2051 2023 L22 LGBTQ health-GN

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2051 2023 LGBTQIA+ Health Today: - Bias in health care - Pathologization - Intersectionality - Structural violence Bias in Health Care Robert said: “They tested me for many other STDs and the implication the whole time was that one of them was going to come back positive. ‘It’s very likely that you have an STD based on what you’re telling us.’ 'I didn’t tell you anything except the fact that I’m gay, and that I was sexually assaulted, and that I’m sexually active.' ” (Source: https://www.kunr.org/public-health/2019-11- 21/lgbtq-health-care-struggles-one-mans-story ) “I remember the first thing that she said to me was, 'Well, don’t put yourself in situations where this is going to happen again.’ I was like, 'How could you even say that?' I thought that we had moved past that sort of thing, like, 'Well, what was she wearing when this happened?' or anything like that.” “LGBTQ+ people avoid seeking health care services, even urgent and preventative health care, due to fear of being mistreated by health care staff as a result of their sexual orientation or gender identity. And we hear this from our patients all the time."( Dr. Alex Keuroghlian, National LGBT Health Education Center at the Fenway Institute. https://www.kunr.org/public-health/2019-11- 21/lgbtq-health-care-struggles-one-mans-story ) Write: LGBTQ people often avoid seeking health-care services, including urgent and preventive care, because of fear of being mistreated by clinicians due to their sexual orientation or gender identity. Why is this a problem? What would you do about it? What concepts from class help you think about it? (How many hours on average did medical spend on LBGTQIA+ health in 2011?) (Reflection question: Is that amount of time adequate? Why? Why not?) 1

(What percentage of transgender people faced physical assaults connected with their gender identity?) Write: How do you think encountering multiple areas of stigma and violence (family, medical system, political system, street violence, etc.) affects the health of queer and trans people? What role can/should the medical system play in dealing with these issues? What class concepts help you think about this? Why? (What disproportionate health risks do more gay men and men who have sex with men face?) (What disproportionate health risks do transgender people face?) (What disproportionate health risks do lesbians face?) 2

(What percentage of transgender people faced harsh or abusive language from their healthcare provider?) “There’s no education. . . we, as a community, figure it out in our own right, through talking to each other [online]. It’s not like when you go to a fertility clinic, they have some sort of workshop where they explain all of that to you.” (Raven quoted in Emma Carpenter (2021) “The Health System Just Wasn’t Built for Us”: Queer Cisgender Women and Gender Expansive Individuals’ Strategies for Navigating Reproductive Health Care,” Health Equity 31(5) 478-484. Pathologization (What did Alfred Kinsey’s famous survey of sexual behaviors say about homosexuality?) 1952. The American Psychiatric Association’s Diagnostic and Statistical Manual DSM-I, said homosexuality was a “sociopathic personality disturbance.” 1968: DSM-II abeled homosexual a “sexual deviation.” 1970: Gay-rights activists crashed the APA meeting and pushed to depathologize homosexuality. 1971-2: APA discussed homosexuality at multiple APA meetings. 1971: 20 US states decriminalized sodomy 1973: APA board voted to remove homosexuality from the DSM, effectively depathologizing it. 1986: US Supreme Court declares anti-sodomy laws unconstitutional. 1992: The World Health Organization removed homosexuality from its diagnostic manual. 2015: US Supreme Court legalizes gay marriage On-going: Efforts to roll back gay rights 2019: World Health Organization removes “gender identity disorder” (trans identity) from its diagnostic manual (depathologizing trans-ness). 3

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