Language Sensitivity 101

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Language Sensitivity 101

• CHM LGBT Allies in Medicine and SNMA
• Prepared for National Primary Care Week
• 23 october 2009
• Thanks to
• American Medical Student Association
• Committee on Gender and Sexuality for original
  material

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Goals

• To become familiar with terminology relating to
  minority patients.
• To be comfortable saying out loud what these
  words mean, and come to some working agreement on
  how we use them.
• To encourage participants to respond when they
  hear these terms being used incorrectly.
• To encourage participants to develop tools that
  will help them to connect with and advocate for
  patients who are marginalized.

3
Scenarios/Brainstorm

• You are a lesbian patient who has come in for a
  yearly physical. You have never met this
  physician before. Your partner does not have
  health insurance.
• Underlying feelings
• What should the doctor do to make this patient
  feel comfortable?
• How would you respond if the doctor asked
• Are you married?
• Are you sexually active? What form of birth
  control do you use?
• Youve never had sex with men/women, right?
• Oh youre a lesbian? You arent at risk for HIV.
• I HAVE to ask, do you have sex with men, women or
  both?
• Do you have sex with men, women or both?

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Scenarios

• Gay man concerned about partners care
• Lesbian who wants to have children
• Bisexual married woman
• Gender-transitioning person
• Questioning teen
• Immigrant (Legal or undocumented)
• Iraqi man
• African American woman

5
Have we observed prejudiced behavior?

• Among physicians?
• Professors?
• Classmates?

6
Whats wrong with these sentences?

• Although Mary was blonde, she was still
  intelligent.
• Pat is a male nurse.
• Terry Harris, a well-known female productivity
  consultant, will advise the committee.
• Dr. Martinez, a senior citizen, continues to
  maintain his practice despite his age.
• Paraplegic James Alton competes in marathons with
  other crippled racers who train in wheelchairs.
• With the simple nobility that characterizes his
  people, Onondaga Indian leader Leon Shenandoah
  acted as a spiritual and political advocate for
  the Iroquois Confederacy until his death in 1996.

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VOCABULARY
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Sex

• Sex refers to biologically determined
  differences in chromosomes, hormonal profiles,
  internal and external sex organs.
• An identity, derived from anatomical or biologic
  features. People are assigned a sex at birth
  based on the appearance of their genitalia.
  Occasionally chromosomes, genitalia, and hormones
  present in varied combination. Sex identity can
  be changed.

9
Gender

• Gender describes the characteristics that a
  society or culture delineates as masculine or
  feminine.
• Gender identity is an identity derived from the
  individuals internal sense of gender.

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Gender Expression

• Behaviors, derived from the individuals gender
  identity. Involves dress, styling, mannerisms,
  social roles and interactions. Can only be
  understood in the context of given cultural
  expectations and normative gender roles.
• Gender expression may be particularly fluid over
  the course of a persons lifetime.

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Assimilation

• Cultural assimilation is a political response to
  the demographic fact of multi-ethnicity which
  encourages absorption of the minority into the
  dominant culture.
• It is opposed to affirmative philosophy
  (multiculturalism) which recognizes difference.
• Often used with regard to immigrants.

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Acculturation

• The exchange of cultural features that results
  when groups having different cultures come into
  continuous first hand contact the original
  cultural patterns of either or both groups may be
  altered, but the groups remain distinct.
• Exchange of foods, music, dances, clothing,
  tools, technologies.
• Related to Westernization and cultural
  appropriation.

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Racism

• Racism is the belief that race is the primary
  determinant of human traits and capacities and
  that racial differences produce an inherent
  superiority of a particular race.

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Racialism

• Racialism entails a belief in the existence and
  significance of racial categories, but not
  necessarily in a hierarchy between races.

15
Ummah

• Ummah is an Arabic word meaning community or
  nation. In the context of Islam, it is used to
  describe the diaspora, or community of
  believers.

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Ethnic Group

• A category or group of people considered to be
  significantly different from others in terms of
  cultural (ie dialect, religion, traditions) and
  sometimes physical characteristics (ie skin
  color, body shape). Commonly recognized North
  American ethnic groups include American Indians,
  Jews, Latinos, Chinese, African-Americans
  (black), European Americans (white), etc.

17
Multiculturalism

• A salad bowl model of society in which the
  permanent existence of unassimilated and
  partially assimilated ethnic/racial minorities is
  accepted and encouraged. Those who advocate this
  model for the US generally advocate providing
  special attention and assistance to minorities
  that have been underrepresented in the past.

18
Melting Pot

• A society in which immigrants and native
  ethnic/racial minorities are assimilated into the
  dominant national culture. Those who prefer this
  model for the US generally advocate encouraging
  assimilation in order to reinforce national unity.

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Boundary Maintenance

• Generally considered a positive term, reinforcing
  an ethnic groups unity and distinctness by
  emphasizing the traits that set its members apart
  from others, rather than what they share in
  common with them.

