Shining a light on the daily occupational experiences of lesbian and gay adults’ in Ireland: applying an occupational justice lens

Abstract

Purpose

Equality of rights for individuals who identify as being lesbian or gay (LG) have emerged over recent years, and significant advancements have been made in recognition and support of LG rights in Ireland. Given the recent change in legal rights for the LG population, Civil Partnership 2010 and Marriage Equality 2015, this paper aims to explore the lived experience of daily occupations of LG adult’s in Ireland today, by applying an occupational justice lens.

Design/methodology/approach

A qualitative phenomenological research study, examined the concept of occupational justice as experienced by eight adults, who identified as being LG. Data was collected through face to face, semi-structured interviews.

Findings

Four themes capturing the complexity of each participant’s experience of daily occupations and occupational justice emerged, namely, transitions and personal journeys, celebrating differences, empowerment through occupation and inner conflict. Findings demonstrate how occupational justice is experienced as a complex, contextually embedded and dynamic process specific to each individual.

Originality/value

Future research in this area should aim to explore the experiences of both a younger and older LG population, along with those who identify as bisexual, transgender, queer or intersex to continue to raise awareness of the potential for occupational injustice within this minority population.

Citation

Hadden, L., O’Riordan, A. and Jackson, J. (2020), "Shining a light on the daily occupational experiences of lesbian and gay adults’ in Ireland: applying an occupational justice lens", Irish Journal of Occupational Therapy, Vol. 48 No. 2, pp. 117-132. https://doi.org/10.1108/IJOT-12-2019-0017

Introduction

A major theme of equality of rights for lesbian, gay, bisexual and transgender (LGBT+) people has emerged over recent years, and significant progress has been made to support LGBT+ people in Ireland (Gay and Lesbian Equality Network, 2011). Milestones such as the decriminalisation of homosexuality (Department of Justice and Equality, 1993), the prohibition of discrimination in employment on the basis of sexual orientation (Department of Jobs, Enterprise and Innovation, 1998, 2004) and the prohibition of discrimination on the basis of sexual orientation (Department of Justice and Equality, 2000), have made great gains in highlighting sexual orientation as a specific equality ground in Ireland. In 2010, Civil Partnership legislation was introduced and in May 2015, the Marriage Equality Bill was passed recognising marriage of same sex couples.

Understanding the impact individuals’ sexual orientation has on their everyday occupations is particularly appropriate for occupational therapists (Harrison, 2001) as the discipline’s interest is participation in the occupations of daily life. Likewise, occupational science seeks to explain the everyday activities of individuals within their social and cultural worlds and acknowledges that complexity often lies beneath the surface of ordinary, mundane occupations (Bailey and Jackson, 2005). Occupational justice is a principle that supports individuals and communities to participate in valued occupations as part of a just and empowering society. Occupational justice focusses on quality of life, ensuring that people have the capabilities to engage in the occupations that are of meaning and value to them within the context of their social communities (Stadnyk et al., 2010; Bailliard, 2016; Hocking, 2017). The lens of occupational justice focusses on the differing occupational needs, strengths and potential of individuals and groups while considering structural factors such as issues of rights, empowerment, fairness and enablement of occupational opportunities (Stadnyk et al., 2010). A breach of occupational justice occurs when individuals are refused the physical, social, economic or cultural resources and opportunities to engage in their occupations of value and meaning (Wolf et al., 2010). This can be experienced through occupational deprivation, marginalisation, alienation or imbalance (Townsend and Wilcock, 2004).

It is imperative that occupational therapists work to address issues of everyday justice to bring about transformative change at the different structural tiers of society (Durocher et al., 2014; Whiteford et al., 2018). The participatory occupational justice framework offers a structure for therapists to examine and tackle everyday justice issues for individuals and groups (Whiteford and Townsend, 2011). According to the World Federation of Occupational Therapists (2006) Position Statement on Human Rights, occupational therapists have:

[…] a role and responsibility to develop and synthesise knowledge to support participation; to identify and raise issues of occupational barriers and injustices; and to work with groups, communities and societies to enhance participation in occupation for all persons (2006, p. 2).

