Gender and Culturally Concordant Care: An Interview with Dr. Anastasia Young
As we move towards an increasingly multicultural world, it is vital to consider its impact on various facets of our society, particularly in healthcare where providers often care for patients from diverse backgrounds.
Studies show that patient health outcomes are improved when healthcare providers and their patients have alignment in their identities and backgrounds.
I had the privilege of sitting down with Dr. Anastasia Young, DNP, APRN, AGNP-C, an oncology nurse practitioner based in Minnesota, who brings a wealth of experience to the table. Dr. Young has worked across diverse inpatient and outpatient settings as an oncology nurse. She completed her doctorate in nursing practice from the University of Minnesota. Additionally, she co-leads the Interfaith Healthcare Cohort for the Chicago-based non-profit organization Interfaith America.
In the conversation below, Dr. Anastasia Young and I discuss the importance of gender and culturally concordant care in the healthcare sector.
This interview has been edited for length and clarity.
SURAJ: Hi Anastasia! I am excited to have this conversation with you. One of the main reasons I started this newsletter was to explore topics around cultural diversity and gender expression, and I have found that both of these topics are vast and expansive. With your background as a healthcare provider, I would love to hear about your experiences related to gender and culture in the workforce.
ANASTASIA: Yeah! I think a lot about gender in the sense that about 70% of healthcare workers are women globally, yet they only hold 25% of leadership roles in health. It makes me think about the roles women play in the healthcare profession and what this looks like on a day-to-day basis. When you start to consider marginalized communities such as non-binary and trans people, I think about the implications it has on the workforce and the patients.
SURAJ: Particularly regarding not having a diverse representation of gender identities among healthcare providers and leaders?
ANASTASIA: Yeah, gender-concordant care impacts patients, including the trust that patients have with their healthcare team, and their willingness to come and seek care both preventatively and when in dire need.
SURAJ: Do you mind defining what gender concordant care is?
ANASTASIA: Yeah, absolutely. Gender-concordant care is when a patient’s gender identity aligns with their healthcare provider’s gender identity. For me, as a cisgender woman, gender-concordant care would be me caring for another woman.
SURAJ: It makes sense that some people may be more comfortable with a healthcare provider who identifies with the same gender as them. I imagine patients are also most comfortable with healthcare providers who identify as culturally or racially similar as well.
ANASTASIA: We are now seeing more research being done on the implications that culturally or racially concordant care can have on health outcomes for patients. As a personal example, my friend was working at a community health clinic that predominantly served Muslim patients. Although they predominantly served Muslim patients, many women were not coming in for their mammogram screenings. After learning more about why this was not happening, part of it had to do with modesty but also wanting to have a female healthcare provider conduct the screening. When changes were made to provide these women with a female healthcare provider and modest robes for performing the mammogram, the number of women who came in for these screenings increased.
SURAJ: That is amazing! It really showcases why it is important to consider all identities of the patient. It also highlights why it is essential for healthcare providers to build their radar screen for religious and cultural diversity. When they investigate what values or customs are important to their patients, it can shed light on why patients may not be seeking out care such as these mammograms.
ANASTASIA: Exactly. It is so big when you think about the impact of identifying cancer early and being able to treat the condition before it becomes something that moves from curative to non-curative.
SURAJ: It reminds us how important accessibility is. When you make healthcare more accessible for one group, it makes it more accessible for all groups. I’m sure many people who don’t identify as Muslim women would also appreciate more modest gowns, and feel more comfortable accessing healthcare as a result.
Now, I am curious about the feasibility. We know that the healthcare system does not have all the resources we wish it had. In rural communities, for instance, there may not be a diverse representation of healthcare providers. Therefore, culturally or gender-concordant care may not be possible. Is there a way to equip the healthcare providers who are already in these hospitals with skills to make patients feel more comfortable, even if their identities are not in concordance with their patients?
ANASTASIA: That is a really good observation and a very real situation. It’s no secret that we are understaffed. In healthcare, we are not always able to accommodate gender, racial, or culturally concordant care for patients. Then the question is, what do we do in that situation?
SURAJ: Yeah, what can be done?
ANASTASIA: As healthcare providers, we can be curious and ask our patients questions to better understand what they need. Is there a certain aspect of the healthcare encounter that the patient would prefer to have gender-concordant care for? Is there something missing? Would a female patient be willing to have a man examine them if another female is in the room? We can find out where the hard lines are and where we can meet them.
SURAJ: Oh, that is interesting. It seems that being creative and providing patients with options can help them feel more in control of how their healthcare experience will go.
ANASTASIA: Exactly. We can be transparent about wanting to give them the best care possible and that these are the resources we have now. We can ask ourselves if the situation is a life or death situation, or is it care that can be pushed back until a preferred healthcare provider is available? Would they rather have an expert in the field who does not identify with their gender over someone who does identify with their gender but is brand new to the field? We then present all these options to them and have an open conversation with them to understand where they are coming from. It can be hard when we are so busy and time feels so short. But, we need to take a beat to ask the question to figure out whether we can meet the patient where they are. We talk a lot about risk-benefit in health care, so thinking about the benefits of taking that extra minute to help may improve patient care.
SURAJ: I hadn’t considered that. Some care is urgent, while other care can wait. It may also depend on the type of care.
ANASTASIA: Definitely. I find in mental health and OBGYN, we do ask whether the patient would prefer concordant care. Starting to normalize concordant care in other areas can really have a positive impact on patient outcomes.
SURAJ: That makes complete sense. Thank you for sharing more about your work as a healthcare provider and also highlighting the importance of gender and culturally concordant care. As our society becomes more diverse, we will need our healthcare systems to consider all the identities at play among the patient populations.
ANASTASIA: Absolutely!
If you are interested in following Dr. Anastasia Young, you can follow her on LinkedIn.