Master of Science / Department of Family Studies and Human Services / Karen S. Myers-Bowman / There are three different approaches for the treatment of lesbian, gay, bisexual, transgender, questioning, and intersex (LGBTQI) sexual orientations: reparative therapies, gay-affirmative therapies, and person-centered approach. These therapeutic approaches will be discussed individually and Kitchener’s Model of Ethical Decision Making or Moral Justification will be applied to each of them with the purpose of identifying which is the most ethical. The American Association for Marriage and Family Therapy (AAMFT) scholars have not created guidelines for working with LGBTQI or made a clear stance on what they believe would be the best approach to take, therefore, clinical and ethical implications and recommendations for the field of marriage and family therapy will be discussed.

This study aims to contribute to the under-researched area of LGBTQI activism in the ‘Global South’ by performing a case study of LGBTQI activism in India, a country that provides an intriguing setting in which a wide range of sexual expressions has developed over time with attitudes towards them varying alongside. Same-sex activities have since the 1860s been considered a penal offence under Section 377 of the Indian Penal Code but in September 2018, the Indian Supreme Court overruled the law and decriminalized same-sex conduct. Within this context, frame analysis has been applied to six petitions by LGBTQI activists, filed to the Indian Supreme Court between 2016 and 2018, to unveil how Section 377 was framed by these activists. Results from the study show that Section 377 of the Indian Penal Code was framed as intrinsically discriminatory, being violative of constitutional as well as human rights, together with an emphasis on how the law relegates the LGBTQI community to second-class citizenship. Within the dominant framing of the law as discriminatory, the activists engaged in highlighting the imposition of Victorian morals by the British as the origin of the issue, along with factors that have enabled the perseverance of the issue, including the phrasing of the law and court failure to adapt to societal and international change. The subsequent consequences of the law were portrayed as stigmatization and personal losses for members of the LGBTQI community, as well as a negative impact on the state economy. By emphasising such aspects of the law, the activists advocated for the Indian Supreme Court to the overrule Section 377.

Bakgrund HBTQI-personer står för samma hälsoproblematik som övriga befolkningen. Däremot löper de större risk för depression, suicidalitet och ohälsa, såsom bröstcancer, analcancer och övervikt. Inom denna grupp används även beroendeframkallande substanser i högre grad. HBTQI-personer utsätts för sociala påfrestningar vilket påverkar det dagliga livet. Den osynlighet HBTQI-personer har i vården påverkar utkomsten av den medan vårdpersonal samtidigt uttrycker att okunskap finns för HBTQI-specificerad vård. Syfte Syftet var att belysa HBTQI-personers upplevelser av mötet med vården inom somatisk vård. Metod Denna icke-systematisk litteraturöversikt är utförd med en kvalitativ design där 15 vetenskapliga artiklar inkluderats. Sökordskombinationer i databaserna CINAHL och Pubmed användes för att inhämta artiklarna. Artiklarna kvalitetsgranskades utifrån ett bedömningsinstrument för att sedan genomgå en analys. I analysen skapades teman och subteman baserat på de olika artiklarnas resultat. Resulta tHBTQI-personer upplevde främst negativa upplevelser av vårdmötet. Heteronormativitet, bristande kunskaper i HBTQI-specifik vård och vårdkvalitet samt en oförmåga att bilda en tillitsfull relation till vårdgivaren var orsakerna till detta. Framgångsfaktorer i vårdmöte tvar när HBTQI-personer upplevde en personcentrerad vård där kommunikation, respekt, öppenhet, intresse och medkänsla upplevdes. Slutsats Samtliga artiklar påvisade negativa upplevelser av vårdmötet som övervägande. En utökad kunskap hos vårdpersonalen i HBTQI-specifik vård skulle kunna utmana de negativa upplevelserna HBTQI-personer upplever samt bjuda in till en mer välkomnande vård där kvalitet och kunskap finns men också en god kommunikation med öppenhet och intresse.

