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Challenging heteronormativity in the consultation: a focus group study among general practitioners
Anna Westerståhl1, Cecilia Björkelund
1Department of Primary Health Care, The Sahlgrenska Academy at Göteborg University, Göteborg, Sweden. anna.westerstahl@allmed.gu.se
Objective:
To reflect on and further understand mechanisms of heteronormativity in the consultation, with special focus on the relative invisibility of lesbian women.
Design:
Tape-recorded focus group interviews transcribed verbatim and analysed using qualitative methods.
Setting:
General practitioners (GPs) from the city of Göteborg, Sweden, who had formerly answered a postal questionnaire about lesbian women in the consultation, were invited to take part in subsequent focus groups.
Subjects:
Ten GPs from the questionnaire who accepted the invitation and volunteered to participate in focus groups.
Main Outcome Measures:
A discourse analytical approach using interaction regarding consensus and disagreement between informants in creating major and minor themes.
Results:
Consultation skills were forwarded as a major tool in receiving optimal information from patients. However, traditional concepts of family and sexuality restricted information and hampered an accepting attitude. Bringing up issues of sexual identity/orientation was left to the lesbian patient and strongly related to her reason for attending.
Conclusion:
Consultation skills are a useful but not sufficient means of making lesbian women visible in the doctor-patient relationship. Doctors also need to transcend traditional concepts of family and sexuality and reflect on what is a relevant issue from the patient's perspective.
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Cultural barriers:
Differences in values, beliefs, religion, knowledge, and tradition can significantly impact communication. Awareness of nonverbal cues is critical, especially when conversing with a patient from a different culture. What appears appropriate in one culture may be inappropriate in another.
Semantic barriers:
As a result of their tendency to use...