Contextualizing the LGBT Patient in the Health Care System

clinician and medical recordsThe Institute of Medicine (IOM) in its report, The Health of Lesbian, Gay, Bisexual and Transgendered People: Building a Foundation for Better Understanding, recommends that data on sexual orientation and gender identify be collected and included among other demographic information  routinely stored in patients’ electronic health records. The intent of the IOM recommendation is to improve clinical care and to facilitate research that can address health inequalities among LGBT persons. The reality is that many LGBT persons remain reluctant to disclose their sexual orientation or gender identity, or have that information documented in the electronic health record – even when sexual orientation or gender identity is material to a medical  diagnosis or treatment. This reluctance should be contextualized within the backdrop of a health care system where many lesbian, gay, bisexual, and transgendered persons have had negative, invalidating or discriminatory experiences when attempting to access health care, during their care or treatment, or during the care and treatment of a same-sex partner. As the Institute of Medicine observed, it is necessary to create a care environment in which individuals who have historically been stigmatized and discriminated against feel safe providing this information.  What steps can health care organizations take to demonstrate trustworthiness with respect to the collection and use of information related to sexual orientation or gender identify? Should clinicians’ elicit this information as a routine part of clinical care?

Mary Beth Foglia PhD MA

Department of Bioethics and Humanities, School of Medicine

University of Washington – Seattle

Editor and author for The Hastings Center Report

Diane Sawyer’s Interview with Bruce Jenner: What Were Its Lessons?

319px-Diane_Sawyer_2011_ShankboneDiane Sawyer’s April 24, 2015 ABC News interview with Bruce Jenner drew 16.9 million total viewers. The interview was deemed highly anticipated, as the American public, via media reports, expected to hear comments regarding Jenner’s gender identity. During the two-hour block of time, viewership increased as the interview unfolded. Jenner had been in the public eye for several decades, first as an Olympic champion in the 1970s and more recently as a reality television show regular on Keeping Up with the Kardashians. In a sense, Americans thought they knew much about Jenner leading up to this interview; however, they would learn more, such as the fact that Jenner considers himself Republican and Christian.

In reports following the event, CNBC described the two hours as “moving, touching, and affirming” and referred to Jenner as “humble, personable, and flawed.” LGBTQ advocates were generally pleased with the interview, noting that it represented an “accurate portrayal of what it means to be transgender” and did not cater to sensationalism (The Advocate). Trans woman and star of Orange is the New Black, Laverne Cox, offered caution in pointing out that Jenner’s story is “very specific” in that “most trans people don’t have that kind of privilege.” Indeed, violence against trans people, including murder, is endemic in the United States, especially for trans women of color.

Taking Cox’s point that much privilege is embedded within Jenner’s life and story (such that he is not like most trans people), and at the same time, the interview received an overall positive reception in casting Jenner as an everyday and relatable person (via descriptors such as “accurate,” “humble,” and “flawed”), what was the take-away from this interview for most American viewers? In particular, what were its lessons regarding trans experiences and identities?

Mary Bloodsworth-Lugo
Washington State University
Hypatia

We encourage you to share your thoughts and comments below. Please also read our free special collection of articles on LGBT studies now through July.

Understanding Human Sexuality in a Broad Context

Taken from the Introduction to The International Encyclopedia of Human Sexuality, published May 2015, edited by Patricia Whelehan and Anne Bolin www.encyclopediaofhumansexuality.com

Whelehan - web_resSexuality as an academic, legal, medical, and social subject has become increasingly visible over the past thirty years as attested to by the dramatic increase in the number of courses, scholarly and applied peer-reviewed publications, and other resources on the topic. It has also been an ongoing source of anthropological study since the nineteenth century.

However, recent anthropological interest in sexuality has been heightened as a consequence of globalization, the AIDS pandemic, national and international concerns over issues such as sex education, same sex marriage, transgender issues, and sex work among others.

In response to these widespread concerns and an attendant critical need for understanding human sexuality in a broad context, Wiley-Blackwell has commissioned us to produce an inter-disciplinary three-volume encyclopedia titled The International Encyclopedia of Human Sexuality (IEHS).  This print and electronic reference work will be an important resource for undergraduate and graduate universities, law schools, medical schools, and public libraries nationally and internationally.  Not only will this encyclopedia cover the essential content areas as do the other widely selling encyclopedias on human sexuality–including human physiology, life-course issues, contraception, and contemporary Euro-American sexuality and ethnic issues– but the Wiley-Blackwell IEHS will contextualize these topics within their socio-cultural milieu and integrate the cross-cultural and global records of other nationalities.