Literature review

A literature review was carried out to explore and identify existing literature and research on the relationship between LGBT+ sexual orientation and everyday occupations, and the phenomenon of occupational justice as experienced by minority populations.

Three main themes emerged, namely, sexual orientation and everyday occupations; occupational justice and minority populations; sexual orientation and healthcare.

Sexual orientation and everyday occupations

Given that sexual orientation is part of one’s identity and how one presents oneself to society, it is not surprising research has found sexual orientation plays an intrinsic role when engaging in daily occupations (Beagan and Hattie, 2014; Bergan-Gander and von Kurthy, 2006; Birkholtz and Blair, 1999; Devine and Nolan, 2007). When an individual identifies as being lesbian or gay (LG) it influences the intrinsic meaning they place on the occupations in which they engage (Bailey and Jackson, 2005; Beagan and Hattie, 2014; Jackson, 1995; Williamson, 2000). The meaning and value of an occupation can change, the occupation itself can change or the role a person has within the occupation can change. Occupations such as; shopping for groceries (Jackson, 1995), maintaining spiritual ties (Beagan and Hattie, 2014), managing finances (Bailey and Jackson, 2005) and being creative (Williamson, 2000) are all examples of where the meaning of the occupation changed for individuals as a result of assuming an LG identity.

Furthermore, occupations changed for individuals because of challenges and inner conflict experienced as a result of their sexual orientation (Beagan and Hattie, 2014; Bergan-Gander and von Kurthy, 2006; Birkholtz and Blair, 1999; Devine and Nolan, 2007; Jackson, 1995, 2000). Personal relationships posed challenges when lack of support from family and friends meant individuals could no longer partake in previously valued and shared occupations of family life (Bergan-Gander and von Kurthy, 2006; Devine and Nolan, 2007). Moreover, individual’s experience inner conflict in their work when faced with the dilemma of whether or not to come out, fearing the threat of negative comments and discrimination in the workplace, thus effecting job prospects and progress (Bergana–Gander and von Kurthy, 2006; Day and Schoenrade, 1997; Jackson, 1995, 2000). Fear of physical attack in social occupations (Bergan-Gander and von Kurthy, 2006) also added to the dilemma as to whether or not to disclose sexual orientation. Understandably, participants acknowledged that their sexual orientation influenced where and with whom they were open with their sexuality in terms of partaking in their occupations (Bergan-Gander and von Kurthy, 2006; Jackson, 1998a, 1998b).

The transition process to a more authentic sexual identity was a subtheme woven throughout the literature on sexual orientation and everyday occupations (Beagan and Hattie, 2014; Bergan-Gander and von Kurthy, 2006; Birkholtz and Blair, 1999; Devine and Nolan, 2007). Transition often requires a change in roles, occupations, environments, routines and relationships, which, in turn, requires adaptation to bring forth a shift in identity (Beagan and Hattie, 2014; Wiseman and Whiteford, 2009). Kielhofner (2009), used the example of “being homosexual” as a source of detachment from the prevailing heteronormative life course narrative, adding complexity to identity development. It was found that individuals used occupations to express their identity, and in this way, the occupation became a mechanism for the expression and development of identity (Christiansen, 2000; Devine and Nolan, 2007). Occupations such as “eating together” (Birkholtz and Blair, 1999) or nights out (Devine and Nolan, 2007), helped in expressing this new identity. The development of a homosexual identity has shown to present a number of challenges and changes (Bergan-Gander and von Kurthy, 2006; Birkholtz and Blair, 1999; Devine and Nolan, 2007), however participating in activities together with fellow LGBT+ individuals can help with this, thus tying one’s identity with the occupational environment.

