# 2.4.4: Inequality Based on Sexual Orientation

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LEARNING OBJECTIVES

1. Understand the behavioral, psychological, and health effects of bullying and other mistreatment of the LGBT community.
2. Evaluate the arguments for and against same-sex marriage.
3. Provide three examples of heterosexual privilege.

Until just a decade ago, individuals who engaged in consensual same-sex relations could be arrested in many states for violating so-called sodomy laws. The US Supreme Court, which had upheld such laws in 1986, finally outlawed them in 2003 in Lawrence v. Texas, 539 US 558, by a 6–3 vote. The majority opinion of the court declared that individuals have a constitutional right under the Fourteenth Amendment to engage in consensual, private sexual activity.

Despite this landmark ruling, the LGBT community continues to experience many types of problems. In this regard, sexual orientation is a significant source of social inequality, just as race/ethnicity, gender, and social class are sources of social inequality. We examine manifestations of inequality based on sexual orientation in this section.

## Bullying and Violence

The news story that began this chapter concerned the reported beatings of two gay men. Bullying and violence against adolescents and adults thought or known to be gay or lesbian constitute perhaps the most serious manifestation of inequality based on sexual orientation. According to the Federal Bureau of Investigation (2011),Federal Bureau of Investigation. (2011). Crime in the United States, 2010. Washington, DC: Author. 1,277 hate crimes (violence and/or property destruction) against gays and lesbians occurred in 2010, although this number is very likely an underestimate because many hate crime victims do not report their victimization to the police. An estimated 25 percent of gay men have been physically or sexually assaulted because of their sexual orientation (Egan, 2010),Egan, P. J. (2010, spring). Within reach: Reducing LGBT inequality in the age of Obama. Pathways: A Magazine on Poverty, Inequality, and Social Policy, 22–25. and some have been murdered. Matthew Shepard was one of these victims. He was a student at the University of Wyoming in October 1998 when he was kidnapped by two young men who tortured him, tied him to a fence, and left him to die. When found almost a day later, he was in a coma, and he died a few days later. Shepard’s murder prompted headlines around the country and is credited with winning public sympathy for the problems experienced by the LGBT community (Loffreda, 2001).Loffreda, B. (2001). Losing Matt Shepard: Life and politics in the aftermath of anti-gay murder. New York, NY: Columbia University Press.

Gay teenagers and straight teenagers thought to be gay are very often the targets of taunting, bullying, physical assault, and other abuse in schools and elsewhere (Denizet-Lewis, 2009).Denizet-Lewis, B. (2009, September 27). Coming out in middle school. New York Times Magazine, p. MM36ff. Survey evidence indicates that 85 percent of LGBT students report being verbally harassed at school, and 40 percent report being verbally harassed; 72 percent report hearing antigay slurs frequently or often at school; 61 percent feel unsafe at school, with 30 percent missing at least one day of school in the past month for fear of their safety; and 17 percent are physically assaulted to the point they need medical attention (Kosciw, Greytak, Diaz, & Bartkiewicz, 2010).Kosciw, J. G., Greytak, E. A., Diaz, E. M., & Bartkiewicz, M. J. (2010). The 2009 national school climate survey: The experiences of lesbian, gay, bisexual and transgender youth in our nation’s schools. New York, NY: Gay, Lesbian and Straight Education Network.

The bullying, violence, and other mistreatment experienced by gay teens have significant educational and mental health effects. The most serious consequence is suicide, as a series of suicides by gay teens in fall 2010 reminded the nation. During that period, three male teenagers in California, Indiana, and Texas killed themselves after reportedly being victims of antigay bullying, and a male college student also killed himself after his roommate broadcast a live video of the student making out with another male (Talbot, 2010).Talbot, M. (2010, October 25). Pride and prejudice. The New Yorker. Retrieved from http://www.newyorker.com.

