Lesbian Health Care Dissertation

Pages: 75 (25618 words)  ·  Bibliography Sources: 30  ·  File: .docx  ·  Level: Doctorate  ·  Topic: Women's Issues - Sexuality


The final consequence of such circumstances is that the research quality and generalizability is sacrificed in the face of affordability. Despite these challenges, researchers have indeed conducted fruitful and important research on the health status and experiences of sexual minorities, allowing for a thorough review of the literature concerning lesbian health, lesbian access to health care and lesbian experiences with health care services and professionals.Download full Download Microsoft Word File
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TOPIC: Dissertation on Lesbian Health Care Lesbian Health Assignment

After reviewing the methodological issues relevant to studying lesbian health, the exiting knowledge concerning the current health status of lesbian women will be reviewed. A great deal of research has established the various risk factors that are unique to lesbians with respect to health care concerns, such as being at an increased risk for various forms of cancer, substance use, tobacco use and obesity (Roberts, 2006). Very few of the differences found between lesbian women and heterosexual women in health status and health risks are not related to sexual identity itself, but rather to the consequences of sexual identity, such as minority stress and the consequences of persistent discrimination (Cochran, 2001; Meyer, 2003). Many of the sources of minority stress and discrimination experienced by sexual minorities unfortunately begin at home, with the families of origin of sexual minorities, thus after reviewing the issues concerning discrimination and minority stress, the review will move on to examine the family experiences of lesbians and sexual minorities as they relate to issues of mental and physical health. Social support from friends and family plays an important role in determining mental and physical health, and a lack of social support has been linked to health deficits (Blair, 2008). Beyond dealing with the consequences (or benefits) of issues related to family of origin, matters related to chosen families, a concept whereby sexual minorities build social networks of close friends who are not kin, will be reviewed. It is also important to understand the desires of lesbians to build their own families and to understand how the structures of these families influence their experiences with health care access and professionals. This will lead into a discussion of the actual issues concerning health care access and lesbian experiences with health care. This topic ranges from an understanding of the health care education targeted at sexual minority women and the battles of myths concerning sexual health within this community. Health care access issues will be addressed, reviewing the various barriers to access and the issues that lead to negative experiences, or the expectation of negative experiences, when accessing health care services as a sexual minority. Finally, the review will examine a pressing and growing issue related to lesbian health access and experience, the issue of the experiences of aging lesbians. As the population ages, more and more sexual minorities are finding themselves in need of long-term care, nursing home placement and palliative care, an experience that for many has resulted in having to return to the closet or dealing with discrimination within the health care system.

Literature Review

Social Exclusion Theory

In order for any particular group to experience systematic discrimination, there needs to be a mechanism through which such unequal treatment can be dispensed. While there are a number of factors at play that contribute to the marginalization of sexual minorities, this review of the literature will focus on how social exclusion plays a key role in influencing the experiences of lesbians within the health care system, and how these experiences have direct consequences for the mental and physical health of lesbians living in a predominantly heterosexual society.

Social exclusion, as a theory used to explain inequality, has predominantly been applied to racialized groups of minorities (Galabuzi, 2006). The concept of social exclusion refers to both a process and an outcome, such that systemic practices of inequality and discrimination cumulate as a process into the consequences of social exclusion for minority groups. As a theory, social exclusion can explain marginalization of minority groups through an examination of the structural inequalities that consistently produce an environment of substandard access to opportunity and services and unequal treatment. By examining marginalization as a result of social exclusion, the emphasis is placed on society as a whole with respect to assigning responsibility for existing social inequalities (Galabuzi, 2006). This focus on society as opposed to the individual makes social exclusion theory useful for examining marginalization in a variety of contexts, not just those related to race. In the past, sexual diversity, or even sexual deviance as it would have more likely been conceived, was viewed as a failure or flaw of an individual, thereby leaving the individual with full responsibility for dealing with the consequences of their supposedly 'chosen' sexual identity. The past decades have seen this view begin to change, beginning with the removal of homosexuality from the American Psychological Association's list of mental disorders in 1973 (Blair & Holmberg, 2008). Since then, sexual identity and sexual orientation have come to be increasingly viewed as an inherent trait, not chosen, and not indicative of a mental defect or physical ailment. This transition in public attitude, albeit tenuous at times, allows social exclusion theory to be aptly applied to the inequalities experienced today by sexual minorities. As such, the theory holds that society must be held responsible for such social inequities, and can therefore be applied to mean that sexual minorities themselves should not be left to suffer the consequences alone and to seek remedy of such inequities without the assistance of society at large.

Through Galabuzi's (2006) conceptualization, social exclusion theory can be applied to a wide variety of social institutions, ranging from education to criminal justice to spatial isolation and to health care, the area in which this review will apply the theory. It is important to understand though, that while social exclusion is well applied to the experiences of lesbians within the health care system, part of what generates the widespread systemic social exclusion of sexual minorities overall is the fact that this exclusion takes place across all aspects of social and societal life. In other words, while social exclusion theory may specifically explain why lesbians have unequal access to health care, other aspects of social exclusion experienced over the lifespan, such as discrimination in the educational system, or negative experiences with the criminal justice system, all play a contributing role in determining the actual health outcomes for sexual minorities.

Galabuzi (2006) has identified four aspects of social exclusion that contribute to the inability of marginalized groups to access cultural, social, political and economic resources through an ongoing process of oppression and discrimination, both through the marginalization of the group as well as the individual experiences of discrimination, inequality and isolation. The four aspects are as follows:

1) Social exclusion from society through legal sanctions;

2) Failure to provide for the needs of particular groups;

3) Exclusion from social production, or the denial of opportunity to contribute to, or participate actively in society's social and cultural activities; and

4) Economic exclusion from social consumption, or unequal access to normal forms of livelihood and economy.

These four aspects can all be applied to the lived experiences of sexual minorities in North America, especially those living in the United States. Previous research and theory has predominantly applied social exclusion theory to racial minorities, immigrants, and individuals of lower socio-economic status. Lip service has been paid to the applicability of social exclusion theory to sexual minorities (Galabuzi, 2006), but no previous reviews of have systematically applied this theory to the understanding of health inequities among sexual minorities, or the experiences of lesbian women specifically.

Social exclusion from society through legal sanctions.

The first aspect of social exclusion theory, as identified by Galabuzi (2006), refers to the disconnection of from civil society as well as reduced or limited political participation as a function of both material and social isolation due to continued and systemic discrimination. In the case of lesbian women, this discrimination can be based on both gender and sexual orientation or identity. Wilson (1987) has referred to the collective effects of social exclusion, with respect to the experience of inequality over a wide spectrum of life experiences, as the creation of an underclass culture. In many respects, sexual minorities can be seen to form an underclass, or second-class culture within the mainstream society of North America. In the United States, a number of legal sanctions have inhibited the lives sexual minorities. Same-sex sexual activity in the United States was only completely decriminalized on a nation-wide basis in 2003, and there is still no federal recognition of same-sex marriage or relationships (Dysart-Gale, 2010). The "Don't Ask Don't Tell" policy prohibiting the openly acknowledged service of gay men and women in the military has just recently been repealed (December 18, 2010), and access to hospital visitation rights is a recent change in United States health care policy. While the United States prides itself on being built on a foundation of equality for all citizens, in the area of sexual minority rights, the country falls far… [END OF PREVIEW] . . . READ MORE

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