Sexual Minority Women's Gender Identity and Expression: Challenges and Supports

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Sexual Minority Women's Gender Identityand Expression: Challenges and SupportsHeidi M. Levitt a , Julia A. Puckett a , Maria R. Ippolito b & Sharon G.Horne ca Department of Psychology, University of Massachusetts Boston,Boston, Massachusetts, USAb Liverpool, New York, USAc Department of Counseling and School Psychology, University ofMassachusetts Boston, Boston, Massachusetts, USA

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Journal of Lesbian Studies, 16:153–176, 2012Copyright © Taylor & Francis Group, LLCISSN: 1089-4160 print / 1540-3548 onlineDOI: 10.1080/10894160.2011.605009

Sexual Minority Women’s Gender Identityand Expression: Challenges and Supports

HEIDI M. LEVITT and JULIA A. PUCKETTDepartment of Psychology, University of Massachusetts Boston, Boston, Massachusetts, USA

MARIA R. IPPOLITOLiverpool, New York, USA

SHARON G. HORNEDepartment of Counseling and School Psychology, University of Massachusetts Boston,

Boston, Massachusetts, USA

Sexual minority women were divided into four groups to study theirgender identities (butch and femme), and gender expression (tra-ditionally gendered and non-traditionally gendered women whodo not identify as butch or femme). Experiences of heterosexistevents (discrimination, harassment, threats of violence, victim-ization, negative emotions associated with these events), mentalhealth (self esteem, stress, depression), and supports for a sexualminority identity (social support, outness, internalized homopho-bia) were examined across these groups. Findings suggested thatbutch-identified women experienced more heterosexist events thanfemme women or women with non-traditional gender expressions.There were no differences in mental health variables.

KEYWORDS butch, femme, gender identity, gender expression,heterosexist events, sexual minority, minority stress

While the term “sex” is used to refer to biological characteristics, feministstend to define the term “gender” as a cultural construct that typically orga-nizes and designates sets of traits or characteristics to members of differentsexes (e.g., Unger & Crawford, 1993). Within lesbian communities, this samesocial process can categorize members of the same sex into different lesbiangenders—for instance, by differentiating butch and femme lesbians. Like

Address correspondence to Heidi M. Levitt, Department of Psychology, University ofMassachusetts Boston, 100 Morrissey Blvd., Boston, MA 02125. E-mail: [email protected]

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154 H. M. Levitt et al.

heterosexual genders, these genders can function to structure expectationsof personal identity, social interactions, and romantic exchanges within les-bian cultures (e.g., Halberstam, 1998a; Levitt, Gerrish, & Hiestand, 2003;Levitt & Hiestand, 2004).

Although the genders “butch” and “femme” often have been mischarac-terized as imitations of male and female heterosexual genders, these lesbiangender identities can be thought, instead, to transcend and radicalize tradi-tional gender roles (e.g., Feinberg, 1996). From the time butch–femme com-munities first developed in the 1940s and 1950s, butch women stretchedthe image of what being female can mean by appropriating signs ofmasculinity—but without being granted the social and economic powertraditionally afforded to masculine males. Similarly, feminine signifiers infemme women held new meanings as well. By orienting their sexuality to-ward butch women instead of men and by adopting a role of active socialrebellion rather than one of weakness or passivity, femme-ininity took on anew form.

It took courage to be part of these communities and the brutality en-dured by these women also differentiated them from the treatment that tradi-tionally gendered women received during this period (e.g., Faderman, 1991;Lapovsky-Kennedy & Davis, 1993). Lesbian bars were subjected to policeraids and women’s names would be published in the newspaper followingthese raids, which could threaten both the economic security and physicalsafety of these women. Once arrested, women also risked being beaten orraped by police or being targeted for future harassment. And there was nopossibility of anti-discrimination policies or hate-crime legislation that pro-vide some measure of protection today against harassment, discrimination,or violence.

Over the last two decades, there has been a good deal of theoretical,biographical, and creative writing on these lesbian genders and the changingpolitics surrounding them (e.g., Burana & Due, 1994; Butler, 1990; Harris &Crocker, 1997; Halberstam, 1998a; Munt, 1998; Nestle, 1992). Femme andbutch communities virtually disappeared during the late 1960s and 1970s,as the women in the second wave of feminism accused butch women ofclaiming male privilege and femme women of fostering negative femalestereotypes. Butch and femme women during this period either tended towithdraw from the lesbian community or to adopt an androgynous feministaesthetic rather than face expulsion from the community. By the 1980s, how-ever, butch and femme identities were beginning to be reclaimed—emergingnow into post-feminist lesbian communities and a more progressive main-stream culture.

In these communities, gender is increasingly conceptualized as existingalong a continuum or within a sphere (e.g., Spade, 2008). As a result, butchand femme identities tend not to be conceptualized as discrete monolithicgender expressions but as identity terms containing a range of gender expres-sions (e.g., high femme, soft-butch). Butch identity, in particular, is complex

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Sexual Minority Women’s Gender Identity and Expression 155

as it is can be conceptualized as a form of transgender identity (e.g., Feinberg,1996) or as an identity in conflict with female-to-male transgender identity(e.g., Halberstam, 1998b). In either case, however, these identities are ex-pressed using lesbian gender signifiers and are used within communities tostructure women’s ways of conceptualizing gender, their sense of selves, andways of relating and so are meaningful subjects of research. The psycholog-ical research on these modern butch and femme women has been limited,and research focusing on the experiences of harassment, discrimination andviolence for these women has been even more so; however, there is anemerging body of literature on this subject.

