Increasing Discussions on LGBTQ+ in Healthcare in Asia
Year: 2024
Type: article
Abstract: Dear Editor, When the law of Thailand’s parliament was endorsed by King Maha Vajiralongkorn last September 2024 to allow same-sex marriage, it became a watershed moment as Thailand became the first nation in Southeast Asia to allow marriage equality.[1] This paves the way for discussions related to healthcare practice regarding how healthcare professionals, for instance, occupational therapists, can ensure inclusive practices during sociocultural development. Occupational therapists define occupation as meaningful activities of daily living that are necessary for health and survival.[2] Since gender is an act guided by instinctive drives, it can be thought of as an occupation that finds expression in mundane tasks such as dressing, grooming, dating, and working.[3] Sexual orientation, gender identity, and expression then influence how one does everyday activities, and these need to be facilitated and supported, placing them at the very core of individual well-being and social functioning. However, systemic discrimination, stigma, and barriers to healthcare access have placed individuals who identify themselves as either lesbian, gay, bisexual, transgender, queer/questioning, intersex, or asexual/aromantic (LGBTQ+) (The “+” represents non-cisgender and non-straight identities that are not contained in the acronym) at a disadvantage in terms of health outcomes. The health concerns of sexual minorities are unlike those of their heterosexual counterparts.[4] Hence, such health disparities signal the need for culturally sensitive and gender-affirmative healthcare services. The forward step taken by Thailand on marriage equality gives a valuable opportunity to revisit and extend the idea of equality and justice to healthcare systems in Asia. Occupational justice, defined as the right to equal opportunities in meaningful and purposeful occupation in daily life, should be a cornerstone of these discussions. Health professionals, occupational therapists included, are in a good place to support this framework through addressing systemic barriers to participation in occupation for diverse populations. Culturally and gender-sensitive care reduces health disparities and creates conditions respectful of the rights to occupations that promote health and life quality, where every person has a human right.[5,6] Moreover, in a recent scoping review by Delos Reyes and associates,[7] research gaps were highlighted that exist in global LGBTQ+ health care, which encourages more research beyond North America since only a few studies have been done in other countries, especially in developing countries. The gaps could be addressed through interdisciplinary approaches and cross-disciplinary collaborations between occupational therapy, physical therapy, speech and language pathology, public health, and social sciences to establish systems of comprehensive and inclusive models of care. Thailand’s marriage equality law brings new impetus to calls for a reexamination of occupational therapy in view of gender and sexual diversities. By framing occupations within the context of one’s gender identity and/or expression, therapists are encouraged to design interventions that promote their affirming and empowering dimensions. Therapy activities that would support self-expressions and social participations would help LGBTQ+ deal with barriers and stigma faced out in society. Moreover, occupational therapists can demand systemic changes in healthcare institutions for inclusive policies and practices that bestow equal access to care. The sociocultural change brought by Thailand’s acceptance of equality in marriage calls for healthcare development. Occupational justice allows the thinking that everyone deserves to choose any occupation and enjoy health care, while expressing their own gender and sexuality. This builds a healthcare culture that is not just accommodating but also celebrating of diversity. This letter calls for continued research and dialog within your esteemed journal, the Indian Journal of Occupational Therapy (IJOT) to explore the promises, challenges, and progress of LGBTQ+ health equity in Asia and beyond. Financial Support and Sponsorship Nil. Conflicts of Interest There are no conflicts of interest.
Author: Rod Charlie Delos Reyes
Institution: University of the Philippines Manila
Language: English
Subfield: Social Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: hybrid
OpenAlex ID: W4412161457