Inclusive language regarding gender, sexual orientation, and relationship status: the ongoing process and outcome of revising psychiatric materials
| DOI | https://doi.org/10.1108/JMHTEP-02-2018-0009 |
| Published date | 24 October 2019 |
| Date | 24 October 2019 |
| Pages | 385-398 |
| Author | Rebecca Drill,Johanna Malone,Meredith Flouton-Barnes,Laura Cotton,Sarah Keyes,Rachel Wasserman,Kelly Wilson,Monica Young,Holly Laws,Jack Beinashowitz |
| Subject Matter | Health & social care |
Inclusive language regarding gender,
sexual orientation, and relationship status:
the ongoing process and outcome of
revising psychiatric materials
Rebecca Drill, Johanna Malone, Meredith Flouton-Barnes, Laura Cotton, Sarah Keyes,
Rachel Wasserman, Kelly Wilson, Monica Young, Holly Laws and Jack Beinashowitz
Abstract
Purpose –The purpose of this paper is to address the barrier to care experienced by LGBTQIA+populations
by binary language for gender, sexual orientation and relationship status.
Design/methodology/approach –The authors review the research that shows linguistic barriers are a
significant obstacle to healthcare for LGBTQIA+ communities. The authors describe both a process and
revisions for addressing language bias in psychiatric intake/research research materials as well as quantify its
impact in an adult psychotherapy clinic in a public hospital.
Findings –Patients self-identified their gender, sexual orientation and relationship status in a variety of ways
when not presented with binaries and/or pre-established response choices. In addition, the non-response
rate to questions decreased and the authors received positive qualitative feedback. The authors also present
the revisions to the intake/research materials.
Practical implications –Other healthcare settings/clinicians can revise language in order to remove
significant barriers to treatment and in doing so, be welcoming, non-pathologizing and empowering for
LGBTQIA+ consumers of mental health services (as well as for non-LGBTQIA+ consumers who are in
non-traditional relationships).
Social implications –This work is one step in improving healthcare and the healthcare experience for
LGBTQIA+ communities and for those in non-traditional relationships.
Originality/value –This work is set in a public safety-net hospital providing care for underserved and diverse
populations. This paper describes the process of revising psychiatric materials to be more inclusive of the
range of self-identity are: gender, sexual orientation and relationship status.
Keywords Gender identity, Language for gender and sexuality, LGBTQ issues, Relationship status,
Sexual orientation identity, Treatment barriers
Paper type Case study
Introduction
Within mainstream society, there are limited available words to recognize experiences of gender
and sexuality (Davis, 2008; Motschenbacher, 2010). In the context of mental health settings,
binary language for gender and sexuality (e.g. male/female and gay/straight) may particularly limit
patients’and clinicians’ability to express and understand clinical concerns (Budge et al., 2014;
Burdge, 2007; Davis, 2008; Dietz, 2013; Hope et al., 2016; Kuper et al., 2012; Meyer, 2003;
Testa and Hendricks, 2012). In considering this matter across research and clinical settings,
Kuper et al. (2012) emphasize that a “focus on, and use of, specific or dominant categorizations
may exclude and silence the experiences of those whose conceptualizations of their own gender
do not fit into such categories”(p. 246). This issue often first arises with the medical forms and
questionnaires that patients receive when first entering a healthcare facility. In fact, Hagen and
Received 6 February 2018
Revised 6 July 2019
Accepted 19 August 2019
(Information about the authors
can be found at the end of
this article.)
DOI 10.1108/JMHTEP-02-2018-0009 VOL. 14 NO. 6 2019, pp. 385-398, © Emerald Publishing Limited, ISSN 1755-6228
j
THE JOURNAL OF MENTALHEALTH TRAINING, EDUCATION AND PRACTICE
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