Vital Views

Unknown Speaker 0:31
Hi everybody, welcome back to vital views from the School of Nursing. I'm Dr. Janice Henriques. I am faculty and Happy Pride Month. Today we have a special guest, Dr. Samuel Hickson, who is a very good friend and brother to me. And today, I want to talk to Dr. Hickson about his recent PhD research, and how that can impact us as providers in our care for patients. So Dr. Hickson, can you please introduce, introduce yourself to our listeners?

Unknown Speaker 1:04
Yes, absolutely. Thank you so much for having me. As Dr. Henriques just mentioned, I'm Dr. Samuel Hickson. And I am a by profession a health behaviorist, but I have a passion for understanding sexual and gender minority health, particularly as it relates to primary care intervention. So I'm very happy to be here, excited to talk about that, and hopefully be able to share some wisdom on how we can be better in healthcare.

Unknown Speaker 1:30
I love that now, as your sister, it was fun watching you go through that process. But now as professionals, a sibling professionals, I really think that what your findings, you know, from your research were are very impactful and also very meaningful, especially because I am a health care provider, in addition to being faculty, can you share with our listeners, what the topic of your PhD was? Why you decided to pick that topic? And like the highlights of what you uncovered in your research?

Unknown Speaker 2:00
Yeah, absolutely. So my PhD, my dissertation focused on understanding the linguistic and behavioral attributes of primary care providers that would indicate to their patient that they were being stigmatized in health care. And sometimes those minute behaviors those minute sayings would trigger a person's of the sexual and gender minority community or colloquially known as the LGBTQIA plus community. I know we have a lot of acronyms in there. But it was important to understand what stigma looked like because research in the sexual and gender minority space always told us that discrimination exist. We knew that right? This has been decades old. I daresay century, not really a century. But it's been decades old that we knew stigma existed, we knew discrimination existed against members of the community. And I wanted to understand what that looked like. So I took a theory of stigma, or when Kaufman's theory of stigma, that really helped me to uncover how that would impact someone's ability to engage the health care space. And so I found some interesting yet alarming things. Because my study looked at all different members of the community, it wasn't just gay males, or it wasn't just trans persons, or those that identified as lesbians, it was members from all across the community, and understanding their experiences through a qualitative approach to understand the themes, what were we experiencing, because one of the things that we've been finding is everyone now is on this cultural competence, kick, and we want to be able to change the way we educate medical providers. But it's really hard to educate them. If you don't know what's wrong. In the system, we continue to repeat the same process or produce the same research. And a large part of that research came from my own experiences in primary health care being told that if I wasn't a gay male, that I wouldn't have hypertension. And in my brain, I thought, what does that have to do with me being hypertensive? My heart said, Wow, you took an oath not to discriminate against people, you took an oath to do what was right. And yet here you are telling me that if I was not gay, that I would not be hypertensive. It took everything not to jump across the table on that provider, but it launched an understanding of why we needed this type of research. Those statements that we make those those simple behaviors that providers don't think are important stands in the way of someone ever engaging medical practice ever again and for members of the SGM community that can have serious implications for the community at large that causes diseases to spread if we don't catch them. So my dissertation inherently focused on understanding those behavioral linguistic behaviors that providers have, and in how it impacts medical trust, essentially, I

Unknown Speaker 5:14
love that. Will you share with the, with the audience, what SGM stands for? Sure,

Unknown Speaker 5:20
it stands for sexual and gender minority. And that is the formal National Institute of Health way of describing members of the LGBTQIA plus community. So

Unknown Speaker 5:31
let's delve a little bit deeper into that. So with your findings, as you know, again, I'm a health care provider, so directed towards me as far as how I provide the care how I can avoid implicit bias or putting my patient in a predicament where they felt I was judging them, sometimes we're not aware, again, implicit bias, right. So with your findings, what would you what would you share with me as a provider,

