Leslie Bella, PhD.,

Professor

School of Social Work

Memorial University of Newfoundland

St. John’s

Newfoundland, A1B 4P4

Http://www.mun.ca/the

Based on research project

Towards Non-heterosexist Policy and Regulation in Health and Social Security Agencies

funded by the

Maritime Centre of Excellence for Women’s Health

Social agencies often have policies and regulations which are based in heterosexist assumptions about the nature of family and relationships. This action research project used a home page and web conference to address the effects of heterosexism in the context of being lesbian in rural Newfoundland. We found that heterosexism really hurts those who are lesbian, gay, bisexual or transgendered. Tools were developed for practitioners to assess and correct heterosexist bias. These can be used in professional education and continuing education, quality assurance, total quality management, accreditation and in collective bargaining. Results are disseminated through an ongoing on line magazine (THEzine at containing curriculum resources for the human service professions.

Heterosexism is the assumption that heterosexuality is the only natural, normal and moral sexuality. This ideology, or taken for granted belief, constructs heterosexual as superior and entitling one to privileges (Adams, 1994; Wilkinson and Kitzinger, 1993; Robinson, 1997; Rothblum and Bond, 1996; Shortall, 1998). Heterosexuality was first problematized by Rubin (1975) as "obligatory", because it keeps women dependent on men and maintains men’s access to women (Rich, 1983). More recently, Halley (1993) has argued that compulsory heterosexuality coerces people into complicity with heterosexual eroticism, for fear they will be expelled from the privileged heterosexual majority. Much of the social science literature on families (Benkov, 1995) and on aging (Dorfman et al, 1995; Berger, 1984) has a heterosexist bias, so that non-heterosexual people are either rendered invisible, or their problems discounted (Browning, 1995).

Heterosexism is related to homophobia (Epstein, 1994), but was preferable for our work because the former locates the problem in an oppressive social structure rather than in individual fear and pathology (Kantor, 1998). Blumenfield (1992) refers to the structural bias against non-heterosexuals, such as policy concerning gays and lesbians in the military (Britton, 1995), as institutional homophobia. However, this idea remains problematic because it suggests that the bias is based on fear, rather than in privileging the heterosexual as normal.

Challenges to heterosexism have generally had one of three objectives: legislative reform, public education and appropriate mental health strategies. West and Green (1997) document legal and extra legal controls on homosexuality across countries and Wintemute (1995) documents international progress in legislation. Some document "gay rights" initiatives pressing for legislative change (Palmer, 1995; Herek, 1990). Others focus on heterosexism in educational settings (Holzhauer, 1993; Shortall, 1998) and strategies for its reduction (Chan, 1996; Epstein, 1994). The therapeutic and child welfare literature also addresses the issues of gays and lesbians, given their particular family forms (Fairchild et al, 1996; Metz, 1997; Morrow, 1996a; Okun, 1996; Rankow, 1998; Reilly, 1996; Rosenthal, 1982; Rothblum and Bond, 1996; Spaulding, 1993; Sullivan, 1994; Tasker and Golombok, 1997) and life style risks (Otis and Skinner, 1996; Proctor and Groze, 1994; O’Hanlan, 2000). This literature emphasizes the pervasiveness of heterosexism, and the resultant internalized dominance (Di Angelo, 1997) and relative invisibility experienced by non-heterosexual individuals and groups (Potter, 1985). These issues are also being addressed in professional education (Aronson, 1996; Cain, 1996; Herr, 1997; Morrow, 1996; Newman, 1989; Trotter and Gilchrist, 1996).

Social service agencies and programmes have had policies and regulations which have been generally heterosexist in their assumptions about the nature of families and relationships. Some policies have been successfully challenged in the courts, such as initiatives concerning spousal support for same sex partners following their separation (LEAF, 1999). The Canadian charter is now interpreted as forbidding discrimination on the basis of sexual orientation (Wintermute, 1995). The federal government has consequently implemented legal reforms, and some provinces are following suit. Most Canadian provinces have human rights legislation which also prevents discrimination on the basis of sexual orientation.

