Katina Sawyer of GW Business and Mandi Pratt-Chapman of the GW Cancer Center discuss how their research centers the diverse needs of LGBTQ individuals and seeks to reform discriminatory practices.
By Kristen Mitchell
Researchers from across George Washington University investigate the diverse experiences of lesbian, gay, bisexual, transgender and queer or questioning individuals, documenting discrimination and developing recommendations for greater inclusivity in various contexts.
To mark this year’s Pride month, GW Today spoke with two university researchers about their work, and the strategies, guidelines and education they’re developing to reduce harm to LGBTQ individuals.
Workplace Discrimination for Trans Employees
Katina Sawyer, assistant professor of management at the GW School of Business, researches allyship in the workplace. Her research centers transgender voices to document and define the scale of challenges LGBTQ employees face and to ultimately develop strategies for employers to build trans-inclusive workplaces.
There are a few important things cisgender individuals can focus on to become better allies in the workplace, Dr. Sawyer said. They can use inclusive language and educate others on inclusive language, defend colleagues when they witness harassment or discrimination and advocate for more inclusive policies, practices or initiatives within their organizations.
Allyship can have the most significant impact on the well-being of transgender individuals in workplaces that do not prioritize inclusivity, research finds.
“When you are butting up against a norm within the organization, or you are taking an action that might be viewed negatively by others, but which promotes inclusiveness at work, taking those risks sends a stronger message of value to members of the trans community,” she said.
Dr. Sawyer’s research goal is to understand allyship through the lens of transgender employees themselves—a diverse community made up of individuals who have varied perspectives, experiences and needs. Researchers in the field look for commonalities to assert generally what actions tend to be more positive or harmful and seek to model a continuous process for listening and learning.
“What we're finding is that while taking these risks and standing up for the rights of trans individuals is very important, it needs to be done in a way that's also tempered with some humility,” she said. “Allies need to be willing to listen, learn and incorporate feedback so that they're not continuing to act in a way that is not ideal for an ally, or that they're expecting or acting as if every single trans person is going to want the same thing in the workplace instead of asking new questions when they're encountering new situations.”
Researchers have produced a growing body of scholarship on the role sexual orientation plays in the workplaces in the past 20 years. Dr. Sawyer expects research on gender identity and management to follow a similar trajectory.
“There's a lot to be done, but I'm heartened by the progression that I've seen in other areas,” she said. “I think that that progression will continue in this arena as well.”
Equity in Cancer Treatment
Mandi Pratt-Chapman, associate center director for patient-centered initiatives and health equity at the GW Cancer Center and an associate professor of medicine at the GW School of Medicine and Health Sciences, recently launched a pilot training program to help organizations that administer cancer care services or address cancer disparities provide patient-centered, culturally affirming care.
The Together, Equitable, Accessible, Meaningful (TEAM) Cancer Care for Sexual and Gender Minority (SGM) Patients Training aims to provide guidance, tools and resources for health care professionals over 13 weeks. Individuals from organizations across the country are currently going through the program, which covers a range of subjects from implicit bias to understanding how to distinguish between the constructs of sexual orientation, sexual attraction, sexual behavior, gender identity, gender expression, and sex assigned at birth. The training also includes subjects such as how to collect sexual orientation and gender identity data, legal and policy considerations such as potential insurance claim denials for gender nonconforming individuals, trauma-informed cancer screening and care, oncology management considerations for sexual and gender minorities, supportive and palliative care strategies for affirming care, and interpersonal and organizational strategies to advance health equity for LGBTQI patients.
Participants will work in teams to develop an action plan to implement improved practices within their settings. Dr. Pratt-Chapman will follow up with them at three and six months after the training to document what types of changes they made within their system and any barriers they encountered.
Many health care professionals have not received formal training on how to provide affirming and culturally competent care for LGBTQ patients, Dr. Pratt-Chapman said. This became even clearer when analyzing results from a recent community-driven study on transgender cancer screening experiences in the Washington, D.C., area. The need for improved provider communication skills, affirming care environments and clinical and cultural competence of providers were key themes arising from the study, she said.
“There's a whole lot of education that needs to happen to extend the understanding of queer lived experience among people that may not have thought about queer-specific health or healthcare needs, even if they have queer friends or family members,” she said. “None of us can actually be culturally competent, truly culturally competent, in any lived experience other than our own, but we can have an ongoing process of learning. That’s what we are promoting and what we are trying to instill in our trainees.”
Negative health care experiences—even from well-meaning clinicians—can result in LGBTQI individuals delaying care or force them to seek out new providers, which can be time consuming and costly.
Dr. Pratt-Chapman is also working with about 20 other national experts as part of a team led by Whitman-Walker Health and the National LGBT Cancer Network to publish a forthcoming white paper, “Recommended National Standards and Best Practices for LGBTQI Cultural Competency Trainings of Healthcare and Social Service Providers and Staff,” and a corresponding manuscript. The white paper will include example materials such as workshop exercises, readings, video recommendations and role play scenarios that can be used and adapted for training.