Hetero-normativity and homo-negativity can impede LGBTQI individuals from accessing harm reduction services. These concepts assume heterosexuality as the norm and view non-heterosexual attraction negatively. This creates an environment with heterosexual privilege but also homophobia and homo-negativity. Negative language and lack of policies create an unsafe environment for both LGBTQI clients and staff. Service providers must acknowledge and address these issues, educate themselves and others, and create a more inclusive environment through visible support and clear anti-discrimination policies to improve accessibility and quality of services for all.

1. How hetero-normativity and homo-
negativity impedes LBGTQI people
from accessing harm reduction
services
Presented by
Dr Marcus Day
Caribbean Drug & Alcohol Research Institute

2. OBJECTIVE
• To introduce harm reduction service
providers and allied service workers to the
concepts of heteronormativity and
homonegativity and their influence on the
manner in which we treat with people who
we interact with.

3. Heteronormativity
• Heterosexuality is the societial norm
• Assumes that men are sexually and
romantically attracted to women and
women are attracted likewise to men;
• Same-sex attraction is neither
acknowledged by the public nor
recognized by its social institutions.[1]
[1] MacGillivray I.K. Educational equity for gay, lesbian, bisexual, transgendered, and queer/questioning students: the
demands of democracy and social justice for America's schools. Ed Urban Society. 2000;32(3):303–323.

4. Heterosexual Privilege
• Hetrosexual identities and relationships are
celebrated
• There are hetrosexual benefits,
– legalized marriage,
– insurance benefits for spouses and children,
– immediate access to loved ones in case of accident or
emergency.
– military service
– celebrate their sexuality,
– hold hands with their loved ones in public without fear
– see positive images of people who reflect
heterosexual orientation on a daily basis.

5. Homophobia
• defined as the irrational fear and
intolerance of gays, lesbians and
transgendered persons.

6. Homo-negativism
• the negative attitudes and learned behaviors
directed towards non-heterosexuals[1].
• a social context in which negative, prejudicial, or
discriminatory attitudes and/or behaviors toward
non-heterosexuals are developed and
maintained
[1] Krane V, Choi P.Y.L, Baird S.M, Almar C.M, Kauer K.J. Living the paradox: female athletes negotiate femininity and
muscularity. Sex Roles. 2004;50(5–6):315–329.

7. Negative Empowerment
• Hetero-normativity empowers homo-
negativity to reinforce rigid gender
stereotypes that lock men and women into
their respective roles

8. Homo-negativity
• limits the freedom of individuals who do
not identify as heterosexual
• stigmatizes individuals who are
heterosexual and do not fit appropriately
within a particular gender role.
• Limiting an individuals choices to being a
“man” and a “woman”

9. Impediments to accessing service
• Homonegativity may be one reason that
LBGTQI service users may put off
accessing needed services.
• be aware of their use of language and its
effect on the service environment.
• [1] Whitley B.E. Gender-role variables and attitudes toward homosexuality. Sex
Roles. 2001;45(11–12):691–721.

10. Code of Ethics
• built into accreditation standards
• a set of guiding values that direct
professionals to work respectfully and
effectively with diverse populations in
diverse work environments
• ensuring that one aspect of diversity that
is covered is sexual orientation.
• sensitive to physical and mental health
needs of LGBTQI clients

11. A safe environment for staff
• Service providers are a microcosm of
society.
• Some staff self identify as LGBTQI; some
are “out,” and some are “not.”
• Given the societal acceptance of
heteronormativity and homonegativity,
have we created a safe space for these
individuals.

12. a moral imperative
• Our “field” as a social service has a duty,
and perhaps even a moral imperative, to
address issues that affect both the
physical and the mental or emotional
health of both clients and service
providers alike.

13. Assessable services
• Researchers[1] have suggested that the health
of individuals suffers wherever homonegativity is
evident.
• A climate and culture of heteronormativity and
homonegativity affects both staff and clients
negatively.
• Homonegativity may be one reason that LBGT
service users may put off accessing needed
services.
• An environment of diversity and rejection of
homonegative comments and attitudes can
successfully nurture both the physical and
mental health of all involved.
[1] Whitley B.E. Gender-role variables and attitudes toward homosexuality. Sex Roles. 2001;45(11–
12):691–721.

14. Not all hurtful words treated the
same
• The power of racially derogatory words,
including “nigger,” are well known but
“faggot,” “sissy,” and “that's so gay” pass
without much reaction. Although all slurs
can have harmful effects on those to
whom they are addressed, the
consequences are not the same for those
who vocalize these categories of
derogatory terms.

