Our Bodies, Ourselves (20 page)

Whether or not you have made legal changes or undergone surgery, you are entitled to the dignity of being referred to by the name and pronoun of your choice. You should be asked, for example, what you prefer to wear during the exam. A young trans person commented:

Whenever I encounter trans-positive sexual health resources I breathe a deep sigh of relief.
I think trans men and trans women need more vocal support and accessibility in clinics and classrooms, as do those of us who don't transition physically, but find ourselves in sexual, social, and health-related situations that are rarely addressed.

For more information on access to the health care system for LGBT people, see
“Homophobia, Transphobia, and Heterosexism,”

asexual.
Describes someone who does not experience sexual attraction ever, or for a period of time.

bisexual.
Describes people who are romantically/sexually attracted to both men and women—sometimes, though not necessarily, at the same time.

gay/homosexual.
Describes men who are romantically/sexually attracted to men, and sometimes describes women who are attracted to women. Often used to refer to men exclusively.

lesbian.
Refers to women who are romantically/sexually attracted to women. “Same gender loving woman” is sometimes used in the African-American community.

pansexual.
Describes someone who is attracted to people across the range of genders. Often used by those who identify as transgender or genderqueer or who are attracted to people who are transgender or genderqueer.

queer.
Historically a derogatory term for gays, this word is now used positively by many lesbian, gay, bisexual, and transgender people and allies. It is sometimes used to describe an open, fluid sexual orientation and/or gender identity/expression.

straight/heterosexual.
Refers to women who are romantically/sexually attracted to men, and men who are attracted to women.

Some of us have reclaimed historically negative terms, such as queer, fag, and dyke, and use them affirmatively to describe ourselves. This is a political act that attempts to reclaim the power from these slurs. Rejecting labels is another form of resistance:

I don't identify as anything as far as sexuality goes. I was heterosexual for the beginning of high school, then I had a two-year experience with asexuality, and after that I came into a lovely and mixed-up world that resists labels.

Sexual orientation falls along a spectrum. Although people may choose the nearest applicable label, such as lesbian, they may actually have attractions and even relationships that are not in rigid accordance with that label.

Many of us confuse gender identity and sexual orientation. Gender identity is about who we are, while sexual orientation is about who attracts us. Being cisgender or transgender does not predict whether a woman will be straight, bisexual, or lesbian.

The confusion of gender identity with sexual orientation gives rise to misleading stereotypes. For example, some people assume that if a woman is a lesbian, she must have a masculine gender expression—in other words, she keeps her hair short, wears no makeup, and dresses like a man. Likewise, we might assume that because a woman appears masculine, she
must be a lesbian. But being lesbian or bisexual doesn't mean our gender looks or feels a certain way.

© Ellen Shub

The fact that I am femme (that is, traditionally feminine in appearance, with mannerisms perceived as feminine) throws people off; I'm often told I don't “look gay.”

Transgender people can identify as straight, lesbian, bisexual, gay, pansexual, or queer. Some who transition gender find that their sexual orientation changes during the process. Gender and sexual orientation thus interact dynamically, rather than the latter being static.

When my partner began his gender transition, my lesbian identity had been central to my life and my sense of self for well over a decade, and I didn't know what his transition made me. Some people told me I was “obviously” still a lesbian, but it was just as obvious to others that I was now straight, or bisexual. It wasn't obvious to me at all, and I struggled with it for a long time. Now I've been the partner of a trans man for as long as I was a lesbian, and I've gotten comfortable just not having a name for what I am. I think of myself as part of the family of queers and trans people.

The second decade of the twenty-first century is a promising time for women who have intimate and/or sexual relationships with women. With issues important to the lesbian, gay, bisexual, and transgender communities increasingly in the news, more people all over the country and around the world are recognizing who we are and supporting how we live our lives. The debate over the legal recognition of same-sex marriage has engaged the nation. More and more television shows and movies attempt to portray our lives (albeit not always in the most accurate or satisfying ways). Many people in positions of power and authority—politicians, business owners, and celebrities—are out and proud. Thanks largely to activism from within the LGBTQ community and an increasing emphasis on coming out, many women who love women are living more freely and openly than in generations past.
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Those of us who are attracted to both women and men live out our orientation in many different ways. Some of us date women and men serially, some simultaneously, and some enter relationships with women only or with men only, without acting on other attractions.

Thinking of ourselves as bi may reflect the sense that sexual orientation is a fluid aspect of ourselves that changes over the life span. Sometimes bi is a stopping place in a transition from one orientation to another.

