LGBTQIA2S+ Key Terms & Definitions For Nurses

Nurses shape the quality of care patients receive, both at the bedside and as advocates in clinical settings and beyond. Knowing the right language is not the whole job, but it signals competence, and it helps patients feel safe enough to trust you.

Affirming environments are safer environments. When patients feel safe, they disclose the medical history and ask the questions that change care. That reduces misdiagnosis, underdiagnosis, and overdiagnosis. Use this glossary as a starting point for language, not as a script to memorize.

Why Conscious Language Matters

Using accurate, appropriate terminology on purpose builds a more affirming environment for everyone: patients, you, your colleagues, and your communities.

Anyone may hold a stigmatized identity, sometimes in ways that are not visible and sometimes concealed until a patient feels safe enough to disclose. Some patients reveal information that makes them more vulnerable because they believe they have no other option. Approach that disclosure with cultural and intellectual humility.

What LGBTQIA2S+ Patients Bring to the Encounter

Patients do not need their care team to know every term they use. Many of these terms shift continuously within the community as understanding evolves. Some words patients use as reclamation are slurs when used by people outside the community, so never simply copy a patient's language without asking what they mean by it.

Patients value open-mindedness, a willingness to learn, and a clear commitment to an affirming space. Many are used to the opposite: practitioners who are poorly informed about LGBTQIA2S+ issues. Those encounters can be harmful enough that patients avoid care entirely, not just with that provider but with others.

How to Use This Glossary

No glossary is complete, current, or able to cover every term and meaning you will need. Memorizing definitions is not the goal. Work to avoid mistakes, then learn from the ones you make, welcome the people who point them out, and look for chances to repair any harm.

Question this guide the way you would question any source, and invite patients to question you when you are the source. The aim is to bridge gaps in understanding so you can deliver the best possible care without historical prejudice getting in the way.

Navigating Mistakes

Mistakes are inevitable. Prevent what you can by staying open to new information from patients, colleagues, continuing education, and resources like this one.

When a mistake happens, acknowledge it, apologize as appropriate, and thank the person for the feedback. Then change what you can to keep it from happening again. With the patient's consent, invite them into any steps you take to address the error.

Telling patients up front that you know mistakes are possible, and that you want their input, sets up an environment where feedback is routine rather than awkward. Trust takes time, so a patient may need repeated good experiences before they believe you will follow through.

For language slips like an incorrect pronoun, keep the apology and the thanks brief. A long apology can leave the patient feeling obligated to console you, the person who erred. For serious mistakes, consult the patient, advocates who share the patient's identity, and colleagues to determine appropriate followup.

Definitions and connotations vary across communities and shift over time. Use this list as a starting point for conversations that lead to broader, more nuanced understanding, not as a yardstick for judging people who use these terms differently or have never encountered them.

