The past decade has provided increased awareness and understanding of the significant health disparities experienced by the LGBTQ+ community. The past 10 years have also brought around a linguistic and cultural revolution and a subsequent shift in the language used by members of the LGBTQ+ community.
Words and actions are powerful and important and using mindful practice will create a welcome environment to LGBTQ+ patients, families, staff, and visitors. Health care workers including audiologists have been asked to think deeply on how they engage with all people to create safe environments.
Studies of the health disparities experienced by the LGBTQ+ community within audiology are lacking and therefore not well understood. However, health disparities for LGBTQ+ people extend to the signing Deaf community. Research has found greater health disparities among Deaf LGBTQ+ people comparted to Deaf non-LGBTQ+ people for physical and mental health.
LGBTQ+ patients are more inclined to seek medical care when they perceive the provider as accepting of the LGBTQ+ community. One study found that LGBTQ+ patients seek out providers that advertise being LGBTQ+ friendly. Patients feel more comfortable sharing confidential information when there is a perception of trust and that the provider will understand the complexity of the situation.
Social isolation is more common in LGBTQ+ older adults and in adults with hearing loss, suggesting that LGBTQ+ older adults with hearing loss may be particularly susceptible to social isolation because of the intersectional experiences of marginalisation between their hearing loss and their LGBTQ+ identity. Audiologists may find that because of these intrapersonal factors, LGBTQ+ patients have less social support than other populations.
Audiologists can be sources of interpersonal stigma for their patients. A survey of LGBTQ+ individuals receiving services from communication sciences and disorders health care providers found that 79% of LGBTQ+ patients felt that their identity was a barrier to receiving services, and only 4% chose to share their identity with their communication disorders health care provider. Little education about LGBTQ+ identities and the best practices for care of these populations is present in audiology or other health care courses, which leads to health care providers like audiologists often knowing little about the unique challenges that LGBTQ+ people experience. This lack of knowledge contributes to health disparities among LGBTQ+ people, causes health care providers to be a source of stigma and discrimination for LGBTQ+ patients and colleagues, and reduces health care use by LGBTQ+ adults. Unconscious bias may negatively influence patient–provider relationships even with health care providers that do not wish to treat their LGBTQ+ patients differently. People who experience negative interactions with health care providers are more likely to leave a practice and not return. Cultural humility and increased training on LGBTQ+ issues can reduce bias and prejudice among health care providers.
Displaying LGBTQ+ pride flags or posters can indicate to patients that it is a welcoming practice without needing to indicate this individually to each patient. Signs like this allow the patient to recognise that they are in a safe place to come out. Another strategy to provide access to patients is to convert gendered restrooms into gender-neutral restrooms.
An important strategy to ensure that a practice is more welcoming is to use inclusive language on marketing materials, in case history forms, and in records. Rather than asking only for legal name, the clinic could add an additional line asking what name the patient goes by. This helps more than just LGBTQ+ patients as it allows for patients to indicate if they would prefer to go by a middle name or nickname and can make rapport building with these patients much easier.
Being an inclusive provider is recognising when a mistake has been made, making a short apology, and correcting the error. Even the members of the LGBTQ+ community make mistakes when meeting new people or as they learn more.
All people, regardless of their identity, deserve equitable access to quality health care. Audiologists are bound by ethical responsibility to create a safe place for patients to feel welcome and share personal information.
From ‘Providing Mindful and Informed Health Care for Patients Who Are LGBTQ+: Perspectives for Clinical Audiology’ by Shade Avery Kirjava, Douglas P. Sladen and J. Riley DeBacker.
There are surprising parallels in the narratives of being Deaf and being queer.
Just as queer people are for the most part raised by straight-identifying parents, most profoundly deaf children are born to hearing parents. These parents are frequently unable to provide a framework for understanding the experiences of discrimination that their children will encounter in their lives. Consequently, some of these children will grow up to seek shared experience later in life, joining communities that become sources of culture, connection, identity, and pride.
However, as both signing Deaf and queer communities stand outside able-bodied and straight standards of acceptability, both communities have to fight against politics that push them towards invisibility and conformance as opposed to visible identity. Both communities face barriers in accessing equitable health care.
Zoée Montpetit, founder of Queer ASL in Vancouver and the president of the British Columbia Rainbow Alliance of the Deaf, thinks that these parallels may be why queer people are drawn to her sign language classes.
“Before I got involved in the hearing queer community,” says Montpetit “I struggled to expand my signing community.
“But queer people understand how it is to be marginalised. Once they start to learn about sign language and Deaf culture, I think they start to recognise aspects that they relate to.”
Montpetit says that her queer and trans students are motivated by a sense of solidarity with Deaf communities.
“There is a real sense of kinship, a desire to increase access, and an ability to understand how hearing people can oppress Deaf people, just as straight people can oppress queer people.”
Read more from How The Deaf And Queer Communities Are Tackling Oppression Together.