Staying in the Hood: Black Lesbian and Transgender Women and Identity Management in North Philadelphia

ABSTRACT

The concept Don’t Ask, Don’t Tell regarding Black LGBT sexuality in Black communities has been an acceptable form of identity management for Black LGBT people. In other words, Black LGBT people are accepted as long as they are not vocal about their sexuality. However, this is changing with the issue of gay marriage, which is creating a space where Black LGBT people are more open about their gender identity and sexuality in heterosexual Black spaces. This new form of openness allows Black LGBT people to “stay in” their communities, as opposed to coming out. In this article I examine how Black LGBT women in North Philadelphia stay in their communities: being politically active regarding LGBT issues, disengaging from LGBT issues, passing, and educating straight Black people about issues affecting the Black LGBT community. I conclude with implications of staying in and intersectionality among Black heterosexual and LGBT women fighting for social change.     

The Role of Institutional Placement,Family Conflict,and Homosexuality in Homelessness Pathways Among Latino LGBT Youth in New York City

ABSTRACT

Despite the overrepresentation of Lesbian, Gay, Bisexual, and Transgender (LGBT) youth among the homeless, the processes leading to their homelessness are understudied. This ethnographic study sought to elucidate the role of sexual orientation in the pathway to housing instability among young gay men. Fieldwork included 18 months of participant observations in public spaces and at a homeless LGBT youth organization in New York City, as well as formal semistructured interviews with 14 Latino young men and five staff. Three distinct pathways emerged. Some youth became homeless after placement in state systems of care disrupted their social support systems, while others became homeless after extreme family conflict over sexual orientation. Nonetheless, most youths became homeless as a result of long-term processes of family disintegration in which normative adolescent development and disclosure of homosexuality exacerbated preexisting conflict. These findings suggest the need to examine the accumulation of risks before disclosure exacerbates family conflict and increases their risk of homelessness.     

Birth environments for women with complex pregnancies: A mixed-methods systematic review

BackgroundBirth environments can help support women through labour and birth. Home-like rooms which encourage active birthing are embraced in midwifery-led settings. However, this is often not reflected in obstetric settings for women with more complex pregnancies.AimTo investigate the impact of the birth environment for women with complex pregnancies.MethodsThis was a mixed-methods systematic review, incorporating qualitative and quantitative research. A literature search was implemented across three databases (Medline, CINAHL, Embase) from the year 2000 to June 2021. Studies were eligible if they were based in an Organisation for Economic Cooperation and Development country and reported on birth environments for women with complex pregnancies. Papers were screened and quality appraised by two researchers independently.Findings30,345 records were returned, with 15 articles meeting inclusion criteria. Studies were based in Australia, the UK, and the USA. Participants included women and health professionals. Five main themes arose: Quality of care and experience; Supportive spaces for women; Supportive spaces for midwives; Control of the space; Design issues.DiscussionWomen and midwives found the birth environment important in supporting, or failing to support, a positive birth experience. Obstetric environments are complex spaces requiring balance between space for women to mobilise and access birthing aids, with the need for medical teams to have easy access to the woman and equipment in emergencies.ConclusionFurther research is needed investigating different users’ needs from the environment and how safety features can be balanced with comfort to provide high-quality care and positive experiences for women.     

Measuring Heterosexual LGBT Ally Development: A Rasch Analysis

An instrument was developed that measured heterosexual persons' level of lesbian, gay, bisexual, and transgender (LGBT) ally identity. Using a Rasch analysis, 2 dimensions were observed: (a) internal and interpersonal and (b) activity. Persons with high levels of LGBT ally identities endorsed items about having LGBT knowledge, attitudes, and skills; having interpersonal experiences with LGBT communities; and including LGBT ally as part of their identities. The instrument met criteria for the content, substantive, structural, generalizability, and responsiveness validity. The instrument can be used to assist persons to develop their abilities to support and advocate for equality for LGBT communities.     

