Vol. 15 No. 30 (2025): Teoria queer e scienze sociali: tra sfide e prospettive
Monographic Section

Health beyond norms: Queer access, resistance, and the reimagining of care

Salvatore Monaco
Università degli Studi di Napoli, Italia

Published 2026-02-11

Keywords

  • queer,
  • Healthcare,
  • Italy,
  • Health

How to Cite

Monaco, S. (2026). Health beyond norms: Queer access, resistance, and the reimagining of care. Cambio. Rivista Sulle Trasformazioni Sociali, 15(30), 97–106. https://doi.org/10.36253/cambio-18573

Abstract

The paper examines the ways in which healthcare systems, despite formal commitments to universality and equality, reproduce structural inequalities that marginalize people who escape heteronormativity, whether through non-normative gender identities, sexual orientations, or embodied expressions. The analysis situates these dynamics within a global perspective, highlighting how access to affirming care varies across geographical, political, and cultural contexts. Empirical evidence from international statistics and studies illustrates that disparities in healthcare access and outcomes are shaped by the intersection of structural stigma, socio-economic marginalization, and the persistence of pathologizing medical frameworks. The paper devotes particular attention to Italy, using data from the Istituto Superiore di Sanità (ISS) on the health status and healthcare experiences of transgender and non-binary people. These findings reveal marked inequalities in mental health, preventive care uptake, and exposure to discrimination, underscoring the gap between the formal promise of the national healthcare service and the lived realities of access. The discussion argues for a shift from rhetorical inclusion toward structural transformation, identifying key areas for change: destructuring medical epistemologies, reconfiguring the spatial organization of care, transforming professional education, and embedding institutional accountability. The conclusion reflects on the politics of resistance within healthcare systems, emphasizing that confronting normative structures is important for creating environments that are not only accessible, but queer-informed and just.

