From Theory to Praxis: Medical Care of LGBT Individuals

Over this semester, I have been exposed to a broad spectrum of concepts, issues, and questions through our readings and discussions. GSS has given me a new lens through which I see the world and a deeper understanding of the structures and institutions in place that govern our lives. As a senior, I will soon be entering the job market and am really looking forward to taking my newly acquired GSS knowledge to my future endeavors. I am looking for a job in the medical field, a field in which LGBT individuals are underserved and often reluctant to pursue care. In this context, lesbian, gay, bisexual, and transgender individuals are often grouped together in a way that implies homogeneity, which is not the case. These individuals are distinct in terms of race, socioeconomic status, age, and ethnicity in addition to their gender and sexual identities. What groups these people together is the underlying discrimination and stigma that they face in society as a result of living at the intersection of multiple different groups. The intersectionality of marginalized groups is a topic that came up frequently in our class discussion and has really opened my eyes as to how a person’s identity is not defined by just one element or trait, it is the combination of these interlinked traits that make up one’s identity.

There has been a long history of discrimination stemming from a lack of understanding of LGBT individuals in the medical field (i.e. the listing of homosexuality as a mental disorder in the DSM). However, as understanding has improved, the treatment of LGBT individuals in the medical setting has gotten somewhat better. There are certain diseases that disproportionately affect the LGBT community such as HIV and other STDs, and these disparities stem from structural and legal factors, social discrimination, access and availability of medical care, and the lack of culturally informed health care.

There are many things that those in the medical field can do to encourage an inclusive and welcoming medical environment. Below are some suggestions to be implemented in different medical environments, which I hope to bring with me to my future occupation:

  1. Allow patients to privately self-input information about gender identity and sexual orientation (ensure that there are a wide range of options on the questionnaire).
  2. Allow patients to specify the pronouns that they prefer.
  3. Be open and non-judgmental when collecting sexual histories of patients.
  4. Refrain from making assumptions about individuals based on appearance.
  5. Do not assume heterosexuality (i.e. Ask “Do you have a
    partner?” rather than “Do you have a boy/girlfriend?” when conducting sexual
    history).
  6. Make sure all staff are trained to interact respectfully
    with LGBT patients (i.e. ensuring use of their preferred pronouns).
  7. Make sure that the medical environment has a non-discrimination policy that includes discrimination based on gender identity and sexual orientation and publicly display this policy.
  8. The use of brochures and medical information that include images of LGBT people as well as medical information that specifically addresses concerns that
    these individuals face.

All of these suggestions are important, as a clinician may be one of the first people whom an individual discloses non-heterosexual behavior to, and for this to happen, individuals need to be in a space where they feel comfortable. The goals of medicine include providing quality and effective care, and through these suggestions and the scope of my GSS knowledge, I plan to do my best to create an inclusive and welcoming environment for all patients.

Works Cited

http://www.lgbthealtheducation.org/wp-content/uploads/Improving-the-Health-of-LGBT-People.pdf

http://www.aafp.org/dam/AAFP/documents/medical_education_residency/program_directors/Reprint289D_LGBT.pdf

From Theory to Praxis: Marriage and Taxes through a GSS lens

As I prepare to pursue a Masters in Accountancy, it may be difficult to see how topics we discussed in GSS101 will connect to my future career. One of those topics was marriage and the reasons for and against same-sex marriage. Advocates often cited tax benefits as a “pro” for the passage of same-sex marriage, so I wanted to explore what tax benefits couples can receive when married versus not, and how the tax code may subtly discriminate against certain groups.

Married taxpayers can file either of two ways: either individually by the head-of -household or jointly, but only if the marriage is recognized. Before the 2015 Supreme Court Decision in Obergefell v. Hodges that legalized same-sex marriage, couples could not file their taxes jointly, and therefore may have been disadvantaged in the amount of taxes they paid. To determine how much someone pays to the government, every individual is placed in a bracket by the amount he or she earns. The tax code places married couples in brackets by the amount the couple earns together. In progressive tax structures, which many states and the federal government currently use, those in the higher income brackets are taxed at a higher rate. For joint filers, the 10 and 15% brackets, where most people tend to fall, are twice as wide, and the higher tax brackets are less than twice as wide, so a joint-filing couple might be more likely to fall into this lower tax bracket than two individual filers would.

