
he ed
alt wi
 1735

th d
po wi
sit th
iv th
e e
id ad
en ve
tit nt
y of
de ga
ve y-
lo aff
p ir
m m
en ati
t, ve
an th
d er
fo ap
ste eu
rin tic
g int
id er
en ve
tifi nti
cat on
io s
n du
wi rin
th g
th th
e e
op lat
pr e
es 20
so th
r. ce
Th nt
e ur
us y.
e D
of etr
th ac
e tor
ter s
m ha
de ve
ve ar
lo gu
pe ed
1736

th to
at w
usi ho
ng m
th pr
e ej
ste ud
m ic
ph e
ob is
ia dir
e ec
m te
ph d,
asi w
ze he
s re
th as
e ho
fe m
ar- on
ba eg
se at
d ivi
as ty
pe an
cts d
of he
pr te
ej ro
ud se
ice xi
an s
d m
fur lo
th ca
er te
sti pr
g ej
m ud
ati ic
ze e
s wi
th thi
e n
in its
di so
vi ur
du ce
al s
 1737

in ep
so t
cieof
ty int
an er
d na
so liz
ciaed
l ho
strm
uc op
turho
es bi
rata
he is
r ro
th ot
an ed
wi in
thith
n eo
th rie
e s
in of
di sti
vi g
du m
al.a
an
d
Stigm
th
e
sti
g
m
ati
za
tio
n
of
in
di
vi
du
als
an
Th d
e gr
co ou
nc ps
1738

. ps
Th wi
e th
w sti
or g
k m
of ati
G ze
or d
do att
n rib
Al ut
lp es,
ort lo
an w
d er
Er th
vi eir
ng sta
G tu
off s
m wi
an thi
m n
ai th
nt e
ai so
ne ci
d et
th y
at ba
so se
cie d
tal on
att th
itu es
de e
s att
dis rib
cr ut
ed es,
it an
in d
di la
vi be
du l
als su
or ch
gr in
ou di
 1739

vi na
du lly
als ex
de pr
vi es
an se
t d
fro thr
m ou
ac gh
ce re
pt be
ed lli
so on
cie ag
tal ai
no ns
rm t
s. th
Re e
act sti
io g
ns m
to a
su or
ch int
sti er
g na
m lly
a ex
a pr
m es
on se
g d
sti thr
g ou
m gh
ati sel
ze f-
d de
in ni
di gr
vi ati
du on
als an
m d
ay id
be en
ex tif
ter ic
1740

ati so
on ci
wi et
th al
th att
e itu
op de
pr s
es an
so d
r. sti
W g
he m
na a
ga ha
y, ve
les be
bi en
an, dir
or ec
bis te
ex d
ua to
l an
in d
di int
vi er
du na
al liz
ex ed
hi wi
bit thi
s n
int th
er e
na sel
liz f
ed rat
ho he
m r
op th
ho an
bi ex
a, ter
th na
e lly
ne att
ga rib
tiv
e
 1741

ut nc
ed. ep
I tu
nte ali
rn ze
ali s
ze str
d es
ho s
m pr
op oc
ho es
bia se
is s
oft th
en at
co oc
nsi cu
de r
re wi
d a thi
di n
me in
nsi di
on vi
of du
mi als
no as
rit a
y res
str ult
es of
s, th
a e
br sti
oa g
d m
ps ati
yc zat
ho io
so n
cia of
l mi
fra no
me rit
wo y
rk gr
tha ou
t ps.
co Ila
1742

n ex
M ter
ey na
er l
ha en
s vir
de on
scr m
ib en
ed t)
di to
m th
en e
sio pr
ns ox
of im
mi al
no (a
rit ss
y oc
str iat
es ed
s wi
al th
on th
ga e
co sel
nti f).
nu Ex
u ter
m na
ra lly
ng lo
in ca
g te
fro d
m fo
th rm
e s
dis of
tal mi
(as no
so rit
cia y
te str
d es
wi s
th in
th cl
e ud
 1743

e ci
pe al
rc set
ei tin
vi gs
ng .
an Int
d er
an na
tic l
ip str
ati es
ng s
sti pr
g oc
m es
ati se
zi s
ng as
att so
itu ci
de at
s ed
in wi
th th
e mi
ge no
ne rit
ral y
po str
pu es
lat s
io in
n cl
an ud
d e
ex eff
pe ort
rie s
nc to
in co
g nc
dis ea
cri l
mi on
na e’
tio s
n sti
in g
so m
1744

ati (vi
ze a
d th
att e
rib ad
ut op
e(s tio
), n
as of
we sti
ll g
as m
int ati
er zi
na ng
liz att
ed itu
ho de
m s
op wi
ho thi
bi n
a. th
Fr e
o sel
m f)
a co
mi ns
no tit
rit ut
y es
str th
es e
s m
pe os
rs t
pe int
cti er
ve, na
int l
er or
na pr
liz ox
ed im
ho al
m str
op es
ho s
bi pr
a oc
 1745

es on
s. ’s
lif
e,
Li gi
nk ve
s n
W th
it at
h so
Id ci
et
en
al
tit
att
y itu
D de
ev s
el to
op w
m ar
en d
ho
t
m
Th os
e ex
ro ua
ots lit
of y
int ar
er e
na oft
liz en
ed tra
ho ns
m mi
op tte
ho d
bi to
a ch
m ild
ay re
be n
gi pri
n or
ea to
rly th
in eir
a a
pe w
rs ar
1746

en ol
es es
s ce
of nc
sa e
m bu
e- t
se m
x ay
att ex
ra te
cti nd
on int
s. o
De yo
ve un
lo g
p ad
m ult
en ho
t od
of an
se d
xu be
al yo
ori nd
en ,
tat du
io rin
n g
an w
d hi
se ch
xu ti
al m
id e
en th
tit e
y pr
oft oc
en es
be si
gi ng
n of
du di
rin ve
g rs
ea e
rly so
ad ci
 1747

eta ea
l rc
att h
itu fin
de di
s ng
by s
th su
e gg
in est
di th
vi at
du ea
al rly
m so
ay ci
bo ali
lst za
er tio
or n
di ex
mi pe
nis rie
h nc
th es
e m
int ay
er co
na ntr
liz ib
ati ut
on e
of to
ho ne
m ga
op tiv
ho e
bi sel
a f-
or re
he ga
ter rd
os du
ex rin
is g
m. th
So e
m de
e ve
res lo
1748

p m
m en
en t.
t I
of nt
a er
sa na
m liz
e- ed
se ho
x m
id op
en ho
tit bi
y, a
ev ha
en s
if be
su en
bs co
eq nc
ue ep
nt tu
so ali
cia ze
liz d
ati as
on a
ex “f
pe ail
rie ur
nc e”
es of
m th
ay e
su co
pp mi
ort ng
po -
sit ou
iv t
e pr
id oc
en es
tit s
y for
de ga
ve y
lo m
p en
 1749

an d
d be
les ha
bia vi
ns, or
an al
d he
its alt
in h
ve res
rse ea
rel rc
ati he
on rs.
shi Sti
p g
to m
po a
siti m
ve an
ide ag
nti e
ty m
de en
vel t
op str
me ate
nt gi
is es
an an
are d
a res
of ou
int rc
ere es,
st su
for ch
de as
vel se
op ek
me in
nta g
l so
ps cia
yc l
ho su
lo pp
gis ort
ts ,
an be
1750

co w
mi hi
ng ch
aw sti
are g
of m
po ati
siti ze
ve d
L pe
G rs
B on
Q s
rol cr
e eat
m e
od po
els sit
, iv
an e
d pe
fos rs
ter on
in al
g id
L en
G titi
B es,
Q an
co d
m ev
m id
un en
ity ce
aff ex
ili ist
ati s
on, th
ha at
ve in
be di
en vi
su du
gg als
est w
ed ho
as us
wa e
ys th
in es
 1751

e m
str op
ate ho
gie bi
s a
ha ha
ve s
lo be
we en
r id
lev en
els tif
of ie
int d
er as
nal a
ize pa
d th
ho og
m en
op ic
ho pr
bia oc
. es
s
as
As so
so ci
ci at
ati ed
on wi
s th
W in
cr
it
ea
h
se
H d
ea ris
lt k
h fo
Ri r
sk m
en
s
tal
Int di
er str
na es
liz s,
ed m
ho en
1752

tal ex
he ua
alt l
h m
dis al
or es
de an
rs, d
su ot
bst he
an r
ce m
us en
e, w
do ho
m ha
est ve
ic se
vi x
ol wi
en th
ce, m
an en
d .
se In
xu les
al bi
ris an
k an
be d
ha bi
vi se
or xu
ac al
ro w
ss o
nu m
m en
er ,
ou int
s er
stu na
di liz
es ed
of ho
ga m
y op
an ho
d bi
bis a
 1753

ha ad
s ve
be rs
en e
as he
so alt
cia h
te ou
d tc
wi o
th m
m es
en oft
tal en
dis va
tre ry
ss, by
su th
bst e
an he
ce alt
us h
e, be
an ha
d vi
do or
m s
est be
ic in
vi g
ol ex
en a
ce. mi
Th ne
e d,
sp an
eci d
fic be
m ca
ec us
ha e
nis th
ms e
th m
at aj
m ori
ay ty
lea of
d re
to se
1754

ar en
ch tif
on ie
int d.
er T
na he
liz lar
ed ge
ho st
m bo
op dy
ho of
bi ev
a id
ha en
s ce
be for
en int
co er
rre na
lat liz
io ed
na ho
l m
in op
na ho
tur bi
e, a’s
dir eff
ect ect
ca on
us th
al e
m he
ec alt
ha h
nis of
ms L
ha G
ve B
no Q
t pe
be rs
en on
de s
fin ha
iti s
ve fo
ly cu
id se
 1755

d s
on th
its at
ass int
oci er
ati na
on liz
s in
wi g
th ne
de ga
pr tiv
ess e
io att
n, itu
an de
xie s
ty, to
an wa
d rd
sui th
cid e
al sel
ide f
ati sh
on. ou
Th ld
eo pr
ret od
ica uc
lly e
, lo
the we
co r
nc le
ept ve
of ls
int of
er sel
nal f-
ize re
d ga
ho rd,
m sel
op fw
ho ort
bia h,
su an
gg d
est sel
1756

f- t
est int
ee er
m. na
Co liz
nsi ed
ste ho
nt m
wi op
th ho
thi bi
s a
vie co
w, rre
a lat
me es
ta- m
an or
aly e
sis str
of on
sel gl
ect y
ed wi
stu th
die de
s pr
of es
me sio
nta n
l th
he an
alt it
h do
in es
ga wi
y th
me an
n xi
an et
d y.
les Re
bia se
ns ar
ha ch
s ers
sh fo
ow cu
n sin
tha g
 1757

on int
les im
bia at
n e
an pa
d rtn
bis er
ex vi
ual ol
wo en
me ce
n’s ,
rel wi
ati th
on int
shi er
ps na
ha liz
ve ed
ho
Internalized
Homophobia
m
op
ho
fo
bi
un
a
d
as
lin
so
ks
ci
be
at
tw
ed
ee
wi
n
th
int
bo
er
th
na
pe
liz
rp
ed
etr
ho
ati
m
on
op
an
ho
d
bi
vi
a
cti
an
mi
d
za
do
tio
m
n
est
in
ic
les
or
bi
1758

an to
s. be
Re lie
se ve
ar th
ch ey
ers de
ha se
ve rv
ar e
gu to
ed be
th tre
at at
w ed
o ab
m us
en iv
w el
ho y;
ex co
hi nv
bit er
hi sel
gh y,
er int
le er
ve na
ls liz
of ed
int ho
er m
na op
liz ho
ed bi
ho a
m m
op ay
ho pr
bi ed
a is
m po
ay se
be so
m m
or e
e w
lik o
el m
y en
 1759

to di
ab vi
us du
e als
or co
de pe
ni wi
gr th
ate int
th er
eir na
fe liz
m ed
ale ho
pa m
rtn op
ers ho
. bi
Sa.
ub Sp
sta eci
nc fic
e all
us y,
e so
ha m
s e
be L
en G
co B
nc Q
ept pe
ual op
ize le
d m
as ay
a us
str e
ate su
gy bst
by an
wh ce
ich s
so to
me re
L du
G ce
B th
Q e
in ne
1760

gat ed
ive att
aff itu
ect de
ste s.
m Si
mi mi
ng lar
fro ly,
m se
the xu
str al
ess ris
an k
d be
co ha
nfl vi
ict or
tha a
t m
co on
me g
s ga
fro y
m an
liv d
in bis
g ex
wi ua
th l
a m
sti en
g ha
ma s
tiz be
ed en
ide th
nti eo
ty riz
an ed
d as
int a
er po
nal ssi
izi bl
ng e
sti for
g m
ma of
tiz m
 1761

ala er
da na
pti tiv
ve e
co to
pi de
ng ep
am er
on e
g m
me oti
n on
wi al
th co
ele nn
vat ect
ed io
lev ns
els of
of lo
int ve
er an
nal d
ize int
d im
ho ac
m y
op a
ho m
bia on
. g
Se gr
xu ou
al ps
ris of
k m
tak en
in w
g ho
be str
ha ug
vi gl
or e
ma wi
y th
ser int
ve er
as na
an liz
alt ati
1762

on y
of m
sti ed
g iat
ma e
tiz th
in e
g lin
att k
itu be
de tw
s ee
to n
wa int
rd er
the na
ir liz
ide ed
nti ho
tie m
s, op
tra ho
its, bi
an a
d an
be d
ha se
vi xu
ors al
. ris
No k
tab be
ly, ha
so vi
me or
wo a
rk m
su on
gg g
est ga
s y
tha an
t d
su bis
bst ex
an ua
ce l
us m
e en
ma ,
 1763

su lik
ch el
tha y
t to
me en
n ga
wi ge
th in
hi ris
gh ky
lev se
els xu
of al
int be
er ha
nal vi
ize or.
d
ho
m
R
op es
ho ea
bia rc
ma h
y Li
be m
m
it
or
a
e
lik ti
ely o
to ns
us Th
e e
su m
bst ea
an su
ce re
s m
an en
d t
co of
ns int
eq er
ue na
ntl liz
y ed
m ho
or m
e
1764

op lo
ho pe
bi d
a in
ha th
s e
be lat
en e
in 19
co 70
nsi s
ste (th
nt e
ac N
ro un
ss ge
stu ss
di er
es. H
Th o
e m
ea os
rli ex
est ua
an l
d At
m tit
ost ud
wi es
de In
ly str
us u
ed m
sc en
ale t,
to or
m N
ea H
su AI
re ).
th Su
e bs
co eq
nst ue
ru nt
ct m
wa ea
s su
de re
ve s
 1765

in o
cl m
ud op
e ho
th bi
e a
Int Sc
er al
na e.
liz V
ed ali
H dit
o y
m co
op nc
ho er
bi ns
a e
Sc m
ale er
, ge
Int w
er he
na n
liz ex
ed a
H mi
o ni
m ng
on in
eg di
ati vi
vit du
y al
In ite
ve m
nt s
or as
y, so
an ci
d at
Le ed
sbi wi
an th
Int so
er m
na e
liz of
ed th
H es
1766

e liz
m ed
ea ho
su m
res op
. ho
Fo bi
r a
ex pe
a r
m se,
pl su
e, ch
se as
ve Int
ral ern
ite atio
ms nal
in Sur
th
rog
e
acy
N
H /Re
AI pro
ap duc
pe tive
ar Ou
to tso
ali
urc
gn
ing
wi
th
ps g
yc e
ho n
so e
cia r
l a
co li
nst z
ru e
cts d
ot d
he is
r c
th o
an m
int f
er o
na rt
 1767

w o
it p
h h
s o
e b
x i
u a
al m
it e
y. a
R s
e u
v r
is e
i s
o a
n r
s e
a o
n n
d g
a o
d i
a n
p g
ta ,
ti a
o n
n d
s m
t o
o r
e e
x r
is o
ti b
n u
g st
i p
n s
te y
r c
n h
al o
iz m
e e
d tr
h i
o c
m a
1768

n o
al n
y si
s st
e e
s n
o t
f m
m e
e a
a s
s u
u r
re e
s m
ar e
e n
n t
e o
e f
d i
e n
d. te
Sr
e n
v al
er iz
al e
re d
s h
e o
ar m
c o
h p
er h
s o
h b
a ia
v is
e e
n s
ot p
e e
d ci
th al
at l
th y
e p
in r
c o
 1769

bl d
e i
m n
at c
ic r
in e
li a
g s
ht e
o s
f i
a n
d t
v h
a e
n v
c is
e i
s b
in il
L it
G y
B a
Q n
ci d
vi a
l c
ri c
g e
ht p
s ta
o n
v c
er e
th o
e f
p L
a G
st B
fe Q
w i
d n
e d
c i
a v
d i
e d
s u
a al
n s
1770

in c
m h
a c
n o
y m
c m
o u
m n
m it
u ie
ni s,
ti it
e m
s. a
W y
it b
h e
a a
d s
e s
cr u
e m
a e
s d
e t
in h
st at
ig t
m h
at e
iz r
at e
io w
n o
o u
f l
h d
o b
m e
o a
s c
e o
x n
u c
al u
it rr
y e
in n
s t
u d
 1771

e ti
cr e
e s,
a b
s u
e t
in c
in o
te m
r p
n a
al ri
iz s
e o
d n
h s
o a
m c
o r
p o
h s
o s
bi st
a u
a d
m ie
o s
n a
g n
L d
G a
B c
Q r
p o
er s
s s
o d
n if
s f
in e
th r
o e
s n
e t
c h
o is
m t
m o
u ri
ni c
1772

al e
p m
er at
io ic
d st
s u
h d
a ie
v s
e i
b n
e v
e e
n st
di i
ff g
ic at
ul i
t n
to g
c h
o o
n w
d i
u n
ct te
d r
u n
e al
to iz
v e
ar d
ia h
bi o
li m
ty o
in p
m h
e o
a b
s ia
u v
re a
m ri
e e
nt s
. g
S e
y o
st g
 1773

ra a
p g
hi ai
c n
al st
ly L
, G
a B
s Q
w p
el e
l rs
a o
s n
it s,
s h
p a
ot v
e e
nt n
ia o
l t
re b
la e
ti e
o n
n c
s o
hi n
p d
to u
in ct
st e
it d
ut .
io T
n h
al er
iz e
e is
d al
di s
s o
cr i
i n
m s
in u
at ff
io ic
n ie
1774

nt l
d y
at d
a i
o v
n er
e s
x e
p s
er a
ie m
n p
c le
es s
of o
in f
te L
rn G
al B
iz Q
e p
d er
h s
o o
m n
o s,
p a
h s
o t
bi h
a e
a m
m aj
o o
n ri
g t
c y
ul o
tu f
ra re
ll s
y e
a ar
n c
d h
et o
h n
ni i
c n
al te
 1775

rn d
al o
iz f
e W
d h
h it
o e
m m
o e
p n.
h M
o e
bi a
a s
h u
as re
b s
e o
e f
n i
c n
o te
n r
d n
u al
ct iz
e e
d d
w h
it o
h m
sa o
m p
pl h
es o
pr b
e ia
d t
o h
m at
in w
a er
nt e
ly d
c e
o v
m el
p o
o p
se e
1776

d m
w e
it t
h h
s er
u e
c ar
h e
sa n
m o
pl m
es e
m a
a s
y u
n re
ot s
b t
e h
a at
p h
pl a
ic v
a e
bl b
e e
to e
ot n
h v
er al
et i
h d
ni at
c e
gr d
o f
u o
p r
s, u
a s
n e
d w
at it
th h
e d
c i
ur v
re er
nt s
ti e
 1777

p l
o y
p w
ul it
at h
io i
n n
s. c
T o
h m
e m
d u
e n
gr it
e ie
e s
to o
w f
hi L
c G
h B
in Q
te p
rn er
al s
iz o
e n
d s
h o
o f
m c
o o
p l
h o
o r
bi a
a n
m d
a h
y o
o w
p it
er m
at a
e y
di i
ff n
er te
e ra
nt ct
1778

or n.
in L
te a
rs st
e l
ct y,
w m
it o
h re
e re
x s
p e
er ar
ie c
n h
c is
es n
of e
ra e
ci d
s e
m d
a o
n n
d i
in n
te te
rn r
al n
iz al
e iz
d e
ra d
ci h
al o
st m
ig o
m p
a h
ar o
e b
n ia
ot a
w m
el o
l n
k g
n le
o s
w b
 1779

ia x
n u
s al
a i
n n
d d
bi i
se v
x i
u d
al u
p al
er s
s h
o a
n v
s. e
In b
m e
o e
st n
pr c
e o
vi m
o b
u i
s n
st e
u d
di w
es it
of h
in g
te a
rn y
al a
iz n
e d
d le
h s
o b
m ia
o n
p i
h n
o d
bi i
a, v
bi i
se d
1780

u h
al o
s, m
a o
n p
d h
th o
er b
e ia
is m
lit a
tl y
e o
ri p
g er
or at
o e
u d
s if
re fe
se re
ar n
c tl
h y
o i
n n
th b
e is
s e
p x
e u
ci al
fi p
c er
w s
a o
y n
s s.
in D
w o
hi u
c g
h l
in a
te s
rn B
al r
iz
u
e
d
 1781

c les
e bia
ns,
Se ga
e y
als me
o
n,
De
an
pre
ssi d
on; bis
He ex
ter ual
ose s:
xis A
m;
co
Mi
ns
nor
ity eq
Str ue
ess nc
F e
u of
r het
t ero
h se
e xis
r m,
ho
R mo
e ph
a obi
d a,
i an
n d
g sti
s gm
DiPlac ati
idi zat
o, ion
J. .
(19 In
95) G.
. M.
Mi He
nor rek
ity (E
str d.)
ess ,
am Sti
on gm
g a
1782

an l
d he
sex alt
ual h
ori in
ent ga
ati y
on me
(pp n.
. Jo
13 ur
8– na
15 l
9). of
THe
halt
oh
uan
s
d
a
nSo
dcia
l
OBe
aha
kvio
sr,
,
36
,
C
38
A
:–
56.
Meyer
S
a, I.
gH.
e(2
. 00
Meyer 3).
Pr
, I.
eju
H.
dic
(19 e,
95) so
. cia
Mi l
nor str
ity ess
,
str
an
ess d
an me
d nta
me l
nta he
 1783

aal
l iss
t ue
hs
an
id
nres
ear
l ch
eevi
s de
bnc
i e.
aPs
nyc
, ho
lo
gic
g
al
a
Bu
y
lle
,
tin
,
a
12
n
9(
d
5),
67
b4–
i 69
s 7.
e
Ne
x
w
u
c
a
o
l
m
b
p,
o
p
M
u
.
l
a
E
t
.
i
,
o
n
s&
:
M
Cu
os
nt
ca
en
ps
tk
ui
1784

, e
n
B t
. a
l
(
2 h
0 e
1 a
0 l
) t
. h

I p
n r
t o
e b
r l
n e
a m
l s
i .
z
e C
d l
i
h n
o i
m c
o a
p l
h
o P
b s
i y
a c
h
a o
n l
d o
g
i y
n
t R
e e
r v
n i
a e
l w
i ,
z
i 3
n 0
g ,

m 1
 1785

0 (E
1 ds.
9 ),
– Le
1
sbi
0
2 an
9 an
. d
Shidlo ga
, y
A. ps
(19 yc
94) ho
. lo
Int gy
ern :
ali Th
zed eo
ho ry,
mo res
ph ea
obi rc
a: h,
Co an
nce d
ptu cli
al nic
an al
d ap
em pli
piri cat
cal io
iss ns
ues (p
in p.
me 17
asu 6–
re 20
me 5).
nt. T
In h
B. o
u
Gr
s
een
a
e n
& d
G.
M. O
He a
rek k
s
1786

,b
i
Ca
A
:a
n
Sd
a
gh
ee
.a
Wi l
l t
l h
i
a i
m s
s s
o u
n e
, s

I a
. f
f
R e
. c
t
( i
2 n
0 g
0
0 l
) e
. s
b
I i
n a
t n
e s
r
n a
a n
l d
i
z g
e a
d y

h m
o e
m n
o .
p
h H
o e
 1787

a
l S
t U
h
RR
E O
d G
u
AC
c
a Y/
t
i R
o
n EP
R
R O
e
s D
e UC
a TI
r
c VE
h
, O
UT
1
5 SO
( U
1
RC
)
, IN
G
9
7 In
– te
1 rn
0 at
7
io
.
na
l
su
rr
IN og
ac
TE y
RN is
AT a
International Surrogacy/Reproductive Outsourcing
IO m
N et
ho
AL d
of
1788

re re
pr si
od de
uc s
tiv ou
e tsi
ou de
tso th
ur e
ci in
ng di
in vi
w du
hi al’
ch s
an or
inf co
ert up
ile le’
in s
di co
vi un
du try
al of
or ori
co gi
up n.
le Th
e es
m e
pl in
oy di
s vi
th du
e als
ser or
vi co
ce up
of les
a ,
su kn
rro o
ga w
te n
m as
ot in
he te
r nd
w ed
ho pa
 1789

re ei
nt ve
s, or
oft ca
en rr
de y
sir th
ea e
ge ch
ne ild
tic to
co ter
nn m.
ect Int
io en
n de
to d
th pa
eir re
ch nt
ild s
bu oft
t en
ar se
e ek
m su
ed rr
ica og
lly at
, e
so m
cia ot
lly he
, rs
or int
ot er
he na
rw tio
ise na
un lly
wi du
lli e
ng to
or fin
un an
ab ci
le al
to or
co le
nc ga
1790

l ou
ba ld
rri ab
ers ro
at ad
ho .
m M
e. or
E eo
m ve
pl r,
oy m
in an
ga y
su int
rro en
ga de
te, d
for pa
ex re
a nt
m s
pl w
e, ho
m id
ay en
co tif
st y
up as
to L
3 G
ti B
m T
es Q
as m
m ay
uc en
h co
in un
th ter
eir le
o ga
w l
n or
co so
un ci
try al
as co
it m
w pli
 1791

cat tio
io na
ns l
wi re
th pr
su od
rro uc
ga tiv
cy e
du ou
e ts
to ou
pr rci
oh ng
ibi an
tiv d
e th
la e
ws si
rel gn
ate ifi
d ca
to nc
sa e
m of
e- int
se er
x na
co tio
up na
lin l
g. su
Th rr
is og
en ac
try y
dis fo
cu r
ss se
es xu
ge al-
ne mi
ral no
tre rit
nd y
s fa
in mi
int lie
er s.
na
1792

Sre
inc asi
e ng
the ly
ear wi
ly de
20 sp
00 re
s, ad
the .
pr In
ev fa
ale ct,
nc du
e e
of to
int its
en ris
de in
d g
pa po
re pu
nts lar
pa ity
rti an
cip d
ati ex
ng cl
in usi
int vit
er y,
nat thi
io s
nal ph
re en
pr o
od m
uct en
ive on
ou ha
tso s
ur co
cin m
g e
ha to
s be
be kn
co o
me w
inc n
 1793

as att
re e
pr m
od pti
uct ng
ive to
to cr
uri eat
sm ea
, “d
or esi
fer gn
tili er
ty e
to m
uri br
sm yo
, a ”
pr th
act at
ice wi
tha ll
t pr
fal od
ls uc
un ea
de ch
r ild
the wi
br th
oa pa
de rti
r cu
u lar
m ph
br ysi
ell cal
a ,
of e
me m
dic oti
al on
to al,
uri or
sm m
. en
W tal
het ch
he ar
r act
1794

eri to
sti ou
cs, tso
or ur
lo ce
ok re
in pr
g od
to uc
ac tio
qu n
ire to
a for
ge ei
sta gn
tio co
nal un
sur tri
ro es
gat w
e he
m re
ot su
he ch
r re
wh pr
o od
ha uc
s tiv
pr e
ov pr
en act
fer ice
til s
e ar
in e
the les
pa s
st, re
ma gu
ny lat
int ed
en .
de Le
d ss
pa re
re gu
nts lat
op io
t n
 1795

for cy
int ,
en pa
de rti
d ci
pa pa
re nts
nts ,
oft an
en d
sig lo
nif cat
ies io
re ns
du of
ce su
d rro
leg ga
al cy
ba e
rri m
ers pl
as oy
we m
ll en
as t
a ar
les e
s ge
pr ne
oh ral
ibi ly
tiv un
e av
pri ail
ce ab
tag le
. du
Se
tat to
isti th
cs e
pe pri
rta va
ini te,
ng po
to te
fre nti
qu all
en y
1796

sti io
g na
ma ls
tiz an
in d
g, sui
an ta
d bl
po e
ssi fa
bl cil
y iti
ill es,
eg as
al we
nat ll
ur as
e an
of ab
sur un
ro da
ga nc
cy. e
Ho of
we wi
ve lli
r, ng
be su
ca rro
us ga
e te
of m
the ot
wi he
de rs,
av it
ail is
abi we
lit ll
y kn
of o
ski w
lle n
d th
me at
dic In
al di
pr a
of ha
ess s
 1797

be cts
co its
me sh
the ar
pr e
em of
ier th
loc e
ale re
for pr
co od
m uc
me tiv
rci e
al ou
sur tso
ro ur
ga ci
cy, ng
wh m
ich ar
ha ke
s t
be to
co ex
me ce
a ed
bo $2
o bil
mi lio
ng n
m by
ult 20
ibi 20
lli .
on In
- fa
do ct,
lla su
r rro
bu ga
sin cy
ess pr
. act
In ice
dia s
alo in
ne In
pr di
oje a
1798

are s.
pu Br
rp ok
os ers
ef cr
ull eat
y e
un co
re ntr
gu act
lat s
ed for
in th
or eir
de int
r er
to na
dri tio
ve na
do l
wn cli
the en
co ts
sts th
of at
re co
pr st
od up
uct to
ive 3
ou ti
tso m
ur es
cin les
g s
an th
d an
the su
re rro
by ga
att cy
rac w
t ou
int ld
er in
nat th
io eir
nal na
cli tiv
ent e
 1799

co br
un ok
try er
.A m
tra ay
dit ch
io ar
nal ge
sur an
ro int
ga en
cy de
arr d
an pa
ge re
me nt
nt co
in up
the le
Un ap
ite pr
d ox
St im
ate ate
s, ly
for $3
ex 5,
am 00
ple 0,
, w
ma hi
y ch
co in
st cl
up ud
wa es
rds th
of e
$1 br
00, ok
00 er
0; fe
ho es;
we m
ve ed
r, ica
an l
In bil
dia ls;
n an
1800

d an
sti d
pe les
nd s
for re
the gu
sur lat
ro ed
gat su
e rro
he ga
rse cy
lf, pr
us og
ual ra
ly ms
ra in
ng cl
in ud
g e
bet U
we kr
en ai
$5, ne
00 ,
0 G
an ua
d te
$8, m
00 ala
0. ,
Ot an
he d
r Th
co ail
un an
tri d.
es H
wi o
th we
rel ve
ati r,
vel co
y un
we tri
ll- es
de su
vel ch
op as
ed A
 1801

ust uti
ral liz
ia, ed
Ca by
na int
da, en
the de
Un d
ite pa
d re
St nts
ate res
s, idi
an ng
d els
Be ew
lgi he
u re.
m Fo
— r
wh ins
ere ta
sur nc
ro e,
ga so
cy m
is e
re Ja
gu pa
lat ne
ed se
— int
are en
als de
o d
pla pa
ce re
s nts
in ha
wh ve
ich e
sur m
ro pl
gat oy
e ed
m W
ot hit
he e
rs A
are m
1802

eri be
ca so
n ug
sur ht
ro —
gat ar
es e
to als
co o
nc lo
eiv cat
e a io
chi ns
ld. of
Mde
or pa
eo rtu
ve re;
r, th
it at
is is,
tru in
e di
tha vi
t du
th als
os fro
e m
de th
sti es
nat e
io co
n un
co tri
un es
tri m
es ay
— go
co els
un ew
tri he
es re
wh to
ere pu
sur rs
ro ue
gat su
es rro
ma ga
y cy
 1803

. di
Th vi
e du
Un al
ite sta
d tes
St ch
ate oo
s, se
for to
ex re
am gu
ple lat
, is e
a su
co rro
un ga
try cy
wh in
ere dif
pr fer
oc en
rea t
tio wa
n ys
is —
pr so
ote m
cte e
d all
un o
de wi
r ng
the for
co su
nst rro
itu ga
tio te
nal co
rig m
ht pe
to ns
pri ati
va on
cy. (e.
Ho g.,
we Ar
ve ka
r, ns
in as,
1804

Ca w
lif Jer
or se
nia y,
, an
Fl d
ori Vi
da, rgi
an ni
d a).
Illi Fu
no rth
is) er,
an in
d co
ot un
he tri
rs es
all lik
ow e
in Ca
g na
sur da
ro ,
ga A
cy ust
on ral
ly ia,
in an
alt d
rui th
sti e
c U
or nit
un ed
pai Ki
d ng
ca do
ses m,
(e. su
g., rro
Mi ga
chi cy
ga is
n, on
Ne ly
br le
as ga
ka, lly
Ne pe
 1805

rm sta
itt te/
ed co
wh un
en try
it m
is ay
alt se
rui ek
sti su
c. rro
Th ga
us, cy
int thr
en ou
de gh
d int
pa er
re na
nts tio
wh na
o l
ca m
nn ea
ot ns.
fin In
d ad
an dit
alt io
rui n
sti to
c res
sur tri
ro cti
gat ve
e su
or rro
wh ga
o cy
liv la
e ws
in at
a ho
hi m
gh e,
ly int
re en
gu de
lat d
ed pa
1806

re y
nts be
ma to
y o
als co
o stl
fin y,
d m
la ay
ws re
rel qu
ate ire
d ye
to ars
ad of
op wa
tio iti
n ng
an ,
d or
ot th
he e
r co
me up
an le
s m
of ay
be no
co t
mi qu
ng ali
pa fy
re to
nts ad
to op
o t.
li L
mi G
tin B
g. T
Ad Q
op int
tio en
n, de
for d
ex pa
am re
ple nts
, m
ma ay
 1807

en gh
co it
un m
ter ay
su be
ch th
iss e
ue pr
s ef
as err
ad ed
op op
tio tio
n n
ine for
lig so
ibi m
lit e
y int
if en
the de
ir d
co pa
up re
lin nts
g ,
sta int
tus er
is na
no tio
t na
leg l
all su
y rro
rec ga
og cy
niz co
ed m
in es
the wi
ir th
ho its
me o
co w
un n
try set
. of
Ale
lth ga
ou l
1808

pe ar
ril e
s. re
M qu
ate ire
rni d
ty to
in en
m su
ost re
co pa
un re
tri nt
es, al
for rig
ex hts
am ar
ple e
, is tra
aw ns
ar fer
de re
d d
to to
the th
sur e
ro int
gat en
e de
as d
the pa
bir re
th nt(
m s).
ot Le
he ga
r, lit
an y
d ca
the n
ref gr
or o
e w
leg m
al or
arr e
an co
ge m
me pli
nts cat
 1809

ed gh
in te
ca n
ses for
wh L
ere G
the B
sur T
ro Q
gat int
e en
gr de
ow d
s pa
att re
ac nts
he w
d ho
to Inter
the racia
chi l
Rela
ld
tions
an hips
d
ref
us ar
es e
to se
rel ek
in in
qu g
ish du
he al
r m
ma at
ter er
nal nit
rig y
hts or
. pa
Th ter
es nit
e y,
dif de
fic pe
ult nd
ies in
ma g
y up
hei on
1810

th ad
e dit
le io
ga na
l l
res iss
tri ue
cti s
on wi
s th
in pa
th ss
e po
co rts
un ,
try cit
in iz
w en
hi sh
ch ip
th do
e cu
ch m
ild en
wa tat
s io
bo n,
rn. an
Fo d
r pr
m ov
an in
y g
int th
en e
de m
d at
pa er
re nit
nts y
in or
ge pa
ne ter
ral nit
, y
th of
er th
e e
ar ch
e ild
 1811

w m.
he Th
n e
att m
e aj
m ori
pti ty
ng of
to co
ret m
ur m
n er
to cia
th l
e su
co rro
un ga
try cy
in is
w co
hi nd
ch uc
th te
ey d
res be
id tw
e. ee
In
nte int
rn en
ati de
on d
al pa
sur re
ro nts
ga fro
cy m
ha pr
s ed
me o
t mi
its na
sh ntl
are y
of aff
sta lu
rk en
cri t
tic W
is hit
1812

e tri
ba gh
ck t
gr ex
ou pl
nd oit
s, ati
an on
d .
po Ac
or, tiv
us ist
ual s
ly cla
br im
ow th
n- at
ski su
nn rro
ed, ga
sur cy
ro is
gat gl
e ob
m all
ot y
he de
rs. hu
In m
tur an
n, izi
hu ng
ma ,
n as
rig su
hts rro
ad ga
vo te
cat w
es o
co m
nd en
em ar
n e
sur va
ro lu
ga ed
cy on
as ly
ou for
 1813

the ris
ir he
re d
pr co
od nd
uct iti
ive on
or s.
ga A
ns, dd
are iti
no on
t al
pr et
ov hi
ide cal
d co
wi nc
th er
ad ns
eq in
uat cl
e ud
car e
e th
or e
co rig
m hts
pe of
ns th
ati e
on, ch
an ild
d ,
are th
for e
ce pa
d re
int nt
o al
sur co
ro m
ga pe
cy te
by nc
the y
ir of
im int
po en
ve de
1814

d C
pa ry
re st
nts al
, P
an au
d l
the
se Se
pa e
rat als
o
io As
n sis
of ted
the Re
chi pr
ld od
uct
fro
ive
m Te
his ch
or no
he lo
r gie
sur s
(A
ro
R
gat Ts
e );
an S
d/ u
or r
bi r
ol o
g
og
a
ica c
l y
m ;
ot
he S
r. u
r
D r
an o
a g
a
Be
c
rk y
o ,
wi
tz L
an e
g
d
 1815

aW
l om
b
Cfor
oren
nt:
sIn
i dia
d’s
eco
rm
ame
t rci
i al
osur
nro
sga
cy.
oHa
f rv
ar
d
Int
F
er
u na
r tio
t na
h l
e Re
r vie
w,
R 31
(1)
e
,
a 11
d –
i 12.
nDeona
g nd
s an,
R.,
Ch Gr
aee
nn,
gS.,
,&
Va
Mn
. Be
inu
( m,
2A.
0(2
001
92).
) Et
. hic
1816

ais
l m.
Jo
cur
ona
nl
cof
eM
r edi
ncal
s Et
hic
f s,
o38
r (1
2),
74
m
2–
a
74
t
5.
e
Inhorn
r
n,
aM.
l C.,
&
Pat
s
riz
u
io,
r
P.
r
(2
o
01
g
2).
a
Th
c
e
y
glo
bal
a
lan
n
ds
d
ca
pe
r of
ecro
pss-
r bo
orde
dr
urep
cro
t du
i cti
vve
ecar
e:
tT
owe
unty
r ke
 1817

yste
tri
f cs
i an
nd
dGy
i ne
ncol
gog
s y,
24
f (3)
o,
r 15
8–
16
t
3.
h
e

n
I
e N
w
TE
mRR
i
AC
l
l IA
e
nL
n
i
R
uEL
mAT
.
IO
CNS
uHI
r
r PS
e
nTh
te
ter
Om
pin
i te
nrr
i
ac
o
nia
l
i ref
ner
s
Oto
bco
1818

up ci
les al
in sci
w en
hi tis
ch ts
on w
e ho
pa be
rtn lie
er ve
is th
of es
a e
dif rel
fer ati
en on
t sh
ra ip
ce s
th of
an fer
th in
e si
ot gh
he ts
r. int
Int o
err br
aci oa
al de
co r
up ra
les ce
ha rel
ve ati
lo on
ng s.
ca M
pt os
ur t
ed re
th se
e ar
att ch
en on
tio thi
n s
of to
so pi
 1819

c ci
fo all
cu y
se be
s tw
up ee
on n
he Bl
ter ac
os ks
ex an
ua d
l W
co hit
up es.
les Th
, is
bu en
t a try
gr ex
o pl
wi or
ng es
nu th
m e
be pa
r tte
of rn
stu s,
di hi
es st
ex or
a y,
mi an
ne d
sa co
m nt
e- e
se m
x po
int rar
err y
aci ch
al all
int en
im ge
ac s
y, of
es sa
pe m
1820

e- ab
se le.
x Be
int gi
err nn
aci in
al g
rel in
ati 20
on 00
shi ,
ps. th
e
U
Pa nit
tt ed
er St
ns at
es
Na
Ce
tio
ns
na
us
l
be
da
ga
ta
n
on
co
sa
lle
m
cti
e-
ng
se
da
x
ta
rel
on
ati
“u
on
n
shi
m
ps
arr
ha
ie
s
d
on
pa
ly
rtn
re
er
ce
ho
ntl
us
y
eh
be
ol
co
ds
m
,”
e
in
av
cl
ail
ud
 1821

in lat
g er,
les th
bi e
an U.
co S.
up Ce
le ns
ho us
us all
eh o
ol w
ds, ed
ga sa
y m
m e-
ale se
co x
up pa
le rtn
ho er
us s
eh to
ol id
ds, en
an tif
d y
he as
ter “s
os po
ex us
ua es.
l ”
un In
m 20
arr 10
ie ,
d an
co est
up im
le at
ho ed
us 0.
eh 6
ol %
ds. of
Te all
n U.
ye S.
ars ho
1822

us al
eh e
ol int
ds err
be ac
lo ial
ng rel
ed ati
to on
sa sh
m ip
e- s
se ar
x e
pa un
rtn co
ers m
. m
Fo on
cu .
sin O
g nl
on y
th ab
es ou
e t
sa 14
m %
e- of
se ga
x y
co m
up al
le e
ho co
us up
eh les
ol an
ds d
sh 11
o %
ws of
th les
at bi
fe an
m co
ale up
an les
d ar
m e
 1823

int l
err co
aci un
al. ter
W pa
hil rts
e to
th be
os in
e a
pe rel
rc ati
en on
ta sh
ge ip
s wi
ar th
e so
rel m
ati eo
ve ne
ly fr
sm o
all m
, an
sa ot
m he
e- r
se ra
x ce
pa .
rtn (O
ers nl
ar y
e 4
m %
or of
e str
lik ai
el gh
y t
th m
an arr
th ie
eir d
he co
ter up
os les
ex an
ua d
1824

9 H
% a
of w
str ai’
ai i,
gh Ca
t lif
un or
m ni
arr a,
ie O
d kl
pa ah
rtn o
ers m
ar a,
e an
int d
err Al
aci as
al. ka
) .
M C
ost en
m su
ale s
an da
d ta
fe als
m o
ale re
int ve
err al
aci dif
al fer
co en
up ce
les s
liv in
e th
in e
th pr
e ev
W ale
est nc
, e
es of
pe pa
cia rti
lly cu
 1825

lar er
ty et
pe hn
s ic
of rel
mi ati
xe on
d shi
rel ps
ati be
on tw
shi ee
ps. n
Int Hi
ere sp
th an
nic ics
ga an
y d
an no
d n
les Hi
bia sp
n an
pai ics
rs ,
are w
3 hi
ti ch
me ac
s co
as un
co te
m d
m for
on 10
as %
int of
err all
aci sa
al m
pai e-
rs. se
Co x
m co
pa up
re les
d ,
to on
int ly
1826

2 ers
% .
of A
sa no
me th
- er
se wa
x y
co to
up co
les nsi
we de
re r
W thi
hit s
e/ pa
As tte
ian rn
pai is
rs, to
an ex
d a
3 mi
% ne
of ho
all w
sa lik
me el
- y
se se
x xu
ho al
us mi
eh no
ol riti
ds es
we fro
re m
Bl dif
ac fer
k/ en
W t
hit ra
e cia
int l
err gr
aci ou
al ps
pa ar
rtn e
 1827

to shi
for ps
m (1
mi 2
xe %
d of
sa W
me hit
- e
se an
x d
rel 23
ati %
on of
shi Bl
ps. ac
W k
hit sa
es m
an e-
d se
Bl x
ac pa
ks rtn
are ers
the en
lea ter
st th
lik es
ely e
to un
for io
m ns
int ).
err In
aci co
al ntr
or ast
int ,
ere a
th m
nic on
sa g
me sa
- m
se e-
x se
rel x
ati pa
on rtn
1828

ers ka
, n
45 In
% di
of an
no s
n- an
Hi d
sp Na
ani tiv
c e
As A
ian m
s, eri
62 ca
% ns
of ar
no e
n- in
Hi int
sp err
ani aci
c al
Na or
tiv int
e er
Ha et
wa hn
i’i ic
an/ rel
Pa ati
cif on
ic shi
Isl ps.
an
de
rs, Hi
an st
d or
70 y
%
Ev
of
en
no
as
n-
th
Hi
eir
sp
nu
ani
m
c
be
Al
rs
as
 1829

ar ce
e rel
rel ati
ati on
ve s.
ly H
sm et
all er
, os
int ex
err ua
aci l
al int
rel err
ati ac
on ial
shi ity
ps ha
ha s
ve re
lo ce
ng iv
he ed
ld a
sy va
m st
bo a
lic m
m ou
ea nt
ni of
ng att
to en
th tio
os n
e in
int sc
er ho
est lar
ed ly
in an
un d
de po
rst pu
an lar
di wr
ng iti
U. ng
S. s,
ra in
1830

pa e
rt su
be pr
ca e
us m
e ac
pr y.
oh Th
ibi e
tin so
g ci
he al
ter si
os gn
ex ifi
ua ca
l nc
int e
err of
aci sa
al m
se e-
xu se
ali x
ty int
an err
d ac
m ial
arr rel
ia ati
ge on
wa sh
s ip
lo s,
ng on
co th
nsi e
de ot
re he
d r
cr ha
uc nd
ial ,
to is
up be
ho st
ldi un
ng de
W rst
hit oo
 1831

d pl
in ori
th ng
e th
co e
nt wa
ex ys
t in
of w
L hi
G ch
B th
T e
Q co
co lor
m lin
m e
un be
iti tw
es. ee
En
xa sa
mi m
ni e-
ng se
the x
his pa
tor rtn
y ers
of ha
sa s
me lo
- ok
se ed
x si
int mi
err lar
aci to
ali an
ty d
ne dif
ce fer
ssa en
ril t
y fro
in m
vo th
lve e
s he
ex ter
1832

os an
ex d
ual int
col im
or ac
lin y
e. hi
On gh
e ly
co vo
m lat
m ile
on an
ali d
ty da
lie ng
s er
in ou
the s.
wa A
ys n
in ov
wh ert
ich sy
W ste
hit m
e of
su ra
pr cia
em l
ac str
y ati
in fic
the ati
19 on
th m
ce ad
nt e
ur it
y hi
re gh
nd ly
ere un
d lik
int el
err y
aci for
al W
se hit
x es,
 1833

Af m
ric e-
an se
A x
me en
ric co
an un
s ter
(e s
nsl m
av ay
ed ha
or ve
fre oc
e), cu
As rre
ian d,
mi bu
gr t
ant su
wo sta
rk in
ers ed
, rel
or ati
Na on
tiv shi
e ps
A we
me re
ric hi
an gh
s ly
to un
int lik
era el
ct y.
as It
eq is
ual im
s. po
Cl rta
an nt
de to
sti no
ne te
se th
xu at
al th
sa e
1834

cat ic
eg h
or so
y m
of e
“h pe
o op
m le
os to
ex ok
ual pa
” rt,
di bu
d t
no en
t ga
em gi
er ng
ge in
un a
til sa
the m
18 e-
80 se
s. x
Be se
for xu
e al
the act
n, di
sa d
me no
- t
se ne
x ce
se ssi
xu tat
al ea
be sp
ha eci
vi fic
ors la
we be
re l
pr or
act re
ice nd
s er
in on
wh ea
 1835

sp lat
eci io
fic ns
ki int
nd er
of act
pe ed
rso to
n. co
It nst
wa ru
s ct
on th
ly e
in no
the tio
lat n
e of
19 a
th se
ce xu
nt al
ur id
y en
tha tit
t y
ex ar
pa ou
nd nd
in w
g hi
se ch
xu sa
al m
su e-
bc se
ult x
ur de
es sir
an es
d an
me d
dic be
al ha
ex vi
pe or
rts s
’ du
art ra
icu bl
1836

y at
co th
he e
re. tur
Sn
o of
me th
of e
the 20
ear th
lie ce
st nt
his ur
tor y,
ica w
l ho
evi Interracial
de Relationships
nc
e fo
of un
sa d
me sa
se m
x e-
int se
err x
aci so
ali ci
ty ali
co zi
me ng
s an
fro d
m ca
so ro
cia us
l in
ref g
or pa
me rti
rs cu
an lar
d ly
me ab
dic ho
al rre
ex nt.
pe Fo
rts
 1837

r ey
ex w
a er
m e
pl ca
e, lle
in d,
18 as
93 an
a “o
pr rg
o y
mi of
ne las
nt ci
do vi
ct ou
or s
ref de
err ba
ed uc
to he
“d ry.
ra ”
g Su
da ch
nc se
es xu
” al
att rel
en ati
de on
d s
by ca
Bl us
ac ed
k m
an uc
d h
W co
hit ns
e ter
m na
ale tio
“i n.
nv A
ert m
s,” ed
as ic
th al
1838

ex rv
pe ert
rt s,”
on be
se ca
xu us
al e
dis th
or ey
de w
rs er
cal e
le th
d ou
m gh
en t
w to
ho su
en ffe
ga r
ge fr
d o
in m
int a
err pa
aci rti
al cu
se lar
x sy
wi nd
th ro
ot m
he e
r in
m w
en hi
“h ch
o co
m lor
os or
ex ra
ua ci
l al
co dif
m fer
pl en
ex ce
io su
n bs
pe tit
 1839

ut l
ed op
for pr
th es
e si
ge on
nd th
er at
dif fo
fer un
en d
ce he
fo ter
un os
d ex
in ua
he l
ter Bl
os ac
ex k–
ua W
l hit
rel e
ati int
on im
shi ac
ps. y
Th to
ou be
gh im
sh m
ap or
ed al
in or
lar un
ge na
pa tur
rt al,
by th
th es
e e
sa hi
m st
e ori
sy ca
ste l
m ch
of ar
ra ac
cia ter
1840

iza ce
tio -
ns mi
re xi
ve ng
al wi
th th
at a
sa tro
m ub
e- lin
se g
x pe
int rv
err er
aci si
ali on
ty —
oc ho
cu m
pi os
ed ex
an ua
es lit
pe y.
cia I
lly n
str th
an e
ge ea
po rly
sit 20
io th
n. ce
Sa nt
m ur
e- y,
se ur
x ba
int n
err ce
aci nt
ali ers
ty lik
co e
m Ne
bi w
ne Y
d or
ra k
 1841

an Bl
d ac
Ch k
ica se
go xu
we al
re mi
sit no
es riti
wh es
ere ha
ho d
m bu
os ilt
ex an
ual ex
s te
co nsi
ul ve
d ho
fin m
d os
ve ex
nu ua
es l
for w
da orl
nci d
ng, in
so th
cia eir
liz o
in w
g, n
or Ha
illi rle
cit m
se ne
xu ig
al hb
en or
co ho
un od
ter s,
s. a
By w
the orl
19 d
20 th
s, at
1842

cel es,
eb w
rat hi
ed ch
m co
usi m
cia m
ns, on
art ly
ist cat
s, er
wr ed
ite to
rs, m
an ult
d ipl
ent e
ert “v
ain ice
ers s”
. —
Fl in
ou cl
tin ud
g in
Pr g
oh dri
ibi nk
tio in
n g
la an
ws d
, pr
Ha ost
rle itu
m tio
als n,
o in
co ad
nta dit
ine io
d n
nu to
me ho
ro m
us os
sp ex
ea ua
ke l
asi so
 1843

cia ex
liz cl
in usi
g. on
Th ult
ere im
is ate
iro ly
ny be
in ca
the m
fac ea
t po
tha int
t of
the fas
se ci
pa na
rat tio
e n
wo for
rld W
cul hit
tiv es.
ate Bu
d t
by th
Af at
ric is
an ex
A act
me ly
ric w
an ha
s t
in ha
res pp
po en
ns ed
e .
to A
ov m
ert on
an g
d aff
oft lu
en en
vi t
ole an
nt d
1844

mi rh
dd oo
le- ds
cla for
ss lei
W su
hit re
es, an
“sl d
u se
m xu
mi al
ng a
” m
in us
Ha e
rle m
m en
be t.
ca Ne
me ig
a hb
po or
pu ho
lar od
di s
ve lik
rsi e
on, Ha
an rle
d m
W we
hit re
e se
ur en
ba by
nit W
es hit
ve es
nt as
ur at
ed on
int ce
o for
Bl bi
ac dd
k in
nei g
gh an
bo d
 1845

lur us
id. e
Oit
bs ill
er ust
vi rat
ng es
ear th
ly e
sa er
me oti
- ciz
se ati
x on
int of
err ra
aci ce
ali th
ty at
ag ha
ain s
st so
the m
ba eti
ck m
dr es
op ch
of ar
a act
no eri
rth ze
er d
n W
me hit
tro es’
po de
lis sir
lik e
e for
Ne Bl
w ac
Yo kn
rk es
is s.
ins Af
tru ric
cti an
ve A
be m
ca eri
1846

ca hit
ns’ en
de es
sir s
e w
for ou
W ld
hit no
en t
ess ha
ma ve
y be
ha en
ve en
als ou
o gh
be to
en re
fu ca
ele st
d th
by e
po
Inter
raci
w
al
er
Rela
di
tions
sp
hips
ari
tie
a s
se be
ns tw
e ee
of n
da W
ng hit
er e
an an
d d
int Bl
rig ac
ue, k.
bu It
t m
ob ay
jec se
tif e
yi m
ng in
W co
 1847

ng se
ru gr
ou eg
s ati
th on
at en
int ve
err lo
aci pe
al d
so m
cia uc
liz h
in of
g th
qu e
iet U
ly nit
pr ed
os St
pe at
re es,
d bu
in t
Ha th
rle es
m e
sp tre
ea nd
ke s
asi ref
es le
at ct
th a
e si
sa mi
m lar
e un
ti de
m rly
e in
as g
ha tru
rs th:
h B
Ji ot
m h
Cr W
o hit
w es
1848

’ fr
er o
oti m
ciz W
ati hit
on es.
an B
d y
de th
ni e
gr 19
ati 70
on s
of an
Af d
ric 19
an 80
A s,
m sa
eri m
ca e-
ns se
ste x
m int
m err
ed aci
fro ali
m ty
a ha
se d
ns be
e co
th m
at e
Bl th
ac e
ks fo
we cu
re s
fu of
nd po
a liti
m cal
en te
tal nsi
ly on
dif s,
fer es
en pe
t cia
 1849

lly gu
in ed
Bl th
ac at
k a
ga ga
y y
an id
d en
les tit
bia y
n wa
co s
m co
m ntr
un ad
iti ict
es. or
Le y
ad to
ers an
su “a
ch ut
as he
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mi c”
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ra cal
ka Bl
of ac
the k
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ac en
k tit
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s A
m cri
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em ue
ent of
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un no
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cal s
ly ta
ar ke
1850

n y
up pr
ov ecl
er ud
the ed
ne a
xt cel
se eb
ve rat
ral io
de n
ca of
de Bl
s ac
by k
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k .
se Bl
xu ac
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mi ga
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a att
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or n
les to
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n e
ide no
nti tio
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in of
no “t
wa he
 1851

Bl gg
ac s
k in
co To
m ng
m ue
un s
ity U
” nti
an ed
d ,
rei “B
ma lac
gi k
ne m
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rac lo
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aut ng
he Bl
nti ac
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inc th
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In ga
the ins
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fil ba
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M int
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1852

int as
im Bl
ac ac
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siti ho
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sit hit
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or ou
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 1853

cs an
an d
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hit an
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cul iti
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al .
for So
ms m
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In of
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1854

an ce
ni’ (1
s 99
Ro 5).
o Int
m err
(1 aci
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6), de
Au sir
dr e
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(1 ed
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to an
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 1855

ng do
in ze
g. n
Am
no en
the in
r Sa
di n
me Fr
nsi an
on cis
of co
the for
po m
liti ed
cal a
nat gr
ur ou
e p
of cal
int le
err d
aci Bl
al ac
int k
im an
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y W
wa hit
s e
in M
so en
cia To
l ge
act th
ivi er
sm (B
. W
In M
the T)
ear .
ly Th
19 e
80 pu
s, rp
ab os
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t of
tw th
o e
1856

gr ,
ou ot
p he
wa r
s lo
to cal
en ch
ga ap
ge ter
in s
co of
ns B
cio W
us M
ne T
ss- for
rai m
sin ed
g in
act cit
ivi ies
tie lik
s, e
to Ph
so ila
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liz lp
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an a;
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to as
su hi
pp ng
ort to
me n,
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in C.
int ;
err Lo
aci s
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rel ng
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ps. tro
Ov it;
er At
ti la
me nt
 1857

a; int
an im
d ac
Mi y.
lw Th
au e
ke Di
e. str
Th ict
es of
e Co
gr lu
ou m
ps bi
rec a
og br
niz an
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the ’s
lat St
ent ate
an m
d en
so t
me of
ti Pu
me rp
s os
ov e
ert ex
ten pl
sio ai
ns ns,
wi
thi B
n M
ga W
y T
co
m i
m s
un
iti a
es
ov g
er a
int y
err ,
aci
al i
1858

n v
t i
e r
r o
r n
a m
c e
i n
a t
l s

o w
r h
g e
a r
n e
i
z r
a a
t c
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c a
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m
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s b
u a
p r
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v
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 1859

b e
e d
.
o
v T
e o
r
c t
o h
m e
e s
e
a
n e
d n
d
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e
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h i
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z t
1860

i f
c
a d
l e
, a
l
c i
u n
l g
t
u w
r i
a t
l h
,
t
a h
n e
d
r
s a
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c i
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a m
l ,

a s
c e
t x
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t ,
i
e a
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s h
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o
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o ,
 1861

o
a u
n r
d
l
o i
t v
h e
e s
r .

i (
n G
e .
q
u K
a a
l n
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t a
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e ,
s
L
i e
n t
t
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r
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o
m M
m a
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i p
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1862

1 /
.
w
R w
a w
i .
n r
b a
o i
w n
b
H o
i w
s h
t i
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r t
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P y
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o o
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t a
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d n
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t
a A
ls
th
ae
r gr
cou
hp
i ex
vpa
end
. ed
, it
hwa
ts
t lat
per
: re
/ na
 1863

me C
d o
M nt
en
e
of
m
Al
l p
Co or
lor ar
s y
To C
get h
he
all
r,
e
an
d n
in ge
so s
me In
pla th
ce e
s, U
Pe nit
op ed
le St
of at
Al es,
l sa
Co m
lor e-
s se
To x
get int
he err
r, ac
wh ial
ich co
inc up
lu les
de sti
d ll
wo liv
me e
n. at
th
e
co
m
pl
1864

ex x
ju m
nc arr
tur ia
e ge
of bu
ra t
cia re
l m
an ai
d n
se vu
xu ln
al er
in ab
eq le
ua to
liti di
es. sc
Li ri
ke mi
ot na
he tio
r n
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B he
T r
Q ar
co ea
up s
les of
, lif
th e,
ey in
en cl
jo ud
y in
gr g
o e
wi m
ng pl
ac oy
ce m
ss en
to t,
sa ho
m us
e- in
se g,
 1865

ad ai
op ns
tio t
n, int
an err
d ac
ed ial
uc co
ati up
on les
. —
Li su
ke ch
he as
ter cr
os os
ex s
ua bu
l rni
int ng
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al ou
co tri
up gh
les t
, ex
th cl
ey us
liv io
e n
in fr
a o
so m
cie in
ty sti
in tut
w io
hi ns
ch or
ov as
ert so
for ci
ms ati
of on
ho s
sti —
lit ha
y ve
ag be
1866

co pa
m rts
e .
un As
us wi
ua th
l. pr
Ye ev
t io
th us
e er
ex as,
pe ex
rie pl
nc ori
e ng
of th
sa e
m liv
e- es
se of
x sa
int m
err e-
aci se
al x
co int
up err
les ac
is ial
m co
or up
e les
co in
m th
pl e
ex ea
th rly
an de
th ca
e de
su s
m of
of th
its e
co 21
nst st
itu ce
en nt
t ur
 1867

y int
re err
qu aci
ire al
s co
att up
en les
tio oft
n en
to fe
int el
ers th
ect at
io th
ns eir
of int
ra im
ce, ac
se y
xu go
ali es
ty, un
an se
d en
ge in
nd pu
er. bli
Uc.
nli Th
ke e
m sa
ost m
het e
er ra
os cia
ex l
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int
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up
les
,
sa
me
-
se
x
1868 Intersections Between Sex, Gender, and Sexual Identity
difference that may immediately draw strangers’
attention to heterosexual pairs can render same-sex
couples invisible. For couples walking on the streets
of a metropolitan area or patronizing a movie theater,
restaurant, or shopping center, racial difference is
most legible when it is embodied by heterosexual
partners. Lesbian and gay partners’ perceptions of
invisibility emerge from interactions with strangers
in these settings. Some same-sex couples pay little
attention to these moments, but for many they are
troubling. The cumulative effect of these everyday
slights is significant. Social devaluation can affect
relationship experiences, including contributing to
lower levels of commitment and a greater likelihood
of breakups.
Maintaining intimate relationships across racial
inequalities is a challenge for same-sex couples, as it
is for their heterosexual counterparts. This is
especially evident in Black–White relationships.
Occupying different positions in relationship to
discrimination and privilege, African Americans and
Whites grow up with disparate racial orientations. In
a society with deep racial inequalities, Black children
learn to anticipate how others will perceive them.
Not only do they see the world through their own
eyes, but they also see themselves through the
world’s eyes. W. E. B. Du Bois called this “double
consciousness.” Whites, on the other hand, who are
raised almost exclusively among other Whites, as
many are, grow up with-
out racial self-awareness. White racial homogeneity
is seen as normal, neutral, and nonracial. For same-
sex interracial couples, race-based differ-
ences in perspectives emerge in the most ordinary of
settings, and navigating these differences requires
emotional labor. This labor includes adjusting
behaviors, concealing emotions, translating racial
perspectives, deciding whether and how to discuss
racial matters, using humor, and avoidance.
Same-sex interracial relationships offer a unique
lens into how intimacy is shaped by broader social
forces. More research is needed to explore how
Asian Americans and Native Americans experience
interracial relationships and what interracial intimacy
looks like between people of color.
Amy C. Steinbugler
See also African American Sexualities; Asian American/
Pacific Islander Sexualities; Intersections Between Sex,
Gender, and Sexual Identity; LGBTQ People of Color
Further Readings
Dunning, S. K. (2009). Queer in Black and White:
Interraciality, same sex desire, and contemporary African
American culture. Bloomington: Indiana University Press.
Mumford, K. (1997). Interzones: Black/White sex districts in
Chicago and New York in the early twentieth century.
New York, NY: Columbia University Press.
Pearlman, S. F. (1996). Loving across race and class
divides: Relational challenges and the interracial
lesbian couple. Women & Therapy, 19(3), 25–35.
Rostosky, S. S., Riggle, E. D. B., Savage, T. A., Roberts,
S. D., & Singletary, D. (2008). Interracial same-sex
couples’ perceptions of stress and coping: An
exploratory study. Journal of GLBT Family Studies,
4(3), 277–299.
Scott, D. (1994). Jungle fever? Black gay identity politics,
White dick, and the utopian bedroom. GLQ: A
Journal of Lesbian and Gay Studies, 1, 299–321.
Steinbugler, A. C. (2012). Beyond loving: Intimate racework
in lesbian, gay, and straight interracial relationships.
New York, NY: Oxford University Press.
INTERSECTIONS BETWEEN SEX, GENDER,
AND SEXUAL IDENTITY
People are commonly viewed as having discrete
identities. These identity categories are often seen as
or used in isolation from other categories. Therefore,
identity comparisons are often made in dichotomous
ways. For instance, a construct such as life
expectancy may be distinguished along gender lines
(i.e., between males and females). In some instances,
the description of such constructs may take into
consideration another identity marker. Therefore,
academics and policy makers may consider the
difference in life expectancy among Black men and
women compared with White men and women,
thereby creating a 2x2 matrix (gender along one axis
and race along the other). Rarer still are the instances
where yet another identity marker is added to the mix
 Intersections Between Sex, Gender, and Sexual Identity 1869

—for example, considering how social class relates Intersectionality

to life expectancy of Black and White men and
Intersectionality has been conceptualized as an
women. Intersectionality represents an approach to
organizing framework, a theory, a heuristic, or even
theorizing multiple identity statuses, which helps in
as a reading strategy. Kimberlé Crenshaw is credited
problematizing these individual categories by
with coining the term intersectionality in 1989, to
questioning who is represented, who is left out, what
demonstrate how multiple systems of oppression and
are the similarities and differences between and
discrimination intersect with each other. Initially
within categories, who is privileged and who is
studied from a gender and race perspective within the
disadvantaged because of their position within a
field of law and legal studies, it is now used to
specific constellation of identities, and what power
explore the lived experiences of many other
differentials are enacted in interactions between
individuals with “minority” categories and identities,
people. Therefore, intersectionality is not about
and has found its place in disciplines such as
demonstrating who is most subjugated by adding one
sociology, social policy, and psychology. The word
minority status to another, but how when these
minority is used here not to describe a group that is
minority statuses collide, they offer a unique position
smaller in numbers than a majority group, but one
for the person inhabiting that space.
that, because of its social position in society, has
Historically, the distinction between sex and
been disempowered and subjugated by those who are
sexual identity has not always been clearly made,
more powerful. Therefore, minority groups could
with both terms conflated with the term sexuality. As
include those who do not identify as heterosexual
a result, some researchers, health care professionals,
(such as LGBTQ groups), those with physical or
and activists have assumed that each of these
mental disabilities, those who are poor, and so on.
concepts can be understood without necessarily
However, it is worth noting that even within each of
attending to the others. This has produced unintended
these minority groups, there are subgroups of people
negative consequences: Groups have been
who face varying levels of disenfranchisement as a
marginalized, health care interventions and social
function of other minority statuses. For instance,
care initiatives have been mistargeted, and the unique
some lesbians experience discrimination because of
experiences of certain individuals and subgroups
their gender or sexuality, but also their minority
have been made invisible. More recent writing and
ethnic or religious status. This discrimination could
practice has learned from the perils of focusing on
be from a sexual majority (e.g., heterosexual) group
single identity agendas, and has begun to appreciate
or from other lesbians, thereby creating a variety of
the complexity of people’s multiple identities and
in-groups and out-groups within the minority group
how they are interlinked. These recent efforts fall
itself. This kind of fractioning of identities has
under the umbrella term of intersectionality.
historical precedent, perhaps most prominently in the
This entry continues with a discussion of the
feminist and civil rights movements of the late 1960s
concept of intersectionality and how it illuminates
and early 1970s in the United States. In this context,
the intersections between sex, gender, and sexual
women of color challenged the notion of a shared
identity. Other factors, such as culture (typified here
history and destiny with their White sisters, arguing
in terms of racial and ethnic identity), and their
that gender was not the only organizing principle of
influence on definitions of sex and gender will then
their disadvantage and that race played a significant
be considered. The challenges and opportunities of
role in structuring the different forms of
considering gender, sex, and sexuality within an
disadvantage they experienced in their daily lives.
intersectional framework will be explored. Finally,
Therefore, the underlying concept of intersectionality
this entry concludes with some of the challenges
is not new, and in fact goes back to other African
faced by the concept of intersectionality itself.
American women’s movements over the past
century. What is new since Crenshaw’s work is the
explicit articulation of these concepts within an
overarching framework.
1870 Intersections Between Sex, Gender, and Sexual Identity
Although intersectionality has been championed
as more progressive and effective than “single
identity” approaches to civil rights, it is not
universally embraced as a force for progress; in fact,
some groups have experienced it as a threat to unity.
Within groups that have been fighting on a single-
identity agenda (e.g., based only on gender or race or
sexuality), an emphasis on within-group differences
is perceived to break the single voice, thereby
reducing the strength of the voice and diluting the
effect of the cause. However, the emphasis on a
single voice makes the erroneous assumption that all
voices within the group are in fact equal, and has the
unintended consequence of silencing the minority
within the minority (or the “meta-minority”).
Intersectionality, therefore, draws attention to these
silences and the erasures of mixed (or “hyphenated”)
identities and their effects on individuals and
communities.
Intersectionality also focuses attention on what
lies beyond the obvious or the prototypical depiction
of any one social group or identity, helping to
provide nuance and depth to our understanding of
how complex social hierarchies are perceived and
maintained. For example, if we set aside social class
differences, we may conclude that White men are
perceived as holding a more dominant position in
contemporary Western society than Asian men. But
what about an unemployed White man versus a
wealthy Japanese banker? By taking into
consideration factors such as finance, education, and
social class, these perceived hierarchies can be
dismantled. Similarly, intersectionality allows us to
observe and understand how individuals within
oppressed groups can use other identity categories to
marginalize and oppress one another (e.g., Black
heterosexual women discriminating against Black
lesbians).
Intersectionality has mainly been used to highlight
and critique discrimination and prejudice, but
increasingly it is also used to document how the
disadvantaged negotiate their intersectional positions
within their environments to allow themselves not to
be subjugated. Therefore, people may identify
situations or encounters where they can use their
minority status as a strength in order to disrupt
dominant structures or systems. They may be able to
achieve this aim by way of articulating a previously
unarticulated or hidden identity in a way that would
assert their own power within an interaction. For
instance, a woman who is erroneously assumed to be
heterosexual may assert her bisexual identity among
a group of other heterosexuals. This disclosure may
immediately change her relative power within the
group. In a conversation about sexuality or gender,
her disclosure may enable her to speak
authoritatively from lived experience rather than
vicariously. Intersectionality theory also
demonstrates that another way of negotiating
minority identities is to make certain aspects of the
self “invisible” to those who cannot read these
identity markers. For instance, an Asian lesbian may
not explicitly articulate her sexual orientation or
identity among her ethnic groups or family members,
but may still be able to enjoy physical contact and
closeness with her same-sex companions because the
society she inhabits expects women to be segregated
from men. This, to some activists, may be seen as a
retrogressive act of concealment, but to others it can
be interpreted as an authentic (and perhaps the only)
strategy for preserving same-sex relationships in
one’s daily life without risking one’s own safety.
According to this view, people who use such
strategies should not be seen as “closeted,” as this
judgment wrongly presumes that everyone has the
same opportunities (or indeed, desires) to be “out and
proud” LGBTQ people in all the different walks of
their lives, when clearly this is not the case.
Therefore, intersectionality demonstrates how
visibility, hypervisibility, and invisibility can each be
alienating as well as liberating for different
individuals in different circumstances. It also
facilitates an appreciation of the plurality of an
individual’s identities, and forces critical engagement
with problematic concepts such as the “true” or
“authentic” or “primary” identity and self.
The Perils of Focusing Only on
Single-Identity Issues
Single-identity agendas tend to create hierarchies of
importance, with some identities being seen as more
important than others. This allows for the dominance
of one identity over others and can serve to
disadvantage those who do not fit the presumed ideal
(or “average”) of that identity. This may explain the
prejudice and marginalization that some individuals
experience. Lesbian-only groups, for example, may
 Intersections Between Sex, Gender, and Sexual Identity
perpetuate transphobia by recognizing only
cisgendered women (i.e., those born with
biologically female bodies) as lesbians. By excluding
those who do not fit the group’s own definition of
“woman,” the group uses a sexualbased identity
(lesbian) to maintain guardianship of a gender-based
identity (woman).
There are other instances where one identity is
considered more important than others. For example,
if an individual considers religion to be the most
significant identity, then all other identities (e.g.,
sexuality) may assume a subsidiary role to the
primary identity. This, for some individuals, can
cause conflicts that may lead to the subsidiary
identity being denied, rejected, conflicted, or
compromised. Such conflicts may be not only
internal (i.e., within the person) but also external
(i.e., from the wider social groups). Other group
members may force individuals to make their
allegiance clear: for instance, “You are first a
Christian, then a lesbian” (i.e., religion is more
significant than your sexuality).
Research on people’s lived experiences shows that
identities are constantly in a state of flux. Some
identities that were initially considered primary may
move to the background as other identities take
precedence. But even within this flux, some identities
may continue to remain a core component of an
individual’s sense of self. This is another reason why
intersectional approaches to understanding the self in
society are crucial.
Interconnections Between Sex, Sexuality, and
Gender
It is important to demarcate sex from sexual identity,
although these terms are sometimes conflated. This
conflation may result from the fact that sexuality is
used as an umbrella term to encompass sex, gender,
reproduction, sexual orientation, and so on. One such
wide definition of sexuality has been proposed and
popularized by the World Health Organization,
particularly in health-related research and initiatives.
However, “sexuality” as a colloquial term usually
refers to sexual orientation, and it is in this vein that
the term is used here.
Multiple constellations of sexuality, sexual
practice, and gender identity exist. People may
1871
selfidentify as men (based on gender), as gay men
(based on sexual identity), and as “bottoms” who
prefer the receptive role in penetrative sex (based on
sexual practice). However, identities such as bottom
(or “bot”) may not always be constrained to sexual
practices. For some, these identities may also be
relevant for their nonsexual interactions and
relationship patterns. These patterns or ways of
relating to each other may consciously mimic or
parody what is seen as traditional heterosexual ways
of relating (based on gender-role stereotypes enacted
by heterosexuals). Therefore, these categories are
more than simple words or labels: Rather, we must
understand the interconnectedness of sex, sexuality,
and gender underlying these categories to understand
their relevance in the context of health, politics,
legislation, subcultures, and social structures.
Asexuality presents another case in which it is
important to distinguish sexual practices from sexual
behaviors and identity concerns. The term asexuality
often presents problems for researchers and policy
makers because in some cases it is used solely as a
descriptor of sexual activity (or the lack thereof),
independent of one’s sexual orientation identity (such
that an asexual gay man is a gay man who is not
currently sexually active), whereas in other cases it is
used as an independent sexual identity (such that
asexual individuals are distinguished from
heterosexuals, bisexuals, and gays/ lesbians by their
overall lack of sexual attractions and not simply their
lack of sexual behavior). This again highlights the
significance of language and the importance of using
an intersectional perspective to disentangle the
multiple meanings of sex, sexuality, and gender that
are often conflated.
In relation to health, for example, research has
found that rates of HIV infection are greater among
men than women, greater among gay men than
heterosexual men, and greater among bottoms (those
taking the receptive role in penetration) than tops
(those taking the insertive role in penetration).
Therefore, sexual health initiatives need to examine
the nuances of both sexual practices and identities in
order to develop effective interventions. This is often
best achieved through understanding the terms of
self-reference for particular individuals and groups,
which is particularly pertinent in populations that do
not necessarily use terms or notions related to
1872 Intersections Between Sex, Gender, and Sexual Identity
Western ideas of gender and sexuality. For example,
sociologists and anthropologists working in the
Global South have documented numerous terms and
identities representing distinct sexual identities,
sexual practices, and gender identities, and although
some of these terms may find a parallel with
dominant sexual identities such as “gay,” “lesbian,”
and so on, others have no such direct translation, and
must be understood and interpreted within their own
cultural context.
Since the 1990s, health care researchers have
attempted to elide the complexities of sexual
identities by categorizing people mainly on the basis
of their gender and sexual behaviors, which was also
felt to reduce the stigma associated with specific
sexual identity labels (e.g., “gay”). Thus, terms such
as “men who have sex with men” (MSM) and (the
more recently coined and less frequently used)
“women who have sex with women” (WSW) have
been in use among researchers and policy makers.
These terms are problematic, however, as they
reduce individuals to a single aspect of their
sexuality: their sexual behaviors. Furthermore, there
is evidence to suggest that these behavior-based
descriptors can themselves become identity labels for
some people, often then incurring stigma within the
LGBTQ community because they are perceived to be
less “authentic” identities. These groups may then be
seen as unwilling to “commit” to a sexual identity
and to be living “double lives.” There is also concern
that because terms such as “men who have sex with
men” necessarily incorporate the gendered terms
“men” or “women,” these terms neglect the sexual
behaviors and identities of those with liminal gender
identities as well as younger individuals who may see
themselves as “boys” or “girls” rather than “men” or
“women.”
More complex cultural understandings of gender
are also poorly represented by these behaviorally
based terms. For instance, men in some Indian
contexts may see themselves as kothi or panthi,
based on the gender roles that they enact in
relationships with others. In a Northern Indian and
Bangladeshi context, kothis perform a feminized
gender performance and desire to be the “female”
(sometimes penetrated) partner in a same-sex sexual
interaction, often with a panthi. Panthis perform a
typically masculine gender performance and desire to
be the “male” partner in a same-sex sexual
interaction with a kothi. These are viewed as
indigenous sexual identities, but they incorporate
more than just sexuality, since they involve one’s
relational sense of gender. Hence, these identities
cannot be considered akin to the Western “trans”
identities or “gay” or “bi” identities, and must be
understood within their local cultures and histories.
“Culture” in this context refers not only to nation-
states or geographical regions but also to the cultures
that are negotiated within certain strata in society.
For example, Indian men from more urban, English-
speaking communities may be more comfortable
with terms such as gay, whereas those with different
social locations may prefer the more precise
descriptors such as kothi, which offer a sense of
community with other kothi-identified individuals.
Therefore, an intersectional perspective highlights
how the constructs of gender, age, social class,
race/ethnicity, and sexuality coalesce to create a
variety of unique experiences for different
individuals or groups that cannot be generalized with
global terms such as MSM or WSW. Such
generalizations are fraught with omissions and gaps
that limit our knowledge of the lived experiences of
different individuals and groups.
Just as some “indigenous” sexualities can conflate
issues of gender and sexuality, similar conflations are
made regarding gay and lesbian sexualities.
These conflations hinder our understanding of
distinct performative identities within gay and
lesbian culture, such as “camp” and “butch” among
gay men and “femme” and “butch” among lesbians.
Historically, the butch/femme dynamic in lesbian
relationships was seen as a reproduction of
traditional heterosexual ways of relating, with the
butch person performing the stereotypical masculine
role and the femme person performing the
stereotypical feminine role. Yet this interpretation
fails to appreciate how this dynamic serves to subvert
and parody heteronormative ways of relating by
making evident the performative nature of all
gendered relationship behavior. In gay men,
identities such as camp and butch relate to the overall
performance of a gay or bisexual identity, whereas
identities such as top and bottom are more specific
identities of their own, relating mainly (but not
exclusively) to sexual practices. Therefore, even
 Intersections Between Sex, Gender, and Sexual Identity
sexual identities such as gay and lesbian may be
further subdivided according to some aspect of
gender, in some cases only reflecting one’s role
within sexual encounters but in other cases reflecting
one’s dominant way of relating to one’s self and
others.
With any type of grouping, characteristics that are
seen as emblematic of the most visible members of
the group are exaggerated and caricatured to create a
stereotype of this group. Therefore, gay men are
often portrayed as uniformly flamboyant, camp, and
effeminate. However, even within LGBTQ
communities, there are stereotypes of different sexual
identities and ways of presenting. Camp men, for
instance, may be assumed to be bottoms, whereas
muscled men may be seen as dominant and assumed
to be tops. These are gendered stereotypes. Although
distinctly gendered expressions of sexuality can help
individuals and groups to express their unique
identities and make them visible and heard, the use of
conventional gender stereotyping within the LGBTQ
community as well as mainstream society can foster
prejudice and disenfranchisement toward such
individuals. Camp or effeminate men, for instance,
are more likely to experience homophobia because
they “stand out,” are seen as prototypically “gay,”
and are seen as violating gendered norms of
masculinity. Similarly, butch lesbians tend to be
targets of homophobia because of their visibility and
perceived nonconformity to the norms of
womanhood and femininity.
Another further intersection between gender and
sexuality relates to bisexual identity and experience.
This is a further stigmatized identity, which receives
censure from both heterosexual groups (with the “no
one is safe” [from their sexual advances] discourse)
and homosexual groups (with the “can’t make up
their mind,” “just experimenting,” or “in denial” [of
being gay] discourses). Here, the perceived sexual
identity is often obfuscated by the gender of the
bisexual person’s partner(s). Bisexual individuals
with same-sex partners are misread as gay/lesbian,
and those with other-sex partners are misread as
straight/heterosexual. Therefore, bisexuals may only
be visibly perceived as bisexual if they are seen to be
with both men and women at the same time. This
way of thinking perpetuates the stereotype of
bisexuals being “unfaithful” or incapable of
1873
monogamy. Furthermore, this stereotype denigrates
and misinterprets the choices that some bisexuals
make to pursue polyamory (i.e., multiple sexual or
romantic attachments, with the agreement and
consent of all involved). The stereotype of bisexuals
as promiscuous may be more pernicious for women,
given that sexual permissiveness in women has long
been considered a cause for censure and shaming.
The same stereotype of promiscuity in men might be
seen as a triumph of their masculinity and sexual
prowess, further highlighting the gendered nature of
prejudice.
Race, Ethnicity, Gender, and Sexuality
Race and ethnicity intersect critically with gender
and sexuality, specifically defining these identities
by creating a language and practices that shape these
identities. The term race refers to groupings of
people based on biological traits that are visible to
society and that are treated as significant
distinguishing features between groups (e.g., skin
color). The term ethnicity refers to groupings of
people based on shared cultural practices that
distinguish them from others (e.g., language or
religion). It is important to treat race and ethnicity as
separate, but often interlinked social constructs,
because the way in which they interact with gender
and sexuality may vary. This section examines how
race and ethnicity influence the way in which gender
and sexuality intersect.
While there are certain gendered constructs that
appear to carry across cultures, such as women being
seen as “mothers,” other gendered constructs may be
more culture-specific, such as “paid paternity leave.”
This is significant because while there may be some
“globalized” stereotypes of gender and sexuality,
many others are limited to certain cultures and
certain points in history. For instance, there may be a
shared experience of homophobia among Black
African men, both in Africa and abroad. However,
gay/bi Black African men in a White-majority state
or country have a unique experience of receiving
both homophobia and racism from both White and
Black communities.
Not all societies and people specifically label their
sexual identity. In some instances, even what is
thought of as “sex” by most people in the West may
1874 Intersections Between Sex, Gender, and Sexual Identity
not be coded as sexual activity. Here, “sex” (the
activity) is not determined solely by behavior, but by
the individuals and the circumstances in which such
activity takes place. For example, people detained in
prisons may engage in same-sex sexual behaviors,
but not all of them will identify as lesbian, gay, or
bisexual (LGB), or even mark their same-sex activity
as being linked to a sense of who they are (i.e., their
identity). Similarly, in certain cultures where men
and women do not or cannot openly mingle, the
ensuing homosocial environments may offer
possibilities to experiment or “have fun,” without
attributing a sexuality label to these activities. This,
therefore, marks a distinction between doing
(activity) and being (identity). The norms of
sexuality are also culture-bound, and because of this,
gestures and performances such as same-sex public
hand-holding may in the West be coded as “gay,”
whereas such an activity may be considered
camaraderie without any sexual/ sexuality
connotations attached to it in some other cultures.
Added to the mix of activity and identity are the
people involved (the “actors”). In some societies, it is
only the feminine (or receptive partner in anal
intercourse) male partner who is marked with a
sexuality identity or label, while the masculine (or
insertive) partner is not so marked. Sometimes,
however, both partners may take on unique sexuality
identities based on the predominant sexual role in
their relationship (e.g., kothi and panthi, described
earlier).
A gendering effect on sexual identity is also found
when race is added to the mix. Research has shown
that gay men of certain races are perceived as being
more masculine or feminine simply because of their
race. For instance, Asian lesbians have reported that
their physical attributes (such as long hair) are read
as symbols of their ethnicity or religious affiliation,
but are also read as being femme. Similarly, East
Asian gay men are seen as feminine (i.e., bottoms),
whereas Black men are seen as masculine (i.e., tops).
Thus, the sexuality of these individuals is prejudged
based on their racial features.
Racial identity codes not only the person who
inhabits that identity but, in some gay communities,
the sexuality of the partner as well. Culinary argots
such as “rice queen” refer to a White man (usually
older) who prefers (younger) East Asian men.
Similar terms suggest such racialized desires (e.g.,
“potato queen” [Asian man desiring a White man],
“curry queen” [White man desiring South Asian
man], “sticky rice” [Asian men desiring other Asian
men]). These terms are not neutral descriptors of
sexual orientation or relationship preference of
others, but are value-laden terms portraying the
“queen” not as a connoisseur having developed an
exotic taste in men, but as someone who has failed to
acquire the ideal gay partner(s).
Intersectionality, as seen through this race–
gender–sexuality matrix, allows for exploration of
these complexities, and enables the problematization
and critique of taken-for-granted dominant
discourses about these identities and their meaning.
Intersectional analyses highlight points of difference
and dissonance for people whose lives are lived at
the crossroads of multiple identity statuses.
Intersectional Identities: Challenges and
Opportunities
Everyone has intersectional, or hyphenated, identities
(e.g., White-Jewish-Mother), but for those whose
identities are marginalized by the dominant society,
there are unique challenges that must be negotiated
on a daily basis. Combatting racism, sexism,
homophobia, and so on can take its toll on an
individual’s health and well-being. Often, this is
mitigated by social support from one’s communities.
However, for those with intersectional identities, the
very notion of “community” is complex. Black and
minority ethnic people in the West, who typically
rely on their own ethnic community as a primary
source of support and a haven from racism within the
wider society, may suddenly find such support
revoked if they are exposed to be nonheterosexual.
Minority ethnic people who identify as LGBTQ may
find solace within the LGBTQ community, but these
communities may harbor racism, or may be
insensitive to the unique challenges of individuals
whose LGBTQ status intersects with their ethnicity.
These factors are even more of a concern for
individuals who may be more vulnerable than others
because of their age (e.g., teenagers or older adults),
gender (women), ability (e.g., those with mental or
physical disabilities), parenting status (e.g., single
mothers), social class (e.g., the poor). Such
individuals may be even less likely to have access to
 Intersections Between Sex, Gender, and Sexual Identity 1875

adequate support to deal with the challenges of most, intersectionality remains a buzzword. Part of
marginalization. the problem with incorporating intersectionality into
Thinking intersectionally has challenged the more research and policy is that it is not always clear
notion that there is a monolithic gay identity and a how it can be put into practice.
unitary LGBTQ community. It has also challenged First, the term itself is rather difficult and can be
ideologies related to the benefits or necessity of seen as academic and exclusionary. To become more
coming out (i.e., disclosing one’s LGBTQ status widely adopted, the concept needs to be used in
openly) as a prerequisite for a healthy, fulfilled life. nonacademic discourse. There have been some
Decisions related to coming out and expressions of inroads made on this front, but not nearly enough.
sexuality can be complex for people who find Another problem concerns the definition and scope
themselves in vulnerable positions in society, and a of the term. Intersectionality has been variously
careful evaluation of the risks and benefits of coming described as a theory, framework, methodology, and
out need to be undertaken. For some, this process organizing principle that describes a
may be a challenge that requires careful identity
negotiation across different social spaces, and hence
individuals may benefit from supportive services
(e.g., psychological services, social services,
women’s groups). Most important, however, this is
not a “one-off” process that has a clear ending point,
but requires constant vigilance and skill as
individuals move through different social situations
and contexts that require new decisions about
disclosure and new forms of identity negotiation.
The holding of multiple identity positions presents
opportunities as well as challenges. Belonging to
multiple identity groups may open up multiple
avenues of support, allowing people to selectively
seek the support they need for a particular purpose.
There may also be instances whereby those who have
learned to deal with one form of oppression are able
to transfer this learning to deal with another form of
oppression. Furthermore, at the group level, we can
imagine transformative possibilities in which
different identity groups might grow and thrive by
learning from one another’s unique ideas and
experiences. The development of LGBTQ churches
and the establishment of different women’s groups
devoted to fighting for LGBTQ causes provide
examples of such beneficial linkages.

Conclusion: Challenges Facing

Intersectionality
In the final analysis, sex, sexuality, and gender
cannot be fully appreciated unless they are viewed
from an intersectional perspective. Despite this fact,
institutions and social systems have not always
embraced the notion of intersectionality, and for
1876
matrix, crossroads, junction, and so forth. Some
scholars have argued that these multiple
conceptualizations aim to show what
intersectionality can be, rather than what it “is,” and
that this flexibility in definition enables people to use
the term in various ways to cover personal,
interpersonal, group, process, and institutional and
systems levels. It is vital to retain this broad scope
for intersectionality because concepts such as sex
and gender are inherently broad, and only a holistic
approach can enable us to fully understand them.
Roshan das Nair
See also African American Sexualities; East Asian
Sexualities; Homonormativity; Native American/First
Nations Sexualities; Psychological Approaches to
Studying LGBTQ People; Sexual-Identity Labels
Further Readings
Butler, C., das Nair, R., & Thomas, S. (2010). The colour of
queer. In L. Moon (Ed.), Counselling ideologies:
Queer challenges to heteronormativity (pp. 105–122).
Surrey, England: Ashgate.
Choo, H.-Y., & Ferree, M. M. (2010). Practicing
intersectionality in sociological research: A critical
analysis of inclusions, interactions, and institutions in
the study of inequalities. Sociological Theory, 28(2),
129–149.
Crenshaw, K. (1991). Mapping the margins: Intersectionality,
identity politics, and violence against women of color.
Stanford Law Review, 43, 1241–1299.
das Nair, R. (2013). If singularity is the problem, could
intersectionality be the solution? Exploring the mediation
of sexuality on masculinity. In R. Dasgupta & M.
Gokulsing (Eds.), Masculinity and its challenges in India:
Essays on changing perceptions. Jefferson, NC:
McFarland.
das Nair, R., & Butler, C. (2012). Intersectionality,
sexuality, and psychological therapies: Exploring
lesbian, gay, and bisexual diversity. London, England:
Wiley Blackwell.
Davies, K. (2008). Intersectionality as buzzword: A sociology
of science perspective on what makes a feminist theory
successful. Feminist Theory, 9(1), 67–85. Erel, U.,
Haritaworn, J., Rodriguez, E. G., & Klesse, C.
(2008). On the depoliticisation of intersectionality
talk: Conceptualising multiple oppressions in critical
sexuality studies. In A. Kuntsman & E. Miyake (Eds.),
Out of place: Interrogating silences in queerness/
raciality (pp. 265–292). York, England: Raw Nerve.
Fisher, D. (2003). Immigrant closets: Tactical-
micropractices-in-the-hyphen. Journal of
Homosexuality, 45(2/3/4), 171–192.
McCall, L. (2005). The complexity of intersectionality.
Signs, 30, 1771–1800.
Shields, S. A. (2008). Gender: An intersectionality
perspective. Sex Roles, 59(5–6), 301–311.
INTERSEX SOCIETY OF
NORTH AMERICA
From 1993 to 2008, the Intersex Society of North
America (ISNA) was at the forefront of the effort to
destigmatize intersex and reform the medical
treatments regularly practiced by doctors treating
intersex conditions. As a result of this activism, this
medical approach was propelled into crisis and
reform and remains in a state of flux today. The
timing of the intersex patients’ rights movement in
the mid-1990s followed on the heels of the
considerably larger lesbian, gay, bisexual, and
transgender movements. This entry defines intersex;
examines the medical treatment model in question;
and discusses the development, impact, and
dissolution of the Intersex Society of North America.
Background
The term intersex is synonymous with the word
hermaphrodite and refers to anatomical and
physiological attributes such as genitalia and gonads,
chromosomes, hormones, and secondary sex
characteristics that are difficult to categorize as
clearly female or male. For example, in the case of a
newborn with ambiguous genitalia, it might be
unclear whether the child has a small penis or an
enlarged clitoris. In a culture that privileges
heterosexuality and sex/gender/sexual normalcy,
intersex variations of sex development create social
upheaval.
Intersex variations are generally not
physiologically harmful and occur in newborns as
well as in
Intersex Society of North America

early childhood or during puberty when secondary
sex characteristics develop. For example, a young
woman who has female sexual anatomy may not
menstruate or develop pubic or underarm hair despite
developing female-typical breasts and hips. Upon
further examination, it might be discovered that this
young woman has XY (male-typical) chromosomes;
no uterus, ovaries, or fallopian tubes and
undescended testes. This type of intersex is known as
complete androgen insensitivity syndrome (CAIS).
Other common intersex conditions include
congenital adrenal hyperplasia, Klinefelter
syndrome, Turner syndrome, and hypospadias, to
name just a few.
Intersex variations are often characterized as
extremely rare, but that is not actually the case.
Frequency estimates put the occurrence of intersex at
1 or 2 out of every 2,000 births. These estimates are
consistent with the prevalence of both Down
syndrome and cystic fibrosis.
Medicalization of Intersex: A Rather
Recent Development
The treatment protocol to make an intersexed
child appear unambiguously female or male was
created in the United States in the mid-1950s at
Johns Hopkins University. This model is most
closely associated with the late psychologist John
Money and typically involves early surgical and
hormonal intervention to decrease or remove sexual
ambiguity. The rationale for this treatment is to help
intersex children form “normal” gender and sexual
identities and to prevent them from experiencing
stigma.
This treatment model encourages parents to keep
the child’s ambiguous anatomy a secret, even from
the child. The rationale behind this deception is that a
child’s gender and sexual identity may develop
problematically if he or she were to learn that the
child once had intersex features that were medically
“corrected.” By intervening early and erasing visible
sexually ambiguous features, the parents and intersex
child will presumably be able to develop a healthy
bond, and the child will form normative gender and
sexual identities.
This treatment model was made famous by its
application to a child born as Bruce Reimer. Bruce
was a non-intersexed identical twin whose penis was
burned off in 1966 during a circumcision accident.
Intersex Society of North America 1877
He was 8 months old at the time. The Reimer family
worked with Dr. Money to attempt to bring about
optimal gender identity development through a
surgical castration and social reassignment of Bruce
as female when he was 22 months old. At that time,
they changed his name from Bruce to Brenda. This
case was widely reported as a success and as
evidence that socialization holds more sway than
biology with regard to gender identity development,
given that baby Brenda had reportedly grown up to
be a feminine girl, while her identical twin brother,
Brian, had grown up to be a masculine-identified
boy.
Medical intervention on intersexed children relied
on the apparent success of this model until Brenda
Reimer spoke out in 1997. Brenda had rejected the
female gender that he had been assigned and had
been living as a boy named David since the age of
14. David reported that the treatments that were
intended to bring about a feminine gender identity
were, in fact, a cause of great shame and stigma. He
spoke out after learning that other children were
being subjected to the same treatments he received
and that his case had been lauded as evidence of the
success of sex reassignment in early childhood.
Notably, David/ Brenda eventually committed
suicide in 2004 at the age of 38.
The First Wave of Intersex Activism
In the 1990s, a patients’ rights model emerged as
the first generation of intersex adults who had
undergone childhood sex reassignment began to
mobilize and speak out. While the objective of these
medical treatments is to decrease social stigma and
optimize the formation of clear gender and sexual
identities, adults who underwent these procedures in
early childhood conveyed that they experienced
feelings of isolation, stigma, and shame—the very
feelings that such procedures attempt to alleviate.
Many clinicians initially dismissed these critiques
as representative of only an unhappy vocal minority.
As the criticism grew to include a second and third
generation of adults who experienced such treatments
as harmful, this treatment came under greater
scrutiny.
Founding of the Intersex Society of
North America
1878
The most vocal and visible intersex activist of the
1990s and 2000s was Cheryl Chase. Chase founded
the Intersex Society of North America (ISNA) in
1993 (using the pseudonym Cheryl Chase). Chase
was born in 1956, just 1 year after the initial
publication by John Money and colleagues that put
intersex medicalization on the map. ISNA’s mission
was to destigmatize intersex and put an end to
cosmetic genital surgery on intersexed infants and
children. The group’s critique of the medical
“normalization” of intersex infants and children
centered on the following points: (1) Most cases of
intersex do not cause physiological harm, (2) sexual
and psychological satisfaction and function are often
impaired by medical normalization procedures, and
(3) the secrecy surrounding their intersex traits
results in feelings of shame and isolation.
ISNA was the most active and visible intersex
support and advocacy organization from its inception
in 1993 to its dissolution in 2008. Its website remains
operational as a historical artifact. People often
falsely attribute the beginning of the intersex
movement to the founding of ISNA in 1993 and even
equate the intersex movement with ISNA itself. In
actuality, there were three intersex parent support
groups already in existence several years before
Chase founded ISNA, and the movement extends far
beyond the life of this now-defunct organization.
ISNA and Chase had acquired so much media
attention by 1998 that Chase was voted one of the
100 “most interesting and influential gay men and
lesbians in America” in Out magazine’s top 100
people of the year. In 1999, Chase’s own amicus
brief was paramount in the Supreme Court of
Colombia’s decision to establish human rights
protections for people born intersex. In 2004, Chase
was successful in getting the San Francisco Human
Rights Commission to investigate the medical
treatment of intersex children. They ruled that these
medical interventions were violations of patients’
human rights. In 2005, Chase had a seat at the table
with 49 other professionals at an international and
controversial “consensus meeting,” which resulted in
the 2006 publication of “The Consensus Statement
on the Management of Intersex Disorders” and a
change in nomenclature from “intersex” to “disorders
of sex development” (DSDs) in medical and some
activist communities.
This change in nomenclature spawned the death of
ISNA and the birth of a new organization, Accord
Alliance, also formed by Cheryl Chase, using her
legal name: Bo Laurent. While Accord Alliance
embraces the DSD terminology, many activists,
scholars, and some clinicians do not, and this is
currently a very heated issue. Accord Alliance
continues to work alongside medical professionals to
help educate and build alliances between parents
with intersex children and the clinicians who treat
them.
There are now many other intersex support and
advocacy groups around the world, aided
significantly by the growth of the Internet and
various social media outlets.
How ISNA Got Its Start
Chase initially founded ISNA by publishing a
letter to the editor in the July–August 1993 issue of
the New York Academy of Sciences’ journal The
Sciences. This letter was a response to biologist Anne
Fausto-Sterling’s article, “The Five Sexes: Why
Male and Female Are Not Enough.” In her letter,
Chase critiqued intersex medical sex assignment as
destructive, raising concerns about the ethics and
effectiveness of surgical procedures that impair
sexual and psychological function. In the last line of
her letter, Chase announced the formation of a
support group called the Intersex Society of North
America. In actuality, the organization was formed
by Chase’s letter to the editor. In her signature line,
Chase listed a mailing address for ISNA at a San
Francisco P.O. box, and she soon
Intersex Society of North America
began receiving mail from people with intersex
anatomy around the world.
Hermaphrodites With Attitude
ISNA published the first issue of its newsletter
Hermaphrodites with Attitude in the winter of 1994.
By that time, ISNA had established a mailing list that
included recipients in 14 states within the United
States and five countries. The political content of the
publication and the organization itself worked to
transform intersex and the word hermaphrodite from
being sources of shame into sources of pride and
empowerment. The newsletter consisted primarily of
personal stories, essays, poetry, and humor,
providing formerly isolated individuals with the

means to connect with others who had similar
experiences. Hermaphrodites with Attitude was
published on a fairly regular basis from 1994 to
1999.
Political Activism and Social Support
In addition to its newsletter, ISNA also provided
support groups, a popular website, and annual
retreats. Early on, ISNA’s mission was divided
between providing peer support to its members and
its objective of medical reform. While other intersex
organizations chose to address the mission of
support, ISNA ultimately decided to pursue social
change. The group’s political action alienated them
from some other activists and groups.
ISNA made deliberate appeals to queer activists,
press outlets, and medical organizations, framing
intersex as an issue of gender and sexuality. LGBTQ
organizations both in and outside medicine could
easily relate to intersex grievances of stigma, shame,
and alienation. At the same time, aligning intersex
issues with sexual or gender minorities compromised
intersex activists’ ability to establish credibility with
the non-LGBTQ medical mainstream, who viewed
heterosexual normalcy as one of the primary
objectives of intersex medical sex assignment.
In September 1996, U.S. Representative Patricia
Schroeder’s (D-CO) anti–female genital mutilation
(FGM) bill became law. This law banned genital
cutting on girls under the age of 18 years old except
in cases where “health” demands its necessity, thus
allowing for intersex “emergencies” to be exempt
from the law. Press coverage of this law included a
front-page article in the New York Times. Chase and
other members of ISNA were outraged by the law’s
complicit endorsement of intersex genital surgeries.
They began to stage protests to draw attention not
only to this law’s loophole, but to “intersex genital
mutilation” (IGN) as well.
In addition to lobbying members of Congress to
extend the anti-FGM bill to include IGM, ISNA
staged protests at medical conferences. ISNA’s first
major protest was at the 1996 American Academy of
Pediatrics meeting in Boston. Members of ISNA and
activist Riki Anne Wilchins’s group Transsexual
Menace joined together for this event—calling
themselves “Hermaphrodites with Attitude” (HWA)
—to picket after intersex activists were denied floor
time to address the doctors in attendance. ISNA
Intersex Society of North America 1879
representatives used the name HWA frequently
during the 1990s when they were engaging in
protests. ISNA’s protest propelled the American
Academy of Pediatrics to create a position statement
on infant and childhood genital surgery.
Early Medical Response to ISNA’s Activism
By 1997, the broader medical community began
engaging in a debate about best practices for intersex
infants and children, largely in response to the first
reports of David Reimer’s unsuccessful sex/ gender
reassignment, which served to discredit the validity
of the medical model as the best standard of care.
Early debates were quite polarized and framed the
issue as immediate versus delayed treatment (rather
than whether and not when to intervene), and many
physicians felt that they were being put on the
defensive. In more recent years, some physicians
have begun to advocate watchful waiting rather than
emergent intervention in an appeal for additional and
more systematic research on intersex children and
adults.
Calls for Additional Research and Collaboration
This debate came to a head in 2000 and was
described as a crisis in medicine by physicians who
had formerly considered this treatment to be in the
best interest of intersex children and their families.
The North American Task Force on Intersex was
formed that year with the intention of open and
interdisciplinary conversations and collaboration.
This group was charged with coming to some
consensus on best practices and included key
members of the American Academy of Pediatrics and
ISNA, as well as scholars and clinicians in many
related fields. While the task force was not long-
lived, some of the conversations were and ultimately
led to the National Institutes of Health (NIH) issuing
a program announcement in 2001 for funding
dedicated to new and continued research on intersex.
More than a decade later, the NIH continues to
dedicate resources to and requests for research on
culturally competent care for intersex patients and
their families.
1880
Depoliticization of ISNA
As ISNA sought credibility in medical circles by
shedding its former confrontational Hermaphrodites
with Attitude activism, it retooled itself to put forth a
more professional image. This included the
publication of its new newsletter, ISNA News, in
2001. In addition to the newsletter’s change in title,
ISNA News moved away from the personal stories
and humor that were commonplace in its
predecessor, Hermaphrodites with Attitude, to
professional and organizational concerns such as
financial reports, profiles of board members, and the
continued coverage of medical conferences and
research. This shift mirrors an overarching change
within the intersex movement at the beginning of the
21st century, when intersex activists and doctors
began working alongside one another for change
rather than against each other as political adversaries.
A mere 4 years after picketing outside of such
events, Cheryl Chase began to be featured as an
invited keynote speaker at prominent medical
conventions.
ISNA distancing itself from a narrative of
personal medical trauma was furthered when Chase
stepped down as the executive director and a non-
intersexed medical sociologist, Monica Casper, took
the helm for 1 year, from 2003 to 2004. Chase
stepped back in to serve as ISNA’s executive director
in 2004 until ISNA closed down in 2008. During her
time at ISNA, Casper helped connect the intersex
movement’s concerns to other movements and
communities including women’s health, disability
rights, children’s rights, sexual rights, and
reproductive rights. She also helped grow ISNA’s
Medical Advisory Board and distribute the recently
developed handbooks for clinicians and parents.
Other intersex organizations formed or expanded
to fill the void created by ISNA’s transition from
support and activism to professionalism. Examples of
these organizations include Bodies Like Ours,
Intersex Initiative, Organisation Intersex
International, Inter/Act Youth, the Androgen
Insensitivity Syndrome–Disorders of Sex
Development Support Group, Advocates for
Informed Choice, and the Interface Project. The
Interface Project has created a website featuring brief
videos of people with intersex traits discussing their
experiences and the belief, as stated in a widely
publicized banner, that “No Body Is Shameful,”
reminiscent of the “It Gets Better” video campaign.
Sharon E. Preves
See also Coming Out, Disclosure, and Passing;
Embodiment; Intersexuality; It Gets Better; Nonbinary
Genders; Resilience and Protective Factors, Youth
Further Readings
Accord Alliance. http://www.accordalliance.org/
Advocates for Informed Choice. http://aiclegal.org/
Androgen Insensitivity Syndrome-Disorders of Sex
Development Support Group. http://aisdsd.org/
Chase, C. (1993, July/August). Letter to the editor. The
Sciences, p. 3.
Dreger, A. D., Chase, C., Sousa, A., Gruppuso, P. A., &
Frader, J. (2005). Changing the nomenclature/
taxonomy for intersex: A scientific and clinical
rationale. Journal of Pediatric Endocrinology &
Metabolism, 18(8), 729–733.
Fausto-Sterling, A. (1993, March/April). The five sexes:
Why male and female are not enough. The Sciences,
33(2), 20–25.
Inter/Act Youth. http://interactyouth.org/
Interface Project. http://www.interfaceproject.org/ Intersex
Society of North America. http://www.isna.org/ Lee, P. A.,
Houk, C. P., Ahmed, S. F., & Hughes, I. A. (2006).
Consensus statement on management of intersex disorders.
International Consensus Conference on Intersex. Pediatrics,
118(2), e488–e500.
Intersexuality
Money, J., Hampson, J. G., & Hampson, J. (1955). An
examination of some basic sexual concepts: The
evidence of human hermaphroditism. Bulletin. Johns
Hopkins Hospital, 97(4), 301–319.
Organisation Intersex International.
http://oiiinternational .com/
Preves, S. E. (2004). Out of the O.R. and into the streets:
Exploring the impact of intersex media activism.
Research in Political Sociology, 13, 179–223.
INTERSEXUALITY
This entry provides a historical overview that situates
debates and alliances over/between the largely
European American call for human rights protections
for intersex persons, and contemporary LGBTQ
human rights movements in the West. The alliances
 Intersex Society of North America 1881
that formed in the 1990s as each movement grew population was being forced to have their genital
alongside the others have been the subject of debates appearance reshaped, and for many, also to have
with political and clinical import arising in the mid- certain internal organs removed or “rebuilt” in an
2000s and continuing since. The sections that follow effort to produce a “normal” body.
make clear the central importance of LGBTQ By the early 1990s, when Fausto-Sterling felt
support to the formation of intersex rights compelled to write her article, it was becoming quite
movements’ challenges to heteronormativity. clear that the young adults who had been treated
using these protocols, largely dependent on models
developed by John Money at Johns Hopkins hospital
History and Definitions in the 1950s and 1960s, were struggling with both
The term intersex has a clinical history almost 100 organic dysfunctions caused by the surgeries and
years old; medical historian Lizzie Reis traced its feelings of shame about the differences in their
first use to geneticist Richard Goldschmidt who, in bodies that they had been forced to ignore, to
1917, described humans with apparently ambiguous conceal, and not to discuss even in the face of
biological or anatomical sex characteristics first obvious scars, multiple hospital stays, and so forth.
noticed in infancy or early childhood. It was not,
however, until Brown University geneticist and
Intersex Society of North America Is Born of Five
professor of biomedicine Anne Fausto-Sterling
published an article intended for more popular Sexes
readership in 1993 that the term intersex entered Fausto-Sterling’s 1993 article prompted an
popular awareness. The article proposed that the immediate response from a reader who identified
medical management of intersex states imposed a herself as Cheryl Chase, director of the Intersex
social expectation of two distinct and opposite sexes Society of North America (ISNA). Chase, who has
onto a biological reality in which anatomical and since come out publicly as Bo Laurent, was a student
genetic sex characteristics develop along a spectrum. at the time in San Francisco, and also the owner of a
Further, Fausto-Sterling proposed that we could
easily see that a large percentage of the population
would have sex characteristics that resided
somewhere in the middle of the spectrum, with the
extreme poles of male and female representing
merely those whose bodies most closely met the
dichotomized and idealized requirements of maleness
and femaleness. For the sake of convenience, Fausto-
Sterling argued that we might think of five sexes—
males, merms, herms, ferms, and females— as a bare
minimum for capturing this human diversity—but,
most importantly, she argued against using surgical
or other medical methods to try to force intersexed
persons to meet social expectations about
appearance. Fausto-Sterling did not mean that there
were literally five sexes;
rather, her argument drew attention to the injustice of
altering the bodies and biochemistry of children
using a model based on heterosexist assumptions
about what a proper adult sexuality should be. In
other words, the expectation of heterosexual
marriage as the goal of successful treatment, and the
definition of such marriage resting on the idea of
“opposite” sexes, meant that an estimated 1% of the
1882
technology and communications company based in
the Bay Area. Because of her professional interests,
Laurent decided to work for a number of years under
the Cheryl Chase pseudonym, and published a
number of editorial letters and articles under that
name.
In an almost parallel timeframe, Suzanne Kessler,
a professor of psychology at the State University of
New York, Purchase, was publishing findings from
her ethnographic work in hospitals with families.
Kessler’s work on intersex first appeared in a lengthy
article in the journal Signs in 1990. Kessler’s
research was remarkable because it showed
unequivocally that parents had to be taught how to
see their children as problems in the same way that
clinicians and surgeons did. In the majority of cases,
Kessler realized that parents had to be taught, for
example, to understand that where they saw an
ordinary baby boy, the clinicians had identified a
biological female—by which they meant that the
infant had internal ovaries and a uterus, and might
one day get married and have babies. If such children
were to be left as they were, medical experts opined,
they would surely “fail” as males in adulthood
because they might not mature to have an average-
sized penis, and they would not be able to father
children. In other cases, where parents perceived
their infants as ordinary girls, parents had to be
taught that these children were genetic males with
internal testes that would require removal in early
infancy or childhood. Other surgeries, such as
vaginoplasty, were often recommended for these
infants and children as well, intended as they were to
produce heterosexually viable female adults. In sum,
the parental perception of their children as healthy
babies had to be corrected to match the clinical view
of the children as intersex, and successful
management of parents was measured by obtaining
consent to surgeries meant to produce adults who
would be socially, and, optimally, reproductively
heterosexual.
Chase’s response to Fausto-Sterling marked the
active start of peer-based intersex activism in North
America, and quickly drew attention and support
from gay and lesbian associations in academic and
medical circles. For example, the gay and lesbian
division of the American Psychological
Intersexuality
Association (APA) and members of the Gay and
Lesbian Medical Association (GLMA) were early
supporters. Indeed, during the mid-1990s, both
organizations welcomed members from the rapidly
growing ISNA to present critical work and make
requests for recognition of intersex rights as human
rights concerns. However, not all professional
organizations were equally enthusiastic about this
critical work taking place in dialogue with their
larger professional bodies, and so it was highly
important that intersex activists received support
from openly gay and lesbian practitioners and
scholars. William Byne at Mount Sinai Hospital in
Manhattan, for example, along with Suzanne
Kessler, helped ISNA to present a panel at a medical
conference on plastic surgery in April of 1996. The
Mount Sinai presentation was covered at length by
Anne D’Adesky in an Out magazine feature article
that highlighted the drive of surgeons to produce
adults who would effectively “pass” as females in
heterosexual relationships.
Alliance With Transgender and Queer
Activists and Scholars
In October of 1996, ISNA had gained the support of
activist Rikki Wilchins and the Transsexual Menace,
who brought along members for moral support when
ISNA members Max Beck (d. 2008) and Morgan
Holmes sought to confront surgeons at the American
Association of Pediatrics meeting held in Boston that
year. Although surgeons at that meeting, who were
advocating aggressive surgical intervention for
intersex infants, did not welcome any dialogue with
the group of protesters, the day (October 26) is now
observed annually around the world as Intersex
Awareness Day. This tradition was started by Betsy
Driver, founder of the intersex support group Bodies
Like Ours. In cooperation with activist member and
former ISNA intern Emi Koyama, Driver was able to
secure the support of Edward Stein at Yeshiva
University’s Cardozo School of Law to hold a 2-day
conference that gathered together the growing
population of critical scholars working on intersex
issues. These scholars included Sharon Preves, Julie
Greenberg, Emi Koyama, and Morgan Holmes, and
resulted in
Intersexuality

a dedicated issue of the Cardozo Journal of Gender
and Law that appeared in 2005.
Until 2005, then, the collaborative relationship of
intersex activism and activists with various lesbian
and gay organizations and individual scholars was
strong. The relationship stemmed in part from the
concentration of intersex activists who also identified
as “queer” in some way or another, or who
experienced social gender transition (i.e.,
nonmedical/nonsurgical) as part of their aging
process—as happened in Max Beck’s case. While
medical practitioners had long noted the common
outcome for some populations of intersexualized
patients to grow up to identify as lesbian or gay,
practitioners had approached these people as
problematic examples. Indeed, some practitioners
worried that the relatively common tendency for girls
with congenital adrenal hyperplasia (CAH) to
develop into adults who identified as lesbian was
evidence of so-called androgenic hormones having
“masculinized” their brains, and mused on different
ways such outcomes might be prevented in future.
The Creation of “DSD” Language for
Clinical Use
By around 2005, the association of intersex activism
with LGBTQ supporters and cross-population
pollination of ideas, as well as social and financial
support, had hit the mainstream, and in 2006, the
Lawson Wilkins Pediatric Endocrinology Society
(LWPES), meeting with a small number of intersex
representatives, determined to change the
nomenclature of intersex to “disorders of sex
development” (DSD) in an effort to depoliticize and
unqueer the movement. On the heels of the change,
medical historian and bioethics professor Alice
Dreger explained that parents were typically put off
by the association of intersex with perceived
“radical” gay, lesbian, and trans groups. The use of
DSD, it was thought, would help direct attention
away from sexual identity politics and toward
reducing the frequency and aggressiveness of early
intervention. Eight years after the DSD language was
decided on at the LWPES meetings, indications
from clinical practice and publication suggest that
treatment remains as aggressive as it was in earlier
decades, and that the time frame to try to alter
1883
intersex bodies may even have been pushed back to
the prenatal stage.
In particular, suggestions abound regarding the
off-label use of dexamethasone (a very powerful
steroid usually administered as an
immunosuppressant) to prevent fetal masculinization
of CAH fetuses who are biologically female, as do
suggestions to terminate pregnancies in which
complete androgen insensitivity is diagnosed in a
chromosomal XY fetus. Those scholars who do
critical intersex studies—in particular Iain Morland,
Lena Eckert, Margriet van Heesch, and Adrienne
Asch— have argued that these prenatal efforts to
remove intersex traits or to terminate fetuses in
which intersex is genetic and unalterable are based
on fears that such persons simply cannot grow up to
be “normal,” that is, heterosexually reproductive
adults.
Global Activist Responses to “DSD”
Conceptual and political tensions persist between
those who argue in favor of using DSD language to
mark a treatable set of disorders, and those who
advocate for the recognition of intersex as a
legitimate identity based on bodily differences
present from birth. For example, the development of
DSD language in North America led to the more
vocally queer international advocacy group,
Organisation Intersex International (OII). Many
activists from OII around the globe have been
welcomed by the International Lesbian and Gay
Association (ILGA), a larger international lobbying
and advocacy body that recognizes the need to
contest the heterosexist clinical view of intersex, to
protect intersexualized infants and children from
heteronormative expectations, and to secure human
rights recognitions for intersex persons. ILGA has
also welcomed individuals not affiliated with OII,
and sees the need for an international secretariat
(elected for the first time in 2014) for intersex issues.
In general, LGBTQ support and recognition of
intersex does not deny that many intersex persons
mature to identify as heterosexual, but recognizes
that even those adults have their rights to bodily
integrity threatened by the continued
heteronormative social demands and expectations. In
terms of activism, it is largely parents who feel their
concerns are best represented by the shift to DSD
1884
language, and it is largely adults who have come to
understand their differences as part and parcel of the
ways their bodies and relationships challenge
heterosexism who have embraced intersex as an
identity that should be valued and protected.
M. Morgan Holmes
See also Heteronormativity; Heterosexism; Intersex Society
of North America; Queer
Further Readings
Beck, M. (2001). My life as an intersexual. PBS
Broadcasting. Retrieved November 12, 2015, from
http://www.pbs.org/wgbh/nova/body/intersexual-life.html
Chase, C. (1996). Affronting reason. In D. Atkins (Ed.),
Looking queer (pp. 205–219). Binghamton, NY:
Haworth Press.
D’Adesky, A. (1996, September). The third sex. Out, p. 104f.
Dreger, A., Chase, C., Aaron, S., & Gruppuso, P. (2005).
Changing the nomenclature/taxonomy for intersex: A
scientific and clinical rationale. Journal of Pediatric
Endocrinology and Metabolism, 18(8), 729–733.
Fausto-Sterling, A. (1993). The five sexes: Why male and
female are not enough. The Sciences , 33(2), 20–25.
Holmes, M. M. (2008). Intersex: A perilous difference.
Selinsgrove, PA: Susquehanna University Press.
Kessler, S. (1990). The medical construction of gender: Case
management of intersexual infants. Signs: Journal of
Women in Culture and Society, 16(1), 3–26.
Preves, S. (2003). Intersex and identity: The contested self.
New Brunswick, NJ: Rutgers University Press.
Reis, E. (2009). Bodies in doubt: An American history of
intersex. Baltimore, MD: Johns Hopkins University
Press.
INTIMATE PARTNER
VIOLENCE, FEMALE
This entry describes intimate partner violence (IPV)
victimization of females, with a particular focus on
lesbian and bisexual women. It provides a definition
of IPV, describes dynamics of IPV relationships,
presents estimates of the prevalence of
Intimate Partner Violence, Female
IPV among female victims, describes suspected
causal factors in IPV perpetration, lists consequences
of IPV victimization, and briefly describes barriers to
helping resources.
Definition of Intimate Partner Violence
Intimate partner violence is the use of physical,
psychological, or sexual violence against current or
former intimate partners. A couple need not have
been sexually intimate, nor to cohabitate, for abusive
behaviors to be categorized as IPV. Intimate partner
violence may vary in frequency and severity, ranging
from chronic, severe battering to as little as one hit
with no victim impact. Historically, IPV has also
been called spousal abuse, marital violence, domestic
violence, partner violence, intimate partner abuse,
and partner aggression.
Subtypes of Intimate Partner Violence
One problem in the field of IPV prevention is that
professionals from different sectors (e.g., law
enforcement, medicine, child protection, advocacy)
do not always define IPV in the same way, or share
viewpoints on why it occurs. Conflicting definitions
have contributed to debate about whether women
perpetrate IPV at rates equivalent to men. In an
attempt to refine our understanding, researcher
Michael Johnson proposed that IPV is an umbrella
concept that includes four subtypes of couple abuse:
situational violence, self-defensive partner violence,
mutually abusive partner violence, and intimate
terrorism. The form of IPV upon which domestic
violence shelter workers typically focus is intimate
terrorism. Intimate terrorism involves one partner
maintaining power and control over the other using a
range of coercive tactics. The other forms of IPV
(i.e., situational violence, self-defensive violence,
and mutual abuse) are more likely to involve
bidirectional violence—that is, abuse perpetrated by
both members of a couple.
The Prevalence of Intimate Partner
Violence Among Females
The U.S. National Intimate Partner and Sexual
Violence Survey (NISVS) found that more than 4 in
Intimate Partner Violence, Female

