Chapter 11: Terminology

The following reading is to introduce you to some basic concepts we will be covering in greater depth throughout the second half of this text (and in some cases, the next class in the human sexuality series). Some terminology overlaps and will be a review for those who have taken the first human sexuality class, but overall much of this information will be new. Re-read Chapter 1 if you would like a refresher on general terminology and do note that the course guidelines discussed in Chapter 1 will also be applied for this second half of the text/course as well. If you’d like an overall refresher, visit PFLAG’s National Glossary of Terms.

The rest of the definitions and topics covered below offer a preview to specific topics of this second half of the text, as it is more clinical in perspective with many overlaps to health psychology, nursing, medicine, public health, community health, and more.

Health Psychology and Human Sexuality

Health psychology is a subfield that seeks to understand the health-seeking and risk-taking behaviors of people. Self-efficacy, feeling competent to engage in certain behaviors, plays a central role in determining the actions people will take based on a number of social, interpersonal, personal, and structural factors. Health psychology explores ways that public health workers and medical providers can communicate effectively to not reproduce social stigma and shame and ways that educational materials can be developed utilizing health communication techniques to make them more relevant and representative of the target audience. Take for instance the Covid-19 pandemic, to outreach to community members, public health departments needed to make sure testing and vaccination information was available in the languages spoken by the populations who needed the information and that the testing and vaccination sites had staff who were able to communicate with the public effectively. In many cases, partnering with local agencies, such as local chapters of the NAACP (National Association for the Advancement of Colored People) or LULAC (the League of United Latin American Citizens), was vital to the success of the public outreach campaign. The intersecting identities of the target audiences of health information need to be represented in the outreach materials, and centering the voices of those who identify as members of the target audience is a priority.

Relating this to human sexuality, health psychology is utilized to attempt to predict risky sexual behaviors and develop interventions to alter behaviors toward being safer. Sex education in high school as well as public service announcements are ways to educate the public. More specific campaigns can be utilized when there is an outbreak of certain STIs within communities or when therapists are creating brochures for their offices to normalize sexual dysfunctions and inform the public about possible treatments. This course will be focused on developing community-based educational tools for specific populations with intersecting identities in mind to make the messages more relevant and representative in order to address gaps in human sexuality outreach.

People with Disabilities/Disabled

While definitions were previously provided in Chapter 1 related to gender, LGBTQIA+ identities, and intersecting identities as a whole, differently-abled/disabled were not previously defined. Later in the text, we will pay special attention to the way that being disabled may impact sexual functioning and relationships and are defined in the following ways:

• Although the term “differently-abled” has been applied as an umbrella term, some say that the term can be considered patronizing, offensive, or a way to avoid talking about disability. Others say that “differently abled” is a positive alternative that describes how all people have needs.
• Some individuals still prefer the term disabled and, indeed, this textbook will strive to use people first language and/or the term ‘disabled.’ In 2021, the United Nations published a useful tool, Disability-Inclusive Language Guidelines.
• Can be visible or invisible
• Could be constant or flare up at different times
• May be mental (intellectual, cognitive, information processing, mental health, etc.) or physical
• Have genetic or environmental causes
• Chronic pain may be a factor

Most people will become disabled at some point in their life; some permanently, some only for a period of time.

Disorder versus Atypical

Sexual disorders, dysfunctions, paraphilias, and fetishes will be explored from a mental health and psychopharmacological clinical perspective. We will also explore atypical sexual behaviors that others often label using similar terms to clinical diagnoses but are not related to mental health concerns. Keep this in mind:

• Atypical means less common; this is not a mental health diagnosis
• Disorder means that it causes an individual distress, impairment in daily functioning, relationships, work, or schooling, or causes the self or others (including animals) harm; a mental health practitioner can provide a diagnosis

Did you know that homosexuality used to be classified as a disorder by the American Psychiatric Association up until 1973 (Drescher, 2015)? For a great summation of the DSM, as well as these important shifts, be sure to check out Uyeda’s 2021 article in JSTOR.

Conversion Therapy, an emotional or physical process used to “cure” or “repair” a person’s attraction to the same sex, or their gender identity and expression, is still practiced in many states even today. There are dozens of states who have enacted some type of conversion therapy bans, however recent legislation in a number of states have reversed policies or are attempting to do so (Sreenivas, 2024).

Two highly debated psychological disorders remain: transvestic fetishism and gender dysphoria (this will be discussed in more detail in Chapter 16).

Interesting Statistics

LGB people make up about 5.5% (The Williams Institute, 2023)-7.6% (Jones, 2024) of the general population.

According to Gallup (2024), bisexual adults make up the largest proportion of the LGBTQ+ population (4.4% of U.S. adults and 57.3% of LGBTQ+ adults reported they are bisexual). Trends have definitely shifted with time as fewer older adults identify on the LGBT continuum, but nearly one in six young adults (ages 18 to 24) identifying as LGBT (Williams Institute, 2023).

BDSM or kink–How many people are into it? Check out this interesting read from Magliano (2015).

Sexual Disorders

Later this term, we will discuss sexual disorders. As a preview, it’s important to note that sexual disorders are divided into two categories (Comer, 2016):

1. Sexual dysfunctions–problems with sexual responses
2. Paraphilias–repeated and intense sexual urges and fantasies in response to socially inappropriate objects or situations

*Again, must meet the threshold for distress, impairment or harm to be diagnosed

Sex Work

Sex work is an umbrella term that encompasses many roles within the sex industry in which an individual receives compensation for their role. Sex work includes:

• Those who provide direct sexual services, even through the phone or online
• Staff members at all levels within the sex industry and talent managers
• Anyone engaged in exotic dancing, stripping, and/or burlesque for income

In ideal situations, sex workers are freely consenting at all times, but, due to the underground and unregulated nature of much of the sex industry, exploitation and harm are still possible.