Not all same-sex couples may benefit from joint filings. Married couples usually receive either a penalty or a bonus on their taxes. Penalties occur when a couple has to pay more taxes than it would if it filed individually, and bonuses occur when couples save money by filing jointly. When spouses earn similar and relatively high-incomes, they are more likely to receive a penalty. These penalties tend to occur because as joint filers, these couples are less likely to be able to take deductions for children, but if they separated into single and head-of-household, they would be able to receive deductions for dependents.

On the other hand, joint filers can also receive marriage bonuses, which most often occur when one spouse earns all the familial income. A joint filing would likely shift this couple into a lower tax bracket because the lower brackets are twice as wide and, therefore, incorporate even some high earners. In reality, those who make less money, like many LGBTQ individuals who felt same-sex marriage argument was only a battle for upper-class, white gays and lesbians, could benefit from a decrease in taxes if married. These people, however, were largely arguing against this very idea. They realized that the institution of marriage is all about protecting wealth, not love, and if LGBTQ couples want to “redefine love,” they should not feel the need to buy into the heteronormative institution of marriage. In examining this tax structure, I would argue that, beyond LGBTQ individuals, heterosexual women should also be more aware of the patriarchal assumptions that the tax code for joint-filers makes. While a heterosexual couple can still earn a marriage bonus if the woman earns most of the income, it is clear that those who have set up the code over the years have assumed that women would not earn an income, or at least not one that would be competitive enough to negate a bonus.

As we have learned, using a GSS lens can give a new perspective to the assumptions and subtle discrimination that exists in every part of our society. Even in progressive tax structures, ones that liberals fight to protect, discrimination, unfortunately, still exists, and if we intend to ameliorate this pervasive issue, we must at first recognize it. It will be beneficial to take this interpretation into my future career, as I may help people choose a filing, not necessarily just based on money, but also understanding their stance in their relationships.

Sources Referenced:

http://taxfoundation.org/blog/how-many-taxpayers-fall-each-income-tax-bracket

http://www.bankrate.com/finance/taxes/3-tax-traps-same-sex-couples-can-avoid-2.aspx

http://www.taxpolicycenter.org/briefing-book/what-are-marriage-penalties-and-bonuses

Beyond Marriage: Valuing All Families under the Law

“A woman married to a man for nine months is entitled to Social Security survivor’s benefits when he dies; a woman living for nineteen years with a man or woman to whom she is not married receives nothing.”[1] The debate over marriage equality for same-sex couples was one that took over the country’s social and political agenda in the early 2000’s. Nancy Polikoff’s Beyond (Straight and Gay) Marriage challenges this agenda by asking both straights and gays alike to consider a broader definition of what constitutes a family and how this structure should be protected under the law. Those protected by the institution of marriage have privileged status in regards to tax benefits, estate benefits, government benefits, employment benefits, medical benefits, and death benefits among others. Polikoff calls for a revamping of family law; one that takes into consideration the changing nature of family units while also deemphasizing the status of marriage in our society.

Nancy Polikoff is a professor of law at American University Washington College of Law. She teaches Family Law and a seminar on Children of LGBT Parents and has been writing about, litigating about, and speaking about cases involving LGBT families for the past thirty years. Her accomplishments include co-founding the Washington, DC Feminist Law Collective, supervising family law programs at the Women’s Legal Defense Fund, and co-authoring one of the first law review articles on the custody rights of lesbian mothers. Beyond (Straight and Gay) Marriage is Polikoff’s first book. She has a daughter in her twenties and lives with her partner in Washington, DC.

The first half of the Beyond Marriage gives the reader historical context as to how we got to the position we are in with marriage today. It begins with the advances made by the second-wave feminist movement in the context of marriage, and then describes how those advances have been attacked since the 1970s by the religious right. Betty Freidan, Gloria Steinem and others are cited in this section, along with groundbreaking legislature like Title IX. From there, she moves into the gay rights movement and the intersection of lesbianism and feminism. Eventually she delves into the marriage movement of the conservative right and the how the push for preserving marriage as an institution for heterosexual couples strengthened marriage’s societal status. She then brings the reader to the contemporary fight for marriage equality, the most thorough part of the first half of the monograph.