In other effects, LGBT teens are much more likely than their straight peers to skip school; to do poorly in their studies; to drop out of school; and to experience depression, anxiety, and low self-esteem (Mental Health America, 2011).Mental Health America. (2011). Bullying and gay youth. Retrieved from http://www.nmha.org/index.cfm?objectid=CA866DCF-1372-4D20-C8EB26EEB30B9982. These mental health problems tend to last at least into their twenties (Russell, Ryan, Toomey, Diaz, & Sanchez, 2011).Russell, S. T., Ryan, C., Toomey, R. B., Diaz, R. M., & Sanchez, J. (2011). Lesbian, gay, bisexual, and transgender adolescent school victimization: implications for young adult health and adjustment. Journal of School Health, 81(5), 223–230. According to a 2011 report by the Centers for Disease Control and Prevention (CDC), LGBT teens are also much more likely to engage in risky and/or unhealthy behaviors such as using tobacco, alcohol, and other drugs, having unprotected sex, and even not using a seatbelt (Kann et al., 2011).Kann, L., Olsen, E. O. M., McManus, T., Kinchen, S., Chyen, D., Harris, W. A., et al. (2011). Sexual Identity, Sex of Sexual Contacts, and Health-Risk Behaviors Among Students in Grades 9–12—Youth Risk Behavior Surveillance, Selected Sites, United States, 2001–2009. Morbidity and Mortality Weekly Report, 60(June 10), 1–133. Commenting on the report, a CDC official said, “This report should be a wake-up call. We are very concerned that these students face such dramatic disparities for so many different health risks” (Melnick, 2011).Melnick, M. (2011, June 6). CDC: Why gay and bisexual teens are more likely to risk their health. Time. Retrieved from http://healthland.time.com/2011/2006/2006/cdc-gay-and-bisexual-teens-are-more-likely-to-risk-their-health/.

Ironically, despite the bullying and other mistreatment that LBGT teens receive at school, they are much more likely to be disciplined for misconduct than straight students accused of similar misconduct. This disparity is greater for girls than for boys. The reasons for the disparity remain unknown but may stem from unconscious bias against gays and lesbians by school officials. As a scholar in educational psychology observed, “To me, it is saying there is some kind of internal bias that adults are not aware of that is impacting the punishment of this group” (St. George, 2010).St. George, D. (2010, December 6). Gay and lesbian teens are punished more at school, by police, study says. The Washington Post. Retrieved from http://www.washingtonpost.com/wp-dyn/content/article/2010/12/06/AR2010120600035.html.

Children And Our Future

The Homeless Status of LGBT Teens

Many LGBT teens are taunted, bullied, and otherwise mistreated at school. As the text discusses, this mistreatment affects their school performance and psychological well-being, and some even drop out of school as a result. We often think of the home as a haven from the realities of life, but the lives of many gay teens are often no better at home. If they come out (disclose their sexual orientation) to their parents, one or both parents often reject them. Sometimes they kick their teen out of the home, and sometimes the teen leaves because the home environment has become intolerable. Regardless of the reason, a large number of LGBT teens become homeless. They may be living in the streets, but they may also be living with a friend, at a homeless shelter, or at some other venue. But the bottom line is that they are not living at home with a parent.

The actual number of homeless LGBT teens will probably never be known, but a study in Massachusetts of more than 6,300 high school students was the first to estimate the prevalence of their homelessness using a representative sample. The study found that 25 percent of gay or lesbian teens and 15 percent of bisexual teens are homeless in the state, compared to only 3 percent of heterosexual teens. Fewer than 5 percent of the students in the study identified themselves as LGB, but they accounted for 19 percent of all the homeless students who were surveyed. Regardless of their sexual orientation, some homeless teens live with a parent or guardian, but the study found that homeless LGBT teens were more likely than their heterosexual counterparts to be living without a parent.

Being homeless adds to the problems that many LGBT teens already experience. Regardless of sexual orientation, homeless people of all ages are at greater risk for victimization by robbers and other offenders, hunger, substance abuse, and mental health problems.

The study noted that LGBT teen homelessness may be higher in other states because attitudes about LGBT status are more favorable in Massachusetts than in many other states. Because the study was administered to high school students, it may have undercounted LGBT teens, who are more likely to be absent from school.

These methodological limitations should not obscure the central message of the study as summarized by one of its authors: “The high risk of homelessness among sexual minority teens is a serious problem requiring immediate attention. These teens face enormous risks and all types of obstacles to succeeding in school and are in need of a great deal of assistance.”

