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Welcome to the nexus of ethics, psychology, morality, technology, health care, and philosophy
Showing posts with label Sexual Orientation. Show all posts
Showing posts with label Sexual Orientation. Show all posts

Friday, January 19, 2024

Asexuality Is Finally Breaking Free from Medical Stigma

Allison Parshall
Scientific American
Originally posted 1 Jan 24

Here is an excerpt:

Over the past two decades psychological studies have shown that asexuality should be classified not as a disorder but as a stable sexual orientation akin to homosexuality or heterosexuality. Both cultural awareness and clinical medicine have been slow to catch on. It's only recently that academic researchers have begun to look at asexuality not as an indicator of health problems but as a legitimate, underexplored way of being human.

In biology, the word “asexual” typically gets used in reference to species that reproduce without sex, such as bacteria and aphids. But in some species that do require mating to have offspring, such as sheep and rodents, scientists have observed individuals that don't appear driven to engage in the act.

This behavior is more analogous to human asexuality, a concept rarely mentioned in medical literature until recently. In a pamphlet published in 1896, pioneering German sexologist Magnus Hirschfeld described people without sexual desire, a state he called “anesthesia sexualis.” In 1907 Reverend Carl Schlegel, an early gay rights activist, advocated for the “same laws” for “the homosexuals, heterosexuals, bisexuals [and] asexuals.” When sexologist Alfred Kinsey devised his scale of sexual orientation in the 1940s, he created a “Category X” for the respondents who unexpectedly reported no sociosexual contacts or reactions—exceptions from his model whom he estimated made up 1.5 percent of all males between the ages of 16 and 55 in the U.S. Asexuality was largely absent from scientific research over the subsequent decades, although it was occasionally referenced by activists and scholars in the gay liberation movement.


Here are some quick bullet points:
  • Asexuality is a sexual orientation characterized by a lack of sexual attraction to others.
  • In the past, asexuality was often misunderstood and misdiagnosed as a mental health disorder.
  • Today, asexuality is increasingly recognized as a legitimate sexual orientation.
  • People who identify as asexual may or may not experience sexual attraction, and there is a spectrum of asexuality.
  • Asexual people can face challenges in getting proper medical care, as some healthcare providers may not be familiar with asexuality.

Thursday, January 9, 2020

How implicit bias harms patient care

Jeff Bendix
medicaleconomics.com
Originally posted 25 Nov 19

Here is an excerpt:

While many people have difficulty acknowledging that their actions are influenced by unconscious biases, the concept is particularly troubling for doctors, who have been trained to view—and treat—patients equally, and the vast majority of whom sincerely believe that they do.

“Doctors have been molded throughout medical school and all our training to be non-prejudiced when it comes to treating patients,” says James Allen, MD, a pulmonologist and medical director of University Hospital East, part of Ohio State University’s Wexner Medical Center. “It’s not only asked of us, it’s demanded of us, so many physicians would like to think they have no biases. But it’s not true. All human beings have biases.”

“Among physicians, there’s a stigma attached to any suggestion of racial bias,” adds Penner. “And were a person to be identified that way, there could be very severe consequences in terms of their career prospects or even maintaining their license.”

Ironically, as Penner and others point out, the conditions under which most doctors practice today—high levels of stress, frequent distractions, and brief visits that allow little time to get to know patients--are the ones most likely to heighten their vulnerability to unintentional biases.

“A doctor under time pressure from a backlog of overdue charting and whatever else they’re dealing with will have a harder time treating all patients with the same level of empathy and concern,” van Ryn says.

The info is here.

Monday, February 26, 2018

How Doctors Deal With Racist Patients

Sumathi Reddy
The Wall Street Journal
Originally published January 22, 2018

Her is an excerpt:

Patient discrimination against physicians and other health-care providers is an oft-ignored topic in a high-stress job where care always comes first. Experts say patients request another physician based on race, religion, gender, age and sexual orientation.

No government entity keeps track of such incidents. Neither do most hospitals. But more trainees and physicians are coming forward with stories and more hospitals and academic institutions are trying to address the issue with new guidelines and policies.

The examples span race and religion. A Korean-American doctor’s tweet about white nationalists refusing treatment in the emergency room went viral in August.

