Speaking with Care:

LGBTQIA2S+ Inclusive Language

Tiffany Sostar
[Company name]
[Date]
LGBTQIA2S+ Language
This is a brief introduction to speaking with, and about, members of the LGBTQIA2S+ community. It’s a
big, diverse community and the language is always changing.

It can be difficult to keep up, but it’s worth it to create safer and more inclusive medical practices,
homes, schools, and workplaces.

A Brief Set of Definitions

LGBTQIA2S+
These definitions are widely, but not universally, accepted. An individual’s self-definition always takes
precedence over any dictionary definition.

So, for example, a woman who says she is a lesbian but has dated men is a lesbian. A bisexual who has
only ever dated people of one gender is still a bisexual. The most important thing about definitions is
that people define their own identities for themselves.

These labels are valuable – being able to find each other, and to see ourselves reflected in the available
language, can save lives. But these labels are a lot like boxes and cats: there’s a world of difference
between the box you choose to sit in, and the box someone is trying to stuff you into.

Here are some definitions of sexual

orientations and gender identities:
Asexual: Asexual folks are not sexually LGBTQIA2S REFERS TO LESBIAN, GAY,
attracted to people of any gender. BISEXUAL, TRANSGENDER,
Bisexual: Bisexual is both a specific identity QUEER/QUESTIONING, INTERSEX,
referring to folks who are attracted to two or ASEXUAL, TWO SPIRIT.
more genders, and also sometimes used as an
umbrella term for non-monosexual identities
(non-monosexual refers to any orientation that includes attraction to more than one gender). Bisexual
does not necessarily mean “attracted to men and women” (though some bisexual folks are only
attracted to men and women!) and it is not inherently transphobic.

Cisgender: Cisgender folks have a gender identity that is in alignment with their assigned sex at birth,
meaning that if they were assigned female at birth, they are a woman, and if they were assigned male at
birth, they’re a man. (The sex you are assigned at birth refers to what the doctors put on your birth
certificate.)

Gay: Gay has a few meanings. At its broadest, gay folks are anyone who is attracted to people of their
own gender. But gay also, and perhaps most commonly, refers to a man who is attracted to men. Both
transgender and cisgender men can be gay. Gay is also sometimes used to refer to anything that isn’t
straight.

Intersex: Intersex refers to a wide range of sexes outside of simple male and female. Intersex folks are
born with a variety of sex characteristics (including chromosomes, gonads, sex hormones, and/or
genitals) that are outside the standard definitions of male and female. Intersex folks can have a range of
gender identities, and some identify as non-binary while others identify as women or men.

Lesbian: Lesbian refers to a woman who is attracted to women. Both transgender and cisgender women
can be lesbians.

Non-binary: Non-binary gender refers to a wide range of gender identities that are not “man” or
“woman.” Some of these are genderqueer (an identity without a clear definition, see Queer), agender
(not having a gender), bigender (having two genders), or genderfluid (a gender identity that shifts
regularly). Many non-binary folks use the gender neutral pronouns “they/them/theirs,” but other
gender neutral pronouns also exist. Some non-binary folks identify as transgender, and some do not.

Pansexual: Pansexual sometimes refers to attraction to all genders, and sometimes refers to attraction
regardless of gender.

Queer: Queer is an identity that essentially means not straight, and it is often used as an umbrella term
for the whole non-heterosexual community. It is also a political statement, because queerness
intentionally has no single definition beyond “not straight.” When someone says they are queer, there is
no way to know exactly what that means, and that is often intentional.

Straight: Straight (or heterosexual) folks are either men who are attracted to women, or women who
are attracted to men. Both cisgender and transgender folks can be straight.

Transgender: Transgender is not a sexual orientation (transgender folks can be gay, straight, bisexual,
asexual, or any other orientation). Transgender refers to having a gender identity that is not in
alignment with the assigned sex at birth. Trans folks can be trans men (men who were assigned female
at birth, previously referred to as FTM, though this terminology is no longer commonly used), trans
women (women who were assigned male at birth, formerly referred to as MTF), or a wide range of non-
binary (meaning not man or woman) genders.

Two Spirit: Two spirit is an Indigenous-created word for traditionally recognized identities. It means
different things in each nation and to each person who holds that identity, and it is an identity that is
culturally-specific, meaning that it belongs to Indigenous communities and cannot be used by non-
Indigenous.

What’s not included?

