Queer Allyship. 1. Learn the Lingo. The queer community is filled with a constantly-evolving list of acronyms and buzzwords. While some of this is taught in medical curriculums, much can be overlooked or glossed over! Take the time to educate yourself on the vocabulary. Learn why we include a “+” sign at the end of LGBTQ+; teach yourself the difference between bisexual and pansexual. 2. Visibility. Small visual tokens of allyship – such as rainbow pride flag stickers on the IDs and pronoun pins on white coats – might seem too trivial to make a different. However, they can be important signals that you are an LGBT+-friendly clinician to colleagues and patients. 3. Engage with the evidence. As with all other fields of medicine, it’s crucial to remain current on the academic literature behind queer-centric practices. 4. Speak up. Being a vocal advocate for those who may feel empowered to speak for themselves is a crucial component of any form of allyship.

Sexual History. Best practices: 1. Clue them in. Before starting, let your patient know you’ll be inquiring about their sexual practices. These questions can often feel very personal, so clarifying that these are routine questions with a medical purpose can make you and your patient much more comfortable! 2. Confidentiality. Reminders about privacy can be helpful before taking the sexual history. 3. Keep an open mind. Try to avoid assumptions based on appearance, age, relationship status, gender identity. Any patient can have any sexual practice!

The Eight “P”s. Partners: When inquiring about your patient’s partners, it’s useful to ask about number and gender. Both impact the screening or counseling you might offer during the visit! Parts: Checking in about the “parts” (i.e. anatomy/genitalia) of your patient and their partner(s) is a great way to acknowledge that gender and sex do not always align for all people. Practices: Plain and simple! Props: It can be worthwhile to ask about “props” – meaning toys or other accessories – as some folks may not know to include this information when discussing their sexual habits. Protection: Now that you’ve asked about partners, parts, and practices, you’re well-appointed to screen for STI prevention! Problems: It’s easy to get caught up in risk assessment and prevention – but it’s just as important to check in about sexual satisfaction. Past: Ask about past STI history! Pregnancy: Check in about birth control, but also inquire about plans for pregnancy – a question not always asked of queer-identifying patients. For trans patients, pregnancy may be playing a material role in decisions about proceeding with gender-affirming treatments (eg surgery, hormone therapy).

Queer Vocab. Alphabet soup: The “LGBT” acronym is likely familiar to many – however, the letters that follow the “T” are often different depending on who’s talking. Q: queer or questioning (of one’s sexuality, gender identity, etc). I: intersex. A: asexual, agender, ally. +: meant to encompass ALL other identities not denoted by L, G, B or T! Some use the adjective “queer” to describe the LGBTQ+ community (e.g. “queer competent physician” or “queer ally”) as it avoids this “alphabet soup” entirely!

Sex: Biological anatomy and secondary sex characteristics; assigned at birth and can be different than one’s gender identity. Gender identity: One’s own perception of one’s gender – could be as male, female, or neither/none of the above. Does not relate to one’s sex. Gender expression: External ways one exhibits gender (via clothing, behaviors, etc). Sexuality: Describes attraction for others. Is separate from sex or gender! Bisexual: Used to describe someone who is attracted to both men and women. Pansexual: Used to describe someone who is attracted to anyone with any form of gender expression – including non-binary folks. Aromantic (aro): One who has no romantic attraction for others (may have sexual attraction). Asexual (Ace): One who has no sexual attraction for others (may have romantic attraction)> Demisexual: Experiencing minimal sexual attraction until emotionally connected to one’s partner. Demiromantic: Experiencing minimal romantic attraction until sexually connected to one’s partner.