Glossary of LGBTQIA2S+ Terms for Nurses

Term	Definition
Ableism / ablism	The belief that disabled people, people with disabilities (some communities prefer "identity-first language," some prefer "person-first language"), and anyone perceived to have a disability are inferior to able-bodied and able-minded people, and that disabilities are "wrong," "unfortunate," or deserving of pity and should be "cured" or "fixed." It can be obvious or subtle, as when people blame a patient or family for having done something "to deserve" a perceived disability, even when the disabled person values their own characteristics as they are. Ableism touches the LGBTQIA2S+ community in specific ways, such as framing LGBTQIA2S+ identity as "sick" or as an illness to be forcibly "cured." See "conversion therapy."
Agender	Not having a gender. An agender person does not perceive themselves as having a gender. Sometimes included under the transgender umbrella, sometimes considered a nonbinary gender, and may be claimed alone or alongside other genders.
Affirmed gender	A patient's gender(s), regardless of the gender assigned at birth. Many cultures assign gender at or before birth, so a person can be assigned a gender they later recognize as incorrect. An affirmed gender is one they have chosen for themselves.
Ally	Someone who fights alongside a group they are not part of, for example straight people working as allies of people who are not straight. In anti-oppression work, it is generally seen as presumptuous to designate yourself an ally rather than be recognized as one by the group you support.
Anatomic(al) inventory	A list of the anatomy and physiology a patient has, has had, or wants. It improves data integrity and reduces unnecessary procedures across all genders (for example, not ordering a pregnancy test for a patient without a uterus based on a binary marker in the record).
Androgynous	Neither masculine nor feminine, or having both masculine and feminine traits. Can describe people, an aesthetic, or the objects used to craft a presentation, and often refers to presentation regardless of gender. Androgynous patients may present in many ways and can be any gender, including cisgender.
Asexual	Literally "without sex." Used of relationships, it can mean partners are not sexually active for any number of reasons. Used as an orientation, it covers a growing set of subcategories, many involving conditional or variable attraction or desire. It is usually the "A" in LGBTQIA2S+. See also "demisexual." For some, being "ace" means a complete lack of desire for any sexual activity including masturbation; for others, a lack of sexual attraction to others or low desire, sometimes both. Asexuality differs from celibacy, which is a choice or status to abstain rather than an identity. It can be useful to recognize that even "allosexual" people do not experience constant attraction or desire across a lifetime.
BDSM	Bondage, discipline, domination, submission, sadism, and masochism, also called "kink." Covers many practices: giving and receiving sensation (impact, restraint), intentionally shifting power or control, managing risk in ways that transgress social norms, and more. It may involve sexual or erotic interaction and frequently does not. See also "kink." Many people include BDSM elements in their relationships without identifying with the community. It is included here because, while people of all genders and orientations practice it, for some it is an element of sexuality or expression that is not "straight," and the histories of the LGBTQIA2S+ and BDSM communities are intertwined through shared figures, shared stigma, and shared cultural expression (fashion, terminology such as "top" and "bottom," and body modification).
Bigender	Having two genders.
Biphobia	The disapproval, invalidation, erasure, hatred, or fear of bisexuality. Affirm bisexuality as a full identity in its own right, not a stop "on the way" to "real" gayness or straightness. Bisexual people can be monogamous or nonmonogamous; orientation and preferred relationship structure are separate elements of identity.
Binding	Wrapping or compressing parts of the body, usually the upper front torso, breast, or chest, to alter its appearance or the sensations a person receives from it. For some, binding relieves gender dysphoria. If your patients bind, stay informed about the risks and how to mitigate them.
Bisexual	An orientation in which a person can experience attraction to someone of the same gender as their own and someone of a different gender. The "B" in LGBTQIA2S+. People who do not recognize more than two genders may read "bisexual" as attraction to both men and women only. Orientation does not predetermine relationship structure; bisexual people can be monogamous, nonmonogamous, or shift over a lifetime.
Bottom	Usually the person perceived as receiving an action or sensation, such as being penetrated during sexual activity. The role may map differently onto activities like oral sex. Stereotypes cast bottoms as submissive, but the role is separate from any power dynamic; bottoms can be dominant, power-neutral, or switch with partners.
Bottom surgery	Any procedure that alters a patient's genitals. Often part of a medical transition, and sometimes required to change a gender marker on a birth certificate.
Cisgender	Describes patients whose affirmed gender is the same as the one assigned at birth.