The aim of this thesis is to examine how LGBTQI people are represented in archives. This is done by studying how a municipal archival institution in southern Sweden captures and makes arcchival material concerning LGBTQI people available. The thesis is based on a qualitative case-study, where interviews and documents are used to collect data and to gain a deeper understanding of the respondents’ experience of representation in archives. Postmodern theory is used in the discussion and analysis to highlight the power and responsibility archival staff, political organisations and communities have and use in dealing with the struggles that is representation in archives. The result shows that records regarding LGBTQI people are not actively captured in the studied archival institution but used in several projects in 2021 due to both internal work with inclusion and external factors like an upcoming Pride event.

The purpose of this study is to see how present the heteronormative is perceived to be within Christian contexts in Sweden today. I have conducted an interview study with priests, pastors, and deacons who either belong to the Swedish Church or the Equmenia Church to get an insight into what their experiences are about norms connected to gender identity and sexuality. I have also included a perspective on the culture of silence that has been shown to be present in previous research to see if it is something the informants have noticed in their workplaces. The interviews have been of a qualitative nature and carried out semi-structured. The material on which the analysis is based is the experiences of the informants. The study's theoretical framework is based on Judith Butler's gender theory of heteronormative and what consequences this can have for those who do not fit into the template for how the norm says a person should be. The results show that heteronormativity is present in the Swedish Christian contexts today, but that there are many people who want to work so that everyone can feel welcome. All informants believe that silence arises in some way related to LGBTQI, even if not all mention a pronounced culture of silence. There is still much to do so that the church can be a safe place for all people, but there are people who want to work for a church that affirms the identities of all people.

Bakgrund: HBTQI personer är en minoritetsgrupp som historiskt sett har blivit diskriminerade och inte haft samma rättigheter som andra. Studier visade att många HBTQI personer möter diskriminering, fördomar och stigmatisering både i vardagen och även i kontakt med vården vilket ledde till psykiska problem som bland annat depression, ångest, självmordstankar och självmordsförsök. HBTQI personer berättade om rädslor att bli avvisade. Sjuksköterskans roll är att främja hälsa, återställa hälsa, förebygga sjukdom och lindra lidande. Syfte: Att belysa sjuksköterskor och sjuksköterskestudenters HBTQI kunskap för att vårda HBTQI personer. Metod: En litteraturöversikt som i resultatet utgår från tio vetenskapliga artiklar varav fyra var kvalitativa, fem kvantitativa och en av mixad metod. Resultat: Resultatet redovisas under tre teman: ”Kunskapsnivåer; upplevda och mätbara”, ”Konsekvenser av bristande kunskap, känslor och attityder” samt ”Kommunikation med HBTQI personer”. Första temat visade en genomsyrande brist av HBTQI kunskap inför att vårda HBTQI personer hos sjuksköterskor och sjuksköterskestudenter. Andra temat visade att bristande kunskap hade samband med negativa attityder och känslor av obekvämhet, vilket ledde till konsekvenser för vårdandet av HBTQI personer. Tredje temat visade att en brist på kunskap innebar bristande förståelse för hur man som sjuksköterska eller sjuksköterskestudent kommunicerar med HBTQI personer. Sammanfattning: Resultatet av denna litteraturöversikt visade att sjuksköterskor och sjuksköterskestudenter hade en både upplevd och mätbar brist på HBTQI kunskap inför att vårda HBTQI personer. HBTQI kunskap som saknades var relevant terminologi, information om hälsa och förståelse för hur man kommunicerar med HBTQI personer. Andra teman som kom upp i resultatet var påverkan av känslor och attityder mot HBTQI personer. Bristande HBTQI kunskap är delvis en konsekvens av brist på HBTQI fokus i läroplanen för sjuksköterskeutbildningar. / Background: LGBTQI people are a vulnerable minority who have historically been oppressed by society. Studies showed that many LGBTQI people face discrimination, prejudice, and stigmatization both in everyday life and in contact with healthcare, which lead to psychological problems such as depression, anxiety, suicidal thoughts, and suicide attempts. LGBTQI people talked about fears of being rejected. The role of the nurse is to promote health, restore health, prevent disease, and relieve suffering. Aim: To illustrate nurses' and nursing students' LGBTQI knowledge to care for LGBTQI people. Method: A literature review based on the results of ten scientific articles, of which four were qualitative, five quantitative and one from a mixed method. Results: The results are reported under three themes: “Knowledge levels; perceived and measurable”, “Consequences of lack of knowledge, feelings and attitudes” and “Communication with LGBTQI people”. The first theme showed a pervasive lack of LGBTQI knowledge around caring for LGBTQI people among nurses and nursing students. The second theme showed that a lack of knowledge was associated with negative attitudes and feelings of discomfort, which led to consequences for the care of LGBTQI people. The third theme showed that a lack of knowledge also meant a lack of understanding over how to communicate with LGBTQI people as a nurse or nursing student. Summary: The result of this literature review showed that nurses and nursing students had both a perceived and measurable lack of LGBTQI knowledge over caring for LGBTQI people. The LGBTQI knowledge that was missing was relevant terminology, information about health and understanding of how to communicate with LGBTQI people. Other themes that came up in the results were the influence of feelings and attitudes towards LGBTQI people. Lack of LGBTQI knowledge is partly a consequence of a lack of LGBTQI focus in the curriculum for nursing education.

