Hidden forms of discrimination against LGBTQ+ individuals have been pervasive in many areas, including healthcare. These include denial of access to care, verbal harassment and abuse, physical violence, misgendering, and forced heteronormativity. In this article, I will explore how these forms of discrimination impact moral and ethical obligations towards LGBTQ+ patients.
Denial of Access to Care
Denying access to care is one of the most insidious ways that hidden forms of discrimination manifest in healthcare settings. This can take several forms, from refusing to provide treatment altogether to offering substandard care or simply delaying it. Healthcare providers may justify their actions by claiming that they are following religious beliefs or personal values, but this does not excuse their failure to meet professional standards of care.
Some hospitals refuse to perform gender affirmation surgery based on "moral" grounds even though it is medically necessary for trans individuals' mental and physical health. Others may deliberately delay diagnosing HIV/AIDS infections in gay men until it becomes an emergency situation due to fear or prejudice. By denying access to essential medical care, healthcare providers violate fundamental principles of patient-centeredness, beneficence, autonomy, and justice.
Verbal Harassment and Abuse
Verbal harassment and abuse are another common form of discrimination faced by LGBTQ+ patients. This includes insulting language, derogatory terms, and unwanted sexual comments. It can also include withholding information about available treatments or preventive measures. Healthcare providers who engage in verbal harassment and abuse not only fail to meet professional standards of behavior but also contribute to a hostile environment that deters other LGBTQ+ people from seeking medical attention. They perpetuate stigma and discrimination, undermine trust in the healthcare system, and create barriers to effective communication between provider and patient.
Such acts can harm patients physically and emotionally.
Physical Violence
Physical violence against LGBTQ+ patients occurs frequently in healthcare settings, particularly when they are perceived as nonconforming to societal norms regarding sex, gender, or sexuality.
Some providers have been known to use restraints on queer patients or refuse them pain medication during childbirth. These actions violate fundamental principles of nonmaleficence and respect for patient dignity. Patients should be treated with compassion and understanding regardless of their identities or experiences.
Misgendering
Misgendering is an important issue affecting trans individuals, who may be referred to by the wrong pronouns or incorrectly identified based on their appearance. This can lead to disrespect, humiliation, and confusion, which can further damage the patient-provider relationship. Providers must be sensitive to the needs of all patients and avoid making assumptions about their gender identity. Doing so contributes to creating a safe and welcoming environment for everyone.
Forced Heteronormativity
Forcing heteronormative ideals upon LGBTQ+ patients is another form of hidden discrimination in healthcare. This can include pressuring patients to hide their sexual orientation or gender identity, forcing monogamy on gay men, or promoting abstinence for people living with HIV/AIDS. Such practices deny the reality of many LGBTQ+ people's lives and violate their right to self-determination. They also perpetuate harmful stereotypes and contribute to stigma and prejudice. Healthcare providers must provide information that accurately reflects diverse lifestyles and choices and create safe spaces for open discussion of these topics.
How do hidden forms of discrimination in healthcare affect moral and ethical obligations toward LGBTQ+ patients?
Many hidden forms of discrimination against LGBTQ+ patients are present in healthcare settings, including stereotyping, misinformation about their sexual orientation and gender identity, and lack of access to appropriate medical care. These issues can create barriers for LGBTQ+ individuals in receiving adequate treatment and support from healthcare providers. This may violate their rights to receive high-quality, culturally competent care that is sensitive to their unique needs.