● Fifteen percent of LGBTQ Americans reported postponing or avoiding medical treatment because of discrimination. ● Transgender individuals faced unique obstacles to accessing healthcare, including one in three who had to teach their physicians about transgender people. ● LGBTQ Americans may have also experienced significant mental and behavioral health issues that are related to the COVID-19 pandemic. Self-Assessment Quiz Question #4 All the following statements are accurate EXCEPT: a. In the U.S. 61 million adults live with a disability. b. The most common type of functional disability is related to cognition. c. More than half of LGBTQ Americans report hiding a personal relationship. d. Transgender individuals face unique obstacles to accessing healthcare. The complexity of individual diversity is inclusive of not just racial and ethnic identity but also of variables such as socioeconomic class, disability, and LGBTQ status. While these facets of diversity are not exhaustive, they do represent some important categories of diversity. Healthcare professionals must consider the unique array of diverse identities that are represented within each individual encountered in each therapeutic relationship. The complexity embodied within each patient affects the way that the patient understands and views the healthcare professional and the professional relationship, just as the complexity of the healthcare provider’s diversity dimensions affects the way that the healthcare professional understands and views each patient. It is impossible to provide information that allows healthcare professionals to gain knowledge about categories of people and how they behave or view the world, because not only is the variation within individual ethnicities and races endless, but the variation within each individual also is endless. Instead, healthcare professionals should aim to understand the societal landscape that privileges and oppresses individuals. The experiences of oppression experienced by various diverse groups are likely to provide them with a unique perspective on both the larger society and on their relationship with healthcare professionals.
of retaliation. Providing some credence to these concerns, of those students who did report the harassment and assault, more than half (60.5%) reported that school staff either “did nothing” or told the reporting student to “ignore it.” As an extension of this type of engagement from school staff, most LGBTQ students (59.1%) reported personally experiencing discriminatory policies and practices at school, ranging from prohibited access to gender-consistent facilities (28.4%) and being prevented from utilizing chosen pronouns or names (22.8%), to being prohibited from discussing or writing about LGBTQ topics (16.6%) and being disciplined for even identifying as LGBTQ (3%). In fact, stigma consciousness, the personal understanding that historically and currently you are a member of a group that is a stigmatized population, is high among the LGBTQ population and often prevents individuals from being authentic or “out” at work (Gates, 2014). Having to hide such an important part of their identity can be stressful and have personal and professional negative effects on LGBTQ clients. The Center for American Progress conducted a national public opinion study on the state of the LGBTQ community in 2020. The survey included interviews with 1,528 self- identified LGBTQ adults ages 18 and older. The project was funded and operated by the National Opinion Research Center (NORC) at the University of Chicago (Gruberg et al., 2020). Major findings from the survey include the following (Gruberg et al., 2020): ● More than one in three LGBTQ Americans faced discrimination of some kind in the past year. ● More than three in five transgender Americans faced discrimination of some kind in the past year. ● Discrimination adversely impacted the mental and economic well-being of many LGBTQ Americans, including one in two participants who reported moderate or significant negative psychological impacts. ● More than half of LGBTQ Americans reported hiding a personal relationship to avoid experiencing discrimination. ● An estimated 3 in 10 LGBTQ Americans faced difficulties accessing necessary medical care because of cost issues.
OPPRESSION, PRIVILEGE, AND MARGINALIZATION
Understanding the concepts of oppression, privilege, and marginalization is essential for practicing with cultural humility. There are various aspects of individual identities that oppress or privilege people vis-a-vis their marginalization or empowerment. Oppression is a commonly referenced term in many of the mental and behavioral health disciplines. Because the term has several definitions, or in some instances, the term is left undefined, there can be confusion regarding its meaning in a therapeutic context. Oppression can be defined as “unjust or cruel exercise of authority or power” (Merriam-Webster, 2021), but a more expansive description is that oppression consists of the barriers present as a result of cultural and sociopolitical forces that serve to prevent certain populations of people, based on group characteristics (e.g., LGBTQ, impoverished, African American, Muslim), from accessing resources and/or opportunities that are readily available to others (Frye, 2019; Seethaler, 2014; Van Soest, 2013). Barriers include restricted access to resources and opportunities such as high-quality public education and stable, well-paying jobs.
Oppression is a pervasive system. It has its foundation in history and is maintained via individual and institutional systematic discrimination, personal bias, bigotry, and social prejudice. Oppression leads to a condition of privilege for the person or the group that is the oppressor(s) (NCC, 2021). Oppression is expressed in a systematic manner and enforced by cultural ideology and the threat of violence (Van Soest, 2013). It is not accidental, and it is not avoidable by the populations that experience it. It is meant to maintain the current societal status quo (Seethaler, 2014). It is important to understand “the unavoidability of oppressive forces for many groups” (Seethaler, 2014, p. 43). Oppression is not something individuals can work their way out of or avoid by changing their behavior. In the context of counseling, it is essential to recognize and address the systemic nature of oppression and the role it plays in clients’ and counselors’ lives. In individual counseling sessions the power dynamic within the counseling relationship needs to be identified. Attention needs to be paid to equalizing the relationship and to entering into a partnership with clients; it must be recognized that both the counselor and client
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Book Code: SWUS1525
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