2.8.2 ms edda lampis
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2.8.2 ms edda lampis
- 1. Same Dame but Different Lesbian friendly service provision Presented by Edda Lampis - Community Health Promotion Officer ACON Northern Rivers elampis@acon.org.au
- 2. Health Inequalities Anxiety and depression Marginalisation, stigmatisation and isolation Violence and abuse Smoking, drug and alcohol use and abuse Access to health services
- 5. “The first person I encountered at the oncology clinic asked me where my husband was. I recall [them] taking down my health care card number, you know, and I just thought, wow, not only am I babbling incoherently because of the fear I was feeling from coming into this place for the first time, but I was also taken aback from the heterosexualness of the environment”. Sarah ‘Coming Out About Lesbians and Cancer’ 2004
- 6. 5 principles for lesbian inclusive practice 1. An inclusive and safe environment 2. Open and inclusive communication 3. GLBT sensitive practices 4. Staff education and training 5. Organisational policies and procedures
Editor's Notes
- I would like to begin this presentation by acknowledging the traditional owners and custodians of this country, the Gadigal People of the Eora Nation, whose country we all gather upon for this conference. My name is Edda Lampis. I am currently the Community Health Promotion Officer for ACON Northern Rivers up in Lismore, in the beautiful Northern Rivers Region of Northern NSW. ACON has been the leading HIV and GLBT health and wellbeing organisation in NSW for the past 27 years, tho I’ve only been in my position for a year. GLBT… not familiar with this acronym? G- Gay L- lesbian B- bisexual And T- transgender A long acronym encompassing a number of diverse communities and identities, each with its own history and specific health needs. I wont be going into an explanation of the various identities covered by these letters, except to say that Gay, lesbian, and bisexual, the GLB are sexuality based and the T, transgender refers to gender identity that differs to that allocated at birth. All of these idenities experience marginalisation and discrimination and this directly impacts upon the health and well being of these individuals in multiple and significant ways. My role at ACON involves promoting the health and well being of GLBT communities, with particular focus on the sexual health of lesbian and same sex attracted women. As this term lesbian and same sex attracted women is a cumbersome one, to save syllables I will continue by mostly using the term lesbian to refer to this group. I do need to say however that not all women who have relationships with women identify with the label of lesbian. Women who have relationships with women may identify as lesbian, gay, bisexual, queer or may even identify as straight. Labels have and continue to be politically charged and each woman is likely to identify differently according to her own background and experiences. So when I use the term lesbian, please bear in mind I am talking about a very diverse group of women, who incorporate a variety of identities, with diverse lifestyle practices, value systems and ways of being in the world . Despite being a country town, our region (thankfully) has the highest gay and lesbian population outside of Sydney, making it a great place to live for a lesbian woman such as myself!. This means great things socially, for a small country town, and it also means that my organisation has an important role to play to ensure that health services in our region are providing appropriate and effective service delivery to our communities. ACON Northern Rivers has been conducting local, regionally based studies on lesbian experiences of accessing health care services since 2001, with most recent research findings coming out of the Pink Lace project in mid 2012. Although this research project focused specifically access of cancer care services, the findings are relevant in the broader discussion of how we make health services more appropriate and accessible to lesbians. PINK LACE The Pink LACE (Lesbian Affected by Cancer Explored) Project was a partnership initiative between ACON and Cancer Australia’s Building Better Networks. The Pink LACE Project aimed to reduce the impact of cancer on lesbians and same-sex attracted women in the Northern Rivers region of NSW by developing an evidence base and conducting a needs assessment. This was done through distributed questionaries to lesbian and same sex attracted women and cancer related service providers in our area. This project identified strategies to increase effectiveness, availability and accessibility of cancer support and services to lesbians and SSAW and to service providers. Questions posed related to: service practice; support and referral networks as well as the experience of accessing the mainstream services on offer. The Pink LACE project has contributed to the body of knowledge in Northern Rivers region regarding the barriers, issues and complexities faced by lesbians and same sex attracted women when accessing mainstream health services. The research has highlighted the need for changes in service provision to address inequalities in health outcomes for women who do not identify as heterosexual. Findings Concern raised by lesbians through Pink lace were of discrimination, isolation and limited community supports. It was found that some service providers were more knowledgeable than others on the health and service needs of Lesbians, and in the extreme some had an obvious limited understanding of ‘lesbian specific factors’ when it came health service provision . In general, service providers reported limited referral options; lack of knowledge about lesbian specific needs and limited access diversity awareness training around GLBT issues to address this. To ensure inclusive practice, mainstream service providers could benefit from training opportunities that explore the myths, stereotypes and differences relevant to this group. HEALTH INEQUALITIES In the last session, Rhonda Browne explored the prevalence of cancer and cancer risk factors among Australian sexual minority women, so I won’t spend much time going over the same ground. It is critical however to mention, that whilst many lesbians are part of broad networks of support, many face a number of health challenges. These include disproportionately higher rates of depression and anxiety, obesity, smoking, alcohol and other drug use. Lesbian and same sex attracted women have also been found to access breast and cervical screenings significantly less regularly than other women and demonstrate a lack awareness of the risk of sexually transmissible infections. Same sex attracted young women face higher suicide rates, high rates of homophobic violence and bullying, self harming behaviours, unwanted pregnancies and a whole host of mental health issues. Being a lesbian or a same-sex attracted women is not a health problem in itself. There is nothing about being a lesbian that causes ill health. However, sexual orientation can be a social determinant of health in much the same way as are factors such as gender, socio-economic status or ethnicity. The impacts of minority stress, discrimination, social isolation and marginalisation has been shown to lead to a variety of poor health outcomes for groups who somehow do not fit into the norm of straight, white, middle class, heteronormative identities. When talking health inequalities, lesbian and same sex attracted women fare much worse then their heterosexual counterparts, highlighting this group as a priority population whose health and access issues demand action.