A trauma surgeon at a hospital in Charlotte, N.C., published a piece on KevinMD, a website for physicians, last year detailing his own experiences with discrimination given his Middle Eastern heritage.

Penn State College of Medicine adopted language into its patient rights policy in May that says patient requests for providers based on gender, race, ethnicity or sexual orientation won’t be honored. It adds that some requests based on gender will be evaluated on a case-by-case basis.

The article is here.

Tuesday, April 4, 2017

Two licensing boards, for psychologists and counselors, at impasse with governor over sexual orientation language

Nancy Hicks
Lincoln Journal Star  
Originally posted March 11, 2017

Two state licensing boards that oversee psychologists and mental health counselors have been at odds with two Nebraska governors and the Nebraska Catholic Conference for almost a decade over sexual orientation and gender identity language in their rules.

The two licensing boards -- the Board of Psychology and the Board of Mental Health Practice -- have been unable to update their rules because they have refused to compromise on these issues.

And it looks like that impasse will continue, after the administration of Gov. Pete Ricketss recently rejected both sets of rules and provided its own draft of acceptable language.

That proposed language -- which strips out antidiscrimination protection based on sexual orientation and gender identity -- “is completely unacceptable and egregious,” said Dr. Anne Talbot, president of the Nebraska Psychological Association, which represents psychologists across the state.

Her group will oppose the administration's proposed changes when the issue is before the state licensing board May 31.

The article is here.

Wednesday, January 4, 2017

Beware Bogus Theories of Sexual Orientation

By Michael Shermer
Scientific American Magazine
Originally published on December 1, 2016

Here is an excerpt:

Shouldn't such principles apply to everyone regardless of whether or not their sexual orientation is biologically determined? Of course, and in most Western countries today they do. But in Judeo-Christian America, the argument goes like this: The Bible says that homosexuality is a sin (Leviticus 20:13). If sexual orientation has a strong biological component, then gays and lesbians can hardly be held morally culpable for their sinful ways. But if it's a choice, then they can be rehabilitated (through “conversion therapy”) and forgiven (“love the sinner, hate the sin” goes the popular trope). Evangelist Jimmy Swaggart articulated the logic this way: “While it is true that the seed of original sin carries with it every type of deviation, aberration, perversion, and wrongdoing, the homosexual cannot claim to have been born that way any more than the drunkard, gambler, killer, etc.”

While the authors of the New Atlantis article are not this crude and overtly bigoted in their conclusions, according to geneticist Dean Hamer, emeritus at the National Institutes of Health, “it is a selective and outdated collection of references and arguments aimed at confusing rather than clarifying our understanding of sexual orientation and gender identity.”

The article is here.

Wednesday, May 13, 2015

Born this way? How high-tech conversion therapy could undermine gay rights

By Andrew Vierra and Brian Earp
The Conversation
Originally published on April 21, 2015

Here is an excerpt:

We fully agree with the President and believe that this is a step in the right direction. Of course, in addition to being unsafe as well as ethically unsound, current conversion therapy approaches aren’t actually effective at doing what they claim to do – changing sexual orientation.

But we also worry that this may be a short-term legislative solution to what is really a conceptual problem.

The question we ought to be asking is “what will happen if and when scientists do end up developing safe and effective technologies that can alter sexual orientation?”

Based on current scientific research, it is not unlikely that medical researchers – in the not-too-distant future – will know enough about the genetic, epigenetic, neurochemical and other brain-level factors that are involved in shaping sexual orientation that these variables could in fact be successfully modified.

The entire article is here.

Wednesday, July 24, 2013

Senate panel OKs bill banning anti-gay job bias

By SAM HANANEL
The Associated Press
Originally published on July 10, 2013

Gay rights advocates notched another victory Wednesday after a Senate panel approved a bill that would prohibit employers from discriminating against workers on the basis of sexual orientation or gender identity.

The measure won support from all the Democrats and three Republicans on the 22-member committee, signaling it has a strong chance of passage in the full Senate.

The vote is another sign of rapidly changing attitudes on gay rights in Congress and the nation. It comes just two weeks after the Supreme Court ruled that same-sex spouses are entitled to the same federal benefits as other married couples in states where gay marriage is legal.

