|
| Main
| français
| CWHN home |
|
Download the PDF (404 KB, 20 Pages)
Reduce Differences in Health Status Build Healthy Public Policy Strengthen Community and Personal Action
|
|
Out in the Cold: Lesbian Health in Northern BC Lynda Anderson, Theresa Healy, Barbara Herringer, Barbara Isaac and Ty Perry, British Columbia Centre of Excellence for Women’s Health and the Northern Secretariat ¹
Out in the Cold, a study involving forty lesbians living in northern communities, reveals that place, sexual orientation, personal safety and community values interact and have impact upon health. In northern British Columbia where this study took place, anti-homosexual rhetoric is expressed in everyday encounters and through local media. Health services are also influenced by these biases. In focus groups and interviews, participants described the abiding dilemma of having to decide whether to reveal or conceal their sexual identity in the community and in health care. This study flags this dilemma and the condition of personal threat it denotes as a determinant of lesbian health and wellness. The interaction of place and sexual identity/personal safety, however, gives rise to a reality that is more complex and contradictory than would initially seem to be the case. The lesbians who participated in the study ranged in age from eighteen to "too-old-to-want-to-talk-about-it," women who had identified as lesbians for decades and "baby dykes" newly claiming their sexuality. Most women had lived in the north from five to fifteen years. The objectives of the study included an investigation of lesbians’ experiences in northern health care services and the barriers they encounter. An analysis of their narratives reveals three major groups of findings. 1. The northern context has a critical impact on the health and wellness of lesbians living there. Criticism and hatred allowed in the media and homophobia within the educational system and in publicly distributed religious propaganda inflicted an overwhelming fear in some women. "Because I have had to really hide who I am for such a long time, I’m finding I’m a lot more stressed," one participant said. "There’s the fear of, the risk of, losing my job if I’m out." "I realized I hadn’t built a support system," another woman recounted. "The most detrimental thing to my overall well-being is the isolation, the feeling of not belonging, of not being included." Rural respondents who were not "out" assumed that neighbours, co-workers and health care providers knew they were lesbians. These women relied on people’s good will to "not say the words" that might result in rejection, threat or lack of care. Although many lesbians described a day-to-day oppressiveness, others cited the benefits of living outside of cities and close to wilderness. Some expressed this in spiritual terms. Others emphasized the satisfactions of self-reliance, self-determination and privacy. "I’m free to grow a lot of what I eat. Just being able to stand out in my backyard and breathe in fresh air and hold my partner’s hand if I want to." 2. Formal health care services are permeated by the homophobia and heterosexism of northern society. "A heterosexual woman doesn’t go in afraid to say, ‘This is my partner.’ She will not have to think about whether or not this doctor in an emergency will hate her if she discloses that she is in this relationship, or if he will treat her differently," one woman told us. Another participant laughed ruefully as she recounted how a receptionist yelled across a full waiting room, " ‘Your medical card says your husband’s name is Sally... How can that be?’ " Other women, who stated they had not experienced biases and barriers, later revealed that they had not come out. Although some participants described positive encounters, most used formal health care services minimally. Sometimes this withdrawal was described in terms of a rejection of a western medical model that focuses on disease rather than wellness. However, most often rejection of health care services was related to demeaning experiences of homophobic responses by health care providers. "[The doctor] was very attentive and real talkative before I told him that I was a lesbian," one woman said. "And then the room became silent. His whole attitude changed, you could tell. And he stared at me. Like stared at me, you know." Many participants were also very aware of the history in medicine of pathologizing homosexuality. "To be labeled is a fear. Labeled as sick because you are a lesbian, labeled as depressed because you are a lesbian." For lesbian women who took their children to health services, the dilemma of disclosure was exacerbated by fear of reprisal against their children from other institutions such as school. 3. Many participants perceived the biases and barriers they encountered in health services as unremarkable. Generally, participants emphasized their own strengths and coping abilities. Many women did not access formal health care except in the case of a critical incident, yet few women used the word "barrier" to define their negative experiences. Instead they emphasized the increased health, wellness and self-esteem gained from their autonomous health care practices. Although several participants did consider their disengagement to be involuntary, they shared the belief that disengagement had enhanced their health. Some women remarked on the painful irony that while they were "proactive" and doing "all the right things" in their selfcare approach, they might also be risking stress-related and undiagnosed illnesses by disengaging from health care services. In the final report of this study we recommend changes at the community level to support the inclusion and personal safety of lesbians in the North; in health care services to educate providers and create equitable, welcoming protocols; and within the lesbian community to enhance social contact and support. Social belonging and personal security—key components of health and wellness—are largely unavailable to lesbians who live in northern cities and towns. This study shows that considerations of personal freedom, safety and health are complexly and uniquely intertwined, suggesting new understandings about the determinants of lesbian health and wellness in the context of place. For a copy of the full report contact: NOTES |
| This page updated |