The literature highlights that sexual orientation is understood to be one of many factors, which can impact a person’s experience of occupation. The meaning and value of an occupation can change, as can the role a person has within the occupation.

Occupational justice and minority populations

Occupational justice is about supporting the human desire and requirement to be engaged in occupations of meaning, value, necessity and choice (AlHeresh et al., 2013; Causey-Upton, 2015; Bailliard, 2016; Gupta, 2016; Hocking, 2017; Stadnyk et al., 2010). Occupational justice is concerned with the enablement of inclusive and diverse participation in society with a focus on the connections between occupation, health and quality of life (Durocher et al., 2014; Gupta, 2016; Stadnyk et al., 2010; Whiteford et al., 2018). Fundamental to the concept of occupational justice is the belief that humans must have some choice about what they can do in their daily lives (Stadnyk et al., 2010). However, as Stadnyk et al., (2010) illustrate, structural factors such as national policies, economic systems, cultural values and attitudes set the boundaries in which choice occurs. Therefore, whereas some people have the liberty to make choices about what they will or will not do, others, arguably minority populations, severely lack that freedom (Whiteford, 2000). Unfortunately, to sustain a somewhat congruous social order, dominant discourses, ideologies and policies often exist that determine normative behaviours, attitudes and occupations. Assuming that these normative ways of being are universal can be of disservice to the rich variety of behaviours and occupations associated with cultural diversity. Furthermore, individuals who do not appear to comply with this “normativity” are often identified as abnormal, deviant or “the other” (Jackson, 1998a, 1998b; Bailliard, 2016) and therefore, at risk of occupational injustice.

Minority populations, who are marginalised because of their ethnicity, culture, religion or sexual orientation, are at greater risk of being unable to participate in meaningful occupations (Beagan et al., 2012; Whiteford, 2000), thus existing in a world of limited occupational choice and opportunities (Whiteford, 1995). Some LGBT+ individuals experience occupational deprivation for extended periods, leading to a lack of engagement in meaningful occupations (Beagan et al., 2012; Bergan-Gander and von Kurthy, 2006). This lack of engagement can have far reaching effects including minority stress (Harcourt, 2006; Sandfort et al., 2006) and mental health issues (Gay and Lesbian Equality Network, 2011; Harcourt, 2006; Meyer, 1995).

Research suggests that due to fear of discrimination or rejection, LGBT+ people are often required to hide their true sexual orientation (Bergan-Gander and von Kurthy, 2006; Jackson, 1995, 2000) or engage in occupations that are not fully in line with their true sexual identity to survive in a predominantly heteronormative culture (Birkholtz and Blair, 1999; Devine and Nolan, 2007; Jackson, 2000). The complex relationship of occupational choice and occupational injustice is recognisable (Galvaan, 2012), whereby some people can be effective occupational agents, consciously conveying particular identities through the channel of occupation (Beagan et al., 2012). These individuals make occupational choices in alignment with their sense of personal identity, for the purpose of presenting a particular social identity (Laliberte-Rudman, 2002), however not every person feels they have the choice to do this. Despite growing research into occupational justice issues, research examining the daily occupations of those marginalised as a result of sexual orientation (Beagan et al., 2012) is only emerging, and continues to be a topical and unique area of study.

