Shadow dancing in the wings : lesbian women talk about health care : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Nursing at Massey University

Abstract

Women who claim a lesbian identity as part of their cultural articulation have to date been poorly represented within research particularly within a New Zealand setting. Rather than couch this single identifier within a contextualised environment, research has predominantly sought to pathologise lesbian existence at an individualistic level. Lesbian women are a minority group for whom crucial differences from the dominant culture may not readily be recognisable. Such differences may be associated with existing in a society where silence and invisibility subsume a meaningful and tangible cultural expression. This study aims to explore the factors which hinder or facilitate sense of safety for lesbian women, when accessing health care, in order to provide information from which health professionals may judge the appropriateness of their current service delivery. A participatory approach grounded in both critical social and feminist research has been utilised to explore issues relevant to health care and it's access with seven women who claim lesbian as part of their identity. The representational void is uncovered and forms a suitable backdrop from whence to explore with these participants health issues and factors relevant for them in the context of their daily lives. The concept of cultural safety gives power to the users of services to determine whether or not they feel safe. From the perception of the service user then, cultural safety assumes that the nurse (or other health care professional) is the extraordinary element as opposed to the neo-colonial held view that the user is the extraordinary member of the interaction (Ramsden, 1995). Cultural safety is the term originally employed in New Zealand to describe the partnership between nursing and the indigenous people intent upon removing barriers in order to facilitate safe access and delivery of health care. From this juncture the Nursing Council of New Zealand (1996) acknowledging that prejudicial and judgmental attitudes exist with regard to lesbian women has fostered awareness. Subsequently the need for appropriate qualitative research has been recognised. In support of the tenets of cultural safety this study will prove useful to nurses and other health professionals intent upon ensuring safe care provision for this marginalised group.