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PHRM 100 – PPHC > PPHC 17: Sex, Gender, Sexuality, and Determinants of 2SLGBTQ+ Health > Flashcards

PPHC 17: Sex, Gender, Sexuality, and Determinants of 2SLGBTQ+ Health Flashcards

1
Q

Sex

What is sex?

A

assigned sex at birth is the physical sex designation someone is given at birth (medical and legal assignments)

  • typically based on external physical anatomy
  • commonly assigned sexes are female or male
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2
Q

Sex

What factors may go into categorizing sex?

A

chromosome compositions, hormone levels, secondary sex characteristics, water content, fat distribution, etc.

  • these factors can change over the course of a person’s life
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3
Q

Intersex

What is intersex?

A

born with anatomy or sex characteristics (such as genitals, hormones, chromosomal patterns) that fall outside of ranges generally assigned female or male

  • some intersex people are not aware that they are intersex, while others may realize when they enter puberty or when they try to have biological children
  • can be subjected to non-consensual medical procedures that change their anatomy to fit with typical definitions of male and female, experiencing medical trauma as a result
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4
Q

Gender

What is gender?

A

includes, but is not limited to, an individual’s gender identity and gender expression, along with society’s constructed gender norms, roles, behaviours, activities, and attributes

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5
Q

Gender

What is gender identity?

A

person’s understanding of their gender

  • separate from assigned sex at birth
  • can be fluid
  • include woman, man, non-binary, gender-fluid, and agender
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6
Q

Gender

How are all identities, not only gender, constructed?

A

constructed in the context of societal narratives and have cultural contexts that influence how individuals behave, perceive labels, etc.

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7
Q

Gender Expression and Gender Roles

What is gender expression?

A

how one outwardly expresses gender – ie. through name and pronoun choice, style of dress, voice modulation, etc.

  • how one expresses gender might not necessarily reflect one’s perceived or actual gender identity – ie. person with a beard presenting at your pharmacy may not identify as male
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8
Q

Gender Expression and Gender Roles

What are gender roles?

A

socially constructed and culturally specific behaviours, such as communication styles, careers, family roles, and more, that are imposed on people based on their biological sex assigned at birth

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9
Q

Gender Expression and Gender Roles

How does gender vary among cultures?

A
  • gender interpretations and expectations vary widely among cultures and often change over time
  • some cultures have more than two genders, and consequently more than two gender roles
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10
Q

Gender Modality

What is gender modality?

A

how a person’s gender identity stands in relation to their assigned gender or sex at birth

  • not everyone uses terms related with gender modality uniformly – some people may choose to claim their gender modality as part of their gender identity, or not
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11
Q

Gender Modality

What is transgender?

A

person’s gender identity does not align with the cultural expectations of their assigned sex at birth

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12
Q

Gender Modality

What is cisgender?

A

person’s gender identity aligns with the cultural expectations of their assigned sex at birth

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13
Q

Gender Diversity

What is gender diversity?

A

all genders together make up the gender diversity of humanity

  • gender diversity is not a synonym for transgender or non-binary people
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14
Q

Describe the imprecision of sex and gender today.

A
  • society continues to use imperfect or imprecise language to describe sex and gender – ie. use of terms male and female
  • in the context of research, what and how data is collected impacts the ways in which we view and experience the world – what we measured (ie. variables) in health and clinical research can have long-term consequences, and findings from research inform policy makers on how they should allocate resources and create policies
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15
Q

What is sexuality?

A

important part of a person’s identity

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16
Q

What is sexual orientation?

A

person’s attraction (or lack thereof) to another person or persons

  • include sexual attraction, romantic attraction, aesthetic attraction, etc.
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17
Q

Two-Spirit (2S)

What is Two-Spirit?

A

community organizing strategy or tool, or way to describe one’s self for the Indigenous people of Turtle Island

  • this terminology can be used to facilitate Indigenous Peoples’ connections with Nation-specific expressions and roles of gender and sexual diversity
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18
Q

Two-Spirit (2S)

In what contexts can 2S be used?

A

in the context of gender, sexual orientation, or neither

19
Q

Two-Spirit (2S)

How is 2S used in the context of sexual orientation?

A

2S can be claimed by an Indigenous person who also identifies as LGBTQ+ in the Western context, or as an expression of sexual orientation for an Indigenous person who does NOT identify with Western LGBTQ+ communities

20
Q

Two-Spirit (2S)

How is 2S used in the context of gender?

A

2S is often claimed by an Indigenous person as a placeholder or an opt-out from the Western gender binary

21
Q

Relationship Structures

What are the different types of relationships?

A
  • monogamy (one partner)
  • non-monogamy (not to exclusive to one partner)
  • polyamory (more than one partner)
  • platonic relationships (intimate relationships without sex or romance)
22
Q

Relationship Structures

Are relationships romantic or sexual

A

can be both romantic and sexual in nature, only one of the two, or neither

23
Q

Fluidity

A
  • concepts and language around sexual orientation, gender identity and expression are not set in stone
  • concepts and labels exist to help people make sense of and describe their experiences and find and build communities – these concepts and labels evolve over time to better serve the communities that use them
24
Q

What are the factors that can result in the underrepresentation of 2SLGBTQ+ people in large-scale surveys?

A
  • research may overlook and exclude 2SLGBTQ+ communities
  • research may conflate multiple 2SLGBTQ+ identities
  • society may criminalize 2SLGBTQ+ people
  • people may feel guilt or shame about their identities
  • people may not know enough about 2SLGBTQ+ identities to put a name to their experiences
  • people may not feel safe disclosing their identities
25
Q

What are determinants of health?

