LGBTQIA+ Health

There are many different gender identities and sexual orientations.

Your identity makes you your unique self. Whether you are an ally or a member of the LGBTQIA+ community, we hope that this page helps you learn something new and love yourself and others! 

Important Terms

Biological Sex:

We all have chromosomes in our cells that determine our biological sex, like male, female, or intersex. 

Sexual Identity:

Sexual identity describes a person's sexual preferences - for example, whom they are attracted to and with whom they choose to have sexual relationships. 

  • Terms include straight (heterosexual), gay (homosexual), lesbian (homosexual), bisexual, pansexual, asexual, and unsure (questioning).

  • Some people have little or no sexual attraction to anyone. This is called asexuality (often shortened as ace). You can imagine it like a spectrum from black to white, where some people are in the gray area between sexuality and asexuality. 

  • Some people have little or no romantic attraction to anyone. Thi sis called aromanticism (often shortened as aro)

  • A common misconception is that asexual and aromantic people lack emotions and the ability to form social connections, but in reality, many meet their emotional needs through other forms of relationships.  

  • Sexual preferences and identity can be confusing or surprising for people and can change over time. Try to give yourself time and be patient with yourself as you learn and grow. 

Labels can be helpful

for some people, but don't feel pressure to label

yourself with a specific sexual orientation or

gender identity. Using an umbrella term such as "queer" may feel better to some members of the LGBTQ+ community. 

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Gender Identity:

Gender identity is the gender a person feels they are, like a man, woman, neither, or other.  

  • Many people grow up with a gender identity that is the same as their biological sex.  They are considered cisgender. 

  • Other people feel that their gender is different from the physical aspects of their reproductive organs.  They may call themselves transgender. 

  • Some people feel neither fully male nor fully female but rather are nonbinary and/or gender nonconforming. They may prefer to go by gender-neutral pronouns like they/them, xe/xem (pronounced zee), ze/hir, or ey/tem. 

  • Some nonbinary folks may consider themselves transgender, but some may not. 

Gender Expression:

Gender expression refers to how a person walks, talks, dresses, and behaves. It may change from day to day depending on what they’re doing or how they’re feeling. 

  • Some people who are genderfluid (identify as different genders during different time periods) change aspects of their appearance and style to reflect the gender they're feeling. 

Gender Stereotypes:

Gender stereotypes are qualities many in society attribute to one gender or another. Examples include that boys don’t cry and girls play with dolls. Like all stereotypes, people do not necessarily follow the stereotype.

  • People might assume that following gender stereotypes means you are heterosexual, and that not following gender stereotypes means you are queer/gay. However, these stereotypes may not mean anything about gender identity or sexual orientation!  

 
This diagram can help you learn more about the differences between identity, expression, sex, and attraction. 
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Examples from The Violet Project

Violet is a cis-gender woman, meaning that she was born with female anatomy, and identifies as a woman. She is pansexual, meaning that she is romantically and sexually attracted to people of all genders. 

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Nellie is cis-gender and identifies as straight, or heterosexual. 

Tchala is a cis-gender man and identifies as pansexual. Tchala is on PrEP, as his partner, Michelle, is living with HIV.

Treasure is a transgender woman. She identifies as a lesbian.

Michelle uses she/they pronouns, meaning they are genderfluid. They identify as queer. Michelle is living with HIV.

Zoe is a cis-gender woman and she doesn't know her sexual orientation yet!

Don is a non-binary person and uses the pronouns they/them/theirs. Don's sexual orientation is asexual (or "ace"). 

Transitioning and Medically Transitioning

Medically transitioning is just one of the ways a person who does not identify with their assigned gender at birth can transition. Other forms of transitioning can include changing your name, pronouns, and gender expression.

