AMERICAN ACADEMY OF DEVELOPMENTAL MEDICINE & DENTISTRY

LGBTQ People with Disabilities

BY H. BARRY WALDMAN, DDS, MPH, PHD, BEVERLY L. MUNTER AND STEVEN P. PERLMAN, DDS, MSCD, DHL (HON)

"More than one-third of LGBTQ adults identify as having a disability" 1 (Note: LGBTQ is the abbreviation for lesbian, gay, bisexual, transgender and queer or questioning persons.2)

"Working with gay and lesbian consumers with disabilities has become an imperative of cultural diversity." 3

"Both people who identify as LGBTQ and people who have invisible disabilities such as learning disabilities like dyslexia, mental health or ADHD have to decide whether or not to 'come out of the closet.'"1

Norm-breaking sexuality and gender identity are still relatively invisible in habilitation centers. People with ID are still predominately desexualized and perceptions regarding their sexuality are lagging behind the rest of society. 4 The decision to go public is not an easy decision for most people because of the uncertainty of whether or not they will be accepted. LGBTQ youths who come out sometimes are rejected by their families and friends. Some are even kicked out of their homes and forced to live on the streets. According to a University of Chicago report, LGBTQ young adults had a 120 percent higher risk of reporting homelessness compared to youth who identified as heterosexual and cisgender (i.e., a person whose gender identity corresponds with the sex the person had or was identified as having at birth). 1,2

There is substantial literature regarding young gay people with intellectual disabilities (ID) that emphasize the complexity and the invisibility of this group. The possibilities to demonstrate a variety of sexual expressions are dependent on the attitudes and behaviors toward them. "Therefore it is important to teach about different sexualities in the sex education at schools… without having the heterosexual norm as a starting point." 5

SOME SPECIFICS

• Within an ableist culture, people with ID have been recognized as eternal children and asexual. (Ableism is the discrimination of and social prejudice against people with disabilities based on the belief that typical abilities are superior. At its heart, ableism is rooted in the assumption that people with disabilities require 'fixing' and defines people by their disability.6)

• Individuals on the autism spectrum may be more likely to identify as homosexual and experience more unpredictable gender identity. 8

• In dire situations, gay men with ID have exercised self-harm, either intentionally ending one's life or attempted suicide, to alleviate emotional distress and combat the stigma associated with internalized homophobia.

• There are reports that lesbian women with ID are under-represented in society when compared to gay men with ID. Conducting sexuality research among youngsters has been proven to be difficult due to the sensitive and confrontational

OUTLOOK

Dysphoria is the state of unease or generalized dissatisfaction with life, which can result in adolescents with depression, mania, and anxiety disorders. Gender dysphoria has a very real impact on people's lives. It is important that we acknowledge and respond to the needs of those with an intellectual disability who experience gender dysphoria.

"Society makes judgements about gender based on what individuals wear (gender expression), what they do (gender role) or even who they are attracted to (sexual orientation), but we must caution against such assumptions as they can often be wrong. Gender is a uniquely individual experience, one that no one can impose on another. Biological sex is generally considered to be binary but neither is this an accurate classification." 10

"Both people who identify as LGBTQ and people who have invisible disabilities such as learning disabilities like dyslexia, mental health or ADHD have to decide whether or not to 'come out of the closet." 1•

ABOUT THE AUTHORS:

H. Barry Waldman, DDS, MPH, PhD is a SUNY Distinguished Teaching Professor, Department of General Dentistry, Stony Brook University, NY. E-mail: h.waldman@stonybrook.edu. Steven P. Perlman, DDS, MScD, DHL (Hon) is the Global Clinical Director and founder, Special Olympics, Special Smiles; and Clinical Professor of Pediatric Dentistry, The Boston University Goldman School of Dental Medicine. Beverly L. Munter is the Former Vice President of American Medical & Life Insurance Company, Long Island NY.

References

1. Acher E, More than one-third of LGBTQ adults identify as having a disability. Respect the Disability. Hollywood Inclusion, 2018, June

2. Merriam-webster Dictionary. Available from: merriam-webster.com/dictionary/cisgender Accessed January 8, 2021.

3. Harley DA, Hall M, et al Working with gay and lesbian consumers with disabilities: helping practitioners understand another frontier of diversity. Available from: search.proquest.com/openview/56a33a26d2fa15d0c48205c9c1270ed4/1?pq-origsite=gscholar&cbl=35933 Accessed January 9, 2021.

4. Sommarö S , Andersson A, et al. Deviation too many? Healthcare professionals' knowledge and attitudes concerning patients with intellectual disability disrupting norms regarding sexual orientation and/or gender identity. Available from: pubmed.ncbi.nlm.nih.gov/32281226 Accessed January 9, 2021.