Closeted	Keeping an element of one's identity private, or "in the closet," for comfort, convenience, safety, or survival. It applies beyond the LGBTQIA2S+ community, for example being closeted about HIV+ status. A person may be closeted to some people but not others; someone extremely closeted may be considered "stealth." People stay closeted about identities that draw violence, stigma, and harm. Members of the LGBTQIA2S+ community have faced violence, death, and rejection both for being out and for "tricking" others by staying closeted. Take extreme care to protect privacy and seek explicit, informed consent before sharing information with other providers, insurers, social service agencies, family, or partners. That can mean reviewing records and correspondence with the patient before anyone else sees them, and explaining the options and consequences of different responses.
Coming out	Revealing a previously private identity. Because people often assume gender or assume everyone is straight, those with stigmatized or erased identities may have to come out repeatedly, including to every new provider, which compounds existing stress. Coming out can be ordinary, celebratory, an act of self-acceptance, or an act of defiance, and it connects with improved mental health and resilience. Some members of the community never "come out" yet are not closeted.
Conversion therapy	Programs or procedures meant to "cure," "fix," or "convert" people who are gay, lesbian, bisexual, queer, transgender, or gender nonconforming so they will be "straight," often tied to religious belief. It has been banned in many jurisdictions because it is frequently traumatic and deadly. Be especially sensitive to the mental and emotional health needs of patients who have experienced it, particularly during interviews, tests, and procedures.
Cross-dresser	Someone who dresses in ways associated with a gender other than their own, regardless of their gender, gender status, or orientation. Anyone of any gender can cross-dress, and "drag" is a kind of cross-dressing. Cross-dressing does not determine orientation. Although some community members have reclaimed it, avoid the term "transvestite" unless a patient explicitly requests it.
Cultural (mis)appropriation	A complex concept rooted in power dynamics and histories of colonization. It can occur when someone from a more favored group benefits from another group's cultural expression (language, fashion, music) without permission or credit, sometimes profiting where the originators do not. With some cultural elements, no single person has the authority to grant permission. For example, people across the queer community, including those who are not Black, often borrow inflections and phrasing from Black English or African American Vernacular English (AAVE), gaining social capital, while Black and African diasporic people are penalized for the same speech as "unprofessional."
Demisexual	A subcategory of asexuality. Someone who experiences attraction or desire for sexual activity only after an emotional connection forms.
Endearments	Terms of affection such as "honey," "sweetie," "dear," "mama," and "sugar." Because they can read as overly personal or patronizing in clinical settings, and may carry meaning you are unaware of, avoid them without explicit permission. Many patients do feel cared for when nurses use them, so the point is not to drop them entirely but to stop using them as a default without consent.
Family	Anyone an LGBTQIA2S+ patient considers close. Biological relatives, legal guardians, and birth or adoptive parents sometimes reject community members or attach harmful conditions such as conversion therapy, so a "chosen family" can matter as much as or more than a "bio family." Let patients designate whoever they wish as family or next of kin for medical disclosures and legal and financial records.
Fatphobia	Fear, hatred, or discomfort with fatness, usually tied to misperceptions about the link between health and body fat. Clinical terms like "morbidly obese" can carry strong negative connotations that interfere with care. This bias exists across all orientations and genders and adds stress for anyone already facing other discrimination. Ask whether a patient prefers terms like "plus size," "of size," or "larger bodied," or uses "fat" as a neutral or positive word.
Female	A category of characteristics associated with sex and reproduction (internal and external anatomy, hormones, chromosomes), which can be congenital or developed. Not equivalent to "woman." Many female humans are women, but not all are, and some women are not female.
Femme	Literally "woman" in French, used broadly for community members of any gender who present as feminine or embrace femininity. It carries deep historical and cultural meaning, including as a counterpart to "butch" in lesbian and gay communities, and appears in blended identities like "stem" (femme and stud, from Black lesbian communities) and "futch" (femme butch). Clarify what a patient wants recorded or used to describe them, and get specific consent before applying these terms.
Fetishization	A kind of objectification in which a person is valued mainly, or only, for one aspect of their existence, whether a body part, identity, characteristic, or ability. LGBTQIA2S+ people are frequently fetishized and then met with hostility if they do not appear "grateful" for the attention. "Tokenization" is a related, often milder form: a person from an underrepresented group is valued for that one trait and made to carry a "burden of representation" for everyone who shares it.
