Welcome to the Nexus of Ethics, Psychology, Morality, Philosophy and Health Care

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

Thursday, February 23, 2023

Moral foundations partially explain the association of the Dark Triad traits with homophobia and transphobia

Kay, C. S., & Dimakis, S. M. (2022, June 24). 


People with antagonistic personality traits are reportedly more racist, sexist, and xenophobic than their non-antagonistic counterparts. In the present studies (N1 = 718; N2 = 267), we examined whether people with antagonistic personality traits are also more likely to hold homophobic and transphobic attitudes, and, if they are, whether this can be explained by their moral intuitions. We found that people high in Machiavellianism, narcissism, and psychopathy are more likely to endorse homophobic and transphobic views. The associations of Machiavellianism and psychopathy with homophobia and transphobia were primarily explained by low endorsement of individualizing moral foundations (i.e., care and fairness), while the association of narcissism with these beliefs was primarily explained by high endorsement of the binding moral foundations (i.e., loyalty, authority, and sanctity). These findings provide insight into the types of people who harbour homophobic and transphobic attitudes and how differences in moral dispositions contribute to their LGBTQ+ prejudice.

General discussion

We conducted two studies to test whether those with antagonistic personality traits (e.g., Machiavellianism, grandiose narcissism, and psychopathy) are more likely to express homonegative and transphobic views, and, if so, whether this is because of their moral intuitions.Study 1 used a convenience sample of 718undergraduate students drawn from a university Human Subjects Pool. It was exploratory, in the sense that we specified no formal hypotheses. That said, we suspected that those with antagonistic personality traits would be more likely to hold homonegative and transphobic attitudes and that they may do so because they dismiss individualizing morals concerns (e.g., do no harm; treat others fairly). At the same time, we suspected that those with antagonistic personality traits would also deemphasize the binding moral foundations (e.g., be loyal to your ingroup; respect authority; avoid contaminants, even those that are metaphysical),weakening any observed associations between the antagonistic personality traits and LGBTQ+ prejudice. The purpose of Study 2 was to examine whether the findings identified in Study 1 would generalize beyond a sample of undergraduate students.  Since we had no reason to suspect the results would differ between Study 1 and Study 2, our preregistered hypotheses for Study 2 were that we would observe the same pattern of results identified in Study 1.

There was clear evidence across both studies that those high in the three antagonistic personality traits were more likely to endorse statements that were reflective of traditional homonegativity, modern homonegativity, general genderism/transphobia, and gender-bashing. All of these associations were moderate-to-large in magnitude (Funder & Ozer, 2019), save for the association between narcissism and traditional homonegativity in Study 1. These results indicate that, on top of harbouring racist(Jones, 2013), xenophobic (Hodson et al., 2009), and sexist (Gluck et al., 2020) attitudes, those high in antagonistic personality traits also harbour homonegative and transphobic attitudes.

Tuesday, August 23, 2022

Tackling Implicit Bias in Health Care

J. A. Sabin
N Engl J Med 2022; 387:105-107
DOI: 10.1056/NEJMp2201180

Implicit and explicit biases are among many factors that contribute to disparities in health and health care. Explicit biases, the attitudes and assumptions that we acknowledge as part of our personal belief systems, can be assessed directly by means of self-report. Explicit, overtly racist, sexist, and homophobic attitudes often underpin discriminatory actions. Implicit biases, by contrast, are attitudes and beliefs about race, ethnicity, age, ability, gender, or other characteristics that operate outside our conscious awareness and can be measured only indirectly. Implicit biases surreptitiously influence judgment and can, without intent, contribute to discriminatory behavior. A person can hold explicit egalitarian beliefs while harboring implicit attitudes and stereotypes that contradict their conscious beliefs.

Moreover, our individual biases operate within larger social, cultural, and economic structures whose biased policies and practices perpetuate systemic racism, sexism, and other forms of discrimination. In medicine, bias-driven discriminatory practices and policies not only negatively affect patient care and the medical training environment, but also limit the diversity of the health care workforce, lead to inequitable distribution of research funding, and can hinder career advancement.

