Table Of ContentP
“If you feel uninformed or simply confused by the cur- o
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rent language of gender and sexuality, the Pocket k
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Guide to LGBTQ Mental Health, edited by Petros Levounis, t Pocket Guide to LGBTQ
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M.D., M.A. and Eric Yarbrough, M.D., will answer all your u
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questions. Concise and exhaustive, the book provides def- d
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nitions, history, questions, therapeutic implications, and t Mental Health
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explanation of social determinants of terms such as gay, L
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queer, questioning, allies, and many more. B
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The Pocket Guide to LGBTQ Mental Health is an in- Q
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dispensable book for psychiatrists, psychologists, and all Gender and Sexuality
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practitioners dealing with gender issues in their clinical n
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work. This book flls an empty spot in the understanding of a
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gender minorities. You cannot do without it.” H
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Ubaldo Leli, M.D., DLFAPA, Faculty, lt
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Columbia Center for Psychoanalytic Train- :
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“Levounis and Yarbrough collect here succinct reviews s
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of the important issues to understand in working with n
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individuals with diverse sexual orientations and gender in
identities. If you’ve ever wondered what to make of the ex- g
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tended range of letters in the LGBTQ+ initialism, this is the he
book for you. Although the focus of the chapters is mental S
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health, this book is valuable for those working with these e
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populations in any feld.” tr
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Christopher A. McIntosh, M.D., FRCPC,
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Editor-in-Chief, Journal of Gay and Lesbi- G
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an Mental Health n
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Petros Levounis, M.D., M.A., is Professor and Chair of r a
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the Department of Psychiatry at Rutgers New Jersey Med- d
ical School and Chief of Service at University Hospital in S
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Newark, New Jersey. xu
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Eric Yarbrough, M.D., is in private practice in New York, lit
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New York.
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u Edited by
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• Petros Levounis, M.D., M.A.
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b Eric Yarbrough, M.D.
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Cover design: Tammy J. Cordova u
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Pocket Guide to
LGBTQ Mental Health
Understanding the Spectrum of
Gender and Sexuality
Pocket Guide to
LGBTQ Mental Health
Understanding the Spectrum of
Gender and Sexuality
Edited by
Petros Levounis, M.D., M.A.
Eric Yarbrough, M.D.
Note: The authors have worked to ensure that all information in this
book is accurate at the time of publication and consistent with general
psychiatric and medical standards, and that information concerning
drug dosages, schedules, and routes of administration is accurate at the
time of publication and consistent with standards set by the U.S. Food
and Drug Administration and the general medical community. As
medical research and practice continue to advance, however, therapeutic
standards may change. Moreover, specific situations may require a
specific therapeutic response not included in this book. For these reasons
and because human and mechanical errors sometimes occur, we
recommend that readers follow the advice of physicians directly
involved in their care or the care of a member of their family.
Books published by American Psychiatric Association Publishing
represent the findings, conclusions, and views of the individual authors
and do not necessarily represent the policies and opinions of American
Psychiatric Association Publishing or the American Psychiatric
Association.
If you wish to buy 50 or more copies of the same title, please go to
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Copyright © 2020 American Psychiatric Association Publishing
ALL RIGHTS RESERVED
First Edition
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Library of Congress Cataloging-in-Publication Data
Names: Levounis, Petros, editor. | Yarbrough, Eric, 1979– editor. |
American Psychiatric Association, issuing body.
Title: Pocket guide to LGBTQ mental health : understanding the
spectrum of gender and sexuality / edited by Petros Levounis, Eric
Yarbrough.
Description: First edition. | Washington, D.C. : American Psychiatric
Association Publishing, [2020] | Includes bibliographical references
and index.
Identifiers: LCCN 2020007953 (print) | LCCN 2020007954 (ebook) |
ISBN 9781615372751 (paperback ; alk. paper) | ISBN 9781615373109
(ebook)
Subjects: MESH: Sexual and Gender Minorities—psychology | Sexual
Behavior | Sexuality | Gender Identity | Counseling—methods |
Handbook
Classification: LCC RC451.4.G39 (print) | LCC RC451.4.G39 (ebook) |
NLM WM 34 | DDC 616.890086/6—dc23
LC record available at https://lccn.loc.gov/2020007953
LC ebook record available at https://lccn.loc.gov/2020007954
British Library Cataloguing in Publication Data
A CIP record is available from the British Library.
Contents
Contributors . . . . . . . . . . . . . . . . . vii
Preface: LGBTQ2IAPA . . . . . . . . . . .ix
1
Lesbian: The L in LGBTQ2IAPA . . . .1
Daena L. Petersen, M.D., M.P.H., M.A.
Mary E. Barber, M.D.
Nix Zelin, M.D.
Eric Yarbrough, M.D.
2
Gay: The G in LGBTQ2IAPA . . . . . .17
Ahmad A. Mohammad, M.D., M.A.
Eric Yarbrough, M.D.
3
Bisexual: The B in LGBTQ2IAPA. . .47
Sarah Noble, D.O.
4
Transgender:
The T in LGBTQ2IAPA . . . . . . . . . .61
Murat Altinay, M.D.
5
Queer:
The First Q in LGBTQ2IAPA . . . . . .87
Sam Marcus, M.A.
E.K. Breitkopf, M.A.
6
Questioning:
The Second Q in LGBTQ2IAPA . . . 109
Mark Joseph Messih, M.D., M.Sc.