Sources: Connolly, 2011; Corliss, Goodenow, Nichols, & Austin, 2011Connolly, C. (2011, July 21). 1 in 4 gay/lesbian high school students are homeless. EurekaAlert. Retrieved September 8, 2011, from http://www.eurekalert.org/pub_releases/2011-07/chb-1i4072111.php; Corliss, H. L., Goodenow, C. S., Nichols, L., & Austin, S. B. (2011). High burden of homelessness among sexual-minority adolescents: Findings from a representative Massachusetts high school sample. American Journal of Public Health, 101, 1683–1689.

## Employment Discrimination

Federal law prohibits employment discrimination based on race, nationality, sex, or religion. Notice that this list does not include sexual orientation. It is entirely legal under federal law for employers to refuse to hire LGBT individuals or those perceived as LGBT, to fire an employee who is openly LGBT or perceived as LGBT, or to refuse to promote such an employee. Twenty-one states do prohibit employment discrimination based on sexual orientation, but that leaves twenty-nine states that do not prohibit such discrimination. Employers in these states are entirely free to refuse to hire, fire, or refuse to promote LGBT people (openly LGBT or perceived as LGBT) as they see fit. In addition, only fifteen states prohibit employment discrimination based on gender identity (transgender), which leaves thirty-five states in which employers may practice such discrimination (Human Rights Campaign, 2011).Human Rights Campaign. (2011). Laws: Employment non-discrimination act. Retrieved September 5, 2011, from http://www.hrc.org/.

The Employment Non-Discrimination Act (ENDA), which would prohibit job discrimination based on sexual orientation or gender identity, has been proposed in Congress but has not come close to passing. In response to the absence of legal protection for LGBT employees, many companies have instituted their own policies. As of March 2011, 87 percent of the Fortune 500 companies, the largest 500 corporations in the United States, had policies prohibiting sexual orientation discrimination, and 46 percent had policies prohibiting gender identity discrimination (Human Rights Campaign, 2011).Human Rights Campaign. (2011). Laws: Employment non-discrimination act. Retrieved September 5, 2011, from http://www.hrc.org/.

National survey evidence shows that many LGBT people have, in fact, experienced workplace discrimination (Sears & Mallory, 2011).Sears, B., & Mallory, C. (2011). Documented evidence of employment discrimination & its effects on LGBT people. Los Angeles, CA: Williams Institute. In the 2008 GSS, 27.1 percent of LGB respondents said they had been verbally harassed at work during the past five years, and 7.1 percent said they had been either fired or not hired during the same period (SDA, 2008).SDA. (2008). GSS 1972–2010 cumulative datafile. Retrieved from http://sda.berkeley.edu/cgi-bin/hsda?harcsda+gss10. In other surveys that are not based on nationally representative samples, the percentage of LGB respondents who report workplace harassment or discrimination exceeds the GSS’s figures. Not surprisingly, more than one-third of LGB employees say they conceal their sexual orientation in their workplace. Transgender people appear to experience more employment problems than LGB people, as 78 percent of transgender respondents in one study reported some form of workplace harassment or discrimination. Scholars have also conducted field experiments in which they send out resumes or job applicants to prospective employers. The resumes are identical except that some mention the applicant is LGB, while the others do not indicate sexual orientation. The job applicants similarly either say they are LGB or do not say this. The LGB resumes and applicants are less likely than their non-LGB counterparts to receive a positive response from prospective employers.

LGBT people who experience workplace harassment and discrimination suffer in other ways as well (Sears & Mallory, 2011).Sears, B., & Mallory, C. (2011). Documented evidence of employment discrimination & its effects on LGBT people. Los Angeles, LA: Williams Institute. Compared to LGBT employees who do not experience these problems, they are more likely to have various mental health issues, to be less satisfied with their jobs, and to have more absences from work.

APPLYING SOCIAL RESEARCH

How Well Do the Children of Same-Sex Couples Fare?

