The Insulation of Heteronormativity and Inequity By the Medical System

As a society, we are taught from a young age to believe that racist, classist, sexiest and other such acts of bigotry and discrimination have been purged from society and the public consciousness as a whole, and are rather remnants of a more primitive, less educated state. However, as ubiquitous and idealistic as this belief is, it is a romanticized construct established by the hegemonic power structures which have, in turn, established a false consciousness within society and an erroneous understanding of the discrimination and inequality that currently pervades culture. This construct is exemplified, with eerie eloquence, in the story of baby Bay, a baby girl born to partners Krista and Jami.[i] Upon Bay’s first check up at six days of age, it was discovered that their agreed upon doctor, Dr. Roi had decided to refuse to take Bay on as a patient as a result of her mothers’ sexual orientation.[ii] The birth of a child is generally an overwhelmingly joyous event, one that is pervaded by themes of exultation, jubilation and glee. However, in the case of Bay, her first exposure to the world was one riddled by overt heteronormative, heterosexist and marginalizing scripts.[iii] It is in relation and response to such overt and blatant examples of the detrimental and destructive influence that heteronormative and heteropatriarchal power structures have on people’s lived experiences that a critical analysis and adjudication of these systems is needed in order to bring about vitally needed change.

It is easy to look at this example as an isolated incident in which an individual doctor acted in accordance to her own personal beliefs, and by doing perpetuated heteronormative and heterosexist rhetoric. This example is, however, illustrative of the greater non-inclusionary paradigm and systemic issues which ruminate about the medical system. The case of Bay is illustrative of the systemic and insulated heteropatriarchal, heteronormative and cisgender rhetoric that is situated in the current medical system, particularly in the American Medical Association (AMA) ethos.[iv] [v] The AMA code is one riddled by ambiguity and seemingly apparent contradictions. On one hand, it actively prevents discrimination based on sexual orientation or preference; that is, a physician is unable to negate treatment on the grounds of one’s sexual orientation.[vi] [vii] However, a physician can withhold treatment if they feel that the patient’s character is at odds with their own ethical, spiritual or moral principles.[viii] [ix] First and foremost, this established clause in AMA rhetoric re-enforces the established power structure, and in turn neo-liberal, classist and educational scripts as it confers an unequal power relationship between doctor and patient. That is, in order to obtain treatment and help, at times in dire circumstances, one may be required to conform to normalized and standardized scripts, in order to obtain help. This apparent choice that a doctor has, in regard to being able to selectively choose who is eligible for care, further exemplifies the institutionalized nature of patriarchal, cisgender, heteronormative power structures in the medical system and culture as a whole.

As troubling as this is, the larger concern lies in the degree of insulation and allotted protection and manipulation that exists, at every level of society. In the case of baby Bay, the right of Dr. Roi to refuse to take her on as a patient, was understood in accordance to her rights as a physician as allotted by the AMA.[x] However, this justification doesn’t hold true – that is, Bay was refused treatment based on association, rather on an apparent character flaw, as dutifully noted by Bay’s mothers, in that she has no known sexual orientation at this point.[xi] Thus, the idea that Dr. Roi was within her right to refuse such treatment in accordance to AMA protocols is erroneous, but rather illustrative of the continual protection that the heteronormative, heterosexist system allots in an attempt to secure the perpetuity of the pervading ideology and power structures.[xii] What is even more irksome and exemplary of the insulated nature of the established ideological apparatuses is the qualification that Dr. Roi gave Fox News when asked to comment on the events which had unfolded in respect to baby Bay, with her citing doctor patient confidentially as her inability to comment on the case, even though she blatantly refused to take Bay on as a patient.[xiii]

This case exemplifies not only the institutionalized heteronormative and heterosexist scripts that persist in the medical system but further poignantly determines the insulated nature of the cultural hegemony that pervades society. Critical analysis of the iconography and prescribed righteousness and sanctity allotted to the medical field is necessary in order to be able to aptly and accurately understand the disparaging and disenfranchising mechanisms which adversely affect individual’s lived experiences.

~ Elin

Bibliography

[i] “Doctor Refuses Treatment of Same-Sex Couple’s Baby,” myFOXdetroit.com 18 Feb. 2015.

[ii] “Doctor Refuses Treatment of Same-Sex Couple’s Baby,” 2015.

[iii] “Doctor Refuses Treatment of Same-Sex Couple’s Baby,” 2015.

