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not to the extreme. Soft butch women have a more
androgynous appearance. Stone butch women tend to
be masculine in appearance and may dislike any vaginal
penetration themselves. It is common to see a femme
woman partnered with a butch, but other pairings are not
unusual. These roles may not be all-encompassing: some
women identify with the saying "butch in the streets,
femme between the sheets."

It can be tempting to try to impose the structures of

typical heterosexual relationships on same-sex pairings,
looking for the "man" and the "woman." While some
same-sex couples identify with this paradigm, many do not,
and will be extremely offended if you make assumptions
regarding their roles.

Bisexuals or bi's are sexually attracted to both men

and women. There are political forces that impel people
to either embrace or deny the term bisexual; as one
woman told me, "I have sex with both men and women,
but mostly women, so that makes me a lesbian."

Many people engage in bisexual behavior without

identifying as bisexuals. Just because your patient states
that s/he is heterosexual or gay does not mean that s/he
does not have sex with a gender other than his or her
usual choice.

Do not assume that bisexuals are always non-

monogamous; bisexuality is a matter of identity and
attraction, not necessarily of behavior.

Men who like lesbians are called dyke daddies, but

sometimes this term is used instead to mean butches
and transgendered women interested in daddy/boy play.
Heterosexual women who like gay men are called fag hags