BUTCH AND FEMME IDENTITIES, DISCRIMINATION,AND PSYCHOLOGICAL DISTRESS

Levitt and Horne (2002) conducted a survey of 149 adult women withina lesbian community in which women were asked to identify as butch,femme, androgynous or “other.” When asked about discriminatory eventsbased upon their gender expression within heterosexual contexts, butchwomen were found to report higher frequencies than either femme or“other” identified women. Androgynous women reported higher frequen-cies than femme-identified women or “other” identified women. As well,butch women indicated that they became aware of their sexual orientationearlier than femme women (at approximately 15 years of age instead of at22 years), and so were more likely to experience a sense of difference andpossible discrimination during the developmentally challenging period ofadolescence. It may be that this age difference is diminishing for contem-porary butch and femme youth (Rosario, Schrimshaw, & Hunter, 2008), butgender difference may still lead to early bullying and stress. For instance,Wyss’ (2004) qualitative research has documented the terrible distress ofgender non-conforming youth in high schools.

There appear to be different forms of stressors that butch and femmewomen face as well. Hequembourg and Brallier (2009) conducted focusgroups with sexual minority participants and found that women with a mas-culine presentation frequently experienced conflict with heterosexual men,finding these men to be threatened by women’s masculinity. In contrast,feminine women encountered difficulties from heterosexual men when theirsexual orientation identities were questioned because of their physical ap-pearance. Also, feminine women reported that they felt marginalized withinthe lesbian community as well due to their feminine presentations. Thesefindings replicated earlier findings from two grounded theory analyses offemme and butch women (Levitt et al., 2003; Levitt & Hiestand, 2004) thatfound butch women to report much more stranger harassment and femmewomen more sexual harassment.

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This discrimination may extend to physical heath care as well. Hies-tand, Horne, and Levitt (2008) examined experiences of discrimination inhealthcare within a sample of 220 butch- and 296 femme-identified women.Butch women reported poorer treatment within healthcare settings and moredifficulty finding lesbian-affirmative physical healthcare practitioners. Thesedifferences were not replicated for mental health treatment, which appearedto be more supportive of gender atypicality.

Rosario et al. (2008) found that butch women have higher rates of sub-stance abuse than femme women. In addition, this relationship betweengender nonconformity and substance abuse was accounted for by gay re-lated stress, internalized homophobia, and emotional distress. A study bySkidmore, Linsenmeier, and Bailey (2006), however, did not find a link be-tween gender nonconformity and distress in sexual minority women. Thestudy did find a relationship between gender nonconformity and distressin men though and stated that this was likely due to the greater societalacceptance of gender nonconformity in women. Hence, the data on the re-lationship between gender conformity, heterosexist events, and distress forwomen appears conflicted and warranting further investigation.

HETEROSEXIST EVENTS AND THE EFFECTS OF DISCRIMINATIONAND VIOLENCE

Although there is a dearth of research on the effects of harassment, discrim-ination and violence for butch- and femme-identified women, researchershave examined the impact of these experiences for LGB (lesbian, gay, bi-sexual) people more broadly and have documented the high frequenciesat which they occur (e.g., D’Augelli & Grossman, 2001; D’Augelli, Pilk-ington, & Hershberger, 2002; Herek, Cogan, & Gillis, 2002; Herek, Gillis,Cogan, & Glunt, 1997). Because LGB people might be wary of reportingthese events, particularly if they are closeted or if they live in regions wherenon-discrimination policies do not exist or are not enforced, researchershave tended to rely on self-report to assess these experiences. In the largestof such studies, Herek et al. (1999) surveyed 2,259 LGB participants, find-ing that 56% of participants were verbally harassed, 19% threatened, 17%chased/followed, 12% had objects thrown at them, and 5% were spat onin reaction to their sexual orientations. Rates of heterosexist experiencesalso were high in a more recent study by Huebner, Rebchook, and Kege-les (2004) who, in a sample of 1,248 gay and bisexual men, found that37% reported verbal harassment, 11.2% reported discrimination and 4.8% re-ported being victims of physical violence related to their sexual orientation.And in a recent large national sample of ethnically diverse sexual minoritywomen, Morris and Balsam (2003) found that 62.3% had experienced a hate

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crime or had been victimized, 56.6% experienced verbal harassment, 9.2%experienced job loss, 9% had property damaged, and 6.5% were victims ofphysical attacks. In addition, Balsam, Rothblum, and Beauchaine (2005) com-pared 1245 lesbian, gay, and bisexual participants with heterosexual siblingsand found that sexual minority participants experienced more victimization(including physical, psychological, and sexual) during both childhood and asadults.

Minority stress is a concept that was introduced by racial and ethnicminority theorists to understand the additional stressors that these groups en-counter on top of the general stressors that most people face (e.g., Mirowsky& Ross, 1980; 1989). This concept was adopted and developed by Meyer(1995; 2003) to help explain the unique stressors that sexual minority peopleface. Meyer (2003) suggested that factors such as experiences of heterosexistevents, the appraisal of environmental conditions and expectations of het-erosexism, and the internalization of heterosexist values lead to increasedminority stress. As well, he speculated that hiding one’s sexual orientationwould also increase this stress. In contrast, he argued that resilience to minor-ity stress could be increased via both individual resources, such as personalitytraits like hardiness, and group resources, such as being with affirming othersor using affirming services.

Effects of these heterosexist events include higher levels of negativeaffect, internalized homophobia, depression, and stress when compared tonon-victimized LGB people (e.g., Herek et al., 1997; Herek, Gillis, & Co-gan, 1999; Huebner et al., 2004; Szymanski, 2009). Lowered self-esteem andhigher reports of suicidal ideation were other consequences, particularly ifindividuals experienced multiple such incidents (Huebner et al., 2004). Neg-ative psychological effects of these events, such as loneliness, poorer mentalhealth, and lower self-esteem, were stronger if individuals experienced phys-ical attacks as opposed to verbal harassment alone (D’Augelli & Grossman,2001). Experiences of stigmatization, including factors such as discrimina-tion, violence, expectations of rejection, and internalized homophobia, havebeen found to negatively affect the mental and physical health of sexualminority individuals (Meyer & Dean, 1998; Rosario, Rotheram-Borus, & Reid,1996), and to predict psychological distress (Diaz et al., 2001; Hatzenbueler,Nolen-Hoeksema, & Erickson, 2008; Mays & Cochran, 2001; Morris & Bal-sam, 2003). Minority stressors, such as heterosexism, racism and internalizedhomophobia, accounted for a third of the variance in psychological distressfor Asian Americans in another study (Syzmanski & Sung, 2010).