References

  1. Ahmed S. (2006), Queer Phenomenology: Orientations, Objects, Durham: Duke University Press. DOI: https://doi.org/10.1515/9780822388074
  2. Alencar Albuquerque G., de Lima Garcia C., da Silva Quirino G., Alves M. J. H., Belém J. M., dos Santos Figueiredo F. W., da Silva Paiva L., Barbosa do Nascimento V., da Silva Maciel É., Engrácia Valenti V., de Abreu L.C., Adami F. (2016), Access to health services by lesbian, gay, bisexual, and transgender persons: systematic literature review, in «BMC international health and human rights», 16, 1, 2-4. DOI: https://doi.org/10.1186/s12914-015-0072-9
  3. Ayhan C.H.B., Bilgin H., Uluman O.T., Sukut O., Yilmaz S., Buzlu S. (2020), A systematic review of the discrimination against sexual and gender minority in health care settings, in «International Journal of Health Services», 50, 1, 44-61. DOI: https://doi.org/10.1177/0020731419885093
  4. Beagan, B., Fredericks E., Goldberg, L. (2012), Nurses’ work with LGBTQ patients: “they’re just like everybody else, so what’s the difference”?, in «The Canadian Journal of Nursing Research», 44, 44-63.
  5. Bell D., Valentine G. (1995), The sexed self: strategies of performance, sites of resistance. In: Pile S., Thrift N. (Eds.), Mapping the Subject. Geographies of Cultural Transformation (pp. 143–157), London: Routledge.
  6. Berro T., Zayhowski K. (2024), Toward depathologizing queerness: An analysis of queer oppression in clinical genetics, in « Journal of Genetic Counseling», 33, 5, 943-951. DOI: https://doi.org/10.1002/jgc4.1819
  7. Brown M., Knopp L. (2014), The birth of the (gay) clinic, in «Health Place», 28, 99-108. DOI: https://doi.org/10.1016/j.healthplace.2014.04.003
  8. Butler J. (2004), Undoing gender, London: Routledge. DOI: https://doi.org/10.4324/9780203499627
  9. Carabez R., Pellegrini M., Mankovitz A., Eliason M., Scott M. (2015), Does your organization use gender inclusive forms? Nurses’ confusion about trans* terminology, in «Journal of Clinical Nursing», 24, 21, 3306-3317. DOI: https://doi.org/10.1111/jocn.12942
  10. CAP (2020), The State of the LGBTQ Community in 2020, New York: Center for American Progress.
  11. Corbisiero F., Monaco S. (2024), Manuale di Studi LGBTQIA+, Turin: UTET.
  12. Castro-Peraza M.E., García-Acosta J.M., Delgado N., Perdomo-Hernández A.M., Sosa-Alvarez M.I., Llabrés-Solé R., Lorenzo-Rocha N.D. (2019), Gender identity: The human right of depathologization, in «International Journal of Environmental Research and Public Health», 16, 6, 978. DOI: https://doi.org/10.3390/ijerph16060978
  13. Daley A.E., MacDonnell J.A. (2011), Gender, sexuality and the discursive representation of access and equity in health services literature: implications for LGBT communities, in «International Journal for Equity in Health», 10, 1, 40-51. DOI: https://doi.org/10.1186/1475-9276-10-40
  14. Duncan, N. (1996, ed.), BodySpace: Destabilizing geographies of gender and sexuality. London: Psychology Press. DOI: https://doi.org/10.4324/9780203974070
  15. Durkheim E. (1951), Suicide, Paris: Free Press.
  16. Enson S. (2015), Causes and consequences of heteronormativity in healthcare and education, in «British Journal of School Nursing», 10, 2, 73-78. DOI: https://doi.org/10.12968/bjsn.2015.10.2.73
  17. Epstein S. (1994), A queer encounter: Sociology and the study of sexuality, in «Sociological Theory», 1, 188-202. DOI: https://doi.org/10.2307/201864
  18. Fonzo M., Cocchio S., Centomo M., Baldovin T., Buja A., Majori S., Baldo V., Bertoncello C. (2021), Sexual and gender minorities and risk behaviours among university students in Italy, in « International Journal of Environmental Research and Public Health», 18, 21, 11724. DOI: https://doi.org/10.3390/ijerph182111724
  19. Foucault M. (1976), Histoire de la sexualité. Vol. 1, Paris : Éditions Gallimard.
  20. Fricker M. (2007), Epistemic injustice: Power and the ethics of knowing, Oxford: Oxford University Press. DOI: https://doi.org/10.1093/acprof:oso/9780198237907.001.0001
  21. Gagnon J.H., Rosen R.C., Leiblum S.R. (1982), Cognitive and social aspects of sexual dysfunction: sexual scripts in sex therapy, in «Journal of Sex and Marital Therapy», 8, 44-56. DOI: https://doi.org/10.1080/00926238208405811
  22. Griffin N., Crowder M., Kyle P., Holding E., Woodrow N., Dodd-Reynolds C., Summerbell C., Scott S. (2023), ‘Bigotry is all around us, and we have to deal with that’: Exploring LGBTQ+ young people’s experiences and understandings of health inequalities in North East England, in «SSM-Qualitative Research in Health», 3, 100263. DOI: https://doi.org/10.1016/j.ssmqr.2023.100263