A review of studies involving physicians, nurses, and other medical professionals found that health care providers’ implicit racial bias is associated with diagnostic uncertainty and, for Black patients, negative ratings of their clinical interactions, less patient-centeredness, poor provider communication, undertreatment of pain, views of Black patients as less medically adherent than White patients, and other ill effects.1 These biases are learned from cultural exposure and internalized over time: in one study, 48.7% of U.S. medical students surveyed reported having been exposed to negative comments about Black patients by attending or resident physicians, and those students demonstrated significantly greater implicit racial bias in year 4 than they had in year 1.

A review of the literature on reducing implicit bias, which examined evidence on many approaches and strategies, revealed that methods such as exposure to counterstereotypical exemplars, recognizing and understanding others’ perspectives, and appeals to egalitarian values have not resulted in reduction of implicit biases.2 Indeed, no interventions for reducing implicit biases have been shown to have enduring effects. Therefore, it makes sense for health care organizations to forgo bias-reduction interventions and focus instead on eliminating discriminatory behavior and other harms caused by implicit bias.

Though pervasive, implicit bias is hidden and difficult to recognize, especially in oneself. It can be assumed that we all hold implicit biases, but both individual and organizational actions can combat the harms caused by these attitudes and beliefs. Awareness of bias is one step toward behavior change. There are various ways to increase our awareness of personal biases, including taking the Harvard Implicit Association Tests, paying close attention to our own mistaken assumptions, and critically reflecting on biased behavior that we engage in or experience. Gonzalez and colleagues offer 12 tips for teaching recognition and management of implicit bias; these include creating a safe environment, presenting the science of implicit bias and evidence of its influence on clinical care, using critical reflection exercises, and engaging learners in skill-building exercises and activities in which they must embrace their discomfort.

Friday, May 29, 2020

When Is “Gay Panic” Accepted? Exploring Juror Characteristics and Case Type as Predictors of a Successful Gay Panic Defense

Michalski, N. D., & Nunez, N. (2020).
Journal of Interpersonal Violence. 


“Gay panic” refers to a situation in which a heterosexual individual charged with a violent crime against a homosexual individual claims they lost control and reacted violently because of an unwanted sexual advance that was made upon them. This justification for a violent crime presented by the defendant in the form of a provocation defense is used as an effort to mitigate the charges brought against him. There has been relatively little research conducted concerning this defense strategy and the variables that might predict when the defense is likely to be successful in achieving a lesser sentence for the defendant. This study utilized 249 mock jurors to assess the effects of case type (assault or homicide) and juror characteristics (homophobia, religious fundamentalism, and political orientation) on the success of the gay panic defense compared with a neutral provocation defense. Participant homophobia was found to be the driving force behind their willingness to accept the gay panic defense as legitimate. Higher levels of homophobia and religious fundamentalism were found to predict more leniency in verdict decisions when the gay panic defense was presented. This study furthers the understanding of decision making in cases involving the gay panic defense and highlights the need for more research to be conducted to help understand and combat LGBT (lesbian, gay, bisexual, and transgender) prejudice in the courtroom.

The research is here.

Thursday, July 18, 2019

The Theory That Justified Anti-Gay Crime

Caleb Crain
The New Yorker
Originally posted June 26, 2019

Here is an excerpt:

As preposterous as the idea of homosexual panic may sound today, for much of the twentieth century it was treated as something like common sense. “When a beast attacks, you are justified in killing him,” is the way one defense attorney phrased the principle behind it, in 1940. The press, too, sometimes discussed the idea approvingly. The New York Daily News described a 1944 murder of a gay man as an “honor slaying.” In 1952, homosexual panic was listed as a mental disorder in the first edition of the American Psychiatric Association’s Diagnostic and Statistical Manual, and, as late as the nineteen-nineties, the notion was still so current in the popular mind that a Christopher Street shop selling gay-themed T-shirts was called, in what seems to have been ironic homage, Don’t Panic.

It turns out that the psychological concept has a less than illustrious origin. The term “homosexual panic,” Polchin reports, was coined by a psychiatrist named Edward Kempf, in a 1920 treatise titled “Psychopathology.” Polchin garbles a key quote from Kempf, printing “sexually attracted” where Kempf wrote “sexually attractive,” and I took a look at the relevant chapter to see if I could make sense of it. It’s understandable that Polchin got confused. Kempf’s text is neither lucid nor coherent.

