title: Exiting the closet daily: Examining the repetitive nature of minority gender and sexual identity self-disclosures.

authors: Stanley, Jessica

subjects: identity

abstract: The process of minority gender and sexual identity self-disclosure is inherently complex. The act of ‘coming out’ is often perceived as a significant, singular event; however, those with lived experiences recognise that it is an ongoing, repetitive experience influenced by varying social contexts—a concept referred to within this research as identity maintenance. Understanding this phenomenon is paramount in addressing the psychosocial realities of LGBTQIA+ people—both individually and collectively—as they navigate the decision to disclose their minority identity in a range of environments, contexts, and interactions. Specifically, this thesis seeks to illuminate the processes of identity maintenance within the context of Aotearoa New Zealand, providing a foundational understanding of the lived experiences of LGBTQIA+ individuals. To do so, five research questions were constructed, these include: 1. How do participants interpret their experiences of identity self-disclosure or non-disclosure? 2. What social factors influence the decision to self-disclose minority gender and/or sexual identity? 3. How does the repetitive nature of identity self-disclosure affect participants? 4. How does identity self-disclosure vary in different social environments? and 5. How does language shape identity self-disclosure? This research utilises Interpretive Phenomenological Analysis (IPA) to analyse qualitative data gathered from a cohort of 10 self-identifying LGBTQIA+ participants. By focusing on lived experiences, the research captures the psychosocial factors involved in self-disclosure practices. Participants were selected through a purposive sampling method, ensuring a range of backgrounds and identities were represented, including age, ethnicity, neurological and physical ability, and religious status. Semi-structured face-to-face interviews were conducted with each of the 10 participants, and five participants elected to complete a diary entry task following their interview. Participants described navigating their LGBTQIA+ identities across different contexts, drawing on a range of psychosocial tools in their day-to-day practice of identity maintenance. Four themes arose from the findings. Firstly, The Temporality of Identity highlighted how the LGBTQIA+ identity is experienced over time, from early identity development to the long-term, ongoing practice of identity maintenance. Secondly, The Tax of Identity theme identified how participants experienced mental, emotional, and educational taxes as a result of their LGBTQIA+ identity. Thirdly, The Ecology of Identity theme identified the ways in which participants experienced effects from distal and proximal environments on the development and embodiment of their LGBTQIA+ identities. Finally, The Language of Identity theme highlighted how participants engaged with both verbal and non-verbal forms of communication to disclose their LGBTQIA+ identity as well as the social monitoring tools they utilised in disclosure decision-making. The findings of this thesis contribute to existing discourse on LGBTQIA+ identities and form the first known literature on the identity maintenance experiences of Aotearoa’s LGBTQIA+ community. Ultimately, this research highlights the ways in which identity maintenance serves as a beneficial tool for restoring the agency of LGBTQIA+ people in choosing when, where, how, why, and to whom identity self-disclosures will be made.

text: Exiting the closet daily: Examining the repetitive nature of minority gender and sexual identity self-disclosures. The process of minority gender and sexual identity self-disclosure is inherently complex. The act of ‘coming out’ is often perceived as a significant, singular event; however, those with lived experiences recognise that it is an ongoing, repetitive experience influenced by varying social contexts—a concept referred to within this research as identity maintenance. Understanding this phenomenon is paramount in addressing the psychosocial realities of LGBTQIA+ people—both individually and collectively—as they navigate the decision to disclose their minority identity in a range of environments, contexts, and interactions. Specifically, this thesis seeks to illuminate the processes of identity maintenance within the context of Aotearoa New Zealand, providing a foundational understanding of the lived experiences of LGBTQIA+ individuals. To do so, five research questions were constructed, these include: 1. How do participants interpret their experiences of identity self-disclosure or non-disclosure? 2. What social factors influence the decision to self-disclose minority gender and/or sexual identity? 3. How does the repetitive nature of identity self-disclosure affect participants? 4. How does identity self-disclosure vary in different social environments? and 5. How does language shape identity self-disclosure? This research utilises Interpretive Phenomenological Analysis (IPA) to analyse qualitative data gathered from a cohort of 10 self-identifying LGBTQIA+ participants. By focusing on lived experiences, the research captures the psychosocial factors involved in self-disclosure practices. Participants were selected through a purposive sampling method, ensuring a range of backgrounds and identities were represented, including age, ethnicity, neurological and physical ability, and religious status. Semi-structured face-to-face interviews were conducted with each of the 10 participants, and five participants elected to complete a diary entry task following their interview. Participants described navigating their LGBTQIA+ identities across different contexts, drawing on a range of psychosocial tools in their day-to-day practice of identity maintenance. Four themes arose from the findings. Firstly, The Temporality of Identity highlighted how the LGBTQIA+ identity is experienced over time, from early identity development to the long-term, ongoing practice of identity maintenance. Secondly, The Tax of Identity theme identified how participants experienced mental, emotional, and educational taxes as a result of their LGBTQIA+ identity. Thirdly, The Ecology of Identity theme identified the ways in which participants experienced effects from distal and proximal environments on the development and embodiment of their LGBTQIA+ identities. Finally, The Language of Identity theme highlighted how participants engaged with both verbal and non-verbal forms of communication to disclose their LGBTQIA+ identity as well as the social monitoring tools they utilised in disclosure decision-making. The findings of this thesis contribute to existing discourse on LGBTQIA+ identities and form the first known literature on the identity maintenance experiences of Aotearoa’s LGBTQIA+ community. Ultimately, this research highlights the ways in which identity maintenance serves as a beneficial tool for restoring the agency of LGBTQIA+ people in choosing when, where, how, why, and to whom identity self-disclosures will be made.

