Experiences of LGBTQIA+ migrants with nurses and other healthcare professionals in Canada

Abstract

Background:LGBTQIA+ migrants may have experienced discrimination and victimization related to ethnicity, culture, and race over the course of their migration journey, as well as in relation to their sexual orientation, gender identity and expression. Despite the work of some nurses in education, practice, policy, and research, there is a scarcity of literature investigating the experiences of LGBTQIA+ migrants with nurses and healthcare professionals in Canada. Methods: By utilizing Gadamerian hermeneutics research methodology with intersectional analysis, this study draws on 16 semi-structured individual interviews with LGBTQIA+ migrants who received care from nurses and other healthcare professionals (NHCPs) in Canada. Results: Two overarching areas of intersecting experiences were identified: (a) challenges and (b) supports. Four interwoven interpretations emerged from experiences of challenges: (a) unwanted visibility, (b) hearing a dead name and being misgendered, (c) cultural stigma, and (d) being asked intrusive hetero-cis-normative questions. Supportive experiences were evident when NHCPs accepted the unique needs of LGBTQIA+ migrants and acted as advocates.Conclusions: Nursing interactions should not be traumatic for LGBTQIA+ migrants, but rather should be encounters where care providers ask relevant nonhetero-cisnormative questions, offer inclusive safe sex education for people's diverse identities, avoid dead naming and misgendering, and provide supportive and affirming care. To support the provision of safe care and mitigate trauma, systemic changes in nursing practice must include the experiences of LGBTQIA+ migrants.

Trauma-informed care in the emergency department: concepts and recommendations for integrating practices into emergency medicine

“…Routinely clarifying a patient’s name and pronouns and sharing this information with the care team will reduce misnaming or misgendering a patient. When a mistake is made in name or pronoun, it should be repaired sincerely with an honest apology, rather than ignored or rationalized [ 45 , 46 ]. Prioritize safety and privacy by addressing others in the room When a patient presents with others confirm that the patient wants others with them.…”

“Ally Theater Is a Problem”

“…A comprehensive discussion of the research findings is to be published elsewhere. 5,6 Since the Gadamerian hermeneutics research methodology with intersectionality as an analytical lens was used, an opportunity was presented to "peel the layers back" to uncover "performative allyship" or "ally theater" in relation to nursing. Utilizing this approach, I conducted semistructured, in-depth, individual interviews.…”

“…In this section, I provide a summary of my previous study where LGBTQI+ migrants felt nurses' ontological presence versus performative allyship, whenever the nurses demonstrated solidarity through inclusive and affirming care. 5,6 The participants felt that they had received affirming care when nurses spent time listening attentively to their needs. This act was demonstrated when nurses asked relevant questions, listened to LGBTQI+ migrants' responses, provided applicable resources, and in some cases wrote letters for their refugee court hearing.…”

“…4,33,41 In particular, nonverbal behaviors are seen by LGBTQI+ migrants as nurses' signs of disapproval. 6 It seems that nurses may assume migrant and racialized ADVANCES IN NURSING SCIENCE/JANUARY-MARCH 2023 people may not identify as LGBTQI+. 5,6 Although physically present in the health care arena, LGBTQI+ migrants often feel invisible when they encounter nurses who seemed uncomfortable with SOGIE that did not align with normative ideologies.…”

“…Racialized LGBTQI+ migrants feel safe and respected in the health care system when nurses stand up for misgendering, provide relevant resources, and are nonjudgmental. 5,6,33,[43][44][45]…”