Gender Identity and Social Services: Barriers to Care

Stotzer, Rebecca L.; Silverschanz, Perry; Wilson, Andre

doi:10.1080/01488376.2011.637858

Cited by 55 publications

(35 citation statements)

References 34 publications

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“…Community-based DV/SA advocacy organizations are often better situated to provide support and resources to survivors outside the criminal legal system, such as emergency and confidential shelters, crisis hotlines, support groups, individual counseling, and advocacy services. Yet patterns of discrimination and mistreatment in social service settings and shelters, including DV/SA advocacy programs, are well documented (e.g., James et al, 2016; Kattari & Begun, 2017; Mottet & Ohle, 2006; Seelman, 2015; Stotzer, Silverschanz, & Wilson, 2013). Guadalupe-Diaz and Jasinski (2017) found that trans survivors of IPV often avoid gender-based DV services in anticipation of misunderstandings or mistreatment and may perceive these services as inaccessible or irrelevant to their situation.…”

Section: Introductionmentioning

confidence: 99%

Mandating Inclusion: Critical Trans Perspectives on Domestic and Sexual Violence Advocacy

Jordan

Mehrotra

Fujikawa³

2019

Violence Against Women

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In 2013, the Violence Against Women Act became one of the first federal laws to explicitly prohibit discrimination against transgender people, yet little is known about its impact in practice. This qualitative study draws on in-depth interviews with transgender people working in domestic and sexual violence advocacy organizations. Building on critical and intersectional perspectives, the findings suggest that the persistence of inequities for trans survivors are tied to the reliance on criminal legal responses, contingent access to gender-specific services, compliance-focused approaches to inclusion, operating theories of gender-based violence, and the diversion of responsibility to LGBTQ (lesbian, gay, bisexual, transgender and queer) programs. This study highlights the participants’ recommendations for change.

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Section: Introductionmentioning

confidence: 99%

Mandating Inclusion: Critical Trans Perspectives on Domestic and Sexual Violence Advocacy

Jordan

Mehrotra

Fujikawa³

2019

Violence Against Women

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“…For many, obstacles may include outright discrimination and lack of provider sensitivity 27 ; subpar provider treatment, illequipped and inadequate facilities, and exclusionary office climates. 28 Deaf LGBTQ patients may face sim-ilar challenges. However, when seeking help for mental health-related concerns, Deaf LGBTQ patients may be required to manage additionally complex processes of determining relative safety around disclosure of SOGI information to health care providers, potentially as providers may be unfamiliar both with communication needs of Deaf individuals and culturally competent practices for working with LGBTQ patients.…”

Section: Discussionmentioning

confidence: 99%

Health Disparities Among Mid-to-Older Deaf LGBTQ Adults Compared with Mid-to-Older Deaf Non-LGBTQ Adults in the United States

Kushalnagar

Miller

2019

Health Equity

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To compare chronic health and mental health conditions between mid-to-older deaf lesbian, gay, bisexual, transgender, and queer (LGBTQ) and mid-to-older non-LGBTQ adults who are 45 years or older. Methods: Medical conditions and mental health disorders data were gathered from 981 mid-to-older deaf adults (178 LGBTQ and 803 non-LGBTQ) who took the Health Information National Trends Survey in American Sign Language between 2015 and 2019. Modified Poisson regression with robust standard errors was used to calculate relative risk estimates and 95% confidence intervals for all medical conditions and mental health disorders with self-reported LGBTQ status as the main predictor, adjusting for known health correlates. Results: Consistent with the LGBTQ health disparity in the general population, our study findings indicated health disparities for certain medical conditions (e.g., lung disease, arthritis, and comorbidity) and mental health disorders (e.g., depression and anxiety) among mid-to-older deaf LGBTQ compared with non-LGBTQ deaf adults. Conclusion: Like the LGBTQ counterparts in the general population, deaf LGBTQ adults may require more frequent and comprehensive health care services. Culturally and linguistically competent care by providers may be invaluable in reducing such health inequities, particularly when provider education and training is undertaken through an intersectional framework that considers the interaction and context of multiple patient and provider social identities.

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“…Some trans/GNC youth experience psychological distress—gender dysphoria—associated with the discrepancy between their gender identity and sex assigned at birth (APA 2015 ). Trans/GNC youth also frequently report experiences with bullying, harassment, and discrimination in school and social service settings based on their gender identity (Mallon 2009 ; Mallon and Hess 2014 ; Shelton 2015 ; Stotzer et al 2013 ). In schools, whether or not trans/GNC students report gender-based bullying is frequently driven by the degree to which youth feel a climate is safe and filled with staff who will meaningfully intervene (Meyer 2007 , 2008 ).…”

Section: Part Imentioning

confidence: 99%

Street-Level Bureaucrats and Intersectional Policy Logic: a Case Study of LGBTQ Policy and Implementation Barriers

Baker

Hillier

Perry

2020

J of Pol Practice & Research

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Without clear federal mandates protecting the rights of transgender and gender nonconforming people, local governments are drafting their own legislation that either protects or limits these populations' rights. This leaves street-level bureaucrats situated in between competing auspices, conflicting mandates, and a constrained sense of selfdetermination when they are tasked with applying emerging legislation in a policy gray area. This paper considers the policy logic of an intersectional approach to LGBTQ policy, as well as the implementation barriers street-level bureaucrats may face when operationalizing LGBTQ policy in a politically complex environment. First, we use a piece of local legislation designed by transgender and LGB youth as an implementation case study focused on policy logic and policy triggers. Second, we employ thematic analysis for analyzing open-ended responses to 281 surveys completed by teachers and other school staff after training around implementation of a new district-wide policy anchored in an intersectional approach. Beyond normative, protracted implementation timelines, even when front-line workers were in full support of LGBTQ rights, tension still surfaces around the internalization of bureaucracy, fear of disciplinary sanctions, a perception of competing rights, and ambivalence with mediating between personal, familial, and youth agency. Even when using equity-focused policy approaches, stakeholders can expect to encounter implementation barriers with street-level bureaucrats (SLBs) while trying to influence higher orders of government through local advocacy and action. Altering the discourse on gender identity remains difficult in the current political environment surrounding LGBTQ rights.

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Gender Identity and Social Services: Barriers to Care

Cited by 55 publications

References 34 publications

Mandating Inclusion: Critical Trans Perspectives on Domestic and Sexual Violence Advocacy

Mandating Inclusion: Critical Trans Perspectives on Domestic and Sexual Violence Advocacy

Health Disparities Among Mid-to-Older Deaf LGBTQ Adults Compared with Mid-to-Older Deaf Non-LGBTQ Adults in the United States

Street-Level Bureaucrats and Intersectional Policy Logic: a Case Study of LGBTQ Policy and Implementation Barriers

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