Positionality: The Lens Through Which We See The World

Positionality is the lens through which we see the world and it is shaped by many factors. These include fixed factors: gender, race, ethnicity, nationality, etc. As well as contextual or subjective factors: life history, personal values, etc.

Positionality can impact implicit biases and lead to microaggressions. One’s social position in the system will influence their experiences and opportunities, as well as their perceptions of other people.

Here are some examples of how positionality and implicit bias may impact the delivery of healthcare:

  1. Assuming all patients are heterosexual and cisgender: Asking a female patient, “do you have a boyfriend?” vs “are you in a relationship”?”
  2. Implicit biases about LGBTQIA+ people being sexually promiscuous, and using harsh and disapproving tones and body language toward LGBTQIA+ patients.

3. Assuming any healthcare complaint for transgender people relates to their gender identity.

“…what it's like being black and being part of the LGBTQ+ community… It's really kind of taboo… I don't speak for all black people, but like we kind of have to be strong. We already face so much scrutiny and so much opposition just in life that it's difficult being black and becoming a woman and then plus being part of [the] LGBTQ community, you get so much hate on all of those things… we are so scrutinized and judged by all of society that it's hard to give someone one more reason to hate you or to hate that part about you. Especially as a black person of the LGBTQ community things are already kind of rough, being black plus being LGBTQ. Feel like I get questioned a lot more.”
Ohio YouthAge 15, she/they