Sexual orientation and healthcare

Much of the literature sourced, makes mention to sexual orientation and how it is addressed in healthcare environments (Harbin et al., 2012; Harrison, 2001; Hinchliff et al., 2005; Kingsley and Molineux, 2000; Twinley, 2014). Some research alluded to staff inexperience when dealing with the issue of sexual orientation (Kingsley and Molineux, 2000), some to a lack of knowledge around the issue (Harbin et al., 2012; Harcourt, 2006; Hinchliff et al., 2005), while others found a non-willingness amongst staff to address an individuals’ sexual orientation, as it was not considered relevant to their healthcare (Harrison, 2001; Kingsley and Molineux, 2000). Moreover, research highlighted the discomfort experienced in navigating the issue of disclosure of sexual orientation, both on the part of the client and the healthcare professional (Harbin et al., 2012; Hinchliff et al., 2005). In contrast, from the clients’ perspective, fear of being denied safe and good quality healthcare was a significant concern when facing the dilemma of whether or not to disclose sexual orientation to their healthcare provider (Harbin et al., 2012). Previous negative experiences, a reluctance to disclose sexual orientation, and a fear of being stigmatised were all identified as factors that lead to an avoidance of seeking appropriate healthcare within the LGBT+ population.

Assumptions of being heterosexual, coupled with heteronormative environments, are common within the healthcare literature (Bergan-Gander and von Kurthy, 2006; Jackson, 1995, 2000; Neville and Henrickson, 2006). Heterosexist environments are maintained through assumed heterosexuality (Kingsley and Molineux, 2000; Jackson, 2000), perceived stereotypes and heterosexual discourse (Jackson, 2000). Therefore, being non-heterosexual can potentially lead to experiences of occupational exclusion and disempowerment.

Across the literature, it is demonstrated that sexual orientation does play a role in an individual’s life, and therefore, their choice of occupations. With progressive steps towards inclusion and equality for the LGBT+ population in Ireland, coupled with the concept of occupational justice being one of inclusion and empowerment while embracing difference (Whiteford et al., 2017) the question the researchers posed was: are LG people, in Ireland, able to experience and fully engage in their everyday occupations of choice or do they experience any form of occupational injustice?

Methodology

In attempting to answer this question and in seeking to understand it from a narrative standpoint, a qualitative phenomenological research study was designed. Given that the aim of phenomenology is to describe an individual’s lived meaning of the world (Bannigan, 2004), and given the personal experience of occupational justice (Bailliard, 2016), the researchers felt that a phenomenological approach best supported the essence of this research. Given the diversity of the LGBT+ population and time limitations, for the purpose of this study, the researchers decided to set the boundary of working only with adults who identify as being LG. Ethical approval for this study was received at a university in Ireland.

The research team comprised of three researchers, of three different nationalities, namely, Irish, Australian and American. Varied life experiences, sexual orientations and differing academic backgrounds ensured a critical, rich and diverse lens during data analysis.

Recruiting participants involved purposive and snowball sampling. A poster was displayed on notice boards around the college campus and in local LGBT+ support organisations. Snowball sampling required the researchers initially identifying one or two informants with knowledge or experience of the topic. These informants were asked if they knew others who might be interested in being involved in the study and who met the sampling requirement. Eight participants, who identified as being either LG, participated in the study. While the aim was to include a wide range of participants, the sensitive nature of the topic and a limited timeframe resulted in a sample size of eight, which the researchers felt was sufficient in Table 1.

Data was generated during one face-to-face, in-depth, semi-structured interview with each participant. Interviews explored topics such as: what being gay meant to each individual, how occupations were related to their sexual identity, whether being gay inhibited them from participation in occupations, whether being gay felt different in society and whether they felt fully supported and integrated within society today. Interviews lasted between 30 min to 1 h and 15 min. The interviews were recorded using an audio recording device. Immediately following interviews, field notes were taken, exploring any important insights gained from the interview process and any reflections the researchers had. Research was conducted using an inductive, interpretive, thematic analysis approach. All interviews were transcribed verbatim, following which the researchers searched for meaning in the data rather than imposing a previously defined coding system (Thorne, 2000). Interpretive thematic analysis was used to find, analyse and report themes within the data (Braun and Clarke, 2006).

As the research contained deeply personal, sensitive and potentially challenging stories, various methods were used to ensure confidentiality, anonymity and safety throughout the research process. Participant’s names were changed and any personally identifiable information that may indicate identity was omitted. Prior to receiving informed consent, information was provided to participants outlining their rights, obligations and any possible disadvantages or risks involved in taking part. The benefits of participating were also outlined. Interested participants were invited to ask any questions and seek further clarification if necessary.