Queering Poetics: The Impact of Poetry on LGBT+ Identity in Singaporean Adolescents

ABSTRACT

This qualitative study explores identity formation in LGBT+ Singaporean adolescents, and how reading, writing, and listening to poetry shapes Singaporean adolescents’ social identities as queer people. Analyzing in-depth interviews with nine LGBT+ Singaporean adolescents, four themes were found: (1) LGBT+ Singaporean adolescents interested in poetry believe that reading, writing, and/or listening to poetry has been an integral part of constructing their queer identities; (2) the poems that have impacted LGBT+ Singaporean adolescents’ queer identities the most have been informed by queer sociocultural values; (3) poetry provides validation to LGBT+ Singaporean adolescents that their identities are real and that others before them have experienced the same challenges they are going through; and (4) poetry serves as a third space for LGBT+ Singaporean adolescents to safely construct their growing queer identities. Implications for teachers, counselors, and adult supporters of queer Singaporean adolescents are discussed, and recommendations for future research are provided.     

Undocuqueer Stress: How Safe are “Safe” Spaces,and for Whom?

ABSTRACT

Exploring the intersection of race/ethnicity, gender, sexuality, and immigration status, this study explored the concept of minority stress among 31 Latinx undocuqueer immigrants within the context of LGBTQ “safe” spaces. For participants, LGBTQ nightclubs and relationships represented important physical and symbolic spaces where they were able to understand what it meant to be undocuqueer. Participants described experiences of fear, anxiety, and rejection as they attempted to enter and exist within spaces presumably “safe” for LGBTQ people. The cumulative effect of feeling unsafe led participants to avoid certain spaces and inhibited their capacity to engage in relationships authentically. This study raises implications for research and policy related to serving LGBTQ and immigrant communities.     

Women's maternity care needs and related service models in rural areas: A comprehensive systematic review of qualitative evidence

BackgroundUnderstanding the needs of rural women in maternity care and service models available to them is significant for the development of effective policies and the sustainability of rural communities. Nevertheless, no systematic review of studies addressing these needs has been conducted.ObjectivesTo synthesise the best available evidence on the experiences of women's needs in maternity care and existing service models in rural areas.MethodsLiterature search of ten electronic databases, digital theses, and reference lists of relevant studies applying inclusion/exclusion criteria was conducted. Selected papers were assessed using standardised critical appraisal instruments from JBI-QARI. Data extracted from these studies were synthesised using thematic synthesis.Findings12 studies met the inclusion criteria. There were three main themes and several sub-themes identified. A comprehensive set of the maternity care expectations of rural women was reported in this review including safety (7), continuity of care (6) and quality of care (6), and informed choices needs (4). In addition, challenges in accessing maternity services also emerged from the literature such as access (6), risk of travelling (9) and associated cost of travel (9). Four models of maternity care examined in the literature were medically led care (5), GP-led care (4), midwifery-led care (7) and home birth (6).ConclusionThe systematic review demonstrates the importance of including well-conducted qualitative studies in informing the development of evidence-based policies to address women's maternity care needs and inform service models. Synthesising the findings from qualitative studies offers important insight for informing effective public health policy.     

Evaluating the Phobias,Attitudes, and Cultural Competence of Master of Social Work Students Toward the LGBT Populations

Abstract

Background. Evidence suggests there is bias toward lesbian, gay, bisexual, and transgender (LGBT) persons by social workers; unfortunately, little research has been conducted to examine Master of Social Work (MSW) students' views toward these populations. The purpose of this study was to develop an assessment scale to evaluate the attitudes, phobias, and cultural competence of MSW students toward the LGBT populations.

Methods. An assessment scale was developed and administered to MSW students (n = 173) at a Midwestern American university.

Results. The majority of MSW students reported low phobia and a positive attitude toward the LGBT populations, yet participants reported having a low level of cultural competence in serving LGBT clients.

Conclusion. More education and training is needed for MSW students to effectively serve the LGBT populations.     