Gay	Sometimes used for anyone in the LGBTQ+ community or the community in general; the "G" in LGBTQIA2S+. See also "homosexual." Most narrowly, within a gender binary, it refers to men interested in romantic or sexual interaction with other men, and sometimes women interested in other women. See also "lesbian." Avoid using "gay" as a slur or as slang (for example "that's so gay"). Some community members use it in a reclamatory way, and some out of internalized homophobia.
Gender	An aspect of social identity (a social construct), including expectations for behavior, appearance, and role. These expectations change across time, geography, culture, age, race, ethnicity, disability, and other identities. Use phrasing such as "all genders" or "all or no genders," and avoid "both genders" or "opposite genders."
Gender affirmation / confirmation / (re)assignment surgery and/or therapy	Any surgical or therapeutic procedure undertaken to change the body to reflect gender identity. Not all trans people seek these, and some cis people pursue them without it being seen as "confirming gender" (for example, estrogen replacement therapy for osteoporosis). The idea of a fixed set of steps that "complete" a transition can be harmful; completion is specific to a patient's desired outcome.
Gender binary	The concept that gender is limited to two options, "man" and "woman," typically framed as opposites.
Gender dysphoria	Psychological distress of varying intensity specific to the experience of gender, usually but not only because a person was assigned an incorrect sex and gender at birth and has lived as that gender. Ask about dysphoria rather than assuming from assignment status: some cisgender people experience it, and some transgender people never do. It can attach to genitals but also to traits like height, fat distribution, and hand or foot size. The opposite, "gender euphoria," is what patients may feel with access to affirming spaces and care.
Gender essentialism	The belief that gender is binary and fixed by unchangeable biological characteristics such as genitals, chromosomes, or hormones in all people. Strict adherence to this framework gets in the way of accurate care, because it cannot account for natural variation in reproductive and endocrine systems or for surgeries, body alterations, and trauma, and it harms people of all genders by enforcing fixed binary roles.
Gender expansive	Describes people or settings where concepts of gender are not limited to a binary.
Gender expression	How a patient presents their gender, including clothing, behavior, hairstyle, vocal inflection, and any other perceivable characteristic.
Gender fluid / genderfluid	Having a gender that can change. Some genderfluid people move between man and woman; fluidity can also include any gender or a lack of gender. Shifts can happen predictably or at random, quickly or over long periods, and in response to different situations.
Gender identity	A person's gender, and how they perceive it. See also "gender."
Gender neutral	A place, object, or concept that has no gender or where gender is not relevant (for example, gender-neutral restrooms for anyone to use). It may also describe a person with no gender identity preference, who may be agender.
Gender (binary) nonconforming	Not aligning with traditional binary gender roles. A patient of any identity, including ones outside the LGBTQIA2S+ community, can be gender nonconforming. For example, people who believe in a strict binary may distrust "male nurses" or "female doctors." Some treat any LGBTQIA2S+ identity as inherently nonconforming; others reserve the term for more intentional, perceivable deviation from binary norms. "TGNC" stands for trans and/or gender nonconforming.
Gender role	The set of expectations a society holds for how people should be, internally and toward others, based on gender, including the consequences for defying them.
Genderqueer	A gender identity that does not conform to the binary. Genderqueer people typically reject fixed, stereotypical beliefs about gender and may express it outside common norms. The reclamation of "queer" often carries a tone of political resistance.
Genitals	Reproductive organs, internal or external. Clinical terms for genitals can carry such strong gendered connotations that using them interferes with care, so some patients prefer alternates like "front hole" and "back hole." Colloquial usage is also often inaccurate (for example, calling the vulva the vagina). Ask patients how they refer to their own body parts.
Gestational parent / partner	An alternative to "pregnant person" or "birthing person" that does not presume gender; the complement is "nongestational partner/parent." LGBTQIA2S+ parents and caregivers may use "mother," "father," or terms of their own. Ask what a patient wants to be called and note it for other staff.
Gray (grey) asexuality / graysexuality	An orientation between asexuality and allosexuality; can include demisexuality ("demigraysexual") or other combinations. See also "asexual."
Heteronormative	The belief that it is normal to be straight, that humans exist as only one of two fixed genders attracted to the "opposite" sex, and usually that these relationships should be monogamous, with the corollary that anything else is wrong, "sinful," or "perverted."
