Understanding Gender Identity to Better Serve LGBTQIA Populations

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Gender identity comes up often in the work of behavioral health professionals, and understanding gender identity is one key to respectfully serving LGBTQIA populations. 

What is the difference between sex and gender? What are some of the most common terms used to describe someone’s gender identity? Why are pronouns important, and what is the most respectful way to determine someone’s preferred pronouns?

Learning how to better serve LGBTQIA individuals is part of becoming a trauma-informed practitioner or organization.  

Sexual Orientation and Gender Identity

In this Connecticut Women’s Consortium video, Mara Gottlieb, PhD, LMSW, shares a straightforward primer on sexual orientation, sexual identity, gender identity, and mental health challenges for LGBTQIA youth.

Why is it important to understand gender identity? “Each and every one of us is more likely to thrive when we feel loved, when we feel valued, and when we feel respected,” says Gottlieb.

What is “normal” for one person may not be for another, she adds. Different cultures have different languages, ways of eating, and worship. One of the best things we can do as behavioral health professionals, and as human beings, is to be open to new ideas and information and see how it feels to us.

Gottlieb begins by exploring some common misconceptions about the LGBTQIA community.


The LGBTQIA community is as diverse and varied as the general population. For example: 

  • 42% of LGBTQIA people are people of color.
  • 29% of LGBTQIA people are raising children.

Challenges for Youth

Despite sharing many similarities with the general population, LGBTQIA youth face particular challenges. They need allies, and behavioral health professionals are on the front lines of a crisis for these young people. As Gottlieb explains in the video:

  • As many as 40% of homeless youth are LGBTQIA.
  • LGBTQIA youth are more than 7 times more likely to experience acts of sexual violence than heterosexual homeless youth.
  • LGBTQIA youth are 5 times more likely to attempt suicide than heterosexual youth.
  • LGBTQIA people of color are at greater risk for bullying and other types of discrimination because of the intersection of race and sexual identity.
  • In 2019, at least 331 transgender people of color were murdered worldwide. This is likely underreported.
  • LGBTQIA youth face particular risks for sex trafficking.  

To better understand and connect with members of this population, it is important to understand some of the terminology of sex and gender.

Words Matter: Sex, Gender, and Beyond

This guide to gender identity published by NPR provides a basic introduction to gender identity and a glossary of commonly used terms. Here are a few important ones.

  • Sex refers to the biological status that is usually assigned at birth when someone sees the genitals of a baby. Sex is typically male, female, or intersex.

  • Gender is a socially constructed set of roles and behaviors that is not fixed. Most commonly gender is categorized as male, female, or nonbinary.

  • Gender identity is a person’s own internal sense of self and their gender. They may identify as a man, a woman, neither, or both.

  • Gender expression is how someone presents themselves to the world through their behavior, voice, dress, or other characteristics.

  • Cisgender (or cis) means that someone’s gender identity matches the sex they were assigned at birth.

  • Transgender (or trans) is when someone’s gender identity is different from the one they were assigned at birth.

  • Nonbinary is when someone’s gender does not neatly fit into the category of man or woman.

  • Agender is when someone does not identify as either gender.

  • Gender-expansive describes someone with a flexible gender identity.

  • Gender transition is the process someone undergoes to align themselves with their gender identity. There are many different variations of transition for trans people, from social to medical/surgical.

  • Gender dysphoria is a diagnosis in the DSM that refers to psychological distress from someone’s sex assigned at birth differing from their gender identity. It is a contested term that not all trans people experience or embrace.

  • Sexual orientation is the physical, romantic, or emotional attachments to members of the same gender, or other genders.

  • Intersex is a term used to describe people with hormonal, anatomical, or reproductive differences that don’t clearly fit male or female definitions. For more information on the intersex community, see InterAct.

One of the first steps we can take to demonstrate our care and respect for LGBTQIA individuals is to learn and respect their preferred pronouns.

Pronoun Primer

Pronouns are an important part of acknowledging someone’s gender identity. Getting them right is important. Getting them wrong is sometimes called “misgendering.”

In this CWC blog post, A Journey Through Gender, Kay Warchol shares their story of coming out as nonbinary and asking to be addressed with they/them pronouns. 

“The questions and confusion start when you meet me,” they write. “I do not always express myself in androgyny. I wear dresses, heels, makeup, and love decorating with ‘girly’ things in my cubicle. These choices do not make me any less nonbinary.”

Warchol suggests normalizing by asking a person’s name and pronouns as soon as you meet them. Better yet, introduce yourself with your pronouns to take the pressure off trans and nonbinary people.

Here are a few suggestions from GLSEN for normalizing the sharing of pronouns.

  • When you meet someone, you can say, “My name is X, and my pronouns are X/X. What are yours?”
  • Add your pronouns to your email signature.
  • Add pronouns to name tags at events.
  • Practice gender-neutral pronouns such as “they” and “ze” while imagining the person who uses them.
  • Use gender-neutral language to describe mixed groups: 
    • “Siblings” instead of “brothers and sisters”
    • Examples to include: “Folks,” “all,” “y’all,” “students,” “friends”  
    • Examples to avoid: “guys,” ladies,” “ma’am,” “sir”

Continue the Journey

Trauma is all too common for LGBTQIA people, and part of being a trauma-informed practitioner and organization is learning how to better serve this population. 

The world is changing, and language is always evolving. When we normalize discussing gender identity and respectfully identify people in our communities and practices, we are on a journey along with millions of LGBTQIA people who are seeking to be understood and loved for who they are.

Many online guides, courses, and resources are available for behavioral health professionals who want to continue to serve all clients. Mara Gottlieb’s on-demand course, LGBTQIA…SOS! Gender and Sexuality, Differentiated and Demystified, provides an excellent introduction to the terminology and practices that can help us become better practitioners and more inclusive human beings.

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