RESPECTFUL CARE AND SUPPORT FOR

LGBTQ CLIENTS AND COLLEAGUES

Part 2: Reflecting on Personal Attitudes and Values
Webinar: February 4, 2015
Facilitators: Jean Clipsham NP
Dianne Roedding RN Non Practising Class

LGBTQ OPINION POLL

REVIEW OF SEXUAL ORIENTATION AND

GENDER IDENTITY

SEXUAL ORIENTATION AND GENDER

IDENTITY
Sexual orientation: refers to an individuals emotional and/or

sexual attraction to a gender or genders. Some sexual

orientations include heterosexual, gay, lesbian, bisexual,
pansexual and asexual.
Gender Identity: is ones private and subjective sense of being
male, female, trans or a persons internal sense of self and
identification as a man or woman or both or neither.
These include male, female, trans, intersex, two-spirit, genderqueer,

bigender, gender fluid.

Gender Expression
refers to the external
ways in which an
individual communicates
their gender identity
(e.g. through
mannerisms, interests,
attire, voice pitch etc.)

 Gender Identity can be thought of as a

continuum:
Male_______Two-Spirit, Bigender,
Intersex_____Female
Genderqueer

OR ON A GENDER CONTINUUM FROM NONGENDERED TO MALE/FEMALE

GENDERQUEER:

an umbrella word for people whose gender

identity is outside the typical categories of man

or woman. Similar words include bigender,
agender, third-gender or gender fluid.

PERSONAL ASSESSMENT TOOL

LGBT Inclusivity - Personal Assessment Tool

This tool is not scored because all of us need to assess

ourselves continually as we exist in a heterosexist society. We

are all a work in progress and it is alright to say no or not
sure. No one has achieved complete freedom from
heterosexism.

Please answer Y for Yes, N for No, IP for In Progress or NS for Not Sure

I have an equal rights statement posted in my work

area (e.g. positive space sticker).

N IP
NS

I am honest about the limits of my understanding of

sexual
orientation and gender diversity.
I endeavour to use inclusive language such as
partner
instead of girlfriend/boyfriend or wife/husband.

N IP
NS

N IP
NS

I treat people of all sexual orientations and gender

identities
as individuals with many roles and identities.

N IP
NS

I ask questions to understand the personal lived

realities of
others.

N IP
NS

I have been/or would be accepting of an LGBTQ

person coming out to me.

IP

NS

I examine my own beliefs for heterosexism.

IP

NS

IP

NS

I recognize that a persons appearance, actions

or words may not be reflective of that persons
sexual orientation or gender identity, and I avoid Y
making assumptions based on these
characteristics.

I encourage education about sexual orientation and

gender
identity in my workplace.

N IP
NS

I work to safeguard the rights of sexual orientation and

gender diverse minorities.

N IP
NS

I confront statements and jokes that discriminate or

make fun of gays, lesbians, bisexuals, transsexuals or
two-spirit people.

N IP
NS

PERSONAL STORY

adapted from Smedly BD and Syme SL 2000 by Rainbow Health Ontario

ECOLOGICAL MODEL OF THE MULTILEVEL INFLUENCES ON LGBT HEALTH

LGBTQ CITIZENS
experiences or fear of harassment, discrimination, violence
avoidance of routine health care services
difficulties finding accessible, competent services
lack of knowledge of own health issues and risks
higher burden of illness and poverty in some segments
high levels of stress, stigma and social isolation

FAMILY, FRIENDS AND COMMUNITY

may by rejecting or abusive when member comes out
family may be ostracized or lack supports
friends or colleagues may become distant
bullying and harassment common in schools and workplaces
few community programs to support healthy self-image, new friendships
LGBTQ rarely an accepted or valued segment of the community

INSTITUTIONS AND ORGANIZATIONS

health organizations lack training and policies to ensure they are welcoming,

culturally competent
health and social service providers lack knowledge of LGBTQ issues, health

disparities
professional schools do not include LGBTQ health in core curricula
workplaces may be unsafe for LGBTQ staf
health promotion programs rarely include LGBTQ people
overall environment of discomfort and silence regarding LGBTQ issues