Many opponents of same-sex marriage claim that children are better off if they are raised by both a mother and a father and that children of same-sex couples fare worse as a result. As the National Organization for Marriage (National Organization for Marriage, 2011)National Organization for Marriage. (2011). Same-sex marriage: Answering the toughest questions. Retrieved September 8, 2011, from http://www.nationformarriage.org/site/c.omL2KeN0LzH/b.4475595/k.566A/Marriage_Talking_Points.htm. states, “Two men might each be a good father, but neither can be a mom. The ideal for children is the love of their own mom and dad. No same-sex couple can provide that.”

Addressing this contention, social scientists have studied the children of same-sex couples and compared them to the children of heterosexual parents. Although it is difficult to have random, representative samples of same-sex couples’ children, a growing number of studies find that these children fare at least as well psychologically and in other respects as heterosexual couples’ children.

Perhaps the most notable published paper in this area appeared in the American Sociological Review, the preeminent sociology journal, in 2001. The authors, Judith Stacey and Timothy J. Biblarz, reviewed almost two dozen studies that had been done of same-sex couples’ children. All these studies yielded the central conclusion that the psychological well-being of these children is no worse than that of heterosexual couples’ children. As the authors summarized this conclusion and its policy implications, “Because every relevant study to date shows that parental sexual orientation per se has no measurable effect on the quality of parent-child relationships or on children’s mental health or social adjustment, there is no evidentiary basis for considering parental sexual orientation in decisions about children’s ‘best interest.’”

Biblarz and Stacey returned to this issue in a 2010 article in the Journal of Marriage and the Family, the preeminent journal in its field. This time they reviewed almost three dozen studies published since 1990 that compared the children of same-sex couples (most of them lesbian parents) to those of heterosexual couples. They again found that the psychological well-being and social adjustment of same-sex couples’ children was at least as high as those of heterosexual couples’ children, and they even found some evidence that children of lesbian couples fare better in some respects than those of heterosexual couples. Although the authors acknowledged that two parents are generally better for children than one parent, they concluded that the sexual orientation of the parents makes no difference overall. As they summarized the body of research on this issue: “Research consistently has demonstrated that despite prejudice and discrimination children raised by lesbians develop as well as their peers. Across the standard panoply of measures, studies find far more similarities than differences among children with lesbian and heterosexual parents, and the rare differences mainly favor the former.”

This body of research, then, contributes in important ways to the national debate on same-sex marriage. If children of same-sex couples indeed fare well, as the available evidence indicates, concern about these children’s welfare should play no part in this debate.

## Same-Sex Marriage

Same-sex marriage has been one of the most controversial social issues in recent years. Nearly 650,000 same-sex couples live together in the United States (Gates, 2012).Gates, G. J. (2012). Same-Sex Couples in Census 2010: Race and Ethnicity. Williams Institute. Retrieved May 29, 2012, from http://williamsinstitute.law.ucla.edu/wp-content/uploads/Gates-CouplesRaceEthnicity-April-2012.pdf. Many of them would like to marry, but most are not permitted by law to marry. In May 2012, President Obama endorsed same-sex marriage.

We saw earlier that a narrow margin of Americans now favors the right of same-sex couples to marry, and that public opinion in favor of same-sex marriage has increased greatly in recent times. As of June 2012, same-sex marriage was legal in seven states (Connecticut, Iowa, Maryland, Massachusetts, New Hampshire, New York, Vermont, and Washington) and the District of Columbia. Nine other states permitted same-sex couples to form civil unions or domestic partnerships, which provide some or many of the various legal benefits that married spouses enjoy. In the remaining thirty-five states, same-sex couples may not legally marry or form civil unions or domestic partnerships. The federal Defense of Marriage Act (DOMA), passed in 1996 (and under legal dispute at the time of this writing), prohibits federal recognition of same-sex marriage. This means that even when same-sex couples legally marry because their state allows them to, they do not enjoy the various federal tax, inheritance, and other benefits that married couples enjoy. Most of the states that do not allow same-sex marriage also have laws that prohibit recognition of same-sex marriages performed in the states that allow them.

