Journal of Bioethical Inquiry

, Volume 9, Issue 2, pp 149–160 | Cite as

Discomfort, Judgment, and Health Care for Queers

Original Research

Abstract

This paper draws on findings from qualitative interviews with queer and trans patients and with physicians providing care to queer and trans patients in Halifax, Nova Scotia, Canada, to explore how routine practices of health care can perpetuate or challenge the marginalization of queers. One of the most common “measures” of improved cultural competence in health care practice is self-reported increases in confidence and comfort, though it seems unlikely that an increase in physician comfort levels with queer and trans patients will necessarily mean better health care for queers. More attention to current felt discomfort in patient–provider encounters is required. Policies and practices that avoid discomfort at all costs are not always helpful for care, and experiences of shared discomfort in queer health contexts are not always harmful.

Keywords

Queer health Transgender health Discomfort Family physicians Cultural competence 

References

  1. Ahmed, S. 2006. Queer phenomenology: Orientations, objects, others. Durham, and London: Duke University Press.Google Scholar
  2. Barbara, A., S. Quandt, and R. Anderson. 2001. Experiences of lesbians in the health care environment. Women & Health 34(1): 45–62.CrossRefGoogle Scholar
  3. Baylis, F., N.P. Kenny, and S. Sherwin. 2008. A relational account of public health ethics. Public Health Ethics 1(3): 196–209.CrossRefGoogle Scholar
  4. Beagan, B., and Z. Kumas-Tan. 2009. Approaches to diversity in family medicine: “I have always tried to be colour blind.” Canadian Family Physician 55(8): e21–e28.PubMedGoogle Scholar
  5. Betancourt, J.R. 2006. Eliminating racial and ethnic disparities in health care: What is the role of academic medicine? Academic Medicine 81(9): 788–792.PubMedCrossRefGoogle Scholar
  6. Champaneria, M., and S. Axtell. 2004. Cultural competence training in US medical schools. Journal of the American Medical Association 291(17): 2142. doi:10.1001/jama.291.17.2142.PubMedCrossRefGoogle Scholar
  7. Diprose, R. 1994. The bodies of women: Ethics, embodiment and sexual difference. New York: Routledge.Google Scholar
  8. Diprose, R. 2002. Corporeal generosity: On giving with Nietzsche, Merleau-Ponty, and Levinas. Albany: SUNY Press.Google Scholar
  9. Dogra, N., S. Reitmanova, and O. Carter-Pokras. 2010. Teaching cultural diversity: Current status in U.K., U.S., and Canadian medical schools. Journal of General Internal Medicine 25(Supplement 2): S164–S168.PubMedCrossRefGoogle Scholar
  10. Fowler, R.A., N. Sabur, P. Li, et al. 2007. Sex- and age-based differences in the delivery and outcomes of critical care. Canadian Medical Association Journal 177(12): 1513–1519. E-publication November 14.PubMedCrossRefGoogle Scholar
  11. Fox, R.C. 1980. The evolution of medical uncertainty. The Milbank Memorial Fund Quarterly. Health and Society 58(1): 1–49.PubMedCrossRefGoogle Scholar
  12. Fryer, D.R. 2008. Thinking queerly: Posthumanist essays on ethics and identity. Eastbourne: Gardners Books.Google Scholar
  13. Goldberg, L., A. Ryan, and J. Sawchyn. 2009. Feminist and queer phenomenology: A framework for perinatal nursing practice, research, and education for advancing lesbian health. Health Care for Women International 30(6): 536–549.PubMedCrossRefGoogle Scholar
  14. Goldberg, L., A. Harbin, and S. Campbell. 2011. Queering the birthing space: Phenomenological interpretations of the relationships between lesbian couples and perinatal nurses in the context of birthing care. Sexualities 14(2): 173–192.CrossRefGoogle Scholar
