Considering First Nations LGBTIQ+ identity in anti-racist healthcare: Relations between comfort in healthcare, microaggressions and wellbeing

Bep Uink (Noongar) , Rebecca Bennett (non-Aboriginal) , Sian Bennett (Gamilaroi) , Dameyon Bonson (Aboriginal and Torres Strait Islander) , Braden Hill (Nyungar Wardandi)
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Abstract

First Nations scholars and practitioners have increasingly called for anti-racist healthcare to address disparate health outcomes between First Nations and non-First Nations Australians. However, these arguments largely miss the significant negative impact that colonial heterosexism and cisgenderism (i.e. discrimination and marginalisation of queer and transgender peoples) have on LGBTIQ+ (lesbian, gay, bisexual, transgender, intersex, queer/questioning) First Nations peoples’ wellbeing. To address this gap, survey data from 63 First Nations LGBTIQ+ adults in Western Australia were utilised to illustrate the impact of racism, heterosexism and cisgenderism in healthcare settings on First Nations LGBTIQ+ peoples’ wellbeing. This study examined relations between participant wellbeing and 1) their comfort in being asked about their LGBTIQ+ and First Nations identity by a health provider, and 2) their experiences of race-based and LGBTIQ+-based discrimination (microaggressions) in broader community settings. Higher comfort in being asked about LGBTIQ+ identity was associated with higher wellbeing, whereas experiencing LGBTIQ+-based microaggressions within First Nations communities was associated with lower wellbeing. These findings add to the literature by showing that First Nations LGBTIQ+ patients experience additional discrimination. This paper also discusses findings with reference to settler-colonial racism (i.e. the racism enacted against First Nations LGBTIQ+ peoples to maintain settler norms and control) and offers suggestions for updating anti-racist healthcare.

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在反种族主义医疗保健中考虑原住民 LGBTIQ+ 身份:医疗保健中的舒适度、微小诽谤和福祉之间的关系
原住民学者和从业人员越来越多地呼吁反种族主义医疗保健,以解决原住民和非原住民澳大利亚人之间的健康结果差异。然而,这些论点在很大程度上忽略了殖民时期的异性恋主义和顺性别主义(即对同性恋和变性人的歧视和边缘化)对 LGBTIQ+(女同性恋、男同性恋、双性恋、变性人、双性人、同性恋/质疑者)原住民福祉的重大负面影响。为了弥补这一不足,我们利用了来自西澳大利亚州 63 名原住民 LGBTIQ+ 成年人的调查数据,以说明医疗环境中的种族主义、异性恋和顺性别主义对原住民 LGBTIQ+ 人群福祉的影响。本研究考察了以下两个因素之间的关系:1)医疗服务提供者在询问 LGBTIQ+ 和原住民身份时,参与者的舒适度;2)在更广泛的社区环境中,参与者遭受的基于种族和 LGBTIQ+ 的歧视(微小诽谤)。被问及 LGBTIQ+ 身份时感到更舒适与更高的幸福感相关,而在原住民社区中遭受基于 LGBTIQ+ 的微观诽谤与较低的幸福感相关。这些研究结果表明原住民 LGBTIQ+ 患者遭受了更多的歧视,为相关文献增添了新的内容。本文还结合定居者殖民地种族主义(即为维持定居者规范和控制而针对原住民 LGBTIQ+ 实施的种族主义)对研究结果进行了讨论,并提出了更新反种族主义医疗保健的建议。
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