Positive Approaches Journal, Volume 10, Issue 1

Boyd | 8-14




Positive Approaches Journal - Volume 2 Title

Volume 10 ► Issue 1 ► May 2021



Embracing Inclusion: Prioritizing Lesbian/Gay/Bisexual/Transgender/Queer (or Questioning)/Intersex/Asexual/+ (LGBTQIA+) Inclusion for People with Intellectual and Developmental Disabilities

Parris Boyd


Abstract

This article explores the importance of LGBTQIA+ inclusion for people with intellectual and developmental disabilities. People at this intersection face unique barriers such as choosing between expressing their gender and/or sexual identity and losing life-sustaining supports. After identifying some of these barriers, the article gives readers ways to be inclusive when working with LGBTQIA+ people with disabilities.

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You may have looked at the title of this article and wondered, “Where did the Q, I, A, and + come from?” What has traditionally been known as the “LGBT” community has been growing in recent years due to the understanding of what the LGBTQIA+ community means. Largely, this community has defined itself by being outside of the heterosexual lens. As more identities figure out that they are outside of that lens, they have advocated to become a part of the acronym. This has left us with the acronym LGBTQIA+ which usually translates to:

- Lesbian

- Gay

- Bisexual

- Transgender

- Queer/Questioning

- Intersex

- Asexual

- + The many sexualities that are not included in the acronym

In discussing inclusion, it’s important we are aware that people with developmental disabilities can be any, and multiple, identities within the LGBTQIA+ spectrum. For instance, a transgender woman with an intellectual disability can be a lesbian. It is especially important for those who work with people with support needs to be inclusive because supporters can often be barriers to identity in ways able-bodied people do not experience. I came across this a lot in my work in gender-affirming care (gender-related healthcare for transgender patients). When conducting intake assessments for patients who had a developmental disability, the process was often different than intake assessments with folks who had fewer formal supports. A person with few formal supports often experiences barriers like losing employment, familial estrangement, and other life-shifting consequences. These are often difficult barriers to overcome but worth it for the people who came to my office. When someone with an intellectual or developmental disability would speak with me, they would not only mention the same barriers, but they would also have additional barriers related to their supporters. These supporters can often be in control of transportation, communication, and other vital resources that people without these needs don’t have to consider. One client of mine who managed to defeat many obstacles to meet with me was still rejected when the doctor said they were not equipped to handle someone with an intellectual disability. Another client’s family said they would disown her if she even went to an appointment to talk about her gender dysphoria. Roadblocks to expression are not limited to transgender people with disabilities, many identities within the LGBTQIA+ spectrum are controlled by those around them.

In a study on resilience of LGBTQIA+ people with disabilities1, a participant detailed an experience where her parents found out that she was in a same-sex relationship and threatened to stop providing care if the relationship didn’t end. The “care” her parents were providing was life-sustaining, which forced the participant to choose between a fulfilling relationship and physical safety. This is one of countless examples of how people with higher support needs have to navigate more significant barriers. A more common example that I have been met with is supporters questioning the identity of the LQBTQIA+ person with a disability. When supporters question people about their identities, they are doing several things that they may not be aware of. For starters, they are making themselves the experts of that person’s experience. Asking people to prove their identities with questions like “Are you sure you’re a lesbian?” or “How do you know you are transgender?” instantly place the person as the student, and the asker as the expert. The truth is, by the time people express their gender or sexual identities to others, they have usually gone through a lot of internal turmoil beforehand. They likely know far more than their supporters realize. Further, these questions other the individual by treating their identity as something they have to prove to the asker. Being inclusive means that a person’s gender and/or sexual identity shouldn’t matter. The concern of the supporter should be focused on how to support them.

Supports are where LGBTQIA+ inclusion becomes most important for the well-being of a LQGBTQIA+ person with a disability- no matter the role. The Trevor Project National Survey on LGBTQ Youth Mental Health 2020 found that 29% of LGBTQ youth experienced homelessness, were kicked out of their homes, or ran away2. This statistic shows how many LGBTQIA+ youth are facing unsupportive homes and families. This is exacerbated when it comes to LGBTQIA+ individuals who have disabilities because running away or being kicked out could be impossible due to not physically being able to leave, having medication that is not otherwise accessible, or even death due to their reliance on supports. This leaves LGBTQIA+ individuals with disabilities in a position where they have to choose whether to be themselves or their mental, and sometimes physical health. The word “choose” is not exactly fitting when it comes to the positions LGBTQIA+ people with disabilities are faced with around unsupportive people. This “choice” is often between expressing gender identity, which has been noted by the CDC to lead to better health outcomes or facing hostility and even physical violence for being open about one’s sexuality and/or gender identity3. People within the LGBTQIA+ community are very attuned to who is and is not homophobic but even still, there are risks to coming out to a person who has the best intentions. In short, there are many reasons why people may not come out and those reasons are only amplified when individuals have higher support needs.