Reciprocity is an important part of conducting ethical and responsible qualitative research. The researchers were fully committed to involving participants in all phases of the research from gaining initial consent to receiving a copy of the final research paper. Participants were aware that they could leave the study at any time. Trustworthiness was achieved by ensuring that credibility, transferability, dependability and confirmability were considered and achieved at each appropriate phase of the study (Carpenter and Suto, 2008). Meticulous efforts were made to ensure credibility. Two researchers were present for interviews ensuring an authentic and honest interpretation of the data. Researchers were jointly involved in the transcribing and coding processes. Interpretation of emerging categories and themes were discussed regularly. To further ensure credibility and confirmability and to limit researcher bias, several strategies were used, namely, reflective journals, field notes, memos, peer discussion, supervision and member checking. The researchers strived to achieve transferability and felt that the data obtained from the participants provided a thick description of experiences and contexts. As the study sought to explore the lived meaning of the world as experienced by individuals, thematic data analysis from face to face interviews was considered a dependable way to express findings, which were of a deeply personal and unique nature.

Findings

Through the iterative process of thematic analysis, four themes emerged from the data, namely, transitions and personal journeys, celebrating differences, empowerment through occupation and inner conflict.

Transitions and personal journeys

All participants alluded to the passage of time, whereby they became more comfortable with their sexual orientation, which, in turn, impacted their occupational engagement. This was described from three different perspectives, namely, personal, environmental and societal.

On a personal level some participants noted the growing acceptance and confidence, which developed as they aged:

I think I’m much more secure in myself and I suppose I’m much more secure in all aspects of my life and I think for a lot of people that happens as you get older anyway. and you think […] I’m not putting up with this (Darcy).

I had worked so hard to be so out and so. visible in terms of LGBT issues I was like. I’m not putting all that back in a box just to play a game of football or a game of hurling or anything like that (Darcy).

I suppose I was actually quite late coming out […]. I was probably sitting on the fence for a long time […] but I thought […] do I want to turn thirty and still not be living the way I want to be […] No […] and since then I have never doubted who I am. I know I made the right choice […] and I’m happier as I approach forty (Emma).

Maybe it’s just because of my age it’s just a part of who I am (Noel).

Darcy acknowledged that growing older has influenced her personal values and standards, therefore, resulting in a lower level of tolerance for people or experiences that would aim to undermine her lesbian identity. Emma acknowledges that growing older sharply focussed her innate decision-making process about living a more authentic life, while Noel acknowledged that is it just a part of who he is, perhaps, because of his age. Participants acknowledged that growing older has contributed to their level of acceptance and comfort with regard to their sexual identity, whereby it becomes more a part of who they are and less of a conscious part of their day.

In relation to the environment, time was measured by experiences of transition. Transition often meant relocating from one environment to another (a rural to an urban setting), which had a direct impact on occupational engagement. Some changes as a result of this transition were almost instantaneous while others took a bit longer:

[…] when I came to Cork I found I blew up it’s the only way I can describe it. I kind of just came out of my shell […] it took me a year but I just went knee deep into the LGBT society and got involved in everything and it was just like the rainbow is part of my skin essentially at this point (Simon).

I think that it was nice to sort of break away from home and […] start over, a clean slate, not necessarily a new identity but just a chance to sort of start again and be introduced for the first time as you know. Me, authentically (Phoebe).

I love going out in Cork, and I have done for years […] because maybe it gives me that bit of freedom you’ve got that freedom to be yourself and you know that you’re probably not going to get hassled(Emma).

Phoebe, Simon and Emma all felt that a change in environment played a role in transitioning to a more authentic sense of self, over varying time frames. It was also identified that the change from a rural environment to a more urban environment offered a new social network that supported the participants’ LG identity thus, expanding their choice of occupation and meaningful engagement.