Types of medical transition for trans men, trans masculine individuals, and nonbinary individuals include:

  • Hormone therapy to encourage masculine characteristics including deeper voice, facial hair, muscle growth

  • Top surgery to remove breast tissue

  • Hysterectomy to remove the uterus, ovaries, and other female reproductive organs

  • Phalloplasty to construct a penis using tissue from other areas in your body

  • Metoidioplasty to grow and alter clitoris to function in a manner similar to a penis

Types of medical transition for trans women, trans feminine individuals, and nonbinary individuals include:

  • Hormone therapy to encourage feminine characteristics including higher voice, development of breasts, reduction in body hair

  • Breast augmentation or implant insertion to increase breast size

  • Laser hair removal to reduce presence and thickness of body hair

  • Tracheal shave to reduce size of Adam’s apple

  • Facial feminization surgery to alter features such as lips, nose, eyebrow ridge to appear more feminine

  • Vaginoplasty to surgically invert penis into vagina

If you are considering medically transitioning, speak to a doctor or therapist to determine the best steps to move forward. You can talk to a doctor at Violet or a Violet team member can help walk through insurance options.

What does it mean to be intersex?

No one’s body is exactly the same, including people who don’t have intersex anatomy. If you are intersex, it may be helpful to get to know someone who’s had similar experiences as you.  You can check out the website interACT, ask questions as your next doctor’s visit, or chat with Violet. 


Some people are born with bodies that don’t exactly fit into the 2 physical categories of “man” and “woman.” For example, some babies are born with only female anatomy on the outside (like a vulva and clitoris) but only male anatomy on the inside (like internal testicles). Some people have some cells in their body with XX chromosomes (female chromosomes) and some cells with XY chromosomes (male chromosomes).


Sometimes it is not obvious at all that someone has intersex anatomy, and it may not be discovered until they go to the doctor when they can’t get pregnant despite trying (although many intersex people can still have biological babies).  Or some people may live their whole lives not knowing they technically have intersex anatomy!


Like with all people, those with intersex anatomy are free to identify as whatever gender best represents them.  Just because your body looks more typically “male,” doesn’t mean that you feel like a man on the inside, or that you need to identify as a man.  Like all people, those with intersex anatomy can enjoy sexual pleasure in many different ways.

 
 

Navigating Coming Out

“Coming out” is the action of telling people in your life—whether that’s family, friends, classmates, or any community member—that you are part of the LGBTQIA+ community. There is no right or wrong way to navigate this decision, but below are some questions that may arise and considerations to keep in mind. 

Do I have to come out? 

No! Coming out is a personal decision, and your identity as a member of the LGBTQ+ community is valid whether or not you choose to tell those around you. There are many reasons that an individual may choose not to come out in the short or long term. These include: 

  • Not knowing if you will be accepted or safe. In many communities, being part of the LGBTQ+ community can make you a target of discrimination and prejudice, and coming out may place someone in social or physical danger. 

  • Feeling emotional stress and pressure. Even with support from those around you, your sexuality and gender identity can be stressful and difficult to talk about. If you aren’t emotionally comfortable discussing these topics, take your time to feel ready! 

  • Just not wanting to come out! While coming out can be an important experience for many members of the LGBTQ+ community, it is not mandatory to inform the people around you of your sexuality at any point. You can simply be in relationships with whoever feels right or express your gender in the way you are most comfortable with—even without ever having a formal conversation with those around you. 

How do I know if it’s safe to come out? 

Members of the LGBTQ+ community can be targets of discrimination, prejudice, and violence. Before coming out, it may be helpful to reflect on some of the following questions: 

  • What are the laws and policies of my school, workplace, state, or country? Are there rules/laws/policies that protect me from discrimination due to my sexuality or gender identity?  

  • How are openly queer individuals or relationships treated in my community? How have I heard the people around me discuss queer relationships or LGBTQ+ individuals? 

  • If I am coming out to one person or a small group of people rather than my entire community, do I have trust that these people will keep this information confidential? 