Generally, there are two dominant perspectives in the contemporary marriage debate. First, there are those who support the institution of marriage and believe that opening it up to non-heterosexual couples will undermine social structure. Second, there are those who support equal access to marriage for LGBT individuals since they deserve the same access to benefits as married heterosexual couples. Throughout the book, Polikoff makes reference to groups on both sides of the argument. Frequently mentioned supporters of the marriage movement include The Institute for American Values, the Alliance Defense Fund, and the Liberty Counsel. Those often mentioned on the side of marriage equality include Lambda Legal, the Human Rights Campaign, and the National Gay and Lesbian Task Force. All of these groups fight for legislation supporting their side of the argument or represent individuals in relevant court cases. Polikoff separates herself from these prominent groups by taking a third stance. She questions the legitimacy of marriage as the necessary qualification for receiving legal benefits and questions whether it is fair to exclude so many other family forms by limiting such benefits. This allows her to reframe the debate over marriage by making the point that the benefits associated with marriage are not inherent, they have been constructed over time and have increasingly drawn a line between families formed through marriage and families formed through other means. By fighting for the right to marriage for LGBT couples, dominant organizations like the Human Rights Campaign are reinforcing the place of marriage in our society as cultural institution that unfairly awards rights to the married and leaves those who are unmarried out to dry. She enforces the argument that marriage is outdated and the benefits that accompany it were developed decades ago when having sex outside of marriage was taboo, illegitimate children were considered outcasts, and marriage had gender roles legally entwined within it. Through the examination of historical movements, she determines that people have changed the way that they view and structure their lives and the current marriage equality movement does not reflect this change.

The second half of the book is dedicated to describing specific aspects of her proposed approach, called “valuing all families,” to make marriage matter less. The most important aspect of this approach is identifying the purpose of specific laws that currently grant marriage-specific legal consequences. By understanding the specific objectives of these laws, relationships can be identified that would further the law’s objective without creating a specific special status for married people. In regards to this approach, she addresses health care, medical leave, medical care, domestic partner benefits, the dissolution of relationships, death, and economic compensation. Polikoff argues that by taking this approach, our society can move more towards a legal system based on the nature of care and dependency in relationships, not just the relationship’s specific name. Her solutions are not only for same-sex couples, they are also for people non-conjugal relationships, like unmarried elderly people, caregivers and the people they help, or friends living together. For instance, through this approach she examines the current family and medical leave practices of businesses across the country, supported by anecdotes of those who were not allowed such leave to care for an ill family member. Many medical leave policies are limited to caring for a spouse or child with serious illness and are often unpaid. Polikoff proposes support of the “Healthy Families Act,” a bill that provides seven days of paid leave per year “to care for a child, a parent, a spouse, or any other individual related by blood or affinity whose close association with the employee is the equivalent of a family relationship.”[2] This kind of reform breaks down barriers and helps to redefine the law’s narrow definitions of family that do not accurately reflect today’s society.

Polikoff’s breadth of knowledge of her field is evident as she provides a comprehensive overview of legal history as it applies to social movements throughout the decades. This method is extremely effective in giving the reader context into the foundational aspects of marriage and establishing the true dividing line that it has become. By making interdisciplinary links through feminism, sexual liberation, class, and justice, her argument is multidimensional and looks at marriage through the views of different legal lenses. The inclusion of a significant amount of laws and court cases is appropriate since the nature of her “valuing all families” solution focuses on reforming these laws. In contrast to the formality of the included law, Polikoff includes many anecdotes and case studies throughout the monograph to explain how the law has failed certain families because of the marriage dividing line. These short stories help to break up the dense law material and make it easy to envision why her reform needs to be implemented in real world situations.

Although at first the idea of diminishing and eventually removing the significance of marriage in a society may seem radical to the general population, Polikoff’s presentation of her argument makes it seem truly possible and reasonable. She provides concrete solutions for reforming laws, many based at the state and local level, and also provides several examples of places where similar laws have been successfully enacted. Even with the abundance of case law, the Beyond Marriage is very much readable by those without Polikoff’s extensive background. This monograph is meant to reach a broad audience due to its increasing relevance, however, due to its connectedness with the marriage equality movement and gay rights, the audience becomes more limited.