Finally, in exploring the concept of time in relation to societal change, there were mixed feelings as to whether society mirrors the participant’s growing acceptance, comfort and confidence. Some found the progress palpable in society, acknowledging it as positive:

The day after the referendum result […]. The world was a different place it was the same city but a different dimension. It was like […] We’ve had a referendum and it is now ok to be gay […] and there are no legal impediments and it was amazing (John).

[…] actually Ireland has moved on and maybe we are a society where it is possible to be Irish, proud and gay, you know (Darcy).

However, for some, a change in social culture was not as obvious or as felt:

[…] with the referendum there’s been progress, but the same sort of aggressions still happen […] […] […]. I haven’t noticed a difference (Jen).

[…] we are equal in the eyes of the law but we are not equal in the eyes of social culture and it’s the social culture that is the bit that impacts us the most(Simon).

From these responses, it is evident that although some feel the impact of the legal changes in a wider social context, others believe that social culture has yet to catch up. This theme demonstrates that change occurs over time and is influenced by structural factors (policy/legislation and cultural values) and contextual factors (age and environment). How an individual experiences these factors or chooses to interpret these factors, will impact on their ability to express their authentic self.

Celebrating difference

Many participants agreed that an LG identity equates to being different in society. However, it was noted that being different is not necessarily a negative experience, and in some cases calls for celebration:

[…] it does mean being different, but it also means celebrating that difference and finding the common strands with other people as well (Darcy).

[…] it has always meant being different […] so […] a positive way that I’ve looked at it is, it allows me or encourages me to […]. Actually make active decisions about choices that I make and things that I do or you know decisions that I make in my life (John).

Yeah […] a minority community at the same time though. I think there is a sort of kinship. I think there is a community in there and while you’re different from society as a whole you also slot in, in different ways (Phoebe).

These examples reflect the differing but similar understandings of what being different within society feels like, and how each person chooses to experience it. Darcy for instance was empowered by the difference and thought it should be celebrated whereas John uses it to inform decisions about choices he makes in life. Phoebe described a minority “community” whereby there was a sense of affinity and kinship.

While the participants all acknowledge belonging to a minority population, this did not necessarily equate to a feeling of marginalisation. Noel reported feeling no different to anyone else in relation to his sexual orientation; however, this was as a result of choosing to feel that way about it:

I think it probably, it probably does (feel different being gay) […] but as I said, I don’t really think about it. I don’t go there […]. I’m sure it does, but I don’t feel any different about it […] […] (Noel).

These examples highlight the variable, sometimes subtle, sometimes obvious, but always very individual experiences of belonging to a minority population. It is evident that being different is part of the LG identity in Ireland. Difference and diversity is an essential element of a just and empowered society and many of the participants spoke of being able to celebrate and express their authentic self thus, adding to the rich tapestry of society.

Empowerment through occupation

Many participants spoke about a strengthened sense of self while being with, interacting with and participating in activities with other people who identify as being LG.

The sense of community and belonging was further strengthened by the collective approach to campaigning and advocacy, which had been particularly prevalent in Ireland given the recent marriage referendum. Participants spoke of feeling empowered by the occupation of campaigning and volunteering, as well as feeling a sense of duty to make society a better place:

[…] because I got involved in canvassing. I’d never canvassed before it’s a very therapeutic thing for someone in that position […] canvassing allowed me to go out and feel like I was doing something about it (John).

[…] one minute gay was like this really oppressive thing and now I see it as a really empowering thing […] I must of canvassed nearly 4000-5000 doors over the course of that referendum and basically […] you were going. Hi, my name is Simon. I’m a gay man and I want to get married and so do everyone else in my community (Simon).

I volunteer at a call centre and although it’s not targeted at the […] LGBT population, it would be like one of those issues that would come up a lot […] and I would volunteer there because I wish there was something like that for me (Jen).

