Queerness in Healthcare
Content warning: mental health, substance abuse, bullying, suicide, trans discrimination
Being an openly queer nurse in healthcare, especially mental health care, is a weird place to be.
Your peers either think you’re the only person who can relate to certain patients or they think there’s something off about you in general. I can get both options in the same day depending on who is working with me. I have dual degrees in nursing and psychology and I work in an acute inpatient psychiatric hospital caring for patients in crisis. Many of my patients identify as gay (in the umbrella sense of the term) or transgender. Even in 2019 where most people are aware of the differences in sexual and gender orientations, many patients, families, and hospital staff show a complete lack of understanding or empathy for identity issues.
LGBTQ patients, especially bisexual patients, are far more likely to struggle with mental health, substance abuse, and suicide compared to heterosexual populations (Lee & Kanji, 2017). They are also less likely to have a primary care physician and to seek healthcare assistance for fear of discrimination (McCrone, 2018). When I work on the pediatric unit, I witness many kids complain about bullying at school for being gay or trans or that their parents do not support them. Consequently, they attempted to kill themselves and required assistance from healthcare providers.
Queer adults who seek care both inpatient and outpatient run into discrimination and micro-aggressions from providers frequently.
I remember caring for a young adult male who was open about his sexuality and his job as a go-go dancer at a gay club in town. I had to confront other male patients throwing homophobic slurs at him and reprimanding male staff who refused to intervene. One male tech actually stated to me, “I don’t want to be anywhere near him, he makes me uncomfortable.”
Transgender patients have an extra layer of complications to deal with.
I have had transgender patients complain to me that multiple staff members have misgendered and deadnamed them. It is common for me to hear statements like “I don’t care what so-and-so identifies as, I’m calling him a he” or “she just wants attention and to feel special.” It is hospital policy to not allow transgender patients to have a roommate. When I questioned the policy, I was told, “The policy exists so that we don’t have men pretending to be women to gain access to female rooms.”
It is unacceptable for healthcare to repeat the same tired transphobic trope that trans women are men or have predatory tendencies.
This idea is what contributes to the oppression of trans people and puts them at a higher risk for suicide. A survey done by the American Association of Pediatrics showed that over half of transgender boys in the sample attempted suicide and nearly 30% of transgender girls thanks to family rejection, bullying, and/or harassment (Hassanein, 2018). How can we as healthcare providers claim to advocate for our patients when we participate in the exact things that contribute to their oppression? Sadly, I am considered the odd one by many of my peers because I ask trans patients what their preferred name is and what pronouns they use. A doctor at my facility legitimately thinks trans women fake their gender to gain access to female bathrooms and prey on little girls and supports the current Trump ban on transgender people in the military. This same doctor has subtly mocked me for my sexual orientation, making comments like “when you’re sick of men you’ll switch over to women” or “I can’t keep track of who you’re into this week.”
Speaking of being mocked, I get quite a bit of homophobic bullshit from doctors, nurses, and patient assistants when they find out my sexual orientation. When I first started working at the facility, I had a boyfriend and a girlfriend as a polyamorous setup and people acted like I must be a greedy slut and why wasn’t I just satisfied with my boyfriend? I ended up breaking things off with him but still staying with my girlfriend and the number one question I got was not “how are you doing?”, it was “so are you a lesbian now or what?” One time I was about to answer that question but another male nurse interrupted and said “nah she’s still about 30% into men.” I used to get angry and speak up for myself but it happens so frequently that I’m over it and I just ignore the stupid questions and comments. I now joke that if I had a dollar for every time someone asked me who I preferred, I could retire. It’s now rather amusing to me how fascinated and concerned my coworkers are with my sex life, and I tend to tell them that their heterosexuality must be boring them if they’re so interested in mine.
I know this all seems disheartening, especially for any queer person reading this struggling with physical or mental health problems.
However, there are some positive changes coming down the pike. My peers generally respect my clinical opinion on issues and will come to me asking questions about sexual and gender identities. I had one man disparaging trans individuals for pronoun use but after a few conversations with him I noticed he was sticking to gender-neutral pronouns for many of the patients. When I asked him why, he replied, “Well, I don’t know how people want to identify as these days so I’d rather not offend anybody.” I can’t make everyone in the hospital see things the way I want them to, but his willingness to learn and change is a good start. Weirdly enough, many of my peers are queer themselves. I’m not the only bisexual nurse, we have several gay and lesbian techs and social workers. I am very grateful for them and their perspectives, because we badly need queer people in healthcare. I cannot be the only person advocating for the little gay boy crying because his parents told him homosexuality is a sin and he’s supposed to like girls, or the young trans woman wanting to die because she cannot afford surgery and the dysphoria is overwhelming. I wish we had more trans nurses and doctors at the hospital to care for trans patients because I’m cisgender and my ability to relate is limited.
So if you’re a healthcare provider reading this, please take the time to think about how you treat queer and trans individuals and if you need to do a better job of accepting them. Frankly, if you cannot give unbiased care to these people, you shouldn’t be in healthcare, regardless of what your religion states. I have cared for Nazis, rapists, and child sex offenders as a nurse, so I’m pretty sure you can get your shit together and not be homophobic or transphobic towards a person looking for help. If you’re a queer person reading this and interested in in the health field, know that I and the rest of the queer community needs you. Oppression and stigma is not going to disappear unless we do something about it.
- Hassanein, R. (2018, September 12). Study Shows Shocking Rates of Attempted Suicide Among Trans Teens. Retrieved from https://www.hrc.org/blog/new-study-reveals-shocking-rates-of-attempted-suicide-among-trans-adolescen
- Lee A, Kanji Z. Queering the health care system: Experiences of the lesbian, gay, bisexual, transgender community. Canadian Journal of Dental Hygiene. 2017;51(2):80. https://search-ebscohost-com.ezp.waldenulibrary.org/login.aspx?direct=true&db=edo&AN=123816860&site=eds-live&scope=site. Accessed June 20, 2019.
- McCrone, S. (2018). Lgbt Healthcare Disparities, Discrimination, And Societal Stigma: The Mental And Physical Health Risks Related To Sexual And/or Gender Minority Status. American Journal of Medical Research, 5(1), 91. doi:10.22381/ajmr5120189