Michele J. Eliason

Nursing's silence on lesbian, gay, bisexual, and transgender issues: the need for emancipatory efforts.

The purpose of this study was to selectively review the nursing literature for publications related to lesbian, gay, bisexual, and transgender health, using (1) a key word search of CINAHL, the database of nursing and allied health publications; (2) from the top-10 nursing journals by 5-year impact factor from 2005 to 2009, counting articles about lesbian, gay, bisexual, and transgender issues; and (3) content analysis of the articles found in those journals. Only 0.16% of articles focused on lesbian, gay, bisexual, and transgender health (8 of nearly 5000 articles) and were biased toward authors outside of the United States. We discuss the impact of this silence.

Nowhere to go: How stigma limits the options of female drug users after release from jail

BackgroundDrug and alcohol using women leaving prison or jail face many challenges to successful re-integration in the community and are severely hampered in their efforts by the stigma of drug or alcohol use compounded by the stigma of incarceration.MethodsThis qualitative study is based on individual semi-structured interviews and focus groups with 17 women who had recently left jail about the challenges they faced on reentry.ResultsOur analysis identified three major themes, which are related by the overarching influence of stigma: survival (jobs and housing), access to treatment services, and family and community reintegration.ConclusionStigma based on drug use and incarceration works to increase the needs of women for health and social services and at the same time, restricts their access to these services. These specific forms of stigma may amplify gender and race-based stigma. Punitive drug and social policies related to employment, housing, education, welfare, and mental health and substance abuse treatment make it extremely difficult for women to succeed.

Lesbian, Gay, Bisexual, and Transgender (LGBT) Physicians' Experiences in the Workplace

Little is known about the experiences of lesbian, gay, bisexual, and transgender (LGBT) physicians in the workplace. There is little formal education in medical school about LGBT issues, and some heterosexual physicians have negative attitudes about caring for LGBT patients or working with LGBT coworkers, setting the stage for an exclusive and unwelcoming workplace. The current study used an online survey to assess a convenience sample of 427 LGBT physicians from a database of a national LGBT healthcare organization, as well as a snowball sample generated from the members of the database. Although rates of discriminatory behaviors had decreased since earlier reports, 10% reported that they were denied referrals from heterosexual colleagues, 15% had been harassed by a colleague, 22% had been socially ostracized, 65% had heard derogatory comments about LGBT individuals, 34% had witnessed discriminatory care of an LGBT patient, 36% had witnessed disrespect toward an LGBT patients partner, and 27% had witnessed discriminatory treatment of an LGBT coworker. Few had received any formal education on LGBT issues in medical school or residency. It appears that medical schools and health care workplaces continue to ignore LGBT issues and operate in discriminatory fashion far too often.

A national survey of faculty knowledge, experience, and readiness for teaching lesbian, gay, bisexual, and transgender health in baccalaureate nursing programs

AIM This article assesses the knowledge of faculty in baccalaureate nursing programs and their readiness to teach about lesbian, gay, bisexual, and transgender (LGBT) health. BACKGROUND Although health disparities affecting the LGBT population are increasingly acknowledged in the literature, a dearth of information exists on how LGBT health is integrated in nursing programs. METHOD A survey was sent to a nonprobability purposive sample of nursing school administrative leaders (N = 739); they were asked to share the link with their faculty. More than 1,000 faculty completed the survey. RESULTS The knowledge, experience, and readiness for teaching LGBT health among baccalaureate faculty are limited. LGBT faculty reported greater awareness, knowledge, and readiness compared with heterosexual faculty. The estimated median time devoted to teaching LGBT health was 2.12 hours. CONCLUSION Findings will help inform the design of faculty development programs and guide in aligning the curricula with current LGBT health priorities.

The Last Drag: An Evaluation of an LGBT-Specific Smoking Intervention

Many studies in the past 20 years have documented that lesbian, gay, bisexual, and transgender (LGBT) individuals smoke at rates that exceed the general population, yet, there have been few reports of smoking cessation interventions targeting this population. This study reports on data from 233 participants in The Last Drag, a seven-session, six-week group education and support intervention tailored for LGBT smokers. Data on smoking rates were collected during the first and last sessions, and at one, three, and six months post-intervention. As with many interventions over time, missing data is a challenge in determining success rates, but even using the most conservative estimates, nearly 60% were smoke-free at the end of the intervention, and 36% remained smoke-free by six months post-intervention. This success rate is comparable to, or better, than many mainstream smoking cessation interventions reported in the literature. The Last Drag is an effective, low-cost, LGBT-specific community intervention that can be replicated in other communities.