The World Health Organization (2021) states that decriminalizing sex work will benefit health outcomes.

Sex Trafficking

• Sex traffickers target vulnerable populations, particularly foster care youth, sexual minorities, transgender women, racial minorities, and undocumented immigrants–if any of these identities intersect, then the person becomes even more vulnerable to exploitation due to social, structural and systemic barriers.
• Psychological and physical abuse are used as tools by sex traffickers.
• Sometimes the individuals being trafficked can begin to believe their captors and even help them in recruiting others.
• The individuals being trafficked are always victims and consent is not possible due to many factors.

Trauma-Informed Care

Trauma-informed care means interacting with others in a safe and sensitive way that prevents retraumatization and promotes the development of healthy coping skills. Many individuals will experience trauma, specifically a trauma of sexual nature, so it is important to develop skills to promote healing. Important competencies:

• Recognize trauma symptoms and address behaviors rather than further blame the individual (re-victimizing)
• Develop interpersonal, community-based, and institutional levels of intervention and support

Resources:

Overview of trauma and what being trauma-informed looks like with the mental health field (SAMHSA, 2014) and the medical field (Tello, 2018)

Questions and Empowerment

Questions: Society

1. What is the role of shame and stigma in influencing sexuality? How can we work to promote consent, healthy communication, and community-based change?
2. What are some ways that society might influence people in developing harmful sexual behaviors?
3. What is the role of isms (sexism, racism, ableism, classism, etc.) in promoting sexual violence?
4. How has colonialism contributed to the shaming and spread of disinformation regarding sexuality?
5. What changes need to be made in order to make our society better?

Questions: Allyship

1. What can we do in our interactions with others to be supportive rather than further add to the shame and stigma people may feel?
2. What can we actively do to counter isms both intrapersonally (within ourselves in the form of bias, stereotyping, cognitive schemas, etc.) and interpersonally (in our communication and interactions with other people)?
3. What can we do to support victims of sexual violence?
4. How can we support people who are at risk of harming others, and how can we support perpetrators of sexual violence in their change process?

Empowerment

This will be a recurring theme throughout this course in order to:

1. Analyze and heal from society-based harms related to sexuality
2. Understand our rights and the resources available
3. Advocate for ourselves and others
4. Maintain a sex-positive and consent-based perspective and be able to recognize when our own or others’ behaviors are harmful
5. Develop a sense of community and support
6. Utilize skills to be a changemaker in our relationships, workplace, community, and society

References

Comer, R. J. (2016). Fundamentals of abnormal psychology 8th ed. Worth Publishers: New York, NY.

Drescher, J. (2015). Out of DSM: Depathologizing homosexuality. Behavioral Sciences, 5, 565-575. doi:10.3390/bs5040565.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4695779/pdf/behavsci-05-00565.pdf

Flores, A.R. & Conron, K.J. (2023). Adult LGBT Population in the United States. The Williams Institute, UCLA, Los Angeles, CA. https://williamsinstitute.law.ucla.edu/wp-content/uploads/LGBT-Adult-US-Pop-Dec-2023.pdf

Jones, J. M. (2024). LGBTQ+ identification in U.S. now at 7.6%. Gallup. https://news.gallup.com/poll/611864/lgbtq-identification.aspx

Magliano, J. (2015). The surprising psychology of BDSM. Psychology Today. https://www.psychologytoday.com/us/blog/the-wide-wide-world-psychology/201502/the-surprising-psychology-bdsm

Movement Advancement Project. (2024). Equality maps: Conversion therapy laws. https://www.lgbtmap.org/equality-maps/conversion_therapy.

Newport, F. (2018). In U.S., estimate of LGBT population rises to 4.5%. Gallup. https://news.gallup.com/poll/234863/estimate-lgbt-population-rises.aspx

PFLAG. (2024). PFLAG national glossary. https://pflag.org/glossary/

Sreenivas, S. (2024, March 6). What is conversion therapy? WebMD. https://www.webmd.com/sex-relationships/what-is-conversion-therapy

Substance Abuse and Mental Health Services Administration. (2014). SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach. HHS Publication No. (SMA) 14-4884. Rockville, MD: Substance Abuse and Mental Health Services Administration.

Tello, M. (2018). Trauma-informed care: What it is, and why it’s important. Harvard Health Publishing.  https://www.health.harvard.edu/blog/trauma-informed-care-what-it-is-and-why-its-important-2018101613562

Uyeda, R. L. (2021).How LGBTQ+ activists got “homosexuality” out of the DSM. JSTOR Daily. https://daily.jstor.org/how-lgbtq-activists-got-homosexuality-out-of-the-dsm/

Weir, K. (2020). A growing number of states ban sexual orientation change efforts. American Psychological Association.  https://www.apa.org/news/apa/2020/sexual-orientation-change

The Williams Institute. (2011). How many people are lesbian, gay, bisexual, and transgender? University of California, Los Angeles.  https://williamsinstitute.law.ucla.edu/publications/how-many-people-lgbt/

World Health Organization. (2021). Sex work. https://www.who.int/hiv/topics/sex_work/about/en/