1. An Introduction to working with lesbian, gay, & bisexual patients
LGB & U:
An Introduction to working with
lesbian, gay, & bisexual patients
A Panel Discussion
Presented by the LGBT Education & Advocacy Sub-Committee
April 21st, 2017

2. Panelist: Jennifer Evans, Psy.D.
Psy.D. from the California School of Professional Psychology - Alliant International University
Licensed Psychologist CPANCF

3. Panelist: John T. Super, Ph.D.
Ph.D. in Counselor Education from University of Central Florida
Clinical Assistant Professor in Counselor Education, UF

4. Panelist: Alyssa N. Zucker, Ph.D.
Ph.D. in Psychology with certification in Women’s Studies from the University of Michigan
Associate Professor & Vada A. Yeomans Chair of Women’s Studies, UF

5. Outline Background Clinical Topics Advocacy and Outreach
Terms
LGB Bio-Psycho-Social Issues
Clinical Topics
Cultural Sensitivity
Techniques
Advocacy and Outreach
Patients
Professionals
Case Experiences

6. The Lingo… Terms to Use Terms to Avoid Rationale • gay (adj.)
• lesbian (n. or adj.)
• bi (adj.)
• bisexual (adj.)
• Men who have sex with men (MSM)
• homosexual
• gay (n.)
Gay is an adjective, not a noun; sometimes used as a shorthand term encompassing gay, lesbian and bisexual orientations (though not transgender people or gender identity). Also, while many lesbians may identify as gay, the term lesbian(s) is clearer when talking only about a woman/women.
Anti-gay activists often use words like “homosexual” to stigmatize gay people by reducing their lives to purely sexual terms.
• being gay
• homosexuality
• lesbianism
• “That’s so gay.”
Talking about a person’s “homosexuality” can, in some cases, reduce the life of that person to purely sexual terms. Talk about being gay instead.
The term “lesbianism” is considered pejorative.

7. The Lingo… Terms to Use Terms to Avoid Rationale • orientation
• sexual orientation
• “sexual preference”
• “gay lifestyle”
• “homosexual lifestyle”
• “same-sex attractions”
• “sexual identity”
The term “sexual preference” is used by anti-gay activists to suggest that being gay is a choice, and can be changed or “cured.”
The term “gay lifestyle” stigmatizes gay people and suggests that their lives should be viewed only through a sexual lens. Just as one would not talk about a “straight lifestyle,” don’t talk about a “gay lifestyle.
• gay and transgender
• lesbian, gay, bisexual and transgender (if needed for clarity)
• “LGBT” (when talking with those who are unfamiliar with the issues or not yet supportive)
Reference sexual orientation and gender identity when talking about issues pertaining to both.
The abbreviation “LGBT” can be confusing and alienating though it is essential when talking to LGBT and strongly supportive audiences. Use the term that allows your audience to stay focused on the message.

8. The Lingo… Terms to Use Terms to Avoid Rationale • openly gay
• “admitted he was gay”
The term “admitted” suggests prior deception or that being gay is shameful.
• fairly and equally
• fairness and equality
• rights
• civil rights
• gay rights
“Rights” language is generally unpersuasive with most audiences, and civil rights comparisons can be especially alienating to African Americans.
• intolerance
• hurtfulness
• unfairness
• exclusion
• rejection
•“hate” / “haters” / “hatred”
• “bigot” / ”bigots” / “bigotry”
• “prejudice”
Avoid highly charged, argumentative terms like “hate” and “bigotry,” which may alienate people. Instead, use language that is measured and relatable to create empathy and a sense of how rejecting attitudes and actions hurt LGBT people.
• anti-gay activists
• far-right activists
• “religious extremists/
extremism”
• “anti-gay Christians”
Avoid language that unfairly paints an entire religious tradition or denomination as being antigay or extremist.

9. LGB Health Disparities
Youth Disparities:
Higher rates of suicidal ideation & attempts
Higher prevalence of risk factors for MH
Higher prevalence of substance use d/o
Higher rates of homelessness
HIV among MSM

10. LGB Health Disparities
Adult & Older Adult Disparities
Generally
Higher rates of alcohol use & smoking
Higher rates of depression
Women
More likely to experience rape, physical violence, stalking & psychological aggression
Less engagement with preventative health services
Higher rates of obesity & breast cancer
Men
Higher rates of HIV and HPV
Higher prevalence of BDD

11. Clinical Topic: Cultural Sensitivity
General suggestions for working with LGB patients for those that may be unfamiliar with the population.
Discuss best practices for working with patients displaying signs of internalized homonegativity / homophobia.
Navigating a conversation with a patient whom you believe may be LGB, yet has not disclosed their sexual identity.
Disclosure in a systems context … do’s and don’ts for talking to the:
Child patient
Parent
Spouse
Child non-pt. / adult child non pt.

12. Advocacy and Outreach Do’s and Don’ts
Patients
Professionals
How to make clinical spaces more LGB friendly.
Recommendations to assist patients in managing non-gay-friendly environments

13. Case Experiences
Best practices for working with patients displaying signs of homonegativity / homophobia.
What is the best way to manage conflicts between your own personal beliefs and potential beliefs of your patients?
What are some common conflicts that we may not be aware of?
Self-Disclosure with patients?

14. Acknowledgements Distinguished Panelist! Lori Waxenberg, Ph.D.
Kathryn Ross, Ph.D.
Michael Marsiske, Ph.D.
intervention Research Advancing Care Equity (iRACE)
Nicole Ennis, Ph.D.
McKnight Doctoral Fellowship / FEF
Office of Graduate Minority Programs
UF Multicultural & Diversity Affairs
LB Hannahs

15. References
U.S. Department of Health and Human Services (2012). Lesbian, gay, bisexual, and transgender health. Retrieved from: 2
Institute of Medicine. (2011). The health of lesbian, gay, bisexual, and transgender people: Building a foundation for better understanding. Washington, DC: The National Academies Press.
National Institutes of Health (2013). Consideration of the Institute of Medicine (IOM) report on the health of lesbian, gay, bisexual, and transgender (LGBT) individuals. Retrieved from:
Kann, L., O’Malley Olsen, E., McManus, T., Kinchen, S., Chyen, D., Harris, W. A., & Wechsler, H. (2011). Sexual identity, sex of sexual contacts, and health-risk behaviors among students in grades 9 – 12: Youth Risk Behavior Surveillance, selected sites, United States, Morbidity and Mortality Weekly Report, 60,
Walters, M. L., Chen, J., & Breiding, M. J. (2013). The national intimate partner violence and sexual violence survey (NISVS): 2010 findings on victimization by sexual orientation. Retrieved from:

16. On Behalf of the LGBT Subcommittee