Serious indecency: Talking about LGB issues in a country where being gay is criminalised

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I took my very first research poster to my profession’s international association conference in 2001 (ISRRT). It happened to be in beautiful Barbados and the combination of rum punch, meeting other therapists interested in research and finding out just how much great work is happening in other countries was intoxicating! My wife and I made the poster together – I can’t remember how we decided who presented it but I do remember being proud to see our two names together on the top. It’s still listed on both of our CVs, along with the journal articles we have co-authored since.

We’ve always worked in the same field, our eyes first met across an electron cut out (a romantic location only radiation therapists would appreciate!). Our relationship at work has always been a bit of a balancing act – a kind of double-managing of the usual professional coming-out dilemma. In the 90s we weren’t eligible for joint medical coverage through our health insurance as a same-sex couple. When I took some time off after my father died (and needed dental work), we filed a human rights complaint that led to a swift exit from the workplace closet. As attitudes and legislation changed, we worried less about being fully who we are there, but there’s considerable evidence that even in progressive Canada many people still actively manage their sexual identity at work.

My research interest is LGB issues, specifically how/if radiation therapists deal with this. Is it an issue? How does it affect relationships with patients? What about LGB patients? I’ve done a few talks already in this area, just preliminary and broad findings from the literature along with some recent research about LGB patients and their experiences with healthcare. There is growing interest in doing a better job – we know there are fairly easy things we can improve, and we need better education across the board. This is true for many Western countries, the UK are well ahead of most of Canada and we all know about some of the issues the US LGB population are facing with Trump attempting to roll back many hard-won rights such as freedom from discrimination legislation.

But what about other countries? Mostly not so great. I logged onto Twitter this morning to see posts about the “Chechnya 100” – gay men imprisoned and possibly killed because of who they love. While gay rights progress in many parts of the world, there are still at least 74 countries that punish same-sex relationships with life imprisonment or even death. Many of these countries are in the Caribbean and one is Trinidad, where the next international association conference is being held. In that country “consensual intercourse between men is punishable by up to 25 years in prison, while “serious indecency” between women is punishable by 15 years in prison. In addition, an unenforced law calls for a prohibition on homosexuals entering Trinidad” (1).  Also not great.

While I was happy to see that the law that would prevent me from entering the country is unenforced (and to be honest I wasn’t planning on having any kind of sex – let alone the seriously indecent sort) this has given me significant pause. What would you do? Go anyway? Go and change your topic from “homosexuality” to something else? Not go as a protest? (To whom?) I talked to the ISRRT’s Public Relations Regional Coordinator for the Americas last week at our national conference and asked her about this. She has gay friends, she doesn’t think it is a big deal – and was unaware of the law. I imagine it wasn’t even on the radar when they picked the venue. But I think it is a big deal and I am aware of it. I just don’t know what to do!

Reference:

  1. Stewart, C. “Legal challenge confronts Trinidad’s anti-gay laws”. 76 Crimes

Image:

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Where does this quotation end?

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….said my prof as she tried to unravel my latest draft paper. A good question and one I have been mulling over at length.  In the spirit of academic metaphors, at the moment I feel my reading is like a game of pick up sticks or perhaps Jenga. I can’t touch one thing, or idea, without bumping up against another.  A good friend who has been through this told me that “after the proposal” was the best time in her professional doctorate, you have the ground work done and can actually get on and do the thing you’ve been working towards for (often) years.  That bit before the proposal though, and before the comprehensive exam? That’s the teetering Jenga tower, the mess of sticks … the time when you realise how much you don’t know and what it’s going to take to stand up in front of the comprehensive exam panel, your supervisory committee and convince them that you’re ready to get going.

So my reading has been around theory, both queer and feminist, and then a quick tour around my conceptual framework – meaning what concepts will be foundational to my future work and how do they fit together? My research question is how do LGB radiation therapists manage their identities at work? How do they negotiate the complexities of coming out – and how do they decide? When you unpack this idea it’s obvious some work will have to be done on non-heterosexual identities, what “being out” means and why it’s (still) an issue. Our fundamental idea of being “professional” relies on an underlying and usually unarticulated assumption that the person at work is male (rational, unemotional), straight, white, able bodied etc. (Colgan and Rumens, 2015).  So sexual orientation in the workplace is an area of research that has examined this tension – with a small subset that looks at the health care workplace.  It’s also good to see a growing body of work on improving the experience of queer patients, this will also be important to look at – although most of it assumes they (we) are a “problem” to fix  (with our inconveniently high rates of cancer, mental illness and whatnot).