There are a number of characteristics that appear to be associated withincreased likelihood of victimization. Across a number of studies, beingout as LGB to more people or more open about being LGB appears tobe associated with increased victimization (D’Augelli & Grossman, 2001;Herek et al., 1999; Huebner et al., 2004; Smith, 2005) as increased visibil-ity might make individuals more susceptible to heterosexist attacks. Higher

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socioeconomic status has been associated with less victimization, perhapsbecause a higher standard of living can allow one to live in lower crimeareas or to afford more protections against crime, and, correspondingly, un-employment has been associated with greater chance of victimization (Hereket al., 1999; Smith, 2005).

INTERNAL AND EXTERNAL SUPPORTS FOR LGB IDENTITIES

Given the risk of stressors that LGB people face, social supports for LGBpeople and specific support for their sexual orientation might be expectedto act as a needed buffer against minority stress. Three indicators of supportare examined: general social support, level of outness about one’s sexualorientation, and internalized homophobia.

The data on general social support is mixed. For instance, Kuyper andFokkema (2010) found that social support buffered the minority stress ofolder LGB adults. Also Kurdek (1988) found that social support was positivelyassociated with psychological adjustment in gay and lesbian couples andYakushko (2005) found that social support predicted higher self esteemin gay men and lesbian women. In contrast, Syzmanski (2009) found thatalthough self-esteem moderated the relationship between heterosexist eventsand distress in gay and bisexual men, social support did not.

Internalized homophobia is the degree to which a sexual minority per-son internalizes negative sentiment about sexual minorities from generalsociety and suggests that their support for their own sexual orientation islacking. It has been related to increased substance abuse (e.g., Amadio,2006; Meyer & Dean, 1998; Weber, 2008) and psychological distress (e.g.,Igartua, Gill, & Monoro, 2003; Szymanski, 2005; Szymanski & Gupta, 2009).In the present study, the absence of internalized homophobia was conceptu-alized as a form of support for LGB people’s own sexual orientation. A scalemeasuring internalized homophobia (Szymanski & Chung, 2001) was usedthat measured aspects such as connection to an LGB community, personalfeelings about being a sexual minority woman, and public identification as asexual minority woman. These aspects can be seen as internal and externalsupport for one’s sexual minority identity.

Deciding to be open, or out, about one’s sexual orientation also sug-gests a greater level of comfort with one’s sexual orientation as well as beingin a more supportive environment. For instance, Jordan and Deluty (1998)found that, for lesbian women, being more out was associated with less anx-iety, positive affect, greater self-esteem, and higher levels of social support.Rostosky and Riggle (2002) found that, for gay and lesbian couples, beingout at work was positively correlated with both partners’ workplaces havingan anti-discrimination policy and partners endorsing less internalized homo-phobia. Being out also has been associated with lower psychological distress

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that, in turn, was related with lower suicidality (Morris, Waldo, & Rothblum,2001) although also associated with higher incidents of direct heterosexistevents (e.g., Waldo, 1999).

THE CURRENT STUDY

Because masculine gender expression can be read by others as a sign of alesbian sexual orientation, sexual minority women may be outed by the waytheir appearance is read. The researchers hypothesized that having a non-traditional gender expression would increase vulnerability to heterosexistexperiences and would be associated with increased psychological distress.Similarly, it was hypothesized that having a feminine gender expressionmight be associated with less experiences of heterosexism and distress, asa woman might be less recognizably lesbian. We thought that having abutch gender identity, however, might offer a connection to butch–femmelesbian community that offers social support for gender expression diver-sity and alleviates internalized homophobia as well as some psychologicaldistress when compared to women with nontraditional genders who lackthis identity. Finally, we hypothesized that femme women’s connection tobutch–femme community would offer sexual minority supports that femininewomen without this identity might lack.

METHOD

Participants

The current study was part of a large, online study completed by 1,084 sexualminority women from the United States and Canada. The data included in thisstudy came from the 909 participants who either (1) identified their genderas butch or femme, or (2) rated their gender expression as being more butchor femme as opposed to completely androgynous (see Measures section:Gender Identity and Expression). Participants were recruited by advertisingthe survey on various LGB listservs, bulletin boards, and websites; and effortswere made to obtain a racially and regionally diverse set of respondents. Toparticipate, women had to be at least 18 years of age (M = 31.9 years; SD =10.3), born female, and identify as female (n = 834; 91.7%) or transgenderbut not male (n = 75; 8.3%). Participants who identified as transgender werenot excluded from the sample because some sexual minority women viewbutch as a transgender identity. Participants identified their sexual orientationprimarily as lesbian (597; 65.7%), and some identified as bisexual (n = 234;25.7%), women loving women (n = 28; 3.1%) or ‘other’ (n = 50; 5.5%). SeeTable 1 for additional demographic information.

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TABLE 1 Demographic Information

n %

Racial/ethnic backgroundCaucasian 718 79Black/African American 38 4.2Jewish 45 5Latina 31 3.4Asian/Asian American 21 2.3Native American/Indigenous Canadian 8 0.9Biracial or Multiracial 44 4.9

Education levelSome high school or high school diploma 57 6.3Vocational school or some college 332 36.5Bachelor’s degree 249 27.4Advanced degree 271 29.8

IncomeLess than $30,000 280 30.8$30,000–$60,000 307 33.8Greater than $60,000 322 35.4