Lesbian, Gay, Bisexual, Transgender, and Queer/Questioning Nurses' Experiences in the Workplace

Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) nurses constitute one of the largest subgroups within the profession of nursing, yet there is very little empirical research in the nursing literature and virtually no attention to issues of discrimination and exclusion in the workplace by nursing education or professional nursing organizations. This study reports the findings of an online survey of 261 LGBTQ nurses from a database of an LGBTQ health advocacy organization. The survey contained both quantitative and qualitative items and revealed that many workplaces lacked policies and procedures that would make LGBTQ nurses feel safer and more included and that many coworkers, supervisors, and patients had exhibited discriminatory behavior or verbal harassment, sometimes leading to significant consequences for the LGBTQ worker. LGBTQ nurses expressed a need for a professional organization that would educate the nursing profession and the general population about LGBTQ issues and address their advocacy and health care policy needs. Efforts to correct the current workplace climate for LGBTQ employees would involve (a) changes in workplace policies, (b) education of the health care workforce, and (c) advocacy from nursing professional organizations.

An Ecological Framework for Sexual Minority Women’s Health: Factors Associated With Greater Body Mass

In recent years, many studies have focused on the body of sexual minority women, particularly emphasizing their larger size. These studies rarely offer theoretically based explanations for the increased weight, nor study the potential consequences (or lack thereof) of being heavier. This article provides a brief overview of the multitude of factors that might cause or contribute to larger size of sexual minority women, using an ecological framework that elucidates upstream social determinants of health as well as individual risk factors. This model is infused with a minority stress model, which hypothesizes excess strain resulting from the stigma associated with oppressed minority identities such as woman, lesbian, bisexual, woman of color, and others. We argue that lack of attention to the upstream social determinants of health may result in individual-level victim blaming and interventions that do not address the root causes of minority stress or increased weight.

Correlates of Wellbeing Among African American Lesbians

Although there is a growing body of knowledge about health among African American women in general, there is a dearth of information on African American lesbians. The primary purpose of this study was to investigate the correlates of health-related quality of life among African American lesbians using a cross-sectional anonymous survey with topics and measures developed by members of the African American lesbian community. Surveys were completed by 123 English speaking adult women who identified as African American lesbians and were attending the Zuna Institutes National Black Lesbian Conference. Overall, we found a very high health-related quality of life, in spite of a high frequency of health impairments. The average body mass index (BMI) for this sample was 32.2 (SD = 8.0); 13% were morbidly obese, having a BMI of 40 or more and only 15% of the women were in a healthy weight range; advancing age was associated with poorer physical functioning, decreased physical role functioning, and more pain. Health-related quality of life was associated with depression and spirituality, but not religion. This study highlights the need for subjective measures of health-related quality of life as well as checklists of diseases and disorders.

An Exploration of Terminology Related to Sexuality and Gender: Arguments for Standardizing the Language

There is currently no consensus on the best ways to define and operationalize research concepts related to sexuality and gender. This article explores some of the ways that sex/gender and sexuality terms have been used in health-related research and in keyword searches in the health sciences. Reasons for the diversity of terms and measurement approaches are explored and arguments for and against standardizing the language are presented. The article ends with recommendations for beginning a productive dialogue among health researchers to create some consistency in the terminology used to assess sexuality and gender.

Challenging the Assumption of Fusion in Female Same-Sex Relationships

In psychotherapeutic and lesbian popular culture literatures, there is an assumption that female same-sex couples are overly close and lack boundaries, a concept called “fusion.” Empirical efforts have yet to demonstrate whether fusion is experienced more often among women in same-sex relationships than among men in same-sex relationships or among men and women in heterosexual relationships. Furthermore, research on the topic has yet to fully incorporate feminist perspectives that challenge assumptions that high levels of closeness in and of themselves are problematic. Our study employed measures of Inclusion of Other in Self (Aron, Aron, & Smollan, 1992) to examine the distribution of indicators of fusion among 76 women and 58 men in same-sex relationships and 1,221 women and 285 men in heterosexual relationships. Women in same-sex couples differed from the other groups on only one indicator of fusion—they were more likely to desire less closeness in their relationships, even though their current relationships were rated as close as other types of relationships. Our study suggests that widely held assumptions that women in same-sex couples experience and idealize pathologically high closeness are not accurate.