10 lesbian women (44%), more than 6 in 10 bisexual
women (61%), and more than 1 in 3 (35%)
heterosexual women reported rape, physical
violence, and/or stalking by an intimate partner
during their lifetimes. Translating those percentages
into numbers of women affected means that
presently there are approximately 714,000 lesbian
women, 2,000,000 bisexual women, and 38,300,000
heterosexual women over the age of 17 years old in
the United States who are survivors of IPV.
According to the NISVS data, bisexual women have
a statistically significantly increased risk of lifetime
IPV victimization as compared to either lesbian or
heterosexual women, but the difference in prevalence
rates between lesbians and heterosexual women
(44% and 35%, respectively) is not statistically
significant. In other words, according to this source,
lesbians are not at increased risk for victimization as
compared to heterosexual women.
Importantly, the NISVS reveals that lesbian and
bisexual women who report ever having been raped,
assaulted, or stalked by an intimate partner are not
always reporting violence inflicted by a female
perpetrator. In fact, 90% of bisexual women and 33%
of lesbian women who report lifetime IPV
victimization indicate that it was perpetrated by a
male. While it seems counterintuitive that lesbians
could report IPV victimization perpetrated by male
partners, the most likely explanation is that a
substantial proportion of lesbians who report having
experienced IPV in their lifetimes are recalling
experiences from a time in their lives when they had
dated, been married to, or been having sex with a
male partner.
The prevalence of IPV victimization among
lesbian and bisexual youth is also high. A nationally
representative study of adolescents in the United
States, conducted by Carolyn Halpern and her
colleagues, found that among female youth who
reported only having same-sex sexual partners, 29%
had ever experienced physical or emotional IPV
victimization, and 13% had ever experienced
physical IPV victimization. This study did not
establish whether the perpetrators of these incidents
were male or female, however.
Estimates of IPV victimization among lesbian and
bisexual women in nations other than the United
States are rare, but Andrew Frankland and Jac Brown
in Australia found that the past-year prevalence rates
1885
of IPV victimization among lesbians and gay men
(who were grouped together) was 36% for physical
IPV and 26% for sexual coercion. A study of Italian
lesbian and bisexual women conducted by Concetta
Pellulo and colleagues found that 41% had ever
experienced physical or sexual violence by a partner,
and 17% did in the year prior to the survey. Data on
IPV victimization among transgender people is also
scant, although one Massachusetts-based study found
that 14% of gay men and lesbians, 18% of bisexual
people, and 34% of transgender people reported that
they had ever been threatened with physical violence
by an intimate partner.
Causes and Consequences of Intimate
Partner Violence
Victims of IPV may experience a range of adverse
consequences. These include depression, anxiety,
posttraumatic stress symptoms, disordered eating,
unhealthy substance use, poor academic
performance, sexually transmitted infections (STIs),
injury, and death. There are a number of different
theories about why IPV occurs. Although no single
explanation is applicable to all IPV cases, there are
several factors that appear to elevate risk for
perpetration.
These include experiencing parental abuse or
neglect; witnessing interparental partner violence;
having antisocial personality characteristics;
perpetrating violence toward nonintimates;
associating with aggressive peers; sustaining a
frontal lobe head injury; using alcohol or drugs;
experiencing deprivation (i.e., low employment,
poverty); having an attachment disorder, trait
hostility, or stress; living in a neighborhood
characterized by disorder or low collective efficacy;
and living in a community with social norms
supportive of using violence to resolve conflict.
Importantly, violence may become more severe
during or immediately after a breakup. It should also
be noted that some research finds that the use of
violence and abuse by one member of a couple
appears to increase the likelihood that the other
partner will also use violence, either aggressively or
in self-defense. There are also a few factors that
appear to prevent IPV perpetration. These include
having strong social support, better friendship
quality, high verbal IQ, and experiencing close
1886
supervision and support from parents or guardians as
a child.
Historically, the grassroots advocacy perspective
on IPV has been rooted in feminist theory, which
contends that men who abuse their female partners
capitalize on male societal, political, and economic
privilege to do so, and that the gender roles promoted
by male-dominated societies create conditions in
which women may more easily be oppressed in
intimate relationships. That explanation for IPV has
been problematic for LGBTQ advocates, because it
fails to adequately explain the victimization of gay
males or perpetration by females. Today, the
majority of IPV prevention efforts are guided by a
more nuanced perspective on how traditional gender
norms can influence relationship behavior, even in
same-sex couples. This perspective holds that the
pressure to conform with traditional gender roles can
exacerbate risk for IPV perpetration for all people,
and that the same values that privilege males also
encourage homophobia, which intensifies the
difficulties that gay and lesbian IPV victims face
when they are being abused or seeking help. An
important caveat is that research on gender identity
and IPV perpetration suggests that there is no higher
likelihood of IPV being perpetrated by a “butch” (or
masculine-identified) lesbian than a “femme” (or
feminine-identified) one.
Dynamics of Intimate Partner Violence for
Females in Same-Sex Relationships
Women in abusive same-sex relationships may
experience all of the same aggressive behaviors that
victims in opposite-sex relationships do. Verbal and
emotional abuse (e.g., threats, insults, name-calling,
making a partner feel emotionally unstable, isolating
a partner from friends or family members) is the
most common form of IPV. Other forms can include
physical violence (e.g., hitting, slapping, punching,
kicking, biting, choking); sexual assault or coercion
(e.g., rape, using threats to
Intimate Partner Violence, Female
obtain sex, convincing a partner to participate in
sexual acts that he or she does not want to do,
humiliating or shaming someone about sex without
consent); reproductive or sexual health coercion
(e.g., tampering with birth control, refusing to wear a
condom, failing to disclose sexually transmitted
infection status); stalking (e.g., constant texting,
showing up uninvited, spying, reading partner’s e-
mail or text messages, using the Internet to track a
partner’s activities, placing a GPS device in a
partner’s vehicle to monitor his or her whereabouts);
or economic abuse (e.g., withholding money, forcing
a partner to do things for money that he or she does
not want to do). In addition, there are potentially
lethal or severe IPV behaviors such as threatening
suicide or to harm a pet, child, or other loved one;
threatening to kill one’s partner; displaying or using
a weapon such as a gun or knife; using an object like
a bat or cell phone as a weapon; or inflicting injuries
that require medical attention.
Women and men in same-sex relationships are
vulnerable to additional abusive tactics. Abusive
partners may threaten to “out” or expose their
partner’s sexual orientation without consent, may
attempt to convince their partner that IPV does not
occur in same-sex relationships, may monopolize
helping resources such as domestic violence agencies
or friends by claiming to be the “real” IPV victim, or
may claim that the abusive behavior is a normal part
of non-normative gender behavior (e.g., acting
powerful or controlling is an attractive quality).
LGBTQ and heterosexual people who engage in
bondage, dominance, sadism, or masochism (BDSM)
can also be vulnerable to additional forms of partner
abuse; IPV perpetrators may claim that abusive
behaviors are part of a BDSM scene or relationship
dynamic.
Helping Resources for Lesbian and Bisexual
Victims of Intimate Partner Violence
Many female survivors of same-sex IPV feel hesitant
about seeking help. Lesbians and bisexual women
can face discriminatory responses from the criminal
justice system, and may be met with heteronormative
and homophobic responses from
Intimate Partner Violence, Male
social service and health care providers. The
discriminatory response of law enforcement has been
empirically established. For example, one study
found that police were less likely to make an arrest in
domestic violence cases where both parties were
female than in cases involving an opposite-sex

couple. The lower arrest rate for same-sex female
couples may reflect cultural assumptions that women
are not as violent or dangerous as men. These types
of assumptions, and heterosexism embedded in many
social service practices, create a need for LGBTQ-
specific IPV helping resources.
Emily Rothman and Nkiru Nnawulezi
See also Dating, Sexual-Minority Men; Dating,
SexualMinority Women; Relationships with Former
Spouses;
Sexual Minorities and Violence; Violence and
Victimization of Youth; Youth and Dating
Further Readings
Balsam, K. F., & Szymanski, D. M. (2005). Relationship
quality and domestic violence in women’s same-sex
relationships: The role of minority stress. Psychology of
Women Quarterly, 29, 258–269.
Dank, M., Lachman, P., Zweig, J. M., & Yahner, J. (2014).
Dating violence experiences of lesbian, gay, bisexual, and
transgender youth. Journal of Youth Adolescence, 43,
846–857.
Frankland, A., & Brown, J. (2014). Coercive control in
same-sex intimate partner violence. Journal of Family
Violence, 29, 15–22.
Halpern, C. T., Young, M. L., Waller, M. W., Martin, S. L.,
& Kupper, L. L. (2004). Prevalence of partner violence in
same-sex romantic and sexual relationships in a national
sample of adolescents. Journal of Adolescent Health,
35(2), 124–131.
Johnson, M. P. (1995). Patriarchal terrorism and common
couple violence: Two forms of violence against women.
Journal of Marriage and the Family, 57(2), 283–294.
Messinger, A. M. (2011). Invisible victims: Same-sex IPV in
the National Violence Against Women Survey. Journal of
Interpersonal Violence, 26(11), 2228–2243.
Pattavina, A., Hirschel, D., Buzawa, E., Faggiani, D., &
Bentley, H. (2007). A comparison of the police
response to heterosexual versus same-sex intimate
partner violence. Violence Against Women, 13(4),
374–394.
Walters, M. A., Chen, J., & Breiding, M. J. (2013). The
National Intimate Partner and Sexual Violence Survey:
2010 findings on victimization by sexual orientation.
Atlanta, GA: National Center for Injury Prevention and
Control, Centers for Disease Control and Prevention.
1887
INTIMATE PARTNER VIOLENCE, MALE
This entry describes intimate partner violence (IPV)
victimization of males, with particular focus on the
experiences of men who are gay and bisexual, and
men who have sex with men (MSM). It provides a
definition of IPV; describes dynamics of IPV
relationships; presents estimates of the prevalence of
IPV among male victims; describes suspected causal
factors in IPV perpetration; lists consequences of
IPV victimization; and briefly describes barriers to
helping resources that gay, bisexual, and transgender
men have experienced.
Definition of Intimate Partner Violence
Intimate partner violence is the use of physical,
psychological, and/or sexual violence against a
current or former intimate partner. A couple need not
have been sexually intimate, nor to cohabitate, for
abusive behaviors to be categorized as IPV. Intimate
partner violence may vary in frequency and severity,
meaning that as little as one hit with no victim
impact may constitute IPV, as does chronic, severe
battering. Historically, IPV has also been called
spousal abuse, marital violence, domestic violence,
partner violence, intimate partner abuse, and partner
aggression.
Subtypes of Intimate Partner Violence
Researcher Michael Johnson proposed that IPV is an
umbrella concept that includes four subtypes of
couple abuse including situational violence, self-
defensive partner violence, mutually abusive partner
violence, and intimate terrorism. The form of IPV
upon which domestic violence shelter workers
typically focus is intimate terrorism, which involves
one partner maintaining power and control over the
other using a range of coercive tactics. The other
forms of IPV (i.e., situational, self-defensive, and
mutually abusive partner violence) are more likely to
involve bidirectional violence—that is, abuse
perpetrated by both members of a couple.
The Prevalence of Intimate Partner
Violence Among Males
1888
Using data from the U.S. National Intimate Partner
and Sexual Violence Survey (NISVS), Mikel Walters
and colleagues found that more than 1 in 4 gay men
(26%), more than 1 in 3 bisexual men (37%), and
more than 1 in 4 (29%) heterosexual men reported
rape, physical violence, and/or stalking by an
intimate partner during their lifetimes. Translating
those percentages into numbers of men affected
means that presently there are approximately
708,000 gay men, 711,000 bisexual men, and
30,250,000 heterosexual men over the age of 17
years in the United States who are survivors of IPV.
The lifetime IPV victimization rate among
heterosexual women in the United States is 35%,
which is approximately equivalent to the risk for
bisexual men (37%), but greater than the risk for gay
men (26%) and heterosexual men (29%). The
differences in IPV victimization for gay, bisexual,
and heterosexual men participating in the NISVS
was not statistically significant, meaning that
according to this data source, gay and bisexual men
are no more or less likely than heterosexual men to
experience IPV. The finding that gay men are at
equivalent, but not increased, risk for lifetime IPV
victimization as compared to heterosexual women
and heterosexual men was also reported by
researchers who used the nationally representative
Behavioral Risk Factor Surveillance System
(BRFSS) to estimate rates.
Importantly, the NISVS reveals that gay and
bisexual men who report ever having been raped,
assaulted, or stalked by an intimate partner are not
always reporting about a same-sex perpetrator. More
than 90% of gay men who have experienced
Intimate Partner Violence, Male
IPV report that it was perpetrated by a male partner.
However, 79% of bisexual male IPV survivors
reported that it was perpetrated by a female.
The nationally representative estimates of IPV for
gay and bisexual men found by the NISVS parallel
rates from state-level studies. For example, a study of
a representative sample of Californians conducted by
Naomi Goldberg and colleagues found that the
lifetime IPV victimization rate was 27% for gay men,
20% for bisexual men, and 17% for men who have
sex with men (MSM). Ana Buller and her colleagues
reviewed the results of 18 research studies on IPV
against gay men and found lifetime prevalence rates
of IPV victimization for gay men that ranged from
32% to 82%. The wide range is attributable to
varying definitions of sexual orientation and of IPV
that were used across the studies.
The prevalence of IPV victimization among gay,
lesbian, and bisexual youth is also high. A nationally
representative study of adolescents found that 9% of
gay male and 13% of lesbian adolescents reported
physical IPV victimization during the 18 months
preceding the survey. Another study conducted by
Meredith Dank and colleagues grouped lesbian, gay,
and bisexual youth together and found that 43%
experienced physical IPV by the time they were in
Grade 12, as compared to only 29% of heterosexual
youth; this difference was statistically significant.
A 2009 report from the Massachusetts Department
of Public Health found that 35% of transgender
people and 14% of non-transgender people were
threatened with physical violence by an intimate
partner in the preceding year, indicating increased
risk for transgender people (with maleto-female and
female-to-male transgender people grouped
together).
Dynamics of Intimate Partner Violence for
Males in Same-Sex Relationships
Males in same-sex relationships may experience all
of the same forms of partner aggression that women
and men in opposite-sex relationships do (with the
exception of abuse related to contraception and
Intimate Partner Violence, Male
pregnancy). Specifically, they may experience verbal
and emotional abuse (e.g., threatening, insulting,
isolating from friends and family); physical abuse
(e.g., hitting, punching, kicking, choking); sexual
abuse (e.g., being forced or coerced into sexual
activity, being humiliated because of sexual desires);
stalking (e.g., electronic or in-person monitoring of a
partner’s whereabouts or activities); and economic
abuse (e.g., withholding money). In addition, men in
same-sex relationships are vulnerable to additional
abusive tactics. Abusive partners may threaten to
“out” or expose their partner’s sexual orientation
without consent, may attempt to convince their
partner that IPV does not occur in same-sex
relationships, may monopolize helping resources

such as domestic violence agencies or friends by
claiming to be the “real” IPV victim, or may claim
that the abusive behavior is a normal part of non-
normative gender behavior (e.g., acting powerful or
controlling is an attractive quality). Abusive partners
may also call the other’s sexual orientation into
question in an attempt to control the person, or they
may minimize and deny abuse perpetration. People
who engage in bondage, dominance, sadism, or
masochism (BDSM) can also be vulnerable to
additional forms of partner abuse; IPV perpetrators
may claim that abusive behaviors are part of a
BDSM scene or relationship dynamic.
Risk Factors for Intimate Partner Violence
Perpetration
There is no singular personality profile of a domestic
violence offender. Numerous risk factors for IPV
perpetration have been identified. These include
experiencing parental abuse or neglect; witnessing
interparental partner violence; having antisocial
personality characteristics; perpetrating violence
towards nonintimates; associating with aggressive
peers; sustaining a frontal lobe head injury; using
alcohol or drugs; experiencing deprivation (e.g., low
employment, poverty); having an attachment
disorder, trait hostility, or stress; living in a
neighborhood characterized by disorder or low
collective efficacy; and living in a community with
social norms supportive of using violence to resolve
conflict. Importantly, violence may become more
severe and potentially lethal during or immediately
after a breakup. It is possible for a person to
perpetrate IPV even if none of the above-listed
factors is present. It should also be noted that some
research finds that the use of violence and abuse by
one member of a couple appears to increase the
likelihood that the other partner will also use
violence, either aggressively or in self-defense. There
are also a few factors that appear to prevent IPV
perpetration. These include having strong social
support, better friendship quality, high verbal IQ, and
experiencing close supervision and support from
parents or guardians as a child.
Consequences of Intimate Partner
Violence Victimization
1889
Male victims of IPV may experience all of the same
adverse consequences as female victims, which can
include depression, anxiety, posttraumatic stress
symptoms, disordered eating, unhealthy substance
use, poor academic performance, sexually
transmitted infections (STIs), injury, and death.
Research suggests that male victims of female-
perpetrated IPV are significantly less likely to sustain
an injury than female victims of male-perpetrated
IPV. Male victims of female-perpetrated IPV are also
less likely to be sexually abused or stalked by their
partner than female IPV victims.
Helping Resources for Male Survivors of
Intimate Partner Violence
Regardless of their sexual orientation, men who
attempt to report IPV victimization to law
enforcement are sometimes not believed or are
denigrated because of societal beliefs that women are
rarely violent and that men who are physically or
sexually assaulted are weak and deserving of the
abuse. Men who are in same-sex relationships are
sometimes discriminated against by the criminal
justice system. Not all states grant civil orders of
protection (i.e., restraining orders) to gay and lesbian
people. Advocates have also documented cases
where courts consider both members of a same-sex
couple equally at fault, without reviewing the facts.
Helping services and social service providers have
also discriminated against male and transgender
victims of IPV, including denying them access to
domestic violence shelters and other community- and
state-supported resources. When granted access to
mainstream helping services, some male and
transgender IPV victims face inappropriate behavior
from other victims who are also receiving services—
for example, being insulted by a member of a support
group or bullied by a fellow shelter resident. In some
cases, the potential consequences of having to reveal
a gay or bisexual sexual orientation to local law
enforcement or service providers prevent IPV
victims from seeking help altogether. The insular
nature of LGBTQ social networks in some locales
may also inhibit help-seeking, because gay and
bisexual victims fear they will be disbelieved and
subsequently socially isolated from their community.
Despite these barriers to help-seeking and
receiving services, some men do call mainstream or
1890
gay-specific domestic violence hotlines for
assistance. Some seek and receive emergency shelter,
obtain restraining orders, are granted victim recovery
funds, or join support groups with success. There are
numerous LGBTQ-specific domestic violence
service providers around the world, and increasingly,
mainstream service providers are par-
ticipating in cultural competency trainings in order to
improve their capacity to help LGBTQ and
heterosexual male survivors of IPV.
Emily Rothman and Nkiru Nnawulezi
See also Dating, Sexual-Minority Men; Dating, Sexual-
Minority Women; Intimate Partner Violence, Female;
Relationships With Former Spouses; Sexual Minorities
and Violence; Violence and Victimization of Youth;
Youth and Dating
Further Readings
Buller, A. M., Devries, K. M., Howard, L. M., & Baccus, L.
J. (2014). Associations between intimate partner
violence and health among men who have sex with men:
A systematic review and meta-analysis. PLOS
Medicine, 11(3), 1–12.
It Gets Better
Dank, M., Lachman, P., Zweig, J. M., & Yahner, J.
(2014). Dating violence experiences of lesbian, gay,
bisexual, and transgender youth. Journal of Youth
Adolescence, 43, 846–857.
Finneran, C., & Stephenson, R. (2014). Antecedents of
intimate partner violence among gay and bisexual
men. Violence and Victims, 29(3), 422–435.
Frankland, A., & Brown, J. (2014). Coercive control in
same-sex intimate partner violence. Journal of Family
Violence, 29, 15–22.
Goldberg, N. G., & Meyer, I. H. (2013). Sexual orientation
disparities in history of intimate partner violence:
Results from the California Health Interview Survey.
Journal of Interpersonal Violence, 28(5), 1109–1118.
Johnson, M. P. (1995). Patriarchal terrorism and common
couple violence: Two forms of violence against women.
Journal of Marriage and the Family, 57(2), 283–294.
Messinger, A. M. (2011). Invisible victims: Same-sex IPV in
the National Violence Against Women Survey. Journal of
Interpersonal Violence, 26(11), 2228–2243.
Walters, M. L., Chen, J., & Breiding, M. J. (2013). The
National Intimate Partner and Sexual Violence Survey:
2010 Findings on victimization by sexual orientation.
Atlanta, GA: National Center for Injury Prevention and
Control, Centers for Disease Control and Prevention.
IT GETS BETTER
It Gets Better (IGB) is a video project that was
initiated by writer Dan Savage in September 2010 as
a way to speak directly to lesbian, gay, bisexual,
transgender, queer, and questioning (LGBTQQ)
youth who are coping with the challenges of coming
of age. Savage, best known for his nationally
syndicated sex advice column, was inspired to start
IGB in response to a series of suicides by youth who
identified as, or were perceived to be, gay. The video
that launched the project features Savage and his
husband Terry Miller talking to the camera about
their difficult experiences as gay teenagers and how
happy and fulfilling their lives are now as adults. In
the video, Savage and Miller assure LGBTQQ youth
viewers that their lives will get better and insist that
suicide is never the answer to the challenges they are
facing in adolescence.
It Gets Better
IGB rapidly went viral, with hundreds of people
uploading their homemade videos within the first 2
weeks of its inception. Since then, over 50,000
unique IGB videos have been made and uploaded to
YouTube. Among the most prominent of IGB video
makers are U.S. President Barack Obama, former
U.S. Senator and Secretary of State Hillary Clinton,
actor Neil Patrick Harris, comedian Ellen
DeGeneres, pop star and American Idol winner
Adam Lambert, and pop star Ke$ha. As of
September 2014, IGB videos have been viewed over
50 million times. According to its Facebook profile,
IGB seeks to show LGBTQ youth the levels of
happiness, potential, and positivity their lives will
reach. IGB has been hailed by some as a remarkable
grassroots social justice project that helped ensure
that the related issues of bullying and queer youth
suicides are part of conversations on sexuality and
mental health.
The popularity of IGB is further evidenced by the
establishment of multiple IGB-related platforms,
including a foundation, which manages a YouTube

channel of IGB videos; as well as a book; speaking
engagements; an hour-long MTV episode devoted to
IGB; and an MTV television series in which Savage
dispenses sex advice to college students, called
Savage U. In addition, the Academy of Television
Arts & Sciences announced that IGB was the
recipient of its prestigious Governors Award of 2012.
The explicit message of IGB centers on imploring
queer youth not to kill themselves while assuring
them that their lives will improve once they finish
high school and can escape their hostile environment.
While not all video makers are themselves LGBTQ-
identified, the videos produced by those who are
include testimony about their own challenging
experiences with growing up and how rewarding
their lives are now. Videos made by LGBTQ-
identified employees of prominent companies such
as Facebook and Google are good examples of this
format. Regardless of the sexual and gender
identities of the video makers, all assert that it will
eventually get better once LGBTQQ youth transition
from adolescence to adulthood.
IGB has met with a significant amount of
criticism. First, critics contend that the IGB approach
does not go far enough in helping LGBTQQ youth to
cope with bullying and related forms of social
ostracism and harassment in their present
circumstances. Missing from the messages
communicated through IGB are clear and practical
strategies for young people to manage their day-to-
day realities and to challenge the anti-LGBTQ
practices that produce hostile environments in the
first place. Second, concerns have been raised about
the extent to which IGB treats LGBTQQ experiences
as homogenous and centers the experiences of White,
middleclass, gay-identified cisgender male teenagers.
This focus arguably obscures the lived experiences of
economically disadvantaged queer youth; queer
youth of color; gender-nonconforming and
transgender youth; and sexually nonconforming girls
who also experience bullying and harassment that is
compounded by racism, sexism, classism, cissexism,
and/or transphobia. Third, IGB has been criticized
for ignoring the persistence of racial, gender, and
economic discrimination within the LGBTQ
community. By positioning urban, predominantly
White gay male enclaves as enlightened and
inclusive safe havens compared with more
geographically isolated, less cosmopolitan areas, IGB
1891
tells a story about unconditional acceptance in queer
communities that many critics argue is simply not
accurate. In addition to these criticisms, attention has
also been paid to the ways in which “it gets better”
within the IGB framework are predicated on
socioeconomic success, including college-level
educational attainment, and coupling with a long-
term domestic partner, which amounts to a
prescription for how to live and ignores the ways in
which social mobility is relatively limited in the
United States.
In response to criticisms of IGB, other groups
formed to try to address its perceived limitations.
One example is Make It Better, a project initiated by
the Gay–Straight Alliance Network that focuses on
improving conditions for LGBTQQ youth in their
schools and communities. Groups such as Make It
Better, however, lack the resources and celebrity-
related notoriety of IGB and have not enjoyed as
much attention and support. While it is clear that
IGB has made an important contribution to a U.S.-
specific national conversation about the social
problem of bullying and its relationship to queer
youth suicide, and sought to reach LGBTQQ youth
who are socially isolated, it is hard to measure the
impact of IGB on the schools and communities that
produce the conditions that necessitate a project like
IGB.
Emily S. Mann
See also Bullying; Gay–Straight Alliances (GSAs); Suicide,
Risk Factors for and Prevention of; Transgender Youth
and Well-Being; Violence and Victimization of Youth
It Gets Better
Further Readings
Goltz, D. B. (2013). It Gets Better: Queer futures, critical
frustrations, and radical potentials. Critical Studies in
Media Communication, 30, 135–151.
Grzanka, P. R., & Mann, E. S. (2014). Queer youth
suicide and the psychopolitics of “It Gets Better.”
Sexualities, 17, 369–393.
Puar, J. K. (2012). The cost of getting better: Suicide,
sensation, switchpoints. GLQ: A Journal of Lesbian and
Gay Studies, 18, 149–158.
Savage, D., & Miller, T. (Eds.). (2011). It gets better:
Coming out, overcoming bullying, and creating a life
worth living. New York, NY: Penguin.
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marria e
ge. move
The ment
Conser —
vative allows
branch LGBT
of Q
Judais Jews
m to
views engag
Halakk e in
ah as religio
subject us
to activit
human ies,
interve gain
ntion, admitt
and is ance
less into
literal religio
in their us
interpr school
etation s and
s of the
Scriptu clergy
re than , and
the partici
Orthod pate
ox in
comm same-
unity. sex
As marria
such, ge
the cerem
Comm onies.
ittee The
on CJLS
Jewish recom
Law mends
and each
Standa indivi
rds dual
(CJLS) rabbi
—the and
 1905

congre guidin
gation g
determ princi
ine the ples of
extent the
to Refor
which m
they move
enact ment
these rely
opport on
unities Tikku
in n
their Olam
own —a
comm dedica
unities tion to
. bringi
The ng
Refor about
m chang
move e in
ment the
is the world
largest throug
branch h acts
of U.S. of
Judais social
m, justice
with , such
the as by
longest advan
history cing
of the
suppor rights
ting of
LGBT wome
Q n or
Jews advoc
while ating
embra on
cing a behalf
flexibl of
e LGBT
interpr Q
etation famili
of es. In
Halakk 1972,
ah. Congr
The
1906

egatio e
n Beth admitt
Chayi ed its
m first
Chada openl
shim y
opene transg
d its ender
doors studen
in Los t in
Angel 2003,
es as and
the the
first Refor
LGBT m
Q move
Refor ment
m has
synago initiat
gue, ed
and in progra
1990, ms
the focuse
Refor d on
m transg
move ender
ment’s inclusi
rabbini on.
cal Re
school constr
(Hebre uction
w ist
Union Judais
Colleg m is
e) the
voted most
to end recent
sexual branch
orienta to
tion emerg
discri e, and
minati it was
on. found
Moreo ed in
ver, the
the United
Hebre States
w when
Union it split
Colleg from
 1907

Conser strong
vative empha
Judais sis on
m in comm
the unity
1960s. and
Recon comm
structi unal
onists decisi
view on-
Halakk makin
ah as g is
an one of
import the
ant differe
cultura nces
l betwe
touchst en the
one, Refor
but not m and
as Recon
religio structi
us law. onist
The move
move ments.
ment LGBT
sees Q
Judais people
m as enjoy
an a long
evolvi histor
ng y of
religio accept
us ance
civiliz within
ation this
and move
observ ment.
es the Simila
state r to
of the
Israel Refor
as m
import move
ant to ment,
buildin Recon
g this structi
ideal. onists
Indeed have
, a institu
1908

ted Mana
progra ging
ms Multi
focuse
ple
d on
Mino
transge
nder rity
inclusi Identi
on, ties
includi Jewish
ng and
welco LGBT
ming Q
transge identit
nder ies are
rabbis both
into minori
the ty
move status
ment. es. In
All the
LGBT Unite
Q d
memb States,
ers are Christ
allowe ianity
d full is
partici practi
pation ced by
in the
Recon majori
structi ty of
onism the
as popul
comm ation,
unity and
memb hetero
ers and sexual
leaders ity is
. the
predo
minan
t
sexual
orient
ation
identif
ier.
Thus,
 1909

a racism
Jewish . Yet,
LGBT unlike
Q gende
person r and
must race,
be which
prepar are
ed to easier
manag for
e others
confro to
ntation assess
s with ,
antiSe religio
mitism n and
, sexual
homop ity
hobia, status
and may
possibl be
y more
transp difficu
hobia. lt to
A deter
Jewish mine
LGBT on the
Q basis
woma of
n may visual
encou cues.
nter Jewis
gender h
discri LGBT
minati Q
on and people
sexism may
as strive
well, to
and a keep
Jewish those
LGBT aspect
Q s of
person the
of self
color invisi
may ble.
confro Howe
nt acts ver,
of given
1910

the when
potenti it
al comes
confro to
ntation reveali
s ng
descri their
bed statuse
above, s.
this Some
means Jewish
Jewish rituals
LGBT , such
Q as the
people Mikve
must h,
exercis expos
e e the
cautio human
n body
when as part
decidi of the
ng cerem
whom ony. A
to Mikve
come h is a
out to purifyi
about ng
their bath
Jewish perfor
ness, med
their in
LGBT front
Q of a
status, memb
or er of
both. the
Jew rabbin
ish ate
transge and
nder select
individ attend
uals ants
may during
face a a
particu conver
larly sion-
challen to-
ging Judais
path m
 1911

cerem y,
ony. It certain
is rituals
comm may
on in prove
Conser difficu
vative lt for
and partici
Orthod pation
ox . The
traditio Jewish
ns. In comm
additio unity,
n, the too,
Jewish may
burial be
ritual faced
of with
Tahara rethin
require king
s certain
proper rituals
prepar and
ation ideals
of about
deceas sex,
ed gender
bodies, , and
and bodies
the sex .
of the For
prepar some
ers Jewish
must LGBT
match Q
the sex people
of the , it can
deceas be
ed. If a difficu
Jewish lt to
transge integr
nder ate
person their
has sexual
chosen identit
not to y with
disclos a
e his religio
or her us
identit identit
1912

y that and
disapp partici
roves pate in
of LGBT
homos Q-
exualit affirm
y. ing
Furthe synag
r ogues
compli experi
cations ence
includ less
e difficu
family lty
closen negoti
ess, ating
and their
since identit
family ies.
is Engag
central ing in
to activis
Jewish m
culture efforts
, , such
receivi as
ng worki
accept ng in
ance synag
and ogues
suppor to
t from increa
family se
memb aware
ers is ness
import of
ant for Jewish
a LGBT
health Q
y identit
blendi ies
ng of and
identiti Jewish
es. LGBT
Jewish Q
LGBT famili
Q es, or
people worki
who ng as
attend volunt
 1913

eers, m
educat ati
ors, or on
clergy
people Securi
, not ng
only roman
assists tic
with relatio
the nships
blendi and
ng of buildi
identiti ng a
es, family
is
Jewish LGBTQ
import
People
ant for
LGBT
but Q
can Jews.
also Even
act as if a
paths Jewis
to new h
friends LGBT
hips Q
and indivi
romant dual
ic discon
relatio nects
nships. for a
period
of
Roman
time
tic
from
Re
the
la
religio
tius and
on
cultur
sh
al
ip
practi
sces of
Judais
an
dm
(e.g.,
Fa
during
mi
young
ly
adulth
Fo
ood),
renteri
1914

ng into slaver
a y in
romant ancien
ic t
relatio Egypt
nship ),
may allowi
assist ng for
the the
person blendi
in ng of
easing family
back ,
into religio
Jewish n, and
(religi a
ous) newfo
life. und
For roman
examp tic
le, relatio
family nship.
memb Jewis
ers h
may holida
extend ys and
invitati cultur
ons for al
the events
couple are
to signifi
attend cant
a to
Passov cultiv
er ating
Seder family
meal cohesi
(a on,
traditi and
onal denote
Jewish a time
event when
comm the
emorat entire
ing the family
release (inclu
of the ding
Israelit extend
es ed
from kin)
 1915

comes m in
togeth the
er; couple
thus, relatio
the nship.
welco As
ming with
of the many
LGBT Jews
Q and
couple nonJe
into ws
these alike,
events the
strengt decisi
hens on to
percep parent
tions is
of filled
social with
accept many
ance questi
and ons,
relatio one of
nship which
legitim involv
acy. es
Mo wheth
reover, er to
the raise
decisio the
n to child
parent with a
a child specifi
togeth c
er may religio
further us
bolster and/or
family cultur
suppor al
t and identit
serve y.
as a When
means both
to indivi
introdu duals
ce, or in the
reinfor relatio
ce, nship
Judais identif
1916

y as r to
Jewish raise
, the their
decisio child
n to in the
raise a Jewish
child faith.
Jewish Ultim
is met ately,
with raising
less a child
resista as
nce Jewish
than if includ
only es
one variou
person s
in the religio
couple us–
identifi cultur
es as al
Jewish celebr
. For ations
Jewish surrou
LGBT nding
Q develo
people pment
, the al
mergin events
g of throug
family hout
identit one’s
y and life.
religio For
us– examp
cultura le,
l when
identit the
y child
comes is
into born,
sharpe a Bris
r (male
focus, circu
as they mcisio
maneu n
ver ritual)
discuss or
ions of namin
whethe g
 1917

cerem ng
ony cerem
can onies
welco are
me the additi
child onal
into rituals
the celebr
family ating
and develo
into pment
the al
faith. milest
Aroun ones.
d 12 Famil
years y
later, a(inclu
Bar ding
(boys) parent
or Bat s,
(girls) grand
Mitzva parent
h s,
recogn siblin
izes gs,
the and
child extend
as an ed
adult kin)
of the and
Jfriend
os unite
iand
n
ackno
t
wledg
A
e the
dchild
o—and
pby
textens
iion,
othe
n
LGBT
Q
synago family
gue. —in
Confir the
mation spirit
and of
weddi Jewis
1918

h gender
traditi , or
on. racial
Family identit
relatio y. For
nships examp
may le,
be celebr
further ating
strengt signifi
hened cant
with life
the events
arrival surrou
of a nded
grandc by
hild, suppor
niece/ tive
nephe indivi
w, or duals
cousin with a
. comm
Fa on
milial backgr
and ound
social and
accept shared
ance experi
that ence
can can
arise encour
in light age a
of deeper
parent apprec
hood iation
may for the
work varyin
to g
buffer identit
percei ies
ved that a
barrier Jewish
s LGBT
based Q
on person
religio might
us– be
cultura attemp
l, ting to
sexual, reconc
 1919

ile. In tandin
additio g of
n, what
throug it truly
h the means
format to be
ion of Jewish
romant ,
ic LGBT
relatio Q, and
nships a
and family
intenti .
onal
Katie
parenti
ng, M.
Jewish Barro
LGBT w
Q See
people also
are Familie
challen s of
ging Origin,
Jewish Relatio
nships
ideals
With;
of Minorit
family y
and Stre
sexuali ss;
ty. Reli
Their gio
very n/S
pirit
existen
uali
ce is ty
ignitin and
g LG
conver BT
sations Q
within Peo
ple;
all
Reli
faction
gio
s of us
Judais Ide
m, and ntit
broade y
ning a and
deeper Sex
uali
societa
ty,
l Rec
unders onc
1920

iliati ions
on hips
of .
Jou
rna
l of
F
GL
u
BT
r Fa
t mil
h y
e Stu
r die
s,
R 7,
e 470
–
a
492
d .
i doi:
n 10.
g 108
s 0/1
550
Barrow, 428
K. X.2
M., 011
&
.62
Kuv
398
alan
0
ka,
K. Davis,
A. D.
(201 S.
1). (20
To 08).
be Reli
Jewi gio
sh n,
and gen
lesbi etic
an: s,
An and
expl sex
orati ual
on orie
of ntat
relig ion:
ion, The
sexu Jew
al ish
iden trad
tity, itio
and n.
fami Ken
lial ned
relat y
Inst
 1921

itute Lusten
of ber
Ethi ger,
cs S.
Jou (20
rnal 14).
, 18, Que
125 stio
– ns
148. of
doi: belo
10.1 ngi
353/ ng:
ken. Sa
0.00 me-
08 sex
Glassgo pare
ld, J. nth
M. ood
(200 and
8). Jud
Brid ais
ging m
the in
divi tran
de: sfor
Inte mat
grati ion.
ng Sex
lesbi uali
an ties,
iden 17,
tity 529
and –
Orth 545.
odo doi:
x 10.1
Juda 177
ism. /13
Wo 634
men 607
& 145
The 261
rapy 17
, 31, Schnoo
59– r, R.
72. F.
doi: (20
10.1 06).
300/ Bei
027 ng
031 gay
408 and
021 Jew
452 ish:
27 Neg
otia
1922

ting person
intermay
secti
becom
ng
iden
e a
titiefully
s. recog
Soci nized
olog legal
y of parent
Reli
. If
gion
, 67,
two
43–
people
60. (gener
doi: ally a
10.1 couple
093/ )
socr adopt
el/6
a
7.1.
43
child
Shneer,
togeth
D., & er,
Aviv, this is
C. a joint
(Eds.). adopti
(2002). on.
Queer
Once
Jews.
a joint
New
Yor adopti
k, on has
NY: been
Rou proper
tled ly
ge. compl
eted,
each
memb
JOINT er of
the
ADOP couple
TION is a
full
legal
Adopti parent
on is a of the
formal child.
proces The
s by rights
which of the
a adopti
ng
 1923

individ there
uals are
are signifi
equal, cant
and conse
the quenc
parent es to
al compl
status eting
of a joint
each adopti
individ on. At
ual the
does same
not time,
depen joint
d on adopti
the on is
contin not
uing alway
relatio s
nship availa
betwee ble to
n the same-
adults. sex
Thus, couple
if the s. This
adults entry
separat discus
e, each ses
remain both
s a the
legal conse
parent quenc
of the es and
child. the
Disput availa
es bility
about of
child- joint
rearing adopti
at that on.
point Sta
may tus as
lead to a legal
custod parent
y is of
litigati critica
on. l
Thus, import
1924

ance. their
In childr
genera en and
l, legal to
parents have a
have right
the to
right spend
to time
make with
signifi them.
cant In
decisio additi
ns for on,
their legal
minor parent
(or s are
otherw subjec
ise t to
incom obliga
petent) tions.
childre The
n, primar
includi y
ng obliga
decisio tion is
ns that
about they
medica care
l care, for
educati and
on, suppor
religio t their
n, and child.
with An
whom adopti
a child ve
will parent
spend is
time. subjec
Legal t to
parents this
are obliga
presu tion,
med to the
act in same
the as any
best biolog
interes
t of
 1925

ical ed,
parent. this
A cannot
legal be
parent accom
has plishe
greater d
rights witho
with ut
regard formal
to a legal
child procee
than dings
anyone and
else, genera
save lly
for requir
anothe es
r legal proof
parent. of
Legal parent
parents al
are unfitn
also ess.
grante If a
d couple
substa plans
ntial to
(thoug adopt
h not and
unlimit raise a
ed) child
protect togeth
ion er, it
from is
state genera
interfe lly
rence best if
with both
their memb
childre ers of
n. the
While couple
parent have
al status
rights as
can be legal
termin parent
ated or s. The
restrict simple
1926

st way copare
to nting
achiev relatio
e this nship.
result While
is to legal
compl relatio
ete a nships
joint betwe
adopti en
on. adults
This can be
secure dissol
s each ved,
person legal
’s relatio
relatio nships
nship with
with childr
the en
child. genera
In the lly
event cannot
that be. A
one couple
parent pursui
dies, ng
the joint
other adopti
parent’ on
s must
relatio unders
nship tand
with that
the each
child memb
contin er of
ues. In the
the couple
event is
that undert
the aking
parents a
separat perma
e, they nent
will be relatio
oblige nship
d to to the
contin child
ue the and,
 1927

therefo assess
re, ed.
very This
likely will
to each requir
other. e
Eac extens
h ive
memb disclo
er of a sure
couple of
pursui person
ng a al
joint inform
adopti ation
on is and
subject some
to the form
same of
evaluat home
ive study.
proces The
ses as stabilit
an y of
individ the
ual relatio
seekin nship
g to may
adopt. also
These be
proces subjec
ses t to
may inquir
differ y.
from Wh
state to ile all
state, states
but in permit
genera single
l, the people
parent to
al adopt,
fitness many
of states
each have
memb laws
er of that
the restric
couple t the
is circu
1928

mstanc ed to
es deter
under mine
which wheth
a joint er the
adopti law in
on can any
be given
compl state
eted. permit
The s
most unmar
comm ried
on couple
restrict s to
ion is a adopt.
require )
ment His
that torical
the ly,
couple restric
seekin ting
g to access
compl to
ete a joint
joint adopti
adopti on to
on marrie
must d
be couple
marrie s has
d. been a
(Note seriou
that s
some imped
states iment
do to
permit same-
unmarr sex
ied couple
couple s.
s to Same-
jointly sex
adopt. couple
A s were
local not
lawyer permit
should ted to
be marry
consult or
 1929

were lar,
not states
recogn that
ized as are
marrie hostile
d and to
so same-
could sex
not couple
qualify s may
for attemp
joint t to
adopti contin
ons. ue
While restric
the tions
right on
of access
same- to
sex joint
couple adopti
s to on to
marry differe
is now nt-sex
the marrie
law d
nation couple
wide, s
it does Joint Adoption
not
necess
only.
arily
The
follow
legal
that
validit
same-
y of
sex
such
couple
restric
s will
tions
have
is as
ready
yet
access
untest
to joint
ed.
adopti
States
on
may
proces
argue
ses in
that
all
whate
states.
ver
In
the
particu
1930

right ng
to that
marry, ideall
the y a
right child
to should
adopt have a
is mothe
histori r and
cally a
control father
led by in
state order
law to
and thrive.
that While
there this
is no positi
funda on is
mental at best
or debata
constit ble,
utional hostile
right courts
to be and
allowe legisla
d to tures
adopt may
a attem
child. pt to
States rely
may on
also what
attemp resear
t to ch
justify there
differe is to
ntial justify
treatm prefer
ent of ential
same- treatm
sex ent for
and differe
differe nt-sex
nt-sex couple
marrie s.
d Wheth
couple er
s by courts
insisti will
 1931

permit ete an
this initial
remain indivi
s to be dual
seen. adopti
It is on and
possibl then
e that have
in the
some other
states, person
recogn compl
ition ete a
of a secon
same- d-
sex parent
couple adopti
’s on in a
marria jurisdi
ge will ction
not where
necess secon
arily d-
entail parent
the adopti
right ons
to are
joint permit
adopti ted.
on for While
that more
couple cumbe
. rsome,
If this
joint proces
adopti s
on is could
not result
availab in
le, a each
same- memb
sex er of
couple the
could couple
consid having
er full
having recogn
one ition
person as a
compl legal
1932

parent. gained
The throug
limited h that
availab adopti
ility of on.
second Thus,
-parent if a
adopti couple
ons adopts
(discus in
sed in state
a A,
separat where
e entry joint
in this adopti
volum on is
e) may permit
limit ted,
the and
practic later
al moves
feasibi to
lity of state
this B,
course where
of joint
action. adopti
Onc on is
e an not
individ availa
ual or ble,
a state
couple B
has must
properl noneth
y eless
compl recogn
eted an ize
adopti both
on in memb
any ers of
state, the
all couple
other as
states legal
must parent
recogn s. This
ize the outco
legal me is
status manda
 1933

ted by law of
the the
Full state
Faith compl
and eting
Credit the
Clause adopti
of the on be
United follow
States ed
Constit carefu
ution, lly.
which Consu
require ltation
s state with a
courts compe
to give tent
effect local
to lawyer
court is
orders essenti
from al.
other
states. Julie
Thus, Shapi
a ro
couple
might J
consid u
v
er
e
movin n
g to a i
favora l
ble e
state in
order J
to u
compl s
t
ete a
i
joint c
adopti e
on. If
this S
strateg y
y is s
pursue t
d, it is e
m
essenti
al that
the
1934

See F
also u
Adopti r
on,
t
Choices
h
About;
Adopti e
on, r
Legal
Con R
side e
ratio a
ns d
in; i
Ado
n
ptio
g
n
and s
Fost Joslin,
er C. G.,
Car Minter,
e S. P.,
Disc &
rimi Sakimu
nati ra, C.
on; (2014).
Cust Les
ody
bia
and
n,
Liti
gati gay
on, ,
LG bise
BQ xua
Pare l
nts;
and
Pare
tra
nt–
Chil nsg
d end
Rela er
tion fam
ship
ily
s;
law
Sec
ond- .
Pare Eag
nt en,
Ado MN
ptio :
n
Tho
mso
n
Reu
ters.
 1935

into
and
JUVE out of
the
NILE
JJS
JUSTI for
LGBT
CE Q
youth,
SYSTE media
M ted by
factor
s such
LGBT as
Q child
youth welfar
are e
dispro involv
portio ement
nately , the
repres spectr
ented um of
in the family
juvenil accept
e ance
justice and
system rejecti
(JJS), on,
as well experi
as in ences
the within
child school
welfar s,
e comm
system unity-
, and based
among experi
homel ences,
ess and
youth experi
popula ences
tions. within
Resear the
ch JJS
points itself.
toward Under
compl standi
ex ng
pathw LGBT
ays Q
1936

youth’ ences
s of
compl LGBT
ex Q
pathw youth
ays in the
into JJS,
and includ
out of ing
the JJS rates
should of
look at incarc
this eratio
constel n,
lation pathw
of ays
factors into
holisti the
cally JJS,
across and
the experi
lifespa ences
n to within
illumi it.
nate Factor
the s
ways contri
in buting
which to
pipelin LGBT
es or Q
“revol youth’
ving s
doors” overre
are presen
create tation
d at within
the the
interse JJS,
ction includ
of ing
system hostile
s. This school
entry climat
provid es,
es an comm
overvi unity-
ew of level
the profili
experi ng,
 1937

and hobia.
family For
rejecti examp
on, le,
will LGBT
also be Q
explor youth
ed. have
less
access
LGBT
to safe
Q shelter
Youth s and
Home housin
lessne g; are
ss at
increa
LGBT
sed
Q
risk
youth
for
are
sexual
severel
assaul
y
t and
overre
other
presen
forms
ted
of
among
physic
homel
al
ess
violen
youth
ce;
popula
and
tions
are
and
more
experi
likely
ence
to
unique
engag
vulner
e in
abilitie
excha
s as a
nge of
result
sex
of
for
interpe
food,
rsonal
shelter
and
, or
institut
mone
ional
y than
homop
their
hobia
hetero
and
sexual
transp
and
1938

cisgen for
der HIV
(i.e., and
non- hepati
transg tis C
ender) than
counte hetero
rparts. sexual
Homel and
ess cisgen
LGBT der
Q youth.
youth Resea
also rch
have a regard
higher ing
likelih LGBT
ood of Q
having youth
attemp homel
ted essnes
suicide s has
, also
having demo
been nstrate
enrolle d that
d in a LGBT
substa Q
nce youth
abuse move
progra freque
m, and ntly
having betwe
been en
in the their
child famili
welfar es of
e origin,
system child
. They welfar
are e
also place
signifi ments,
cantly the
more street,
likely reside
to ntial
have treatm
been ent
tested progra
 1939

ms, are
shelter
overre
s, andpresen
other ted
informwithin
al the
livingpublic
arrangchild
ementswelfar
as they
e
seek syste
out a m and
supporsometi
t mes
systemface
and uniqu
livinge
situati
ports
on of
among entry
frequeinto
ntly the
hostile
foster
socialcare
service
syste
systemm due
s. to
family
rejecti
LGBTQ on or
Yo
confli
ut
ct
hrelate
an
d to
dyouth
th
sexual
eorient
ation
Ch
or
ild
Wgende
r
elf
identit
ar
y. For
e
examp
Sy
le, the
ste
Los
mAngel
LGBT es
Q Foster
youth Youth
1940

Survey minati
(LAF on,
YS) harass
recentl ment,
y and
found violen
that ce
LGBT within
Q the
youth child
repres welfar
ent e
19% syste
of m,
youth which
in care is
in the overut
child ilized;
welfar underr
e esourc
system ed;
in Los and
Angel suffer
es s from
Count a
y. chroni
Althou c
gh shorta
some ge of
states compe
have tent
anti- staff,
discri caregi
minati vers,
on and
policie servic
s to e
protect provid
the ers to
interes care
ts of for the
LGBT more
Q than
youth, 500,0
they 00
comm young
only people
experi in the
ence Unite
discri d
 1941

States are
who also
are more
residin likely
g to be
outsid hospit
e of alized
the for
homes emoti
of onal
their reason
birth s. This
familie has
s. led
LG some
BTQ jurisdi
youth ctions
are to
vulner begin
able to the
repeate proact
d ive
move recruit
ment ment
and of
unstabl affirm
e ing
placem foster
ents parent
and s,
are althou
more gh
likely such
to be efforts
placed remai
in n the
congre except
gate ion
care rather
faciliti than
es, or standa
group rd
homes, policy
rather .
than Resear
with chers
foster associ
familie ate
s. LGBT
They Q
1942

youth’ work
s schola
increas r
ed risk Gerald
for Mallo
multipl n and
e child his
welfar collea
e gues
placem attribu
ents te the
with freque
nonaffi nt
rming moves
placem for
ents LGBT
that Q
either youth
passiv to four
ely factors
encour : (1)
age staff
LGBT memb
Q ers not
youth accept
to ing or
leave not
their affirm
placem ing
ents by youth’
neglect s
ing sexual
their orient
needs ation,
or (2)
activel youth
y feelin
discri g
minate unsafe
against becaus
them, e of
resulti their
ng in sexual
premat orient
ure ation,
ejectio (3)
n or youth’
depart s
ure. sexual
Social orient
 1943

ation c
being e
seen as S
a y
“mana s
gemen
t
t
e
proble
m
m,”
Strong
and (4)
youth parall
not els
being betwe
accepten the
ed by child
peers welfar
because
e syste
of
their m and
sexualthe
JJS
orienta
tion. indica
te that
many
LGBTQ of the
Ystereot
oypes,
ubiases
t,
hdiscri
aminat
nory
dpracti
tces,
hand
estruct
ural
J
barrier
u
s that
vshape
ethe
nlives
iland
eexperi
Jences
uof
sLGBT
tQ
iyouth
are
1944

shared presen
across ted. In
both one
system study,
s, LGBT
likely Q
explai youth
ning repres
LGBT ented
Q betwe
youth en
overre 13%
presen and
tation 15%
in of
both. youth
Most in the
states JJS.
and Given
jurisdi the
ctions dual
do not realiti
collect es of
data overre
related presen
to tation
youth’ of
s both
sexual LGBT
orienta Q
tion youth
and and
gender youth
identit of
y, color
makin within
g it the
difficu JJS, it
lt to follow
assess s that
the the
exact majori
degree ty of
to LGBT
which Q
LGBT youth
Q in the
youth syste
are m are
overre also
 1945

youth ng
of arrest,
color. trial,
The senten
Equity cing,
Project and
, an incarc
initiati eratio
ve to n. For
ensure examp
that le,
LGBT LGBT
Q Q
youth youth
in are
juvenil more
e likely
delinq to be
uency detain
courts ed
are prior
treated to
with senten
dignity cing
, and
respect pathol
, and ogized
fairnes based
s, has on
also their
found sexual
dispari orient
ties ation
that or
disadv gender
antage identit
LGBT y, at
Q times
youth resulti
in ng in
variou inappr
s opriat
stages e “sex
of Juvenile Justice
juvenil System
e
justice offens
involv e”
ement, (e.g.,
includi
1946

lewd hetero
condu sexual
ct) and
charge cisgen
s. der
These counte
charge rparts,
s then an
impact occurr
not ence
only that
hearin paves
gs and the
senten way
cing for
but furthe
also r
eventu potent
al ial
dispro syste
portio mic
nate abuses
place ,
ment includ
of ing
LGBT unnec
Q essary
youth sex
in the offend
JJS. er
LGBT treatm
Q ent.
youth Conse
tend to quenc
be es
overch someti
arged mes
with includ
sex e
offens courto
es rdered
related repara
to age- tive or
ofcons conve
ent rsion
laws therap
when y,
compa which
red to aims
their to
 1947

change partic
a ularly
person youth
’s of
same- color,
sex who
attracti are
on dispro
based portio
on the nately
premis target
e that ed and
it is a appre
mental hende
disord d for
er, a “quali
practic ty of
e that life”
has offens
been es
conde (e.g.,
mned loiteri
by ng,
every litterin
major g,
U.S. public
health drunk
and enness
mental )
health when
organi compa
zation. red
In with
additio their
n, hetero
findin sexual
gs and
from cisgen
multip der
le counte
studies rparts.
indicat Institu
e tional
large- mistre
scale atmen
profili t and
ng of abuse
LGBT within
Q the
youth, syste
1948

m often
includi justifi
ng by ed as
police being
in the a
comm safety
unity measu
and by re
guards used
, or to
correct protec
ional t
officer LGBT
s, Q
within youth,
detenti but is
on know
faciliti n to
es have
have injurio
additio us
nally conse
been quenc
widely es for
docum physic
ented. al and
This menta
mistre l
atment health
takes , as
the well
form as
of prospe
physic cts for
al releas
assault e.
; Finall
verbal y, the
harass Prison
ment; Rape
and Elimi
increas nation
ed use Act
of (PRE
solitar A),
y passed
confin in
ement, 2003,
which recog
is nized
 1949

the the
unique lives
vulner and
ability experi
of ences
LGBT of
Q queer
inmate or
s to same-
sexual sex–
assault practi
while cing
incarc wome
erated. n and
transg
ender
Gender, youth
Gen occup
der y a
Iden partic
tity, ularly
and margi
Scho nalize
ol- d
Base place.
d A
Hara small
ssm numb
er of
ent
studie
and
s have
Disci
begun
pline to
Within explor
the e the
alread relatio
y nship
sparse betwe
body en
of juveni
researc le
h on justice
LGBT involv
Q ement
youth’ , court
s proces
experi ses,
ences J
in the u
JJS, v
1950

erly
nattenti
ion has
l
been
e
given
J
to the
uoverre
spresen
ttation
iof
clesbia
en and
bisexu
S
al
y
s
girls
twithin
ethe
mJJS.
Data
from
same- the
sex Natio
attracti nal
on, Longit
gender udinal
nonco Study
nformi of
ty, and Adole
gender scent
identit Health
y , a
among nation
young ally
people repres
who entati
are ve,
placed popul
in ation-
faciliti based
es sampl
design e, has
ated as been
being used
“for to
girls.” demo
For nstrate
examp that
le, nonhe
recent terose
schola xual
 1951

adoles school
cents, -based
particu victim
larly ization
girls, and
are life
dispro outco
portio mes
nately and
sanctio pathw
ned by ays,
school paying
s and unprec
crimin edente
al d
justice attenti
authori on to
ties, the
despite mediat
the ing
fact roles
that of
they gender
are not and
engagi gender
ng in identit
more y and
lawbre their
aking interse
or ction
transgr with
essive race.
behavi In a
or than study
their condu
hetero cted
sexual by
peers. sociol
Rec ogical
ent resear
researc cher
h has Angel
begun a
to Irvine,
explor sampli
e the ng
relatio youth
nship from
betwee the
n JJS in
1952

six gay,
jurisdi bisexu
ctions al,
around questi
the oning,
nation, and
27% gender
of self- -
identifi nonco
ed nformi
girls ng
survey boys.
ed Irvine
reporte additi
d that onally
they confir
were ms
LGBT that
Q, these
compa youth
red to are
only more
8% of likely
self- than
identifi hetero
ed sexual
boys, or
sugges gender
ting -
that norma
lesbian tive
, peers
bisexu to
al, have
questio entere
ning, d the
and JJS
gender becaus
- e they
nonco ran
nformi away
ng from
girls home
remain or
more becaus
invisib e of
le in status
these offens
system es
s than such
 1953

as o
school nc
truanc o
y. nf
Finally or
, she
m
notes
in
that
g
youth’
s fear Y
of o
reprisa ut
l from h
correct a
ions n
staff, d
peers, th
and e
judges Ju
was ve
one of ni
many
le
reason
Ju
s why
they sti
may ce
not Sy
disclos st
e their e
sexual m
orienta As
tion or with
gender many
identit school
y. setting
s and
Tra the
child
ns
welfar
ge
e
nd
syste
er m, the
an JJS
d sites
Ge involv
nd e
er partic
- ular
N hostili
1954

ty freque
toward ntly
and have
vulner to do
ability with
for petty
transg crimes
ender relate
and d to
gender efforts
- to live
nonco out
nformi their
ng felt
youth. gende
Legal r (e.g.,
schola shopli
r Jody fting
Marks wome
amer n’s
has clothi
highlig ng,
hted engagi
the ng in
crimin surviv
alizing al sex
and in
abusiv order
e to
pathw afford
ays for street
transg hormo
ender nes)
youth or are
who a
come result
to the of the
attenti discri
on of minati
the on
law, and
noting abuse
that that
their they
reason experi
s for ence
involv within
ement their
in the famili
JJS es,
 1955

school ment
s, of
foster these
care youth
faciliti in sex-
es, segreg
homel ated
ess faciliti
shelter es
s, and based
places on
of birth-
emplo assign
yment. ed
Onc gender
e can
involv subjec
ed in t
the transg
JJS, ender
transge youth
nder to
and harass
gender ment,
- sexual
nonco assault
nformi , and
ng other
youth forms
are of
comm violen
only ce.
housed Moreo
in sex- ver,
segreg transg
ated ender
faciliti youth
es often
where do not
their receiv
gender e
identit adequ
y is ate
police legal
d or repres
placed entatio
in n and
isolati advoc
on. acy
Place becaus
1956

e of of
attorne these
y bias factors
and , in
lack of conjun
unders ction
tandin with a
g of freque
gender nt lack
and of
sexuali suppor
ty. The t from
lack of family
trans- memb
affirmi ers,
ng results
social in
service dispro
s and portio
treatm nately
ent poor
progra outco
ms mes
also for
results transg
in the ender
exclusi youth
on of involv
transge ed in
nder the
youth JJS.
from Such
“rehab poor
ilitativ outco
e” mes
alterna includ
tives e
to vulner
incarce ability
ration to
that assault
may , lack
be of
availab sociali
le to zation
other and
youth. progra
The mmin
combi g, loss
nation of
 1957

connec n the
tion stated
with “rehab
comm ilitativ
unity e”
and promi
family, se of
and an the
increas JJS
ed and
likelih the
ood of “healt
becom hful”
ing family
further enviro
ensnar nment
ed in s of
the the
juvenil child
e welfar
justice e
and syste
adult m, on
crimin the
al one
justice hand,
system and
s. the
Thu reality
s, for of
LGBT institu
Q tional
youth respon
in ses
genera that
l, and are at
gender least
nonco highly
nformi stressf
ng ul and
youth in
in extre
particu me
lar, cases
profou potent
nd ially
discrep lethal,
ancies on the
exist other
betwee hand.
1958

This that
portrai contri
t of bute
large- to
scale health
system dispari
ic and ties
institut and
ional shorte
bias ned
illustra lifespa
tes a ns.
system In
of their
revolvi book
ng Queer
doors, (In)Ju
where stice,
LGBT activis
Q t legal
youth schola
are all rs
too Joey
comm Mogul
only in ,
consta Andre
nt flux, a
denied Ritchi
access e, and
to Kay
opport Whitl
unity ock
structu argue
res, that
experi crimin
encing alizing
a tropes
depriv about
ation queer
of and
opport transg
unities ender
, and people
expose have
d to becom
violen e
ce and solidif
other ied
conditi within
ons legal
 1959

discou experi
rses, ences
where of
they LGBT
are Q
repeate young
dly people
used to .
classif These
y grand
queer narrati
and ves
trans are
individ also
uals raciali
within zed,
crimin classe
al d,
cases. gender
These ed,
tropes nation
of alized,
crimin and
ality embed
and ded in
devian histori
ce cal
underg narrati
ird the ves
JJS, about
policin the
g, place
courtb and
ased worth
proces of
ses, lives
and within
social the
service coloni
provisi al
on, projec
and t that,
have accord
been ing to
tacked many
on to critics,
the has
bodies been
and the
lived basis
1960

of U.S. ent
nation- confla
buildin tion of
g queern
pursuit ess
s and a and
contin gender
ually nonco
unfoldi nformi
ng ty
nation with
al devian
identit ce is a
y. contri
Unfort buting
unatel factor
y, they to the
remain crimin
the alizati
lens on of
throug LGBT
h Q
which youth,
policy as is
is school
shaped bullyi
and ng,
articul family
ated, rejecti
social on,
service lack
system of
s are social
structu servic
red es, the
and hostili
funded ty of
, legal the
proces child
ses are welfar
carried e
out, syste
and m, and
prison LGBT
expans Q
ion is youth’
justifie s
d. dispro
The portio
persist nate
 1961

represe to
ntation further
and violen
increas ce and
ed victim
vulner ization
ability while
among mitiga
homel ting
ess access
youth to
popula opport
tions. unity
All of and
these creatin
challen g
ges pathw
land ays
LGBT with
Q poor
youth outco
in mes.
public
Sarah
spaces
where Moun
they tz
are See
likely also
to be Foster
targete Care;
d by Homel
police essness
;
and
School
ensnar -to-
ed in a Prison
JJS Pip
whose elin
structu e;
ral and Tra
explici nsg
end
t
er
homop and
hobia Gen
and der-
transp No
hobia nco
subject nfor
min
LGBT
g
Q
youth
1962

You F
th u
and r
the
t
Leg
h
al
Syst e
em; r
Tra
nsge R
nder e
and a
Gen d
der
i
Non
n
conf
orm g
ing s
You Himme
th of lstei
Col n,
or; K.
Tra E.
nsge W.,
nder &
Inm Bru
ates; ckn
Tran er,
sgen H.
der (20
You 11).
th Cri
and min
Wel alju
l- stic
Bei e
ng and
sch
ool
san
ctio
ns
agai
nst
non
hete
rose
xual
you
th:
A
nati
onal
lon
gitu
dina
l
 1963

stud ce
y. syst
Pedi em.
atri Col
cs
um
127(
1), bia
49– Jou
57. rna
l of Justice
Juvenile
System
Ge
nde
r
Irvine,
and
A.
La
(201
w,
1).
19(
“We
3),
’ve
675
had
–
thre
701
e of
.
the
Majd,
m”:
K.,
Add
Mar
ressi ksa
ng mer
the , J.,
invi &
sibil Rey
ity es,
C.
of
(20
lesbi 09).
an, Hid
gay, den
bise inju
xual stic
, e:
Les
and
bia
gen
n,
der gay
non- ,
conf bise
ormi xua
ng l,
yout and
tra
hs
nsg
in end
the er
juve you
nile th
justi in
1964

juve .
nile T
cour h
ts. er
Equi e’
ty s
Proj n
ect. o
Retr pl
ieve a
d c
Nov e
emb li
er k
14, e
201 h
5, o
fro m
m e:
http: A
//w c
ww. hi
equi e
typr vi
ojec n
t.org g
/pdf s
s/ af
hidd et
en_i y,
njus p
tice. er
pdf m
Mall a
o n
n, e
G n
., c
A y,
le a
d n
or d
t, w
N el
., l-
& b
F ei
er n
re g
ra f
, o
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Rev (20
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LG
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sexual y” is
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ences a
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transg ular
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social tion
1974

of incre
“norm asingl
al” y
and consi
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figura as
tion appro
of priate
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perso ssion
nal s of
limits. sexua
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xual desire
norms and
still lovin
tend g
to relati
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ge ps,
vagin other
al sexua
interc l
ourse practi
as the ces
gold remai
standa n
rd. margi
Even nalize
thoug d or
h patho
mutua logiz
l ed.
mastu Amo
rbatio ng
n and them
oral are
sex sexua
for l
same- intera
sex ctions
intera not
ctions focus
and ing
anal on
sex genit
for al
gay stimu
men lation
are or
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ing the
intens statist
e ical
(“extr sense
eme” has
in the been
eyes consi
of the dered
norm) suffic
kinds ient
of reaso
physic n to
al and regar
psych d it as
ologic devia
al nt,
stimul sick,
ation, or
those moral
involv ly
ing wron
techni g by
cal societ
artifac y at
ts, and large,
those as
with well
more as by
than scien
two ce,
partici rather
pants than
or just
outsid as a
e the value
privat -
e neutr
sphere al
. minor
Oft ity
en, practi
the ce.
fact This
that taken
an -for-
activit grant
y is ed
less distin
comm ction
1976

betwe d an
en individu
“norm al
al, emotion
health al
y, response
safe, to
good, possessi
respec ng or
table” acting
and on non-
normativ
637 e sexual
“deviant, desires.
sick, The
dangerou fact that
s, bad, social
queer” and
sex has moral
been values
questione are
d from emotion
various ally
perspecti charged
ves, for may be
instance, one of
by the the
sex- reasons
positive why
moveme some
nt. Yet people
social experien
norms ce the
remain transgres
effective sion of
and leave such
an cultural
imprint norms
on and
individua taboos,
ls as well
socialize as their
d in a individu
certain al
culture. boundari
Shame es, to be
may, for erotic.
instance, Anythin
be g that is
considere not
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d than for
“normal” a gay
to either man,
society at being
large or urinated
the upon
individua may be
l in experien
question ced as
may even
therefore more
be humiliati
considere ng or
d as a transgres
kinky sive (and
sexual therefore
activity, eroticall
not in the y
sense of stimulati
an ng) in
aberratio front of
n, but as witnesse
a part of s than in
sexual private,
variation. and so
If kink is on. This
therefore highly
defined subjectiv
by a e
concept element
of in the
transgres experien
sion, it ce of
becomes kink
relative creates a
to the broad
context. field of
For potential
instance, ly erotic
anal sex and
on the sexual
receiving practices
end .
could be Therefor
considere e, only a
d more few
transgres common
sive for a example
heterosex s of
1978

different can be
kinds of consider
kink can ed kink.
be For
mentione instance,
d in the so-called
following “age
. play,”
The especiall
inserting y
of a enacting
whole “incest”
hand into scenario
the s (by
vagina or actual
anus unrelate
(“fisting” d
) can be adults),
considere is
d an utilizing
intense the
Ki transgres
n sion of a
k great
taboo
stimulati and
on of therefore
body can lead
(and to
mind) intense
and is psycholo
one of gical
those experien
sexual ces.
practices Infantilis
that m is one
requires variant
specific of
skills and playing
training. with
Role- age, in
playing which a
in grown-
general, up
but person
particular takes up
ly with the part
cultural of a
taboos, baby,
wearing
diapers kinky
and and
being taboo-
cared for breaking
by a , but not
responsib humiliati
le adult ng.
figure. Practices
To like
some, spanking
humiliati the
on is buttocks
erotically may also
charged, be
and experien
being ced as
forced to humiliati
wear ng if
diapers given as
or punishm
chastity ent,
devices, while
being simply
urinated providin
or g a
defecated sensual
upon, or experien
being ce for
forced to others or
consume in a
urine or different
feces setting.
(“water Sex is
sports”/“ common
scat”) ly still
may regarded
provide as
them occurrin
with this g
kind of “naturall
erotic y.”
humiliati Therefor
on. For e, those
others, in practices
contrast, utilizing
the same technical
practices artifacts
may be (“sex
experienc toys”)
ed as such as
1980

penetrati with
on erotic
devices value.
(dildos), Commo
other n
tools that fetishes
stimulate are
the body leather,
(for rubber,
instance, silk,
vibrators) stretch
, or fabrics,
clothing neoprene
and , boots,
adornme feet,
nts that various
are uniforms
erotically (for
charged instance
and military,
worshipp police,
ed nurse),
(fetishes) as well
are as
considere stereotyp
d as ical
“unnatur clothing
al,” of
“artificial another
,” and gender
possibly (as in
as kinky cross-
in a dressing
positive or
sense to playing
those with
engaging gender).
in them. For
Fetish fetishists
ists are ,
people wearing
for certain
whom clothing
specific and
fabrics, seeing
aesthetics and
, objects, feeling it
or body on their
parts are partners
imbued is a
means of two
arousal people
and in a
enhances (loving)
their monoga
sexual mous
experienc relations
e. But the hip in a
traditiona private
l setting.
psychoan This
alytical includes
idea that activities
the fetish with
is a more
substitute than two
for the participa
genitals nts such
does not as
seem to swinging
hold, as , group
many sex, and
fetishists orgies;
tend to sexuality
also in the
enjoy presence
and of
incorpora others,
te genital such as
sex into at a sex
their party, in
fetish a sex
life. club, or
Anoth in a
er group public
of sexual park or
practices restroom
is ; and
considere finally,
d as the
kinky phenome
because na of
it voyeuris
violates m
the idea (getting
that sex aroused
should by
only take watching
place others
between have
1982

sex) and F
exhibitio u
nism r
(getting t
sexual h
pleasure e
out of r
being
watched) R
. e
a
Robin d
Bauer i
n
See also g
Bondage,
s
Dominanc
e/Submissi Bienv
on, en
Sadism/ u,
Masoc R.
hism V.
(BDS (1
M); 99
Monog 8).
amy Th
and e
Non- de
Monog ve
amy; lo
Sex p
Positiv m
e en
Move t
ment; of
Sexual sa
Norms do
and m
Practic as
es oc
his
m
as
a
cu
ltu
ral
sty
le
in
th
e
tw
en
tie
th
 cen on
tur of
y the
Un
wor
ite
d ld
Sta of
tes. sex
Di ual
sse do
rta
min
tio
n anc
Ab e
str and
act sub
s mis
Int
sion
er
nat .
ion Ne
al, w
59( Yor
02 k,
A),
NY:
06
20. Vill
(U ard
MI Boo
No ks.
. Califia,
98 P., &
25 Sween
50 ey, R.
7) (Eds.).
Brame, (1996)
G., . The
Bra secon
me, d
comin
W.
g: A
D., leathe
& rdyke
Jaco reader
bs, J. . Los
(199 Angel
es,
3).
CA:
Diff
Alyso
eren n.
t Thompson
lovi , M.
ng: (Ed.).
An (2004)
expl .
orati Leathe
1984

rfolk:equal
Radicaity
l sex,for
lesbia
people,
n and
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gay men, sheriff
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bisexuals to arrest
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citing of the
lack of film
evidence, Boys
and they Don’t
later Cry.
killed Prior
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and two landmar
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friends in U.S.
revenge. Supreme
In Court
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v. Lawrenc
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on Texas,
County, Lambda
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Nebraska helped
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Court state
held the courts to
sheriff strike
responsib down
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damages. e v.
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ented successf
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communi laws
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intimacy Lambda
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based. court.
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contemp Hawai’i
orary Supreme
moveme Court
nt for the was the
freedom first
1992

state “Recipro
supreme cal
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the tions in
Hawai’i Californi
legislatur a in
e passed 2008. In
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freedom Legal
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couples lesbian
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Virginia, dying
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addition to the
to adoption
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1994

rules that told her

require supervis
fair or that
visitation she
practices planned
for same- to
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couples n from
in all male to
hospitals female.
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decision on of an
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from the positive
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Appeals initially
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Circuit, years in
in Glenn prison
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General during
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discrimin used a
ated condom.
against a The
transgend 2014
er decision
woman recogniz
who was ed that
fired HIV-
from her positive
state job individu
after she als who
have a
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viral load
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result of
effective
treatment
pose
little risk
of
transmitti
ng HIV.
Leslie J.
Gabel-
Brett
See also
Bullying,
Legal
Protection
s Against;
Discri
minat
ion
on the
Basis
of
HIV/
AIDS
in
Healt
h
1996
Care; Gay Exclusion in the U.S. Military: Evolution and
Demise of Don’t Ask, Don’t Tell; Gender Transition at
Work; Hospital Visitation; Legal
Recognition of Nonmarital Same-Sex Relationships;
Marriage Equality, Landmark Court Decisions
Further Readings
Eskridge, W. N., Jr., & Hunter, N. J. (1997). Sexuality, gender,
and the law (3rd ed.). St. Paul, MN:
Foundation Press.
Lambda Legal. http://www.lambdalegal.org
Rubenstein, W. B., Ball, C., Schachter, J., & NeJaime, D.
(2014). Cases and materials on sexual orientation and the
law (5th ed.). St. Paul, MN: West.
LATINA/O SEXUALITIES
Latina/o sexualities is a relatively young area of
research, but it is one that has expanded considerably in
recent years, adding valuable insight to LGBTQ
studies. Three of the most well-developed areas of
study include research on (1) the sexual practices and
health risks of Latino men who have sex with men, (2)
Latinas and their sexualities, and (3) the intersections of
sexualities and migration studies. This entry provides a
brief overview of these three areas.
Latina/o Sexualities: A Note on Terminology
Latina/o, an adjective referring to a person of Latin
American descent, combines both the masculine and
feminine forms of the word in an effort to more
inclusively describe individuals irrespective of gender.
When not combined, the adjective Latina typically
refers to a woman and Latino typically refers to a man
of Latin American descent. The term Latina/o
sexualities is not without its limitations. The term can
imply that Latinas’ and Latinos’ sexualities exist
separate and apart from that of Whites in the United
States. On the other hand, the panethnic category
Latina/o coupled with sexualities can promote the idea
that issues of sexuality do not vary across Latina/o
groups, or that findings on one group will somehow
apply to another. This is particularly problematic
Latina/o Sexualities
because, while the panethnic category Latina/o
encompasses many different nationalities, research in
the area of Latina/o sexualities has predominately
focused on people of Mexican, Puerto Rican, and
Cuban descent. Latina/os of other nationalities are
sorely understudied. This limitation should not be
overlooked. Latina/o sexualities scholarship explores
issues of sexuality among some (but certainly not all)
Latina/o groups. Latina/o sexualities research is limited
in its ability to offer a nuanced analysis of diverse
experiences across Latina/o groups. Still, despite its
limitations, the area of Latina/o sexualities has much to
offer LGBTQ scholarship. Research in this area
contributes an analysis of how Latina/o cultures,
immigration narratives, and economic disadvantage
impact lived sexual experiences.
Sexual Practices and Health Risks
A great deal of research on Latina/o sexualities has
placed an emphasis on male same-sex sexual behaviors.
Scholarship generated along these lines has focused
predominantly on Latino gay men and men who have
sex with men (MSM). In the early 1990s, sociologist
Tomás Almaguer was among the first to explore this
theme, advancing the understanding that sex among
Chicano (Mexican American) men can be framed from
within an activo–pasivo paradigm. Activo–pasivo is a
system for organizing sexual relations between men
whereby one partner takes on the active or penetrative
sexual role, and the other takes on the passive or
penetrated role. Under this sexual system, a gay identity
is reserved for a man who takes on the pasivo role
during sexual intimacies, and a man taking on the
activo role during these encounters is not automatically
stigmatized with the gay identity label. Since its
inception, the activo–pasivo paradigm has been refined
and complicated by many Latina/o sexualities scholars
who criticized the rigid and static ways this paradigm is
often taken up in the larger scholarship. In part due to
the paucity of available research, the activo–pasivo
paradigm is often interpreted by researchers in
essentialist and culturally reductive ways. Furthermore,
this paradigm is used to reify the difference between
Mexican men (and to some degree Latino
Latina/o Sexualities
men more broadly) and White gay men in the United
States. The activo/pasivo paradigm should be
understood as one of a variety of different ways of

organizing sexual cultures among Mexican American
MSM. It is a point of departure for organizing sexual
intimacy among some men, but like all cultures, it is
always in flux and can evolve for couples within a
relationship or from one sexual encounter to another.
Other research on Latino men’s sexual behaviors
with other men has focused on health disparities and
HIV and sexually transmitted infection (STI) risk. This
work explores sexual behaviors with an emphasis on
risk reduction. Social inequality such as poverty,
racism, homophobia, and antiimmigrant sentiment have
left Latino MSM at increased risk for HIV and other
STI transmission. Despite these inequities, it is
important that Latino men who have sex with men are
not solely portrayed as passive victims who are
paralyzed by their oppression. Latino MSM are also
sexual agents who, while negotiating their
marginalities, mobilize their family and community
resources for social support. While understanding
sexual behaviors is important for a larger assessment of
risk, this emphasis in research has stifled a larger
dialogue about these men’s sexual lives, their pleasures,
desires, and needs.
Latinas and Their Sexualities
Research on Latina adolescent sexualities has focused
on the negotiation of first sexual encounters among
teenagers as well as the sexual messages young Latinas
receive regarding their bodies and proper sexual
comportment. The tensions between mothers and
daughters, particularly around the preservation of
female virginity and sexual purity, have been a popular
theme for this work. Much of the tension between
Latina mothers and daughters emerges from
intergenerational differences in sexual socialization.
Mothers and daughters have differing ideas regarding
when and how to approach sex, with mothers
promoting abstinence and daughters wanting sexual
autonomy. When it comes to sexual communication,
Latina/o families at times promote sexual silencing in
the home. The absence of clear dialogue within
Latina/o families regarding sex can lead young Latinas
to struggle with advocating for their own sexual needs
in relationships and ultimately contribute to their
disempowerment. Familial tensions regarding sexual
behavior and virginity are governed by gendered sexual
double standards that romanticize virginity for young
Latinas and result in restrictions of their sexual
freedom. Parents promote the idea that virginity is a
1997
status marker for Latina girls and preserving virginity
helps to secure a young Latina’s prospects for familial
stability in adulthood.
Like the research on Latino MSM, much of the
research on adolescent Latina/o sexualities has used a
disease model for understanding sexual behavior.
Emphasis has been narrowly placed on safe sex at the
expense of analyses of young Latinas’ agency or the
ways in which they negotiate the familial, peer group,
and individual constraints placed on their sexualities.
Sociologist Lorena Garcia’s work elucidates how
within their peer groups, adolescent Puerto Rican and
Mexican American girls experience sexual double
standards and constraints on their sexualities based on
peer group labeling, slut shaming, and overall policing
of their sexual desires. Garcia finds that while Latinas
in heterosexual relationships are savvy in their efforts to
negotiate safe sex practices, there is a relative lack of
discussion regarding sexual pleasure among them. In
contrast, Garcia finds that adolescent Latinas in same-
sex relationships are more comfortable negotiating
pleasure and exploring their sexual needs but less so
discussing safe sex practices.
Research on Latinas in relationships with other
women has been particularly understudied. As is the
case with adolescent Latinas in relationships with men,
many familial tensions arise for sexually
nonconforming Latinas, particularly around parents’
shame and concern for the potential stigmas their
daughters may face in life. This fear is mitigated for
sexually nonconforming Latinas who are willing and
able to mitigate the visibility of their sexualities in
public spaces. Religion can also play a major role in
how sexually nonconforming Latinas and their families
negotiate sexualities. Sexually nonconforming Latinas
must themselves try to reconcile the contradiction
between their love for other women and their religious
convictions. In this effort, sexually nonconforming
Latinas share similarities with heterosexual Latinas who
must also reconcile their sexualities with their religious
beliefs. Sociologist Gloria González-López finds that
Mexican American women redefine the purpose of
Catholicism in their lives, separating their religiosity
from their sexuality and challenging the Church’s
ability to weigh in on issues of procreation and
contraception in their daily lives.
1998
Sexualities and Immigration
Given that migratory experiences are central to the lives
of many Latina/o groups, it is no surprise that some
researchers have focused on the ways immigrant
identities intersect with sexual identities to shape
experience for Latinas and Latinos. This work
complicates our understanding of what motivates
migration and has contributed to advancing the
understanding that Latina/o migrants’ decisions to leave
their countries of origin are motivated not only by
economic need but also the desire for sexual freedom
and familial anonymity. Research at the intersections of
immigration and sexualities scholarship offers an
analysis of the ways in which sexual identity fuels
individual migrants’ decisions to leave their home
countries. These decisions are at times motivated by a
desire to lead a more authentic gay existence or by a
desire not to bring shame onto their families. As the late
sociologist Lionel Cantú noted, even for those who
name economic opportunity as their primary motivator
for migration, sexual and gender identities impact
migrants’ decisions. LGBTQ Latina/os describe a need
to overcome the economic hindrances imposed by
limited opportunities and homophobia, such as being
shut out of economic opportunities on account of their
sexual or gender nonconformity.
The new economic opportunities available to
Latina/o migrants in the United States can shape
Latina/o Sexualities
their sexualities in unexpected ways. GonzálezLópez
notes that for heterosexual Mexican women, living in
the United States and gaining opportunities to earn their
own wages allow them to negotiate more sexual
autonomy within their homes. Furthermore, in separate
studies, Cantú and American Studies scholar Carlos
Decena both find that for Mexican and Dominican men,
respectively, economic autonomy buys bargaining
power with families of origin—making them less likely
to experience rejection or judgment from families of
origin because of their financial contributions.
Scholarship at the intersections of sexualities and
migration studies has also considered how immigration
policies impact sexual-minority subjects. Changes made
to asylum policies in the United States have opened up
the opportunity for sexual minorities to immigrate to
the United States if they are being politically persecuted
on account of their sexual or gender nonconformity in
their countries of origin. While this change marks an
effort to improve upon homophobic biases in
immigration policy, it is not without its limitations.
While these policy changes have created a path to
citizenship for many persecuted LGBTQ individuals, it
also promotes an idea that sexual identities are
immutable and static, and places the burden on
individual asylum seekers to prove their active
persecution in the form of violence from family,
community members, and/or government. Such a
burden constructs the successful asylum seeker as an
individual whose sexual and gender marginalities are
visible and public even within communities where such
expressions are otherwise frowned upon. Thus, without
additional immigration reform, the changes to asylum
policies continue to create inequities for LGBTQ
Latina/o migrants.
Conclusion
Consistently missing from Latina/o sexualities
scholarship is an analysis of sexual desire or pleasure in
Latinas’ and Latinos’ lives. This limitation is
particularly detrimental because it reinforces the
misconception that Latinas and Latinos are not in
control of their sexualities or are uninterested in
Laws Banning Homosexuality and Sodomy
sexual pleasure. Because a great deal of the work on
Latina/o sexualities has been framed around public
health concerns, scholarship on the love relationships of
Latinas and Latinos of varying sexual orientations has
been slower to emerge. This is especially the case for
research on bisexual, queer, transgender or other non–
gender binary–identifying individuals, which is scant
and where available is confined primarily to a health
risk analysis. Crucial future directions for Latina/o
sexualities research should include more empirical
studies on Latina/o groups from underrepresented
nationalities. More scholarship is also needed on aging
Latina/o populations. More research on the
intersections of race
and sexuality is also missing. Most scholars have relied
on an analysis of cultural differences and have
oversimplified the vast racial heterogeneity among
Latina/os and the ways in which this difference shapes
experience. Given the recent growth and expansion
Latina/o sexualities have experienced, some of these
gaps may soon cease to exist.
Katie L. Acosta

See also Adolescent Pregnancy; African American
Sexualities; HIV/AIDS and Racial/Ethnic Disparities;
Immigration; LGBTQ People of Color
Further Readings
Acosta, K. L. (2013). Amigas y amantes: Sexually
nonconforming Latinas negotiate family. New
Brunswick, NJ: Rutgers University Press.
Almaguer, T. (1993). Chicano men: A cartography of
homosexual identity and behavior. Differences: A
Journal of Feminist Cultural Studies, 3(2), 75–100.
Alonso, A. M., & Koreck, M. T. (1993). Silences:
“Hispanics,” AIDS, and sexual practices. In H. Abelove, M.
Barale, & D. Halperin (Eds.), The lesbian and gay studies
reader (pp. 110–126). New York, NY:
Routledge.
Asencio, M. (Ed.). (2010). Latina/o sexualities: Probing
powers, passions, practices, and policies. New
Brunswick, NJ: Rutgers University Press.
Cantú, L., Jr. (2009). The sexuality of migration: Border
crossings and Mexican immigrant men. New York, NY: New
York University Press.
Garcia, L. (2012). Respect yourself, protect yourself:
Latina girls and sexual identity. New York, NY:
New York University Press.
González-López, G. (2005). Erotic journeys: Mexican
immigrants and their sex lives. Berkeley: University of
California Press.
Zavella, P. (2003). Talkin’ sex: Chicanas and Mexicanas
theorize about silences and sexual pleasures. In G. F.
Arredondo, A. Hurtado, N. Klahn, O. Nájera-Ramírez, & P.
Zavella (Eds.), A critical reader: Chicana feminisms (pp.
228–253). Durham, NC: Duke University Press.
LAWS BANNING HOMOSEXUALITY
AND SODOMY
While it has never technically been illegal to be an
LGBTQ person in the United States, government actors
enacted and enforced many laws that were used to
functionally criminalize homosexuality, starting in the
late 19th century. Governmental oppression of lesbian,
gay, bisexual, and trans (LGBT) people accelerated
through the 1950s, but began to lose steam thereafter.
Eventually, most laws and policies designed to
functionally criminalize LGBT people were dismantled,
1999
although problem areas remain. This entry describes
these laws and their evolution in the United States.
Although laws prohibiting sodomy (most commonly
defined as anal sex) have existed since colonial days,
sodomy was not considered to be a serious social
problem prior to the late 19th century; prosecutions
were extremely rare. However, in the late 19th century,
sexologists and psychologists began to reclassify
homosexuality as an identity rather than an act. A rapid
consensus emerged that inverts (as LGBTQ people
were then called) were a danger to society, prompting
massive efforts to criminalize and contain them.
The expansion of sodomy laws was central to these
efforts. States without sodomy laws quickly enacted
them, and three-quarters of U.S. states expanded the
meaning of sodomy to include fellatio (oral sex
performed on a man); a few states also added
prohibitions on cunnilingus (oral sex performed on a
woman). Some states even expanded their sodomy laws
to include mutual masturbation. Although these laws
nominally applied to heterosexual acts as well,
enforcement against those who were not lesbian, gay, or
bisexual (LGB) was exceedingly rare except in cases of
prostitution and sexual assault. In contrast, enforcement
of such laws against inverts (primarily gay men)
skyrocketed.
The functional criminalization of homosexuality
extended far beyond sodomy laws. Police used existing
laws against solicitation, cross-dressing, loitering,
vagrancy, and disorderly conduct to harass LGBTQ
people, particularly in larger cities where
homosexuality was more visible. LGBTQ people were
also caught up in the rise of the eugenics movement. In
the first few decades of the 20th century, over 30 states
passed laws providing for compulsory sterilization of
individuals deemed unfit to reproduce. So-called sexual
degenerates, sexual perverts, and sex offenders were
often included in these laws.
The years between the 1930s and the early 1960s
were particularly difficult for LGBTQ people. During
this time, over half the states passed legislation
requiring that individuals convicted of sodomy and
other sexual offenses be evaluated by psychiatrists for
possible commitment to mental hospitals; in some
states, mere suspicion of homosexuality was enough to
trigger mandatory psychiatric examinations. In 1949,
the U.S. Department of Defense issued formal rules
barring LGB people from military service. In 1950, the
U.S. Senate held hearings designed to ferret out LGB
people working for the federal government. President
2000
Eisenhower followed up with a 1953 Executive Order many states and localities instituted laws prohibiting
barring LGB people from all federal jobs and also discrimination on the basis of sexual orientation and
requiring that all businesses with federal contracts sometimes gender identity. Congress enacted the Don’t
dismiss their LGB employees. The Immigration and Ask, Don’t Tell (DADT) law, which permitted LGB
Nationality Act of 1952 treated homosexuality as (but not T) people to serve in the military so long as
evidence of a “psychopathic personality” and made it they did not reveal their
grounds for deportation. The FBI and Post Office both
developed surveillance programs to expose LGB
people. In addition, many states had regulations
prohibiting bars and restaurants from
Laws Banning Homosexuality and Sodomy

serving LGB people; bars suspected of having LGB

clientele were regularly raided and the patrons arrested.
Police even raided private parties suspected of having
LGB people in attendance.
Criminalization of homosexuality began to ease by
the late 1960s. A major reason for this was the
American Law Institute’s promulgation of a Model
Penal Code (MPC), designed to standardize criminal
codes across state lines. The MPC decriminalized all
sex acts performed in private by consenting adults. By
1983, a total of 22 states had adopted the MPC in full—
although 7 other states removed penalties for non-LGB
people while continuing to criminalize sodomy when
performed by same-sex couples. A second reason was
the removal of homosexuality from the American
Psychiatric Association’s list of mental disorders in
1973, thereby undercutting a major rationale for
penalizing homosexuality. A third reason was the
emergence of the modern LGBTQ rights movement in
the years after the 1969 Stonewall rebellion; the
movement focused heavily on the eradication of laws
and policies targeting LGBTQ people.
While LGBTQ people made several gains in the
1970s and early 1980s (for example, the federal
government lifted its ban on LGB employees in 1975),
the 1986 Supreme Court decision in Bowers v.
Hardwick placed a major roadblock in the path of
LGBTQ rights. The Court held that Georgia’s sodomy
law was constitutional, dismissing the claim that LGB
people had a fundamental right to have consensual
same-sex sex as “at best, facetious.” This ruling, along
with panic over the AIDS epidemic, strengthened
opposition to LGBTQ rights. Another roadblock was
the 1992 passage of Amendment 2 in Colorado that
repealed all existing LGBTQ rights laws in the state and
prohibited the enactment of any future laws.
Yet the tide was clearly shifting. Over the next
decade, 10 more states decriminalized sodomy, and

sexuality—a small but real improvement over the
previous policy. In 1996, the Supreme Court held in
Romer v. Evans that Colorado’s amendment was
unconstitutional. In 2003, the Court overturned
Bowers with its decision in Lawrence v.
Texas, holding that sodomy laws were
unconstitutional; this removed the major remaining
rationale for discrimination against LGBTQ people.
But the most telling indicator of this shifting tide
was the astonishingly rapid evolution of marriage
law. In 2004, Massachusetts became the first state in
the nation to permit same-sex couples to marry. Over
the next 11 years, the edifice of constitutional and
statutory laws excluding same-sex couples from
access to marriage collapsed completely. In 2015, the
Supreme Court ruled that same-sex couples had a
fundamental right to marry (Obergefell v. Hodges).
Problem areas remain, however. While LGB
people have been able to serve openly in the military
since 2011, when DADT was dismantled, the
military still retains the right to dismiss transgender
service members, although it is currently reviewing
its stance on that matter. Police harassment still
occurs, especially with respect to gender-
nonconforming people, who are also
disproportionately subject to hate crimes. Congress
has consistently refused to pass a law protecting
LGBT people from discrimination in employment
and public accommodations. Yet, by any measure,
the legal position of LGBT people has improved
dramatically in recent decades.
Ellen Ann Andersen
See also Discrimination Against LGBTQ People by Law
Enforcement; Discrimination Against LGBTQ People in
the Public Sector; Military and LGBTQ People; No
Promo Homo Policies; Sexology
Further Readings
Chauncey, G. (2004). “What gay studies taught the court”:
The historians’ amicus brief in Lawrence v. Texas. GLQ:
A Journal of Lesbian and Gay Studies, 10(3), 509–538.
D’Emilio, J., & Freedman, E. B. (1988). Intimate matters:
A history of sexuality in America. Chicago, IL: University
of Chicago Press.
Leadership 2001
Eskridge, W. N. (2008). Dishonorable passions: Sodomy
laws in America, 1861–2003. New York, NY: Viking
Press.
LEADERSHIP
Although there is a great deal of scholarship on the
general topic of leadership, the study of LGBTQ
leadership is in its infancy. This entry summarizes
what is known at present about leadership as enacted
by LGBTQ individuals, bringing to bear pertinent
scholarship in several related areas: stigma and
marginalization of LGBTQ people, leadership in
particular status groups (e.g., women, college
students), and LGBTQ career and workplace issues.
Much of this discussion is based on the only (known)
model of LGBTQ leadership articulated in the
research literature, developed by psychologists Ruth
Fassinger, Sandra Shullman, and Michael Stevenson
in 2010. The entry begins with a brief foundational
introduction, followed by consideration of the
context of stigma and marginalization in which the
LGBTQ leadership process occurs. Then, three
important dimensions or aspects of LGBTQ
leadership are presented: sexual orientation, gender,
and group composition. The entry concludes with a
glimpse at the future of scholarship in LGBTQ
leadership.
Foundations
Leadership is an interpersonal influence process in
which an individual (the leader) uses power (the
ability to influence) to move others (followers) in a
particular direction to bring about change. The
influence process can affect many aspects of the
followers’ psychological and psychosocial worlds—
attitudes, values, beliefs, goals, motivations, skills,
perceptions, desires, judgments, behaviors, and the
like—and the leader may use a variety of strategies
to exert influence (e.g., rewards, praise,
encouragement, education, inspiration, feedback, and
punishment). There are several bases of power upon
which leaders’ capacities to influence others rest, and
2002 Leadership
they depend upon different human motivations.
Coercive power, for example, is based on followers’
fear of the leader, whereas expert power relies on
followers’ respect for the knowledge and skills the
leader brings to the leadership role; legitimate power
emanates from the formal position the leader
occupies relative to followers, and referent power
derives from personal traits (e.g., charisma) of the
leader that motivate followers to embrace the
leader’s vision and direction.
Until the middle of the 20th century, most
discussion of leadership focused solely on the leader
(e.g., personality traits, skills and competencies,
power bases, and behavioral styles) to understand
why some leaders were more successful than others.
However, the radical social upheaval of the second
half of the century ushered in new attention to the
contexts in which leadership is enacted and what
followers thought, felt, and did when leaders
attempted to lead them. Models of leadership that
focused on the interactions between leaders and
followers appeared, and the study of leadership
became more embedded in group and social
processes. Most contemporary theories acknowledge
that leadership is a complex process in which leaders
and followers interact; followers interact with each
other; leaders interact with other leaders; outsiders
exert influence on the interactions; and all of this
intense interpersonal activity takes place in a
particular social milieu, culture, and time that
constrains it in unique ways. This complexity is
extremely important in understanding the challenges
of LGBTQ leadership.
There are numerous historical and contemporary
examples of formal leadership roles taken by
LGBTQ people (e.g., San Francisco Supervisor
Harvey Milk in the 1970s; current Wisconsin Senator
Tammy Baldwin), as well as leadership that is
informal or even accidental—for example, the
coming out of an important public figure (e.g.,
entertainer Ellen DeGeneres in 1997, Apple CEO
Tim Cook in 2014, and star NBA athlete Jason
Collins in 2013) may place that person in a position
of considerable influence in becoming an inspiration
and role model for others. Regardless of whether the
leadership role is formal or informal, long-term or
short-term, pursued or conferred, one’s status as a
sexual-minority individual—that is, one who
transgresses societal expectations regarding gender
and sexuality and thus faces stigma and
marginalization—complicates leadership enactment
for all involved.
Context of LGBTQ Leadership: Stigma
and Marginalization
Because sexual stigma—defined by psychologist
Gregory Herek as the inferior status, negative regard,
and relative powerlessness society accords anyone
associated with nonheterosexual behaviors, identity,
relationships, or communities—is so formative in the
lives of LGBTQ people, even in the relatively liberal
United States at this point in history, it is critical to
understand the context in which LGBTQ leadership
occurs. Sexual stigma occurs at both a cultural level,
embedded as heterosexism in social institutions (e.g.,
education, law, religion, the military) and at an
individual level (e.g., enacted as exclusion,
discrimination, hostility, and violence). Sexual
stigma is well documented in both its ongoing
presence in contemporary life and its negative effects
on LGBTQ individuals’ mental and physical health,
interpersonal relationships, education and work, and
in LGBTQ communities. Research shows, for
example, that even a very mild derogatory remark
(“He’s so gay”) can cue negative perceptions of a
gay leader by others, regardless of the leader’s
exemplary performance, and the permitted
expression of such overt prejudice can lead to
unsupportive, discouraging, and even hostile
education and work environments for sexual
minorities. Negative environments, in turn, heighten
feelings of stigmatization and foster minority stress
in LGBTQ people, in which anxiety, fear, and the
constant exercise of self-protective strategies (e.g.,
identity concealment) become their daily reality. In
addition, stereotype threat also proliferates in such
environments, where awareness of the negative
stereotypes of one’s stigmatized group constantly are
evoked, leading to actual performance impairment
over and above individuals’ internal feelings of
anxiety and marginality.
Societal and individual expressions of
stigmatization affect LGBTQ core self-evaluations as
well, in the form of internalized heterosexism and
stigma, or self-stigma, in which one consciously or

unconsciously accepts the legitimacy of
marginalization and incorporates self-hatred, identity
denial, and disempowerment into one’s sense of self.
In this experience of compromised self- evaluation,
even the most benign forms of environmental and
interpersonal heterosexism serve as constant
reinforcers of stigmatized status, thus maintaining the
disempowerment of LGBTQ individuals and groups.
This is why affirming education and work
environments are so important, because the
deleterious impact of negative environments not only
is not confined to overt manifestations of bias and
prejudice, but also fosters the internalization of
stigmatizing experiences into negative core
evaluations of the self. Core self-evaluations, in turn,
are strongly linked to life success and happiness.
Research shows that positive core self-evaluations
confer many advantages in the workplace; they are
associated with career success, high job performance,
high job and life satisfaction, low levels of stress and
conflict, high coping ability, and capacity to
capitalize on opportunities and advantages—all
important factors in leadership development.
For LGBTQ leaders, the effects of sexual stigma
likely function at all stages of leadership
development. For example, sexual-minority
individuals may be prevented in some occupational
environments (e.g., religious or military institutions)
from assuming or even considering leadership roles,
or they may be reluctant to take on leadership roles
for fear of being more publicly scrutinized,
particularly if they are concealing their sexual-
minority status from others. If they do assume
leadership positions, they may find their
effectiveness and success compromised by sexual
prejudice and stigma, often based on mere suspicion
that they might be LGBTQ. Finally, even when their
record suggests clear accomplishment, they may be
perceived or formally evaluated as unsuccessful. To
the extent that the leader is struggling with
internalized heterosexism and selfstigma—a
predictable aspect of sexual-minority identity for
most LGBTQ individuals in a stigmatizing culture—
the ability to cope effectively or address some of
these challenges to leadership development will be
compromised, and leadership trajectories truncated
or altogether derailed.
Leadership 2003
Increasingly, however, scholarship is
documenting the more positive possibilities of
having a marginalized identity. LGBTQ leaders may
benefit from their own developmental experiences of
learning to cope with opposition and negative
feedback, finding and building strong support
systems, advocating for themselves and others within
systems of power and privilege, deeply exploring
their own identities and life goals, and creating their
own norms and ways of living outside the constraints
of heterosexual expectations. Indeed, research on
diverse women leaders (also marginalized in
dominant culture) suggests similarities in their
leadership experiences in such areas as inclusion of
diverse others, open communication, sharing of
power, collaboration, and values-based problem
solving; they also are more likely than men to
manifest transformational approaches to leadership,
which emphasize follower empowerment and
collaborative movement toward mutually determined
goals. These findings make sense, given that
marginalization provides an outsider perspective that
may free an individual from unthinking adherence to
traditional notions of authority and power, and open
the possibility that a minority sexual identity, too,
offers something unique to the leadership process.
Sexual Orientation in LGBTQ Leadership
Sexual orientation pertains to the organization of
one’s identity around particular intimate partner
choices—that is, identifying as lesbian, gay,
bisexual, or similar self-label. The limited research
on sexual orientation and leadership begins, in terms
of the life course, with studies of college students.
Research has found the development of
sexualminority identity and leader identity as
mutually reinforcing for many LGBTQ students,
particularly those who lead LGBTQ identity–based
organizations (e.g., outness catalyzes being tapped to
lead LGBTQ organizations, and leading such
organizations increases outness). Personal identity
also appears to affect leadership approach in that
students who identify as “queer” may espouse more
radical goals (identity affirmation, social change)
than those who identify as lesbian, gay, bisexual, or
transgender (LGBT), who appear more focused on
securing acceptance, inclusion, and equitable
2004 Leadership
treatment in existing systems. As compared to
heterosexual socially responsible student leaders,
LGBTQ student leaders self-report more civil
management of controversy, more recognition of
interconnectedness among community members, and
greater belief in the possibility of change when
people work together. Self-efficacy or self-
confidence in performing leadership roles
successfully appears to be affected by self-esteem,
and confidence seems to be similar for sexual-
minority and -majority students across types of
organizations.
Research on adult LGBTQ leaders indicates that
they recognize how pervasive societal heterosexism
and sexual stigma can set limits on their
advancement trajectories, and they cite achieving and
demonstrating high competence as a defense against
possible or actual discrimination. Studies show that
LGBTQ leaders view many of their most effective
leadership practices as grounded in and emanating
from their sexual-minority identities. These include
leadership behaviors and qualities such as
challenging the status quo of the organizational
culture; fostering inclusion, nurturance, and
affirmation; empowering others (particularly
marginalized organization members); inspiring
shared vision; modeling integrity and honesty;
tolerating ambiguity and being flexible; showing
inner strength and willingness to take reasonable
risks; being willing to listen and learn; modeling
personal authenticity and humility; understanding
oppression and valuing diversity; fostering
collaboration; exhibiting creative problem solving;
and being willing to take reasonable risks. That these
kinds of leadership behaviors are linked to positive
workplace outcomes for LGBTQ leaders is suggested
by research findings that gay male executives’ ability
to adapt, to solve problems creatively, and to
communicate intuitively and sensitively was related
positively to the engagement, job satisfaction, and
workplace morale of their employees.
One of the problems with the existing studies in
LGBTQ leadership is that self-disclosure of one’s
sexual-minority status is assumed or controlled for in
the sampling for the study—that is, the leaders
studied are known by themselves and others to be
LGBTQ, and their identities thus are assumed to
exert influence in overtly recognized ways.
However, many LGBTQ leaders are not publicly out
(some not even to themselves), or are out only
selectively to a few trusted others. The fact that
sexualminority status is largely invisible to others
means that most LGBTQ individuals—including
leaders— engage in a constant internal decision-
making process about the revelation of their identity
to every new person and group with whom they
come into contact. For leaders, this renders each
small coming-out event a test of their perceived
legitimacy and acceptance as a leader by others,
necessitating different kinds of
conversations/disclosures to different audiences and
for different reasons. Research has not addressed this
aspect of LGBTQ leadership, and it is a unique issue
that has no counterpart in any other kind of
leadership process or group in the scholarly
literature.
Similarly, researchers have not explored the
unique question of how a hidden minority status
affects both leaders and their followers. Research on
disclosure suggests that LGBTQ individuals are less
likely to disclose their minority identities in
educational or workplace environments viewed as
unsupportive or unsafe (for very understandable
reasons). However, when an individual moves into a
leadership role, it may be more difficult (and even
undesirable) to continue to try to protect a concealed
identity. Research generally supports coming out in
the workplace, and finds many LGBTQ individuals
to be out, at least selectively. Studies not only
indicate that identity avoidance or concealment takes
a substantial psychological and performance toll on
LGBTQ individuals themselves, but the concealment
of a suspected or assumed sexualminority identity
also leads to negative judgments by others. In
addition, research shows that identity disclosure in
the workplace generally is associated with positive
outcomes such as greater organizational commitment
and job satisfaction, higher performance, less stress,
more effective coping, better relationships with
coworkers, and greater career success.
However, the positive effects of coming out in
education and at work are attenuated by the degree of
discrimination and stigma present in one’s immediate
environment, necessitating careful identity
management and disclosure decisions for many
LGBTQ leaders in unsupportive environments.

