How Identity Nonrecognition Shapes the Health Experiences of LGBTQ+ People

Abstract

Drawing on 40 interviews with LGBTQ+ people about their health experiences, we examine the consequences of identity nonrecognition—which occurs when mutual recognition of the situationally relevant identities for self and other in an encounter cannot be established—and discordance in the definition of the situation. We found that respondents experienced identity nonrecognition in two ways: (1) identity reductionism, or moments when providers leaned on medical authority, heteronormativity, and essentialist ideas to reduce their LGBTQ+ patients to biological entities, and (2) identity rejection, or interactional moments between patient and provider outside of medical decision-making when respondents asserted their gender and/or sexual identities mattered in the health encounter but found that providers rejected these identities. This work contributes to social psychological theories of identities and medical sociology scholarship by situating identity nonrecognition as an overlooked but important identity-relevant stressor, examining the importance of power differentials in defining the situation, and offering new conceptual tools for understanding the perpetuation of inequality.