Experiences of and visions for collaboration between midwives and nurses in Nova Scotia

ProblemIn jurisdictions where midwifery and nursing are autonomous and separate health care professions, little is known about how they collaborate during the delivery of perinatal health care services.BackgroundMidwifery became a regulated profession in the province of Nova Scotia, Canada in 2009. Since regulation, midwives and nurses have worked together at three models sites for the delivery of midwifery services and perinatal care.QuestionHow do midwives and nurses collaborate during the provision of birthing care in Nova Scotia, Canada?MethodsThis was an instrumental case study guided by feminist poststructuralism. Individual interviews of 17 participants were audio-recorded and transcribed verbatim. Twenty-five documents were reviewed, and field notes were gathered. Feminist poststructuralist discourse analysis was used.FindingsMidwives and nurses collaborated well together. Participants described how positive collaborative experiences could influence a new way for midwives and nurses to work together. In this paper we present the theme Moving forward: A Modern Model for Nurses and Midwives working together, and its sub-themes of 1)’The birthing culture has changed’ and 2) ‘Allies and advocates’.DiscussionWithin the global context of strengthening midwifery and nursing, this study illustrated the potential for developing formal, collaborative perinatal models of care led by midwife and nurse teams to address inequities in perinatal health care services.ConclusionMidwives and nurses need more opportunities to collaborate and to build professional relationships. Establishing a midwife-led and nurse supported model of care may transform existing perinatal health care values, beliefs, and practices.     

Women’s experiences of health care utilization in cases of early pregnancy loss: A scoping review

BackgroundApproximately 25% of pregnancies end in miscarriage, most occurring within the first trimester (<13 weeks). For many women early pregnancy loss has implications for short- and long- term mental health, and women’s well-being following early pregnancy loss is impacted by their experiences within the healthcare setting. To improve quality of care, it is crucial to understand women’s’ experiences within the healthcare system in cases of early pregnancy loss.QuestionsWhat does the research literature tell us about the experiences of early pregnancy loss within healthcare settings? Are these experiences positive or negative? ‘How can care improve for those experiencing early pregnancy loss?’MethodsA scoping review of the research literature was undertaken. Three research databases were searched for relevant articles published in English since 2009, with key words related to ‘Experience’, ‘Healthcare’ and ‘Early Pregnancy Loss’. A thematic analysis was undertaken to identify and summarize key findings emerging from the research literature.FindingsTwenty-seven (27) articles met our inclusion criteria. Three main themes were identified: (1) issues related to communication, (2) challenges within care environments, and (3) inadequacies in aftercare.DiscussionThe literature suggests that women’s experiences related to healthcare for early pregnancy loss are largely negative, particularly within emergency departments. Recommendations to improve women’s experiences should extend beyond attempts to improve existing care structures, to include emerging environments and providers.ConclusionWomen’s experiences identified within the literature provide further insights on what women are seeking from their care, and how care models can be improved.     

LGBT Family Lawyers and Same-Sex Marriage Recognition: How Legal Change Shapes Professional Identity and Practice

ABSTRACT

Lawyers who practice family law for LGBT clients are key players in the tenuous and evolving legal environment surrounding same-sex marriage recognition. Building on prior research on factors shaping the professional identities of lawyers generally, and activist lawyers specifically, I examine how practice within a rapidly changing, patchwork legal environment shapes professional identity for this group of lawyers. I draw on interviews with 21 LGBT family lawyers to analyze how the unique features of LGBT family law shape their professional identities and practice, as well as their predictions about the development of the practice in a post-Obergefell world. Findings reveal that the professional identities and practice of LGBT family lawyers are shaped by uncertainty, characteristics of activist lawyering, community membership, and community service. Individual motivations and institutional forces work to generate a professional identity that is resilient and dynamic, characterized by skepticism and distrust coupled with flexibility and creativity. These features are likely to play a role in the evolution of the LGBT family lawyer professional identity post-marriage equality.     