However, changes in national and provincial macro-level policy may not be associated with mezzo and micro level change. The heterosexist bias in community attitudes, particularly outside large metropolitan centres, encourages gays, lesbians, bisexual and transgendered individuals to remain closeted (except for small groups of friends), so local challenges to heterosexist policies and regulation can be risky. We addressed this issue in the context of being lesbian in rural Newfoundland, because such lesbians are particularly marginalised and vulnerable in a context where social values may be conservative and anonymity cannot be maintained.

Heterosexism had already been identified as a problem in Newfoundland. Muzychka (1992) identified lesbians’ concerns with kin rights (such as access to one’s partner in an intensive care unit), and quality of care issues related to insensitivity and inappropriate treatment. A paper to the province’s social policy committee (Hodder, Lacy and Shortall, 1995) also documented the need for change. In 1997 Newfoundland and Labrador was one of the last Canadian provinces to amend its Human Rights Act to prohibit discrimination according to sexual orientation (Shortall, 1998;Wintemute, 1995). However, both heterosexism and homophobia persist. Shortall (1998) and Morrison (1994) found evidence of both in the province’s schools. A anti-heterosexist poster context attracted no entries from one rural school district, in spite of generous prizes (Hynes, in interview, 1999). Workshops directed to "acceptance" of diverse sexual orientations were not well received, but revised workshops focussed on "tolerance" were more successful. Newfoundland Gays and Lesbians for Equality (NGALE) endorsed and collaborated in our initiative to challenge heterosexism. Partnerships with community based and government agencies concerned with women’s issues and with violence prevention also helped us guide this project appropriately.

We moved beyond the macro level of legislation to look at the mezzo and micro level policies that affect lesbians’ access to programs and services. While some examples are listed in the popular literature, these more local and specific examples of heterosexism have not been systematically researched or challenged (Ortiz and Scott, 1994). We developed tools to identify heterosexism and strategies for its remedy. An ongoing THEzine ( continues this challenge by providing curriculum resource for human service professionals.

Following the suggestions of Balka (1997) and Spender (1996), we used a web site (www.mun.ca/the or "the definite article") and associated web conference. A fuller discussion of methodological and technical issues is available (Bella and Yetman, 2000). The web site defined the nature of the problem of heterosexism, explained the project and introduced the project partners. The name The Heterosexism Enquirer, or THE, derived from our choice of a tabloid format like that of The National Enquirer. This format introduced humour and increased accessibility. Visitors were guided through "safe surfing" and informed consent pages to the research oriented web conference. Over the course of the project we attracted 4000 site visitors and 32 web conference registrants.

The Heterosexism Enquirer was well received as a quality web site combining the serious with the humourous. Unsolicited feedback variously described The Heterosexism Enquirer as "amazing", "a triumph", and "fabulous". The following are typical of this enthusiasm:

I really love The Heterosexism Enquirer! I’ve been wandering around the site, and just finished looking through the Answers to Politically Incorrect Questions, which is a really terrific page.

The creativity and skill are quite evident even in quick run.. And it is FUN!!

One online journalist described the site as "elaborate spoof" put together by "a couple of very smart lesbians in Newfoundland". Further recognition of technical excellence came when research coordinator Lori Yetman was nominated as technodyke of the month for August 2000.

The content of the web conference from November 1999 to July 2000 formed a data base which we analysed to identify examples of heterosexism that impacted upon health and health care access. Participants shared their own stories about heterosexism, and gave suggestions and examples of how it can be remedied. Participants also used this safe space on the web to work out ways of negotiating their way through the world, exchanging information about gay positive spaces in our community and on the web. In analysis the web conference content was organized by communication strings, grouping together an initiating message and all responses to it. These strings were grouped by the month in which the initiating message was posted. Those registered in the web conference described a number of painful situations that show how heterosexism jeopardises well-being.