The LGBTQIA2S+ acronym is not complete (that’s what the “+” indicates), and it’s not perfect. The
choices about which identities get a letter in the acronym are always challenging, and there are many
THE ACRONYM ALSO DOES NOT INCLUDE ROMANTIC
identities that are not explicitly included in the acronym and are still entirely valid. This is particularly
ATTRACTION, AND SO IT MISSES A LOT OF NUANCE
true of many culturally-specific identities that exist outside of Western understandings of gender and
sexuality. BECAUSE SEXUAL ATTRACTION (THE PEOPLE WE WANT TO
BE PHYSICALLY INTIMATE WITH), AND ROMANTIC
If you would like a comprehensive list of identities and terms,(THE
ATTRACTION The Transgender
PEOPLE WELanguage
WANT TOPrimer project
BE EMOTIONALLY
is a live document (meaning it is regularly updated) available at [Link]
INTIMATE WITH) ARE (this link leads to
DIFFERENT THINGS.
a publicly viewable google document).
Asking and answering questions
What can I ask?
The best guideline when you’re thinking about asking someone a question related to their identity or
orientation, is to ask yourself whether you would ask this of an acquaintance you assumed to be straight
and/or cisgender, or to ask yourself whether the information is required in order to provide adequate
medical care.

Medical professionals often do need to ask intrusive questions, but asking these questions respectfully,
carefully, from a position of affirming awareness, and with clear justification for why you need to ask the
question will make a difference in the feeling of safety for your LGBTQIA2S+ community members.

It’s okay to be curious, and it’s great to become more informed! For many LGBTQIA2S+ folks, though,
overly personal or invasive questions can be an imposition.

If you’re curious about what an identity is or the experiences of a group, Google can be your best friend.

Google can also be your worst enemy, because all the misinformation and harmful stereotypes that your
LGBTQIA2S+ friends, coworkers, and family members face out there in the world is amplified on the
internet. If what you’re reading seems to dismiss, invalidate, or delegitimize the identity groups you’re
trying to learn about, look elsewhere! This is particularly true for information about transgender and
bisexual/pansexual/asexual folks, since those groups are so frequently misunderstood and
misrepresented. Since these two groups (trans and non-monosexual) also experience significantly lower
health outcomes, it is critical for medical professionals to seek out and access good information.

Here are a few recommended resources:

- Gender Spectrum. [Link]. You’ll find articles, book and media

recommendations, FAQs, and even resources designed for everyone from schoolkids to
grandparents. If someone in your life is, or might be, transgender – this is a great place to
learn about what that means, how to support them, and how to advocate for them in
medical settings, schools, workplaces, and at home.
- PFLAG. [Link] PFLAG offers a wide range of resources, including an “Our
Stories” archive that lets you hear the stories of queer folks in their own words.
- Everyone Is Gay. [Link] Everyone Is Gay (and the offshoot site, My Kid
Is Gay [Link] offers an advice column, resources, and a funny, accessible
format for people who have questions.
- Native Youth Sexual Health Network. [Link] The Native
Youth Sexual Health Network provides a wide range of information for and about
Indigenous LGBTQIA and Two Spirit identities, as well as offering mentorship and support for
youth and their families.
- Queer Kid Stuff. [Link] Queer Kid Stuff is a resource designed for
kids aged 3-7. There are videos on specific topics, with printable resources to go along with
them. This is a great resource for families.
Answering children’s questions
How can you respond to children who bring up issues of sexuality or gender?

A lot of folks are anxious about answering kids’ questions when it comes to sexuality and gender. We’re
worried that they’re not old enough to understand, or that we’re going to somehow change their
identity if we say the wrong thing.

Shielding kids from information about LGBTQIA2S+ identities doesn’t actually protect them, though.
Some kids know that they’re transgender as early as 3 or 4, and non-heterosexual kids start having
crushes at the same age as their peers – anywhere from late elementary to junior high. Recognizing,
normalizing, and validating queer and trans identities from a young age can help kids be more accepting
of their peers or of themselves.

Although it’s long been known that trans youth are at higher risk for mental health challenges, a study of
kids aged 3 to 121 found that, in a supportive family environment, transgender kids experienced
depression and anxiety at the same rates as their cisgender peers. This means that creating supportive
home environments buffers kids from the kinds of distress that we once assumed would be inevitable.

So, how do you answer their questions?

Tell them the truth about the incredible diversity of experiences. Some kids have two dads. Some kids
have two moms. Some people like boys and girls. Some people aren’t boys or girls.

And don’t be afraid to be honest when you don’t have the answers. There’s nothing wrong with saying,
“You know what, I’m not sure. We can look it up. But no matter what, I know that people are people and
everyone deserves love and happiness.”