The Body as a Site of Gender-Related Distress: Ethical Considerations for Gender Variant Youth in Clinical Settings

ABSTRACT

The present article maps out understandings about embodied distress among gender-nonconforming youth. Feminist bioethics and queer-inflected clinical perspectives are used to inform thinking about ethical, nonpathologizing health care in the case of gender-related distress. Specific attention is directed at self-harming among gender variant and trans youth. This is contextualized in relation to the role that self-harm plays for some LGBT youth, where it may be seen as a rite of passage or as reasonable and inevitable way of coping. The particular complexities of self-harm among trans youth seeking clinical intervention are examined. Queer bioethics is proposed as potentially facilitating productive uncertainty with regard to the diverse imagined futures of gender variant and trans youth.     

Does the way maternity care is provided affect maternal and neonatal outcomes for young women? A review of the research literature

BackgroundYoung pregnant women who continue a pregnancy are primarily from a socioeconomically deprived background. The risk factors associated with low socio-economic status may independently affect perinatal and neonatal morbidity to a greater extent than the young age of the woman. Young pregnant women are frequently sceptical about health care providers who they can perceive to be judgemental. This may lead to late booking for pregnancy care, attending few appointments, or not attending the health service for any antenatal care.QuestionDoes the way maternity care is provided affect maternal and neonatal outcomes for young women?MethodA systematic search of the major health databases.ResultsNine research articles met the eligibility criteria: one randomised controlled trial, three prospective cohort studies, two comparative studies with concurrent controls, two comparative studies with historical controls, and one case series.DiscussionProviding young women with a non-standard model of maternity care has some beneficial and no known detrimental effects on childbirth outcomes. While there is a dearth of evidence on the effectiveness of a Midwifery Group Practice model of care for young women, there is strong evidence to suggest that a Group Antenatal Care model increases antenatal visit attendance and breastfeeding initiation, and decreases the risk of preterm birth. There is research to indicate that a Young Women's Clinic model may also increase antenatal visit attendance and decrease the incidence of preterm birth.ConclusionMore well-designed and resourced midwifery models of care for young women should be implemented and rigorously researched.     

Health Needs and Experiences of a LGBT Population in Georgia and South Carolina

ABSTRACT

The 2016 Municipal Equality Index rated Augusta, the largest city in the Central Savannah River Area (CSRA), as one of the least lesbian, gay, bisexual, and transgender (LGBT) friendly cities in America. To understand the context of our region in relation to LGBT wellness, we conducted the first LGBT health needs assessment of the CSRA, assessing physical and mental health status and health care needs and experiences in the community. Participants (N = 436) were recruited using venue and snowball sampling and completed an anonymous online survey. Overall, the health problems experienced (i.e., obesity, depression) were not uniformly experienced across sexual orientation and gender identity; some groups experienced significantly higher rates of these conditions than others. Similarly, transgender individuals in particular reported higher rates of negative experiences with health care providers. Regional and national dissemination of these findings is critical to reducing health disparities and improving wellness of our local LGBT community.     

The future in their hands: Graduating student midwives’ plans,job satisfaction and the desire to work in midwifery continuity of care

BackgroundMidwife-led continuity of care models benefit women and the midwives who work in them. Australian graduate midwives are familiar with, and educated to provide, continuity of care to women although the opportunity to work exclusively in positions providing continuity of care on graduation is uncommon.AimTo explore the immediate and aspirational employment plans and workforce choices, reasons for staying in midwifery and perceptions around factors likely to influence job satisfaction of midwives about to graduate from one Australian university during the years 2012–2016.MethodsThis longitudinal study draws on survey responses from five cohorts of midwifery students in their final year of study.FindingsNinety five out of 137 midwifery students responded to the survey. Almost nine out of ten respondents either aspired to work in a continuity of care model or recognised that they would gain job satisfaction by providing continuity of care to women. Factors leading to job satisfaction identified included making a difference to the women for whom they care, working in models of care which enabled them to provide women with ‘the care I want to give’, and having the ability to make autonomous midwifery decisions.ConclusionAligning early graduate work experiences with continuity of care models may have a positive impact on the confidence and professional development of graduate midwives, which in turn may lead to greater satisfaction and retention among a workforce already committed to supporting the maternity healthcare reform agenda.     