7
Intersex:
The I in LGBTQ2IAPA . . . . . . . . .127
Adrian Jacques H. Ambrose, M.D., M.P.H., FAPA
8
Asexual:
The First A in LGBTQ2IAPA . . . . . 145
Selale Gunal
Petros Levounis, M.D., M.A.
9
Pansexual:
The P in LGBTQ2IAPA. . . . . . . . .159
Victoria Formosa, L.C.S.W.
10
Ally:
The Second A in LGBTQ2IAPA . . . 177
Angeliki Pesiridou, M.D.
Serena M. Chang, M.D.
Index. . . . . . . . . . . . . . . . . . . . .189
Contributors
Murat Altinay, M.D.
Assistant Professor of Medicine and Staff Psychiatrist, Cleve-
land Clinic Foundation, Cleveland, Ohio
Adrian Jacques H. Ambrose, M.D., M.P.H., FAPA
Child and Adolescent Psychiatrist, Massachusetts General
Hospital, Harvard Medical School, Boston, Massachusetts
Mary E. Barber, M.D.
Clinical Assistant Professor, Columbia College of Physicians
and Surgeons, New York, New York
E.K.Breitkopf, M.A.
Doctoral candidate, The New School for Social Research,
New York, New York
Serena M. Chang, M.D.
Associate Director of Psychiatry, Callen-Lorde Community
Health Center; Clinical Assistant Professor, Department of
Psychiatry and Department of Child and Adolescent Psychi-
atry, New York University, New York, New York
Victoria Formosa, L.C.S.W.
Psychotherapist, Behavioral Health Department, Callen
Lorde Community Health Center, New York, New York
Selale Gunal
Senior, Hunter College High School; American Museum of
Natural History Brown Scholar, New York, New York
Petros Levounis, M.D., M.A.
Professor and Chair, Department of Psychiatry, Rutgers New
Jersey Medical School; Chief of Service, University Hospital,
Newark, New Jersey
Sam Marcus, M.A.
Doctoral candidate, The New School for Social Research,
New York, New York
vii
Mark Joseph Messih, M.D., M.Sc.
Child and Adolescent Psychiatry Fellow, University of Roch-
ester Medical Center, Rochester, New York
Ahmad A. Mohammad, M.D., M.S.
Resident Physician, Maimonides Medical Center, New York,
New York
Sarah Noble, D.O.
Medical Director, Outpatient Behavioral Health Einstein
Medical Center, Philadelphia, Pennsylvania
Angeliki Pesiridou, M.D.
Director of Psychiatry, Callen-Lorde Community Health
Center, New York, New York
Daena L. Petersen, M.D., M.P.H., M.A.
Psychiatric Services Director of HIV Psychiatry and Gender
and Sexuality, Berkeley County Mental Health Center, South
Carolina Department of Mental Health; Staff Psychiatrist,
Berkeley Community Mental Health Center, Moncks Corner,
South Carolina
Eric Yarbrough, M.D.
Private practice, New York, New York
Nix Zelin, M.D.
Founding member and vice president of the Northeast Stu-
dent Queer Alliance, Moraga, California
Disclosures
The following contributors have indicated that they have no finan-
cial interests or other affiliations that represent or could appear to
represent a competing interest with the contributions to this book:
Adrian Jacques H. Ambrose, M.D.; E.K. Breitkopf, M.A.; Ser-
ena M. Chang, M.D.; Victoria Formosa, L.M.S.W.; Petros
Levounis, M.D., M.A.; Sam Marcus, M.A.; Mark Joseph
Messih, M.D., M.Sc.; Eric Yarbrough, M.D.
viii Pocket Guide to LGBTQ Mental Health
Preface
LGBTQ2IAPA
What an acronym!
What are all these letters doing up there? What do they
even mean? Are human beings really all that diverse? Well,
yes. And probably much more than what this alphabet soup
implies and what we have included in the little volume that
you are now holding in your hands.
The purpose of this book is to help clinicians (as well as
patients, parents, teachers, students, administrators, and
anyone else who is interested in how humans operate) mas-
ter the fundamentals of sexual orientation and gender iden-
tity. Building on our previous American Psychiatric
Association Publishing books (Petros was the lead editor of
The LGBT Casebook, with Jack Drescher and Mary Barber, back
in 2012, and Eric wrote the Transgender Mental Health text-
book in 2018), we have put together a pocket guide to the
wonderful world of gender and human sexuality.
For this new edition, we have asked experts in the field of
LGBTQ mental health to reflect on both the scientific litera-
ture and their own clinical experience in order to end up with
a volume that aims to be informative, practical, and easy to
read. The book is organized, very simply, in 10 chapters: les-
bians, gay men, bisexuals, transgender people, queers, ques-
tioning people, intersex people, asexuals, pansexuals, and
allied heterosexuals. Some chapters overlap because it is pos-
sible for one individual to identify with several of these iden-
tities. Each chapter begins with the psychological and
cultural context of that particular facet of human sexuality,
which includes history and definitions, as well as the twenty-
first-century reality of the people who identify with the title
of the chapter. We then address questions that well-meaning
people may ask: What would patients, their friends, their
parents, their physicians like to know about being X, Y, or Z?
Finally, we discuss some common themes that may emerge in
counseling and psychotherapy with LGBTQ2IAPA people.
ix