A

factors that contribute to a person’s health

26
Q

What are some of the determinants of health? (5)

A
  • biology and genetics – ie. sex, age
  • individual behaviour – ie. smoking
  • social environment – ie. discrimination, income, gender
  • physical environment – ie. air quality
  • health services – ie. having health insurance
27
Q

What are health disparities?

A

type of difference in health that is closely linked with social or economic disadvantage

28
Q

Health Disparities

What are the physical health disparities among 2SLGBTQ+ individuals?

A

2SLGBTQ+ individuals often have poorer physical health compared to cisheterosexual counterparts

  • increased rates of cancer, CV disease, asthma, diabetes, arthritis
29
Q

Health Disparities

What are the mental health disparities among 2SLGBTQ+ individuals?

A

2SLGBTQ+ communities experience higher rates of depression, anxiety, OCD, suicidality, self-harm, and substance use, and twice the risk of PTSD in compared to cisheterosexual peers

  • 2SLGBTQ+ youth are more likely to struggle with depression and more likely to seriously consider suicide
  • self-harm: > 50% of gender diverse (TG, NB, questioning) youth in BC cut or injured themselves on purpose in the past year
30
Q

Health Disparities

What are the sexual health disparities among 2SLGBTQ+ women?

A

cisgender lesbian and bisexual women, and women who have sex with women (WSW) are at higher risk of:

  • breast, ovarian, and endometrial cancers

and are less likely to access regular pap testing and HPV vaccines

31
Q

Health Disparities

What are the sexual health disparities among 2SLGBTQ+ men?

A

cisgender gay and bisexual men, and men who have sex with men (MSM) are at greater risk of:

  • STIs– including syphilis, HPV, hepatitis, HIV
32
Q

Health Disparities

What are the sexual health disparities among 2SLGBTQ+ trans, non-binary, and gender-nonconforming clients?

A

trans, non-binary, gender-nonconforming clients are at higher risk of:

  • HIV
  • unintended pregnancies

and are less likely to access preventative health services such as STI screening and pelvic exams due to fear of discrimination, discomfort

33
Q

Health Disparities

How robust is data on 2SLGBTQ+ populations?

A
  • few large-scale studies have examined the health of 2SLGBTQ+ communities
  • when interpreting statistics about 2SLGBTQ+ communities, be mindful that terminology used in research questions do not always reflect the language and identities used and claimed by communities – ie. if a survey limits its sexual orientation options to straight, gay/lesbian, and bisexual, which option should a person who does not use any of those labels choose
  • 2SLGBTQ+ people in Canada are underrepresented and sometimes misrepresented in health research
34
Q

What are the determinants of health that affect 2SLGBTQ+ people?

A
  • income
  • education
  • employment
  • social and community context
  • health and health care
  • neighbourhood and built environment
35
Q

Determinants of Health that Affect 2SLGBTQ+ People

Income

A
  • higher rates of poverty among bisexuals, trans people
  • racialized 2SLGBTQ+ individuals are paid less than their cisheterosexual counterparts
  • white and racialized SGM people have higher poverty rates than same-race cisheterosexual counterparts
36
Q

Determinants of Health that Affect 2SLGBTQ+ People

Education

A

gender diverse youth maybe more likely to be absent if they feel unsafe in a hostile school climate

37
Q

Determinants of Health that Affect 2SLGBTQ+ People

Employment

A

trans people – 15% unemployed (vs. 5% of the USA population)

38
Q

Determinants of Health that Affect 2SLGBTQ+ People

Social and Community Context

A
  • LGBTQ+ youth may be overrepresented in juvenile justice systems
  • in 2023, majority of gender diverse youth had experienced bullying in the past year, including 78% of trans boys, 72% NB youth, 65% of questioning students, and 58% of trans girls
  • BC has a law to protect and promote human rights (BC Human Rights Code) – protects from being treated badly or denied a benefit
39
Q

Determinants of Health that Affect 2SLGBTQ+ People

Health and Health Care

A
  • lack of insurance coverage
  • discrimination in healthcare – refusal of care, health provides being rough or abusive
40
Q

Determinants of Health that Affect 2SLGBTQ+ People

Neighbourhood and Built Environment

A

trans people particularly experience housing discrimination

41
Q

What is intersectionality?

A

recognition that social identities (such as race, class, disability, sexual orientation, and gender identity) create overlapping and interdependent systems of discrimination or disadvantage

  • different factors of one’s identity (ie. race, gender, disability) are all tied to one’s SDH (ie. income, employment, food security, housing) –they should not be considered as separate and unrelated factors
42
Q

Describe intersectionality and the 2SLGBTQ+ population.

A

racialized 2SLGBTQ+ people experience 5% high rate of unmet mental health needs in compared to non-racialized 2SLGBTQ+ people, and 16% higher rate of unmet mental health needs in compared to non-racialized, cisheterosexual people

43
Q

What are the resilience factors of 2SLGBTQ+ people and communities?

A

they have always advocated for themselves, leading to improvements to healthcare access and services we see today

  • connectedness – access to spaces and relationships that affirm identities (ie. supportive families, schools, and communities) lowers rates of suicide
  • formal and informal peer networks have formed in response to inequitable healthcare to meet the needs and support the health of 2SLGBTQ+ people
  • community organizations conduct research on the health of 2SLGBTQ+ communities to better represent 2SLGBTQ+ people in health research

individual and community resilience help 2SLGBTQ+ people thrive but it does not mean that resilience can always overcome structural barriers

PHRM 100 – PPHC (18 decks)

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