Gender Justice JEAN-MICHEL BREVELLE MARYLAND DEPARTMENT OF HEALTH JULY 20, 2017 Working Assumptions . Everybody has a body . Every body is different . Every body deserves to be treated with respect . Every body needs health care
July 20, 2017 INFECTIOUS DISEASE PREVENTION AND HEALTH SERVICES BUREAU 2 50+ Shades of Gender
July 20, 2017 INFECTIOUS DISEASE PREVENTION AND HEALTH SERVICES BUREAU 3 Language: Enemy or Ally? . Stigma is given life in our mouth . What you mean may not be what people hear . Mindfulness promotes inclusion
July 20, 2017 INFECTIOUS DISEASE PREVENTION AND HEALTH SERVICES BUREAU 4 From Stigma to Inclusion
AVOID THIS USE THIS promiscuous multiple sex partners addict; junkie person with substance use disorder prostitute; hooker; whore sex worker; person doing sex work tranny; he/she; shemale; transvestite transgender male condom external condom female condom internal condom; insertive condom homosexual gay; lesbian (woman) illegal alien undocumented immigrant handicapped person living with a disability poor; impoverished low- or lower-income; economically vulnerable
July 20, 2017 INFECTIOUS DISEASE PREVENTION AND HEALTH SERVICES BUREAU 5 Know Your Pronouns! .Binary pronouns .She, her, hers and he, him, his . (Xena ate her food because she was hungry.) .Common gender-neutral pronouns : . They, them, theirs . (Xena ate their food because they were hungry.) . Ze, hir . (Xena ate hir food because ze was hungry.) . Just use my name! . (Xena ate Xena's food because Xena was hungry)
July 20, 2017 INFECTIOUS DISEASE PREVENTION AND HEALTH SERVICES BUREAU 6 Misgendering
.Feels humiliating and disrespectful .Damages your rapport .Makes the person wonder if you are cruel or clueless .Can “out” someone and make them emotionally or physically unsafe .Can contribute to someone being so uncomfortable they do not get the care they need Pronouns are a Really BIG DEAL
July 20, 2017 INFECTIOUS DISEASE PREVENTION AND HEALTH SERVICES BUREAU 7 Sex, Gender, Sexual Orientation
Biological Psycho-Social
SEX GENDER
- CHROMOSOMES -IDENTITY: SELF-CONCEPT - GENITALIA AS MALE / FEMALE / OTHER - REPRODUCTIVE - EXPRESSION: ORGANS COMMUNICATING YOUR - SECONDARY SEX GENDER TO OTHERS CHARACTERISTICS - ATTRIBUTION: WHAT OTHERS SEE AND RESPOND TO SEXUAL ORIENTATION
EROTIC & EMOTIONAL Biological & ATTRACTION TO OTHERS Psycho-Social
July 20, 2017 INFECTIOUS DISEASE PREVENTION AND HEALTH SERVICES BUREAU 8 Gender & Gender Roles . Category for grouping . Binary model most common . Socially constructed . culturally sensitive . division of labor . Relies on stereotypes . sex . race / ethnicity . age . culture
July 20, 2017 INFECTIOUS DISEASE PREVENTION AND HEALTH SERVICES BUREAU 9
Sex/Gender Stereotypes ** DO NOT CROSS ** GENDER LINE **DO NOT** **DO CROSSLINE NOT DO GENDER **** CROSS
.Aggressive .Submissive .No Emotions .Emotional .Loud .Quiet .Messy .Neat/Clean .Athletic .Clumsy .Math/Science Oriented .Artsy .CEO .Housewife .Money Maker .Child rearing
July 20, 2017 INFECTIOUS DISEASE PREVENTION AND HEALTH SERVICES BUREAU 10 Gender Bias . Correspondence bias . Conflation with sexuality and sexual “norms” . Explicit vs. Implicit . Reinforcing gender and gender behavior
July 20, 2017 INFECTIOUS DISEASE PREVENTION AND HEALTH SERVICES BUREAU 11 Negative Impacts . Prior to the ACA, women paid more for health insurance than men in 37 US states – anywhere from less than 25% more up to 100% more. . Women are more likely to die of a heart attack than men, because physicians discount symptoms as “anxiety”, “panic attack”, or “indigestion”, and do not order the proper diagnostic tests that are standard for men.
July 20, 2017 INFECTIOUS DISEASE PREVENTION AND HEALTH SERVICES BUREAU 12 Negative Impacts . Women are more likely than men to die of trauma related blot clots, because physicians are less likely to provide appropriate blood clot prevention treatment. . LGBT people in the US are more likely to be uninsured than heterosexual/cisgender people.
July 20, 2017 INFECTIOUS DISEASE PREVENTION AND HEALTH SERVICES BUREAU 13 Negative Impacts . Transgender people, especially transgender women, are more likely than any other group to be without health insurance. . Transgender people experience high rates of negative healthcare experiences, including verbal harassment and denial of services due to their transgender status (33% USTS 2015); and many (25% USTS) delay seeking care due to fears of mistreatment because of their transgender status, or avoid care altogether (33% USTS) because they cannot afford it.
July 20, 2017 INFECTIOUS DISEASE PREVENTION AND HEALTH SERVICES BUREAU 14 Transgender Health Equity
. American Medical Association . World Professional Association for Transgender Health . American Psychological Association . American Academy of Family Physicians . American Congress of Obstetricians and Gynecologists . American Academy of Pediatrics . American Counseling Association . Endocrine Society . and more…
July 20, 2017 INFECTIOUS DISEASE PREVENTION AND HEALTH SERVICES BUREAU 15 Working Assumptions . Everybody has a body . Every body is different . Every body deserves to be treated with respect . Every body needs health care
July 20, 2017 INFECTIOUS DISEASE PREVENTION AND HEALTH SERVICES BUREAU 16 Jean-Michel Brevelle Sexual Minorities Program Manager Infectious Disease Prevention and Health Services Bureau 500 N. Calvert Street, 5th Floor Baltimore, MD 21202 (410) 767-5016 p | (410) 333-6333 f [email protected] http://health.maryland.gov
July 20, 2017 INFECTIOUS DISEASE PREVENTION AND HEALTH SERVICES BUREAU 17