An irrational fear and resulting hatred of homosexual individuals
The societal expectation that heterosexuality is the expected normal
Men having sex with men
Women having sex with women
Knowledge of one’s self as male or female
Outward expression of being male or female
Does not follow society’s ideas about how they should act according to gender roles
Chromosomal and anatomic gender
Process and time when a person goes from living as one gender to living as the other
Male transitioning to female
Female transitioning to male
Conversion or reparative therapy
Attempts to “convert” the individual to heterosexual
Engaging in sexual intercourse in exchange for shelter, food, or money; often includes high-risk or unprotected sexuality
Using Gender Neutral Terms in the Psychosocial History
“Do you have a girlfriend?”
“Are you dating anybody?”
“Are you involved any romantic relationship?”
“What do you and your boyfriend do together?”
“What do the 2 of you do together?”
“Tell me about your partner.”
“Are you and your girlfriend sexually active?”
“Are you having sex?”
“Are the 2 of you in a sexual relationship?”
Sexual History Questions About Sexual Behaviors
• Have you ever had sex? What have you done sexually with a partner?
• Have you ever had oral sex? Has a partner ever “gone down” on you or have you ever “gone down” on a partner?
• Have you ever had vaginal sex? Have you ever engaged in penile-vaginal sex?
• Have you ever had anal sex? Did you put your penis in your partner’s anus or did your partner put his penis in your anus?
• If there was any insertive or receptive sex: Do you use condoms? What percentage of the time? What about last time?
• If there was any oral-genital contact: Do you use dental dam or another barrier? What percentage of the time? What about last time?
Summary of Sexually Transmitted Diseases Screening Guidelines for MSM
• HIV serology, if HIV negative or not tested within the previous year
• Syphilis serology
• Test for urethral infection with Neisseria gonorrheae and Chlamydia trachomatis using NAATs in men who have had insertive anal intercourse during the preceding year
• Test for rectal infection with N gonorrheae and Ctrachomatis in men who have had receptive anal intercourse during the preceding year, using either preferred NAATs (for laboratories that have met regulatory requirements for an off-label procedure) or culture for N gonorrheae and enzyme immunoassay or direct fluorescent antibody assay for C trachomatis
• Test for pharyngeal infection with N gonorrheae in men who have acknowledged practicing receptive oral intercourse during the preceding year using NAATs (for those laboratories that have met regulatory requirements for an off-label procedure) or culture; testing for Ctrachomatis pharyngeal infection is not recommended98
NAAT, nucleic acid amplification test.
LGBTQ Support and Advocacy Organizations
• The Gay, Lesbian, and Straight Education Network mission is “Every student deserves a safe space” (http://www.glsen.org).
• Parents, Families, and Friends of Lesbians and Gays (PFLAG) is a long-standing support and advocacy organization (http://community.pflag.org).
• The National Youth Advocacy Coalition (NYAC) is a social justice organization that advocates for and with young people who are lesbian, gay, bisexual, transgender, or questioning in an effort to end discrimination against these youth and to ensure their physical and emotional well-being (http://www.nyacyouth.org).
• The Trevor Project (http://www.thetrevorproject.org) operates the only nationwide, around-the-clock crisis and suicide prevention hotline for sexual minority youth (866-4-U-TREVOR).
• Youth Resource is a Web site created by and for LGBTQ young people. Sponsored by Advocates for Youth, Youth Resource takes a holistic approach to sexual health and exploring issues of concern to LGBTQ youth, by providing information and offering support on sexual and reproductive health issues through education and advocacy (http://www.amplifyyourvoice.org/youthresource).
• For patients, communities, and health care professionals, the Gay and Lesbian Medical Association (http://glma.org) has referral and information resources.
• The World Professional Association for Transgender Health, Inc (WPATH). Formerly known as the Harry Benjamin International Gender Dysphoria Association, Inc, WPATH is a professional organization devoted to the understanding and treatment of gender identity disorders (http://www.wpath.org).
• Transfamily provides support and education for transgender people, their families, friends, and significant others. The group is associated with PFLAG to bring awareness to school systems, through their principals and counselors, by offering literature, speakers, consultation, and support (http://www.transfamily.org).
• Other resources are available on the Adolescent Reproductive and Sexual Health Education Project Web site at the end of the presentations, “Gay, Lesbian, Bisexual, Transgender, and Questioning Youth” and “Caring for Transgender Adolescent Patients” found at http://www.prh.org/ARSHEP. These presentations are also outstanding for both self-education and for use in training current and future medical professionals.