LGBTQ Cultures: What Health Care Professionals Need to Know About Sexual and Gender Diversity

LGBTQ Cultures: What Health Care Professionals Need to Know About Sexual and Gender Diversity


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Product Details

ISBN-13: 9781496394606
Publisher: LWW
Publication date: 11/21/2017
Edition description: Third
Pages: 272
Sales rank: 652,814
Product dimensions: 6.00(w) x 8.90(h) x 0.40(d)

About the Author

Michele J. Eliason, PhD, is Assistant Dean of the College of Health and Social Sciences at San Francisco State University in San Francisco, California.

Peggy L. Chinn, RN, PhD, FAAN, is Professor Emerita of Nursing at the University of Connecticut and the Editor of Advances in Nursing Science.

Table of Contents

Preface v

Chapter 1 Overview and Theoretical Framework

Terminology 2


Sexual and Gender Minorities 3

Healthcare Professional 4

Patient/Client/Consumer 4

Culturally Appropriate Care 4

Why a Book on LGBTQ Cultures? 5

Why Should I Learn So Much About Such a Small Segment of the Population? 6

Our Philosophy and Basic Assumptions 8

Underlying Assumptions Within this Book 8

Theoretical Framework for the Book 9

Conclusion 10

Chapter 2 What's in a Word? Concepts Related to Sex/Gender and Sexuality

Sex 13

Gender 13

Sexual Orientation 14

Sexual Expression 17

Gender Identity 17

Intersex/Differences in Sexual Development 19

Gender Expression 20

Sexuality, Gender, and Cultural Diversity 21

Disclosure 23

Coming Out 23

Disclosure to Healthcare Professionals 25

Conclusions 27

Chapter 3 The Deadly Effects of Stigma

Terms/Concepts Related to Stigma 33

Homophobia 33

Biphobia 34

Transphobia 36

HIV/AIDS-Related Stigma 37

Heterosexism/Heteronormativity 38

Gender Normativity 39

Microaggressions 40

Internalized Oppression 41

Lifestyle 42

Other Forms of Stigma 43

Social Effects of Stigma 45

Lack of Recognition of Relationships and Family 45

The Right to Adopt 46

Hate Crimes and Violence 47

Discrimination in Employment and Education 50

Discrimination in Housing 51

Effects of Living in the "The Closet" 52

Conclusions 52

Chapter 4 Myths and Facts about Sexual Orientation and Gender Identity

Myths Related to Sexuality 58

Myths Related to Gender Identities 71

Conclusions 75

Chapter 5 LGBTQ Families

Defining "Family" 80

Relationships with Families of Origin 83

Coming Out to Parents 83

Coming Out to Children 85

Coming Out to Spouses/Partners 86

Intimate Relationships 87

Dating 87

Significant Other Relationships 87

Parenting 89

Child Outcomes 91

Divorce 93

LGBTQ Grandparenting 93

Health-Related Family Issues 94

Conclusion 94

Chapter 6 Developmental Transitions

LGBTQ Childhood 100

LGBTQ Adolescence 101

LGBTQ Young Adulthood 104

LGBTQ Midlife 107

LGBTQ Elders 109

Conclusion 112

Chapter 7 Cultures Within Cultures: Diversity and LGBTQ Communities

Race/Ethnicity 120

Religion/Spirituality/Moral Beliefs 123

Ability/Disability Status 126

Gender Expression Within Sexual Identities 127

Resiliency 129

Conclusions 130

Chapter 8 The Effects of Stigma on Health

Sources of Stigma 135

Effects of Stigma on Health 139

The Effects of Living in Fear/Uncertainty 141

Domestic Violence/Intimate Partner Violence 141

The Role of Stress/Distress on Health 143

LGBTQ People's Experiences with Healthcare 144

Disclosure Decisions 145

Reactions/Responses from Health Care Providers 147

LGBTQ People's Treatment in Healthcare Settings 148

Treatment of Partners and Family 148

Accessing Healthcare Services 149

Conclusions 149

Chapter 9 Substance Abuse and Mental Health

Substance Abuse 154

Alcohol Use and Abuse 154

Drug Abuse 155

Treatment for Alcohol and Drug Problems 157

Smoking 158

Smoking Cessation Programs 160

Mental Health 162

Depression and Anxiety 162

Suicide 163

Body Image 164

Treatment of Mental Health Issues 166

Conclusions 166

Chapter 10 Physical Health Disorders

Risk Behavior and Health Screening Behaviors 177

