Why Training on LGBTQIA Issues Is Not Enough Elizabeth Victor MSM PhD Assistant Professor Philosophy William Paterson University Megan Dean MA Doctoral Student in Philosophy Georgetown ID: 306128
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Inhospitable Healthcare Spaces:
Why Training on LGBTQIA Issues Is Not Enough
Elizabeth Victor, M.S.M., Ph.D., Assistant Professor, Philosophy, William Paterson UniversityMegan Dean, M.A., Doctoral Student in Philosophy, Georgetown UniversityLaura Guidry-Grimes, M.A., Doctoral Candidate in Philosophy, Georgetown University
American Society for Bioethics and Humanities 2014Slide2
Disclosure
We have no financial interest or other relationships that could be considered a conflict of interest by participants.
American Society for Bioethics and Humanities 2014Slide3
Introduction and OutlineSlide4
Outline
Micromessages DefinedMicromessages and Healthcare
Common Micromessages in Healthcare SettingsBarriers to Standards of CareCycle of PerpetuationWhy Training is not EnoughSolutionsSlide5
MicromessagesSlide6
Micromessages Defined
Micromessages are the persistent, nuanced, often unconscious, behaviors that underlie verbal and nonverbal communication.
They are conveyed through various means, including tone of voice, body language, eye contact patterns, and focus during communication.They can convey hostility, disgust, and other problematic attitudes.Slide7
Micromessages and HealthcareSlide8
Common Micromessages in Healthcare
ContextsHeterosexist
micromessages can be conveyed through:improper gendered pronounsheterosexist words for partnersinsistent questions about birth controlintake forms with no space for preferred name, gender, or queer relationshipsheterosexist brochures, posters, reading materialsprovider discomfort around and avoidance of LGBTQIA patientsSlide9
Barriers to Standard of Care
LGBTQIA patients may be reluctant to disclose to providersLack of disclosure and lack of trust make a strong therapeutic relationship difficultHeterosexist
micromessages contribute to poor mental and physical health of LGBTQIA populationsSome populations have different risksE.g., higher risk of substance abuse, mental health problemsAvoidance of careSlide10
Cycle of Perpetuation
Heterosexist micromessages contribute to a double bind
Double bind: “situations in which options are reduced to a very few and all of them expose one to penalty, censure or deprivation,” (Frye, 1983, 2).Disclosure risks prejudice, discrimination, and improper careVS. Lack of disclosure risks improper care, exclusion of partners in care, and inadvertent outingSlide11
Why Training is Not EnoughSlide12
Limitations of Training
BacklashMicromessages are habitual, and often unintentional and unconsciousPolicy cannot easily address habits or unconscious actionsSlide13
Individuals should be
held responsible for negative micromessages,
not blamed for them (Young, 1990).Blame is backward-looking. Blame demands reparations and apologies for an act already committed. Holding responsible is future-oriented. To hold someone responsible means we hold her to a commitment to do better in the future, to “submit such unconscious behavior to reflection, to work to change habits and attitudes” (Young, 1990, 134)Slide14
SolutionsSlide15
Solutions
Individual strategiesEngaging in positive activities with members of LGBTQIA populationInstitutional strategiesProcedural changes: intake forms, scripts with behavioral cues
Education about LGBTQIA health care needsSlide16
Continue the conversation
Visit our website for resources and more…http://
lgbtqia-healthcare-spaces.weebly.comSlide17
Acknowledgements
Megan Dean is supported by the Social Sciences and Humanities Research Council (SSHRC) and Georgetown University