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BISEXUAL or BI: A person who experiences sexual, romantic, physical, and/or spiritual attraction to people of their own gender as well as other genders, not. Lesbian, Gay, Bisexual, and Transgender HealthNew or State surveys, making it difficult to estimate the number of LGBT individuals and their health needs. On 1 August , the Sex Discrimination Act was amended to make physical homophobic abuse (18 per cent) and other types of homophobia (9 per cent) Gay, lesbian, bisexual and transgender people are three times more likely to.

In cases in which the literature refers only to lesbian, gay, and bisexual populations, the term LGB appears more Approach to the Literature While acknowledging that peer-reviewed journals are the gold standard for the reporting of research results and making every effort to consult works published in major research journals, the committee chose to include in this study what it judged to be the best empirical literature available: Recognizing that academic journals differ in their publication criteria and the rigor of their peer-review process, the committee gave the greatest weight to papers published in the most authoritative journals.

Given that chapters, academic books, and technical reports typically are not subjected to the same peer-review standards as journal articles, the committee gave the greatest credence to such sources that reported research employing rigorous methods, were authored by well-established researchers, and were generally consistent with scholarly consensus on the current state of knowledge.

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With respect to articles describing current health issues in the LGBT community, the committee attempted to limit its review to these articles published since In the area of transgender populations, however, much of the most current research was conducted prior to and is cited throughout the report. Likewise, in the case of history and theory, the committee reviewed and cites older literature.

When evaluating quantitative and qualitative research, the committee considered factors affecting the generalizability of studies, including sample size, sample source, sample composition, recruitment methods, and response rate. The committee also considered the study design, saturation the point at which new information ceases to emergeand other relevant factors.

In some cases, the committee decided that a study with sample limitations was important; in such cases, these limitations and limits on the extent to which the findings can be generalized are explicitly acknowledged. The inclusion of case studies was kept to a minimum given their limited generalizability. In cases in which no U. This was frequently the case for research involving transgender people. Only English-language articles were considered. The committee considered papers whose authors employed statistical methods for analyzing data, as well as qualitative research that did not include statistical analysis.

For papers that included statistical analysis, the committee evaluated whether the analysis was appropriate and conducted properly. For papers reporting qualitative research, the committee evaluated whether the data were appropriately analyzed and interpreted. The committee does not present magnitudes of differences, which should be determined by consulting individual studies. In some cases, the committee used secondary sources such as reports. However, it always referred back to the original citations to evaluate the evidence.

Conceptual Frameworks In understanding the health of LGBT populations, multiple frameworks can be used to examine how multiple identities and structural arrangements intersect to influence health care access, health status, and health outcomes. This section provides an overview of each of the conceptual frameworks used for this study. First, recognizing that there are a number of ways to present the information contained in this report, the committee found it helpful to apply a life-course perspective.

A life-course perspective provides a useful framework for the above-noted varying health needs and experiences of an LGBT individual over the course of his or her life. Central to a life-course framework Cohler and Hammack, ; Elder, is the notion that the experiences of individuals at every stage of their life inform subsequent experiences, as individuals are constantly revisiting issues encountered at earlier points in the life course.

This interrelationship among experiences starts before birth and in fact, before conception. A life-course framework has four key dimensions: Linked lives—Lives are interdependent; social ties, including immediate family and other relationships, influence individuals' perspective on life.

Life events as part of an overall trajectory—Significant experiences have a differential impact at various stages of the life course. Personal decisions—Individuals make choices influenced by the social contexts in which they live e.

Historical context—A historical perspective provides a context for understanding the forces and factors that have shaped an individual's experiences; those born within the same historical period may experience events differently from those born earlier or later.

From the perspective of LGBT populations, these four dimensions have particular salience because together they provide a framework for considering a range of issues that shape these individuals' experiences and their health disparities. The committee relied on this framework and on recognized differences in age cohorts, such as those discussed earlier, in presenting information about the health status of LGBT populations.

Along with a life-course framework, the committee drew on the minority stress model Brooks, ; Meyer,a. While this model was originally developed by Brooks for lesbians, Meyer expanded it to include gay men and subsequently applied it to lesbians, gay men, and bisexuals Meyer, b.

This model originates in the premise that sexual minorities, like other minority groups, experience chronic stress arising from their stigmatization. Within the context of an individual's environmental circumstances, Meyer conceptualizes distal and proximal stress processes.

A distal process is an objective stressor that does not depend on an individual's perspective.

Face the facts: Lesbian, Gay, Bisexual, Trans and Intersex People

In this model, actual experiences of discrimination and violence also referred to as enacted stigma are distal stress processes. Proximal, or subjective, stress processes depend on an individual's perception. They include internalized homophobia a term referring to an individual's self-directed stigma, reflecting the adoption of society's negative attitudes about homosexuality and the application of them to oneselfperceived stigma which relates to the expectation that one will be rejected and discriminated against and leads to a state of continuous vigilance that can require considerable energy to maintain; it is also referred to as felt stigmaand concealment of one's sexual orientation or transgender identity.

Related to this taxonomy is the categorization of minority stress processes as both external enacted stigma and internal felt stigma, self-stigma Herek, ; Scambler and Hopkins, There is also supporting evidence for the validity of this model for transgender individuals. Some qualitative studies strongly suggest that stigma can negatively affect the mental health of transgender people Bockting et al. The minority stress model attributes the higher prevalence of anxiety, depression, and substance use found among LGB as compared with heterosexual populations to the additive stress resulting from nonconformity with prevailing sexual orientation and gender norms.

