Embodied disruption: “Sorting out” gender and nonconformity in the doctor's office

Abstract

Among LGBTQ people, those who are gender nonconforming (GNC) may be at heightened risk of both discrimination and underutilization of healthcare-yet little is known about what happens during healthcare encounters to compel GNC individuals to continue or avoid seeking future care. This study qualitatively examines the healthcare experiences of a racially diverse sample of 34 adult LGBTQ cis women, transgender men, and nonbinary individuals in a metropolitan area of the United States who do not conform to dominant biomedical schemas of sex and gender. GNC individuals experience embodied disruption in medical settings when patients are mis/recognized; providers respond to disruption in ways that further distress patients. Broadly, participants report similar experiences across racial and gender identities, but patients manage disruption somewhat differently depending on their embodied positions to gender norms. This study contributes to literature of stress, stigma, and sex, gender, and sexuality within medicine by illuminating how stigmatizing healthcare interactions deter LGBTQ individuals from seeking healthcare. Findings point to the importance of considering both structural factors and embodied visibility in future research addressing how stigma and discrimination manifest within health settings to disadvantage LGBTQ groups.

Gendered social practices in reproductive health: A qualitative study exploring lived experiences of unwed single mothers in China

“…The social rejection and the blame of not fulfilling a women's, a daughter's, and a wife's role also caused instances of depression and mental harm. These findings echo previous studies that women who are sexual nonconformists are always vulnerable to dominance and exploitation (Paine, 2018) and contribute to the literature on gender, identity, relational context and health.…”

“…In many ways, gender system creates internal conflict and stress, compromising unwed single mothers’ reproductive and mental health. Scholars highlighted high rates of discrimination and healthcare underutilization among sexual nonconformists (Paine, 2018). Previous studies have offered critical insights concerning the social processes of differentiation as a form of ‘stratified reproduction’ (Beynon‐Jones, 2013; Ginsburg & Rapp, 1995).…”

Correlations between healthcare provider interactions and mental health among transgender and nonbinary adults

“…Uncertainty and ambivalence regarding serving diverse patient populations amongst providers have been shown to be correlated with a lack of TNB exposure and education (Poteat, German, & Kerrigan, 2013). Due to this, clinicians may try to fit their patients into binary gendered medical schema and not provide transgender-affirming interactions (Paine, 2018). Transgender patients who identify along the gender binary may face less misgendering by providers than their nonbinary counterparts, and experience less mental health distress (Goldberg, Kuvalanka, Budge, Benz, & Smith, 2019).…”

Hearing Gender: Voice-Based Gender Classification Processes and Transgender Health Inequality

“…As a group, transgender individuals face persistent forms of marginalization, discrimination, and stigma in everyday interactions, such as at the workplace, at the doctor's office, and in family life (Bradford et al 2013;James et al 2016;Meadow 2018;Paine 2018). Based on these factors, it is reasonable to believe that some portion of transgender health inequality can be explained through the minority stress model.…”