Moreover, there are widely publicized cautionary
stories of the tragic effects of antigay prejudice on
LGBTQ leaders in contemporary life—the 2006
suicide of Denise Denton, an “out” lesbian and then-
chancellor of the University of California Santa
Cruz, is a case in point. The Denton case also
implicates sexism as a contributing factor, suggesting
the critical importance of considering
intersectionality in identities—that is, the ways in
which other marginalized statuses based on gender,
race, ethnicity, disability, and the like intersect with
sexual-minority status. For LGBTQ leaders, the most
salient of these intersectional identities is gender.
Gender in LGBTQ Leadership
Gender consideration refers not only to biological
gender, but also to chosen and expressed gender—
the attitudes, roles, behavior, and presentation of
oneself in relation to the social category of gender. It
is important to LGBTQ leadership because the
frequent and erroneous confounding of gender and
sexual orientation that occurs in society (i.e., the
assumption that same-sex desire indicates wanting to
be the other sex, or the belief that gender-
nonconforming behavior signals homosexuality)
renders sexual orientation profoundly gendered, and
gender expression profoundly sexualized. Thus,
LGBTQ leaders cannot be discussed without
reference to their gender and gender presentation,
and the effect of gender is intensified by the fact that
this status indicator is the only one related to sexual-
minority status actually seen by others (compared to
the invisibility of sexual desire and intimate partner
preferences)—so inferences about sexual orientation
will be made on this basis alone.
Fortunately, there is a substantial scholarly
literature on gender and leadership that offers
direction for considering gender in LGBTQ
leadership enactment. It is a well-known fact that
women remain severely underrepresented in
management and leadership roles in contemporary
workplaces, and are subject to a wide range of
discriminatory forces in hiring, evaluation,
compensation, and advancement. Research
consistently implicates gender roles and gender
expectations in the seemingly intractable glass
ceiling, as they exert significant and negative
Leadership 2005
influence on every phase of women’s leadership
development: from getting recruited or hired in the
first place, to obtaining the kinds of on-the-job
experiences and opportunities that allow the building
of important skills, to being mentored and integrated
into professional networks, to receiving fair salaries
and performance evaluations, to being considered for
and offered advancement opportunities, to receiving
support in leadership roles by one’s colleagues and
superiors. Gender role expectations are the reason
that both women and men are seen as more effective
when they function in leadership situations viewed as
congruent or congenial for their gender (e.g., a
woman leading an educational organization
consisting mostly of women or a male leading a
business group composed primarily of men).
However, the acceptable ranges of leadership
situations and behaviors are far more tightly
circumscribed for women than men, and women’s
success depends upon their ability to navigate a very
narrow band of behaviors—not so masculine as to
challenge their credibility as women, but not so
feminine as to compromise their credibility as
leaders. An angry professional woman, for example,
is viewed by others more negatively than an angry
professional man, and her emotions are presumed to
be due to internal factors, whereas a man’s emotions
are attributed to external factors. Evaluations of
leadership in managerial situations generally result in
lower ratings of key leadership skills for women than
men, even when women’s actual performance
exceeds men’s, and in self-ratings, men tend to rate
themselves as higher in effectiveness than women
rate themselves.
Given the oft-conflated notions of gender and
sexual orientation, it might be expected that gender
role expectations and gender stereotypes figure
importantly in LGBTQ lives—and in fact, they do. In
a stigmatizing culture, sexual minorities’ acceptance
by others depends heavily on the extent to which
they camouflage (i.e., don’t “flaunt”) their
transgression of societal norms. Those who seem
more similar (in looks and behavior) to their
heterosexual peers are likely to garner less negative
attention than those who deviate more obviously
from proscribed roles, such as in one study in which
gay men behaving in ways perceived as feminine and
lesbians behaving in masculine ways elicited more
2006 Leadership
negative judgments from others than did more
gender-conforming gay and lesbian individuals. For
LGBTQ leaders, such stereotypes profoundly
complicate the ways in which they are perceived by
others based on their own status and self-
presentation.
Because gender stereotypes render the default
image of a “leader” as male, a woman who leads is
viewed as a “woman leader,” with her gender clearly
signified. Applying these gender stereotypes to
sexual-minority leadership, the default image of
“leader” also presumably is heterosexual and living
in the gender to which he was born, while a sexual-
minority leader might be a “gay leader,” “lesbian
leader,” or “transgender leader,” with aspects of the
person’s gender and sexual transgression also
signified clearly. For a gay male leader who is not
out, he is likely to be assumed heterosexual, and his
leadership probably will be judged with all of the
benefits accorded him by his male status. However,
if he is out, then his status as a gay leader will
highlight his sexual orientation (with all of the
attendant heterosexist and antigay attitudes of
others), and judgment of his leadership is likely to be
confounded further by his gender presentation—is he
masculine enough to be a credible male and therefore
a credible leader, or will the epithet “He’s so gay” be
in the minds of others and compromise perceptions
of his maleness, and therefore his leadership?
For a lesbian leader, whether out or not, the
disadvantages of default assumptions come into play
immediately based on her gender, and if she is out,
the double bind she faces is obvious—as a lesbian,
she is not viewed as a “real” woman (and thus might
transcend some of the leadership disadvantages of
her female status), but as a woman, she is not a “real”
leader (and thus subject to all of the prejudices
against women in leadership positions). Her gender
presentation further complicates the situation: If she
displays a traditionally feminine appearance and
behaviors, she highlights her marginalized status as a
woman, but if she is more masculine (or even
gender-neutral) in appearance and behaviors, she
emphasizes her gender transgression and
marginalized sexual-minority status (and others may
assume she is a lesbian even if she is not out). In any
of these instances, her leadership is potentially
compromised, and it becomes extraordinarily
difficult to sort out and address sources of bias and
marginalization based on the intersections of her
identities. When other intersectionalities of identity
due to race, ethnicity, disability status, and the like
are integrated, one can easily see how sexual-
minority leadership complexity becomes exponential.
For transgender leaders who choose a
binarygendered identity as clearly male or female,
the default assumptions regarding gender and
leadership likely will prevail, captured dramatically
in the experience of Stanford biologist Ben Barres,
whose scientific work rose in prestige after he
transitioned from female to male in the 1990s.
However, if transgender leaders choose
selfidentifications/presentations that are less
traditionally demarcated by gender and more
ambiguous to others, their gender-minority status is
highlighted— opening themselves to some of
(arguably) the most virulent prejudice operating in
contemporary society. Moreover, it is impossible to
overcome or discount years of socialization into a
particular gender, so regardless of the current self-
identifications of transgender leaders, their styles and
behaviors likely are marked by the gender that
constituted their formative years, rendering their
leadership highly unpredictable to followers. If they
grew up male, for instance, with all of the attendant
male privilege, but identify currently as female, their
deeply unconscious presumption of their own power
and privilege likely will assert itself at some point in
their leadership, often to the shock of those around
them. Moreover, given societal beliefs in the
immutability of gender, followers’ awareness of the
leader’s transgender status likely will result in
vigilant anticipation of the leader’s “real” gender
asserting itself, regardless of what the leader actually
says or does—thus highlighting the importance of
others’ expectations in the enactment of leadership.
Group Composition in LGBTQ Leadership
As the foregoing discussion suggests, LGBTQ
leadership cannot be understood without reference to
others involved in the process—not just because
researchers have found the situation to be a
significant aspect of the leadership process more
generally, but also because of issues that LGBTQ
leaders face uniquely: stigma and marginalization in

the environment and internalized into the self,
pervasive stereotypes about sexual orientation and
gender, and the need for constant negotiation of
identity disclosure. Leaders and followers each bring
to the leadership process their own personal core
identities, ideas and beliefs, worldviews, values and
goals, prior experiences, skills and capacities, needs
and desires, and even assumptions about what
“good” leadership looks like. No two followers will
be having the same experience of a leader at any
given time, and no leader will have exactly the same
experience with two or more followers.
There are myriad aspects of situational influences
on leadership enactment studied by researchers, but
one that is particularly relevant to LGBTQ leaders is
that of group composition, or more specifically,
whether a group is—or is not—an identity-focused
group and whether it consists primarily of LGBTQ
members. Research suggests that many LGBTQ
leaders have early experiences leading LGBTQ
advocacy groups or other similar political and social
identity–focused organizations. They probably
experience a fair amount of congruence with
followers in goals, values, approaches, respect for
identity authenticity and transparency, and the
experience of shared stigma. As leadership research
indicates that followers’ willingness to follow a
leader is based largely on the extent to which the
leader reflects their identities and values, the
congruence or congeniality of the fit between leader
and followers in homogeneous groups (i.e., mostly
LGBTQ members) probably facilitates the leadership
process significantly.
On the other hand, in heterogeneous, or
mixedmember groups (largely or mostly heterosexual
members), the situation for LGBTQ leaders may be
less predictable. The expectations of the leader by
members may be strongly influenced by conscious or
unconscious sexual prejudice, which research has
shown to be linked to maleness, conservative
religious views, authoritarian or dogmatic attitudes,
lack of contact with (known) LGBTQ people, and
belief that sexual-minority status is a chosen
attribute. In addition, because sexual orientation is a
concealable stigma (and anyone could be LGBTQ),
some people may feel especially threatened, asserting
and exaggerating their heterosexuality publicly to
prove their belonging to the dominant group.
Leadership 2007
Whether the LGBTQ leader is out or not, the
heterosexism and sexual prejudice of others likely
will exert influence, forcing adherence to a careful
line of identity management, with different kinds of
groups evoking different kinds of identity responses.
For example, a sexual-minority leader in a military or
paramilitary (e.g., police) group may conceal identity
initially for fear of being forced out, but as leadership
success and reputation grow and confidence rises,
that same leader may begin to selfdisclose identity in
the safest sectors of the organization, gradually
extending self-disclosure as positive (or at least
nonnegative) reactions ensue.
A sexual-minority leader who has learned
leadership in congenial group situations may be
unprepared for the challenges of leading more
heterogeneous groups. Moreover, leadership in
identity-focused groups may include expectations
regarding personal identity openness that are
irrelevant at best, or unwelcome at worst, in
organizations that are not identity-based. For
example, in a business organization with no overt
focus on social justice strategies or ideologies,
followers may find proclamations of sexual-minority
status by the leader unnecessary and annoying,
unless delivered in the context of a relevant
organizational event (e.g., bringing one’s partner to
the company picnic). In addition, even if an LGBTQ
leader has been hired specifically to work to broaden
the diversity goals of an organization, it is wise to
ascertain exactly what meanings, expectations, and
readiness the members of the organization attach to
that task before implementing change—particularly
regarding the use of one’s own identity in the change
process.
In sum, the process of leading by LGBTQ
individuals is likely to be influenced strongly by a
context of pervasive societal heterosexism and
stigma that filter down into education and work
environments; by the leader’s own sexual orientation
and gender identity—and the presentation and
disclosure of those identities; and characteristics of
the followers and the groups being led. How these
factors intersect is merely speculative at present,
because little scholarship has tackled the
complexities of LGBTQ leadership to date, and
clearly such study is much needed.
2008 Leadership

The Future of LGBTQ Leadership experiences. Psychology of Sexual Orientation and

LGBTQ leadership is ripe for study. Among the
many research questions that future scholarship can
and should explore are the following:
1. Under what circumstances does the sexualminority
status of an LGBTQ leader matter? What conditions
support or detract from a leader’s self-identification
as LGBTQ?
2. How do marginalization and stigma affectLGBTQ
leadership? How does LGBTQ leaders’ handling of
their identities affect leadership outcomes?
3. Does good LGBTQ leadership differ from
poorLGBTQ leadership, and is it related to the
leader’s identity?
4. What does LGBTQ leadership have to contributeto
the larger scholarship about leadership and
followership? Is there something unique that
LGBTQ people bring to leadership?
5. How can LGBTQ leaders learn and be mentored,
especially in circumstances of concealed identities?
6. How can supportive, affirmative environmentsbe
built for LGBTQ individuals to develop their
leadership capacities, move into positions of
leadership, and lead successfully across all kinds of
groups?
Gender Diversity, 1(2), 159–169.
Browne, J. (2014). The glass closet: Why coming out is good
for business. New York, NY: HarperCollins. Chin, J. L., Lott,
B., Rice, J. K., & Sanchez-Hucles, J. (Eds.). (2007). Women
and leadership: Transforming visions and diverse voices.
Oxford, England: Blackwell.
Davies, P. G., Spencer, S. J., & Steele, C. M. (2005).
Clearing the air: Identity safety moderates the effects of
stereotype threat on women’s leadership aspirations.
Journal of Personality and Social Psychology, 88(2),
276–287.
Eagly, A. H., & Carli, L. L. (2007). Through the labyrinth:
The truth about how women become leaders. Boston,
MA: Harvard Business School Press.
Fassinger, R. E. (2008). Workplace diversity and public
policy. American Psychologist, 63(4), 252–268.
Fassinger, R. E., & Arseneau, J. R. (2007). “I’d rather get wet
than be under that umbrella”: Differentiating among
lesbian, gay, bisexual, and transgender people. In K. J.
Bieschke, R. M. Perez, & K. DeBord (Eds.), Handbook of
counseling and psychotherapy with

Ruth E. Fassinger
See also Career Development and Trajectories; Education;
Employment Non-Discrimination Act (ENDA); Work
Environments; Workplace Discrimination; Workplace
Policies

Further Readings
Badgett, M. V. L., Lau, H., Sears, B., & Ho, D. (2007).
Bias in the workplace: Consistent evidence of sexual
orientation and gender identity discrimination. Los
Angeles, CA: Williams Institute.
Bieschke, K. J., Hardy, J. A., Fassinger, R. E., & Croteau, J.
M. (2008). Intersecting identities of gendertransgressive
sexual minorities. In W. B. Walsh (Ed.), Biennial review
of counseling psychology (Vol. 1, pp. 177–207). New
York, NY: Routledge/Taylor & Francis.
Brewster, M. E., Velez, B. L., Mennicke, A., & Tebbe, E.
(2014). Voices from beyond: A thematic content
analysis of transgender employees’ workplace

Leather Culture
lesbian, gay, bisexual, and transgender clients (2nd ed., pp.
19–50). Washington, DC: American Psychological
Association.
Fassinger, R. E., Shullman, S. L., & Stevenson, M. R. (2010).
Toward an affirmative lesbian, gay, bisexual, and
transgender leadership paradigm. American Psychologist,
65(3), 201–215.
Herek, G. M., Gillis, R., & Cogan, J. C. (2009).
Internalized stigma among sexual minority adults:
Insights from a social psychological perspective. Journal of
Counseling Psychology, 56(1), 32–43.
Judge, T. A. (2009). Core self-evaluations and work success.
Current Directions in Psychological Science, 18(1), 58–
62.
Madera, J. M., King, E. B., & Hebl, M. R. (2012). Bringing
social identity to work: The influence of manifestation
and suppression on perceived discrimination, job
satisfaction, and turnover intentions. Cultural Diversity
and Ethnic Minority Psychology, 18(2), 165–170.
Meyer, I. H. (2003). Prejudice, social stress, and mental health in
lesbian, gay, and bisexual populations: Conceptual issues and
research evidence. Psychological Bulletin, 129, 674–697.
Mohr, J. J., & Fassinger, R. E. (2013). Work, career, and sexual
orientation. In C. J. Patterson & A. R. D’Augelli (Eds.),
Handbook of psychology and sexual orientation (pp. 151–
164). New York, NY: Oxford University Press.
Ragins, B. R., Singh, R., & Cornwell, J. M. (2007). Making the
invisible visible: Fear and disclosure of sexual orientation at
work. Journal of Applied Psychology, 92, 1103–1118.
Renn, K. A. (2008). LGBT student leaders and queer
activists: Identities of lesbian, gay, bisexual,
transgender, and queer identified college student
leaders and activists. Journal of College Student
Development, 48(3), 311–330.
Velez, B. L., Moradi, B., & Brewster, M. E. (2013). Testing the
tenets of minority stress theory in workplace contexts.
Journal of Counseling Psychology, 60, 532–542.
LEATHER CULTURE
The leathermen community is a group of men within
greater gay culture who display a hypermasculine
gender expression and engage in scripted sexual roles
and practices. Their presence within the sexual-
minority communities has played an important role in
expanding the images of gay masculinity and sexuality.
In addition, their capacity to create and maintain a
2009
community of the 1960s to the present day
demonstrates the powerful effects of social organizing
and visibility. This entry provides a brief history of the
leathermen community; an understanding of how
leathermen define their identity, gender and sexuality,
and a consideration of women and others who have
adopted leather culture; and an overview of
controversies that have arisen through its history.
A Brief History of the Leathermen
The gay community is often reduced to a homogeneous
group defined by their same-sex sexual orientation;
however, within this community there are multiple
movements, cultures, subcultures, and identities. The
leathermen movement was initiated by a group of gay
men who aimed to challenge mainstream
representations of gay men in the early to mid-1950s.
Gay men had been stereotyped in popular media as
effeminate and weak, treated as the subject of humor,
and were subjected to heterosexist hostility. In
response, a new gay masculinity was shaped through
donning leather attire and adopting a hypermasculine
gender expression with scripted sexual roles and
practices. By implementing techniques from the 1980s
civil rights and 1990s human potential movements, the
leathermen structured and organized a community,
creating a culture of their own.
Leathermen were, and continue to be, identified by
their leather apparel and sadomasochistic (S/M) sexual
practices. Their distinct form of dress gained the group
visibility within the gay community, featuring boots, t-
shirts, biker jackets, heavy belts, and Harley caps. Their
aesthetic was formed against the backdrop of
proliferating heterosexual biker clubs. These
establishments were frequented by heterosexual
military and working-class men. Given the context, the
leathermen, who also originated from a working-class
background, began to tap into these empowering
constructions of masculinity.
Leather bars at the time opened in major cities like
New York, Los Angeles, Chicago, and San Francisco.
By 1962, Folsom Street in San Francisco had opened
multiple leather bars creating what could be considered
“leather square,” or as it was nicknamed at the time, the
“Miracle Mile.” As the sixties came to a close, those
interested in S/M practices began creating their own
S/M spaces at home (i.e., dungeons). They bought gear
2010
and equipment that had become readily available by
this time through mail-order catalogues.
During the 1970s, recognition of the leather
community began to increase following the
development of interstate and international
organizations. Unfortunately, in the same decade, the
gay community suffered great stigmatization from
psychiatrists within the American Psychiatric
Association, who pointed to leathermen’s sexual
practices as justification for labeling homosexuality as
pathological and degenerative. Fortunately,
countermovements from within psychiatry were able to
oppose these ideas and in 1973, homosexuality was
removed from the Diagnostic and Statistical Manual of
Mental Disorders (DSM).
As the 1970s progressed, so did the S/M and
leathermen movement. The Eulenspiegel Society and
Society of Janus are two examples of mainly
heterosexual organizations that developed a political
agenda to move the community forward by creating
more S/M spaces. Even though these were mainly
composed of heterosexual men and women, the
organizations accepted gay members as well. In 1974,
the European Confederation of Motorcycle Clubs
(ECMC) was established to bring together the different
motorcycle, leather, uniform, and fetish communities
that were emerging throughout Europe. In the United
States, the era saw the birth of special invitation–only
parties, such as the Chicago Hellfire Club, which hosted
a special annual party called the Inferno; the Mineshaft
in New York City, in 1976, year-round nights of these
private gatherings; and the Catacombs (1975–1981), in
San Francisco, which was primarily a leather gay male
club that was also invitation only. Later on, the
Catacombs held a separate night for women, and had
mixed-sex and -sexual orientation parties. In 1978,
Samois, the
Leather Culture
first lesbian S/M organization, was created, but it was
disbanded in 1982.
By the 1980s, the leather community was fully
integrated into mainstream gay culture. Open and
sponsorship-free S/M groups for gays and lesbians were
created, such as Gay Male S/M Activists (GMSMA)
and the Lesbian Sex Mafia. The organizations formed a
space of communication and education via bimonthly
meetings for the leather community in New York City.
A year later, GMSMA helped further unify the leather
community by creating the Leather Pride Night
Committee, a coalition of New York City leather
organizations. Moreover, seats were reserved in the
steering committee of the 1987 March on Washington
for Gay and Lesbian Rights for both male and female
representatives of the leather community, which
signified their influence within the greater gay
community. By 1991, leathermen and leatherwomen
were included in gay pride marches around the country,
furthering their visibility.
Today, leathermen continue to have a strong
presence in gay pride parades both in the United States
and abroad. Folsom Street in San Francisco remains the
mecca of the S/M movement, and continues to host the
Folsom Street Fair, a major yearly event for the S/M
community. The fair was originally created in 1984
with the aims of fundraising, political activism, and
general entertainment for S/M aficionados. Currently,
the Folsom Street Fair continues to offer workshops and
demonstrations with the purpose of educating those
interested in S/M.
In 1997, the Folsom Street Fair propelled
GMSMA to create an East Coast equivalent, the Folsom
Street East—the largest S/M block party on the East
Coast. The year after, across the Atlantic, the “Berlin
Leder and Fetisch e.V.” (Berlin Leather and Fetish) was
established as a nonprofit organization to give a space,
build a community, and promote events focused on S/M
practices in Germany. Now called the BLF, the
organization holds a yearly event in the month of
March or April called Easter Berlin, which brings
people interested in S/M from all over Europe.
In 2003, Folsom Street Europe was also created in
Berlin with the goal to increase education about
Leather Culture
S/M practices and fund-raise for the European S/M
community. Currently, Europe continues to have a
flourishing leather community, with ECMC uniting
over 35 fetish groups across the continent, and through
the Leather History Foundation, which tracks, archives,
and promotes knowledge about contemporary and past
history of the leather movement throughout Europe.
Unfortunately, in the United States, GMSMA ceased its
operations in 2009 due to decreases in membership and
lack of leadership. The organization transitioned into a
nonprofit foundation with the role of providing support
to Folsom Street East and commenced an annual
Leather Pride Night and auction fund-raiser with the

goal to protect the rights of consenting adults who want
to practice S/M.
Identity, Sexuality, and Gender Expression
of Leathermen
Leathermen utilize leather gear and engage in S/M
practices, also termed leathersex, to accentuate their
hypermasculine identity and style. However, the usage
of leather is not primarily for bondage and pain, as with
those who practice S/M, but rather to mark their
masculinity. The leather community counters
stereotypes of a less masculine, genteel, mainstream
gay community by positioning itself as not only more
masculine than gay male stereotypes but also
surpassing heterosexual norms around masculinity.
Leathermen value tough and severe appearances,
utilizing vests, chaps, and cuffs made of leather to
accentuate muscular physiques. Leather garb and
equipment communicate belonging to the leather
community as well.
The leather community provides these men with a
sense of connection and camaraderie, resulting in
greater self-acceptance and positive self-concept. The
leathermen have criticized the gay community for
holding superficial and classist values in contrast to
their own working-class values that emphasize loyalty,
egalitarianism, nondiscrimination, and acceptance.
Therefore, the social and psychological perspective of
the leathermen may be considered one of pride in
connection to their gender, sexual orientation, and class.
Their community can be seen as an organized
bolstering of resilience in the face of multiple social
stigmas.
The leather community is symbolically represented
by flags that are composed of black, blue, and white
stripes with a heart in the upper-left quadrant. These
flags are used to mark leather spaces, and in gay pride
events they are used to announce the presence of
leathermen. Another form of symbolic communication
developed within the leather community is the “hanky
code.” Leathermen place handkerchiefs or bandanas in
their back pockets to signal preferred sexual roles;
pocket placements signify top, bottom, or versatile
positions, and specific colors indicate desired sexual
practices.
The sexual practices of leathermen can be viewed as
intriguingly complex and highly structured. For
instance, different sexual rites imbue leather garb with
2011
emotional significance, and these sexual rituals further
mark the identity formation of leathermen. Within their
sexual lexicon, leathermen sometimes use the terms
Leather Daddy and Leather Boy as ways to mark power
differentials in relationships, a categorization style that
is similar to Master and Slave within the S/M
community. Age and physical appearance also play an
important role for leathermen; individuals who are more
sexually experienced, older, and physically larger tend
to take on more dominant roles within sexual
relationships.
It is important to note, however, that submission in
leathersex is not considered a lesser position, and
dominance is not viewed as a more desirable position.
Instead, submission is constructed as a sign of strength
and commitment, while dominance is viewed as
dependency on the submissive partner’s willingness. In
addition, care and nurturance are attributes associated
with the dominant partner; however, the relationship
style of leathermen is one marked by a mutual exchange
of nurturance. Key to their sexuality is trusting and
transparent communication about sexual desires,
decisions, and consensus about participation in S/M.
This communication style results in a deeper
attunement between sexual partners.
Ultimately, the leathermen, through their sexual and
social rites, have come to reinterpret submission,
vulnerability, and nurturance, values traditionally seen
as unmasculine, and have integrated them into a
hypermasculinity identity.
Controversies Related to Leathermen
Many different interpretations have been put forward to
understand the role of masculinity in the leather
community. The leathermen’s form of masculinity has
been viewed as a self-protective reaction to the
feminized gay man, as an internalization of sexism that
drives heterosexism, and as a challenge to heterosexual
masculinity. However, within the leathermen
community some members have critiqued their
contemporary S/M practices, suggesting that leathersex
has departed from its emphasis on power differentials
based upon the original Old Guard codes—viewed by
some as the emasculation of S/M. These codes
established rules around the treatment of the slave by
the master. Whereas originally it was expected for a
slave to provide pleasure to his master, today the master
is seen as responsible for the pleasure of his slave. This
2012
trend was partly propelled by trends of the human
potential movement of the 1990s that viewed S/M as a
self-realization practice. These changes also reduced
psychiatric stigma and attempted to address feminist
critiques regarding the problematic nature of power
differentials.
In addition, radical feminists criticized the S/M
culture, and by association leathermen, claiming that
internalized patriarchal forces are present throughout all
practices of domination and submission. Feminists held
that S/M perpetuated patriarchy by endorsing the
economic, psychological, and sexual abuse of women.
They charged that the abuse present in lesbian S/M
practice was evidence of patriarchy internalized from a
misogynist society that derived pleasure from
objectifying and harming women. The critique was
extended to gay leathermen who, due to internalized
patriarchy and heterosexism, derived pleasure from the
pain imposed on submissive men.
Leather Culture
Conclusion
The leathermen movement was formed in sharp contrast
to mainstream gay culture. Members developed a
complex understanding of masculinity, along with
elaborate relational, social, and sexual practices that
established a sense of sensuality, community, and pride
for gay men who endorsed historically working-class
values and gender presentations. The practices of
leathermen have not only expanded the boundaries of
gay aesthetics but also furthered our understanding of
gay masculinities. The leathermen movement has
demonstrated the powerful effect of social organizing in
increasing the visibility of marginalized identities and
in creating a sense of camaraderie and belonging across
differences within the gay community.
Francisco I. Surace and Heidi M. Levitt
See also Bondage, Dominance/Submission, Sadism/
Masochism (BDSM); Hypermasculinity; Kink;
Masculinities; Sexual Attraction, Behavior, and
Identity; Social Class; Social Class and Sexuality,
Intersections Between
Further Readings
Deckha, M. (2011). Pain as culture: A postcolonial feminist
approach to S/M and women’s agency.
Sexualities, 14, 129–150.
Harris, D. (1997). Metamorphosis of the modern dungeon.
Harvard Gay & Lesbian Review, 4, 29. Hopkins, P. D.
(1994). Rethinking sadomasochism: Feminism,
interpretation, and simulation. Hypatia, 9(1), 116–141.
Mosher, C. M., Levitt, H. M., & Manley, E. (2006). Layers
of leather: The identity formation of leathermen as a
process of transforming meanings of masculinity.
Journal of Homosexuality, 51, 93–123.
Rubin, G. (2004). The Catacombs: A temple of the butthole. In
M. Thompson (Ed.), Leatherfolk: Radical sex, people,
politics, and practice (pp. 119–140). Los Angeles, CA:
Daedalus.
Smith, T., & Bale, C. (2012). Guide for the modern bear. Port
Townsend, WA: Pixelita Press.
Legal Consciousness
LEGAL CONSCIOUSNESS
Legal consciousness is a term used in sociolegal studies
to consider the role that law plays in everyday life. It is
different from legal awareness, which refers to
individuals thinking about the place of law in their
lives. Legal consciousness, by contrast, often involves
individuals engaging with law in the everyday without
necessarily reflecting upon law. Legal consciousness
scholars are interested not only in how law shapes
people’s lives, but also how people interact with law,
how they engage with law, and how the social world
shapes law as much as law shapes the social world.
They are also interested in who is privileged, and who
is marginalized by law.
Legal consciousness scholars describe three ways in
which individuals engage with law: before the law, with
the law, and against the law. In before the law,
individuals face a detached, expertdriven system of
rights, rules, and processes. In standing before the law,
individuals may hope for justice, but it is out of their
control, with power lying not in their own hands but in
the hands of law itself. By contrast, with the law
involves seeing law as a game, something to be played,
manipulated, and strategically deployed, as in
courtroom tactics, for example. In against the law,
rather than being seen as something to be engaged with,
law is seen as something to be resisted, something
risky, something that is beyond the reach of certain
marginalized groups or individuals and that is to be
avoided/subverted. These three types of engagement are
 2013
not mutually exclusive and can overlap in individuals’ housing, and health and social care provision
understanding and mobilization of law in their lives. (especially in older age). Knauer has also highlighted
Legal consciousness has been applied to such areas as the differences in state and federal recognition in the
employment contexts, workplace rights, and sexual United States. Historically, samegender couples
harassment in the workplace; transcultural comparison recognized as married in one state could become legal
in everyday constructions of law; street harassment; strangers when in others. A nonbiological parent of a
prison dynamics; citizenship participation, including child in a same-gender
illegal citizens; and marginalized family formations and
recognition. It has only been applied in a limited way so
far to LGBTQ issues, in relation to lesbian and gay
families, partnership and parenthood recognition, and
U.S. civil rights.
Rosie Harding, writing in the UK, has suggested that
lesbians and gay men engage with all
three forms of legal consciousness in relation to debates
about recognition. They mobilize “before the law”
discourse in relation to notions of equality, human
rights, and citizenship to articulate how their
relationships should be recognized in law. They also
recognize the inequalities and injustices of uneven
recognition in law, compared with heterosexual
individuals, mobilizing “with the law” legal
consciousness in discourse about tactics and strategies
to change law. The most dominant form of legal
consciousness discourse found by Harding related to
resistance in relation to lesbian and gay sexualities
being regarded as lesser or deviant, different methods
of relationship recognition for lesbians and gay men
and heterosexual individuals, and unequal treatment in
law of lesbians and gay men as individuals. Harding
proposed that this activist, equality-seeking resistance
constituted a form of legal consciousness insufficiently
encompassed by the three standard categories. She
argued that lesbian and gay activism involved
resistance that was not, as would usually be the case,
“against the law” (i.e., defying law) nor even “with the
law” (i.e., cynically playing the “game” of law).
Lesbian and gay activism, Harding proposed, is
positioned “before the law,” in that it appeals for
inclusive citizenship on the basis of entitlement within
existing legal structures, such as human rights, equality,
parity with heterosexual individuals, and so on.
Nancy Knauer, writing in the United States, has
observed the many ways in which LGBTQ individuals
are marginalized in law. Lesbians and gay men face
challenges in relationship and parenting recognition,
adoption rights, access to health and social care, estate
management, housing, and immigration status. They
experience discrimination in education, employment,
2014
couple, recognized as a parent in one state, is not
necessarily recognized as that child’s parent in another.
Transgender individuals also face discrimination in
education, employment, housing, and health and social
care provision. All LGBTQ individuals are at risk of
physical and mental health problems associated with
minority stress. Transgender individuals are at
heightened risk of major depression, selfharm, and
attempts to end their lives. Transsexual individuals—
that is, those who are transitioning/ have transitioned to
a gender not assigned at birth—have variable access to
treatment and support and also experience variable legal
recognition of their revised gender status, again
differentiated at state and federal levels in the United
States. These variable recognitions complicate the
practicalities of everyday living in legal contexts, and
also how they are approached and engaged with by
transgender individuals.
Legal consciousness has been criticized in four main
ways: by those who question the relevance or
appropriateness of studying law in everyday life; by
those who interrogate the use of the term consciousness
because often unconscious or semiconscious processes
are involved; by those who object to the way it
individualizes issues that belong in collective,
sociopolitical structural arenas; and lastly, by those who
argue that it is overly descriptive, rather than
explanatory. Other scholars have defended the
approach, arguing that it can offer a nuanced analysis of
how law plays out in individuals’ lives, at the
intersection of social divisions. They also assert that
legal consciousness studies highlight how law is
differently experienced by individuals—especially
marginalized individuals—according to context and
social location, and how law is implicated in both
power and resistance. Given their ongoing social
exclusion and marginalization, in both formal and
informal law, further research using a legal
consciousness approach could offer illuminating
Legal Recognition of Nonmarital Same-Sex Relationships
insights into how this is understood, experienced, and
engaged with by LGBTQ individuals.
Sue Westwood
See also Discrimination Against LGBTQ Elders;
Discrimination Against LGBTQ People by Law
Enforcement; Discrimination Against LGBTQ People in the
Public Sector; Heteronormativity; Heterosexism; Laws
Banning Homosexuality and Sodomy; Policing
Masculinities and Femininities; Psychological
Approaches to Studying LGBTQ People
Further Readings
Ewick, P., & Silbey, S. (1998). The common place of law:
Stories from everyday life. Chicago, IL: University of
Chicago Press.
Harding, R. (2011). Regulating sexuality: Legal
consciousness in lesbian and gay lives. Abingdon,
England: Routledge.
Knauer, N. J. (2012). Legal consciousness and LGBT
research: The role of the law in the everyday lives of
LGBT individuals. Journal of Homosexuality, 59(5), 748–
756.
Richman, K. D. (2006). LGBT family rights, legal
consciousness, and the dilemma of difference. In B.
Fleury-Steiner & L. B. Nielsen (Eds.), The new civil rights
research: A constitutive approach (pp. 77–99). Aldershot,
England: Ashgate.
LEGAL RECOGNITION OF NONMARITAL
SAME-SEX RELATIONSHIPS
The demand for legal recognition of same-sex
relationships in the United States began as a natural
extension of the broader goals of equality and
individual freedom espoused by the LGBTQ rights
movement. Starting in the late 1970s, the earliest efforts
to secure recognition focused primarily on employee
benefits, specifically employer-provided health
insurance. Framing the issue as a question of “equal pay
for equal work,” employees lobbied their employers to
extend spousal benefits to their same-sex partners in the
form of “domestic partner” benefits. The first wave of
the HIV/AIDS epidemic in the mid1980s highlighted
the
importance
of legal recognition. Same-sex partners were refused
hospital visitation rights, disregarded in medical
decision making, evicted from apartments, and denied
the property rights typically extended to surviving
spouses or family members. Under the law, samesex
partners were considered legal strangers, regardless of
the length or quality of their relationship.
Since the 1980s, the law has developed a number of
mechanisms on both the state and local levels that
 Legal Recognition of Nonmarital Same-Sex Relationships
address these inequities and provide various levels of
recognition, ranging from the limited grant of domestic
partner employee benefits to laws that extend all the
rights and obligations of marriage. These forms of
nonmmarital recognition have been called by different
names, including domestic partnerships, reciprocal
beneficiaries, and civil unions. With the advent of
marriage equality, nonmarital legal recognition has
declined in importance, and many jurisdictions
discontinued nonmarital recognition when they adopted
marriage equality. This practice reflects the widely held
view that nonmarital recognition was only a temporary
measure until same-sex couples could legally marry.
However, marriage is not a universally shared goal
within the LGBTQ community, and some same-sex
couples may prefer a legally recognized nonmarital
relationship over marriage.
This entry discusses the way that the law privileges
family members in terms of property rights and decision
making and how this preferential treatment led to the
demand for legal recognition of same-sex relationships.
It then outlines the various ways that the law has
recognized nonmarital same-sex relationships and
concludes with a discussion of the future of nonmarital
recognition in light of marriage equality.
The Law and Family Relationships
Despite many advances, the law continues to privilege
relationships defined by blood, marriage, and adoption.
Without relationship recognition, a same-sex partner is
considered a legal stranger who stands behind children,
parents, siblings, grandparents, aunts and uncles,
cousins, and even the state in terms of priority and legal
standing. The absence of a legally recognized
relationship can have significant bearing in cases of
relationship dissolution, employee benefits, parenting
decisions, second-parent adoption, inheritance, and
health care decision making. When same-sex couples
are considered legal strangers, they must rely on private
contracts; beneficiary designations; dependent
classifications; and, at times, the goodwill of family
members to secure recognition for their relationship.
Historically (i.e., prior to marriage equality in 2015),
surviving same-sex partners in jurisdictions that did not
recognize same-sex marriage have been especially
vulnerable because they were denied the property rights
and decision-making authority that inure automatically
to the benefit of a surviving spouse or next of kin,
2015
including the right to inherit under the rules of intestate
succession or standing to file a wrongful death action.
In these jurisdictions, courts generally upheld an
otherwise valid will that primarily benefited a samesex
partner, but the relatives of the deceased partner had
standing to challenge the will. Moreover, estate
planning documents have historically often been
insufficient to grant a same-sex partner all the rights
that automatically attach to family members, such as the
authority to make funeral and burial arrangements.
Lack of Uniformity in Nonmarital
Relationship Recognition
States and municipalities have been experimenting with
a variety of nonmarital forms of relationship
recognition since the early 1980s. These forms of
recognition have successfully secured important rights
for same-sex couples on the state and local level, but
they have also been the source of confusion and
additional stress for same-sex couples. The degree and
nature of the recognition have tended to vary by
jurisdiction. Depending on where the couple lived and
worked, they could be considered legal strangers,
spouses, or something in between. In addition,
nonmarital recognition was rarely portable, meaning
that same-sex couples could lose their status if they
ventured out of the jurisdiction. In 2004, both the
American Psychiatric Association and the American
Psychological Association came out in support of equal
marriage rights and specifically recognized the stress
caused by the lack of uniform relationship recognition.
Local Domestic Partnership Ordinances
The legal recognition of same-sex relationships first
began on the local or municipal level with the adoption
of domestic partnership ordinances. Although these
ordinances were a significant step forward in the
recognition of same-sex relationships, they were often
largely symbolic and granted few substantive rights
because they could only extend to same-sex couples the
rights that were within the power of the city
municipality to grant. The first ordinances focused on
employee benefits and offered domestic partner benefits
to city employees. They were later followed by more
comprehensive ordinances that established domestic
partnership registries; extended full spousal rights to
2016
domestic partners; and, in some instances, required city
contractors to provide domestic partner benefits.
The term domestic partnership was coined in 1979
by gay rights activist Tom Brougham. At the time,
Brougham worked for the City of Berkeley, California,
which had just passed an ordinance that outlawed
discrimination based on sexual orientation. Brougham
asked the city to extend spousal employee benefits to
his same-sex partner, whom he referred to as his
“domestic partner.” Although Berkeley did not approve
the request, Brougham’s idea gained momentum,
especially given the importance of employer-provided
health insurance. The first ordinance to recognize
samesex domestic partners was introduced in San
Legal Recognition of Nonmarital Same-Sex Relationships
Francisco in 1982. Private employers also began to
offer domestic partner benefits at approximately the
same time. Berkeley eventually became the first
municipality in the United States to extend domestic
partner benefits to its city employees in 1984. Its
domestic partner ordinance was gender-neutral and
applied to any unmarried partners who satisfied the
eligibility criteria.
In addition to extending domestic partner benefits,
municipalities created official domestic partnership
registries that provided couples an opportunity to
solemnize and record their relationships. The City of
West Hollywood, California, became the first
municipality to create a domestic partner registry in
1985. Some cities later expanded their recognition of
domestic partnerships by enacting broader ordinances
that granted domestic partners all of the rights and
obligations that were available to spouses within the
municipality. These rights were limited in scope, but
could include the right to visit a same-sex partner
incarcerated at a county prison; municipal spousal tax
benefits; and the ability to transfer certain municipal
licenses, such as a liquor license, to a same-sex partner.
In 1996, San Francisco became the first municipality to
pass an equal benefits ordinance that expanded the
domestic partner mandate by requiring all city
contractors to extend spousal employee benefits to the
domestic partners of their employees.
In order to determine who qualified as a domestic
partner, employers and municipalities developed a
multipart inquiry that attempts to identify and
disaggregate the features of a committed spousal-type
relationship. Standard eligibility requirements include a
statement of commitment and proof of financial
interdependence. In addition, domestic partners may be
required to satisfy minimum age requirements, pledge
exclusivity, and certify that they are not closely related
to each other. The definition of a domestic partner has
also influenced court decisions where same-sex couples
have asked for recognition on the grounds that the
couple was financially interdependent and functioned as
a family.
Statewide Recognition: Limited Rights
In advance of marriage equality, a number of states
adopted laws that extended limited rights to samesex
couples. The statutory schemes varied considerably in
terms of scope and went by different names, including
reciprocal
beneficiaries, domestic partnerships, and civil unions.
Some of the statutory schemes were restricted to same-
sex couples, whereas others were also open to different-
sex couples. Some of the statutes were based on the
municipal domestic partnership ordinances that had
created an alternative status to marriage, whereas other
statutes emphasized individual beneficiary
designations. All of the states that extended limited
recognition to same-sex couples later adopted full
marriage equality. Only a handful of states and the
District of Columbia continue to extend nonmarital
recognition.
In 1997, Hawai’i became the first state to provide
nonmarital relationship recognition for samesex couples
when its legislature enacted the Reciprocal
Beneficiaries Act in response to ongoing marriage
litigation that had begun years earlier.
In 1993, the Hawai’i Supreme Court ruled in Baehr v.
Lewin that prohibiting same-sex couples from marrying
constituted gender discrimination and violated the
Equal Rights Amendment to the state constitution. The
case was remanded to the trial court to determine
whether the prohibition against same-sex marriage was
justified by a compelling state interest. While the
litigation was pending, the state legislature created the
status of reciprocal beneficiary, which extended
approximately 60 rights and responsibilities commonly
associated with marriage to individuals who registered
as “reciprocal beneficiaries.” These rights included
wrongful death rights, the right to inherit through
intestate succession, and the right to make certain
health care decisions. The status of reciprocal
beneficiary was not limited to same-sex couples. Any
 Legal Recognition of Nonmarital Same-Sex Relationships
two single adults who were otherwise prohibited from
marrying were eligible to register, including a brother
and sister. Although the Reciprocal Beneficiaries Act
was not repealed when Hawai’i adopted marriage
equality in 2012, samesex couples are no longer eligible
to register as reciprocal beneficiaries unless they are
also disqualified from marriage, which would only
happen if they were closely related to each other.
In 2009, Colorado enacted similar legislation known
as the Designated Beneficiary Agreement Act that
grants limited rights to “designated beneficiaries.”
Although the Colorado status also focuses on
beneficiary designations, it is more flexible than the
“reciprocal beneficiary” status offered in Hawai’i. The
Colorado designation does not have to be reciprocal,
nor do the parties have to be prohibited from marrying.
Even though Colorado adopted civil unions and later
marriage equality, it has not repealed the Designated
Beneficiary Agreement Act, which continues as a form
of nonmarital legal recognition.
California was the first state to recognize samesex
domestic partners in 1999. The California legislature
later expanded the scope of the recognition to extend a
number of rights traditionally reserved for spouses to
“registered domestic partners,” including inheritance
rights, certain health care decision-making authority,
and standing to sue for wrongful death. Although other
states followed suit, the scope of the statewide
recognition varied widely. In 2004, Maine adopted a
statewide domestic partnership registry, but only
extended certain health care decision-making authority
and inheritance rights to domestic partners. Rhode
Island passed domestic partnership legislation in 2009,
but it only included the right to make funeral
arrangements. That same year, the Wisconsin
legislature passed domestic partner legislation that
granted same-sex couples 43 rights and protections,
including inheritance rights and health care decision-
making authority. All of these states now have marriage
equality. Only California and Maine continue to offer
domestic partnership recognition.
Statewide Recognition:
Marriage Equivalents
A number of states created a statutory status designed to
grant same-sex couples all of the rights and obligations
of marriage, but without the designation of marriage.
These states created the parallel status in order to
2017
extend equal rights to same-sex couples, while
maintaining marriage as a special status reserved for
different-sex couples. Some of these states, such as
Vermont and New Jersey, created the parallel status in
response to a decision of their state supreme court. All
of the states offering an equivalent status to marriage
eventually adopted full marriage equality in advance of
nationwide marriage equality as mandated by the 2015
U.S. Supreme Court case Obergefell v. Hodges. The
question remains as to what status the couples should
have who entered into the now-defunct relationships.
In 1999, the Vermont Supreme Court ruled in Baker
v. Vermont that same-sex couples were entitled to the
same rights and privileges afforded to married couples
under the Vermont state constitution. The decision
specifically suspended the issuance of marriage licenses
to same-sex couples until the state legislature could
attempt to remedy the situation. A year later, the
legislature enacted the parallel status of civil unions,
which granted same-sex couples all of the rights of
marriage and effectively avoided the recognition of
same-sex marriage in Vermont. Unlike what happened
in Hawai’i after the decision in Baehr v. Lewin, the
Vermont voters were not able to overturn the court
decision by amending the state constitution because
Vermont does not have a statewide referendum process.
In 2006, the Supreme Court of New Jersey held in
Lewis v. Harris that limiting access to the protections
and benefits of civil marriage to differentsex couples
violated the state constitution, but it did not require the
state to permit same-sex couples to marry. In response
to the decision, the New Jersey state legislature passed
the Civil Union Act, which created a parallel status
extending all of the rights and responsibilities of
marriage to same-sex couples. New Jersey had earlier
extended limited rights to same-sex partners and
different-sex partners over 62 years of age who
registered as
“domestic partners.”
The creation of a wholly equivalent parallel status to
marriage led to arguments that the dual status,
especially when restricted to same-sex couples, violated
the Equal Protection Clause of the Fourteenth
Amendment because it created a status that was
“separate, not equal.” In 2008, the Connecticut Supreme
Court ruled in Kerrigan & Mock v. Dept. of Public
Health that excluding same-sex couples from marriage
violated the Connecticut state constitution and ordered
the state to issue marriage licenses to same-sex couples.
2018
Case-by-Case Recognition sexual orientation. As a result, many of the jurisdictions
that had offered nonmarital recognition for same-sex
The courts have also recognized same-sex relationships
relationships discontinued their recognition of
in the absence of authorizing legislation in certain
nonmarital status upon the adoption of marriage
specific instances, such as protection from eviction
equality. A similar trend has been observed in the
under municipal rent control guidelines, and standing to
private sector where employers have been discontinuing
sue for wrongful death. These decisions are based on
domestic partnership benefits after same-sex marriage
the notion of a “functional” family or equitable
is recognized in their jurisdiction.
principles, not a declaration of equality for same-sex
This phase-out of nonmarital recognition assumes
couples. Although taken together, they represent a trend
that it was designed as a temporary measure, rather than
toward greater legal recognition for same-sex
an alternative to marriage. Accordingly, the
relationships, they have been decided on a case-by-case
jurisdictions where the nonmarital status was also
basis and rest on a variety of theories.
available to different-sex partners as an alternative to
For example, New York City rent control guidelines
marriage have been more likely to continue the
allowed a member of a decedent’s immediate family
nonmarital status after marriage equality. For example,
who shared the household to stay in a rentcontrolled
the District of Columbia has maintained its domestic
apartment, even where the surviving family member
partnership status for both same-sex and different-sex
was not a named party to the lease. The groundbreaking
couples, even though it began recognizing samesex
1989 case of Brashi v. Stahl Associates Co., extended
marriage in 2009.
this protection to a surviving same-sex partner through
For jurisdictions that had nonmarital recognition,
the adoption of a functional definition of family, with
marriage equality also raises the question of how to
an emphasis on mutual interdependence.
treat the couples who had entered into those legally
Some courts have used equitable principles to
recognized nonmarital relationships. For example,
recognize same-sex partners. In the 2001 case of
Vermont discontinued its civil union status when it
Vasquez v. Hawthorne, the Washington State Supreme
adopted marriage equality, but couples who have
Court upheld a claim by a surviving same-sex partner
entered into a civil union will remain in that
against his partner’s estate, even though they had not
relationship unless they dissolve it by court order or
formalized their relationship and the partner had not left
choose to get married. Illinois, on the other hand, kept
a valid will. Other courts have interpreted anti-
its civil union status for both same-sex and different-sex
discrimination laws to compel employers to provide
couples, but provided a streamlined process by which
domestic partner benefits and private business to offer
same-sex couples in civil unions could convert their
spousal rates to same-sex couples. For example, the
relationship to a
California Supreme Court ruled in the 2005 case of
marriage. Connecticut took yet another approach. When
Koebke v. Bernardo Heights Country Club that
it discontinued its civil union status, which had been
registered domestic partners were equivalent to married
restricted to same-sex couples, Connecticut
couples for purposes of discrimination laws applying to
automatically converted all civil unions to marriages.
private businesses.
Nancy J. Knauer
See also Defense of Marriage Act (DOMA); Domestic
Marriage Equality and the Future of
Partnership; Marriage, Reasons for and Against;
Nonmarital Recognition Marriage Equality, Landmark Court Decisions
The advent of marriage equality has placed the future of Further Readings
nonmarital forms of relationship recognition into Baehr v. Lewin, 852 P.2d 44, 53 (Haw. 1993).
question. The prominence of the marriage Baehr v. Miike, No. 91–1394, 1996 WL 694235, at *21
Legal Rights of Nonbiological Parents
(Haw. Cir. Ct. 1996), aff’d 950 P.2d 1234 (Haw. 1997).
Baker v. Vermont, 744 A.2d 864 (Vt. 1999).
equality movement has established marriage as the Brashi v. Stahl Associates Co., 74 N.Y.2d 201 (1989).
desired benchmark, and anything short of marriage may
be perceived as an example of inequality based on
 Legal Recognition of Nonmarital Same-Sex Relationships 2019
Chauncey, G. (2004). Why marriage? The history shaping
today’s debate over gay equality. New York, NY: Basic
Books.
Defense of Marriage Act, Pub. L. No. 104-199, 110 Stat.
2419 (1996).
Kerrigan & Mock v. Dept. of Public Health, 289 Conn. 135
(2008).
Knauer, N. (1998). Domestic partnership and same-sex
relationships: A marketplace innovation and a less than
perfect institutional choice. Temple Political & Civil Rights
Law Review, 7, 337–349.
Knauer, N. (2006). The recognition of same-sex relationships:
Comparative institutional analysis, contested social goals,
and strategic institutional choice. University of Hawai’i Law
Review, 28, 23–83.
Knauer, N. (2014). LGBT elders in a post-Windsor world:
The promise and limits of marriage equality. Texas Journal
of Women and the Law, 24(1). Available at
http://ssrn.com/abstract=2557402
Koebke v. Bernardo Heights Country Club, 31 Cal. Rptr.
3d 565 (2005).
Koppelman, A. (2002). The gay rights question in
contemporary American law. Chicago, IL: University of
Chicago Press.
Lewis v. Harris, 188 N.J. 415 (2006).
Obergefell v. Hodges, 135 S. Ct. 2584 (2015).
Polikoff, N. (2008). Beyond gay (and straight) marriage:
Valuing all families under the law. Boston, MA:
Beacon Press.
Vasquez v. Hawthorne, 33 P.3d 735 (Wash. 2001).

LEGAL RIGHTS OF NONBIOLOGICAL

PARENTS
The term nonbiological parent can be a confusing one.
It is not a term with a fixed legal meaning but rather a
generally descriptive term that is commonly used in
specific circumstances. This entry first considers the
usage of the term and then discusses its potential legal
importance.
2020
Taken literally, nonbiological parents could
describe a wide range of parents. Adoptive parents,
for instance, are nonbiological parents in that they do
not have a biological relationship with the children
they raise. Similarly, stepparents may fall within the
category of nonbiological parents. In practice,
however, the term nonbiological parent is usually
used much more narrowly. It is most commonly used
in the context of lesbian couples who create families
using donor sperm and assisted insemination. The
woman who does not give birth to the child is often
referred to as a nonbiological parent or, more
commonly, a nonbiological mother. By contrast, the
woman who gives birth to the child is described as a
biological parent or biological mother.
In some unusual circumstances, this terminology
may be difficult to apply. Some lesbian couples
conceive children through in vitro fertilization. One
lesbian partner contributes an egg, which is fertilized
in vitro and then transferred to the uterus of the other
partner. This means that one woman is genetically
related to the child and hence may be called a
“genetic mother,” while the other woman, who gives
birth to the child, may be called the “birth mother.”
Whether the genetic mother falls within the category
“biological mother” is unclear, as some people use
“biological mother” as a synonym for “birth mother.”
Generally, these fine distinctions are irrelevant. In
vitro fertilization is expensive and invasive, and it is
far more common for lesbian couples to use simple
insemination, which means that one member of the
lesbian couple will be both the birth mother and the
genetic mother and therefore clearly the biological
mother.
In this context, the term is important because the
nonbiological mother may not be recognized as a
legal parent, or her legal parental rights may be
subject to challenge. Historically, these challenges
have most often been raised by the biological mother
after an acrimonious separation. The superior legal
rights of the biological mother will often give her an
insurmountable advantage over the nonbiological
mother in any postseparation litigation over the child.
Generally, a woman who gives birth to a child is
recognized as a legal parent (a legal mother) of the
Legal Rights of Nonbiological Parents
child. (Some states do have special legal treatment
for surrogate mothers.) Thus, the legal parental rights
of biological mothers—including lesbian biological
mothers—are generally secure and wellrecognized.
Legal parents have significant rights (as well as
obligations) with regard to their children. These
include the right to make important decisions, such
as decisions about with whom a child spends time.
Legal parents can curtail contact between nonparents
and their children. Thus, the legal status of a
nonbiological mother is an important concern.
Unless the nonbiological mother has a claim to legal
parentage, her access to the child may be in jeopardy.
There are three main avenues by which a
nonbiological mother can claim legal status as a
parent. First, she can adopt the child to whom her
partner gave birth. This form of adoption is often
called a second-parent adoption and is discussed
elsewhere in this encyclopedia. Second-parent
adoptions are not available in all states, and in some
states they may only be available in certain counties.
However, once a second-parent adoption is
completed, it must be recognized by all other states.
The precise procedures required to complete a
second-parent adoption vary. A local lawyer must be
consulted.
For those lesbian couples who are married, a
nonbiological mother may attempt to invoke the
marital presumption. Historically, when a married
woman gave birth, her husband was presumed to be a
legal parent. While the presumption has changed
over time and now varies widely from state to state,
it is still often true that if a husband wishes to assert
his parental rights over a child born to his wife, he
will be able to do so. Some states permit the wife to
defeat his claim with evidence that he is not
genetically related to the child, but others do not and
will afford the husband parental rights, even if he
cannot demonstrate a genetic connection to the child.
Before 2004, this presumption could not benefit
nonbiological lesbian mothers, because the
presumption is founded on marriage, and only
marriages between a man and a woman were granted
legal recognition. The legal landscape has changed
dramatically with regard to marriage, but in many
states the parental status of married nonbiological
Leisure
legal mothers remains uncertain. In particular, it is
possible that states that are hostile to same-sex
relationships and recognize marriage only because
they are required to do so by court order will refuse
to extend the marital presumption to samesex

couples. Even in states where a nonbiological mother
is permitted to invoke the marital presumption, a
court might permit the biological mother to rebut the
presumption with evidence that the nonbiological
mother is not genetically related to the child—and
this evidence will generally be available.
There are, of course, a number of states that will
recognize parental status of the nonbiological mother
by virtue of the marital presumption. However, while
this might mean her status is secure as long as all
parties remain in the hospitable state, other more
hostile states may not be obliged to recognize her
status. Thus, a nonbiological mother could lose
parental recognition if the family relocated to a
hostile state.
A final avenue by which a nonbiological mother
may gain legal recognition is through some version
of de facto parenthood. In some states, a person who
acts as a parent for a sufficient period of time may
gain legal recognition of her or his relationship with
the child. The circumstances under which recognition
will be granted vary from state to state as does the
extent of recognition. Some states will recognize a de
facto parent as a full legal parent, while others will
only recognize more limited rights. Because local
law varies greatly, a lawyer should be consulted as to
the relevant details in any given place. Also, as with
the marital presumption, this recognition may not be
respected by other states. Thus, adoption remains the
most certain way of securing the rights of a
nonbiological parent.
Julie Shapiro
See also Custody and Litigation, LGBQ Parents;
Parent–Child Relationships; Second-Parent Adoption
Further Readings
Joslin, C. G., Minter, S. P., & Sakimura, C. (2014).
Lesbian, gay, bisexual and transgender family law. Eagen,
MN: Thomson Reuters.
LEISURE
Leisure for lesbian, gay, bisexual, and transgender
(LGBT) people can be understood in terms of gay
commercial spaces. These spaces have long offered
respite from heterosexual worlds, and for some they
2021
still do. However, studies of leisure are increasingly
recognizing that we need to take into account
mundane/boring leisure activities that LGBT people
partake in, and also recognize that not all
heterosexual space is hostile.
Leisure is a broad subject area and has many
different definitions. For the purposes of this entry,
leisure is defined as activities and spaces outside of
paid employment. This is problematic when we think
about gay people’s leisure, because for some, being
paid to work in gay/queer/LGBT spaces might also
be leisure. Nonetheless, it enables an examination of
key leisure sites and changes in leisure practices and
scholarly analyses.
Leisure for LGBT people has been a key topic for
academic debate and discussion for over 40 years.
This is because in the late 20th century, leisure
spaces were seen as sites of safety, community,
political power, and identity formation. It was in
(mainly gay) leisure spaces that many gay men and
lesbians created opportunities to socialize and create
their sexual and gender identities. This occurred
because these spaces and the practices that made
them were, and are, sheltered from the hostile,
heterosexual, and unaccepting “outside” world.
This entry begins by exploring these spaces and
their exclusions. It then examines the space of the
home, before examining how the normalization of
heterosexuality and the dangers of straight space
played a part in forming gay leisure spaces and how
these sites can also be reworked. The final section
examines the ways that studies of leisure activities
and contexts where there are increasing rights for
LGBT people have changed the ways scholars
approach LGBT leisure.
Gay Leisure Spaces
Gay territories are places that are usually visibly
recognizable as gay. They can also be called gay
ghettos. These sites of economic and political power
in places like San Francisco and New York were
seen as exemplary of tolerant and then cosmopolitan
“queer” urbanities, because of their large gay scenes.
Reading gay scenes as, in part, sites of leisure means
that a significant proportion of the literature on these
spaces is focused on leisure for LGBT people,
although this term is rarely used. Yet leisure is core
to understanding LGBT lives and the development of
gay politics. The term gay is used here deliberately,
2022
as these politics and spaces are focused
predominantly on gay men.
Because of the place of leisure in the construction
of contemporary postindustrial identities and
landscapes, the growing visibility of lesbian and gay
lives and landscapes has been celebrated in relation
to the economic benefits of the “creative classes”
(e.g., artists/actors). The “pink pound,” as it is called
in the UK, or the “gay dollar” (that is, the
presumption that gay men have more disposable
income than other groups), and other financial
myths/assumptions that advocate the wealth and
disposable incomes that are read as creating gay
lifestyles, draw on and reiterate the assumption that
gay men (and to an extent, lesbians) define their
identities through consumption or leisure and
lifestyle.
Scholars have discussed the heterosexualization of
gay social spaces. That is, these spaces can be read as
trendy, edgy, and popular with certain heterosexual
groups. This can be about having an exotic or risky
experience, for example, when celebrating the end of
your single life at a stag and hen
(bachelor/bachelorette) night out. For some, this is an
invasion of gay space and “degays” the space,
diluting the possibilities for politics and visibility.
Moreover, it can also be seen as making gay spaces
unsafe, especially for those who are not out at work
or school or in certain social circles. The arrival of a
large group of straight people who might talk about
the “freak show” that they have seen can be
threatening and alienating in spaces that are supposed
to be by and for gay (and at times lesbian, bisexual,
and trans) people.
The use of the term gay rather than LGBT when
discussing gay ghettos, villages, and commercial
spaces, as noted earlier, has been deliberate. Gay
Leisure
refers specifically to gay men. Lesbians have been
shown to occupy and use territories differently. In
terms of leisure, lesbians do create commercial
spaces, as well as use mixed “gay” spaces. However,
lesbians and lesbian leisure spaces are less visible
and often are temporally created, having, for
example, 1 night a month, rather than a permanent
space 7 days a week. Gay women are likely to have
less economic power to support public sites of
leisure and are also more likely to have caring
responsibilities that result in less time and resources
for leisure activities.
It is clear, then, that engagement with and
enjoyment of such spaces is not homogeneous, and
there are power relations between individuals and
groups who are part of LGBT collectives.
Homonormative (referring to when gay identities are
offered inclusion and privilege because they conform
to dominant social norms in terms of monogamy,
class, race, and/or gender) gay (and lesbian) lives are
often associated with leisure spaces, and particularly
commercial ones. Equating leisure and the
commercial means that there are only some who can
buy into safe spaces where they may feel more able
to enact same-sex desires and practices. Social
differences such as ethnicity, social class, age, and
ability/disability are important in terms of who is
welcomed and valued in gay spaces and who is
disparaged. It has also been noted that L, G, B, and T
people have different experiences of gay spaces. For
example, Black and minority ethic people can be
excluded from predominantly White gay spaces in
places such as the United Kingdom and the United
States. However, other scholars have noted that gay
spaces can be used by people of color to create
alternative events and leisure sites.
In contrast to gay commercial scenes, some queer
leisure spaces offer open, fluid, transgressive spaces
for both play and resistance. People can use these
spaces to question and expose homonormative
structures that exist within more commercial spaces,
and these places can also offer alternatives to
commercialization, monosexual lifestyles, and other
forms of normalizing imperatives. However, queer
leisure spaces have also been accused of excluding
people for not having the education to understand the
politics of these spaces.
Leisure
Home
The home can be exclusionary, marginalizing, and
dangerous for LGBT people, in that parents, spouses,
children, or other kin may reject them because of
their sexual or gender identity. However, the home, a
space that is often presumed to be heteronormative
(referring to a combination of heterosexuality and
normative gender, class, ethnic, and other dominant
and privileged identities), can also be an important
site for LGBT social networks, for expressing
identities, and for socializing. It can be an important

social space that exists outside of gay commercial
scenes and places that are read as “straight” such as
bars, restaurants, and the cinemas. Historically, the
home and private spaces have been primary sites for
LGBT leisure. Parties and other events in the home
can create opportunities to explore sexual desires and
gender identities outside of the public gaze. While
most LGBT people will have some experiences of
socializing in the home, scholars have also shown
that the home can be a primary site of leisure for gay
men and for lesbians, including African American
lesbians.
Research has shown that the use of the home for
socializing is dependent on the existence of
friendship groups and relationships, which not all
will have. Social networks are central in engaging the
home as a leisure space, and how and where they
form/are dissolved is key to understanding isolation
and other forms of vulnerability for LGBT people.
Nonetheless, in thinking about leisure and LGBT
people, the home is an important site to consider.
Straight Exclusions
In contrast to commercial gay scenes as spaces of
acceptance for some, heterosexual spaces are
understood as intolerant and dangerous for LGBT
people. These spaces include leisure spaces that are
often seen as “normal” or “asexual,” but actually are
straight. Because the enactment of heterosexual
identities passes unnoticed, heterosexualized
performances (holding hands, kissing, touching, and
so on), symbols, and representations are seen as
natural and also pass unnoticed.
Heterosexual spaces such as work and
institutional spaces like school also serve as a
counterpoint to gay/lesbian/LGBT and queer leisure
spaces. These spaces are seen as unfriendly,
intolerant, potentially violent, and dangerous.
However, the presumed heterosexuality of public
spaces of the street have been challenged by events
such as gay pride, which can be seen as showing how
normally heterosexual streets can be queered through
the enactment of non-normative sexualities and
gender expressions. During pride events, those in
parades and at times lining the routes can question
that these spaces are necessarily heterosexual, and
instead show how who is in these spaces and what
they are doing at that particular time (holding hands,
kissing, camping it up, etc.) matter. For 1 day a year,
2023
the streets are different; for the duration of the pride
parade, the space is not heteronormative.
Similarly, sports activities that are pursued as
leisure can be both homo-/bi-/transphobic in ways
that reiterate heterosexual norms (such as
homophobic chanting in football stadiums), and also
welcoming. For example, women’s football (soccer)
in the UK (especially during the late 20th century)
and women’s softball in the United States are
understood as “lesbian” sports. While this can result
in vilification, these sporting practices can also create
time-spaces where same-sex relationships, lesbian
identities, and same-sex attraction can be normalized
and welcomed, or at least considered to be “part of”
the sport.
Leisure spaces such as public parks can also be
subverted through cruising, mainly by gay men, but
car parks and remote locations can also serve those
interested in dogging (engaging in public sex) and
heterosexual sexual practices. Although these spaces,
particularly through the daylight hours, might be read
as normatively heterosexual, in darkness and at
certain times, the normative heterosexuality of these
leisure spaces can be subverted.
Beyond Gay Commercial Socializing
It is important to be wary of both seeing gay/LGBT
spaces as necessarily inclusive and welcoming and,
conversely, viewing straight leisure spaces as those
where violence is perpetrated and as necessarily
exclusionary.
In discussing the ways that straight social space
can be appropriated, it has been suggested that at
times there can be a gaying of straight space. In other
words, that gay men, and LGBT people, can use
supposedly heterosexual spaces in ways that
challenge the supposed norms of these spaces.
Therefore, it is important to look at the different
ways that LGBT people socialize, and not only look
at “gay” or “LGBT” spaces. This is because LGBT
people use a broad range of spaces to socialize in;
they don’t just go to gay bars and clubs. Indeed,
LGBT socializing (and to a larger extent, leisure
activities) may not occur only (or even
predominantly) in commercial gay leisure spaces.
There is also a need to look at generic commercial
leisure spaces such as cinemas, restaurants, and other
places that are often considered heteronormative.
2024
Contemporary leisure activities, and particularly
socializing, are directly affected by legislative and
cultural shifts over the past 10 to 15 years. In certain
parts of the world, legislation and cultures have
changed to offer a different context for LGBT (or at
least gay and lesbian) lives, relationships, and
identities. Equalities and cultural shifts have meant
that some “acceptable gay” identities are increasingly
recognized in mainstream arenas and sexual and
gender identities can be protected in workplaces, the
provision of goods and services, and so on. This is
important for considering LGBT leisure practices.
Whereas formerly, rejection and prosecution might
have been the result of same-sex enactments in
“straight” spaces in places like South Africa, Canada,
and the United Kingdom, this is now illegal. This is
not to say that LGBT people are no longer harassed,
abused, and violently attacked. Instead, it is to
suggest that expectations of certain places have
changed the way LGBT people are socializing. This
has resulted in some claiming the end of the “gay
village,” as this is understood as no longer being
necessary for protection, safety, and politics. As
sexual and gender identities (apparently) have
become more fluid, the division of gay/straight can
be seen as outdated.
Leisure
Leisure activities such as socializing and cruising
can, for some, take place anywhere.
Thus, in summary, LGBT leisure is diverse and
varied. While historically, scholars have often
focused on gay scenes, gay spaces, and gay tourism
to discuss leisure, these have more recently been
shown to be potentially exclusionary to the broad
diversities of LGBT people. Taking an account of
leisure through socializing practices that are not
confined to narrowly defined gay (safe) or straight
(dangerous) spaces has shown that LGBT socializing
may not be focused on sexual/gender identities, sex,
or providing formal support.
Kath Browne
See also Gayborhoods; Heteronormativity;
Homonormativity; Rural and Urban Communities;
Visual Arts
Further Readings
Bassi, C. (2006). Riding the dialectical waves of gay political
economy: A story from Birmingham’s commercial gay
scene. Antipode: A Radical Journal of Geography, 38(2),
213–235.
Browne, K., & Bakshi, L. (2011). We are here to party?
Lesbian, gay, bisexual and trans leisurescapes beyond
commercial gay scenes. Leisure Studies, 30(2), 179–196.
Caudwell, J. (2007). Queering the field? The complexities of
sexuality within a lesbian-identified football team in
England. Gender, Place & Culture, 14(2), 183–196.
doi:10.1080/09663690701213750
Caudwell, J., & Browne, K. (2013). Sexualities, spaces and
leisure studies. London, England: Routledge.
Gorman-Murray, A. (2007). Reconfiguring domestic values:
Meanings of home for gay men and lesbians.
Housing, Theory and Society, 24(3), 229–246.
Gorman-Murray, A. (2008). Queering the family home:
Narratives from gay, lesbian and bisexual youth coming
out in supportive family homes in Australia.
Gender, Place & Culture, 15(1), 31–44.
doi:10.1080/09663690701817501
Johnston, L. (2005). Queering tourism: Paradoxical
performances at gay pride parades. London, England:
Routledge.
Moore, M. (2012). Invisible families: Gay identities,
relationships, and motherhood among Black women.
Berkeley: University of California Press.
Lesbian “Bed Death”
Visser, G. (2013). Challenging the gay ghetto in South
Africa: Time to move on? Geoforum.
doi:http://dx.doi .org/10.1016/j.geoforum.2012.12.013
LESBIAN “BED DEATH”
Lesbian “bed death” is the idea, whether real or
simply feared, that for same-sex coupled women,
their sexual desire and sexual activity begin to wane
and even cease to exist over time. This topic is
controversial among researchers, therapists, and the
popular press, with some arguing that it is a real
problem that lesbians face, and others arguing that
the concept of lesbian bed death is inaccurate and
should be put to rest. Despite the controversy
surrounding the topic of lesbian bed death, it
continues to be discussed and joked about in popular

literature and television shows (e.g., The L Word)
geared toward sexual-minority individuals.
The topic of lesbian bed death began to be
popularized following a landmark study in the early
1980s by Philip Blumstein and Pepper Schwartz that
addressed four types of American couples: lesbians,
gay men, cohabiting heterosexuals, and married
heterosexuals. This study found that lesbians
reported the lowest frequency of sexual activity
compared to gay men and both types of heterosexual
couples. Other scholars, in the early 2000s, compared
lesbian women with heterosexual women, and found
that lesbians were less frequently sexually active
compared to their heterosexual counterparts.
There is much debate as to why these findings
might exist. One argument in support of lesbian bed
death is that women are not socialized to initiate
sexual activity, and they have a lower libido and sex
drive. A second argument, suggested by many
feminist therapists studying this issue, is that women
in a sexual relationship begin to merge and develop
an overly close connection that can resemble incest;
as this happens, the desire for genital sexual relations
diminishes.
Additional arguments as to why there may be
findings of lower sexual behavior among lesbian
couples have taken into account the fact that this
issue is far more complex than simply viewing
lesbians as less sexual than others. That is, there are
many definitions and types of sexual behavior that
also include nongenital sexual behaviors such as
kissing, cuddling, and touching. These sexual
behaviors may be just as important, if not more, to
women’s sexual experience and pleasure. Thus,
according to this perspective, even though sexual
frequency has been found to be lower for lesbian
couples, the amount of time spent per sexual
encounter tends to be greater than for heterosexual
couples. These arguments have led some researchers
and lesbian activists to call for an end to studies
promoting the concept of lesbian bed death. Still, the
concept continues to attract the attention of
researchers, therapists, activists, and the popular
press. As such, lesbian bed death continues to be
examined and debated.
Research on lesbian bed death has benefited from
increasing social acceptance of same-sex couples.
Namely, new directions in lesbian bed death research
have broadened the definitions of and questions
about sexual behaviors and expanded the range of
2025
participants to include all women who are in same-
sex relationships, regardless of their sexual
orientation identity. One of the key findings from this
body of research is that there is only a small
difference in the sexual frequency or satisfaction
among women who are in the early phase of a same-
sex relationship compared with women in long-term
same-sex relationships. This research takes into
account the general waning of sexual behavior in any
relationship over time.
Studies that have examined lesbian sexual desire
have noted the connection between emotional
intimacy and sexual behavior. Although it is still
generally accepted that women, more so than men,
desire committed relationships when engaging in
sexual activity, the lower levels among some lesbians
in long-term relationships, but not among lesbians
who are in dating relationships, may reveal more
about the passage of time than about the nature of
sexual behavior between two women. Overall, the
reduction or lack of genital sexual behaviors, then,
appears not to be due to a lack of intimacy but may
be more reflective of the way that any long-term
relationship unfolds.
To critically evaluate and understand the concept
of lesbian bed death, then, clearly requires broader
definitions of sex and sexual encounters. Women and
particularly lesbian women may define sexual
activity and connection differently. They may engage
in a range of physical contact, including genital
sexual contact, that others do not define as sexual
encounters. It is important, then, to measure the
quality of sexual behavior rather than simply the
frequency. Just like heterosexual relationships,
lesbian couples have an ebb and flow of sexual
behaviors and desires. Examining the complexity of
how gender and sexual orientation work together to
influence sexual behavior has led to a new
understanding of sexuality in general and lesbian
sexual relationships in particular.
Erin S. Lavender-Stott and Katherine R. Allen
See also Aging, Sex, and Sexuality; Couples Therapy;
Dating, Sexual-Minority Women; Homosexuality,
Female; Intersections Between Sex, Gender, and Sexual
Identity; Long-Term Same-Sex Couples; Sexual Desire
and Relationship Quality; Sexual Norms and Practices
2026
Further Readings
Blumstein, P., & Schwartz, P. (1983). American couples:
Money, work, sex. New York, NY: William Morrow.
Cohen, J. N., & Byers, E. S. (2014). Beyond lesbian bed
death: Enhancing our understanding of the sexuality of
sexual-minority women in relationships. Journal of Sex
Research, 51, 893–903. doi:10.1080/00224499.20
13.795924
Diamond, L. M. (2008). Sexual fluidity: Understanding
women’s love and desire. Cambridge, MA: Harvard
University Press.
Nichols, M. (2004). Lesbian sexuality/female sexuality:
Rethinking “lesbian bed death.” Sexual and Relationship
Therapy, 19, 363–371. doi:10.1080/14681990412331
298036
Peplau, L. A. (2003). Human sexuality: How do men and
women differ? Current Directions in Psychological
Science, 12, 37–40. doi:10.1111/1467-8721.01221
Rose, S., & Zand, D. (2000). Lesbian dating and courtship
from young adulthood to midlife. Journal of
Lesbian Studies, 6, 85–109. doi:10.1300/
J041v11n02_04
LGB Parenting Styles and Values
LGB PARENTING STYLES
AND VALUES
In spite of concerns that lesbian, gay, and bisexual
(LGB) parents’ sexual orientation will negatively
affect their children, studies have shown that
sexuality is irrelevant with respect to one’s ability to
parent. This entry describes parenting styles and
values among lesbian and gay parents. It explains
how they divide household labor and child care, and
identifies values that lesbian and gay (LG) parents
instill in their children, as well as gender and
discipline practices. Much of the research in this area
has compared LG-parent households to heterosexual-
parent households, focusing most intensely on
lesbian-parent households and almost entirely
neglecting bisexual-parent families.
Division of Labor
Within heteronormative society, there is a great deal
of pressure for LGB couples to fall into traditional
gender roles. Many couples struggle to resist these
traditional roles, particularly in the division of
household and child care labor. Most of the research
in this area has concentrated on lesbianparent
couples, comparing them to heterosexual parents,
although there is a growing body of research on gay-
parent couples in comparison to heterosexual
parents.
Housework
There are differences in division of household
labor in gay-, lesbian-, and heterosexual-parent
families. For instance, egalitarianism seems to be
more important to lesbian mothers than to gay
fathers. In lesbian-parented families, the role of
income earner is more flexible, with both partners
alternating breadwinning roles or both reducing or
switching their working hours to be more involved at
home. Lesbian parents tend to have more equal
distributions of unpaid family labor than
heterosexual parents. However, lesbian mothers
spend less time on taking care of the house when
compared to heterosexual mothers.
LGB Parenting Styles and Values
When there are differences in labor in
lesbianparented households, they tend to occur along
the lines of biology. That is, in lesbian-parent
families formed through donor insemination,
biological mothers do more of the housework than
nonbiological mothers. As a result, they tend to have
more power over making decisions related to the
household.
Child Care
Division of child care occurs differently between
lesbian-, gay-, and heterosexual-parent families. For
instance, in comparison to heterosexual couples,
same-sex couples tend to share child care labor more
equally and report greater satisfaction with the
division of labor and their relationship than
heterosexual parents. Lesbian mothers also tend to be
more emotionally involved in childrearing than
heterosexual mothers, and in lesbianparent families
formed through donor insemination, nonbiological
mothers tend to be more involved in parenting than
fathers in heterosexual-parented families.
Within lesbian-parent households formed through
donor insemination, although couples may share
household tasks and decision making, biological
mothers tend to be more involved in child care, while

nonbiological mothers work more in paid
employment. This division is often due to early
demands of parenthood, such as breastfeeding, since
only the biological mother can fulfill that role.
Biological mothers tend to have greater access to
parental leave than nonbiological mothers, making
the biological mother the more likely choice for
which parent will take care of the child. However,
mothers who share child care more evenly tend to be
more satisfied and to have children who are more
well-adjusted than those families where the division
of child care labor is not equal.
For LG parents who adopt, there is a greater
likelihood of egalitarianism, since even the process
of adoption itself requires both parents to be fully
engaged in the process. Both partners tend to be
highly motivated to parent, having invested extensive
time and resources into an often drawn-out adoption
process. In addition, since neither parent experiences
pregnancy nor breastfeeding, child care can be more
equally distributed starting at infancy.
Parenting Values
Just as with child care and housework, LG parenting
styles tend to emphasize equality, with a focus on
preparing children for the challenges they will likely
face outside the family. Parental concerns around
discrimination and stigmatization shape the values
they bring to parenting. LG parents prepare their
children for discrimination; they raise their children
with strong values, particularly around gender roles;
and they are careful to discipline their children in a
way that reflects flexibility in parenting roles.
Preparing Children for Discrimination
LG parents are aware of the implications that their
family structure might have for their children. LG
parents must decide how and when to divulge their
family identity and to prepare their children for
reactions from people outside the family. They report
that they prepare their children for the outside world
in ways that heterosexual parents do not, knowing
that their children might face challenges and
discrimination from peers, friends, family, and
others.
Children of LG parents will likely have concerns
about how their family is different from others.
Studies on lesbian-parent families have shown that
these mothers communicate to their children that
2027
people have different beliefs, and that these beliefs
might support or not support their family. Lesbian
parents want their children to be critical thinkers
regarding outsider messages about family. Lesbian
mothers also emphasize how families are diverse,
and that diversity is good. LG parents teach their
children to be confident in the family they have.
Teaching Children Values and Traditions
Some research on lesbian-parent households has
revealed the kinds of values these mothers work to
instill in their children. For example, lesbian- parent
households teach their children to show respect to
others, through being sympathetic toward the needs
and feelings of other people. These mothers strive to
raise their children to be sensitive and considerate of
others.
Many LG-parent families report working to instill
religious values and traditions in their children.
However, in the domain of religious observance, LG
parental roles may shift away from traditional
heterosexual parental role expectations. For instance,
in traditional Jewish households, the male head of the
house is the one who says the prayers, and the
woman lights the candles. In LGparent households,
couples may shift roles between each other when
practicing religion, even while maintaining
traditional values.
Teaching Children About Gender
Children who grow up in same-sex–parent
households typically lack a different-sex live-in
parent, and this has raised attention to whether or not
these children demonstrate gender-typed play,
behaviors, and attitudes that differ from those of
children with different-sex parents. Social learning
theory, for instance, would suggest that parents
influence the gender development of their children.
As a result, much research has been done on whether
or not the absence or presence of samesex parents in
LG-parent households might impact gender-typed
play and behavior to the point that children might
model LG-parent behavior.
Lesbian mothers tend to be more liberal in their
attitudes toward their children’s genderrelated
behavior than heterosexual mothers. For example,
lesbian mothers might encourage their daughters
more than heterosexual mothers do to play with toy
trucks. Gay fathers might deliberately choose to
2028
deconstruct gender stereotypes by allowing their
children to pick out which toys they want to play
with, and allowing their children to wear gender-
neutral clothing. In general, LG parents tend to
demonstrate less genderstereotyped attitudes and are
more accepting of gender-unconforming behavior in
their children than heterosexual parents.
LGB Parenting Styles and Values
As a result, there is evidence that the children of
lesbian- and gay-parent families display less gender-
stereotyped play behavior than children of
heterosexual-parent families. In addition, sons of
lesbian mothers are typically less masculine in their
play than sons of gay and heterosexual parents.
However, other research has indicated that
preschool-aged and elementary-aged children do not
show differences in gender-typed play, regardless of
their family structure. Even within same-sex– parent
households, there may still be gender stereotyping,
since some parents want their children’s gender
performance to not be considered radical.
In spite of how well-adjusted and resilient
children of LG parents tend to be, many parents
express the desire to provide different-sex role
models for their children. Parents view these role
models as important in their children’s development,
wanting them to be comfortable around all genders.
Lesbian mothers, for instance, might seek out male
role models for their children through extended
family members, teachers, caretakers, or church
members. Other LG parents may not feel the need to
seek out these relationships for their children,
pointing out that their children are exposed to a wide
range of adults through school, family members,
friends, and caretakers.
Discipline
Through discipline, LG parents both extend and
defy heterosexual norms in parenting. LG parents are
similar to heterosexual parents in discipline
techniques. Time-outs, for instance, are the primary
way of disciplining children. Parents put their child
in a quiet corner or space, giving the child time to
calm down. Positive reinforcement is also frequently
used to teach children how to behave in socially
appropriate ways.
In comparison to heterosexual parents, gay fathers
are more likely to set boundaries and limits for their
children, preferring to reason with their children
rather than punishing them. They tend to be more in
tune with the needs of their children, and although
they are more structured and strict in comparison to
heterosexual fathers, they tend to set reasonable
limitations on behavior
LGBQ Parents, Coming Out to Children
and teach their children how to make good decisions.
Lesbian mothers are less likely than heterosexual
mothers or fathers to use physical punishment in
disciplining their children. LG parents tend to praise
and reward their children for good behavior.
Many LG parents choose to share roles in order to
make discipline easier. Gay fathers, for instance, may
express tendencies to discipline their children in a
way that is different from that of their partner. When
one parent is flexible, the other can be more rigid,
and when necessary they can switch roles.
This ability to shift roles can reduce stress that is
often associated with discipline.
Conclusion
LG parents are able to defy heterosexual norms in
parenting through flexibility of parenting roles. In
spite of concerns that LG parents’ sexuality might
negatively affect their children, LG parents are quite
capable of raising them to be well adjusted.
Kaitlin A. Black and Abbie E. Goldberg
See also Adults With LGBQ Parents; Caregiving;
Parent–Child Relationships; Stepfamily Division of
Labor and Money Management
Further Readings
Berkowitz, D., & Ryan, S. (2011). Bathrooms, baseball, and
bra shopping: Lesbian and gay parents talk about
engendering their children. Sociological Perspectives,
54, 329–350. doi:10.1525/sop.2011.54.3.329
Biblarz, T. J., & Savci, E. (2010). Lesbian, gay, bisexual,
and transgender families. Journal of Marriage and
Family, 72, 480-497. doi:10.1111/j.1741-3737.2010
.00714.x
Bos, H., & Sandfort, T. (2010). Children’s gender identity in
lesbian and heterosexual two-parent families. Sex Roles,
62, 114–126. doi:10.1007/s11199-009-9704-7
Goldberg, A. E. (2010). Lesbian and gay parents and their
children: Research on the family life cycle.

Washington, DC: American Psychological Association.
Goldberg, A. E., Gartrell, N. K., & Gates, G. (2014).
Research report on LGB-parent families. Los Angeles,
CA: Williams Institute. Retrieved November 17, 2015,
from http://williamsinstitute.law.ucla.edu/wp-content/
uploads/lgb-parent-families-july-2014.pdf
Patterson, C. J., Sutfin, E. L., & Fulcher, M. (2004). Division
of labor among lesbian and heterosexual parenting
couples: Correlates of specialized versus shared patterns.
Journal of Adult Development, 11, 179–189.
doi:10.1023/B:JADE.0000035626.90331.47
LGBQ PARENTS, COMING OUT
TO CHILDREN
Coming out, or disclosing one’s sexual identity, to
family members is a key aspect of living as a lesbian,
gay, bisexual, or queer (LGBQ) adult because family
is at the heart of both psychological and social life.
There are two distinct contexts in which LGBQ
parents come out to their children. The first is within
a de novo LGBQ-parenting family (i.e., a planned
LGBQ-parent family, in which children are born or
adopted into a same-sex relationship). The second
context is when an LGBQ parent had his or her
children within a different-sex relationship (post–
heterosexual parenting). Depending on the timing of
the parent’s coming out, and the children’s age and
other factors, children will understand the meaning
and implications of the parent’s sexual identity in
different ways as they grow up. When parents come
out to their children, both children’s and parents’
emotional reactions may be magnified because of the
importance of the parent–child relationship and a
fear on both sides that the relationship may be cut off
because of the disclosure.
LGBQ Parents Coming Out to Children Post–
Heterosexual Parenting
While being out is an ongoing challenge when
parenting children who were brought up within a
same-sex relationship, it is in some ways more
difficult when parents come out in the context of or
after the dissolution of a different-sex relationship in
which the children were adopted or conceived. Other
family members (including children) tend to assume
2029
that a parent is heterosexual in the absence of
information to the contrary. Thus, parents have to
assume a new sexual identity within their
preestablished identity as a mother or a father. For
example, studies of gay fathers coming out of
heterosexual relationships in the 1970s and 1980s
vividly described how men struggled with the
differing demands made of them as fathers in
mainstream North American culture and when
entering a gay subculture in which the concept of
fatherhood was largely ignored. It often took 2 to 3
years for the family and social networks surrounding
a new LGBQ parent to change or accept him through
a process of integrative social sanctioning, whereby
network members acknowledged and endorsed the
gay father across all his social worlds.
Studies with gay fathers, lesbian mothers, and the
children of LGBQ parents have indicated that simply
because a parent has begun a same-sex relationship,
it does not necessarily mean that a child will pick up
on a parent’s new sexual identity. Research with the
adult children of LGBQ parents who had them within
heterosexual relationships indicates a variety of
different ways through which they came to know
about their parent’s sexual identity. Some young
people were told by their LGBQ parent at the time of
or after their parents’ separation, whereas others
were told by their other parent or another family
member, and still others recollected a dawning
awareness of their parent’s sexual identity before
having any conversation with their parent on this
topic. Only a minority of young people recalled
finding out by accident—for example, finding a gay-
related magazine or seeing their parent being
affectionate with their partner. However they found
out, it took time for the children to come to an
understanding of what an LGBQ identity meant in
terms of their parent’s life, and to appreciate the
news fully. For example, a child might appear to
accept a single parent’s new same-sex partner staying
overnight but then seem shocked when a parent
announces an LGBQ identity, or vice versa.
Nevertheless, research studies have indicated that
children generally tend to be more accepting of their
parent’s lesbian or gay identity than parents had
thought they would be. Younger children may be
more accepting than older children, and research
studies of lesbian
2030
LGBQ Parents, Coming Out to Children
mothers and gay fathers have suggested that
adolescent daughters may be easier to talk to and
more accepting of disclosure than adolescent sons.
Clinical work with children of lesbian mothers has
indicated that children pass through different stages
of acceptance in relation to their mother’s coming
out as a lesbian, moving from anger or denial
through depression to subsequent acceptance and
sometimes pride. Children, like other family
members, may feel a sense of confusion and loss at
their parent’s news and wonder what this news
means for them. Young children may need
reassurance that a parent will still love and care for
them, and they may be concerned about changes to
their daily routine. Older children may be curious as
to whether their parent’s news has any implications
for their own gender identity or their sexual identity.
Adolescents in particular may experience concern
about their parent as they become fully aware of their
own sexuality. Also, children are likely to experience
concern about the possible reaction of peers and
teachers at school if they disclose their family
background. Ultimately, children may become
worried about their parent’s safety and so need
information and reassurance about this. Children of
LGBQ parents may often benefit from hearing the
stories of other children with LGBQ parents, since
children may feel they are coping alone, particularly
if they live in an area without visible LGBTQ
groups.
Therapists have suggested the usefulness of
preparatory work with the LGBQ parent prior to
coming out so that the acceptance–rejection terrain of
the family can be mapped and the possible
implications of disclosure assessed. Coming out to
children may be particularly difficult if it coincides
with the LGBQ parent separating from the child’s
other parent, and it may be useful to consider some
joint therapy sessions that include the ex-partner. In
clinical work with LGBQ parents and their children,
it is important to consider that a child’s concerns may
be linked to broader concerns or prejudice expressed
by extended family members or within the social
networks to which they belong. Both the LGBQ
parent and his or her child are connected to a web of
extended family relationships contained within
specific religious,
LGBQ Parents, Coming Out to Children
cultural, ethnic, and social class contexts. Children
may not necessarily hold prejudiced views
themselves but may be bothered that others they trust
and respect do. Coming out as an LGBQ parent may
be more difficult when religious or cultural views
held by racial or ethnic groups seem to demand
heterosexuality, especially when family conformity
has been important in providing a safe haven from
racial or ethnic prejudice. Further, older generations
in a family network may not share the same views as
younger members given rapid change in social
attitudes over the last 50 years, creating a generation
gap in terms of accepting LGBTQ equal rights. A
parent in the process of coming out may consider
warning his or her child that not everyone may
accept an LGBQ-parent family, and the parent may
have decided not to disclose to specific family
members. However, while there are often good
reasons to be cautious, keeping secrets within
families can create resentments and may become a
strain.
LGBQ Parents Coming Out to Children
Within a De Novo LGBQ-Parenting Family
A child born to an LGBQ-parent couple via assisted
reproductive technology (ART), or who has been
adopted at a young age, will have grown up with the
knowledge that the child has two moms, two dads, or
multiple parents. Nevertheless, children in de novo
families develop a gradual awareness about the
meaning of their parent’s sexual identity—for
example, first knowing that they have two moms or
two dads instead of a mom and a dad and only later
realizing others may be prejudiced against this or
that their parents have a sexual relationship.
Therefore, coming out to children about parental
sexual identity is about giving information about
how the parents came to have children; about how
other children’s family constellations are different
from their own; and, later, about sexuality.
In one study, many lesbian mothers reported that
coming out to their preschool-aged children
conceived via donor insemination had begun when
their children started to ask questions about how they
came into being. The lesbian mothers had generally
responded to these questions by explaining that they
had gone to visit a sperm bank to fertilize an egg in a

special part of the child’s birth mother’s tummy.
Lesbian mothers also reported having conversations
about family diversity with their children from
preschool onward, in which they had introduced the
idea of two women (or two men) loving each other,
with some introducing the words lesbian and gay to
their children alongside these explanations. Most of
the lesbian mothers also emphasized the importance
of being true to personal feelings of love and family
membership, even though other people might be
intolerant.
Telling children about their adoptive parents’
same-sex relationship is easier in jurisdictions where
joint adoption is legal as compared to those in which
same-sex couple adoption is not possible. For
children adopted by LGBQ parents, coming out is
often linked to telling children about their birth
family and adoption. In one study of elementary
school–age adopted children in the UK, most of the
lesbian and gay adoptive parents had already begun
to discuss their family composition and their child’s
adoption story with their child in the context of
broader discussions about family diversity.
In all LGBQ families, parents engage in a delicate
balancing act between wanting to come out and
honestly present their family form, and not wanting
their child to be exposed to homophobia because of
other people’s prejudice when their child talks about
their family to others. Thus, it is valuable not only to
consider how to come out and inform children about
their family, but also to discuss how the child might
manage any heterosexism or prejudice he or she
could encounter in the particular local environment.
Fiona Tasker
See also Adoption, Openness in; Adults with LGBQ
Parents; Children With LGBQ Parents, Psychosocial
Outcomes; Coming Out, Disclosure, and Passing;
Custody and Litigation, LGBQ Parents; Divorce and
Relationship Dissolution, Psychological Experience of;
Divorce and Separation, Historical
Perspective on; Joint Adoption; Parent–Child
Relationships; Therapy With Children of LGBQ
Parents; Therapy With LGBTQ Parents
Further Readings
Bozett, F. W. (1987). Gay and lesbian parents. New York,
NY: Praeger.
2031
Fitzgerald, T. J. (2010). Queerspawn and their families:
Psychotherapy with LGBTQ families. Journal of Gay
& Lesbian Mental Health, 14, 155–162.
Lynch, J. M., & Murray, K. (2000). For the love of the
children: The coming out process for lesbian and gay
parents and stepparents. Journal of Homosexuality,
39(1), 1–24.
Mitchell, V. (1998). The birds, the bees . . . and the sperm
banks: How lesbian mothers talk with their children about
sex and reproduction. American Journal of
Orthopsychiatry, 68, 400–409.
Mitchell, V. (2013). Coming out to family: Adrift in a sea of
potential meanings. In J. J. Bigner & J. L. Wetchler
(Eds.), Handbook of LGBT-affirmative couple and family
therapy (pp. 131–148). New York, NY:
Routledge.
Tasker, F., Barrett, H., & De Simone, F. (2010). “Coming out
tales”: Adult sons and daughters’ feelings about their gay
father’s sexual identity. Australian & New Zealand
Journal of Family Therapy, 31, 326–337.
Tasker, F. L., & Golombok, S. (1997). Growing up in a
lesbian family: Effects on child development. New
York, NY: Guilford.
Van Voorhis, R., & McClain, L. (1997). Accepting a lesbian
mother. Families in Society, 78(6), 642–650.
LGBQ PARENTS AND THE
HEALTH CARE SYSTEM
Many lesbian, gay, bisexual, or queer (LGBQ)
people experience marginalization or discrimination
within the health care system. When they become
parents, this can also affect their children.
Discrimination within the health care system may
occur as a result of discriminatory attitudes or
practices on the part of health care providers.
LGBQ Parents and the Health Care System
However, more commonly, it occurs because formal
systems within health care organizations are not
inclusive of same-sex couples, and providers often
make heterosexist assumptions about LGBQ parents
and their families. This has the effect of
marginalizing, and rendering invisible, LGBQ
people, which may result in poorer standards of
health care for LGBQ parents and their children.
2032
Negotiating the Health Care System providers who are unfamiliar or uncomfortable with
LGBQ families. Providers sometimes make
There are many points at which LGBQ parents or
heterosexist assumptions about an individual or
prospective parents may access the health care
family, such as assuming one parent is a friend or
system. To become a parent, some lesbians or
asking insensitive questions such as, “Who is the
bisexual women seek fertility services, and most
parent?” Providers may also insist on collecting
seek obstetric services. Gay or bisexual men may
information about a child’s genetic parentage, even
also engage fertility or obstetric services if they
where it is not relevant to the consultation. This can
conceive children via a surrogacy arrangement. As
be experienced by LGBQ parents as insulting or
parents, LGBQ adults are likely to access health care
disrespectful of their family makeup, as it does not
services for their children. This may include early
acknowledge the parental care of nonbiological
childhood nursing, general practitioners, and
parents. Many LGBQ parents have also encountered
pediatric services, along with other specialist clinical
providers who engage with only one parent during
services as required.
health care consultations, usually excluding the
Negotiating the health care system for their own
nonbiological or nonlegal parent.
needs or those of their children can be complex for
There is a small body of research on the attitudes
LGBQ parents. At an administrative level, intake or
of health care providers—including general
medical history forms often do not accommodate
practitioners, nurses, and specialist pediatric
same-sex couples. At the most basic level, this can
providers— toward LGBQ parents and their families.
mean providers do not have appropriate information
In these studies, many providers report that they do
about a child’s family circumstances. But more
not consider it important to know the sexuality of
significantly, nonrecognition of same-sex couples
patients (or a patient’s parents in the case of children)
within health systems may mean that one parent is
because they generally feel that this knowledge
not recognized as a legal parent for the purposes of
would not alter the quality of service they offer.
medical decision making or in cases where only
Researchers have pointed out that this attitude places
“next of kin” are allowed visiting
the onus on families to disclose their sexuality, rather
rights in a hospital.
than on providers to ensure families feel safe to do
this. Several studies have shown that LGBQ parents
Attitudes of Health Care Providers find it anxiety provoking to “out” themselves to
providers. In particular, LGBQ people fear
Studies conducted across the globe have shown that
judgmental attitudes from doctors about their
the attitudes of health care providers to LGBQ
capacity to be good parents.
patients vary according to demographic
characteristics of individual providers including
religiosity, culture, ethnicity, and age. Negative Implications of Marginalization
attitudes among providers may lead to strained and
Concerns about judgment or discrimination may lead
difficult consultations with LGBQ patients. Some
LGBQ parents to put off seeking care for themselves
providers
or their children, which has potential to compromise
LGBQ Parents and the Health Care System
the timeliness and quality of treatment. Some LGBQ
parents may choose not to disclose their sexuality to
may be uncomfortable touching an LGBQ patient, health care providers. However, this is likely to
make inappropriate jokes or comments, or ask exclude one parent from being involved in his or her
invasive questions about sexuality or relationships. child’s health care.
However, research has suggested that few LGBQ Many LGBQ parents report that they have
parents have experienced incidents of overt hostility consciously adopted a stance of being upfront about
or discrimination from health care providers, and their sexuality to health care providers that they
most are generally satisfied with the health care they access for their children. This has the dual benefit of
and their children have received in most settings. demonstrating a sense of family pride for their
More commonly, LGBQ parents report indirect children, while also educating providers about
forms of marginalization—for example, encountering LGBQ-parented families.

