“You have to do mental gymnastics to get any form of care”: How Two Spirit, lesbian, bisexual, trans, and queer women and gender-diverse people navigate racism and cisheterosexism in Canadian healthcare
Bibliographic record
Abstract
Access to healthcare is impacted by a range of factors, including assumptions about gender, sexuality, and race that are reproduced on individual and systemic levels. In this paper we show how cisheterosexism and racism shape healthcare access for Two Spirit and racialized lesbian, bisexual, trans, and queer women and gender diverse people in Canada. Drawing on findings from a broader community-engaged qualitative study focused on health and healthcare access experiences and priorities, we elaborate on how participants experienced barriers to equitable healthcare access in the form of queer erasure and assumptions; medical gaslighting; and denial and delay of care; while engaging in multiple forms of labour as resistance to access health care. Analyzing these experiences through lenses of biopolitics, structural racism, and cisheterosexism, we argue that the labour Two Spirit and racialized lesbian, bisexual, trans, and queer women and gender diverse people engage in to access care is best characterized as survival practices, in the face of oppressive systems.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.006 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.032 | 0.025 |
| Scholarly communication | 0.007 | 0.003 |
| Open science | 0.002 | 0.006 |
| Research integrity | 0.002 | 0.005 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".