Andrea Daley

Traversing the Margins: Intersectionalities in the Bullying of Lesbian, Gay, Bisexual and Transgender Youth

SUMMARY This study explores the perspectives of service providers and youth advocates on bullying of lesbian, gay, bisexual and transgender (LGBT) youth and intersectionalities in LGBT peer victimization. In depth, semi-structured interviews were conducted with nine key informants (4 male, 4 female, 1 transgender male; 4 gay, 3 lesbian, 2 non-identified; 6 white, 1 South Asian, 2 Middle Eastern) recruited using purposive sampling from diverse education and social service settings. Narrative thematic analysis and a constant comparative method were used to identify themes. Five themes emerged from the data: (1) “transgressing gender norm boundaries”; (2) homophobic sexism vs. sexist homophobia; (3) “you choose sexuality or you choose race”; (4) newcomer youth and citizenship; and (5) “multiple wires together … create the cage.” Findings suggest the importance of an intersectional approach to conceptualizing and addressing LGBT bullying and to uncovering the differential experiences of bullying among LGBT youth. Bullying related to sexual orientation should not be assumed to be the only or primary form of violence shaping the lives of LGBT youth.

Development of expertise in mental health service provision for lesbian, gay, bisexual and transgender communities

Medical Education 2012: 46: 903–913

Promoting LGBT health and wellbeing through inclusive policy development

In this paper we argue the importance of including gender and sexually diverse populations in policy development towards a more inclusive form of health promotion. We emphasize the need to address the broad health and wellbeing issues and needs of LGBT people, rather than exclusively using an illness-based focus such as HIV/AIDS. We critically examine the limitations of population health, the social determinants of health (SDOH), and public health goals, in light of the lack of recognition of gender and sexually diverse individuals and communities. By first acknowledging the unique health and social care needs of LGBT people, then employing anti-oppressive, critical and intersectional analyses we offer recommendations for how to make population health perspectives, public health goals, and the design of public health promotion policy more inclusive of gender and sexual diversity. In health promotion research and practice, representation matters. It matters which populations are being targeted for health promotion interventions and for what purposes, and it matters which populations are being overlooked. In Canada, current health promotion policy is informed by population health and social determinants of health (SDOH) perspectives, as demonstrated by Public Health Goals for Canada. With Canadas multicultural makeup comes the challenge of ensuring that diverse populations are equitably and effectively recognized in public health and health promotion policy.

Community heroes or high-risk pariahs? Reasons for declining to enroll in an HIV vaccine trial

Sustained recruitment over time of tens of thousands of clinical trial volunteers is essential to the development of safe and efficacious HIV vaccines. This study explored, in depth, reasons for declining to enroll among persons screened in as eligible for a Phase IIb prophylactic HIV vaccine trial. Thirteen non-enrollees completed a self-administered questionnaire; of those, 11 completed a 1-h follow-up interview. Interviews were transcribed verbatim and themes derived using narrative thematic analysis and NVivo software. Concerns about negative social consequences of false HIV-positive tests, trial uncertainties, side effects, double-blind assignment, trial duration, uncertain efficacy, behavioral disinhibition and stigma emerged as reasons for declining to enroll. Social, psychological and emotional dimensions of HIV vaccine trial participation--including false-positives and anticipated stigma and discrimination, possible impact on intimate relationships, and concerns about behavioral disinhibition--suggest that provision of voluntary trial-related psychosocial counseling, a trial ombudsperson, alternate trial sites, and systematic community engagement in trial planning, recruitment and evaluation may facilitate informed participation in safe and ethically conducted HIV vaccine trials.

Safe, Positive and Queering Moments in Teaching Education and Schooling: A conceptual framework

This article introduces a conceptual framework for thinking about the development of anti‐homophobia education in teacher education and schooling contexts. We bring the safe, positive, and queering moments framework to bear on three distinct anti‐homophobia education practices: coming out stories, homophobic name‐calling analysis, and Pride Week activities. Our analysis of these education practices through the lens of our conceptual framework illuminates its usefulness for thinking through both the intent and impact of anti‐homophobia education within classrooms. Importantly, our analysis also reveals that within a classroom of students who are taking up anti‐homophobia education in different ways any one moment can be all three—safe, positive, and queering. We advocate an approach to anti‐homophobia education that seeks change through the creation of all three moments, and that locates anti‐homophobia strategies on points in a constellation of “safe moments”, “positive moments”, and “queering moments”.