A lesbian came to emergency with serious abdominal pain. Asked whether she is "on the pill" she answered "no". In spite of her protests her doctor conducted an unnecessary and very painful internal examination to see if she was pregnant;

Income security programs in Newfoundland recognize only heterosexual couples, so that a same sex couple is required to apply as two single individuals;

Someone’s life partner was excluded from intensive care on the basis they are "friends" not family;

Gays and Lesbians found that living in rural Newfoundland generally means being "in the closet", and that isolation increased their risk for mental health difficulties. As one said, "living in rural Newfoundland is like drowning".

When they found their posters defaced or removed, gays and lesbians reported feeling discounted and even physically threatened. This was not good for their health and well-being.

Gay and lesbian young people found that heterosexism and homophobia in their schools encouraged them to drop out. If they stayed in school, they found themselves more vulnerable to mental health difficulties and even suicide.

A bank would not let a same sex couple open a joint bank account unless they identified themselves as "friends". The bank insisted that they were not spouses and that "partner" would be assumed to mean "business partner". These women felt angry and discounted.

A same sex couple could not get each other covered by health benefits programs at work, and had to pay more for coverage as two single individuals. This is contrary to the Canadian charter.

Gays and lesbians told us they found broadcaster Dr Laura’s supposedly expert advice to gays and lesbians to be "anti-gay." This could be directly damaging to gays and lesbians by increasing their internalised homophobia, and indirectly damaging by promoting homophobic community attitudes.

Heterosexist (and sexist) T-shirts were being worn on our university campus, creating a hostile and therefore unhealthy working and studying environment.

Anti-gay jokes and humour on campuses and in work places created a hostile environment in which students and workers were afraid to disclose their minority sexual orientation. Being closeted is not good for your mental health.

Anti-gay graffiti made sexual minorities sick - literally! For example, the word "faggot" spray painted on a house and mail box in a gay man’s neighborhood in St John’s made him feel very vulnerable and physically unsafe.

A transexual was denied hormone treatment to continue her transition from male to female by physicians who claim they lack the expertise. She felt trapped in the someone else’s body.

These examples show us that as "straight" social workers we need to know that heterosexism really hurts those who belong to non-heterosexual minorities - whether gay, lesbian, bisexual or transgendered. Therefore, in the course of this project we developed several strategies for successfully challenging heterosexism:

A "self test" questionnaire allows individuals to assess their own heterosexism. This was discussed on the web conference, and after revisions was posted on the web and published in hard copy.

Another "self test" questionnaire allows agencies to evaluate the heterosexist bias in their services. After feedback from those using the web conference, this was also made available on the web.

Positive space campaigns can reduce heterosexism by creating space in which sexual minorities feel welcome as themselves. Those using our "self test" questionnaires have begun a process that could lead to such a campaign. Clinics, offices, hospitals and nursing homes are all candidates for effective "positive space" campaigns. Such initiatives can be considered as part of quality assurance (Galea-Curmi and Hawkins, 1996), or accreditation.

The "gay straight alliance" model as promoted in schools in Nova Scotia and British Columbia is also promising. An alliance is created including both gay and lesbian members and straight members, who make the commitment to work together to challenge heterosexism and homophobia and to support members from sexual minorities. This model may be useful for human service workers’ organizations, such as unions and professional groups.

We continue to challenge heterosexism through our ongoing THEzine, The Heterosexism Enquirer. The site continues to provide materials from the research phase, including bibliographies, the final project report, our self-test questionnaires, our descriptions of "safe space campaigns" and "gay straight alliances" and even our PIQ page of answers to "politically incorrect" questions. These will be helpful curriculum resources for students in the health care professions, and in staff development for health care agencies. Resources will help professional associations and unions address the needs of sexual minorities among their own memberships, and the needs of sexual minorities seeking a healthy world and appropriate health care. We are developing our subscription list, attracting new contributors and publishing new issues three times a year. Current issues address gay marriage, spoof the old testament position on gay sex, and address the needs of gay and lesbian older people, particularly those in institutional care. The challenge to heterosexism in health care continues, and we encourage you to join our challenge.

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