Measures

GENDER IDENTITY AND EXPRESSION

The items assessing gender identity and expression were created for thepurposes of this study. One item assessed participants’ gender identities byasking “How would you describe yourself?” with the following options: butch(soft butch, boi, stone, etc.), femme (high femme, etc.), androgynous (kiki,etc), or none. Most participants identified as femme (n = 320, 35.2%), andothers identified as butch (n = 243, 26.7%), androgynous (n = 111, 12.2%),or none (n = 235, 25.9%). In a separate question, participants rated theirgender expression. This item was worded as follows: “The term butch refersto feeling comfortable with a gender expression style typically consideredmore masculine and the term femme refers to feeling comfortable with agender expression style typically considered more feminine. With this inmind, please answer the following question: Even if I don’t identify as butchor femme, on a butch–femme scale from 0–10, I would rate myself as” andparticipants were provided with an 11-point Likert-type scale where 0 meantmost butch, 5 meant androgynous, and 10 meant most femme. Participantswere considered to have a nontraditional gender expression if they ratedthemselves anywhere from 0 to 4; they were considered to have a traditionalgender expression if they rated themselves anywhere from 6 to 10. For thosewomen who did not identify as butch or femme on the gender identityquestion, 129 (37.3%) scored on the nontraditionally gendered end of thegender expression scale and 217 (62.7%) scored on the traditionally genderedend of the gender expression scale. Using this data, the participants weredivided into four groups: those who self-identified as (1) butch; (2) femme; or

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who did not identify as butch or femme and rated their gender expression as(3) nontraditional (on the butch end of the gender expression continuum);or (4) traditional (on the femme end of the gender expression continuum).

GENDER NON-CONFORMITY

This 16-item measure was adapted from the Boyhood Gender ConformityScale (BGCS; Hockenberry & Billingham, 1987) and assessed participants’identification with a traditionally masculine (gender non-conforming) or fem-inine gender role in childhood. The measure included statements such as “Iliked rough-and-tumble play” and “I liked dolls.” Participants were askedto reflect upon their childhoods and indicate how frequently they identifiedwith each statement. Items were measured on a 7-point scale ranging from1 (never) to 7 (always). Items that described traditionally feminine activitieswere reverse-coded before item scores were summed. Therefore, participantswith a higher score on this measure indicated a greater degree of gendernon-conformity. Cronbach’s alpha based upon responses to this scale was.87 and scores ranged from 23 to 107 (M = 64.86, SD = 16.43).

SELF-ESTEEM

The 10-item Rosenberg Self-Esteem Scale (Rosenberg, 1989) was used toassess participants’ levels of global self-esteem, or general evaluations oftheir self-worth without regard to specific areas of their lives. For each item,participants read a statement and rated it on a 4-point scale where 1 indicatedthat they strongly agree and 4 indicated that they strongly disagree with thestatement. Items included both positive self-evaluations such as, “I feel thatI have a number of good qualities,” and negative self-evaluations such as, “Iam inclined to feel like a failure.” Responses to negative items were reverse-coded and final scores were calculated by adding participants’ ratings foreach item (lower scores indicated lower levels of self-esteem). Cronbach’salpha based upon responses to this scale was .91 and scores ranged from 10to 38 (M = 17.41, SD = 5.53).

PERCEIVED STRESS

The 4-item version of the Perceived Stress Scale (PSS; Cohen, Kamarck, &Mermelstein, 1983; Cohen & Williamson, 1988) was used to measure par-ticipants’ general stress levels. For each item, participants read a statementreflecting general experiences of high or low stress (two items each). Foreach statement they rated how frequently, within the past month, they ex-perienced similar sentiments with scores ranging from 1 (very often) to 5(never). The two questions reflecting low stress experiences were reverse

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coded before adding to calculate a final score; and lower scores on thismeasure indicated higher levels of perceived stress. Cronbach’s alpha basedupon responses to this scale was .84 and scores ranged from 4 to 20 (M =13.63, SD = 3.18).

DEPRESSION

Depression levels were measured using the Center for Epidemiologic StudiesDepression Scale–Revised (CES-D Revised; Andresen, Malmgren, Carter, &Patrick, 1994). This instrument is a revised version of Radloff’s (1977) Centerfor Epidemiological Studies Depression Scale (CES-D). This revised versionincluded 10 items that describe thoughts and behaviors common to depres-sive symptomatology. Participants rated each item on a 4-point Likert scaleto indicate how often they experienced each symptom in the past week. Re-sponses ranged from 1 (none to less than one day) to 4 (five to seven days).A scale score was created by summing participants’ responses, with higherscores indicating more frequent experiences of depressive symptomatology.Cronbach’s alpha based upon responses to this scale was .90 and scoresranged from 10 to 40 (M = 17.78, SD = 6.84).

VICTIMIZATION BY BIAS-MOTIVATED OFFENSES AND THEIR EFFECTS

A series of questions were adapted from a survey conducted by Herek andBerrill (1990) to assess participants’ experiences of violence and victimizationdue to their sexual orientation. Items addressing experiences of threats ofviolence, actual violence, discrimination, crime victimization, and negativeemotional experiences associated with victimization were examined sepa-rately for the purposes of this study and are described separately below.Participants were asked to answer all of the following items in reference totheir experiences in the last year. When participants did not indicate that aform of victimization had occurred their response was coded as “0.”

Frequency of Threats of Violence. Participants were asked to indicatethe frequency with which they had been threatened with violence due totheir sexual orientation. This stem was presented three times followed bythree frequency options, for a total of three items (i.e., (1) You were threat-ened with violence once, (2) You were threatened with violence twice, and (3)You were threatened with violence three or more times). Response optionswere no or yes. Scores were then transformed to reflect the number of expe-riences of threats the participant endorsed experiencing (with a 3 indicating3 or more experiences of threats). Scores ranged from 0 to 3 (M = 0.10,SD = 0.47).

Frequency of Violence. Participants were asked to indicate the fre-quency with which they had been threatened, insulted, spat at, chased, orhad things thrown at them. This stem was presented three times followed by

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three frequency options (occurred once, twice, or three or more times) fora total of 15 questions. Response options were no or yes. Scores were thentransformed to indicate the frequency with which the participant endorsedhaving the above experiences. Scores ranged from 0 to 12 (M = 1, SD = 1.61).

