The National Medical Association is the organization that represented the interests of the 35,000 Black physicians in the USA. It is over 100 years old, and was founded because there was a time when Black physicians were not allowed to join the other medical associations. Times have changed, but the NMA continues to be a giant force in American politics. NMA 2007 conference was held in Honolulu. One of the outstanding presentations was given by Dr. Yolanda Wimberly from Morehouse. She basically reviewed gender issues in adolescent medicine. A summary is given below.
First, sexual orientation refers to an individual’s pattern of physician and emotional arousal toward other persons. These basic categories include heterosexual, l homosexual (including gay and lesbian), and bi-sexual. Sexual orientation is a combination of influences that include hormonal, genetic, and environmental. Whether sexual orientation is a choice remains debatable. The real debate evolves around environmental factors. Adolescents who are raped and molested during childhood can be greatly influenced and often will seek drugs to drown out their past, many young women become obese or hypersexual, and many young men develop effeminate tendencies. The lack of a male role model in the home may lead to further confusion but no study has been done . There is no evidence to show that sexual orientation is influenced by parenting.
Gender identity differs from sexual orientation. Gender identity is the knowledge of oneself as being male, female or other. Gender expression is the outward expression of one’s gender. Gender identity usually conforms to the anatomic l sex in both heterosexual and homosexual individuals. Those whose anatomic sex does not match their gender identity may be called transgender.
Within transgenderism are trans-sexuals, individuals who have had or in the process of planning sexual reassignment surgery; Androgynies or persons whose behavior combines both genders or is gender neutral; Intersexuals are persons born with sex chromosomes, external genitalia, or an internal reproductive system not standard for either male or female. Transgender persons are often described as male to female, or female to male, and usually recognized by the sex they currently identify.
Awareness of gender identity occurs early. Children become conscious of the differences between genders between ages 1 and 2; by age 3 they can label themselves and by age 4 their identity is stable. Transgender persons often report conflict over gender assignment throughout childhood and adolescence.
And last it is important to realize that identity and behavior may be different, that is, sexual orientation and gender identity are not always synonymous with sexual activity. Many men who engage in sexual acts with men do not identify as being gay, or even homosexual. Likewise, many women who engage in sex with other women do not identify as being gay or lesbian. Furthermore individuals do not need to be sexually active to identify as being gay, lesbian, bisexual, or transgender.
When interviewed at the OASIS Clinic, male clients who had been infected from having sex with another male were asked if they identified as being gay. Only 12 percent of Black males said they identified as being gay all the time, an additional 24 percent said sometimes, 37 per cent preferred homosexual, 8 percent said same gender loving, and over 30 per cent preferred no term. They simply engaged in sex with someone of their gender. We commonly refer to these men as “closeted” . The next issue will address some of the dynamics of closeted men.