Elizabeth McDermott

Avoiding shame: young LGBT people, homophobia and self-destructive behaviours

This paper reports on findings from qualitative research conducted in the UK that sought to explore the connections between sexual identities and self‐destructive behaviours in young people. International evidence demonstrates that there are elevated rates of suicide and alcohol abuse amongst lesbian, gay, bisexual and transgender (LGBT) youth. Rarely included in this body of research are investigations into young LGBT peoples views and experiences of self‐destructive behaviours. Data from interviews and focus groups with young LGBT participants suggest a strong link between homophobia and self‐destructive behaviours. Utilising a discourse analytic approach, we argue that homophobia works to punish at a deep individual level and requires young LGBT people to manage being positioned, because of their sexual desire or gendered ways of being, as abnormal, dirty and disgusting. At the centre of the complex and multiple ways in which young LGBT people negotiate homophobia are ‘modalities of shame‐avoidance’ such as: the routinization and minimizing of homophobia; maintaining individual ‘adult’ responsibility; and constructing ‘proud’ identities. The paper argues that these strategies of shame‐avoidance suggest young LGBT people manage homophobia individually, without expectation of support and, as such, may make them vulnerable to self‐destructive behaviours.

Resilient Young Mothering: Social Inequalities, Late Modernity and the ‘Problem’ of ‘Teenage’ Motherhood

This paper draws on a systematic review of qualitative research to explore the resilient mothering practices that young, British, working-class mothers employ to care for their children. The synthesis of studies of UK mothers under the age of 20 demonstrates how young working-class women must mother in impoverished circumstances, at the same time as being discursively positioned outside the boundaries of ‘normal’ motherhood. Consequently, they utilize the only two resources to which they may have access: their families and their own personal capacities. Engaging with debates regarding the extent of the transformations of the social in late modernity, the paper discusses the most prominent of the young mothers’ practices: investment in the ‘good’ mother identity, maintaining kin relations, and prioritization of the mother/child dyad. The paper argues that, while the young mothers’ practices display reflexivity and individualism, they are also deeply embedded in, and structured by, social inequalities.

Qualitative Research and the Evidence Base of Policy: Insights from Studies of Teenage Mothers in the UK

Qualitative research is ambiguously placed as a source of evidence for policy. It provides a way of accessing the experiences and perspectives of those targeted by welfare interventions, yet it is routinely excluded from the evidence reviews undertaken to inform these interventions. The article explores what qualitative research – mapped and synthesised through a systematic review – can contribute to evidence and policy. Taking teenage motherhood as a case study, it juxtaposes the conclusions of quantitative reviews with themes emerging from a systematic review of qualitative studies of teenage mothers’ lives. It highlights how teenage motherhood, identified in quantitative reviews and in policy interventions as a route to social exclusion, emerges in these studies as an act of social inclusion. It highlights, too, how social disapproval as well as material hardship weigh on teenage mothers, and the potential role that policies could play in supporting the identities and resilient practices mothers develop in the face of material and social disadvantage.

Surviving in dangerous places: Lesbian identity performances in the workplace, social class and psychological health

This article examines the ways in which the psychological health of women may be influenced by workplace sexual identity performances and social class positioning. It draws on UK research through in-depth interviews with 24 women who self-defined as mainly lesbian and/or gay. The article demonstrates that, for the women in the study, sexual identity performances at work involved negotiating employment settings that render heterosexuality compulsory and thus lesbian/gay performances a risk. As a result, the women engaged in risk-assessment strategies that were psychologically demanding. The womens narratives also suggest that the psychological effects of managing an ‘othered’ sexual identity in work was mediated by social class. The working-class women were more likely to be employed in settings where heterosexuality was heavily regulated and their ‘practices of survival’ were potentially more detrimental to their psychological health.

Making sense of dying: a review of narratives written since 1950 by people facing death from cancer and other diseases:

This article reviews a sample of narratives written since 1950 by people knowingly facing death as a result of cancer and other diseases, in order to compare experiences and show how these relate to wider changes in practice in end of life care. Methods: A bibliographic search of libraries, archives, journals and internet sources located English spoken literature, including books, poems, newspapers, journal articles, diaries, and internet postings of writings by people facing terminal disease. Bibliometric and qualitative content analysis explored changing authorship, experiences, purpose in writing, and reported the impact on readers. Results: The initial search located a wide range of published and unpublished narratives, to which inclusion/exclusion criteria were applied, yielding 148 narratives by different authors since 1950. A purposive sub-sample of 63 of these narratives was reviewed. Discussion: Over the last half century there have been changes in both the volume of available literature and patterns of writing about end of life experience. Therapeutic benefits of writing are reported as a way of making sense of dying combined with a strong sense of purpose in sharing the story. There is a clear awareness of social needs when dying, along with issues of communication with medical staff, symptom control, realities of suffering, and spiritual aspects of dying. Differences are found in the nature and style of writing about cancer in comparison to other illnesses.

