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https://www.infirmiere-canadienne.com/blogs/ic-contenu/2025/02/03/cri-ralliement-infirmier-genre-queer

Actions you can take to support and affirm patients and colleagues who identify as 2SLGBTQIA+

By Adam Brandt
February 3, 2025

It’s the middle of winter, but I am comforted by the thought that Pride month is coming up in June. Every year during Pride month, I feel queer joy and a lightness as I’m surrounded by my chosen family.

But I also feel exhausted. I see the pushback on social media from people who don’t know why Pride is needed, which is evidence that it is needed. I see a rise in hateful rhetoric and discourse against the rights of people who identify as 2SLGBTQIA+ and, in particular, people who identify as gender expansive and/or transgender. Nursing is inherently political, and so is Pride.

Because of this, I purchased a Pride pin online to add to my work badge, with the hope of creating safer spaces for my patients who are 2SLGBTQIA+. I put a rainbow pin on my work identification badge, but when I was parked in the facility’s parking lot, I decided that today wasn’t the day, and I took the pin off. It’s not that I didn’t feel pride or lacked comfort in my identity. I simply didn’t feel comfortable subtly outing myself to everyone, and feared that being my authentic self would open me up to discrimination.

It’s 2025, and we should be past this. However, the reality is that disclosing my identity to patients and colleagues alike opens me up to discrimination. Taking off my rainbow badge was easier than subtly communicating with colleagues and patients about my queerness.

I recognize the irony in this as nurses inherently hold power in their roles over patients, but in this moment, I felt disempowered. Conversely, I worry that my patients who lack power, specifically patients who identify as 2SLGBTQIA+, don’t feel comfortable being their true selves with their nurses because they do not see themselves reflected back to them in our profession.

Growing up in southeastern Manitoba

I grew up in southeastern Manitoba, which is considered the “bible belt” of the province. I didn’t see people like me in the small farming community I grew up in. There was no representation of people who weren’t heterosexual (a person who is sexually or romantically attracted to people of the opposite gender or sex) or cisgender (a person whose gender identity is congruent with their sex assigned at birth). This lack of representation furthered cisheteronormativity (the assumption that everyone is cisgender and heterosexual) within the community and me.

Coming to terms with my sexual orientation was a very challenging time in my life. Before recognizing my queerness, I loved school and was very engaged academically; after, however, I disengaged from the academic world. This is likely one of the reasons why nursing was never on my radar (never mind the idea of graduate school). I didn’t feel safe being myself in my community, which is why I chose to leave when I graduated high school. Going back now, I still do not feel safe or comfortable.

To this day, I grapple with internalized homophobia (the acceptance of external negative attitudes toward homosexuality that creates a negative self-concept) and learning how it manifests itself in my life in insidious ways. For example, I didn’t understand that my frequent discomfort in talking about my sexual orientation with others, and the fear of making others uncomfortable by sharing my identity, was a manifestation of internalized heteronormativity and homophobia. This is something I will be unlearning for the rest of my life.

From undergraduate nursing school to clinical practice

I didn’t see people who identify as 2SLGBTQIA+ represented in my undergraduate curriculum, the faculty or the student body. This lack of inclusion and representation taught me that the nursing profession wouldn’t have a place for me either. I witnessed and experienced covert discrimination based on sexual orientation and gender identity.

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It wasn’t until the last year of my undergraduate coursework that I felt comfortable indirectly indicating, in a self-reflection paper, my sexuality to my instructors. I wasn’t out to my peers, and this was only the second time I disclosed my identity, my whole self, to an instructor. When the instructor returned the paper with feedback to me, I was anxious. Their response to my self-reflection was positive and they encouraged me to pursue graduate studies. In my undergraduate education, I was trying to survive, without having a target on my back, and did not know if nursing would be a good fit for me.

After school, I worked as a bedside nurse and my colleagues supported my identity. It helped that many of my colleagues were queer themselves, and that was in and of itself affirming. Throughout my nursing career, I have seen firsthand the insidious nature of cisnormativity and heteronormativity within the health-care system. Grappling with this has been disempowering and led me to ask myself how I can work within a system that has harmed many people. This ultimately led me to question whether other nurses who identified as 2SLGBTQIA+ have had similar experiences.

Despite the nursing profession being rooted in social justice and advocacy, I was shocked to find little peer-reviewed and grey literature centred on my community’s experiences in all aspects of academia and practice.

Graduate school

Looking back now at the feedback my undergraduate nursing instructor gave me, it’s unsurprising that I applied to graduate school. My experiences as a queer person in nursing inspired me to study the health and wellness of people who identify as 2SLGBTQIA+. The lack of literature about nurses who identify as 2SLGBTQIA+ , the nursing colleagues who identify as 2SLGBTQIA+ I have had the privilege of working with, and the rich history I uncovered of many nurses identifying as 2SLGBTQIA+ within the profession led me to my thesis research exploring the lived experiences of nurses who identify as 2SLGBTQIA+ in Winnipeg, Manitoba.

While listening to and analyzing the interviews I conducted with nurses, I have been struck by not just the blatant discrimination, such as the transphobic and homophobic slurs. I have been more affected by hearing the covert and insidious ways cisheteronormativity seeps into everyday interactions and how I have had similar experiences.

One example of the insidious nature of cisheteronormativity is the constant need to assess if “coming out” or disclosing my sexuality is safe to do so in the workplace, and if I’m willing to engage in the necessary vigilance after disclosure to reassess my safety. My heterosexual colleagues do not have to worry about mentioning their partner’s gender because it is congruent with the societal norm of cisheteronormativity.

Throughout my thesis research I have struggled with reliving harmful past experiences and feeling as if I, as the researcher, am too close to my study participants. I think about the phrase “nothing about us without us,” and I am reminded that I may be the best person to do this research. And maybe being queer, and self-identifying at the start of every interview and in my recruitment materials, has made nurses who identify as 2SLGBTQIA+ feel more comfortable sharing their experiences with me.

Allyship

The word “ally” is often used as a noun, but it is also a verb that describe an action. I believe many nurses would like to call themselves allies to equity-deserving people, such as those who identify as 2SLGBTQIA+. But what are the concrete actions you are doing every year, every month, every shift, to enact your allyship? It’s okay if you don’t know, but I urge nurses to reflect on their practice and lives. The simple things can mean the world to patients who are equity-deserving.

A few examples of allyship in action:

• Offering your pronouns and chosen name before asking your patients theirs.
• Asking your patient who they have with them instead of assuming relationships.
• Wearing a rainbow badge, as your colleagues may not feel safe doing so.
• Starting or participating in an equity, diversity, inclusion and accessibility (EDIA) committee.
• Advocating for education sessions in your facility/department about the experiences of patients identifying as 2SLGBTQIA+.
• Advocating for inclusive intake and assessment forms.

Conclusion

I am left with the question of how we can make health care, the nursing profession, and nursing school safer for people and nurses identifying as 2SLGBTQIA+. I don’t think there is one answer. I think it begins with individual nurses reflecting on their practice and making small changes. This may mean seeking opportunities to learn what tangible and continual steps you need to maintain allyship toward 2SLGBTQIA+ patients and colleagues. I urge nurses to step into the discomfort they may feel to challenge their assumptions. Learning is often uncomfortable because it challenges assumptions. Diversity is our strength and, as nurses, we must commit to making this our focus.

Adam Brandt (he/they), RN, BN, is a master of nursing student in the College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, and works part-time in an acute care setting and as a graduate research assistant.

#opinions
#equity-social-justice
#nurses-health-and-well-being
#patient-experience
#sexuality
#stigma