Intersectional education: Taking steps towards humane healthcare  

A study of queer people accessing healthcare in South Africa at government hospitals has revealed that many avoid getting vital healthcare because of the judgement they face from healthcare providers.

Part of the findings of Challenges in sexual and reproductive healthcare access for queer people in Gauteng, South Africa, by Raikane J. Seretlo, Hanlie Smuts and Mathildah M. Mokgatle, include that healthcare professionals believe that queer people are afraid when seeking healthcare, while queer people perceive healthcare professionals as having negative attitudes and acting as gatekeepers.

Consequently, there’s a massive gap in the care that queer people are receiving. The good news is, that this is something that the next generation of healthcare providers is aiming to close.

Someone who is well-qualified to speak on this topic, is Rene Sparks, an award-winning public health professional and health equity activist. Sparks recently gave a  guest lecture on gender and sexuality inclusive health at Stellenbosch University, where I was immediately struck by the desperate need for an intersectional approach to healthcare education.

Closing the education gap

Sparks’ presentation included a detailed exploration of the difference between gender and sexuality. She unpacked the diversity that exists on the spectrum of gender expression and spoke of the importance of using the right language to describe this diversity. If healthcare workers don’t properly understand and appreciate gender diversity, they won’t be fully equipped to provide quality care to patients.

This is especially noticeable around HIV treatment and prevention, when queer patients are often not given the type of treatment and care they need because healthcare workers simply don’t know how to provide them with the necessary care. The unique vulnerabilities that queer people have in terms of healthcare are often not discussed, leading to a gap in the understanding of how to provide the right kind of care. 

The need for intersectional education

The feminist concept of intersectionality is a vital tool to creating a caring and patient- centred practice. Intersectionality put simply, is the way that the multiple facets of a person’s identity all interact together to create their lived experience. When we look specifically at healthcare, a queer person would face the barrier of queerphobia when trying to access medical care. For instance, a person whose gender identity does not match the gender marker on their ID book may not get the specific care that they need. This acts as the important first barrier in the clinic setting.

The lack of education on the specific medical needs of queer people is something that Quote This Woman+ (QW+) and its current fellowship program are hoping to close. QW+ is an intersectional feminist organisation working to transform gender representation in the media landscape by promoting women+ voices and narratives that reflect African demographics and perspectives. Sparks has been a key element of this program.

During the presentation, one participant told her story of being a queer black woman in South Africa. Her narrative provided a human face for the class of both the deeply personal impact of queerphobia, as well as the joy that is felt in living openly as a queer person. Her story also showed the immense violence queer people face, as she told the class about her friend’s experience of homophobic rape. The story illustrated the deep need for healthcare providers to be sensitive to the unique vulnerabilities that queer people face.

Maintaining a human centred approach to care

Human-centred healthcare means not only putting the individual needs of each patient at the centre of the entire care experience, but also knowing how to respect each person’s unique intersectional identity.

Applying an intersectional lens to healthcare, allows healthcare practitioners to meet the needs of each person, in a holistic way. In her lecture, Sparks focused on using human-centred language, for example asking each patient what their preferred pronouns are, instead of assuming what they are. This helps those with diverse gender expressions to be put more at ease and have their experience respected.

Recent global developments have highlighted the distinct lack of education and sensitivity towards the needs of queer people. The recent funding freeze has pragmatically meant that many clinics addressing the specific needs of queer and gender diverse populations were shut down. Programmes like QW+ lectures, and more broadly the fellowship programme that highlights the voices of queer people, act to humanise this group of marginalised people whose experiences are often rendered invisible to the general public. By speaking in a way that humanises queer people, the general current of queerphobia, both in a healthcare setting and in general culture, can be challenged.

The more action that is taken to centre queer experience, the more humanised queer people become. The study by Seretlo, Smuts and Mokgatle concluded that policies need to be strengthened to ensure inclusivity in the healthcare sector. This, like the programmes mentioned above, will help queer people to begin to experience a more humane healthcare experience. 

Tegwyn Megannon is an M& E intern at QW+