“Coming Out” of Prison: An Exploratory Study of LGBT Elders in the Criminal Justice System

ABSTRACT

This two-phase qualitative study explores the experiences of 10 formerly incarcerated LGBT elders’ experiences prior to, during, and after release from prison. A core theme of self and the social mirror emerged from the data that represented LGBT elders ongoing coming-out process of unearthing their “true selves” despite managing multiple stigmatized identities or social locations, such as being LGBT, elderly, HIV positive, formerly incarcerated, and a racial/ethnic minority. These findings further our awareness of an overlooked population of LGBT who are older and involved in the criminal justice system. Recommendations that incorporate suggestions from formerly incarcerated LGBT elders for services and policy reform are presented.     

Exploring Perceived Discrimination Among LGBT Individuals in Turkey in Education,Employment, and Health Care: Results of an Online Survey

This article explores the discrimination practices encountered by lesbian, gay, bisexual, and transgender (LGBT) individuals in education, income, employment, and health care in Turkey. Limited quantitative data on LGBT individuals are available in Turkey. This study collected data from 2,875 LGBT individuals through a Web-based survey. The findings suggest that LGBT individuals report perceived direct and indirect discrimination in accessing education, employment, and health care. In a country where LGBT rights are not yet recognized and antidiscrimination legislation covering sexual orientation and gender identity is still nonexistent, findings demonstrate perceived discrimination of LGBTs rarely turns into a legal complaint. Even when they do, most LGBTs in our sample report that they did not feel that the justice system addressed their grievances.     

Lesbian, gay, bisexual, and transgender (LGBT) physicians' experiences in the workplace

Little is known about the experiences of lesbian, gay, bisexual, and transgender (LGBT) physicians in the workplace. There is little formal education in medical school about LGBT issues, and some heterosexual physicians have negative attitudes about caring for LGBT patients or working with LGBT coworkers, setting the stage for an exclusive and unwelcoming workplace. The current study used an online survey to assess a convenience sample of 427 LGBT physicians from a database of a national LGBT healthcare organization, as well as a snowball sample generated from the members of the database. Although rates of discriminatory behaviors had decreased since earlier reports, 10% reported that they were denied referrals from heterosexual colleagues, 15% had been harassed by a colleague, 22% had been socially ostracized, 65% had heard derogatory comments about LGBT individuals, 34% had witnessed discriminatory care of an LGBT patient, 36% had witnessed disrespect toward an LGBT patient's partner, and 27% had witnessed discriminatory treatment of an LGBT coworker. Few had received any formal education on LGBT issues in medical school or residency. It appears that medical schools and health care workplaces continue to ignore LGBT issues and operate in discriminatory fashion far too often.     

Assessing LGBT People’s Perceptions of Police Legitimacy

ABSTRACT

Although lesbian, gay, bisexual, and transgender (LGBT) people have achieved increased acceptance and access to social institutions in recent years, they have continued to be confronted with persistent homophobic attitudes, including from U.S. law enforcement personnel. Police culture often fosters these beliefs, and consequently results in the under-policing of LGBT citizens when victimized, but over-policing in places of leisure. This relationship is exacerbated when considering the intersectional effect of gender and sexual orientation, undoubtedly impacting legitimacy perceptions due to perceived (and actual) procedural injustice. Using original data collected at an LGBT festival in Arizona (N = 428), the current study examines the relationship between procedural justice and perceptions of police legitimacy among a historically marginalized population. Implications for theory and policy are discussed, with special attention given to contextualizing the findings within the current legitimacy crisis faced by American law enforcement.