5. Lofgren-Martenson L. The invisibility of young homosexual women and men with intellectual disabilities. Sexuality and Disability 2009,27:21-26.

6. Eisenmenger A. Ableism 101: What it is, what it looks like, and what we can do to fix it. Available from: accessliving.org/newsroom/blog/ableism-101 Access from: January 9, 2021.

7. JBI Evidence Synthesis Experiences of adults with intellectual disability who identify as lesbian, gay, bisexual, transgender, queer or questioning, intersex or asexual: a systematic review protocol. Available from: 2017 (15): 2234 – 2241.

8. Hiller A, Gallop N, et al. LGBTQ + and autism spectrum disorder: Experiences and challenges. Available from: International Journal Transgender Health 2019 (21):98-119.

9. Reach Out USA - Breaking Old Stereotypes, Gaining New Ground for Lesbian, Gay, Bisexual, & Trans Identities. Impairment and disability; LGBTQIA Healthcare. Available from: healthcareguild.com/impairment.html Accessed January 9, 2021

10. Bevan R, Laws A. Available from: Gender dysphoria and people with intellectual disability intellectualdisability.info/mental-health/articles/gender-dysphoria-and-people-with-intellectual-disability Accessed January 12, 2021.

AMERICAN ACADEMY OF DEVELOPMENTAL MEDICINE AND DENTISTRY

The American Academy of Developmental Medicine and Dentistry (AADMD) was organized in 2002 to provide a forum for healthcare professionals who provide clinical care to people with neurodevelopmental disorders and intellectual disabilities (ND/ID). The mission of the organization is to improve the quality and assure the parity of healthcare for individuals with neurodevelopmental disorders and intellectual disabilities throughout the lifespan.

IT WILL GET BETTER: HEALTH AND SOCIAL SERVICES FOR LGBTQs WITH DISABILITIES

"Having to 'come out.' Being called 'abnormal.' Or described as 'queer.' All of these phrases are regularly used as descriptions of non-straight sexualities, yet they work equally well as definitions of disability." 9

REACHOUT USA reachoutusa.org  ReachOut USA focuses on the intersection between disability and LGBTQ concerns. ReachOut USA seeks to influence people with disabilities to be more responsive to LGBTQ individuals and at the same time influence LGBTQ individuals and organizations to be more accountable to people who have disabilities. ReachOut USA pursues these goals through advocacy, training, and technical assistance.

THE DEAF QUEER RESOURCE CENTER (DQRC) deafqueer.org The Deaf Queer Resource Center is a national nonprofit resource and information center for, by and about the Deaf Lesbian, Gay, Bisexual, Transgender, Transsexual, Intersex and Questioning communities (hereafter referred to as the "Deaf Queer community"). This is "the place" to find the most comprehensive and accurate information about this unique community.

BLIND LGBT PRIDE INTERNATIONAL wwww.blindlgbtpride.org Blind LGBT Pride International is the largest organization of its kind in the world serving vision-impaired people in Canada, England and Japan, as well as the United States.

AXIS DANCE COMPANY axisdance.org AXIS Invalid began in 1987 with vision to gather a group of dancers with and without disabilities to explore dance and create a performance piece. 9

RAINBOW ALLIANCE OF THE DEAF Resources for Deaf Lesbian, Gay, Bisexual, Transgender Individuals deafrad.org "The Rainbow Alliance of the Deaf (RAD) is a 501(c)(3) nonprofit organization established in 1977. The purpose of this Alliance is to establish and maintain a society of the Deaf LGBT to encourage and promote the educational, economical, and social welfare; to foster fellowship; to defend our rights; and advance our interests as Deaf LGBT citizens concerning social justice; to build up an organization in which all worthy members may participate in the discussion of practical problems and solutions related to their social welfare. RAD has over fifteen chapters in the United States and Canada." 9

WHISPERS4U Disabled Dating Service whispers4u.com Having a disability can sometimes hinder your prospects of finding BLIND LGBT PRIDE INTERNATIONAL wwww.blindlgbtpride.org Blind LGBT Pride International is the largest organization of its kind in the world serving vision-impaired people in Canada, England and Japan, as well as the United States. love. It's a fact that many so- called "Able" folk are just not as receptive when it comes to disabled people and matters of love. If you happen to also be Gay or Lesbian, then that narrows the field even further. Here at Whispers4u, we aim to bring together Gay & Lesbian Disabled Singles in one community without prejudice, to share thoughts, make new friends, and maybe even find love! (87% Users Are Women).

SINS INVALID sinsinvalid.org A performance project that incubates and celebrates artists with disabilities, centralizing artists of color and queer and gender-variant artists as communities who have been historically marginalized.