Given the contemporary cultural and academic concerns for cultural diversity in education, we believe that our encyclopedia has the potential to offer new and richer perspectives on human sexual behavior.  No other encyclopedia currently on the market incorporates cultural diversity as a central theme for both the Euro-American and cross-cultural material. In addition, the IEHS’ attention to evolutionary and primatological considerations are attractive to those disciplines that have a biological and evolutionary emphases such as ethology, evolutionary psychology, biology, ecology, medicine, nursing and health among others, providing a deeply historical and bio-cultural lens.

Find out more at www.encyclopediaofhumansexuality.com

Patricia Whelehan and Anne Bolin

Educating the Next Generation on LGBTQ Rights

120px-TangopenguinDo you remember when you first learned what the word ‘gay’ meant? Maybe you had a classmate with two mothers, maybe you saw it on TV, or maybe you heard it being used as an insult on the playground. It’s possible that your first encounter with the LGBTQ spectrum involved an open-minded and mediated conversation with adults, but it’s also possible that you had to discover it on your own and deduce meaning based on context, even if that context was an insult.

There is a pressing need to educate about the LGBTQ experience, through events and forums like this one, but also throughout childhood. It is our responsibility to teach children tolerance instead of prejudice. But who is responsible for this education? Should it be built into curricula or is it the role of the family and the parents to educate on this topic?

LGBTQ education is an uphill battle because of a lack of resources. And Tango Makes Three, a picture book about same-sex penguins mating and raising a baby (based on a true story of penguins at a zoo), is consistently one of the most banned books in the United States. It joins the ranks of the few books published about the LGBTQ experience for children, most of which are frequently banned in libraries and schools. The lack of accessibility to these teaching resources is hugely detrimental to LGBTQ education.

The importance of LGBTQ education in an open and accepting environment cannot be overstated. How can classrooms and families work together to teach children about the LGBTQ experience? How can we ensure that children—both LGBTQ and not—never have to learn about what ‘gay’ means from an insult on the playground?

Samantha Green, Marketing Manager, Wiley
MA candidate in Children’s Literature, Simmons College Graduate School of Library and Information Science


We encourage you to share your thoughts and comments on this post below. If you’re interested on reading scholarly content, made free this month only to support the continuation of conversations surrounding the LGBT Community.

Education and the Classroom

‘No Outsiders’: Moving beyond a discourse of tolerance to challenge heteronormativity in primary schools British Educational Research Journal

The declining significance of homohysteria for male students in three sixth forms in the south of England British Educational Research Journal

Analyzing Talk in a Long-Term Literature Discussion Group: Ways of Operating Within LGBT-Inclusive and Queer Discourses Reading Research Quarterly

“You’re Wearing Kurt’s Necklace!” The Rhetorical Power of Glee in the Literacy Classroom Journal of Adolescent & Adult Literacy

Moving Beyond the Inclusion of LGBT-Themed Literature in English Language Arts Classrooms: Interrogating Heteronormativity and Exploring Intersectionality Journal of Adolescent & Adult Literacy

Culturally Diverse Literature: Enriching Variety in an Era of Common Core State Standards The Reading Teacher

Telling our story: a narrative therapy approach to helping lesbian, gay, bisexual and transgender people with a learning disability identify and strengthen positive self-identity stories British Journal of Learning Disabilities

“So, You Think You Have a History?”: Taking a Q from Lesbian and Gay Studies in Writing Education History History of Education

Special Issue: Lesbian and gay issues in art, design and media education International Journal of Art & Design Education

Queering High School Biology Textbooks Journal of Research in Science Teaching

What Would Universal Marriage Equality Mean for Culture?