From my own experiences, I think the results won’t be unequivocally “this is what it is like”, but I do have a sense that some of the issues above will be important. There are likely others that I can’t see yet, or might not know until I have talked to the participants of the study. But I’ve already found a chance reference; discussion or recommendation can open up a new way of looking at something.  A paper I found by accident, for example, that looked at how LGB practitioners manage clinical examination of their patients (including scenarios where they may have a chaperone for an opposite-sex patient). The authors concluded that:

 (LGB) healthcare professionals engage in a complex interplay of identity management strategies to avoid homophobic abuse; as a signal of safety from homophobia and understanding for their lesbian, gay, and bisexual patients and as a desexualisation strategy principally for gay men and their women patients. (Riordan, p. 1227)

 I love the idea of “a signal of safety” – healthcare professionals flagging to queer patients that they are understood, and that they are safe to come out. We strive for that level of cultural competence and empathy for many different groups; it’s rarely discussed for queer patients.  One part of the Jenga tower, one of the entangled sticks but hopefully one that will remain.

concept-map
Concept map exercise

References:

Colgan, F., & Rumens, N. (2015). Understanding sexual orientation at work. In F. Colgan & N. Rumens (Eds.), Sexual orientation at work: Contemporary issues and perspectives. New York, NY, USA: Routledge

Riordan, D. C. (2004). Interaction strategies of lesbian, gay, and bisexual healthcare practitioners in the clinical examination of patients: qualitative study. BMJ, 328(7450), 1227–1229

So this is Christmas – you should be writing

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This week I wrap up my narrative inquiry course and look ahead to the very last (!!!) class in January. We began the EdD last summer with a doctoral seminar (aka: this is what you are letting yourself in for, and here’s a film about Hannah Arendt smoking on a couch). This January’s class is the second and last doctoral seminar (aka: I hope you were paying attention because this shit is about to get real). In June we have “comps” (aka: stand up there and prove you know what you’re talking about, and we’ll let you do some research for reals). Just in case you thought it was smooth sailing after that, there’s the research proposal next and then the infamous institutional ethics hurdle and then…… we are deemed ready to go off and gather data followed by a long period of writing, crying and dark nights of the soul. Next, that fledgling dissertation runs the gamut of revisions and re-revisions before a final submission. Oh, and then a defense. But yay, last class….

The narrative inquiry course has solidified my thinking about how I want to do my research. I knew that my story would be part of the work, but didn’t have a good idea of whether that was possible. Now I do. I am going to write a series of stories using the data from my participants, and my narrative will be part of that. I’ve also become increasingly interested in poetry. I am thinking I might use it as several placeholders or introductions to sections in the writing.

The research is on “coming out”, I have been reflecting on and reshaping some of my memories – in part to prepare and practice. Here is a gift you didn’t know you wanted – a glimpse into negotiating LGB disclosure with patients having radiation therapy treatments for cancer.

Happy Christmas – see you next year!

 He is one of them and all of them, my next patient

The bluff King of Orangeville, or Orillia, or far away Bobcaygeon

Doesn’t like the traffic, supports the Jays (don’t we all) and this disease

This indignity has caught him, like a poleax, right between the eyes

He’s warming up on day 3, unlike my hands – but you know what they say

We cover the weather (seasonal), the traffic (catastrophic) and his daughter’s wedding

He needs a suit, the wife is asking if he’ll be well enough, will he, will he?

How about that diarrhea, that pain, will he last, will he last, what do I think?

I demur, I support, I encourage. I pat his hand as we leave the room

Not long, keep still, we can see you on the cameras, wave if you need us.

Then we’re back, he smiles – my girls, my girls, you take good care of me.

How lucky your husbands are, to have such kind and clever girls.

I pull up his pants; lift him as he grips me tight, catching his breath

He looks at my bare hand, smiles. I should introduce you to my son.

By the time the words come, he has left the room. Same time tomorrow.

I move the machine back around. Seen and not seen, there and not there.

Coming out: a family dinner drama

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This month I am trying out different ways of personal writing and narrative  – here is a poem for #NationalComingOutDay. It’s a lovely memory I have of my Grandfather – who saved the day when my mother finally put two and two together!  

Home from Canada, an extended family dinner

My granddad, parents and us all with

The best dishes, wobbly spare chairs

Gravy and fags, with roast potato top note.

Dad promising again to clear the attic

Stuffed with car coats, rugs and old TVs

A dusty Aladdin’s Cave, if Ali Baba collected

Shit that no one else would want.

