Changing the culture of neurodisability through language and sensitivity of providers: Creating a safe place for LGBTQIA+ people

Abstract

Abstract. BACKGROUND:There is an increasing interest in sexual and gender diversity in neurorehabilitation. Healthcare professionals wanting to improve their practice know the importance of understanding the needs and expectations of specific communities. OBJECTIVE: To critically review the literature about neurological disorders in people who identify as lesbian, gay, bisexual, transgender, queer, intersex, asexual, and people with other sexual orientations and forms of gender expression (LGBTQIA+). METHODS: Systematic search in electronic databases (CINAHL, EMBASE, Medline, PsycINFO, Scopus, and Web of Science) and identification of relevant studies. RESULTS: Quantitative and qualitative findings are summarized and reported by neurological disorders: a) neurodisability/epilepsy (17.7%), b) intellectual disability/autism spectrum disorders (19.6%), c) dementia/HIV-related dementia (39.2%), d) spinal cord injury (7.8%), and e) traumatic brain injury/stroke (15.7%). CONCLUSIONS:LGBTQIA+ people with neurodisabilities and their partners/families of choice can conceal their sexual orientation or gender identity for fear of diminished quality of care. Their invisibility translates into health disparities, lack of policies and services that meet their unique needs. Dementia is the most common neurodisability documented in LGBTQIA+ people. We provide recommendations to increase LGBTQIA+ cultural competency for clinical practice, research, and policy to help different stakeholders to promote a positive change in the culture of neurodisability.

Cross-cultural perspectives of LGBTQ psychology from five different countries: current state and recommendations

“…LGBTQ issues in different areas of psychology to broaden perspectives and promote inclusiveness. This can be done in areas such as sports psychology (Lucas-Carr & Krane, 2011;Mattey, McCloughan, & Hanrahan, 2014;Shang, 2013), organizational psychology (Anderson & Croteau, 2013), school psychology (Betts, 2013;Russell & Horn, 2017;Salazar, 2015;Whitman, Horn, & Boyd, 2007), positive psychology (Lytle, Rodriguez, Vaughan, & Shmerler, 2014;Meyer, 2014;, counselling psychology (Malouf, 2013;Walinsky, 2013), community psychology (Wheeler, Mitchell, Budge, & Hunt, 2017), health psychology (Schlittler, Grey, & Popanz, 2017;Ussher, 2009;Wallace & Santacruz, 2017a, 2017c) and neuropsychology (Moreno, Laoch, & Zasler, 2017…”

Sex and Gender Issues for Individuals With Acquired Brain Injury During COVID-19: A Commentary

“…Although men have significantly higher rates of ABI, women and LGBTQ+ individuals have worse long-term outcomes and experience higher rates of social, financial, and structural barriers than men with ABI. 10 , 11 , 12 …”

“…Previous experience with natural disasters suggests that marginalized groups experience substantially more negative consequences in times of natural disaster, which warrants enhanced support and advocacy. For example, LGBTQ+ individuals are at a disadvantage, both for greater risk of COVID-19 mortality 25 and poorer ABI related treatment, 12 such as “lack of specialized and knowledgeable screening, education, and treatment for reproductive health, sexuality, and sexual performance related issues.” 12 (p377) Although the current COVID-19 pandemic is certain to lead to many unknown and unanticipated outcomes in this and other groups, there are specific areas known to affect women and LGBTQ+ individuals with ABI, namely IPV, social and financial disparities, and technological accessibility. Disparities in these domains can be expected to be exacerbated by the current state of the world and lead to further marginalization, making them critical to highlight as potential intervention targets.…”

“…Women and LGBTQ+ individuals with ABI are more likely to be affected by poverty, social isolation, lack of familial support, lack of transportation, and lack of community resources. 12 Furthermore, women report more symptoms of depression, anxiety, fatigue, and sleep disturbance than men with ABI. 28 The restructuring of the social and health care system (eg, conversion of rehabilitation units into COVID-19 units 29 and some therapy services being deemed nonessential 30 ) are likely to magnify the inequities in the accessibility of necessary services among women with ABI.…”

“…significantly higher rates of ABI, women and LGBTQþ individuals have worse long-term outcomes and experience higher rates of social, financial, and structural barriers than men with ABI. [10][11][12] Worldwide, the rehabilitation community has been affected by coronavirus disease 2019 . The effect of COVID-19 has been disproportionately devastating for individuals with disabilities, particularly those with ABI owing to injury-related cognitive or sensory and physical difficulties.…”