640px-Eric_Stonestreet,_Jesse_Tyler_FergusonUntil recently, American culture has been relatively devoid of representations of the LGBTQ couple. In fact, one of the frequent observations made by critics of television programs and films particularly has been the tendency of those forms to depict lesbians and gays as singular figures isolated from continuing relationships or larger community. There are,
one supposes, a few notable (or infamous) exceptions if one wishes to press the issue: Gertrude Stein and Alice B. Toklas had attained a certain celebrity status by the 1920s and 1930s, though their salon days were spent in Paris and not in America. Likewise, Nathan Leopold and Richard Loeb were by all accounts a couple in the 1920s but their infamy as murderers hardly made them role models.  Lesbian and gay couples did exist, to be sure, among them Del Martin and Phyllis Lyon, who were together more than five decades before Martin’s death in 2008, and Jorn Kamgren and gay activist Harry Hay, who were together for nearly a dozen years, but they were not well-known.  And novelist Henry James popularized “Boston Marriages” — close romantic relationships between women – in 1886’s The Bostonians, though the sexual nature of these relationships was likely neither universal nor well-understood. Lesbian and gay couples were becoming more culturally visible by the 1970s, thanks in part to a series of efforts by gay couples to marry in Minnesota, Seattle, and Colorado, as well as to their appearance in works such as the play and television series Hot L Baltimore.  Even as LGBTQ characters began to emerge in television and film, on-screen couples remained relatively scarce until the new millennium, with press accounts of states’ legalizing, first, civil unions and domestic partnerships, and eventually marriages.  When the TV series Modern Family debuted in 2009, the gay couple Mitch and Cam soon became audience favorites. The current U.S. Supreme Court case Obergefell v. Hodges, which seeks to overturn state bans on the conduct and recognition of same-sex marriages, has dramatically increased the visibility of LGBTQ couples. But would universal marriage equality also mean greater cultural visibility or would an end to the legal and political battles over marriage equality lead to normalization and a return to invisibility?

Bruce E. Drushel, Ph.D.
Guest Editor, Journal of American Culture
Associate Professor, Media, Journalism & Film, Miami University

We encourage you to share, comment, and engage with us in the comment section below! Please also check out our free special collection of scholarly articles and books in LGBT studies.

Ageing into Lesbian-Feminism – An Excerpt from a Life

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It was 1969, I was just 12 years old, and Stonewall had not yet happened. My best friend Linda and I hung out at the local schoolyard wearing army jackets with male names emblazoned on the pocket. She was not just my friend, though I had no name for what we were.

When I smacked a boy upside the head who tried to grab my breasts, the home economics teacher said if I couldn’t stop acting like that no boy would ever marry me. I had no vision of what life could be without marrying a boy and gay marriage was still an oxymoron; I decided that marriage was a trap that I would never willingly step into. I mostly still think that.

I discovered feminism with an insatiable hunger. I read every book, bought every woman’s music album and joined consciousness raising groups, and coming out groups.

Today my female students often insist they are not feminists. My feminism is quaint to them, not the radical edge of human transformation, but nostalgia from a bygone generation. In their eyes I am a woman who still thinks that gender matters. Of course they believe in equal rights and equal pay for equal work. Of course they think that “girls” should go to college and become doctors. Their definition of feminism is: a woman who hates men. I try to explain that it was actually men who hated women, and we rebelled, us feminists. I tell them that all they have in their lives today is the fruits of a movement that women planted with our own hands, the soil was our very bodies. Gender, I insist, still matters.

The lesbian-feminist community that reared me does not exist anymore. The small coffee houses, the sense of commonality are relics of another day. Partially the movement that was, has been absorbed into the larger LGBTQQI-alphabet soup movement for queer civil rights. Partially it became transformed into academic women’s studies programs. Partially it has been co-opted, sold out to the dazzle of consumer capitalism and the lure of romantic security, represented by gay business and gay marriage. A friend smiles and says, “We really thought we could change the world,” and I remind her: we did. We changed the world.

I work for transgender rights and argue queer theory, and insist that it is feminism which was the mother of these freedoms. I give credit to women’s liberation for not only changing my world, but for changing the whole world, for starting a dialogue about rethinking gender that continues on today. Like all important tasks, dismembering patriarchy is the work of my many lifetimes.

I am nearly a crone now — more than half a century on this blessed planet, and I’m still doing my work. I still devour feminist books, but I do not allow feminism to devour me. I am critical of some of what has been done in the name of feminism, but I will not let other women define feminism for me, or dictate which acts of mine are feminist and which are colonized. I keep insisting that feminism is not a dirty word, but is a movement that has made possible all that has come since.

I embrace the queer youth of today, and I know they can do what they are doing precisely because we did the work of feminism. I plan to get old, grow my facial hair, get another tattoo, and wear bright red lipstick. Feminism has given me the freedom to be fully myself.

By Arlene Istar Lev LCSW, CASAC

Arlene Istar Lev is a social worker, family therapist, activist, and mother. She is the Founder of Choices Counseling and Consulting (www.choicesconsulting.com), and The Institute for Gender, Relationships, Identity and Sexuality (TIGRIS – www.tigrisinstitute.com). She can be reached at 518-438-2222 or Arlene@choicesconsulting.com.

