The word "gay" can be applied to men and women equally. Nevertheless, when referring to female homosexuality, "gay" is often replaced with "lesbian." It might seem unnecessarily cumbersome to use a pair of words, "gay and lesbian," when just one word would suffice. Unlike references to "gays," however, which could include homosexual women as well as homosexual men, references to "gays and lesbians" are explicit about including women.

While it is more inclusive than "gay," the label "gay and lesbian" does not reflect the full range of alternatives to heterosexuality. Given the popular misconception that bisexuality is a temporary identity that people eventually overcome, either by fully committing to homosexuality or by fully committing to heterosexuality, it is especially important to assert bisexuality as a sexuality distinct from both homosexuality and heterosexuality. In order to encompass a broader range of identities and issues, references to alternative sexualities often include the phrase "gay, lesbian, and bisexual." A drawback of this phrase is that it is longer and somewhat more awkward than "gay" or even "gay and lesbian," hence the abbreviation "GLB." Recognizing that women always seem to come second, some people prefer to rearrange the order the letters, "LGB," symbolically putting women ahead of men.

The recent addition of yet another identity category gives us the now familiar list, "GLBT" or "LGBT," with "T" representing "transgender." This is distinct from the related term "transsexual." Whereas "sex" refers to physiology, "gender" refers to masculine and feminine characteristics that are acquired through socialization. We might therefore assume that transsexuals are people who have altered their bodies to occupy a different sex category, male or female, than they were assigned to at birth. Although "transsexual" is usually reserved for those who complete such a transition through surgical procedures and hormone treatments, some people who identify as transsexual do not pursue medical intervention. Ultimately, individuals make subjective decisions concerning the path of their own transformations. Those who have not yet completed the surgical transition from male-to-female (MTF) or from female-to-male (FTM), but intend to do so, often identify as "preoperative transsexuals" or as "transitioning" MTFs and FTMs. Some people who conform to this brief description, and could therefore identify as transsexual, choose instead to identify as "transgender." The fundamental difference between "transsexual" and "transgender," like the difference between "sex" and "gender," is that the former is concerned with bodies while the latter is concerned with behaviors and attitudes. Thus, "transsexual" refers to a person who has the inner experience of belonging to one sex despite having been born into a body that conforms to the other sex. In contrast, "transgender" often implies a criticism of the system of categorization that expects human beings to fall unambiguously into just one sex category, male or female, and to conform to the corresponding gender category, masculine or feminine. Some who identify as transsexual endorse this system, at least indirectly, through their commitment to and participation in exactly one of the two available categories. Some who identify as transgender, however, reject the system by refusing to participate in just one of the available categories.

The distinction between transsexual and transgender is complicated by the fact that those who identify as transsexual are not always accepted by others as members of their chosen sex category, while those who identify as transgender are sometimes accepted as relatively unproblematic members of just one sex category. The distinction is complicated even further by the fact that, just as those who identify as transsexual do not always pursue surgical or hormonal intervention, those who identify as transgender occasionally do. This suggests that the decision someone makes between identifying as transsexual and identifying as transgender reveals as much about that person's critical stance toward existing definitions of sex and gender categories as it reveals about anything else. Unlike "gay," "lesbian," and "bisexual," neither "transgender" nor "transsexual" are concerned with sexual partner choice. The inclusion of transgender issues in discussions of alternative sexualities is not altogether arbitrary, however. Many gays, lesbians, and bisexuals experience discrimination and violence for deviating from accepted sexual norms, and this is no less true for those who are transgender and transsexual. Gay, lesbian, bisexual, and transgender identities all challenge the widespread expectation that biological males and females should exhibit the specific collection of attitudes and behaviors that our social history has assigned to each sex category, and that they should partner only with biological members of the opposite sex and corresponding gender categories.

Finally, it is worth noting the occasional addition of "Q" to the list of alternative sexualities. In some cases, "Q" is short for "questioning," and this addition suggests that sexual identities develop over time, perhaps as the result of experimentation or exploration. In other cases, "Q" stands for queer, and this addition serves as a "catch all" for any remaining sexualities with which people might identify. More often, however, "queer" stands alone, and this usage replaces the effort to catalogue the complete range of alternatives to mainstream sexuality. This is not merely a form of shorthand. It carries an implicit assumption, first, that sexuality is far too diverse to be articulated in the form of a comprehensive list and, second, that the existing terms establish a contrast between "homosexual" (or "gay and lesbian") and "heterosexual" (or "straight") which obscures the inherent diversity of sexuality while inadvertently affirming heterosexuality as the norm.

Taken literally, "queer" is used to describe something as odd or unusual. When we recognize that sexuality is unique to each and every individual, it is difficult to imagine that there would be many among us with sexualities that are not odd or unusual in some way or another. This invites us to think about sexuality in a way that no longer grants priority to heterosexuality, but instead regards as queer even some people who might otherwise be expected to identify as heterosexual. The point of this shift is not to allow heterosexuals to claim homosexual identities if they decide they can gain some advantage by doing so. Instead, the point is to shift the balance of power, at least symbolically, by acknowledging that far more of us are queer than not.