20

• Original rainbow flag had 8 stripes, with
  specific meanings ascribed to the colors
• Pink sexuality
• Red life
• Orange healing
• Yellow sunlight
• Green nature
• Turquise magic/art
• Indigo serenity/harmony
• Violet spirit

21
GLBT/LGBT

• LGBTQIA
• Lesbian, Gay, Bisexual,
• Transgender someone whose gender identity does
  not match their anatomical sex
• Queer (sometimes Questioning)
• Intersex an individual who is born with
  external/internal genitalia and/or secondary sex
  characteristics determined as neither exclusively
  male nor female
• Ally someone who doesnt identify as, but
  supports LGBTQI social movements.

22
Human Rights Campaign logo symbolizing
equality. HRC is the largest LGBT lobby
group/political action committee in the
US.
23
Straight Allies

• Straight ally describes a heterosexual person who
  supports equal civil rights, gender equality, and
  LGBT social movements.
• Straight allies can also have a coming out
  process.

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MSM

• Men who have sex with men
• Refers to men who engage in sexual activity with
  other men, regardless of how they identify
  themselves. Many choose not to accept social
  identities of gay or bisexual.

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Intersex

• An individual who is born with external/internal
  genitalia and/or secondary sex characteristics
  determined as neither exclusively male nor
  female.
• Hermaphrodite is an antiquated term that is
  stigmatizing. Current change to Disorder of Sex
  Development (DSD).

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Two-Spirit

• A term used by individuals who are part of
  American Indian and Canadian First Nations
  groups.
• Usually implies both a masculine and feminine
  spirit living in the same body.
• Also used by some contemporary LGBT Native
  Americans to describe themselves.
• Native terms for these individuals exist in
  various Native American languages.

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MTF/FTM

• Male to Female/Female to Male
• Generally refers to transsexual individuals.

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Genderqueer

• Similar to how Queer might refer to any
  non-normative sexual orientation, Genderqueer
  relates to a non-binary sense of gender identity
  and refusal of labels that may or may not involve
  sexual orientation.

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Transvestite

• Regardless of motivation, a person who wears
  clothes (make-up, etc) that are considered
  culturally appropriate for the opposite gender,
  but not for ones own.
• Drag queen/king a person who dresses in clothes
  of the opposite gender specifically for an event
  or performance.
• Crossdressing a term given to those who dress in
  clothes of the opposite gender for any reason
  other than performance or special occasions.
  Usually satisfied with ones own gender identity,
  but finds satisfaction in crossdressing.

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Sexual Preference

• Similar to sexual orientation, indicating a
  pattern of emotional, romantic and sexual
  attraction to men, women or both genders.
  Sexual preference is more commonly used by
  people who believe that sexual orientation is a
  matter of choice.

31
Sexual Orientation

• The preferred term used to describe pattern of
  emotional, romantic and sexual attractions to
  men, women, or both (or neither).
• Also has a social component sexual orientation
  refers to a persons sense of personal and
  social identity based on those attractions,
  behaviors expressing them, and a membership in a
  community of others who share them.

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Affectional Orientation

• Used alternatively to sexual orientation. It
  is based on the perspective that sexual
  attraction is one component of a larger dynamic
  ones orientation is defined by those with whom
  one is predisposed to fall in love.

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Hypodescent

• In societies that regard some races of people as
  dominant or superior and others as subordinate or
  inferior, hypodescent is the assignment of
  mixed-race children to the race that is
  considered subordinate or inferior. The opposite
  practice is hyperdescent, in which children are
  assigned to the race that is considered dominant
  or superior.
• The Nazis used this criterion for labeling people
  as Jews whose only connection with Judaism was a
  grandparent.  Similarly, it has been used in
  North America to label people as African American
  even if they were mostly European in biological
  ancestry.  Hypodescent is also known as the "drop
  of blood" criterion.

34
Stonewall

• Birth of the gay rights movement in the US the
  Stonewall riots were a series of spontaneous,
  violent demonstrations against a police raid in
  Greenwich Village, NYC, June 28, 1969. Commonly
  cited as the first instance in US history when
  people in the LGBT community fought back against
  persecution of sexual minorities.

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Minority

• Less than one-half.

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Majority

• Greater than one-half.

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AHANA

• African-American Hispanic Asian Native American
  inclusive term coined at Boston College in 1979
  by two students who objected to the name Office
  of Minority Programs. They cited the definition
  of the word minority as less than and proposed,
  instead, to use AHANA which they felt celebrated
  social and cultural differences.

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Debrief

• What did you learn?
• How do you feel about how the words were defined?
  Did it change your perception after hearing the
  definition?
• Are we in agreement over these definitions or
  not?
• How can we speak up if we hear questionable
  language coming from a
• Professor
• Peer
• Attending Physician