Queering the Clinic: Constructing Gender and Sexuality in LGBT Healthcare

• In Event: 4113 - Gender, Sexuality, and Medicine (Cosponsored with the Section on the Sociology of Sex and Gender)

Abstract

How are gender and sexuality constructed, embedded, and deployed in the alternative case: a LGBT Healthcare organization? And how do organizational processes shape care for LGBT patients least likely to seek healthcare? I triangulate data from observations and interviews with providers and staff at a LGBT Community Health Center, as well as interviews with LGBTQ patients who are most likely to avoid care: cisgender women, transgender men, and non-binary people. The Center deploys gender and sexual schemas wherein sexuality is fluid, gender is non-binary, and both are subject to change. These challenge the construct of a LGBT patient with unique needs, shifting the locus of “difference” from patient to the organization. Instead, LGBT is normalized by queering the clinic: cultivating an informal, discursively nonhierarchical, de-medicalized culture, stylized queer. An organizing principle of the Center is advocacy ethos; the Center is tasked with improving LGBT health and well-being within and beyond their walls, an ethos which can be leveraged to make changes to protocols, but also complicates patient and employee experiences of care and work. Although patients typically report feeling affirmed by care interactions, cis women also feel that the Center is not “for” them. Indeed, organizational priorities and material factors often conflict with discursive ethos, and women become marginalized in the Center’s construction and deployment of LGBT health. Findings illuminate gender and sexual schemas that may improve the experiences of LGBTQ patients in typical settings, and suggest non-transferrable processes at play within LGBT health spaces are uniquely compelling for some LGBT patients. All settings, however, must address how such alternative schemas and practices may further marginalize women. This study also advance theories of gender, sexuality, and medicine as well as organizations by illustrating progress and pitfalls within the case of a queer healthcare organization.

Author

• Emily Allen Paine, Columbia University and NYSPI