Another barrier that comes with being disabled and in the LGBTQIA+ community is that they are sometimes faced with even more marginalization. LGBTQIA+ people with disabilities have to deal with homophobia and/or transphobia in the disability community and ableism in the LGBTQIA+ community. This is an oversimplification as you can also face ableism within the disability community and homophobia and transphobia in the LGBTQIA+ community. To live at the intersection of these identities has been documented by many people with lived experience to be even more severe (see Hayden Kristal’s TEDX “The Importance of Intersectional Accessibility in Activism4”). This creates few, or no, places of safety for LGBTQIA+ individuals with disabilities and may force them to navigate each identity while trying to find community. This is exactly why the interactions with the people closest to them are so important. Having to navigate multiple marginalized identities to find a place of belonging takes a large toll on one’s mental health5 There are concrete ways supporters can be inclusive and therefore lifting the burden of feeling outcasted:

- When someone tells you they are gay, transgender, asexual, etc. you should believe them. Questioning how they came to know this is simply not important. A more appropriate question is, “How can I support you?”

- If someone says that they are transgender, it is important to recognize that gender is more than genitals. People express their gender in many ways that don’t include a doctor (i.e. nail polish, haircuts, clothing, etc.).

- There isn’t an IQ test related to being gay, straight, transgender, etc. People of all backgrounds and disabilities can be within the LGBTQIA+ spectrum- even if they do not have the words for it.

- Be careful with your words. Though you may think there isn’t anyone who is LGBTQIA+ around you, you never know, so it’s best to avoid derogatory comments about any identity.

- Be open to making mistakes- we all make them. If you say the wrong thing, just apologize and take it as a lesson. It’s important to remember that just because you apologize doesn’t mean they owe you forgiveness.

If we truly want an inclusive world, we have to give all people the space to be themselves (within the parameters of legality and not harming others). For too long, the answer to embracing LGBTQIA+ people with disabilities has been met with fear of teasing. This puts the onus on the individual rather than addressing the actual perpetrator of the harm- the bully, especially considering that bullying is usually not restricted to one facet of a victim’s identity. Being inclusive isn’t hard but it does require explicit effort. The effort is worth it and will pay off for people who have had their identities pushed aside for far too long.



References


1.      Hunter T, Dispenza F, Huffstead M, Suttles M, Bradley Z. Queering disability: Exploring the resilience of sexual and gender minority persons living with disabilities. Rehabilitation Counseling Bulletin. 2020;64(1): 31-41. doi:10.1177/0034355219895813.

2.      The Trevor project national survey 2020.” The Trevor Project website. Accessed April 25, 2021. www.thetrevorproject.org/survey-2020/?section=Suicide-Mental-Health.

3.      Mental health for gay and bisexual men. Centers for Disease Control website. Published February 29, 2016. Accessed April 25, 2021. www.cdc.gov/msmhealth/mental-health.htm.

4.      Kristal H. The importance of intersectional accessibility in activism. YouTube. Published June 2, 2016, Accessed April 25, 2021. www.youtube.com/watch?v=W0I9kXwxIu0

5.      Conover KJ, Israel T. Microaggressions and social support among sexual minorities with physical disabilities. Rehabilitation Psych. 2019; 64(2): 167-178. doi:10.1037/rep0000250



Biography

Mr. Boyd (he/him) is a project coordinator at the Institute on Disabilities where he principally works on projects related to criminal justice and sexuality. He earned his Master’s in Social Work at Temple University. Mr. Boyd has previously worked in gender-affirming care at a medical practice and in transition for refugee populations.

Contact information

Parris Boyd

Institute on Disabilities, College of Education and Human Development at Temple University

Parris.Boyd@temple.edu