The world some have won: Sexuality, class and inequality

This article addresses inequalities and injustices arising at the intersection of class and sexuality. Recent legislation has enshrined sexual diversity within the UK creating the possibility for lesbian, gay, bisexual and transgender (LGBT) people to lead legitimated lives. The experience of living within this new liberal sexual framework is likely to be mediated by social class. Drawing on two empirical studies and utilizing Bourdieu’s conceptualization of class, and queer theory, I highlight, using the example of young LGBT people’s post-compulsory schooling choices, the importance of focusing upon the interaction between sexual identity and class to understand the unequal ways LGBT people may negotiate the transformations in intimate and sexual life.

Hospice and Palliative Care Development in India: A Multimethod Review of Services and Experiences

Palliative care has been developing in India since the mid-1980s, but there is a dearth of evidence about service provision on which to base national policy and practice. The aim of this study was to assess the current state of palliative care in India, mapping the existence of services state by state, and documenting the perspectives and experiences of those involved. A multimethod review was used, which included synthesis of evidence from published and grey literature, ethnographic field visits, qualitative interviews with 87 individuals from 12 states, and collation of existing public health data. The review identified 138 hospice and palliative care services in 16 states and union territories. These are mostly concentrated in large cities, with the exception of Kerala, where they are much more widespread. Nongovernmental organizations, public and private hospitals, and hospices are the predominant sources of provision. We were unable to identify palliative care services in 19 states/union territories. Development of services is uneven, with greater provision evident in the south than the north, but for the majority of states, coverage is poor. Barriers to the development of palliative care include: poverty, population density, geography, opioid availability, workforce development, and limited national palliative care policy. Successful models exist for the development of affordable, sustainable community-based palliative care services. These have arisen from adapting Western models of hospice and palliative care for implementation in the Indian cultural context. Further work is required to ensure that the growing interest in hospice and palliative care in India is used to increase the momentum of progress.

Youth on the Virtual Edge: Researching Marginalized Sexualities and Genders Online

Research shows clear links between lesbian, gay, bisexual, and transgender (LGBT) youth and deliberate self-harm (DSH), but there is a lack of research investigating the social context of young LGBT people’s lives and helping to explain the higher DSH risk. In this article, we report on a small-scale methodological study intended to test the feasibility of online qualitative interviews for investigating young people, sexual and gender identity, and emotional distress. There are many methodological dilemmas arising from researching such sensitive issues with marginalized groups. The study reported here was designed to examine (a) sampling diversity in terms of sexuality, gender identities, and class; and (b) the type of data produced. We found that a virtual methodology was effective in recruiting young LGBT participants who might otherwise not take part in research. Online interviewing successfully produced in-depth, “immediate” data that potentially gave access to insights that might not emerge through face-to face interviews.

Making sense of suicide: A discourse analysis of young people's talk about suicidal subjecthood

Though there is a substantial body of literature on youth suicide, relatively few studies provide a detailed analysis of young peoples own understandings of suicidal behaviour. The present research pays particular attention to how young people make sense of suicide, in the understanding that suicide only becomes possible insofar as it is imaginable. Interviews and focus groups (including 69 participants in total) with people aged 16-24 years provide the empirical material for this study. Research participants were recruited across a range of ethnic groups and sexual orientations, and drawn from rural and urban areas in the North of England and South Wales. Four frameworks for understanding youth suicide are discussed in this paper. These frameworks of understanding variously (i) cast suicidal subjects as Other, (ii) highlight suicide as something that is accessible to young people, (iii) demonstrate the desire to rationalise suicidal behaviour, and (iv) define suicidal subjects in terms of their relationships with others. The interwoven meanings that run through these four frameworks, and their connection with existing literature, are discussed and the implications for suicide prevention are indicated.

Asking for help online:lesbian, gay, bisexual and trans youth, self-harm and articulating the 'failed' self

International evidence suggests that young people are less likely to seek help for mental health problems in comparison with adults. This study focused on lesbian, gay, bisexual and trans young people who are a population group with an elevated risk of suicide and self-harm, and little is known about their help-seeking behaviour. Utilising qualitative virtual methods, lesbian, gay, bisexual and trans youth web-based discussions about seeking help for suicidal feelings and self-harming were investigated. Findings from a thematic analysis indicate that these young people wanted assistance but found it difficult to (1) ask for help, (2) articulate emotional distress and (3) ‘tell’ their selves as ‘failed’. This analysis suggests that key to understanding these problems are emotions such as shame which arise from negotiating norms connected to heterosexuality, adolescence and rationality. I argue that these norms act to regulate what emotions it is possible to feel, what emotions it is possible to articulate and what type of young lives that can be told. The future development of health and social care interventions which aim to reduce lesbian, gay, bisexual and trans youth suicide and self-harm need to work with a nuanced understanding of the emotional life of young people if they are to be effective.