[iv] “Doctor Refuses Treatment of Same-Sex Couple’s Baby,” 2015.

[v] America, American Medical Association, AMA Policies on LGBT Issues, H-65.992 Continued Support of Human Rights and Freedom.

[vi] American Medical Association, AMA Policies on LGBT Issues.

[vii] “Doctor Refuses Treatment of Same-Sex Couple’s Baby,” 2015.

[viii] “Doctor Refuses Treatment of Same-Sex Couple’s Baby,” 2015.

[ix] America, American Medical Association, AMA’s Code of Medical Ethics.

[x] “Doctor Refuses Treatment of Same-Sex Couple’s Baby,” 2015.

[xi] “Doctor Refuses Treatment of Same-Sex Couple’s Baby,” 2015.

[xii] “Doctor Refuses Treatment of Same-Sex Couple’s Baby,” 2015.

[xiii] “Doctor Refuses Treatment of Same-Sex Couple’s Baby,” 2015.

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8 thoughts on “The Insulation of Heteronormativity and Inequity By the Medical System

  1. Moira

    Hi Elin – thank you for your post! You were the only one who looked at this article, so I was excited to hear your thoughts. I really liked your analysis of the AMA code of conduct. It is true that physicians can abstain from treating individuals based on personal values and ideals. This sort of argument has held for physicians who are pro-life, and do not want to perform abortions, and clearly has been extended to the utmost of prejudiced absurdity in this example. This is an issue that truly fascinates me as a graduating student in the process of applying to medicine. It makes one realize how institutionalized homophobia and sexism are; indeed, Daniel Vena even told us in last week’s lecture that the psychiatrists in Kingston refer trans-identifying individuals to a form of gender conversion therapy. Then again, there are times when this power to refuse treatment based on principle is more appealing – for me, performing non-religious infant circumcision seems objectionable (and non-consensual…) so I would be able to refuse this on the basis of my own morals.
    I wonder: how do you think the AMA code might be changed to uphold the rights and freedoms of doctors, but also work against the facilitation of institutional homophobia (racism, transphobia, misogyny, poverty prejudice, etc.)?

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    1. Elin

      Hi Moira!

      I feel that one change that could be made to the AMA code which might uphold the rights and freedoms of doctors, but also work against the facilitation of institutional homophobia, is to introduce some sort of council or board to oversee such cases where the doctors morals or ethics are resulting in them not wanting to treat a patient. In this way, hopefully discriminatory thinking will be curbed.

      Thanks!

      ~Elin

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  2. Rosa Queen

    Hi Elin,
    As always, your piece was provocative and eloquent, using researched topics in order to better prove your point. I liked how you brought up that the AMA is allowed to refuse treatment on the grounds of the patient’s character not conforming with the ethics or belief of the doctor. This clause, used multiple times before in such cases is seen in a different light in this article, as the patient was not at odds with the beliefs of the doctor. Baby Bay, being only six days old and having no sexual preference apparent yet, was refused treatment on the grounds of her association with lesbian parents. This exemplifies how far society has alienated the LGBTQ community, where simply being associated with such individuals is enough to be treated differently. The absurdity of this case to the public shows us that although we would like to think that our society is free of discrimination, it is being clearly enforced, not only in the general public but also in the medical community. The shocking part of this case is due to the emphasis we place on the medical system to serve our well being and health. When this system then goes to deny members of our society this much needed care, we see the true dark underbelly created by discriminatory, patriarchal, cisgender and heteronormative power structures, especially in institutionalized settings such as the medical system. My question to you is since this type of thinking and discriminatory practices is common in institutional settings, how can we ensure that patients are given the treatment they deserve without analysis of their intersectionality?

    Thanks again for a great post
    -Rosa Queen

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    1. Elin

      Hi Rosa Queen, thanks for your thoughtful response. I should probably preface this response by stating that I am, by no means, any sort of expert on this subject, and the politics and bureaucracy of the medical system are far beyond my scope of expertise. With that being said however, I believe that one way in which the medical system’s functioning could be altered to ensure that patients are given the treatment they deserve without analysis of their intersectionality, while at the same time protecting the rights of the doctors, is to have some sort of board or council which would have to oversee such cases. In that way, hopefully discriminatory thinkings of one individual could not hinder any persons ability to get treatment.