The situation for sexual orientation, gender identity or expression (SOGIE) minority persons is difficult in many places and in much of Africa their lives are illegal in some form. This thesis focuses on how local organisations and European actors address this problem and what local actors believe could be done better to improve the situation for SOGIE minorities. This includes mapping the work conducted by the actor groups and how it intersects. An abductive, qualitative, desk study has been conducted studying the internet presence of relevant organisations. The main data sources have been the websites of the organisations, but other resources have been used for more nuance. The thesis used postcolonial theory and a human rights framework. Postcolonial theory explains some of the actions taken by African governments but also sheds light on the power structure between the African and European organisations. The findings underline that there are improvements in the relationship between the two groups compared to previous literature on the topic, including better dialogues, more local control in projects and some efforts to fund the organisations’ functional needs. However, the local organisations still feel that too much money and decision making power go to Western actors. The local organisations often focus on economic stability, health and legal assistance, as well as research about the groups they are working with and attempting to influence governments and improve local perceptions. The European organisations also focus on health, legal and economic assistance as well as media training and security.

Bakgrund: Äldre personer har större risk att drabbas av sjukdom vilket innebär ett ökat behov av omvårdnad. Hbtqi-personer världen över riskerar att utsättas för diskriminering samt upplever sämre hälsa än jämnåriga heterosexuella cispersoner. Sjuksköterskor upplever sig ha en bristande kunskap om hbtqi-personers specifika omvårdnadsbehov. Syfte: Syftet var att belysa äldre hbtqi-personers upplevelser av omvårdnad. Metod: En allmän litteraturöversikt genomfördes med induktiv ansats där 14 kvalitativa artiklar och en artikel med mixad metod analyserades vilket resulterade i fyra kategorier. Resultat: Kategorierna som framkom var: Upplevelser av diskriminering, Upplevelser av okunskap hos vårdpersonal, Upplevelser av att tillämpa strategier samt Upplevelser av inkludering. Resultatet visade att äldre hbtqi-personer hade både positiva och negativa upplevelser av omvårdnad. Faktorer som bidrog till upplevelser av diskriminering och upplevelser av okunskap hos vårdpersonal var heteronormativt förhållningssätt, bristande utbildning samt fördomar. Olika strategier tillämpades för att undvika diskriminering. Trots tidigare negativa erfarenheter av omvårdnad upplevde flertalet äldre hbtqi-personer inkludering av vårdpersonal. Empati och respekt var egenskaper hos vårdpersonalen som bidrog till en god relation och därmed god omvårdnad. Konklusion: Äldre hbtqi-personers upplevelser av diskriminering visar på att hälso- och sjukvården inte är jämlik. För att öka inkluderingen krävs ökad kunskap om äldre hbtqi-personers omvårdnadsbehov. / Background: Elderly people are at greater risk of falling ill, which means an increased need for nursing care. LGBTQI-persons worldwide are at risk of being discriminated against and experience poorer health than heterosexual cis people of the same age. Nurses feel they have a lack of knowledge about the specific nursing needs of LGBTQI-persons. Aim: The aim of this study was to shed light on older LGBTQI-persons’ experiences of nursing care. Method: A general literature review was conducted using an inductive approach where 14 qualitative articles and one mixed method article were analysed which resulted in four categories. Results: The categories that showed were Experiences of discrimination, Experiences of ignorance in healthcare workers, Experiences of applying strategies and Experiences of inclusion. The results showed that elderly LGBTQI-persons had both positive and negative experiences of nursing care. Factors that contributed to experiences of discrimination and experiences of ignorance among healthcare workers were heteronormative attitudes, lack of education and prejudice. Various strategies were applied to avoid discrimination. Despite previous negative experiences with nursing care, most elderly LGBTQI-persons experienced inclusion by healthcare workers. Empathy and respect were qualities of the healthcare workers that contributed to a good relationship and thus good nursing care. Conclusion: Elderly LGBTQI-persons experiences of discrimination show that the healthcare system is not equal. To increase inclusion, increased knowledge of elderly LGBTQI-persons nursing care needs is required.

