Healthcare and Social-Services Institutions in the Face of Radical Differences

Abstract

When people at risk of discrimination on multiple grounds or experiencing identity-based oppression meet healthcare and social services, their complex life stories often result in mistrust and prejudice. The aim of this article is to show how individuals themselves locate their multiple dimensions of difference in specific situations and contexts and how they perceive the ways in which healthcare and social services encounter them. We further point out how the different social divisions are enmeshed with and influenced by each other in given situations and contexts. The article points out that dynamics of mistrust and prejudice can not be overcome by treating people equally, as that approach would require abstracting from individuals’ specificities and ignoring asymmetries in the relationship between institutions and their clients. As the article shows, what is required instead is a practice of creating trust and responding to individual differences societies produce. Methodologically, we worked with in-depth interviews conducted with 22 persons in the Geneva region (during 2012) who possessed at least two categories of difference related to their sexual orientation, their physical and psychological abilities, and/or their origins. The number of interviewed people was determined by the logic of saturation. Based on these 22 in-depth interviews with people at risk of discrimination on multiple grounds and experiencing identity-based oppression, this study describes dynamics of incomprehension between them and healthcare and social services and how they might be overcome.