  15. Grosz, E. 1994. Volatile bodies: Toward a corporeal feminism. Bloomington: Indiana University Press.Google Scholar
  16. Gustafson, D.L., and S. Reitmanova. 2010. How are we “doing” cultural diversity? A look across English Canadian undergraduate medical school programmes. Medical Teacher 32(10): 816–823.PubMedCrossRefGoogle Scholar
  17. Harbin, A. 2012. Bodily disorientation and moral change. Hypatia 27(2). doi:10.1111/j.1527-2001.2011.01263.x.
  18. Heyes, C. 2007. Self-transformations: Foucault, ethics, and normalized bodies. Oxford: Oxford University Press.Google Scholar
  19. Joseph, K.S., R.M. Liston, L. Dodds, L. Dahlgren, and A.C. Allen. 2007. Socioeconomic status and perinatal outcomes in a setting with universal access to essential health care services. Canadian Medical Association Journal 177(6): 583–590.PubMedCrossRefGoogle Scholar
  20. Kumas-Tan, Z.O., B. Beagan, C. Loppie, A. MacLeod, and B. Frank. 2007. Measuring cultural competence: Examining hidden assumptions. Academic Medicine 82(6): 548–557.PubMedCrossRefGoogle Scholar
  21. McNair, R. 2003. Lesbian health inequalities: A cultural minority issue for health professionals. The Medical Journal of Australia 178(2): 643–645.PubMedGoogle Scholar
  22. Queer Bioethics Consortium. No date. Bioethics, sexuality, gender identity. http://www.queerbioethics.org.
  23. Reitmanova, S. 2011. Cross-cultural undergraduate medical education in North America: Theoretical concepts and educational approaches. Teaching and Learning in Medicine 23(2): 197–203.PubMedCrossRefGoogle Scholar
  24. Ryan-Flood, R. 2009. Lesbian motherhood: Gender, families and sexual citizenship. New York: Palgrave Macmillan.Google Scholar
  25. Salamon, G. 2009. The sexual schema: Transposition and transgender. In You’ve changed: Sex reassignment and personal identity, ed. L.J. Shrage, 81–97. Oxford: Oxford University Press.Google Scholar
  26. Sherwin, S. 1992. No longer patient: Feminist ethics and health care. Philadelphia: Temple University Press.Google Scholar
  27. Shildrick, M., and R. Mykitiuk (eds.). 2005. Ethics of the body: Postconventional challenges. New York: MIT Press.Google Scholar
  28. Steele, L.S., J.M. Tinmouth, and A. Lu. 2006. Regular health care use by lesbians: A path analysis of predictive factors. Family Practice 23(6): 631–636. E-publication June 23.PubMedCrossRefGoogle Scholar
  29. Sullivan, N. 2008. Dis-orienting paraphilias? Disability, desire, and the question of (Bio) ethics. Journal of Bioethical Inquiry 5(2–3): 183–192.CrossRefGoogle Scholar
  30. Tong, R. 1996. Feminist approaches to bioethics. Boulder: Westview Press.Google Scholar
  31. Turner, L. 2005. Is cultural sensitivity sometimes insensitive? Canadian Family Physician 51(4): 478–480.PubMedGoogle Scholar
  32. Valanis, B.G., D.J. Bowen, T. Bassford, E. Whitlock, P. Charney, and R.A. Carter. 2000. Sexual orientation and health: Comparisons in the women’s health initiative sample. Archives of Family Medicine 9(9): 843–853.PubMedCrossRefGoogle Scholar
  33. Wear, D. 2003. Insurgent multiculturalism: Rethinking how and why we teach culture in medical education. Academic Medicine 78(6): 549–554.PubMedCrossRefGoogle Scholar
  34. Weiss, G. 1999. Body images: Embodiment as intercorporeality. New York: Routledge.Google Scholar
  35. Young, I.M. 2005. On female body experience: Throwing like a girl and other essays. Oxford: Oxford University Press.Google Scholar

Copyright information

© Springer Science+Business Media B.V. 2012

Authors and Affiliations

  1. 1.Dalhousie UniversityHalifaxCanada
  2. 2.School of Occupational TherapyDalhousie UniversityHalifaxCanada
  3. 3.School of NursingDalhousie UniversityHalifaxCanada

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