Jennifer Power
See also Health Care Providers, Disclosure of Sexual Identity
to; Health Care System
Further Readings
Chapman, R., Watkins, R., Zappia, T., Nicol, P., & Shields,
L. (2012). Nursing and medical students’ attitude,
knowledge and beliefs regarding lesbian, gay, bisexual
and transgender parents seeking health care for their
children. Journal of Clinical Nursing, 21, 938–945.
Hutchinson, M. K., Thompson, A. C., & Cederbaum, J. A.
(2006). Multisystem factors contributing to disparities in
preventive health care among lesbian women. Journal of
Obstetric, Gynecologic, & Neonatal Nursing, 35, 393–
402.
McNair, R., Brown, R., Perlesz, A., Lindsay, J., De Vaus, D.,
& Pitts, M. (2008). Lesbian parents negotiating the health
care system in Australia. Health Care for Women
International, 29(2), 91–114.
Mikhailovitch, K., Martin, S., & Lawton, S. (2001). Lesbian
and gay parents: Their experiences of children’s health
care in Australia. International Journal of Sexuality and
Gender Studies, 6, 181–191.
Nicol, P., Chapman, R., Watkins, R., Young, J., & Shields,
L. (2013). Tertiary paediatric hospital health
professionals’ attitudes to lesbian, gay, bisexual and
transgender parents seeking health care for their children.
Journal of Clinical Nursing, 22, 3396–3405.
O’Neill, K. (2012). Health sector attitudes to lesbian families.
Kai Tiaki Nursing New Zealand, 18(7), 14.
Shields, L., Zappia, T., Blackwood, D., Watkins, R.,
Wardrop, J., & Chapman, R. (2012). Lesbian, gay,
bisexual, and transgender parents seeking health care for
their children: A systematic review of the literature.
Worldviews on Evidence-Based Nursing, 9, 200–209.
LGBT CONSUMER MARKET, THE
Since the lesbian, gay, bisexual, and transgender
(LGBT) population was first labeled the “dream
market” in the 1980s, corporations have changed
from stigmatizing and avoiding homosexuals to
establishing a gay market niche. Based on a study of
New York Times news articles over three decades,
social scientist Angela Ragusa suggests that
corporate America moved through three distinct
phases in its treatment of the LGBT population:
2033
(1) corporate shunning in the 1980s, (2) corporate
curiosity and fear in the 1990s, and (3) corporate
pursuit in the 2000s. The LGBT consumer market is
currently estimated to have an overall buying power
of over $835 billion.
Over the past decade, corporate recognition of the
attractiveness of LGBT consumer spending patterns
has led to quite a dramatic increase in LGBT-
oriented promotional activities. In 2013, annual
advertising spending in LGBT print media jumped
18.2% to $381 million, according to the Gay Press
Report from Rivendell Marketing and Prime Access,
which tracks 284 U.S. LGBT press publications.
Total circulation of LGBT print media increased
15.1% to 2.7 million over the same period. This
growth in ad spending in LGBT print media contrasts
with declining ad spending for consumer magazines
overall. Much more has been spent in sponsorships
and online advertising. Another $12 million was
spent in online LGBT media, and over $7 million
more was spent annually on sponsorships in the
LGBT community, totaling over $231 million in
annual corporate spending in the LGBT community.
This entry provides a broad discussion of the
LGBT consumer market and corporate activities in
pursuit of the “gay dollar.” It will consider whether a
consumer market composed of gay, lesbian,
LGBT Consumer Market, The
bisexual, and transgender individuals exists in reality
or is merely a co-option of the sociopolitical
movement for LGBT civil rights.
From Corporate Pursuit to Corporate
Advocacy
As corporate America “evolved” in its treatment of
LGBT consumers, the gay social movement shifted
from the calls for sexual freedom and fluidity that
flourished in the 1970s and 1980s to present-day
demands for equal treatment under the law. While
corporations can be quickly labeled as pursuing the
gay dollar, the social visibility gained from corporate
attention may be seen by some LGBT individuals as
pivotal to the fight for societal rights. In discussing
the role of the marketplace within social movements,
academic scholar Lisa Peñaloza has stated that the
marketplace may be viewed as an important domain
of social contestation whereby disenfranchised
groups engage in ongoing struggles for social and
2034
political incorporation. She suggests that the
marketplace incorporation is important in the path to
social legitimization of gay males and lesbians.
Hence, many LGBT consumers embrace the power
of their spending by rewarding companies that are
considered “gayfriendly” in terms of their corporate
policies and their marketing activities.
Many corporations appear to have moved beyond
mere inclusion of gay consumers in their marketing
activities to a role of corporate advocacy in the
current decade. Recently, many corporations have
shown an increasing willingness to move ahead of
public policy in affording equal rights to LGBT
employees. The Human Rights Campaign (HRC), an
LGBT advocacy group, has tracked corporations’
positions on gay rights for more than a decade. In
2002, the first year the campaign published its
Corporate Equality Index— which evaluates anti-
discrimination policies, domestic partnership
offerings, LGBT or diversity group resources for
employees, and public commitment to the LGBT
community, among other things—only 13 businesses
achieved a score of 100%. In 2015, nearly 200 were
given the top rating. According to the HRC, in 2009,
86% of
LGBT Consumer Market, The
Fortune 500 companies prohibited discrimination
based on sexual orientation, while 16% of the
companies also included gender identity or gender
expression in their nondiscrimination policies. In
2012, companies such as Microsoft, Starbucks, and
Google were among 48 corporations signing a brief
arguing to the federal appeals court in Boston that
the Defense of Marriage Act was bad for business. In
New York, corporations were influential in
persuading legislators to pass a bill legalizing same-
sex marriage.
Does an LGBT Consumer Market Exist?
The gay social movement’s fight for equal rights for
LGBT individuals may unite gay males and lesbians
for a common cause, while the marketplace may not.
In order for the LGBT population to be considered as
a homogeneous consumer segment, it must be
defined by clearly identified segmentation variables.
In reality, it is difficult to identify what binds
together gay men, lesbians, bisexuals, and
transgender individuals other than shared, but
different, societal stigmatization and cooperative
movements to counteract it. At its simplest
demographic levels, the LGBT population includes
individuals that vary based on sex, sexual
orientation, and gender identity.
Even when narrowing the focus to gay males and
lesbians as a consumer population defined by sexual
orientation, a lack of homogeneity would exist in a
gay and lesbian consumer segment. In the vast
majority of situations, sexual orientation cannot be
considered a meaningful segmentation variable that
results in homogeneous responses to a firm’s
marketing mix. A closer examination of both of these
groups’ lifestyles and resulting behavior patterns
suggests meaningful difference between those of
lesbians and gay men. Lesbians are more likely than
gay men to be in a relationship, live with a partner,
and have children. Conversely, they are less likely
than gay men to socialize at gay bars or events, being
more oriented toward private social and
entertainment behavior, and less likely to live in
urban neighborhoods.
In addition, research in the social sciences
suggests that a homogeneous gay identity is more
likely to exist in opposition to high societal
intolerance of homosexuality. Societal shifts in
attitude toward homosexuality in many countries
over the past few decades may have changed the
prominence of gay identity among LGBT people’s
selfconcept. The majority of Americans both believe
that same-sex couples should be allowed to be
married and oppose job discrimination on the basis
of sexual orientation. In addition, the growing
fluidity of gender roles and gender expression in
Western society (e.g., metrosexuals, female hockey
players, female heads of state) diminishes the
culturally defined link between homosexuality and
gender-inappropriate behaviors. Thus, as societal
stigmatization of people based on sexual orientation
diminishes, it follows that a gay man or lesbian is
less likely to consider that identity more definitive of
his or her self-concept than identities such as sex,
gender, and race. In turn, the efficacy of sexual
orientation as a meaningful segmentation variable in
the consumer market will diminish.
To meet the criteria of a meaningful consumer
segment, a consumer group must be actionable so
that all consumers are homogeneous in their response
to targeted marketing activities. Many observers
view gay men and lesbians to be on opposite ends of
an emotional and behavioral spectrum; thus, it is

important that marketers fully understand both what
separates and what connects these two groups and
how it may affect the efficacy of various gay-
oriented marketing efforts. Lesbians appear to place
more importance than do gay men on LGBT-oriented
corporate policies, such as provision of domestic
partner benefits and LGBT nondiscrimination
policies, when evaluating a company’s gay-
friendliness. Lesbians also place more weight than do
gay men on a company’s effort to identify itself as
gay-friendly in its marketing communications and
provide financial support for gay causes. Sex
differences also appear to exist in gay males and
lesbians’ attitude toward gayoriented advertising in
general. Lesbians are less interested in appropriate
homosexual portrayals in advertising than are gay
men. Academic scholar Gillian Oakenfull has
conducted empirical research that suggests that gay
males and lesbians appear to respond differently to
advertising based on whether the advertising content
depicts gay males, lesbians, or nongendered gay
imagery.
Recently, it has been suggested that differences in
advertising response can be attributed to fundamental
differences in gay identity between the sexes.
Feminist theorists claim that the lesbian identity is
distinct from that of gay males, as lesbians face
simultaneous oppression based on their sex as well as
their sexual orientation. The late lesbian feminist
Adrienne Rich believed that a definition of the
lesbian existence necessitates a disassociation of
lesbian from male homosexual values and
allegiances. Finally, the 2004 Gay/Lesbian
Consumer Online Census indicates that there are
differences in media habits between the sexes, as gay
males consume more of all types of gay media than
do lesbians.
The Gay Consumer Market
Despite calls for an appreciation of the diversity
between the gay male and lesbian markets, in
practice, marketers have failed to delineate between
lesbians and gay men as consumers within the LGBT
population. Some have gone so far as to say that they
have neglected lesbians and failed to acknowledge
bisexuals and transgender individuals as consumers.
Since the 1980s, marketers have, almost exclusively,
used gay male imagery in advertising placed in gay
print media. Given the need for gay men and lesbians
2035
to unite as a homogeneous group based on sexual
orientation in the public policy arena as they fight for
the same basic civil rights, an explanation of the
predominance of gay male–oriented ads is that
advertisers may assume, while pursuing the gay male
market, that a one-size-fits-all approach to the gay
market will also capture lesbians. This argument
would also have an implicit acceptance of the
patriarchal selection of gay males to represent both
gay men and lesbians. Alternately, advertisers may
have simply chosen to ignore the lesbian market,
preferring to devote their advertising research to the
more “lucrative” gay male market.
Academic research has mirrored this bias, as the
vast majority of published consumer research focuses
exclusively on gay men. Given the resulting
LGBT Consumer Market, The
paucity of data on lesbian consumers, advertisers
eyeing the lesbian market often are left either to
make assumptions about the segment’s spending and
media habits or to advertise via lesbian publications
and grassroots marketing efforts, which reach a tiny
proportion of the market. While there’s no doubt that
lesbians have different demographics and buying
habits than do gay males, little is formally known
about their purchase motivation or attitudes, leaving
corporations to rely on stereotypes.
While stereotypes about gay men have drawn the
attention of marketers (they earn more money than
the general population; have expensive tastes; enjoy
fashion, theater, home decorating, dance, music, art,
design, gourmet goods), stereotypes about lesbians
have caused most mainstream marketers to stay
away. Common stereotypes inaccurately label them
as politically minded feminists who don’t subscribe
to consumerism and, as a result, don’t like fashion,
makeup, or shopping in general. In addition, lesbian
couples are wrongly assumed to suffer twice as much
as a heterosexual couple from the sex differential in
incomes in the United States, making a lesbian
household less attractive than both gay male and
heterosexual households to marketers. Analysis of
the U.S. Census also indicates that 57% of samesex
couples have both partners of a household working,
compared to 48% of opposite-sex couples. Further, in
a recent survey, 59% of lesbians lived with a partner
compared with 37% of gay men. Hence, while
lesbians are likely to earn less than all men, lesbian
2036
households are more likely to consist of two incomes
than are either gay male or heterosexual households.
Marketers often defend their neglect of the lesbian
market by citing the difficulty of accessibility.
Katherine Sender, author of the 2005 book Business,
Not Politics: The Making of the Gay Market, quotes
the head of an ad agency that supposedly focuses on
the LGBT market as saying, “there are just hundreds
of thousands, millions of lesbians who are paired off,
living together, who are living quiet lives on the edge
of woods or in the heart of the city or whatever . . .
[and] are very hard to reach.” Apparently, what
makes lesbians
LGBTQ Grandparenting
inaccessible is their lack of similarity to the distinct
behavior patterns of gay men. However, rather than
being insular and invisible, this places them in line
with mainstream culture, especially at similar life
stages. From a market segmentation perspective,
lesbians may be more meaningfully similar to
heterosexual women, who also are likely to have
children and are less likely to socialize in bars than
are gay men. It’s clear that a far more granular
treatment of the LGBT population is required to
delineate meaningful consumer segments from
participants in the LGBT social movement.
Gillian Oakenfull
See also Leisure; Queer Anticapitalism; Rural and Urban
Communities; Social Class
Further Readings
Badgett, L. (1998). Income inflation: The myth of affluence
among gay, lesbian, and bisexual americans. Amherst,
MA: Institute for Gay and Lesbian Strategic Studies.
Bhat, S. (1996). Some comments on marketing to the
homosexual (gay) market: A profile and strategy
implications. In D. Wardlow (Ed.), Gays, lesbians, and
consumer behavior: Theory, practice, and research
issues in marketing. Binghamton, NY: Haworth.
Bristor, J., & Fischer, E. (1995). Exploring simultaneous
oppression: Towards the development of consumer
research in the interest of diverse women. American
Behavioral Scientist, 38(4), 526–536.
Burns, C. (2012, March 22). The costly business of
discrimination: The economic costs of discrimination
and the financial benefits of gay and transgender
equality in the workplace. Center for American
Progress. Retrieved November 18, 2015, from
https://www.americanprogress.org/issues/lgbt/
report/2012/03/22/11234/the-costly-business-of-
discrimination/
Ettorre, E. (1980). Lesbians, women, and society. London,
England: Routledge.
Experian Simmons. (2012). The 2012 LGBT report:
Demographic spotlight. New York, NY: Author.
Kates, S. M. (2004). The dynamics of brand legitimacy:
An interpretative study in the gay men’s community.
Journal of Consumer Research, 31, 455–464.
Oakenfull, G. (2007). Effects of gay identity, gender and
explicitness of advertising imagery on gay responses to
advertising. Journal of Homosexuality, 53(4), 49–69.
Oakenfull, G. (2013). What matters: Factors influencing gay
consumers’ evaluations of “gay-friendly” corporate
activities. Journal of Public Policy & Marketing, 32
[Special issue], 79–89.
O’Connell, M., & Feliz, S. (2011). Same-sex couple
household statistics from the 2010 Census, report, U.S.
Bureau of the Census. Retrieved November 18, 2015,
from http://www.census.gov/hhes/samesex/
Peñaloza, L. (1996). We’re here, we’re queer, and we’re
going shopping: A critical perspective on the
accommodation of gays and lesbians in the U.S.
marketplace. In D. Wardlow (Ed.), Gays, lesbians, and
consumer behavior: Theory, practice, and research
issues in marketing (pp. 9–42). Binghamton, NY:
Haworth.
Rich, A. (1980). Compulsory heterosexuality and lesbian
existence. Signs, 5, 631–660.
Schulman, S. (1998, Winter). The making of a market niche.
Harvard Gay and Lesbian Review, 17–20.
LGBTQ GRANDPARENTING
This entry describes the intergenerational
relationships when grandparents self-identify as
LGBTQ. This entry begins with a brief overview of
the grandparent–grandchild relationship by focusing
on the factors that influence this significant and
enduring multigenerational relationship. These issues
include an exploration of the salience of sexual
orientation and gender identity for the grandparent–
grandchild relationship as well as the grandparent–
adult child (parent) relationship.
To date, the available research that has focused on
the centrality of sexual orientation in the
grandparent–grandchild relationship has only been
conducted with lesbian, gay, and bisexual (LGB)

grandparents. Therefore, this entry is limited in its
scope to highlighting this research with LGB
grandparents. Recommendations for future research
on the grandparent–grandchild relationship when
grandparents self-identify as questioning or
transgender are provided.
Grandparent–Grandchild Relationships
Because of the dramatic increase in life expectancy
in the United States (i.e., men 76.2 years; women
81.0 years), there is a greater likelihood that
individuals will be members of multigenerational
families. It is expected that children will have
extended relationships with their grandparents, and it
is most likely that children will also have extended
relationships with their great-grandparents and
possibly great-great-grandparents. Grandparenthood
often begins in middle adulthood, with the average
age of becoming a first-time grandparent being 47,
and most grandparents can expect to experience this
family role for 30 or more years.
The grandparent–grandchild relationship has been
examined for over 50 years by multiple researchers,
and all have concluded that this relationship is
significant, either directly or indirectly, for both
grandparents and grandchildren. However, most
researchers have also found that the significance and
meaning of this relationship vary considerably
depending on a host of factors that contribute to the
quality and experience of the grandparent–grandchild
relationship. Factors that have been found to
influence the grandparent– grandchild relationship
include the age and gender of the grandparent and
grandchild, socioeconomic variables (e.g.,
employment status, educational level, economic
resources), geographical proximity and frequency of
contact between grandparents and grandchildren,
psychosocial compatibility, personality
characteristics, and disruptive life events (e.g.,
divorce, death of a parent). In addition, most
researchers have found that parents play a
tremendous role in setting the conditions by which
the grandparent–grandchild relationship functions.
Parents can facilitate a positive relationship between
grandparents and their grandchildren or create
barriers to the formation of a positive and close
relationship. Therefore, any discussion of the
grandparent–grandchild relationship must include a
parallel discussion of the relationship between the
grandparent and adult child (parent).
LGBTQ Grandparenting
2037
LGBTQ Grandparents
Despite the national recognition of the important role
that grandparents play in the lives of their
grandchildren, it was not until the early 2000s that
researchers started to explore the significance of
grandparents’ sexual orientation for the grandparent–
grandchild relationship. While the research and
publications of studies on LGBTQ persons who are
mothers and fathers have rapidly increased within the
past decade, with studies on lesbian mothers being
the most published in LGBTQ family research, such
studies are still limited (or nonexistent) regarding
LGBTQ grandparents. There remains relatively little
scholarship on bisexual or questioning grandparents,
and to date there is no research on transgender
people as grandparents. Therefore, the following
sections will focus on the research that has explored
the experiences of lesbian and bisexual grandmothers
and gay grandfathers.
Lesbian and Bisexual Grandmothers
The majority of early conceptualizations of lesbian or
bisexual grandmothers appeared in limitedcirculation
outlets. A popular lesbian magazine, for example,
began to appear in the 1980s that included personal
narratives of lesbian grandmothers. In these limited-
circulation publications, both the struggles and joys
of being lesbian grandmothers were highlighted. The
struggles included stories of lesbian grandmothers
who wanted to be with their female partners but did
not live with them for fear of raising suspicions
about their sexuality. The joys included receiving
unconditional love from their grandchildren. During
the 1990s, the situation comedy Roseanne introduced
a key character who was a lesbian grandmother, and
in 2005, a short film documented the crosscountry
bicycle ride of two lesbian grandmothers who were
riding for marriage equality.
In 2000, the first scholarly paper reporting the
experiences of self-identified lesbian grandmothers
was published. In this article, however, the authors
indicated that the effect of the grandmothers’
LGBTQ Grandparenting
sexual orientation was not specifically explored.
Instead, the findings were compared to heterosexual
grandmothers’ enacted roles, and the authors
2038
reported that all grandmothers provided emotional
support to their grandchildren.
In the first scientific study specifically focused on
lesbian grandmothers, interviews were conducted
with 14 Canadian lesbian grandmothers. All lesbian
grandmothers in the study reported that they came to
their identity as a lesbian late in their lives, usually
after their children were adults or their heterosexual
marriages ended through divorce or death. Although
these lesbian grandmothers were aware of their
sexual orientation prior to entering into heterosexual
relationships and bearing children, they were also
living within a distinct historical period in which
homosexuality was considered shameful, immoral,
deviant, pathological, and criminal. Therefore, they
remained within their heterosexual relationships for
fear that if they disclosed their homosexuality, they
would risk not only custody of their children, but
also the respect and love of their children and
families. They viewed their delay in coming out as
being rational and psychologically sound, yet tragic
and a consequence of the era in which they were
living. For some of the lesbian grandmothers who
disclosed their sexual orientation, they faced the
tragic reality of full or partial estrangement from
their adult children and grandchildren. However, the
majority were able to experience the acceptance of
their homosexuality by their adult children and
grandchildren, and these lesbian grandmothers
reported being validated with the subsequent sense of
experiencing a wholeness within themselves.
The next development in this field was the
methodical and systematic exploration of the effects
of sexual orientation on the grandparent– grandchild
relationship. In a study of the perceptions, attitudes,
beliefs, and experiences of 12 self-identified lesbian
grandmothers and 4 selfidentified bisexual
grandmothers, these grandmothers discussed the
psychological significance of being able to self-
identify as either lesbian or bisexual and how they
had to incorporate their lesbian and bisexual
identities with the important identity of being a
mother. There were differences as to when the
lesbian or bisexual grandmothers identified
themselves as lesbian or bisexual, but all of these
women reported that they grieved for the years lost
when they remained in heterosexual relationships
purely for the financial and emotional security that
they believed the heterosexual marriage provided.
Previously married lesbian or bisexual grandmothers
indicated that ending their heterosexual marriages
with a divorce was both a personal and social marker
of their acceptance of their homosexuality or
bisexuality.
Managing disclosure about their sexual
orientation was a primary issue for all of the
grandmothers in the early published research on
lesbian and bisexual grandmothers. However, their
decisions to disclose were linked to social and
cultural attitudes as well as familial attitudes toward
homosexuality. Lesbian and bisexual grandmothers
were concerned with the possibility of losing the love
and respect of their children and grandchildren
because of their sexual orientation. However, there
were some grandmothers who specifically concealed
their sexual orientation because they believed that
this would protect their grandchildren from societal
prejudice, especially if their grandchildren were
young. Thus, the grandmothers’ disclosure of their
sexual orientation was often dependent on the
grandchild’s age or developmental stage. The
research also found that lesbian or bisexual
grandmothers believed that their adult children either
facilitated or hindered their relationships with their
grandchildren, and their adult children’s attitudes
toward their sexual orientation played a tremendous
role in the strength of the grandmother– grandchild
relationship. This finding of the mediating role of
parents in the lesbian/bisexual grandmother–
grandchild relationship supports previous research
with heterosexual grandparents that found that
parents are the gatekeepers to the grandparent–
grandchild relationship, and they facilitate or
discourage the development of an emotionally
intimate relationship between grandparents and
grandchildren.
Gay Grandfathers
In the late 2000s, scholars began to investigate the
experiences of gay grandfathers. Research focusing
on the role of gay grandfathers in the grandparent–
grandchild relationship was especially needed since
the only available information on gay
grandfatherhood was on LGB elder websites or
featured in newspaper articles. The gay grandfathers
who were willing to share their stories in national
publications about being gay and a grandfather were
not hesitant about disclosing their sexual orientation.
The freedom that these gay grandfathers experienced
in being out to family members may have been a

reflection of society’s general acceptance of older
men being out to family, as compared with older
women. However, research was needed to
specifically examine the coming-out process of gay
grandfathers to their adult children and
grandchildren.
In the first study on this topic, 11 White gay
grandfathers who ranged in age from 40 to 79 years
were interviewed in order to obtain information
about their coming-out process. This research
revealed that gay grandfathers believed that their
adult children played a tremendous role in their
coming out to their grandchildren. This research also
revealed that gay grandfathers enacted their
grandfathering identities and practices in ways that
were shaped by their family context, specifically the
middle generation. Again, this research points to the
tremendous role that parents play in the development
of the grandparent–grandchild connection. Another
important finding was that gay grandfathers wanted
to be involved in the lives of their grandchildren, but
with an understanding of the cultural norm that they
would support but not interfere with their adult
children’s wishes for their grandchildren.
Future Research With LGBTQ Grandparents
Future research focusing on the experiences of
LGBTQ grandparents must place an emphasis on
bisexual, transgender, and questioning grandparents.
As mentioned, to date, there have been no studies
that have investigated older transgender people’s
relationships with their grandchildren, and this
research is especially needed. Just as transgender
parents face unique concerns and issues that differ
significantly from those of lesbian and gay parents,
transgender grandparents face various forms of
LGBTQ Grandparenting
transphobia and discrimination that would require an
understanding of transgender-grandparent
relationships with their grandchildren.
Because the available research has only explored
the experiences of LGB grandparents who conceived
children when they were in heterosexual
relationships, research is also needed to explore the
perceptions of LGBTQ grandparents from families in
which they conceived children within the context of
LGBTQ relationships. To date, the available research
on LGB grandparents focused on grandparents who
2039
were primarily White. Additional research is needed
that would include LGBTQ grandparents of color.
Research is also needed to explore the unique
perceptions, attitudes, beliefs, and experiences of
LGBTQ cograndparents (i.e., the partners of LGBTQ
grandparents). Cograndparents are the nonbiological
LGBTQ grandparents. Although their role is less
visible than the biological LGBTQ grandparents, the
cograndparents’ role may still be significant if their
relationship status with the biological grandparent
was recognized and affirmed.
Most importantly, future research on LGBTQ
grandparenting must include the voices of
grandchildren. Very early research on heterosexual
grandparenting portrayed a one-way socializing
influence of grandparents on grandchildren, and
more recent research has continued to explore the
socializing influence of grandparents on
grandchildren, but with an emphasis on the
mediating role of the middle generation on the
grandparent–grandchild relationship. Although the
available research on LGB grandparenting also
emphasizes the mediating role of adult children on
the grandparent-grandchild relationship, it is also
very important to investigate how other family
members may influence the nature of this
relationship within LGBTQ families. Future research
should include all three generations in order to fully
understand the grandparent– grandchild relationship
in contemporary society. Exploring the issues and
concerns facing LGBTQ grandparents and their
grandchildren will enable the development of
programs and social policy that will ideally
strengthen intergenerational relationships and family
well-being.
Nancy Orel
2040 LGBTQ Health in Non-Western Contexts
See also Aging, Social Relationships, and Support; Coming
Out, Disclosure, and Passing; Families of Origin,
Relationships With; Heterosexist Bias in Research
Further Readings
Fruhauf, C., Orel, N., & Jenkins, D. (2009). The comingout
process of gay grandfathers: Perceptions of their adult
children’s influence. Journal of Gay, Lesbian, Bisexual,
and Transgender Family Studies, 5, 99–118.
doi:10.1080/15504280802595402
Orel, N. (2005). Lesbian and bisexual women as
grandparents: The centrality of sexual orientation in the
grandparent-grandchild relationship. In D. Kimmel, T.
Rose, & S. David (Eds.), Lesbian, gay, bisexual, and
transgender aging: Research and clinical perspectives
(pp. 248–274). New York, NY: Columbia University
Press.
Orel, N., & Fruhauf, C. (2014). Lesbian, gay, bisexual, and
transgender grandparents. In A. E Goldberg & K. R.
Allen (Eds.), LGBT-parent families: Innovations in
research and implications for practice (pp. 177–192).
New York, NY: Springer. doi:10.1007/978-1-
4614-4556-2
Patterson, S. A. (2005). Better one’s own path: The
experience of lesbian grandmothers in Canada.
Canadian Women’s Studies, 24, 118–122.
Sevda, B., & Herrera, D. (1998). Women in love: Portraits of
lesbian mothers and their families. New York, NY:
Bullfinch.
Walker, K., & Walker, J. (1995). Still family after all these
years. In K. Arnup (Ed.), Lesbian parenting: Living with
pride and prejudice (pp. 160–166). Toronto, Ontario,
Canada: Canadian Scholars’ Press and Women’s Press.
Whalen, D., Bigner, J., & Barber, C. (2000). The
grandmother role as experienced by lesbian women.
Journal of Women and Aging, 12, 39–57. doi:10.1300/
j074v12n03_04
LGBTQ HEALTH IN NON-WESTERN
CONTEXTS
Across the globe, individuals who either are
perceived to be or identify as LGBTQ are often
denied basic human rights, and, depending on
cultural norms (e.g., gender role expectations),
LGBTQ individuals may experience oppression and
legalized discrimination based on their sexual
orientation, gender identity, or gender expression. As
of 2013, among the 190 member states of the United
Nations, 76 countries continue to make sexual
relations between same-sex adults illegal, and the
consequences vary based on age and gender, among
other factors. Indeed, Iran, Saudi Arabia, Yemen,
Mauritania, Sudan, Northern Nigeria, and Southern
Somalia continue to enforce the death penalty for
individuals convicted of homosexuality, and
legalized discrimination against LGBTQ individuals
is allowed, if not encouraged, throughout some parts
of Asia and Africa. On the other hand, there are
places throughout the world where LGBTQ diverse
gender identities and sexual orientations are accepted
and even celebrated.
This entry provides an overview of LGBTQ
individuals from non-Western contexts. Specifically,
it addresses LGBTQ health disparities across
cultures and examines how the intersection of gender
and religion impact cultural beliefs, regulations, and
health care. Further, this entry considers how non-
Western traditions could provide a new perspective
on how to promote and advocate for equal rights for
LGBTQ individuals.
Global LGBTQ Health Disparities
The Pan American Health Organization (PAHO)
report on LGBTQ individuals’ access to and
utilization of health care services suggests that
LGBTQ individuals face barriers to care such as
providers who lack awareness of LGBTQ-specific
health concerns; refuse to provide treatment; have
insufficient availability of services; and, in turn, may
make health care decisions based on assumptions or
stereotypes. Indeed, many LGBTQ individuals
avoid seeking mental and physical health care due to
the discrimination and violence they experience from
the very individuals who are supposed to help them,
which in part may explain why some LGBTQ
individuals prefer to self-medicate (i.e., abuse
substances and use home remedies) over seeking
formal health care. Because of these barriers, there is
a high prevalence of depression, suicide, and anxiety,
among other mental health concerns in the LGBTQ
community, and in terms of physical health, LGBTQ
individuals may be at risk for higher rates of cancer,

HIV, obesity, and sexually transmitted illnesses
(STIs), among other health concerns.
The American Psychiatric Association (APA)
removed homosexuality from the Diagnostic and
Statistical Manual of Mental Disorders (DSM) in
1974, and the World Health Organization (WHO)
followed suit in 1990; however, the International
Statistical Classification of Diseases and Related
Health Problems (ICD) still includes the F66
category of mental illnesses, which is labeled
Psychological and Behavioral Disorders Associated
with Sexual Development and Orientation, and these
“disorders” can be used to diagnose LGBTQ
individuals with a mental illness. There are a variety
of advantages and disadvantages of maintaining
diagnoses such as sexual maturation disorder, ego-
dystonic sexual orientation, sexual relationship
disorder, other psychosexual development disorders,
and psychosexual development disorder unspecified,
but they arguably cause more harm than good. For
instance, in some countries, reorientation therapy is
still used to attempt to change an individual’s sexual
orientation or gender identity, and the F66 category
of diagnoses may provide justification for this
unethical practice. In fact, most medical and mental
health professional organizations have stated that
homosexuality is not a mental illness and have
ethical codes against trying to change their clients’
sexual orientation. Further, the APA has started the
process of de-pathologizing diverse gender identities
and gender expressions by replacing the Gender
Identity Disorder diagnosis with Gender
Dysphoria in the fifth edition of the Manual (DSM
5). This decision ensures that transgender individuals
who are interested in transitioning have a diagnosis
for insurance purposes while at the same time
acknowledging that diverse gender identities and
gender expressions beyond the male–female binary
are healthy and normal human expressions.
In addition to mental health disparities, many
LGBTQ individuals report physical health disparities
as well. For instance, lesbian and bisexual women as
well as transgender men (i.e., female-tomale) who
have not had children, who avoid gynecological
services, and who use substances (e.g., alcohol and
tobacco) may be at greater risk for breast and
cervical cancer. Similarly, men who have sex with
men (MSM) may be at risk for anal cancer, but due
LGBTQ Health in Non-Western Contexts 2041
to a lack of education, awareness, and utilization of
services, these men are not getting the preventive
care they need. Another underserved population is
that of transgender individuals, who may face, in
addition to inexperienced and prejudiced providers,
the additional health burden of receiving
unsupervised health care. Specifically, some
transgender individuals take hormones without a
prescription and may undergo nonmedical body-
modification procedures (e.g., castration or use of
industrial silicone) when sex reassignment surgery
(SRS) is unavailable or unaffordable.
Even when health care services are available,
LGBTQ individuals may avoid treatment due to
social, economic, and legal barriers. For example, in
the countries where same-sex relations are against
the law, police often target health care providers and
nongovernmental organizations (NGOs) that are
geared toward LGBTQ individuals. Therefore,
LGBTQ individuals and advocates are at risk of
imprisonment and legalized discrimination. For
example, staff at LGBTQ organizations may be
arrested or charged with breaking morality,
prostitution, or homosexuality laws. However,
depending on cultural beliefs and traditions, there are
some non-Western nations that provide LGBTQ
individuals not only with appropriate health care, but
also with support to help cover the costs.
Impact of Patriarchy on Laws, Policies, and
Health
In many parts of the world, women do not enjoy the
same rights and freedoms as men do. In some
countries, women do not have equal access to health
care, work, education, land ownership, or leadership
roles, among other rights and freedoms; therefore,
lesbian and bisexual women may be forced into
marriage and are at risk of domestic violence, among
other dangers. Although transgender individuals may
have some leeway and fluidity to move between
masculine and feminine roles, gender role
expectations and legal systems that were developed
on the foundation of a gender binary put many
transgender individuals at risk for domestic violence,
especially those who live with their families. On
account of the heteronormative traditions and
expectations that marriage is between a man and a
2042 LGBTQ Health in Non-Western Contexts
woman and that gender as well as sexuality are
binary, in many places across the globe everyone is
assumed to be heterosexual and cisgender (i.e., sex at
birth aligns with gender), and those who do not fit
into the social mores do not always receive legal
protection.
Although laws and policies have been developed
to protect women from violence, many of these
codes are not extended to lesbians, bisexual women,
and transgender (LBT) individuals, and in fact these
laws may be used against them. For instance, LBT
persons who seek legal support for domestic violence
may put themselves at risk of being arrested for
homosexuality. Further, sexual minorities are often
charged with rape instead of homosexuality, and
although the accuracy of sexual violence charges is
usually false, the mislabeling of charges makes it
difficult for LGBTQ NGOs to gain support in
fighting for human rights. Lastly, reports from the
International Gay and Lesbian Human Rights
Commission describe how perpetrators of violence
against LGBTQ individuals in the Middle East may
receive lesser penalties if the crime was allegedly
based on preserving family honor or there was unjust
provocation. Hence, LGBTQ persons could be
assaulted or even murdered by their relatives, and
their family members could receive reduced
sentences for claiming that their actions were to
protect their family’s honor.
Due to legalized discrimination, LBT individuals
face a number of risk factors that have a direct effect
on their health. LBT individuals in Africa, Asia, and
other places around the world are at risk of
corrective rape, in which LBT individuals are
sexually assaulted as punishment or under the false
pretense that sexual orientation or gender identity
can be changed. As a result, LBT individuals may be
at higher risk for HIV, STIs, and unwanted
pregnancies, among other health concerns from these
violent crimes, and the combination of harassment,
abuse, and discrimination has an impact not only on
physical health but on mental health as well. Even
when mental and physical health care focused on
women’s needs is available, LBT individuals do not
always receive equal access to these services, if they
are eligible for any services at all. In some countries
such as Japan and Pakistan, LBT individuals have
been denied care at shelters for domestic violence,
and when counseling services are available, LBT
clients are not allowed to discuss their sexual
orientation or gender identity, even when these
characteristics are associated with the presenting
problem. Hence, many individuals turn to self-
medication and substance use. However, in other
countries like Malaysia and Sri Lanka, LBT
individuals reported that they have some access to
mental health support, at least through local LGBTQ
organizations.
Religion, Gender Diversity, and
Sexual Orientation
In addition to the patriarchal influence on gender role
expectations and the legal system, religion also plays
a significant role in how gender diversity is viewed
in non-Western contexts. Interestingly, some Eastern
religions such as Hinduism and Buddhism provide a
cultural framework for recognizing and embracing
gender diversity. Similarly, in some Middle Eastern
countries, Islamic law has become increasingly
accepting of transgender individuals who fit into the
gender binary. However, as with the American
Indian, Polynesian, and Asian cultures described
later in this entry, colonization along with the rise
and fall of ancient empires often placed long-lasting
limits on social expectations of gender expression
and sexuality.
In India, Hinduism provides a cultural context for
such diverse gender expression as hijra (men who
are neither man nor woman) and sādhin
(women who reject marriage and live as men).
Within the Hindu religion, there are deities that are
partially male and partially female as well as deities
that flow between masculine and feminine forms; in
addition, there are epic tales about hijras that helped
to establish their place in society (i.e., offering
blessings as well as entertainment at wedding and
birth ceremonies). Specifically, hijras worship
Bahuchara Mata (a Hindu goddess that is associated
with transgender individuals and procreation) and,
based on a Hindu story, they often undergo a
culturally specific type of SRS. In general, hijras are
forced to leave their families, live in small
communities, and live as women; however, sādhins
are viewed as holy men, live with their families, and
are allowed to take part in some masculine as well as

some feminine roles. In addition to their roots in
Hinduism, these diverse gender roles have been
described in ancient medical texts and rather than
being attributed to mental health, gender diversity
was believed to be biologically based. Therefore, in
India, transgender individuals have a religious and
medical context for their gender identity that is not
based in pathology, and although they may
experience discrimination and stigma, it appears as
though there is some level of cultural acceptance for
gender diversity.
Regardless of the social support for gender
diversity, however, sexual minorities in India have
less freedom. The penal code that criminalized same-
sex relations in India was overturned in 2009 based
on a ruling that it interfered with HIV/AIDS
prevention efforts; however, this law was reinstated
in December 2013 after a religious group appealed
the judgment. As a result, sexual minorities may
have an increased risk of being diagnosed with
HIV/AIDS among other health concerns, since many
of the HIV prevention efforts are geared toward
LGBTQ individuals, and seeking services may put
these individuals at risk of police harassment and
imprisonment.
As with India, transgender individuals in Iran
have more freedom than sexual minorities. After the
fall of the Ottoman Empire, Iran returned to Sharia
law (i.e., Islamic law) and the use of capital
punishment for homosexuality. However, Islamic
law has also been used to give transgender
individuals in Iran more rights. Specifically, in 1967,
Ayatollah Khomeini issued a fatwa (legal opinion)
stating that SRS was acceptable for intersex
individuals, since this would help their bodies and
souls align. In 1985, the Ayatollah of Iran reissued
and expanded this fatwa to include transgender
individuals. Although transgender individuals in Iran
are sanctioned to have SRS or to live as certified
nonoperative transsexuals, some individuals continue
to face discrimination and prejudice. For instance,
transgender individuals must complete months of
therapy to confirm they are not sexual minorities
trying to pass as transgender, they are required to
have their chromosomes and hormone levels
assessed before they can become a certified
transsexual, and throughout the process they must
carry documentation of their referrals and letters
LGBTQ Health in Non-Western Contexts 2043
from their providers in case of random searches by
the police.
Despite the hurdles that transgender individuals
experience in Iran, after they receive certification
they become eligible for health insurance, assistance
with covering the cost of surgery, and military
exemptions. Individuals whose gender expression
does not align with their sex and are not “certified”
are at risk of breaking dress code laws, and even
certified nonoperative transgender individuals may
be suspected of being a sexual minority. Further,
sexual minorities are often pressured to have SRS as
a preventive measure against such risks as the death
penalty if convicted of homosexuality.
Unfortunately, given the religious sanctions, there
may be a push for individuals to have SRS without
being fully informed about its risks and benefits. For
example, individuals convicted of homosexuality
may be offered SRS instead of the death penalty;
however, this option could have significant
consequences on interpersonal relationships.
Moreover, Iranians who have SRS may lose their
eligibility for refugee status since gender identity is
not explicitly listed under the 1951 Convention and
1967 Protocol.
Buddhism, like Hinduism, also references sexual
and gender identities that extend beyond the binary,
and Buddhist teachings about tolerance and karma
provide a framework for how transgender individuals
may be perceived in Thailand. For instance, high
proportions of transgender individuals in Thailand
reported that they were accepted by their family
members and viewed their gender identity as karma
for their behavior in a past life. Despite the influence
of Buddhism on Thai culture, LGBTQ individuals
have been historically ostracized in Thailand, and it
was not until recently that these individuals began to
receive more cultural acceptance. Currently, kathoey
(transgender individuals) do not have equal rights
since they are not allowed to change the gender on
their documentation, and although there is limited
financial support and access to SRS, more SRS
procedures are performed in Thailand than in any
other country. Moreover, unlike India and Iran,
same-sex relations in Thailand are legal and sexual
minorities have more freedoms.
These are just a few examples of how religion can
impact the legal system and social norms, especially
2044 LGBTQ Health in Non-Western Contexts
as they relate to LGBTQ individuals. Although
religious teachings and religious leaders provide
transgender individuals and their families with some
rationale for their gender identities and gender
expression, many penal codes only recognize two
genders, and transgender individuals are often forced
into this binary. In some cases, transgender
individuals are recognized by their gender identity,
whereas other nations only label an individual based
on his or her assigned sex at birth. Hence, having a
religious context for one’s gender expression may be
associated with higher levels of wellbeing, especially
when the gender identity fits into a binary, but it
appears as though religious support is a source of
validation that may or may not be associated with
mental and physical health benefits.
Acceptance of Gender Identity and
Gender Expression
In some non-Western cultures across the world,
diverse gender expression and identities have been
embraced and woven into cultural traditions,
whereas sexual orientation often remains a
stigmatized identity. For instance, some American
Indian cultures, as well as those of Polynesia and
Indonesia, have historically been more accepting of
gender expression and gender identities beyond the
binary, and despite the impact of colonialism,
Christianity, and Islam, many of these traditions
have either remained or have been reclaimed over
the years. While transgender individuals in many
Western cultures are often diagnosed with gender
dysphoria and may have a higher prevalence of risk
for certain health concerns such as suicide, substance
abuse, and STIs, as well as having such potentially
medical necessities as hormones or surgery, some of
these issues are not as prevalent in many non-
Western cultures.
Specifically, in some Polynesian cultures, boys
may be raised as girls, and identify as fa’afafine in
the Republic of Samoa and as fakaleiti in the
Kingdom of Tonga, and it is not unusual for parents
to be accepting and supportive of their children’s
gender expression. For instance, fa’afafine tend to be
more socially accepted within their cultures, and
these individuals do not experience distress over
their gender expression and gender identity. As with
other identities that may fit under the transgender
umbrella, individuals who identify as fa’afafine and
fakaleiti do not fit neatly into the gender binary and
have the capacity to move between the masculine
and feminine. Due to their assigned sex at birth,
fa’afafine and fakaleiti may receive some forms of
male privilege; however, since Samoa and Tonga are
both patriarchal societies, these individuals may
experience some of the same oppressions as do
cisgender women. Further, in many Polynesian
countries, sexual acts between individuals of the
same sex remain illegal. Therefore, sexual
relationships between heterosexual men and
fa’afafine or fakeleiti appear to be culturally
acceptable, since they are not viewed as same-sex
relationships, whereas some fa’afafine and fakeleiti
consider same-gender relationships with women as
sinful.
Prior to colonization, many American Indian
cultures had a rich history of accepting and
celebrating gender diversity, and although some
individuals transitioned between masculine and
feminine expression of their gender depending on
their roles in society, others subsumed all
characteristics of the other gender. For instance, in
the Mohave culture, men who identified as women
were referred to as alyha and would go through a
ceremony that celebrated their transition to
womanhood. Comparable to the fa’afafine of Samoa,
gender diversity among children was often identified
based on their interests, and at times their parents
encouraged diverse gender expression. Indeed, in
some American Indian cultures, transgender
individuals played such key roles as shamans,
warriors, and priests. Another commonality between
gender-diverse individuals in Polynesian and
American Indian cultures is how their beliefs about
sexual orientation appear to be tied to gender instead
of sex. Same-gender relationships were highly
disapproved of, but a relationship between two
people of the same sex was acceptable as long as one
individual was transgender.
Over the past 20 years, many American Indians
have reclaimed the Algonquin term niizh, or
twospirit, which refers to an individual’s gender
fluidity. Although the contemporary use of this term
refers to LGBTQ individuals, two-spirit is more akin
to gender diversity, especially since sexual

relationships are tied to gender roles. Unlike the
fa’afafine, much of this gender diversity in American
Indian cultures was lost during the colonization
process, since Christian Europeans viewed same-sex
relationships, regardless of gender identity, as sinful
and unacceptable. In fact, research suggests that two-
spirits often report histories of trauma, substance use,
symptoms of anxiety, and posttraumatic stress
symptoms in higher proportions than heterosexual
American Indians, and perhaps some of these
negative outcomes may be associated with the
ongoing homonegativity and transnegativity that
stem from Western culture.
Similarly, Indonesia is a culturally diverse nation
with a strong history of gender diversity, and such
groups as the bissu (priests who live as a different
gender from what they were assigned at birth),
warok (gender-diverse actors), waria (men who
express themselves as females), and tomboi (women
who express themselves as males) have evolved over
time due to Arab and European influences. For
instance, until 2002, Indonesia did not have any laws
prohibiting same-sex relations between individuals
of consenting age. However, in the Aceh and
Palembang regions, Sharia law has been
implemented for Muslims, making same-sex
relations illegal.
Currently, waria live throughout Indonesia, tend
to have higher social status than sexual minorities,
and often believe that they have the body of a man
and the soul of a woman. Some waria and LGBTQ
individuals use their religion (i.e., Islam) to accept
their gender identity or sexual orientation. For
example, waria may embrace their femininity during
their daily routines but will pray as men, whereas
gay men may recognize that although their sexual
orientation was created by God, what matters is their
actions and cultural duties (i.e., marriage and
family). More recently, resources that promote the
intersection of gender identity and religion have
emerged. Specifically, an Islamic school for waria
was opened in Yogyakarta, and in addition to
religious teachings, waria receive vocational training
that may provide a range of job opportunities other
than sex work. This training is especially important,
since evidence suggests that waria are more likely to
report that they have HIV or other STIs in
comparison to MSM and male sex workers,
LGBTQ Health in Non-Western Contexts 2045
regardless of their knowledge of HIV prevention. In
response to some of these health disparities, a
medical clinic (Bali Medika) geared toward LGBTQ
individuals recently opened, and many LGBTQ
organizations such as the Gaya Dewata Foundation
are devoted to addressing some of these sexual
health disparities among LGBTQ individuals.
Despite having the knowledge and resources to
address LGBTQ health concerns, some barriers to
accessing health care remain.
Worldwide, LGBTQ individuals are at risk for
numerous health disparities due, in part, to stigma
and discrimination. However, there are multiple non-
Western cultures that have a history of accepting if
not embracing some diversity in terms of sexual
orientation and gender diversity. Perhaps further
examination of these non-Western traditions may
help Western cultures learn to be more accepting and
supportive of LGBTQ individuals.
Conclusion
Individuals who either are perceived to be or identify
as LGBTQ do not always receive basic human
rights, and in some countries, sexual minorities still
face imprisonment or the death penalty if convicted
of homosexuality. Therefore, LGBTQ individuals
may not have access to appropriate mental and
physical health care, and as a result they may have a
higher prevalence of suicide, certain types of cancer,
and STIs, among other health concerns. Despite the
tendency to pathologize and criminalize LGBTQ
individuals, in some non-Western nations, religion
and cultural traditions provide a somewhat
supportive context for them. Although many of the
examples provided in this entry still place boundaries
on what is considered to be culturally acceptable
expressions of LGBTQ identities and the issue of
discrimination appears to be a constant, there are
important lessons to be learned.
To begin with, although the APA and WHO have
determined that homosexuality is not a mental
illness, there are diagnoses in the DSM and ICD that
can be used to pathologize and criminalize LGBTQ
individuals; therefore, additional advocacy work is
needed to depathologize LGBTQ persons. Further, in
response to the human rights violations and legalized
discrimination against LGBTQ individuals, an
2046 LGBTQ Health in Non-Western Contexts

international panel of experts (LGBTQ NGOs, UN comparison of heterosexual and lesbian, gay, bisexual,
officials, and academics) introduced the Yogyakarta and two-spirit Native Americans. Cultural Diversity and
Ethnic Minority Psychology, 10(3), 287.
Principles: Principles on the Application of
Boellstorff, T. (2004). Playing back the nation: Waria,
International Human Rights Law in Relation to
Indonesian transvestites. Cultural Anthropology, 19(2),
Sexual Orientation and Gender Identity in 2007, and
159–195.
while it is not legally binding, this document
Cochran, S. D., Drescher, J., Kismödi, E., Giami, A.,
provides recommendations and encourages nations to
García-Moreno, C., Atalla, E., et al. (2014). Proposed
ensure that all individuals are recognized as having declassification of disease categories related to sexual
basic human rights, regardless of sexual orientation, orientation in the International Statistical Classification
gender identity, and gender expression. Aside from of Diseases and Related Health Problems (ICD-11).
the Yogyakarta Principles, additional research, Bulletin of the World Health Organization, 92, 672–679.
advocacy, and dissemination of knowledge are Farran, S. (2010). Pacific perspectives: Fa’afafine and
needed to work toward reducing lesbian, gay, Fakaleiti in Samoa and Tonga: People between worlds.
bisexual, and trans (LGBT) health disparities. Liverpool Law Review, 31, 13–28.
Moreover, in some parts of the world gender International Gay and Lesbian Human Rights Commission.
inequality contributes to the risks that lesbian, (2011). Human rights violations on the basis of sexual
bisexual, and trans (LBT) individuals face; thus, orientation, gender identity, and homosexuality in the
enhancing collaborations with women’s rights Islamic Republic of Iran. Retrieved October 15, 2014,
movements may help to reduce some barriers to care. from http://iglhrc.org/ content/human-rights-violations-
For instance, if LGBTQ organizations provided basis-sexualorientation-gender-identity-and-
outreach to women’s rights groups, at minimum, homosexuality-islamic
LBT individuals could be referred to appropriate
resources instead of being turned away. In addition,
non-Western cultural traditions and religious
teachings appear to have some ameliorating effects,
which suggests that having some sources of support
such as family acceptance, religious validation, and
social acknowledgement may, on some level, balance
the negative impact of discrimination. Perhaps
Western cultures could examine previous research
that suggests transgender individuals in non-Western
cultures often experience a high level of distress over
their gender identities and consider how the Western
world can better address the needs of LGBTQ
individuals through validation and acceptance.
Lastly, this entry demonstrates that LGBTQ
individuals are represented throughout history and
across cultures, and it is essential to think about how
we can better address health disparities so LGBTQ
individuals can thrive.
Megan C. Lytle

See also Health Disparities

Further Readings
Balsam, K. F., Huang, B., Fieland, K. C., Simoni, J. M., &
Walters, K. L. (2004). Culture, trauma, and wellness: A

Itaborahy, L. P., & Zhu, J. (2013). State-sponsored homophobia:
A world survey of laws: Criminalization, protection, and
recognition of samesex love. Retrieved October 15, 2014,
from http://old
.ilga.org/Statehomophobia/ILGA_State_Sponsored_
Homophobia_2013.pdf
Najmabadi, A. (2008). Transing and transpassing across sex-
gender walls in Iran. Women’s Studies Quarterly, 36, 23–
42.
Nanda, S. (2000). Gender diversity: Crosscultural variations.
Long Grove, IL: Waveland Press.
Pan American Health Organization. (2013). Addressing the
causes of disparities in health service access and utilization
for lesbian, gay, bisexual and trans (LGBT) persons.
Retrieved October 15, 2014, from http://
www.who.int/hiv/pub/populations/lgbt_paper/en/
Penrose, W. (2001). Hidden in history: Female homoeroticism
and women of a “Third Nature” in the South Asian past.
Journal of the History of Sexuality, 10, 3–39.
Pillay, N. (2011). No place for homophobia here.
Retrieved October 15, 2014, from http://www.iglhrc .org/cgi-
bin/iowa/article/publications/reportsand
publications/1416.html
Pisani, E., Girault, P., Gultom, M., Sukartini, N., Kumalawati,
J., Jazan, S., et al. (2004). HIV, syphilis infection, and
sexual practices among transgenders, male sex workers,
and other men who have sex with men in Jakarta,
Indonesia. Sexually Transmitted Infections, 80, 536–540.
Poore, G. (2014). Violence: Through the lens of lesbians,
bisexual women, and trans people in Asia. Retrieved
November 19, 2015, from https://www.outright
international.org/content/violence-through-lens- lbt-people-
asia
Rao, T. S., & Jacob, K. S. (2014). The reversal on gay rights
in India. Indian Journal of Psychiatry, 56, 1–2. Vasey, P. L.,
& Bartlett, N. H. (2007). What can the Samoan “Fa’afafine”
teach us about the Western concept of gender identity disorder
in childhood? Perspectives in Biology and Medicine, 50, 481–
490.
Winter, S. (2006). Thai transgenders in focus: Their beliefs
about attitudes towards and origins of transgender.
International Journal of Transgenderism, 9, 47–62.
Winter, S. (2012). Lost in transition: Transgender people, rights
and HIV vulnerability in the Asia-Pacific region. Retrieved
October 15, 2014, from http://
www.undp.org/content/dam/undp/library/hivaids/ LGBTQ
(In)Visibility Within College Contexts
UNDP_HIV_Transgender_report_Lost_in_Transition_
May_2012.pdf
2047
The Yogyakarta Principles: Principles on the application of
international human rights law in relation to sexual
orientation and gender identity. (2007). Retrieved
November 19, 2015, from http://www
.yogyakartaprinciples.org/
LGBTQ (IN)VISIBILITY WITHIN COLLEGE
CONTEXTS
Higher education policies, initiatives, and organizations
often reflect general societal values and attitudes
regarding LGBTQ individuals. For example, American
higher education administrators of the 1950s responded
to the Diagnostic and Statistical Manual of Mental
Disorders’ (DSM’s) classification of homosexuality as
a mental disorder by expelling or “treating” students
engaged in or accused of same-sex activity or attraction
(e.g., with sexual orientation conversion therapy).
Similarly, transgenderism—referred to as
transsexualism in the DSM prior to 1973—was also
regarded by college administrators as an innate
psychological deficiency that could be cured with
appropriate psychological interventions. Following the
1973 DSM declassification of homosexuality as a
disorder, sexual- and gender-minority student visibility
increased alongside social and campus activism
regarding institutional and health reforms (e.g.,
Stonewall Riots, Campus Pride).
While sexual- and gender-minority students’ rights
continue to improve, current U.S. legislation is limited
by its focus on preventing overt aggression rather than
promoting LGBTQ student integration (e.g., Tyler
Clementi Higher Education Anti-Harassment Act of
2014). As a result, LGBTQ college and continuing
education students often report subtle, although
damaging, hostilities (termed microagressions) as well
as social exclusion at both an institutional and
interpersonal level (e.g., fraternity and sorority life,
sports teams/student athletics, religious organizations).
Moreover, such campus dynamics often intimidate
undisclosed LGBTQ students, preventing them from
LGBTQ (In)Visibility Within College Contexts
coming out and joining LGBTQ support networks.
Higher education researchers describe this as the
(in)visibility dynamic: Campus awareness of sexual-
2048
and gender-minority students (visibility) is often
discriminatory in nature, leading to LGBTQ identity
repression (invisibility). In addition, higher education
researchers such as Ronni Sanlo suggest that LGBTQ
student invisibility is further exacerbated by a lack of
college campus information regarding LGBTQ student
needs. However, further information regarding LGBTQ
college students is imperative given that an estimated
3% to 10% of students will identify as transgender;
gender- nonconforming; and/or lesbian, gay, bisexual
or queer/questioning while attending college. The goal
of the present entry, therefore, is to analyze the
prevailing issues sexual- and gender-minority students
encounter within college contexts as well as how
administrators and activists are addressing LGBTQ
campus (in)visibility.
(In)Visibility and Campus Climate
College signifies a primarily emerging adulthood
milestone (18–29 years) that is often characterized by a
sense of general instability and identity exploration on
the part of students. This complex developmental
period is often associated with a variety of stressors,
potentially limiting students’ academic, physical, and
psychological development. For example, the American
College Health Association reports that depression and
anxiety are among the top obstructions to academic
performance, with 31% of college students being too
depressed and 50% being too anxious to function
within academic settings. Alcohol is often used as a
means of coping; indeed, approximately 4 out of every
5 college students consume alcohol on a weekly basis,
and about half of these students binge drink (i.e.,
consume multiple drinks within a limited time period).
Unfortunately, emerging-adulthood stressors are further
compounded for sexual- and gender-minority college
students due to hostile campus interactions. Indeed,
many scholars suggest that it is the combined stress of
emerging adulthood and campusbased LGBTQ
hostilities that lead to the higher rates of depression and
substance abuse among LGBTQ college students.
LGBTQ Campus Climate
LGBTQ students often first encounter their campus
(in)visibility when applying to college, since many
applications either ignore sexual and gender orientation
as an identity marker or only acknowledge these
complex categories as a binary status (e.g.,
male/female). Moreover, gender identification has
become a particularly challenging issue on women’s
campus applications, as Title IX funding may be lost if
biologically male students identifying as female (MtF)
are admitted. While these issues are legally and
politically complex for college administrators to
navigate, the effects of the resulting policies can
negatively impact the campus climate for LGBTQ
students. Educational psychologists have defined
campus climate as the collective behaviors, standards,
and attitudes of college employees and students
concerning the inclusion of, as well as access and level
of respect for, individuals and groups possessing
different identities and unique needs. The LGBTQ
campus climate is determined by the following: (1)
LGBTQ persons’ perceptions and experiences of the
college community, (2) heterosexual students’
perceptions about LGBTQ persons in the college
context, and (3) the status of campus policies and
programs designed to improve the experiences of
LGBTQ students.
Annually assessing the LGBTQ campus climate is
important, as the vast majority of United States
colleges/universities are only just beginning to address
heterosexist policies (e.g., campus housing, restrooms,
fraternity/sorority membership). In addition, recent
research suggests that sexual and gender minorities tend
to perceive the college campus climate as being more
hostile and dangerous than do their non-LGBTQ peers.
Moreover, nonheterosexual, transgender, and
gendernonconforming students are more likely to
consider leaving school, stop attending classes, and
avoid campus locations necessary for their
socioemotional development (e.g., gymnasiums,
campus health clinics, student housing, student centers).
Furthermore, gender-minority students tend to view the
campus climate more negatively than do sexual-
minority students, possibly due to the lack of emphasis
placed on most educational and psychological research
initiatives with respect to the trans population. A hostile
campus climate may also prevent LGBTQ students
from disclosing their identities and orientation, leading
to psychological strain. Alternatively, research has
found that LGBTQ students who are either entirely or
mostly out within the campus community have overall
higher academic performance and are more likely to
engage in extracurricular activities and LGBTQ
advocacy work within the campus community as
compared to undisclosed LGBTQ students. By the

same token, similar research argues that positive
encounters on campus, such as acceptance from
heterosexual or gender-conforming peers, improves the
level of comfort that sexual- and gender-minority
college students who are coming out experience.
However, it is important to note that disclosed LGBTQ
students are more likely to experience personal and
overt verbal and physical harassment from their peers,
often with the harasser(s) receiving little to no
institutional consequences either because of LGBTQ
students’ fear of reporting the incident or the lack of
formal campus policies.
The (In)Visibility of Multiple Minorities
LGBTQ college students with intersecting minority
social identities, such as racial/ethnic minority or
disability status, tend to rate the campus climate even
more negatively than persons of only one minority
identity. For example, racial/ ethnic minority students
of color who also identify as nonheterosexual and/or
trans and/or gender nonconforming experience a
compounded marginalization and invisibility. The
assumed phenotypic markers of students’ racial and
ethnic groups may isolate them from largely White
campus communities, while the cultural values of
minority racial/ ethnic groups may prevent them from
disclosing their sexual or gender identities. For
example, some gay Latinos engage in secretive (i.e.,
“down low”) homosexual activities adhering to the
cultural value of machismo, which is often associated
LGBTQ (In)Visibility Within College Contexts
with stereotypical traits of masculinity (e.g., strength).
In the same vein, African American men often identify
as men who have sex with men (MSM) instead of
affiliating with a gay community that is culturally
viewed as being White and effeminate. Similarly,
although psychological research tends to concentrate on
an individual’s visible disability (e.g., cerebral palsy) or
invisible disability (e.g., learning disability) separately
from his or her sexual or gender identity, college
students with disabilities have reported the additional
strain of being desexualized by others—both within and
outside of the LGBTQ community. Disabled sexual and
gender minorities signify a unique population of college
students considering they may not have faculty, peers,
or family member who look like them, while also not
being accepted by the LGBTQ community due to their
2049
visible difference. These complex interactions of
identity, unfortunately, further contribute to the
psychological and physical complications experienced
by LGBTQ college students.
Campus Climate and LGBTQ Faculty
LGBTQ higher education employees may also
experience campus tension and risks. For example,
multiple studies have reported that the majority of
college students prefer heterosexual and
gendernormative professors. Specifically,
approximately 9 out of 10 college students indicate a
preference for having a straight instructor in the
classroom as opposed to a gay instructor. In addition,
despite institutional nondiscrimination clauses, coming
out or being out in the college atmosphere is also
financially risky for LGBTQ instructors due to limited
federal protection—and as a result, many LGBTQ
professors remain invisible (i.e., undisclosed/closeted)
for their personal safety despite promises of academic
freedom. Moreover, disclosed LGBTQ faculty also
report more negative perceptions of the campus
climate’s LGBTQ sensitivity than do both disclosed
and undisclosed LGBTQ students. Although
researchers are uncertain of how to explain this
differential, it is possible that LGBTQ employees have
a heightened awareness of discriminatory actions due to
the
LGBTQ (In)Visibility Within College Contexts
financial and professional risks they incur within their
employment settings. Unfortunately, a damaging
although unintentional outcome of faculty members not
disclosing their sexual- or genderminority status is the
absence of positive role models and mentors for
LGBTQ college students. Moreover, this problem is
further exacerbated by reports that heterosexual
colleagues and administrators do not positively view
LGBTQ research during tenure reviews (e.g., “LGBTQ
research is not real research”).
Improving LGBTQ Visibility on
College Campuses
Given the historic and present conditions regarding
sexual- and gender-minority (in)visibility within
college contexts, educational activist organizations such
as Campus Pride recommend that colleges develop
2050
extensive LGBTQ campus support networks, such as Further Readings
LGBTQ resource centers, Gay–Straight Alliance Blumenfeld, W. (2012). LGBTQ campus climate: The good
organizations, free or lowcost counseling support and the still very bad. Diversity & Democracy:
groups, LGBTQ residential options, and LGBTQ Association of American Colleges and Universities, 15(1),
faculty–student mentoring programs. In addition, 20–21.
activists encourage the development of campuswide Connolly, M. (2000). Issues for lesbian, gay, and bisexual
training programs in order to increase student, staff, and students in traditional college classrooms. In V. Wall & N.
faculty member general sensitivity toward, and Evans (Eds.), Towards acceptance: Sexual orientation issues
on campus (pp. 109–130). Lanham, MD: University Press of
awareness of, LGBTQ issues. For example, the
America.
Minority Conflict Mediation (MCM) Lab at Barnard
D’Augelli, A. R. (1989). Lesbians and gay men on campus:
College, led by
Visibility, empowerment, and educational leadership.
Chana Etengoff, explores gender-minority and - Peabody Journal of Education, 66(3), 124–142.
majority student perspectives regarding the policy of
D’Augelli, A. (2006). Coming out, visibility, and creating
accepting legally female students identifying as queer change: Empowering lesbian, gay, and bisexual people in a
or male to a women’s college. The MCM project aims rural university community. American Journal of
to identify students who are successfully negotiating Community Psychology, 37(3/4), 203–210.
gender-based campus tensions (e.g., “positive Hart, J., & Fellabaum, J. (2008). Analyzing campus
deviants”) in order to develop peerled conflict- climate studies: Seeking to define and understand.
mediation programs. Similar efforts by Meredith Journal of Diversity in Higher Education, 1(4), 222–
Worthern have been met with success in the U.S. 234.
South, suggesting that ally and peer LGBTQ programs Minority Conflict Mediation Lab, Barnard College, Columbia
University. https://sites.google.com/a/ barnard.edu/mcmlab/
can be a successful model across a diverse range of
campus communities. Such student-empowerment
programs are particularly timely, since the majority of
researchers largely approach LGBTQ campus inclusion
as a student issue to be mediated by administrators,
educators, and school counselors. However, scholars
have not yet adequately addressed how majority and
minority students independently negotiate such
conflicts outside of administratively structured settings.
Lastly, activists recommend the inclusion of additional
courses and lessons about the lived experiences and
historical oppression of sexual and gender minorities.
Implementing the above recommendations is likely to
lead to the development of more inclusive college
contexts for LGBTQ students (e.g., LGBTQ anti-
bullying policies and guidelines), hopefully positioning
this entry as a historical review rather than a statement
of current LGBTQ issues on college campuses.
Charles Joseph Polihronakis, Chana Etengoff,
and Eric M. Rodriguez

See also Activists in College; Campus Climate; College

Athletes; College Students; Down Low;
Microagressions; Transgender Inclusion on College
Campuses
 LGBTQ Issues in K–12 Education Across Global Contexts
Oswalt, S. B., & Wyatt, T. J. (2011). Sexual orientation and
differences in mental health, stress, and academic
performance in a national sample of U.S. college students.
Journal of Homosexuality, 58(9), 1255–1280.
Rankin, S. R. (2006). LGBTQA students on campus: Is higher
education making the grade? Journal of Gay & Lesbian
Issues in Education, 3(2/3), 111–117.
Sanlo, R. (2004). Lesbian, gay, and bisexual college students:
Risk, resiliency, and retention. Journal of College Student
Retention: Research, Theory & Practice, 6(1), 97–110.
Worthen, M. G. (2011). College student experiences with an
LGBTQ ally training program: A mixed methods study at a
university in the southern United States. Journal of LGBT
Youth, 8(4), 332–377.
LGBTQ ISSUES IN K–12
EDUCATION ACROSS GLOBAL CONTEXTS
K–12 LGBTQ students comprise nearly 15% of the
world’s population; however, LGBTQ students across
the globe still report experiencing marginalization (e.g.,
powerlessness and isolation), stigmatization (e.g.,
feelings of disgrace due to their social identity),
invisibility (e.g., feeling overlooked or suppressed), as
well as overt and covert discrimination. For example,
84% of K–12 U.S. LGBTQ students report being
harassed for their sexual orientation, and more than
45% of these students report that the term gay is used
derogatively within school contexts. Moreover, close to
90% of LGBTQ middle and high schoolers worldwide
report experiencing antigay slurs, suggesting that
LGBTQ Issues in K–12 Education Across Global Contexts
LGBTQ hostility increases during adolescence. Hostile
K–12 environments are particularly concerning given
the amount of time students are in school at this age as
well as the central role that peer interactions play in K–
12 student development. Researchers in the United
Kingdom reported in 2000 that 40% of bullied LGBTQ
students attempted suicide or engaged in self-harming
behaviors such as cutting and burning—with more than
16% reporting posttraumatic stress disorder (PTSD)
later in life. In addition, although some countries have
established policies to protect the rights of sexual- and
gender-minority youth within educational contexts,
research suggests that most K–12 students are hesitant
2051
to address harassment and discrimination due to the
fear of reprisal and the perceived lack of administrative
response (e.g., 60% of harassed LGBTQ K–12 students
in the United States did not file harassment reports). In
addition, while the age of initial sexual orientation and
gender-minority awareness differs across studies, most
researchers agree that the pressure to conform to
heteronormative standards begins during childhood.
The goal of this entry, therefore, is to highlight the
multidimensional challenges encountered by LGBTQ
students in global K–12 educational contexts and how
best to address them. It includes a discussion of
educational policies from an (inter) national
perspective, followed by an exploration of the impact of
non-inclusive K–12 educational context on the
psychological and physical health of sexual and gender
minorities. Further analyzing the adverse effects of
these environments, this entry then addresses the unique
experiences of LGBTQ persons possessing more than
one minority identity. Lastly, several recommendations
aimed at improving K–12 educational contexts across
global contexts, and in turn the educational experiences
of sexual and gender minorities within these settings,
will be presented.
LGBTQ K–12 Policies Across Global Contexts
The current global climate regarding sexual- and
gender-minority persons ranges from varying levels of
acceptance to overt hostility. For example, while same-
sex unions have been legal in Norway since 1989,
Nigeria and Malaysia continue to prohibit homosexual
interactions, and many other countries still limit
LGBTQ rights (e.g., marriages/civil unions, adoption,
college admittance). This global ambivalence
concerning
LGBTQ
issues sets the tone for LGBTQ K–12 student
experience, with nearly 25% of elementary school
students and 40% of K–12 teachers worldwide
reporting gender-nonconforming name-calling (e.g.,
sissy, faggot, dyke). Foreign affairs research suggests
that the supportiveness of governmental policies
regarding LGBTQ minors and education exists on a
continuum. For instance, policies can be described as
persecutorial (e.g., corporal and capital punishment in
the Middle East and Africa); homophobic (e.g.,
criminalization of male–male sexual behavior in
Jamaica); heteronormative (e.g., police harassment and
2052
army service restrictions in Japan); supportive (e.g.,
anti-discrimination legislation in Israel); or proactive
(e.g., Dutch Federation of Associations for the
Integration of Homosexuality).
Researchers suggest that the sociopolitical climates
of a nation, in conjunction with its traditional cultural
roots (e.g., religious/spiritual affiliation and the
existence of indigenous transgender persons), have a
direct impact on LGBTQ policies. For example,
Chinese researchers report that both personal and
structural conservative religious beliefs prevent sexual-
minority youth in Hong Kong from receiving necessary
counseling and mental health services. Moreover, many
Middle Eastern countries (e.g., Sudan, Yemen, Iran)
explain the illegal status of homosexuality and the
persecution of sexual- and gender-minority youth based
on religious grounds. For example, although Saudi
Arabia signed and ratified the UN Convention on the
Rights of the Child (UNCRC), the document’s promise
of young people’s universal protection from harm is
undermined by Saudi Arabia’s reservation regarding
articles that seemingly conflict with Islamic law such as
same-sex relationships/orientation. Within such cultural
climates, LGBTQ rights are absent from all contexts—
including educational settings. Contrastingly, Scotland
recently began an initiative to respond to young
people’s concerns that the UNCRC was not being
equitably applied to sexualand gender-minority youth.
In 2004, Scottish LGBTQ student activists worked
together with government representatives and educators
to draft the LGBT Youth Charter of Rights, which
emphasizes specific UNCRC rights that are particularly
important to LGBT youth such as the right to a safe
education, as well as the right to privacy and the right to
protected health information. While Scotland has a
strong Christian Protestant history that is often
associated with anti-homosexual attitudes, it is possible
that the country is sensitive to LGBTQ rights due to its
cultural narrative as an oppressed minority of the
British Empire.
Other countries with supportive LGBTQ policies
(such as Israel, France, and Australia) have embedded
legal or constitutional rights for LGBTQ persons,
protecting them from discrimination (e.g., education,
workplace, adoption, marriage). Some of these
initiatives precede the ratification of the UNCRC, such
as France’s efforts to incorporate LGBTQ information
into its schools’ health education curriculum, while
other countries’ efforts are more recent. For example,
British Columbia’s 2002 incorporation of K–12
LGBTQ literature within school libraries was a
legislative milestone decades after the UNCRC (e.g.,
Chamberlain vs. Surrey School Board). However, it is
important to note that there is often a gap between
federal policies and their local/regional implementation.
For example, despite Israel’s more inclusive
educational policies, recent research suggests that
nearly 50% of Israeli students ages 11 to 18 report
hearing homophobic remarks from their teachers, and
33% report experiencing peer harassment regarding
sexual- and gender-minority issues. Such conflicts
between policy and practice have more than likely led
to the mixed results regarding gay students’ health in
Israel—although Israeli gay youth are more likely to
report more depressive symptoms and negative affect
than their heterosexual peers, they are also more likely
to report a high level of positive affect. Researchers
suggest that these negative and positive emotions may
facilitate adaptation among gay Israeli youth, although
further research is still needed.
Gaps between policy and application are often
further complicated by the judicial tensions between the
rights of religious freedom and the rights of LGBTQ
persons, and as such, many religious schools in
progressive countries still employ discriminatory
policies. In a similar vein, some activists note that the
United States’ struggle between the personal freedoms
of the family and children’s need for governmental
protection prevented the United States from ratifying
the UNCRC in 1989 and still continues to limit LGBTQ
K–12 student protections. For example, while many
LGBTQ activists advocate for the inclusion of LGBTQ
issues in sex and health education curricula, states and
districts will often defer to parental preferences on these
issues because they view sex education as a protected
parental right.
LGBTQ K–12 Student Experience in the
United States
The United States Department of Education’s Title IX
of the Education Amendments of 1972 was amended in
April 2014 to protect transgender and gender-
nonconforming persons from discrimination within
educational contexts. However, recent general
population surveys indicate that most transgender and
gender-nonconforming individuals are unaware of this
amended federal right. In this vein, 33% of U.S.
 LGBTQ Issues in K–12 Education Across Global Contexts
elementary school students report that they have been
instructed by educators and peers regarding what they
should and should not wear with respect to their sex,
and 70% of U.S. LGBTQ middle and high school
students report being regularly harassed about their
nonconforming gender expression. Moreover, there is
still no federal protection from sexual identity
discrimination, and as a result, educational policies
regarding lesbian, gay, and bisexual youth vary from
state to state. For example, only 17 states and the
District of Columbia have anti-bullying/harassment
legislation in relation to gender identity and sexual
orientation. Likewise, only 12 states require local
school systems to provide discussions regarding sexual
orientation. However, just 9 of these 12 states
encourage inclusive discussions, while the remaining 3
provide only negative data regarding LGBTQ identities
LGBTQ Issues in K–12 Education Across Global Contexts
(e.g., HIV, suicide, substance abuse). Moreover, eight
states have established “No Promo Homo” policies that
forbid the positive portrayal of homosexuality in K–12
contexts, thereby perpetuating the invisibility of
LGBTQ students. This complex sociopolitical
landscape has contributed to the statistics regarding
LGBTQ bullying, with 90% of LGBTQ students in
U.S. middle and high schools being verbally harassed
(e.g., called names or threatened) and 60% being
physically harassed (e.g., being pushed or shoved) in
school because of their sexual orientation. Moreover,
80% of these students report being harassed on a daily
basis, thus highlighting the lack of administrator
response.
The Impact of Non-Inclusive School
Environments
Throughout their K–12 education, LGBTQ students
often experience isolation—increasing the likelihood of
internalized homophobia and decreases in self-esteem.
International and crosscultural research suggests that
LGBTQ youth’s lower levels of self-esteem, combined
with the avoidance of hostile academic settings (e.g.,
high rates of absenteeism), may contribute to poor
academic performance and lower levels of
extracurricular involvement. For example, almost half
of all transgender students worldwide reported skipping
a class or missing at least 1 day of school in the past
month because they felt unsafe or uncomfortable.
Similarly, more than 15% of LGBTQ high school
2053
students internationally are likely to withdraw from
school due to harassment and assault, further hindering
their academic pursuits.
Homophobic and heteronormative messages from
peers, educators, parents, and the media may also
prevent LGBTQ adolescents from addressing
identity development. LGBTQ students who become
aware of their sexual and romantic attractions, as well
as their gender identity, during this developmental stage
may begin to repress these desires and thoughts,
preventing them from achieving self-acceptance.
Unfortunately, the lack of selfacceptance, in
conjunction with the lack of social acceptance (i.e.,
sexual-minority stress), can contribute to the
development of mental health challenges. For example,
LGBTQ students across the globe may experience
heightened levels of anxiety related to the fear of peer
harassment
and the
perpetual strain of identity suppression. In addition,
negative self-perceptions may lead to suicide attempts
and the development of a major depressive disorder.
Lastly, it is important to note that many of these issues
are compounded by the comparatively higher rates of
parental rejection and related homelessness among
LGBTQ youth.
As a means of coping with these intense emotions,
many LGBTQ students self-medicate with substances
(e.g., alcohol and marijuana) and engage in risky sexual
behavior due to the lack of viable confidants and
resources within the school community. Indeed,
LGBTQ students are more likely to engage in
potentially dangerous sexual behavior, as well as to
contract HIV and STIs, in comparison to their
heterosexual counterparts. Moreover, transgender
individuals—particularly male-to-female (MtF)
transgender persons—have a statistically significantly
higher prevalence of HIV/STIs in comparison to other
sexual-minority populations. Researchers suggest that
this disparity may be due to a combination of
abstinenceonly programs (e.g., in the United States or
Uganda), religious homophobia, and a lack of
information regarding sexual activities among
nonheterosexual and transgender populations.
LGBTQ Intersectionality: Navigating Multiple
Minority Identities
2054
The aversive experiences of sexual and gender
minorities within global K–12 educational contexts
becomes even more complex when considering
intersectionality—the ongoing interaction of multiple
social identities (e.g., gender and sexual identity,
race/ethnicity, socioeconomic status, religion,
[dis]ability, etc.). Though research focusing on
intersectionality is fairly new—and therefore sparse—
there is a general consensus among experts in this area
that LGBTQ youth with intersecting minority identities
are faced with more frequent discrimination and
prejudice during their lifetime. For instance, learning
disabilities (e.g., dyslexia, auditory processing
disorder), which are diagnosed due to a discrepancy
between an individual’s expected level of achievement
and actual performance, have historically served as
justification for discrimination against students, from
both peers and educators. Educational research often
describes students with learning disabilities as being on
the margins of the school community, as educators
often have limited expectations for them, and peers may
isolate them from social interactions (e.g., group
projects). Thus, LGBTQ students with learning
disabilities experience a dualistic marginalization in the
K–12 educational context, which has the potential to
further inhibit social functioning, self-esteem, and
academic performance.
In addition, researchers suggest that LGBTQ African
American and Hispanic/Latino students, as well as most
other students who identify as persons of color, tend to
be at an increased risk of depression and suicide.
Moreover, gay males of color are at a higher risk of
contracting HIV/STIs compared to White heterosexual
males. Psychologists and public health researchers
suggest that such health disparities may be due to
culturally biased health education information. Scholars
also attribute health inequalities to the perpetual
feelings of isolation and discrimination LGBTQ
students of color encounter. Furthermore, researchers
note that African Americans and Hispanics/Latinos
have strong religious/spiritual traditions— many of
which are reported to be associated with homophobia.
Alternatively, an emerging body of research suggests
that individuals identifying as both LGBTQ and a
cultural minority are more resilient to hostile
circumstances than individuals with only one minority
identity. Researchers who explore LGBTQ
intersectionality, such as Bonnie Moradi and Melanie
Brewster, report that racial/ethnic-minority LGBTQ
persons may have lower levels of comingout anxiety
than White LGBTQ persons because LGBTQ persons
of color are able to generalize their coping skills from
racist to homophobic contexts. It is important to note
that researchers are still attempting to determine if such
forms of resilience are universally experienced by
LGBTQ youth of any cultural minority group or if
resilience is a culturally specific phenomenon. For
example, analyses of U.S. Add Health data in 2000
determined that same-gender attraction was a
significant predictor of depression and suicidal ideation
for White, African American, and Hispanic/Latino
youth—although not for Asian or Pacific Islander
youth. Follow-up research by developmental scholars
Yuko Homma and Elizabeth Saewyc suggest that it is
only Asian youth from supportive family environments
who are likely to demonstrate this type of resilience.
Further research is still needed to determine if there are
common cultural values and supportive skills displayed
across LGBTQ youth of multiple minority statuses
(e.g., family cohesiveness, coping skills).
Improving LGBTQ K–12 Environments
Responding to the negative effects of heteronormative
school climates and biased curricula, civil rights
activists and organizations such as the Gay, Lesbian &
Straight Education Network (GLSEN) have developed
reform efforts to enhance educational settings for
LGBTQ students. For example, the United States’
Dignity for All Student Act (DASA) and New
Zealand’s Human Rights Act of 2001 prohibit LGBTQ
bullying. In addition to the development of legislative
reforms—both nationally and internationally—LGBTQ
activists worldwide have encouraged the integration of
sensitivity training and workshop programs for
students, employees, and parents as well as the
implementation of Gay–Straight Alliances within
schools. Through these programs, members of the
school community learn how to effectively address
student bullying and harassment and are informed of
the unique experiences of LGBTQ youth. Emerging
research suggests that such programs are highly
effective, with U.S. researchers in Oregon finding that
lesbian and gay Grade 11 students from school districts
promoting inclusive antibullying policies are 2.25 times
less likely to attempt suicide than those living in
counties with fewer participating school districts.
Similarly, lesbian, gay, and bisexual U.S. youth living
 LGBTQ Issues in K–12 Education Across Global Contexts 2055
in youths in high school. School Psychology Quarterly, 17(2),
cities and states with more protective school climates 148–167.
report fewer suicidal thoughts than those living in
communities with less protective climates.
Feminist researchers such as André Grace and
Kristopher Wells also argue that LGBTQ information
should be incorporated into educational curricula
through the lens of queer theory. Originally developed
in the 1990s, queer theory challenges the dichotomous
relationship associated with heterosexuality and
homosexuality and postulates an understanding of
sexuality and gender that highlights shifting boundaries.
Queer theory challenges heterosexuality as a social-
sexual norm and rejects the social construct of stable
identity categories. Educational reforms motivated by
queer theory may consist of including queer literature in
a school’s library and curriculum, featuring LGBTQ
issues within physical and health education classrooms,
or discussing the LGBTQ civil rights movement in a
history class. Educational psychology research on these
and similar initiatives suggest positive improvements in
LGBTQ students’ academic performance and their
mental and physical health as well as the development
of an increasingly integrated school community.
Charles Joseph Polihronakis, Chana Etengoff,
and Eric M. Rodriguez

See also Education; Gay, Lesbian & Straight Education

Network (GLSEN); Internalized Homophobia;
Intersections Between Sex, Gender, and Sexual
Identity; LGBTQ-Parent Involvement and Advocacy in
Schools; Queer Theory

Further Readings
Birkett, M., Espelage, D. L., & Koenig, B. (2009). LGB and
questioning students in schools: The moderating effects of
homophobic bullying and school climate on negative
outcomes. Journal of Youth and Adolescence, 38, 989–1000.
Casement, R. (2002). Breaking the silence: The stories of gay
and lesbian people in children’s literature. New Advocate,
15(3), 205–213.
Chesir-Teran, D. (2003). Conceptualizing and assessing
heterosexism in high schools: A setting-level approach.
American Journal of Community Psychology, 31(3–4), 267–
279.
D’Augelli, A. R., Pilkington, N. W., & Hershberger, S. L.
(2002). Incidence and mental health impact of sexual
orientation victimization of lesbian, gay, and bisexual
2056
LGBTQ Online Communications: Building Community Through Blogs, Vlogs, and Facebook
Fox, M. (1993). Politics and literature:
Chasing the “isms” from children’s
books. The Reading Teacher, 46(8),
654–658.
Grace, A. P., & Wells, K. (2009). Gay and
bisexual male youth as educator activists
and cultural workers: The queer critical
praxis of three Canadian high-school
students. International Journal of Inclusive
Education, 13(1), 23–44.
Griffin, P., & Ouellett, M. (2003). From silence
to safety and beyond: Historical trends in
addressing lesbian, gay, bisexual,
transgender issues in K–12 schools. Equity
and Excellence in Education, 36(2), 106–
114.
Homma, Y., & Saewyc, E. M. (2007). The
emotional wellbeing of Asian-American
sexual minority youth in school. Journal of
LBGT Health Research, 3(1), 67–78.
Horn, S. S., & Nucci, L. (2003). The
multidimensionality of adolescents’ beliefs
about and attitudes toward gay and lesbian
peers in school. Equity and Excellence in
Education, 36, 136–147.
Kosciw, J. G., Greytak, E. A., & Diaz, E. M.
(2009). Who, what, where, when, and why:
Demographic and ecological factors
contributing to hostile school climate for
lesbian, gay, bisexual, and transgender
youth. Journal of Youth and Adolescence,
38(7), 976–988.
Lesser, L. K., Burt, T., & Gehaw, A. (2005).
Making room in the circle: Lesbian, gay,
bisexual and transgender families in early
childhood settings. San Rafael, CA: Parent
Services Project.
Moradi, B., Wiseman, M., DeBlaere, C.,
Goodman, M., Sarkees, A., Brewster, M.
E., et al. (2010). LGB of color and White
individuals’ perceptions of heterosexist
stigma, internalized homophobia and
outness: Comparisons of levels and links.
Counseling Psychologist, 38, 397–424.
Saewyc, E. M., Singh, N., Reis, E., & Flynn, T.
(2000). Intersections of gender, racial, and
orientation harassment in school and
associated health risks among adolescents.
Journal of Adolescent Health, 26, 148.
LGBTQ ONLINE
COMMUNICATIONS:
BUILDING COMMUNITY THROUGH
BLOGS, VLOGS, AND FACEBOOK
In recent years, the Internet has become
more accessible and socially oriented—
leading to its key role in sexual-minority
identity formation, self-acceptance, and
disclosure. For example, 70% of
LGBTQ American college students
report using the Internet to research their
sexual orientation. Moreover, health
psychologist Gary Harper suggests that
LGBTQ youth primarily use the Internet
to connect with supportive peers—
leading to increases in sexual orientation
knowledge, selfawareness, and comfort.
In addition, anonymous online
sexual/gender orientation disclosures and
explorations are particularly appealing to
those living within communities that
disapprove of or persecute LGBTQ
persons. For example, gay men from
Christian and Orthodox Jewish
backgrounds use online communications
more frequently (61%) than religious
supports such as prayer or religious
counseling (34%) to make sense of the
coming-out period. Moreover, research
indicates that the ability to continuously
create and edit new online profiles
(personas) can help users to enact and
merge multiple, and often conflicting,
identities. While it may be challenging to
assert a gay Muslim identity within a
traditional mosque or to live life as a
masculine, gay, Black man, Internet
communities can often provide a safe
place to integrate and negotiate multiple
identities. In this vein, gay Mormon
youth have responded to a lack of
support from the Latter Day Saints
community by developing an elaborate
online community network via the

MoHo Directory—a global listing of
over 100 gay Mormons and their blogs.
For many, the MoHo Directory
functions as a family of choice—a
committed relationship network bound
by friendship rather than blood.
Sociocultural psychologists Chana
Etengoff and Colette Daiute suggest that
online family-of-choice structures are
characterized by members’ access to and
awareness of other individual members,
dialogues about positive and negative
experiences, empathy and relatedness, as
well as unconditional group membership.
Establishing supportive and validating
systems of nonbiological relations is
often imperative for LGBTQ persons, as
this can help facilitate relational
resilience (i.e., providing and receiving
LGBTQ Online Communications: Building Community Through Blogs, Vlogs, and Facebook
social support), thereby buffering the
impact of minority stress (i.e., tensions
between majority and minority culture)
and family-of-origin (birth) rejection. It
is important to note that such online
mental health benefits seem to be
LGBTQ-specific; indeed, in contrast,
many media scholars report that online
engagement is generally associated with
increases in anxiety, loneliness, and
social isolation. It is possible that
LGBTQ persons are more likely to
benefit from online communications than
heterosexual persons, as LGBTQ social
networking is more focused on
redefining cultural narratives and identity
development. However, further research
is still needed to determine whether these
online communication goals generalize
to all members of the LGBTQ
community or across online
communication systems (e.g., Twitter,
LinkedIn). In light of this emerging body
of research regarding the distinctive
nature of LGBTQ online engagement,
the present entry will focus on how
blogs, vlogs, and Facebook—all of
2057
which will be defined below—contribute
to LGBTQ community development.
LGBTQ Blogs: A Forum for
Collective Action
Blogs (short for weblogs), an online
network of publicly searchable
journals/diaries, have become
increasingly popular—with
approximately 8 million Americans
using blogs to post updates, videos, and
links for nearly 57 million American
blog readers. Commercial reports
indicate that sexual minorities (54%) use
social networking and blogs more than
do heterosexuals (40%). However, the
Pew Research Center has drawn an
important distinction between the rates
of LGBTQ active, online participation
versus readership: For example, while
84% of LGBTQ persons reported
reading about LGBTQ issues online,
only 16% of LGBTQ persons reported
discussing LGBTQ issues online. That
being said, sexual-minority respondents
are more likely to read blogs about
sexual-minority issues (35%) as
compared to blogs about politics (22%),
music (16%), or travel (16%), suggesting
that sexual minorities primarily use
blogs as an avenue to address sexual-
minority experiences and stress.
Moreover, LGBTQ blog use peaks
immediately before and during the
coming-out period and then steadily
declines as the time since initial
disclosure increases.
Israeli counseling psychologists Azy
Barak and Meyran Boniel-Nissim of
Haifa University have found that blog
writing improves self-esteem and
reduces social-emotional difficulties for
youth at a higher rate than other writing
tasks, thereby positioning blogs as a
potentially helpful LGBTQ resource.
Moreover, online writing allows authors
2058
to filter life experiences through
narrative lenses that can provide new
meaning to challenging events (i.e.,
sense-making). For example, recent
qualitative research exploring online
identity integration has found that 61%
of American gay men from Christian and
Jewish backgrounds make sense of their
complex coming-out experiences by
authoring blogs—a process often
reported to be healing and cathartic. In
addition, coming- out blogs by gay men
wrestling with their sexual and religious
identities are often designed to be
collaborative—with the majority of
bloggers linking their blog to another
blog, Google followers, or a Facebook
page, or posting the number of times
their blog was viewed. Similarly, UK life
history researcher Sue George notes that
the interactive relationship between the
reader/commenter and blogger is the key
beneficial factor of coming-out blogging.
However, George cautions that once a
blog becomes public, it is vulnerable to
critical and condemnatory feedback as
well.
It is important to note that blog use
and its benefits may vary between
sexual- and gender-minority groups. For
example, media scholars report that 83%
of youth blogs discussing homosexuality
are authored by men, and there is a
notable lack of lesbian bloggers.
Although researchers have yet to
determine the cause for this disparity, it
is possible that this is an outgrowth of
lesbians feeling marginalized and
repressed due to both their gender and
sexual orientation—perhaps leading to a
general reduction in mediated interaction
or an alternative focus and forum. It is
additionally possible that these variations
in LGBTQ blog use may be culturally
specific, as emerging research suggests
that Egyptian lesbian and queer women’s
LGBTQ Online Communications: Building Community Through Blogs, Vlogs, and Facebook
blogs are also actively addressing both
their personal and political identities.
Although differences between Egyptian
lesbian/queer women’s and gay men’s
blogs continue to emerge, gay men’s
blogs have largely focused on legal
concerns and the freedom from
homophobic violence, whereas
lesbian/queer women’s blogs have
emphasized community building and
collective action. In either case, the
Middle Eastern queer emancipation
movement is largely limited to online,
blogging forums—highlighting the need
for further research regarding LGBTQ
blogging activism across the globe.
Vlogs: A Vehicle for Identity
and Cultural
Transformation
Online communications offers
opportunities for individuals to achieve
relational goals that may otherwise be
beyond their reach (e.g., supportive
relationship networks/families of
choice). For example, many LGBTQ
youth have developed serial video blog
streams, otherwise known as vlogs, to
make sense of challenging coming-out
experiences such as religious conflicts,
employment discrimination, difficult
family reactions, and social
ignorance/prejudice. Vlogs have been
defined as a public archive of feelings
and a medium of transformation for
minority groups struggling to make
meaning of stigma and trauma. While
vlogs have been used by a diverse range
of individuals within the LGBTQ
community, the greatest number of
LGBTQ-related vlog channels seem to
be produced by the transgender
community—often referred to as
transvlogs.
At the time of this writing, a YouTube
search for transgender video blogs
yielded 6,774 results, illustrating the

growing popularity of this medium for
the transgender community. Vlogs may
be particularly popular within the
transgender community due to their
longitudinal and serial presentation— the
living narratives simultaneously
document and contribute to the ever-
evolving FtM (female-tomale) and MtF
(male-to-female) trans-identity
construction. Social media and
transgender scholar Tobias Raun also
suggests that these online video
narratives of transgender development
often serve as helpful resources for
others struggling with trans-identity
concerns. In addition, the selfpublishing
nature of vlogs offers transgender
individuals an opportunity to assertively
develop their community and create
change within cultures that have
otherwise silenced them. For example,
many transgender vlogs are focused on
developing collaborative knowledge
regarding medical misinformation,
hormone usage, intersecting minority
statuses (e.g., gender, sexual orientation,
LGBTQ Online Communications: Building Community Through Blogs, Vlogs, and Facebook
socioeconomic status, and racial/ethnic
identity) and the general coming-out
process.
LGBTQ Facebook
Networks: A
Medium of
Disclosure
A social networking site with an
estimated 850 million global users,
Facebook enables individuals to (1)
construct a public or semipublic profile
consisting of photos, links, short status
updates, and longer narrative posts; (2)
share this profile with select users who
are then publicly listed as friends; (3)
visit and engage with friends’ profiles;
(4) connect to like-minded (i.e.,
LGBTQ-supportive) groups and
organizations; and (5) create and join
2059
(“like”) group pages. Similar to most
social networking sites, Facebook
provides users with a profile template
consisting of optional demographic
points such as name, date of birth, place
of residence, relationship status, and
sexual orientation.
Facebook users can select privacy
controls that enable information to be
publicly or privately accessible. While
the Pew Research Center reports that
56% of lesbian, gay, bisexual, and
transgender (LGBT) persons disclose
their sexual/gender orientation on
Facebook, the remaining 44% may not
feel comfortable posting a sexual
orientation status due to the high rates of
LGBTQ online bullying—by some
estimates, LGBT youth encounter online
bullying 3 times as often as their
heterosexual peers. In this vein, a recent
Gay, Lesbian & Straight Education
Network (GLSEN) study reported that
42% of LGBT youth encounter online
bullying, and 27% report feeling unsafe
online—a problem that can be
exacerbated by Facebook’s requirement
that users list their legal name. In
addition, the rates of social network
disclosure seem to differ across LGBTQ
groups—50% of gay men and lesbians
have come out on a social network as
compared to only 34% of bisexuals. In a
similar vein, transgender youth report
higher levels of online victimization
compared with gay and bisexual youth. It
is possible that such differentials are due
to bisexual and transgender persons’
reports of being excluded from both
sexual-minority and heterosexual
networks.
While research focused on LGBTQ
Facebook communications is currently
limited, Chana Etengoff and Colette
Daiute suggest that family allies can
productively use Facebook to facilitate
their LGBTQ relative’s online and
2060
offline disclosure. For example, family
members have reportedly attempted to
educate hostile relatives by posting
endorsements of LGBTQ rights on
Facebook. In light of the foregoing, it
may be useful for clinicians to
incorporate online community
participation into the therapeutic process
for both LGBTQ clients and their
families. However, perhaps due to its
relative novelty, social media networks
such as Facebook are still not widely
used within clinical contexts.
Conclusion
Given the increasing popularity of social
networks, it is likely that LGBTQ
researchers and therapists will begin to
focus more attention on LGBTQ online
engagement and community building in
the coming years. In addition to online
networks facilitating interpersonal
development (e.g., relational resilience,
meaning-making), social media is now
playing a pivotal role in political
disclosure and debate. For example, Dan
Savage’s 2010 “It Gets Better” YouTube
campaign quickly garnered celebrity and
political attention—culminating in
50,000 videos in support of LGBTQ
teens, including videos by President
Barack Obama and former Secretary of
State Hillary Rodham Clinton. Similarly,
Twitter reported a peak of 9,188 tweets
minutes after the 2013 repeal of the
Defense of Marriage Act, including a
victory tweet from President Obama that
reached 150 million people. In this way,
integrated Internet networks provide
collaborative tools for creating new
forums for LGBTQ and ally community
development.
Chana Etengoff and Eric M. Rodriguez
See also Bisexual People and Community;
Bullying, Rates and Effects of; Families of
Choice; Media Representations of LGBTQ
People; Social Media, Use for Recruitment;
Transgender Identities
Furt
her
Rea
ding
s
Bond, B. J., Hefner, V., & Drogos, K. L.
(2009). Information-seeking practices
during the sexual development of lesbian,
gay, and bisexual individuals: The influence
and effects of coming out in a mediated
environment. Sexuality & Culture, 13(1),
32–50.
Boniel-Nissim, M., & Barak, A. (2013). The
therapeutic value of adolescents’ blogging
about social-emotional difficulties.
Psychological Services, 10(3), 333.
doi:10.1037/a0026664
Etengoff, C., & Daiute, C. (2015). Online
coming out communications between gay
men and their religious family allies:
Family of choice and origin perspective,
Journal of GLBT Family Studies, 11(3),
278–304.
doi:10.1080/1550428X.2014.964442
George, S. (2011). Blogging bisexuals and the
coming-out process. Journal of Bisexuality,
11(2–3), 320–328.
GLSEN. (2013). Out online: The experiences
of lesbian, gay, bisexual and transgender
youth on the Internet. Retrieved November
24, 2015, from http://www.glsen
.org/press/study-finds-lgbt-youth-face-
greater- harassment-online
Harper, G. W., Bruce, D., Serrano, P., & Jamil,
O. (2009). The role of the Internet in the
sexual identity development of gay and
bisexual male adolescents. In P. L.
Hammack & B. J. Cohler (Eds.), The story
of sexual identity: Narrative perspectives
on the gay and lesbian life course (pp. 295–
325). New York, NY: Oxford University
Press.
Harris. (2010). Gay and lesbian adults are
more likely and more frequent blog readers.
Retrieved November 24, 2015, from
http://www.prnewswire.com/news-releases/
gay-and-lesbian-adults-are-more-likely-and-
morefrequent-blog-readers-98317299.html
Huffaker, D. A., & Calvert, S. L. (2005).
Gender, identity, and language use in
 2061
teenage blogs. Journal of Computer-
Mediated Communication, 10(2).
MoHo Directory—Gay Mormon Blogs.
http://www
.mohodirectory.com
Pew Research Center. (2013). A survey of
LGBT Americans: Attitudes, experiences
and values in changing times. Retrieved
November 24, 2015, from
http://www.pewsocialtrends.org/2013/06/13
/a-survey-oflgbt-americans/
2062
LGBTQ People of Color
Raun, T. (2014, January 16). Video blogging as a vehicle of
transformation: Exploring the intersection between trans
identity and information technology. International Journal
of Cultural Studies. Retrieved November 24,
2015, from http://ics.sagepub.com/content/early/2014/0
1/13/1367877913513696.abstract#cited-by
Shaw, D. F. (1997). Gay men and computer communication:
A discourse of sex and identity in cyberspace. In S. Jones
(Ed.), Virtual culture: Identity and communication in
cybersociety (pp. 133–145).
Thousand Oaks, CA: Sage.
Walsh-Haines, G. (2012). The Egyptian blogosphere:
Policing gender and sexuality and the consequences for
queer emancipation. Journal of Middle East Women’s
Studies, 8(3), 41–62.
LGBTQ PEOPLE OF COLOR
This entry describes the distinctions between different
sexual and gender identities and how the development
and navigation of these identities can be different for
LGBTQ people of color. It discusses how LGBTQ
people of color have to negotiate racism and sexism
within mainstream, White, heterosexual-dominant or
White LGBTQ spaces, as well as navigate
heterosexism, homophobia, and transphobia within
ethnic/racial minority communities. It explores the use
of an intersectional framework within research and
practice, and how LGBTQ people of color experience
identity from an intersectional lens, working through
multiple and converging oppressions. In addition, the
entry discusses how some LGBTQ people of color
(particularly gay, bisexual, and queer [GBQ] men of
color) may differentially experience oppression, and
how GBQ men of color have points of access, privilege,
and engagement in patriarchy— which can at times
marginalize feminized, woman, and transgender people
of color. Moreover, the entry examines how resilience
and strength through community engagement, group
formation, and political resistance have benefited
LGBTQ people of color. Finally, the entry addresses
how future research and practice need to (1) increase
the visibility of LGBTQ people of color both within
academic/practice work and in leadership and executive
roles and (2) further explore LGBTQ people of color’s
interpersonal relationships and families.
Identity and Intersectionality
Locating and incorporating a common identity language
for identifying and describing LGBTQ people within
research and practice is important for two key reasons:
(1) It allows us to be specific with regard to our
population(s) of focus, and (2) it ensures that we are
respecting the individually preferred identities and
language that identify the people we are seeking to
describe and serve. This is particularly true for
exploring the lives of LGBTQ people of color, who
often must navigate ethnic/racial identity, sexual
orientation identity, and gender identity. For some
LGBTQ people of color, there may be a desire to
distance themselves from mainstream White LGBTQ
culture. LGBTQ people of color may do this by
choosing to identify using other terms such as “same-
gender loving,” “same-gender practicing,” “two-
spirited,” or deliberately or inadvertently placing one’s
racial or ethnic identity in front of his or her sexual and
gender identity (e.g., Black gay man compared to gay
Black man; Latina transgender woman compared to
transgender Latina woman). In addition, given that the
racial and ethnic identities of this population are often
lost within a White-dominant LGBTQ culture, LGBTQ
people of color may go through an active negotiation of
blending or navigating their sexual, gender, racial, and
ethnic identities in various spaces and contexts.
One construct that can be useful in understanding
and exploring the multiple, and sometimes complex,
identities of LGBTQ people of color is
intersectionality. Intersectionality helps to advance our
understanding of the range of human experiences for
LGBTQ people of color by allowing for the
consideration of various political and social categories,
with attention to how all people embody multiple
identities and core social statuses. The general concept
of intersectionality is in part rooted in the writings of
Black and Chicana feminist activists, many of them
lesbian identified. Intersectionality, as an academic
term, was initially coined by Kimberlé Crenshaw to
refer to the sociopolitical position of Black women
within U.S. culture in the context of critical race
studies, a subfield of legal studies.
Although intersectionality has its roots in activism
among women of color and academic legal scholarship,
subsequent researchers and practitioners have explored
intersectionality through terms such as multiple
identities, reflecting the more varied ways scholars have
examined individuals from multiple (usually minority)
groups. These approaches to studying multiple

identities examine various levels of the human
experience, and offer insights into how people
understand, construct, and navigate their lived
experiences of both individual and institutionalized
oppression.
LGBTQ people of color may experience varying
degrees of acceptance, as well as oppression and
marginalization, from their intersectional communities.
The presence of strong religious influence in ethnic
communities may account for differential treatment of
LGBTQ people of color by community members, given
that some religious doctrine has historically been used
to justify discrimination against LGBTQ people. For
example, the hostile sociopolitical climate for LGBTQ
individuals living within some African, Latin
American, or Caribbean states that have criminalized or
marginalized nonheterosexual or gendernonconforming
behavior has historical origins in the religious
colonization that was imposed by European states.
Assimilation into White mainstream LGBTQ culture
also may not be a priority for LGBTQ people of color,
as some believe that assimilation renders their
ethnic/racial identities invisible. For example, Sylvia
Rivera, a Latina bisexual transwoman and transgender
activist, and Marsha P. Johnson, an African American
transgender activist and drag queen, discussed how the
mainstream White gay movement often excluded
people of color, transgender and gender-nonconforming
individuals, and drag queens and was working to
assimilate into heteronormativity.
For LGBTQ youth of color, integrating an
ethnic/racial identity into their overall sense of self is an
important developmental task. Experiencing
LGBTQ People of Color
differential treatment in both their ethnic/racial
community and mainstream White LGBTQ community
may negatively impact ethnic/racial identity
development among LGBT youth of color, and may
lead young people to conceal aspects of their various
identities, depending on the context of their interactions
with others. This may result in youth experiencing
varying degrees of visibility and invisibility within their
own intersectional communities.
Researchers have noted this process of LGBTQ
concealment among youth of color, as they found that
lesbian and gay youth of color may exclude themselves
from cultural activities to avoid bringing shame to their
families. Other forms of concealment and self-
censorship have also been demonstrated among
2063
LGBTQ adults, including role flexing, whereby youth
intentionally alter their actions, dress, and mannerisms
to conform to standards of masculinity (including
committing verbal or physical antigay violence toward
others); censoring information about their sexuality to
others; and avoiding confronting others who made
antigay statements.
It is important to note, however, that not all LGBTQ
people of color manage oppression and marginalization
by engaging in identity concealment and self-
censorship. Researchers have noted how LGBTQ
people of color may challenge heterosexist comments
within their communities and develop ties with
members of their social support network in order to
assist with integrating their sexual orientation and
gender identities with their racial/ethnic identity. These
instances of ethnic/ racial and LGBTQ identity
integration demonstrate the complex ways that LGBTQ
people of color may integrate their multiple intersecting
identities. Future work in the area of intersectional
identities for LGBTQ people of color will benefit from
exploring stories of resilience and success, and better
understanding the ways in which people navigate and
negotiate their multiple identities. Such work should
acknowledge changing norms within various
communities of color, and recognize that labeling
ethnic/racial communities as virulently more
homophobic compared to White communities is
problematic
LGBTQ People of Color
for—and hindering the progress being made within—
many ethnic/racial communities.
Multiple Layers of Oppression: Fluidity of
Oppression, Access, and Privilege
LGBTQ people of color may evidence varying degrees
of well-being as a function of their experiences with,
and reaction to, multiple forms of oppression related to
their sexual orientation, gender identity, and
ethnicity/race. Both individuallevel and
institutionalized racism, heterosexism, and transphobia
may lead to rejection, isolation, discrimination,
harassment, violence, and microaggressions, as well as
limited economic opportunities and lack of access to
ameliorative services. All of these experiences can
negatively impact an LGBTQ person of color’s
physical and mental health.
2064
It is important to continually explore the ways in
which societies impose differential sanctions upon their
citizens who may be different, and the impact this may
have on those individuals and communities.
Unfortunately, given the intersectional nature of
LGBTQ people of color, they may experience such
oppression and sanctions related to different aspects of
their identity. Some scholars, for example, have
documented the racialized struggles that sex work
policy can present for transgender women of color. In
addition, racial profiling by police, police brutality, and
criminalization/incarceration have had negative and far-
reaching effects on the well-being of LGBTQ people of
color. For example, HIV-exposure criminalization laws
disproportionately affect Black men more often and
more severely than they do White men.
Although all LGBTQ people may share experiences
of oppression related to their sexual orientation or
gender identity, their membership in other identity
groups (e.g., ethnicity/race, gender, social class) may
provide varying levels of social power and privilege
that can compound the societal challenges they
experience. In addition, the interplay between
oppressed and privileged statuses related to gender,
race/ethnicity, social class, and sexual orientation has
been shown to have differential effects on an individual,
depending on the composition and visibility of his or
her oppressed and privileged statuses.
When locating men of color within LGBTQ
communities, it is helpful to explore how their access
and privilege as men and their participation in
patriarchy impact the lives of LGBTQ women of color.
This examination will not diminish the marginalization
that is experienced by gay, bisexual, and queer (GBQ)
men of color. Heterosexism, racism, and sexual risk
have been studied among gay and bisexual men of
color, and there is clear and growing documentation of
how GBQ men of color experience oppression and
marginalization. However, an examination of sexism,
misogyny, and patriarchy within LGBTQ communities
of color will hold GBQ men of color accountable for
their role in the individualized and institutional
oppression of other bodies, particularly feminized,
woman, or transgendered people.
Resilience and Strength Among LGBTQ
Communities of Color
Despite the multiple layers of oppression that LGBTQ
people and communities of color may face, there are
many narratives of strength and success among LGBTQ
people of color. Resilience provides a strengths-based
framework for understanding how individuals who are
exposed to the threats and risks detailed in the prior
section not only survive but thrive in the face of
oppressive forces. Resilience has been viewed as a
dynamic process whereby a person is able to positively
adapt within the context of significant adversity and
overcome the negative effects of risk exposure.
LGBTQ people of color have promoted resilience
through community action, group formation, and
political resistance. For example, although Latina
lesbians were involved in many of the social activist
activities of the gay rights/liberation movement in the
1960s, they began organizing in autonomous groups in
the early 1980s in major U.S. cities as a way to show
solidarity and to provide support and assistance to each
other. Many of these women organized themselves as
networks, as opposed to formal organizations that were
often viewed as hierarchical, and groups such as Las
Buenas Amigas were formed to create a safe space for
Latina lesbians to build connections with other Latina
lesbians in other parts of the world.
Resilience has also been documented among Black
GBQ men who used different political and community-
organizing strategies to cope with and combat the
HIV/AIDS epidemic. The framework of resilience and
strengths-based approaches is exceedingly different
from deficiency-based approaches that are often
employed in research and practice. The latter typically
focus only on examining experiences of oppression and
marginalization among LGBTQ people of color. While
it is necessary to document and interrogate such
injustices in order to bring light to situations and
circumstances that may otherwise be “swept under the
rug” by people in positions of power and privilege,
doing so without also celebrating the successes and
strengths of LGBTQ people and communities of color
presents a biased view that may further serve to
marginalize the community. While researchers are
expanding the literature that examines resilience within
LGBTQ communities of color, more work needs to be
done in this area by those in LGBTQ studies, as such
work may help to promote resistance against the
difficulties faced by LGBTQ people of color.
Future Directions for Research, Theory, Practice,
and Social Action

Although there has been increasingly more research
dedicated to LGBTQ people of color, there is still a
need for more work that is geared toward increasing
positive outcomes among this community. For
example, within public health there are a limited
number of empirical studies and interventions that
focus on the experiences of GBQ men of color, and this
gap increases for lesbians, queer women, and
transgender people of color and the health risks that
they face. There has also been a lack of scholarship
within other LGBTQ studies fields that have brought
visibility to the realities faced by LGBTQ people of
color.
Furthermore, major LGBTQ political organizations
and media outlets often fail to account for the diverse
experiences of LGBTQ people of color. Major LGBTQ
organizations have been criticized for their lack of
inclusion of LGBTQ people of color, and they do not
always address the specific ethnic/racial issues
impacting this community.
LGBTQ People of Color
2065
relationships through an intersectional lens will be
helpful in understanding the complexity of such
interactions.
The navigation of families of birth, and the
construction and negotiation of families of choice, is
another fruitful area of exploration among LGBTQ
people of color. These families may not follow a
traditional nuclear family format, and may include
various individuals across generations, sexual
orientations, gender identities, ethnicities/races, and
other identity characteristics. For some, the family unit
in its many conceptualizations and permutations can
serve as a source of strength, support, and affirmation;
while for others it can serve as a source of distress,
rejection, and alienation. Thus, it will be important to
understand how to best support the creation and
maintenance of family structures that will provide the
support and nurturance

Many religious institutions that serve communities of

color, and that are composed of community members,
also fail to include LGBTQ people of color within their
organizational and community structure. Moreover,
inclusion within research, theory, practice, political
advocacy, and activism means more than just being
aware of, speaking about, targeting, or sampling
LGBTQ people of color. It also includes intentionally
placing LGBTQ people of color within leadership and
executive roles and approaching issues with a more
complex framework or understanding.
Future research, theory, practice, and social action
efforts should not only explore the lived experiences of
LGBTQ people of color as individuals, but also
examine their multiple and varied connections and
relationships with others. The role of interpersonal
relationships of all types (e.g., romantic, sexual,
friendship, work) among LGBTQ people of color is a
fruitful area of inquiry and discovery, including those
that involve interactions with people who have shared
identity characteristics and those that do not (e.g.,
interracial romantic relationships). While marriage
among LGBTQ people in the United States has become
a topic of much public policy and social discourse,
future efforts may explore the extent to which these
conversations are including LGBTQ people of color
and are exploring other ways to socially validate
romantic and sexual unions. Viewing interpersonal
2066 LGBTQ Social Movements (Assimilation vs. Liberation)
needed to promote the resilience and well-being of
LGBTQ people of color, especially LGBTQ youth of
color. The growing amount of research, theory, and
practice targeting LGBTQ people of color is important
to creating more sustainable and holistic approaches
and models that can eliminate the disparities and
inequities experienced by this population.
Gary W. Harper, Kenneth M. Pass, and
Ryan M. Wade
See also African American Sexualities; Latina/o Sexualities;
LGBTQ Social Movements (Assimilation vs. Liberation);
Racialized Masculinity; Transgender Identities; Transgender
Sexualities
Further Readings
Bailey, M. M. (2013). Butch queens up in pumps: Gender,
performance, and ballroom culture in Detroit. Ann Arbor:
University of Michigan Press.
Byrd, R. P., & Guy-Sheftall, B. (Eds.). (2001). Traps:
African American men on gender and sexuality.
Bloomington and Indianapolis: Indiana University
Press.
Cohen, C. J. (1999). The boundaries of blackness: AIDS and the
breakdown of black politics. Chicago, IL:
University of Chicago Press.
Collins, P. H. (2004). Black sexual politics: African
Americans, gender, and the new racism: New York, NY:
Routledge.
Crenshaw, K. (1989). Demarginalizing the intersection of race
and sex: A black feminist critique of antidiscrimination
doctrine, feminist theory and antiracist politics. University of both informing tactics and goals in social movements at
Chicago Legal Forum, 140, 139–167.
Gopinath, G. (2005). Impossible desires: Queer diasporas and
South Asian public cultures. Durham, NC: Duke University
Press.
Manalansan, M. F., IV. (2003). Global divas: Filipino gay men
in the diaspora. Durham, NC: Duke University Press.
Moraga, C., & Anzaldúa, G. (1983). This bridge called my
back: Writings by radical women of color. New York,
NY: Kitchen Table: Women of Color Press.
LGBTQ Social Movements (Assimilation vs. Liberation)
Reddy, C. (2011). Freedom with violence: Race, sexuality, and
the U.S. state: Durham, NC: Duke University Press.
Toro-Alfonso, J., Díaz, N. V., Andújar-Bello, I., & Nieves-
Rosa, Luis, E. (2006). Strengths and vulnerabilities of a
sample of gay and bisexual male adolescents in Puerto
Rico. Revista Interamericana de Psicología, 40(1), 55–64.
Tremble, B., Schneider, M., & Appathurai, C. (1989). Growing
up gay or lesbian in a multicultural context. Journal of
Homosexuality, 17(3–4), 253–267.
Wilson, B. D. M., & Miller, R. L. (2002). Strategies for
managing heterosexism used among African American gay
and bisexual men. Journal of Black Psychology, 28(4), 371–
391.
LGBTQ SOCIAL MOVEMENTS (ASSIMILATION
VS. LIBERATION)
Conflicts over whether to pursue assimilationbased or
liberation-based strategies on behalf of LGBTQ
communities have consistently arisen in LGBTQ social
movements. Assimilationist approaches have been
described as seeking to pursue greater rights and access
for LGBTQ communities within existing social and
political contexts and institutions. In contrast,
liberationist approaches have focused on transforming
or restructuring society overall, as opposed to working
for inclusion in existing institutions. The two
approaches contain differences in method, with
assimilationists characterized typically as working
within existing systems to pursue rights, and
liberationists more interested in working outside of
existing systems and favoring a broader array of
political strategies in pursuit of their goals. These
strategies are not necessarily mutually exclusive, with
various times, sometimes simultaneously. Assimilation
and liberation have also taken on evolving meanings at
different points in time, depending on social context
and other factors.
This entry discusses some key contexts in which
LGBTQ social movements have grappled with the
tension between assimilation and liberation. Examples
here will mainly be drawn from movements in the
United States, but it should be noted that many of these
tensions have
been present in other countries, and more globally.
Assimilation Versus Liberation in Early Social
Movements
“Homophile” (meaning “loving the same”) groups
during the 1950s and 1960s addressed discrimination

against lesbian and gay people in housing and the
workplace, advocated to ensure safer social
environments, and engaged with the scientific
community about its views of same-sex sexual
orientation. These groups generally used approaches
aimed at increasing understanding and minimizing
differences based on sexual orientation.
Although rooted in communist ideology and
aspirations toward overarching social reform at its
founding in 1951, the Mattachine Society, the leading
homophile organization, came to be primarily identified
by the late 1960s—like the lesbianfocused Daughters of
Bilitis—with the goal of public education in pursuit of
social acceptance.
Assimilationist tactics of mainstream homophile
groups came under scrutiny at the time of the police
raids on the Stonewall Inn in New York City’s
Greenwich Village on June 28, 1969, and the ensuing
resistance, often referred to as the Stonewall Rebellion
or Stonewall Riots. Critics challenged Mattachine for
seeking to work with law enforcement to end violence
following the Stonewall raid.
Gay liberation activists, many of whom were
connected to the African American civil rights and the
anti–Vietnam War movements, sought societal
transformation in lieu of pursuing rights within existing
institutions. The Gay Liberation Front (GLF)
envisioned widespread societal reform in coalition with
organizations outside of the LGBTQ sphere. As
embodied by Carl Wittman’s “Refugees From America:
A Gay Manifesto,” the gay liberation movement relied
heavily on the rhetoric of liberation and freedom from
oppressive social institutions.
The idea of liberation also informed the GLF’s
concern with language. Through the GLF’s influence,
“coming out” came into common use during this period,
referring to the liberatory, public act of self-
identification as gay or lesbian. This approach broke
with homophile groups’ preference for greater privacy
to ensure safety for LGBTQ communities.
Further manifesting the tension between liberation
and assimilation, the Gay Activists Alliance (GAA) was
formed in 1969 following the Stonewall Rebellion. The
GAA’s founders had grown concerned that the Gay
Liberation Front’s alliances across the political left,
including with the Black Panther Party and the antiwar
movements, undermined the goal of achieving gay
rights. The GAA sought to pursue the single issue of
gay rights through political organizing within the
2067
electoral system rather than through efforts aimed at
broadbased societal reform. Although viewed by some
(particularly former GLF members) as assimilationist,
the GAA used direct confrontation tactics (called
“zaps”) in public places to draw attention to its issues.
Lesbian feminist organizations emerging in the
1970s, including The Furies and Radicalesbians, drew
from the liberation politics of the time to challenge
prevailing social institutions. This included critiquing
sexism within the gay liberation movement and
homophobia within the women’s rights movement. The
experience of marginalization led some, but not all,
lesbian feminists to advocate for social and political
separatism.
Assimilation Versus Liberation in Modern
U.S. Social Movements
Debates about liberation as compared to assimilation
have persisted in issues addressed by modern LGBTQ
movements. The following are some key examples.
AIDS Activism
Strands of assimilation- and of liberation-based
approaches emerged in activism regarding AIDS in the
1980s and 1990s. AIDS activist groups have historically
used both insider and outsider tactics to bring public
awareness to the AIDS crisis and advocate for public
funding, treatment availability, medical coverage,
federally controlled and funded needle-exchange and
condom-distribution programs, sex education, and
nondiscriminatory treatment of people with HIV and
AIDS.
Organizations like the AIDS Coalition to
Unleash Power (ACT UP), Lesbian Avengers, and
Queer Nation used nonviolent direct-action tactics to
draw public attention. Targets of ACT UP’s highly
visible protests, for instance, included pharmaceutical
companies, hospitals, government agencies, and the
Catholic Church to accelerate and broaden access to
drugs and drug trials, reduce the price of medication,
urge more effective government responses, and push
for condom distribution and establish needle exchanges.
Other organizations like the AIDS Action Council
and the Treatment Action Group (TAG) focused on
working directly within the political system to pursue
their agendas to create federal policy for improved
HIV/AIDS care and services, for effective HIV
2068 LGBTQ Social Movements (Assimilation vs. Liberation)
prevention, and for expeditious and vigorous drug
development and research. These efforts included
legislative lobbying within established political circles. the rights of marriage starting from the early 1970s, but
Some AIDS groups, however, adopted assimilation-
and liberation-based approaches simultaneously or over
time. For instance, the Gay Men’s Health Crisis
(GMHC), founded in 1981, emerged to serve the
specifically articulated need for the gay community to
serve the gay community. Later, GMHC came to be
viewed as an established voice with access to
government and influence in policymaking circles.
Debates about assimilation and liberation approaches
have pervaded questions facing AIDS activists,
including how much to associate AIDS with gay people
in the public eye, how much to challenge the existing
medical care system, and whether to use insider or
outsider tactics in AIDS advocacy.
LGBTQ Social Movements (Assimilation vs. Liberation)
Military Policy and Don’t Ask, Don’t Tell
Political debate concerning the status of lesbian and
gay people in the military during the 1990s raised
questions of assimilation and liberation. President Bill
Clinton’s election in 1992 appeared to many as a sign
that the ban on lesbian and gay people serving in the
military would be overturned. During his campaign,
Clinton had voiced support for lesbian and gay service
members and had supported overturning the ban.
LGBTQ groups saw the failure to overturn the ban and
the compromise Don’t Ask, Don’t Tell policy (signed
into law in 1993 and in effect until 2011), which banned
lesbian and gay service members from being open about
their sexuality, as furthering discrimination in harmfully example, legal scholars William Eskridge and Nan
assimilationist ways.
The tension between assimilation and liberation also
emerged in the very discussion of whether LGBTQ
energy should focus on access to the military in the
1990s. Some, for example, resisted focusing on military
access based on concerns that such an agenda
reinforced the legitimacy of war and controversial
exercises of American military power.
Marriage
The contemporary movement in support of same-sex
marriage arose against a backdrop of internal discussion
about the value of, and tactics in pursuing, same-sex
marriage in the context of assimilation and liberation.
Individual lesbian and gay people sought legal access to
discussions have circulated within LGBTQ movements
for the past several decades about the wisdom of
pursuing marriage as part of a movement agenda.
Many gay liberationists and lesbian feminists of the
1960s and 1970s disfavored pursuing access to
marriage, pointing to its associations with
heterosexuality and patriarchy and its conflict with
more pluralistic notions of kinship and intimate
association. In later years, a pair of essays by leaders of
the major LGBTQ organization Lambda Legal Defense
and Education Fund appeared in Out/
Look National Gay and Lesbian Quarterly in 1989 and
encapsulated the debate over assimilation and liberation
in the context of marriage.
In one essay, Thomas Stoddard, then executive
director of Lambda, argued that obtaining access to
marriage was
key to eliminating discrimination against lesbians and
gay people because of the special place of marriage in
our social structure.
In contrast, Paula Ettelbrick, then legal director of
Lambda, questioned the assumption that pursuing
marriage would yield benefits for lesbian and gay
people. Ettelbrick argued that marriage would threaten
lesbian and gay identity and culture by forcing
assimilation and would undermine the lesbian and gay
movement’s interest in protecting and recognizing a
diverse array of relationships.
Addressing concerns about inequality between
women and men in marriage, some scholars have
argued that same-sex couples’ access could transform
marriage into a more egalitarian institution. For
Hunter argued that same-sex marriage would disrupt
gender-based patterns and divisions of labor in
marriage.
These debates about assimilation and liberation
continued through the 1990s and 2000s, as marriage
took an increasingly prominent place on the agendas of
LGBTQ organizations. The call for greater societal
transformation beyond marriage took the form of a
statement in 2006 titled “Beyond Same-Sex Marriage:
A New Strategic Vision for All Our Families and
Relationships,” organized by Queers for Economic
Justice. The statement, signed by numerous lesbian,
gay, bisexual, and transgender activists, as well as

scholars, educators, writers, artists, lawyers, journalists,
and community organizers, urged the LGBTQ
movement to adopt a vision seeking recognition of
diverse families, partnerships, and relationships, beyond
those fitting the marriage model.
On June 26, 2015, the United States Supreme
Court issued a decision in the case of Obergefell v.
Hodges that extended the right to marry to samesex
couples nationwide. The Supreme Court issued its
decision based on principles of liberty and equality for
same-sex couples. Impacts of the legal change on social
movements and on debates about liberation and
assimilation remain to be seen.
Transgender Identity and Rights
Movements in favor of recognition and rights for
transgender and gender-nonconforming people have
struggled with debates about assimilation and liberation
internally and in relation to lesbian and gay movements.
Early organized transgender activism took the form of
protests against police harassment and discrimination in
daily life. One such instance of resistance, the
Compton’s Cafeteria Riot in San Francisco in the late
1960s, stemmed from and catalyzed the formation of
several transgender organizations, with more
organizations emerging throughout the 1970s. These
organizations were focused on public education,
societal reform, and providing support for transgender
individuals.
Transgender activists have alternately worked
alongside lesbian, gay, and feminist movements and
critiqued them for overlooking transgender concerns.
Transgender activists Sylvia Rivera and Marsha P.
Johnson, who founded the Street Transvestite Action
Revolution (STAR) in 1970, experienced this
marginalization as part of the GLF and GAA.
Transgender activists have criticized the lesbian and
gay movement’s assimilative focus on marriage for
same-sex couples instead of targeting a variety of forms
of oppression. Focusing on class- and race-based bias,
some transgender activists have faulted mainstream
LGBTQ movements for focusing on issues of concern
to more privileged Whites, instead of considering the
interests of communities of color, the economically
disadvantaged, the incarcerated, and other marginalized
groups.
Additional issues facing the transgender movement
implicate tensions between assimilation and liberation.
These include the legal and social implications of living
2069
in stealth as opposed to being out about being
transgender; conforming to binary sex categories;
recognition of marriages with transgender partners; and
whether being transgender should be viewed as a
psychiatric condition, a medical condition, or neither.
At stake in each of these disputes are the daily
consequences for transgender and gender-
nonconforming people regarding important rights,
access to meaningful support and institutions, and social
and political recognition.
Bisexual Identity and Rights
Bisexual identity, activism, and scholarship have
been viewed as posing challenges to dichotomous (and
assimilationist) understandings of sexual orientation
and identity. Bisexual social organizations founded in
the 1970s and more explicitly politically active groups
that emerged in the 1980s and 1990s comprised
movements focused on greater visibility and inclusion
of bisexual communities in society in general, within
lesbian and gay political efforts, and within queer
studies.
The recognition of bisexual identity has been viewed
as an important, and liberatory, move away from
understanding sexuality in exclusively binary terms,
consisting solely of either same-sex orientation on one
hand or different-sex orientation on the other. The
efforts of bisexual advocacy organizations, activists,
and scholars to highlight the experience of bisexuality
have challenged “biphobia” and the phenomenon of
“bisexual erasure,” whereby bisexuality’s existence is
questioned and, relatedly, dismissed as a transitional
phase between heterosexuality and lesbian/gay identity.
Organizations like the American Bisexuality Institute,
founded in 1998, continue to contest bisexual erasure
by supporting academic research, including research
that confirms the existence of bisexuality.
By the mid- to late 1980s, new bi political
organizations were aggressively pushing for inclusion,
including in AIDS public outreach materials, college
organizations, and titles of national marches. With
efforts aimed at inclusion meeting resistance (with
skepticism focused on perceived benefits of
heterosexual privilege enjoyed by some bisexuals and
related questions about the legitimacy of bisexuality as
an identity), bisexual advocacy organizations in the
1990s like BiNet USA began to succeed in their efforts
to convince gay groups to add “B” for “bisexual” to
their organization names.
2070 LGBTQ Social Movements (Assimilation vs. Liberation)
The very category of bisexuality, however, has been
the subject of dispute even among those who study
bisexuality or identify as such. While the concept of
bisexuality challenges the dominant model of
monosexuality (whether lesbian/gay or heterosexual),
some scholars and activists have argued that the
continued use of the term bisexual threatens to reinforce
rigid categorization of sexual identity. Based on this
perspective, the use of the term bisexual may be viewed
as a form of assimilation into conventional
understandings of sexual orientation. For some who
view the category of bisexual as assimilationist, the
term queer presents a productive alternative to binary
understandings of sexuality.
Queer Identity and Rights
The concept of queerness, and its relationship to
other identity categories, has embodied tensions
between assimilation and liberation in LGBTQ social
movements. Originally used as a pejorative term to
refer to same-sex sexuality (used alternately with fairy
by the early part of the 20th century, although the terms
bore different in-group meanings), queer came to be
reappropriated by the 1990s as an act of political
resistance by sexualminority groups, including by the
activist organization Queer Nation, founded in 1990.
For some, the concept of queerness, as reclaimed in
the 1990s, served as an alternative to the dominant and
limited category of gay and lesbian, providing a more
encompassing umbrella for the diverse range of gender-
and sexuality-nonconforming identities challenging
heterosexual privilege. As an umbrella term, queer has
been used to include bisexual, gay, lesbian, and
transgender identities. It has also sometimes been used
to include intersex communities as well as other sexual
identities or practices, such as sadomasochism (S/M),
non-monogamy, or asexuality.
Some also embrace queer identity as a more
liberatory alternative to mainstream sexuality or gender
classification or dominant binaries. Queer theorists
Teresa de Lauretis, Judith Butler, and Eve Kosofsky
Sedgwick, writing in the late 1980s and 1990s,
established a basis for understanding identity as
untethered from categorical understandings of gender
and sexuality.
Despite the appeal of queer identity as a broad
umbrella or as a discursive alternative to dominant
classification schemes, some scholars and activists have
raised concerns that the concept of queerness lacks
specificity or sufficient content for effective political
mobilization. Similarly, some have raised concerns that
the more expansive identity category obscures or
neutralizes the lived experience of particular minorities
who might fall under the mantle of queer. Since at least
the 1990s, scholars have highlighted the need for
activism and academic
work to examine the intersectional nature of queer
experience, as it interacts, for example, with race,
ethnicity, class, education, and other aspects of identity.
Suzanne A. Kim
See also Bisexual Inclusion in the LGBTQ Rights Movement;
Gay Exclusion in the U.S. Military:
Evolution and Demise of Don’t Ask, Don’t Tell;
Gender Binaries; Homonormativity; Military and
LGBTQ People; Nonbinary Genders; Queer
Further Readings
Alexander, J., & Anderlini-D’Onofrio, S. (Eds.). (2012).
Bisexuality and queer theory: Intersections, connections,
and challenges. New York, NY:
Routledge.
Bronski, M. (2011). A queer history of the United States.
Boston, MA: Beacon Press.
Butler, J. (1990). Gender trouble: Feminism and the
subversion of identity. New York, NY: Routledge. Currah, P.,
Juang, R. M., & Minter, S. (Eds.). (2006). Transgender rights.
Minneapolis: University of Minnesota Press. de Lauretis, T.
(1987). Technologies of gender: Essays on theory, film, and
fiction. Bloomington: Indiana University Press.
Eaklor, V. L. (2008). Queer America: A people’s GLBT history
of the United States. Westport, CT:
Greenwood.
Eng, D., Halberstam, J., & Munoz, J. E. (Eds.). (2005).
What’s queer about queer studies now? Durham, NC:
Duke University Press.
Rimmerman, C. A. (2008). The lesbian and gay movements:
Assimilation or liberation? Boulder, CO:
Westview.
Sedgwick, E. K. (1990). Epistemology of the closet.
Berkeley: University of California Press.
Stryker, S. (2008). Transgender history. Berkeley, CA: Seal
Press.
Udis-Kessler, A. (1996). Identity/politics: historical sources of
the bisexual movement. In B. Beemun & M. Eliason (Eds.),
Queer studies: A lesbian, gay, bisexual, and transgender
 2071
anthology (pp. 53–63). New York, NY: New York include all individuals who feel unrepresented by the
University Press. current social norms of gender and sexuality.
LGBTQ Umbrella

