Lesbian, Gay, Bisexual, Transgender, and Questioning (LGBTQ+) Individuals

LGBTQ+ people are members of every community. They are diverse, come from all walks of life, and include people of all races and ethnicities, all socioeconomic statuses, and are from all parts of the country. According to the Williams Institute’s review, conducted in 2011, an estimated 3.5% of adults in the United States identified themselves as lesbian, gay, or bisexual and an estimated 0.3% of adults are transgender. The review reported that there are approximately 9 million LGBTQ+ Americans.

Although there is a paucity of national data, more than a decade of research indicates LGBTQ+ populations have been associated with high rates of alcohol consumption and substance abuse.

Sexual Orientation and Gender Identity

(The following information is taken from A Provider’s Introduction to Substance Abuse Treatment for Lesbian, Gay, Bisexual, and Transgender Individuals; U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatments.)

Understanding the appropriate terminology is essential to understanding LGBTQ+ clients. Sexual orientation, sexual behavior, gender identity, and gender role are different concepts. Sexual orientation is the affectional or loving attraction to another person. Heterosexuality is the attraction to persons of the opposite sex; homosexuality, to persons of the same sex; and bisexuality, to both sexes. Sexual orientation can be considered as ranging along continuum from same-sex attraction only at one end of the continuum to opposite-sex attraction only at the other end.

Sexual behavior, or sexual activity, differs from sexual orientation and alone does not define someone as an LGBTQ+ individual. Sexual identity is the personal and unique way that a person perceives his or her own sexual desires and sexual expressions.

Biological sex is the biological distinction between men and women. Gender is the concept of maleness and masculinity or femaleness and femininity. Gender identity is the sense of self as male or female and does not refer to one’s sexual orientation or gender role. Gender role describes the behaviors that are viewed as masculine or feminine by a particular culture. Transgender individuals are those who conform to the gender role expectations of the opposite sex or those who may clearly identify their gender as the opposite of their biological sex. In common usage, transgender usually refers to people in the transsexual group that may include people who are contemplating or preparing for sexual reassignment. A transgender person may be sexually attracted to males, females, or both.

Sexual orientation and gender identity are independent variables in an individual’s definition of himself or herself. How an individual learns to acknowledge, accept, and then act on a sexual orientation that is different from that of the majority is shaped by cultural, religious, societal, and familial factors.