Arguments against same-sex marriage. Opponents of same-sex marriage make at least three central points (Emrich, 2009; National Organization for Marriage, 2011).Emrich, B. (2009, September 2). Same-sex marriage would be harmful to society. Bangor Daily News. Retrieved from http://bangordailynews.com/2009/2009/2001/opinion/samesex-marriage-would-be-harmful-to-society/; National Organization for Marriage. (2011). Marriage talking points. Retrieved September 5, 2011, from http://www.nationformarriage.org/site/c.omL2KeN0LzH/b.4475595/k.566A/Marriage_Talking_Points.htm. First, and in no particular order, marriage is intended to procreate the species, and same-sex couples cannot reproduce. Second, the children that same-sex couples do have through adoption or artificial means experience various psychological problems because their parents are gay or lesbian and/or because they do not have both a father and a mother. Third, allowing gays and lesbians to marry would undermine the institution of marriage.

Arguments for same-sex marriage. In reply, proponents of same-sex marriage make their own points (Barkan, Marks, & Milardo, 2009; Human Rights Campaign, 2009).Barkan, S., Marks, S., & Milardo, R. (2009, September 22). Same-sex couples are families, too. Bangor Daily News. Retrieved from http://www.bangordailynews.com/detail/121751.html; Human Rights Campaign. (2009). Answers to questions about marriage equality. Washington, DC: Human Rights Campaign. First, many heterosexual couples are allowed to marry even though they will not have children, either because they are not able to have them, because they do not wish to have them, or because they are beyond childbearing age. Second, studies show that children of same-sex couples are at least as psychologically healthy as the children of opposite-sex couples (see Note ABOVE "Children and Our Future"). Third, there is no evidence that legalizing same-sex marriage has weakened the institution of marriage in the few states and other nations that have legalized it (see Note BELOW "Lessons from Other Societies").

LESSONS FROM OTHER SOCIETIES

Same-Sex Marriage in the Netherlands

At the time of this writing, same-sex marriage was legal in ten nations: Argentina, Belgium, Canada, Iceland, the Netherlands, Norway, Portugal, Spain, South Africa, and Sweden. All these nations have legalized it since 2001, when the Netherlands became the first country to do so. Because more than a decade has passed since this notable event, it is informative to examine how, if at all, legalization has affected the lives of gays and lesbians and the institution of marriage itself in the Netherlands.

One thing is clear: There is no evidence that the institution of marriage in the Netherlands has in any respect become weaker because same-sex couples have been allowed to marry since 2001. Heterosexual couples continue to marry, and the institution appears at least as strong as it was before 2001. It also seems clear that same-sex marriages are working and that same-sex married couples’ unions are accepted as normal features of contemporary Dutch life. As Vera Bergkamp, a gay rights leader in the Netherlands said, “Gay marriage is Holland’s best export because we have shown that it is possible.”

In an interesting development, same-sex couples have not exactly rushed to marry. There was an initial spurt in 2001, and many such couples have married since. However, the Dutch government estimates that only 20 percent of same-sex couples have married compared to 80 percent of heterosexual couples.

Three reasons may account for this disparity. First, there is less pressure from family and friends for same-sex couples to marry than for heterosexual couples to marry. As Bergkamp put it, “For heterosexuals, it’s normal when you’re in a steady relationship for more than a year, that a lot of people start asking, ‘well when are you getting married?’ With two women or two men you don’t get that yet.” Second, fewer same-sex couples than heterosexual couples decide to marry in order to have children. Third, gays and lesbians in the Netherlands are thought to be somewhat more individualistic than their heterosexual counterparts.

The same-sex couples who have married in the Netherlands seem happy to have done so, at least according to anecdotal evidence. As one same-sex spouse reflected on her marriage, “It was a huge step. For me it was incredible…I’d been to my brother’s wedding and my sister’s wedding and their spouses were welcomed into the family. Now finally I was able to have my family take my partner in. The moment we got married there was a switch, she was now one of us.”

The experience of the Netherlands is mirrored in the other nine nations that have legalized same-sex marriage. Legalization seems to be working from all accounts, and the institution of marriage seems to be thriving at least as well as in other nations. As the first openly gay member of the Dutch parliament who played a key role in legalization wryly described its outcome, “Heterosexual couples did not turn away from the institution of marriage, and nor did the world isolate my country. After the Netherlands acted, civilization as we know it didn’t end.” As the United States continues to debate same-sex marriage, it has much to learn from the Netherlands and the other nations that have legalized this form of marriage.

