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I am often asked why it is so important to use other words like queer, pansexual or non-binary and not “stick with the basics” like gay or lesbian. My response is because words matter! Just like our struggle to achieve same gender (or “gay”) marriage, the word “marriage” matters as it implies and defines the institution of marriage; not separate but equal like “union.” Therefore, I patiently explain, words like queer, non-binary and gender-queer also matter. When I am introducing myself at a professional presentation, I say I am a “white, spiritual, cis-gender, gay male”. These words (or some word call labels) matter as they define further who I am as a person. To be inclusive is to be accepting and affirming of everything about someone as a person. For example, in the LGBTQ+ community to say we’re all “human” is not inclusive because it’s like saying about race “I don’t see color, I look at the person”, which implies “I’m forcing you to confirm to my white privilege culture” while invalidating you for who you really are. By not using appropriate or affirming words, is frankly, invalidating and dehumanizing.

Most of us in the LGBTQ+ community come from some form of trauma from our past and by not honoring or supporting someone for who they are can potentially retraumatize them; this concept is more often referred to as “micoraggressions.” Briefly, microaggressions are defined as subtle often unconscious slights or digs made at a verbal or more often non-verbal level of communication. Over a period of time, these small resentments can build up leading to unconscious trauma and pain; unfortunately then, more often in our community this is suppressed with alcohol, other drugs, sex or other process addictions.

So, let’s begin with the basics: biological sex is the gender assigned at birth, usually by a doctor. Gender identity is one’s sense-of-self as predicated by societal and cultural norms, in terms of gender expression, and usually matches one’s biological sex. Transgender refers to people whose gender identity differs from the societal and cultural norms of the biological sex assigned at birth. Gender expression is the way one dresses and exerts their own personality in an outward fashion, via body language, speech, clothing, etc. Finally, sexual orientation refers to which gender one prefers to have sexual or romantic relationships with. Another common term is men who have sex with men (MSM), often used in some sub-cultures to identify men who are having sex with men and not utilizing the usual labels most often associated with this behavior (e.g., gay, bisexual, experimenting). It’s also important to keep in mind that transgender is NOT a sexual orientation or behavior, but rather a gender identity. Lastly then, problematic sexual behavior is best described as out-of-control sexual behavior, lessening the stigma and judgment most of us from this community have been struggling with for years. From these basic concepts, we can ascribe a plethora of other words, which can be used to denote more about who we are as a person, inclusively. These other words then, can seem annoying or burdensome, yet these are some of the main sources of trauma and pain fueling most of our community’s out of control behavior.

Let’s briefly move now to terms and labels associated with substance abuse. In talking about alcohol and other drug use (yes tobacco and caffeine are technically considered other drugs!), it is important to keep in mind that some changes were made in how a diagnosis is made. For the purpose of this article, the focus of diagnosis has shifted to behavior first, instead of focusing first on alcohol or other drug use. However, “sex addiction” still remains outside the scope of consideration as being a diagnosable disorder. Today, substance abuse and substance dependence has been combined as a single disorder; where each is addressed individually, on a continuum from mild to severe. Now clinicians must choose 2 or 3 criteria from a list of 11, that also includes problems with law enforcement and drug craving that previously were not listed, in order to make a more inclusive substance use diagnosis. This helps to remove stigma and shame often associated with terms like “addiction” and “alcoholic” and places more focus on behavior. So now we can discuss out-of-control alcohol or drug use, while still referring to the listed criteria for a proper diagnosis. So, for someone in the LGBTQ+ community who is struggling with substance use disorder, but also struggling with problematic sexual health issues or sexual identity issues, we can show support and understanding by using more affirming and accepting language when they reach out for our support.

Given the recent news of celebrity suicides from Anthony and Kate, I should mention the importance of talking openly and supportively about suicide and suicide ideation. Especially for those of us struggling with who we are or where we fit in, these individuals most especially need to hear appropriate, affirming language at all times in order to feel safe enough to honestly talk about what is really going on for them. Using wrong or offense language not only retraumatizes your LGBTQ+ friends or loved ones, it may put them at further risk of continuing harmful and dangerous behavior due to not receiving the appropriate help they need and deserve.

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