Kempf theorized that homosexual panic emerged from “the pressure of uncontrollable perverse sexual cravings,” that is, from the frustration of homosexual urges that typically arose in same-sex environments, such as prison or the military. According to Kempf, symptoms of the panic included a fearfulness that could lead to catatonia, a “compulsion to seek or submit to assault,” and delusional perceptions of being poisoned or entranced. Indeed, the hallucinations and paranoid delusions that many of Kempf’s patients suffered from were quite serious. One patient imagined that broken pills were being surreptitiously put into his pudding; another went through spells of believing he was God.

The info is here.

Thursday, October 13, 2016

Richard Swinburne’s Toxic Lecture on Christian Morality

By J. Edward Hackett
Philosophical Percolations
Originally published September 24, 2016

Here is an excerpt:

While Swinburne did not think homosexuality was intrinsically wrong in the same way that adultery was wrong, he argued (if that’s the right verb under some principle of charity) that homosexuality was extrinsically wrong. Homosexuality was a disability in the lacking of the ability to have children, and God’s commands of abstaining from homosexuality might prevent others from fostering this incurable condition in others.

Yeah. I know.

My response was mixture of abhorrence and overwhelming anger, and I tried as I might to encounter this idea calmly. I told him he medicalized being gay in the same way that phrenology medicalized racism. It was obnoxious to listen to Christians lay claim to sacrificial love at this conference, but at the same time not see the virtue of that same love as a possible quality underlying other configurations, yet I told others this is the reason why Christians should read Foucault. When you do, you start to notice how power manifests in local contexts in which those discourses occur.

There was a way power was working in this discourse. Specifically, Foucault exposes how medicalizing discourse divorces the condition apart from the body of the patient. Swinburne advocated “sympathy and not censure” for homosexuals, those with the “incurable condition” and “disability.” In this medical context, medicine acts as a way to dehumanize the person without appearing as if that’s what you’re doing.

The blog post his here.

Friday, April 18, 2014

Defending Disgust

By Jason A. Clark and Philip A. Powell
Emotional Researcher

Many argue that moral disgust developed as a regulator of social behavior, and that it still dutifully serves that purpose (Tybur et al. 2013). However, a growing number have criticised disgust as a morally objectionable emotion in modern society, emphasizing features that, while adaptive in response to pathogens, render disgust unsuitable for policing morality (Nussbaum 2009; Kelly 2011; Bloom 2013). These include: cognitive and behavioral inflexibility, the generation of “dumbfounded” moral judgments lacking reasons, insensitivity to contextual factors and reappraisal, dehumanization, and a focus on the whole person, rather than their actions (Schnall et al. 2008; Russell & Giner-Sorolla 2011).

Critics of disgust compare it unfavorably with other moral emotions (especially anger), which they hold to be more flexible and reasoned, and lump it together with related emotions such as shame, which are often viewed negatively for similar reasons. Specifically moral critiques of disgust have been largely qualitative, based on historical case studies and anecdotal examples. Arguments condemning disgust as a moral emotion emphasise disgust’s negative role in instances of stigmatization, such as homophobia, racism, and genocide.

The entire article is here.

Thursday, February 13, 2014

Suicide risk reduced for all students by gay-straight alliances in schools

By Medical News Today
Originally published January 23, 2014

Canadian schools with explicit anti-homophobia interventions such as gay-straight alliances (GSAs) may reduce the odds of suicidal thoughts and attempts among both sexual minority and straight students, according to a new study by University of British Columbia researchers.

Gay-straight alliances are student-led clubs that aim to make the school community a safer place for all students regardless of their sexual orientation. Their members include lesbian, gay, bisexual, transgender, queer or questioning (LGBTQ) youth and their straight allies.

The entire story is here.

Thursday, June 6, 2013

Gag Orders on Sexuality

By Allie Grasgreen
Inside Higher Ed
Originally posted on May 23, 2013

When Brittney Griner, Baylor University’s star basketball player and one of the most celebrated athletes in the history of the sport, came out publicly as gay last month, she was rather nonchalant about it. She didn’t write a Sports Illustrated cover story – à la professional basketball player Jason Collins, a few weeks later – she just sort of mentioned it in media interviews. Griner is “someone who’s always been open,” she said, with family, friends and teammates.

