their sex designation in official documentation and records, encouraging appropriate pronoun use, and obtaining appropriate medical services" (Levy et al., 2015; Parco et al., 2015a, 2015b). Another challenge that they face is transphobia, which is "the intense dislike or prejudice against transsexual or transgender people" (Hill & Willoughby). Criticism Criticism of LGBTQ+ culture comes from a variety of sources, much of which is critique from within the community itself. Some, like Michael Musto, view the culture as conforming to caricatures or stereotypes that alienate "fringe" members of the community. Mattilda Bernstein Sycamore and movements like Gay Shame have argued that LGBT culture has been depoliticized by a tiny minority of relatively privileged queer people, who participate in "institutions of oppression" at the expense of the vast majority of LGBT people. Some consider the very notion of "separatism", or a group lifestyle, alienating (including of LGBTQ+ members in the broader society). Another problem is that bisexual and transsexual/transgender individuals experience social pressure to identify as gay or lesbian, and may face ostracism and discrimination from the mainstream LGBTQ+ culture. For bisexuals, this pressure is known as bisexual erasure. New York University School of Law professor Kenji Yoshino has written, "Gays de-legitimatize bisexuals...the lesbian and gay community abounds with negative images of bisexuals as fence-sitters, traitors, cop-outs, closet cases, people whose primary goal in life is to retain 'heterosexual privilege'". Identity politics Criticism has been made that the LGBTQ+ community represents an artificial separation, rather than one based on tangible customs or ethnic identification. In particular, labels that LGBTQ+ members use to describe themselves vary widely; some simply prefer to identify as loving a particular gender. Some believe that the LGBTQ+-community concept is alienating; the term itself implies estrangement from straight people as a separate group. Further, including three groups involved with sexuality and one group exploring transsexual/transgender identity (a broader phenomenon) is artificial. Mattilda Berstein Sycamore argues that the single-issue focus of LGBT politics, which ignores all intra-group differences, has naturally led to a movement and culture focused on the needs of white, middle-class gay cisgender men, which alienates anyone who does not fit that description. Cultural focus on promiscuity Some gay male commentators who are in monogamous relationships argue that mainstream gay culture's disdain of monogamy and its promotion of promiscuity has harmed efforts to legalize same-sex marriage. Yuvraj Joshi argues that efforts to legalize same-sex marriage have emphasized the