- With the confidence and commitment of participating agencies, building an understanding of the principles and values of inclusion and cultural safety issues relevant to this client group, in taking part in GLBT awareness training, use of quality improvement approaches and policy development, services can work to becoming more responsive to their lesbian clients. The Pink LACE project has developed training resources to support organisations in their move towards becoming more lesbian inclusive. The Resource Kit provides materials that ACON Northern Rivers can offer to agencies to assist their increased capacity in the area of sexual diversity. I’ve brought a few copies with me as examples, and you come and see me after this presentation and I will arrange to post you one. ACON is also providing training to service providers to increase their capacity to deliver inclusive service delivery for our priority populations. Discrimination, homophobia and heterosexism have no place in service delivery. Homophobia and heterosexism are known to create access barriers. Don’t assume lifestyle, values, sexual practices, religious affiliations or anything for that matter. Let your client tell you about herself and her issues. This is aligned with principle of client-centred care, where a collaborative and respectful partnership between service user and service provider is developed. This facilitates and enhances a client’s quality of life by acknowledging and respecting the individual care needs and unique history, life experiences and personal choices.
- Treating everyone the same is not necessarily treating everyone equally. There is an abundance of training programs available to increase service capacity and competency in responding to the service and health needs of GLBT people and communities. Currently ACON is running GLBT awareness training for workers in cancer treatment care and support, aged care sector workers, mental health professionals, and other Community and Health sector workers. This training not only covers the basics such as understanding the difference between sexuality and gender identity, but identifies specific issues and health needs of GLBT and communities. We are seeing an increase in demand for this kinds of training and one seen this as necessary as cultural training programs for working with other priority populations. As GLBT seniors are now listed by both the Commonwealth and NSW governments as a ‘special needs group’ for aged care services.
- Experiences and/or fear of experiencing homophobia and heteronormativity from health care providers is limiting access to health services for same sex attracted women. Theres that word again, heteronormativity. SLIDE
- “It takes courage for an organisation to embrace LGBTI-inclusive practice. It requires the organisation to identify what it is not doing well and what it needs to improve. It also often involves seeking feedback from stakeholders and risking criticism.” ‘Beyond we treat everyone the same’ 2011 Intake forms, relevant and targeted resources, and a visible celebration of the diversity of your clients Referral pathways and interagency collaboration Specifically, lesbian and same sex attracted women want health care providers to be: open-minded knowledgeable about lesbian and bisexual health care needs able to create and sustain a safe space for disclosure of sexuality realises that disclosure is not restricted to the health care environment, but happens sometimes many times per day sensitive to the reality of living in society as lesbian and its effect on health acknowledgment of same-sex partners is important in medical decision making and care plans belief in equity of access to health care for all Australians; education regarding discrimination, health needs of GLBT subgroups and information about referral networks. Poster Intake forms Resources that lesbian specific
- A key strategy in ensuring the inclusion of lesbian health and service needs is to systematically plan the process of where GLBT-inclusive practice sits in a diversity policy framework. It is important to consider how the integrity of the particular needs of same sex attracted women is maintained in your service. Consumer access is the first priority and the service system needs to be in place to support the development of a co-ordinated and seamless response to the health needs of lesbians and same-sex attracted women, who I can guarantee already use your service. It is important that when organisations promote their service as GLBT inclusive that they have systems in place to ensure that they are. Gay and Lesbian Health Victoria, in their Rainbow Tick accreditation program, speak of the importance of first ensuring that professional development and organisational systems are in place to help staff respond appropriately to GLBT clients who disclose their sexual orientation or gender identity in response to posters declaring that the service is gay and lesbian friendly So, when we are talking about Lesbian inclusive service delivery, what exactly are we talking about?