  23. Heyes C., Dean M., Goldberg L. (2016), Queer phenomenology, sexual orientation, and health care spaces: learning from the narratives of queer women and nurses in primary health care, in «Journal of Homosexuality», 63, 2, 141–155. DOI: https://doi.org/10.1080/00918369.2015.1083775
  24. Hollenbach A.D., Eckstrand K.L., Dreger A.D. (2014, ed.), Implementing curricular and institutional climate changes to improve health care for individuals who are LGBT, gender nonconforming, or born with DSD: A resource for medical educators, New York: Association of American Medical Colleges.
  25. Iantaffi A. (2020), Gender trauma: Healing cultural, social, and historical gendered trauma, London: Jessica Kingsley Publishers. DOI: https://doi.org/10.5040/9781805014966
  26. ISS (2022), Salute della popolazione transgender, Rome: Istituto Superiore di Sanità.
  27. ISS (2024), Salute mentale, Rome: Istituto Superiore di Sanità.
  28. Jewkes R., Abrahams N. (2002), The epidemiology of rape and sexual coercion in South Africa: an overview, in «Social Science & Medicine», 55, 7, 1231-1244. DOI: https://doi.org/10.1016/S0277-9536(01)00242-8
  29. Johnston L. (2015), Sexuality and space. International Encyclopedia of the Social & Behavioral Sciences, 2, 808–812. DOI: https://doi.org/10.1016/B978-0-08-097086-8.72080-0
  30. Kaya Ş., Calpbinici P. (2022), A discriminational attitude and behavior in the healthcare field: Homophobia level in healthcare professionals working in primary health services and the affecting factors, in «Perspectives in Psychiatric Care», 58, 4, 1-18. DOI: https://doi.org/10.1111/ppc.13059
  31. Keuroghlian A.S., Ard K.L., Makadon H.J. (2017), Advancing health equity for lesbian, gay, bisexual and transgender (LGBT), people through sexual health education and LGBT-affirming health care environments, in «Sexual Health», 14, 1, 119-122. DOI: https://doi.org/10.1071/SH16145
  32. Klein T. (2008), Querying medical and legal discourses of queer sex and genders in South Africa, in «Anthropology Matters Journal», 10, 2, 11-23. DOI: https://doi.org/10.22582/am.v10i2.37
  33. Lee A., Kanji Z. (2017), Queering the health care system: Experiences of the lesbian, gay, bisexual, transgender community, in «Canadian Journal of Dental Hygiene», 51, 2, 1-15.
  34. Lewis N.M. (2016), Researching LGB health and social policy: methodological issues and future directions, in «Journal of Public Health Policy», 1, 1-8. DOI: https://doi.org/10.1057/s41271-016-0039-7
  35. Logie C. (2012), The case for the world health organization’s commission on the social determinants of health to address sexual orientation, in «American Journal of Public Health», 102, 7, 1243–1246. DOI: https://doi.org/10.2105/AJPH.2011.300599
  36. Marconi M., Brogonzoli L., Ruocco A., Sala E., D’Arienzo S., Manoli M., Pagano M.T., Fisher A., Iardino R., Pedale R., Grattagliano I., Cricelli C., Pierdominici M. (2024), Examining the training needs and perspectives of Italian general practitioners on transgender and gender diverse healthcare: Insights from a national survey, in «International Journal of Transgender Health», 1, 1-9. DOI: https://doi.org/10.1080/26895269.2024.2369615
  37. Marella M.R. (2017), Queer Eye for Straight Guy. Sulle possibilità di un’analisi giuridica queer, in «Politica del diritto», 48, 3, 383-414.
  38. Martin D., Miller B. (2003), Space and contentious politics, in «Mobilization: An International Quarterly», 8, 2, 143-156. DOI: https://doi.org/10.17813/maiq.8.2.m886w54361j81261
  39. Meer T., Müller A. (2017), “They treat us like we’re not there”: Queer bodies and the social production of healthcare spaces, in «Health, Place», 45, 92-98. DOI: https://doi.org/10.1016/j.healthplace.2017.03.010
  40. Merton R.K. (1957), The Role-Set: Problems in Sociological Theory, in «The British Journal of Sociology», 8(2). DOI: https://doi.org/10.2307/587363
  41. Mkhize S.P., Maharaj P. (2020), Structural violence on the margins of society: LGBT student access to health services, in «Agenda», 34, 2, 104-114. DOI: https://doi.org/10.1080/10130950.2019.1707000
  42. Monaco S. (2025), Non-binary narratives: subjectivation and lived experiences in contemporary Italy, in «Culture, Health, Sexuality», 27, 7, 868-883. DOI: https://doi.org/10.1080/13691058.2024.2408340
  43. Moore M.R. (2015), LGBT populations in studies of urban Neighborhoods: making the invisible visible, in «City Community, 14, 3, 245-248. DOI: https://doi.org/10.1111/cico.12127
  44. Müller A. (2018), Beyond ‘invisibility’: Queer intelligibility and symbolic annihilation in healthcare, in «Culture, Health, Sexuality», 20, 1, 14-27. DOI: https://doi.org/10.1080/13691058.2017.1322715