LGBTQ UMBRELLA

The LGBTQ umbrella is an inclusive term for members

of sexual- and gender-minority groups. LGBTQ is an
acronym representing lesbian, gay, bisexual,
transsexual (or transgender), and queer people, and
though this is the most commonly used ordering of the
letters, no specific order is necessary. The unifying
metaphor of the umbrella has been used to represent a
larger community and to combine the efforts of many
nonheterosexually and non-cisgender–identifying
members in addressing problems affecting the
community such as a lack of legal recognition,
discrimination, and violence. To this effect, the LGBTQ
umbrella has been important in assisting its identifying
members to fight for equality. However, in more recent
years, the LGBTQ umbrella has come under scrutiny by
a more diverse community. The umbrella has been
criticized for being exclusionary, Whitedominated,
unable to support the needs of its members universally,
and for the marginalization of bisexual and trans*
issues. Reactions to these criticisms include additional
letters in the acronym and using more general terms
such as “queer” and “gender and sexual minorities”
(GSM).
The first umbrella term used for the sexual minority
community was the “gay community,” which by the
mid-1980s became the “gay and lesbian community.”
At first there was resistance to the inclusion of other
groups representing sexual and gender minorities for
reasons including the desire for a cohesive group
message, and some bi- and transphobia. However,
bisexuals were added under the umbrella, followed by
the trans* communities, in order to strengthen the fight
against inequality for all groups, creating the shorthand
LGBT acronym that is familiar today. In 1996, the
LGBTQ umbrella was born with the addition of a Q to
represent people who identified as either queer or
questioning. However, the Q primarily represents
queer, as it can be used as a catch-all term for other
groups that are currently unrepresented in the acronym.
Therefore, the LGBTQ umbrella is generally used to
2072
LGBTQ Umbrella simultaneously have both a masculine and feminine
spirit), U for unsure, C for curious, P for Pansexual, P
for Polyamorous, an additional T to delineate
The LGBTQ umbrella has been instrumental in
transsexual and transgender, T for transvestite, and O
bringing about greater equality for those it
for other. If all of these groups were included, the result
encompasses, and in the continued fight toward
would be LGBTIQQAAFH2UCPPTTO, which many
furthering that equality and ending discrimination and
argue defeats the purpose of using an acronym in the
violence. LGBTQ umbrella organizations such as
first place. Yet even then there are many who are left
GLAD (Gay & Lesbian Advocates & Defenders) and
out such as those who identify as mostly heterosexual,
PFLAG (Parents, Families, Friends, and Allies United
genderqueer, hijra, swingers, sexually fluid, gender
with LGBTQ People) have done much to further the
fluid, third gender, nonbinary, agender, aromantic, and
rights of those they represent, such as removing sodomy
others. Because of this, the possibility of a non–label-
laws, fighting for health coverage of transition-related
identifying and allencompassing term has been
care, defending against discrimination, and supporting
proposed, though none has gained the popularity or has
marriage equality. By bringing many smaller groups
the historical clout of the LGBTQ umbrella. These
together into a larger, more powerful, and more
alternatives include queer, though many remember the
influential group, the LGBTQ umbrella can be more
use of this term in a derogatory fashion; LGBTQ+,
effective in bringing about change.
which still has the problem of prioritizing the named
Although creating a label such as the LGBTQ
groups; gender and sexual minorities (GSM); and most
umbrella has resulted in many positive outcomes, there
popularly and inclusive, gender and sexual diversity
are also consequences to having a static boundary
(GSD) or gender, sexual, and romantic diversity
around any identity. In recent years, the label of the
(GSRD).
LGBTQ umbrella has come under fire for a variety of
reasons, primarily regarding the inclusion of people Sarah M. Merrill, Matthew C. Stief, and
whose identities are already a part of the LGBTQ Ritch C. Savin-Willams
umbrella. For example, some have criticized the
LGBTQ umbrella for not distinguishing differences See also Bisexual Inclusion in the LGBTQ Rights
between sexual orientation and gender identity. This Movement; LGBTQ People of Color; Queer; SexualIdentity
Labels; Transgender Inclusion in the LGBTQ
can be especially difficult for those in trans*
Rights Movement
communities who feel their concerns are not as
commonly addressed by the LGBTQ umbrella and that
trans* issues are not an intrinsic part of the LGBTQ
movement. Bisexually identified people have also felt Further Readings
unwelcomed in the umbrella because of biphobia within Barclay, S., Bernstein, M., & Marshall, A. (2009). Queer
the gay community. In addition, many people of color mobilizations: LGBT activists confront the law. New York,
who identify as LGBTQ feel separated from that NY: New York University Press.
community because of the predominance of Whites. Fassinger, R. E., & Arseneau, J. R. (2007). I’d rather get wet
than be under the umbrella: Differentiating the experiences
Importantly, the LGBTQ umbrella is also
and identities of lesbian, gay, bisexual, and transgender
confronting the issue of inclusion. There are many people. In K. J. Bieschke, R. M. Perez, & K. A. DeBord
sexual- and gender-minority individuals who are not (Eds.), Handbook of counseling and psychotherapy with
represented with the five-letter acronym. Some have lesbian, gay, bisexual, and transgender clients (2nd ed., pp.
suggested adding letters to account for this, such as the 19–49). Washington, DC: American Psychological
LGBTQ-Parent Families With More Than Two Parents Association.
increasingly more common LGBTQIQA, which Stone, A. L. (2009). More than adding a T: American
includes I for intersex, Q for questioning, and A for lesbian and gay activists’ attitudes towards transgender
allies (heterosexually identified people who support inclusion. Sexualities, 12(3), 334–354.
LGBTQ causes). However, that does not even scratch
the surface of the possibilities for additions such as A
for asexual, F for fetish, H for HIV-affected, 2 for Two-
Spirit (people in the Native American tradition who

LGBTQ-PARENT FAMILIES WITH MORE
THAN TWO PARENTS
Although many children are raised by more than two
adults who function as parents, the law rarely entertains
the possibility that a child could have more than two
legal parents. In a stepfamily situation, for example, a
child’s custodial parent has remarried and the
stepparent may function as a parent. As long as the
child also has a noncustodial parent, the stepparent
customarily cannot attain the status of a legal parent.
Lesbians and gay men may wish to form families
with more than two parents in a number of situations.
Like children of heterosexual couples, a child raised
from birth by a same-sex couple may acquire a
stepparent if the parents separate and acquire new
partners or spouses. Because partners in same-sex
couples do not both have a genetic relationship to their
child, it may seem more natural than it is for
heterosexuals for a third adult with no genetic
connection to the child to assume a parental role.
Similarly, lesbians and gay men may embark on
parenting with chosen family in circumstances where
more than two adults will raise a child together.
Because a lesbian couple cannot have a child without
semen from a man, and a gay male couple cannot have
a child without both an egg from a woman and a
woman who will bear the child, the possibility of more
than two parents arises for same-sex couples before a
child is conceived. A lesbian couple that plans to be
their child’s only parents will use semen from an
anonymous donor or a known donor who agrees not to
be a parent. A gay male couple may similarly choose a
gestational surrogacy arrangement in which an egg is
LGBTQ-Parent Involvement and Advocacy in Schools
obtained from an anonymous donor, and a woman who
will bear the child is identified and screened by an
agency specializing in such arrangements. Sometimes,
however, lesbian couples intend that the donor (and
perhaps his partner) will also be the child’s parent.
Although less frequent, a gay male couple may plan to
coparent with a woman who is the child’s genetic
and/or birth mother.
The legal status of the adults functioning as
parents matters for a number of purposes. If there is
disharmony among the adults about where the child
2073
should live, how much time the child should spend with
each adult, who should make major decisions, or who
must support the child financially, a court will have to
resolve that dispute, and in the process will identify the
child’s legal parents. If one adult dies, the child’s
eligibility to receive benefits or to inherit may also
depend upon whether the deceased was the child’s legal
parent.
Customarily, legal parentage is an all-or-nothing
situation whereby an adult is a parent for all of the
above purposes or has none of the rights or
responsibilities of a parent. A child can have more than
two such parents when a court grants an adoption
naming more than two parents or when more than two
individuals meet the legal criteria to be declared a
parent under a state’s law and the state does not limit
the number of parents a child can have. Both of these
scenarios remain unusual.
There are no published court opinions allowing
adoptions that create more than two parents for a child.
However, lawyers report that such adoptions have been
granted by trial judges in Alaska, California, Florida,
Massachusetts, Oregon, Texas, and Washington. It is
possible there have been such adoptions in other states;
adoption records are sealed and therefore come to light
only if someone with knowledge of the adoption reveals
it publicly.
A small number of statutes authorize a determination
that a child has more than two parents. In the District of
Columbia, three legal parents are possible when
conception takes place through donor insemination. The
woman giving birth and the partner with whom she
intends to raise the child can agree that they will both
be the child’s parents. Although the semen donor is
ordinarily not a legal parent, the statute provides that he
is if he and the woman giving birth so agree in writing.
In Canada, British Columbia has a statute that allows a
couple who
plan to
raise a child conceived through assisted conception to
include the egg or semen donor, or the woman who
bears the child in a surrogacy situation, as the child’s
third parent. All three parents can be listed on the
child’s birth certificate. This approach has been rightly
criticized because a lesbian couple and a gay male
couple may wish to raise a child as four parents, but the
law will recognize only three.
In 2014, a judge in Brazil determined that the three
adults who planned for a child—the birth mother, her
2074
female spouse, and the biological father—should all be
listed as parents on the child’s birth certificate.
In California, a child may have more than two
parents if more than two individuals meet the statutory
criteria for presumed parental status. A presumed parent
includes a person who receives a child into his or her
home and holds out the child as his or her own; a
biological relationship with the child is not necessary. A
judge must determine that it would be detrimental to the
child to recognize only two parents.
In Delaware, a child with two parents may acquire a
third parent if that person meets the statutory criteria to
be a de facto parent, which include exercising parental
responsibilities for a long enough time to develop a
bonded parent– child relationship. The two original
parents must consent to the formation of the parent-like
relationship.
The term de facto parent can be confusing. Although
the Delaware de facto parent is a full legal parent, in
other states courts have assigned limited parental rights
or responsibilities to individuals who may be called de
facto parents or may simply meet certain criteria. For
example, in a Minnesota dispute over a child conceived
with a known donor who was involved in the child’s
life,
the court awarded joint custody to a biological mother
and her former partner and gave visitation rights to the
donor. In Pennsylvania, a court resolved a dispute over
child support by determining that the biological mother,
LGBTQ-Parent Involvement and Advocacy in Schools
her former partner, and the semen donor who had been
involved in the child’s life were all responsible for
supporting the child. In New Jersey, a court awarded
visitation rights to a lesbian stepmother who had raised
the child with the biological mother for many years,
even though the child had an adoptive mother— the
biological mother’s former partner—as well.
This is a newly evolving area of law made more
complex by the fact that every state establishes its own
legal definition of parentage. When more than two
adults wish to be considered a child’s legal parents,
they should consult an attorney with specialized
expertise in this area.
Nancy D. Polikoff
See also Adoption, Legal Considerations in; Assisted
Reproductive Technologies (ARTs); Coparenting;
Families of Choice; Joint Adoption; Legal Rights of
Nonbiological Parents; Polyamorous Parenting;
Second-Parent Adoption; Sperm Donors, Known
Further Readings
Bennett, D. (2010, October 24). Johnny has two mommies—and
four dads. Boston Globe, p. K1.
Jacobs, M. B. (2007). Why just two? Disaggregating traditional
parental rights and responsibilities to recognize multiple
parents. Journal of Law and Family Studies, 99, 309–339.
Joslin, C., Minter, S., & Sakimura, C. (2014). Lesbian, gay,
bisexual and transgender family law. Eagan, MN:
Thomson West.
Kelly, F. (2014). Multiple-parent families under British
Columbia’s new Family Law Act: A challenge to the
supremacy of the nuclear family or a method by which to
preserve biological ties and opposite-sex parenting?
University of British Columbia Law Review, 47, 565–595.
Lovett, I. (2012, July 14). Measure opens door to 3 parents, or
more. New York Times, p. A9.
LGBTQ-PARENT INVOLVEMENT AND
ADVOCACY IN SCHOOLS
The concepts of parent involvement and advocacy in
schools have been widely explored in research and
practice, and
these terms
have been defined in a variety of ways. However, there
are key components that characterize meaningful parent
involvement and advocacy in schools. This entry
provides a comprehensive definition for these terms,
based on common factors across the literature and the
most recent research.
Parent involvement in school refers to the active
participation in the education of one’s child, including,
but not limited to, assisting in the learning process at
home and being actively involved in communicating
with the child, the school’s personnel, and all other
parties involved in the child’s education. Parent
involvement is a key component in a child’s academic
and emotional success in school.
Advocacy in schools describes the act of speaking on
behalf of students or parents for the purpose of helping
them address their needs and rights in schools. It is
important to mention that in addressing advocacy in

schools, there are several key parties that play a crucial
role, including parents, teachers, administrators, mental
health professionals, and other school personnel. As
will be explored in this entry, depending on the
circumstances, parents could be viewed as advocates
(when speaking on behalf of their children or other
parents) or the ones being advocated for (when other
parents or school personnel stand up for their rights).
However, while parent involvement and advocacy are
natural for some parents, they are quite challenging for
others. For example, some parents avoid questioning
school personnel and school district representatives
because they fear being perceived as intrusive. Further,
some school districts do not allow individual parents to
be part of the district’s plans of action, and make it
clear that there is a power differential that favors the
system and not the parents. In addition, parent
involvement and advocacy may be difficult for parents
from diverse backgrounds, including LGBTQ parents.
Taking into consideration the importance of and
barriers to parent involvement and advocacy,
researchers and practitioners suggest a series of
strategies for being an active parent and advocate. Some
of these strategies include partnering with active
advocates, networking, and self-education. Partnering
with active advocates is a powerful resource for those
parents who would like to advocate for their children
but do not know the best way to do so. Research
suggests that partnering with active advocates can
provide beginner advocates a voice within the child’s
school and the school system while demonstrating how
to interact with school personnel in a nonthreatening
but assertive manner. In addition, networking, or
building relationships with different influential
individuals in the school system (e.g., principals, school
representatives, and superintendents), will allow school
personnel to realize the importance of incorporating
parents in the decision-making process regarding
policies and rules that directly affect students and their
parents, regardless of the parents’ diverse backgrounds.
Furthermore, when parents take the initiative to gain
greater awareness of the laws, policies, and procedures
of the education system, the effect is to lessen the
imbalance of power between schools and parents to
their mutual benefit, as parents are better able to
understand and communicate with education
professionals.
However, it is important to discuss ways in which
school personnel can advocate for students and parents
2075
of diverse backgrounds, including LGBTQ parents and
their children. According to researchers and
practitioners, the most effective way in which schools
can advocate for LGBTQ parents and their children is
by creating an inclusive school environment and by
school personnel becoming active agents of change
within the school system. Inclusive school policies lead
to safe environments where LGBTQ parents can be
active members of the schools their children attend.
Also, when schools have policies that are inclusive of
LGBTQ individuals, including parents, it is a good
indication that the school is invested in the protection of
diverse families, which enables LGBTQ parents to have
greater security and trust in the school system. In
addition, while many states across the United States
have laws and policies that protect the rights of LGBTQ
individuals, this is not true for all states. Therefore,
creating inclusive school policies that protect the rights
of LGBTQ parents, regardless of state support toward
LGBTQ individuals, can provide a safe haven for
LGBTQ-parent families. Moreover, in creating a
LGBT/Queer Studies Programs
supportive school environment and advocating for
LGBTQ parents and their children, some
recommendations include displaying LGBTQ-friendly
symbols (e.g., rainbow stickers and “safe zone” posters)
around the school; incorporating LGBTQ history and
literature within the school curriculum, with the goal of
challenging stereotypes that are oppressive toward
LGBTQ individuals (including parents and their
children); joining LGBTQ national organizations that
could provide reading and other education materials for
school libraries; and creating clubs and other
extracurricular activities to allow the school community
to discuss LGBTQ issues.
Becoming an active agent of change is perhaps the
most important step toward parent involvement and
advocacy of LGBTQ parents and their children. Within
a system that values the traditional family unit of one
cisgender (someone who conforms to the gender he or
she was assigned at birth) mother and one cisgender
father, school personnel can provide a strong voice in
advocating for LGBTQ parents and their children.
However, advocacy is a collaborative effort that must
be a priority for all school personnel, from the district
superintendent and staff to individual school members.
Research suggests that school districts would be well
served by creating mandatory workshops for all school
2076
personnel in order to explore and understand issues that
affect LGBTQ people and ways in which school
personnel can advocate for these families. Also,
considering that school districts play a crucial role in
how curricula for all subject areas are presented, school
districts could become essential advocates of LGBTQ
parents by mandating schools to showcase LGBTQ
individuals in a positive and celebratory manner. At a
school level, principals and other administrative staff,
as the most influential leaders within the school, can set
an example by providing opportunities for LGBTQ
parents to be active members of the school and have a
voice in the implementation of policies that directly
affect LGBTQ individuals (e.g., students and families)
within the school. In addition, teachers play a crucial
role in parental involvement and advocacy of LGBTQ
parents, as they interact directly with students and
parents on a daily basis. Teachers could advocate for
LGBTQ parents and their children by inviting parents
to visit their classrooms and collaborate on lesson plans
that explore diversity, such as LGBTQ issues.
Furthermore, teachers could advocate for LGBTQ
parents during parent–teacher conferences by validating
LGBTQ parents’ experiences and becoming an ally in
advocating for their rights within the school system.
Finally, other school staff, such as secretaries and
teaching assistants, could promote parent involvement
and advocacy by getting to know LGBTQ parents and
inquiring about how to better make their experiences
more pleasant within the school and school system.
Roberto L. Abreu and Alicia L. Fedewa
See also Home–School Partnerships in LGBTQ-Parent Families;
Schools as Heteronormative Spaces
Further Readings
Byard, E., Kosciw, J., & Bartkiewicz, M. (2013). Schools and
LGBT-parent families: Creating change through
programming and advocacy. In A. E. Goldberg & K. R.
Allen (Eds.), LGBT-parent families:
Innovations in research and implications for practice
(pp. 275–290). New York, NY: Springer Science+Business
Media. doi:10.1007/978-1-4614-4556-2_18
Lamme, L. A. (2001). Welcoming children from gay
families into our schools. Educational Leadership,
59(4), 65–69.
Rapp, N., & Duncan, H. (2012). Multi-dimensional parental
involvement in schools: A principal’s guide. International
Journal of Educational Leadership Preparation, 7(1), 1–14.
LGBT/QUEER STUDIES PROGRAMS
This entry briefly describes the origins of lesbian, gay,
bisexual, and transgender (LGBT)/queer studies as an
academic field as well as the development of specific
academic programs in LGBT/queer studies and the
debates over the naming of the field. It then turns to the
current state of the field, outlining the extent of
available academic programs and discussing both the
growing acceptance of LGBTQ issues in academia as
well as some of the recent controversies the field has
experienced.
Origins of the Field
LGBT/queer studies is an interdisciplinary field of
academic study that has as its focus the experiences and
ideas of LGBT/queer people and communities. Queer
studies emerged in the 1960s and 1970s, with the first
scholarly journals, conferences, and college courses
specifically focused on homosexuality coming into
being during those decades. Initially, the field was
called gay studies, and later gay and lesbian studies,
while queer studies programs did not come into being
until the 1980s. These name changes reflect broader
political debates within LGBTQ communities: Just as
in LGBTQ communities more generally, the exact
terminology individuals prefer to use to refer to this
field as well as who exactly is contained within its
boundaries are contested topics. Thus, the initial focus
on gay studies left many lesbians feeling excluded. The
expanded title of gay and lesbian studies was
challenged as limited and exclusionary by scholarship
on bisexual and transgender people and scholars who
identified as such. Queer studies as a title seemed to
represent a more inclusive category, permitting
consideration of a wide variety of concepts and ideas
that might not have fit under the LGBT umbrella, such
as non-normative heterosexual sex practices. But it is
exactly this inclusivity that is seen as problematic by
some scholars, who do not want to see the field’s
original focus on gay and lesbian lives diluted.
Today, although many students and scholars use the
field’s different names interchangeably, these different
names do suggest a slightly different research and
teaching focus. Gay and lesbian studies focuses more
 2077
on assimilation; equal rights; the naming and claiming most important accomplishments of queer studies.
of sexual self-identity; and the inclusion of gay and Specifically, the emergence of queer studies brought
lesbian people and themes in studies of literature, LGBTQ experiences into college classrooms and
history, and culture. In contrast, queer studies is more academic scholarship—especially scholarship
radical and involves strong linkages to postmodernism, concerned with issues other than sex acts themselves—
a critique of sexual and political conventionality, and helped legitimize academic research on LGBTQ
gender and topics.
LGBT/Queer Studies Programs Despite this growing acceptance of LGBTQ issues in
both the classroom and academic research, queer
studies has continued to face opposition from both
sexuality fluidity and inclusion, sexual power, and the
inside and outside the academy. Opponents of queer
deconstruction of categories. Queer studies tends to
studies sometimes argue that the course topics divert
draw heavily on the concepts, texts, and ideas of queer
attention from the traditional canon, that programs are
theory. Of course, in real life, many scholars and
too radical or use unusual pedagogical methods, or that
academic programs do work that transcends these
queer studies is not appropriate preparation for high-
distinctions.
demand career fields. In addition, social conservatives
Queer studies exists both as a broader field of study
worry that queer studies coursework exists to “convert”
and as a specific academic program at some colleges
young people to “the homosexual lifestyle.” These
and universities. The first major in gay and lesbian
critiques have kept queer studies out of conservative—
studies was established at San Francisco City College in
especially religious—colleges and universities and have
1989, and that program hired the first full-time, tenure-
led to funding battles for some public colleges and
track faculty member in gay and lesbian studies in
universities. For example, two institutions in South
1991. While a number of colleges and universities
Carolina selected books with gay or lesbian themes as
developed minors and other academic programs
texts to be used in common reading programs for all
through the 1990s and 2000s, such programs have
first-year students in 2014, and the state legislature
remained rare, and full academic majors are even less
responded by passing legislation reducing both
common. As of 2014, less than a dozen colleges and
institutions’ budgets. Queer studies has also faced
universities in the United States and Canada offer full
territorial struggles within the academy. Since queer
majors in queer studies or closely related fields,
studies is an interdisciplinary field, it draws its
including “sexuality studies” programs that may offer
concepts, methods, and scholars from a wide variety of
only a minority of coursework in queer studies areas.
disciplines, especially those in the social sciences and
More common are minors, certificates, concentrations,
humanities. Given the increased willingness of
or other programs—well over 50 such programs exist in
traditional disciplines, and of women’s and gender
North America as of 2014. While graduate programs in
studies, to focus on LGBTQ issues and experiences in
queer studies remain rare, a handful of North American
their own coursework and scholarship, queer studies
colleges and universities, and at least two in the United
programs sometimes have to fight for students, funding,
Kingdom, allow students to formally specialize in queer
and even survival. Yet despite these difficulties, queer
or sexualities studies.
studies programs have continued to emerge and grow.
Queer studies programs and scholarship are vital to
The Current State of Queer Studies ensuring that LGBTQ experiences, identities, and issues
are not marginalized in the academy.
Today, students interested in queer studies often find
courses and faculty in other fields, such as women’s Mikaila Mariel Lemonik Arthur
and gender studies, sociology, and literature, that help
See also Activists in College; College Students;
them pursue their academic and intellectual goals even
Disciplinary Tensions in Studying LGBTQ
in the absence of formal academic programs in queer
Populations; Psychological Approaches to Studying LGBTQ
studies on their campuses, and most humanities and
People; Queer Theory; Transgender Inclusion on College
social science fields permit graduate students to focus
Campuses
their research on LGBTQ issues. This openness to
LGBTQ experiences and topics has been one of the

Living Arrangements of Children After LGBQ Divorce/Separation

2078
Further Readings
Arthur, M. M. L. (2011). Student activism and curricular change
in higher education. Surrey, England: Ashgate.
Dynes, W. R. (1993). Queer studies: In search of a discipline.
Academic Questions, 7(1), 34–52.
Gross, L. (2005). The past and the future of gay, lesbian,
bisexual, and transgender studies. Journal of
Communication, 55(3), 508–528.
Halberstam, J. (2003). Reflections on queer studies and queer
pedagogy. Journal of Homosexuality, 45(3/4/5), 361–364.
Minton, H. L. (1992). The emergence of gay and lesbian studies.
Journal of Homosexuality, 24(1/2), 1.
LIVING ARRANGEMENTS OF
CHILDREN AFTER LGBQ
DIVORCE/SEPARATION
on two-mother, lesbian-parent families—is afforded the
same legal and social ties to children as heterosexual
biological parents. Likewise, in cases of surrogacy
among gay men, the biological father is granted
automatic parental rights. Nonbiological parents instead
create ties to children through legal means (e.g.,
marriage, second-parent adoption) or demonstrate their
ties to children through more informal methods (e.g.,
taking on last names, legal guardianship).
In cases of adoption, neither parent has a biological
connection to the child. Often, it is a singleparent
adoption or joint adoption. Single-parent adoption often
occurs in cases where state law prohibits same-sex
couple adoption or individual adoption agencies are
unwilling to place children in a same-sex parent
household. Here, parents must decide which parent will
legally adopt the child or children—a decision that is
often made on the basis of income, each partner’s
respective desire to have children, or anticipated
caregiving arrangements (i.e., who will be the primary
caregiver for the child).

In cases of lesbian, gay, bisexual, or queer (LGBQ)

divorce or separation, family living arrangements Living Arrangements in LGBQ Divorce or
involve difficult, stressful, and often ambiguous Separation
decisions attached to child custody. Types of custody
include sole, joint legal, and joint physical, and custody Living arrangements in the aftermath of LGBQ divorce
determines children’s living arrangements. Courts often or separation are understudied, and most research in
decide custody and living arrangements on the basis of this area has been conducted on lesbian mothers. Of the
parental income, children’s age, children’s needs, existing research on lesbian mothers, most mothers had
fitness of parents, home environment stability, an amicable breakup and the non–birth mother often
proximity, and other factors that aim to serve “the best maintained contact with the birth mother and child. As
interest of the child.” During LGBQ divorce or found in heterosexual divorce literature, post-LGBQ
separation proceedings, custody has usually been divorce living arrangements and parent–child contact
determined outside of the courtroom, and often on the varied. Some instances of same-sex parent divorce
basis of the parents’ biological relatedness to the child. resulted in joint or shared custody, allowing children to
With the introduction of same-sex marriage and legal split time spent in each household equally between the
partnership recognition, however, living arrangements birth and non–birth mothers; others resulted in the birth
are increasingly determined inside the courtroom. This mother restricting contact between the child and the
entry discusses the ways in which LGBQ couples have non–birth mother. On rare occasions, the birth mother
decided the living arrangements of children after a relinquished responsibility for the child, and the child
divorce or separation. lived with the non–birth mother full-time.
Parental rights within same-sex couples often hinge Over time, postdivorce living arrangements may
on the presence or absence of biological ties between change. Some families have stayed in the same
parent and child. Most children in LGBQ families result geographical proximity, living around the corner from
from one or both partners’ previous heterosexual each other, while other families have had one expartner
relationships or marriages. In cases of alternative or spouse move away. When there was more than one
Living Arrangements of Children After LGBQ Divorce/Separation child,
insemination and gestational surrogacy, the biological children’s
parent—often referred to as the birth mother in research living arrangements were often dependent on parent–
 2079
child biological relatedness, such that children remained
with their biological mother and former siblings were
raised in separate households. In most lesbian-mother
households, both mothers repartnered or remarried after
divorce or separation. Therefore, children’s living
arrangements can become more complicated after
LGBQ divorce, as new partners may mean the
possibility of a new geographical location or of creating
a new stepfamily, and introducing new siblings. Few
studies have explored how new LGBQ family
formation can impact postdivorce living arrangements.
Because research on gay fathers’ divorce is
essentially nonexistent, our knowledge of living
arrangements comes from personal stories and
anecdotes. For decades, gay fathers have decided
children’s living arrangements through informal
arrangements, but in recent years they are increasingly
turning to the courts. Children rarely live with the
nonbiological parent, especially after a nonamicable
breakup.

Parental Rights
In same-sex partner dissolution between unmarried
LGBQ parents, living arrangements have been most
often decided through informal conversations, with the
biological parent taking primary custody and agreeing
to grant the nonbiological parent visitation or shared
living arrangements. While judges have decided living
arrangements based on a variety of factors, and
sometimes considered nonbiological parents’ parental
involvement in their ruling, nonbiological and nonlegal
parents ultimately have no legal claim to the child. For
those couples with access to second-parent adoption or
joint adoption, both parents have legal ties to the child;
thus, second-parent and joint adoptions are ideal to
ensure both parents have rights.
2080 Long-Term Same-Sex Couples
In same-sex divorce, the nonbiological parent is
granted the same rights as the biological parent. By
having entered into a legal marriage, the nonbiological
parents gained legal standing in divorce proceedings to
request and negotiate for children’s living
arrangements. Moreover, these parent–child ties are
legally equivalent to biological relatedness, granting
nonbiological parents equal say. Although same-sex
marriage is now legally recognized in all U.S. states,
access to divorce can be restricted due to varying state
laws; this variation can complicate a seemingly
straightforward divorce.
Implications
Determining the living arrangements in the aftermath of
an LGBQ divorce or separation has legal, economic,
and psychological consequences for all family
members. Having contact with both parents and
amicable terms of divorce positively impact children’s
psychosocial well-being. For mothers in nonamicable
divorces, a drawn-out battle to determine contact and
living arrangements has psychological and emotional
consequences. In the absence of legal protections,
nationwide second-parent or joint adoption, and
alternative avenues to establish parentage without
marriage, nonlegal and nonbiological parents have been
cut off from their children. Indeed, these mothers have
experienced ambiguous loss (i.e., a sense of emotional
and physical fracturing of the family) with few, if any,
ways of connecting with their children.
Living arrangements in the aftermath of LGBQ
divorce hinges on both social institutions and
interpersonal relationships. Researchers and scholars
point to the important role that formal predivorce
agreements play in determining custody, and the
increased use of the judicial process, to determine the
“best interests of the child.”
Emma C. Potter and Katherine R. Allen
See also Child Support After LGBQ Divorce/Separation;
Coparenting; Custody and Litigation, LGBQ Parents;
Divorce, Legal Issues in; Legal Recognition of
Nonmarital Same-Sex Relationships; Legal Rights of
Nonbiological Parents
Further Readings
Beekman, J. C. (2012). Same-sex marriage: Strengthening the
legal shield or sharpening the sword—The impact of
legalizing marriage on child custody/visitation and child
support for same-sex couples. Washington and
Lee Journal of Civil Rights and Social Justice, 18,
215–252. doi:10.2139/ssrn.1840749
Gartrell, N., Box, H., Peyser, H., Deck, A., & Rodas, C.
(2011). Family characteristics, custody arrangements, and
adolescent psychological well-being when lesbian
mothers break up. Family
Relations, 60, 572–585. doi:10.1111/j.1741-3729
.2011.00667.x
Goldberg, A. E., & Allen, K. R. (2013). Same-sex relationship
dissolution and LGB stepfamily formation: Perspectives of
young adults with LGB parents. Family Relations, 62, 529–
544. doi:10.1111/ fare.12024
Haney-Caron, E., & Heilbrun, K. (2014). Lesbian and gay
parents and determination of child custody: The changing
legal landscape and implications for policy and practice.
Psychology of Sexual Orientation and Gender Diversity, 1,
19–29. doi:10.1037/ sgd0000020
National Center for Lesbian Rights. (2014). Legal recognition
of LGBT families. Retrieved November 24, 2015, from
http://www.nclrights.org/wp-content/
uploads/2013/07/Legal_Recognition_of_LGBT_
Families.pdf
LONG-TERM SAME-SEX COUPLES
Recent data indicate that the average relationship
duration for same-sex couples is just under 13 years.
This entry provides details on the experiences of long-
term (roughly defined as 5 years or longer) same-sex
couples by presenting information on (1) demographic
characteristics of samesex couples in the United States;
(2) families of same-sex couples; (3) relationship
quality and relationship dynamics in long-term same-
sex couples; (4) relationship stability and dissolution;
(5) same-sex relationships and health; and (6) some of
the unique challenges faced by aging same-sex couples,
particularly in relation to health.
Demographic Characteristics of Same-Sex
Couples
In the 2013 American Community Survey, there were
over 726,000 same-sex couples in the United States,
with 34.6% of those couples describing themselves as
married. As a result of the Supreme Court’s June 2015
ruling, the option of marriage for same-sex couples has
become available not just in some states but

nationwide, and these legal changes mean that the
percentage of same-sex couples that are married is
rapidly increasing. However, due to past legal barriers
to marriage for same-sex couples, most long-term
same-sex couples are now in cohabiting unions. About
a quarter of same-sex couples in the United States have
been together for 10 years or longer. The average age of
people in same-sex unions is about 44, whereas the
average age of heterosexual couples is about 50. In
addition, same-sex partners are more educated than
individuals in heterosexual couples; 2011 data show
that about 46% of same-sex couples and 32% of
heterosexual couples had a college degree.
The Families of Same-Sex Couples
Many same-sex couples have children. Women are
more likely than men in same-sex relationships to be
raising children; about 48% of women and 20% of men
live with a child under the age of 18. One reason that
women in same-sex couples are more likely to be
raising children is that many of these women had
children in heterosexual marriages, and women are
more likely than men to retain primary custody of their
children following divorce. The pathways to
parenthood for same-sex couples have changed over
time, with younger couples more likely to become
parents through adoption or surrogacy, whereas most
older couples became parents through prior
heterosexual unions. Same-sex partners tend to be more
egalitarian than heterosexual partners when it comes to
sharing parenting tasks and responsibilities. Same-sex
and heterosexual parents are similar in their overall
levels of mental health and in providing a supportive
environment for raising children, but some
Long-Term Same-Sex Couples
research has found that same-sex parents are less likely
than heterosexual parents to use physical punishment as
a way to discipline children. Although there have been
heated debates over the effects of having gay or lesbian
parents, the preponderance of the research evidence
indicates that children of gay and lesbian parents are
similar to children of heterosexual parents on social,
psychological, and achievement outcomes.
Because of their sexual-minority status, individuals
in same-sex relationships are more likely than those in
heterosexual relationships to have strained ties with
2081
their families of origin. Relationships with families of
origin may improve as more same-sex couples are able
to marry in the United States. Marriage holds
tremendous symbolic value that may help families of
origin to more fully embrace the same-sex relationships
of their family members. Although same-sex partners
may, on average, have more strained relationships with
their families of origin, most people in same-sex
relationships are involved with their own parents, as
well as their partner’s parents. Indeed, men and women
in same-sex relationships typically play an important
role in caring for their aging parents. Whereas it is
primarily women in heterosexual relationships who
provide care for aging parents and their parents-in-law,
men and women in samesex relationships are more
likely to share in the work of providing care for each
other’s parents.
Although long-term same-sex couples are less likely
than their heterosexual counterparts to have children
and more likely to have strained relationships with their
families of origin, same-sex couples often have
extremely close and supportive ties with friends who
are considered their “families of choice.”
Relationship Quality and Dynamics of
Same-Sex Couples
Same-sex and heterosexual couples are similar in many
ways, including their overall relationship happiness and
satisfaction, levels of conflict, and reasons for conflict.
But same-sex and different-sex unions differ in several
ways, including the division of household labor and
sharing of parental responsibilities, with greater
equality in same-sex unions. This greater equality may
occur because the gender difference between the
members of heterosexual couples produces differences
between partners’ values and their approaches to
relationships. In contrast, the gender similarity in same-
sex partners may produce similarities in these
dimensions.
Same-sex partners also report more satisfaction with
their sexual relationships and less conflict about their
sex lives than heterosexual couples. Male same-sex
couples are more likely than female same-sex couples
or heterosexual couples to permit sexual encounters
outside the primary relationship, and report little
conflict about such encounters. Yet recent studies
suggest that the majority of men in long-term same-sex
2082 Long-Term Same-Sex Couples
relationships are sexually monogamous, even if they
espouse permission for sexual affairs. Same-sex and
heterosexual couples are similar in that they tend to
experience declining sexual frequency over time, yet
they also report increasing emotional intimacy. Despite
such increases in emotional intimacy, overall levels of
relationship satisfaction tend to diminish over time for
both same-sex and heterosexual long-term couples.
Many of the differences between the relationship
dynamics of same-sex and heterosexual couples are
driven by gender. For example, compared to men,
women generally place more value on sharing personal
thoughts and feelings with their partner as a way to
promote emotional intimacy— regardless of whether
they are in a relationship with a man or a woman.
Hence, same-sex female couples often have higher
levels of intimate disclosure than either male–male or
heterosexual couples, because of the presence of two
women in the relationship. Also, because women tend
to value sharing of feelings, women involved with other
women report agreeing about the importance of
monitoring each other’s feelings and talking about those
feelings, whereas women involved with men report
more disagreement with their partners about how to
achieve emotional intimacy.
While stereotypes have sometimes painted same-sex
relationships as deficient in comparison with
heterosexual relationships, the preponderance of
evidence suggests that this is not the case. However,
one distinct area of disadvantage for same-sex partners
is higher levels of stress that can take a toll on their
intimate relationships. Individuals in same-sex
relationships, particularly those in long-term
relationships that were formed during a period of
greater intolerance and discrimination regarding sexual
minorities, have faced higher levels of sexual-minority
stress throughout their lives. Thus, same-sex couples
must cope with sexualminority–related stressors in
addition to the typical life stressors that all couples
face.
Relationship Stability and Dissolution
Although same-sex cohabiting couples are more likely
than heterosexual married couples to break up, they are
not more likely to break up than heterosexual
cohabiting couples. This supports the view that legal
marriage serves as a general barrier to dissolution for
all couples, and that the availability of legal marriage to
same-sex couples will contribute to greater relationship
stability. Other factors associated with more stable
same-sex relationships include older age, more
education, and living in a state that provides legal
recognition to same-sex couples. Although a vast
literature shows how difficult divorce is for
heterosexual couples (with adverse effects on financial
resources, psychological well-being, and health), the
effects of divorce (or breakup) on long-term same-sex
partners is not yet documented.
An overlooked issue for many same-sex couples is
the loss of a long-term relationship when one partner
dies. Most same-sex partners, even those who have
been together for many years, historically have not had
the protections offered by legal marriage, thus they
have often faced legal barriers to inheritance of shared
property and financial assets. This occurs at the same
time that they are dealing with the loss of their most
important relationship, a relationship that may not have
been acknowledged by others. The death of a long-term
partner is the most stressful life event that the majority
of people ever experience, and acknowledgment and
support from others are especially important following
this loss.
Same-Sex Relationships and Health
Involvement in close relationships benefits health and
even reduces mortality risk. Of all close relationships
that have been studied, the marital relationship seems to
be most beneficial to health and longevity, but studies
documenting this association have considered only
heterosexual marriages. A growing body of evidence
points to the health benefits of involvement in same-sex
relationships. National data show that individuals in
same-sex and heterosexual cohabiting relationships are
healthier than unmarried individuals, although
cohabitors are not as healthy as married heterosexuals.
Marriage may benefit health more than cohabitation
because marriage provides greater access to health
insurance and other resources that enhance health.
Marital relationships may be particularly important for
the health of sexual-minority populations given that
sexual minorities experience elevated risk of depression
and anxiety, less frequent use of preventive health
services, and poorer overall health than heterosexuals.
Accordingly, therapists and medical professionals need
to be aware of the relationship experiences of longterm
same-sex couples, experiences that are characterized by
 2083
unique resources and challenges that have real Marriage Equality, Effects on Well-Being and
consequences for the health and wellbeing of men and Relationships
women.
Long-term same-sex partners may influence each
other in a number of ways that promote health and Further Readings
longevity, through shared and reciprocal processes that Goldberg, A. E. (2013). “Doing” and “undoing” gender: The
operate similarly for men and women in same-sex meaning and division of housework in same-sex couples.
couples. For example, samesex partners may encourage Journal of Family Theory & Review, 5, 85−104.
each other to engage in healthier eating and exercise Kurdek, L. A. (2006). Differences between partners from
habits, and they may engage in these behaviors heterosexual, gay, and lesbian cohabiting couples. Journal
together. This is in contrast to heterosexual couples, of Marriage and Family, 68, 509–528.
where partners are much less likely to describe this kind Rosenfeld, M. J. (2014). Couple longevity in the era of same-sex
of teamwork. In heterosexual relationships, a more marriage in the United States. Journal of Marriage and
onesided process often occurs in which women try to Family, 76, 905–918.
influence men. Rothblum, E. S., Balsam, K. F., & Solomon, S. E. (2011). The
Long-Term Same-Sex Couples longest “legal” U.S. same-sex couples reflect on their
relationships. Journal of Social Issues, 67, 302–315.
Umberson, D., Thomeer, M. B., & Lodge, A. (2015).
Aging Same-Sex Couples Intimacy and emotion work in gay, lesbian, and
heterosexual relationships. Journal of Marriage and
The longest-term same-sex couples tend to be middle- Family, 77(2), 542–556.
aged or older, and this is a period in the life course U.S. Census Bureau. (2013). American Community Survey 1-
when chronic conditions and significant health concerns year data file. Retrieved November 24, 2015, from
are more likely to emerge. A committed relationship https://www.census.gov/programs-surveys/acs/
with a supportive partner may be even more important
with advancing age because of age-related increases in
health problems and disability rates. The percentage of
same-sex couples including a senior (aged 65 or older)
has increased over time to a current rate of nearly 10%.
In addition, while about 10% of individuals in same-sex
and heterosexual relationships are disabled, same-sex
couples are twice as likely as heterosexual couples to
have only one partner with health insurance. Despite
these demographic facts, issues of aging and health are
an unaddressed problem for many same-sex couples.
When they experience significant health problems,
same-sex partners (like heterosexual partners) are more
likely to rely on each other rather than someone outside
their relationship. This makes nationwide legality of
same-sex marriage even more significant, as medical
care facilities have often restricted a patient’s access to
one’s spouse or immediate family. A partner’s
participation in health care and health care decisions
benefits the health and wellbeing of the patient and
reduces stress for both partners.
Debra Umberson

See also Aging, Social Relationships, and Support;

Couples Therapy; Defense of Marriage Act (DOMA);
M I
N
M
S
A
T
R
R
I This
A entry
G describes
the
E
reasons
, that
LGBTQ
people
R are for or
E against
A same-sex
marriage
S
. First, it
O describes
N the
S reasons
that
F LGBTQ
people
O
offer for
R being in
favor of
A marriage
N as a legal
D option
for
same-sex
A couples
G and/or
their
A
decision
 2085

to marry. literature
The entry than are
then people
describes who
reasons identify
that as
LGBTQ lesbian
people or gay.
offer for Distincti
being ons by
against LGBTQ
marriage identity
as a legal are noted
option for when
same-sex literature
couples explicati
and/or ng
their differenc
decision es by
not to identity
marry. is
Although available
much of .
the
findings
discussed
Reason
in this s
entry fo
apply to r
LGBTQ Be
people, it in
should be g
noted that in
transgend Fa
er vo
individua r
ls, of
bisexual
Sa
individua
m
ls, and
e-
individua
ls who Se
identify x
as queer M
are ar
sampled ria
less ge
frequentl LGBTQ
y in the people
research
2086

may be in interpersona
favor of l
same-sex relationship
marriage s.
or may
decide to Civil
get Equality.
married The most
for common
various reasons
reasons offered by
dependin LGBTQ
g on each people for
person’s being in
individua favor of
l legal
experienc recognition
es. of same-sex
However, marriage
the can be
research covered
on under the
LGBTQ umbrella of
people’s civil
opinions equality.
about and LGBTQ
experienc people
es with describe
same-sex feeling like
marriage “second-
suggests class
some citizens”
common when and
reasons where their
that they romantic
may be in relationship
favor of s have not
same-sex been
marriage. eligible for
the same
729 civil
Among these recognition
are reasons as male–
related to female
civil couples,
equality, prior to the
politics, June 2015
parenting, Supreme
and social Court
and decision
 2087

legalizing LGBTQ
same-sex people see
marriage same-sex
nationwide. marriage as
In many a tool to
locations, gain civil
this equality.
“secondclass
citizen” Political
status has Reasons.
meant that LGBTQ
same-sex people also
couples were cite political
not eligible reasons for
for tax being in
benefits, favor of
parental same-sex
rights, marriage.
spousal Many
insurance LGBTQ
benefit people have
coverage, seen
shared universal
property legal
benefits, recognition
proxy for same-
medical sex
decisions, marriage as
and other an
civil and important
legal rights goal of the
afforded to LGBTQ
male–female rights
married movement,
couples. and they
Legally support
recognized same-sex
same-sex marriage as
marriage a
eliminates continuation
the unequal of the
treatment of overall
same-sex political
and male– movement
female in support
married of LGBTQ
couples Marr
under the iage,
law. Thus, Reas
ons
many
2088

for marriage
and often do so
Again in the face
st
of political
movements
people. They to impose
have restrictions
described on same-sex
marriage as relationship
a way to be recognition.
“counted” Thus,
not just as LGBTQ
couples, but people have
as people often
who have an supported
important same-sex
voice in the marriage in
political order to
debates and defeat
decisions of proposed
their same-sex
communities relationship
. Marriage recognition
has also restrictions
been that have
described by been shown
LGBTQ to have
people as a negative
tool in the psychologic
politics of al, financial,
visibility in and health
which being effects on
identified as LGBTQ
LGBTQ is people and
seen as a their
way to families.
increase
political Raising
awareness of Children.
LGBTQ Another
needs and common set
decrease of reasons
discriminatio that
n against LGBTQ
LGBTQ people give
people. In for being in
addition, favor of
LGBTQ same-sex
people who marriage
favor relates to
 2089

having and the belief

raising that being
children married will
together. make same-
First, same- sex parents
sex marriage more visible
may make it and more
easier for accepted by
LGBTQ society.
people to Further,
become having
parents. married
Without the parents is
civil and believed by
legal LGBTQ
recognition people to
provided by benefit the
same-sex children, in
marriage, that the
same-sex family will
couples may be more
encounter easily
difficulties defined,
with accepted,
becoming and
legal supported
guardians, by peers
becoming and society
foster in general.
parents,
adopting a Social
partner’s Reasons. A
child or a fourth
previously category of
nonrelated reasons that
child, LGBTQ
working people offer
with a for being in
surrogate, or favor of
accessing same-sex
donor marriage
insemination are social
through reasons,
clinic- and which are
hospital- those
based related to
services. perceptions
LGBTQ of and
people have meaning
also reported assigned to
2090

LGBTQ perceived
individuals and situated
and same- within their
sex social
relationships networks,
in society which may
and within include
social family,
networks. friends,
One social acquaintanc
reason that es, and
LGBTQ coworkers.
people are in For
favor of example,
same-sex LGBTQ
marriage is people
because sometimes
marriage explain that
functions as marriage is
a way of a way for
defining the samesex
same-sex couples to
couple be more
within accepted by
society. In their
other words, families of
being legally origin.
married is Some
seen as LGBTQ
transferring people also
a type of believe that
legitimacy, marriage
respect, and will enable
social the
identity to committed
samesex relational
couples. status of
Further, same-sex
marriage is partners to
seen by be more
some readily
LGBTQ understood
people as a and more
mechanism respected
for by LGBTQ
positively and non-
affecting the LGBTQ
ways that friends,
same-sex coworkers,
couples are and
 2091

acquaintance a way to
s. confirm
their love
Relationship and
Reasons. commitmen
LGBTQ t to one
people are another.
also in favor LGBTQ
of same-sex people also
marriage for offer
interpersonal religious
or reasons for
relationship- supporting
related same-sex
reasons. For marriage.
example, the Same-sex
belief that marriage is
same-sex viewed as a
romantic way to have
love and one’s
commitment relationship
should be blessed and
recognized supported
and valued is within a
one reason religious
that LGBTQ community
people and within a
support religious
same-sex belief
marriage. In system.
addition, Religious
feelings of LGBTQ
love for people who
one’s partner choose to
and the get married
desire to have
formally and described
publicly positive
express that feelings of
love are fulfillment
often cited and
as reasons completenes
that LGBTQ s in terms of
choose to both their
marry. faith and
Long-term relationship.
same-sex Finally,
couples have LGBTQ
described people have
marriage as expressed
2092

support for marriage as

same-sex a legal
marriage option,
because LGBTQ
getting people have
married is also
seen as an described
important interpersona
stage in a l reasons
person’s life that they
and choose not
relationship. to get
In this sense, married.
marriage is a
way of Political
fulfilling a Reasons.
relational LGBTQ
script that people who
leads from do not
courtship to support
marriage. same-sex
marriage
have
Reasons for
expressed
Being political
Against misgivings
Same-Sex about
Marriage marriage
itself. These
A minority
misgivings
of LGBTQ
include
people do
rejection of
not support
the idea that
same-sex
government
marriage.
should be
Their
involved in
reasons for
labeling,
nonsupport
defining,
include
and
political
regulating
concerns,
romantic
identity
relationship
concerns,
s. Further
and concerns
misgivings
about safety.
include
In addition,
feminist
regardless of
critiques of
how they
marriage,
think about
which
same-sex
include the
 2093

perspective some
that members of
marriage is a the LGBTQ
way of community
controlling and one
and limiting relationship
people form over
(especially other
women), and possibilities
distrust of . Moreover,
the LGBTQ
institution of people have
marriage expressed
given its concerns
long history that
as a means marriage is
of treating a way of
people “mainstrea
(especially ming” them
women) as and their
property. In relationship
addition, s to be less
some unique, less
LGBTQ creative,
people have less diverse,
concerns and more
that like those of
marriage heterosexua
equality has l people.
become the
focal point Identity.
of the Another
LGBTQ category of
movement. reasons
This focus offered by
on marriage some
is viewed as LGBTQ
misguided people who
because it are not in
does not favor of
adequately samesex
address all marriage
of the forms includes
of those
discriminatio related to
n that identity.
LGBTQ Research
people face, has shown
and that some
privileges members of
2094

the LGBTQ people,

community same-sex
feel that marriage is
marriage perceived as
may serve to threatening
obscure the to personal
uniqueness safety and
of identities, the safety of
especially other
bisexual and LGBTQ
transgender individuals.
identities. That
Some M
bisexual a
men and r
r
women have
i
expressed a
concerns g
that e
marriage to a ,
same-sex R
partner will e
make their a
s
bisexual
o
identity n
invisible to s
both
LGBTQ and f
non-LGBTQ o
others. Some r
transgender
individuals a
have n
d
expressed
misgivings
A
with same-
g
sex marriage a
because, i
much like n
male–female s
marriage, it t
is based on a
binary
perception
is, LGBTQ
of sex and
people who
gender.
have been
threatened
Safety. For
or attacked
some
because of
LGBTQ
 2095

their sexual LGBTQ

orientation people.
or identity
have Interperson
expressed al Reasons.
concerns In addition
that by to reasons
getting for being
married, against
same-sex marriage as
couples are a legal
making option for
themselves samesex
more easily couples,
and publicly LGBTQ
identifiable people have
and, offered
therefore, interpersona
more l, or
vulnerable. relationship
LGBTQ -related,
people have reasons for
also choosing
indicated not to
that getting marry.
married to a Some same-
same-sex sex couples
partner may have chosen
lead to them not to marry
being because
discriminate they do not
d against in value
the marriage as
workplace or a form of
fired from expressing
their jobs. their
Concerns commitmen
about t to one
personal another.
safety and Other
well-being couples
related to choose not
same-sex to marry
marriage because
reflect the they
history of previously
discriminatio expressed
n and abuse their
faced by commitmen
t to one
2096

another via of Origin,

another form Relations
hips
of
With;
relationship Marriage
recognition Equality,
and see Effects
marriage as on Well-
redundant Being
and and
Relations
unnecessary.
hips;
LGBTQ Same-
people have Sex
described Wedding
challenges s
with how
much to
follow F
traditional u
aspects of r
engagements t
h
and
e
weddings as
r
a reason to
not marry.
R
Finally,
e
some same-
a
sex couples
d
have i
expressed n
not wanting g
to marry s
because they
did not feel Badgett, M.
that their V. L.
relationship (2009).
was ready When
for gay
marriage- people
level get
commitment married:
. What
happens
Pamela when
Lannutti societies
legalize
See also
Adoption, same-sex
Legal marriage
Considerat . New
ion in; York,
Families NY: New
 2097

York marriage.
University New
Press. York, NY:
Routledge.
Bernstein,
M., & Lannutti, P.
Taylor, J.
V. (Eds.). (2014).
(2013). Experien
The cing
marrying
same-
kind?
Debating sex
same-sex marriag
marriage e:
within Individu
the als,
lesbian
couples,
and gay
movemen and
t. social
Minneap networks
olis: . New
Universit York,
y of
NY:
Minnesot
Peter
a Press.
Fingerhut, A. Lang.
W., Riggle, E. Stiers, G. A.
D. B., & (1999).
Rostosky, S. S. From this
(Eds.). day
(2011). forward:
Marriage
Commitme
restriction
amendmen nt,
ts and marriage,
Marriage Equality, Effects on Well-Being and Relationships
the same-sex and family
marriage in lesbian
debate: The and gay
social, relationshi
psychological,
ps.
and policy
New
implications
York, NY:
[Special
St.
issue].
Martin’s
Journal of
Griffin.
Social Issues,
Wharton,
67(2). G., &
Galupo, M. P. Philips
(Ed.). , I.
(2009). (Eds.).
Bisexuality (2004)
and same- . I do,
sex I
2098

don’t: partners and

Queers any children
on
they have.
marria
ge. San
While the
Francis available
co, CA: studies
Suspect addressing
Though issues
ts related to
Press.
marriage
equality are
still few,
mostly
MARRIAGE exploratory
in nature,
EQUALITY, and
EFFECTS complicated
by
ON methodolog
ical
WELL- limitations,
BEING AND the
evidence
RELATIONS they
HIPS provide
offers some
preliminary
With the answers to
U.S. inquiries
Supreme about the
Court having potential
recently benefits and
declared costs of the
same-sex expansion
marriage of legal
legal in all rights for
50 states, persons in
social samesex
scientists are relationship
increasingly s. In doing
focusing so, this
their small but
attention on growing
the effects of body of
marriage work makes
equality on an
those most important
directly and timely
affected: contribution
same-sex to the study
 2099

of LGBTQ indirect
people and approach—
their family for
and personal example, by
relationships comparing
. outcomes
In a few for
instances, individuals
researchers in
have been “marriage-
able to like” same-
examine the sex
effects of relationship
marriage s to that of
equality their peers
directly, in different-
using data sex marital
that included or
same-sex nonmarital
spouses from cohabiting
states or relationship
countries s. Suffice it
where same- to say,
sex marriage much of the
is legal or findings
where same- from the
sex couples emerging
have had literature
legal rights should be
resembling interpreted
those of with
people in caution.
different-sex This
marriages. entry
However, provides an
because overview of
marriage research
equality exploring
legislation, the effects
like the of same-sex
Court’s marriage
ruling in and other
Obergefell v. legally
Hodges, is sanctioned
still same-sex
relatively relationship
new, most s (e.g.,
studies have domestic
had to rely partnerships
on an , civil
2100

unions), as like same-

well as sex
findings for relationship
nonmarital, s confer the
same-sex same
cohabiting intangible
relationships benefits as
. Because marriage
data on the between a
effects of man and a
legal same- woman,
sex unions including
are relatively favorable
scarce, this health and
entry will well-being.
also discuss Obviously,
the effects of marriage,
marital and regardless
nonmarital of who
different-sex enters into
relationships it, provides
when tangible
relevant. The benefits,
sections that including
follow income tax
explore a benefits;
number of inheritance,
topics, insurance,
includ- and
ing health survivorshi
and well- p rights;
being, child- and spousal
rearing, benefits,
divorce and such as
stability, and social
the division security and
of household public
labor. pensions,
and these
benefits
Health and may
Well-Being indirectly
A number of influence
studies have health and
considered well-being.
whether However,
same-sex research
marriages or among the
marriage- general
(mostly

Marriage Equality, Effects on Well-Being and Relationships

 2101

heterosexual problems, a
) population higher self-
also suggests rated health
that status, and
marriage and lower rates
relationships of substance
that abuse and
resemble problem
marriage can drinking.
directly There also
enhance the is evidence
health and that people
well-being who are
of individual married are
men and better off
women. psychologic
Indeed, a ally, with
positive lower
relationship instances of
between depression
marriage and and a lower
physical and likelihood
psychologica of suicide.
l wellbeing Married
has been people also
documented tend to
in literally perceive
hundreds of themselves
studies over as happier
a period of and more
decades. satisfied
Historically, with life
researchers than their
have found unmarried
that married peers, both
people live those who
longer lives have never
than married and
unmarried those who
people, are divorced
whether or widowed.
single, In fact, in a
separated, comparative
divorced, or study,
widowed. married
They also respondents
have fewer were found
acute and to be
chronic happier than
health the
2102

unmarried in enhances
16 of 17 people’s
industrial health and
nations, the well-being.
one According
exception to the
being prevailing
Northern view,
Ireland, marriage
where there enhances
were no well-being
significant because it
differences provides
between the substantial
two groups. benefits not
For the most enjoyed by
part, these the
physical and unmarried,
psychologica including
l health interpersona
benefits of l
marriage are relationship
greater for s and
men than emotional,
they are for social, and
women. financial
Although support. In
part of the theory,
advantage of marriage
the married provides
over the individuals
unmarried is with
due to the someone
self-selection who will
of healthy monitor
and well- their health
adjusted and health-
individuals related
into behaviors.
marriage, Marriage
most also
scholars who provides
have studied lifelong
the data companions
believe that hip, a sense
there is of
something belonging,
about and
marriage that emotional
also ties, and
 2103

thus may relationship

serve as a s usually
defense report better
against outcomes
loneliness than those
and who are
isolation, single, and
particularly equivalent
in later life. outcomes to
Thus far, those in
the available nonmarital,
evidence on different-
same-sex sex,
marriage and cohabiting
“marriage- relationship
like” same- s, they
sex typically
relationships report worse
suggests that outcomes
individuals than persons
do, in fact, in different-
benefit from sex
their marriages,
involvement at least on
in such some
arrangement measures of
s. However, health and
the evidence well-being.
is less clear For
about example,
whether merged data
individuals from the
in these General
relationships Social
benefit as Survey
much as (GSS), the
those in National
different-sex Health and
marriages. Social Life
On the one Survey
hand, several (NHSLS),
studies using and the
data from Chicago
nationally Health and
representativ Social Life
e samples Survey
indicate that (CHSLS)
while show that
persons in while
same-sex persons
2104

reporting a —have
same-sex similar
romantic levels of
partner self-rated
perceive health to
themselves different-
to be just as sex
happy as cohabiters,
their peers in they tend to
different- rate their
sex, health lower
nonmarital, than that of
cohabiting different-
relationships sex spouses.
, they This finding
perceive holds even
themselves with
to be less controls for
happy, on demographi
average, than c variables,
their peers in including
different-sex race/ethnicit
marriages. y, gender,
This finding and
holds for socioecono
both those in mic status.
male–male What this
relationships evidence
and female– tells us is
female that
relationships “marriageli
. Similarly, ke” same-
studies using sex
data from the relationship
National s such as
Health same-sex
Interview cohabitation
Survey, , similar to
conducted different-
by the sex
National cohabitation
Center for , are not
Health exactly
Statistics, equivalent
indicate that to marriage
while same- in terms of
sex the
cohabiters— psychologic
both male al or
and female physical
 2105

health those in
benefits they nonmarital
afford. The same-sex
reason for and
this is not different-
entirely sex
clear, though relationship
it may be s.
that marriage On the
differs from other hand,
other forms the
of intimate available
living, not studies do
necessarily not provide
because of a consistent
Marriage Equality, Effects on Well-Being and Relationships
the picture that
companionsh same-sex
ip, sexual partners fare
relations, or worse than
economic partners in
cooperation different-
that marriage sex
provides, but marriages.
because of For
the example,
institutional while data
nature of from the
marriage, GSS,
which NHSLS,
involves and CHSLS
norms of indicate that
obligation same-sex
and formal partners are
laws— less happy,
guidelines on average,
that define than
how different-
individuals sex spouses,
should act the same
toward one data suggest
another in that same-
intimate life. sex partners
This are no
difference different
may explain from
the different-
advantage of sex married
the married, persons in
relative to how they
2106

rate the including at

status of least one
their using data
physical from a large
health. In representati
fact, ve sample,
according to suggest that,
these data, like their
samesex heterosexua
partners in l peers,
general, and sexualminor
male–male ity persons
partners in receive
particular, equivalent
report higher psychologic
mean levels al benefits
of health from same-
than their sex legal
different-sex marriage
married and other
peers. In types of
addition, the legally
data suggest recognized
that when same-sex
same-sex relationship
partnered s (e.g., civil
respondents unions,
are separated registered
into different domestic
relationship- partnerships
type ). For
categories, example,
those who according to
classify data from
themselves the 2009
as being California
“married,” Health
even if not Interview
legally Survey,
married, there are no
report levels statistically
of happiness significant
that are differences
comparable in
to those of psychologic
married al distress
heterosexual between
s. heterosexua
Further, a l
few studies, individuals,
 2107

regardless of this sense,

marital individuals
status, and who choose
same-sex to enter into
married, legal same-
lesbian, gay, sex unions
and bisexual may
persons and experience a
lesbian, gay, “marriage
and bisexual benefit”
persons in similar to
registered their
domestic different-
partnerships. sex married
Moreover, peers.
persons in Clearly,
each of these more
relationship research is
categories needed to
are less explore how
likely to the health
experience and well-
psychologica being of
l distress individuals
than lesbian, in samesex
gay, and relationship
bisexual s are shaped
persons who by the
are not in legalization
any type of of same-sex
legally marriage. In
recognized the future,
relationship. researchers
Such will need to
findings consider
suggest that whether
providing associations
legal between
avenues for same-sex
same-sex marriage
couples to and health
marry or and well-
register their being are
relationships causal or
may offer at due to
least the selection
possibility of effects.
improved Further
psychologica research
l health. In should use
2108

longitudinal area of
data to research is
address this relatively
limitation. new, future
Future work should
studies of examine
same-sex how other
marriage and physical or
health and psychologic
well-being al health
should also measures—
consider such as
whether the substance
average use, body
effects of weight,
marriage mental
equality are health (e.g.,
the same for depression
persons of symptoms)
differing —relate to
social union status
categories. for
In other sexualminor
words, while ity
same-sex populations.
marriage on
average may
confer health Other
and well- Outcomes
being In addition
benefits, this to research
positive exploring
association the potential
may not hold benefits to
across individual
different health and
contexts or well-being
groups of associated
people. For with
some, same- marriage,
sex marriage numerous
may be studies have
unrelated to investigated
physical or the
psychologica relationship
l health or between
even be marriage
harmful to it. and child
Finally, well-being,
while this
 2109

relationship compare the

stability, and well-being
household of children
labor raised in
patterns. same-sex
Given that and
few studies different-
examine sex parent
same-sex households.
marriage Although
relationships more
(seeing as research is
how most needed, the
jurisdictions current
that have literature
legalized indicates
same-sex that children
marriage who are
have done so raised by
only same-sex
recently), and
much of the different-
information sex couples
in this fare equally
section will well on a
detail variety of
existing indicators,
research including
about social
unmarried developmen
same-sex t,
couples and psychologic
different-sex al
marriage developmen
partnerships t,
in relation to performanc
these topics. e in school,
and sexual
health.
Child Well-
Research on
Being
children’s
Dozens of wellbeing
studies indicates
utilizing a that
diversity of differences
datasets, in outcomes
research between
methods, and various
sampling family types
strategies are

Marriage Equality, Effects on Well-Being and Relationships

2110

influenced married
by a variety same-sex
of factors, couples on
including the well-
socioeconom being of
ic status and children—
transitions in versus
family stable,
structure (for cohabiting
example, same-sex
individuals couples—
with children currently
entering into exists.
new Using more
partnerships) general data
, but not the from
gender different-
composition sex
of the couple partnerships
or the , however, it
sexuality of is possible
individuals to see a
raising the general
children. trend in the
Having literature:
considered Children of
the effects of single
same-sex parents tend
parenting to fare
more worse on
generally on many social
the well- indicators
being of (e.g., teen
children, it is pregnancy
now rates,
important to juvenile
examine the delinquency
effects of , academic
marriage performanc
itself. Given e) than
that same- children of
sex marriage cohabiting
is a recent parents,
social who in turn
development perform
, little more poorly
research than
detailing the children of
effects of married
stable, couples.
 2111

Many “marriage-
researchers like”
have found relationship
similar s without a
differences marriage
between certificate,
children due in part
living with to factors
cohabiting such as a
parents historical
compared to lack of legal
a recognition
biological/st in many
epparent places and
cohabiting the social
arrangement, acceptabilit
and between y of having
children nonmarital
living with partnerships
married in many
parents lesbian, gay,
compared to and bisexual
a biological/ (LGB)
stepparent communitie
marriage. s. As such,
Although future
socioeconom research is
ic status necessary to
plays a large determine
role in these whether
differences, outcomes
research similar to
suggests that those with
the effects of different-
marriage— sex
such as partnerships
institutional are
support and observed
greater with the
relational children of
commitment cohabiting
by both versus
partners— married
also same-sex
contribute to couples.
these
disparities.
Many same- Divorce and
sex couples Stability
live in
2112

Little is higher
research has than it is for
been differentsex
conducted married
on the couples.
stability of Disparities
either legal in
same-sex dissolution
unions likelihood
(marriages, remain after
registered taking into
partnerships, consideratio
etc.) or n age
same-sex differences
cohabiting between
relationships partners,
, so this topic age of entry
must be into the
approached relationship,
with caution. and the
Existing data presence of
from children.
Norway and This
Sweden evidence
suggest that falls in line
legal union with other
dissolution is research
much higher about
for gay and cohabitation
lesbian , which
couples than demonstrate
it is for s that
different-sex cohabiting
marriages. couples, as
Similarly, well as
data from the married
Netherlands couples that
and Britain cohabited
indicate that prior to
separation marriage,
between have less
cohabiting stable
same-sex relationship
couples is s than
much higher couples that
than it is for did not
cohabiting cohabit
different-sex before
couples, marriage.
which in turn
 2113

Greater experience
relationship similar
instability of benefits of
same-sex marriage to
couples different-
(legal or sex couples
within a until social
cohabiting prejudice is
relationship) lessened
may be and full
partially legal rights
explained by are granted.
a variety of
factors: less
institutional Relationship
support of Dynamics:
same-sex Household
relationships Labor
, fewer legal There is
barriers to a large body
separating, a of research
greater about the
prevalence division of
and household
acceptance labor within
of different-
singlehood sex and
in LGB same-sex
communities relationship
, and less s. Much
relationship research
investment shows that
by same-sex different-
partners sex
because of cohabiting
(1) couples
internalized have a more
homophobia egalitarian
and (2) a division of
desire to housework
maintain low than
relationship different-
visibility due sex married
to couples, and
widespread that
prejudice. different-
Accordingly, sex married
same-sex couples that
couples may cohabited
not prior to
2114

marriage
have a more
equal
division than
married
different-sex
couples that
did not
cohabit. In
addition,
most
research
demonstrates
that same-
sex couples,
both male
and female,
have a more
egalitarian
division of
housework,
child care,
and finances
than

different-sex couples. This is perhaps because same-
sex partners must undergo an active process of
negotiation about household labor, rather than
relying on conventional gender-related roles.
Concerning between-partner differences in
household labor performed by same-sex couples, the
data suggest that this is explained in part by hours
worked in the labor market; income generated in paid
jobs; and a partner’s performance of femininity, with
the more feminine partner performing more
housework. Although same-sex couples generally
divide their household labor more equally than
different-sex couples, some research suggests that
this difference has narrowed over time. This could be
explained by one of two factors: (1) greater
egalitarianism among differentsex couples over time
or (2) less egalitarianism among same-sex couples
over time. It remains to be seen whether same-sex
couples will stay more egalitarian than different-sex
couples in marriages and other legal arrangements, or
whether same-sex couples in legal unions will
undergo a “traditionalizing effect” and more closely
reflect married different-sex couples in household
labor.
New Directions
Research exploring the effects of same-sex marriage
needs to expand beyond the topics discussed above.
One issue to consider is how legalized same-sex
marriage affects the sex lives of same-sex couples. In
general, married people have sex more frequently
than people who are not married, and they are
typically more satisfied with their sex lives. It will be
of interest to see whether such findings apply to
persons in same-sex unions. Similarly, researchers
should consider the economic outcomes of same-sex
marriage, and whether they are similar to those of
different-sex marriage. For example, when compared
to never married,
divorced, and widowed people, different-sex married
persons have been found to have more money and
economic security, even when accounting for racial
and ethnic differences. Finally, there is a need for
research that explores whether and how marriage
equality influences the prevalence and dynamics of
domestic violence. Among male– female couples,
being married tends to reduce women’s risk of
experiencing violence. It is unclear whether the same
Marriage Equality, Landmark Court Decisions 2115
pattern will extend to women and men in same-sex
marriages.
Chris Wienke and Tony James Silva
See also Children With LGBQ Parents, Psychosocial
Outcomes; Division of Labor in LGBTQ-Parent
Families; Health Disparities; Long-Term Same-Sex
Couples; Minority Stress
Further Readings
Andersson, G., Noack, T., Seierstad, A., &
WeedonFekjaer, H. (2006). The demographics of same-
sex marriages in Norway and Sweden. Demography,
43, 79–98.
Denney, J. T., Gorman, B. K., & Barrera1, C. B. (2013).
Families, resources, and adult health: Where do sexual
minorities fit? Journal of Health and Social Behavior, 54,
46–63.
Perlesz, A., Power, J., Brown, R., McNair, R., Schfield, M.,
Pitts, M., et al. (2010). Organising work and home in
same-sex parented families: Findings from the Work Love
Play Study. Australian & New Zealand Journal of Family
Therapy, 31, 374–391.
Schmeer, K. K. (2011). The child health disadvantage of
parental cohabitation. Journal of Marriage & Family, 73,
181–193.
Wienke, C., & Hill, G. J. (2009). Does the “marriage
benefit” extend to partners in gay and lesbian
relationships? Evidence from a random sample of
sexually active adults. Journal of Family Issues, 30,
259–289.
Wight, R. G., LeBlanc, A. J., & Badgett, M. V. L. (2013).
Same-sex legal marriage and psychological well-being:
Findings from the California Health Interview Survey.
American Journal of Public Health, 103, 339–346.
MARRIAGE EQUALITY, LANDMARK COURT
DECISIONS
In the United States, major advancements in
marriage equality have been secured through court
challenges on both the state and federal levels. The
first same-sex marriage cases date from the 1970s
and the early days of the gay liberation movement.
However, the concerted push for marriage equality
2116 Marriage Equality, Landmark Court Decisions

did not begin until the mid-1990s, when a series of The Early Marriage Cases, 1970s
positive decisions from the Hawai’i state courts
Several same-sex marriage cases date from the 1970s
signaled that same-sex couples could secure the right
when gay activists in a number of jurisdictions
to marry under state constitutional law. The Hawai’i
applied for and were denied marriage licenses. In
marriage litigation provoked a popular backlash, and
some instances, the same-sex couples who had been
voters in many states amended their state
denied marriage licenses challenged the decisions in
constitutions to prohibit same-sex marriage, thereby
state court. These early claims for equal marriage
eliminating the power of the courts to use state
rights were rejected by the courts largely on
constitutional protections to compel samesex
definitional grounds. Although the plaintiffs raised
marriage. Beginning in 2009, the focus of the
federal constitutional claims, the courts ruled that
marriage litigation shifted from the state level to the
marriage, by definition, could only exist between a
federal level, as litigants began to argue that same-
man and a woman.
sex marriage was protected under the U.S.
In the 1973 case of Jones v. Hallahan, the Court
Constitution. In 2015, the U.S. Supreme Court
of Appeals of Kentucky consulted three different
recognized that marriage was a fundamental right
dictionaries for the definition of marriage before
guaranteed under the Due Process Clause and the
ruling that Marjorie Jones and Tracey Knight were
Equal Protection Clause of the Fourteenth
not eligible to receive a marriage license. Even
Amendment to the U.S. Constitution in Obergefell v.
though the Kentucky marriage statute was
Hodges. Obergefell invalidated the state-level
genderneutral and did not expressly require the
marriage bans and mandated nationwide marriage
parties to be of different sexes, the court reasoned
equality.
that Jones and Knight were “prevented from
While the Hawai’i litigation was ongoing, the
marrying, not by the statutes of Kentucky or the
U.S. Congress enacted the Defense of Marriage Act
refusal of the County Court Clerk of Jefferson
(DOMA), which erected a federal barrier to marriage
County to issue but rather by their own incapability
equality. The 1996 statute declared that for all federal
of entering into a marriage as that term is defined”
purposes, a marriage was only between one man and
(Jones v. Hallahan, p. 589).
one woman. It also authorized states to refuse to
The Minnesota Supreme Court had reached a
honor same-sex marriages performed in other states.
similar decision in the 1971 case of Baker v. Nelson.
DOMA was challenged in federal court on the
Jack Baker and Michael McConnell sued in state
grounds that it violated the Due Process Clause and
court after being denied a marriage license by the
the Equal Protection guarantees of the Fifth
clerk of Hennepin County District Court in
Amendment to the U.S. Constitution. After numerous
Minnesota. Even though the Minnesota statute was
favorable appellate court decisions, the U.S. Supreme
silent regarding the gender of the parties to a
Court agreed to hear the case of United States v.
marriage, the Supreme Court of Minnesota held that
Windsor and rule on the constitutionality of DOMA.
marriage, by definition, was between a man and a
In its 2013 landmark decision, the U.S. Supreme
woman. The court rejected the plaintiffs’ reliance on
Court invalidated the portion of DOMA that
Loving v. Virginia, the 1967 U.S. Supreme Court
established the federal marriage prohibition. This
case that had invalidated antimiscegenation laws.
decision led to the widespread recognition of same-
The plaintiffs appealed to the U.S. Supreme Court,
sex marriage at the federal level, pending the Court’s
but the Court dismissed the case in 1972, citing the
2015 decision in Obergefell. This entry outlines the
lack of a “substantial federal question.” The case
major marriage equality cases that challenged the
garnered media attention, and Baker and McConnell
state and federal marriage prohibitions. It first
were featured in a 1971 Look magazine article, The
discusses the cases that argued for marriage equality
Homosexual Couple. As late as 2014, some federal
and sought to invalidate the state-level marriage
courts continued to cite Baker v. Nelson for the
prohibitions. It then discusses the cases that
proposition that same-sex marriage was not protected
challenged the federal marriage prohibition, DOMA.
under the U.S. Constitution.

The early marriage litigation highlighted the fact
that many states had gender-neutral marriage laws.
By 1978, a total of 15 states had amended their state
laws to remedy this omission and specifically define
marriage as a union between one man and one
woman. The cases also showed that courts were not
ready to entertain federal constitutional arguments in
favor of same-sex marriage. It would take more than
30 years before the first courts ruled that the U.S.
Constitution protected the right of same-sex couples
to marry.
Hawai’i Marriage Litigation, 1993 to 1998
Instead of seeking relief under the federal
constitution, same-sex couples looked to state
constitutions for protection. The first pro-marriage
state supreme court decision came from Hawai’i in
1993. In Baehr v. Lewin, the Hawai’i Supreme Court
ruled that the failure to issue marriage licenses to
same-sex couples presumptively violated the Equal
Rights Amendment to the Hawai’i Constitution
because the denial constituted discrimination based
on gender. The Supreme Court of Hawai’i remanded
the case to the trial court to determine whether the
prohibition against samesex marriage could be
justified by a compelling state interest. After
extensive fact-finding and hearings, the trial court
ruled in 1996 that the state had failed to meet its
burden of proof. At this stage of the litigation, the
name of the case was changed to Baehr v. Miike to
reflect the name of the new state director of health
who had replaced Lewin as the defendant of record.
While an appeal was pending, the Hawai’i
legislature passed the Reciprocal Beneficiaries Act in
1997 in an attempt to avoid judicially mandated
same-sex marriage. The legislation extended some
rights that were associated with marriage to samesex
couples, as well as to certain different-sex couples.
The following year, while the case was still being
appealed to the state supreme court, the voters
amended the Hawai’i state constitution to provide
that the definition of marriage could only be changed
by legislative action. The Supreme Court of Hawai’i
eventually affirmed the trial court decision in favor
of marriage equality, but by then the constitutional
amendment had rendered the court’s decision moot
because it no longer had the power to alter the
definition of marriage.
Marriage Equality, Landmark Court Decisions 2117
The Hawai’i litigation prompted antimarriage
legislation at the state and federal level, including the
enactment of the federal Defense of Marriage Act
(DOMA) in 1996. It also illustrated the effectiveness
of voter initiatives and referenda to reverse or
prevent pro-marriage court decisions through the
adoption of state constitutional amendments. By
2004, a total of 45 states had laws or constitutional
amendments restricting marriage to a union of one
man and one woman, and a number of states had
both. Nineteen states eventually amended their state
constitutions to prohibit not just samesex marriage,
but also the grant of any of the “incidents of
marriage” to same-sex couples. In addition to
marriage, these broader amendments were designed
to prohibit any nonmarital form of relationship
recognition, including civil unions, domestic
partnerships, municipal registries, and the grant of
domestic partner employee benefits to public
employees.
Baker v. Vermont, Vermont (1999)
Following Hawai’i, the next state to consider
marriage equality was Vermont. In 1999, the
Vermont Supreme Court ruled in Baker v. Vermont
that same-sex couples were entitled to the same
rights and privileges afforded to married couples
under the Vermont Constitution. The decision did not
mandate same-sex marriage. Instead, it suspended
the issuance of marriage licenses to same-sex
couples until the state legislature could attempt to
remedy the situation. A year later, the Vermont
legislature enacted civil union legislation rather than
extend marriage to same-sex couples. The legislation
complied with the court ruling because parties to a
civil union were entitled to “all the same benefits,
protections and responsibilities . . . whether they
derive from statute, administrative or court rule,
policy, common law or any other source of civil law,
as are granted to spouses in marriage” (Knauer,
2006, p. 62). The Vermont civil union legislation
represented the first time a state created a parallel
status for same-sex couples that was equivalent to
marriage.
Goodridge v. Department of Public Health,
Massachusetts (2003)
2118 Marriage Equality, Landmark Court Decisions
In 2004, Massachusetts became the first state to issue
marriage licenses to same-sex couples. A year
earlier, the Massachusetts Supreme Court held in
Goodridge v. Department of Public Health that the
Massachusetts Constitution requires equal treatment
of same-sex couples with respect to marriage. In an
advisory opinion, the majority of the Justices of the
Massachusetts Supreme Court concluded that
Vermont-style civil union legislation would not cure
the constitutional infirmity, noting that the difference
between civil unions and civil marriage “is more than
semantic” (Knauer, 2006, p. 291). Anti–marriage
equality voters mobilized around a state
constitutional amendment that would have prohibited
same-sex marriage.
The advent of same-sex marriage in
Massachusetts created a lack of uniformity on the
federal level because same-sex couples who were
legally married in Massachusetts were considered
unmarried for all federal purposes, including taxes
and social security benefits. In an effort to limit the
spread of same-sex marriage to other states,
thenGovernor Mitt Romney instructed the Attorney
General of Massachusetts to enforce a 1912 state law
that forbade issuing a marriage license to a
nonresident couple if the marriage would be void in
the couple’s state of residence. At the time, this
would have included every other state in the union.
The statute had been originally enacted to respect
antimiscegenation laws that were prevalent in the
southern states by not permitting residents of those
states to circumvent their state law by traveling to
Massachusetts to marry.
In re Marriage Cases, California (2008)
Same-sex marriages began taking place in
California in June 2008, but marriage equality in the
most populous state was short-lived. The California
State Supreme Court mandated same-sex marriage in
the 2008 case of In re Marriage Cases. The court
held that sexual orientation was not a sufficient basis
for withholding or restricting the fundamental right
to marry guaranteed under the California
Constitution. Prior to In re Marriage Cases, the
California legislature had been gradually expanding
its legal recognition of same-sex relationships. In
2004, the legislature extended to “registered
domestic partners” a number of rights traditionally
reserved for spouses, including inheritance rights,
certain health care decision-making authority, and
standing to sue for wrongful death. The next year,
the legislature granted registered domestic partners
substantially all the rights and responsibilities
enjoyed by spouses under California law. The
legislature then twice passed legislation that would
have legalized same-sex marriage, but Governor
Arnold Schwarzenegger vetoed both bills.
In November 2008, California voters approved
Proposition 8, a ballot proposition that amended the
California Constitution to restrict marriage to a union
between a man and a woman. After Proposition 8,
California continued to recognize the marriage-
equivalent status of “registered domestic partners,”
as well as approximately 18,000 same-sex marriages
that took place during the brief period when same-
sex marriage was legal.
Hollingsworth v. Perry (2013)
Hollingsworth v. Perry was a much-anticipated
federal case that was decided by the U.S. Supreme
Court in 2013. Unlike the earlier marriage litigation,
Hollingsworth raised federal constitutional claims on
behalf of two same-sex couples who had been denied
marriage licenses in California because of
Proposition 8. The case challenged Proposition 8 in
federal court under the Due Process and Equal
Protection Clauses of the Fourteenth Amendment of
the U.S. Constitution. Because the case challenged a
marriage prohibition under the U.S. Constitution
rather than a state constitution, it had the potential to
mandate marriage equality nationwide. Although the
Supreme Court decision in Hollingsworth resulted in
same-sex marriage once again being recognized in
California, it did not have any impact beyond
California because it was decided on very narrow
grounds.
The case was originally filed in the U.S. District
Court for the Northern District of California in 2009.
When the State of California declined to defend
Proposition 8, the conservative action organization
Alliance Defense Fund was granted permission to
take its place, but the governor remained the named
defendant. The Alliance Defense Fund took over
defending Proposition 8 and was referred to as the
“defendant-intervenor.” The City of San Francisco

was also granted permission to intervene on behalf of
the same-sex couples challenging Proposition 8.
The plaintiffs made two separate constitutional
arguments under the Fourteenth Amendment, which
protects individuals from the actions of state
governments. They first argued that Proposition 8
violated the Due Process Clause of the Fourteenth
Amendment because it substantially impaired their
fundamental right to marry that the Court had
recognized in Loving v. Virginia when it invalidated
antimiscegenation laws in 1967. This is the same
claim that had been brought in the early marriage
cases from the 1970s. When a state action
substantially burdens a fundamental right, the action
is unconstitutional unless the state can prove that the
action is narrowly tailored to further a compelling
state interest. This level of review is known as “strict
scrutiny” and is the highest standard of review that a
state must satisfy in order to justify an official action.
In Hollingsworth, the plaintiffs argued that the
defendantintervenor had not only failed to identify a
compelling state interest, but had also failed to
identify a single legitimate state interest. This level
of review is referred to as “rational basis review” and
is the lowest standard of proof that is required to
justify state action.
The plaintiffs also claimed that Proposition 8
violated the Equal Protection Clause of the
Fourteenth Amendment. State action that burdens the
exercise of a fundamental right or discriminates
against a “suspect class” of individuals who deserve
special protection from the courts is also subject to
strict scrutiny under the Equal Protection Clause. At
trial, the plaintiffs argued that gay men and lesbians
qualify as a suspect class because they (1) have been
subjected to a long history of discrimination, (2) are
defined by a characteristic that bears no relationship
to their ability to contribute to society (i.e., sexual
orientation), and (3) are subject to political
disabilities. If federal courts recognize gay men and
lesbians as a suspect class, then any state action that
disadvantages them would be subject to strict
scrutiny and most likely fail constitutional review.
Accordingly, a finding that gay men and lesbians
constitute a suspect class would have wide
consequences beyond marriage equality.
In defense of Proposition 8, the
defendantintervenor asserted that it furthered the
following state interests: (1) procreation, (2)
Marriage Equality, Landmark Court Decisions 2119
“responsible procreation,” (3) tradition, (4)
recognition of California marriages by other states,
(5) administrative convenience, and (6) moral
disapproval. The plaintiffs charged that the stated
reasons were mere pretense, and Proposition 8 was,
in fact, motivated by animus. They argued that
animus against gay men and lesbians is not a
legitimate state interest according to the 1993 U.S.
Supreme Court case Romer v. Evans. Romer
invalidated Amendment 2 to the Colorado
Constitution that had outlawed anti-discrimination
protections based on sexual orientation.
In 2010, the federal District Court for the
Northern District of California ruled that Proposition
8 violated the plaintiffs’ rights under the Equal
Protection and Due Process Clauses of the U.S.
Constitution. Although the trial court was willing to
apply strict or at least a heightened form of scrutiny,
it specifically ruled that the defendantintervenor had
failed to satisfy even the lowest burden of proof
required to justify Proposition 8 because it was found
to serve no legitimate state interest. The ruling
enjoined the State of California from enforcing
Proposition 8, but the decision was stayed pending
appeal. Two years later, the Ninth Circuit Court of
Appeals affirmed the lower court decision, but on
more narrow grounds that were limited to the
particular facts and circumstances surrounding the
passage of Proposition 8. It did not reach the
question of whether the U.S. Constitution guaranteed
a fundamental right to same-sex marriage. Basing its
decision on the lower rational basis standard, the
court held the following:
Proposition 8 serves no purpose, and has no effect,
other than to lessen the status and human dignity of
gays and lesbians in California, and to officially
reclassify their relationships and families as inferior
to those of opposite-sex couples. The [United
States] Constitution simply does not allow for “laws
of this sort.” (Perry v. Hollingsworth, 2012, p.
1063)
The 2013 U.S. Supreme Court decision was both
confusing and anticlimactic. It did not mandate
nationwide same-sex marriage by finding a
fundamental right to same-sex marriage or a
violation of Equal Protection as many commentators
had predicted. Instead, the Court declined to reach
2120 Marriage Equality, Landmark Court Decisions
the merits of the case, finding in a 5-to-4 decision
that the defendant-intervenor did not have the
required appellate standing to defend the case.
Without legal standing, Hollingsworth did not meet
the constitutional requirement of a “case or
controversy,” and the Court was without power to
render a decision. The Court returned the case to the
Ninth Circuit with instructions to vacate its prior
ruling. The result was to reinstate the decision of the
District Court and dissolve the stay on same-sex
marriages, which then allowed same-sex marriage to
begin in California for the second time.
Obergefell v. Hodges (2015)
Two years later, in 2015, the Supreme Court had the
opportunity to revisit the issue of marriage equality
in Obergefell v. Hodges. In a landmark 5-to-4
decision, the Court held that same-sex couples have a
fundamental right to marry under the Due Process
Clause and the Equal Protection Clause of the
Fourteenth Amendment. It invalidated state laws
prohibiting same-sex marriage and further held that
no state had the right to refuse to recognize a same-
sex marriage performed in another state. Obergefell
also overturned Baker v. Nelson. As a result of the
opinion, marriage equality is now the law in the
United States.
Obergefell actually involved four consolidated
cases from four different states (Kentucky, Michigan,
Ohio, and Tennessee) that all presented substantially
the same question of law. In each case, the state had
either refused to grant a samesex couple a marriage
license or refused to recognize a marriage performed
in another state. The plaintiff in the lead case, Jim
Obergefell, had a particularly poignant story. When
his partner of many years, John Arthur, was
diagnosed with amyotrophic lateral sclerosis (ALS),
they travelled to Maryland, where they could legally
marry. By that time, Arthur was extremely frail and
had to travel on a medical transport plane. On July
11, 2013, Obergefell and Arthur were married in
Baltimore on the tarmac at the airport. Arthur died
three months later, and Ohio refused to list
Obergefell as his spouse on the death certificate.
Obergefell sued to be included as surviving spouse
on his husband’s death certificate and to have his
husband’s status at death recorded as “married.”
The federal District Court for the Southern
District of Ohio ruled that Ohio must recognize
outof-state marriages and ordered that Arthur’s death
certificate reflect his marriage to Obergefell. The
Ohio Attorney General appealed the case to the U.S.
Court of Appeals for the Sixth Circuit. The Sixth
Circuit ruled 2 to 1 that Ohio’s ban on samesex
marriage did not violate the U.S. Constitution, stating
that it was bound by the Supreme Court 1972
decision to dismiss Baker v. Nelson “for want of a
federal question.” The majority opinion concluded
that “[n]ot one of the plaintiffs’ theories . . . makes
the case for constitutionalizing the definition of
marriage and for removing the issue from the place it
has been since the founding: in the hands of state
voters” (Deboer v. Snyder, 2014, pp. 402–403).
Obergefell appealed the decision to the U.S. Supreme
Court.
In January 2015, the Supreme Court agreed to
review the case and consolidated it with three other
same-sex marriage cases that were pending before
the Court. The arguments in favor of samesex
marriage closely tracked those that had been made in
Perry v. Hollingsworth 2 years earlier. On June 26,
2015, the Court ruled in favor of marriage equality in
a 5-to-4 opinion. The opinion was announced on the
second anniversary of United States v. Windsor and
the twelfth anniversary of Lawrence v. Texas, which
had invalidated criminal sodomy laws. Justice
Anthony Kennedy authored the majority opinion and
was joined by Justices Ginsburg, Breyer, Sotomayor,
and Kagan. Justice Kennedy’s opinion cited Loving
v. Virginia and affirmed that marriage is a
fundamental right guaranteed under the Due Process
Clause of the Fourteenth Amendment. It further
found that the denial of that right violated that
amendment’s Equal Protection Clause. The Court
rejected the argument that the decision should be left
to the states, as well as the argument that allowing
samesex couples to marry would harm the institution
of marriage. The majority opinion concluded,
No union is more profound than marriage, for it
embodies the highest ideals of love, fidelity,
devotion, sacrifice, and family. In forming a marital
union, two people become something greater than
once they were. As some of the petitioners in these
cases demonstrate, marriage embodies a love that
may endure even past death. It would misunderstand

these men and women to say they disrespect the
idea of marriage. Their plea is that they do respect
it, respect it so deeply that they seek to find its
fulfillment for themselves. Their hope is not to be
condemned to live in loneliness, excluded from one
of civilization’s oldest institutions. They ask for
equal dignity in the eyes of the law. The
Constitution grants them that right. (Obergefell v.
Hodges, p. 2608)
Chief Justice Roberts and Justices Scalia, Thomas,
and Alito all authored separate dissenting opinions.
Chief Justice Roberts’s dissent was joined by Justices
Scalia and Thomas. The Chief Justice disagreed with
the majority’s Due Process and Equal Protection
analysis, but his dissent is most notable for its claim
that the Court had overstepped its constitutional
authority. According to Chief Justice Roberts, the
question of marriage equality should have been left
to the political process rather than decided by the
Court. He also warned that the majority opinion
would have negative consequences for religious
liberty and said that Justice Kennedy had unfairly
maligned the opponents of marriage equality.
DOMA Litigation
After the federal marriage prohibition, DOMA, was
enacted in 1996, it took another 8 years before
Massachusetts became the first state to issue
marriage licenses to same-sex couples. Not
surprisingly, the first federal cases challenging the
constitutionality of DOMA came from
Massachusetts and did not arise until the late 2000s.
Once states began to adopt marriage equality, the
inequalities created by DOMA became clear.
Couples who were legally married under state law
were considered unmarried for federal purposes and
denied access to a wide range of important federal
benefits. This section discusses the three main cases
that challenged DOMA: Gill v. Office of Personnel
Management, Massachusetts v. HHS, and the
groundbreaking U.S. Supreme Court decision
United States v. Windsor that invalidated the
definition section of DOMA and led to the
widespread federal recognition of same-sex
marriage. All of the challenges were successful,
although they presented different arguments. Gill v.
OPM and Massachusetts v. HHS both originated in
Marriage Equality, Landmark Court Decisions 2121
Massachusetts and were companion cases that were
considered at the same time by the U.S. District
Court for the District of Massachusetts and the First
Circuit Court of Appeals.
DOMA
Enacted in response to the Hawai’i marriage
litigation, DOMA was designed to stop the potential
spread of same-sex marriage. The 1993 Hawai’i
Supreme Court decision, Baehr v. Lewin, had
signaled the possibility that states could require
same-sex marriage as a matter of state constitutional
law. The recognition of same-sex marriage by even a
single state would have had repercussions on the
federal level and created a domino effect in other
states. Prior to DOMA, a same-sex couple who were
married under state law would have been considered
married for all federal purposes because marriage
was traditionally a matter of state law. Other states
might also have been required to recognize the
marriage under the Full Faith and Credit Clause of
the U.S. Constitution that requires states to honor the
judgments of other states. DOMA addressed each of
these concerns through two separate provisions.
Section 3 of DOMA adopted a restrictive federal
definition of marriage that defined marriage as a
union of one man and one woman. Section 2
authorized states to refuse to recognize out-of-state
same-sex marriages.
The U.S. Department of Justice (DOJ) had
initially defended DOMA in the federal court
challenges, although it stated in pleadings that the
Obama “Administration believes the Defense of
Marriage Act (‘DOMA’) is discriminatory and
should be repealed.” During the course of the DOMA
litigation, the U.S. Attorney General, Eric Holder,
announced that the DOJ would no longer defend
DOMA because he had determined that it violated
the U.S. Constitution. Congressional interests
intervened, and the U.S. House of Representatives
Bipartisan Legal Advisory Group (BLAG) continued
the defense of the statute in federal court.
Gill v. OPM
In Gill v. OPM, eight same-sex couples who were
legally married in Massachusetts and two surviving
spouses challenged Section 3 of DOMA. One of the
2122 Marriage Equality, Landmark Court Decisions
surviving spouses was Dean Hara, who had been
married to the first openly gay member of Congress,
former Representative Gerry Studds. Mr. Hara had
been denied federal spousal benefits despite his valid
marriage to Congressman Studds under
Massachusetts law. The plaintiffs argued that
DOMA, as applied to their particular circumstances,
denied them equal protection guaranteed under the
Fifth Amendment to the U.S. Constitution. DOMA
claims arose under the Fifth Amendment rather than
the Fourteenth Amendment because DOMA was a
federal statute. The Fifth Amendment protects
individuals from overreaching federal action,
whereas the Fourteenth Amendment protects
individuals from state action such as Proposition 8.
The plaintiffs argued that DOMA should be
subject to a heightened level of judicial review, and,
in the alternative, that DOMA did not satisfy even
the lowest level of judicial review because it is not
rationally related to a legitimate state interest.
Plaintiffs further alleged that even if heightened
review were not warranted, DOMA failed to satisfy
rational review under the precedent of Romer v.
Evans because its enactment was motivated by
animus toward same-sex relationships. Animus is
defined as a desire to harm motivated by hostility or
ill will. To support their allegation that DOMA was
motivated by animus, the plaintiffs cited liberally
from the official comments regarding DOMA that
were in the Congressional Record and reflected the
fiery and inflammatory rhetoric of the day.
In 2010, the U.S. District Court for the District of
Massachusetts found for the plaintiffs, ruling that
irrational prejudice never constitutes a legitimate
government interest. Although the court found that
Section 3 of DOMA lacked a rational basis, it did not
address the question of whether heightened scrutiny
was warranted. A unanimous decision by the First
Circuit Court of Appeals affirmed the lower court
decision and declared Section 3 of DOMA
unconstitutional. BLAG appealed the decision to the
U.S. Supreme Court, but the Court dismissed the
case the day after it decided United States v.
Windsor.
Massachusetts v. HHS
In Massachusetts v. HHS, the core issue was
federalism or states’ rights, not individual rights.
Brought by the Commonwealth of Massachusetts, the
case asserted that DOMA violated the Tenth
Amendment and the Spending Clause of Article I of
the U.S. Constitution. Specifically, Massachusetts
claimed that DOMA impermissibly interfered with
its distribution of Medicare and Medicaid funds and
its management of certain cemeteries that are funded
by the U.S. Department of Veterans Affairs. The
Tenth Amendment to the U.S. Constitution expressly
reserves to the states all powers except those limited
powers granted to the federal government.
Massachusetts argued that these retained powers
include the authority to regulate and define marriage
for its citizens.
The trial court decided Massachusetts v. HHS on
the same day as Gill v. OPM. The U.S. District Court
for the District of Massachusetts ruled that DOMA
Section 3 violates the Tenth Amendment and falls
outside Congress’s authority under the Spending
Clause of the Constitution. A unanimous decision by
the First Circuit Court of Appeals affirmed the lower
court decision and declared Section 3 of DOMA
unconstitutional. With Gill v. OPM, BLAG appealed
to the U.S. Supreme Court, but the Court dismissed
both cases the day after it decided United States v.
Windsor.
United States v. Windsor
The 2013 landmark U.S. Supreme Court case
United States v. Windsor invalidated Section 3 of
DOMA that had established a federal definition of
marriage as a union between one man and one
woman. The decision opened the door for
recognition of same-sex marriage at the federal level.
Its rationale has also served as the basis for court
decisions invalidating state marriage prohibitions
under the U.S. Constitution.
The case was brought by Edie Windsor, an 83-
year-old widow who had to pay over $363,000 in
federal estate tax when her same-sex spouse, Thea
Spryer, died because the federal government did not
recognize their marriage. Windsor and Spryer were
together for over 40 years before they were married
in Canada in 2007. Their marriage was recognized
under the law of the state of New York, where they
lived at the time of Spryer’s death, but it was not
recognized at the federal level due to DOMA.
Windsor has remarked on this, saying that if Thea’s
 Marriage Equality, Landmark Court Decisions 2123

name had been “Theo,” everything would have been marriage prohibitions. Justice Scalia’s concern
different. proved to be well founded. Numerous federal court
Windsor challenged Section 3 of DOMA, arguing decisions invalidating state marriage
that it violated the U.S. Constitution. Her arguments
were very similar to those made in Gill v. OPM.
Windsor argued that Section 3 violated the Due
Process Clause and Equal Protection guarantees of
the Fifth Amendment of the U.S. Constitution. She
also argued that heightened scrutiny was the
appropriate level of review for state action that
involved matters of sexual orientation. In 2011, the
District Court for the Southern District of New York
held that Section 3 of DOMA did not pass the
rational basis test. The decision ordered the federal
government to refund Windsor the tax that she had
paid. Later that year, the Second Circuit of the U.S.
Court of Appeals affirmed the District Court opinion,
but also held that heightened judicial scrutiny was
the appropriate level of review. It was the first
federal appellate court opinion that adopted the
standard of heightened scrutiny for cases involving
sexual orientation.
In 2013, the U.S. Supreme Court issued a 5-to-4
decision invalidating Section 3 of DOMA. Justice
Kennedy authored the majority opinion and was
joined by Justices Ginsburg, Breyer, Sotomayor, and
Kagan. Justice Kennedy’s opinion speaks in
sweeping terms regarding the disabilities that DOMA
imposed on married same-sex couples, noting that
Section 3 of DOMA “demean[ed] the couple, whose
moral and sexual choices the Constitution protects.”
Applying what seems to be a rational basis test,
Justice Kennedy concluded,

The federal statute is invalid, for no legitimate

purpose overcomes the purpose and effect to
disparage and to injure those whom the State, by its
marriage laws, sought to protect in personhood and
dignity. By seeking to displace this protection and
treating those persons as living in marriages less
respected than others, the federal statute is in
violation of the Fifth Amendment. (United States v.
Windsor, 2013, p. 2696)

Chief Justice Roberts and Justices Scalia and Alito

authored dissenting opinions that were joined by
Justice Thomas. Justice Scalia’s dissent expressed
concern that the majority ruling in Windsor would be
used, improperly in his view, to overturn state
2124
prohibitions under the U.S. Constitution cited
Windsor as precedent.
The invalidation of Section 3 of DOMA meant
that legally married same-sex couples were
considered married for all federal purposes and
eligible to receive federal spousal benefits. However,
Windsor did not address what state law would apply
to determine whether a couple would be considered
married for federal purposes—the law in the state
where the couple was married or in the state where
the couple lives. Although it was clear that a married
same-sex couple who resided in a state that
recognized same-sex marriage would be considered
married for both state and federal purposes, it was
not clear what would happen in the case of a married
same-sex couple who lived in a state that did not
recognize same-sex marriage. In response to this
uncertainty, the Obama Administration announced
that it would recognize same-sex marriages under a
“state of celebration” rule wherever permitted by
relevant statutory provisions. Under this rule, a
married same-sex couple would be considered
married for federal purposes provided their marriage
was valid in the state of celebration, even if it is not
valid in their state of residence. In some instances,
such as social security benefits, the federal
government had to apply a “state of residence” rule
because of a statutory requirement that the marriage
be recognized by the state of the couple’s residence.
This uncertainty was resolved in 2015 when
Obergefell v. Hodges mandated nationwide marriage
equality and also invalidated Section 2 of
DOMA.
Nancy J. Knauer
See also Domestic Partnership; Legal Recognition of
Nonmarital Same-Sex Relationships; Marriage,
Reasons for and Against
Further Readings
Baehr v. Lewin, 852 P.2d 44, 53 (Haw. 1993). Baehr v.
Miike, No. 91–1394, 1996 WL 694235, at *21 (Haw. Cir.
Ct. 1996), aff’d 950 P.2d 1234 (Haw.
1997).
Baker v. Nelson, 191 N.W.2d 185 (Minn. 1971), appeal
dismissed, 409 U.S. 810 (1972).
Masculinities
Baker v. Vermont, 744 A.2d 864 (Vt. 1999).
Chauncey, G. (2004). Why marriage? The history shaping
today’s debate over gay equality. New York, NY: Basic
Books.
Cott, N. (2002). A history of marriage and the nation.
Cambridge, MA: Harvard University Press.
Deboer v. Snyder, 772 F.3d 388 (6th Cir. 2014).
Defense of Marriage Act, Pub. L. No. 104-199, 110 Stat.
2419 (1996).
Gill v. Office of Personnel Management, 682 F.3d 1 (1st
Cir. 2012).
Goodridge v. Dep’t of Pub. Health, 798 N.E.2d 941 (Mass.
2003).
Hirshman, L. (2013). Victory: The triumphant gay revolution.
New York, NY: HarperPerennial.
In re Marriage Cases, 183 P. 3d 384, 452 (Cal. 2008). Jones
v. Hallahan, 501 S.W.2d 588 (Ky. 1973).
Knauer, N. (2006). The recognition of same-sex
relationships: Comparative institutional analysis,
contested social goals, and strategic institutional choice.
Hawai’i Law Review, 28, 23–83.
Knauer, N. (2014). LGBT elders in a post-Windsor world:
The promise and limits of marriage equality. Texas
Journal of Women and the Law, 24(1).
Koppelman, A. (2002). The gay rights question in
contemporary American law. Chicago, IL: University
of Chicago Press.
Lawrence v. Texas, 539 U.S. 558 (2003).
Massachusetts v. HHS, 682 F.3d 1(1st Cir. 2012).
Obergefell v. Hodges, 135 S.Ct. 2584 (2015).
Perry v. Hollingsworth, 671 F.3d 1051 (9th Cir. 2012).
Perry v. Hollingsworth, 133 S. Ct. 2652 (2013).
Singer v. Hara, 522 P.2d 1187 (Wash. App. 1974). United
States v. Windsor, 133 S. Ct. 2675 (2013).
MASCULINITIES
This entry is focused on masculinity as it is
constructed, maintained, and challenged by LGBTQ
populations. The entry begins by providing gender
development concepts and some of the theoretical
orientations used to examine how masculinity has
been constructed within various contexts (e.g.,
psychology, culture, society). The second section
examines the historical and traditional definitions of
masculinity in the United States through a
Foucauldian-based analysis. This entry concludes
Masculinities

by considering the transactional associations between
masculinity and international LGBTQ communities.
Throughout, the entry considers various ways in
which people perform what is deemed “masculine,”
and the varying ways such a performance may
interact with other identities (e.g., race/ethnicity,
socioeconomic status [SES], gender, sexual
orientation, immigration status).
Gender Development
Once a child’s biological sex is ascertained at birth,
family and society typically place the child into
socially constructed and compartmentalized roles
that consist of masculine and feminine schematic
ideals. Some of these gendered beliefs have changed
across time, while others are more stable and impose
gender and other social roles in familial and other
intrapersonal domains (e.g., employment). Within
the psychological and sociological literature, gender
has been described as a socially produced construct
that is contextualized within a system of behaviors,
beliefs, attitudes, and even stereotypes, all operating
within contemporary culture. Gender theorists have
described gender idealization as a system of gender
inequality that devalues certain naturally occurring
features of gender while at the same time
overvaluing others, thus introducing gender-based
inequalities in power and life opportunities. In other
words, the natural ecology does not introduce gender
inequalities. Instead, these inequalities, such as
valuing males over females, are introduced and
perpetuated by socially constructed gendered beliefs,
attitudes, and practices that are based on idealized
schemas of behavior.
If one adopts the concept of gender idealization,
then gender is a malleable and complex idea that is
socially constructed rather than an innate biological
entity, and as is the case within many cultures, the
practice of gender idealization often imposes power
inequality. In the case of gender schema theory,
internalized gender schemas consist of mental
representations of the most appropriate forms of
behavior for each biological sex. These schemas are
developed through early interactions with family and
society. Furthermore, gender idealization does not
occur as an individual’s choice or pursuit. Rather, it
is a form of imposed social status that perpetuates a
“gender binary” (i.e., male and female traits are
separate and unequal).
2125
Gender roles often intersect with other social
identities, including sexuality and race/ethnicity. For
example, for many adult, African American, lesbian
females who are single heads of households, social
pressures to be self-reliant, strong, and assertive have
expanded flexibility in female gender roles. In the
past, these traits and their related behaviors would
have been considered “masculine.” Ironically, this
emergent gender equality with males can empower
women to accept these more traditionally masculine
gender roles, which are not biologically determined,
and thus these women and their social groups can
more easily accept these new “masculine” roles
within themselves. Nonetheless, such changes may
still be tied to a class system that has been built on a
foundation of patriarchy and racism. For example,
researchers found that among African American
heterosexual parents, the gender socialization of their
children was mediated by social class status and
patterns of social mobility. Results indicated that
African American heterosexual parents who
supported gender equality and who socialized their
children accordingly were able to do so only because
they were secure in their social and economic status.
However, some research has indicated that African
American heterosexual parents of gay sons
experience distress and concern for the safety of their
sons due to their child’s perceived inability to
perform the role of hypermasculinity within the
African American community (e.g., emotional
stoicism, toughness, and hyperheterosexuality). The
young African American gay men in these studies
also reported experiencing immense pressure to
reproduce Black male gender-role expectations, and
when they failed, they also experienced alienation,
loneliness, and anxiety. Thus, these examples
illustrate that the performance of masculinity is
transactional, in that both the performer and idealized
masculinity are continually and mutually defined.
Foucault and Masculinity in
the United States
The work of French philosopher and social theorist
Michel Foucault (1928–1984) regarding, among
many other aspects of human experience, sexuality,
gender, and mental illness continues to play a role in
contemporary understanding and study of human
lives. From a Foucauldian perspective, one’s gender
identity and the respective gender-related behaviors
2126
associated with that identity are grounded in the
power relations and social discourse that is shared
and perpetuated by varying levels within one’s life
(e.g., at the macro level, sociopolitical bodies; and at
the micro level, family of origin). Indeed, the
privilege associated with behaving in a manner
consistent with one’s perceived gender begins at
birth, and these behaviors are continually monitored,
shaped, and judged within the cultural confines of
one’s society. Moreover, the meaning that is
associated with “appropriate” behavior, as defined by
an individual’s collective discourse and shaped by
social learning, may be deemed more important than
the actual behaviors, due in part to the amount of
power and privilege that is provided to those who
successfully actualize gendered behaviors associated
with one’s perceived biological sex.
Yet, as Foucauldian theorists assert, gender norms
are not consistent and are at times contradictive of
how masculinity may have been previously defined.
Thus, men, and those who seek to be masculine, must
be vigilant for the dominant gender norms of what a
society deems as normative male behavior. For
example, in the United States early constructs of
masculinity were defined by a man’s position in the
household as sole provider. In Colonial America, this
may have included a specific trade (e.g., carpenter,
blacksmith) or farming. In addition, men were the
only ones entitled to own land and hold high
positions in the community, government, and
religious institutions. These forms of masculinity
changed in later periods (e.g., industrial revolution,
American frontier settlement, California gold rush),
where men left the home to work in factories, mining
operations, land procurement, and other vocations
that made them dependent on others for food
production. During these times, the concept of the
“self-made man” began to take hold and change how
men perceived of themselves in the social hierarchy,
allowing them to transcend legal and cultural barriers
to achievement. As a result, these new American
Masculinities
notions of masculinity championed the ideals of
democracy, equality, and individualism, and for the
first time masculinity was no longer defined by class
and social duty. Nonetheless, men still retained their
power. At times, violence and aggression were also
celebrated aspects of masculinity, underscoring the
belief that men require space to vent their “natural
male passions,” leaving behind the Puritan masculine
ideal of self-control.
Performing Masculinity: LGBTQ
Populations/Communities
Body comportment—the way one carries oneself—is
influenced by gender norms regarding the ways that
people shape and hold their bodies, the types of
clothing they wear, and how the hair is styled. Early
on, these practices were modeled largely by family
members, and later they were modeled and shaped
by society outside of the family. Gender norms and
racially/ethnically identified practices are also used
as functions of body comportment. Moreover, body
comportment and gender norms are politically
charged and have been used throughout U.S. history
as a means to control Native Americans and later,
immigrant populations. In this way, the body became
the “body politic,” and has been used as a means to
declare a person deviant and unworthy for
citizenship in a host country (i.e., naturalization). For
example, in the American colonial past, regional
borderland laws and moralities transformed Mexican
and Native American bodies into those that were
similar to the American ideal (e.g., in Indian
boarding schools). In addition, scholars have noted
that in order for non-White, gay Latinos to assimilate
and gain access to the United States, they needed to
disidentify with their queer identity so as to perform
like their heterosexual masculine counterparts. Thus,
a Latina/o attempting to cross the border had to
perform the appropriate gender practices or lose the
ability to migrate. Moreover, immigration officials
previously used genderstereotyped body
comportment as a means to detain those who did not
perform gender “appropriately” through their
clothing and hairstyles. They believed homosexuals
were sexual “inverts” and that gay men acted
effeminate, lesbians were
Masculinities
masculine, and those who were transgender would be
the “easiest” to identify. Otherwise, immigration
service agents during that time believed there was no
measureable way to determine the difference
between a heterosexual and a homosexual body.
The Western medical model has also used non–
gender-normative body comportment to determine
deviance or pathology. In 1853, the medical literature

first presented the term transsexualism, which was
then regarded as a “mental illness” characterized by
deviations from socially prescribed and culture-
specific social roles that were expected for one’s sex
(i.e., one’s gender role). Transgender individuals
were thus believed to suffer from a disorder (i.e.,
sexual inversion) that caused the individual to
confuse his or her gender, and that may have
included a same-sex attraction. In efforts to target
children who displayed “unusual” amounts of “cross-
gender behavior,” a number of psychiatrists in the
1970s began to study and treat children who were
perceived to be at risk for “adult transsexualism.”
Although certain subcultural groups within the
United States persist in pathologizing individuals
who display atypical gendered behaviors, other
subcultural groups embrace non-normative gendered
behavior. For example, in the LGBTQ community,
there are several cultural practices that support non-
normative gender performance (e.g., live shows
featuring drag queens and drag kings) and that also
allow for others to engage in gendernormative
behaviors (e.g., masculine—Bear community;
feminine—lipstick lesbians). Masculinity in
mainstream U.S. culture has also been influenced by
LGBTQ culture and has in a way given permission
for heterosexual men to engage in female-typical
hygiene and dress behaviors (i.e., as a metrosexual).
Thus, the subcultures within the LGBTQ community
are still a part of the broader U.S. mainstream
culture, and the performance of masculinity is
challenged and upheld in varying degrees within a
gender binary.
Some cultures do not abide by a gender binary
wherein individuals who do not identify with the
roles or behaviors of their own sex must adopt the
opposite gender role. Within these cultures, some
individuals can be neither male nor female; indeed,
they fall under a separate gender classification. For
example, Samoan fa’afafine adopt an alternative
gender role for biological males, and are not
uniformly feminine. Moreover, the fa’afafine live in
a culture that is tolerant toward feminine males, and
feminine men do not experience the same levels of
distress associated with transgender individuals in
the United States. In the Mexican state of Oaxaca,
the term Muxe is used to refer to men who dress and
live as women. While Muxes hold an honored place
within their local communities as models of feminine
dress, makeup, and domestic skills such as cooking,
2127
Muxes still perform within the boundaries of a gender
binary, although this binary is not shrouded with
negative attitudes about the propriety of taking on
this gender identity. Similarly, accounts of the Kaska
Indian tribe of the Subarctic note that parents can
choose to “transform” their young daughter into a
son by conducting a ceremony, after which she is
treated by the community as a male. These
transgender men go on to become skilled hunters and
warriors and can take a woman as a wife. Thus,
cultural and social norms have a significant influence
on individual and group masculinity formation that,
depending on norms, can yield multiple identities, or
a more orthogonal gender binary.
Conclusion
Masculinity is a diverse and precarious construct that
is best understood through a critical analysis of the
cultural, theoretical, and historical discourse that has
shaped the multiple definitions and performance of
masculinity. Moreover, in examining the ways that
other identities (e.g., race, class, sexuality, culture)
intersect with masculinity, this entry has maintained
that there are transactional associations between
performers and their idealized masculinity. Indeed,
hegemonic masculinity within the LGBTQ
community is both maintained and challenged, and
can also have a negative impact on those who are
unable to attain their perceived notion of masculine
behavior or body comportment.
Joshua G. Kellison
See also Gender Binaries; Masculinity Stereotypes;
Racialized Masculinity; Transgender Identities
Further Readings
Butler, J. (2004). Undoing gender. New York, NY:
Routledge.
Connell, R. W. (2005). Masculinities. Los Angeles:
University of California Press.
Connell, R. W., & Messerschmidt, J. W. (2005).
Hegemonic masculinity: Rethinking the concept.
Gender & Society, 19, 829–859. doi:10.1177/
0891243205278639
Foucault, M. (1986). The history of sexuality (R. Hurley,
Trans.). New York, NY: Pantheon. (Original work
published 1978)
2128
Goldberg, A. E. (2013). “Doing” and “undoing” gender:
The meaning and division of housework in same-sex
couples. Journal of Family Theory & Review, 5,
85–104. doi:10.1111/jftr.12009
Kimmel, M. S., & Messner, M. A. (Eds.). (2013).
Men’s lives (9th ed.). New York, NY: Pearson
Education.
La Sala, M. C., & Frierson, D. T. (2012). African
American gay youth and their families: Redefining
masculinity, coping with racism and homophobia.
Journal of GLBT Family Studies, 8, 428–445. doi:10.1
080/1550428X.2012.729948
Luibheid, E. (2002). Entry denied: Controlling sexuality at
the border. Minneapolis: University of Minnesota Press.
Peplau, L. A., & Huppin, M. (2008). Masculinity,
femininity, and the development of sexual
orientation in women. Journal of Gay & Lesbian
Mental Health, 12, 145–165. doi:10.1300/
J529v12n01_09
Rotundo, E. A. (1993). American manhood: Transformations
in masculinity from the Revolution to the modern era.
New York, NY: Basic Books.
Spence, J. T., & Buckner, C. E. (1995). Masculinity and
femininity: Defining the undefinable. In P. J.
Kalbfleisch & M. J. Cody (Eds.), Gender, power, and
Masculinity and Pregnancy
In North American culture, assumptions about
sex, gender, and reproduction are so naturalized that
they typically go unnoticed. Lara Karaian, a
criminologist focused on gender and sexuality
studies, argues that repronormativity (i.e., the
inevitability and naturalness of gendered assumptions
regarding reproduction, and the binding of identities
to bodies) is more powerful than heteronormativity.
The assumptions of what Judith Butler calls the
“heterosexual matrix” involve gendered body parts
(ovaries, uterus, testicles, penis) producing gendered
gametes (sperm, eggs) that are tied to sexed bodies
(male/female) with binary gender identities
(man/woman), normative gender expressions
(femininity/masculinity), normative sexual
orientation (heterosexual), and normative sexual
practices (heterosexual intercourse—which is called
“sex”). The desire to have children in a heterosexual
context is taken to be “natural,” as are a set of
feelings, attitudes, and behaviors associated with
womanhood and manhood, femininity and
masculinity, and maternity and paternity. Adrienne
Rich, in her groundbreaking 1976 book, Of Woman
Born, differentiates between the
Masculinity and Pregnancy

communication in human relationships (pp. 105–138).