Polikoff reinforces in Beyond Marriage that people should have the choice to marry based on their individual beliefs, whether they be cultural, spiritual, or religions in nature. It should not be a choice that people are forced into to obtain unique legal benefits that are specific only to marriage. The end goal of her efforts is a system in which marriage is not the rigid dividing line between who is in and who is out regarding family law, through her “valuing all families” approach. This monograph is a valuable resource for people in all family structures and can help our society move towards a legal system that helps improve the lives of all individuals and families.

Works Cited

Polikoff, Nancy D. Beyond Straight and Gay Marriage: Valuing All Families under the Law. Boston: Beacon Press, 2008.

[1] Nancy D. Polikoff, Beyond Straight and Gay Marriage: Valuing All Families under the Law (Boston: Beacon Press, 2008), Cover page.

[2] Nancy D. Polikoff, Beyond Straight and Gay Marriage: Valuing All Families under the Law (Boston: Beacon Press, 2008), 172.

Alternate Grant Proposal Assignment: Virginity as a Social Construct Poster at 1972 Sex Positivity Fair

As an alternative to the Grant Proposal assignment, Caroline Okel, Vance Graves, Felicia Zi, and Collin Epstein created a poster for the Sex Positivity Fair hosted by 1972, ‘a group at Davidson College focused on gender expression on campus and issues affecting women’, according to their Facebook page. We chose to examine virginity as a social construct, hoping to start a conversation with attendees at the fair about how they experience virginity. We researched information on four topics related to virginity that caught our interest, and provided sticky notes and pens so that those who came to the fair could respond to our poster by adding their thoughts to it.

 

One of the topics that we were interested in exploring for our poster was the comparison between the expectation that people have for losing their virginity versus the experience that they actually have. As Hanne Blank describes in her book Virgin: The Untouched History, we are able to define virginity without describing its loss. She recognizes that we “speak of virginity loss rather than virginity itself… [because] virginity is because it ends” (Blank 96-97). Their definitely is a fascination with the topic of “the first time,” especially in a college setting, but we have noticed that for most people we know, the first time was not all what it is cracked up to be. For example, in Laura M. Carpenter’s Virginity Loss, she interviews people about their stories of losing their virginity. As Bryan Meyers summarizes in her book, “It was just so unbelievable that this, like, this thing you talk about your life is actually happening. And honestly, I think that… it’s not as, like, as mind-blowing as you expect it to be” (Carpenter 72). Therefore, we asked individuals to answer questions about their expectations that they have for their first time or that they had prior to their first time. We found that those who had not lost their virginity expressed desire for a first time with someone they loved and that they feel comfortable with. When actually discussing the first time, the sticky notes expressed more of a feeling of less than ideal conditions such as disappointment, a lack of feeling changed by the experience, and awkwardness. One person simply answered “NO” when asked if it met their expectations. This portion aimed to shed light on the fact that the first time may not be a romantic, life-changing moment like the virginity loss scenes portrayed in popular movies like Titanic and The Notebook and that this is perfectly okay.

 

A topic that was initially a starting point for conversation in our group was the definition of virginity. We were interested in social and cultural constructions of virginity, and the myth of the hymen was something we discussed and included in our poster, with the main takeaway being that no medical definition exists for what constitutes virginity. One of the open-ended questions we asked on the poster read, “How do you define virginity?” People posted a variety of answers, demonstrating that different individuals defined virginity differently, and that virginity had a different value for every individual. An answer that we found particularly striking was, “IT ISN’T REAL.”  Our group also discussed stigmas and double standards surrounding the idea of virginity, such as social perceptions of male versus female virginities. We included a few memes from pop culture films to demonstrate these double standards, and people seemed to find them not only amusing, but relatable. A female responded to the question, “How did your parents influence your views?” with, “My parents taught me that virginity is purity. I should wait until marriage.” Another female responded with, “Same!”, demonstrating that these gendered perceptions still exist in today’s society. Given that most of the posts were anonymous, it was difficult to find connections between people’s answers and their gender, but the clear variety of answers demonstrated that virginity meant something different for everyone. Ultimately, our group was pleasantly surprised with the amount of people willing and eager to participate in the open-ended questions. It was interesting to generate conversation about a topic that is not normally discussed in everyday conversation and read what people had to say about it.