  45. Müller A., Hughes T.L. (2016), Making the invisible visible: a systematic review of sexual minority women’s health in Southern Africa, in «BMC Public Health», 16, 1, 1-12. DOI: https://doi.org/10.1186/s12889-016-2980-6
  46. Murray S.B., Kanter C., O’Brien A. Clark K.D. (2025), Faculty inclusion of lesbian, gay, bisexual, transgender, and queer populations in health curriculum, in «Teaching and Learning in Nursing», 20, 2, e395-e401. DOI: https://doi.org/10.1016/j.teln.2024.11.033
  47. Nath D., Mthathi S. (2011), “We’ll Show You You’re a Woman”: violence and Discrimination Against Black Lesbians and Transgender Men in South Africa, New York: Human Rights Watch.
  48. Pega F., Veale J.F. (2015), The case for the world health organization’s Commission on social determinants of health to address gender identity, in «American Journal of Public Health», 105, 3, e58--e62. DOI: https://doi.org/10.2105/AJPH.2014.302373
  49. Petroll A.E., Mosack K.E. (2011), Physician awareness of sexual orientation and preventive health recommendations to men who have sex with men, in «Sexually transmitted diseases, 38», 1, 63-67. DOI: https://doi.org/10.1097/OLQ.0b013e3181ebd50f
  50. Philo C. (1996), Staying in? Invited comments on ‘coming out: exposing social theory in medical geography, in «Health Place», 2,1, 35–40. DOI: https://doi.org/10.1016/1353-8292(95)00024-0
  51. Philo C. (2000), The birth of the clinic: an unknown work of medical geography, in «Area», 32, 1, 11-19. DOI: https://doi.org/10.1111/j.1475-4762.2000.tb00110.x
  52. Podmore J.A. (2001), Lesbians in the crowd: Gender, sexuality and visibility along Montréal’s Boul. St-Laurent, in «Gender, Place and Culture: A Journal of Feminist Geography», 8, 4, 333-355. DOI: https://doi.org/10.1080/09663690120111591
  53. Rispel L.C., Metcalf C.A., Cloete A., Moorman J., Reddy V. (2011), You become afraid to tell them that you are gay: health service utilization by men who have sex with men in South African cities, in «Journal of Public Health Policy», 1, S137–S151. DOI: https://doi.org/10.1057/jphp.2011.29
  54. Röndahl G., Innala S., Carlsson M. (2006), Heterosexual assumptions in verbal and nonverbal communication in nursing, in «Journal of Advanced Nursing», 56, 4, 373-381. DOI: https://doi.org/10.1111/j.1365-2648.2006.04018.x
  55. Rosati F., Pistella J., Baiocco R. (2021), Italian sexual minority older adults in healthcare services: Identities, discriminations, and competencies, in «Sexuality Research and Social Policy», 18, 1, 64-74. DOI: https://doi.org/10.1007/s13178-020-00443-z
  56. Searle J. (2019), Queer phenomenology, the disruption of heteronormativity, and structurally responsive care, in «Advances in Nursing Science», 42, 2, 109-122. DOI: https://doi.org/10.1097/ANS.0000000000000258
  57. Searle J., Goldberg L., Aston M., Burrow S. (2017), Accessing new understandings of trauma‐informed care with queer birthing women in a rural context, in «Journal of Clinical Nursing», 26, 21, 3576-3587. DOI: https://doi.org/10.1111/jocn.13727
  58. Smith R. (2015), Healthcare experiences of lesbian and bisexual women in Cape Town, South Africa, in «Culture, Health & Sexuality», 17,2, 180–193. DOI: https://doi.org/10.1080/13691058.2014.961033
  59. Tanenbaum R., Oberman T., Carroll L. (2025), Structural Violence in Transgender Health: Perspectives From Medical Students in the South, in «Hospital Pediatrics», 15, 4, e165-e168. DOI: https://doi.org/10.1542/hpeds.2024-008017
  60. Visser G. (2003), Gay men, leisure space and South African cities: the case of Cape Town, in «Geoforum», 34, 1, 123–137. DOI: https://doi.org/10.1016/S0016-7185(02)00079-9
  61. Visser G. (2008), The homonormalisation of white heterosexual leisure spaces in Bloemfontein, South Africa, in «Geoforum», 39, 3, 1347-1361. DOI: https://doi.org/10.1016/j.geoforum.2007.11.004
  62. Vitelli R., Scandurra C., Pacifico R., Selvino M.S., Picariello S., Amodeo A.L., Valerio P., Giami A. (2017), Trans identities and medical practice in Italy: Self-positioning towards gender affirmation surgery, in «Sexologies», 26, 4, e43-e51. DOI: https://doi.org/10.1016/j.sexol.2017.08.001
  63. Wilton T. (2004), Sexual (Dis)Orientation: Gender, Sex, Desire and Self-Fashioning, New York: Palgrave MacMillan. DOI: https://doi.org/10.1057/9780230506213
  64. Worthen M.G., Lingiardi V., Caristo C. (2017), The roles of politics, feminism, and religion in attitudes toward LGBT individuals: A cross-cultural study of college students in the USA, Italy, and Spain, in «Sexuality Research and Social Policy», 14(3), 241-258. DOI: https://doi.org/10.1007/s13178-016-0244-y