Unknown Speaker 5:58
I would share Be careful, No, I'm joking, I would share that, first of all, we have to remember, in health care the person is first, there is a reason why we say person centered care or person first care. Because irregardless of our gender, regardless of our orientation, the person matters, they are the ones living with the condition, they are the ones living with the diseases, they are the ones living with the fear. And it's important to acknowledge those things. Now, as providers, I will say that there's a little saving grace here for you, because sometimes the law forces you to do things that you know, are inaccurate, that you know, are wrong, for example, now we have become so so entrenched in trying to gather sexual orientation on medical forms, that sometimes providers don't know that it's okay not to ask someone that if they are not ready to disclose that information. But if they do, if you are one of those privileged providers whose offices created a space where that person felt safe, understand that little things such as asking a question, but then scooting your chair back just a little, can indicate that that person might feel stigmatized, right? Asking them or, or misgendering them or calling them by the wrong pronoun versus saying, I see here that you have marked X, how would you like for me to address you. And this is incredibly important for providers that are taking medical history, especially when it comes to persons that identify as trans. Part of that is because their identity comes from two different worlds. They were the person that they were born, but they are the person that they identify now. So asking that question, I know that you identify this way, how would you like me to address the earlier version of you, or along some of that line there. And that is important, because then that person feels heard, right? We cannot assume and it is a mistake for the medical community to assume that we can separate gender orientation from disease. Because what that does is it causes us to miss vital questions that are important. For example, from my own experience, my provider had no idea what an annual pap smear was, and looked at me like I was an alien with my head cut off. But if they didn't know that I was a gay male, if they didn't know that I identified as a bottom at one time, that necessary test would have been missed had I not advocated for myself? So providers being careful of how do you ask certain questions and recognizing, I know this might be uncomfortable for you. But I have to ask it anyway. And then processing with that patient? How do you feel before they walk out of your office? Because you just opened up a can of worms for them that they may not have been ready to answer. Now keep in mind and I say this medically because we seem to be integrating medicine with behavioral health now. So when we say medical providers, sometimes we get those those entities confused. Medical care is not the same as mental health care and mental health, we can table a discussion if you are not ready to have that. In medical care providers don't always have the space anymore to bring a person in weekly as we can in mental health. So sometimes those questions have to be asked even if both parties are uncomfortable. So the implications of my research really identifies what the community saw as stigmatizing. Even something as long as an extra second on your pause in between a question can make someone feel that they are being discriminated against or stigmatizing the other One thing I want to put out there for medical providers is my research demonstrated the importance of recognizing nonverbal communication, which I don't think we are very good at in medicine. To be honest, we're good at looking at forms. We're good at taking vitals, but we're not very good at identifying those nonverbals. If you ask a question of your patient, and you notice a flinch, you notice their head go toward the floor, you notice their eyes divert. Look at that. Because if it happened, after you said a question, or after you asked a question, bring that forward. I noticed by asking this question, you diverted your eyes, you put your head down, can you help me understand what that was about? Right. I

Unknown Speaker 10:44
think that's awesome. I think reading your patient, and understanding your patient is reading you. I think that's so important when you're in those interactions in those moments, right? Like, you're in a situation where you're being trusted with maybe information they won't other people, my patients won't share with anybody else in that world. And I honor and I respect that. Because you know, like, they could easily choose a million other people to come and talk about those things. But here they are with me, right? So I get that. And I think it's awesome from where you're coming from in the type of care you provide, that you're able to share that with our our listeners and our future health care providers and behaviorists. And I really want to thank you for taking the time to be with us today. Is there anything else you want to share with our listeners? Before we sign out?

Unknown Speaker 11:31
Yes, the last thing that I would share is don't be afraid. I think our community has become so polarized when it comes to topics of health care for LGBTQIA plus persons. And I want all future current providers to no fear helps us grow as humans. But if you let it stop you, then we get nowhere. It's okay to make a mistake. As long as you own that mistake. When you start to try to excuse yourself, that's when we have problems. So my last piece of advice is, please don't be afraid of us. We are here we're not going anywhere. So you might as well just learn to interact with us because we need you. We need you to help us when we're sick when we're scared when we feel alone. So don't be afraid, because then we die in silence. We die alone. But if we have someone that we can trust in medicine, that makes a world of difference to us, even if you're just giving us a band aid, so don't be afraid.

Unknown Speaker 12:35
I love that. Thank you so much how your listeners find you.

Unknown Speaker 12:40
They can find me on every social media platform on the planet. I am everywhere. Or if you would like to reach out to me professionally, I am at Sammys corner@gmail.com. So please feel free to reach out to me. No matter the question no matter the issue. Even if you think it's a stupid question. There's no such thing as a stupid question. Just that which goes on asked. So please feel free to reach out to me.

Unknown Speaker 13:04
Thank you so much, Boris. Thank you

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