Discrimination. Participants were asked to indicate the types of dis-crimination they had experienced due to their sexual orientation. They wereasked: (1) You were discriminated against in a job, (2) You were discrimi-nated against in housing, and (3) You were discriminated against in publicservices. Response options were no or yes. A scale score was created by tal-lying the number of positive responses and higher scores indicated havingexperienced discrimination in more areas. Scores ranged from 0 to 3 (M =0.28, SD = 0.62).

Victimization. Participants were asked to indicate the forms of vic-timization they experienced due to their sexual orientation, including rape,physical attack, robbery, theft, vandalism, witnessing a murder, or attemptsof physical or sexual assault. A scale score was created by tallying the num-ber of experiences participants endorsed having and higher scores indicatedhaving experienced more forms of victimization. Scores ranged from 0 to 5(M = 0.11, SD = .50).

Negative Emotion. Participants were asked to indicate the kinds ofnegative emotions (e.g., depression, anxiety, sleep disturbances, increasedvigilance, and fear) they experienced due to being harassed or discriminatedagainst based upon their sexual orientation. This scale included 14 items.A scale score was created by tallying the number of negative experiencesand emotions the participants endorsed having and higher scores indicatedhaving more negative emotions. Cronbach’s alpha based upon responses tothis scale was .81 and scores ranged from 0 to 14 (M = 1.48, SD = 2.27).

SOCIAL SUPPORT

The Multidimensional Scale of Perceived Social Support (MSPSS; Zimet,Dahlem, Zimet, & Farley, 1988) is composed of 12 items assessing the over-all social support of participants. Questions included items addressing socialsupport from family, friends, and significant others. Items were measured ona 5-point Likert scale ranging from 1 (strongly agree) to 5 (strongly disagree).A scale score was created by summing the responses to the 12 items. Higherscores indicated higher amounts of social support received from individualsin the participant’s life. Cronbach’s alpha based upon responses to this scalewas .89 and scores ranged from 12 to 60 (M = 23.63, SD = 8.27).

OUTNESS

Participants’ levels of outness were assessed using one item asking “I amout to:” with the following response options: no one (1), a select few people

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(2), some friends only (3), some friends and family (4), almost all friendsand family (5), and all friends and family (6). Higher scores indicated higherlevels of outness, meaning that more people knew of the participant’s sexualorientation. Scores ranged from 1 to 6 (M = 4.91, SD = 1.17).

INTERNALIZED HOMOPHOBIA

The Lesbian Internalized Homophobia Scale (LIHS; Szymanski & Chung,2001) is a 52-item scale used to assess the level of internalized homophobiaparticipants have across five dimensions. The original version of this scalewas slightly modified for the purposes of this study. Because participantsincluded a variety of sexual minority women, including women who identi-fied as lesbian, bisexual, and woman-loving-woman, participants were toldto interpret the scale as it would apply to their own sexual orientation iden-tities. Each item was rated on a 7-point Likert scale from 1 (strongly agree)to 7 (strongly disagree). A scale score was created for each subscale by av-eraging responses and higher scores indicated higher levels of internalizedhomophobia.

The first subscale of the LIHS consists of 13 items measuring connec-tion with the LGB community. Cronbach’s alpha based on responses to thissubscale was .82 and scores ranged from 1.46 to 6.08 (M = 2.99, SD = 0.88).The second subscale consists of 19 items measuring public identification asa sexual minority woman. Cronbach’s alpha based upon responses to thissubscale was .92 and scores ranged from 1 to 5.94 (M = 2.33, SD = 1.09).The third subscale consists of eight items measuring personal feelings aboutbeing a sexual minority woman. Cronbach’s alpha based upon responses tothis subscale was .85 and scores ranged from 1 to 6.88 (M = 1.64, SD = 0.82).The fourth subscale consists of seven items measuring moral and religiousattitudes towards homosexuality. Cronbach’s alpha based upon responsesto this subscale was .79 and scores ranged from 1 to 7 (M = 1.36, SD =0.60). The fifth subscale consists of five items measuring attitudes towardsother sexual minority women. Cronbach’s alpha based upon responses tothis subscale was .86 and scores ranged from 1 to 6.13 (M = 2.00, SD =0.94).

RESULTS

Gender Expression and Nonconformity

A one-way between-groups ANOVA was conducted to see if differences ex-isted between the four groups’ gender expressions (butch-identified, femme-identified, neither-identity non-traditionally gendered, neither-identity tradi-tionally gendered). There was a statistically significant difference for gender

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expression across the four groups: F (3, 905) = 481.971, p < .001. The ef-fect size, calculated using eta squared, was .615 which is a large effect size(Cohen, 1988). Post-hoc comparisons using the Tukey HSD test indicatedthat butch women (M = 3.407, SD = 2.127) were significantly different fromfemme women (M = 7.65, SD = 1.573) but the comparisons between butchand nontraditionally gendered women and between femme and traditionallygendered women were not significantly different. Of course, nontradition-ally gendered women (M = 3.45, SD = .884) had different means from thetraditionally gendered women (M = 6.751, SD = .795) as these groups werecategorized using the values on this same scale. There were larger differ-ences between butch and femme women (mean difference of –4.24) thanthere were between nontraditionally gendered and traditionally genderedwomen (mean difference of –3.30).

Another one-way between-groups ANOVA was conducted to examinedifferences between the groups on gender nonconformity. There was a sta-tistically significant difference for gender nonconformity across the groups:F (3, 884) = 169.51, p < .001. The effect size, eta squared, was .36, whichis a large effect size. Tukey HSD post-hoc comparisons revealed that allfour groups were significantly different from each other, with butch womenhaving the most gender nonconformity (M = 78.92, SD = 12.74), followedby nontraditionally gendered women (M = 71.30, SD = 13.01), traditionallygendered women (M = 60.41, SD = 12.97), and lastly femme women (M =54.85, SD = 13.51) with the least gender nonconformity.