Heterosexual	Someone who exists as a gender within a binary (cis or trans) and is attracted to people of a different gender and sex than their own; also "straight." Some who identify as heterosexual may have romantic or sexual interest in people of the same gender or sex.
Homosexual	A person romantically or sexually interested in people of the same sex or gender. It can be a neutral synonym for "gay" and "lesbian," but it carries negative connotations from religious stigma and from its clinical tone. Ideally you would not need it in patient care. Before asking about orientation, identify whether and why you need that information, and if you do, explain how the answer affects care as part of informed consent. Often an anatomical inventory of the patient and their partner(s) is more useful: for contraception, for instance, ask whether the patient and partners have sperm or eggs.
Homophobia	Hostility, hatred, fear, or marginalization of anyone perceived as homosexual, including straight people who do not conform to gender roles. When directed by a community member toward another member or toward themselves, the underlying feeling can be described as "internalized homophobia."
Honorifics	Titles added to names to convey respect, such as Ms., Miss, Mrs., Mr., sir, and ma'am. Many reflect a binary gender or a job title. Gender-neutral options include Dr., Mx. (often pronounced "mix" or "mixter"), and military and law enforcement ranks. Ask patients how they wish to be addressed rather than assuming an honorific will feel respectful.
Human milk feeding / breastfeeding / chestfeeding / bodyfeeding	Terms you can offer alongside lactation and infant feeding when discussing the feeding, nursing, or pumping of human milk. "Breastfeeding" works for many, but for some it does not connect or may trigger dysphoria. Offering additional terms includes more families and keeps the focus on the people and physiology involved.
Intersectionality / intersectional feminism	The theory, coined by Kimberlé Crenshaw, that elements of identity such as class, race, sex, and gender are interconnected, inseparable, and shape one another, advantaging and disadvantaging people based on how those identities meet the societies they live in.
Intersex	A category of natural variations in characteristics associated with sex and reproduction (internal and external anatomy, hormones, chromosomes), congenital or developed, that can be ambiguous or include traits associated with both male and female variations. The "I" in LGBTQIA2S+. Never use "hermaphrodite," widely considered a slur, though some intersex people reclaim it; if it appears in records, patients may appreciate changing it to terms of their own. Avoid comparing the frequency of intersex variation to the frequency of red hair, a Eurocentric comparison that does not hold across racial and ethnic groups. Many forms still offer only "male" and "female" for sex, leaving intersex patients no way to disclose their histories, so work to update those systems.
Kink	A "bend" or "twist" in conventional human interaction. See also "BDSM." Kink may involve sexual elements or none at all, and much of it overlaps with widely accepted hobbies and movement. For nonsexual kink, focus on specific health concerns related to high-risk activity, as you would for martial arts, extreme sports, or dance. For sexual kink, the usual sexual history is generally sufficient. Mental health providers may explore the patient's sense of agency, fulfillment, and support with partners and peers.
Lesbian	Commonly understood as a woman sexually or romantically attracted to other women; the "L" in LGBTQIA2S+. Ask patients to self-identify, offer a list of labels to choose from, or use an anatomical inventory, since language shifts: some gay women do not identify as lesbians, some nonbinary people do, and some lesbians do not identify as women.
LGBTQIA2S+	Lesbian, gay, bisexual, transgender, queer, questioning, intersex, asexual, two spirit, and those whose identities are not captured in the abbreviation.
Lifestyle	Usually implies that LGBTQIA2S+ people choose to endure injustice and could "just choose to be straight." For care, it rarely matters whether orientation is chosen or innate. Avoid presuming either that anyone can choose their orientation or that everyone is "born" a given orientation and cannot choose.
Male	A category of characteristics associated with sex and reproduction (internal and external anatomy, hormones, chromosomes), congenital or developed. Not equivalent to "man." Many male humans are men, but not all are, and some men are not male.
Men who have sex with men (MSM) / women who have sex with women (WSW)	Describes patients by behavior rather than identity labels. MSM and WSW may or may not identify as straight, homosexual, or bisexual. You may also see abbreviations using "L" for "loving," such as MLNB (men who love nonbinary people) or WLW (women who love women).
Misgender	To perceive someone as a different gender than they are. It becomes evident when someone communicates the misperception, for example addressing a woman as "Sir" or referring to an agender person as a man.
Monogamy	A relationship structure in which two people commit exclusively to each other; unrelated to gender and orientation. A monogamous person wants one partner at a time. Some require their partner to be monogamous too, and some partner with people who are nonmonogamous.