Gender, sexuality and the discursive representation of access and equity in health services literature: implications for LGBT communities

BackgroundThis article considers how health services access and equity documents represent the problem of access to health services and what the effects of that representation might be for lesbian, gay, bisexual and transgender (LGBT) communities. We conducted a critical discourse analysis on selected access and equity documents using a gender-based diversity framework as determined by two objectives: 1) to identify dominant and counter discourses in health services access and equity literature; and 2) to develop understanding of how particular discourses impact the inclusion, or not, of LGBT communities in health services access and equity frameworks.The analysis was conducted in response to public health and clinical research that has documented barriers to health services access for LGBT communities including institutionalized heterosexism, biphobia, and transphobia, invisibility and lack of health provider knowledge and comfort. The analysis was also conducted as the first step of exploring LGBT access issues in home care services for LGBT populations in Ontario, Canada.MethodsA critical discourse analysis of selected health services access and equity documents, using a gender-based diversity framework, was conducted to offer insight into dominant and counter discourses underlying health services access and equity initiatives.ResultsA continuum of five discourses that characterize the health services access and equity literature were identified including two dominant discourses: 1) multicultural discourse, and 2) diversity discourse; and three counter discourses: 3) social determinants of health (SDOH) discourse; 4) anti-oppression (AOP) discourse; and 5) citizen/social rights discourse.ConclusionsThe analysis offers a continuum of dominant and counter discourses on health services access and equity as determined from a gender-based diversity perspective. The continuum of discourses offers a framework to identify and redress organizational assumptions about, and ideological commitments to, sexual and gender diversity and health services access and equity. Thus, the continuum of discourses may serve as an important element of a health care organizations access and equity framework for the evaluation of access to good quality care for diverse LGBT populations. More specfically, the analysis offers four important points of consideration in relation to the development of a health services access and equity framework.

Reflections on Reflexivity and Critical Reflection as Critical Research Practices

This article explores reflexivity and critical reflection as they were applied during an exploratory study of the psychiatric and mental health service experiences of lesbian and queer women. Reflexivity and critical reflection are centered as critical research practices toward recognizing and responding to micropractices of power and power relations in the interviewing relationship, structural forms of power and its impact on the recruitment of participants and therefore the inclusion and exclusion of particular participants in the research process, and the limitations of the social process of knowledge production vis-a-vis research methods and interviews.

Being Recognized, Accepted, and Affirmed: Self-Disclosure of Lesbian/Queer Sexuality Within Psychiatric and Mental Health Service Settings

This article explores the relationship between self-disclosure of lesbian/queer (LQ) sexuality and well-being and recovery as described by women who either identify as consumer/survivors of psychiatric and mental health services and/or who work as mental health service providers within hospital- and community-based psychiatric and mental health service settings. I explore the relationship between self-disclosure and well-being and recovery by examining three points that frame womens ideas and experiences of self-disclosure including: (a) The negation and dismissal of lesbian/queer sexuality as an identity, (b) the closing off or compartmentalizing of concerns by lesbian/queer women, and (c) sexuality as a potential source of stress and/or support for lesbian/queer women.

Lesbian and gay health issues: OUTside of Canada’s health policy

This article uses the notion of sexual citizenship as an analytical tool to uncover the ideology of heterosexuality underlying the assumptions in current ideas of citizenship. It highlights how this ideology, as reflected in the Canadian health care delivery model, is embedded in the Canada Health Act, as a health policy. It indicates that the process of sexualizing citizenship focuses attention on the monolithic construct of the heterosexual citizen while, paradoxically creating a space for lesbian and gay visibility within the health care arena. This visibility, however, is based on a partial citizenship, in that, the ideology of heterosexuality prevents lesbian women and gay men from exercising their full right as citizens to health provisions as guaranteed by the Canada Health Act. In this way, lesbian and gay visibility is characterized by exclusion. The notion of sexual citizenship is used as a strategy towards inclusion.

‘That would have been beneficial’: LGBTQ education for home‐care service providers

This paper reports qualitative findings from a pilot study that explored the lesbian, gay, bisexual, transgender and queer (LGBTQ) education needs of home-care service providers working in one large, urban Canadian city. The pilot study builds upon research that has documented barriers to health services for diversely situated LGBTQ people, which function to limit access to goodquality healthcare. LGBTQ activists, organisations and allies have underscored the need for health provider education related to the unique health and service experiences of sexual and gender minority communities. However, the home-care sector is generally overlooked in this important body of research literature. We used purposeful convenience sampling to conduct four focus groups and two individual interviews with a total of 15 professionally diverse homecare service providers. Data collection was carried out from January 2011 to July 2012 and data were analysed using grounded theory methods towards the identification of the overarching theme, ‘provider education’ and it had two sub-themes: (i) experiences of LGBTQ education; and (ii) recommendations for LGBTQ education. The study findings raise important questions about limited and uneven access to adequate LGBTQ education for home-care service providers, suggest important policy implications for the education and health sectors, and point to the need for anti-oppression principles in the development of education initiatives.