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UBC Theses and Dissertations

An autoethnographic lens on the identity work of lesbian and gay radiation therapists in practice Bolderston, Amanda


The healthcare environment reflects and embeds sociocultural norms, including heteronormativity, which pervades workplaces through policies, cultural norms and informal interpersonal interactions. Coming out is a process of continual identity management. Subsequently, there is evidence that lesbian and gay people (LG), both patients and healthcare professionals (HCPs), engage in significant identity work to manage who they tell about their sexual identity, and in what circumstances. For patients this can result in barriers to healthcare that can substantially affect their health and wellbeing. Radiation therapists (RTs) are a group of healthcare professionals who treat people diagnosed with cancer using radiation therapy. HCPs, like RTs, are subject to explicit and implicit bias, and may feel they need to disguise or downplay their sexual orientation at work. This research explored the issues of LG RTs and their experiences with managing sexual identity in the workplace, and how this has impacted their relationships with co-workers and patients. The research used an authoethnographic narrative inquiry approach. Three LG participants from a large Canadian urban cancer centre worked with the researcher to co-construct stories of coming out at work using their shared personal histories. An iterative development process was used. The co-constructed stories include fictionalised narratives of identity management as a radiation therapist at work, relationships with patients and peers, the experiences of sexual minority patients and the researcher’s accompanying lived research journey. The results showed the participants engaged in highly contextualized and continual identity work and utilized a series of different strategies or tools. Additionally, it was clear that both the discourse around professionalism, and the pervasive biomedical healthcare culture served to further inhibit disclosure at work. There is growing evidence that some patients from minority groups, including LG patients, feel more comfortable and may have better health outcomes when treated by healthcare professionals from the same background. For RTs, coming out at work might be a risky business. However, it seems likely that focused attention on improving the work environment, so RTs can be open about their identities in the professional setting would be beneficial for both patients and staff.

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