Introduktion: HBTQI-personer har genom historien blivit diskriminerade och kränkta, och har sämre erfarenheter av vården jämfört med heterosexuella och cis-personer. Distriktssköterskans uppdrag är bland annat att arbeta för god och säker vård, och ska ha god kännedom om de kulturella och sociala skillnader som påverkar hälsan. Syfte: Studiens syfte var att undersöka distriktssköterskans uppfattningar om att möta HBTQI-personer. Metod: Studien genomfördes som en empirisk studie där distriktssköterskor intervjuades, och där datan sedan analyserades utifrån kvalitativ innehållsanalys. Resultat: Tre huvudkategorier framkom i dataanalysen - Förutsättningar för ett gott bemötande, Ett personcentrerat bemötande, och Distriktssköterskans perspektiv på HBTQI-patienten.  Konklusion: Det finns goda intentioner hos distriktssköterskan kring att ge ett gott bemötande och en personcentrerad vård till HBTQI-personer. Dennes egenskaper, arbetssätt och språk har stor betydelse. Det krävs specifik kompetens och kunskap för att ge ett gott bemötande till HBTQI- personer, något som saknas både kliniskt och i utbildningar. / Introduction: Throughout history, LGBTQI individuals have faced discrimination and mistreatment, experiencing poorer healthcare outcomes compared to heterosexual and cisgender individuals. One of the district nurse's responsibilities is to work towards providing good and safe care, requiring a thorough understanding of the cultural and social differences that impact health. Aim: The study aimed to explore district nurses' perceptions of interacting with LGBTQI patients. Method: The study was conducted as an empirical investigation, involving interviews with district nurses. The collected data were then analyzed using qualitative content analysis. Results: Three main categories emerged from the data analysis - Preconditions for a good reception, A person-centered approach, and The district nurse's perspective on LGBTQI patients. Conclusion: District nurses express positive intentions towards providing a welcoming and person-centered care for LGBTQI patients. The nurse's qualities, approach, and language play a significant role. Specific competence and knowledge are required to ensure a positive interaction with LGBTQI patients, an aspect currently lacking in both clinical practice and education.

This thesis is a Minor Field Study carried out in Cape Town, South Africa, during March - May 2022. South Africa is suffering a high level of sexual and gender-based violence. LBGTQI people are extra vulnerable when it comes to sexual and gender-based violence, especially when it comes to corrective rapes. The aim of study was therefore to investigate how people from the LGBTQI community in South Africa understands the problem with sexual and gender-based violence and how they perceive that the Government is addressing these issues. To answer our three research questions, we used focus group interviews to gather data. Our research shows that the sexual and gender-based violence is a widespread phenomenon and is affected by intersectional inequalities. Even though South Africa by law has forbidden any discrimination based on sexuality after abolishing the Apartheid regime, there still seems to be a gap between what the Government is constituting and what the citizens, institution, and society values.