Experiences of Heterosexism

In the remaining MANOVA analyses, effect sizes were calculated usingpartial eta squared (η2

p) with the following cutoffs: small = .01, medium =.06, and large = .138 (Cohen, 1988). A one-way MANOVA was conductedto compare the four groups on experiences of heterosexism revealing asignificant multivariate main effect, Wilks’ λ = .945, F (15, 2159.16) = 3.007,p <.001, η2

p = .019. This was accompanied by significant univariate effectsfor experiences of violence, F (3, 786) = 6.009, p < .001, η2

p = .022, threats ofviolence, F (3, 786) = 4.718, p = .003, η2

p = .018, discrimination, F (3, 786) =6.803, p < .001, η2

p = .025, victimization, F (3, 786) = 7.594, p < .001, η2p =

.028, and negative emotions, F (3, 786) = 4.401, p = .004, η2p = .017.

Tukey post-hoc tests showed that butch identified women experiencedmore violence and threats of violence than both femme identified women(p = .002, p = .015, respectively) and traditionally gendered women (p =.003, p = .004, respectively). The results approached significance (p = .064)for butch identified women experiencing more threats of violence than non-traditionally gendered women. Butch identified women also experiencedmore discrimination and victimization than femme identified (p < .001 for

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TABLE 2 Group Means and Standard Deviations for Experiences of Heterosexism

Nontrad Traditional ButchID FemmeIDVariable M (SD) M (SD) M (SD) M (SD)

Experiences of Violence 1.12ab (1.80) 0.77b (1.18) 1.31a (1.83) 0.80b (1.40)Discrimination 0.66ab (0.99) 0.51b (0.93) 0.92a (1.13) 0.52b (0.85)Threats of Violence 0.08ab (0.38) 0.05b (0.28) 0.22a (0.69) 0.08b (0.47)Negative Emotions 1.77ab (2.48) 1.36ab (2.28) 1.83a (2.64) 1.15b (1.76)Victimization 0.31ab (0.58) 0.18b (0.58) 0.43a (0.84) 0.18b (0.52)

Nontrad = nontraditionally gendered women; Traditional = traditionally gendered women. Means sharinga common subscript are not statistically different at the p < .05 level according to Tukey post-hoc tests.

both) and traditionally gendered women (p = .003, p = .001, respectively).Additionally, butch identified women experienced more negative emotionsdue to experiences of heterosexism than femme identified women (p =.006). The results approached significance (p = .066) for nontraditionallygendered women experiencing more negative emotions than femme identi-fied women. Means and standard deviations for these analyses are availablein Table 2. The percentages of women within each comparison group whoexperienced each category of heterosexism are included in Table 3. This de-scriptive data reveals that butch identified women have higher percentagesfor the majority of experiences of heterosexism categories.

TABLE 3 Group and Overall Percentages for Experiences of Heterosexism

Variable Nontrad Traditional ButchID FemmeID Overall

Threatened 5.1% (6) 4.1% (8) 11.4% (24) 5.9% (16) 6.8% (54)Insulted 44% (52) 36.3% (70) 50.2% (106) 38.7% (104) 42% (332)Spat at 3.4% (4) 1.6% (3) 3.3% (7) 0.7% (2) 2% (16)Chased 5.1% (6) 3.1% (6) 8.1% (17) 4.5% (12) 5.2% (41)Things Thrown At 3.4% (4) 1.6% (3) 6.6% (14) 3% (8) 3.7% (29)Housing Discrim 6.8% (8) 5.2% (10) 11.4% (24) 4.1% (11) 6.6% (52)Employment Discrim 15.4% (18) 12.4% (24) 20.4% (43) 10.8% (29) 14.43% (114)Public Service Discrim 6% (7) 4.1% (8) 11.4% (24) 4.5% (12) 6.5% (51)Physically Attacked 3.4% (4) 3.6% (7) 8.1% (17) 3% (8) 4.6% (36)Sexually Assaulted 5.1% (6) 1.6% (3) 3.3% (7) 3% (8) 3.04% (24)Robbed 0.9% (1) 0 0.5% (1) 0 0.2% (2)Property Stolen 0.9% (1) 0.5% (1) 3.8% (8) 1.5% (4) 1.8% (14)Property Vandalized 6% (7) 6.2% (12) 10.9% (23) 4.5% (12) 6.8% (54)Attempt Physical Attack 8.5% (10) 1% (2) 9.5% (20) 2.6% (7) 4.9% (39)Attempt Sexual Assault 2.6% (3) 0.5% (1) 2.4% (5) 1.1% (3) 1.5% (12)Attempt to Steal or

Damage Property0 1.6% (3) 1.4% (3) 0.7% (2) 1% (8)

Nontrad = Nontraditionally gendered; Traditional = Traditionally gendered; Discrim = Discrimination.Numbers in parentheses indicate the number of women within each category that endorsed having thatexperience.

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TABLE 4 Group Means and Standard Deviations for Mental Health


Self-esteem 17.84 (5.58) 17.66 (5.55) 16.97 (5.64) 17.07 (5.28)Perceived Stress 13.69 (3.49) 13.71 (3.28) 13.68 (3.07) 13.71 (3.00)Depression 18.15 (7.30) 17.68 (6.93) 17.91 (6.84) 17.57 (6.61)

Nontrad = nontraditionally gendered women; Traditional = traditionally gendered women. There werenot any statistically significant differences between the groups on these variables.

Mental Health

A one-way MANOVA was conducted to compare the groups on self-esteem,perceived stress, and depression. This analysis did not reveal any significantmain effects for the comparisons between butch identified, femme identified,nontraditionally gendered, and traditionally gendered women (Wilks’ λ =.992, F(9, 1903.33) = 0.734, p = .678, η2

p = .003). The four comparisongroups did not significantly differ in their reported levels of mental health.Means and standard deviations for these analyses are available in Table 4.

Identity Supports

A one-way MANOVA was conducted to compare the four groups on socialsupport, outness, and internalized homophobia (composed of five subscales:connection with LGB community, public identification as a sexual minoritywoman, personal feelings about being a sexual minority woman, moral andreligious attitudes toward homosexuality, and attitudes toward other sexualminority women). Means and standard deviations for these analyses areavailable in Table 5.