I do feel that since the YES EQUALITY […] there was a real sense of ‘It’s OK now’, and I think that people got braver […] and people felt a little bit prouder to be holding hands out on the street […] I think it’s improving (Emma).

It is evident that some participants felt a strong sense of community and duty, through the power of campaigning for what they believed to be a crucial step towards changing key structural factors (national policy and legislation; cultural values) to increase the recognition and equality of LG people in Ireland. Furthermore, these findings show that participants gained support, a sense of belonging and empowerment through collectively participating in shared, valuable and meaningful occupations.

Inner conflict

There was an underlying tension across all participants, which spoke to the frequent need to gauge and scan an environment. This was essential to determine whether it was safe to express their sexual orientation. The thought process around having to express a fundamental part of their identity was a challenging aspect of inner conflict, the “don’t I’? conflict:

[…] it’s probably more the feeling that you constantly have to out yourself (Emma).

[…] like you would have to gauge people I think […] for example going into work […] ehm if you’ve to work with these people everyday you don’t want to make it awkward (Laura).

Public facilities such as the gym or sports changing rooms posed challenges for some of the participants with regard to inner conflict. Here, the conflict centred on the perceived discomfort other individuals may experience, and the discomfort experienced by the participant:

[…] I was always very nervous about joining sports teams, em […] there definitely was a thing around having had unpleasant experiences in secondary school in terms of changing rooms and things like that […]. (Darcy).

Most participants with regard to socialising on nights out also experienced this discomfort. Various levels of harassment were reported, including physical violence and exclusion:

I remember talking to one of my gay friends one time, we were having a chat and this fella goes ‘You fucking gay bastards’ […] and he just like grabbed my hand […] you know there’s this, homophobia, it’s not just verbal, there’s a very physical aspect to homophobia (Simon).

I once got told to move seats in a pub because I was with a girl and there were some older women and they didn’t approve particularly (Phoebe).

I mean like there are times where I feel like I’ve been turned away from clubs and stuff because I feel like they see me with my girlfriend and they’re like no […] like that’s happened like two or three times where the rest of my group of friends get in […]. I feel like it’s because we’re gay […] (Jen).

Furthermore, conflict and discomfort were experienced when travelling, either for leisure or work. The concern here centred on safety and acceptance as an LG individual in other countries:

[…] like there are certain countries that I wouldn’t visit as a gay person […] I would never go to Russia […]. I would never go to a lot of African countries because it’s just not safe […] (Darcy).

[…] like when I was away in Kenya for the summer, it was very different.I found that very difficult actually […] it was like kind of going back into the closet again and it’s very difficult to hide such a massive part of yourself for such an extended period of time […] it’s a cultural thing […] you only let people know certain things. ehm just for safety really (Laura).

Finally, some participants reported conflict when faced with different healthcare scenarios. These included an assumption of heterosexuality, a blatant exclusion from donating blood and concerns regarding healthcare practitioners’ knowledge and experience when working with an LG population:

You know what I couldn’t do […] was give blood […]. I was shocked […] em and kinda hurt over it […]. I’m a gay man and I’m not sleeping around, like, surely my blood can be fine (Noel).

I would worry about the level of knowledge and understanding amongst health workers […] a few years ago there was no real clear guidance around things like getting smear tests as a lesbian, and in fact doctors were saying, ‘oh no, you don’t need them’ […] (Darcy).

It is evident from the data that many different environments pose challenges and create conflict and a feeling of dis-ease for LG individuals. From socialising on nights out to visiting a healthcare provider, LG individuals have the added pressure of needing to choose whether to express a fundamental part of their identity within a predominantly heteronormative society.