Chronic Physical Health Disorders 179

Diabetes 180

Heart Disease 181

Asthma 182

Disability 183

Cancer 183

Cancer and Women 184

Cancer and Men 184

Cancer and Transgender People 185

Risk Factors for Cancer 185


Conclusions 187

Chapter 11 Provider Attitudes and Knowledge

Existing Provider Attitudes and Knowledge 193

Historical Overview of Healthcare Provider Attitude Studies 194

Nursing 195

Medicine 196

Other Health Disciplines 198

Improving Health Professional Education 198

Advocacy Efforts with Mainstream Health Organizations/Institutions 199

Resources for Improving Practice and Curricular Inclusion 201

Training Requirements for Practitioners 203

Conclusions 204

Chapter 12 LGBTQ Healthcare Professionals

Physicians and Medical Schools 209

Nurses and Nursing Schools 214

Other Healthcare Professions 219

Improving the Climate for LGBTQ Healthcare Workers 220

Conclusion 223

Chapter 13 Structural Barriers to Quality Care

Making Healthcare Settings Inclusive 226

The Website and other Public Information 226

The Waiting/Reception Area 228

Electronic Medical/Health Records 228

Healthcare Intake Forms 229

Clinician Personal Interaction with the Client 231

Confidentiality 232

Dignity and Safety Issues 233

Making Referrals 234

Policies in Healthcare Setting 234

Healthcare Equality Index 235

Health Insurance 237

Legal Issues 238

Living Will/Medical Directive 238

Durable Power of Attorney for Health Care/Healthcare Prosy 239

Hospital Visitation Authorization 239

Authorization for Consent to Medical Treatment of Minor 239

Durable Power of Attorney for Finances 239

Wills 239

Trusts 240

Nomination of Conservator or Guardian for a Minor 240

Elder Guardian/Conservator 240

Autopsy and Disposition of Remains 240

Conclusions 242

Chapter 14 Conclusions and A Call to Action

A Levels Approach to Change 244

Individual Level 245

Interpersonal Level 245

Institutional Level 245

Community Level 245

Societal Level 245

The Ten Things Healthcare Professionals Can Do 246

Number 10: Understand the Far-Reaching Effects of Social Stigma on LGBTQ People, Families, and Communities 247

Action Steps 247

Number 9: Know Inclusive Language and Use it in Written and Oral Communications 247

Action Steps 248

Number 8: Develop Written Policies That Are Inclusive of LGBTQ People and Their Families 248

Action Steps 248

Number 7: Recognize the Broad Diversity and Creativity of LGBT Family Structures 248

Action Steps 249

Number 6: Develop Policies and Procedures for How to Deal with Confidentiality Issues and Recording of Information about Sexuality and Gender in Patient Records, and for Dealing with Inappropriate Comments in Verbal Communications Among Staff 249

Action Steps 249

Number 5: Recognize The Legal Issues: Have Forms or Information Available for LGBTQ Families for Release of Information, Power of Attorney for Health Care, Guardianship, etc. 249

Action Steps 250

Number 4: Know the Potential Consequences of Stress Related to Stigma: Assess for Substance Abuse, Including Tobacco Dependence, Mental Health Problems, Body Image and Weight Issues, Unsafe Sexual Practices, and Domestic Violence as well as Physical Health Problems 250

Action Steps 250

Number 3: Celebrate the Diversify of LGBTQ Communities, Based on Differences in Age, Racial/Ethnic Identities, Geography, Immigration Status, Language, Socioeconomic Class, and Education 250

Action Steps 251

Number 2: Understand the Effects of Homophobia/Biphobia/Transphobia in the Healthcare Workplace Setting for LGBTQ Employees 251

Action Steps 251

Number 1: Reflect on What It Might Be Like to Be an LGBTQ Patient in Your Healthcare Setting-Do You Have Realistic Concerns about How an LGBTQ Person Might Be Treated? If They Are Not Realistic, How Can You Convey to Patients that Your Environment Is Safe? 252

Action Steps 252

Conclusions 252

Index 254

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