Hillsdale, NJ: Lawrence Erlbaum.
Zitz, C., Burns, J., & Tacconelli, E. (2014). Trans men and
friendships: A Foucauldian discourse analysis.
Feminism & Psychology, 24,
doi:10.1177/0959353514526224
MASCULINITY AND PREGNANCY
Masculine pregnancy is contested terrain. While
medical/legal frameworks for the most part presume
that body parts determine sex, which determines
gender, pregnant butch women, transmasculine
people (i.e., people assigned female at birth who
identify with masculinity), and trans men challenge
this rigid gender binary and subsequently the
communities, services, and institutions they
encounter. This entry explores the experience,
significance, and social implications of masculine
pregnancy.1
experience of motherhood and the institution of
motherhood. She suggests that the institution of
motherhood is oppressive in that it defines women
216–237.
through pregnancy, childbirth, and motherhood.
Bolstered by consumer culture and the medical
system, pregnancy is positioned as a universally
desired and quintessentially female experience that
enhances and reinforces femininity and womanhood.
Michelle Walks, a queer feminist medical
anthropologist, suggests that the cultural obsession
with the association of femininity with pregnancy is
so powerful and pervasive that it can be labeled a
fetish. Many, if not most, cisgender (i.e., not
transgender) women, queer and straight, have
pregnancy, childbirth, and parenting experiences that
do not line up with gendered social expectations.
Femmeidentified queer women who struggle with
queer invisibility often find that pregnancy renders
their queerness even less apparent. Further, of course,
butch, transmasculine people, and trans men, who are
the focus of this entry, complicate any easy
associations between gender identity and pregnancy.
Historically, LGBTQ people have been denied the
right to become parents, and have had children taken

away from them. Many of the arguments used to
discredit LGBTQ people as parents rely on
assumptions about the gendered nature of parenthood
and the best interests of children, i.e., the essential
need for a female and a male parent, a mother and a
father, or at the very least, male and female “role
models.” At the root of these arguments are
assumptions about the binary nature of both sex and
gender: Sexed bodies are either female or male, and
gender identity is tied to one’s body—those with
“female” body parts (womb, cervix, ovaries) are
women and mothers, and those with “male” body
parts (testicles, penis) are men and fathers. Those
who identify as butch or trans contradict these
assumptions, challenging the fundamental premises
of the discourse that ties body parts to sex and to
gender.
So, what of the bodies and identities that are not
culturally intelligible in a framework that assumes
repronormativity? The man with a womb? The father
who gives birth? The pregnant butch? The lesbian
dad? Cherríe Moraga, Karleen Pendleton Jiménez,
and A. K. Summers, among others, have written
about being pregnant and butch, underscoring their
experiences of feeling like gender outsiders, both
within queer and trans communities and outside
them. Rachel Epstein, a sociologist and LGBTQ
parenting activist, explores the ways that butch
pregnancy, by linking a queer masculinity and
sexuality to the attachments of the female body,
offers possibilities for the reconfiguration of butch to
include new relations to vulnerability, dependence,
and attachment, while at the same time reconfiguring
motherhood as a sexualized subject position.
The fields of trans and queer studies continue to
grapple with social and theoretical frameworks that
can account for the complexities of sex, sexuality,
and gender. In contrast, medical/legal frameworks,
for the most part, continue to assume a rigid gender
binary through which bodies and gender identities
remain neatly categorized. People are either men or
women, and trans people are defined as those who
wish to transition from one to the other. A trans
person’s desire to reproduce has been interpreted by
medical/legal professionals as confusion or
ambivalence about a gender transition, and has been
used to deny access to surgeries, hormones, and
fertility care, including assisted reproductive
technology and fertility preservation, as well as to
changes to governmentissued identification. In this
2129
framework, a trans man who wants to get pregnant,
or a trans woman who wants to use her sperm to
reproduce, loses credibility as a “true” or “authentic”
transsexual. Most countries that allow gender
reassignment surgery have, until recently, predicated
access to surgery on the assumption that,
postsurgery, one would lose the capacity to
biologically reproduce—in other words, the surgery
would mean forced sterilization. These assumptions
are shifting, and trans reproductive rights are rapidly
becoming more widely recognized and reflected in
policies and practice, as evidenced by the 2012
World Professional Association for Transgender
Health (WPATH; see http://www.wpath.org) 2
guidelines that recognize trans people’s right to
reproduce, recommending that people be advised
about their reproductive options prior to
transitioning. However, normative assumptions about
gender and reproduction remain powerful.
Masculine pregnancy, which was until recently
viewed as an impossibility, and subsequently, a joke,
has produced a new social category: the pregnant
man. In 2007, the LGBTQ Parenting Network (at
Sherbourne Health Centre) and the 519 Church St.
Community Centre in Toronto, Canada, offered an
11-week course for transmasculine people
considering pregnancy. That same year, Thomas
Beatie went public in the mainstream media with the
first of his three pregnancies, including a much-
publicized appearance on The Oprah Winfrey Show
and a multipage writeup in
People magazine. Despite positioning himself as “the
world’s first pregnant man,” Beatie was not the first
trans man to get pregnant. However, his very public
presence did significantly contribute to the visibility
of male pregnancy.
As of 2015, increasing numbers of trans men are
choosing pregnancy as a viable route to parenthood,
spurring a conversation within queer and trans
communities, among perinatal service providers and
legal workers, and in the broader culture, about its
meaning and significance. Trans people are
publishing personal accounts of their journeys to
parenthood; service providers and legal workers are
being pushed to modify their assumptions and to
develop practice guidelines to address the needs of
trans clients; and researchers, including T. Garner,
Maura Ryan, Jasper Verlinden, Michelle Walks,
Rachel Epstein, Sarah James-Abra, and Lori Ross,
2130
are contributing to a growing body of research and
theoretical reflections related to trans reproduction.
Masculine pregnancy is contested terrain,
involving a complex negotiation with femininity and
with the world. Some butch, transmasculine people
and trans men have no desire to carry a child, for a
range of reasons, including the association of
pregnancy with a particular kind of femininity, and
sometimes vulnerability, with which they may not
identify. Others are grateful for the capacity of their
bodies to reproduce, but do not
Masculinity and Pregnancy
find pregnancy a pleasurable experience, positioning
it as a functional sacrifice or as something to endure
in service of a long-term pragmatic goal. Many
describe negative reactions from families and
friends, at times rooted in what is perceived as a
policing of masculinity within queer/trans
communities, as well as transphobia in individuals
and social institutions. Some see themselves acting
as a surrogate or gestational carrier or as an incubator
or vessel, housing a guest. Often, people describe a
contrast between their experience of being pregnant
at home; in private; with their loved ones; and the
reception they receive in the larger social world
where they are frequently read as female, or
sometimes, as non-pregnant, fat men. Some describe
pregnancy as affirming of their maleness—rather
than seeing themselves as engaging in a feminine or
womanly act, they view pregnancy as an experience
for which they are uniquely equipped, as men who
have the capacity to carry a child. Some feel
comfortable in their bodies during pregnancy in a
new and unique way—experiencing their bodies as
having a purpose, doing what they were supposed to
do.
A desire to get pregnant can sometimes involve
difficult dilemmas with regard to the timing of a
gender transition. The decision to delay a transition
or to go off testosterone in order to become pregnant
can be emotionally complicated, particularly as going
off testosterone can have a feminizing effect which,
when coupled with a pregnancy, can mean being read
as female in many situations. This is coupled with
myriad ways that pregnant masculine people are
rendered unintelligible or invisible in public and
institutional settings.
LGBTQ people across the board experience
barriers to receiving good and appropriate health
care, and trans people face particular challenges. The
2009–2010 Trans PULSE survey (http://
transpulseproject.ca), conducted in Ontario, Canada,
documented the systemic barriers that trans people
experience in the form of informational and
institutional erasure in the health care system. The
2011 U.S. Trans Survey found that health outcomes
for trans people illustrate the effects of social and
economic marginalization, including
Masculinity and Pregnancy
much higher rates of HIV infection, smoking, drug
and alcohol use, and suicide attempts than the
general population. Trans people are more likely to
be unemployed, to live in poverty, and to be
homeless or underhoused, and most find it difficult
to find health care practitioners who have the skills,
knowledge, and attitudes necessary to provide good
health care. In the U.S. Trans Survey noted above,
19% of respondents reported being refused medical
care due to their transgender or
gendernonconforming status, with even higher
numbers among people of color; 50% reported
having to teach their medical providers about
transgender care; and many reported that when they
were sick or injured, they postponed medical care
due to discrimination (28%) or inability to afford it
(48%). The survey also found that few health care
providers address reproductive needs, desires, and
options with their trans clients, although the majority
of trans people are interested in parenting.
Pregnancy-related services, including fertility
clinics and sperm banks, midwifery, obstetrics and
gynecology, and lactation services are designed for
heterosexual, cisgender women. Though all these
services are being challenged and are slowly shifting,
fertility clinics operate from a paradigm of
heterosexual infertility, midwifery from a paradigm
of “women-centered” care, and lactation is about the
“nursing mom.” Butches, transmasculine people, and
trans men are typically unintelligible in these
settings, resulting in various forms of invisibility and
erasure. Some people are denied service altogether,
and there have been instances where Child Protective
Services has been called in when it becomes known
that a parent is trans. Those who do receive service
must endure bathrooms, waiting rooms, ultrasound
and andrology labs, maternity wards, and other sex-
segregated spaces that can become painfully difficult
to negotiate, particularly when one is referred to by
 2131
the wrong gender, pronoun, or name. Masculine pregnan
people who are pregnant often feel like a spectacle, cy in
those
severely out of place in institutions that are entirely
who
premised on service to women. identify
As masculine pregnancy becomes more common, as
service providers are recognizing the policy and transme
practical work involved in making their services n,
welcoming. Butches, transmasculine people, and female-
trans men who are pregnant require access to to-male
(FtM) or
providers who respect, understand, and support their
on the
gender identities. They need information related to FtM
reproductive options and goals, and forms and spectru
documentation that reflect a diversity of sexual m,
orientations, gender identities, and family structures. transma
Inclusive practice requires the use of language that sculine,
does not presume heterosexual, cisgender identities, boi,
butch-
for example, referring to the “pregnant person” rather
identifie
than the “mother”; to “internal reproductive organs” d
and “external reproductive organs,” rather than lesbians/
“vagina” or “testicles”; and, in general, respecting queer
the terms people use to refer to their bodies. women,
Fundamentally, queer and trans people require genderq
respectful and compassionate treatment that ueers, or
others
challenges the assumption that body parts determine
who
one’s sex or gender, or that sex or gender is identify
determined by the ability to reproduce in a particular as
way. Queer and trans reproductive practices call for masculi
the separation of body parts from gender, and gender ne of
from parenting roles—separations that stand to free center.
all pregnant people and parents from the confines of 2.
rigid and culturally idealized assumptions about The
womanhood and manhood, femininity and World
masculinity, and motherhood and fatherhood. Professi
onal
Rachel Epstein Associat
ion for
See also Assisted Reproductive Technologies (ARTs); Transge
Butch–Femme; Children With LGBQ Parents, Female/ nderHea
Male Role Models; Custody and Litigation, LGBQ lth
Parents; Custody Issues in Transgender Parenting; (WPAT
Transgender Health Care; Transgender Identities; H),
Transgender Parents and Well-Being; Transition to formerly
Parenthood for LGBTQ People known
as the
Harry
Notes Benjami
1. n
Mas Internati
culine onal
pregnan Gender
cy refers
Dysphor
to
2132
ia people
Associat in all
ion cultural
(HBIGD settings.
A), is a
nonprofi
Further Readings
t,
interdisc Bauer, R. B., Hammond, R., Travers, R., Kaay, M.,
iplinary Hohenadel, K. M., & Boyce, M. (2009). “I don’t think
this is theoretical; this is our lives”: How erasure impacts
professi
health care for transgender people. Journal of the
onal and
Association of Nurses in AIDS Care, 20(5), 348–361.
educatio
Butler, J. (1990). Gender trouble: Feminism and the
nal
subversion of identity. New York, NY: Routledge.
organiza
De Sutter, P. (2009). Reproductive options for transpeople:
tion
Recommendations for revision of the WPATH standards
devoted
of care. International Journal of Transgenderism, 11(3),
to
183–185.
transgen
Epstein, R. (2002). Butches with babies: Reconfiguring
der
gender and motherhood. Journal of Lesbian Studies,
health. 6(2), 41–57.
WPAT Epstein, R. (2015). Married, single or gay? Queerying and
H aims trans-forming the practices of assisted human
to reproduction services. Unpublished doctoral dissertation,
promote York University. URI: http://hdl.handle
evidenc
.net/10315/27697
e-based
Garner, T. (2011). Stitching up the natural: “Manboobs,”
care,
pregnancy, and the transgender body. Unpublished
best
doctoral dissertation, Simon Fraser University. http://
practice
summit.sfu.ca/item/12080. Identifier: etd6994.
s, and
James-Abra, S., Tarasoff, L. A., Green, D., Epstein, R.,
supporti Anderson, S., Marvel. S., et al. (2015). Trans people’s
ve experiences with assisted human reproduction services:
policies A qualitative study. Human Reproduction, 30(6),
that 1365–1374. doi:10.1093/humrep/dev087
promote Jimenez, K. P. (2011). How to get a girl pregnant.
health, Toronto, Ont., Canada: Tightrope Books.
research Karaian, L. (2012). Pregnant men: Repronormativity, critical
, trans theory and the re(conceive)ing of sex and pregnancy
educatio in law. Social & Legal Studies, 22(2), 211–230.
n, Light, A. D., Obedin-Maliver, J., Sevelius, J. M., & Kerns, J.
respect, L. (2014). Transgender men who experience pregnancy
dignity, after female-to-male gender transitioning. Obstetrics &
and Gynaecology, 124(6), 1120–1127.
equality Masculinity Stereotypes
for
transgen
Moraga, C. (1997). Waiting in the wings: Portrait of a queer
der,
motherhood. Ithaca, NY: Firebrand.
transsex
Nixon, L. (2013). The right to (trans) parent: A reproductive
ual, and
justice approach to reproductive rights, fertility, and
gender-
family-building issues facing transgender people.
variant

William & Mary Journal of Women and the Law, 20(1),
73–103.
Rich, A. (1976). Of woman born: Motherhood as experience
and institution. London, England: Virago Press.
Ross, L. E., Tarasoff, L. A., Anderson, S., Green, D., Epstein,
R., Marvel, S., et al. (2014). Sexual and gender minority
peoples’ recommendations for assisted human
reproduction services. Journal of Obstetrics and
Gynaecology Canada, 36(2), 146–153.
Ryan, M. (2013). The gender of pregnancy: Masculine
lesbians talk about reproduction. Journal of Lesbian
Studies, 17, 119–133.
Summers, A. K. (2014). Pregnant butch: Nine long months in
drag. Berkeley, CA: Soft Skull Press.
Verlinden, J. (2012). Transgender bodies and male
pregnancy: The ethics of radical self-refashioning.
In M. Hampf & M. Snyder-Korber (Eds.), Machine:
Bodies, genders, technologies (pp. 107–136).
Heidelberg, Germany: Universitätsverlag.
Walks, M. (2014). Stratified reproduction: Making the case
for butch lesbians’, transmen’s, and genderqueer
individuals’ experiences in British Columbia. In S.
Paterson, F. Scala, & M. Sokolon (Eds.), Fertile ground:
Exploring reproduction in Canada (pp. 74–93). Montreal,
Quebec, Canada: McGill-Queen’s University Press.
Ware, S. M. (2009). Boldly going where few men have gone
before: One trans man’s experience. In R. Epstein (Ed.),
Who’s your daddy? And other writings on queer
parenting (pp. 65–72). Toronto, Ontario, Canada:
Three O’Clock Press.
WPATH. (n.d.). Standards of care (SOC) for the health of
transsexual, transgender, and gender nonconforming
people (7th version). Retrieved June 25, 2015, from
http://www.wpath.org
MASCULINITY STEREOTYPES
The gender binary system of Western culture is based
on a masculine–feminine dichotomy. While the
masculine gender consists of cultural and social
attributes, behaviors, norms, and roles associated
Masculinity Stereotypes
with being boys and men, the feminine gender
consists of the cultural and social elements
associated with being girls and women. Masculinity
stereotypes refer to the categorically particular and
fixed expectations and ideas pertaining to attributes,
behaviors, norms, and roles of a biologically sexed
2133
male within cultural contexts. These stereotypes
emerge through processes of gender assignment,
identity, roles, and attribution. The dichotomous
relationship between masculine and feminine
positions the stereotypical characteristics of
masculinity in opposition to femininity. When boys
or men enact stereotypically feminine characteristics,
they violate social and cultural expectations and face
negative outcomes. These processes and
performances have significant value to LGBTQ
studies.
Gender and Stereotyping
Cognitive psychologists have focused on stereotypes
as cognitive processes that work as shortcuts to
reduce the burden on the brain of minute details in
everyday life. However, stereotypes are also
criticized for biasing perceptions and experiences
while relying on gross overgeneralizations of large
groups of people. Gender stereotypes are attitudes
and beliefs about the characteristics and behaviors
that are appropriate for men or women. Gender
stereotyping works as a categorization and
organization system for thinking about people based
on their gender, which influences their expectations
not just of others but also of themselves. Gender
stereotypes are one way that individuals learn how
others see them. To gender stereotype is to form a
judgment about someone based solely on gender,
overlooking an individual in favor of an
overgeneralization.
As soon as children begin to learn about gender,
they begin gender stereotyping. There are three
stages of gender stereotype development. In the first
stage, children under 4 years of age learn
things directly associated with each gender, such as
who plays with which toy. During the second stage,
around 4 to 6 years old, children begin to learn
complex and indirect associations for their own
gender and begin self–gender stereotyping. By the
third stage, around 8 years old, children understand
the associations of their own gender and those of the
other. The older children get, the more stereotypic
judgments they begin to make. However, around 8
years old, gender-stereotypic thinking peaks and
begins to decline. Once children learn gender
stereotyping, the possibility of encountering
something counter-stereotypical exists. Through a
phenomenon known as illusory correlation, children
2134
and adults are able to perceive that gender and
specific attributes are related to each other, even
when they are not. In a sense, people see what they
want to see in order to uphold their attitudes and
beliefs. This bias is a mechanism for maintaining
gender stereotypes and, in this case, the gender
binary system.
Gender stereotypes limit access to specific traits
and behaviors based on gender. Gender stereotypes
can be considered along four dimensions that
distinguish masculine from feminine: physical
appearance, traits, gender role behaviors, and
occupation. Each dimension has different gendered
expectations for masculine and feminine. When
someone learns something about a person he or she
has just met along one of the dimensions, the
individual can begin, on the basis of gender
stereotypes, to make inferences about the other
dimensions. While learning information about
someone’s occupation can affect inferences about
gender role behaviors, finding out information about
someone’s gender role behaviors leads to inferences
about traits. For example, learning that a woman is a
CEO may cause someone to stereotypically infer that
she is competitive and aggressive. Physical
appearance influences inferences made on traits,
gender role behaviors, and occupations more strongly
than all three affect judgments based on physical
appearance.
Gender Assignment, Identity, Roles, and
Attribution
Gender stereotypes are often learned from family,
friends, school, religion, and the media. Masculinity
stereotypes are enacted and acted upon through the
interrelationships of gender assignment, gender
identity, gender roles, and gender attribution. Gender
assignment refers to cultural and social rules that
assign one gender to individuals from the moment
they are born (if not in utero). Gender identity differs
from gender assignment in that individuals make
sense of their gendered selves in relation to how they
have been culturally and socially positioned through
interactions with others. Again, family members,
friends, school, religion, the government, and the
media largely influence this. Gender roles are the
social and behavioral norms set within specific
cultures and times and are dictated largely by
biological sex. The more closely individuals perform
the gender roles that are associated with their
assigned gender, the more they will be perceived as
conforming to gender norms and, in most cases,
gender stereotypes. Finally, gender attribution refers
to the everyday interactional practices of individuals
being interpreted by others as man or woman and
masculine or feminine. Those interpreting another’s
gender generally distinguish their gender
expectations based on how they perceive the other’s
biological sex—often correlating back to gender
assignment. This is integral to the stereotyping
process because it invokes social and cultural
expectations of gender roles. Masculinity stereotypes
are manifested in gender roles.
Characterizing Masculinity Stereotypes
Scholars have recently noted that little has changed
during the last 30 years in terms of masculinity and
what it means, culturally and socially, to be a boy or
man and how to accomplish that. One way to
characterize masculinity is through its committed
rejection of femininity. Conversely, femininity does
not necessarily rely on its juxtaposition with
masculinity in order to be defined. As a result, the
foundational stereotypical characteristics of
masculinity are rooted in denying the feminine. It is
not possible to provide an exhaustive list of
masculinity stereotypes. Instead, common
characteristics and processes of masculinity
stereotypes will be discussed.
As gender scholars have long known, the
gendering process begins before we are even born.
For example, consider the gender stereotype that blue
is for boys and pink is for girls. Family members,
friends, and the media socialize children from the
Masculinity Stereotypes
start that there are boy things and certain
accomplishments that count toward being a boy.
These social constructions of gender and color typify
the way in which gender stereotypes portray a binary
through an oversimplification of the subjects at play
and misrepresentation of the categorical groups that
they attempt to describe. In fact, gendered colors as
we know them did not exist until the early 20th
century—blue was designated for girls and pink for
boys. It was not until the mid20th century that the
colors were switched. Today, if a boy wears pink, he

faces the potential of being ridiculed for not acting
like a boy.
Another characteristic of masculinity stereotypes
is embedded within the interactional and prescriptive
discourse of telling someone, or being told by
someone, to “act like a man.” Consider, for example,
the idiom “man up.” This gendered discourse
illustrates the relational aspect of masculinity. When
someone instructs another to act like a man, the
instruction is meant to alter the behavior of that
person to conform to masculine expectations.
Masculine ideology includes prescriptions for how to
behave, attitudes to hold, ways to look, and
expectations to meet in order to be a man. It follows,
then, that masculinity dictates how men and boys
move through the world with others, rendering
behaviors desirable, acceptable, or not acceptable.
Gender has been conceptualized as an act for
which there is always an audience. This audience is
not tacitly compliant. Sexist idioms and expressions,
such as “man up,” are all used to pressure boys and
men into conforming to cultural and social ideals of
masculinity and masculine behavior. As such, the
colloquialisms of masculinity stereotypes are
embedded in everyday discourses. They are methods
of conveying that, for a male (boy or man), there are
clear rules and rigid expectations. When expectations
are violated, violators may be punished through
teasing and, potentially, violence. However, when
boys, for example, get into trouble, the “boys will be
boys” idiom may be deployed in their defense to
excuse misbehavior. This reinforces the masculine
stereotype that men, who boys are supposed to be
aspiring to become, are just bound to get into some
trouble along the
Masculinity Stereotypes
way to manhood. In a sense, it rewards the efforts
toward becoming a man while maintaining a culture
that is tolerant of misbehavior from boys. Whereas
this idiom positively reinforces masculine behaviors,
others work through punishment such as, “you run
like a girl.” This simultaneously guides boys toward
masculine behavior, through disparaging femininity,
and subordinates girls and women. Indeed, the
rejection of femininity underscores many masculinity
stereotypes.
Masculinity stereotypes have not always existed
as we now experience them. For example, the idiom
“boys don’t cry” serves the same punishment
2135
function as “you run like a girl”: to decrease
feminine behaviors in favor of masculine behaviors.
A look back in time, as recently as the 19th century,
reveals that men who cried were considered to have
had good character. With the modern invention of
homosexuality, masculinity stereotyping undergirded
by the rejection of the feminine became coupled with
enacting homophobia. Scholars have argued that
masculinity feeds on homophobia. Gay men are
deviant not just because they have sex with men but
also because of their gender performance. In gay
men, masculinity is threatened by the possibility of
subverting the directive to reject femininity. As such,
being mistaken for gay is akin to being gendered
feminine and implicates an unacceptable gender
performance because a man, by definition, does not
act feminine.
Influenced by social and cultural factors, the
social construction of masculinity and masculinity
stereotypes ranges widely depending on location,
context, and time. As individuals establish their
gender identities, intersecting identity factors, such as
race, class, and sexuality, play a large role.
Masculinities vary greatly, but broad masculinity
stereotypes remain socially and culturally
institutionalized. In addition to rejecting the feminine
and enacting homophobia, masculinity stereotypes in
Western culture generally dictate that men control
their emotions; be competitive, aggressive, and
physical; aspire for status and success; relate through
doing, not talking; and be like a sturdy oak that
stands alone and needs no one.
Masculinity Stereotypes and LGBTQ
Studies
Masculinity stereotypes and their supporting
masculine gender roles intersect with the identities
and lives of all LGBTQ people. For example, butch
lesbian identities have been scrutinized as a result of
masculinity stereotype constructs, and queer theorists
have written on female masculinity. Gay men’s
masculinities have been characterized as
subordinated, the lowest of all masculinities. Yet
straight-acting gay men are revered in gay culture,
while homophobia is argued to be the bedrock of
masculinity. Masculine gender roles have been cited
as perpetuating the critique that male bisexuality
does not exist, and female bisexuality exists solely
for the pleasure of masculinity. Trans* masculinities
are often wrapped up in desires for passing and fears
of not doing so. Finally, queer is caught in and
2136
animated by the heteronormativity of hegemonic
masculinity. Masculinity stereotypes are significant
to many facets of LGBTQ studies.
Derek M. Bolen and Devin B. Collins
See also Cisgenderism; Effeminacy; Gender Binaries;
Gender Nonconformity, Youth; Hypermasculinity;
Masculinities; Racialized Masculinity; Sissyboy
Experience
Further Readings
Basow, S. (1992). Gender: Stereotypes and roles (3rd ed.).
Pacific Grove, CA: Brooks-Cole.
David, D., & Brannon, R. (Eds.). (1976). The forty-nine
percent majority: The male sex role. Reading, MA:
Addison-Wesley.
Garfinkel, P. (1985). In a man’s world: Father, son, brother,
friend and other roles men play. New York, NY: New
American Library.
Kimmel, M. (1994). Masculinity as homophobia: Fear,
shame, and silence in the construction of gender identity.
In H. Brod & M. Kaufman (Eds.), Theorizing
masculinities (pp. 119–141). Thousand Oaks, CA: Sage.
Kimmel, M. (2011). Manhood in America: A cultural history.
New York, NY: Oxford University Press.
Martino, W. (2006). Straight-acting masculinities:
Normalization and gender hierarchies in gay men’s
lives. In C. Kendall & W. Martino (Eds.), Gendered
outcasts and sexual outlaws: Sexual oppression and
gender hierarchies in queer men’s lives (pp. 35–60).
Binghamton, NY: Harrington Park Press. Nardi, P. M.
(Ed.). (2000). Gay masculinities. Thousand Oaks, CA:
Sage.
O’Neil, J. M. (1981). Patterns of gender role conflict and
strain: Sexism and fear of femininity in men’s lives.
Personnel and Guidance Journal, 60(4), 203–210.
Seem, S. R., & Clark, M. D. (2006). Healthy women,
healthy men, and healthy adults: An evaluation of gender
role stereotypes in the twenty-first century. Sex Roles,
55(3–4), 247–258.
MEDIA REPRESENTATIONS OF
LGBTQ PEOPLE
Representations of LGBTQ people in various types
of media ranging from film, television, and print to
the Internet and other forms of new media have
evolved and changed through time. As a process
whereby a social group—in this case, LGBTQ
people—is symbolically created, defined,
maintained, perpetuated, and challenged in the larger
social domain, media representation has been an
important personal, social, cultural, and political
concern for sexual minorities. This process involves
power in at least two ways. First, representation is a
complex negotiation of power, such as the question
of who gets to represent a group (e.g., heterosexuals
with limited knowledge about sexual minorities
creating widespread images of LGBTQ people) and
what abilities and resources a group has to negotiate,
and possibly resist, such representation in society
(e.g., how sexual minorities deal with homophobic
representations). Second, representation is also
powerful: It enables and constrains how society
understands a social group (e.g., how society gets to
view sexual minorities) and how members of such a
group understand themselves (e.g., how sexual
minorities develop and maintain their identities based
on mainstream cultural images). Recognizing the
ongoing oppression and marginalization of sexual
minorities, this
Media Representations of LGBTQ People
entry describes three important historical moments of
representation of LGBTQ people in the United
States: silence and invisibility, emerging visibility,
and the new visibility.
Silence and Invisibility
The emergence of mass media, such as print and film
and later television, created opportunities for massive
distribution of mediated images of various social
groups to communities, nations, and the world.
Historically, LGBTQ people have been socially,
legally, and politically persecuted by culturally
endorsed forms of prejudice and discrimination. For
example, homosexuality was considered a sin against
nature, a biological abnormality, a mental illness, and
a general threat to society and national security,
which created numerous forms of state-sanctioned
behavior, including violence, against lesbians and
gay men (e.g., social stigma, employment
discrimination, police brutality). Reflecting this
hostile cultural climate, media industries and
producers attempted to eradicate any representation
of homosexuality through silence and erasure. As

such, LGBTQ people became invisible, through the
lack of acknowledgment of their very existence, in
mediated representations.
Emerging Visibility
Cultural repression and symbolic annihilation could
not remain absolute and complete as LGBTQ
representations started emerging in the media.
Although rarely labeled explicitly as lesbian or gay,
stereotypes of these groups surfaced to signify their
deviant status. Three prominent stereotypes
appeared: the effeminate gay man and the mannish
lesbian, whose “nonconforming” gender
performance and behavior were used to signal
homosexuality; the sexual degenerate, whose
excessive and abnormal sexual desires and appetites
(e.g., cross-dressing and taboo sexual fetishes) were
deployed to signal sexual deviance; and the gay or
lesbian murderer, who was portrayed as a sociopathic
killer and danger to mainstream society. Such
stereotypes, presented in print and film, reflected and
perpetuated the U.S. cultural fears of the 1940s and
1950s.
Media Representations of LGBTQ People
Along with the increasing visibility of
stereotypical lesbian and gay characters in
mainstream media, Hollywood started portraying
them in its cinematic releases. However, such films
culminated in the predictable tragic ending. Perhaps a
warning to mainstream culture about transgressing
boundaries of normativity, the story lines of sexual-
minority characters did not end happily in the
narrative. Lesbian and gay killers were blown up.
Repressed and neurotic sexual minorities committed
suicide. Freakish and maladjusted sexual and gender
minorities were condemned to lonely and unhappy
lives. Self-hating and violent lesbian and gay lovers
ended their relationships tragically. Although not a
commercially successful film, Christopher Larkin’s
A Very Natural Thing (1973) provided a romantic
and hopeful ending to a gay male relationship,
marking the beginning of a shift in mediated
representations of sexual minorities.
Although homosexuality was often framed as a
“problem,” U.S. television programs, such as That
Certain Summer (1972), An American Family (1973),
and A Question of Love (1978), started presenting
less violent, troubling, and tragic representations of
2137
lesbians and gay men. At the same time, openly
lesbian and gay filmmakers started producing their
own independent films, which created
representations that reflected their own lived
experiences as sexual minorities rather than the
homophobic images of heterosexual producers. This
trend was complicated by the advent of the
HIV/AIDS epidemic at the beginning of the 1980s.
Fear of AIDS along with pervasive homophobia in
U.S. culture fueled images of sexual minorities—
gay men, in particular—as threats to the moral fabric
of society and the health of the nation. Although such
images are troubling, homosexuality was becoming a
more mainstream topic in mediated representations,
which was a positive step. The increasing presence
of LGBTQ characters on television, in film, and in
the news, along with the emergence of the “new
queer cinema” in the early 1990s and new forms of
media years later, became the cultural backdrop for a
dramatic shift in representation of sexual minorities.
The New Visibility
Global media corporations, driven by market
expansion and profit, were largely involved in the
production of what media scholars such as Suzanna
Danuta Walters have referred to as the “new gay
visibility.” In particular, the new visibility was fueled
by neoliberalism, which is characterized by an
aggressive push toward commodification,
privatization, and government deregulation while
eliminating funding for public services and
community development. Media industries, in an
attempt to tap into new global markets to pursue
“pink dollars,” created a particular brand of media
visibility for sexual minorities. As such, the new
visibility is a complex state of hypervisibility
wherein once explicitly ostracized groups (e.g.,
lesbians and gay men) now find themselves at the
center of a stage, built on market demands and
corporate greed rather than sexual liberation,
represented for mainstream consumption and profit.
While society is moving toward a tentative inclusion
of nonnormative sexual and gender identities, it is,
along with media industries, concurrently attempting
to normalize their very existence. In the process, new
standards of normal—new normativities—are
created for sexual minorities in mainstream media.
Heteronormativity sought to create an idealistic
version of the cisgender, heterosexual experience,
assuming that a person’s gender identity and sexual
identity would—by default—lead him or her to
2138
particular sexual experiences. Homonormativity are becoming more visible transnationally and
functions in similar ways for creating the ideal globally, rainbow washing serves to paint a picture of
version of the homosexual experience based on the a false reality, as illustrated by perusal of the online
heterosexual prototype. In other words, comments in response to these articles, for U.S.
heteronormativity refers to the societal assumption sexual minorities, many of whom continue to
that all people are cisgender, straight, and participate experience implicit and explicit forms of
in “vanilla” sexual practices. It relies on Whiteness; homophobia, thwarting the need for deep cultural
able-bodiedness; the gender binary; and a change.
dichotomous view of sexuality situated in a Western, In U.S. television and film, gay, lesbian, and trans
urban setting to produce the “ideal” version of sexual characters have increased in number, are
and romantic relationships and experiences. Media Representations of LGBTQ People
In an attempt to replicate experiences that are
familiar, relatable, nonthreatening, and easily
more visible within plotlines, and are portrayed as a
digestible, homonormativity maintains a strict
“normal” part of everyday life—participating in
binaried view of gender and celebrates imitations of
immediate and extended familial units and upholding
heterosexual sex practices, monogamy, and nuclear
heteronormative ideals. As these characters are often
families within LGBTQ communities. Earlier
portrayed through a heteronormative lens, images of
versions of homonormativity assumed that LGBTQ
LGBTQ identities have become depoliticized,
people wanted to assimilate into heteronormative
nonthreatening, and digestible to presumably
cultural values of monogamy and “true love.” Later
heterosexual audiences.
versions added the goal of equality and visibility
The second feature of the new visibility is the
through political change within social institutions
creation of a sexual conundrum of the LGBTQ
like marriage and military service. Changed by
person. In U.S. film and television, these characters
neoliberal expansion in a globalized world, the “new
operate within a strict dichotomy of
homonormativity” presents lesbians and gay men as
oversexualization and asexualization. On one hand,
depoliticized consumers who adhere uncritically to
LGBTQ characters, specifically gay men, are
the domestic ideals of heteronormativity.
portrayed as promiscuous, engaging in unsafe
Created by media industries, the new
behaviors and talk about sex more frequently and
homonormativity is a commodified version of
openly than their heterosexual counterparts. This side
homosexuality designed for mainstream
of the conundrum serves to reify popular stereotypes
consumption. Through prevalent images in film,
and cultural myths surrounding LGBTQ identities.
television, print, and the vast ocean of the Internet,
On the other hand, they are seldom depicted as
there has been a shift in the representation of
actively engaging in explicit sexual acts (e.g.,
LGBTQ identities. The “new visibility” has two key
anything from hand holding and kissing to oral sex
features: denial of homophobia through celebration
and intercourse) when compared to their heterosexual
of homonormativity, and a simultaneous
counterparts. When lesbian, gay, or bisexual
hypersexualization/asexualization of LGBTQ
characters engage in explicit sexual acts, their bodies
identities.
are normative (e.g., young, thin, fit, White appearing,
The first feature of the new visibility is the denial
and able) and the depiction is obscured (e.g., in the
of homophobia through the celebration of
dark, under bedcovers, shot from fragmented camera
homonormativity. Sometimes referred to as “rainbow
angles). This side of the conundrum serves as a
washing,” media outlets have been flooded with
means of placating those who are calling for more
positive stories to generate the cultural myth that
visibility of queer sex, while still maintaining a
homophobia is a phenomenon of the past and that
palatable, nonthreatening, and consumable version of
LGBTQ identities are becoming widely accepted and
queer sexuality.
celebrated. This often includes an abundance of
The sexual conundrum affects trans characters in
rainbow flags, gay and lesbian couples sharing their
unique ways because they are simultaneously
first married kisses on the steps of their local
hypersexualized and asexualized. Popular portrayals
courthouses, and viral images of gay fathers holding
of trans identities like Laverne Cox’s Sophia Burset
their newborn babies. In a world where gay politics
on the Netflix original series Orange Is the New

Black depict hyperfeminine trans women of color
who are passable as their desired gender. Their story
lines (if they are given them) tend to be focused
around their physical—specifically genital—
transitions, reducing their identities to that of their
“non-normative” gender expression. Though there is
a focus on their sexual
Men Who Have Sex With Men (MSM)
functionality, transgender characters are seldom, if
ever, seen actively engaging in any range of romantic
or sexual practices.
As the new visibility continues to produce and
maintain certain LGBTQ representations on a global
stage, it is critical to examine which experiences
(e.g., normative relational arrangements such as
monogamy, normative erotic practices such as
vanilla sex) and identities (e.g., White, middle-class,
cisgender, able-bodied, U.S. individuals) are legible
and celebrated while others become invisible, erased,
and marginalized. Representations of LGBTQ people
have changed over time, but they remain personally,
socially, culturally, and politically important as
sexual minorities seek deep cultural and political
change.
Gust A. Yep and Sage E. Russo
See also Effeminacy; Heteronormativity;
Homonormativity; Homophobia; Homosexuality,
Female; Homosexuality, Male; Transgender Identities;
Visual Arts
Further Readings
Alwood, E. (1996). Straight news: Gays, lesbians, and the
news media. New York, NY: Columbia University Press.
Becker, R. (2006). Gay TV and straight America.
New Brunswick, NJ: Rutgers University Press.
Duggan, L. (2003). The twilight of equality? Neoliberalism,
cultural politics, and the attack on democracy. Boston,
MA: Beacon.
Dyer, R. (2003). Now you see it: Studies on lesbian and gay
film (2nd ed.). London, England: Routledge.
Gross, L. (2001). Up from invisibility: Lesbians, gay men,
and the media in America. New York, NY: Columbia
University Press.
Peele, T. (Ed.). (2007). Queer popular culture: Literature,
media, film, and television. New York, NY: Palgrave
Macmillan.
2139
Phillips, J. (2006). Transgender on screen. New York, NY:
Palgrave Macmillan.
Rich, B. R. (2013). New queer cinema: The director’s cut.
Durham, NC: Duke University Press.
Russo, V. (1987). The celluloid closet: Homosexuality in the
movies (Rev. ed.). New York, NY: Harper & Row.
Streitmatter, R. (2009). From “perverts” to “fab five”:
The media’s changing depiction of gay men and
lesbians. New York, NY: Routledge.
Walters, S. D. (2001). All the rage: The story of gay visibility
in America. Chicago, IL: University of Chicago Press.
Yep, G. A., & Elia, J. P. (2012). Racialized masculinities and
the new homonormativity in LOGO’s Noah’s Arc.
Journal of Homosexuality, 59, 890–911.
MEN WHO HAVE SEX WITH MEN
(MSM)
This entry describes the term men who have sex with
men (MSM). It begins by defining the term MSM,
giving its historical context. Then, it discusses the
benefits and controversies to using the term in
research and intervention. The entry next provides a
general overview of the types of interventions using
an MSM-tailored framework, and it concludes with a
guide for future directions regarding MSM’s
intervention and research needs.
Describing Men Who Have Sex With Men
The term men who have sex with men has been used
in research to describe a route of HIV transmission
during same-sex encounters in epidemiologic HIV
studies. Early in the HIV/AIDS epidemic, this term
was intended to remove sexual orientation identities
from the disease as a strategy to remove identity-
based stigma toward the gay community. The term
has since gained popularity in medicine and public
health due to its behavioral— rather than identity—
focus for varying populations.
Some scholars have argued that the term is
beneficial because it includes all same-sex sexual
identities for males, and because it is sensitive to the
fact that individuals’ identities, behaviors, and
desires are not always aligned. Moreover, many
scholars point to how it was successful in helping to
remove much of the stigma that labeled HIV as a gay
male–specific disease (i.e., HIV/AIDS was originally
discussed as the “Gay-Related Immune Deficiency”
2140
or GRID). The label MSM pointed out that one of the
routes by which HIV could be transmitted was
through sexual behaviors in samesex relations,
irrespective of whether men identified as gay or
homosexual. This shift from identity to behavior
paved the way for future research to investigate other
HIV-risk behaviors among many different groups.
The term has similar benefits in fields of study
outside HIV/AIDS, as it allows investigators to look
at multiple populations at once that all have similar
sexual behaviors, irrespective of their defined sexual
identity.
On the other hand, there has been significant
criticism of the use of the term MSM, both within
and outside the field of sexual health. Much of the
criticism is that the term is insensitive to individuals’
self-determined sexual identity. Some argue not only
that labeling people as MSM undermines the
importance of sexual identity development in men’s
lives, but also that many men would not feel that
MSM is an accurate description of themselves or
their communities. This has significance in both
research and politics, as using a blanket term such as
MSM may alienate some men and make gay,
bisexual, and queer communities less visible. For
example, some critics have noted that the term MSM
may have a potentially stigmatizing component, in
which the term gay is traditionally associated with a
White male—whereas the term MSM has implied, in
some research, poor men of color, while referencing
the disproportionate burden of HIV/AIDS that they
experience.
Another concern raised with regard to the term
MSM is that its focus on behavior detracts from
important social elements of public health. Scholars
have argued that without looking at local and
selfdetermined community identities, we miss out on
cultural variations and understanding of how
sociodemographic and psychosocial identities relate
to HIV and other disease transmission, prevalence,
and prevention. Finally, a major complaint about the
term MSM is that it is not an accurate description of
behaviors that may be linked to HIV/STI (sexually
transmitted infection) exposure. For example, for
research intending to examine sexual health–risk
behaviors, simply
Men Who Have Sex With Men (MSM)
knowing that a male has sex with another male may
not be sufficient. Rather, examining specific
behaviors (e.g., condomless anal intercourse with a
partner who is HIV-positive) may provide greater
understanding.
While acknowledging the foregoing critiques of
the term MSM, this entry will proceed in discussing
men using MSM as a terminology, in order to
maintain a broad approach that parallels the research
and interventions that have coined and employed the
term.
Common Topics in Research
Overall, there is more research regarding MSM than
there is regarding sexual-minority women or gender-
minority individuals. Most research on MSM is
conducted in the sphere of public health, and the
majority of it focuses on HIV transmission,
prevalence, treatment, and prevention. Within the
purview of HIV/AIDS research, there is a growing
body of interdisciplinary research between the social
sciences and medical and public health fields. For
example, researchers are increasingly acknowledging
the importance of sexual identity, mental health,
social context, and stigmatization among MSM.
There is also emerging work looking at relationships
among MSM, and their implications for physical and
psychological health. However, the body of literature
on MSM relationships is still quite small compared
with that regarding heterosexual males.
MSM and Interventions
Since its development, the term MSM has been used
in reference to health interventions for sexual-
minority men. Given MSM’s vulnerability to
HIV/AIDS and other STIs across the life course,
researchers have sought to identify and promote risk-
reduction strategies. Several successful interventions
were scaled up by governments and became known
as evidence-based interventions (EBIs). These EBIs
focus on a series of outcomes including promotion of
condom use, reduction of the number of sexual
partners with whom men
Mentoring
have unprotected sex, HIV/STI testing initiatives,
and adherence to antiretroviral medications for HIV-
positive MSM. These programs are commonly
implemented by health departments and community-
based organizations.

Future Directions
Although there have been great advancements in
HIV/STI interventions using behaviorally focused
approaches, there is still much work that needs to be
done—especially for MSM. Despite the increasing
body of research regarding MSM’s sexual health, the
amount of research and interventions focused on
MSM’s social well-being and nonsexual health
outcomes has trailed behind. As research and
interventions potentially advance with the use of the
MSM terminology, it is important to be cognizant of
the possible downsides of the term. As mentioned
above, there are several ways in which the term
MSM falls short, or proves insensitive. Thus, while
using MSM is advantageous for placing the focus on
behavior, it may oversimplify the complexities of
individuals when it comes to their identities,
attractions, and behaviors.
José A. Bauermeister and Peter J. D. Ceglarek
See also Dating, Sexual-Minority Men; Health
Disparities, Transgender People; HIV and Treatment
Further Readings
Grossman, C. I., Forsyth, A., Purcell, D. W., Allison, S.,
Toledo, C., & Gordon, C. M. (2011). Advancing novel
HIV prevention intervention research with MSM—
meeting report. Public Health Reports, 126(4), 472–479.
Grov, C., Breslow, A. S., Newcomb, M. E., Rosenberger,
J. G., & Bauermeister, J. A. (2014). Gay and bisexual
men’s use of the Internet: Research from the 1990s
through 2013. Journal of Sex Research, 51(4), 390–409.
Jiwatram-Negrón, T., & El-Bassel, N. (2014). Systematic
review of couple-based HIV intervention and prevention
studies: Advantages, gaps, and future directions. AIDS
and Behavior, 18(10), 1864–1887.
doi:10.1007/s10461-014-0827-7
Kertzner, R. M., Meyer, I. H., Frost, D. M., & Stirratt, M.
J. (2009). Social and psychological well-being in
lesbians, gay men, and bisexuals: The effects of race,
gender, age, and sexual identity. American Journal of
Orthopsychiatry, 79(4), 500–510.
Mustanski, B. S., Newcomb, M. E., Du Bois, S. N., Garcia,
S. C., & Grov, C. (2011). HIV in young men who have
sex with men: A review of epidemiology, risk and
protective factors, and interventions. Journal of Sex
Research, 48(2–3), 218–253.
Newcomb, M. E., & Mustanski, B. (2010). Internalized
homophobia and internalizing mental health problems: A
meta-analytic review. Clinical Psychology Review, 30(8),
1019–1029.
2141
Preston, D. B., Augelli, A. R. D., Cain, R. E., & Schulze, F.
W. (2010). Issues in the development of HIV-preventive
interventions for men who have sex with men (MSM) in
rural areas. Journal of Primary Prevention, 23(2), 199–
214.
Schnall, R., Travers, J., Rojas, M., & Carballo-Diéguez, A.
(2014). eHealth interventions for HIV prevention in high-
risk men who have sex with men: A systematic review.
Journal of Medical Internet Research, 16(5), e134.
Young, R. M., & Meyer, I. H. (2005). The trouble with
“MSM” and “WSW”: Erasure of the sexual-minority
person in public health discourse. American Journal of
Public Health, 95(7), 1144–1149.
MENTORING
This entry provides an overview of scholarship on
mentoring, applying it to LGBTQ mentoring.
Although no known research addresses LGBTQ
mentoring specifically, study in related areas (e.g.,
gender and race in mentoring, psychology graduate
training, LGBTQ career issues) offers considerations
for LGBTQ mentoring.
Mentoring is an interpersonal process in which an
experienced individual (the mentor) provides
professional guidance to a less experienced person
(the mentee or protégé). Guidance typically occurs in
two domains: career-related or instrumental support
(often termed sponsorship in the corporate world),
including such activities as coaching, network
building, fostering opportunities, and facilitating
exposure; and psychosocial support, consisting of
emotional support, counseling, rolemodeling, and
friendship. Mentoring is considered important to
educational and professional success and has been
linked to many related variables: academic
participation, grades and honors, promotions and
advancement, compensation, career and
organizational commitment, specific kinds of
productivity (e.g., completing school, publishing
research), job and career satisfaction, self-efficacy
and self-esteem, and avoidance of difficulties (e.g.,
delinquency, premature workplace exit).
Attention to mentoring began in the 1970s
business arena, and spread to education, health, the
sciences, and many other professional fields,
resulting not only in a robust scholarly literature but
also in the development of innumerable mentoring
2142
programs for particular groups of people (women in
science, disadvantaged youth, racial/ethnic and
sexual-minority college students, etc.). Moreover, the
traditional focus on formal dyadic mentoring
relationships in which age, experience, and
hierarchical positions are disparate has broadened to
include more informal kinds of arrangements such as
peer mentoring, mentoring in groups or teams, and
engagement of multiple mentors at different career
stages. These trends have made mentoring more
accessible, and many educational and professional
organizations offer mentoring opportunities targeted
toward specific individuals, including sexual
minorities. For example, the American Psychological
Association’s graduate student association (APAGS),
as well as its division focused on sexual-minority
issues (Division 44; Society for the Psychological
Study of Lesbian, Gay, Bisexual, and Transgender
Issues), sponsor mentoring and other professional
development activities for LGBTQ students.
Mentors and Mentees
Although mentors and mentees who are similar
(demographically, and in interests, values, styles, and
Methodological Decisions by Researchers of LGBTQ Populations
worldviews) often report the most satisfying
mentoring relationships, research on actual
Mentoring
outcomes suggests that mixed-pair relationships also
are successful—often more so if the mentor’s power
and status can advance the mentee in ways others
cannot. This is good news for women, people of
color, and others (e.g., sexual minorities) who are
marginalized in contemporary workplaces. Because
leadership in most organizations remains firmly in
the hands of White, heterosexual men, it is unlikely
that members of marginalized groups will find
mentors who are demographically similar. However,
research finds that diverse women, for example,
receive mentoring (some of it even by
demographically similar mentors), but it is mostly
psychosocial (e.g., advice on personal development,
managing multiple roles) rather than instrumental (in
contrast to men, who more often receive career
sponsorship); this leaves women feeling supported
but not necessarily advancing in their careers at the
same pace as men. Research on mentors themselves
indicates that women tend to provide more
psychosocial mentoring, whereas men focus more on
career-related functions, reinforcing the likelihood
that marginalized group members may be seeking
and obtaining mentoring from similar others, but
those mentors may not be positioned powerfully
enough in organizational hierarchies to offer
instrumental support. Thus, being mentored by those
who actually possess power is as important to
successful outcomes as demographic matching. For
sexual-minority individuals, pervasive societal
heterosexism and sexual stigma (the disregard,
decreased status, and disempowerment that society
accords nonheterosexuals) render it unlikely that
most education and work settings will have visible
LGBTQ leaders in them; thus, mentoring will be
done by non-LGBTQ individuals, and research
indicates that positive outcomes can ensue.
Mentoring Process
Mentoring is a relational process, with all of the
attendant issues that emerge in any close
relationship. Research on psychology graduate
training finds that dysfunction arising in mentoring
relationships can include such factors as a bad match
between the expectations or styles of the two parties,
boundary violations (e.g., sexual harassment),
incompetence, conflict, cross-gender or cross-race
concerns, or undermining of the mentoring
relationship by outsiders. Successful mentoring
relationships are linked to shared goals and styles,
open communication, willingness to address
disagreements and conflicts, and commitment to the
process and the relationship by both the mentor and
the mentee.
For mentoring relationships in which one or both
people are LGBTQ, there is unique potential for both
challenge and support. For example, an “out”
mentor’s influence on a sexual-minority mentee
looking for role models or struggling with identity
can be transformative (this is borne out in narrative
studies of LGBTQ student experiences), but there
also is potential for the mentee to use the mentor as a
therapist or the mentor to impose an identity-
disclosure approach on the mentee that is
inappropriate. In educational settings, there may be
pressure on mentees to work with the only LGBTQ
mentor available, whose interests may or may not
match those of the mentee, or there may be
inflexibility in the system to allow the mentee to

work with multiple mentors. Mentors or mentees
who are not “out” may be challenged by the identity
disclosure of the other in ways that may be
uncomfortable or threatening, but they also may find
inspiration for living a more authentic existence.
Finally, although mentoring relationships are
established for the benefit of the mentee, mentors
also often find them rewarding experiences of
professional collaboration and growth, and even
though mentoring tasks may end formally, the
collegiality of the relationship can last throughout the
lives of both people.
Ruth E. Fassinger
See also Career Development and Trajectories; Education;
Employment Non-Discrimination Act (ENDA); Work
Environments; Workplace Discrimination; Workplace
Policies
Methodological Decisions by Researchers of LGBTQ Populations
Further Readings
Brown, R. T. (Ed.). (2009). Special section: Mentoring in
professional psychology, Parts I, II. Professional
Psychology: Research and Practice, 40(2), 181–212 and
40(3), 284–320.
Croteau, J. M., Lark, J. S., Lidderdale, M. A., & Chung, Y.
B. (2005). Deconstructing heterosexism in the
counseling professions: A narrative approach.
Thousand Oaks, CA: Sage.
Mohr, J. J., & Fassinger, R. E. (2013). Work, career, and
sexual orientation. In C. J. Patterson & A. R. D’Augelli
(Eds.), Handbook of psychology and sexual orientation
(pp. 151–164). New York, NY: Oxford University Press.
METHODOLOGICAL DECISIONS BY
RESEARCHERS OF LGBTQ POPULATIONS
Social scientists make many methodological
decisions that can influence their research findings
and the conclusions they draw about them. Scholars
must decide how they will define their key concepts,
design survey questions that measure these concepts
appropriately, conduct multiple data analyses, decide
which analyses make the most sense, and carefully
identify the claims that they can make based on the
entirety of their research. These challenges apply to
2143
all kinds of research, but may be even greater for
scholarship that examines LGBTQ populations, as
well as other groups that constitute a small
percentage of the population. This entry reviews
some key methodological issues and highlights one
example of research to illustrate key issues that
researchers examining LGBTQ populations may
encounter and should be especially mindful of if their
goal is to produce highquality research.
Research on LGBTQ Families
One of the most controversial articles that
purportedly studied lesbian, gay, and bisexual (LGB)
families was written by sociologist Mark Regnerus.
This study provides a compelling example of both
the challenges of studying LGBTQ populations and
the many problems that scholars might find in their
own and in
others’ research. Using data from the New Family
Structures Survey (NFSS), which he constructed,
Regnerus concluded that adult children from same-
sex families experience greater disadvantages than
do children from two–biological parent families.
This conclusion is counter to the social scientific
consensus on this topic, a consensus that is based on
the extant research on samesex families. Research in
sociology, psychology, and other social behavioral
sciences has consistently documented minimal
differences between children who were raised in
same-sex households and their counterparts who
were raised in father– mother households.
Regnerus’s study elicited strong reactions, some
positive, but mostly negative. It has been referred to
positively by those in favor of same-sex marriage
bans and critiqued by those that oppose such bans.
Although critiques and reanalyses of the NFSS data
have pinpointed serious problems in the
methodological decisions made by Regnerus and
noted that his findings are highly contingent on these
decisions, this study has been cited in multiple court
cases nationwide, as evidence that states should not
recognize same-sex marriage. In a “Brief of
Amicus/Amici Curiae Social Science Professors,” for
example, Regnerus and his colleagues argued that his
study supported the claim that government should
continue to restrict the definition of marriage to a
union between a woman and a man.
The small group of scholars who have defended
Regnerus’s study claim that he relied on highquality
2144
data. Specifically, they argue that the NFSS is the
best survey on children’s outcomes because it relied
on the population-based random sampling techniques
preferred by most social scientists and it measured a
broad range of outcomes. This group of scholars
favorably compares this study to other studies that,
because of the difficulty of capturing such a small
portion of the population, use nonrandom,
Methodological Decisions by Researchers of LGBTQ Populations
convenience samples. The assessment by this group
ignores the multiple studies that use population-
based random sampling techniques and find minimal
differences between children from LGB and
heterosexual families.
Although efforts to obtain a population-based
sample of LGB families are laudable, these efforts
also must be accompanied by careful attention to all
methodological decisions. Critics of Regnerus’s
study maintain that the findings from the study were
a product of methodological decisions that do not
reflect the standard recommendations of LGB
scholars and the social and behavioral sciences more
broadly. In other words, it is difficult to have
confidence in the patterns reported in his article
because there are serious concerns regarding
measurement and data analysis. In the following
sections, this entry discusses some of these concerns
to show how methodological decisions during the
design and analysis phases of research play a large
role in shaping researchers’ conclusions.
Design
In order to produce high-quality survey research,
scholars must design surveys that measure what they
claim to measure. This is a matter of validity.
Admittedly, it is not straightforward to come up with
valid measures, especially when studying LGB
families. Without valid measures, however, even the
most representative data sets cannot yield believable
results. This concern has been directed to the
Regnerus study as scholars have questioned whether
Regnerus was really examining children who were
raised in same-sex families.
Defining and Measuring Concepts
There are several different measurement issues
that scholars who study LGB people and issues will
encounter. First, researchers must consider how they
define “lesbian” and “gay.” Regnerus only used
relationship history to define the respondents’
parents as lesbian or gay, which may underestimate
the number of same-sex families because some
individuals who identify as lesbian and gay may not
have been in a relationship with someone of the same
sex. Researchers should ask questions about
individuals’ sexual attraction and behaviors, as well
as
how individuals define their sexual orientation.
Second, scholars need to be specific about how
they define LGB families. For example, researchers
should consider the amount of time a child should
reside in a family in order to be defined as “raised” in
that family structure. In Regnerus’s definition of
same-sex family, he included children who reported
that they never had lived with a lesbian or gay parent
or spent as little as 1 year living in a household with
a parent who had had a same-sex romantic
relationship. Since Regnerus’s study was used—by
others and himself—to advocate against same-sex
marriage, it also is important to distinguish between
children who were raised by a single parent who had
had a same-sex romantic relationship; children who
were raised by two same-sex parents; and children
who experienced family transitions, such as parental
divorce, that might lead to disadvantages for them,
regardless of the relationship history of their parents.
Third, researchers have to consider whether they
have constructed appropriate comparison groups.
Regnerus’s definition of same-sex families was very
broad (it included mostly unmarried and single-
parent families), but his definition of two– biological
parent families was quite specific (it only included
two-parent married families). Some critics suggest
that to fairly and systematically compare these
groups, Regnerus should have focused on parents
who identified as lesbian or gay and who were also
married and in a relationship prior to having children
together.
Survey Pretests
Researchers need to test their survey questions
before conducting the survey to understand how
respondents will interpret their questions. Frequently,
respondents do not interpret the questions in the way
that the researcher intends or may not understand
certain words or questions. This problem may be
exacerbated when being asked questions regarding
sexuality or sexual relations. In fact, subsequent

analyses of the Regnerus study suggest that a non-
negligible number of respondents misinterpreted
questions about parental relationship history,
resulting in a mislabeling of several respondents as
being raised in same-sex households.
Analysis
Even after survey data are collected and recorded,
researchers must make many decisions during the
data analysis phase. Scientists should take multiple
steps, known as sensitivity analyses, to ensure that
their results are not tied to just one of the many
possible methods of analysis and data presentation.
In other words, they should double-check and triple-
check their results using multiple methods. If the
original findings change in the subsequent analyses,
this is evidence that results are tied to a particular
method, and the researcher should determine and use
the most logical analysis strategy, regardless of
whether that strategy results in the findings the
researcher expects or wants to find.
Once again, it is helpful to use Regnerus’s study
as an example of the analysis problems that arise
when conducting research. In order to identify
whether Regnerus’s findings changed based on
different types of analyses, University of Connecticut
sociologist Simon Cheng and Indiana University
sociologist Brian Powell reanalyzed the NFSS data
and conducted many sensitivity analyses. They
carefully examined respondents’ data because they
were concerned that some respondents may not have
answered questions correctly because they (1)
misinterpreted the meaning of the questions,
(2) accidentally clicked on the wrong answer, (3)
gave a response as a joke, or (4) were not paying
attention.
Cheng and Powell found that some of the
responses did not make sense. For example, one
respondent categorized as being raised in a samesex
family also claimed that he was 25 years old, was 7
feet, 8 inches tall, weighed 88 pounds, had been
married 8 times, and had 8 children. Another
respondent reported being arrested as a 1-year-old.
These examples are accompanied by other
implausible answers by respondents who were
categorized as being from a same-sex family. When
respondents have apparent errors in their reports,
research should, at minimum, assess the extent to
Methodological Decisions by Researchers of LGBTQ Populations
2145
which the key findings are due to these cases. Cheng
and Powell concluded that over one third of the cases
that Regnerus had categorized as a “same-sex
family” were unreliable or inconsistent, and they
could not confidently categorize these individuals as
children raised in same-sex families.
There are many other analysis techniques that
researchers must use to make sure that their findings
are robust. For example, Cheng and Powell used
statistical techniques to ensure the differences found
between same-sex families and two– biological
parent families were not a result of other potential
differences between these two family types, such as
family income and region of residence. When Cheng
and Powell performed these analyses on the NFSS
data, they found that there were few differences
between same-sex families and two–biological parent
families. Cheng and Powell concluded that
Regnerus’s findings were a product of one particular
analysis strategy, which did not reflect the preferred
methods of the field. In addition, the differences that
did remain, which Regnerus called “disadvantages,”
were not in fact disadvantages (e.g., whether or not
the respondent identified as entirely heterosexual and
the number of sex partners the respondent had had).
Conclusion
Social scientists must make many methodological
decisions about measurement and analysis. These
decisions will shape their findings and the
conclusions they make about their data. Data on
small groups, such as LGBTQ populations, are
particularly sensitive to analytical decisions.
Therefore, it is even more essential to carefully
design surveys and to use multiple statistical
techniques to make sure one’s findings are not the
product of any single method of analysis. Although
this entry uses a single study to illustrate
methodological pitfalls, other studies may be limited
because of data design and analysis strategies.
Researchers in any field should carefully consider
whether they can make certain claims based on their
research design and methods of analysis. For
example, Regnerus claimed he was measuring the
outcomes of adult children who were raised in same-
sex households. Yet much of his sample consisted of
children who had no sustained experience living with
lesbian or gay parents, and even fewer lived in a
household
with two
2146
same-sex parents—making it imprudent, at
minimum, to conclude from his findings that children
raised in same-sex families experience any
disadvantages. The methodological limitations of his
study make it difficult to reject the longstanding
empirical consensus in the social and behavioral
sciences that there are minimal differences between
children raised by LGB parents and those raised by
heterosexual parents.
Kristin Kelley and Brian Powell
See also Children With LGBQ Parents, Academic Outcomes;
Children With LGBQ Parents, Psychosocial
Outcomes; Ethical Research With Sexual and Gender
Minorities; Population-Based Surveys, Collection of
Data on Sexual Orientation and Gender Identity;
Quantitative Research; Scientific Integrity, Debates
About
Further Readings
American Sociological Association Committee on
Professional Ethics. (2008). ASA code of ethics.
American Sociological Association. Retrieved February
22, 2015, from http://www.asanet.org/images/asa/docs/
pdf/CodeofEthics.pdf
Barrett, D. (2012). Presentation, politics, and editing: The
Marks/Regnerus articles. Social Science Research, 41,
1354–1356.
Brief of Amici Curiae Social Science Professors in Support
of Defendants. Robicheaux, et al., v. James D. Caldwell,
et al. (May 12, 2014) (No. 13–5090).
Brief of Amicus Curiae American Sociological Association
in Support of Respondent Kristin M. Perry and
Respondent Edith Schlain Windsor. Dennis
Hollisgworth et al. v. Kristin M. Perry, et al. and United
States v. Edith Schlain Windsor (February 28, 2013)
(Nos. 12–144, 12–307).
Cheng, S., & Powell, B. (2015). Measurement, methods, and
divergent patterns: Reassessing the effects of samesex
parents. Social Science Research, 52, 615–626.
Cohen, P. N. (2013, August 6). Regnerus affair timeline, with
maze. Family Inequality. Retrieved February 17, 2015,
Microaggressions
from https://familyinequality.wordpress.com/
2013/08/06/regnerus-affair-timeline-with-maze/
Cohen, P. N. (2015, February 13). Children in same-sex
parent families, dead horse edition. Family Inequality.
Retrieved February 17, 2015, from https://
familyinequality.wordpress.com/2015/02/13/ children-in-
same-sex-parent-families/
Gates, G. J., et al. (2012). Letter to the editors and
advisory editors of social science research. Social
Science Research, 41, 1350–1351.
Herek, G. (2008, July 1). From Russia with hate: Paul
Cameron at Moscow State U. Sociology Dept. Beyond
Homophobia. Retrieved February 17, 2015, from
http://www.beyondhomophobia.com/blog/category/ junk-
science/
Meadow, T. (2013, August 14). Queer numbers: Social
science as cultural heterosexism. Social (In)Queery.
Retrieved February 17, 2015, from http://
socialinqueery.com/2013/08/14/queer-numbers- social-
science-as-cultural-heterosexism/
Moore, M. R., & Stambolis-Ruhstorfer, M. (2013). LGBT
sexuality and families at the start of the twenty-first
century. Annual Review of Sociology, 39, 491–507.
Osborne, C. (2012). Further comments on the papers by
Marks and Regnerus. Social Science Research, 41, 779–
783.
Perrin, A. J., Cohen, P. N., & Caren, N. (2013). Are
children of parents who had same-sex relationships
disadvantaged? A scientific evaluation of the no-
differences hypothesis. Journal of Gay & Lesbian
Mental Health, 17, 326–336.
Regnerus, M. (2012). How different are the adult children of
parents who have same-sex relationships? Findings from
the New Family Structures Study. Social Science
Research, 41, 752–770.
Regnerus, M. (2012). The New Family Structures Study.
Austin: Population Research Center, the University of
Texas at Austin.
Regnerus, M. (2012). Parental same-sex relationships,
family instability, and subsequent life outcomes for
adult children: Answering critics of the New Family
Structures Study with additional analyses. Social
Science Research, 41, 1367–1377.
Sherkat, D. E. (2012). The editorial process and politicized
scholarship: Monday morning editorial quarterbacking
and a call for scientific vigilance. Social Science
Research, 41, 1346–1349.
Stacey, J., & Biblarz, T. J. (2001). (How) does the sexual
orientation of parents matter? American Sociological
Review, 66, 159–183.
MICROAGGRESSIONS
Individuals who identify as LGBTQ face overt
discrimination (e.g., physical violence) as well as
less conspicuous forms of stigmatization, which are

denoted as microaggressions. Microaggressions are
subtle experiences of discrimination that
communicate derogatory messages to members of
marginalized groups (e.g., women, people of color,
and LGBTQ people). Microaggressions frequently
go unrecognized, typically resulting from
unconscious beliefs regarding the characteristics of
specific groups. For example, someone may tell a
lesbian that she is “too pretty to be gay.” Although
intended as a compliment, such a statement
communicates a derogatory message (that lesbian
women must be unattractive) based upon a
potentially unrecognized personal belief (that lesbian
women are usually unattractive).
Microaggressions can be grouped into three
categories: microassaults, microinsults, and
microinvalidations. Microassaults are explicit
attacks, such as using the phrase “that’s so gay!” to
describe something as undesirable. Microinsults are
communications (verbal or nonverbal) that
demonstrate insensitivity regarding an individual’s
identity, such as expressing disgust when observing a
same-sex couple. Microinvalidations are statements
that belittle the experiences of oppressed groups,
such as claiming that an LGBTQ individual is just
going through a phase.
Microaggressions can be grouped into eight
common themes: use of heterosexist or transphobic
terminology, endorsing heteronormative/ gender-
normative culture, assuming a universal LGBTQ
experience, exoticization, discomfort
with/disapproval of LGBTQ experiences, denying
the existence of heterosexism/transphobia, assuming
that sexual and gender minorities have a form of
sexual pathology or perversion, and denying one’s
own heterosexism. Examples of each type of
microaggression are provided below.
Examples of heterosexist terminology include
terms such as “faggot,” “dyke,” “tranny,” and the use
of “gay” as a negative descriptor. Examples of
endorsing heteronormative/gender-normative culture
include telling someone to not “act gay in public” or
requiring a transgender child to dress according to
social expectations for his or her birth sex (e.g., pink
for children assigned female at birth, blue for boys).
Such practices communicate to LGBTQ individuals
that they should conform to heterosexist norms for
gender-related dress and behavior, imposing a sense
of shame for individuals whose gender expression
may not conform to these standards.
2147
Examples of assuming a universal LGBTQ
experience include assumptions that all lesbians
identify and dress in a masculine fashion or that all
gay males have effeminate mannerisms. To assume
that all LGBTQ individuals look, think, feel, or act in
a specific, stereotyped manner invalidates their
individualism. Examples of exoticization include
treating sexual and gender minorities as objects
rather than complex human beings. For instance, an
individual may declare a specific erotic preference
for sexual or gender minorities or may claim that
“I’ve always wanted a gay best friend!” These
processes serve to dehumanize
LGBTQ individuals.
Examples of expressing discomfort/disapproval
regarding LGBTQ experiences include visible
behaviors communicating stigma and discrimination.
Regardless of whether these behaviors are verbal
(e.g., shouting “there are children here!” to a same-
sex couple holding hands) or nonverbal (e.g., glaring
or covering a child’s eyes), these behaviors imply
that being LGBTQ is socially undesirable and that
LGBTQ people should remain hidden from
mainstream society. Examples of denying the reality
of heterosexism/transphobia include telling LGBTQ
individuals that they are just being paranoid, that
discrimination against LGBTQ individuals does not
exist, and that LGBTQ individuals need to “get over
it” or “stop complaining.”
Microaggressions
Examples of assuming sexual
pathology/perversion among sexual and gender
minorities include holding beliefs that LGBTQ
individuals are sexually deviant by virtue of their
LGBTQ identities. This may include
hypersexualizing LGBTQ people (focusing
disproportionately on sexual encounters when
considering the person’s identity, or assuming that
LGBTQ are more interested in sex and more sexually
active than heterosexuals) as well as the incorrect
assumptions that all gay men have HIV/AIDS, that
LGBTQ people are pedophiles, or that all
transgender women are sex workers. These false
beliefs communicate that LGBTQ people are
inherently worthy of fear and disgust, thus
invalidating their actual experiences, intentions, and
desires.
Examples of denying one’s own heterosexism
include insisting that one has no personal biases
2148
regarding LGBTQ individuals, often communicated
through statements such as, “I’m not homophobic. I
have a gay best friend!” Denial of one’s own biases
invalidates the realities of an LGBTQ person who
experiences discrimination and marginalization and
communicates that the LGBTQ person’s experience
is invalid or unworthy of acknowledgment. Denying
biases such as heterosexism (normalization of
heterosexual lifestyles) or cis-sexism (normalization
of gender as corresponding directly and exclusively
to birth sex) further marginalizes the LGBTQ
population.
Research finds that LGBTQ individuals cope with
microaggressions behaviorally (by changing one’s
actions), emotionally (by changing one’s feelings),
and cognitively (by changing one’s thoughts about
oneself and the world). Behaviorally, some react
overtly, such as responding to a verbal slur (e.g.,
being called a “faggot,” “dyke,” or “tranny”) by
physically assaulting or shouting at the perpetrator.
Others may respond with self-protective behaviors
aimed at avoiding future attacks, such as taking a
different route home in the future. Emotionally, some
individuals experience sadness or diminished self-
worth after experiencing a microaggression, while
others may feel an enhanced sense of pride in their
LGBTQ identity. Cognitively, some individuals may
view the world as a

cruel, harsh place following a microaggressive
experience, whereas others may view it as a space in
need of activism, education, and open dispersal of
accurate information. These examples show that
LGBTQ individuals have diverse positive and negative
responses to microaggressions.
However, regardless of how an LGBTQ individual
copes with microaggressions, repeated discriminatory
experiences have the ability to wear down defenses
over time, resulting in negative impacts on physical and
psychological health. Studies have reliably shown that
LGBTQ individuals are at increased risk for physical
health problems, symptoms of anxiety, depression,
traumatic disorders, and panic disorder, and for suicidal
ideation, suicide attempts, and substance abuse. These
risks are significantly higher for transgender
individuals, who face increased discrimination and
increased disparities in the availability and quality of
health care (psychological or physiological).
LGBTQ individuals experience microaggressions
regularly. How these individuals cope varies widely, as
does the nature of discrimination experienced.
Regardless, a number of common themes have emerged
regarding the types of discrimination experienced, how
individuals cope, and the negative psychological and
physical impacts of increased discriminatory
experiences.
Chassitty N. Whitman and Kevin L. Nadal
See also Biphobia; Discrimination Against LGBTQ
People, Cost of; Heteronormativity; Homophobia;
Minority Stress; Queer; Transphobia
Further Readings
Makadon, H. J., & American College of Physicians. (2008). The
Fenway guide to lesbian, gay, bisexual, and transgender
health. Philadelphia, PA: American College of Physicians.
Nadal, K. L. (2013). That’s so gay! Microaggressions and the
lesbian, gay, bisexual, and transgender community.
Washington, DC: American Psychological Association.
Sue, D. W. (2010a). Microaggressions and marginality:
Manifestation, dynamics, and impact. Hoboken, NJ: Wiley.
Sue, D. W. (2010b). Microaggressions in everyday life:
Race, gender, and sexual orientation. Hoboken, NJ: Wiley.
2149
MILITARY AND LGBTQ PEOPLE
This entry describes the current and past policies of the
United States military toward LGBTQ individuals.
Effective September 2011, the United States military
now allows lesbian, gay, bisexual, and queer (LGBQ)
individuals to serve openly, with equal pay and
opportunity for promotion and access to benefits; this
change, however, was preceded by decades of shifting
arguments and policies that previously restricted the
full participation of LGBTQ individuals. Here, we
focus on the following issues connected to LGBQ
individuals and the military: the policies that previously
determined their suitability for service; arguments for
inclusion and exclusion; the impact of current policies
on LGBQ service members; and transgender people in
the military. Although LGBQ and transgender
individuals often are grouped together, their acceptance
and integration in the United States military are
different, especially in legal terms. This entry deals
with LGBQ personnel only, until the last section, which
discusses the unique experiences and stressors shaping
the experience of transgender individuals in the
military.
Policies on Service of LGBQ Military Personnel Over
Time
The laws regarding LGBQ individuals and military
service have fluctuated over time. During World War I,
the military did not concern itself with homosexuality.
Commanders determined how troops who identified as
homosexual were to be integrated into their units,
which led to variability in treatment, and often an
overlooking of homosexual behavior. Following World
War I, the first governing regulations concerning
homosexual conduct emerged under the Articles of War
of 1916, which limited the use of sodomy charges to
assault cases that involved the act, or the intent to
commit. Medical experts viewed homosexuality as an
illness during this time, so efforts were made to identify
and treat homosexuals. Those whose behavior did not
change with treatment were removed for psychological
unfitness. Oversight and regulations focused on
homosexual behaviors, rather than identity and
orientation; thus, service members who identified as
being gay were allowed to serve.
2150 Military and LGBTQ People
Under these lax prohibitions, LGBQ individuals
served in World War II; however, there were limitations
on their service. Commanders placed LGBQ
individuals, whether self-identified or perceived, into
jobs viewed as not requiring masculine characteristics
and deliberately removed them from the combat arms.
Following World War II, changes within the Uniform
Code of Military Justice led to a ban of sodomy among
all service members, regardless of the sex of the
partner.
It was not until the mid-1970s when the institutional
perspective on LGBQ individuals moved beyond
commander discretion and the treatment and separation
model. The Carter Administration supported the view
that “homosexuality is incompatible with military
service” and called for the mandatory separation of all
homosexuals. It was perceived that LGBQ individuals
threatened good order and discipline, violated privacy
norms, and soiled public respect for the military. This
new Department of Defense directive prevented
homosexuals from enlisting or serving in the Armed
Forces. Those in violation of this directive faced
administrative discharge, or if in violation of the
Uniform Code of Military Justice, of court-martial with
the possibility of a punitive discharge. Thus, post–
World War II, homosexuals observed a closing of the
institution. Homosexuals were banned from military
service because of institutional concerns and
irrespective of individual behavior.
This policy of mandated separation of homosexuals,
regardless of conduct or self-identification, did not
change until President William J. Clinton directed the
1993 implementation of “Don’t Ask, Don’t Tell, Don’t
Pursue” (commonly referred to as Don’t Ask, Don’t
Tell [DADT]) policy. LGBQ individuals were allowed
to serve in the military;
Military and LGBTQ People
thus, orientation alone was not a bar to service.
Admission of homosexual orientation or homosexual
conduct, however, led to a mandated investigation, and
if proven, resulted in discharge. By making sexual
orientation a private manner, this policy prevented the
investigations of the past, but it also furthered the idea
that homosexual orientation alone should prevent
enlistment or continued service. This policy was vastly
criticized because it assumed that the conduct of LGBQ
individuals— regardless of the actual behavior itself—
had a negative effect on the military’s ability to fulfill
its mission. The policy also required LGBQ individuals
to purposefully mask their sexual orientation, even if it
required deceit, to stay in compliance. However,
proponents of the policy argued that it granted LGBQ
individuals the right of military service by preventing
investigations based on hearsay. They also argued that
it protected the rights of service members who were
uncomfortable with serving alongside LGBQ
individuals.
Calls to repeal DADT continued through the next
decade, but were not seriously heeded until President
Barack Obama announced in 2010 that he would work
with Congress and the Department of Defense to repeal
the policy. At that time, the Pentagon began to loosen
enforcement guidelines; it also published a
scientifically sound study arguing that the repeal of
DADT would have minimal to no impact on military
effectiveness. Citing this research as justification, as
well as broader appeals for the human rights and dignity
of LGBQ service members, a Democratic-led House
and Senate voted to repeal DADT in December 2010.
President Obama signed the repeal into law a week
later, but gave the Joint Chiefs of Staff time to prepare
all service members for the policy change. The repeal
officially went into effect on September 20, 2011.
Although the repeal of DADT allowed LGBQ
service members to serve openly without fear of
investigation or discharge, they still experienced
inequities in accessing benefits available to
heterosexual service members and their families due to
the federal government’s Defense of Marriage Act
(DOMA). Benefits they were excluded from included
health care, housing, and next-of-kin casualty
notification. A critical provision in the act was ruled
unconstitutional by the Supreme Court in 2013,
allowing the families of LGBQ service members access
to federal benefits. Current policy now allows for the
open service of LGBQ service members and, if legally
married, provides equal benefits to their spouses and
children.
Reasons for Exclusion and Inclusion of LGBQ
Service Members
Prior to the policy changes in 2011, opponents of open
service and full integration of LGBQ service members
used various categories of arguments to frame their

opposition. These arguments, generally, have fallen into
two categories: framing the individual competencies of
LGBQ individuals as deficient and, after that argument
faded, focusing on the perceived negative consequences
LGBQ service members would have on their units.
Initially, opponents claimed that LGBQ service
members were physically weak and morally
compromised; their sexuality, it was argued, made them
incompetent and a security risk. Both in the past and
today, gay men are associated with feminine traits, such
as physical weakness, that are not valued within the
combat-driven armed forces. In addition, scientific
opinions, such as past characterizations in the American
Psychiatric Association’s Diagnostic and Statistical
Manual of Mental Disorders, linked homosexual
orientation and behaviors to psychological and social
illness and emphasized the need for rehabilitation and
military separation. In addition to past mental
characterizations, gay men also have had to negotiate
the stereotypically associated behavior of sexual
deviance and promiscuity. Although gay men are
perceived as lacking the masculinity, and by extension
the aggressiveness, necessary for military effectiveness,
they are characterized as sexual deviants that undermine
privacy and subvert the heteronormative, masculine
behaviors of the military. Lesbians, in contrast, are
stereotypically portrayed as too masculine and,
therefore, as threats to the hegemonic masculinity of the
military. These arguments fell out of favor in the early
1990s when performance reviews demonstrated that
LGBQ service members, in the aggregate, performed at
a comparable level to their colleagues.
Once individual performance concerns were
addressed, the dominant argument for excluding LGBQ
personnel focused on their potentially negative impact
on the social cohesion, and as a consequence, the
overall effectiveness of military units. There was
concern that gay men and women disrupted the social
norms and rituals found in singlesex military units
critical for group solidarity.
There is modest evidence that highly cohesive
groups are more effective in task accomplishment than
less cohesive groups. At its basic level, cohesion
traditionally is defined as a type of social glue that
keeps individuals tied to the group; it is conceptualized
mainly in terms of peer relationships. Methodological
and theoretical advances have led to increased
specification of different types of cohesion, with the
2151
greatest difference existing between “social cohesion”
and “task cohesion.” Social cohesion describes positive
interpersonal attractions where individuals develop
group friendships. This affective bonding extends
beyond formal military duties to informal interactions;
the individuals, in short, are friends and like to spend
time together. Socially cohesive groups tend to be
socially homogeneous as well. In contrast, task
cohesion is the shared dedication to a goal and the
ability of the group to come together for its completion.
Rather than relying on social homogeneity, task
cohesion relies on group recognition that each
individual brings a different, yet valued, skill set. The
focus on social cohesion not only overstates the
importance of homogeneity and affective bonding, but
also overlooks the importance of task cohesion, and the
role of each individual member in completing the
group’s goals. With the integration of gay men and
lesbians (as well as other minority groups), the military
has had to rely more on task cohesion than on social
cohesion; a decrease in military effectiveness as was
feared with this change has not been noted.
Reasons for including gay men and lesbians in the
military focus more on individual rights and
responsibilities. The military often is viewed as a
desired employer, particularly because it offers “pull
factors” such as standardized pay, equal entry at the
bottom ranks, and a willingness to train unskilled
personnel. In addition, in the citizen-soldier tradition of
the United States, military participation is viewed as a
civic duty, like voting, that implies shared
responsibilities in exchange for equal citizenship. As a
result, LGBQ individuals have sought to join the
military as a way to benefit from its economic stability
as well as to demonstrate their willingness to serve as
equal citizens. At the organizational level, allowing gay
men and women to serve openly moves the policies of
the United States military to be more in line with 25
other countries that already allow open service. Since
many military missions now involve international
coalitions—the International Security Assistance Force
in Afghanistan has involved most of these 25 countries
—our service members already were serving alongside
openly gay men and lesbians from allied countries.
2152 Military and LGBTQ People
How Policies Affect Military Units
Prior to the repeal of Don’t Ask, Don’t Tell, civilian
and military opponents asserted that military cohesion
and readiness would suffer to the point of catastrophic
failure. Claims included an inability to recruit and
retain qualified people because they would not serve
with openly gay service members, as well as other
concerns voiced in opposition about the prevalence of
assaults and harassment and ruining morale of military
units. However, the data provided very different
outcomes after the repeal of DADT. Specifically, there
was no evidence to support any overall negative impact
in relation to readiness, morale, cohesion, recruitment,
retention, assaults, and harassment. In fact, there was
reason to believe there were enhancements to areas of
morale, cohesion, and readiness in terms of discipline,
command, and family readiness.
The repeal of DADT created higher levels of trust
among service members through the ability of LGBQ
individuals to be honest about their sexual identity and
not hide anymore. Morale for LGBQ
Military and LGBTQ People
service members has improved because they no longer
live in fear of reprisals such as losing their job or
career. Military leaders who administer and adjudicate
military rules and regulations report a higher level of
integrity within their units where a higher sense of
professionalism based on dignity and respect has
improved the command climate. LGBQ service
members can now serve with dignity and honor as the
profession of arms demands.
How Policies Affect LGBQ Personnel
While the repeal of DADT has largely improved the
quality of life for LGBQ service members, there are
still policies and lingering effects of the policy. In
addition to the repeal of DADT, the repeal of DOMA in
June 2013 was critical for LGBQ military families. This
repeal allowed LGBQ service members’ families
official recognition and benefits almost identical to
heterosexual military families. Benefits provided to
legally married same-sex couples by the repeal of the
Defense of Marriage Act include Department of
Defense identification cards, TRICARE health care
benefits, basic allowance for housing, family separation
allowance, Service Members Group Life Insurance
beneficiaries, Death Gratuity benefit, Commissary and
Exchange privileges, Wounded Warrior designated
caregiver, Thrift Savings Plan beneficiaries, Survivor
Benefit Plan beneficiaries, casualty notification, person
eligible to receive effects of deceased persons,
presentation of the flag of the United States, hospital
visitation rights, and joint duty assignments for dual
military couples.
The landmark ruling involving DOMA in 2013,
however, did not change the patchwork of state laws on
same-sex marriage. LGBQ service members could enter
into a same-sex marriage in a state where it was legal—
such as Iowa—and then get stationed in a state where
their marriage was not recognized and where
fundamental rights and protections were not offered to
LGBQ families. For example, spouses of gay National
Guard personnel in states where gay marriage was not
allowed were initially denied dependent identification
cards because of state bans. The workaround required
guard personnel to enroll their spouse at a federal
military installation instead. The Department of
Veterans Affairs also denied some benefits to same-sex
couples if they resided in states where their marriage
was not recognized. However, the status of all LGBQ
families positively changed on June 26, 2015, when the
Supreme Court ruled that same-sex couples have the
right to marry in all states. LGBQ families in the
military no longer have to negotiate differing states
laws regarding the legality of their union and now have
full access to Department of Defense and Veterans
Affairs benefits.
There still remain challenges for LGBQ families
who must reside in a foreign country. Command
sponsorship allows service members’ families to
accompany them to duty stations in other countries
based on the terms of the Status of Forces Agreement
(SOFA) with each country. Most importantly, SOFAs
provide dependent family members exceptions to visa
and passport requirements and access to military
installations. Without recognition of same-sex marriage
by the host country, LGBQ service members have not
been able to bring their spouses to their overseas duty
station. Countries with the largest numbers of U.S.
military personnel include Germany, Italy, Japan, and
South Korea, out of which Korea is the only country
with a SOFA that does not allow same-sex couples.
 2153
Currently, there are 47 countries with SOFAs services have elevated the decision-making authority on
recognizing same-sex families. separations to the Under Secretary of Defense for
There remain indications that the effects of DADT Personnel and Readiness rather than leaving it with unit
may still linger for LGBQ service members. However, commanders. If the ban is removed, the United States
it is challenging to measure and observe the extent of will join 18 other countries who already allow the
these effects because the military does not track sexual service of transgender military personnel.
orientation of personnel. Sexual orientation only
Karin De Angelis and David G. Smith
became a category for equal opportunity issues of
harassment or discrimination in the military in June See also Defense of Marriage Act (DOMA); Gay Exclusion in
2015, making it challenging to analyze. As a the U.S. Military: Evolution and Demise of Don’t Ask,
stigmatized group that is susceptible to bias and Don’t Tell; Military and Transgender
prejudice, LGBQ service members would be expected People
to have more stress-related symptoms observed by
mental health care providers. However, early research
shows that LGBQ service members are not comfortable
disclosing their sexual orientation to medical health
care providers that may lead to inadequate care. Even
with the repeal of Don’t Ask, Don’t Tell and the
Defense of Marriage Act, there are still lingering effects
of distrust between LGBQ military personnel and the
military.

Transgender People in the Military

Transgender individuals in the military—who are
addressed in the subsequent entry—are not covered by
the repeal of DADT and are still prohibited from
military service once they publicly engage in
transgender behaviors or claim a transgender identity.
This omission was partly intentional, as LGBQ
advocates did not want to confound an already
politically charged policy change surrounding sexual
orientation with issues about gender identity. However,
the service of transgender military personnel currently
is a visible topic of research, and there is an emerging
discussion about reasons for keeping and for repealing
the ban. The medical and psychological care of
transgender military personnel has been the primary
reason for discharge, as it has been argued that the
Department of Defense does not have the expertise or
resources to provide this specialized care. However,
this claim has been disputed by medical professionals
and senior military leaders who no longer see this as a
legitimate bar to service. There is no set timetable on
when the United States will repeal this ban, if it does at
all; however, changes already are occurring. Although
the formal policy remains in place regarding the
mandatory separation of transgender personnel, the
2154
Further Readings
Belkin, A., Ender, M. G., Frank, N., Furia, S., Lucas, G.,
Packard, G., Jr., et al. (2012). Readiness and DADT repeal: Has
the new policy of open service undermined the military? Armed
Forces & Society, 39, 587–601. Bérubé, A. (2010). Coming out
under fire. Chapel Hill: University of North Carolina Press.
Elders, M. J., Brown, G. R., Coleman, E., Kolditz, T. A., &
Steinman, A. M. (2014). Medical aspects of transgender
military service. Armed Forces & Society,
41, 199–220. doi:10.1177/0095327X14545625 Frank, N.
(2009). Unfriendly fire. New York, NY:
Thomas Dunne Books.
Moradi, B., & Miller, L. (2010). Attitudes of Iraq and
Afghanistan war veterans toward gay and lesbian
service members. Armed Forces & Society, 36, 397–
419.
Parco, J. E., Levy, D. A., & Spears, S. R. (2014). Transgender
military personnel in the post–DADT repeal era: A
phenomenological study. Armed Forces & Society, 1, 1–22.
Stanley, S. C., & Scott, W. (Eds.). (1994). Gays and lesbians in
the military: Issues, concerns, and contrasts. Chicago, IL:
Aldine Transaction.
MILITARY AND TRANSGENDER PEOPLE
This entry introduces the topic of transgender people
and the military. It begins by reporting estimated
prevalence rates of transgender people in the U.S.
military, and then explains possible reasons to account
for the particularly high percentage of transgender
service members. The entry goes on to review policies
that have historically banned transgender people from
military service in the United States and, in contrast,
policies for inclusion and treatment of transgender
veterans. Since people’s opinions vary on the topic of
transgender people and the military, different
perspectives are provided. Finally, militaries outside the
United States that allow transgender people to serve
openly are considered.
In this entry, the term transgender is used broadly to
describe any individual who does not identify with the
gender he or she was assigned at birth. Similarly, the
term transgender service member is used generally to
include transgender people who participate in the armed
forces, regardless of their expressed identity at the time
of service. For instance, service members can consider
themselves transgender prior to enlisting in the military,
but still express the gender they were assigned at birth.
Service members can also begin identifying as
transgender once they are part of the military— some of
these individuals may still express the gender they were
assigned at birth and keep their identity private, but
others may choose to transition (whether socially,
physically, or legally), which could risk discharge from
the U.S. military. Finally, service members may not
legally identify or express themselves as transgender
until after they have been discharged from the military.
The term cisgender is used in this entry to describe
nontransgender people, that is, individuals who identify
with the gender they were assigned at birth.
Prevalence
In a 2014 Williams Institute report, Gary Gates and
Jody Herman estimated that 150,000 transgender
people had served, or were currently serving, in the
U.S. Armed Forces. They further identified that 8,800
transgender service members were on active duty and
6,700 were in the National Guard or Reserve forces,
totaling 15,500 current service members. An additional
134,400 transgender people were reported as being
veterans or retired from the National Guard or Reserve
forces. These estimates were calculated using U.S.
census data and a nationwide survey of transgender
people, as no data exist that could provide for a direct
tabulation of transgender people in the military.
However, preliminary research on transgender veterans
and autobiographical accounts by transgender veterans
similarly suggest a strong presence of transgender
people in the U.S. military.
These figures indicate that transgender people are
twice as likely as others in the general population to
serve in the military. Specifically, it was estimated that
21.4% of transgender people serve in the armed forces,
while only 10.7% of adults in the
Military and Transgender People
United States do. Within the transgender population,
individuals who were born male, such as maleto-female
(MtF) transgender individuals, are more than 5 times as
likely as those born female, such as female-to-males
(FtMs), to serve. The general and transgender
populations can also be compared by the gender
someone was assigned at birth. Transgender individuals
who were assigned female at birth, such as FtMs, were
about 3 times more likely to serve in the military than
women in the general population; and transgender
people assigned male at birth, such as MtFs, were 1.6

times more likely than men to serve in the general
population.
Explanation
Experts on transgender people and the military have
considered possible reasons to explain the especially
high rates of transgender service members. Essentially,
transgender individuals may be particularly drawn to
the military for its emphasis on masculinity.
This notion is relatively straightforward when
considering the high rates of FtM transgender people in
the military. Since FtMs identify more with the male
gender role, they may seek opportunities that allow
them to express their maleness safely. The military
allows (and even encourages) individuals who are
assigned female at birth to adopt masculine traits to
fulfill their duties; individuals who act this way in
general society more often experience discrimination
and victimization. FtMs could seek military service
prior to identifying as transgender, but once they take
on maleoriented attributes, they form a more authentic
identity as transgender. Alternatively, an FtM who
identifies as transgender but decides against transition
(at least for the time being) could enlist in the military
—he would be choosing one of the most masculine
professions while continuing to be identified by others
as a woman.
Military interest by MtFs is a bit more complicated
since people in this group more often identify with
feminine traits and roles, which are not characteristic of
the military. However, long before someone forms his
or her identity as transgender and considers transition,
the person may seek to repress, hide, and purge any
feminine attributes. During this early stage of identity
development, an MtF may seek out opportunities to
take on the most masculine of roles and traits—the
military is a perfect prospect. Autobiographical
accounts by MtF service members elaborate on this
process; for instance, people assigned male at birth
recognize feminine traits in themselves and
subsequently join the military, believing that it will help
them become more male.
Another factor that could contribute to the high
proportion of transgender service members relates to
the risks associated with active duty. Transgender
people may seek such risks more often than others. The
transgender population has been found to experience
mental health problems more often than others,
particularly depression. Common symptoms associated
Military and Transgender People 2155
with depression include hopelessness and suicidality.
When people experience these symptoms, including
transgender people, they can be more likely to engage
in dangerous (and even deadly) behaviors. Therefore, it
is possible that some transgender individuals choose
(consciously or unconsciously) the military for its risks.
Finally, transgender people may seek military
service for many of the same reasons as cisgender
people, including patriotism, following family tradition
of military service, securing financial help for school,
and seeking adventure and international travel. While
these interests alone do not explain the elevated rates of
transgender service members, they may be a part of
what attracts any given transgender service member.
Autobiographical accounts of transgender service
people similarly suggest that transgender people are not
only interested in the military for its emphasis on
masculinity or opportunities for risks—but these in
combination with reasons that attract members of the
general population can help explain the incidence of
transgender people in the military.
U.S. Military Policies
The Department of Defense has historically banned
transgender people from serving in all branches of the
U.S. Armed Forces. Policies for exclusion are outlined
in the medical standards used to assess all potential
recruits—this document states that transgender people
are unfit to serve as a result of medical and
psychological conditions. More specifically,
transgender people have been considered ineligible for
military service if they had had surgery to their genitals.
Therefore, transgender people who chose to undergo
gender-affirming surgery were automatically
disqualified for military duty. A transgender individual
could also have been ineligible for military service for
having a psychological condition called transsexualism.
Criteria for this diagnosis are not included in the
medical standards, but this diagnosis can be found in
the third edition of the Diagnostic and Statistical
Manual of Mental Disorders (DSM-III), published in
1980. Transgender people could have been refused
entry into the military or discharged as a result of these
medical standards, since it was assumed they had a
medical or psychological condition that precluded
service. Each individual branch of the U.S. military has
policies that reflect the same prohibition of transgender
service members.
2156
In July 2015, the Pentagon announced its intention to
lift the general ban on transgender service members;
updated guidelines are expected to be released in early
2016. In addition, current policies affecting transgender
people are not to be applied without approval from a
Pentagon top official.
Scholars have been unable to discover the origin of
policies concerning transgender people and the military.
However, a few court cases are known to have dealt
with transgender service members, thereby applying
these policies. In the case of Doe
v. Alexander (1981), an individual (MtF) was denied
reentry into the Army after having undergone gender-
affirming surgery. In Leyland v. Orr (1987), an Air
Force reservist was discharged for having undergone
gender-affirming surgery while serving. Finally, in
DeGroat v. Townsend (2007), a member of the Air
Force who identified as transgender was discharged for
cross-dressing. Each service member could have been
discharged or excluded simply due to the existing
general medical standards that ban transgender service
members. However, testimony was additionally used to
further support the basis for such policies and,
therefore, reject the service members.
There are likely numerous other examples of
transgender service members being excluded or
discharged from the military, but they were never
brought to court. In 2014, Jocelyn Elders and her
colleagues reported awareness of about two dozen
service members being discharged in recent years for
being transgender.
Transgender service members also could have been
discharged from the service and criminally indicted
using the Uniform Code of Military Justice (UCMJ).
According to Article 133 of the UCMJ, if an individual
is convicted of behavior unbecoming to an officer, he or
she is to be punished by the court. Article 134 also
states that a person is to be punished by the court, but
only in the case that the person’s conduct somehow
negatively impacts the military or its reputation. A
transgender person might have been punished for any
behaviors that are considered discrepant with the values
of the military. Two such instances can be found in the
cases of United Sates v. Davis (1988) and United States
v. Guerrero (1991). In each case, an individual was
punished, using Article 134, for cross-dressing. While it
is unclear whether these individuals identified as
transgender, crossdressing is a common behavior for
transgender people. Therefore, a transgender person
may have been discharged using these articles,
especially if the person did not fit the exclusionary
criteria outlined in the general medical standards.
Transgender Veterans
According to a directive released in 2011, transgender
veterans are entitled to the same health care benefits as
cisgender veterans. In addition, transgender veterans are
provided transgender-specific services, including
hormone therapy, mental health treatment, presurgical
evaluations, and postsurgical care; however, gender-
affirming surgeries are not covered. Since it was
introduced, guidelines for providing health care to
transgender and intersex veterans have been
implemented throughout the Veterans Health
Administration (VHA), and educational workgroups
have provided trainings to
Military and Transgender People
help improve staff competency for working with
transgender veterans. These guidelines do not apply to
active duty military, retired military, or military
dependents. Therefore, a transgender veteran can only
access benefits if the person does not identify himself
or herself as transgender until after being discharged
from the military and the person’s status changes to
veteran.
Research has yet to be conducted about transgender
veterans following the 2011 directive. However, their
experiences of accessing services at the VHA were
studied in earlier research. Generally, transgender
veterans reported receiving inconsistent, insensitive,
and sometimes prejudiced care. Some individuals said
they were denied necessary services, such as
mammograms and prostate exams. Other transgender
veterans reported receiving mixed responses about the
type of care covered by the VHA. Because of these
negative experiences, some research revealed
underutilization of VHA services by transgender
veterans, and that some individuals sought treatments
elsewhere as a result. However, other research indicated
that transgender veterans utilized VHA services more
often than others because they have limited other
options as part of a marginalized population.
U.S. Debate
Deliberation over the inclusion of transgender people in
the military seems more common now than ever before

in
U.S. history. The question as to whether transgender
individuals should be considered for military service
has been increasingly asked since 2011—when gay,
lesbian, and bisexual people became allowed to serve
while being open about their sexual orientation. Those
in favor of including transgender people in the military
are seeking removal of the existing policies, while
individuals on the opposing side of the issue are
seeking to uphold the policies in favor of excluding
transgender people from service. In the following
sections, each perspective is explored.
Opponents of Transgender Inclusion
People who support the continued exclusion of
transgender individuals from the U.S. Armed Forces
maintain two assertions: (1) Transgender people are
mentally ill, and (2) transgender people require costly
and specialized medical and mental health care. The
first premise of caution relates to believing that all
transgender people are inherently mentally ill. From
this perspective, transgender individuals are seen as
unstable and, therefore, unfit for military service.
Concern is expressed for how such a vulnerable
population would be impacted by the demands of
serving one’s country, as their mental condition could
even worsen while in the military. Going a step further,
there is fear about the effect of allowing mentally ill
individuals to serve alongside other service people,
potentially having a negative influence on others’
mental stability as well.
The second point of contention relates to the costs
and sensitivity associated with caring for transgender
service people. Based on the first premise, that
transgender people are mentally ill, they could be
assumed to need more extensive mental health care,
which would be costly. Further, for those seeking
physical transition, they would require specialized
medical care, such as hormone therapy. Even beyond
the expense, those supporting this perspective see it as
unfathomable that such treatment should be provided to
service people on active duty in remote locations.
Advocates of Transgender Inclusion
Those in support of including transgender people in
the military have challenged the above points. They
deny that all transgender people are inherently mentally
ill. They refer to research about the transgender
population, which does indeed indicate higher rates of
Military and Transgender People 2157
mental illness. However, they elaborate that this finding
is similarly found among other marginalized groups,
and that discriminatory institutional policies, like those
of the military, contribute to this outcome. Even if a
group experiences illness more commonly, this
perspective asserts, not all individuals can be assumed
to suffer similarly—doing so contributes to stereotyping
and discrimination.
Advocates in favor of inclusion also refer to the most
recent, fifth edition of the Diagnostic and Statistical
Manual of Mental Disorders (DSM-5) to discredit the
belief that all transgender people are inherently
mentally ill. They identify gender dysphoria as the most
up-to-date diagnostic term for transgender people, but
assert that not all transgender people warrant this
diagnosis. They point out that the military policies use
terminology taken from an outdated version of the DSM
—the third edition (DSM-III), published in 1980, which
was informed by research that has since been
superseded.
To challenge the second argument, that transgender
people require costly and specialized medical and
mental health care, advocates of inclusion compare the
needs of transgender people with those of the general
population. It is suggested that treating transgender
people is not very different from handling the unique
medical and mental health needs of others in the
military. After all, they argue, other service members
require ongoing medications (comparable to hormone
therapy) and undergo corrective surgeries that require
subsequent rehabilitation (comparable to gender-
affirming surgery). It is pointed out that cisgender
service members are sometimes provided identical
treatments in remote locations, so it would be just as
easy for transgender service members on active duty to
receive the same care. This side also notes that not all
transgender people require psychological care or seek
physical changes that result from hormone therapy and
surgeries.
Proponents of including transgender people in the
military are also concerned about current transgender
service members. They state that these individuals are
unprotected without policies that include them and, as a
result, they could suffer even more medical and mental
health problems on account of their going without
necessary treatments. This outlook seeks removal of the
existing policies, and recommends transgender people
be evaluated for duty fitness, just like other service
members. They encourage the United States to follow
2158
the examples of other countries that include transgender See also Gay Exclusion in the U.S. Military: Evolution and
people in their armed forces. Demise of Don’t Ask, Don’t Tell; Military and

International Militaries
At least 18 countries worldwide permit transgender
people to serve in their armed forces, including
Australia, Austria, Belgium, Bolivia, Canada, Czech
Republic, Denmark, Estonia, Finland, France,
Germany, Israel, Netherlands, New Zealand, Norway,
Spain, Sweden, and the United Kingdom. Some
countries have official policies for the inclusion and
treatment of transgender service members, and other
nations consider potential transgender service members
on a case-by-case basis, similar to the recruitment and
enlistment of other, cisgender service members.
The United Kingdom is one example of a nation that
has an established policy for recruitment and
management of transgender service members. The
policy, adopted in 2009, holds that transgender people
should be dealt with similarly to others who have a
medical condition, such that they are provided
treatment, if necessary, and that their job duties may be
influenced by any limitations, if necessary. It clearly
states that excluding individuals on the basis of being
transgender is illegal and, moreover, that people should
not be directly referred for treatment as a result of being
transgender, as not all transgender individuals require
medical or psychological care. The United Kingdom
offers transgender-related health care to its service
members, except for any type of surgeries.