Sources: Ames, 2011; Badgett, 2009; Dittrich, 2011Ames, P. (2011, April 20). Dutch gays don’t take advantage of opportunity to marry. GlobalPost. Retrieved from http://www.globalpost.com/dispatch/news/regions/europe/benelux/110419/netherlands-gay-rights-same-sex-marriage; Badgett, M. V. L. (2009). When gay people get married: What happens when societies legalize same-sex marriage. New York, NY: New York University Press; Dittrich, B. O. (2011, April 17). Gay marriage’s diamond anniversary: After the Netherlands acted, civilization as we know it didn’t end. Los Angeles Times. Retrieved from http://articles.latimes.com/2011/apr/17/opinion/la-oe-dittrich-gay-marriage-20110417.

Although the children of same-sex couples fare at least as well as those of heterosexual couples, it is still difficult in many states for same-sex couples to adopt a child. Two states at the time of this writing, Mississippi and Utah, prohibit adoptions by same-sex couples, but half of the other states make it very difficult for these adoptions to occur (Tavernise, 2011).Tavernise, S. (2011, July 14). Adoptions rise by same-sex couples, despite legal barriers. New York Times , p. A11. For example, in some states social workers are required to prefer married heterosexual couples over same-sex couples in adoption decisions. Moreover, several states require that a couple must be married to be adopted; in these states, a single gay or lesbian may adopt, but not a same-sex couple. Still, adoptions by same-sex couples have become more numerous in recent years because of the number of children waiting for adoption and because public opinion about gays and lesbians has become more favorable.

### Costs of the Illegality of Same-Sex Marriage

Marriage provides many legal rights, benefits, and responsibilities for the two spouses. Because same-sex couples are not allowed to marry in most states and, even if they do marry, are currently denied federal recognition of their marriage, they suffer materially in numerous ways. In fact, there are more than 1,000 federal rights that heterosexual married couples receive that no married same-sex couple is allowed to receive (Shell, 2011).Shell, A. (2011, July 22). Legal gay marriage doesn’t end money headaches. USA Today. Retrieved from http://www.usatoday.com/money/perfi/index.

We have space here to list only a few of the many costs that the illegality of same-sex marriage imposes on same-sex couples who cannot marry and on the same-sex couples whose marriages are not federally recognized (Human Rights Campaign, 2009):Human Rights Campaign. (2009). Answers to questions about marriage equality. Washington, DC: Author.

• Spouses have visitation rights if one of them is hospitalized as well as the right to make medical decisions if one spouse is unable to do so; same-sex couples do not have these visitation rights.
• Same-sex couples cannot file joint federal tax returns or joint state tax returns (in the states that do not recognize same-sex marriage), potentially costing each couple thousands of dollars every year in taxes they would not have to pay if they were able to file jointly.
• Spouses receive Social Security survivor benefits averaging more than $5,500 annually when a spouse dies; same-sex couples do not receive these benefits. • Many employers who provide health insurance coverage for the spouse of an employee do not provide this coverage for a same-sex partner; when they do provide this coverage, the employee must pay taxes on the value of the coverage. • When a spouse dies, the surviving spouse inherits the deceased spouse’s property without paying estate taxes; the surviving partner of a same-sex couple must pay estate taxes. Notice that many of these costs are economic. It is difficult to estimate the exact economic costs of the illegality of same-sex marriage, but one analysis estimated that these costs can range from$41,000 to as much as \$467,000 over the lifetime of a same-sex couple, depending on their income, state of residence, and many other factors (Bernard & Leber, 2009).Bernard, T. S., & Leber, R. (2009, October 3). The high price of being a gay couple. New York Times, p. A1.

## Military Service

LGBT individuals traditionally were not permitted to serve in the US military. If they remained in the closet (hid evidence of their sexual orientation), of course, they could serve with impunity, but many gays and lesbians in the military were given dishonorable discharges when their sexual orientation was discovered. Those who successfully remained in the closet lived under continual fear that their sexual orientation would become known and they would be ousted from the military.