The MANOVA revealed a significant multivariate main effect, Wilks’ λ =.904, F (21, 2280.49) = 3.877, p < .001, η2

p = .033. This finding was accom-panied by a significant univariate effect for outness, F (3, 800) = 11.279,p < .001, η2

p = .041, with Tukey post-hoc tests revealing that butch identi-fied women were more out than femme identified women (p < .001) andtraditionally gendered women (p < .001) and that nontraditionally genderedwomen were more out than femme identified women (p = .016). There werealso significant univariate effects for each of the five components of inter-nalized homophobia: connection with LGB community, F (3, 800) = 7.557,p < .001, η2

p = .028, public identification as a sexual minority woman, F (3,800) = 9.836, p < .001, η2

p = .036, personal feelings about being a sexualminority woman, F (3, 800) = 2.83, p = .038, η2

p = .011, moral and religiousattitudes, F (3, 800) = 2.85, p = .037, η2

p = .011, and attitudes toward othersexual minority women, F (3, 800) = 3.185, p = .023, η2

p = .012.

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TABLE 5 Group Means and Standard Deviations for Identity Supports


Social Support 23.63a (7.87) 22.59a (7.37) 24.37a (8.79) 23.10a (7.90)Outness 5.12ac (1.10) 4.82ab (1.23) 5.29c (0.90) 4.75b (1.19)LIH-Connection 3.00ab (0.82) 3.20b (0.94) 2.79a (0.86) 2.99b (0.86)LIH-Public ID 2.13ac (1.00) 2.44ab (1.06) 2.07c (0.99) 2.54b (1.16)LIH-Personal Feelings 1.60ab (0.89) 1.70ab (0.79) 1.51a (0.74) 1.71b (0.86)LIH-Moral and Religious 1.23a (0.54) 1.40a (0.68) 1.32a (0.55) 1.39a (0.57)LIH-Attitudes 1.87a (0.85) 2.09a (0.97) 1.89a (0.85) 2.09a (1.02)

Nontrad = nontraditionally gendered women; Traditional = traditionally gendered women; LIH-Connection = lesbian internalized homophobia-connection with LGB community; LIH-Public ID = les-bian internalized homophobia-public identification as a sexual minority woman; LIH-Personal Feelings =lesbian internalized homophobia-personal feelings about being a sexual minority woman; LIH-Moraland Religious = lesbian internalized homophobia-moral and religious attitudes towards homosexuality;LIH-Attitudes = lesbian internalized homophobia-attitudes towards other sexual minority women. Meanssharing any common subscript letter are not statistically different at the p < .05 level according to Tukeypost-hoc tests.

Although there were significant univariate effects for each of these ar-eas, the post-hoc comparisons only approached significance (p = .057) forfemme identified women and (p = .062) traditionally gendered womenhaving more negative moral and religious attitudes than nontraditionallygendered women. Post-hoc comparisons also revealed that butch identifiedwomen had higher levels of connection to the LGB community than bothfemme identified women (p = .047) and traditionally gendered women (p <

.001). Results approached significance (p = .06) for femme identified womenhaving higher levels of connection than traditionally gendered women. Ad-ditionally, butch identified women had more public identification as sexualminority women than both femme identified women (p < .001) and tradi-tionally gendered women (p = .002), and nontraditionally gendered womenhad more public identification than femme identified women (p = .003).The results approached significance (p = .053) for nontraditionally gen-dered women having more public identification than traditionally genderedwomen. Also, femme identified women had more negative personal feelingsabout being sexual minority women than butch identified women (p = .045).

DISCUSSION

Based on the findings in this study, butch identified women encounter moreexperiences of violence, threats of violence, discrimination, and victimizationthan both femme identified women and traditionally gendered women andmarginally more discrimination and threats of violence than non-traditionallygendered women. In addition, butch women experience more negative

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emotions due to these experiences of heterosexism than femme women.Even though this is the case, there were no significant differences betweenthe four groups examined on the mental health variables of self esteem, per-ceived stress, or depression. Furthermore, butch women were more out andhad more of a connection to the LGB community than femme and tradition-ally gendered women, as well as having higher levels of public identificationas a sexual minority individual. Butch women also had more positive feelingsabout being a sexual minority person than femme women. These findingssuggest that although these women are subject to greater minority stressors,they may utilize more LGB-positive support and are psychologically resilient.

The findings of this study supported the research of Levitt and Horne(2002) by finding that butch women experience more heterosexist eventsthan femme women. Whereas that study looked at women within one com-munity, the current study draws from a national sample (including 814women from 47 states—as well as 95 women from 9 provinces) suggest-ing that this relationship might be more broadly generalized. As well, thesefindings suggest that the more atypical a woman’s gender expression themore heterosexist experiences she is likely to face. This trend was suggestedby the finding that not only did butch women face more heterosexist eventsthan traditionally gendered and femme women (i.e., violence, victimization,discrimination, and threats of violence), but the difference in reports of dis-crimination and threats of violence also approached significance betweenthe groups of butch and non-traditionally gendered women. The followingsections discuss these findings in relation to the workings of minority stressand implications for counseling and advocacy.

The Workings of Minority Stress and Gender Expression

The current research sheds light on how gender expression and noncon-formity interact with minority stress. It suggests that women are at a higherrisk for prejudicial events when their gender expression is less traditional.As described previously, increased experiences of heterosexist events hasbeen associated with higher levels of negative affect, depression, stress, andinternalized homophobia and lower self esteem (e.g., D’Augelli & Grossman,2001; Herek et al., 1997; 1999; Huebner et al., 2004; Syzmanski, 2009). Onthis basis, it might be expected that the mental health of these women wouldbe significantly influenced by the increased exposure to heterosexist events.Findings, however, suggest that there is not any correlation between genderexpression and the mental health factors examined (self esteem, perceivedstress, depression). A factor that might explain this resilience was the findingthat butch-identified and nontraditionally gendered women both appearedto be more visible as sexual minority women (i.e., higher levels of outness,more public identification as a sexual minority women, less negative attitudes

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about being sexual minority women) and so might be able to utilize moreidentity supports that are specifically LGB positive than femme-identifiedand/or traditionally gendered women.