Limitations
Despite growing interest in studying transgender people
and the military, both research and literature available
on this topic remain limited. In 2014, Jocelyn Elders
and her colleagues reported that only 7 peer-reviewed
and 3 non–peer-reviewed studies focused on
transgender people and the military, and that only 7 of
these 10 studies included original empirical research.
Knowledge and awareness of transgender people and
the military will surely expand as more research and
literature become available on this topic. Furthermore,
as policies for transgender service members continue to
change worldwide, so will the experience of being
transgender in the armed forces.
Adam F. Yerke

LGBTQ People; Transgender Identities; Transgender
Inclusion in the LBGTQ Rights Movement;
Transphobia
Further
Readings
Brown, G. R. (1988). Transsexuals in the military: Flight
into hypermasculinity. In S. Stryker & S. Whittle (Eds.),
The transgender studies reader (pp. 537–564).
New York, NY: Routledge.
Bryant, K., & Schilt, K. (2008, August). Transgender people
in the U.S. military: Summary and analysis of the 2008
Transgender American Veterans Association Survey.
Palm Center White Paper. Retrieved November 28, 2015,
from http://www.palmcenter.org/ node/1137
Elders, J., Steinman, A. M., Brown, G. R., Coleman, E., &
Kolditz, T. A. (2014, March). Report of the
Transgender Military Service Commission. The Palm
Center. Retrieved November 28, 2015, from http://
www.palmcenter.org/files/Transgender%20
Military%20Service%20Report_0.pdf
Gates, G. J., & Herman, J. L. (2014, May). Transgender
military service in the United States. Los Angeles, CA:
Williams Institute. Retrieved November 28, 2015, from
http://williamsinstitute.law.ucla.edu/research/ military-
related/us-transgender-military-service/
Jones, F. D., Deeken, M. G., & Eshelman, S. D. (1984).
Sexual reassignment surgery and the military: Case
reports. Military Medicine, 149, 271–275.
Kerrigan, M. F. (2011). Transgender discrimination in the
military: The new don’t ask, don’t tell. Psychology,
Public Policy, and Law. doi:10.1037/a0025771
McDuffie, E., & Brown, G. R. (2010). 70 U.S. Veterans with
gender identity disturbances: A descriptive study.
International Journal of Transgenderism, 12, 21–30.
doi:10.1080/15532731003688962
Shipherd, J. C., Mizock, L., Maguen, S., & Green, K. E.
(2011). Male-to-female transgender veterans and VA
health care utilization. International Journal of Sexual
Health, 24(1), 78–87. doi:10.1080/19317611.2011.63
9440
Witten, T. M. (2007, February). Gender identity and the
military: Transgender, transsexual, and
intersexidentified individuals in the U.S. Armed Forces.
The Palm Center. Retrieved November 28, 2015, from
http://www.palmcenter.org/files/active/0/
TransMilitary2007.pdf
Yerke, A. F., & Mitchell, V. (2013). Transgender people in
the military: Don’t ask, don’t tell, don’t enlist! Journal of
Homosexuality, 60(2), 436–457.
2159
MINORITY STRESS
This entry describes the unique stressors that sexual
and gender minorities experience as a result of their
stigmatized social status. It provides a conceptual
overview of minority stress theory; describes
specific minority stressors; and introduces
extensions of minority stress theory to the areas of
physical health, interpersonal relationships, and
structural stigma. This entry focuses predominantly
on experiences of minority stress among lesbian,
gay, and bisexual (LGB) individuals, but the
application of minority stress theory to gender
minorities (e.g., transgender individuals) will also be
discussed. Readers are encouraged to consult the
specific entries in this volume on gender minorities
for more nuanced discussions of the unique stressors
that they experience.
Minority Stress Theory
It is well documented that rates of psychiatric
disorders are higher among sexual minorities
compared to heterosexuals. In his seminal work in
2003, Ilan
Meyer advanced a conceptual framework— minority
stress theory—to explain why sexual minorities are
at increased risk for psychiatric disorders compared
to heterosexuals. The main tenet of minority stress
theory is that sexual minorities experience unique
stress associated with their stigmatized social status
(referred to as minority stress) and that this stress
accounts for their increased risk for psychiatric
disorders. Meyer proposed that minority stress exists
on a continuum ranging from distal to proximal, in
which distal stress refers to objective experiences of
stress (e.g., discrimination, violence), and proximal
stress refers to subjective experiences of stress that
depend on an individual’s perceptions and appraisals
of the experiences. Of note, an individual does not
have to identify as a sexual minority to experience
distal stress. If an individual is perceived to be a
sexual minority, regardless of his or her actual
identity, then he or she may be targeted for
discrimination or violence. In contrast, given the
subjective nature of proximal stress, it is more
dependent on an individual’s self-identification as a
sexual minority. Meyer described several proximal
minority stressors, including the internalization of
2160 Minority Stress
negative attitudes toward nonheterosexuality
(internalized homophobia), vigilance for cues of
potential rejection (expectations of rejection), and
hiding one’s sexual identity to avoid potential
negative consequences (concealment). Each of these
minority stressors will be discussed in subsequent
sections.
While minority stress theory provides a
conceptual framework for understanding why sexual
minorities are at increased risk for psychiatric
disorders, it does not specify the mechanisms
through which discrimination influences mental
health. Mark Hatzenbuehler extended minority stress
theory by proposing that discrimination leads to
cognitive, affective, and social processes that
increase risk for mental health problems. An
important aspect of his model is that it integrated
general risk factors for psychopathology with those
that are unique to the experiences of sexual
minorities. In regard to general risk factors, he
proposed that discrimination can lead to cognitive
phenomena (hopelessness, pessimism, and negative
views of the self), affective phenomena (maladaptive
coping and emotion dysregulation), and social
phenomena (social isolation), all of which are risk
factors for mental health problems. For instance,
experiences of discrimination may lead sexual
minorities to have negative thoughts about
themselves and their futures as well as difficulties
regulating their emotions, which in turn may lead to
depression and anxiety. In regard to unique risk
factors, Hatzenbuehler advanced minority stress
theory by articulating that an individual’s subjective
experience of minority stress (e.g., his or her
perceptions or appraisals) may be mechanisms
through which
Minority Stress
objective experiences of minority stress influence
mental health. Thus, if a sexual minority is
discriminated against, then he or she may experience
negative thoughts and feelings about his or her
sexual orientation as well as expectations of future
rejection, which in turn may result in mental health
problems.
In addition to describing the unique stressors that
sexual minorities experience and their impact on
mental health, minority stress theory also proposes
that there are factors that may strengthen or weaken
the impact of minority stress on mental health.
Consistent with the broader literature on stress and
mental health, minority stress theory posits that
social support can function as a stress buffer,
reducing the negative impact of minority stress on
mental health. In addition, an individual’s tendency
to use adaptive coping strategies in the face of
minority stress may also be protective against mental
health problems. For instance, responding to
discrimination by seeking advice or emotional
support from others or by engaging in pleasurable or
meaningful activities is more likely to lead to
positive outcomes compared to using substances to
diminish one’s emotional pain or focusing on the
causes and consequences of the discrimination. Of
note, in addition to the individual-level supports that
a person has and his or her coping skills, sexual
minorities can also turn to others in the LGBTQ
community for support and resources. This group-
level coping is unique to minority group members,
and it highlights the fact that belonging to a minority
group involves benefits in addition to stressors.
Finally, in addition to social support and coping,
minority stress theory proposes that the impact of
minority stress on mental health may depend on
characteristics of one’s sexualminority identity. For
instance, minority stress may have a stronger impact
on mental health for those whose sexual-minority
identities are more central to their overall sense of
self. If being a sexual minority is an important aspect
of one’s identity, then being targeted for
discrimination or violence because of that aspect of
one’s identity may be particularly harmful.
Specific Minority Stressors
Discrimination and Violence
Despite increases in societal acceptance of sexual
minorities, discrimination and violence remain
widespread experiences among this population.
Sexual minorities report high rates of discrimination
specific to their sexual-minority identity as well as
high rates of other types of violence that may or may
not be related to their sexual-minority identity, such
as verbal harassment, threats of violence, physical
assault, sexual assault, and property crime. Notably,
sexual minorities report higher rates of violence
compared to heterosexuals, and sexual minorities
reporting high rates of discrimination and violence
have poorer mental health outcomes. The work of

Kevin Nadal demonstrates that even minor forms of
stigmatization can be harmful. He proposed that
sexual minorities frequently experience
microaggressions, defined as verbal, behavioral, or
environmental slights that communicate hostile,
derogatory, or negative judgements about one’s
sexual-minority status. He described numerous
microaggressions toward sexual and gender
minorities, such as the use of heterosexist language
(e.g., saying “that’s so gay”), the endorsement of
heteronormative or genderconforming behaviors
(e.g., telling a gay person to “act straight” in public),
and the assumption of a universal lesbian, gay,
bisexual, or queer (LGBQ) experience (e.g.,
assuming that all gay men are effeminate). As with
discrimination and violence, sexual minorities who
report experiencing higher levels of
microaggressions have poorer mental health
outcomes. Further, given that microaggressions tend
to be subtler than other types of discrimination,
sexual minorities may experience them more
frequently, thus increasing their impact on mental
health.
In addition to the minority stress that lesbians and
gay men experience, bisexual individuals experience
unique stressors related to their sexual identity.
Heterosexual individuals tend to have more negative
attitudes toward bisexual individuals than toward
lesbians and gay men. Further, lesbians and gay men
can also be the perpetrators of discrimination against
bisexual individuals. Thus, bisexual individuals can
experience marginalization from heterosexuals as
well as from other sexual minorities. Negative
attitudes toward bisexual individuals can take many
forms. First, a common misperception of bisexuality
is that it is an illegitimate and unstable sexual
orientation. As such, bisexuals can be perceived as
confused, experimenting, in transition to a
gay/lesbian identity, or in denial about their true
sexual orientation. Second, bisexuals can be
perceived as sexually irresponsible, such that they
can be perceived as promiscuous or unable to have
monogamous relationships. Finally, bisexuality can
be perceived as immoral or pathological, reflecting a
general hostility toward bisexuality.
There are also gender differences in the types of
discrimination and violence that sexual minorities
experience. Studies have found that both
heterosexual men and heterosexual women express
2161
more negative attitudes toward sexual-minority men
than toward sexual-minority women. In addition,
sexual-minority men are more likely than
sexualminority women to experience discrimination
from medical professionals, given common
assumptions that gay and bisexual men have HIV or
AIDS. In contrast, sexual-minority women are at risk
of experiencing sexual objectification by
heterosexual men. Heterosexual men may eroticize
female same-sex sexual behavior and, in turn,
proposition sexual-minority women to have sex with
them and another female.
Internalized Homophobia
A major consequence of living in a society that
values heterosexuality over other sexual orientations
is exposure to negative attitudes toward
nonheterosexual attractions, behaviors, and
identities. These negative attitudes can be
internalized by LGBTQ people as negative thoughts
and feelings about one’s own sexual identity, which
has been referred to as internalized homophobia (as
well as internalized heterosexism, internalized
homonegativity, internalized stigma, and self-
stigma). Of note is that sexual minorities can
experience internalized homophobia in the absence
of discrimination or violence directed at them, given
their general knowledge of negative societal
attitudes toward nonheterosexuality. It is common
for individuals to experience some degree of
internalized homophobia as they develop their
sexualminority identity, and the process of
overcoming this internalized homophobia may
eventually contribute to the process of developing a
healthy selfimage. Internalized homophobia is
proposed to decrease as one moves toward
developing a positive sexual identity, in part due to
increased contact with the LGBTQ community and
the support and resources that this contact provides.
Still, given the strong impact of early life
experiences and ongoing exposure to societal stigma
and prejudice, it is possible that some degree of
internalized homophobia could remain even after
one has accepted a positive sexual-minority identity.
Consistent with minority stress theory, research has
demonstrated that internalized homophobia is a
robust risk factor for mental health problems.
However, the impact that internalized homophobia
2162 Minority Stress
has on sexual minorities is heterogeneous and
depends on an individual’s access to social support
and adaptive coping skills.
Expectations of Rejection
Given the presence of societal stigma and
prejudice, sexual minorities often anticipate rejection
from others. As a result, they learn to be vigilant
toward cues of potential rejection in an effort to
avoid discrimination and violence. Although
vigilance may be used as a strategy to cope with a
realistic possibility of rejection, it can have the
unintended consequences of draining one’s cognitive
and emotional resources. In fact, research has
demonstrated that expectations of rejection can have
a negative impact on social and academic
functioning as well as mental and physical health.
Similar to internalized homophobia, expectations of
rejection do not require discrimination or violence to
occur. A sexual minority may learn to be vigilant
toward cues of potential rejection based on his or her
knowledge of societal stigma and
Minority Stress
prejudice regardless of his or her personal
experiences with discrimination and violence.
Although not specifically discussed in the context
of minority stress theory, rejection sensitivity is a
closely related construct to expectations of rejection.
Rejection sensitivity refers to the extent to which an
individual anxiously expects to be rejected based on
one’s stigmatized identity. It shares some features
with social anxiety, such as concerns about the
reactions of others, but it is unique in that it
acknowledges that minority group members may
have realistic concerns about rejection given their
stigmatized social status. Rejection sensitivity is
theorized to result from experiences of
discrimination, which can lead minority group
members to be vigilant for cues of potential
rejection, to experience intense reactions to
rejection, and to expect to be rejected. Research has
demonstrated that rejection sensitivity is associated
with vigilance for, and sensitivity to, cues of
potential rejection as well as with mental health
problems.
Concealment
A common strategy used by sexual minorities to
cope with the potential for discrimination is to
conceal one’s sexual identity from others. However,
concealing one’s sexual identity can have the
paradoxical effect of leading to mental health
problems, given the stress associated with doing so.
The act of disclosing one’s sexual-minority identity
is not a one-time experience. Sexual minorities make
constant decisions about whether to disclose their
sexual-minority identity to specific individuals as
well as when and how to do so. Several explanations
for the negative consequences of concealing a
stigmatized identity have been proposed. For
instance, concealment can prevent sexual minorities
from identifying and affiliating with other sexual
minorities, which can reduce their access to support
and resources from the LGBTQ community. In
addition, the process of constantly monitoring one’s
behavior in an effort to avoid unintentionally
disclosing one’s sexual-minority identity or
behaving in ways that may be perceived as
stereotypical of sexual minorities places demands on
cognitive and emotional resources, which can lead to
mental health problems.
Extensions of Minority Stress Theory
Although minority stress theory was initially
proposed as a conceptual framework to understand
sexual minorities’ vulnerability to mental health
disparities, it has since been extended to the domains
of physical health and relationship functioning. For
instance, sexual minorities are at increased risk for
physical health problems compared with
heterosexuals, ranging from poor general health
status to cancer, cardiovascular disease, and
HIV/AIDS. Minority stress has been identified as a
risk factor for physical health problems, and
research has begun to focus on the specific
mechanisms responsible for this association. For
instance, sexual minorities may be reluctant to seek
medical care due to fear of discrimination, and the
resulting delay in treatment may exacerbate physical
health problems. Further, those who do seek medical
care may conceal their sexual orientation, which
could lead to inappropriate and ineffective treatment.
In regard to relationship functioning, sexual
minorities may experience unique challenges to their

relationship quality and functioning due to their
stigmatized status and the fact that they and their
partners may be ignored or rejected by family,
friends, and society. As a result, sexual minorities
may internalize negative messages about their
relationships as well as their sexual identity.
Notably, studies have found that sexual minorities
with higher levels of internalized homophobia report
decreased relationship quality. Furthermore, the
broader literature on stress and coping in couples
suggests that each partner’s unique experience of
minority stress may influence the other partner’s
mental health. For instance, if one partner is verbally
harassed or physically assaulted as a result of his or
her sexual orientation, it could increase the extent to
which the other partner fears that it could happen to
him or her or that it could happen to his or her
partner again.
Finally, recent advances in minority stress theory
have included novel operationalizations of minority
stress, particularly in regard to structural stigma.
Scholars have long recognized that stigma can
operate at the structural level. Structural stigma
refers to societal-level conditions, norms, and
institutional practices that constrain the opportunities
and resources for stigmatized populations. Sexual
minorities who live in areas with greater structural
stigma (e.g., states in which same-sex marriage had
been banned prior to the June 2015 Supreme Court
decision legalizing such marriages nationwide), or
communities with greater prejudicial attitudes
toward sexual minorities, have higher rates of
psychiatric disorders, higher rates of suicidality, and
earlier mortality than those living in areas with lower
structural stigma. Thus, stigma at various levels has
been identified as a robust risk factor for psychiatric
disorders.
Transgender Populations
As noted, minority stress theory was developed to
explain why sexual minorities are at increased risk
for psychiatric disorders. However, it is also well
documented that transgender individuals (i.e., those
whose birth-assigned sex is discordant with their
current psychological gender identity) are at
increased risk for psychiatric disorders relative to
cisgender individuals (i.e., those whose
birthassigned sex is concordant with their current
2163
gender identity). Further, transgender individuals
experience unique stressors associated with their
stigmatized social status as gender minorities,
including variations of the stressors previously
described for sexual minorities. Thus, researchers
have extended minority stress theory to explain why
transgender individuals are at increased risk for
psychiatric disorders. Transgender individuals
experience particularly high rates of discrimination
and violence and, as a result, they are at risk for
internalizing negative societal attitudes toward
gender nonconformity and for developing
heightened expectations of rejection due to their
genderminority identity. In addition, transgender
individuals experience additional stressors that
sexual minorities do not experience. For instance,
transgender individuals are often concerned with
whether or not others will perceive them as their
desired gender versus their birth-assigned sex. There
is some evidence that transgender individuals at the
beginning of their transition may experience more
anxiety than those at later stages of their transition,
which may be related to greater concern about
others’ perceptions of their gender at earlier stages
of their transition.
Brian A. Feinstein
See also Biphobia; Closet, The; Hate Crimes;
Heterosexism; Homophobia; Internalized
Homophobia; Microaggressions; Sexual Minorities
and Violence
Further
Readings
Budge, S. L., Adelson, J. L., & Howard, K. A. S. (2013).
Anxiety and depression in transgender individuals: The
roles of transition status, loss, social support, and coping.
Journal of Consulting and Clinical Psychology, 81, 545–
557.
Feinstein, B. A., Goldfried, M., & Davila, J. (2012). The
relationship between experiences of discrimination and
mental health among lesbians and gay men: An
examination of self-stigma and rejection sensitivity as
potential mechanisms. Journal of Consulting and
Clinical Psychology, 80, 917–927.
Hatzenbuehler, M. L. (2009). How does sexual minority
stigma “get under the skin”? A psychological mediation
framework. Psychological Bulletin, 135, 707–730.
Hatzenbuehler, M. L., McLaughlin, K. A., Keyes, K. M., &
Hasin, D. S. (2010). The impact of institutional
2164 Minority Stress
discrimination on psychiatric disorders in lesbian, gay, may arise from these mixed-orientation marriages.
and bisexual populations: A prospective study. The following section will explore the experiences
American Journal of Public Health, 100, 452–459.
of both members of the couple; next, the entry will
Meyer, I. (1995). Minority stress and mental health in gay
discuss the future of these relationships after
men. Journal of Health and Social Behavior, 36, 38–56.
disclosure; and lastly, it will examine the
Meyer, I. (2003). Prejudice, social stress, and mental
experiences of children conceived within these
health in LGB populations: Conceptual issues and
research evidence. Psychological Bulletin, 129,
relationships.
674–697.
Nadal, K. L. (2013). That’s so gay! Microaggressions and The Disclosing Spouse
the lesbian, gay, bisexual, and transgender community.
In the late 1980s and early 1990s, researchers
Washington, DC: American Psychological Association.
estimated that approximately 10% to 20% of gay
Mixed-Orientation Marriages
men had been married to women in the past. It is
also believed that the number of LGBQ people
Newcomb, M. E., & Mustanski, B. (2010). Internalized
homophobia and internalizing mental health problems: A
meta-analytic review. Clinical Psychology Review, 30,
1019–1029.
Pachankis, J. E., Goldfried, M. R., & Ramrattan, M. E.
(2008). Extension of the rejection sensitivity construct to
the interpersonal functioning of gay men. Journal of
Consulting and Clinical Psychology, 76, 306–317.

MIXED-ORIENTATION MARRIAGES

Mixed-orientation marriages are marriages between

individuals of differing sexual orientations. For
instance, in a mixed-orientation marriage, one
partner identifies as heterosexual and the other
identifies as lesbian, gay, bisexual, or queer
(LGBQ). In the United States, over 2 million
married couples have been or are currently in mixed-
orientation marriages. Some individuals enter
marriage aware of their partner’s sexual orientation,
some become aware as a result of a disclosure that
happened months or years into the marriage. In other
cases, the LGBQ partner does not disclose until after
the relationship has dissolved. Much of what we
know about mixed-orientation marriages has focused
on marriages of a presumed heterosexual couple
where one partner “comes out” or discloses his or
her sexual orientation as LGBQ. In addition, much
of this work has explored the experiences of
heterosexual women and their gay or bisexual male
partners (which will be specified when relevant).
This entry will examine the situations and issues that

Mixed-Orientation Marriages
entering mixed-orientation marriages will decrease
over time, owing to an increase in acceptance of
LGBQ people. Older LGBQ individuals who are
currently married tend to disclose their sexual
orientation much later than younger people. Some
LGBQ individuals get married to different-sex
partners completely unaware of their own sexual
orientation, because of psychological denial or not
being completely sure how they identify. Others have
had same-sex sexual experiences or have noticed
same-sex sexual attraction before getting married to
a different-sex partner. For still others, the realization
of their sexual orientation doesn’t occur until after
they are married to a different-sex partner. In one
study, about a third of gay men disclosed their sexual
interest or attraction prior to getting married, a third
during the marriage, and a third after the separation
or divorce.
Why do LGBQ people get married to differentsex
partners? For bisexual individuals, getting married to
a different-sex partner is not atypical, but many of
these individuals do not disclose their sexual
orientation prior to marriage. Bisexual men describe
wanting to marry a woman because they wished to
have a family, they were in love with their partner, or
they were hoping that the samesex feelings would go
away. Many bisexual men report experiencing long,
enduring monogamous relationships with a female
partner. Many gay men, on the other hand, list
society and family pressure, as well as wanting to
feel “normal,” as the most important reasons for
getting married. Although many report love for their
different-sex spouse, after the divorce or separation
some report the relationship as being more like a
close friendship. Experiences of homophobia and
negative views toward being LGBQ, especially due
to religious beliefs, are other factors that fuel the
decision to get married. Many gay men who marry
women are more homophobic at the time that they
got married than after their marriage dissolved,
suggesting that this homophobia may be related to
their own struggle regarding their sexual orientation.
What does the future look like for these
individuals? Of those who stay in mixed-orientation
marriages, bisexual men experience less life stress
than do married gay men. Among gay men, those
who stay married are less satisfied in their
relationships with their female partners, less likely to
2165
disclose their sexual orientation, and have more
sexual-identity difficulties, compared with those who
divorce and remain single or create new relationships
with male partners. For many of these men, it is
incredibly difficult to integrate their identities from
the past to current lives, assimilate into the LGBQ
community, and define the roles of both married to a
different-sex spouse and being an LGBQ person.
Spousal Response to Disclosure
Often when an LGBQ person discloses his or her
sexual orientation to a different-sex spouse, either
deliberately or accidentally, the LGBQ person has
had some time to process his or her identity. For the
heterosexual spouse in this situation, however, the
disclosure is often a surprise—and may be
devastating, even if the spouse was previously
suspicious about his or her partner’s sexual
orientation. Sexual rejection by a partner is the first
sign for many couples that something is wrong in the
marriage. After disclosure, betrayal is the most
common feeling experienced, but some spouses also
experience relief as a result of finally understanding
why the marriage was failing. There may be a sense
of rejection or sexual inadequacy (e.g., “if my
partner is LGBQ, he is saying he is not sexually
attracted to me, or I could not live up to my role as a
wife”). Depending on the spouse’s values or
religious beliefs, this disclosure often causes the
person to question his or her own belief system. In
some cases, the LGBQ individual’s disclosure
concerns not only the individual’s sexual identity,
but also his or her own sexual infidelity. These
incidences of infidelity raise concerns about the risk
of sexually transmitted infections for spouses, who
are often unaware of the extramarital affairs and
unprotected sex.
Researchers have attempted to explain what a
spouse may experience when a partner discloses his
or her sexual orientation. Many heterosexual spouses
in mixed-orientation marriages first go through a
stage of disbelief and denial following the disclosure.
After some time, the spouse may begin to
acknowledge the new reality of the romantic
relationship. The spouse may notice that the LGBQ
partner has a renewed sense of self, maybe even
changing his or her hair or clothing style, or
integrating himself or herself into the LGBQ
community. Feelings of anger and grief are often
2166
present during this time. Over time, this
acknowledgment may lead to acceptance of the
current situation. The spouse may begin to let go of
dreams and expectations of the relationship. This
often develops into a time of healing and
selfreflection. For the first time, the heterosexual
spouse begins thinking about his or her own
wellbeing and next steps. There comes a point where
one starts to reconfigure one’s own life, both for
oneself and for the marital relationship. Lastly, the
spouse begins to think about the future, with or
without the partner, and begins moving forward.
A spouse’s disclosure forces the partner to
contemplate how and when the person will disclose
his or her relationship situation to others. Until
recently, many spouses coped with this alone or with
little or no social support. However, this is changing.
Currently, there are more supports available for
individuals in mixed-orientation marriages than ever
before. The increase in societal acceptance of LGBQ
people has allowed for greater discussion and support
for heterosexual spouses in mixed-orientation
marriages. Peer support and therapy are beneficial
options to help people process their feelings and
determine the next steps in their lives.
The Future of the Relationships
After Disclosure
The individual context of the disclosure is
important (e.g., is the disclosure voluntary or
accidental? Does it include infidelity?). After
disclosure, the couple need to decide what is to be
the future course of their relationship. Many of these
couples have been married for quite a few years.
According to research conducted in the early 1990s,
immediately after disclosure about
Mixed-Orientation Marriages
one-third of the couples divorce or separate, about a
third remain together for a year or two, and the rest
try to figure out a way to make their relationship
work long-term. Of the couples who attempt to make
it work, about half divorce or separate within 3 years
after the disclosure. The major reasons why couples
attempt to save their marriage are the desire to keep
their family together and their love for their spouse.
The process of understanding and resolving issues
surrounding the marriage can vary in length for each
individual couple but on average, this process takes
about 3 years.
For the couples who decide to remain together, the
most important strategy for making the relationship
last is open and honest communication. The next
most important strategy for these couples is peer
support for both spouses. About half of these couples
seek counseling in an attempt to understand each
other’s experiences and figure out the best situation
for each member of the couple. Often, these couples
need to negotiate how the relationship will function
after the disclosure. Some couples choose to keep
their monogamous agreements, and some decide to
create some type of open relationship.
For couples who choose an open relationship,
some elect to be informed of relationships occurring
outside of the marriage and some do not.
Polyamorous relationships require trust, openness,
clear discussion, and negotiation. These
arrangements can be difficult due to the lack of social
support and societal approval surrounding polyamory
and open relationships. This can cause both members
of the couple to feel like they have to hide their
relationship and experiences from the outside world.
The biggest issue reported by couples in these
situations is the negative reactions from their families
of origin and from the LGBQ community. Little is
known about how these arrangements and marriages
fare long-term.
Children in the Context of a MixedOrientation
Relationship
The exact number of mixed-orientation marriages
that include children is unknown.
Mixed-Orientation Marriages
However, the majority of married heterosexual
couples have children, and there is no reason to
believe that this group would be much different.
Couples in mixed-orientation marriages who have
children are more likely to attempt to stay together
than those who do not have children. One of the most
common issues after disclosure is the decision to tell,
or not to tell, the children. Some children find out
accidentally, such as through reading e-mails
between a parent and a lover; some find out from one
or both of their parents; and some are not told at all.
The additional layer to this disclosure is that these

discussions often include talking about the parents’
separation and divorce.
Reactions vary depending on the child’s age at
disclosure and are unique for each child and
situation. Usually, it is the divorce, not the parent’s
sexual orientation, that causes children the most
emotional turmoil. As with any divorce, some
children feel abandoned or confused. Very young
children may not completely understand and usually
have a neutral-to-positive reaction. Some children
may be fearful that their peers will learn of the
family’s situation and will tease or make hurtful
antigay remarks. For an adolescent, this new
information may create personal feelings of
confusion about his or her own sexuality, identity,
and belief system. By adulthood, children have
typically resolved most of their negative feelings and
have learned to accept their parent as a human being,
however complex, and not simply in terms of sexual
orientation. Little is known about LGBQ parents in
mixed-orientation marriages, but one study found
that gay fathers in mixed-orientation marriages
experience similar levels of parenting-related stress
compared to men who separated from their wives
and remained single or had a relationship with a male
partner.
Conclusion
Mixed-orientation marriages are not a new
phenomenon. However, there is reason to believe
that the number of LGBQ people who are entering
different-sex marriages will decrease as a result of
the changes in social acceptance of LGBQ people.
Same-sex marriage is beginning to be seen as an
acceptable avenue to love, children, and a family.
With greater social acceptance of LGBQ people and
marriage between same-sex partners, there will be a
likely shift in how these marriages are created and
how they function over time. Mixedorientation
marriages can include intense emotions and an array
of different needs and personal feelings from both
members of the couple. Counselors, social workers,
and other professionals who work with these families
need to acknowledge the uniqueness of each family
and work with individuals to figure out the best
situation for everyone involved.
Samantha L. Tornello
See also Bisexuality, Female; Bisexuality, Male; LGBQ
Parents, Coming Out to Children; Monogamy and
2167
Non-Monogamy
Further Readings
Buxton, A. P. (1994). The other side of the closet: The
coming-out crisis for straight spouses and families.
New York, NY: Wiley.
Buxton, A. P. (2005). A family matter. Journal of GLBT
Family Studies, 1, 49–70.
Buxton, A. P. (2006). Counseling heterosexual spouses of
bisexual men and women and bisexual–heterosexual
couples: Affirmative approaches. Journal of Bisexuality,
6, 105–135.
Hernandez, B. C., Schwenke, N. J., & Wilson, C. M.
(2010). Spouses in mixed-orientation marriage: A 20-year
review of empirical studies. Journal of Marital and
Family Therapy, 37, 307–318.
Higgins, D. J. (2006). Same-sex attraction in heterosexually
partnered men: Reasons, rationales, and reflections.
Sexual and Relationship Therapy, 21, 217–228.
Malcolm, J. P. (2008). Hetoersexually married men who have
sex with men: Marital separation and psychological
adjustment. Journal of Sex Research, 45, 350–357.
Tornello, S. L., & Patterson, C. J. (2012). Gay fathers in
mixed-orientation relationships: Experiences of those who
stay in their marriage and of those who leave. Journal of
GLBT Family Studies, 8, 85–98.
MONOGAMY AND NON-MONOGAMY
This entry defines and provides examples of
monogamy and non-monogamy. Monogamy and
nonmonogamy are relationship formations that are
rooted in gendered and heterosexually imbued social
structures and institutions. Monogamy is the
exclusive sexual coupling of two individuals in a
long-term relationship.Non-monogamy is the practice
of an individual having multiple, concurrent sexual
partners. Marriage is a social mechanism that
distinguishes monogamy from non-monogamy.
Marriage as an institution and social norm provides
assumptions and relationship rules regarding
monogamy upon which to compare forms of
nonmonogamy such as cheating, hooking up,
polyamory, polygamy, and others.
2168
Construction of Monogamy Through
(Heterosexual) Marriage
Monogamy is defined as exclusive, dyadic sexual and
intimate coupling. Those who practice monogamy
sexually and emotionally commit to only one partner
over some period of time. The legal institution of
marriage requires monogamy as a central tenet.
However, monogamy is also important in exclusive-
coupled relationships in which marriage is not a part.
In Western culture, the typical sexual model is a
dyad, or two individuals in a committed relationship,
rather than multiple partners or sexually
nonpartnered individuals. Exclusive coupling is the
foundational organizational component of the
institution of marriage and nuclear family formation.
Monogamy is the taken-for-granted yet defining
characteristic of the institution of marriage, for it is
the grounds on which, if cheating occurs, a divorce
court decision can be made.
European predecessors and founders of the United
States defined monogamy as a religiously based
mode of controlling the sexuality of citizenry and
defined marriage as the means of harnessing sexual
desire. Normalizing marriage and monogamy assured
that families would form, creating more stable
economic foundations upon
Monogamy and Non-Monogamy
which to procreate. Reproducing the heterosexual
structure of the family assured (at least theoreti-
cally) that women and children were cared for and
that the workforce would be reproduced. Further,
structuring the family in this way (again,
theoretically) assured bloodlines and kinship for the
generational production, reproduction, and passage
of wealth.
Construction of Non-Monogamies
Non-monogamies are generally socially constructed
as deviant in relation to monogamy. Importantly,
however, Western culture dictates that individuals
pass through a life stage in which it is appropriate to
date. Being single and dating, although a form of
non-monogamy, is constructed as a normal stage of
the life course in which one searches for a
marriageable partner. Only when the individual
violates some norm of dating does “dating” become
deviant. Non-monogamies come in many forms and
function in different ways. Some forms of non-
monogamy include marriage. Despite the social
construction of monogamy as a single dyadic
relationship rooted in marriage, all marriage does not
specifically entail monogamy.
Cheating/Infidelity
Cheating occurs when individuals secretly pursue
relationships outside of the primary, dyadic,
monogamous relationship. Cheating is defined as
any sexual behavior that is not made public in the
dyadic relationship and would be met with
disapproval by one’s partner. This includes kissing
and touching as well as outside sexual-emotional
contact.
It is important to delineate between cheating and
infidelity. Cheating suggests that the partners in the
primary relationship are not married; instead, they
are monogamous in their long-term, committed
relationship. Infidelity, then, is a term used to show
that an individual is married. In cases of legal
divorce proceedings, infidelity in the marital
relationship can be used to call the validity of the
marriage into question, to determine parental
competence and moral aptitude in final court
judgments.
Monogamy and Non-Monogamy
Scholars in the area of cheating and infidelity use
and critique the 19th-century notion that men,
generally, have a furious sex drive that must be
contained and restrained. In other words, men must
fight the urge to “spread their seed” because the rule
of marriage and monogamy is the norm according to
religious and governmental institutions. Feminist
critiques of this naturalized account of men’s
sexuality reveal that institutional valuation of men’s
sexuality is a means of social control and is, thus,
socially constructed to reflect the social values of
those in power: religious figures and governmental
bodies. Institutions that naturalize men’s “wild
sexual urges” take for granted the ways in which men
are socialized to harness their sexuality and dismiss
women’s sexuality. Outcomes of this sexual
inequality make women subordinate to men in the
sex act and devalue women’s sexual agency.
Further, scholars state that it is difficult to
interpret research findings on rates of cheating and
infidelity in relationships because measurement
 2169
varies widely from study to study. For example, Polyamory
some studies define and measure cheating/infidelity
Polyamory is defined as an intimate relationship
as all intimate touch (kissing, petting, and the sex
form in which one has multiple, long-term,
act), while others define and measure cheating/
simultaneous, loving, sexual partnerships. The
infidelity as only the sex act. To complicate matters
relationship configuration is open and clearly
further, the addition of online cheating and infidelity
communicated to all involved individuals.
tends to be a variable that is measured and defined in
Polyamory need not involve marriage, although
multiple and inconsistent ways. Because online
married couples too participate in polyamory. Many
relationships take place in a different context from
times, “swinging” and polyamory are conflated.
face-to-face relationships, research studies have had
Swinging is the non-monogamous practice of having
to look more closely at the emotional dimension
multiple sexual partners specifically to engage in sex
(rather than simply rates) of cheating and infidelity.
acts. In contrast to this, polyamory is the non-
Overall, and most importantly, research shows that
monogamous practice of engaging in longterm,
cheating and infidelity remain prevalent and rather
simultaneous, intimate relationships that may or may
commonplace in Western culture.
not include sex.
Fidelity, jealousy, and equal time given to each
Singles/Dating/Hooking Up partner are concerns for polyamorous individuals.
Commitment to multiple partners, while described as
Scholars in the area of singlehood, dating, and
fulfilling, nurturing, and loving, can be difficult to
hookups find that there have been cultural shifts in
maintain. Further, because polyamory distorts norms
the norms around teenage dating and time spent in
of relationship and family formation, the practice is
relationships before marriage over the last century.
policed and persecuted. Polyamorous families have
Premarital, monogamous, heterosexual coupling of
found themselves in dire straits in the courtroom. The
the 1950s variety has been supplanted by a culture of
“deviant” family form has been cited as amoral and
hookups. Hookup culture allows for multiple sexual
an unethical site to raise children despite children’s
partners without the commitment. Hookups are, thus,
access to multiple loving adults for guidance.
defined as casual sexual encounters. Hooking up is
Subsequently, children have been removed from
viewed as a temporary alternative to one’s
polyamorous families.
participation in marriage/ monogamy culture.
Research on polyamorous relationships and
Currently, hookups seem to be the primary form
families focuses on relationship dynamics of
of intimate interaction among college students.
polyamorous people, relationship satisfaction, and
Studies point to college campuses as spaces in which
family formation. Because polyamorous individuals
hookup culture is regularly practiced. These
engage in emotional attachment differently, and
encounters often include large amounts of alcohol
perhaps more regularly, than their monogamous
consumed and close contact with many people.
peers, research interest in multiple attraction and
Social events like clubbing or partying tend to be the
attachment among polyamorous triads (three or more
primary means to meet potential hookup partners.
people in the relationship), quads (four or more
Research suggests that all individuals do not
people in the relationship), and more is on the rise. In
participate in hookup culture equally. Participation in
addition, questions about jealousy and relationship
hookup culture varies by gender, social class/ status,
satisfaction tend to come up in these studies.
race, sexuality, and other social phenomena. For
Similarly, studies on families formed around and
some, hooking up is advantageous because of the
by polyamorous individuals have become more
little time commitment and patience it requires
visible. Polyamory persists despite the fact that it is
compared to a dyadic, long-term, monogamous
not a legal family form. Studies have found that
relationship. For others, moral and ethical concerns
children thrive in such family forms, despite social
sometimes rooted in religious beliefs trump the
pressures to conform. Children in polyamorous
appeal of hookup culture. These individuals prefer to
families tend to have more adult figures in their lives
find companions who are equally committed to a
upon which to rely. This structure makes the child
long-term, monogamous relationship.
feel nurtured and cared for while simultaneously
spreading parental duties over more individuals.
2170
However, the cushion of home cannot prevent what
the child faces outside of the home when others are
made aware of the unusual family form. Bullying and
teasing and other threats of violence are concerns
that arise for children in polyamorous families.
Polygamy/Polygyny/Polyandry
Polygamy is a broad term to refer to one person who
has multiple spouses. The language used in the
definition is specific to married individuals and is
rooted in religious doctrine. Therefore, most LGBTQ
individuals are excluded from these practices. To
have a nonheterosexual identity is considered
unacceptable by the religions considered here. The
most visible form of polygamy is polygyny, or one
man married to multiple wives. However,
Monogamy and Non-Monogamy
polygyny as a family formation is only one global
example of religion-based non-monogamies.
Polygyny is rooted in teachings of the Latterday
Saints (LDS) or Mormons, and is the principle upon
which the Church was founded in the United States.
Joseph Smith (1805–1844), the church’s founder,
believed that it was incumbent on the LDS man to
marry many women. It was, thus, his job to care for
the women economically and to form families on this
basis. The LDS Church has experienced a waxing
and waning of polygamous practice. However, an
internal division over this practice initiated a break
from the LDS by those more orthodox who wanted to
continue to practice polygyny. Thus, the current form
of the Fundamentalist Church of Jesus Christ of
Latter-day Saints (FLDS) was born. Contemporary
FLDS groups have come under fire for continuing to
practice polygyny. Specifically, the practice of young
females marrying older males has been the focus.
Polyandry, the practice of one woman having
multiple husbands or male partners primarily found
in traditional matriarchal societies such as the Mosuo
of Western China, is a relationship formation found
less often.
Research on polygamy/polygyny tends to have a
global focus, though there is a dearth of research on
the U.S.-based form of polygyny in Mormonism.
Mormon polygyny, while illegal in the United States,
continues to thrive through the FLDS Church.
Polygyny has recently been made visible in Western
popular culture with cable television shows like
Home Box Office’s (HBO’s) Big Love and The
Learning Channel’s (TLC’s) Sister Wives. In areas of
the world such as South Africa and Muslim-
identified counties in the Middle East, polygyny is a
lawful religious practice. While Western feminists
have often critiqued polygyny as
oppressive to women, some have now stated that in
countries where women are economically and
socially disadvantaged, polygyny might prove useful
for social mobility and to defend against HIV/AIDS.
Alison Rose Moss
See also Divorce, Legal Issues in; Divorce and Separation,
Historical Perspective on; Families of Choice;
Marriage, Reason for and Against; Monosexism;
Polyamorous Parenting; Polyamory
Monosexism
Further Readings
Anderson, E. (2013). The monogamy gap: Men, love, and the
reality of cheating. New York, NY: Oxford University
Press.
Barker, M., & Langdridge, D. (2010). Understanding
nonmonogamies. New York, NY: Routledge.
Barlow, P. L., & Mariano, S. (2014, Fall). Marriage is
always complicated in Utah. Religion in the News,
12–14.
Cott, N. F. (2002). Public vows: A history of marriage and
the nation. Cambridge, MA: Harvard University Press.
England, P., & Ronen, S. (2013). Sex and relationships
among youth: An intersectional gender lens.
Contemporary Sociology, 42, 503–513.
Hamilton, L., & Armstrong, E. L. (2009). Gendered
sexuality in young adulthood: Double binds and
flawed options. Gender & Society, 23(5), 589–616.
Moss, A. R. (2012). Alternative families, alternative lives:
Married women doing bisexuality. Journal of GLBT
Family Studies, 8, 405–417.
Rubin, G. (1975). The traffic in women: Notes on the
“political economy” of sex. In R. Reiter (Ed.), Toward an
anthropology of women (pp. 157–210). New York, NY:
Monthly Review Press.
Schippers, M. (in press). Polyqueer: Compulsory monogamy
and the queer potential of plural sexualities. New York,
NY: New York University Press.
Sheff, E. (2014). The polyamorists next door: Inside multiple-
partner relationships and families. Lanham, MD:
Rowman & Littlefield.
Stacey, J. (2011). Unhitched: Love, marriage, and family
values from West Hollywood to Western China. New
York, NY: New York University Press.

Vassi, M. (1997). Beyond bisexuality. In C. Queen,
L. Schimel, & K. Bornstein (Eds.), Pomosexuals:
Challenging assumptions about gender and sexuality
(pp. 70–75). San Francisco, CA: Cleis Press.
MONOSEXISM
Monosexism is a social structure operating through a
presumption that everyone is, or should be,
monosexual (attracted to no more than one gender).
This system includes institutional and social rewards
for monosexual people, and oppression against
bisexual people and others who are attracted to more
than one gender. The term monosexism is used in
order to address and define oppression of bisexual
people as institutional and systematic rather than as
personalized and individual, and to define broad
trends rather than specific attitudes. Monosexism as a
structure creates multiple and varied effects over
bisexuality and bisexual people, including bisexual
erasure and multiple disparities between bisexual and
monosexual people.
Difference From Biphobia
As opposed to the term biphobia, which mainly
describes personalized attitudes and behaviors aimed
against bisexual people, monosexism describes a
broad social structure. Discussions of biphobia
generally address direct negative attitudes or
treatment of bisexual people, including stereotyping,
rejection, discrimination, negative representation in
the media, and so on. Monosexism, on the other
hand, describes the base structure that enables these
attitudes to take place, meaning that biphobia is only
one form of monosexism. On the other hand,
monosexism addresses multiple factors that are not
necessarily directly or explicitly aimed against
bisexuality or bisexual people, but nonetheless have
the effect of eradicating their existence or legitimacy.
These prominently include bisexual erasure and the
privileging of monosexual identities and behaviors.
Bisexual Erasure
Bisexual erasure is the widespread social
phenomenon of erasing bisexuality from discussions
2171
in which it is relevant or is otherwise invoked (with
or without being named). It is characterized by,
among other things, a lack of representations, lack of
communities, lack of awareness, lack of discussion,
and lack of acknowledgment—all derived from the
presumption that bisexuality does not, and cannot,
exist. The fields in which bisexual erasure takes
place are broad and varied, including the media;
literature; history; academia; and most medical,
psychological, and sexual discourses.
Bisexual erasure is present in multiple spheres,
including the public/cultural sphere, the social/
community sphere, and the private sphere. In the
public and cultural spheres, bisexual erasure is
mainly characterized by a lack of representation. For
example, according to a study made by the UK
organization Stonewall, out of 126 hours of British
television examined, only 5 minutes and 9 seconds
were devoted to depicting bisexual characters. In a
U.S. study by psychologist Gregory Herek,
heterosexual research participants stated that—with
the exception of intravenous drug users—bisexuals
were the group that they felt most negatively about.
In the social/community sphere, bisexual people
are generally believed to be either straight or gay/
lesbian, and bisexual issues and people are often left
unaddressed. Many bi people experience pressure to
change their identity to anything other than bisexual
(usually gay, lesbian, or straight), and experience
social isolation in both heterosexual and lesbian and
gay communities.
In the private sphere, upon coming out as
bisexual, bi people’s families and other close people
often presume that they are in fact heterosexual, gay,
or lesbian (depending on the situation), and continue
to pressure them to “choose” heteronormativity.
American legal scholar Kenji Yoshino identified
three types of bisexual erasure: categorical erasure,
individual erasure, and delegitimization. Categorical
erasure refers to the erasure of bisexuality as a
category. For example, in 2005, U.S. researcher
Michael Bailey published a study reported in the
New York Times under the headline “Gay, Straight,
or Lying.” According to this study, bisexual men did
not exist. As another example, in American theorist
Judith Butler’s theory of gender melancholia,
heterosexuality and homosexuality are both
manifested by rejection of one another, leaving no
room for a possibility of bisexuality. Individual
erasure occurs when bisexuality as a category is
2172
acknowledged but, at the same time, the bisexuality
of a particular person is denied. For example, UK
scholar Kate Chedgzoy has shown that many
Shakespeare scholars attempt to deny the bisexuality
evident in his sonnets and to instead read them
Monosexism
as heterosexual. As another example, American
scholar Terry Castle’s film research names 1920s
film star Greta Garbo as a lesbian, even after
mentioning that Garbo desired men as well as
women. Finally, delegitimation occurs when
negative meanings are attributed to bisexuality and
bisexual people. This is mainly done by stereotyping,
as characteristics are attributed to bisexual people
that are socially perceived as negative. For example,
in heterosexual discourses, bisexual people are often
described as promiscuous, treacherous, or as vectors
of STIs. In gay and lesbian discourses, bisexual
people are often described as closet cases, fence-
sitters, or traitors to the community.
Effects of Monosexism
Due to its structural nature, monosexism negatively
affects the lives of bisexual people and others who
are attracted to more than one gender. This can be
observed through research about bisexual people that
shows various disparities with other groups. For
example, in the United States: • Over 40% of bisexual
people have considered suicide, compared with 8.5% of
straight people and 27% of gay people.
• Nearly 50% of bisexual women are survivors of
rape, compared with 17% of straight women and
13% of lesbians.
• Nearly 45% of bisexual youth have been bullied on
the Internet, compared with 19% of straight youth
and 30% of gay youth.
• More than 1 in 4 bisexual people (27.6%) live in
poverty, compared with 18.2% of straight people
and 21.6% of gay people.
• About 1 in 4 bisexual people (25%) receives food
stamps, compared to 15% of straight people and
14% of gay people. Nearly half of African American
bisexuals (47%) and 39% of multiracial bisexuals
receive food stamps.
• More than 1 in 5 bisexual people (22%) suffer from
poor health, compared with 9.7% of straight people
and 9.8% of gay people.
• In the United Kingdom, 55% of bisexual people are
not out at work, compared with 8% of gay men and
6% of lesbians.
Monosexism
Moreover, in the years 2008 and 2009, out of over
$200 million given by U.S. foundations to lesbian,
gay, bisexual, and transgender (LGBT) organizations
as grants, no money went toward bisexual-specific
organizations or projects.
Intersections
Monosexism intersects with other oppressive social
structures, such as misogyny, cis-sexism, and racism.
These intersections create unique influences over
bisexual women, transgender people, and people of
color, for example. The fact that bisexual people are
disproportionately women, trans people, and people
of color is also of note.
Sapphobia
Sapphobia is a word coined by bisexual blogger
mercurialvixen, denoting the intersection of
misogyny and monosexism. This concept is helpful
in discussing and defining bi women’s particular
experience of monosexism and misogyny, as
separate from bi people of other genders, as well as
from women of other sexual identities.
One of the central ways in which sapphobia works
is through the sexual objectification of bisexual
women, as they are often perceived or presented as
hypersexual, mainly as part of cisgender straight
male fantasy (for example, as part of threesomes).
This widespread trend of objectification generates a
great deal of sexual and intimate violence against
bisexual women. As a recent U.S. government study
has found, bisexual women are far likelier than
monosexual women to have experienced rape
(almost 50% of bi women), sexual assault (75%), and
intimate partner violence (61%). Further, bisexual
women are often blamed for the violence aimed
against them, using the same type of problematic
discourse. Accusers suggest that bisexual women are
more vulnerable to sexual violence because they are
more “sexually available” to men.

Bisexual women’s unique circumstances also
show in statistical findings (from the United States),
which indicate that bisexual women are at higher risk
than monosexual people as well as bisexual men:
• An estimated 45% of bisexual women have reported
suicidality.
• Bisexual women are significantly more likely to
experience depression and anxiety.
• Bisexual women are significantly more likely to be
in poverty.
• Almost 1 in 3 (28%) bisexual women receives food
stamps.
• In the UK, 1 in 3 (31%) bisexual women suffers
from poor health.
• Bisexual women report the lowest levels of social
support.
Monosexism and Cis-sexism
Cis-sexism is the social system according to which
everyone is, or should be, cisgender (identifying as
the gender they were assigned at birth). This system
includes the privileging of those who are cisgender,
and social punishment for transgender people. The
intersection between cis-sexism and monosexism
negatively impacts bisexual transgender individuals.
One of the central intersections between
monosexism and cis-sexism is that of erasure.
Bisexual trans people suffer from double erasure, as
both bisexual and transgender. Not only are
bisexuality and transgender erased in culture and
society separately, but they are also erased in
combination, as the particular existence of bisexual
trans people is symbolically obliterated. This
happens on all levels discussed above, including the
public/cultural sphere, the social/community sphere,
and the private sphere. In addition, this happens on
all three levels of categorical erasure, individual
erasure, and delegitimation. In these cases, bi
people’s difficulty in receiving social
acknowledgment or validation of their identities is
exacerbated by the additional difficulty of cis-sexism
and trans erasure.
It is important to note that bisexual trans people
not only face erasure in the context of straight
culture, but must also contend with it in LGBTQ
communities. Within gay and lesbian communities,
both bisexual and transgender erasure is widespread,
meaning that the existence of bi trans people is rarely
2173
acknowledged. Transgender erasure is also present in
bisexual communities, while bisexual erasure is
present in transgender communities. Another way in
which bisexual trans people are erased is via the
accusation that the bisexual identity promotes the
gender binary (the idea that there are only two
opposing genders— woman and man). This
argument erases the existence of bisexual trans
people in particular.
Due to this very erasure, little to no statistical
research exists about bisexual trans people. However,
it should be noted that trans people are one of the
most vulnerable populations within LGBTQ
communities, showing extreme disparities in
comparison with cisgender people (including lesbian,
gay, and bisexual [LGB] people who are cisgender).
Combined with the significant disparities between
bisexual and monosexual people, it might be inferred
that transgender bisexual people face unique
disparities as a distinct population. However, more
research is needed in this area.
Monosexism and Racism
Bisexual people of color often experience a
combination of monosexism and racism, which
negatively impacts their well-being. Like bisexual
trans people, bi people of color suffer from cultural
erasure and exclusion, finding little representation or
acknowledgment within straight culture or within
particular communities. Many report having to
contend with biphobia within communities of color,
and with racism in LGBTQ communities.
Another prominent way in which this intersection
works is through the exacerbation of racial
stereotypes via biphobia. For example, both bisexual
people and people of color are often stereotyped as
hypersexual, as having a “wild” sexuality, or as
sexual predators. Bisexual women of color
experience a combination of racism and sapphobia
that constructs them as exotified sexual fetishes,
while bisexual men of color are often imagined as
sexual predators or as vectors of sexually transmitted
infections (STIs).
Due to the erasure of this group, little statistical
information is available regarding it. However, a
recent study regarding food insecurity (i.e., limited
Monosexism
2174
access to adequate food) among U.S. LGBTQ people
shows that bisexual people of color are significantly
more vulnerable to it, compared both with White
bisexual people and with monosexual people of
color.
Gay and Lesbian People’s Complicity in
Monosexism
Though monosexism is a structure that is based in,
and originates from, heterosexism and straight
culture, gay and lesbian people are often complicit in
enacting it. Bisexual people report high levels of
biphobic treatment within gay and lesbian
communities, including erasure, hostility, rejection,
and even verbal and physical violence. Indeed, many
bisexual activists and researchers theorize that the
disparities between bisexual and monosexual people
are partially caused by lack of resources devoted to
bisexuality within LGBTQ communities.
The broadest form of monosexism in gay and
lesbian communities is the notion that bisexuality
either doesn’t really exist, or is not valid as a sexual
identity. As a result, bisexual people are broadly
erased in gay and lesbian communities or have their
identities invalidated. In addition, bisexual people are
often stereotyped by gay and lesbian people as being
either “really gay” or “really straight,” as being
indecisive, or as going through a phase. Since many
bisexual people come out to gay and lesbian
communities looking for support around their
sexuality, this negatively impacts their mental health
and general well-being.
Shiri Eisner
See also Biphobia; Bisexual Inclusion in the LGBTQ Rights
Movement; Bisexuality, Female; Cisgenderism;
Gender Binaries; Heteronormativity; Heterosexism;
LGBTQ People of Color
Further Readings
Barker, M., Richards, C., Jones, R., Bowes-Catton, H., &
Plowman, T. (2012). The bisexuality report: Bisexual
inclusion in LGBT equality and diversity. Milton Keynes,
England: The Open University.
Morality and Respectability
Eisner, S. (2013). Bi: Notes for a bisexual revolution.
Berkeley, CA: Seal Press.
Ulrich, L. (2011). Bisexual invisibility: Impacts and
recommendations. San Francisco, CA: San Francisco
Human Rights Commission LGBT Advisory Committee.
Yoshino, K. (2000). The epistemic contract of bisexual
erasure. Stanford Law Review, 52(2), 353–461.
MORALITY AND RESPECTABILITY
The notion of morality encapsulates ideas of how
positive or negative value judgments are assigned to
particular sexual behaviors. These judgments are
then used to label individuals as moral or immoral.
The idea of “respectability” emerges when
individuals conform to behaviors that are attached to
positive value judgments. In order for behaviors to
have positive or negative value judgments, a society
has to declare these behaviors as either moral or
immoral. Sexual morality in contemporary Western
society has largely been shaped by Judeo-Christian
values of purity and chastity. As a result,
homosexuality, declared as impure and lustful, was
marginalized and categorized as
“immoral.”
The United States was heavily influenced by its
early Puritan settlers. Much of Puritan ideals of
sexuality derived from biblical interpretations. This
included maintaining virginity until marriage.
Likewise, procreative heterosexuality was valued as
the only acceptable form of sexual behavior, for it
was perceived that the sole purpose of sex was to
beget children. These sexual ideals extended beyond
the purview of sex itself and into gendered behaviors.
Women were expected to demonstrate modesty,
fragility, and subservience to men. Men were also
expected to be modest, but they had to take a
sexually assertive role in procreation. Any deviation
from this system meant that the individual was
sexually deviant, and thus a sinner. There was, then,
a link between theological values and the values
imposed on the behaviors of the Puritans.
What was sexually moral was eventually tied to
ideas of being sexually natural. With an emphasis on
heterosexual, procreative sexuality, sexual morality
was codified into biomedical understandings of
human behavior. During the 19th century,
biomedicine became a dominant institution that was
used to explain human behavior. These explanations
of human behavior rested on anatomy, psychology,
 2175
and biology. For example, according to theories of
evolution, humans naturally procreate in order to
perpetuate the human species. Thus, behaviors such
as those associated with heterosexuality become
normalized and naturalized. Consequently, as these
behaviors became characteristic of “normal” sexual
behavior, heterosexuality became morally
acceptable. Conversely, homosexuality was seen as
pathological and therefore morally unacceptable.
Also during the 19th century, women were declared
“frigid” if they did not engage in heterosexual
relations. Frigidity meant that women had a
psychological disorder in which they were not
aroused by men. This label pathologized lesbian
sexuality and was placed on women who were older,
unmarried, performed nontraditional female gender
roles, or found other women sexually attractive.
With the expansion of sexual morality into the
purview of biological and psychological sciences, it
became tied to issues of health and illness. For
example, those infected with HIV tend to face
stigma. This stigma has two layers. HIV is seen as a
“marker” that connotes that an individual committed
the perceived immoral act of engaging in an
unprotected, same-sex—or, to a lesser extent,
opposite-sex—penetrative sexual act. The second
layer of stigma arises out of a rationalist tradition in
Western society, in which the individual is blamed
for an act that is considered socially deviant. Thus,
certain diseases can mark individuals— in this case,
gay men—for committing acts that are interwoven
with sexual moral systems.
In addition to the social processes that inculcated
sexual norms into Western society, other social
processes, as noted by the anthropologist Gayle
Rubin, explain how communities produce sexually
moral/immoral behaviors. Within particular
communities, sexual morality is also tied to concepts
of social control. A moral panic occurs when an
individual engages in what is considered to be
unacceptable behavior that is believed to harm one’s
community. In the case of sexuality, the community
attaches value to particular sexual
2176
identities/practices, which are then privileged within
communities. Sexual identities/practices that fall
outside of those that are privileged (such as
homosexuality) are publicly condemned. Some
societal institutions may use the media to portray
sexually unprivileged identities/practices in a
negative light. This then elicits various forms of
public disapproval and hostility that define and
reassert the boundaries between sexually privileged
and unprivileged identities/practices. Sometimes,
moral panics are solidified in terms of sex laws that
outlaw certain sexual identities and practices. When
individuals break said laws, they face public scorn
and harsh legal sanctions. Thus, moral panics are
used to attach a moral significance to sexual
behaviors and identities and define boundaries of
morally acceptable/unacceptable behaviors.
Sexual morality intertwines with other social
factors such as gender and race. Women are often
held to higher standards of sexual chastity than those
for men. Furthermore, sexual stereotypes of race
intertwine with notions of gender. For example,
White women have been seen as sexually pure,
whereas women of color (e.g., Black, Latina, or
Asian women) have been eroticized. As eroticized
objects, they are then seen as being sexually
promiscuous. This then complicates how women in
communities of color are held to different standards
of sexual morality, which can be seen in the
stereotyping of Latina and Black women as
hypersexual sex objects. This stereotype is reinforced
through various discourses in various institutions,
such as the
media, education, and family. For instance, in the
media, Black women have often been depicted as
hypersexual through emphasis of certain physical
signifiers such as the breasts and buttocks. In
addition, depictions of women of color’s sexual
behavior are also used to mark them as hypersexual
objects. Latina women, for example, are often
portrayed as sexually aggressive. At the same time,
although some women of color are painted as
hypersexual, other women of color (e.g., Asian
women) are depicted as submissive and docile
compared with their White counterparts. Whether
depicted as hypersexual or sexually submissive,
women of color face additional sanctions because
they are perceived to have violated “moral codes”
established by their White counterparts. This then
means that sexual morality exists not only as a tool
of social control but also as a tool that maintains
preexisting social hierarchies such as those found in
the case of both sexuality and gender.
Angelique Harris and Omar Mushtaq
See also HIV/AIDS and Gay Masculinity; HIV/AIDS and
Racial/Ethnic Disparities; HIV/AIDS in Prison;
Intersections Between Sex, Gender, and Sexual Identity;
Queer Politics; Religious Identity and Sexuality,
Reconciliation of; Sexual Norms and Practices
Further Readings
Plummer, K. (1995). Telling sexual stories: Power, change,
and social worlds. London, England: Routledge.
Rose, J. (2005). Sexuality in the field of vision (Vol. 9).
London, England: Verso.
Rubin, G. (1993). Thinking sex: Notes for a radical theory of
the politics of sexuality. In L. Kauffman (Ed.), American
feminist thought at a century’s end:
A reader (pp. 3–64). Oxford, England: Blackwell.
Vance, C. S. (Ed.). (1984). Pleasure and danger: Exploring
female sexuality. London, England: Routledge & Kegan
Paul.
MSM
See Men Who Have Sex With Men (MSM)
MULTIRACIAL LGBTQ-PARENT
FAMILIES
Multiracial families are increasingly common in the
United States. In the context of heterosexualparent
families, the term multiracial families often refers to
interracial couples and their multiracial children, or
to transracial adoptive families. For most LGBTQ
couples, neither parent is biologically related to the
child, as is the case with adoption, or only one parent
is biologically related to the child (through donor
insemination or surrogacy, or from a previous
heterosexual relationship). LGBTQ-parent families
are diverse in both family structure and racial
identification, and their

Multiracial LGBTQ-Parent Families
child’s racial identity might not be a product of their
own racial identities. In this entry, the term
multiracial LGBTQ-parent families refers to families
in which LGBTQ parents have children with
different racial identities from at least one parent.
Multiracial LGBTQ-parent families encounter
unique experiences in which sexual orientation
intersects with race, gender, and family structure.
This entry will address the construction of identity
within multiracial LGBTQ-parent families, the types
of challenges that these families often encounter, and
the unique strengths of these families.
The Construction of Identity
Multiracial LGBTQ-parent families hold multiple
minority statuses on account of their family
structure, diverse racial heritage, and parental sexual
orientation. For multiracial LGBTQ-parent families,
being grouped outside of multiple normative
structures can add complexity to identity formation.
Within the family unit itself, identity is diverse. A
child’s racial identity might be similar to one
parent’s identity, to aspects of both parents’
identities, or to neither parent’s identity, and the
child’s identity might be very different from his or
her siblings or extended family. How these children
emphasize or prioritize different aspects of identity
can change over time and across context. In a
racially diverse setting, a multiracial teenager might
feel proud of his or her racial heritage but hesitant to
disclose his or her parents’ sexual orientation. Yet at
an event for children with gay parents, where he or
she is one of few racial minorities, he or she might
feel more comfortable disclosing sexual orientation
than racial identity. As another example, a
transracially adopted individual might not view race
as a salient aspect of identity until he or she
encounters racism at school or begins to connect
with others who share his or her racial heritage.
The Social Construction of Race
Racial-identity formation is a complex process
that involves many factors related to culture, social
class, skin color, and power dynamics. Although the
term race is used to group individuals according to
genetics, it is now commonly believed to be a
Multiracial LGBTQ-Parent Families 2177
socially constructed concept. People are assigned to
racial categories based on their appearance, culture,
and ethnicity, yet these categories are often
adjustable. For example, President Barack Obama is
often referred to as the United States’ first Black
president, but because he has a White mother and a
Black father, some people categorize him as biracial.
One’s self-identification may not be the same as how
others identify the person. A family or individual
who moves to the United States from Peru, for
example, might identify as Peruvian, only to be
categorized as “Latino” upon entrance to the United
States.
Racial-Identity Socialization
When children have different racial identities
from their parents, they must build a racial identity
and learn to navigate racism without a parental role
model. Typically, in monoracial-minority families,
the parents can teach their children how to cope with
discrimination based on personal experience, and
they can model a positive racial identity for their
children. However, parents in multiracial families
face the challenge of going beyond personal
experience to foster a healthy, positive racial identity
in their children. Although they might not have had
personal experiences with racism, some research
suggests that LGBTQ parents are in a position to
facilitate ongoing communication with their children
about issues related to racial tensions; power
dynamics; and discrimination based on skin color,
ethnicity, and culture.
Research on racial-identity formation in
multiracial families indicates that it is important for
parents to strive for cultural competency—that is, to
feel comfortable talking with their children about
racial identity and differences, and to understand
both what they can offer and what their limitations
are. With regard to research on the latter, parents
have been found to turn to their broader communities
for assistance in modeling positive racial identities
and facilitating connections to their children’s culture
of origin. For example, when they are choosing
where to settle geographically, parents often consider
the diversity of the neighborhood and local schools,
access to cultural events, and availability of family
and friends who share their children’s racial heritage.
LGBTQ parents are also faced with helping their
children to form a positive attitude about their
identity as an LGBTQ-parent family. In addition to
2178
locating access to multiracial communities, then,
many parents have found it important for themselves
and for the children to have connections to other
LGBTQ-parent families, thus taking into account
how LGBTQ-“friendly” a particular area or
community is.
Among both heterosexual and LGBTQ parents,
research suggests that some parents choose to take a
“color blind” approach to race, believing that race
does not matter and emphasizing that their child is
not different from them (e.g., that their child is not a
person of color, but simply a person). Although these
parents usually have good intentions, researchers,
clinicians, and theorists argue that it is preferable for
parents to take a “color conscious” approach to racial
issues. Instead of ignoring differences, research has
found that it is more beneficial for parents to
proactively address issues of both race and sexual
orientation by engaging their children in difficult
discussions, encouraging them to ask questions,
seeking guidance from others, and communicating
openness to understanding their child’s experiences.
Challenges Faced by Multiracial LGBTQ-
Parent Families
Multiracial LGBTQ-parent families are marked as
“different” on account of their multiracial status,
their LGBTQ status, and their atypical family
structure (in that the children might not be
biologically related to one or both parents). LGBTQ
parents face the task of fostering a positive attitude
about their sexual orientation, their children’s racial
identity, and their family structure. Such a task can
become complicated because multiracial LGBTQ-
parent families are also vulnerable to discrimination
on account of their multiple minority identities.
Some research highlights that, given their personal
experiences as members of same-sex couples,
lesbian, gay, bisexual, and queer (LGBQ) parents are
often aware of the need to prepare their children for
prejudice they are likely to encounter, and to
confront issues related to sexual orientation as they
arise. In addition, research has revealed some unique
challenges that specifically emerge from the
intersection of the family’s LGBTQ and multiracial
identities.
Challenges Within the Family
Multiracial LGBTQ-parent families have unique
experiences within the family, in that they must
navigate potential differences with each other as well
as with extended family members. Research on
multiracial families has demonstrated that challenges
can arise when one parent identifies more with the
children (or vice versa) based on a shared racial
background or identity, leading to tensions or
imbalance within the family. In some families, a
child will automatically feel more connected to one
parent’s racial identity if he or she grows up in an
environment that is dominated by members of that
parent’s race. For example, a biracial child living in a
predominantly White neighborhood might identify
more with his or her White peers, his or her White
parent, and his or her White heritage than with his or
her non-White parent and his or her own non-White
heritage. Complications can arise with regard to skin
color as well; although a child might phenotypically
resemble one parent, he or she might identify more
with the other parent’s racial heritage. On the other
hand, for multiracial children who share aspects of
racial heritage with both parents, they might feel that
their racial identity aligns well with their parents. As
research suggests, however, multiracial individuals
hold unique experiences that a monoracial parent
might not understand.
Diversity within the multiracial LGBTQ-parent
family can also impact relationships with extended
family members, whose racial identities might be
similar to or further removed from the children’s
identities. A family’s multiracial status can
strengthen or solidify bonds with extended family
members who share similar identities with the
children. However, racial tensions have been found
to arise within some predominantly White families,
where it is not uncommon for racial-minority
Multiracial LGBTQ-Parent Families
children to feel marginalized or be viewed as
“exotic” on account of their appearance.
Furthermore, children with light skin who “appear”
White might encounter family members who
overlook or ignore their minority identity.
Multiracial children sometimes culturally identify
more with one side of the family, and yet still feel
“different” from family members if the other parts of
their heritage are not validated or embraced. Just as
experts have demonstrated the necessity for parents
of racialminority children to strive for cultural

competency, there is evidence that it is also
important for extended family to be sensitive to
issues of race, in order to minimize the hurt that can
result from misunderstanding, prejudice, and
marginalization.
In addition, research suggests that it is particularly
beneficial to children of LGBTQ parents when
extended family offer support, understanding, and
sensitivity regarding LGBTQ issues. Many LGBTQ
couples have not felt supported by extended family
on account of their sexual orientation or gender
identity. For some families, the presence of children
exacerbates extended family members’ fear and
disapproval; for example, family members might
become more distant (or even estranged), with no
interest in being a part of the children’s lives. An
LGBTQ couple that was not entirely “out” to family
before having children is now forced to disclose their
relationship, with varying results. It should be noted
that the presence of children often improves parents’
relationships with extended family, for example,
because the couple’s identity as LGBTQ is
overshadowed by their status as new parents.
Extended family might focus on their wish to be a
part of the children’s lives, and this can become more
important than their disapproval of LGBTQ
relationships. In turn, extended family can provide an
important source of support to parents in terms of
emotional support, practical help (e.g., babysitting),
and/or financial assistance.
Challenges Within LGBTQ Communities and
Communities of Color
Hierarchies can exist even within marginalized
communities. For multiracial LGBTQ-parent
families, feelings of difference can emerge within
LGBTQ communities as well as within communities
of color. Similarly to how children’s parents might
not be able to relate directly to their racial identity,
these family units do not necessarily have built-in
communities that reflect all aspects of their identities.
Sometimes they feel excluded from communities on
account of their multiracial status, and at other times
due to their sexual orientation/ gender identity.
Many LGBTQ communities are predominantly
White, and critics argue that these communities do
not sufficiently attend to the unique experiences of
LGBTQ people of color. In addition to people of
color, bisexual and transgender individuals can feel
invisible in White, gay/lesbian-dominated
Multiracial LGBTQ-Parent Families 2179
communities. Because many LGBTQ-parent families
wish to feel like part of a community, it can be
particularly hurtful when they feel judged or
perceived as “different” in communities that are
meant to be welcoming and inclusive. Some research
suggests that whether the communities display overt
racism or more subtle forms of bias, families and
individuals might not feel accepted on account of
their multiple forms of difference.
Furthermore, multiracial LGBTQ-parent families
sometimes feel they must choose between
predominantly White LGBTQ communities and
predominantly heterosexual communities of color.
Some parents do not feel that they would be
supported if they came out as LGBTQ within
racialminority communities. When they do come out,
some feel pressure to minimize their identity as an
LGBTQ-parent family, and to focus more on their
identity as a multiracial family. This can feel
particularly challenging to younger children who
might not understand why there would be varying
levels of outness and acceptance across communities.
For adolescents who strive to fit in with peers,
having to hide or minimize certain aspects of their
families can lead to feelings of guilt, shame, or
confusion regarding their multiple minority
identities.
Challenges Within Mainstream Society
Discrimination can take shape in different forms
and on many levels, from outright instances of
racism and homophobia to everyday
microaggressions. Even for multiracial
LGBTQparent families with both accepting extended
family and welcoming communities, there are ways
in which societal norms impose challenges. It is not
uncommon for multiracial LGBTQ-parent families to
feel misunderstood, invisible, or targeted in public
for being different. Research has found that strangers
sometimes misinterpret families with same-sex
parents and racial-minority children. For example,
they might assume that one parent is the nanny or
that the two parents are siblings, or that the children
are not theirs because of any visible differences in
skin color or appearance.
These types of microaggressions also occur in
school systems, albeit less frequently today than in
the past. Family tree assignments pose challenges for
adoptive families, in that these assignments assume
that each child is biologically related to his or her
2180
parents. Same-sex couples have reported feeling
overlooked and invalidated when they fill out forms
asking them to list the names of the child’s mother
and father. Such challenges can lead to feelings of
exclusion in both parents and children.
It is also notable that families are impacted— both
implicitly and explicitly—by media messages and
societal notions of what is considered “normal.”
Adults and children alike are exposed to homophobic
and racist views in the media, as well as to messages
that subtly convey a hierarchy of identity. Every time
the news features topics such as the same-sex
marriage “debate,” for example, the message being
conveyed is that same-sex couples hold a lower
status in society (and that their rights are worthy of
being debated). It is thus not because families are
LGBTQ and/or multiracial that they experience
certain challenges. Rather, it is society’s
discriminatory norms that privilege certain aspects of
identity over others, invalidating and discriminating
against families who do not fit into the normative
structure.
Strengths of Multiracial LGBTQ-
Parent Families
To varying degrees, multiracial LGBTQ-parent
families thus face unique challenges within and
outside of the family unit. Feelings of difference and
exclusion on account of multiple minority identities
can be difficult for families and individuals to
manage. At the same time, however, these forms of
difference can be a source of pride and lead to some
unique strengths.
For children, learning to navigate different
communities, cope effectively with challenges that
arise, and internalize pride in their multicultural
identity can build strength and resiliency. This
strength can be a foundation for challenges that arise
through childhood and into adulthood. Same-sex
couples are often more open to transracial adoption
than heterosexual couples, perhaps indicating greater
comfort navigating differences. Research findings
suggest that many LGBTQ parents have been able to
apply their experiences with marginalization (on
account of their sexual orientation/gender identity) to
their children’s racial identity and their family’s
multiracial status. In this way, LGBTQ parents have
the potential to bridge differences while also being
mindful that sexual orientation/gender identity and
race hold different places of privilege, status, and
marginalization within society. Experiences with one
form of identity cannot be readily transferred to
another; there are numerous ways in which the
experiences of White or interracial LGBTQ couples
are distinct from those of their racialminority
children. Nevertheless, by drawing from their own
experiences navigating differences, LGBTQ parents
can provide sensitivity and support to their children.
Conclusion
Meanings of race, sexual orientation, gender identity,
and family structure have shifted over time and will
continue to do so. In many ways, multiracial
LGBTQ-parent families exemplify the 21st-century
United States, in that they demonstrate the
challenges and strengths of living in a diverse
society. While they are vulnerable to multiple forms
of stigma and discrimination, multiracial LGBTQ-
parent families (and other nontraditional families)
also hold the potential to explore the role of openness
and communication in fostering acceptance of and
pride in differences. As social constructions of
identity continue
Muslim LGB People
to evolve, navigating multiple forms of difference is
becoming increasingly important.
Hannah B. Richardson
See also Binational Same-Sex Couples and Families;
Interracial Relationships; Intersections Between Sex,
Gender, and Sexual Identity; LGBTQ People of Color;
Transracial Versus Inracial Adoption
Further Readings
Bing, V. M. (2004). Out of the closet but still in hiding.
Women & Therapy, 27, 185–201.
Burton, L. M., Bonilla-Silva, E., Ray, V., Buckelew, R., &
Freeman, E. (2010). Critical race theories, colorism, and
the decade’s research on families of color. Journal of
Marriage and Family, 72, 440–459.
Gianino, M., Goldberg, A. E., & Lewis, T. (2009). Family
outings: Disclosure practices among adopted youth with
gay and lesbian parents. Adoption Quarterly, 12, 205–228.
Goldberg, A. E. (2009). Lesbian and heterosexual
preadoptive couples’ openness to transracial adoption.
American Journal of Orthopsychiatry, 79, 103–117.
 Multiracial LGBTQ-Parent Families 2181
Goldberg, A. E., & Smith, J. Z. (2009). Predicting non– homosexuality in Islamic societies; continues with
African American lesbian and heterosexual preadoptive empirical insights into the identities, experiences,
couples’ openness to adopting an African American child.
and well-being of LGB Muslims; and concludes with
Family Relations: An Interdisciplinary Journal of Applied
Family Studies, 58, 346–360.
recommendations for further research, and policy
Kenney, K. R., & Kenney, M. E. (2012). Contemporary U.S.
and practice.
multiple heritage couples, individuals, and families:
Issues, concerns, and counseling implications. Islamic Positions on Homosexuality
Counselling Psychology Quarterly, 25, 99–112.
In attempting to define the “Islamic position” on
Nadal, K. L., Sriken, J., Davidoff, K. C., Wong, Y., &
homosexuality, it is important to remember that
McLean, K. (2013). Microaggressions within families:
Experiences of multiracial people. Family Relations: An Islam is a diverse faith group with some 1.6 billion
Interdisciplinary Journal of Applied Family Studies, 62, followers on six continents. They adhere to distinct
190–201. branches of Islam—Sunni, Shiite, Sufi, and others—
Richardson, H. B., & Goldberg, A. E. (2010). The and religious identities are often entwined with local
intersection of multiple minority identities: Perspectives ethnocultural norms and customs.
of White lesbian couples adopting racial/ ethnic minority Moreover, the legal position on homosexuality in
children. ANZJFT Australian and New Zealand Journal one’s country (of origin) may shape one’s stance on
of Family Therapy, 31, 340–353.
Samuels, G. M. (2009). “Being raised by White people”:
Navigating racial difference among adopted multiracial
adults. Journal of Marriage and Family, 71, 80–94.
Snyder, C. R. (2012). Racial socialization in cross-racial
families. Journal of Black Psychology, 38, 228–253.
Stanley, J. L. (2004). Biracial lesbian and bisexual women.
Women & Therapy, 27, 159–171.
Szymanski, D. M., & Sung, M. (2010). Minority stress and
psychological distress among Asian American sexual
minority persons. Counseling Psychologist, 38, 848–872.

MUSLIM LGB PEOPLE

The social sciences have long been concerned with

how human beings interact with, and make sense of,
their social environments; indeed, social psychology
seeks to integrate the societal and psychological
levels of analysis and provides the tools for
understanding how the social world, and the social
changes inherent in it, can impact a person’s sense of
identity and psychological well-being, as well as the
individual’s response to change. Drawing upon the
body of available social psychological evidence that
has emerged in recent years, this entry focuses upon
the identities, experiences, and well-being of lesbian,
gay, and bisexual (LGB) Muslims. Much of this
research has centered around gay/bisexual Muslim
men, but some has also focused upon Muslim
lesbians. This entry begins with brief insights into
the theological, legal, and social representations of
2182
homosexuality, especially if that country is regarded as
adhering to Islamic law. Many Muslim countries that
claim to adhere to Sharia (Islamic) law criminalize
homosexuality, but penalties vary— while homosexual
acts in Pakistan can carry a prison sentence of 2–10
years, the Islamic Republic of Iran metes out the death
penalty to men “convicted” of engaging in anal
intercourse.
On the whole, scholars are in agreement that
mainstream Islam is opposed to any theological
accommodation of homosexuality. Mainstream Islamic
scholars tend to invoke the Story of Lut in Islamic Holy
Scripture (the Koran), which recounts the destruction of
the Tribe of Lut allegedly due to their engagement in
homosexual acts, as “evidence” for Allah’s
condemnation of homosexuality. They also point to the
verbal teachings attributed to the Prophet Mohammed
(the Ahadith), which appear to condemn homosexuality.
There are some Muslim groups and individuals that
have attempted to promote a “reverse discourse”
concerning the Islamic position on homosexuality,
arguing that there is scope for the accommodation and
acceptance of homosexuality within Islam. Scott Kugle,
an associate professor of Islamic studies at Emory
College of Arts and Sciences, has argued that the
dominant interpretation of the Story of Lut may be
erroneous and that the destruction of the Tribe of Lut
can be attributed to the tribe’s infidelity and
inhospitality, rather than to their homosexuality.
Although there are some support groups for LGB
Muslims, such reverse discourse is in its infancy and
has faced opposition from mainstream Islamic groups.
Theological, legal, and social condemnation of
homosexuality in Muslim communities serves to create
cultural representations that homosexuality is immoral,
sinful, and dangerous to society. Many LGB Muslims
themselves are embedded within these homophobic
societies and are compelled to construct their identities
against this cultural backdrop, which can result in
threats to their sense of self, negative emotional
experiences, and poor psychological well-being. These
issues have fruitfully been examined through the lens of
social psychological theory.
Muslim LGB People
The LGB Individual: Threats to Identity
In a series of qualitative empirical studies, Rusi
Jaspal, a social psychologist at De Montfort University
in the United Kingdom, has examined the identities and
experiences of Muslim gay/ bisexual men in the United
Kingdom, and the strategies they employ for coping
with threats to their sense of self (henceforth “identity
threat”). The exploration of this population as a case
study for examining LGB Muslim identity has also
provided some insight into how acculturative processes
can serve as an additional threat to identity. For
instance, homosexuality has increasingly gained social
acceptance in the United Kingdom, while it has
remained highly stigmatized and even illegal in most
Muslim-majority countries. Some Muslim gay men
reportedly feel that they are viewed by other Muslims
as being “too British” (that is, as having taken on the
norms and values of British society) due to their sexual
identity. On the other hand, British national identity can
sometimes act as a buffer against threat. For instance,
some individuals may reject the perceived “Islamic
stance” on their sexual identity and, conversely,
embrace the “British stance,” which is perceived as
more readily accommodating to sexual diversity.
On the whole, Muslim gay/bisexual men face severe
psychological challenges in managing their sexual,
religious, and ethnic identities, which in turn can
problematize the construction of a psychologically
satisfying sexual identity. Crucially, evidence suggests
that Muslim gay/bisexual men perceive the norms,
values, and representations associated with their
religious and sexual identities, respectively, as being
incompatible. This can lead to a decreased sense of
psychological coherence. More specifically, they may
feel that, because their sexual identity is at odds with
what God intended and with what their religion teaches,
they are either not “proper” Muslims or are engaged in
highly sinful behavior that will lead to divine
retribution. Individuals may feel that the two identities,
which are socially represented as being
“interconnected” (because Islam appears to have a
stance on homosexuality), are fundamentally
incompatible.
Muslim LGB People
It is easy to see how these perceptions can challenge
gay/bisexual Muslim men’s sense of self-esteem. Many
feel unable to derive a positive self-conception on the
basis of their sexual identity, because they are exposed
to homophobic representations associated with a group
membership that they value—namely, their religion.

Group memberships that matter to an individual will
have clout in shaping their personal beliefs and
representations; people use their group memberships—
and particularly valued group memberships—as sources
of knowledge about the world. Consequently, it is no
surprise that Muslim gay/bisexual men may exhibit
signs of internalized homophobia, that is, the
internalization of negative social attitudes toward their
sexual identity. There is evidence that some LGB
Muslims experience guilt, shame, and self-hatred,
potentially leading to mental distress and suicidal
thoughts. They may come to the conclusion that their
sexual identity is wrong and that it must and, with
God’s help, will change.
We know from decades of empirical research that
LGB youth can experience challenges in developing a
sexual identity due to the initial confusion that arises
upon recognition of difference from the dominant
heterosexual majority. Change is inherent to the
developmental journey. A number of coming-out
models have been proposed, which highlight the
changes in self-definition that arise amid social
developmental processes and more general social
change. Research clearly indicates the grave threats of
coming out to LGB Muslims’ sense of continuity,
which may be considerably more traumatic than those
normally experienced by non-Muslims. LGB Muslims
tend to be socialized in a theological, social, and
familial environment that appends hegemony to
heterosexuality and, in many cases, to arranged
(heterosexual) marriage. LGB Muslims themselves may
aspire to fulfill this religious and cultural expectation of
an arranged heterosexual marriage due to
religious/cultural pressures. This can create a rupture
between past, present, and future, as individuals fail to
construct a coherent temporal narrative. They may feel
unable to get married and, thus, see no “acceptable”
future for themselves as LGB individuals, thereby
threatening continuity.
The LGB Social Group Member: Stigma and
Exclusion
LGB Muslims face a number of social challenges that
are experienced as threatening at a psychological level.
These social challenges concern the LGB Muslim’s
position within relevant social groups and categories,
which can inhibit feelings of acceptance and inclusion
from significant others.
Family identity is central to many Muslims, who
generally adhere to a collectivist cultural orientation
2183
and patriarchal hierarchy. Family and cultural honor are
key for many Muslims, and premarital chastity and an
arranged (heterosexual) marriage are widely perceived
as central to maintaining honor. LGB Muslims often
feel compelled to behave and to construct their
identities in ways that are conducive to family honor.
Typically, many conceal their sexual identities from
their families, which can lead to decreased sense of
identity authenticity. This can become socially
challenging when their parents obliviously encourage
their children to get married. LGB Muslims have
reported problems in interpersonal relations with
parents and other family members, as they feel unable
to disclose their sexual identities, on the one hand, and
are unwilling to enter into an arranged heterosexual
marriage, on the other. Moreover, some LGB Muslims
may decide to come out to family members, which can
result in ostracism, disownment, and even
psychological/physical abuse.
Given the perception of incompatibility between
Islam and homosexuality among many LGB Muslims
and the theologically based homophobia that many are
exposed to, they may themselves begin to question the
authenticity of their Muslim identity. This may lead
them to seek strategies for affirming their Muslim
identity, often at the expense of their devalued sexual
identity, which, for many LGB Muslims, is an identity
that they wish to shed. There is some evidence of a
“hyperaffiliation” to the religious group, as a means of
compensating for any potential doubts surrounding their
identity authenticity. Some have reported using
Ramadan (a Muslim festival of fasting) as a symbolic
opportunity for asserting their piety and for dispelling
their self-accusations of inauthenticity, while others
may espouse what they regard as prototypically
“Muslim attitudes” concerning society, such as anti-
Zionism and even overt homophobia.
The late British social psychologist Henri Tajfel,
who developed social identity theory, described the exit
option, that is, the individual’s self-removal from a
threatening social group identity. The process of self-
removal from a group may not be so simple, given that
for many Muslims, their faith constitutes a meaning
system and an overarching “superordinate” identity that
is entwined with other components of the self, such as
family identity. Departure from a valued social group
requires modification to the structure of identity, such
as loss of other identity components. Some LGB
Muslims have, however, reported distancing themselves
from their religious/ethnic in-groups in order to align
2184
themselves with sexual in-group members, that is, other
(largely non-Muslim) LGB individuals. Interview data
indicate that LGB Muslims may feel other-ized and
discriminated against on the (predominantly White)
“gay scene,” due to rising Islamophobia and racism, in
general. Crucially, racism is said to occur not only on
the gay scene but also in online settings, such as on the
gay social media, where messages like “no Asians” or
“no Muslims” are often interpreted as rejection from the
mainstream LGB community. In short, LGB Muslims
may feel rejected and excluded from the sexual in-
group, which can challenge their sense of belonging and
lead to feelings of isolation.
Social support is known to buffer threats to identity
and well-being, but LGB Muslims may feel that they
simply have no access to social support—from either
their families or their sexual in-group—which can
aggravate their threatened position. This has been
compellingly demonstrated in research into how LGB
Muslims cope with relationship dissolution. Due to the
general lack of social support, individuals may deploy
deflection strategies for coping with associated threats,
such as denial and depersonalization, and further
minimize contact with others (from whom they
anticipate little or no support), which can be conducive
to further isolation and psychological stress.
Muslim LGB People
Rusi Jaspal
See also Catholic LGBTQ People; Christian LGBTQ
People; Coming Out, Disclosure, and Passing;
Discrimination Against LGBTQ People, Cost of;
Homophobia; Internalized Homophobia; Jewish
LGBTQ People; LGBTQ People of Color; Religious
Identity and Sexuality, Reconciliation of; Religious
LGBTQ Youth
Further Readings
Jaspal, R., & Cinnirella, M. (2010). Coping with
potentially incompatible identities: Accounts of
religious, ethnic and sexual identities from British
Pakistani men who identify as Muslim and gay. British
Journal of Social Psychology, 49(4), 849–870.
Kugle, S. S. A. (2010). Homosexuality in Islam: Critical
reflection on gay, lesbian, and transgender Muslims.
Oxford, England: Oneworld Publications.
Murray, S. O., & Roscoe, W. (1997). Islamic
homosexualities: Culture, history and literature. New
York, NY: New York University Press.

Conclusion
LBG Muslims can experience considerable individual
and social challenges in attempting to manage their
sexual and religious/ethnic identities. The principles of
self-esteem, continuity, and psychological coherence
appear to be most susceptible to threat. Individuals may
experience feelings of identity inauthenticity, and
perceive ostracism from relevant social groups due to
homophobia and racism. This can impede access to
social support networks, rendering experiences such as
relationship dissolution particularly challenging at a
psychological level. The research studies summarized
in this entry have been conducted among LGB Muslims
—there is a need to examine the identities and
experiences of transgender Muslims. On a practical
level, policy makers should focus their attention on
attempting to engage Muslim communities in order to
improve attitudes toward sexual diversity, as well as
mainstream LGB communities in order to facilitate
more positive relations between them and
ethnoreligious-minority LGB individuals.
N ly
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 2189

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2190

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 2191

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2192

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Suter, E. A.,
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 2197

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2198

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 2199

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2202

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(Californi same-sex
a Supreme spouse is
Court, entitled to
2005) and survivor
Chatterjee
v. King
(New
Mexico
Supreme
Court,
2012).
Other
notable
family
victories
include
the first
settlement
requiring
Adoption.
com to
stop
discrimina
ting
against
same-sex
adoptive
parents; a
decision in
Florida in
Embry v.
Ryan
(2009)
requiring
Florida to
recognize
second-
parent

benefits from an employer plan; the first successful
contested custody cases granting custody of a
transgender child to a supportive parent; and
numerous earlier decisions establishing the ability of
same-sex parents to adopt in a number of states,
allowing nonbiological and nonadoptive parents to
seek custody, and prohibiting discrimination against
LGBT parents in custody matters.
In 2008, NCLR was lead counsel for several
plaintiff couples in In re Marriage Cases, the
California Supreme Court decision holding that
samesex couples have a fundamental right to marry
under the California Constitution. NCLR also
successfully litigated marriage cases in Alabama,
Idaho, New Mexico, South Dakota, Tennessee, and
Wyoming, as well as Kitchen v. Herbert (2013), the
first federal court of appeals decision striking down a
state marriage ban. NCLR also represented plaintiff
couples from Tennessee in Tanco v. Haslam, one of
the marriage cases consolidated in 2015 before the
U.S. Supreme Court.
Other notable NCLR cases include Christian
Legal Society v. Martinez, a 2010 decision by the
U.S. Supreme Court holding that university student
group nondiscrimination policies do not violate the
First Amendment, and 2014 decisions by the Ninth
Circuit and Third Circuits rejecting First Amendment
challenges to state laws prohibiting therapists from
performing conversion therapy on minors.
Since its founding, NCLR has launched a number
of innovative programs and campaigns to address
emerging issues. In 1993, NCLR became the first
national legal organization to create a project for
LGBTQ youth. Originally focused on providing legal
assistance to LGBTQ youth who are abused in the
mental health system, NCLR’s Youth Project
expanded to include youth in schools
and in the child welfare and juvenile justice systems.
In 2014, NCLR launched #BornPerfect, a campaign
to stop the use of efforts to change sexual orientation
or gender identity through socalled conversion
therapy.
In 2001, NCLR became the first national legal
organization to tackle rampant homophobia,
biphobia, and transphobia in sports. NCLR’s Sports
Project promotes equality through the legal system
and on the playing field to ensure that LGBTQ
athletes and coaches receive fair and equal treatment.
2203
Other NCLR programs and campaigns include the
Family Protection Project, which partners with legal
aid organizations across the country to provide
resources and assistance to poor and lowincome
LGBTQ parents and couples; the Immigration &
Asylum Project, which provides direct services to
LGBTQ immigrants, detainees, and asylum-seekers;
and #RuralPride, a joint campaign with the U.S.
Department of Agriculture to highlight the needs and
issues of LGBT people in rural communities.
NCLR is also actively involved in drafting and
sponsoring local, state, and federal legislation,
ranging from nondiscrimination laws to protections
for LGBTQ parents, elders, and youth.
Shannon Minter
See also Criminal Legal System and LGBTQ People;
Custody and Litigation, LGBQ Parents;
Discrimination Against LGBTQ Elders; Legal
Recognition of Nonmarital Same-Sex Relationships;
Legal Rights of Nonbiological Parents; LGBTQ People of
Color; LGBTQ-Parent Families With More Than Two
Parents; Sexual Orientation Conversion Therapy
Further Readings
National Center for Lesbian Rights (NCLR). http://www
.nclrights.org
NeJaime, D. (2014). Before marriage: The unexplored
history of nonmarital recognition and its relationship to
marriage. California Law Review, 102, 87–172.
NATIVE AMERICAN/FIRST NATIONS
SEXUALITIES
Native sexualities may be understood to refer to
sexual behavior and expression as well as gender
identities within Native American/First Nations
cultures in the Western Hemisphere, specifically in
North and South America. Using “native” as a
modifier for “sexualities” should be viewed with
caution; the construction of the term itself
presupposes a Western European approach to
understanding sexuality and gender, which does not
2204 Native American/First Nations Sexualities
correspond in many ways with the variety of
nonEuropean understandings of sexuality and gender
identity found among native cultures. It is therefore
necessary to set aside a number of Western European
concepts related to sexuality and gender when
speaking of native sexualities:
The binary construction of gender. Many Native
American/First Nations cultures do not see gender in
binary terms of “male” and “female” and may have
more than two genders identified within their cultural
understanding and social practice.
The division of sexuality into “heterosexual” or
“straight” in contrast with “lesbian, gay, bisexual,
transgender, queer,” and other related personal
identities. Again, many Native American/First Nations
cultures did not (and do not) link gender identities,
sexual orientations, and sexual behavior in ways that
correspond with these terms.
Any “stigma” or negative social connotation
connected to transgender or nonheteronormative
behavior or identification. Among many—but not all
— Native American/First Nations cultures, the social
roles associated with what would otherwise be thought
of as non–gender-conforming or nonheteronormative
sexual behavior were viewed as having an important
social and/or spiritual dimension, recognized as such
by other tribal members.
It is worth noting that not all Native American/
First Nations cultures recognized these varied gender
and sexual roles and identities equally, or even at all.
Therefore, speaking about “native sexualities”
requires a balance between finding meaningful
common identities and understandings without
overgeneralizing or engaging in other forms of
misinterpretation due to unexamined cultural bias.
This entry will address examples of native
sexuality and gender identity, showing the variety of
different native understandings of these issues.
Attention is given to the historical context of Native
American–European interaction, and the
Native American/First Nations Sexualities
pattern of forced assimilation of native peoples into
modern American society. Lastly, the emergence of
“Two-Spirit” identity among contemporary native
people, as well as the larger legacy of colonialism
within Native American/First Nations culture is
examined.
Examples of Native Sexuality and
Gender Identity
It is now generally understood that many if not most
of the native tribes and cultures of North America
and the Western Hemisphere have many different
definitions of gender identity, gender roles, and
social expectations around sexual behavior, and these
do not correspond neatly to Western European
definitions or ideas. Some examples include the
following:
• The Navaho culture possesses four different
genders, recognizing the feminine woman or
asdzaan, the masculine man or hastiin, the feminine
man or nádleehi, and the masculine woman or
dilbaa. The Yupik people of Alaska are also said to
have four genders, but these do not correspond with
those of the Navaho.
• Among the Lakota Sioux, someone who was
biologically male, but who took on nonmasculine
gender roles and who could engage in homosexual
as well as heterosexual behavior, was known as a
winkte. Such a person was seen as having a special
gift from Wakan Tanka or “Great Spirit” and was
considered to be a medicine person.
• The muxes of Oaxaca, Mexico, are seen as a “third
sex”—people who are biologically male but who
identify as female, or as a third gender, neither
completely male nor female but partaking of both
and possibly more. The muxes are recognized as a
part of the indigenous Zapotec culture, and
participate in socially accepted roles within modern
Oaxacan society.
• The Cree people of Northern Canada recognize a
variety of different words related to gender, with six
different terms for various gender expressions and at
least three different gender identities.
All of the above are similar to the identity of the
mahu in Hawai’i and Polynesia, males who took on
roles normally reserved for women, and who acted as
shamans. What is important to note is that in many
Native American/First Nations cultures, gender was
seen as occurring along a continuum, rather than

having a fixed dualistic construction. Similarly,
sexuality was not viewed as a personal identity or
orientation, but rather a range of behaviors that were
interpreted through the social roles a person held
within the larger society. Likewise, among some
Native American/First Nations cultures, individuals
who are gender-variant may have wives or husbands
of different genders from their own, but this is not
always the case; they may have sexual experiences
and social bonds with other persons who may have
the same or different genders from themselves. Thus,
using terms such as “gay” or “lesbian” or “bisexual”
or “transgender” may not accurately reflect the
experiences and identities of native people, since
these terms reflect Western European constructions
of gender and sexuality.
Historical Context
Early contacts between European explorers and
settlers and Native American peoples reveal a clear
difference between European understandings of
gender and sexuality, and those of various native
cultures. The historical accounts of European
explorers, traders, and settlers provide examples of
what were perceived to be native men acting as
women, or women acting as men. In many cases,
these persons were noted precisely for their seeming
departure from “normal” gender roles and sexual
behavior. A term used in some accounts was
“berdash” or “bardash,” derived from berdache, a
French term originally of Persian origin. The Persian
word meant a kind of slave boy, while the French
word was derogatory in character, referring to a kind
of effeminate man. The term berdache was later
adopted by anthropologists to refer to gender-
nonconforming people in Native American/ First
Nations cultures, who were recognized as such
among their own people. The term is still
occasionally encountered, but is now considered to
be obsolete and inaccurate.
The life of We’Wha, a member of the Zuni tribe,
provides an illustrative case. Born in 1849, We’Wha
was recognized at an early age as being a Zuni
Ihamana, having been born male but associating with
girls and not dressing as a boy or man. After having
been trained in the various domestic and religious
roles of women, We’Wha became a farmer,
2205
supporting her family on lands originally held by the
Zuni, and practicing both male and female religious
and social leadership roles. In 1877, Christian
missionaries arrived among the Zuni, and from them
We’Wha learned to speak English and later took on
various wage-earning tasks including laundering
clothes for White soldiers and settlers in the
immediate area. In 1879, We’Wha met the
ethnologist Matilda Coxe Stevenson, and the two
became close friends. Stevenson visited We’Wha
several times between 1879 and 1896 as part of her
anthropological work among the Zuni, documenting
the important role played by We’Wha among their
people and the strength of We’Wha’s character and
personality. In 1886, hosted by Stevenson, We’Wha
traveled to Washington, D.C., meeting President
Grover Cleveland, as well as living with Stevenson
for 6 months. Sometime during this period,
We’Wha’s biological sex became known to
Stevenson, who continued to refer to We’Wha using
the feminine gender. We’Wha died in 1896, but
We’Wha’s life was documented by Stevenson and
later by Will Roscoe.
Forced Assimilation
By the end of the 19th century, European
colonization of the Western Hemisphere was largely
complete. Native American/First Nations tribes were
often restricted to reservations or other lands
specifically set aside for them. In North America, a
process of conversion to Christianity was officially
sanctioned by the Grant Administration, and a
longer-term project of assimilation to the dominant
Western culture was initiated. Tribal spiritual
traditions were sometimes set aside or forgotten, and
older cultural patterns were not always maintained or
preserved. In particular, nonheteronormative
behavior became stigmatized. In Canada,
homosexuality and gender nonconformity were
suppressed by the efforts of Christian missionaries
and the actions of the Canadian government, and had
largely disappeared by 1900. Due to the efforts of
Christian missionaries and the Bureau of Indian
Affairs, many Native Americans in the United States
had adopted Western European gender roles and
social expectations of heterosexuality by the 1920s
and 1930s. Similar outcomes were observed in
2206 Native American/First Nations Sexualities
Central American and South American countries,
due to the work of the Catholic Church, local and
national governments, and cultural practices favoring
the lighter-skinned aristocracy.
All of these efforts must be placed in the larger
context of cultural and social assimilation. Beginning
in 1940 and continuing into the 1960s in the United
States, federal and state governments passed laws
and implemented policies intended to terminate tribal
sovereignty and force Native Americans to assimilate
completely into the dominant White culture. These
attempts were of limited success, but did
considerable damage while in effect. Both the
Lyndon Johnson and Richard Nixon Administrations
favored the policy of selfdetermination for Native
American tribes, which largely ended assimilation
efforts. By the 1960s, various Native American/First
Nations political advocacy groups began to form,
most notably the American Indian Movement (AIM)
in Minneapolis, Minnesota, in 1968. But it wasn’t
until the emergence of the HIV/AIDS crisis in the
1980s that work was undertaken within Native
American/First Nations communities to confront the
legacy of colonialism related to gender and sexuality.
This was largely due to Native American
organizations dedicated to dealing with HIV/ AIDS,
such as the Minnesota American Indian AIDS Task
Force (later the Indigenous Peoples Task Force), the
American Indian Community House HIV/AIDS
Project in New York, and (later) the Canadian
Aboriginal AIDS Network and Healing Our Nations.
Native American/First Nations Sexualities
Emergence of “Two-Spirit” Identity
The post-Stonewall era of the 1970s was
characterized by efforts aimed at recognizing
nonheterosexual native sexualities, including the
formation of groups like Gay American Indians,
founded in 1975 in San Francisco. However, it
wasn’t until
1990 that the term Two-Spirit was chosen at the
Third Annual Intertribal Native American/First
Nations Gay and Lesbian Gathering in Winnipeg,
Manitoba, Canada. The term is a translation of the
Anishinaabemowin (Ojibwe or Chippewa) niizh
manidoowag, meaning “having two spirits.” The
term was chosen as a pan-Indian gloss that would
provide recognition of the range of gender identities
and sexual orientations across Native American/
First Nations cultures, and as a much-needed
replacement for the problematic term berdache, with
all of its colonialist and anthropological baggage. It
is important to recognize that “Two-Spirit” is as
intentionally pan-Indian as a term such as “Native
American/First Nations”; both are attempts to build
greater solidarity among native peoples, and—
regarding Two-Spirit—to provide greater recognition
of both similarity with and differences from lesbian,
gay, bisexual, and transgender identities. Yet that
very pan-Indian character of the term “Two-Spirit” is
also very modern in construction, lacking the
specificity of distinct tribal terms of gender
identification and sexual relation, and is thus only an
approximation of the variety of native words
describing people who are recognized as having a
different gender identity or sexual orientation, as
well as a different social role within their tribal
communities, requiring greater examination for full
understanding.
One important distinction between Two-Spirit and
terms such as lesbian, gay, bisexual, and transgender
is the emphasis placed by many Two-Spirit native
people on how it is not simply a label or passive
identity marker; it also implies a way of life or
ongoing self-presentation related to one’s place
within the tribe or community. Such an emphasis is
consistent with the original place of
nonheteronormative and gender-variant people
among Native American/First Nations cultures, and
distinct from more recent constructions of gender
identity and sexual orientation.
Legacy of Colonialism
Despite considerable progress made by Two-Spirit
native people toward recognition in their own
communities and the larger society, discrimination
and prejudice still exist as harmful influences within
Native American/First Nations cultures. Bullying
and violence directed at Two-Spirit people is not
uncommon, and the rate of teenage suicide is
significantly higher among LGBT and TwoSpirit
native people. The case of Fred Martinez is telling:
Martinez, a Diné (Navajo), was nádleehí, and
identified as that or “gay” until being murdered in

2001 at the age of 16 at the hands of another
teenager, with some evidence suggesting that the
murder was a hate crime. Martinez’s life was
documented in the 2011 PBS film Two Spirit¸
directed by Lydia Nibley, which garnered critical
acclaim. The persistence of homophobia and
transphobia within Native communities is made
more problematic by questions of tradition and
authenticity; some Native people do not want to
accept the idea that their culture may have had
greater variation in gender identity and sexuality in
the past, preferring instead a more normative view
consistent with a more recently acquired
Christianity.
Besides the issues surrounding the place and
legitimacy of Two-Spirit people, it must be noted
that Native American/First Nations people are
themselves the target of sexual exoticization within
the larger society. Native women are seen as being
more sexualized, while native men are sometimes
portrayed as lovers of considerable sexual prowess.
Thus “native sexuality” itself is culturally
appropriated, often within the mass media
entertainment industry, to be both exoticized and
eroticized.
Conclusion
Native sexualities can thus be seen as a mosaic of
different and varied understandings of sexuality and
gender, based in and defined by Native
American/First Nations cultures and their
relationship to the larger society in which they are
located. The term itself is located within a specific
contemporary context, distinct from such concepts as
heterosexual, lesbian, gay, bisexual, or transgender—
but clearly connected to all of them, and shaped by
the historical legacy of relations between native
people and the more recent Western European
settlers and the cultural definitions of sexuality and
gender they brought with them.
Victor J. Raymond
See also Asian American/Pacific Islander Sexualities;
Heteronormativity; HIV/AIDS and Racial/Ethnic
Disparities; LGBTQ People of Color; Nonbinary
Genders; Religion/Spirituality and LGBTQ People;
Sexual-Identity Labels; Transgender and Gender-
2207
Nonconforming Youth of Color
Further Readings
Allen, P. G. (1992). The sacred hoop: Recovering the
feminine in American Indian traditions. Boston, MA:
Beacon Press.
Brown, L. B. (Ed.). (1997). Two spirit people: American
Indian lesbian women and gay men. New York, NY:
Routledge.
Driskill, Q., Finley, C., Gilley, B. J., & Morgensen, S. L.
(Eds.). (2011). Queer indigenous studies: Critical
interventions in theory, politics, and literature (First
Peoples: New directions in indigenous studies).
Tucson: University of Arizona Press.
Gilley, B. J. (2006). Becoming two-spirit: Gay identity and
social acceptance in Indian country. Lincoln:
University of Nebraska Press.
Jacobs, S., Thomas, W., & Lang, S. (Eds.). (1997). Twospirit
people: Native American gender identity, sexuality, and
spirituality. Chicago: University of Illinois Press.
Rifkin, M. (2011). When did Indians become straight?
Kinship, the history of sexuality, and native sovereignty.
New York, NY: Oxford University Press.
Roscoe, W. (1988). Living the spirit: A gay American
Indian anthology. New York, NY: St. Martin’s Press.
Roscoe, W. (2000). Changing ones: Third and fourth
genders in Native North America. New York, NY:
St. Martin’s Press.
Taylor, D. (2008). Me sexy: An exploration of Native
American sexuality. Madeira Park, British Columbia,
Canada: Douglas & McIntyre.
Vernon, I. S. (2001). Killing us quietly: Native Americans
and HIV/AIDS. Lincoln, NE: Bison Books.
Williams, W. L. (1992). Spirit and the flesh: Sexual diversity
in American Indian culture. Boston, MA: Beacon Press.
NEW FAMILY STRUCTURES SURVEY
See Methodological Decisions by Researchers
of LGBTQ Populations
NO PROMO HOMO POLICIES
2208 Native American/First Nations Sexualities
No promo homo is shorthand for laws and policies
that prohibit the promotion of homosexuality and
LGBTQ persons, standing for “no promotion of
homosexuality.” No promo homo statutes and
policies have taken two broad forms related to public
schools: where schools and educators are prohibited
from portraying LGBTQ identities and persons
positively, and where educators are required to
remain neutral and/or silent on LGBTQ issues and
about LGBTQ persons. Both forms most commonly
regulate the curricular content in sex and health
education; filter the resources public schools may
make available in their libraries; and limit the
enumeration of specific classes of individuals for
protection from harassment, intimidation, and
bullying.
No Promo Homo Argumentation
Proponents of no promo homo policies argue that
state governments (and the institutions within states,
like schools) should only support “good” lives, and
acceptable identities and behavior. Heterosexual
identities and dating/intimate behaviors are, they
suggest, better and healthier than those taken up by
LGBTQ persons. Therefore, states should only
institute and enforce laws/policies that endorse
heterosexuality and heteronormativity—the
assumption that only
No Promo Homo Policies
identities as criminal within school curricula— often
referencing unconstitutional sodomy laws. Curricula
may also be required to include queerness only in the
context of disease, allowing homosexuality to be
discussed in connection with HIV/AIDS or other
sexual ailments. Lastly, curricula may be required to
assert that LGBTQ identities constitute a lifestyle
that is generally unacceptable to society.
Critics point out that such policies violate the First
Amendment to the U.S. Constitution, which protects
all speech/expression, including speech that makes
adults uncomfortable. Furthermore, there is a
growing body of research documenting the roles no
promo homo policies play in fueling school-level
homophobia. Specifically, research suggests LGBTQ
students under no promo homo laws/policies
experience more harassment and violence than their
queer peers in districts and states without no promo
homo policies.
Examples of No Promo Homo Law and Policy
No promo homo elements exist notably in both state
law and district-level educational policy. Eight states
presently have no promo homo laws: Alabama,
Arizona, Louisiana, Mississippi, Oklahoma, South
Carolina, Texas, and Utah. Two additional states,
Missouri and South Dakota, have statutes prohibiting
enumeration of protected

straight identities exist or should be considered

“normal”—because supporting queer identities and
persons would be tantamount to state endorsement
of “unacceptable” identities. In addition, not
promoting homosexuality has been suggested as a
means for maintaining state-sponsored “neutrality”
as to the religious perspectives of educators,
students, and parents—often alluding to LGBTQ
persons as harmful to the religious faiths of children.
Presented this way, no promo homo policies
frequently require the removal of LGBTQ issues
from school curricula, resources, and policies. They
also mandate that LGBTQ identities and persons be
presented to students as either harmful to children or
undesirable to society. The policies may require
schools and educators to frame LGBTQ persons and

Nonbinary Genders
classes of students, thereby requiring institutional
neutrality with respect to student diversity and issues
such as bullying due to sexual orientation or gender
identity.
One example of a state-level prohibition no promo
homo policy can be found in two of Texas’s present
sex education statutes, which stipulate that curricula
must emphasize that “homosexual conduct is not an
acceptable lifestyle and is a criminal offense under
Section 21.06, Penal Code” (Tex. Health & Safety
Code Ann. § 85.007) and that curricula must present
“in a factual manner and from a public health
perspective, that homosexuality is not a lifestyle
acceptable to the general public and that homosexual
conduct is a criminal offense under Section 21.06,
Penal Code” (Tex. Health & Safety Code Ann. §
163.002). Taken together, these statutes prohibit the
positive portrayal of LGBTQ persons through
requirements that homosexual identities be taught as
a lifestyle, that said lifestyle must be taught as
societally unacceptable, and that homosexual conduct
be taught as illegal under a provision of the Texas
Penal Code that was declared unconstitutional by the
U.S. Supreme Court in 2003.
School districts enacted no promo homo policies
throughout the 1990s. The Anoka-Hennepin School
District in Minnesota is notable for having both a
prohibition and a neutrality no promo homo policy in
place at different times. The district’s initial 1994
prohibition read, in part, that “homosexuality [is] not
to be taught/addressed as a normal, valid lifestyle.”
Schools within the district were prohibited from
representing LGBTQ persons and identities
positively and required to treat homosexuality as
abnormal and socially unacceptable. Fifteen years
later, the district revised its policy to emphasize that
sexual orientation was not a part of its curriculum.
The policy specified that, “staff, in the course of their
professional duties, shall remain neutral on matters
regarding sexual orientation including but not limited
to student-led discussions” (Anoka-Hennepin District
No. 11, 2009). This later policy required the absence
of homosexuality from school curricula and, where
this is not possible—such as when students raise
LGBTQ issues—educators are required to be neither
explicitly supportive nor expressly critical. The
district has since replaced this neutrality policy with
2209
a much more inclusive rule set, finally comporting
with Minnesota state law.
Conclusion
Clearly, while no promo homo policies are facially
neutral, they can inflict great harm on LGBTQ
students who attend public schools where such
policies are in place. Given the threats to both
LGBTQ students and First Amendment freedoms,
many critics and observers have pointed out that no
promo homo policies should not stand legal scrutiny
—if challenged.
Jason P. Murphy and Catherine A. Lugg
See also Bullying, Legal Protections Against;
Homophobia; Laws Banning Homosexuality and Sodomy;
School Climate; Sexual Education Mandates for
Inclusion; Sexualities at School
Further Readings
Eskridge, W. N., Jr. (2000). No promo homo: The
sedimentation of antigay discourse and the channeling
effect of judicial review. New York University Law
Review, 75, 1327–1411.
Hoschall, L. (2013). Afraid of who you are: No promo homo
laws in public school sex education. Texas Journal of
Women and the Law, 22, 219–239.
Lugg, C. A. (2006). Thinking about sodomy: Public
schools, legal panopticons, and queers. Educational
Policy, 20(1), 35–58.
McGovern, A. E. (2012). When schools refuse to “say gay”:
The constitutionality of anti-LGBTQ “no promo homo”
public school policies in the United States.
Cornell Journal of Law and Public Policy, 22, 465–490.
NONBINARY GENDERS
The overwhelming majority of psychological studies
have assumed that gender is binary, often to the point
of focusing on a search for differences between men
and women. The topic of genders that fall outside of
the common cultural binary of women and men has
been underresearched in psychology to date, with
only a small number of psychologists focusing on the
area in any depth.
2210
This entry provides a history of psychological
work that has taken account of gender experiences
that fall outside of the binary, focusing on Sandra
Bem’s classic research on androgyny and gender
schema theory. It then summarizes the findings of the
limited number of recent psychological studies that
understand gender in a more diverse way and explore
the experience of people who identify as nonbinary.
The History of Psychological Research on
Nonbinary Genders
In the early days of psychology, women’s experience
was neglected and the focus was upon men’s
psychology, with much research being conducted
exclusively on men. In recent decades, there has been
a turn toward a pervasive view of the (two) genders
as different, or opposite, with research frequently
seeking to explain why women differ from a
perceived masculine norm. A small minority of
researchers—such as Carol Gilligan—have
challenged this by suggesting that women’s
psychology may be superior to men’s in certain
ways. Others have questioned the entire project of
studying gender difference by pointing to meta-
analyses that reveal that men and women are far
more similar than they are different, and to the
evidence that there are no psychological areas in
which men and women are entirely different. There
has been very little questioning, however, of the
underlying assumption that gender is binary. This is
exemplified by the way in which psychologists—and
other researchers—ubiquitously ask participants
whether they are a man or a woman on the
demographics questions that are commonly included
in surveys and experimental studies.
Perhaps the first psychologist to conceptualize
gender in a different way was Sandra Bem, who
published work in this area from the 1970s through
to the 1990s. Her Bem Sex Role Inventory
Nonbinary Genders
(BSRI) was groundbreaking, as it was a validated
instrument that included separate measures of
masculinity and femininity, rather than following the
prevailing view that masculinity and femininity were
polar opposites on the same scale. On the BSRI,
people were able to score as “sex-typed” (high on
gender traits commonly associated with their birth-
assigned sex and low on those of the “other sex”),
but they could also score in a sexreversed way (the
opposite of this), or they could score high or low on
both masculinity and femininity simultaneously.
Employing this inventory to collect data from
people in the United States, Bem was able to
challenge the popular view in the late 1960s and
early 1970s that people were psychologically
healthier when they conformed to the psychological
characteristics most associated with their gender. On
the contrary, across various arenas, Bem found that
those who displayed both stereotypically feminine
and masculine traits (whom she termed
androgynous) were more flexible, adaptable, and
psychologically healthy than sex-typed people.
Bem’s later research moved away from the
concept of androgyny because she realized that this
perspective still maintained a notion that
psychologically masculine and feminine traits
existed, rather than being culturally and historically
bound concepts. Her gender schema theory focused
on how children internalize cultural gender roles and
the impact of this on their behavior. On the basis of
this research, Bem suggested that gender was not a
useful organizing category, and that psychology—
and people more widely—should move away from
the use of gender categories. Subsequently, she
moved away from binary gender models altogether
and argued for the value of a proliferation of
different gender expressions.
Overall, Bem’s research and theory suggested
both that many people experience gender in ways
that incorporate more than one gender, and that
gender could be flexible and fluid rather than fixed
from birth or early childhood. However, there were
very few people in the United States during the time
of her work who explicitly identified in a nonbinary
way.
Nonbinary Genders
Nonbinary Gender Identities
Of course, there have always been cultures and
communities around the world where gender has not
been experienced or identified according to gender
binaries. Such experiences and identities include the
Hijra identity in India; the Tom, Dee, and Kathoey
identities in Thailand; and the Bissu, Calabai, and
Calalai identities in some communities in Indonesia.