15. Silence as acceptance
• One major concern of LGBT individuals is
that staff are often present when these
epithets are used, remain silent and un-
protesting, and do not educate the user in
the negative emotional effect of this
language.

16. Creating a positive social
environment
• If a positive social environment is to exist
around sexuality and sexual orientation, all
key players must be held accountable for
their comments. In addition to not allowing
the use of derogatory comments,
individuals must be educated on the
effects of using such comments and the
negative connotations.

17. 3-step approach
• Franck suggested a 3-step approach to
address slurs and anti-gay language.
[1] Franck K.C. Rethinking homophobia: interrogating heteronormativity in an urban
school. Theory Res Soc Educ. 2002;30(2):274–286.

18. 1st
Acknowledge
• First, persons in charge must
acknowledge to others that they are
hearing the negative language and must
make their presence known to the
perpetrators.
• leadership conveys the message that
using slurs and anti-gay comments is not
acceptable.

19. 2nd
Educate
• Second, service providers must find ways
to educate staff and clients about the
meaning and weight of their words,
particularly because the word gay is often
used as a synonym for bad or weird.

20. 3rd
Address it, not just reprimand
• Third, service providers must be willing to
address with staff and service users topics
related to the use of hate language or the
gay-rights struggle.
• Franck argued that a dismissive reprimand
only forces attitudes underground and
leaves them unchanged and that they will
likely continue their homophobic remarks.

21. Create safer environment
• take additional steps to create a safer
environment for LGBT service users.
• establish and enforce comprehensive
policies and procedures that specifically
mention sexual orientation and/or gender
identity or expression, Create a grivance
policy that enable individuals to report
incidents of harassment and demonstrates
to service users and employees that
victimizing behaviors will not be tolerated.

22. More then a rainbow sticker
• service users need to be able to identify
supportive staff.
• more than having a “safe space” sticker on
one's door.

23. GIPA for LBGTQI
• The presence of supportive individuals
contributes to a greater sense of safety. Having
a supportive staff that consists of more than 1 or
2 individuals may produce the best outcomes for
LGBT service users.
• If service users experience their service
providers as accepting or open-minded about
sexual orientation, they may be more
comfortable with them and opt to seek care
when necessary.
• This acceptance also may provide a safe space
for exploring questions about sexual orientation
and may promote new positive role models.

24. Role models
• Being a role model or an ally for LGBTQI
individuals is one of the most powerful
actions that service providers can take,
both in the clinic and in outreach. Every
intervention discussed needs role models.
As an LGBT individual working as a
service provider make the invisible visible
and support those clients who are living
“out”.

25. Positive examples for LGBTQI
• Topic of sexual orientation help others
understand how such orientation functions
in one's life. This visibility also allows
service users to consider other options
besides the expected norms, destroys the
assumption that homosexuality is only
about sex, and provides positive examples
for LGBTQI.

26. Ethnic minority LBGTQI
• Identify and address issues relevant to
ethnic minority members and health care
concerns affecting LBGTQI ethnic minority
individuals,
• Advocate for sensitivity toward cultural
diversity throughout the field.
• Include sexual orientationwith race and
ethnicity in our diversity checks.

27. Awareness of our own assumptions
• service providers need to become aware of their
own assumptions about heteronormativity and
homonegativity and how they affect interactions
with other staff, volunteers and service users.
• Service users need to understand their
perceptions of the actions of others around
them. Being aware and addressing personal
assumptions while helping others do the same
can be a positive experience for both providers
and the communities where the work.

28. Inclusive rather than exclusive
• Service providers must continue to
educate themselves and advocate working
in conjunction with communities to change
attitudes toward heterosexism and
homonegativity. Services need to be
inclusive rather than exclusivity.

29. Ongoing Process
• Managing heteronormativity and
homonegativity is an ongoing process on
both a personal and societal level.
Understanding the power of language and
attitude is important for fighting all
discrimination.

30. A theoretical framework
• Having a theoretical framework within
which to develop interventions and
education programs is important.
• Service providers must understand the
interaction of drugs and sex.
• Understand these roles and norms and
suggested interventions to make harm
reduction more inclusive of alternative
sexualities.

31. Skills
• Acquire basic skills that service providers can use to
positively affect their work and the therapeutic
environment to make services inclusive and safer.
• These skills,
• monitoring the use of language,
• being a visible ally to LGBT service users,
• using self-reflection to understand how beliefs and
expectations affect the work and the environment,
• must be supported continually by an overall policy
environment.

32. Thank You
This is an ongoing work
Comments and criticism are welcome
Please send comments to
marcus.p.day@gmail.com