Over time, we may find that a bisexual identity becomes less meaningful in the context of a life partnership with someone. However, for many of us, bisexual identity is lifelong, a proud and essential part of our natures. A woman in a monogamous life partnership may still identify as bi, because this label reflects her inherent capacity for attraction across genders.

I'm a woman who has primarily dated men but has had two short-term relationships with women. I'm in a committed relationship with a man. He is a wonderful, articulate, sensitive feminist whom I hope to marry; and yes, he knows of my past experiences and is open to me having continued relationships with women…. My desire for women isn't based on the inadequacies of my current lover but rather a need for some other, some different, some similar thing—all of which I find in women.

Bisexuals are often misunderstood and maligned. Labeled as confused, or not queer enough, people who identify as bi have often been stigmatized. A thirty-five-year-old Latina writes:

I have known I was interested in both sexes since I was six or seven. But, due to the conservative Catholic home I was raised in, my family did not accept same-sex relationships. In my twenties, when I started college, I began to start to explore women, and in my thirties I started to act on it. I love being with another woman; the connection is something I can't put into words. When I talk with my partner about being bi, he thinks it's just a “phase,” although I've told him many times that I enjoy being with a woman. So now he prefers not to talk about me being bi. I can feel myself distancing myself from him for not being open to how I feel. When he said, “It's just a phase,” it was like he was doubting who I am. It hurt.

In the last few decades, bisexual activists have engaged in ongoing education to dispel common stereotypes, including the idea that bisexual orientation is something that people claim when they are not ready to come out fully as gay or lesbian, or that bisexuals are opportunists who will quickly abandon a same-gender relationship for the greater power and privilege of an opposite-gender connection. We have also continued to contradict the stereotype of bisexuals as inherently promiscuous.

Bi activists have also fought to be included by name in the social, political, and religious organizations that we participate in. In recent years, more and more organizations have changed their names to be inclusive of bisexuals. This has sometimes happened concurrently with those groups working toward greater inclusiveness for and sensitivity to the concerns of people who are transgender. An International Conference on Bisexuality has taken place every few years since 1993, contributing to the growing organization of bi-identified communities nationwide and internationally. There are now active bi organizations in many states and most major cities, and even a bi-specific community center in Boston (biresource.net).

Lesbian and bisexual women have a few different health concerns from heterosexual women. Research done over the past two decades has revealed a number of factors that can lead to less frequent preventive and diagnostic health care, later treatment, and poorer outcomes for women who have sex with women. More information on the health concerns listed below can be found in the
Fenway Guide to LGBT Health
(fenwayhealth.org).

The time interval between Pap tests (for cervical cancer) is almost three times longer for lesbians than for heterosexual women. Cervical cancer screening rates are lower for lesbians compared with heterosexual women, raising concerns that lesbians are not adequately diagnosed or treated.

Stresses that are associated with long-term concealment of sexual identity and many years of exposure to discrimination can affect health negatively. Some research indicates that lesbian and bisexual women have higher rates of heart disease than heterosexual women, and that people who have experienced discrimination based on sexual orientation or race and ethnicity are more likely to have high blood pressure. Studies also suggest that nondisclosure of sexual orientation can be associated with lower life satisfaction, lower self-esteem, depression and suicide, substance abuse, delay in seeking medical treatment, and increased risk of illness.
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© Brook McCormick

Lesbians are more likely to engage in behaviors such as smoking and drinking alcohol that put them at greater risk for certain cancers.
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In 1987, the National Lesbian Health Care Survey of the National Gay and Lesbian Health Foundation found that about 30 percent of lesbians smoke, compared with about 23 percent of heterosexual women.
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More than a decade later, in the Women's Health Initiative, a study of women age fifty to seventy-nine years old, twice as many lesbians reported themselves to
be heavy smokers compared with heterosexual women.
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Research suggests increased rates of problem drinking among lesbians compared with other populations
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and suggests that substance use among lesbians does not decrease as dramatically with age as it does in the general population.
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Alcohol use is associated with many health problems, including breast cancer, and can affect choices about safer sex practices, putting a person more at risk for sexually transmitted infections (STIs).

Contrary to popular belief, women who have sex with women can get sexually transmitted infections. Research shows that many women who have sex with women have current or past sexual relationships with men, and thus have all the traditional risk factors for contracting STIs from men. In addition, STI transmission has been reported in the absence of a history of sexual contact with men: HPV (human papilloma-virus) and genital herpes occur among women who have sex with women and report having had no previous sexual contact with men. Lesbians also have a higher incidence of bacterial vaginosis, and women can transmit candidiasis and trichomoniasis to their female partners. Untreated vaginal infections can make a person more susceptible to transmission of HIV and other STIs. For more information, see
Chapter 11
, “Sexually Transmitted Infections.”