Sexual and Gender Diverse Women Curriculum
Understanding the wellbeing of lesbian, bisexual, transgender, and queer (LBTQ+) women
* Disclaimer *
This presentation uplifts sensitive, enlightening, and potentially triggering discussion topics. Certain topics are empowering and others are challenging to speak about. All feelings are welcome in this space. It may be hard to discuss these topics, it is harder to experience the challenges presented in many of the topics, and that is why we are here.
This project was Made Possible by a Grant from the California Commission on the Status of Women and Girls (CCSWG), and Created by Los Angeles County Commissioner Dr. Bobbie Emetu
Sexual and Gender Diverse Women Curriculum
The Sexual and Gender Diverse Women Curriculum was initiated and coordinated by Commissioner Dr. Bobbie Emetu to educate, empower, and support professionals, advocates, and service providers in delivering inclusive, affirming, and culturally responsive care to women who identify across the spectrums of sexual orientation and gender identity. Grounded in intersectionality and community-informed best practices, this curriculum seeks to increase awareness, reduce disparities, and foster equity by addressing the unique experiences, needs, and systemic barriers faced by lesbian, bisexual, queer, transgender, nonbinary, and other gender-diverse women in Los Angeles County and beyond.
Access Curriculum
Click HERE to watch the training WITHOUT Captions.
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Additional Training Tools, and Resources Coming Soon!
WORDS AND TERMS OF LGBTQ+
It Gets Better Project (n.d.)
Language
History
Transgender Healthcare
HRC Foundation, 2023, Williams Institute, 2023, Austin et al., 2022, Bustos et al., 2021, Wilson, Ronnekleiv-Kelly, and Pawlik
Transgender Healthcare
- Gender-affirming care is life-saving healthcare for transgender, non-binary, and gender diverse individuals. Gender-affirming care is medically necessary for the well-being of many transgender and gender diverse people who experience gender incongruence.
- Research shows that 86% of transgender youth have considered suicide and 56% have attempted suicide. Access to gender-affirming care reduces lifetime suicidal ideation by 70%.
- Less than 1% of individuals that seek gender- affirming care regret their decision. This is less than the 14.4% of the general population that regrets general surgical procedures.
- Every major medical organization supports gender-affirming care as evidence-based, best medical practice. This includes the American Academy of Pediatrics, American Medical Association, Endocrine Society, and American Psychiatric Association.
- Youth with access to puberty blockers report lower depression and suicidality.
Transgender Healthcare
- 24 states ban best practice medication and surgical care for transgender youth
- 6 states have bans that make it a felony crime to provide best practice medical care for transgender youth
- 2 states (AR, MS) explicitly permit insurers to refuse to cover gender affirming care
- AR law allows refusal of coverage for everyone, regardless of age
- MS law allows refusal for minors
- 14 states explicitly exclude gender-affirming care from their state employee health benefits
- 2 states (AR, MS) Medicaid policies explicitly exclude transgender related health care for minors
- 10 states’ Medicaid policies explicitly exclude transgender related health care for all ages
Movement Advancement Project, 2023
Gender Minority or Gender Diverse
It Gets Better Project, (n.d.)
All people for whom their gender identity or gender expression varies from the binary sex they were assigned at birth
Terminology evolution
Transvestite -> transsexual -> transgender Nonbinary, genderqueer, and gender fluid
Feminizing Hormones
- Counteract effects of endogenous testosterone
- Typically take both an antiandrogen and estrogen
- May also take a cyclical regimen of progesterone
- Desired effects ⚬ Softening of the skin (reversible)
- Thinning and slowed growth of body hair (reversible)
- Loss of muscle tone (reversible)
- Breast growth (irreversible)
- Potential side effects
- Decrease in libido
- Risk for heart disease and breast cancer
Hormone and Surgical Risks
- Most of the risks involve moving from a “male” risk level to a “female” risk level
- Risks associated with estrogen treatment
- Deep vein thrombosis, gallstones, weight gain, elevated liver enzymes, and hypertriglyceridemia
- Few studies have been completed that explore the long-term health risks of hormone treatment
- Feminizing surgical risks
- Risks associated with a vaginoplasty
- Fistula, granulation tissue, urinary tract infections, and issues with sensation and orgasm
- Risks associated with a vaginoplasty
Gender Minority Adolescent Health
It Gets Better Project, (n.d.)