LGB-positive support has been found to buffer potential effects of het-erosexist events in other research. For instance, anti-LGB legislative initiatives(i.e., marriage amendments) have been directly associated with psychologicaldistress (Rostosky et al., 2008), however, Russell and Richard (2003) foundthat support from the LGB community and heterosexual allies was associatedwith resilience in the face of such legislative initiatives. Also, being in a sup-portive environment has been associated with less internalized homophobia(Rostosky & Riggle, 2002). To better assess this theory, however, it wouldbe helpful to use a scale specifically exploring LGB-positive social supportin future research. As well, this study has a correlational design and cannotestablish causality, structural equation modeling or path analytic researchto explore these connections would be worthwhile. It could be helpful tolook at the total number of times heterosexist events were experienced inaddition to the types of events experienced.

It may be that developing a butch identity bolsters these women’s re-silience as well in the face of the increased heterosexist events they reported.In Hiestand and Levitt’s (2005) butch identity development model, beingpart of a butch–femme community was found to help butch women developpride in both their sexual orientations and gender expressions—to see theirgenders as desirable, attractive, and political in nature. These experiencesmight limit the damage from heterosexist events and help them to retain apositive sexual/gender minority identity in spite of the challenges they face.Future research should examine how nontraditionally gendered women whoare not butch-identified come to understand their gender expressions andthe minority stress they experience as linked to their genders.

Implications for Counseling and Advocacy

In general, the use of psychotherapy has been found to be widespreadin the lesbian population, with almost three-quarters of lesbians reportinghaving sought counseling compared to less than one-third of heterosexualwomen (29%; Morgan, 1997), and so it is important for counselors to beknowledgeable about this population. This article suggests that the experi-ences of sexual minority women may not be alike. Counselor training onthe intersection of sexual orientation and gender expression may help ther-apists to understand the different social threats experienced and, potentially,expectations held by gender-nonconforming women.

While atypically gendered participants experienced more types of het-erosexist events than typically gendered women, they also utilized supportresources more heavily. A hopeful finding for therapists is that it does not

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seem that gender atypical sexual minority women are suffering from poorermental health despite the higher incidents of heterosexism. Future researchspecifically on the effects of psychotherapy on resilience in coping withheterosexist events would be useful.

Advocacy efforts have been aimed at establishing anti-discriminationpolicies to protect LGB people against heterosexist acts. Research has shownthat legislative initiatives and protections do influence LGB people’s comfortin being out (Rostosky & Riggle, 2002), which in turn has been associatedwith more positive affect, self esteem (Jordan & Deluty, 1998) and less psy-chological distress (Morris et al., 2001). The findings in this study indicatethat atypically gendered women are at higher risk for experiencing someheterosexist events, suggesting the importance of not only having policiesthat offer protection on the basis of their sexual orientation but on the basisof their gender expression and identities as well.

It seems that legislative protections from gender-related discriminationlag behind protections from sexual orientation-related discrimination. Forinstance the Human Rights Campaign reports that, “As of April 2008, twentystates and the District of Columbia have outlawed employment discriminationbased on sexual orientation, and 12 states and the District of Columbia banit based on gender identity” (Human Right Campaign, n.d.). As gender isoften read as a sign of sexual orientation, it may be that these factors areinseparably intertwined and that legislation on gender discrimination shouldalways be passed along side of laws protecting people from discriminationon the basis of sexual orientation.

This study also suggests that within research that surveys sexual minoritywomen for heterosexist events there might be a gender-atypical subgroupthat faces a disproportionate amount of heterosexism. For instance, look-ing more closely at a few of the items from the scale on bias-motivatedoffenses, although butch women were only 26.7% of the sample they ac-counted for 44% of those who had been threatened, 43% of those who hadbeen chased, and 57% who reported having property stolen. They dispro-portionately faced housing discrimination (46%), employment discrimination(38%) and public services discrimination (47%). Research on heterosexismshould consider including gender expression and gender identity variablesso that analyses stressing the need for protective gender-expression focusedlegislation might continue to accumulate and provide a richer understandingof the complexities within sexual minority communities.

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CONTRIBUTORS

Heidi Levitt, Ph.D., is an Associate Professor in the Clinical Psychology Pro-gram in the Department of Psychology, at the University of MassachusettsBoston. She conducts research that examines the construction and evolutionof gender identities within GLBT cultures as well as research on experiencesof discrimination, oppression, and resiliency for GLBT people. In addition,she conducts psychotherapy research and has a particular interest in commonfactors across psychotherapy orientations. She is a fellow of the AmericanPsychological Association and its Division 29 [Psychotherapy] and has beena recipient of the Carmi Harari Research Award for Inquiry from Division 32[Society for Humanistic Psychology].

Julia A. Puckett earned her Master’s Degree in Clinical Psychology from BarryUniversity and is currently pursuing her doctorate in the Clinical PsychologyProgram at the University of Massachusetts, Boston. She is interested in con-ducting research on experiences of marginalization and oppression in LGBTpopulations and ways that these individuals cope with these experiences.

Maria R. Ippolito earned an M.S. Degree in Psychology and a GraduateCertificate in Women’s and Gender Studies from the University of Memphis.Her research interests include the construction of non-traditional genders and

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issues faced by people of non-traditional genders. As well, she has taughtHuman Sexuality at Columbia College Hancock Field. Her interests also includethe study of languages and currently she is traveling in South America.

Sharon G. Horne, Ph.D., is an Associate Professor in the Department ofCounseling and School Psychology, at the University of Massachusetts, Boston,and she is the Director of Training for the Ph.D. specialization in CounselingPsychology. Her research explores LGBT issues related to policy and legalrights, as well as HIV treatment and prevention. As well, she is an Open SocietyFoundation Academic Fellow working in Kyrgyzstan at American University ofCentral Asia and is a fellow of the American Psychological Association.

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Sexual Minority Women's Gender Identity and Expression: Challenges and Supports

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