year: 2024

title: Health literacy: Patients' texts, context and mediation

authors: Balmer, Deborah G. Ballantyne

subjects: Health literacy

abstract: Health literacy encompasses people’s knowledge, motivation and competences to access, understand, appraise and apply health information to make judgments and take decisions in every-day life concerning health care, disease prevention and health promotion (Kickbusch et al., 2013).  Research in health literacy has grown in prominence as a separate entity over the last twenty years, partly in response to the growth of chronic disease requiring greater patient self-management.  Research has found significant relationships between reading comprehension levels and different health outcomes and health behaviours, with reading comprehension being used as a way to measure health literacy despite its accepted definition being much broader.  However, there has been little research which takes a social practices perspective on health literacy.  
In this thesis, health literacy is viewed from a social practices perspective.  Literacy events in this research have been predicated on the existence of written texts as part of a patient’s journey using health related texts, resources and services.  The thesis explores how people go about accessing, understanding, appraising and using health-related services and information, and the social and cultural practices inherent in those activities.  It asks how much written patient text is used with patients in hospital; who is using it; what the discourse features of those texts are; and how patients respond to the texts.  This mode of exploration is called textual ethnography (Swales, 1998).  
The research takes an ethnographic perspective not only on text, but also on participants and their journey.  It shadows eleven patients through a cardiology service of a hospital in New Zealand.  It identifies literacy events and practices occurring in that space and examines the patient texts themselves using a discourse analysis (Bax 2011; Faircough, 2003; Clerehan, Hirsh, & Buchbinder, 2009; Franken & Hunter, 2011) and geosemiotic (Scollon & Scollon, 2003) approach.  
The key themes to emerge from the research centre around the complexity of access to patient information, both physically and linguistically, and around the dynamics of patient agency.  The ability to encode and decode written text played a minor part in patient access to information.  The analysis showed that the amount and types of text material present for patients in hospital were limited.  Access to key texts required a deliberate decision by a health professional to dispense the text items.  Mediation of text in the research by literacy sponsors supported Brandt and Clinton’s (2002) observation that “access to literacy has always required assistance, permission, sanction, or coercion by more powerful others or, at least, contact with existing ‘grooves’ of communication” (p. 349).  Patient agency therefore came to the fore, and practices that patients did actually use to make information personal to them such as talking with room mates, or requesting paper and pencil were dynamic and socially mediated.  
Implications lie in the way health literacy is conceptualised, moving the focus from individual abilities as portrayed in current health literacy definitions, and pointing to the wider role of the health organisation and health care practitioners as literacy sponsors.  Practice implications arising from this reconceptualisation relate to patient information strategies within health care organisations and pedagogical implications for health professionals and adult literacy educators.  The notions of text mediation and full contextualisation of learning also became apparent with evidence pointing to the effectiveness of text mediation by a more knowing other.  The hospital itself was found to be a potentially rich and meaningful setting for adult learning about health where full contextualisation of adult learning is possible.  These patient learning opportunities need to be further exploited by health organisations and professionals.