As a presidential candidate in 1992, Bill Clinton said he would end the ban on LGBT people in the military. After his election, his intention to do so was met with fierce opposition by military leaders, much of the Congress, and considerable public opinion. As a compromise, in 1993 the government established the so-called don’t-ask, don’t-tell (DADT) policy. DADT protected members of the military from being asked about their sexual orientation, but it also stipulated that they would be discharged from the military if they made statements or engaged in behavior that indicated an LGBT orientation. Because DADT continued the military ban on LGBT people, proponents of allowing them to serve in the military opposed the policy and continued to call for the elimination of any restrictions regarding sexual orientation for military service.

In response to a lawsuit, a federal judge in 2010 ruled that DADT was unconstitutional. Meanwhile, Barack Obama had also called for the repeal of DADT, both as a presidential candidate and then as president. In late 2010, Congress passed legislation repealing DADT, and President Obama signed the legislation, which took effect in September 2011. Official discrimination against gays and lesbians in the military has thus ended, and they may now serve openly in the nation’s armed forces. It remains to be seen, however, whether they will be able to serve without facing negative experiences such as verbal and physical abuse.

## Physical and Mental Health

It is well known that HIV (human immunodeficiency virus) and AIDS (acquired immunodeficiency syndrome) racked the LGBT community beginning in the 1980s. Many gays and lesbians eventually died from AIDS-related complications, and HIV and AIDS remain serious illnesses for gays and straights alike. An estimated 1.2 million Americans now have HIV, and about 35,000 have AIDS. Almost 50,000 Americans are diagnosed with HIV annually, and more than half of these new cases are men who have had sex with other men. Fortunately, HIV can now be controlled fairly well by appropriate medical treatment (Centers for Disease Control and Prevention, 2011).Centers for Disease Control and Prevention. (2011). Basic information about HIV and AIDS. Retrieved Septembr 6, 2011, from http://www.cdc.gov/hiv/topics/basic/index.htm.

It is less well known that LGBT adults have higher rates than straight adults of other physical health problems and also of mental health problems (Frost, Lehavot, & Meyer, 2011; Institute of Medicine, 2011).Frost, D. M., Lehavot, K., & Meyer, I. H. (2011). Minority stress and physical health among sexual minorities. Los Angeles, CA: Williams Institute; Institute of Medicine. (2011). The health of lesbian, gay, bisexual, and transgender people: Building a foundation for better understanding. Washington, DC: National Academies Press. These problems are thought to stem from the stress that the LGBT community experiences from living in a society in which they frequently encounter verbal and physical harassment, job discrimination, a need for some to conceal their sexual identity, and lack of equal treatment arising from the illegality of same-sex marriage. We saw earlier that LGBT secondary school students experience various kinds of educational and mental health issues because of the mistreatment they encounter. By the time LGBT individuals reach their adult years, the various stressors they have experienced at least since adolescence have begun to take a toll on their physical and mental health.

Because stress is thought to compromise immune systems, LGBT individuals on the average have lower immune functioning and lower perceived physical health than straight individuals. Because stress impairs mental health, they are also more likely to have higher rates of depression, loneliness, low self-esteem, and other psychiatric and psychological problems, including a tendency to attempt suicide (Sears & Mallory, 2011).Sears, B., & Mallory, C. (2011). Documented evidence of employment discrimination & its effects on LGBT people. Los Angeles, LA: Williams Institute. Among all LGBT individuals, those who have experienced greater levels of stress related to their sexual orientation have higher levels of physical and mental health problems than those who have experienced lower levels of stress. It is important to keep in mind that these various physical and mental health problems do not stem from an LGBT sexual orientation in and of itself, but rather from the experience of living as an LGBT individual in a homophobic (disliking LGBT behavior and individuals) society.