The entire story is here.

Friday, November 2, 2012

Can Gay and Lesbian Parents Promote Healthy Development in High-Risk Children Adopted From Foster Care?

Justin A. Lavner, Jill Waterman, Letitia Anne Peplau

American Journal of Orthopsychiatry
Volume 82, Issue 4, pages 465–472, October 2012

Adoption is known to promote cognitive and emotional development in children from foster care, but policy debates remain regarding whether children adopted by gay and lesbian parents can achieve these positive outcomes. This study compared the cognitive development and behavior problems at 2, 12, and 24 months postplacement of 82 high-risk children adopted from foster care in heterosexual and gay or lesbian households. On average, children in both household types showed significant gains in cognitive development and maintained similar levels of behavior problems over time, despite gay and lesbian parents raising children with higher levels of biological and environmental risks prior to adoptive placement. Results demonstrated that high-risk children show similar patterns of development over time in heterosexual and gay and lesbian adoptive households.

The entire article is here.

Tuesday, October 25, 2011

Would You Like to See a Christian Psychologist?

By Sam Knapp, Ed.D., ABPP
Director of Professional Affairs

Some patients will request a psychologist of a particular gender, and psychologists will usually try to accommodate those concerns. For example, a female patient with sensitive sexual or gender-related issues might not feel comfortable raising them with a male psychologist, and an effort will be made to find a woman psychologist. However, is it possible to implicitly accept or endorse discriminatory practices by agreeing to other similar requests? For example, should psychologists respect the preferences of prospective patients who want to have Christian psychologists?

Some conservative Christians fear that psychologists will mock their religious beliefs or try to blame their problems on their religion. Consequently, having a Christian psychologist may be very important for them. Most non-Christian psychologists I have spoken to have received phone calls from prospective patients who ask them if they are Christian. One psychologist commonly responds, “no, but I am very respectful of Christian beliefs and will help you formulate goals consistent with your beliefs.” So far, no prospective Christian patient has ever failed to make an appointment after that conversation.

How should a psychologist respond if asked to provide a referral for a Christian psychologist? Perhaps one response would be to anticipate the concern of the patients, which is to have someone who respects their beliefs, without necessarily restricting the referrals to a psychologist who happens to be a Christian. It could be possible to respond by saying, “Psychologists are expected to respect the religious beliefs of their patients. I don’t have a list of Christian psychologists, but here are psychologists whom I know to be respectful of Christian beliefs.”

Should race, ethnicity, or sexual orientation be a factor in making a referral? On the one hand, it seems reasonable that some patients may want assurance that the psychologist they have will understand their racial or cultural background or respect their sexual orientation. It is possible to imagine a prospective patient who has not had a history of positive experiences with European Americans, or who has had a background with issues or struggles that even a sensitive European American would have difficulty understanding. Or, consider the case of a European American family who adopted an African American child who generally did well in school and at home. However, as a teenager he struggled to consolidate his racial identity and asked to speak to an African American psychologist.  It appears that race would be a relevant factor in making that referral.

On the other hand, psychologists who defer to patient preferences for race may inadvertently reinforce racist attitudes. So, the perception of the clinical relevance of the request appears important. Psychologists can decide how to respond to these requests by looking to three overarching ethical principles. First, we generally want to respect patient autonomy, including respecting their preferences in a health care professional. Second, we typically want to give patients a referral based on beneficence and nonmaleficence; that is, we want to provide a referral based on who we think can help the prospective patient. Finally, we are also guided by the overarching ethical principle of justice wherein we refuse to engage in unfair discrimination based on race, religion, gender, national origin, or other factors. Often justice is sufficiently important to trump other ethical principles.

I once had a patient who wanted a referral to a different psychiatrist because he said the one I had sent him to was not a “real American” (the psychiatrist was an American citizen of Filipino descent and highly competent). I refused to give him a new referral, and he stayed with the Filipino American psychiatrist, who was of benefit to him. In this case, the overarching ethical principle of justice trumped the other ethical principles. However, I might have responded differently if this patient were highly suicidal or homicidal. Then I would have made inquiries about his concerns, but ultimately deferred to his wish if doing so substantially reduced the risk of death.

Please feel free to contact me with your thoughts on this issue.