As we discuss in Chapter 1, SGM patients come from all backgrounds and reflect multiple identities. For example, SGM patients may live in rural or urban areas, have varying socioeconomic statuses, and come from distinct cultural or religious backgrounds. Being aware that the majority of people hold multiple social identities is necessary. Indeed, acknowledging how our identities influence our life and health is vital for understanding individual patients. From an equity perspective, understanding multiple social identities allows us to consider how to provide clinical services with a uniform outcome (e.g., patient satisfaction) rather than only giving uniform services. Using an intersectionality approach, we can begin to understand how different social categorizations (e.g., race, religion, gender)—and the privileges and oppressions afforded to each—overlap to create interdependent systems of disadvantage.9 Of note, oppression and disadvantage may present in different ways for different social identities. For example, some groups may be more likely to experience harassment and discrimination, whereas others may experience erasure and neglect.
Figure 4.2 highlights the many aspects of self that make up an individual’s identity. As you look at these identities, consider how these may contribute to systems of oppression and privilege in primary care.
Figure 4.2. Aspects of Identity