Despite the health problems that LGBT people experience, medical students do not learn very much about these problems. A recent survey of medical school deans found that one-third of medical schools provide no clinical training about these health issues, and that students in the medical schools that do provide training still receive only an average of five hours of training (Obedin-Maliver et al., 2011).Obedin-Maliver, J., Goldsmith, E. S., Stewart, L., White, W., Tran, E., Brenman, S., et al. (2011). Lesbian, gay, bisexual, and transgender–related content in undergraduate medical education. JAMA, 306(9), 971–977. The senior author of the study commented on its findings, “It’s great that a lot of schools are starting to teach these topics. But the conversation needs to go deeper. We heard from the deans that a lot of these important LGBT health topics are completely off the radar screens of many medical schools” (White, 2011).White, T. (2011). LGBT health issues not being taught at medical schools, Stanford study finds. EurekaAlert. Retrieved September 7, 2011, from http://www.eurekalert.org/pub_releases/2011-09/sumc-lhi083111.php.

## Heterosexual Privilege

In earlier chapters, we discussed the related concepts of white privilege and male privilege. To recall, simply because they are white, whites can go through their daily lives without worrying about or experiencing the many kinds of subtle and not-so-subtle negative events that people of color experience. Moreover, simply because they are male, men can go through their daily lives without worrying about or experiencing the many kinds of subtle and not-so-subtle negative events that women experience. Whether or not they are conscious of it, therefore, whites and men are automatically privileged compared to people of color and women, respectively.

An analogous concept exists in the study of sexual orientation and inequality. This concept is heterosexual privilege, which refers to the many advantages that heterosexuals (or people perceived as heterosexuals) enjoy simply because their sexual orientation is not LGBT. There are many such advantages, and we have space to list only a few:

• Heterosexuals can be out day or night or at school or workplaces without fearing that they will be verbally harassed or physically attacked because of their sexuality or that they will hear jokes about their sexuality.
• Heterosexuals do not have to worry about not being hired for a job, about being fired, or not being promoted because of their sexuality.
• Heterosexuals can legally marry everywhere in the United States and receive all the federal, state, and other benefits that married couples receive.
• Heterosexuals can express a reasonable amount of affection (holding hands, kissing, etc.) in public without fearing negative reactions from onlookers.
• Heterosexuals do not have to worry about being asked why they prefer opposite-sex relations, being criticized for choosing their sexual orientation, or being urged to change their sexual orientation.
• Heterosexual parents do not have to worry about anyone questioning their fitness as parents because of their sexuality.
• Heterosexuals do not have to feel the need to conceal their sexual orientation.
• Heterosexuals do not have to worry about being accused of trying to “push” their sexuality onto other people.

PEOPLE MAKING A DIFFERENCE

Improving the Family Lives of LGBT Youth

Many organizations and agencies around the country aim to improve the lives of LGBT teens. One of them is the Family Acceptance Project (FAP) at San Francisco State University, which focuses on the family problems that LGBT teens often experience. According to its website, FAP is “the only community research, intervention, education and policy initiative that works to decrease major health and related risks for [LGBT] youth, such as suicide, substance abuse, HIV and homelessness—in the context of their families. We use a research-based, culturally grounded approach to help ethnically, socially and religiously diverse families decrease rejection and increase support for their LGBT children.”

To accomplish its mission, FAP engages in two types of activities: research and family support services. In the research area, FAP has published some pioneering studies of the effects of school victimization and of family rejection and acceptance on the physical and mental health of LGBT teens during their adolescence and into their early adulthood. In the family support services area, FAP provides confidential advice, information, and counseling to families with one or more LGBT children or adolescents, and it also has produced various educational materials for these families and for professionals who deal with LGBT issues. At the time of this writing, FAP was producing several documentary videos featuring LGBT youth talking about their family situations and other aspects of their lives. Its support services and written materials are available in English, Spanish, and Cantonese.

Through its pioneering efforts, the Family Acceptance Project is one of many organizations making a difference in the lives of LGBT youth. For further information about FAP, visit http://familyproject.sfsu.edu.

KEY TAKEAWAYS

• Bullying, taunting, and violence are significant problems for the LGBT community.
• LGBT people are at greater risk for behavioral and physical and mental health problems because of the many negative experiences they encounter.
• Federal law does not protect LGBT individuals from employment discrimination.
• The children of same-sex couples fare at least as well as children of heterosexual couples.