Baker Kelly, Beagan Brenda
Department of Anthropology, Western University.
Med Anthropol Q. 2014 Dec;28(4):578-98. doi: 10.1111/maq.12129. Epub 2014 Sep 8.
Despite increased attention to "culturally competent" practice with diverse populations, lesbian, gay, bisexual, transgender, and queer (LGBTQ) people remain relatively invisible within medicine and other health professions. Health care providers (HCPs) frequently dismiss sexual and gender identity as irrelevant to care. This study uses interviews with 24 physicians and 38 LGBTQ-identified women to explore how routine practices in health care can perpetuate or challenge the marginalization of LGBTQ women. While physicians avoid making assumptions to reduce judgment, a "neutral" stance reinforces the hetero- and gender normative status quo. Cultural competence with LGBTQ patients requires learning with, rather than learning about, LGBTQ people's particular health care concerns as well as paying explicit attention to pervasive power relations and normative contexts.
尽管针对不同人群的“文化胜任力”实践受到了更多关注，但女同性恋、男同性恋、双性恋、跨性别者和酷儿（LGBTQ）群体在医学及其他健康专业领域中仍然相对不为人所见。医疗服务提供者（HCPs）常常认为性取向和性别认同与医疗无关而不予理会。本研究通过对24名医生和38名自我认同为LGBTQ的女性进行访谈，来探讨医疗保健中的常规做法如何延续或挑战LGBTQ女性的边缘化状况。虽然医生避免做出假设以减少偏见，但“中立”立场强化了异性恋和性别规范的现状。对LGBTQ患者具备文化胜任力需要与LGBTQ人群一起了解他们特殊的医疗保健问题，而不是仅仅了解相关信息，同时还要明确关注普遍存在的权力关系和规范背景。