But, as Griner revealed a few weeks later, she wasn’t allowed to be open as much as she might have liked. That’s because Baylor head coach Kim Mulkey told her and her teammates not to talk publicly about their sexuality.

“It was a recruiting thing,” Griner told ESPN. “The coaches thought that if it seemed like they condoned it, people wouldn’t let their kids come play for Baylor.”

Griner's account followed on the heels of speculation that her coming out signaled a new age at Baylor – a private Christian university whose nondiscrimination policy does not cover sexual orientation and whose student handbook entry for “sexual misconduct” includes as examples of inappropriate actions "homosexual behavior" and participation in “advocacy groups which promote understanding of sexuality that are contrary to biblical teaching.”

Saturday, July 14, 2012

Google wants the world to "Legalize Love"

By Anna Peirano
Originally published July 8, 2012

Google is launching a new campaign called "Legalize Love" with the intention of inspiring countries to legalize marriage for lesbian, gay, and bisexual people around the world.

The "Legalize Love" campaign officially launches in Poland and Singapore on Saturday, July 7th. Google intends to eventually expand the initiative to every country where the company has an office, and will focus on places with homophobic cultures, where anti-gay laws exist.

Saturday, June 9, 2012

Clinical Considerations When Working With Lesbian Clients

By Jeanne L. Stanley, PhD
The Pennsylvania Psychologist
June 2012

One challenge of working with lesbian clients lies in never assuming all concerns relate to sexual identity issues, while also acknowledging the potential impact of sexual identity. Also important is understanding the intersection of our clients’ sexual orientation with other socio-cultural identities, including age, citizenship status, ability, ethnicity, gender, race, religion, and socioeconomic status. A client’s socio-cultural identities are at times independent, interdependent, and multiplicative, and are best understood individual by individual (Stanley, 2004).

A difference exists between a lesbian’s self-identification and behavior. For example a female client married to a man may not be heterosexual. A recent study found that 67% of “exclusively straight” women had questioned or were questioning their sexual orientation (Morgan & Thompson, 2011). Conversely, a client who identifies as lesbian may never have had a same-sex experience. Fifty percent of self-identified lesbian adolescents had not had same-sex contacts (Savin-Williams, 2005). It is therefore better to ask a client, “With what gender or genders are you sexually active, if you are so?” as well as how they identify themselves, rather than to focus solely on labels. For some women, sexual behavior or attraction is not the basis for their identification as lesbian. In this context, Klein, Sepekoff and Wolf (1990) were instrumental in helping psychologists broaden their understanding of sexual identity to include other factors, such as attraction, emotional connection, and community affiliation.

Coming out to oneself about one’s sexual identity can happen at any age. Sexual orientation may be static over a lifetime or more fluid (Diamond, 2008). I recently met with a 71-year-old client who described experiencing sexual attraction toward women for the first time. Assuming that sexual identity is static may lead mental health professionals to miss subtle comments by clients who may be reaching out for support regarding their orientation.

As they consider coming out for the first time, clients benefit from thorough exploration of the “why” and “how” of their communication. It is useful for clients to choose carefully whom to tell first, in order to identify those with whom they are likely to have a positive experience. Reviewing how particular people have handled potentially disconcerting information in the past may prepare the client.

Coming out is an ongoing, lifelong process. While clients may focus on the major coming-out events, such as telling parents, spouses, friends, and work colleagues about their sexual identity, the decision of whether to come out and the possible consequences may arise daily.  Checking into a hotel as a same-sex couple and assuring the clerk that indeed you would like one queen-sized bed rather than two double beds, or receiving an invitation for one to a cousin’s wedding, even though you have been with your spouse for fifteen years, can take a toll on even the most “out” and empowered individuals. A high school reunion full of questions about relationship status may lead an otherwise “out” lesbian to retreat back into the closet for the night. It is especially important for mental health professionals to be able to normalize for clients the process of “recycling” through the coming-out process based upon life circumstances and to give them a place to discuss their present contexts without pathologizing their needs and decisions. 