Neurodivergent	An umbrella term for identities that often began as clinical diagnoses and have since been reclaimed as neutral or positive, as opposed to "neurotypical." Examples include being autistic (nonautistic people are "allistic"), having depression, anxiety, dyslexia, or variations of PTSD, and for some, being queer.
Nonbinary / non-binary	Literally "not binary." For gender, it can name the whole category of genders and no-gender outside the two binary genders, or a specific gender on its own. Sometimes written or spoken as "enby," but not consistently abbreviated "NB," which means non-Black in many communities. Where both meanings are in play, keep the abbreviations separate for clarity.
Nonmonogamy	A category of relationship structures in which people are not exclusively committed to one partner; unrelated to gender and orientation, and for some synonymous with "polyamory." A nonmonogamous person can have more than one partner at a time, including while single. Some require partners to also be nonmonogamous, and some partner with monogamous people. The category includes swinging, polyamory, open relationships, relationship anarchy, ethical nonmonogamy, and more. If exposures may affect care, focus on the specific concern with your patient rather than on labeling the structure.
Outing	Revealing anything private about someone without consent. Being outed about gender, orientation, or any stigmatized identity can bring consequences from emotional harm to assault and death, loss of housing or income, removal of children, and severed family ties. Help patients understand who can access their records, and ask about their own disclosure practices.
Pansexual	Attracted to or interested in sex with people of all genders; can combine with other orientations and does not dictate relationship structure.
Partner	A widely accepted, flexible way to refer to someone in a relationship of any kind, because it presumes nothing about gender, orientation, legal status, or type of relationship. Use the term to open a conversation and learn the details relevant to care.
Polyamorous	Having the capacity for more than one romantic or sexual partner; separate from gender and orientation. See also "nonmonogamy." For some, polyamory is the same as nonmonogamy; for others, a category of it; for others, distinct.
Polygender, pangender	Literally "multiple gender" and "all gender." People apply these differently, but pangender people may describe their gender as unlimited by categories or as all genders at once.
Pronouns	Words used in place of nouns. Never use "it" for a person unless requested, given its dehumanizing history. Common singular pronouns include she/her/hers, he/him/his, they/them/theirs, xie/xir/xem, elle (pronounced "eh-yeh," as in Spanish), and siya. If you are unsure, ask which pronouns to use; if asking is not possible, default to the patient's name or they/them/theirs, while recognizing that even this can misgender some people. Ask how patients want pronoun mistakes handled when they are present and when they are not. Avoid "preferred pronouns," which can frame an identity as a preference rather than a fact.
QTPOC	Queer and/or trans people of color. A related term is QTBIPOC (queer and/or trans Black, Indigenous, and other people of color). Not everyone with these identities supports the abbreviations, though they are widely used. QTIPOC (queer, trans, and/or intersex people of color) is more common outside the United States.
Queer	A term reclaimed from its origin as a slur for being different from a heterosexual, cisgender norm. It can refer to gender identity, orientation, or both, and is often used by those resisting the status quo; the "Q" in LGBTQIA2S+. Some still consider it a slur. Use it only if you identify as queer yourself or at the specific request of a queer patient.
Questioning	Being unsure and seeking answers about one's gender or orientation; the "Q" in LGBTQIA2S+ can also stand for questioning. It is sometimes used as an orientation label.
Same gender loving	An umbrella phrase, coined by African American activist Cleo Manago, that includes homosexual and bisexual people of any gender as a way to center Black and African diasporic people and cultures. Some patients use SGL alongside other orientations, and some use it exclusively.
Sex	A category relating to potential reproductive characteristics, with variations including male, female, and intersex; different from gender. Avoid treating sex categories as "opposites"; phrasing like "other sexes" or "all sexes" is more accurate. "Sex" can also refer to sexual activity, where perceptions of what counts vary widely; exploratory conversations about specific concerns and behaviors are usually more practical.
Sex assigned / assumed / presumed at birth	In the United States and many countries, clinicians presume a baby's sex at or before birth from the appearance of genitals and an awareness of only two options. Sex and gender are not the same, though they have historically been treated as such. Some babies are later identified as intersex, and efforts are underway to prevent unnecessary surgeries to make ambiguous genitals appear binary. When a sex label is assigned, gender is usually presumed (female = girl, male = boy), but a child cannot develop a concept of gender until they can form and express a social identity. Because of this routine conflation, you will meet patients and colleagues who treat sex and gender as one. Clarifying the terms can help, but it can also create conflict that interferes with care, so proceed carefully and work toward systemic change rather than insisting on correctness in a single interaction.