text: Health literacy: Patients' texts, context and mediation Health literacy encompasses people’s knowledge, motivation and competences to access, understand, appraise and apply health information to make judgments and take decisions in every-day life concerning health care, disease prevention and health promotion (Kickbusch et al., 2013).  Research in health literacy has grown in prominence as a separate entity over the last twenty years, partly in response to the growth of chronic disease requiring greater patient self-management.  Research has found significant relationships between reading comprehension levels and different health outcomes and health behaviours, with reading comprehension being used as a way to measure health literacy despite its accepted definition being much broader.  However, there has been little research which takes a social practices perspective on health literacy.  
In this thesis, health literacy is viewed from a social practices perspective.  Literacy events in this research have been predicated on the existence of written texts as part of a patient’s journey using health related texts, resources and services.  The thesis explores how people go about accessing, understanding, appraising and using health-related services and information, and the social and cultural practices inherent in those activities.  It asks how much written patient text is used with patients in hospital; who is using it; what the discourse features of those texts are; and how patients respond to the texts.  This mode of exploration is called textual ethnography (Swales, 1998).  
The research takes an ethnographic perspective not only on text, but also on participants and their journey.  It shadows eleven patients through a cardiology service of a hospital in New Zealand.  It identifies literacy events and practices occurring in that space and examines the patient texts themselves using a discourse analysis (Bax 2011; Faircough, 2003; Clerehan, Hirsh, & Buchbinder, 2009; Franken & Hunter, 2011) and geosemiotic (Scollon & Scollon, 2003) approach.  
The key themes to emerge from the research centre around the complexity of access to patient information, both physically and linguistically, and around the dynamics of patient agency.  The ability to encode and decode written text played a minor part in patient access to information.  The analysis showed that the amount and types of text material present for patients in hospital were limited.  Access to key texts required a deliberate decision by a health professional to dispense the text items.  Mediation of text in the research by literacy sponsors supported Brandt and Clinton’s (2002) observation that “access to literacy has always required assistance, permission, sanction, or coercion by more powerful others or, at least, contact with existing ‘grooves’ of communication” (p. 349).  Patient agency therefore came to the fore, and practices that patients did actually use to make information personal to them such as talking with room mates, or requesting paper and pencil were dynamic and socially mediated.  
Implications lie in the way health literacy is conceptualised, moving the focus from individual abilities as portrayed in current health literacy definitions, and pointing to the wider role of the health organisation and health care practitioners as literacy sponsors.  Practice implications arising from this reconceptualisation relate to patient information strategies within health care organisations and pedagogical implications for health professionals and adult literacy educators.  The notions of text mediation and full contextualisation of learning also became apparent with evidence pointing to the effectiveness of text mediation by a more knowing other.  The hospital itself was found to be a potentially rich and meaningful setting for adult learning about health where full contextualisation of adult learning is possible.  These patient learning opportunities need to be further exploited by health organisations and professionals.

year: 2015

title: Anti-racism Allyship Amongst Psychologists and Students in Psychology Training in Aotearoa New Zealand

authors: Tan, Kyle K. H.

abstract: Racism is a well-established social determinant of health, impacting Māori, Pacific, and Asian communities in Aotearoa New Zealand. However, few scholarly studies have focused on racial justice allyship in Aotearoa, particularly within the psychology discipline. This study examines demographic and attitudinal factors associated with anti-racism allyship among psychologists and students in psychology training amidst escalating racist rhetoric and opposition to Māori self-determination in Aotearoa. Drawing data from an online anonymous survey (n = 280), we assessed participants’ responses on three scales: 1) Attitudes towards aspects of Māori (taha Māori); 2) Attitudes towards acknowledging the existence of racism and settler colonialism 3) Anti-racist allyship. Certain demographic groups (Pākehā, Asian, older-aged, male, or those who entered training decades ago) scored lower on these scales, indicating the need for targeted training. Regression analyses showed both ‘Attitudes towards taha Māori’ and ‘Attitudes towards racism and colonisation’ scales were significantly correlated with anti-racist allyship. Our findings call for a sustained investment in training anti-racist psychologists who are competent in providing culturally safe care and capable of challenging racial injustices. Future research is required on the development of a racial justice allyship model across all institutions that train, employ and regulate psychologists in Aotearoa that is informed by Te Tiriti o Waitangi.

text: Anti-racism Allyship Amongst Psychologists and Students in Psychology Training in Aotearoa New Zealand Racism is a well-established social determinant of health, impacting Māori, Pacific, and Asian communities in Aotearoa New Zealand. However, few scholarly studies have focused on racial justice allyship in Aotearoa, particularly within the psychology discipline. This study examines demographic and attitudinal factors associated with anti-racism allyship among psychologists and students in psychology training amidst escalating racist rhetoric and opposition to Māori self-determination in Aotearoa. Drawing data from an online anonymous survey (n = 280), we assessed participants’ responses on three scales: 1) Attitudes towards aspects of Māori (taha Māori); 2) Attitudes towards acknowledging the existence of racism and settler colonialism 3) Anti-racist allyship. Certain demographic groups (Pākehā, Asian, older-aged, male, or those who entered training decades ago) scored lower on these scales, indicating the need for targeted training. Regression analyses showed both ‘Attitudes towards taha Māori’ and ‘Attitudes towards racism and colonisation’ scales were significantly correlated with anti-racist allyship. Our findings call for a sustained investment in training anti-racist psychologists who are competent in providing culturally safe care and capable of challenging racial injustices. Future research is required on the development of a racial justice allyship model across all institutions that train, employ and regulate psychologists in Aotearoa that is informed by Te Tiriti o Waitangi.

year: 2025