As the fight for LGBTQ rights continues to build steam on the national stage, our society continues to struggle with the day-to-day vilification of sexual minorities. The UN’s 2015 ‘Born Free And Equal’ report details just how widespread discrimination and violence against the LGBT community is around the world. The spectrum of violence in the United States is wide, ranging from bullying in schools to deadly acts of aggression. One particular form of subtle but wounding discrimination now being studied are what psychologists call “microaggressions.” Micro-aggressions are the seemingly casual looks, words, or actions that indicate hostile, derogatory, or negative feelings towards a group of people, directed at an individual. It is important to consider the ways in which microaggressions enter the health care setting and the ways providers can work to overcome them.
When we think of sexual or gender microaggressions, we think of actions that communicate that nonconforming sexual or gender identities are less than legitimate. A seminal study by Shelton and Delgado-Romero (on LGBQ, not T) in this field revealed seven types of LGBQ-related microaggression that health providers may intentionally or unintentionally inflict. These categories of discrimination are also applicable to the transgender community, and we have noted them below.
- Assumes that sexual orientation and/or gender identity is the cause of all the issues the LGBTQ client presents.
- Avoids or minimizes the importance of sexual orientation or gender non-conforming identities.
- Attempts to over-identify with LGBTQ clients.
- Makes stereotypical assumptions about LGBTQ clients.
- Says things that suggest heteronormative or gender binary practices and behaviors should be the norm against which other practices and behaviors are judged.
- Assumes that LGBTQ individuals need psychotherapeutic treatment.
- Warns about the dangers of identifying as LGBTQ.
Health practitioners seeking to avoid such microaggression must make efforts to understand the complex, evolving, and multilayered nature of sexual and gender identity. So what are some steps health professionals can take to combat these microaggressions in their work? Providers seeking to be LGBTQ culturally competent—even those who identify as lesbian, gay, bisexual, transgender, and/or queer—begin by reflecting on and acknowledging the extent to which their values, attitudes, and behaviors have been shaped by the homophobic and transphobic cultural biases that are so embedded in U.S. culture.
Beyond self-reflection, health professionals can undertake four key actions:
- Learn and teach. Know the language of the clients you work with. Become familiar with LGBTQ-specific psychosocial challenges.
- Create an LGBTQ-affirmative setting. Provide LGBTQ friendly reading material, literature and resources. Ensure that all clinical forms and paperwork use affirming and inclusive language. Use a client’s preferred name. Don’t resort to “heteronormative” assumptions: ask about your client’s “partner,” rather than “girlfriend” or “boyfriend” until you learn from the client otherwise. Don’t assume you know a client’s gender identity, ask.
- Get involved. Strive for social justice and social change. With heterosexual and/or cisgender (describing a person who is not transgendered) clients, act as an LGBTQ advocate by challenging heterosexism and the gender binary.
- Acknowledge your own limitations. If not fully confident in your own ability to provide the best care, keep a list of resources of LGBTQ-affirmative providers to whom you can refer clients.
At AHP, we strive to have all staff, volunteers, and interns trained in these ways to ensure that all our services are LGBTQ-affirmative. We continue to advocate cultural sensitivity training for organizations whose staff and employees are invested in providing better service and quality care to their LGBTQ clients and patients. AHP provides courses on issues such as LGBTQ cultural competence and sensitivity, LGBTQ health policy, human sexuality, and stigma. If you are interested in scheduling a training, contact Brandi Ly or visit us online to find out more.