The Binary Order of Things: A Discursive Study of Nursing Students’ Talk on Providing, and Learning About, LGBT Patient Care

ABSTRACT

Against the backdrop of the healthcare inequities and maltreatment facing LGBT patients, recommendations have been made for the inclusion of LGBT health topics in nursing curricula. Based on data collected in focus group discussions with South African nursing students, we complicate the assumption that training focused on health-specific knowledge will effectively reform providers’ prejudicial practices. Findings reveal ambivalence: silence and discrimination versus inclusive humanism. Participants drew on discourses of ignorance, religion, and egalitarian treatment to justify their inadequacy regarding LGBT patients; while doing so, however, they deployed othering discourses in which homophobic and transphobic disregard is rendered acceptable, and “scientifically” supported through binary, deterministic views of sexuality and gender. Such “expert” views accord with Foucault’s notion of “grotesque discourse.” We conclude with a discussion of the findings’ implications for nursing education; we call for the recognition and teaching of binary ideology as a form of discursive violence over LGBT lives.

KEYWORDS:

• Discursive violence
• education
• grotesque discourses
• homophobia
• LGBT health
• nursing
• sexuality and gender binaries
• transphobia

Acknowledgments

The authors thank: the student nurses who gave of their time in participating in the focus group discussions; the University where the data were collected for permission to do so; the three peer-reviewers of this paper for their supportive and useful input.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1. The interviewer did not ask participants to explicitly self-identify in terms of sexuality or gender. Nothing in the transcripts suggests that the participants identified as anything other than cisgender and heterosexual.

Additional information

Funding

This work is based on research supported by the South African Research Chairs Initiative (SARChI) of the Department of Science and Technology and the National Research Foundation of South Africa under Grant [number 87582].