Facing subtle and more overt forms of discrimination leads lesbian, gay, bisexual, and transgender (LGBT) individuals to seek mental health support services on a higher average than their heterosexual counterparts (Israel, Grocheva, Burnes, & Walther, 2008). Lesbian clients are not more emotionally “flawed” than their heterosexual counterparts; rather the chronic, overt discrimination and prejudice they experience can lead to higher rates of depression, anxiety, and substance abuse. The importance of screening for depression, anxiety, addictions, self-harming behaviors, and suicidality is therefore essential in our initial and continued work with lesbian clients. 

Support from family of origin and/or family of choice (i.e., friends and mentors) plays a crucial role for many lesbians. Therefore, it may be useful to connect lesbian clients to affinity groups related to their interests and their work, whether through local or national venues. LGBT psychologists may find support and recognition through membership in APA’s Division 44. Clients in non-urban areas may benefit from online support groups and other social networking sites. Support for lesbians is often found in their friendships, which may differ in important ways from heterosexual friendships. It is not uncommon for lesbians to work to maintain friendships with their ex-partners (Weinstock & Rothblum, 2004; Stanley, 1996).

Psychologists who see lesbian couples need to consider some of the unique aspects of working with them. If one member of the couple is out to family and friends but the other partner is not because of fear of losing her job or being rejected by her parents or siblings, the disparity may strongly impact their relationship. Domestic violence in lesbian couples may also manifest in unique ways: An angry member of the relationship might threaten to “out” the closeted partner, thereby using the knowledge of her sexual identity to exert control. Working with lesbians who are married to men may involve conflicted feelings about coming out to their husbands and/or children. Their own mixed feelings such as excitement, shame, joy, and fear may interact with the reactions of friends, parents, and neighbors. Support groups are often useful for married or recently divorced lesbians to gain affirmation in their lives.

Unique issues for lesbians considering children range from legal issues (some states do not allow same-sex couple adoptions), to refusals by hospitals to recognize the non-pregnant female partner, to deciding which partner will be the biological mother. Today’s psychologist needs to have at least a basic understanding of fertility, adoption, and donor options for lesbian clients. Lesbian parents may also experience homophobia from teachers, school districts, Boy Scout troops, and others. Psychologists must be aware of local, state, and national laws regarding the protection of LGBT clients in order to best meet their needs. For up-to-date resources for such information in Pennsylvania, see http://www.hrc.org/laws-and-legislation/state/c/pennsylvania.

Lesbian psychologists are also affected by the interconnected nature of the lesbian community (Kessler & Waehler 2005; Brown, 1988).  It is not unusual for lesbians to recommend their own mental health provider to friends and colleagues or for a lesbian psychologist to become well known in the community. Given the limited number of lesbian gatherings, a lesbian psychologist may run into clients socially. Consequently, early in therapy a discussion of professional boundaries may be particularly useful.

Finally, all psychologists benefit from ongoing self-introspection and awareness in regard to their own internalized homophobia. None of us, regardless of orientation, are immune from it. Riddle’s (1990) scale, which ranges from repulsion to nurturance, is a useful measure to assess one’s level of personal comfort regarding sexual orientation. We are ethically bound to recognize our limitations and to refer lesbian clients or consult if our biases or ignorance of a culture may be barriers to treatment. PPA’s Multicultural Resource Guide as well as other online resources may assist you in finding LGBT-affirmative therapists in your area for your client and continuing education trainings for yourself. Since we never know whether we may be working with lesbian clients, we must ensure we are providing a supportive and affirming environment for clients of all sexual orientations. 

References are available from the author at jstanley@gradschoolcoaching.com or on the PPA website, www.PaPsy.org.

Thursday, May 3, 2012

Does Medicine Discourage Gay Doctors?

By Pauline W. Chen, M.D.
The New York Times - Well
Originally published April 26, 2012

During my surgical training, whenever the conversation turned to relationships, one of my colleagues would always joke about his inability to get a date, then abruptly change the subject. I thought he might be gay but never asked him outright, because it didn’t seem important.

But one morning, while we working at the nurses’ station with several of the other doctors-in-training, I realized it was important, because at the hospital, he really couldn’t be himself.

That morning, one of the senior surgeons stormed over. He had found one of his patients feeling slightly short of breath, no doubt because of an insufficient dose of diuretic overnight.

“Which of you idiots,” he growled at us, “gave my patient a homosexual dose of diuretic?”

The entire story is here.