However, it is important not to view such
experiences and identities through the lens of
contemporary minority Western understandings of
either binary or nonbinary genders, and more
research is necessary that is fully embedded within
such cultures and communities in order to avoid the
ethnocentric perspectives that have tainted much
previous work in these areas.
Over the first decades of the new millennium
there has been a burgeoning group of people in
Western countries who have identified their gender
in a nonbinary way. As with other recent sexual
movements, such as the asexual movement of people
who identify as not experiencing sexual attraction,
the Internet has enabled individuals to find others
who share their experiences, and has also enabled
communities to form and people to begin to fight for
various rights on the basis of nonbinary gender. A
number of new terms have developed to capture
different kinds of nonbinary identity or experience,
including the following:
• Being to some extent, but not completely, one
gender (e.g., demi man/boy, demi woman/girl, fem
man)
• Incorporating aspects of both woman and man (e.g.,
androgynous, mixed gender)
• Having no gender (e.g., gender-neutral,
nongendered, genderless, agender, neutrois)
• Being of a specific additional gender (either between
man and woman or additional to those genders, e.g.,
third gender, sometimes pangender)
• Moving between two genders (e.g., bigender,
genderfluid)
• Moving between multiple genders (e.g., trigender,
sometimes pangender)
• Disrupting the gender binary (e.g., genderqueer,
genderfuck)
To date, there has been a limited amount of
psychological research focusing on people who
explicitly identify as nonbinary in terms of gender,
although there has been work in both queer theory
and queer activism on understanding and
experiencing gender in nonbinary ways dating back
to the early 1990s, which is useful to draw upon. The
psychological research so far has particularly focused
on determining the proportion of people who identify
2211
in this way, and on elucidating key aspects of their
experience.
Estimates of the proportion of people who identify
as nonbinary vary depending on the population being
studied. For example, between 10% and 25% of trans
people identify as nonbinary gender in some way,
whereas around 5% of LGBTQ youths identify as
neither male nor female, and several studied concur
that identifying in this way is more common among
younger people.
Key Features of Nonbinary Experience
A main finding from the research conducted so far is
the importance of connecting with others for
embracing a nonbinary gender identity. Many
nonbinary people report struggling to express
themselves, or to comprehend their experiences, until
finding others who identified in such ways.
Nonbinary people also often report that it is difficult
to have a sense of authenticity without any
acknowledgment of their identities from the people
around them, a common experience as wider culture,
and people within it, are often so embedded—and
invested—in binary genders.
Related to this is the trouble many nonbinary
people experience in trying to find specific spaces or
communities in which they fit. Many report not
fitting into either cisgender or trans spaces,
analogous to the common bisexual experience of not
fitting into heterosexual or lesbian/gay spaces. Some
endeavor to find a home within broader trans or
LGBTQ communities, while others create spaces and
communities for themselves as nonbinary people,
often online, although this presents problems for
those who are older and/or not Internet literate, who
may not find such spaces to be inclusive.
Like both trans and bisexual people, people who
identify as nonbinary experience higher rates of
mental health problems than other gender- and
sexual-identity groups, with over a third reporting
they attempted suicide at some point. Experiences of
discrimination and violence are also high, with a
third reporting physical assault. Also highly common
are everyday experiences of being misgendered;
being the target of microaggressions relating to
gender expression; and having to negotiate a hugely
binary world in relation to public toilets, clothing
choices, changing rooms, and the like.
2212
Most nonbinary people do not perceive either
gender or sexuality as discrete, mutually exclusive
categories but rather regard gender embodiment and
expression as complex and diverse. Some report
feeling a sense of responsibility to challenge the
gender binary, even describing themselves as gender
pioneers and feeling that they are engaged in culture-
making.
Nonbinary Language and Expression
A major area of research thus far is the language that
nonbinary people are developing to express their
identities and experiences. The impact of gendered
language on experience is well documented in
psychology, for example, in the research on the use
of the generic “man” and other sexist language and
its impact on women’s performance and experience,
and on the impact of cisgenderist language on trans
people’s sense of exclusion. Thus, it seems likely
that binary language, and misgendering of nonbinary
people, will have similar effects, although the
research has yet to be conducted.
In relation to terms used to capture diverse
nonbinary experiences and identities, U.S.-based
research has found genderqueer to be the most
common gender-identity term used. Nonbinary
people often relate to more than one gender term
(either at the same time, or across time). Some
gender terms used are specific to certain cultural
traditions, for example, Two-Spirit (First Nations)
and Mahuwahine (Hawai’ian); and some people
devise their own unique gender terms or prefer not to
use labels. Such diversification of terms reached
popular attention in 2014 in the decision of the social
Nonbinary Genders
media website Facebook to provide 58 possible
gender terms for its users.
Another key aspect of nonbinary terminology is
pronoun usage. In English, the most common set of
nonbinary gender pronouns are the existing terms
they/their/them, also now adopted by Facebook. This
is grammatically correct in the singular, and there are
examples of such usage dating back to Chaucer and
Shakespeare. However, some still do not like its
association with plurality, and other popular pronoun
sets that have been explicitly developed for
nonbinary people include ze, zir, zem; xe/xyr/xem;
Sie/hir/hir; and per/per/pers.
In addition to pronouns, nonbinary people
frequently struggle with the imposition of gendered
titles (such as Mr./Ms.), with gendered address (such
as Sir/Madam), and with family and friends who
want to use birth names rather than chosen names.
There is also a need to use nonbinary alternatives for
relationship terms (e.g., partner instead of
boyfriend/girlfriend, sibling instead of sister/ brother,
offspring instead of son/daughter, parent instead of
mother/father).
While there is currently a good deal of
diversification in relation to nonbinary gender, with
many different experiences being embraced under
that broad umbrella, there is also a tendency—as
Sandra Bem herself pointed out—for the
proliferation of possibilities to lead to further
“straitjackets,” as people struggle to fit into new,
narrowly defined identities. Perhaps this can be seen
already in relation to appearance, with the vast
majority of available images of nonbinary,
androgynous, or genderqueer people being young,
White, and slim. There were attempts in 2014 to
challenge this on social media using the Twitter
hashtag #whatgenderqueerlookslike. Trans activists
such as Julia Serano have also pointed to a
preference for masculine-of-center over feminine-of-
center people in many LGBTQ, trans, and nonbinary
spaces.
Physical interventions may or may not be desired
or required by nonbinary people. These include
hormones; surgeries; and changes to aspects of
appearance, clothing, gait, or voice. Research so far
suggests there is diversity in the ways such
possibilities are taken up, or not, by different
nonbinary people.
Nonbiological, Nongestational Mother
Finally, a small body of research suggests that far
more people experiences themselves as nonbinary in
some way than actually identify as nonbinary. One
study on a general population found that over a third
of people felt to some extent that they were the
“other” gender, or both male and female, and/or
neither. This highlights the importance of researching
nonbinary experience in general populations rather
than just among nonbinary communities or with
those who explicitly identify in that way.

Meg John Barker
See also Bisexualities; Cisgenderism; Gender Binaries;
Genderqueer; Queer; Queer Theory
Further Readings
Bornstein, K., & Bergman, S. B. (Eds.). (2010). Gender
outlaws: The next generation. New York, NY: Avalon.
Fausto-Sterling, A. (2012). Sex/gender: Biology in a social
world. New York, NY: Routledge.
Joel, D., Tarrasch, R., Berman, Z., Mukamel, M., & Ziv, E.
(2013). Queering gender: Studying gender identity in
“normative” individuals. Psychology & Sexuality,
1–31. doi:10.1080/19419899.2013.830640
Nestle, J., & Wilchins, R. A. (2002). Genderqueer: Voices
from beyond the sexual binary. New York, NY: Alyson
Books.
Richards, C., & Barker, M. (Eds.). (2013). Sexuality and
gender for mental health professionals: A practical
guide. London, England: Sage.
Richards, C., & Barker, M. J. (Eds.). (2015). Handbook of the
psychology of sexuality and gender. Basingstoke,
England: Palgrave Macmillan.
Richards, C., Bouman, W., Seal, L., & Barker, M. (in
press). Non-binary gender. Basingstoke, England:
Palgrave Macmillan.
NONBIOLOGICAL, NONGESTATIONAL
MOTHER
Nonbiological, nongestational mothers in lesbian
couples have been given a variety of names,
including “social mother,” “comother,” “mather,” or
the “other mother.” The meaning of these names has
an emotional, social, and psychological impact upon
the nonbiological, nongestational mother being
labeled, as well as the entire family. These social
labels have connotations toward the social valuation
of the nonbiological, nongestational mother in the
lesbian couple and in their broader social
community. This entry will discuss the concept of
“mother” within the lesbian couple and the
associated relationship factors that have a significant
impact on all involved.
Being the nonbiological, nongestational mother in
a lesbian couple may be both a personal challenge
2213
and a growth opportunity, as it relates to navigating
the role of mother as a shared responsibility. The
sharing of the “mother” role/duties can be an ongoing
negotiation process, and the needs of the family
change in response to the growing child. Positive and
open communication between both parents in the
lesbian couple is important to make this adaptive
family process function well and keep everyone
satisfied.
It is important to acknowledge that the
relationship of the lesbian couple is only one of many
social “circles” of influence that can impact how a
“nonbirth” lesbian mother regards her parenting role
responsibilities and authority. The couple’s families
and/or their extended social community may convey
social messages regarding the degree to which the
nonbiological, nongestational mother is regarded as a
mother of “equal standing.” Who is acknowledged as
being the primary caretaker of the children in the
family can have meaningful implications for a range
of issues, from how effective the nonbiological,
nongestational mother feels in making parenting
decisions to legal parental rights if the lesbian
couple’s relationship dissolves through a divorce or
breakup.
Family therapists or other professionals working
with lesbian couples need to understand the
dynamic social and emotional issues connected with
the rights and responsibilities of both mothers. There
is a relative paucity of research regarding how
lesbian couples work through the process of defining
and implementing their shared parenting roles in a
fair and equitable manner. Certainly education
(aimed at the LGBTQ community) is needed to assist
in the successful navigation of this motherhood
journey shared by both parents within the lesbian
couple.
One important aspect of this mother-related
dynamic in lesbian families that warrants further
discussion is the impact of this primary caregiving
role upon the developing child. There is important
socialization information conveyed to the child
through the expressed attitudes and actions of the
mothering partnership in the lesbian couple. In effect,
the child internalizes an understanding of the role of
a caretaker (i.e., “mother”), and this can shape the
child’s own adult role as a parent and child caretaker.
From a positive role-modeling perspective, it is
important for the developing child to see a
2214
harmonious assumption of parenting duties and
attitudes between the two lesbian mothers.
Another part of the complex role for the
nonbiological, nongestational mother is the
voluntariness of her decision to become a parent. It
might be the case that one partner in the couple
decides to become a biological mother, and the other
partner in the relationship goes along with the
decision to keep the couple together and, thus,
becomes a mother “by default.” In a different
scenario, the non–birth mother may actually have
wished to be pregnant, but different decision-making
factors (e.g., physical health or age of each partner)
may have led to the other partner becoming the birth
mother. Which partner in the lesbian couple becomes
the birth mother has a significant impact on the non–
birth mother if her gender identity or self-esteem is
tied to the desire to experience a pregnancy firsthand.
The emotional and psychological needs of both
partners in the relationship need to be acknowledged
and accounted for throughout this decision-making
process.
In response to this significant life change, the
couple may consult a family therapist to address the
sensitive nature of this decision-making process and
its associated impact upon both the lesbian couple’s
relationship and their potential parenting response to
the child that comes into their lives. This can be a
personal growth opportunity for the non–birth
mother to assume an unanticipated mothering role
and benefit from the
Nonbiological, Nongestational Mother
adaptation process in response to new caregiving role
experiences and responsibilities.
The varied social definition of a nonbiological,
nongestational mother translates into an even more
complex and inconsistent legal definition of this
parental role on a state-by-state basis. In some U.S.
states, lesbian parents may face legal uncertainty in
the court system regarding who is awarded legal
custody of the child if the couple does not remain
together. The legal rights of the nonbiological,
nongestational mother have social, psychological,
physical, and emotional ramifications toward the care
and well-being of the child, regardless of the
relationship status of the couple. Public policy
makers, legislators, and lawyers need to better
address the legal custody rights of lesbian non– birth
mothers to protect the welfare of all involved.
Recognition of the important role of the
nonbiological, nongestational lesbian mother within
the family system is an important issue that needs to
be discussed and reinforced at many levels of
society. Certainly public policy legislation and
community education are critically needed to
determine the best ways to support the emotional,
social, and psychological needs of both lesbian
mothers and their offspring. A societal and legal
valuation of both “mother” roles within the lesbian
family are critical for a long-lasting relationship
within the couple and a strong, loving parental bond
with their offspring. The social labeling and the
associated distinctions made between the biological
and nonbiological, nongestational mothers in a
lesbian couple should be eradicated through
appropriate education and possible family
counseling. There should be an equal societal
valuation of the mothering role, regardless of her
birth experience. A mutual understanding of the
mothering role expectations, a mutual respect of role
boundaries, and an equitable sharing of parental
duties are all important factors for both the birth and
non–birth mothers in the lesbian family.
Lisa Hollis-Sawyer
See also Children With LGBQ Parents, Psychological
Outcomes; Coparenting; Couples Therapy; Families of
Choice; LGB Parenting Styles and Values; Transition to
Parenthood and Parental Roles
Nondiscrimination Protections, State and Local
Further Readings
Ben-Ari, A., & Livni, T. (2006). Motherhood is not a given
thing: Experiences and constructed meanings of
biological and nonbiological lesbian mothers. Sex
Roles, 54, 521–531. doi:10.1007/s11199-006-9016-0
Brown, R., & Perlesz, A. (2007). Not the “other” mother:
How language constructs lesbian co-parenting
relationships. Journal of GLBT Family Studies, 3,
267–308. doi:10.1300/J461v03n02_10
Brown, R., & Perlesz, A. (2008). In search of a name for
lesbians who mother their nonbiological children.
Journal of GLBT Family Studies, 4, 453–467.
doi:10.1080/15504280802191574

Gabb, J. (2005). Lesbian m/otherhood: Strategies of familial-
linguistic management in lesbian parent families.
Sociology, 39, 585–603. doi:10.1177/
0038038505056025
Gartrell, N., Banks, A., Hamilton, J., Reed, N., Bishop, H.,
& Rodas, C. (1999). The national lesbian family study:
2. Interviews with mothers of toddlers. American
Journal of Orthopsychiatry, 69, 362–369.
doi:10.1037/h0080410
Padavic, I., & Butterfield, J. (2011). Mothers, fathers, and
“mathers”: Negotiating a lesbian co-parent identity.
Gender and Society, 25, 176–196. doi:10.1177/
0891243211399278
NONDISCRIMINATION PROTECTIONS,
STATE AND LOCAL
This entry describes legal protections against
discrimination for LGBTQ people at the state and
local levels. It explains the types of discrimination
experienced and the patchwork of laws passed to
address that discrimination.
Prevalence of Discrimination Experienced by
LGBTQ People
The study of discrimination against LGBTQ people
in the United States has disproportionately focused
on employment. However, LGBTQ people also face
bias in areas such as housing, public
accommodations, credit, insurance, and education.
This entry will focus on employment, housing, and
public accommodations, which are typically included
simultaneously in state and local laws passed to
address discrimination.
More than 40% of LGBTQ people have
experienced at least one type of employment
discrimination—such as in hiring, promotion, or job
retention—at some point in their lives as a result of
their sexual orientation, according to the 2008
General Social Survey. The largest study of
transgender people, Injustice at Every Turn, found
that 47% of transgender people experienced a
negative job outcome as a result of their gender
identity, while 90% reported experiencing
harassment, mistreatment, or discrimination on the
job. Discrimination in employment leads not only to
2215
higher poverty levels but also to health-related
problems.
Housing discrimination against LGBTQ people
occurs when an individual or family is charged
higher rent, shown less desirable properties, or
denied the ability to rent or purchase a property
altogether. More than 10% of lesbian, gay, and
bisexual people in a 2000 Kaiser Family Foundation
Survey reported being discriminated against when
renting an apartment or purchasing a home. Of those
who had not experienced housing discrimination
personally, 35% knew someone who had experience
such discrimination based on his or her sexual
orientation. The survey found that nearly 20% of
transgender people have experienced housing
discrimination.
The definition of public accommodations varies
from state to state. Generally, public
accommodations laws cover anyplace an ordinary
person would expect to be able to enter for the
purpose of purchasing goods and services without
express permission—restaurants, theaters, shops, bus
stations, hotels, amusement parks, and salons.
Recently, several high-profile lawsuits have been
filed after same-sex couples experienced
discrimination when attempting to purchase
weddingrelated services and goods. Injustice at
Every Turn reported that more than half of
transgender people have experienced harassment in a
place of public accommodation. Retail stores were
the location of the most harassment and unequal
treatment.
Limitations on Nondiscrimination Laws
Nondiscrimination laws are intended to create an
equal playing field for groups who have historically
been disfavored in the public marketplace. However,
the laws do not prohibit the use of neutral criteria in
making determinations on whom to hire or when
people are eligible for services. Thus, an employer
can take into consideration a job seeker’s education
and previous experience as long as those factors are
relevant to the job. A landlord or shopkeeper can
legitimately take into account a person’s ability to
pay.
Historical Background
After decades of police raids and public harassment,
in the summer of 1969 a group of lesbian, gay,
2216
bisexual, and transgender (LGBT) patrons took to the
streets to protest a raid on the Stonewall Inn, a gay
bar in New York City. The event galvanized the
LGBTQ community and brought broader public
attention to the discrimination faced by LGBTQ
people.
The city council in East Lansing, Michigan,
passed the first ordinance (city law) prohibiting
discrimination on the basis of sexual orientation in
March of 1972. Initially, the ordinance only
protected city employees from employment
discrimination. A decade later, Wisconsin became
the first state to pass a nondiscrimination law that
made it illegal to discriminate against lesbian, gay,
and bisexual people in employment, housing, and
public accommodations. The state had long been a
leader in prohibiting discrimination, also being the
first state to make sex discrimination and disability
discrimination illegal.
In 1975, Minneapolis, Minnesota, became the first
place in the United States to prohibit discrimination
against transgender people. At the time, protections
were given based on “affectional preference,” which
was defined to include “having or projecting a self-
image not associated with one’s biological maleness
or one’s biological femaleness.” The state of
Minnesota passed the first statewide
nondiscrimination law to include gender identity in
1993. However, rather than passing it as
Nondiscrimination Protections, State and Local
a distinct category, the legislature defined sexual
orientation to include language almost identical to
the Minneapolis statute. Many following ordinances
and state-level laws included protections for
transgender people either in the definition of sexual
orientation or in the definition of sex.
The Patchwork of State and Local
Protections
As of this writing, 17 states and the District of
Columbia have laws prohibiting discrimination on
the basis of sexual orientation and gender identity.
The states are California, Colorado, Connecticut,
Delaware, Hawai’i, Illinois, Iowa, Maine, Maryland,
Massachusetts, New Jersey, New Mexico, Nevada,
Oregon, Rhode Island, Vermont, and Washington.
Each prohibits discrimination in employment,
housing, and public accommodations with the
exception of Massachusetts. There, the legislature
did not cover public accommodations protections for
transgender people. Three additional states—New
Hampshire, New York, and Wisconsin—provide
nondiscrimination protections in all employment,
housing, and public accommodations only on the
basis of sexual orientation.
States that have chosen to pass nondiscrimination
laws covering LGBTQ people tend to be clustered on
the coasts or in the Midwest. No state in the South
has adopted legislation to prohibit discrimination on
the basis of sexual orientation or gender identity.
When the state has failed to act, cities and
counties often choose to pass nondiscrimination
ordinances that include sexual orientation and gender
identity as protected categories. More than 175 cities
and counties have passed nondiscrimination
ordinances in states that do not protect people from
discrimination on the basis of sexual orientation or
gender identity. Many more adopted these
protections prior to passage of a statewide law. Cities
such as Austin, Texas; Ann Arbor, Michigan; and St.
Louis, Missouri, are places where most Americans
would not be surprised to find protections for
LGBTQ people. However, a
Nonheterosexual Children of LGBTQ Parents
wide range of cities have chosen to protect their
LGBTQ citizens, including more than a dozen in
Utah and a half dozen in Idaho. Vicco, Kentucky,
with a population of just over 300 people, adopted an
LGBTQ-inclusive nondiscrimination ordinance
in 2012.
Public Support
A supermajority of Americans support laws
prohibiting discrimination on the basis of sexual
orientation and gender identity. According to the
Public Religion Research Institute, 72% of
Americans favor laws protecting gays and lesbians
from discrimination in employment, including a
majority of Republicans and a majority of every
major religious denomination. A national survey of
registered voters conducted by TargetPoint
Consulting found that 68% support employment
nondiscrimination laws that cover sexual orientation
and gender identity.

Sarah Warbelow
See also Bullying, Legal Protections Against;
Discrimination Against LGBTQ People in the Public
Sector; Employment Non-Discrimination Act (ENDA);
Housing, Protection Against Discrimination in
Further Readings
Grant, J. M., Mottet, L. A., Tanis, J., Harrison, J.,
Herman, J. L., & Keisling, M. (2011). Injustice at
every turn: A report of the National Transgender
Discrimination Survey. Washington, DC: National
Center for Transgender Equality and National Gay
and Lesbian Task Force.
Mezey, S. G. (2007). Queers in court: Gay rights law and
public policy. New York, NY: Rowman & Littlefield. Pew
Research Center. (2013, June 13). A survey of LGBT
Americans: Attitudes, experiences and values in changing
times. Washington, DC: Author. Retrieved November 29,
2015, from http://www .pewsocialtrends.org/2013/06/13/a-
survey-of- lgbt-americans/
Pizer, J. C., Sears, B., Mallory, C., & Hunter, N. D.
(2012). Evidence of persistent and pervasive workplace
discrimination against LGBT People: The need for
federal legislation prohibiting discrimination and
providing for equal employment benefits. Loyola of
Los Angeles Law Review, 45, 715–779.
NONHETEROSEXUAL CHILDREN
OF LGBTQ PARENTS
Although LGBTQ people have always been parents,
it is only in the past few decades that they have been
able to do so without fear of negative legal and social
consequences. The children of LGBTQ people have
been analyzed in social science research, and build
their lives under the critical gaze of public opinion.
LGBTQ parents experience pressure to ensure that
their children are heterosexual and gender-normative,
which have been presumed to be more optimal
outcomes. This pressure has burdened these families
to conform to societal heteronormative assumptions,
and this has downplayed honest discourse regarding
the complexity of children’s developing gender
identity and sexual orientation living in LGBTQ
families. Although most children growing up in
LGBTQ-parent families are heterosexual and gender-
2217
conforming, some children in these families are not.
There is scant research on the LGBTQ children of
LGBTQ parents, but the extant research reveals some
interesting information about these “second
generation” children.
Historical Context
Throughout most of modern history, LGBTQ people
have lived closeted lives, and those who had children
—generally produced while in heterosexual
relationships—kept their sexual orientation and
gender identities hidden. It was only with the rise of
the lesbian and gay civil rights movement that same-
sex–headed families were able to be publicly out. In
the past few decades, increasing numbers of same-
sex couples have consciously chosen to become
parents after coming out, which has led to a rise in
the social acceptance of lesbian and gay male–
headed families.
As the LGBTQ movement has grown, increasing
numbers of transgender and queer parents have been
able to claim their right publicly to build families.
Transgender people—those whose gender identity or
gender expression is different from their assigned sex
at birth—can become parents before or after their
transition. Queer, or genderqueer, is often used as an
umbrella term for all people who step out of
commonly expected and prescribed rules for gender
expression and identity, including those who are
lesbian, gay, bisexual, and transgender. Queer people
are increasingly claiming their right to become
parents, which is reshaping the modern definitions of
family outside of a heteronormative context.
Heteronormativity is an ideology that assumes
everyone is heterosexual and should express
traditional gender conventionality. It assumes that
heterosexuality and gender- conforming behavior are
superior to other forms of sexual orientation or
gender expression. All LGBTQ people are the
recipients of institutionalized oppression due to their
non-normative sexual orientation or gender
expression, and these societal rules have historically
limited LGBTQ ability to form families, as well as
maintain custody of their children.
Prior to the 1970s, the prevailing bias of the
judicial system was that homosexuality and
transsexualism were inherently damaging to children
because of the lack of traditional sex roles modeled
2218
for children. The assumption was that these so-called
alternative family structures would create children
who were confused about normative male or female
roles, and they would likely become LGBTQ
themselves; having an LGBTQ child was considered
a parental “failure,” and the courts were expected to
assert social control to protect children.
In the 1970s—in the midst of both the women’s
and the gay and lesbian liberation movements— the
question of whether LGBTQ parenting was
inherently dangerous for children was challenged in
the courts. Lesbian motherhood, and the right of
lesbian mothers to retain custody of their children
following a heterosexual divorce, became the focus
of numerous legal cases, since it was believed that
being reared in a home without a father was not
Nonheterosexual Children of LGBTQ Parents
“in the best interest of children.” In an era when
women routinely won the right of full custody of
their children following a divorce, lesbian mothers
were losing every legal battle to retain custody of
their children based solely on their sexual
orientation. The lack of empirical evidence proving
the supposedly negative effects on children of
lesbian mothers became the impetus for a huge
outpouring of social science research studies that
eventually provided evidence-based support for the
psychological stability of children reared by lesbian
parents. These extensive court battles that lesbian
mothers waged to retain custody of their children
paved the way for other sexual-minority parents in
the years that followed. Much of what is known
empirically about LGBTQ parenting is derived from
studies of lesbians and then generalized to gay male
parents; few studies to date have focused on
parenting by bisexual, transgender/transsexual, or
queer people.
Research Findings and Controversies
When the judicial system determined that lesbian
parenting was not harmful to children, they based it
on social science research that examined
psychological adjustment, self-esteem, academic
performance, and other issues of children reared in
lesbian homes. The research unambiguously revealed
that children of lesbian mothers do not show any
signs of psychological problems; indeed, some
results implied that many children reared in lesbian
homes exhibit specific strengths compared with
peers. This research has been instrumental in
changing social policy for all LGBTQ people
regarding child custody, access to reproductive
technologies, and adoption and foster care
placements, and has led to a “gayby” boom of
LGBTQ parenting.
A major focus of the research involved examining
the development of gender identity and sexual
orientation for children reared in same-sex homes.
The concern was whether lesbian mothers (and, by
extension, other queer parents) would differ from
heterosexual mothers in how they raised their
children to social expectations regarding
heterosexuality and gender-normative behavior.
Nonheterosexual Children of LGBTQ Parents
The research unequivocally affirmed that children of
lesbian parents express traditional gender roles and
behaviors, and are almost always heterosexual.
Same-sex parenting had been justified based on
scientific affirmations of heteronormativity, and
LGBTQ parents have been “allowed” to parent in
part because the research affirmed heterosexual and
gender- conforming outcomes. That is, the children
of LGBTQ parents would maintain the status quo by
heterosexually marrying, and by raising children
according to acceptable gendered standards. This has
placed tremendous pressure on LGBTQ parents to
raise children who are heterosexual and gender-
normative, as well as on their children to be
“normal.”
Given all that has rested on this research for
LGBTQ parents, challenging these results has been
politically complicated. Initially, the challenges came
mostly from those who were opposed to LGBTQ
parenting, based on their conservative values. More
recently, meta-analyses and emerging research have
continued to reexamine the initial questions of how
having LGBTQ parents might influence child-rearing
and identities of children reared outside of
heteronormative presumptions. The assumption that
healthy child development should be defined by
heterosexual and gendernormative narratives is
fraught with heteronormativity and based in false
ideologies that being heterosexual, or demonstrating
gender-conforming behavior, is a superior outcome.
This assumption is being challenged by the

increasing visibility of LGBTQ children of LGBTQ
parents.
LGBTQ Children of LGBTQ Parents
There is scant research on nonheterosexual children
of LGBTQ parents, although the literature on
LGBTQ youth reveals that some have LGBTQ
parents, and the research on LGBTQ parents
suggests that some of their offspring are LGBTQ
themselves. They are an understudied minority group
within a minority group. However, studying this
population is complicated, since outside of the
neutrality of academia, and given the heterosexism of
the culture at large, the results of these studies can
negatively guide social policy and reverse the social
acceptance of the diversity of family forms currently
emerging.
There is no evidence to suggest that LGBTQ
parents encourage nonheterosexual or genderatypical
behaviors in their children. Indeed, coming out may
actually be more complicated for the LGBTQ
children of LGBTQ parents. For example, LGBTQ
parents may feel compelled to ensure that their
children are heteronormative in the face of familial
and social scrutiny. Same-sex parents who are raising
gender-nonconforming children, or those that
identify as transgender, may be as challenged as
heterosexual parents. They may especially fear for
their children due to their own traumatic history of
being reared in far more homophobic times. They
might also fear they will be blamed by their families
and communities for their children’s queer identities.
The children reared in these homes may worry they
are disappointing their parents and may feel the need
to protect their family from judgment and therefore
repress their own emerging identities. Research
suggests that not all LGBTQ children see that their
parents are resources (even if their parents are loving
and supportive), and LGBTQ youth with LGBTQ
parents may hide their sexuality from their parents in
similar ways as do many LGBTQ youth with
heterosexual parents. Sexuality and gender
expression as they emerge in youth are a private
matter; few teens want to be “like” their parents, and
it can be presumed that this is also true for the
LGBTQ children of LGBTQ parents.
If LGBTQ parents are able to step out of their
own experiences and social pressures, they might
2219
serve as positive role models and protective buffers
against societal heterosexism for their LGBTQ
children. Perhaps, given their own experiences and
the cultural influences in their lives, they might allow
their children more freedom to “discover” their
sexuality, outside of the heteronormative
assumptions of much of society. They certainly are
knowledgeable about coming-out processes and have
not only access to LGBTQ cultural communities but
also a unique understanding about the challenges
their children might face.
However, LGBTQ parents commonly have their own
legacy of psychological pain, which may cloud their
ability to be responsive to their children; indeed, they
may project their own histories of pain and
internalized homophobia onto their child.
The nature of homophobia and transphobia is such
that it may be difficult for LGBTQ parents to
celebrate having an LGBTQ child, although it seems
that if “gay pride” has any meaning at all, it should
be a natural reaction. There is enormous societal
pressure on LGBTQ parents to produce heterosexual,
gender-normative children and enormous
expectations on their children to fulfill those social
and parental expectations. Despite these challenges,
LGBTQ children of LGBTQ parents— what some
young people call “queerspawn”— exist, and
nonbiased research into this emerging demographic
is overdue.
Arlene Istar Lev
See also Adults With LGBQ Parents; Children With LGBQ
Parents, Gender Development and Identity;
Nonheterosexual Children of LGBTQ Parents
Children with Transgender Parents, Psychosocial
Outcomes; Custody Issues in Transgender Parenting;
Heteronormativity; Therapy With Children of LGBTQ
Parents
Further Readings
Bigner, J. J., & Wetchler, J. L (Eds.). (2012). Handbook
of LGBT-affirmative couple and family therapy (pp.
57–68). New York, NY: Routledge.
Goldberg, A. E. (2010). Lesbian and gay parents and their
children: Research on the family life cycle. Washington,
DC: American Psychological Association.
2220
Goldberg, A. E., & Allen, K. R. (2012). LGBT-parent
families: Innovations in research and implications for
practice. New York, NY: Springer.
Lev, A. I. (2004). The complete lesbian and gay parenting
guide. New York, NY: Berkley/Penguin.
Riggs, D. W. (2007). Becoming parent: Lesbians, gay men,
and family. Tenerife, Queensland, Australia: Post Pressed.
Tasker, F. L., & Golombok, S. (1997). Growing up in a
lesbian family: Effects on child development. New
York, NY: Guilford.
2222

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2230

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2232

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2234

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2238

Online normal for

surveys researcher
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may also that has
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reliability, misrepres
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surveys research
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potential
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risk of
participant McDermo
s tt and
completing Victoria
the survey Rawlings
more than
See also
once. Ethical
Finally, it Research
is With
important Sexual and
to note that Gender
online Minoriti
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Intersect
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present in Online
the lives of Commu
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people. s:
Online Building
surveys Commu
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Through
corral
Blogs,
participant Vlogs,
s into and
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responses k;
sacrifice Psychol
validity ogical
and Approac
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ntation of Quantita
a tive
population Researc
2240

h; health
Samplin surveys.
g Australian
and New
Zealand
F Journal of
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e Union
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for
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d (2014).
i
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 ves in 3: of
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national mos
exu
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alit
the y,
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wellbein Vrangalova
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same sex
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gender Mostly
questioni heterose
ng young xual and
mostly
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ne: Evidenc
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on
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t, C.
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tech
niqu
es. See
Jour Essenti
nal
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2244

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xuality, postmode
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Pan sexual
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emerge desire,
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new y was also
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orientat ity in that
ion the term
term bisexualit
that y broke
attempt free from
ed to the strict
describ heterosex
e ual–
desires homosexu
al many
dichotomy trans*
of earlier people did
times. not fit
However, neatly
despite the into the
move commonl
away from y
binary understoo
structures d confines
that of
bisexuality bisexualit
represente y
d, some (namely,
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the
considered
requireme
bisexuality
nt to be
to be too
attracted
limiting.
to men
The
and
challenges
women as
to
bisexuality defined
came from by the
several traditional
different gender
communiti binary),
es. there was
First a strong
and desire
foremost, from
the rise of trans*
trans*1 communit
movement ies for a
s, trans* term that
identities, more
and trans* accurately
activism reflected
led to both the
demands desires of
for the trans*
inclusion people
of trans* and the
people in desires of
the realm people
of sexual- who were
identity attracted
terms. to both
Given that trans* and
2246

cisgendere nonbinary
d people. genders.
From this Pa
desire for nse
xu
a new and
alit
more y
inclusive
term, both
pomosexu People
ality and who were
pansexuali active in
ty communit
emerged, ies of
with nonnorma
pansexuali tive
ty sexual
becoming behavior
the also felt
limited by
primary
the exiting
term for
labels and
sexual
pushed for
identities
the
that
creation
included
of
trans* pansexual
people ity. While
through its there were
avoidance many
of people
association who
s with the wished to
gender retain the
binary. heterosex
However, ual label,
writers despite
such as their non-
Shiri normative
Eisner desires
have and
argued that activities,
bisexuality several
can also be key
understood groups of
in ways people
that are pushed for
inclusive terminolo
of trans* gy that
and would
allow
them to during
more fully certain
express BDSM
both their activities,
traditional the
heterosexu definition
al s of man
attraction and
for what is woman
traditionall used in
y called both
“the heterosex
opposite uality and,
sex” and arguably,
their bisexualit
nontraditio y did not
nal desires seem
for certain sufficient
sexual to
activities. describe
Some the
people in actions
BDSM and
communiti desires of
es felt their certain
attractions members
or actions of BDSM
laid communit
beyond ies. Thus,
both the the
traditional adoption
definition of
of pansexual
heterosexu ity by
ality and some
the newer members
concept of of these
bisexuality communit
. Given the ies began,
fluid since it
gender allowed
identity of for
some attraction
participant to a
s and due broader
to the range of
complexiti activities
es of and
identity people of
that occur varying
2248

gender and ality.

sexual Many of
identities. these
In queer
addition to heterosex
BDSM uals also
communiti found
es, groups bisexualit
of y to be too
heterosexu narrow or
als, to be an
sometimes inaccurate
called descriptio
queer n of their
heterosexu desires.
als, also Pansexual
pushed for ity,
a sexual- however,
identity allowed a
term that greater
would number of
include sexual
their acts and
desires and desires to
attractions. fall under
These its
heterosexu umbrella
als were and
attracted to therefore
sexual acts could be
associated used by
with these
homosexu groups of
al heterosex
communiti uals
es, while whose
wishing to desires
perform and
those acts activities
in a were
heterosexu different
al context, than those
and traditional
therefore ly
felt they associated
did not fit with
into the heterosex
strict uality.
confines of Pansex
heterosexu uality is
often seen transition.
as a fluid Furthermo
sexual re,
identity. genderque
Although er, gender
members fluid, and
of the genderfuc
pansexual king
communit individual
y may s are able
maintain a to use the
constant term
set of pansexual
attraction, ity to
people can describe
also their
experience sexual
varying identity as
levels of well.
attraction In
to people some
of various communit
genders ies, the
while still concept of
maintainin queer
g the same sexuality
sexual overlaps
identity. with
The term pansexual
also allows ity to a
for fluidity large
of gender extent,
identity whereas
while still in other
being part communit
of the ies the
same two are
sexual seen as
orientation distinct
. Thus, a terms and
trans* man identities.
or woman One
who notable
transitione difference
d could is that
continue to while
identify as queer can
pansexual be used as
before and a unifying
after term to
2250

encompass es. While

all other the term is
sexual- in popular
identity use in
terms many
other than communit
heterosexu ies, its use
ality, has not
pansexuali been
ty is not an nearly as
umbrella well
term for all document
sexualities. ed as that
Pansexuali of
ty is a lesbian,
distinct gay, or
sexual even
identity bisexual.
that Given the
encompass fluid
es a broad nature of
range of the term,
sexual the study
desires. of
Thus, individual
while in s
some cases identifyin
a lesbian g as
may pansexual
identify as often
queer, involves
when the collecting
word is data from
used as an numerous
umbrella communit
term, ies and
lesbian is being
not part of aware of
the the
pansexual possible
identity. shifts in
In usage of
general, the term
scholarshi in these
p on communit
pansexuali ies. The
ty lags far inherently
behind its fluid
usage in nature of
communiti pansexual
ity means publicatio
that its ns.
exact Additio
usage in nally,
communiti pansexual
es varies ity as a
by term is
location, considere
race, d to be
ethnicity, first used
and gender in
identity English-
and is speaking
influenced U.S.
greatly by contexts
socioecono and
mic and therefore
political can be
factors. found
The more
various frequently
uses of in
pansexuali communit
ty in many ies with
of these ties to that
communiti geographi
es are still c and
an area linguistic
that could area.
benefit However,
from the term
further pansexual
research. ity is in
In common
particular, use in
communiti many
es of color other parts
have of the
various world and
connection seems to
s with the be in use
term in at least
pansexuali some
ty that
have not
been fully
explored
as yet in
academic
Parent Gender Transition and Intimate Relationship Changes
communities in most and beyond, the gender
parts of the globe. spectrum and people
Currently the use of whose desired sexual
pansexuality as a sexual activities exist beyond
identity around the world what has been
is being explored in a few traditionally considered
studies. Of course, the heterosexual sex.
absence of the term in
Autumn Elizabeth
some parts of the world
does not necessitate the See also Bisexualities;
absence of people with Bondage/Domination,
similar desires to those Submission,
who identify as pan- Sadism/Masochism
sexual; it merely indicates (BDSM); Polyamory;
the existence of other Queer;
constructions and Sexual Orientation
Among Transgender
terminology for these
People;
desires.
Transgender Identities;
Despite the importance Transgender Sexualities
of trans* people in the
creation of pansexuality, N
there is no evidence to o
show that all, or even t
most, trans* people e
identify as pansexual.
1. The term trans* is a
Furthermore, even though
way to signify the entire
trans* communities scope of communities of
pushed for a more transsexuals, transgendered,
inclusive term than transvestites, some gender
bisexuality, many trans* queer communities, and
people do not feel anyone who feels part of
excluded by the term these communities.
bisexual. Indeed, some
trans* people identify as
bisexual. While trans*
activists were at the
forefront of the creation
of the term pansexuality,
this by no means implies
that all trans* people are
pansexual or that the term
is limited to use in trans*
communities. Ultimately,
pansexuality is a
sexuality that attempts to
move beyond traditional
binaries associated with
sexuality and gender and
include people across,
 2253
F
u
r Gender transition impacts
t intimate relationships
h with partners and
e spouses, as well as
r relationships with
children, often affecting
R relationship dynamics
e and family roles. A large
a national survey found
d that 41% of transgender
i (trans) participants were
n parents. Many trans
g
parents transition after
s
forming a family, while
Eisner, S. (2013). Bi: Notes others have children after
for a bisexual revolution. or even during transition.
Berkeley, CA: Seal Press. People over the age of 55
Elizabeth, A. (2013). were much more likely to
Challenging the have children than were
binary: Sexual those who transitioned
identity that is not
between the ages of 25
duality. Journal of
Bisexuality, 13(3),
and 44 (82% vs. 38%,
329–337. respectively, in the
Marinucci, M. (2010). national survey). Trans
Feminism is queer. New women (male-to-female
York, NY: Zed Books. individuals, or MtF) are
Vassi, M. (1997). Beyond more likely to be married
bisexuality. In C. Queen and to have children than
& L. Schimel (Eds.), are trans men.
PoMoSexuals: Indeed, it is becoming
Challenging more common for people
assumptions about to transition “in place”—
gender and sexuality that is, with the goal of
(pp. 70–75). San maintaining their families
Francisco, CA: Cleis and careers. The trans
Press. person’s partner or
spouse and children
“transition with” the trans
person as the family
PARENT GENDER creates and adjusts to new
roles. Social location,
TRANSITION AND such as ethnicity,
socioeconomic status, age
INTIMATE at transition, and
RELATIONSHIP employment status,
significantly influence the
CHANGES types of challenges that
trans-parent families face.
Having a higher income
and greater education
increases the likelihood
that trans people have
children. Contrary to
stereotypes that divorce
or separation is the
inevitable result of
partner transition, in the
national survey, 45% of
trans respondents
maintained their partner
and spousal relationships,
and people who
transitioned at a younger
age were more likely to
maintain (59%)
partnerships than people
who transitioned after 45
(36%). Immediate and
extended family
acceptance and support,
or lack thereof, plays a
highly significant role in
the mental, physical, and
practical outcomes
following parental
transition.
Parent Gender Transition and Intimate Relationship Changes
Some trans parents
experience partner
rejection, anger, and
parental alienation when
they reveal their trans
identity. Family rejection
is associated with greatly
increased rates of
homelessness, health
risks, substance abuse,
and suicidality for trans
persons. Others separate
more amicably or work
through their gender
transition with their
partners or spouses. The
negotiation of
transformed intimate
relationships is complex
as partners navigate name
changes as well as bodily
and gender presentation
changes and then move
beyond stereotyped
gender roles. Evidence
suggests that both
partners often experience
sexual identity and legal
challenges as they adjust
to real or perceived shifts
in their sexual orientation.
Non-trans partners report
periods of identity
exploration as they adjust
to their partner’s
transition and social
perceptions that may not
match their personal
identities. Lesbian
women with trans men
partners may become
situated in an
(uncomfortable)
heterosexual binary, and
heterosexual wives of
trans women face being
situated as lesbian
couples.
In the United States,
some trans people are
legally married parents if
they transitioned after
forming a family. Their
marriages’ posttransitions
are recognized by various
institutions and confer all
the same rights and
privileges that same-sex
couples are, in some
places, denied. However,
this legal recognition is
tenuous if the trans
partner makes changes to
legal identification
documents, and social
challenges (e.g., labels in
their children’s school

records) are abundant if
they simply present as a
same-sex couple. Data is
limited on how transition
affects sexual
relationships in preserved
partnerships.
Predominantly qualitative
reports suggest changes
in sexual relationships
ranging from increased
interest in sex due to
increased satisfaction or
comfort with the
transitioned body, to
dissolution of the sexual
part of the marital
relationship. Generally,
trans people, non-trans
partners, and therapists
agree that open
communication about the
degree and timing of
transition, the partner and
parenting relationship,
and the pace of transition
are important to
maintaining and
enhancing the
relationship.
Challenges may be
significant; for example,
the non-trans partner may
prefer a slower transition,
while some trans people
experience a “flood”
period where they prefer
to immerse themselves in
their new identity and
share their identity
broadly. Decisions about
pace and when and to
whom to come out also
depends on the children’s
developmental level and
the extent to which the
parent presents as gender
variant. Although
children report
2255
experiencing periods of
stress, evidence suggests
younger children and
children who have
become empowered
“trans experts” may have
an easier time adapting
and disclosing their trans
parents’ status. In an
empirical study, many
trans parents reported
limiting to whom they
were out and pacing their
transition (e.g., going at a
“glacial” pace or delaying
transition) according to
the needs of their family.
If a relationship is not
salvageable,
transknowledgeable
therapists can help to
reduce conflict and
potential harm to the
children from the
acrimony between the
parents. Many trans
parents report
irreconcilable differences
with spouses and high
levels of family conflict.
In a transphobic culture,
vindictive non-trans
partners may succeed in
preventing access to
children or triggering
trans discrimination in
family court. Black
(33%), multiracial (33%),
MtF (34%), and female-
to-male (FtM; 20%)
individuals reported that
ex-partners or spouses
interfered with or limited
their relationships with
their children. Trans
parents also face social
stigma and systemic
discrimination (e.g.,
transphobia, employment
discrimination, democratic and feminist
inadequate access to styles of parenting and
health care). When were fierce advocates for
compared to lesbian and their children if the child
gay parents, trans parents experienced any bullying
reported less support related to their trans
from their parents, status. Trans parents
extended family, and tended to choose lesbian,
friends. Nevertheless, in a gay, bisexual, and
large sample, more than transgender (LGBT)-
half of trans respondents friendly environments
(63% to 67%) reported when possible as well as
that their family seek support for
relationships gradually themselves, their
improved, with about half partners, and their
reporting that their family children through Web-
was currently as strong as based sources when
it was prior to coming out support was not locally
as trans. Adult children of available. Trans parents
trans parents also attempt to balance their
characterized their need to accept their own
parent–child relationship gender identity and to
as at least as positive as it live authentically with
was prior to transition. their partners, with their
Transgender parents desire for their children to
destabilize gender roles in thrive.
the family, and
consequently reevaluating Beth A. Haines and Alex
parenting roles is another Ajayi
important step for
See also Transgender Parents
intimate partners. Trans
and Well-Being; Transgender
men who bear children
Sexualities
have attracted public
attention as they
reconciled masculinity
with childbearing and
breast-feeding. Although
some trans people prefer
to present as traditionally
gender typed, the
available evidence
suggests that trans parents
are likely to see gender
roles as socially
constructed and to
challenge gender-
stereotyped parenting
roles. In one study, trans
parents endorsed
 2257
F Samons, S. L. (2009). Can
u this marriage be saved?
r Addressing male-to-
t female transgender issues
h in couples therapy. Sexual
e and Relationships
r Therapy, 24, 152–162.
Parent
R Relatio
e nship
a Qualit
d y
i
n Veldorale-Griffin, A. (2014).
g Transgender parents and
s their adult children’s
Downing, J. B. (2013). experiences of disclosure
Transgender-parent and transition. Journal of
families. In A. E. GLBT Family Studies, 10,
Goldberg & K. R. Allen 475–501.
(Eds.), LGBT-parent
families: Innovations in
research and implications
for practice (pp. 105– PARENT
116). New York, NY:
Springer. RELATIONSHIP
Grant, J. M., Mottet, L. A,
Tanis, J., Harrison, J., QUALITY
Herman, J. L., & Keisling,
M. (2011). Injustice at
every turn: A report of the
Relationship quality for
National Transgender
Discrimination Survey.
parents and nonparents
Washington, DC: National alike has been defined in
Center for Transgender different ways in the
Equality & National Gay research literature.
& Lesbian Task Force. Specifically, it has been
Haines, B. A., Ajayi, A. defined in terms of
A., & Boyd, H. (2014). relationship satisfaction,
Making trans parents
the stability of the
visible:
Intersectionality of
relationship, level of
trans and parenting commitment, sexual
identities. Feminism & fidelity, and positive
Psychology, 24(2), versus negative
238–247. interactions between
Hines, S. (2006). Intimate partners. Typically,
transitions: relationship quality has
Transgender practice
been examined within
of partnering and
parenting. Sociology, heterosexual couples and
40, 353–371. gay and lesbian couples
without children. Only
recently have researchers
begun to examine
relationship quality
within the context of
LGBTQ couples with
children. The quality of
partner relationships can
influence children’s well-
being and overall
functioning. Further,
having children can be a
barrier to relationship
dissolution or divorce
among LGBTQ partners.
This entry will discuss
overall relationship
quality for LGBTQ
parents, relationship
quality during the
transition to parenthood,
how division of labor
influences relationships,
and the unique influence
of minority stress on
relationship quality.
Overview
Currently, approximately
22% of gay male couples
and 33% of lesbian
couples are living with
children under the age of
18 in the United States.
There are multiple ways
that LGBTQ couples
bring children into the
household, including
adoption, children from
previous relationships
(including previous
heterosexual
relationships), surrogacy,
and alternative
insemination (using
sperm from a known or
unknown donor), among
others. At the same time
that same-sex marriage
becomes legal throughout
the United States and
internationally, the
incidence of children
living with same-sex
parents is also on the rise.
Historically, one of the
major issues facing
LGBTQ-parent families
is the lack of legal
Parent Relationship
Quality
protections for partners,
parents, and children. As
legal protections for
LGBTQ-parent families
become more accessible,
LGBTQ partners and
their children are able to
live more openly. The
number of legal
protections that facilitate
family relationships and
stability, including
provision for marriage,
divorce, and child
custody, is increasing as
state and federal laws
become less restrictive.
Gaining social
acceptance, visibility, and
basic rights for their
families is an important
step in legitimizing
LGBTQ-parent families
and enhancing family and
couple relationship
quality.
Relationship Quality
Among LGBTQ Parents
Many of the processes of
relationship formation,
maintenance, satisfaction,
and functioning of
LGBTQ couples are
similar to those of
 2259
heterosexual couples. Research on lesbian,
There are certain gay, and heterosexual
characteristics that, when parents with adopted
similar for both partners, children found that
can contribute to couples, regardless of
relationship satisfaction sexual orientation, tended
for couples with and to report long-term
without children, such as relationships, secure
personality, attitudes, attachments, and high
interests, and values. For relationship satisfaction.
example, research has Sexual satisfaction also
found that when lesbian did not differ based on
couples have similar sexual orientation.
levels of social Additionally, relationship
involvement in the satisfaction was
LGBTQ community, the positively related to
partners were happier in sexual satisfaction,
their relationship. frequency of sexual
Additionally, having relations, and greater
similar personality attachment security.
characteristics, such as With the research on
similar levels of LGBTQ couples with
neuroticism, is related to children being somewhat
relationship satisfaction. limited, there is still more
Early research on the research conducted on
relationship quality of lesbian mothers than on
lesbian couples with gay fathers. Existing
children and those work has primarily
without children found focused on relationship
that lesbian couples with functioning among same-
children had higher sex couples during the
relationship satisfaction transition to parenthood
and higher sexual and the year or so after
satisfaction than child- children entered the
free lesbian couples. family. There has also
Stable and happy been work on division of
relationships have been labor and power among
found to exist for both lesbian-parent couples,
types of couples. Recent and—to some extent—
research has found that gay male parent couples,
younger maternal age, as described next.
greater familial social Researchers are just
support, less job-family beginning to document
role strain, and more the experiences of
positive sexual identity relationship quality for
were related to greater transgender parents.
selfreported relationship When a partner
quality for lesbian transitions from one
women. gender identity to another
gender identity during an
intimate relationship, the
non-transgender partner
may also experience an
identity shift as they
negotiate the changes.
Even though it can be
stressful on a relationship
for a partner to transition,
particularly in the context
of being a parent,
research has found
evidence of resiliency and
support in the relationship
that eases the transition.
Having social support and
therapeutic support can
aid in the transition for all
parties involved.
Transition to
Parentho
od and
Relations
hip
Quality
Most of the research on
LGBTQ-parent
relationship quality has
focused on lesbians’
transition to parenthood.
On average, lesbians’
love for their partners
decreased across the
transition to parenthood,
and conflict within the
couple increased. These
trends are similar to
heterosexual couples.
This decrease in love for
a partner may be due to
less available time as a
couple as well as the
stress of the additional
role and identity of being
a parent. Further,
personal and couple
characteristics have been
linked to change in
relationship quality
across the transition.
Namely, lesbian women
who reported higher
levels of neuroticism
reported lower feelings of
love for their partner and
more steep increases in
conflict across the
transition to parenthood.
For mothers who were
not related biologically or
gestationally to the child
(e.g., the nonbiological
mother or social mother),
those who had engaged in
higher levels of
relationship maintenance
behavior prior to the birth
of the child had higher
levels of love for their
partner across the
transition. Also, among
nonbiological mothers,
those who were more
satisfied with the division
of labor in the
relationship reported
higher levels of love.
There was an increased
level of conflict between
couples when the
nonbiological mother’s
expectation that the
biological mother’s
family would be
supportive was not met.
Whether a parent is
biologically related to the
child has other
ramifications for the
relationship and parenting
roles. The gestational
mother (typically the
biological mother but not
always so) tends to take
on more of a caretaking
role and develop closer
 2261
ties to the child. This general decline in time
occurs even when spent and intimacy
LGBTQ parents seek to between partners during
have egalitarian parenting the transition to
roles and practices. The parenthood. Although
biological mother’s couples continued to
involvement in pregnancy consider their relationship
and breastfeeding can romantic, there was some
lead to jealousy among decline in romantic
some nonbiological feelings
mothers. It has also been Parent
shown that nonbiological Relatio
lesbian mothers spend nship
Qualit
more time working
y
outside the home within
planned lesbianparent
families. However, unlike compared to before
heterosexual couples, having children. It is not
child care is split fairly fully clear how viewing
equally between the the relationship as
biological and the romantic translates to
nonbiological mother. relationship satisfaction.
Research on female, One study did suggest
male, and heterosexual that gay fathers were
couples who adopted more satisfied with their
their children found a relationships than
decline in relationship heterosexual fathers.
quality during the first
year of parenthood for
individuals of all sexual Division of Labor
orientations. This decline Many LGBTQ couples
was particularly the case desire to have egalitarian
when parents had higher relationships, especially
levels of depression, used when polarizing gender
more confrontational roles in the couple are not
coping, and had higher at play. This intention
levels of relationship often plays out in the
maintenance behaviors. household division of
Relationship quality can labor. Division of labor
decline as love decreases, has been linked to
as conflict increases, and relationship quality,
ambivalence increases, on particularly among
average, which is lesbian couples, such that
consistent with prior partners who perceive
research on heterosexual more equal division of
biological parent couples. labor tend to report
Research on gay men higher-quality
who became fathers via relationships and greater
surrogacy has reported a satisfaction with their
relationships. On balance, Influence of Minority
research further suggests Stress
that when individuals are
able to work fewer hours, Minority stress is the
they report more positive argument that members
relationship interaction of stigmatized groups
and less conflict between experience a unique form
family life and work life. of stress due to their
status as a member of the
Research on
group. Further, minority
coparenting and the
stress can play out in
division of labor research
in the Netherlands found
that nonbiological
mothers in lesbian
relationships indicated
more satisfaction with the
other parent than
heterosexual fathers.
Further, biological
lesbian mothers were
more satisfied with the
other parent than
heterosexual mothers
were. This distinction
could be due to lesbian
couples sharing
household and child care
tasks more equitably—or
at least feeling like they
do. In another study,
lesbian and gay couples
reported sharing child
care more so than
heterosexual couples, and
the partners tended to
interact more equally
during family time. In
other studies, gay male
couples were more equal
coparents and coparented
more compatibly than
heterosexual couples.
When gay men were
satisfied with their
partners and their
parenting arrangements,
the relationship
satisfaction was higher.

physical, mental, or emotional strain. These strains
are likely to influence relationship quality among
LGBTQ parents given the fact that society is
heteronormative. Relationships and families are
shaped by heteronormative social structures and the
intersecting expectations of extended families,
friendships, and communities. However, being able
to be more open about one’s same-sex romantic
relationship has been found to aid in relationship
quality for lesbian women. There are unique stresses,
problems, and strengths for LGBTQ couples who
parent, and it is important to recognize how their
experiences might differ from, or be similar to, those
of heterosexual parents.
Erin S. Lavender-Stott and Katherine R. Allen
See also Coparenting; Division of Labor in LGBTQParent
Families; Marriage Equality, Effects on Well-
Being and Relationships; Minority Stress; Nonbiological,
Nongestational Mother; Sexual Desire and Relationship
Quality
Further Readings
Bos, H. M. W., van Balen, F., & van den Boom, D. C.
(2007). Child adjustment and parenting in planned
lesbian-parent families. American Journal of
Orthopsychiatry, 77, 38–48. doi:10.1037/0002-
9432.77.1.38
Farr, R. H., Forssell, S. L., & Patterson, C. J. (2010). Gay,
lesbian, and heterosexual adoptive parents: Couple and
relationship issues. Journal of GLBT Family Studies, 6,
199–213. doi:10.1080/155042810037
05436
Goldberg, A. E. (2013). “Doing” and “undoing” gender:
The meaning and division of housework in same-sex
couples. Journal of Family Theory & Review, 5,
85–104. doi:10.1111/jftr.12009
Goldberg, A. E., & Allen, K. R. (Eds.). (2013).
LGBTparent families: Innovations in research and
implications for practice. New York, NY: Springer.
Goldberg, A. E., & Sayer, A. (2006). Lesbian couples’
relationship quality across the transition to
parenthood. Journal of Marriage and Family, 68,
87–100. doi:10.1111/j.1741-3737.2006.00235.x
Goldberg, A. E., Smith, J. Z., & Kashy, D. A. (2010).
Preadoptive factors predicting lesbian, gay, and
heterosexual couples’ relationship quality across the
transition to adoptive parenthood. Journal of Family
Psychology, 24, 221–232. doi:10.1037/a0019615
2263
Koepke, L., Hare, J., & Moran, P. B. (1992). Relationship
quality in a sample of lesbian couples with children and
child-free lesbian couples. Family Relations, 41,
224–229. doi:10.2307/584837
Kurdek, L. A. (2001). Differences between
heterosexualnonparent couples and gay, lesbian, and
heterosexualparent couples. Journal of Family Issues, 22,
727–754. doi:10.1177/019251301022006004
Peplau, L. A., & Fingerhut, A. W. (2007). The close
relationships of lesbians and gay men. Annual Review of
Psychology, 58, 405–424. doi:10.1146/annurev.
psych.58.110405.085701
Tornello, S. L., Johnson, S. M., & O’Connor, E. (2013).
Relationship quality among lesbian mothers in planned
families. Journal of GLBT Family Studies, 9, 346–363.
doi:10.1080/1550428X.2013.801008
PARENTAL WELL-BEING
When lesbian mothers first became the focus of
public attention in the 1970s, questions were raised
about their psychological well-being. Indeed, the
argument that lesbian mothers were likely to
experience psychological problems was used to deny
lesbian mothers custody of their children following
their divorce. Since that time, the psychological well-
being of lesbian mothers has been questioned in
other contexts, particularly in relation to adoption
and access to assisted reproduction. More recently,
similar concerns have been expressed regarding gay
men who wish to become fathers through adoption or
surrogacy. This entry begins by examining the
consequences of difficulties in parental
psychological well-being for children generally,
followed by a review of the research literature on the
psychological well-being of lesbian mothers and gay
fathers.
Well-Being in Heterosexual Parent Families
There is a large body of research on heterosexual
parent families showing that the psychological well-
being of parents is associated with the psychological
well-being of their children. Two aspects of parental
well-being have been studied: (1) mental health and
(2) parents’ relational well-being.
2264 Parental Well-Being
Parents’ mental health can impact the
psychological well-being of children. Among the
many studies of the consequences for children of
parents’ mental health problems, the influence of
parental depression has received the greatest
attention. Children of depressed parents have been
found to show elevated rates of behavioral, social,
and emotional problems. Studies that have diagnosed
the presence or absence of psychiatric disorder in
both children and their parents have shown that
children whose parents are depressed are not only
more likely to show a wide range of psychological
problems but are also more likely to become
depressed themselves.
It is perhaps not surprising that depression in
parents is associated with psychological problems in
children. Of particular interest are the mechanisms
involved in this association. One explanation is that
depression reduces the ability to parent effectively.
Depression is thought to interfere with parents’
control and discipline of their children, with
depressed parents tending to be either very lenient or
very authoritarian, and also with their emotional
availability and sensitivity to them. When mothers
are depressed, their babies are more withdrawn, less
active, more irritable, and less smiley than are other
babies. Moreover, studies that have directly
examined the link between maternal depression and
insecure attachment in children have established an
association between the two. Another explanation is
that the greater marital conflict in couples in which
one partner is depressed is associated with the
behavioral and emotional problems of the children of
depressed parents. Furthermore, depression and
marital conflict may each be caused by external
factors, and these external factors may, in
themselves, be implicated in children’s development
of psychological problems.
Children whose parents are dependent on alcohol
or drugs are also at risk for psychological problems.
Compared with other children, they are more likely
to show conduct problems,
Parental Well-Being
including antisocial behavior and delinquency.
Again, poor parenting has been implicated in the link
between alcohol or drug dependence and the
development of psychological problems in children.
Studies of the association between marital conflict
and negative outcomes for children have found a
consistent link between the two. Children whose
parents are in conflict have been found to be more
aggressive, disobedient, and difficult to control; more
likely to become involved in delinquent behavior and
to perform poorly at school; and more likely to have
difficulty getting on with peers compared with
children whose parents are happily married. But just
because parents are in conflict does not mean that
their children will experience psychological
problems. What seems to matter for children is not
whether their parents fight but how they fight.
Aspects that are harmful to children include frequent
fighting, a belief that the fighting will lead to their
parents’ separation, severe hostility (especially
physical violence), being the subject of their parents’
disputes, and parents’ inability to make up.
The process through which marital conflict affects
children has been the subject of much debate.
Whereas some believe that marital conflict is bad for
children because of its indirect effects on parenting,
in that conflict between parents may result in more
negative relationships between parents and children,
others think that exposure to parental conflict has a
direct effect on children’s psychological well-being,
in that seeing parents argue is, in itself, distressing. It
is now generally agreed that marital conflict may
have both indirect and direct effects on the
psychological well-being of children as well as
interfering with the relationships between the parents
and the child, hostility between parents appears to be
upsetting in its own right. Investigations of the
impact of the quality of parents’ relationship on the
development of their children have focused on the
adverse effects of hostile relationships rather than the
beneficial effects of harmonious relationships.
However, there is growing evidence that the more
favorable outcomes for children of happily married
or cohabiting parents do not simply result from the
absence of serious conflict but, instead, are
associated with positive aspects of the relationship,
such as open communication and the expression of
affection.
Well-Being in Lesbian Mother and Gay
Father Families

Key questions regarding the psychological wellbeing
of lesbian mothers are whether lesbian mothers differ
from heterosexual parents in terms of mental health
problems or relationship quality, and if so, what are
the psychological consequences for their children?
The early studies focused on families formed
following the mother’s separation or divorce from
the father of her children. One study was carried out
in the United States in 1986 by Richard Green and
colleagues, and another was conducted in the United
Kingdom in 1983 by Susan Golombok and
colleagues. These investigations adopted a similar
design, comparing lesbian mothers with single
heterosexual mothers. Both groups of mothers had
experienced divorce or separation. It was important
that the comparison group had also been through a
divorce. Otherwise, any differences identified
between family types may have been associated with
divorce, rather than maternal sexual orientation. In
the United States, in 1986, Richard Green and
colleagues compared 50 lesbian mothers with a
demographically matched group of 40 single
heterosexual mothers. Around half of the lesbian
mothers were cohabiting with their female partner. It
was found that the lesbian mothers were more self-
confident—and less likely to express feelings of
inferiority—than were the heterosexual mothers. In
1983, in the United Kingdom, 27 lesbian mothers
were compared with 27 single heterosexual mothers
by Susan Golombok and colleagues. Around half of
the lesbian mothers were cohabiting with their
female partner and their relationships were generally
harmonious, as measured by a well-validated
assessment, with only two couples showing
relationship difficulties. The lesbian mothers did not
differ from the heterosexual mothers on any of the
measures of psychiatric disorder, which included a
standardized measure of emotional problems and the
use of tranquilizers or antidepressant medication in
the year preceding the study.
The growth of assisted reproductive technologies
(ARTs) in the 1980s and 1990s resulted in donor
insemination (DI) becoming a more accessible route
to parenthood for lesbian women. As a result, lesbian
couples began to plan their family together after
coming out. A number of studies of the well-being of
lesbian women who had become mothers through DI
have since been carried out. In the United States,
2265
Raymond Chan and colleagues compared 55 lesbian
mothers with 25 heterosexual mothers—some of
whom had partners and others who were single
parents. No differences in well-being were found
between the lesbian and heterosexual mothers as
assessed by standardized measures of stress
associated with parenting, depression, self-esteem, as
well as the couple’s relationship quality for two-
parent families. Also in the United States, David
Flaks and colleagues compared 15 lesbian couples
with a demographically matched group of 15
heterosexual couples, all of whom had children
conceived by DI. The lesbian and heterosexual
parents were not found to differ from each other with
respect to relationship quality, as assessed by a
standardized questionnaire. Moreover, the lesbian
couples’ scores did not differ from norms for married
heterosexual couples on this measure.
In Belgium, Anne Brewaeys and colleagues
compared 30 lesbian couples with a child conceived
by DI with 38 heterosexual couples with a child
conceived by DI and 30 heterosexual couples with a
naturally conceived child. The quality of the couple’s
relationship was assessed by questionnaire and did
not differ between the lesbian mother families and
either of the heterosexual parent groups. In a study in
the Netherlands by Henny Bos and colleagues, 100
two-parent lesbian mother families were compared
with a demographically matched sample of 100 two-
parent heterosexual families. No significant
differences were identified between the lesbian
biological mothers and the heterosexual mothers
either in the extent to which they felt burdened by
their child or in relationship satisfaction as assessed
by a standardized measure. Neither was there a
difference between biological and nonbiological
lesbian mothers in the extent to which they felt
burdened by the child. However, in comparison with
heterosexual fathers, lesbian nonbiological mothers
reported greater relationship satisfaction. In a study
in the United Kingdom by Susan Golombok and
colleagues, 30 lesbian couples were compared with
42 single heterosexual mothers and 41 heterosexual
couples. The mean age of the children was 6 years.
No differences were identified between the lesbian
mothers and either the heterosexual mothers from
single-parent families or the heterosexual mothers
2266 Parental Well-Being
from two-parent families in anxiety, depression, or
parenting stress.
A qualitative longitudinal study, the U.S. National
Longitudinal Lesbian Family Study, was initiated by
Nanette Gartrell in 1986 to provide in-depth data on
lesbian families with children conceived by DI.
Eighty-four families were recruited to the study
during insemination or pregnancy, of which 73 were
headed by a couple and 11 were headed by a single
mother at the time of the child’s birth. Subsequent
data collection took place when the children were 2,
5, 10, and 17 years old, by which time 93% of the
families were still participating in the study. Thus,
the sample was not biased by the attrition of those
who have not functioned well. Although the study
does not include a comparison group, the majority of
mothers reported good relationships with their wives
or partners. In the early years of the children’s lives,
the mothers reported concerns over challenges they,
and their children, might face as a result of stigma
against lesbian mother families parenting. However,
while this concern over future stigma caused stress to
mothers at the time, by later follow-up visits the rates
of actual stigma were lower than they had
anticipated. Due to the longitudinal nature of the
study, the effect of parents’ relationship dissolution
could also be examined. For mothers whose
relationships had ended, acrimony and conflict with
the previous partner were predictors of children’s
ratings of family harmony postseparation. This
finding is in keeping with the large
Parental Well-Being
body of literature on the effects of heterosexual
divorce on parental well-being.
In the 1990s, the first opportunities arose for
studying representative samples of lesbian mother
families recruited from the general population. One
such investigation, conducted in the United Kingdom
in collaboration with the Avon Longitudinal Study of
Pregnancy and Childhood, focused on lesbian
mothers with 7-year-old children. Thirty-nine lesbian
mother families, 74 two-parent heterosexual families,
and 60 single heterosexual mothers took part. There
were no differences between lesbian and
heterosexual mothers in anxiety, depression, or
parenting stress as assessed by standardized
measures. Neither were there differences in the
prescription of anxiolytic or antidepressant
medication since the birth of their children. However,
a higher proportion of lesbian than heterosexual
mothers had consulted a doctor for psychological
problems since the birth of their children. For two-
parent families, there was no difference in
relationship satisfaction between lesbian and
heterosexual mothers.
The first controlled study of a systematic sample
of gay father families was carried out in the United
States by Rachel Farr and colleagues.
Twenty-nine gay couples, 27 lesbian couples, and 50
heterosexual couples—all with adopted children
aged between 1 and 6 years—participated in the
research. The gay fathers did not differ from the
lesbian mothers or heterosexual parents in terms of
relationship satisfaction or stress associated with
parenting. A study of adoptive gay father families
was also carried out in the United Kingdom by Susan
Golombok and colleagues. Fortyone gay father
couples, 40 lesbian mother couples, and 49
heterosexual parent couples—all with children aged
between 3 and 9 years—took part. Each parent
completed questionnaire measures of anxiety,
depression, and stress associated with parenting. The
gay fathers showed lower levels of depression and
lower levels of stress associated with parenting than
did the heterosexual parents, with no differences in
psychological well-being between the gay fathers
and the lesbian mothers. The more positive well-
being among the gay fathers may have resulted from
a more stringent screening process for gay couples
who wish to adopt, resulting in even higher levels of
psychological well-being among adoptive gay fathers
than among adoptive heterosexual parents. Unlike
the heterosexual couples and many of the lesbian
couples in the study, it may also be relevant that the
gay fathers had not experienced the stress of
infertility and failed fertility treatments before
adopting a child.
Lesbian, gay, and heterosexual parents’ wellbeing
and relationship satisfaction over the transition to
adoptive parenthood has been studied extensively by
Abbie Goldberg in the United States. In all family
types, support from friends was shown to have a
positive effect, whereas a history of infertility
negatively impacted parental well-being. Abbie
Goldberg has differentiated between factors that

affect parental well-being regardless of sexual
orientation and factors that are particularly or
exclusively experienced by same-sex parents. For
example, lesbian, gay, and heterosexual parents
going through the adoption process reported the
insecurity of the foster-toadopt situation to be
similarly stressful regardless of parent sexual
orientation. However, lesbian and gay parents
additionally reported stress relating to their sexual-
minority status and concerns about stigma within the
child welfare system. One year following adoption,
lesbian and gay parents’ wellbeing was shown to be
negatively influenced by stigma and internalized
homophobia, whereas residing in a state that
acknowledged lesbian and gay parenting was
associated with less internalized homophobia and
higher levels of well-being. At two years
postadoption, the majority of lesbian, gay, and
heterosexual parents reported high levels of well-
being. To assess the impact of changes in legislation
on same-sex parenting, Goldberg studied changes in
well-being before and after the lifting of a state ban
on gay adoption in 2010. Parent well-being improved
after the lifting of the ban, showing that changes in
policy can affect the wellbeing of minority groups.
Although few differences in psychological
wellbeing have been identified between lesbian
mothers, gay fathers, and heterosexual parents,
variation has been found within each family type,
and this variation has been found to relate in
meaningful ways to the psychological well-being of
children. Several of the studies of lesbian mothers
described previously have shown that the
psychological well-being of parents, including the
quality of the couple’s relationship, is associated
with child adjustment. For example, Raymond
Chan’s study of lesbian mother families with donor-
conceived children found stress associated with
parenting to be associated with children’s behavior
problems. In addition, for the two-parent families,
children were rated as better adjusted when their
mothers reported greater relationship satisfaction,
higher levels of love, and lower levels of conflict.
Stigmatization has also been shown to be related to
maternal well-being and child adjustment. The study
by Bos of planned lesbian mother families in the
Netherlands found that mothers who experienced
ridicule, marginalization, or exclusion were more
2267
likely to report emotional and behavioral problems in
their children.
With respect to gay fathers, Farr found that
parents who reported greater happiness with their
partners and less parenting stress had children with
higher levels of adjustment. Similarly, in the study
by Golombok, higher levels of parenting stress were
associated with higher levels of externalizing
problems in children. An Internet survey of 230
adoptive gay fathers by Samantha Tornello and
colleagues examined the factors associated with
raised levels of parenting stress among gay men. It
was found that gay adoptive fathers with less social
support, older children, and children who had been
adopted at older ages reported more parenting stress.
An additional stressor for gay fathers was a less
positive identity as a gay man, with fathers who were
more sensitive to stigmatization reporting greater
parenting stress.
Conclusion
There is no evidence to suggest that either lesbian
mothers or gay fathers show higher rates of
psychological problems or relationship difficulties
than comparison groups of heterosexual parents. As
with heterosexual parents, lesbian mothers and
gay fathers who show psychological problems or
relationship difficulties are more likely to have
children with adjustment problems. Little is known
about the psychological well-being of bisexual,
transsexual, or queer parents.
Kate Ellis-Davies and Susan Golombok
See also Adoption and Foster Care Discrimination;
Nonbiological, Nongestational Mother; Parent Gender
Transition and Intimate Relationship Changes; Parent–
Child Relationships; Single-Parent Adoption;
Stepfamily Family Functioning and Relationship
Stability; Surrogacy; Transition to Parenthood and
Parental Roles; Transition to Parenthood for LGBTQ
People
Further Readings
Bos, H. M. W., van Balen, F., & van den Boom, D. C.
(2004). Experience of parenthood, couple relationship,
social support, and child-rearing goals in planned lesbian
2268 Parental Well-Being
mother families. Journal of Child Psychology and
Psychiatry, and Allied Disciplines, 45(4), 755–764.
Chan, R. W., Raboy, B., & Patterson, C. J. (1998).
Psychosocial adjustment among children conceived via
donor insemination by lesbian and heterosexual
mothers. Child Development, 69(2), 443–457.
Cummings, E. M., & Davies, P. T. (2010). Marital
conflict and children: An emotional security
perspective. New York, NY: Guilford Press.
Farr, R., Forssell, S., & Patterson, C. (2010). Parenting
and child development in adoptive families: Does
parental sexual orientation matter? Applied
Developmental Science, 14(3), 164–178.
Gartrell, N., Banks, A., Hamilton, J., Reed, N., Bishop, H., &
Rodas, C. (1999). The National Lesbian Family Study: 2.
Interviews with mothers of toddlers. American Journal of
Orthopsychiatry, 69(3), 362–369.
Goldberg, A. (2010). Lesbian and gay parents and their
children: Research on the family life cycle. Washington,
DC: American Psychological Association.
Golombok, S. (2015). Modern families: Parents and children
in new family forms. Cambridge, England: Cambridge
University Press.
Parent–Child Relationships
parents in the context of heterosexual relationships or
marriages. For example, these parents entered into a
same-sex relationship after their child was born or
adopted. Those who form families in the context of
same-sex relationships do so via three most common
methods: donor insemination (DI; for women),
adoption, or surrogacy. An additional route to
parenthood that is less common occurs when a
female same-sex couple and gay male couple elect to
parent together.
LGBTQ Parent–Child Relationships in
Intact Families
A small body of research has focused on parent–
child relationships within LGBTQ-parent
households. Existing data suggest more similarities
than differences in bonding patterns and processes
across parents of different sexual orientations.
Parents have not been found to differ, on average, in
parental warmth, emotional involvement, and quality
of relationships with their children, regardless of
family structure. Despite concerns that the sexual
orientation of LGBTQ parents will

PARENT–CHILD RELATIONSHIPS

Despite the increasing number of families headed by

LGBTQ individuals and couples, there is a dearth of
research that examines the relationships between
these parents and their children, especially relative to
the number of studies that examine heterosexual
parent–child relationships. Further, there is even less
research emphasis on bisexual and transgender
parents’ relationships with their children. This entry
discusses what is known about LGBTQ parent–child
relationships. First, a brief explanation of the ways in
which LGBTQ individuals and couples pursue
parenthood is presented. Then, the characteristics of
the relationships between LGBTQ parents and their
children are discussed, for intact and separated
families.

Family Building in LGBTQ Families

Sexual-minority individuals and couples pursue a
variety of routes to parenthood. Some become

Parent–Child Relationships
negatively affect children in both direct and indirect
ways, research is consistent in indicating that
sexuality is not relevant to adults’ mental health or
parenting capacities. Specifically, studies that have
compared lesbian, gay male, and heterosexual
parents in terms of mental health (e.g., psychological
distress, depression), perceived parenting stress, and
parenting competence have found few differences
based on family structure.
Much of the research on LGBTQ parent–child
relationships has been conducted on families formed
through adoption and on lesbian- and gay male-
headed households. Most parents in samesex
relationships who have adopted describe a close bond
to their children. However, both samesex and
heterosexual adoptive parents may encounter certain
challenges in regards to attaching to their children.
These challenges are often in relation to the child’s
characteristics. For example, adopting a child who is
older has been associated with more difficulty
bonding with the child as well as more behavioral
and emotional challenges. Additional challenges to
parent–child attachment include adopting a child
with significant special needs. Furthermore, research
has shown that challenges associated with the
transition to adoptive parenthood in general (e.g.,
struggles with the process, lack of communication
with agencies) can create a strain on the parent–child
relationship early on. In addition, and similar to
heterosexual parents, parents in same-sex couples
sometimes experience the feeling that their child is
more emotionally bonded to one parent than the
other; this perceived or actual imbalance in bonding
may cause tension within the couple. Parents in
samesex relationships may feel an added layer of
frustration when the child shows preference for one
parent over the other because the child’s preference
cannot be explained by gender difference or
biological connection to the child.
Despite their vulnerability to heterosexism (e.g.,
in relation to adoption agencies and their families of
origin) and being more likely to experience legal
complications related to parenthood, parent–child
relationships in adoptive families with LGBTQ
parents have been shown to be as satisfying as
parent–child relationships in families with
heterosexual parents, from the child’s perspective as
well as the parents’ perspective. Further, the existing
2269
research on children’s outcomes has demonstrated
that overall, children’s relationships with their
LGBTQ parents is positively associated with healthy
child outcomes (e.g., life satisfaction). Children with
LGBTQ parents have been shown to exhibit similar
levels of self-esteem, quality of life, and social
functioning compared to those with heterosexual
parents.
LGBTQ Parent–Child Relationships in
Separated Families
Parent–child closeness and contact may be
threatened when parents break up, an outcome
similar to families with heterosexual parents who
separate or divorce. Because of legal inequities and
barriers for same-sex couples, there are additional
challenges to custody when same-sex couples with
children separate. Several studies have examined the
consequences of sexual-minority parents’
relationship dissolution for parent–child relationships
and closeness. Custody of the children in lesbian
families, for example, is more likely to be shared if
the nonbiological mothers had adopted the children
prior to the separation. Adolescents report being
close to both mothers more often in families in which
their nonbiological mothers had adopted them;
further, adolescents whose nonbiological mothers
had adopted them spent more time with both of their
mothers. These data suggest that legal parentage may
have important implications for parent–child
relationships postrelationship dissolution.
Similarly, when parents in same-sex relationships
decide to dissolve their unions, they are less likely
than heterosexual parents to do so with legal
intervention (e.g., lawyers, mediators). This lack of
court involvement carries advantages and
disadvantages for the parent–child relationship. For
example, some youth in these families express
appreciation for the fact that since their parents were
never legally married, they did not get legally
divorced, allowing their families to escape the
bureaucracy of the legal system. Other youth,
however, report disadvantages, especially when their
nonbiological mother lacked legal ties to them (e.g.,
they were not able to or chose not to adopt the child).
In this instance, it is possible that the nonbiological
mother may move away or became less involved in
her children’s lives once she separates from the
biological parent. Thus, it is important to take into
2270
account the legal protections (or lack thereof) of
parents’ unions when considering the parent–child
relationship, in both intact and separated families.
Bisexual and Transgender Parent–
Child Relationships
There is a dearth of research that focuses specifically
on the parenting experiences of parents who identify
as bisexual as well as parents who identify as
transgender. These parents may be excluded from
studies or misidentified, given that their sexual
orientation or gender may be assumed or incorrectly
labeled by researchers. The research that has been
conducted, however, has found that bisexual and
transgender parents do not significantly differ in their
relationships with their children, compared to parents
who identify as lesbian, gay, or heterosexual and
cisgender (individuals whose gender identity
matches their biological sex) parents. Further
research is needed to explore whether and how the
invisibility of bisexual and transgender parents
affects their experiences of
bonding with their children. These parents certainly
do not fit into the heterosexist norms of parenting but
may encounter varying parenting
experiences that have yet to be uncovered by
researchers, related in part, to their identification as
bisexual or transgender.
In conclusion, the body of literature that has
focused on LGBTQ parents and their relationships
with their children demonstrates more similarities
than differences between their experiences and
heterosexual parents’ relationships with their
children. In addition, children of LGBTQ parents
fare similarly to their peers with heterosexual
parents. Overall, LGBTQ parents’ relationships with
their children are positively related to parents’ and
children’s mental health and well-being outcomes.
Further research is needed to continue to examine
Partners in (Gender) Transition
LBTQ parent–child relationships, especially the
experiences of bisexual and transgender parents.
April M. Moyer and Abbie E. Goldberg
See also LGB Parenting Styles and Values; LGBQ Parents,
Coming Out to Children; LGBQ Parents and the
Health Care System
Further Readings
Downing, J. B. (2013). Transgender-parent families. In A.
E. Goldberg & K. R. Allen (Eds.), LGBT-parent
families: Innovations in research and implications for
practice (pp. 105–115). New York, NY: Springer.
Goldberg, A. E., Moyer, A. M., & Kinkler, L. A. (2013).
Lesbian, gay, and heterosexual adoptive parents’
perceptions of parental bonding during early parenthood.
Couple and Family Psychology: Research and Practice,
2, 146–162. doi:10.1037/a0031834
Patterson, C. J. (2006). Children of lesbian and gay parents.
Current Directions in Psychological Science, 15, 241–
244. doi:10.1111/j.1467-8721.2006.00444.x
Ross, L. E., & Dobinson, C. (2013). Where is the “B” in
LGBT parenting? A call for research on bisexual
parenting. In A. E. Goldberg & K. R. Allen (Eds.),
LGBT-parent families: Innovations in research and
implications for practice (pp. 105–115). New York,
NY: Springer.
PARENTS AND FRIENDS OF LESBIANS AND
GAYS
See PFLAG
PARTNERS IN (GENDER) TRANSITION
Transitioning is the process that transgender (or
trans) individuals go through in living as the gender
with which they identify rather than the sex assigned
to them at birth. Transitioning can entail complex
personal, social, and medical changes, including
changes in one’s name, preferred personal pronouns,
and physical presentation as well
Partners in (Gender) Transition
as hormone replacement therapies and sex
reassignment surgeries for those who desire and can
access such medical changes. Contrary to past
assumptions regarding the inevitable dissolution of
intimate relationships following the disclosure of a
trans identity, research suggests that there are
multiple personal, relational, and social changes that

may occur within the context of one partner’s gender
transition. Given the centrality of intimate partners in
shaping the transition process as well as the impact
that a gender transition has on an intimate
relationship, gender transitions within intimate
relationships can be conceptualized as involving a
co-transition process for both partners. This entry
highlights several central issues relevant to trans-
partnered couples, including the timing and impact
of transition, shifts in sexual orientation, and the
implications for mental health on both partners. The
entry focuses on couples in which only one partner in
the dyad is trans.
Timing and Impact of Transitioning
Historically, it was often assumed by clinicians and
researchers that relationships formed prior to
transitioning would lead to separation and divorce
when one partner “came out” as transgender and
began the transition process. Such assumptions were
often supported by limited research that focused
exclusively on male-to-female (MtF) individuals
partnered with women, often in the context of
previously heterosexual-identified marriages.
Current empirical and clinically informed research
has increasingly broadened its scope of focus to
consider various gender identifications, including the
experiences of female-tomale (FtM) individuals and
their intimate partners. Across different kinds of
couples it is clear that there is a diversity of
relationship negotiations that couples may go
through in navigating the impact of one partner’s
gender transition, and relationship dissolution is only
one possible response to a partner’s gender
transition.
The Timing of Transitioning
The timing of transitioning can have a significant
impact on the co-transitioning experiences of both
partners. For instance, a relationship that is created
prior to any knowledge of one partner’s transgender
identification may endure particularly difficult
feelings of hurt, anger, rejection, and confusion by
the non-trans partner. Such relationships may differ
significantly from relationships in which partners
openly discuss gender issues and the possibility of
transitioning throughout early stages of the
relationship. Some research suggests that starting a
2271
relationship posttransition may more easily lead to a
stable and long-lasting relationship compared to
transitioning within the context of an already existing
relationship. Nevertheless, it is increasingly clear that
many couples do remain together throughout
transitioning and couples develop diverse ways to
navigate and embrace the co-transition process.
The Impact of Transitioning
Although there are no definitive rates of
relationship success versus dissolution following
transgender disclosure within intimate relationships,
current research suggests that many partners decide
to work through transition-related challenges in order
to maintain the relationship. Qualitative research on
FtM men and their female partners has generally
indicated that many female partners remain with their
FtM partners throughout the transition. Some
research has indicated that FtM partners and their
female heterosexual partners may have similar rates
of relationship satisfaction compared with
heterosexual couples, thereby strongly challenging
the notion that couples in which one partner is trans
necessarily have lower levels of relationship
satisfaction. FtM men partnered with women may
also have more stable, enduring intimate
relationships compared with MtF women and their
partners. Researchers speculate that this may be a
result of FtM men’s gender socialization as women
prior to transition, which may allow for greater
relational and affective capacity throughout the
transition. Notably, relationship satisfaction
throughout transitioning may have less to do with the
specific gender identity of the trans partner and more
to do with the centrality and rigidity of gender roles
in the relationship. For instance, couples who have
less rigid gender roles pretransition may be less
likely to separate as a result of one partner’s gender
transition.
Moving beyond a focus on whether or not
relationships can survive a partner’s gender
transition, partners navigate various positive and
negative changes in their relationships throughout the
cotransition. Regardless of the trans partner’s gender
identity, gender transitioning is typically a lengthy
and ongoing process that can create significant
stressors within the relationship. Partners may find
themselves intensely involved in transition-related
emotional and practical care. Depending on how far
2272
along the trans partner is in their transition when the
relationship begins impacts how involved the non-
trans partner is throughout the transition. The non-
trans partner may be involved in such activities as
supporting the trans partner through navigating
barriers in accessing health care, recovering from
surgeries, helping with the financial aspects of
transitioning, and managing the impact of social and
legal discrimination. This involvement by the non-
trans partner may provide a much-needed and
appreciated form of support, but it also may place a
strain on the relationship as well as the personal lives
of both partners.
Furthermore, in navigating transition-related
changes, some couples may shift away from an
emphasis on the sexual relationship to a greater
emphasis on the emotional aspects of the
relationship. Such a shift may allow relationships to
temporarily or permanently create new avenues for
developing and maintaining intimacy. How couples
negotiate the co-transition may depend a great deal
on how stable the relationship was prior to transition.
In relationships that were experienced as supportive
and satisfying pretransition, the transition process
may allow for a new realm in which partners can
grow together in new and unexpected ways.
The Role of Social Context
Social context can play a key role in supporting or
challenging the co-transition process. For instance,
depending on the social and geographical context in
which the couple is living, there may be limited
avenues for accessing social support. In rural areas,
for example, there may be few if any
Partners in (Gender) Transition
trans-related support groups and limited available
trans-related information within the community.
Such a lack of tangible community supports may in
turn negatively impact the couple’s experience of the
transitioning process. Other aspects of one’s social
positioning, such as one’s socioeconomic status, can
greatly impact the extent to which transition-related
medical care can be accessed. Trans partners who are
unable to access adequate trans-related health care
may have to endure particularly difficult challenges
in transitioning, which in turn can exacerbate the
healthy functioning of the relationship. Furthermore,
although many trans people have supportive social
networks, many trans people and their partners face
disapproval and rejection from family members,
friends, and coworkers, and diminished social
support can add to the challenges that transitioning
may already provoke within an intimate relationship.
Shifts in Sexual Identity and Orientation
Transitioning in the context of an intimate
relationship may entail changes in sexual identity
and sexual orientation for both the trans partner and
non-trans partner. For instance, a previously
heterosexual-identified male may identify as a
lesbian woman posttransition. This may give rise to
challenges for a non-trans heterosexual female
partner who may feel concerned about her new
sexualminority status, even if her own personal
identity as a heterosexual woman remains
unchanged. Research suggests that heterosexual
women partnered with MtF partners may continue to
feel love toward their partners but find that they
experience a decrease in sexual interest and desire
for their trans partners. This difficulty may
compound an additional struggle of losing their
social status as a heterosexual couple and being
repositioned as a sexual-minority couple.
Couples in which one partner identifies as FtM
and the other partner identifies as a lesbian woman
may also experience unique concerns and challenges
related to one partner’s transitioning and shifts in the
sexual orientation status of the relationship. For
instance, qualitative research has begun to shed light
on some of the tensions that lesbian-identified female
partners may face in
Partners in (Gender) Transition
terms of their lack of visibility as a sexual minority
when partnered with FtM men. While contending
with a publicly appearing heterosexual relationship,
some lesbian female partners may both benefit from
and feel uncomfortable with accessing heterosexual
privilege. Additionally, in such contexts, lesbian
partners may have to contend with a lack of
acceptance from the LGBTQ community as a result
of being socially positioned within a heterosexual
relationship. Similarly, FtM men who previously
identified as lesbian women pretransition may find
that they are no longer as welcomed or accepted
within queer women’s spaces that they had been a
part of prior to transitioning. Lastly, FtM men

partnered with men may struggle with stereotypes
that trans men only partner with women, and such
FtM men may also feel alienated from the LGBTQ
community at the same time that they are newly
negotiating being perceived as a sexual minority.
Although there has been a dearth of research
regarding bisexual individuals’ experiences of
partnering with a trans partner, limited research
suggests that bisexual people may be uniquely
positioned to manage the shifts in a partner’s gender
identification.
Sexual intimacy may also undergo changes
throughout the transition process, with some couples
taking a hiatus from sexual intimacy during
transitioning while others may use intimacy as a
realm in which to reaffirm and support the trans
partner’s gender identity. Sexual practices may
become more limited or more varied and flexible as
the transition process progresses. Some couples may
accommodate changes in the sexual intimacy of the
relationship by transitioning to an open relationship
in which partners may seek other sexual partners
outside of the primary relationship. Other couples
may find that the transitioning process positively
impacts sexual intimacy as the trans partner feels
increasingly comfortable physically and emotionally.
Intimate Relationships and Mental Health
Trans people are at a disproportionate risk for
physical and mental health issues compared with the
general population. Such disparities are further
exacerbated by systemic discrimination and
difficulties accessing adequate health care.
Understanding the role of intimate relationships for
trans people and their partners is therefore
particularly important given that being in a
relationship is an important protective factor that can
positively impact self-esteem. More specifically, it is
the quality of the relationship that is the relevant
determinant impacting self-esteem and relationship
satisfaction. Non-trans partners can play a key role in
providing social support to trans partners through
such behaviors as using correct pronouns, being
emotionally and sexually intimate, and providing
practical and emotional support during and after
transition. Such behaviors can in turn help to bolster
the trans partner’s gender identity and selfesteem
throughout the transitioning process. Trans partners
can similarly provide valuable support to non-trans
2273
partners by openly discussing and understanding
some of the challenges that the non-trans partner may
be experiencing, which can in turn positively impact
the mental health of non-trans partners.
Jordan B. Downing
See also Transgender Geographies; Transgender Health Care;
Transgender Identities; Transgender Inclusion in the
LGBTQ Rights Movement; Transgender Sexualities
Further Readings
Brown, N. R. (2009). “I’m in transition too”: Sexual identity
renegotiation in sexual-minority women’s relationships
with transsexual men. International Journal of Sexual
Health, 21, 61–77.
Brown, N. R. (2010). The sexual relationships of sexual-
minority women partnered with trans men: A
qualitative study. Archives of Sexual Behavior, 39,
561–572.
Hines, S. (2006). Intimate transitions: Transgender
practices of partnering and parenting. Sociology, 40,
353–371.
Joslin-Roher, E., & Wheeler, D. P. (2009). Partners in
transition. The transition experience of lesbian,
bisexual, and queer identified partners of
transgender men. Journal of Gay & Lesbian Social
Services, 21, 30–48.
Lev, A. I. (2003). Couples in transition: When one is trans
and the other is not. In the Family, 8, 18–23.
Lev, A. I. (2004). Transgender emergence: Therapeutic
guidelines for working with gender-variant people and
their families. Binghamton, NY: Haworth Press.
Meier, S. C., Sharp, C., Michonski, J., Babcock, J. C., &
Fitzgerald, K. (2013). Romantic relationships of female-
to-male trans men: A descriptive study. International
Journal of Transgenderism, 14, 75–85.
Theron, L., & Collier, K. L. (2013). Experiences of female
partners of masculine identifying trans persons. Culture
Health & Sexuality, 15, 62–75.
PASSING
See Strategic Disclosure
PFLAG
2274
National PFLAG is the nation’s largest support group
for the lesbian, gay, bisexual, and transgender
(LGBT) communities. It currently boasts some
200,000 members and has grown to more than 350
local chapters. Now more than 40 years old, PFLAG
has evolved into a powerful engine of support,
education, and advocacy relating to a broad range of
issues, including discrimination against LGBTQ
people; so-called reparative therapy that attempts to
“cure” homosexuality; marriage equality for same-
sex couples; human sexuality; and hate crimes law.
The organization also supports the families and
friends of the LGBTQ community.
PFLAG grew out of the early 1970s activism that
followed the Stonewall riots in New York City.
Morty Manford, who had been at the Stonewall Inn
in 1969 when the bar was raided by the New York
City police, was subsequently attacked during a gay
rights rally as the police stood by and watched. To
show support for her son, his mother, Jeanne
Manford, marched with him in a 1972 gay
PFLAG
pride parade, carrying a sign that read “Parents of
Gays Unite in Support of Our Children.” She was
surprised at the number of marchers who asked her if
she would speak to their parents, and the idea for
PFLAG was born.
The first meeting of what was originally called
Parents of Gays (later, Parents FLAG) was held in
New York City in March of 1973. Although about
only 20 people attended, the strong emotions
expressed during the gathering made clear the need
for a family and friend support group for gays and
lesbians. In 1976, a second chapter opened in Los
Angeles, and from there, the idea of a grassroots
organization spread to many other localities. The
national organization known as PLFAG was
launched in 1981, with Adele Starr as its first
president. This was the same year that the
organization first gathered widespread attention,
when popular columnist “Dear Abby” mentioned
PFLAG as a resource to a concerned parent. PFLAG
opened its first national office in Los Angeles shortly
after that, and in 1990, the organization relocated its
headquarters to Washington, D.C., where it remains.
Over the many years of its existence, PFLAG has
become known for its efforts to gather support for an
ever-expanding community of sexual minorities. In
1991, the group sought and received a statement of
support from First Lady Barbara Bush. In 1993,
bisexuals were added to the lists of those PFLAG
supported, and in 1998, the national group officially
added support of the transgender community to its
mission. Although some have taken exception to the
non-inclusion of the bisexual and transgender
populations in the PFLAG name, the organization’s
mission statement is quite clear about including
them: “PFLAG promotes the health and well-being
of gay, lesbian, bisexual and transgender persons,
their families and friends. . . .”
PFLAG advocacy and strong public presence have
involved the organization in several highprofile
controversies. In the 1980s, the organization pushed
back against the efforts of antigay crusader Anita
Bryant, by opposing her campaigns to block or roll
back anti-discrimination laws. During that same
period, PFLAG took the early
Physical Disabilities
lead in vocally opposing the military’s policy of
excluding gays and lesbians because of their sexual
identities.
In 1996, the group became involved in a bitter
legal dispute with evangelist Pat Robertson, who had
made public statements demonizing gays and
lesbians. Robertson threatened to sue the group over
its Project Open Mind ad campaign. As part of that
campaign, PFLAG quoted Robertson’s statement,
from his 700 Club broadcast of January 21, 1993:
“Homosexuality is an abomination. Many of those
people involved with Adolf Hitler were Satanists,
many of them homosexuals. The two things seem to
go together.” The ad then juxtaposed this and other
incendiary statements with images depicting the
costs of homophobia, including an attempted suicide
and a gay bashing. Robertson claimed that the ad
depicted him in a false light, but no suit was ever
filed.
In recent years, PFLAG has been involved in
many advocacy and educational efforts. Now
officially named PFLAG National, the organization
in 2007 launched the Straight for Equality initiative,
enlisting allies who did not otherwise have a
connection to the LGBTQ community. Straight for
Equality has spun off several, more specific
initiatives, including the following: Straight for
Equality in the Workplace (2007), Straight for
Equality in Healthcare (2009), Straight for Equality
in Faith Communities (2012), and Straight for

Equality Trans Allies (2014). PFLAG has also
created the Our House to the Courthouse program
and Our House to the Statehouse, which focus on
judicial and legislative advocacy efforts designed to
gain civil rights for the LGBTQ community. It
sponsors national and local scholarship programs to
support the education of the LGBTQ community.
Each year, PFLAG hosts a gala that honors allies in
three areas: entertainment, the workplace, and faith
communities.
By 2014, PFLAG had become firmly entrenched
as a leading national and regional organization for
LGBTQ issues, advocacy, and education. The
organization now has a large national office and a
staff with wide-ranging responsibilities, including
development, policy, and operations. There are also a
national board of directors, regional directors, and a
roster of corporate partners that in 2014 included
KPMG, Johnson & Johnson, WilmerHale, and Wells
Fargo.
From a mother’s do-it-yourself approach to
standing up for her gay son, PFLAG has grown into
one of the nation’s largest and most influential
LGBTQ advocacy organizations. During its more
than 40 years of existence, PFLAG has continually
expanded its mission, formed new alliances, and
embraced new opportunities to support the LGBTQ
community and their families, friends, and allies.
John G. Culhane
See also LGBQ Parents, Coming Out to Children;
Parent–Child Relationships; Transgender Youth and
Family Relationships; Violence and Victimization of
Youth
Further Readings
Bernstein, R. A. (2003). Straight parents, gay children.
New York, NY: Thunder’s Mouth Press.
Marcus, E. (2002). Making gay history: The half-century
fight for lesbian and gay equal rights. New York, NY:
HarperCollins.
PFLAG. (n.d.). About PLFAG. Retrieved from http://
community.pflag.org/page.aspx?pid=191
PHYSICAL DISABILITIES
2275
The intersection between LGBTQ identities and
physical disability, as defined by the social model of
disability, is highly relevant to LGBTQ disabled
people, who are often considered asexual and
ungendered. LGBTQ disabled people experience a
range of discrimination in multiple aspects of life,
including social barriers to employment, housing,
and health care. Furthermore, the issue of sex and
relationships is especially important to consider
because this is an area where LGBTQ disabled
people’s lives significantly differ from non-LGBTQ
disabled friends and colleagues.
Models of Disability
The dominant model of disability, used by medical
and social policy makers, is the medical model. This
model is a deficit model in that it considers disability
to be the active limitations an impairment places on
an individual to perform their daily functioning. For
example, Sonya experiences pressure from nondeaf
friends to wear a hearing aid to job interviews to
“help” her. The alternate model of disability, used by
disability rights organizations, is the social model.
This model places the emphasis external to the
person by considering disability to be the restrictions
a person faces because of physical and social
barriers. With this model, the disability is caused by
the prejudice, discrimination, or lack of foresight of
others. For example, Sonya expects that if the
interview panel cannot themselves use sign language,
they will at least provide an interpreter. If Sonya
were to get the job, the two models suggest different
ongoing considerations in terms of whether Sonya, or
her new employer, made necessary changes to ensure
she has a productive and enjoyable working life.
Discrimination Faced by LGBTQ Individuals
It is unfortunately the case that disabled LGBTQ
people face discrimination from multiple directions.
As noted, a major myth about disability in general is
that the disabled person is asexual and ungendered,
in that they presumed to have no sexual desires,
needs, or active fulfillment of these wishes. When a
disabled person’s sexuality and gender are
acknowledged, the default position is heterosexual
and cisgendered. This position is routinely taken by
professionals but also by families if an LGBTQ
person has not “come out.” An LGBTQ disabled
person may have grown up in a family where they
are not only the sole disabled member but also the
2276
only LGBTQ identified member. The consequence
of this may be a lack of understanding, acceptance,
and support for either aspect of identity. In fact,
forming a positive identity as either disabled or
LGBTQ may be actively discouraged. People have
reported receiving negative messages about their
sexuality and gender identity
Physical Disabilities
from parents and witnessing their nondisabled,
cisgendered, heterosexual siblings being treated
differently.
Disabilism, the discrimination against disabled
people, together with sexual and trans prejudice,
combine to produce a covert message to LGBTQ
disabled people to appear as “normal” as possible—
that is, in addition to not disclosing their sexual or
trans identity, to hide their impairment as best they
can. The mainstream medical-model message is one
of shame and adaption. To resist the desire to “pass
as normal” is to challenge prejudices that individuals
may hold about themselves as well as those held in
wider social contexts. However, there may be
significant reasons why someone wishes to hide
aspects of one’s identity, including the risk of
violence, losing support, and increasing oppression.
The intersectionality of an individual’s physicality,
sexuality, gender, class, age, and race must be
considered, and it is most likely that someone will be
selective about how much and in which contexts they
choose to disclose disabled or LGBTQ identities,
choosing times that have the most personal and
political significance. It is also the case that some
people may not feel disabled “enough” to adopt a
disabled identity, which is a flip side of a social
expectation that disabled people should feel grateful
or guilty about any concessions made to
“accommodate” their impairment. When
LGBTQ identities are recognized, they can be
considered as a result of being disabled, as opposed
to as a chosen affirmed identity. For example, a
woman may be viewed as having a same-sex partner
because she could not attract a man.
It is unfortunately the case that mainstream
disability movements can be sites of sexual and trans
prejudice and LGBTQ organizations rife with
disabilism. The myth of asexuality pervades both
communities. For example, acceptance in LGBTQ
spaces can come at the cost of one’s active sexual
desires, in that acceptance may be on the level of
politics or friendship but not as a potential sexual or
romantic partner. It has been highlighted that the
terms used within LGBTQ rights movement of
“strength” and “voice” can be experienced as
exclusionary by some (e.g., the statement on the
Physical Disabilities
Stonewall website: “The Stonewall Awards provide a
much-needed platform to showcase the strength,
confidence, visibility and talent of lesbian and gay
people in this country”). The lack in civil rights
movements of an intersectional perspective
combining social diversity around gender, race,
sexuality, and disability has been seen as having led
to a silencing of LGBTQ and race issues within
disability movements, of disability and race issues
with LGBTQ movements, and LGBTQ and disability
issues within race movements. Yet all these
movements share similarities in their struggles
against, and resistance of, discrimination and
oppression, such as in campaigns and petitions to
governments for policy change, with the potential for
building on and learning from each other. However,
while some authors suggest that people choose to
seek support from different communities for different
needs, others suggest that people find support from
the community they have identified with for longest.
An important example of where the intersection
between sexuality and disability won over prejudice
and overt discrimination is in the case of Sharon
Kowalski, which took place in Minnesota, in the
1980s. Following a road traffic accident, Sharon was
left hospitalized with impairment to her motor skills
and communication. She indicated that she wished to
return home to live with Karen, her partner, whose
input at her bedside was applauded by the medical
staff as significantly contributing to her progress.
However, Sharon’s father had been awarded legal
custody, and he forbade this and blocked Karen’s
visits. On the back of Karen’s ardent national
campaigning, a “National Committee to Free Sharon
Kowalski” was formed, linking disability and
lesbian, gay, and bisexual (LGB) activists who raised
money for legal costs and supported the couple.
Together, they won the legal battle: Legal
guardianship was transferred to Karen, and Sharon
returned home.
 2277
Sex and Romance in Adolescence and disabled partner for this very reason, potentially
Adulthood using dating sites specifically created for this purpose
(e.g., Disability Match or The Outsiders Trust).
During adolescence, disabled people have described
Nondisabled partners can have their choices
feeling socially and sexually isolated, with some
questioned and scrutinized, or partners may be
experiencing prejudice and discrimination from the
considered the disabled person’s caregiver rather
attitudes held by peers or accessibility of social
than their romantic and sexual partner. If partners are
venues, so that there are reduced opportunities to mix
involved in physical support of a disabled person, it
socially and create possibilities to start sexual
can shift the dynamics of power within the
liaisons. This is at a time when peers were learning
relationship and potentially place it under strain.
how to flirt, date, and become sexually active. An
Examples of this might be the disabled person not
individual who recognized their same-sex desires or
wishing to upset their partner for fear of withdrawal
trans identity at this time may find this particularly
of support or subtle retaliation (e.g., moving furniture
difficult in the context of living in a sexual and/or
in the home of someone who is blind). The disabled
gender minority. Along with reduced opportunities
person may also fear being a burden and so hide
for sexual experimentation or exposure to role
tiredness or pain.
models, individuals may be denied sex education and
Professionals rarely address the sexual needs of
find it hard to find alternative examples of sex and
disabled people. With acquired disability (e.g.,
sexuality than mainstream cisgendered able-bodied
through accident or illness), previous sexual habits
heterosexual information. Queer can take on
and patterns may have been disrupted or no longer
particular significance as an identity label in
possible, posing a challenge for the individual and/ or
rejecting norms imposed on sexual, gender, and body
couple to find new ways to communicate about sex
expectations. This lack of support, interest, and
and be sexual. Within this context, the sexual needs
information is not only oppressive but also
of trans and sexual-minority disabled people are even
dangerous because it creates an unsafe culture where
more ignored or avoided, as professionals may feel
sexual abuse may remain hidden and unreported.
unskilled, unknowledgeable, or embarrassed to have
Difficulties such as the lack of reporting, reports
this conversation. While LGBTQ people have
being discounted by those to whom they were made,
rejected the notion espoused in most sex education of
or a lack of clear records of the disability status for
sex equaling penises entering vaginas, the idea of sex
victims of crime make it hard to estimate the
cumulating in orgasm remains the dominant model of
prevalence of this abuse, but it has been suggested
sexual satisfaction. The sexual response cycle notion
that disabled people are between 4 and 10 times
of sex creates disability for those who do not fit
more likely t