      ~Elin

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  3. gndsgirl11 Post author

    Hi Elin

    I found this response to the video very interesting. I watched the video myself before writing my own blog, and found it to be very interesting given the fact that the doctor would not help Bay due to her having two mothers. I had only ever heard of the law in Michigan stating that doctors have the right to refuse treatment on patients if their sexuality does not conform to their religious beliefs. When I heard of this law, my first thought was how they would be able to tell the sexuality of a person just by looking at them. I suppose sometimes one can tell, but at the same time it is impolite and ignorant to judge someone based on how they are dressed. In my opinion, I believe that giving a doctor this right is only continuing to force the belief that member of the LGBTQ community are morally harming other, and it is only furthering the ignorance surrounding the community. I believe that issues like this need to be put to end in order for acceptance to be furthered worldwide. Based on your research and this video, do you think it is possible for the LGBTQ to ever be fully accepted into society? What measures need to be taken in order to ensure further acceptance?

    Thank you for your input, and I appreciate further blog posts and comments from you.
    – gndsgirl11

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    1. Elin

      HI gndsgirl11, thank you for your response. The intent of the AMA code is, without a doubt, to act as both an ethical and moral tool which protects the rights of both patients and doctors, and is not fundamentally situated about the exclusion or discrimination of any individuals based on religion, sexuality, socioeconomic status, etc. However, the right of a doctor to refuse treatment based on moral grounds has led a few doctors to abuse the intent of the code, and in this case, refuse treatment to baby Bay. That being said, I do think that it is absolutely possible for the LGBTQ community and individuals to be fully accepted into society. This case highlighted the flaws that still exist in the system, but it also showcases the societal response to such actions and the unwavering support of the LGBTQ community.

      ~Elin

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  4. Darkling

    Hi Elin,
    As you were the only person to analyse this particular article, I was very excited to see what you said, and you did not disappoint! This article is the one that, in my opinion, did the least to place the story within a larger social context. That definitely put more responsibility on you to contextualize an individual incident within a broader framework of injustice. Your analysis of the role of the AMA code, and its role in upholding systemic injustice was really fascinating, and you did a good job in challenging the adherence of Dr. Roi’s actions to that code.

    I find that the medical field is often upheld as being inherently good, and is not examined critically on a regular enough basis. Do you think that medical practitioners like Dr. Roi inadvertently help to combat oppressive tendencies within that field by calling attention to the degree to which personal bias influences medical professionals? Certainly, that does not justify his homophobia: still, it is interesting to consider how public examples of medical discrimination may be able to shed light on institutionalized oppression in the medical community, and by extension, to all fields deemed “objective” within our social narrative. As someone who is queer and autistic, I have experienced a lot of microaggressions from medical professionals regarding both my sexual identity and my neurotype. Often, doctors and nurses make assumptions about my sex life that result in them giving me substandard care. The assumption that I was engaging in penis-in-vagina sex with a cis man, for example, is routinely made if I express that I am sexually active, and this has resulted in me being sent for the wrong checkups and procedures. It is also frustrating that I have to constantly correct the assumption of my heterosexuality: while I am fortunate to never have encountered a doctor as overtly homophobic as Dr. Roi, it is still an anxiety I experience every time I have to see a new doctor at a clinic–I always run the risk of facing bigotry or violence when disclosing my sexual orientation. In terms of being autistic, I have had doctors compliment me on “passing as normal,” on being “high-functioning” (an inherently ableist term), and once, a doctor actually asked me “do you feel emotions or care about people?” When I responded that I did, she informed me that I couldn’t really be autistic, because autistic people were not capable of experiencing emotions or love. All this is to say that the medical community is a huge perpetuator of hegemonic power structures, while also being given unprecedented license over the lives of marginalized people.

    I know this is a tough question with no easy answer, but what do you think can be done to curb the discrimination and bigotry within the medical community so that marginalized people can safely access health care? What kind of education or laws could help?

    Thank you for writing this! It was really interesting and raised a lot of important points!

    -Darkling

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    1. Elin

      Hi Darkling,

      Thank you for yet another thoughtful response! I think that one of the first needed steps to combating the discrimination and bigotry within the medical community is to acknowledge, as a society, its existence and as you alluded to earlier, realize that the medical system is not without fault. The medical system is, fundamentally, a product of culture and is thus predisposed to the same institutionalized constructs that plague society as a whole, however the medical system is herald as inherently good and righteous. It is because of this universal trust and faith in the morality of the medical system, and in turn doctors, that I believe the discrimination and bigotry that exists is not as heavily questioned.

      ~Elin

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