The Priority of Intersectionality in Academic Medicine

Eckstrand, Kristen; Eliason, Jennifer; Cloud, Tiffani St; Potter, Jennifer

doi:10.1097/acm.0000000000001231

Cited by 89 publications

(64 citation statements)

References 13 publications

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“…TGD people who belong to racial and ethnic minority groups face even more challenges [31]. Intersectionality acknowledges that identity is multidimensional and is impacted on by historical, structural, and cultural factors [32,33]. Ng [33] eloquently explains that "Practicing medicine through the lens of intersectionality proactively considers patients' diverse identities and how the sociocultural factors associated with membership in multiple minority groups can affect their health risks and health care experiences, and ultimately health decision making and health outcomes" [33].…”

Section: Brief History Of Pathologisation Diagnostic and Statisticalmentioning

confidence: 99%

Debate: Why should gender-affirming health care be included in health science curricula?

2020

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Background: Every person who seeks health care should be affirmed, respected, understood, and not judged. However, trans and gender diverse people have experienced significant marginalization and discrimination in health care settings. Health professionals are generally not adequately prepared by current curricula to provide appropriate healthcare to trans and gender diverse people. This strongly implies that health care students would benefit from curricula which facilitate learning about gender-affirming health care. Main body: Trans and gender diverse people have been pathologized by the medical profession, through classifications of mental illness in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Classification of Disease (ICD). Although this is changing in the new ICD-11, tension remains between depathologization discourses and access to gender-affirming health care. Trans and gender diverse people experience significant health disparities and an increased burden of disease, specifically in the areas of mental health, Human Immunodeficiency Virus, violence and victimisation. Many of these health disparities originate from discrimination and systemic biases that decrease access to care, as well as from health professional ignorance. This paper will outline gaps in health science curricula that have been described in different contexts, and specific educational interventions that have attempted to improve awareness, knowledge and skills related to genderaffirming health care. The education of primary care providers is critical, as in much of the world, specialist services for gender-affirming health care are not widely available. The ethics of the gatekeeping model, where service providers decide who can access care, will be discussed and contrasted with the informed-consent model that upholds autonomy by empowering patients to make their own health care decisions. Conclusion: There is an ethical imperative for health professionals to reduce health care disparities of trans and gender diverse people and practice within the health care values of social justice and cultural humility. As health science educators, we have an ethical duty to include gender-affirming health in health science curricula in order to prevent harm to the trans and gender diverse patients that our students will provide care for in the future.

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Section: Brief History Of Pathologisation Diagnostic and Statisticalmentioning

confidence: 99%

Debate: Why should gender-affirming health care be included in health science curricula?

2020

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“…woman and under-represented minority, or woman and lesbian or bisexual) have concerns above and beyond those presented here. 20 Supporting women in anaesthesiology: faculty members' perspectives Abraham Maslow's 8 'hierarchy of needs' published in 1943 provides a useful framework for understanding common concerns for women faculty in medicine ( Fig 1); here, we apply the hierarchy to women anaesthesiologists. Briefly, 'higher' levels in the hierarchy, such as self-actualisation, can only be achieved when lower levels are secure.…”

Section: Introductionmentioning

confidence: 99%

Fostering belonging in academic anaesthesiology: faculty and department chair perspectives on supporting women anaesthesiologists

Lane‐Fall

Gordon²,

Valentine³

et al. 2020

British Journal of Anaesthesia

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An increasing number of global initiatives aim to address the disconnection between the increasing number of women entering medicine and the persistence of gender imbalance in the physician anaesthesiologist workforce. This commentary complements the global movement's efforts to increase women's representation in academic anaesthesiology by presenting considerations for fostering inclusion for women in academic anaesthesiology from both the faculty and departmental leadership perspectives in a US academic anaesthesiology department.The past several decades have witnessed a growing appreciation for gender diversity in medicine, 1,2 with an increasing number of women becoming physicians. 3 Despite this change, there is a persistence of specialties in which men are overrepresented, including anaesthesiology. 4,5 Global efforts to foster the inclusion of women in anaesthesiology include the British Journal of Anaesthesia symposium on Women in Anaesthesia Research (https://www.periopmedicine.org.au/index. php/2019prato), the Australian and New Zealand College of Anaesthetists Gender Equity Position Statement and Action Plan, 6 and the US Women in Anesthesiology initiative. 7 The goal of this commentary was to augment these global efforts by presenting a framework that may be useful in planning and evaluating efforts to retain and support women faculty anaesthesiologists. Using Maslow's 8 hierarchy of needs to structure the discussion, we present considerations for fostering inclusion for women in academic anaesthesiology from both faculty and departmental leadership perspectives from the University of Pennsylvania Department of Anesthesiology and Critical Care. We used the terms 'women' and 'men' to indicate gender identity, recognising that there are individuals with non-binary gender identity whose experience is not well captured by these terms.

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“…Similarly, with regards to medical education, medical students trained in overly simplistic approaches to diversity may devalue a patient's multiple identities and miss opportunities to improve rapport with their patients [27]. Although cultural competency is encouraged and medical student training is improving, cultural sensitivity is still lacking with regards to LGBTQ patients which may require additional training, such as differences between behaviour and identity, among other aspects of LGBTQ care [42][43].…”

Section: Discussionmentioning

confidence: 99%

“…Intersectionality requires physicians to take a comprehensive look at all spheres of influence on an individual's health and quality of life. Its importance has been highlighted by the American Association of Medical Colleges (AAMC) as its application in medicine can provide guidance, help remediate structural barriers for underserved populations and so reduce the reliance on simplistic interpretations of identity and culture [27]. While the concept of intersectionality and its application in physician practice is evolving, we believe such an approach can and will improve patient care.…”

Section: Introductionmentioning

confidence: 99%

In Our Own Words: A Qualitative Exploration of Complex Patient-Provider Interactions in an LGBTQ Population

et al. 2019

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While sexual and gender minorities are at increased risk for poor health outcomes, there is limited data regarding patient-provider interactions. In this study, we explored the perspectives of LGBTQ patients and their encounters with physicians in order to improve our understanding of patient-physician experiences. Using purposive selection of self-identified LGBTQ patients, we performed fourteen in-depth semi-structured interviews on topics of sexual orientation and gender identity, as well as their perceived role in the patient-provider relationship. Coding using a modified grounded theory approach was performed to generate themes. We identified three major themes that demonstrate the complexity of LGBTQ patient experiences. The first, Lacking trust, identifies mistrust and loss of the physician-patient relationship resulting from physicians’ poor or judgmental communication, or from physicians making assumptions about gender, using incorrect pronouns, and not recognizing heterogeneity within the transgender community. A second theme, Being vulnerable, describes the challenges and fears related to comfort of patients with disclosing their sexual orientation and/or gender identity. A final theme, Navigating discrimination, outlines racial or ethnic discrimination which creates an additional burden on top of illness and stigmatized identity. Our results reveal the complex needs of individuals with multiple stigmatized identities when developing relationships with providers. By using an intersectional perspective that appreciates the plurality of patients’ identities, providers can help to improve their relationships with LGBTQ patients. Incorporating intersectional training for medical students and residents could greatly benefit both LGBTQ patients and their physicians.

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The Priority of Intersectionality in Academic Medicine

Cited by 89 publications

References 13 publications

Debate: Why should gender-affirming health care be included in health science curricula?

Debate: Why should gender-affirming health care be included in health science curricula?

Fostering belonging in academic anaesthesiology: faculty and department chair perspectives on supporting women anaesthesiologists

In Our Own Words: A Qualitative Exploration of Complex Patient-Provider Interactions in an LGBTQ Population

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