The committee's use of this framework is reflected in the discussion of stigma as a common experience for LGBT populations and, in the context of this study, one that affects health.

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An intersectional perspective is useful because it acknowledges simultaneous dimensions of inequality and focuses on understanding how they are interrelated and how they shape and influence one another. Intersectionality encompasses a set of foundational claims and organizing principles for understanding social inequality and its relationship to individuals' marginalized status based on such dimensions as race, ethnicity, and social class Dill and Zambrana, ; Weber, These include the following: Race is a social construct.

Understanding the racial and ethnic experiences of sexual- and gender-minority individuals requires taking into account the full range of historical and social experiences both within and between sexual- and gender-minority groups with respect to class, gender, race, ethnicity, and geographical location. The economic and social positioning of groups within society is associated with institutional practices and policies that contribute to unequal treatment. The importance of representation—the ways social groups and individuals are viewed and depicted in the society at large and the expectations associated with these depictions—must be acknowledged.

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These representations are integrally linked to social, structural, political, historical, and geographic factors. Nevertheless, in a hierarchically organized society, some statuses become more important than others at any given historical moment and in specific geographic locations.

Race, ethnicity, class, and community context matter; they are all powerful determinants of access to social capital—the resources that improve educational, economic, and social position in society. Thus, this framework reflects the committee's belief that the health status of LGBT individuals cannot be examined in terms of a one-dimensional sexual- or gender-minority category, but must be seen as shaped by their multiple identities and the simultaneous intersection of many characteristics.

Finally, the social ecology model McLeroy et al. This viewpoint is reflected in Healthy People In developing objectives to improve the health of all Americans, including LGBT individuals, Healthy People used an ecological approach that focused on both individual-and population-level determinants of health HHS, With respect to LGBT health in particular, the social ecology model is helpful in conceptualizing that behavior both affects the social environment and, in turn, is affected by it.

A social ecological model has multiple levels, each of which influences the individual; beyond the individual, these may include families, relationships, community, and society.

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It is worth noting that for LGBT people, stigma can and does take place at all of these levels. The committee found this framework useful in thinking about the effects of environment on an individual's health, as well as ways in which to structure health interventions.

WHAT IS LGBT?

Each of the above four frameworks provides conceptual tools that can help increase our understanding of health status, health needs, and health disparities in LGBT populations. Each complements the others to yield a more comprehensive approach to understanding lived experiences and their impact on LGBT health. The life-course perspective focuses on development between and within age cohorts, conceptualized within a historical context.

Sexual minority stress theory examines individuals within a social and community context and emphasizes the impact of stigma on lived experiences. Intersectionality brings attention to the importance of multiple stigmatized identities race, ethnicity, and low socioeconomic status and to the ways in which these factors adversely affect health.

The social ecology perspective emphasizes the influences on individuals' lives, including social ties and societal factors, and how these influences affect health.

The chapters that follow draw on all these conceptualizations in an effort to provide a comprehensive overview of what is known, as well as to identify the knowledge gaps. Chapter 3 addresses the topic of conducting research on the health of LGBT people. Specifically, it reviews the major challenges associated with the conduct of research with LGBT populations, presents some commonly used research methods, provides information about available data sources, and comments on best practices for conducting research on the health of LGBT people.

As noted, in preparing this report, the committee found it helpful to discuss health issues within a life-course framework. Each of these chapters addresses the following by age cohort: Chapter 7 reviews the gaps in research on LGBT health, outlines a research agenda, and offers recommendations based on the committee's findings.

A qualitative needs assessment. The ecology of human development: Experiments by nature and design. Harvard University Press; Minority sexual status among minorities, Sexualities and identities of minority women.

The theory of minority stress, Minority stress and lesbian women. Transgenderism and intersexuality in childhood and adolescence: The psychological world of the gay teenager: Dill TB, Zambrana R. Race, class and gender in theory, policy and practice. Rutgers University Press; The process of transitioning from one gender to another is called gender reassignment. Biological females who wish to live and be recognised as men are called female-to-male FTM transsexuals or trans men.

Biological males who wish to live and be recognised as women are called male-to-female MTF transsexuals or trans women.

Gender Vocabulary (Talking about the LGBT community) – Free Spoken English Lesson

Transvestite or cross-dressing individuals are thought to comprise the largest transgender sub-group. Cross-dressers sometimes wear clothes considered appropriate to a different gender. They vary in how completely they dress from one article of clothing to fully cross-dressing as well as in their motives for doing so. A small number can go on to identify as transsexual.

People who wish to transition often start by expressing their gender identity in situations where they feel safe. They typically work up to living full-time in a different gender, by making gradual changes to their gender expression. Connecting with other transgender people through peer support groups and transgender community organisations is also very helpful for people when they are going through the transition process.

Transitioning typically involves changes in clothing and grooming, a name change, change of gender on identity documents, hormonal treatment, and surgery. Coming Out Coming Out is the term used by lesbian, gay, bisexual and transgender LGBT people to describe their experience of discovery, self-acceptance, openness and honesty about their LGBT identity and their decision to disclose, i. Three sexual orientations are commonly recognised — heterosexual, homosexual gay and lesbian and bisexual.

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