Page 247 - Cultural Competence in Health Education

Culture and Sexual Orientation 225

about preventive measures for his or her health. However, the LGBT community has
specific health needs that should be recognized and addressed. Studies show that

LGBT populations, in addition to having the same basic health needs as the general
population, experience health disparities and barriers related to the expression of their
sexual orientation or their gender identity (Kaiser Permanente National Diversity
Department, 2004). Many avoid or delay care or receive inappropriate or inferior care
as a result of perceived or real homophobia and discrimination on the part of health
professionals and institutions.
In spite of the many differences that separate them, the members of the overall
LGBT community have similar experiences of discrimination, rejection, shame, and
violence. There are numerous ways that health educators and health professionals can
reduce homophobia and heterosexism in their daily work. It is vital that all of us who
are health educators and practitioners strive to provide a welcoming, supportive, and
inclusive environment as we address health promotion and disease prevention for the
LGBT community.
We must address our own attitudes and behaviors about gender identity and
sexual orientation (Matthews, Lorah, & Fenton, 2006). Failure to be authentically
affirming and accepting will invite the continuation of shame among this community.

Consider the health educator who says things intended to show that he is affi rming
and accepting but who also immediately increases the physical space between him-
self and his LGBT client. LGBT people will readily read such negative nonverbal
and verbal cues and will feel validated in their distrust of the health educators and
professionals.
We need to provide a physically welcoming environment. Members of the LGBT
community will immediately scan our environments for clues that invite them to feel
comfortable with a health care experience. Simple symbols such as rainbow fl ags,

pink triangles, and LGBT – friendly stickers can be placed in offices, restrooms, or
waiting areas (Dinkel, 2005). In addition, health educators and health professionals
should consider using posters or brochures that display racially and ethnically diverse
same - sex couples or transgender people. We can visibly display and provide a written
copy of a nondiscrimination policy that addresses gender identity and expression along
with age, race, ethnicity, physical ability or attributes, religion, and sexual orientation
(GLMA, 2006). And we can advocate for gender - inclusive (unisex) restrooms, as they
are safer and more comfortable for transgender people than single - sex restrooms.
We should use culturally sensitive language. Forms, assessments, and conversa-
tion should employ inclusive choices such as partner instead of spouse and relation-
ship status instead of marital status. Adding the option of transgender, with selections
for male - to - female and female - to - male, will invite immediate acceptance. We can use
the same language that the transgender person does to describe self, sexual partners,
relationships, and identity. Remember that an individual may not define herself through

a sexual orientation label, yet she may have sex with persons of the same sex or gender
or with persons of both sexes. For example, men who have sex with men, especially
African American and Latino men, may identify as heterosexual and have both female
and male partners (GLMA, 2006).

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