Unthinking, in a Yorkshire pudding fugue

I ask for a duvet, there’s loads of doubles begging

“We need one”. I say, remembering

The fight and tussle over the single we have now

In our Toronto flat, second bedroom window dressing

For parental visits, when we rush around

And “straighten up” – flinging the lesbian lit,

Big bellied Goddesses and “Queer as Fuck” t-shirts under the bed

Silence. I look around. Rewind in my head.

“What”? My mum’s face, thunderstruck.

“WE need one?” She throws her fork.

My face is burning -and I realise, this is it. Coming out day.

Not news, I think, for some at this table. But never spoken of.

I am 24, not bold, not proud. I want to kill her; and then after die of shame.

I mumble – yes, for us, for us, its love, we are together.

She huffs and puffs, “you’re not one of those….a his and hers – are you?”

My granddad shifts, clears his throat and pushes his plate away

He looks at me, eyes kind and sad as always, and he says

“Love, love is what we need; finding love is what it is about”

And stunned, we stumble onwards to the apple crumble, with custard.

What’s the story? Narrative inquiry 101

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The appeal of using personal story as a focus for research is, I think, an inevitable step given my interest in looking at how people experience the world. I acknowledge the need for quantitative inquiry and have a deep respect for evidence – randomised trials have helped us refine and improve radiation therapy from a fairly scattergun approach when I qualified thirty years ago to the pinpoint accuracy with which we visualise and treat tumours today. But I also think that to treat people, we need to know who they are (to coin a phrase from advocacy for LGBTQ health) and we can do that by eliciting and paying attention to their stories or narratives. It’s often been said that humans are storytelling animals, it’s how we sort out what we’re feeling, how we make sense of the world.  There’s a growing interest in narrative inquiry (NI) in medicine – where currently the story that is usually prioritized is that told by the physician.  We tend to marginalise the patient’s own stories to an afterthought – interrupting, speaking over and jumping to fix problems rather than listening. For people who are ill “stories are a way of redrawing maps and finding new destinations” from the “narrative wreckage” of the illness experience (Frank).

Inquiring with narrative – narratology – also pops up in history, literary theory, drama, art, film, philosophy, anthropology, education and more. The narrative inquiry researcher is not neutral and apart – treating the “subjects” like, well, objects in an attempt to somehow extract the truth without external contamination. Thus this way of inquiry can have a feminist bent, with a firm standpoint in the camp of giving voice to those who were traditionally without.  Research in real life is messy, our canonical view of unbiased investigation is flawed and very much founded in the masculine, the heteronormative, the White and able-bodied – because those are the voices of privilege who don’t/can’t/won’t know that their way of seeing the world is not always our way/the only way. Narrative inquiry stands against this often false neutrality and the approach can be “a political, socially-just and socially-conscious act” (Ellis). In one type of narrative inquiry, autoethnography, the researcher weaves her story into that of her participants – also using herself (auto) to reflect on a particular issue/social environment (ethnography).  In other words it is back to “as I write and theorize the lives of my participants, I theorize my own”.

Good NI can tell a compelling story with aesthetic merit, provide a substantive contribution to a research area and help us understand more about the world and ourselves. It is also risky – writing stories that incorporate our vulnerable selves can open up a Pandora’s Box and feels transgressive to those of us immersed in the norms of scientific writing. Ethical issues abound – personal narratives often involve loved ones or others close to us, how far do we go in storying and restorying their lives? It is not an easy, or straightforward, option. Bear with me as I try it out over the next few months!

My NI academic crush for October is Carolyn Ellis – whose book “The Ethnographic I: A Methodological Novel about Autoethnography” was a surprisingly gripping read for a research methods text! Ellis considers blogging to be online autoethnography, which means I am hopefully on the right track.  She comments that those of us writing from from the margins “are people who seek connections, who have lived on the borders and who now wish to use whatever resources are available to make the world and their loves better”. What better reasons are there to do research?

Influenced by:

Connelly, F. M., & Clandinin, D. J. (1990). Stories of experience and narrative inquiry. Educational Researcher, 19(5), 2-14.

Ellis, C. (2004). The Ethnographic I: A Methodological Novel about Autoethnography. New York: AltaMira Press.

Ellis, C., Adams, T. E., &  Bochner, A. P. (2011). Autoethnography: An Overview. Historical Social Research/Historische Sozialforschung, 36(4), 273-290.

Frank, A. W. (1995). The wounded storyteller: Body, illness, and ethics. Chicago: University of Chicago Press

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