"Automatic assumption of your gender, sexuality and sexual practices is also discrimination": Exploring sexual healthcare experiences and recommendations among sexually and gender diverse persons in Arctic Canada.

Authors:
Carmen H Logie
Carmen H Logie
University of Toronto
Canada
Candice L Lys
Candice L Lys
1 University of Toronto Dalla Lana School of Public Health
Lisa Dias
Lisa Dias
1 University of Toronto
Nicole Schott
Nicole Schott
e Ontario Institute for Studies in Education (OISE)

Health Soc Care Community 2019 Apr 15. Epub 2019 Apr 15.

Fostering Open eXpression Among Youth (FOXY), Yellowknife, NT, Canada.

Sexual and mental health disparities are reported in Arctic Canada as in other Arctic regions that experience shared challenges of insufficient healthcare resources, limited transportation, and a scarcity of healthcare research. Lesbian, gay, bisexual, transgender, and queer persons (LGBTQ+) report sexual and mental health disparities in comparison with their heterosexual and cisgender counterparts, and these disparities may be exacerbated in rural versus urban settings. Yet limited research has explored sexual healthcare experiences among LGBTQ+ persons in the Arctic who are at the juncture of Arctic and LGBTQ+ health disparities. We conducted a qualitative study from May 2015 to October 2015 with LGBTQ+ persons in the Northwest Territories, Canada that involved in-depth individual interviews with LGBTQ+ youth (n = 16), LGBTQ+ adults (n = 21), and key informants (e.g. coaches, teachers, nurses, social workers, and healthcare providers) (n = 14). We conducted thematic analysis, a theoretically flexible approach that integrates deductive and inductive approaches, to identify and map themes in the data. Findings reveal geographical, social, and healthcare factors converge to shape healthcare access. Specifically, the interplay between heterosexism and cisnormativity, intersectional forms of stigma, and place limited LGBTQ+ persons' sexual healthcare access and produced negative experiences in sexual healthcare. Limited healthcare facilities in small communities resulted in confidentiality concerns. Heteronormativity and cisnormativity constrained the ability to access appropriate sexual healthcare. LGBTQ+ persons experienced LGBTQ+, HIV, and sexually transmitted infections stigma in healthcare. Participants also discussed healthcare provider recommendations to better serve LGBTQ+ persons: non-judgment, knowledge of LGBTQ+ health issues, and gender inclusivity. Findings can inform multi-level strategies to reduce intersecting stigma in communities and healthcare, transform healthcare education, and build LGBTQ+ persons' healthcare navigation skills.

Download full-text PDF

Source
http://dx.doi.org/10.1111/hsc.12757DOI Listing
April 2019

Publication Analysis

Top Keywords

sexual healthcare
20
lgbtq+ persons
16
healthcare
16
lgbtq+
12
health disparities
12
sexual mental
8
arctic canada
8
healthcare experiences
8
sexual
8
persons arctic
8
lgbtq+ persons'
8
lgbtq+ health
8
healthcare access
8
mental health
8
persons
6
arctic
5
reveal geographical
4
findings reveal
4
data findings
4
approaches identify
4

References

(Supplied by CrossRef)
Access to health services by lesbian, gay, bisexual, and transgender persons: Systematic literature review
Alencar Albuquerque G. et al.
BMC International Health and Human Rights 2016
Suicide and alcohol‐related disorders in the U.S. Arctic: Boosting research to address a primary determinant of health disparities
Allen J. et al.
International Journal of Circumpolar Health. 2011
Thematic networks: An analytic tool for qualitative research
Attride‐Stirling J. et al.
Qualitative Research 2001
Making assumptions, making space: An anthropological critique of cultural competency and its relevance to queer patients
Baker K. et al.
Medical Anthropology Quarterly 2014
“I Don’t Think This Is Theoretical; This Is Our Lives”: How erasure impacts health care for transgender people
Bauer G. R. et al.
Journal of the Association of Nurses in AIDS Care 2009
Health inequalities among sexual minority adults
Blosnich J. R. et al.
American Journal of Preventive Medicine 2014
Using thematic analysis in psychology
Braun V. et al.
Qualitative Research in Psychology 2006
Unravelling the contexts of stigma: From internalisation to Resistance to change
Campbell C. et al.
Journal of Community and Applied Social Psychology 2006
The health and health care of lesbian, gay, and bisexual adolescents
Coker T. R. et al.
Annual Review of Public Health 2010

Similar Publications