Occupational therapists may encounter every individual and every difference. Our only truth in life is that no disadvantage situation causes discrimination in daily life. Anything can happen to any of us. However, it would not be wrong to say that recovering from accidents, traumas and injuries is related to our coping strategies and that we are affected by these situations personally. Stories, strengths, weaknesses, challenges, support, resources, ethnicity, culture, extent of the situation and yes, sexual orientation and gender identity… All can affect rehabilitation outcomes. Understanding that each of us is different prepares us to have the necessary knowledge and skills to approach us effectively in life. This includes looking at LGBTI+ individuals as well as everyone else, and recognizing common factors and related themes that influence their experience with the healthcare system.
Unfortunately, the rates for populations of LGBTI+ individuals in Turkey are unknown. However, if we look at international statistics, it is said that an average of 2-4% of the population defines itself as homosexual (Kinsey Institute- Bakırcı, 2019). For other sexual identities, unfortunately, it does not seem possible to make assumptions according to current information. Possible studies on this subject will not only examine sexuality in a society; At the same time, I believe that it can be a data source for important social issues such as employment and health services. It was seen that they were less likely to be seen and more likely to see an occupational therapist and psychologist. If we make this assessment in Turkey, we are likely to face a much more unpleasant picture… As healthcare professionals, we ask ourselves, “Why?” and “What should I do to better serve this community?” When I ask, from my professional point of view, the perception, culture, perspective, geography, belief of the society; I can't help but think about the quality of work on occupational therapy and raising general health awareness.
Three key "must know" information when working with LGBTI+:
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Minority Stress:
It is important to recognize/accept the past and experiences LGBTI+ individuals face and continue to face. Minority stress theory, first defined by Meyer in 2003, describes the stress experienced by individuals in minority groups as a result of being a member of a marginalized or oppressed group (Busa, Janssen, & Lakshman, 2018). Minority stress among LGBTI+ individuals has been associated with higher prevalence of mental health problems and psychological distress due to chronic stress resulting from prejudiced approaches such as violence, discrimination, social exclusion, bullying and rejection that this population frequently faces (Austin & Craig, 2015). Understanding the impact of minority stress on a person is in a good position to analyze how it can inform the individual in the theoretical foundations of occupational therapy, professional participation and the presence of potential barriers. For example, an occupational therapist working in mental health can help inform a minority stressed client about their experiences with anxiety and depression, and this resource may affect the occupational therapist's approach to the individual's occupational problems.
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Identity:
Individuals within the LGBT community are stigmatized as a result of their gender identity or sexual orientation, due to the stigma of not conforming to what society considers "normal", are driven to avoid disclosure or engage in undesirable occupations. LGBTI+ individuals who cannot reflect their spirit on their outer appearance to hide their true gender identity and sexual orientation will not need to re-learn or adapt their skills in their inner journey; instead, it is possible to express with occupational therapy that they may need new experiences and activities to explore their bodies/spirits in order to better fit with their gender identity or sexual orientation. It is very important to accept the integrity of the soul and body in occupational therapy. The meanings and values that LGBTI+ individuals attribute to the professions they choose are strong, but these professions are generally i or chosen to hide her sexual orientation or to offer more believable gender visibility. Therefore, as occupational therapists, we are able to help LGBTI+ individuals who want to reflect, describe, construct or affirm their gender identity through the profession. For example, an occupational therapist prepares a transgender person for vocational rehabilitation by assisting them in all aspects of daily life so that they can live more successfully in their designated gender.
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Past Experiences with Healthcare Practitioners:
Although public awareness has renewed its views on LGBTI+ issues and individuals in recent years, anxiety and distrust towards the healthcare system still continue. It is obvious that people have a lack of control over their lives because a part of the society labels LGBTI+ individuals as "mentally ill" or "in need of treatment". Unfortunately, it will take many years for the traces left by the health system in this community to disappear. As occupational therapists and other health professionals, we should consider and accept all these processes and attempt to improve the process.
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