When I first introduced the framework for Creating a Safe and Caring Health Care Context, I was thinking about providers caring for patients. Then I thought, if it works in the provider-patient context, why can't we as WSW use it on ourselves to provide a safe, caring, and loving environment for our own beings?
For a fuller explanation of cultural safety, please visit the What is Cultural Safety? page.
When used in health care, cultural safety is a way of providing a safe space for your patients to feel they are seen and affirmed for who they are. A safe environment for a patient provides an ideal space for healing, growth, and wellness. In the company of my graduate committee, I developed a framework consisting of 4 elements for providers to approach cultural safety. The elements are: reflection, environment, language, and knowledge. I envision them as a Venn diagram. Each element in and of itself is wonderful. But at the center, where the four elements all intersect, is where true cultural safety is, and it cannot exist without all the elements present at once.
If we think about self love and acceptance being at the center of the Venn diagram, and use the 4 elements mentioned above, but use them focused inwards toward ourselves instead of using them in health care for a patient, I believe we can make big strides in acceptance of self-love, happiness, and health.
Reflection, is not a one time event. It is an ever-evolving process. It is examining your beliefs. And, in this case, your beliefs about yourself. How do you feel about your sexuality? What does it mean to you that you are a sexual minority? How do you feel about your body? Your career? What parts of your life make you feel expanded? Small? This is a time-intensive element of the process and may feel overwhelming at first. There is no judging allowed in this element, either. If you feel judgmental, fine. Notice it. And keep reflecting.
One way to make this element more concrete is to do an automatic writing response. The Fenway Guide to LGBT Health suggests that providers think of a term and then write down their reactions to the term. For example, think of the word "woman," and write down your reaction. Or "lesbian," "dyke," "trans," "heterosexual," "homosexual," etc. Your first, unfiltered, emotional reactions to the words you use to identify yourself (or do or do not want to use to identify yourself) tell you a lot about your core beliefs.
In reflection, there is no "assignment," other than noticing. Notice your reaction -- and keep noticing. We invite health care providers to reflect so they can be aware of possible biases they might be holding onto. And you can be aware of beliefs you are holding onto about yourself, whether you approve of your own beliefs or not.
For providers, 'environment' means providing you as the patient with a physical space that makes you feel welcome, safe, and comfortable. For example, displaying a non-discrimination poster in the clinic or LGBT-friendly symbols, showcasing pictures of LGBT couples, and/or offering LGBT-friendly reading material.
For you, on a quest for self love, 'environment' means setting up your physical space to make yourself feel loved, safe, and comfortable. A safe and caring environment will look and feel different for each of us. It might look like taking time for a bath, exercise, or a walk. Keeping a clean house, spending time outdoors, going for a drive in your car, or going on a bike ride. Even taking a nap with freshly-laundered sheets.
Pay attention to your senses. What smells good to you, feels good, tastes good, sounds good, looks good? Focus on these things. Nurture what feels good to you.
The language health care providers use with patients is of utmost importance. We suggest avoiding heterosexist language or language that implies bias and makes assumptions. Instead, we teach using open, non-assuming language.
What kind of language are you using with yourself? Do you continually judge yourself, and beat yourself up for not being thinner? For not being good enough? For _____? Most people, whether or not they are conscious of it or not, have negative self-talk running through their minds. Changing those habits by using loving language with yourself, even if you feel like you are "faking" it at first, is the way to self-acceptance. Louise Hay is a trail-blazer and an inspiring example of how you can heal your life by using affirmation. In the documentary Hungry for Change, Dr. Christiane Northrup discusses the physical benefits of using affirmations (improved heart and lung function, improved hearing, and much more).
Affirmations work because, over time and done consistently, they re-wire your brain.
This is a "fake it 'til you make it" idea. Standing naked in front of the mirror and saying, "I love myself. I am safe," is one example of an affirmation. Working to notice and then transform your negative thoughts about yourself into something loving and accepting will go a long way for you.
When talking with providers about cultural safety, having knowledge about the specific population is important. For providers serving the WSW population (which is really all providers), understanding WSW health risks including common health issues, mental health, cancer risks, health disparities, and recommendations for excellent care, are all part of being knowledgeable. Having a skill set and understanding your patients' needs and health care risks is an essential part of providing culturally safe care.
When approaching cultural safety for yourself, it may help to think of knowledge in an objective way at first. Looking at yourself as a whole person (not just a sexual minority) and learning about your physical health, mental health, emotional, and spiritual health are all parts of being knowledgeable.
You can do this by accessing available resources. While there is not a huge body of research available yet on the WSW population and its physical, emotional, and mental needs/risks, accessing the information that is available will serve you greatly.
As they say, knowledge is power, and if you know your health risks and what to do about them, you'll be ahead of the game. One example: WSW women tend to have higher weights than heterosexual women. Learning about why this may be true and learning about nutrition, a healthy lifestyle, and support networks available are all ways to use knowledge for self-care.
With reflection, environment, language, and knowledge that are all focused on self-love and acceptance of self, you'll be well on your way to a happier, healthier life.
Providing cultural safety for yourself is an ongoing way of life, rather than an exercise or something you can cross of your To Do list. However, if you are willing to invest in it, your returns will greatly outweigh your investment.
Makadon HJ, Mayer KH, Potter J, Goldhammer H, eds. (2007). Fenway Guide to Lesbian, Gay, Bisexual and Transgender Health. Philadelphia: American College of Physicians Press.
In the comments, I'd like to hear from you:
How do you provide cultural safety for yourself? What obstacles, if any, do you face trying to do so? Is this a new way of thinking for you or is it something you've been doing for awhile?