Eliason Michele J Ph.D - LGBTQ Cultures: What Health Care Professionals Need to Know About Sexual and Gender Diversity

3rd Edition

Michele J. Eliason, PhD

Peggy L. Chinn, RN, PhD, FAAN

Acquisitions Editor: Nicole Dernoski

Editorial Coordinator: Jeremiah Kiely

Production Project Manager: Kim Cox

Marketing Manager: Linda Wetmore

Manufacturing Manager: Kathleen Brown

Design Coordinator: Larry Pezzato

Vendor: Aptara, Inc.

Copyright 2018 Wolters Kluwer

Two Commerce Square

2001 Market Street

Philadelphia, PA 19103

All rights reserved. This book is protected by copyright. No part of this book may be reproduced or transmitted in any form or by any means, including as photocopies or scanned-in or other electronic copies, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews. Materials appearing in this book prepared by individuals as part of their official duties as U.S. government employees are not covered by the above mentioned copyright. To request permission, please contact Lippincott Williams & Wilkins at Two Commerce Square, 2001 Market Street, Philadelphia, PA 19103, via email at (products and services).

9 8 7 6 5 4 3 2 1

Printed in China

Library of Congress Cataloging-in-Publication Data

Names: Eliason, Michele J., author. | Chinn, Peggy L., author.

Title: LGBTQ cultures : what health care professionals need to know about

sexual and gender diversity / Michele J. Eliason, Peggy L. Chinn.

Description: 3rd edition. | Philadelphia : Wolters Kluwer, [2018] | Includes

bibliographical references and index.

Identifiers: LCCN 2017038782 | ISBN 9781496394613

Subjects: | MESH: Sexual Minorities | Gender Identity | Attitude of Health

Personnel | Health Services Accessibility | Culturally Competent Care

Classification: LCC RA564.9.H65 | NLM WA 300.1 | DDC 362.1086/6dc23

LC record available at https://lccn.loc.gov/2017038782

DISCLAIMER

Care has been taken to confirm the accuracy of the information present and to describe generally accepted practices. However, the authors, editors, and publisher are not responsible for errors or omissions or for any consequences from application of the information in this book and make no warranty, expressed or implied, with respect to the currency, completeness, or accuracy of the contents of the publication. Application of this information in a particular situation remains the professional responsibility of the practitioner.

To purchase additional copies of this book, please visit Lippincotts NursingCenter.com or call our customer service department at (800) 638-3030 or fax orders to (301) 223-2320. International customers should call (301) 223-2300.

Visit Lippincott Williams & Wilkins on the Internet: http:/www.lww.com. Lippincott Williams & Wilkins customer service representatives are available from 8:30 am to 7:00 pm, EST.

We started this book as a group of four White nurses who had spent many years in educational institutions. We said goodbye to Jeanne DeJoseph and Sue Dibble after the first edition when they retired. Mickey and Peggy updated the content for the second edition, but retained most of the information from the first edition. We dedicate this work to Sue and Jeanne who were pivotal in getting the project up and running in the first place.

We also dedicate this book to the LGBTQ nurses and other health professionals and the allies who helped us see the need for this book, and the LGBTQ people who need to have culturally sensitive healthcare providers to feel safe and included when they seek out health services.

Michele J. Eliason, PhD

Peggy L. Chinn, RN, PhD, FAAN

W hen we wrote the first edition of this book, published in 2007, we felt that there was a dire need for an introductory level book on sexual and gender identities for healthcare provider audiences. There were a few books focused on medical care or specific health issues such as substance abuse and lots of books on HIV/AIDS, but in our own experience, students in healthcare-related educational programs, whether medicine, nursing, physical therapy, psychology, social work, or other majors, often lacked the basics. In that first edition, we found little research on specific physical health problems other than HIV/AIDS and other sexually transmitted infections, and not that much information about the experiences of LGBTQ people in hospitals or clinics either. The only area where research was fairly robust was about substance abuse and mental health problems.

When we updated the book in 2016, there was much more information available about physical health and links between minority stress and chronic illnesses. Along with health information, there was a virtual explosion of writing about gender identities, and much more study of nonbinary identities that expanded the possible identities for people beyond male, female, or transgender. There was an expansion of sexual identities as well. We appreciated how fast the field has evolved.

Now, in 2017 as the ebook becomes available in a physical book format, we are in an almost unimaginable time in the United States when hard-won LGBTQ rights are being threatened at local, state, and especially national levels once again. Religious freedom bills are proliferating, workplace protections for government workers have been rolled back, there are movements to limit adoptions by same-sex couples, and so much more. Repeal of the Affordable Care Act would remove health insurance from thousands of LGBTQ people who were finally covered by health insurance for the first time. Transgender, gender variant, genderqueer, and gender nonbinary folks are the targets of anti-LGBTQ hatred, with much of the emphasis in the media focused on access to bathrooms. At the same time, transgender women of color are being murdered on a regular basis. There is a resurgence of anti-LGBTQ sentiment across the world, from death threats and detention and torture camps for gay men in Chechnya to extremist Islamic groups murdering gay men. White supremacists have gained power and influence in the United States, and they threaten the lives of people of color, women, and LGBTQ people (and some people embody all of these oppressed minority identities in one body).

The only way we can ensure continued progress in civil rights for all people is through thorough and accurate education about human variations and differences, without labeling them as disorders. We hope that having this book available in hardcopy will encourage its use in classrooms across the world as an introductory text that will benefit all students, who will encounter LGBTQ people not only in their work in healthcare settings, but also in their daily lives; in their families, their neighborhoods, their congregations and schools and elsewhere. Education is one part of a larger strategy to ensure human rights, and until healthcare curricula consistently address LGBTQ issues, myths and stereotypes are perpetuated.