Dual Identity Disclosure in Healthcare: Navigating Complex Needs for Inclusive Service Design

Why It Matters

Understanding the layered disclosure process is crucial for designing services that are genuinely inclusive. Current approaches often fail to acknowledge the cognitive and emotional burden of managing multiple identity disclosures, leading to user frustration and potential disengagement from essential services.

Key Finding

LGBTIQA+ individuals with disabilities find it challenging to navigate services because they have to repeatedly explain their intersecting identities, which can be exhausting and prevent them from fully communicating their needs. Strong community connections help them cope with these challenges.

Key Findings

• Participants experienced difficulties in managing and presenting their multiple identities (LGBTIQA+ and disability) to service providers.
• The repeated need to 'come out' in various contexts was a complex and layered process that hindered the full expression of needs and experiences.
• Community support played a vital role in fostering a sense of belonging, resilience, and capacity for health service navigation and advocacy.

Research Evidence

Aim: How do LGBTIQA+ individuals with disabilities experience the process of disclosing their multiple identities when accessing healthcare and community services, and what are the impacts of these experiences on their engagement with these services?

Method: Qualitative research

Procedure: Four focus groups were conducted with LGBTIQA+ individuals with disabilities to explore their experiences with healthcare and community services, specifically focusing on identity disclosure and its implications.

Sample Size: Not explicitly stated, but implied to be multiple participants across four focus groups.

Context: Healthcare and community services in Victoria, Australia.

Design Principle

Design for intersectionality: Acknowledge and accommodate the complex interplay of multiple identities in user experiences.

How to Apply

When designing any service that interacts with diverse user groups, consider how users with multiple, potentially marginalized identities will navigate disclosure and ensure that systems are built to be sensitive to these complexities from the outset.

Limitations

Findings are specific to the context of Victoria, Australia, and may not be directly generalizable to all geographical or cultural settings. The study relies on self-reported experiences, which can be subject to individual interpretation.

Student Guide (IB Design Technology)

Simple Explanation: People who are part of more than one minority group (like being both LGBTIQA+ and having a disability) find it hard when they have to explain all parts of who they are every time they try to get help. Services need to be better at understanding this and making it easier for people to get the support they need without feeling like they have to keep proving who they are.

Why This Matters: This research highlights that 'one-size-fits-all' inclusive design often fails. Understanding the specific challenges faced by individuals with intersecting identities is crucial for creating truly equitable and effective designs.

Critical Thinking: To what extent do current 'inclusive' design frameworks adequately address the complexities of intersecting identities, and what specific design interventions can mitigate the burden of repeated disclosure for users with multiple marginalized identities?

IA-Ready Paragraph: This research underscores the critical need for design practices that acknowledge and accommodate intersectionality. The experiences of LGBTIQA+ individuals with disabilities reveal that current service models often impose a burden of repeated identity disclosure, hindering effective access and support. Therefore, future design projects must prioritize the development of systems and protocols that proactively recognize and integrate multiple identities, thereby fostering genuine inclusivity and user-centered experiences.

Project Tips

• When researching user needs, actively seek out participants with intersecting identities to understand their unique challenges.
• Consider how your design might inadvertently create barriers for users with multiple marginalized identities.
• Involve users with diverse backgrounds throughout the design process, not just at the beginning.

How to Use in IA

• Use this research to justify the need for inclusive design practices that go beyond surface-level accommodations.
• Cite this study when discussing the importance of user research with diverse and intersectional populations.
• Incorporate findings on identity disclosure into your user personas and journey maps.

Examiner Tips

• Demonstrate an understanding of intersectionality in your design choices and justifications.
• Show how your design actively addresses the challenges of multiple identity disclosure.
• Ensure your user research methodology is inclusive and captures the experiences of diverse user groups.

Independent Variable: The process of identity disclosure within healthcare and community services.

Dependent Variable: User experiences, engagement with services, sense of belonging, and resilience.

Controlled Variables: Focus group setting, geographical location (Victoria, Australia), and the nature of the services being accessed.

Strengths

• Utilizes a qualitative approach to gain in-depth understanding of lived experiences.
• Involves peer researchers who share the identities of the participants, potentially fostering trust and richer data.
• Addresses a critical and often overlooked intersection of identities.

Critical Questions

• How can service design proactively build trust and reduce the need for repeated disclosure?
• What are the ethical considerations when designing for disclosure of sensitive personal information?
• How can community-building initiatives be integrated into service design to enhance user resilience?

Extended Essay Application

• Investigate the impact of identity disclosure on user experience in a specific digital service (e.g., a health app, a government portal).
• Design a prototype for a service that aims to reduce the burden of identity disclosure for users with intersecting identities.
• Conduct a comparative analysis of different approaches to inclusive design for intersectional user groups.

Source

Experiences of LGBTIQA+ People with Disability in Healthcare and Community Services: Towards Embracing Multiple Identities · International Journal of Environmental Research and Public Health · 2020 · 10.3390/ijerph17218080