SOCIAL AND ECONOMIC POLICIES

LGBTQ people rarely counted in large population-based surveys
LGBTQ health research and policy focused on gay men and HIV
major gaps in knowledge of health status and specific concerns of LGBTQ

communities
LGBTQ services mostly grass roots or volunteer little capacity for research

or public policy work

culture of invisibility surrounds LGBTQ people in public policy

CULTURAL COMPETENCE

LGBTQ Cultural Competence for Nurses

Understand the far-reaching efects of social stigma and

stress on the health of LGBTQ people, their families and
communities.
Understand how homophobia/biphobia/ transphobia
interact with other oppressions such as racism and sexism
and acknowledge the privilege that society bestows on
certain groups.
Know the health issues that disproportionately afect
LGBTQ people:

LGBTQ HEALTH ISSUES

o For gay men they are: HIV/AIDS, safer sex, hepatitis

immunization and screening, fitness (diet and exercise), alcohol
use, substance use, depression and anxiety, STIs, cancers
(prostate, testicular and colon), Human Papillomavirus.

o For lesbians they are: breast cancer, depression and anxiety,

heart health, gynecological cancers, fitness (diet and exercise),
tobacco use, alcohol use, substance use, intimate partner
violence. sexual health

o For bisexuals they are: HIV/AIDS, safer sex, Hepatitis

immunization and screening, fitness (diet and
exercise), alcohol use, substance use, depression and
anxiety, STIs, cancers (prostate, testicular, breast,
cervical and colon), tobacco use, HPV

o For Trans people they are: access to health care,

hormones, surgeries, cardiovascular health, cancers,
STIs, safer sex, alcohol use, tobacco use, depression,
injectable silicone, fitness (diet and exercise)

 Refrain from making assumptions about

someones sexual orientation or gender identity
based on appearance;
dont assume that everyone is heterosexual;
treat all people as individuals with many roles
and identities.

Utilize efective communication:

remember that patient information is protected by privacy
and confidentiality;
use neutral and inclusive language with all clients, e.g.
partner;
listen to and reflect the clients choice of language when
describing their sexual orientation or gender identity and
relationship to their partner.

 Be honest. If you have not had much experience working

with LGBTQ people and youre anxious about ofending
them, let them know. You may want to say that youre
working to understand these issues, but there are areas
you are still learning about. This will help to create safe
space for dialogue.
If you are unsure of a persons gender identity, ask
neutral questions such as: how would you like to be
addressed? or what pronouns do you prefer?

 Ensure all forms contain gender neutral language, and

allow for self-identity, e.g. parent instead of mother/father;
include trans, intersex as well as male/female for gender
and leave room for write in identities.
Ask permission to document sexual orientation or gender
identity.

SAMPLE INTAKE FORM

What is your sexual orientation?

WHAT IS YOUR GENDER IDENTITY?

Heterosexual (Straight)

Female

Gay

Male

Lesbian

Transsexual

Bisexual

Transgender

Pansexual

Intersex

Asexual

Genderqueer

Other_______________

Two-Spirit
Other___________

 Work to understand the many terms that describe behavior

and characteristics of LGBTQ people. Also be aware that many
terms are derogatory and hurtful or denote a clinical or
medical condition, for example, homosexual or gender
dysphoria.
Be aware of the power of non-verbal signs and their
significance to the LGBTQ communities, such as pride flags,
rainbows, or pink triangles, etc. to communicate that you
support the communities.

 Facilitate Coming Out: honour and respect the clients

timing; ensure forms or questionnaires use inclusive,
gender neutral language; be aware that visible
discomfort by staf or other patients can undermine
comfort
Promote policies that are inclusive of LGBTQ families
such as regarding visiting hours and who can visit,
parenting classes that refer to parents/guardians
rather than mother and father

 Create a welcoming environment: post inclusive posters and

pamphlets and symbols that reflect inclusivity, e.g. resources for
LGBTQ,, symbols such as a pride flag or pride sticker; recognize
the diference between tolerance, acceptance, celebration and
advocacy.
Reflect on your own practice: do you advocate for LGBTQ
inclusivity, challenge homophobic/heterosexist comments or
jokes, reflect on your limits of understanding and seek training?

 Understand the efects of heterosexism in the

workplace: Provide support for colleagues, stand up to
workplace bullying, advocate for staf education. Are
co-workers out or do they feel intimidated and
afraid?

WRAP UP

 questions those that can not be answered now will be compiled and posted

Part 3 February 25
Part 4 March 25