Puberty Blocking
Pubertal suppression
- Peri-adolescents
- Gonadotropin-releasing hormone agonist
- Completely reversible
Hormone treatment
- Puberty congruent with affirmed gender identity
- Documented benefits of pubertal suppression followed by hormone treatment
Fertility
Fertility preservation options
- Pre- or peripubertal
- Ovarian or testicular tissue cryopreservation
Postpubertal
- Cryopreservation of oocyte or embryo
- Sperm banking
Identity Development
Identity development processes
- Gender identity development
- Early onset gender dysphoria
- Pubertal-onset gender dysphoria
Sexual orientation identity development
- Between childhood and adolescence, typically after gender identity
- Youth who discover their gender minority identity at the onset of puberty are more likely to identify as sexual minorities.
Options
- Transgender girls
- Antiandrogen medication
- Blocks further masculinization from endogenous testosterone
- However, treatment option provides the feminization that many gender minority adolescents desire
Barriers
- Barriers to puberty-blocking medication. Parental support and consent is necessary.
- Medical providers lack training
- Youth and families are not aware of options
- Cost is rarely covered by health insurance
- Up to $20,000 annually
Support
- Parental acceptance and support
- Predictors of positive mental health outcomes
- Role of mental health and medical providers
- Educate parents about the negative health outcomes associated with rejection
- Normalize gender minority identities and gender identity and expression exploration ⚬ Provide resources in their local communities
GENDER-NEUTRAL DIALOGUE
National LGBT Health Education Center, 2016
Navigating Implicit Bias
Accountability
Abandon the right/wrong binary.
- Imagine: Yes...and!
Gender Equity is not a destination.
- It is a journey.
“Never a failure, always a lesson.”*
- Loss vs. Lesson
Implicit Bias
- Most of the risks involve moving from a “male” risk level to a “female” risk level
- Risks associated with estrogen treatment
- Deep vein thrombosis, gallstones, weight gain, elevated liver enzymes, and hypertriglyceridemia
- Few studies have been completed that explore the long-term health risks of hormone treatment
- Feminizing surgical risks
- Risks associated with a vaginoplasty
- Fistula, granulation tissue, urinary tract infections, and issues with sensation and orgasm
- Risks associated with a vaginoplasty
What you can do as an Ally in Action!
Gibbs, 2021, and Lewis, 2017
Stand up, even if you are nervous.
- Don’t let the fear of being wrong paralyze into inaction.
Be willing to challenge the status quo.
- Your voice matters. You are the only one with it.
Hold yourself and your circle accountable.
- Align your vision and values with your choices, and you will be equipped to invite other allies to do the same.
Share the benefits of your privilege.
- Simply remembering that we do not have to understand someone, to respect and support them, can have an exponential impact on your compassion.
Allyship
The State or Condition of BEING an Ally
Sequoia Speaks, 2024, and Gibbs, 2021
Inquire rather than assume.
- Seek out the information you do not understand.
Align your intentions with your actions.
- Performing is to appease an audience.
- Allyship is to align your intentions with your choices, principles, and behaviors.
Reflect, Research, and Return.
- Assuming is a human thing; we all do it.
- We do not have to subscribe to our assumptions
Build a relationship with hearing “no”.
- Curiosity and intention do not obligate a “teachable moment.”
- Cultivate dialogue practices to navigate discomfort.
Remember, danger and discomfort... are different.
- You may be in discomfort, while that person, has been in danger in spaces where you can safely exist without fear.
Own Intentions. Respect Impact:
- Taking accountability for behaviors is not an admittance of wrongness.
- An apology and an acknowledgment can go a long way.
Additional Questions?
Contact Commissioner Dr. Bobbie Emetu: laccw@bos.lacounty.gov
V. Zepeda