Sexual orientation	A pattern of sexual attraction toward others. Common labels include straight, gay, heterosexual, homosexual, lesbian, bisexual, queer, pansexual, and asexual. Avoid "sexual preference," which has been used to imply orientation is a wrong choice that can or should be changed.
Sex work	Any occupation in which a person exchanges access to their body in sexual or eroticized contexts for something of value, usually money. Community members disagree about whose work is included and which terms they prefer. Reclaimed words like "whore," "slut," and "prostitute" should not be used by outsiders unless explicitly requested. Do not apply assumptions without confirming with the patient. Common stereotypes (that sex work is only for survival, only women do it, it is always the result of trafficking, or workers would all prefer other work) often do not hold. People who advocate for women's rights but exclude sex workers may be labeled "SWERFs," sex worker exclusionary radical feminists.
Stealth	A trans person who lives as their correct gender without disclosing their gender history, with the implication that they can "pass" as cisgender; this concept exists only because cisgender is treated as the default. "Stealthing" is also a term for a consent violation amounting to sexual assault, in which someone removes a barrier such as a condom during penetrative sex without their partner's knowledge.
Straight	See "heterosexual." Ask patients to self-label and describe their sexual activity rather than assuming orientation.
TERF	Trans exclusionary radical feminist. Applies to those who advocate for women's rights while excluding trans people, for example by claiming trans women are not women.
Top	Usually the person perceived as initiating or giving the action or sensation in a sexual interaction, such as the person penetrating during intercourse. The role can be complex and inconsistent across activities like oral sex. Stereotypes cast tops as dominant, but the role is separate from any power dynamic; tops can be submissive, power-neutral, or switch with partners.
Top surgery	Surgical alteration of the upper torso or chest, whether to remove breast or mammary tissue or to augment breasts.
Trans man / transgender man	A man who was assigned an incorrect gender at birth. Some trans men exist within a gender binary, and some claim additional gender identities. Ask each man how to best support him, as you would any patient.
Trans woman / transgender woman	A woman who was assigned an incorrect gender at birth. Some trans women exist within a gender binary, and some claim additional gender identities. Ask each woman how to best support her, as you would any patient.
Transgender	Describes someone who was assigned an incorrect gender at birth; the "T" in LGBTQIA2S+. It generally refers to anyone who is not cisgender, including agender and other nonbinary people, though some understand it to mean only binary genders. Use it as an adjective ("transgender community," "transgender advocate"). Avoid "transgendered," which implies lost agency and a past identity, and avoid using it as a noun ("a transgender"), which dehumanizes. The same rule applies to other identity terms.
Transition	A process in which a transgender person changes one or more aspects of themselves: name, pronouns, physiology through surgery or hormones, legal documentation, and more. "Cross-sex" therapy is outdated phrasing. Attitudes toward "FTM" and "MTF" vary, since they can conflate sex and gender depending on what the transition involves; "FTF" and "MTM" affirm a constant sex while other aspects change, and "gender affirming" may be more useful still.
Transphobia / transantagonism	Fear, hatred, stigmatization, or erasure of transgender people, active or passive. It often leads to harassment, individual and institutional violence, and a failure to protect transgender people.
Transracial	Refers to adoption across racial categories, not to someone who decides they "feel like" a different race than they or their biological parents are. You may encounter the term because LGBTQIA2S+ families sometimes adopt transracially, and because some people misuse it to undermine the idea of gender as a self-identified social construct.
Transsexual	An outdated term for a transgender person who lives as a different sex than assigned at birth. Still used proudly by some, but default to "transgender."
Two Spirit	An umbrella term for a person of a nation, band, tribe, or community indigenous to Turtle Island (North America) who exists outside the gender binary imposed by European settlers; the "2S" in LGBTQIA2S+. Identifying people as having two or more spirits is not exclusive to Turtle Island communities, but the English phrase generally refers to them. It is sometimes simplified as an Indigenous person who holds both feminine and masculine spirits. It is not the same as being gay or transgender, though the identities may be linked for some, and not everyone claims it. Honor the specific genders and orientations of your patients' cultures rather than letting this phrase erase them.