Being a good ally

Here are some quick tips that can help the LGBTQIA2S+ folks around you feel supported, validated, and
safe:

- Get in the habit of assuming you don’t know people’s orientation until you’re told. Most of
us tend to assume that the people we meet are straight and cisgender until proven
otherwise, but this can make it hard for folks to feel safe. Assume that you don’t know and
make space for people to be themselves. You can do this by not assuming the gender of
someone’s partner (using gender-neutral terms like “partner” can help!).
- Normalize trans and non-binary genders. You actually can’t tell someone’s gender by looking
at them, but it’s very common to assume that we can. You can help to create a safe space
for transgender and non-binary folks by introducing yourself with your pronouns, and
making a habit of asking everyone what pronouns they use.
- Get comfortable with singular they and gender-neutral language. “They/them” is the
gender-neutral equivalent to she/her and he/his. It’s even in the dictionary! You can also
use non-gendered language like “folks,” “friends,” “colleagues,” or “everybody” rather than
gendered terms like “ladies and gentlemen.”
- Speak up if someone makes an antagonistic or unaware comment or a joke at the expense
of the queer community.
1
Olson KR, Durwood L, DeMeules M, et al. Mental Health of Transgender Children Who Are Supported in Their
Identities. Pediatrics. 2016;137(3):e20153223
The best way to be an ally is to educate yourself. Find the blogs of LGBTQIA2S+ folks and read them.
Read books and articles by members of the community. Keep the phrase “nothing about us without us”
in mind, and always consider the voices of the people within the community to be the experts. One of
the most harmful things that has been done to LGBTQIA2S+ folks is being studied rather than heard. You
can be part of the solution by listening to people within the community, and centering their voices.

Making mistakes
We all make mistakes.

Even folks within the queer community make mistakes, because language and norms are constantly
evolving, and because we are all socialized within hetero- and cisnormative culture (meaning that there
is an assumption that straight and cisgender are “normal” and everything else is “not normal”). This can
lead to a lot of shame and fear, both for people within the community and for people outside of it.

It’s also complicated because there are not always simple and universal right answers. If you ask ten
different queer people a question, you’ll probably get ten different answers. And that’s okay! But it can
be overwhelming, and we often don’t want to make a mistake – mistakes hurt people, and none of us
want to cause our coworkers, friends, and family members pain.

Take a deep breath and remind yourself that having these conversations is important. Fumbling through,
making mistakes, saying the wrong thing (and then saying it again next week when you’ve forgotten),
misunderstanding the situation, sharing bad information – this is all normal, and it’s all part of the
learning process. The key is to keep learning. Keep trying, even when it feels overwhelming.

Learning how to use gender neutral and inclusive language and unlearning assumptions about people’s
identities takes effort and you will make mistakes, but that effort will pay off.

If you get something wrong, such as misgendering someone, asking an insensitive question, making an
assumption, or making a statement that turns out to be based on misinformation or harmful
stereotypes, listen to what the person who is hurt is saying.

They may be angry and frustrated – your small mistake may be the tenth time they’ve been
misgendered today, or they may have heard that same biphobic assumption at family dinner the other
night.

Apologize, correct yourself, and then keep working on learning about the community and how to be
supportive. You’re not a bad person for making a mistake. We all do it.

When someone comes out to you

If someone trusts you enough to come out to you, that’s amazing!

The most important thing is to be affirming and supportive. Tell them that you believe them and thank
them for trusting you.

Making the effort to educate yourself will help them feel supported and safe.

Coming out to medical professionals is fraught, and many folks either do not have a choice about
coming out because information is in their file, or because they can’t afford to lose access to care if they
discover that their service provider is not affirming.
If you’re confused or concerned, reach out to some of the resources listed earlier. (It’s important to
respect their confidentiality, so don’t share the new information you’ve received with mutual friends or
coworkers.)

Know that many folks lose friends or family support when they come out. It can be an incredibly painful
experience, even though it is often an important step towards self-acceptance. Check in on the person
who has come out to you, and let them know that you’re still their friend.

Why does inclusive language matter?

The history of the queer and trans movement is one of resistance and resilience. It matters because for a
long time, in a lot of places, the LGBTQIA2S+ communities have been isolated, regulated, and
marginalized.

Gay, lesbian, bisexual, pansexual, asexual, intersex, queer, and questioning folks have always existed.
Trans men, trans women, non-binary and agender folks, two spirit folks and many other culturally
specific identities have always existed. We are not new, but we are newly visible.

This is important.

Visibility is not a universal cure (simply being visible and vocal will not eliminate hatred and
misunderstandings, as we can see in the ongoing resistance to transgender and queer rights) but it is a
critical first step. With visibility comes community, and with community comes safety.

Medical professionals have the opportunity to create safe spaces, to create a kind of inclusion that has
often been missing. Affirming care saves lives.

When we can find each other, and when we can find our allies, we are safer and we are stronger.
Isolation is incredibly painful, and too many LGBTQIA2S+ folks spend too much time feeling isolated.

Queer lives are precious and they are in your hands.

This resource was created by Tiffany Sostar.

Tiffany Sostar is a narrative therapist (working with individuals, couples, polyamorous pods, families, and
groups), workshop facilitator, editor, and writer. Tiffany’s work is trauma-informed, inclusive, and
always available sliding scale. You can work with Tiffany in-person or long-distance.

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