We encourage you to read more on LGBT and family/child ethics with our special collection here on the blog and to comment below.

The Psychological Burden Associated with the Stigmatization of Homosexuality

imagesThe Society for the Psychological Study of Social Issues (SPSSI) has long focused on the psychological burden associated with the stigmatization of homosexuality and, in articles over the past decade, explored the roots of public opposition to marriage equality; examined the rights and responsibilities of gay parents; and critiqued the “psychological” arguments that are typically put forward regarding gay rights.

In “Social Advocacy for Equal Marriage: The Politics of ‘Rights’ and the Psychology of ‘Mental Health’, (Analyses of Social Issues of Public Policy, December 2004), Celia Kitzinger and Sue Wilkinson argue against the discipline’s dominant narrative regarding homosexuality, with its focus on social stigmatization and the mental health damage or deficit that such stigmatization imposes. They argued instead for a discourse of rights, which “asserts universally applicable principles of equality, justice, freedom, and dignity.” The psychological approach, by contrast, seemed fundamentally “antithetical to the conceptual framework of human rights, as a basis for social justice.”

In “The Rights and Responsibilities of Gay and Lesbian Parents: Legal Developments, Psychological Research, and Policy Implications,” (Social Issues and Policy Review, December 2008), Jared Chamberlain, Monica Miller, and Brian Bornstein enrich the discussion about how courts should deal with gay parents who chose to end their relationship. They argue that children benefit from having continued contact with two parents—even if in gay relationships there may be a biological connection to only one of the parents—and that the children’s well-being is unaffected by their parents’ sexual orientation. The same “best interest” standard that prevails among heterosexual parents in determining child custody should prevail among gay parents, with visitation rights allocated accordingly. A review of the literature reveals that children of lesbian parents showed no differences in terms of “psychological development and family functioning,” exhibited similar levels of self-esteem, and experienced similar gender identity formation processes. They concluded by urging psychologists:

to continue to conduct and publicize the results of research on children of same-sex parents, especially in new areas such as dissolution of the same sex-relationship; they can conduct research comparing families with lesbian gay and heterosexual parents; and they can evaluate children in custodial disputes that result from the breakup of same-sex relationships in the same manner that they work with the children in heterosexual divorce cases.

In “Anti-Equality Marriage Amendments and Sexual Stigma,” (Journal of Social Issues, No. 2, 2011) Gregory Herek summarizes the stigma-based analysis of anti-equality marriage laws and campaigns. He discusses how being denied the legal right to marry because of one’s orientation constitutes an instance of stigma; and being subject to political campaigns promoting anti-equality marriage amendments are a source of heightened stress for gays, lesbians, and bisexuals. The personal and political are interrelated: The initial enactment and continuing existence of anti-equality marriage laws depend on the continuing salience of such attitudes among the voting public. He closes by asking two questions: How the process of coming out and discussing one’s sexual orientation impacts one’s friends, relatives, and acquaintances; and second, how and why some heterosexual friends and family chose to become allies in the struggle for marriage equality and related structural stigma and prejudice.

Finally, Melanie Duncan and Markus Kemmelmeier focus on what attitudes fuel opposition to same-sex marriage, in their article “Attitudes Toward Same-Sex Marriage: An Essentialist Approach.” They argue that the negative same-sex marriage (SSM) attitudes are the result of essentialist thinking about marriage—that is, thinking that categorizes marriage as universal, unique, invariant, and not the result of human agency. In fact, “essentialist” attitudes about marriage were a more potent predictor of negative SSM even than essentialist conceptions of homosexuality. In that respect, marriage is often conceptualized as if it predated or had an existence independent of the society in which it is practiced; marriage is viewed by opponents of SSM as if it had an “objective” reality, whose essence is formally enshrined. These attitudes are revealed in studies probing essentialist beliefs about homosexuality and essentialist beliefs about marriage: “Although opponents of SSM may be likely to harbor prejudices against homosexuals, their opposition to SSM seems to be more critically motivated by their essentialist perspective on marriage itself.”

We encourage you to share your thoughts and comments on this post below. If you’re interested on reading scholarly content, made free this month only to support the continuation of conversations surrounding the LGBT Community, read here.

For more from SPSSI, visit Wiley Online Library.  There you’ll find a free sample issue, content alerts, and a host of psychology articles.