Discriminatory Interactions

The second most reported challenge involved harmful interactions based on our identities and lived experiences. While everyone experienced this challenge in different ways, our experiences are connected through the following five themes.

Racism

  • In the process of seeking care, those of us who are people of colour are often exposed to racism.
    • “When I go for blood work, it usually takes the person drawing the blood two to three pokes to get the blood. When they’re not able to get the blood, usually they’re like ‘It’s so hard to find veins with people of your skin tone or people with darker skin.’ I’ve never had this issue when I was in Pakistan. With comments like that, I’ve seen patients apologize, they’re like ‘Oh, I’m so sorry.’ And I’m like, ‘You don’t have to be sorry. This is not your fault. You didn’t do anything wrong in this situation.’ And the practitioner shouldn’t be making a comment. If they’re unable to they should just apologize and find someone to help them out. They don’t have to make a comment on your skin tone and how it’s hard to find veins.”
    • “I went to see a specialist about my nose, and he was going off about the noses of different races. Because I look white, he was thinking he was just being buddy-buddy with some other white person. And I’m like ‘Dude no, like no!’ What was really extra gross about that interaction was that they had all this Native art in their office. So, I walked in, and I was like ‘Yeah!’ and I meet this guy and I’m like ‘Oh…great.’
  • We can also be exposed to racism that is directed towards our loved ones and other patients.
    • “I have witnessed my friends, who are people of colour, trying to access the simplest of healthcare. And doctors being creepily fascinated by and fetishizing Or the doctors completely not listening to my friends and assuming they know what this person needs or what’s wrong with them.”
    • “I’ve heard nurses make fun of a patient who didn’t speak English while standing in front of her. And nurses betting on Indigenous patients’ blood alcohol”

Fatphobia

  • When seeking healthcare, fatphobia often impacts how practitioners provide and withhold care.
    • “As a fat person, fatphobia shows up a lot more than I expect. Even when you’re not going in there for that, fatness is always brought back in. The attitude you get is like ‘It’s weird that you want to be fat and happy in your own body. How weird is that? What’s wrong with you?’ A medical professional telling you that you are wrong for being in your own body.”
    • “There is a way in which healthcare practitioners will blame the individual rather than actually giving healthcare. Fatphobia for example, “It is your fault that you’re eating too many cheeseburgers and you need to cut down on that. You need to, you need to, you need to. It becomes an individual problem rather than in the larger scheme of things, there is no holistic approach to anything, and it becomes a moral failing. When that happens, “because it’s your fault”, actual healthcare is not given to us. There’s that meme of like, Oh I broke my arm, and the doctor is like oh have you tried losing weight?’”

Cisheteronormativity & Transphobia

  • Harmful interactions based on cisheteronormativity and transphobia can take on multiple forms. Here are two examples of how this can show up in our care.
    • “I had my chest binder taken away and was repeatedly misgendered and misnamed.”
    • “Healthcare providers always get my pronouns wrong and often assume I’m straight.”

Stigma-cased care

  • The stigma around HIV, STIs, and being sexually active create barriers to sexual health services. This stigma can impact our relationships with ourselves, our health, and healthcare.
    • “I’m HIV positive and I was talking to a nurse who was very judgmental about the sex that I was having and not having. I told her that I know the legalities around it and that there are risks, but that I also know I’m getting my care properly done and that I’m taking my medications. She was using fear-based analogies and telling me I could go to jail. I was like, ‘Whoa. I know the legalities because I my work focuses on sexual health.’ But imagine if I didn't.”
    • “When I was 19 or 20, I went to a clinic, and I asked for an STI test. And they were like, ‘Why? What kind of risky behavior have you been getting into?’ That was when I was like way younger and I didn't know about sex-positivity. Then I felt bad and gross. I ended up not getting tested for anything because the doctor kept asking me really invasive ”
    • “There’s so much shame if you're having sex with multiple partners. They start putting like the fear on to you. If I didn't have a street nurse, I probably wouldn't have gone to normal care.”

Practitioner Discomfort

  • When practitioners react with discomfort to our identities, this can create pressures for us to educate our providers or to stop seeking care. These additional burdens come at the expense of our well-being and quality of care.
    • “I used to really feel the need to explain my gender identity to every nurse and doctor because I knew they would become uncomfortable if I didn’t. It was really exhausting to be like, ‘I use they, them pronouns and this is the reason, and please call me this. These are the surgeries I’ve had to let you know what my body is doing.’”
    • “I wanted to discuss chronic pain, sexuality and gender, and the dynamics of being a white-passing person with an anglicized name who was routinely told that I didn't have the right to claim my Chinese identity. She was white, cisgender, heterosexual, and able-bodied, and the few times I did bring these topics up were uncomfortable for both of us.”