 

Another one of the topics we researched for our poster on virginity as a social construct is virginity in the LGBT* Community. We examined how views towards virginity differ between the straight and LGBT* communities. For example, it is often debated as to whether or not lesbian women can actually lose their virginities. This belief stems from the idea that one cannot have sex without the involvement of a penis. In order to change how we look at virginity in the LGBT* community, we need to change how we look at sex. Perhaps we, as a society, view things from a very heteronormative viewpoint. This is due to compulsory heterosexuality, a concept put forth by Adrienne Rich in “Compulsory Heterosexuality and Lesbian Existence” (1980). With this concept, it is believed that for most people, straight is the default sexuality. This view is very constricting when it comes to looking at how we view sex, and therefore the construct of virginity. Because we asked questions about what people believe to be sex, it was interesting to see whether or not Davidson students would comply with compulsory heterosexuality when answering questions. Interestingly enough, many of the students who answered questions about what they believe sex to be, left gender out of their answer, like when one student wrote that, “Sex is when two or more people have intimate relations with their sexual organs.” Another student just defined sex as, “when all parties orgasm.” It appears that these students took away something from our poster, or perhaps already came with thought that that when we discuss sex, we need to be more inclusive of other sexual orientations and gender identity.

 

           We also explored historical and cultural representations of virginity in our poster. Historically, virgins have been represented in Western cultures in a series of narrow roles: women as pillars of virtue, men as pathetic or eccentric, and both as holy or deified. Cultural images of virgins contribute to what Barbara Risman refers to as “gender as structure” at the “interactional level of analysis: cultural expectations” in her essay Gender as Structure. These images are crucially dependent on a very heteronormative definition and expectation of gender.

       Female virgins in history are usually portrayed as exceptionally virtuous, usually because of their virgin status (ex: Queen Elizabeth I). Culturally, virginal leaders garnered more respect as virgins, perhaps because of their apparent rejection of men.

        On the other hand, men are typically portrayed as pathetic losers (ex: Steve Carrell in the 40-Year-Old-Virgin) or as eccentric geniuses (ex: rumors about Sir Isaac Newton). In either case, the attitude in which these men are viewed is a sort of bemused surprise. In contrast to women, the expected state for men is as not a virgin. However, failure to conform is not regarded as deeply shameful for men as it is for women.

        The role both men and women have filled as virgins has been as holy people (ex: Joan of Arc, St. Augustine) and as deities. However, even as deities, male and female virgins are represented very differently. There are vastly more female virgin goddesses in Western traditions (ex: Artemis, Athena, the Virgin Mary) than male virgin gods (Jesus). Additionally, the implications for male and female people differ in that all women are implicitly expected to be Mary, but no/few men are held to the standard of Jesus.

        It is important to understand that our telling of history is an important component of how we construct our culture. The clear dichotomy between male and female virginity represented in our culture reinforces the concept of “compulsory heterosexuality” that Adrienne Rich describes in her essay Compulsory Heterosexuality and Lesbian Existence. Learning about how virginity has been understood and portrayed historically allows us to understand virginity as a social construct, and puts the responses of students who reacted to our poster into a wider cultural and historical perspective.

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Photo Project: The Intersectionality of Being African and Queer

After exploring intersectionality this semester, I found this article very interesting. Mikael Owunna is the founded and contributor to Limit(less)–a website that advocates for the freedom of expression of LGBTQ Africans by telling their stories through photographs. Limit(less) aims to bridge the gaps in African communities between those who discriminate and those who are discriminated against. Limit9less) primarily focuses on Africans in the African Diaspora, but also reaches out to Africans trying to express themselves in the face of “homophobia, transphobia, racism, xenophobia and discrimination in their respective communities.”

This photo project reminded me of the past reading “Slivers of the Journey: Using Photovoice and Storytelling to Examine FTM Experiences of Health Care Access” by Wendy Hussey. The similarities these two pieces share is that they illustrate the discrimination and struggles those of the LGBTQ community experience.

http://www.huffingtonpost.com/jaimee-a-swift/this-photo-project-african-lgbtq_b_9775092.html