A strategy that may be helpful is bringing up examples of queer relationships, activism, or individuals in conversation—for example: 

  • “Did you hear about the antidiscrimination bill about transgender youth that passed recently?” 

  • “I saw that Doja Cat came out as bisexual on Instagram the other day!” 

Seeing how people react to these types of comments can give you a sense of how they perceive members of the LGBTQ+ community, and whether they may be supportive towards you. However, the way people react to news or celebrities doesn’t always reflect how they might react to people in their own life. 

How should I prepare to come out to someone? What should I say?

While sometimes coming out may happen naturally in a moment that feels correct, it can be helpful to plan out parts of the encounter or conversation before you come out to someone—such as what to say, when to bring it up, or where to tell them. 

Before coming out, think about what information you want to express. This could include: 

  • Your sexuality or gender identity. If the person isn’t familiar with certain terms (I.e. What is pansexuality? What does it mean to be nonbinary?), you may choose to explain what they mean. 

  • How you would like them to support you. This may include not disclosing the information to other people, being there for you if you are not supported by your family, or standing up for you if others in your community do not accept your identity. 

If you are having an in-person or phone conversation and feel nervous about communicating the intended information in the way you want, it might be helpful to write out a script of what to say. 

In addition, pick a time and location that you are most comfortable with. Here are some factors to consider: 

  • Would I prefer to come out in person, on social media, through a phone call, or over text message? Which option is safest and most comfortable for me? 

  • How private is this location? Am I comfortable with strangers overhearing parts of my conversation? 

  • How will the other person react? If they get angry or violent, is it safer for me to be in public or in private?  

  • Would I feel more comfortable if I had other friends or community members that I am already out to present at the conversation? 

  • When is the next time I will see this person? Would I prefer some time to pass before interacting with them again? 

What reaction should I expect? 

The reaction you receive can vary significantly from person to person, and it may not always be what you expect. The other person may have questions for you, which could include: 

  • How do you know this is actually your sexuality/gender identity? Are you sure? 

  • How long have you known this about yourself? 

  • Why didn’t you tell me sooner? 

  • What are some ways I can support you? 

  • Have you dated anyone before, and are you dating anyone now? 

  • Who else knows this about you? 

Even if the other person has questions, you don’t have to answer anything that makes you uncomfortable! Coming out is about what you are ready to share, and you do not owe anyone information or explanations about your identity. 

Sometimes, the other person may react badly. One type of negative reaction is disbelief or denial—they may refuse to believe you or try to convince you that it’s not true. Another type of negative reaction is anger—they may cry, threaten you, or turn to violence. This type of reaction can be incredibly difficult to handle, especially if it comes from people that you love or value. However, remember that your identity is valid regardless of their opinion, and their reaction reflects their own prejudices rather than any part of your identity.

 

If you feel unsafe or need resources, links to various LGBTQ+ support organizations and resources are included below.

 

Resources & Hotlines

LGBT National Health Center

1-888-843-4564 | www.glnh.org

Multiple hotlines and online forums to support and connect LGBTQ+ people of all ages and identities.

LGBT National Hotline

Text 1-888-843-4564 https://www.glbthotline.org/national-hotline.html

Offers a confidential, anonymous place to talk about issues including coming out, identity, bullying, safe sex, anxiety, and other concerns. 

Trans Lifeline

Text 1-877-565-8860 | https://translifeline.org/

Peer support, care, and resources for trans and nonbinary people; provided and staffed by trans and nonbinary people. 

Crisis Text Line

Text LGBTQ to 741-741 | https://www.crisistextline.org/

Access to a crisis counselor who can offer support, available 24/7.

Parents, Families and Friends of Lesbians and Gays (PFLAG)

(202) 467-8180 | www.pflag.org

Resources to help family and community members better understand and support the LGBTQ+ individuals in their lives.

The Trevor Project

1-866-488-7386 | text START to 678-678

thetrevorproject.org/

Crisis services for LGBTQ+ youth, including phone lines and online community spaces.