Lets talk about sex.... - Auckland District Health Board

Issues identified by service providers for Pacific peoples related to:
• Shame and the inclusion/exclusion of extended family
• Fa’afafine have an accepted role in Pacific Island communities, but the wider Rainbow
community did not necessarily, and many lesbian, gay, bisexual and some trans are
invisible
“In terms of Pacific Island mental health issues, there are cultural issues relating to shame, that mean that
LGBT people tend to hide their sexuality to the wider community. ... Being outwardly LGBT threatens
the cohesion of P.I. society” (DHB/PHO Pacific Island clinician/health professional)
“There is respect for each individual and they have the choice to be who they are, but they are not seen as
an individual by the Pacific Island community, as they are part of a wider family or community” (Pacific
Island cultural support professional)
Shame and stigma was identified as an issue for Asian service users, with little visibility of
Rainbow service users. Lack of specific skill and comfort when providing services to takataapui by
team members, was also commented on by a clinician/health professional.
“Within Asian ethnicity, stigma in the cultural context and rejection by significant others associated with
their sexual identity might present as a major barrier with seeking help; thus delayed treatment until [the]
severity of mental health condition is built up to crisis intervention “ (DHB Pacific Island clinician/health
professional)
“...this is a sensitive subject to discuss. It is challenging to explore the sexuality of the service user. LGBT
has not been openly accepted within the Asian community” (DHB Pacific Island cultural worker)
Many participants commented about the issue of religious beliefs or culture in terms of either the
service provider and service user (or both), in that there may be personal issues/beliefs which
affect the therapeutic relationship, or effective services. One participant described their own
practice of exploring issues or possible “obstacles for a therapeutic alliance” that may interfere
in the therapeutic relationship e.g. their own gender, belief system, political view or culture. The
participant described seeing this as an important first step in establishing if cultural issues are a
barrier for engagement
“Cultural and social sensitivity towards minority groups is essential in good practice”...“[Explore] obstacles for
a therapeutic alliance” (DHB clinician/health professional)
The importance of cultural competence working with Rainbow service users was raised by a few
service providers and they suggested that training is needed to raise the awareness of different
cultural perspectives.
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