LEC 10: Inclusivity, Healthcare, & The LGBT+ Community

Question 1

Each persn has the following identities:

Answer 1

• Sex
  
  • Biological assigned at birth
• Gender
  
  • Socially constructed age 3-4
• Gender expression
  
  • Specific to each person
• Sexual orientation
  
  • Comes into formation around puberty

Question 2

The Societal “Norm”

Answer 2

• Female or Male
  
  • Sex
• Girl/Woman or Boy/Man
  
  • Gender
• Feminine or Masculine
  
  • Gender expression
• Heterosexual
  
  • Sexual orientation

Question 3

Sexual Orientation: Who You Like

Answer 3

• Gay
• Lesbian
• Asexual
• Bisexual
• Pansexual

Question 4

Gay

Answer 4

A non-gendered term for thos who are attracted to the same gender

Question 5

Lesbian

Answer 5

A term for women who are attracted to women

Question 6

Asexual

Answer 6

A term for people who do not experience sexual attraction

Question 7

Bisexual

Answer 7

A person who is attracted to two genders

Question 8

Pansexual

Answer 8

A person who is attracted to people regardless of their gender

Question 9

Gender Identity: Who You Are

Answer 9

• Cisgender
• Transgender
• Two Spirit
• Non-Binary/Genderqueer

Question 10

Cisgender

Answer 10

A term for people who identify with the gender they were assigned with at birht

Question 11

Transgender

Answer 11

A term for people who do not identify with the gender they were assigned at birth. Some trans people will choose to transition while others wont.

Question 12

Two Spirit

Answer 12

A term specific to Indegenous peoples, for those who are gender diverse and gifted with two spirits (masculine and feminie)

Question 13

Non-Binary/ Genderqueer

Answer 13

A term for people whose gender does not fit within the gender binary.

Question 14

Sex: Your Body

Answer 14

• Intersex

Question 15

Intersex

Answer 15

A term for peopel whose sex assigned at birth is ambigous.

Question 16

Queer

Answer 16

• An umbrella term
• A reclaimed term for identities that are seen as “outside the norm” of sexual orientation, gender identity, and sex

Question 17

Experience Related to Gender

Answer 17

1. The patient’s gender becomes the focus of the appoitment rather than the patients actual medical needs
2. The healthcare provider dosen’t respect patient confidentiality
   
   • Doctor/Nurse feelt they must consult with parents/guardians and outs the patient
3. Refusal of care
   
   • Refusing to provide hormones to a trans patient AND refusin to refer them to another doctor who does perscribe hormones
4. Healthcare provider mocks or trivializes the patients gender, pronouns, and/or name
5. The patient’s gender is blamed for their physical or mental health issues
6. Healthcare providers refuses to use the patient’s correct name and correct pronouns

Question 18

Experiences Related to Sexual Orientation

Answer 18

1. Healthcare provider does not respect patient confidentiality
   
   • Outs patient to other healthcare providers
2. Homonegative regarding the patient’s sexual orientation
3. Refusal of care or providing substandard care
4. Indifference or avoidance of the patient’s loved ones
   
   • The patient’s partner is ignored and not given timely updates on their loved ones health or is not allowed visitation rights
5. Healthcare provider views all patients as heterosexual

Question 19

What is at stake?

Answer 19

• Mental health
• Addictions
• Physical health

Question 20

Mental Health

Answer 20

• Compared to the heterosexual and cisgender community, LGBTQ people are at a greater risk of depression, anxiety, and suicidal behaviour
• Compared to heterosexual men, gay and bisexual men have a higher prevalence of eating disorders and body dissatisfaction
• Compared to heterosexual women, lesbians have a lower prevalence of eating disorders and body dissatisfaction
• Transgender people face higher risks of depression, anxiety, and suicidal ideation compared to the rest of the LGBQ community and heterosexual and cisgender community
• 41% of Transgender people attempt to commit suicide vs. %20 – LGBQ vs. 4.6% overall population (Haas, Herman, Rodgers. 2014)

Question 21

Addictions

Answer 21

• LGBTQ people abuse alcohol more than heterosexual and cisgender people
• LGBTQ people are twice as likely to smoke than heterosexual and cisgender people
• 38%-52% of LGBT youth smoke vs. 28%-35% of heterosexual youth
• LGBT people have a higher rate of lifetime use of cocaine, marijuana, ecstasy, and methamphetamine

Question 22

Physical Health

Answer 22

• Lesbians tend to get fewer paps than heterosexual women
• All people with a cervix need to be routinely screened for cervical cancer, which includes trans men
• Lesbians and bisexual women get fewer mammograms
• Gay men have much higher risks of anal cancer
• MSM (men who have sex with men) are at a higher risk of syphilis, HIV, gonorrhea, chlamydia, viral hepatitis, and HPV

Question 23

Why People May Not Come Out to You

Answer 23

1. Fear of reduced or substance care
2. Fear of a confidentiality breach and discrimination
3. Internalized homophobia or transphobia
4. Heteronormative assumption of the part of the caregiver
5. Fear that their disclosure would reinforce anti-LGBT stereotypes

Question 24

Why Patients Need to Come Out

Answer 24

1. To facilitate more appropriate care
2. To identifiy and disclose their own relationships relevant to care
   
   • Same-sex partners
3. To facilitate specific health care needs

Question 25

How to Be Proactive: Actions

Answer 25

1. Examine your own degree of comfort and willingness to learn about sexual orientation and gender identities. Use that as a baseline for a plan to create a more accepting environment.
   
   • What else do you need to learn so that you are comfortable treating queer and trans people? What contacts do you need to make so that you know who to refer patients to? What can your office do so that it’s more inclusive and is ultimately safe for the queer and trans community?
2. Put up OUTSaskatoon’ Safe Space poster in your office, waiting room, etc
3. Wear a rainbow or ally pin on your scrubs or lanyard
4. Acknowledge sexual and gender diverse identities and issues in discussions and in-take forms
5. Use inclusive language (Ex. Partner, they/them pronouns)
6. Gender inclusive washrooms

Question 26

Remember

Answer 26

Remember:

When you publicly identify as an ally or as a safe space you have an accountability to have the knowledge and resources needed to support gender and sexually diverse communities. If you don’t have the knowledge and resources it’s up to you to find out who does. If you or your co-workers mess up, recognize it, apologize, and work with the patient to make the situation right.