Overall, findings suggest LG adults in Ireland experience challenges across many domains as a direct result of their sexual orientation. Individuals are not necessarily prevented from participating in their chosen occupations, however, it is clear that structural factors (cultural and societal values) and contextual factors (age, social network and environment) impact the meaning, participation and choice associated with these occupations. The what, where, when and how of occupational engagement often demands deliberate and careful consideration, arguably impacting the occupational outcomes. Being part of a minority population can present challenges, however, these challenges often provide opportunity for support, for celebrating difference and for empowerment through occupation, resulting in doing, being and becoming (Wilcock, 1998) a more authentic self.

Discussion

The researchers approached the study with an exploratory intention, looking for the narratives and lived experiences of participant’s daily occupations. While it was not the initial focus of the research, all participants in this study spoke of the journey of “coming out”, as it marked fundamental transitions in their lives. Participants spoke to the development and acceptance of a more authentic sense of self, occurring over a period of time and with a change of environment. The transition to an LG identity inevitably meant transitioning to a minority population, a population that is becoming more recognised and accepted in today’s culture but is still a minority. The question whether it was safe or appropriate to “out yourself” was a common theme in this research and others (Bergan-Gander and von Kurthy, 2006; Beagan and Hattie, 2014; Birkholtz and Blair, 1999; Devine and Nolan, 2007; Jackson, 1995, 2000). Participants experienced feelings of inner conflict when faced with the dilemma of expressing their LG identity in different environments. From healthcare environments, to work environments, to deciding a destination for a holiday, participants spoke to the frequent thought process about whether or not it would be safe to express a fundamental part of their identity. It was evident that structural factors (environment, local and international legislation and policy) impacted on their decision-making process. Furthermore, inner conflict was influenced not only by structural factors but also by previous, very real, negative experiences of harassment and exclusion, directly as a result of expressing their LG sexual identity in public.

While instances of both occupational justice (campaigning and advocating for change) and injustice (verbal and physical harassment) were evident, the research also provided insights into the unique journeys experienced by each participant, from inner conflict to empowerment. These insights ignited thought provoking discussions and by applying the lens of occupational justice to the findings, the researchers asked; why, given that Ireland has made such progressive legal steps to recognise equality for the LG population, do findings suggest the social culture of Ireland differs from the progressive legal culture? In fact, while non-heterosexual orientations and identities are increasingly acknowledged as normal, genuine forms of human relations, with legal recognition (Hammack and Cohler, 2011), findings suggest that there continues to be a level of social apathy, with regard to equality of rights for same-sex attracted individuals. This research highlights that a certain amount of homophobia is still experienced through physical and verbal harassment. It is evident that participants are experiencing forms of occupational deprivation and marginalisation purely resulting from their sexual orientation. Many spoke about choosing not to go to certain social venues because, if they were to be fully true to their sexual identity with a partner, for example, it would not be “worth the hassle” that would inevitably follow. Despite reporting this being a choice, the question raised is whether it is in fact their choice or if society, through the repetitive instances of harassment, has taken that choice away from them. What is evident is the social environment affects the types of occupational choices made, thus, shifting the notion of occupational choice from an individual concept to an enforced occupational injustice (Galvaan, 2012).

While occurrences of occupational injustice are evident in the findings, particularly deprivation (being denied entry to certain bars/clubs; being asked to move or leave a venue) and marginalisation (excluded from participating in the socially valued occupation of blood donation), what is also evident is that participants were effective occupational agents, purposively constructing and presenting identities and making choices to express and sometimes celebrate their authentic sexual orientation (Beagan et al., 2012). This was evidenced through individual and collective occupations, e.g. campaigning, advocating, socialising and volunteering. What was encouraging from this study was the overwhelming sense of community, support and empowerment experienced by many of the participants despite negative incidents. All reported feeling comfortable and confident with their LG identity, feelings that resulted from personal growth and aging (contextual factors), moving to a more inclusive and supportive environment or aligning with a welcoming and like-minded social group (structural factors) or as one participant stated becoming part of “a minority community” (Phoebe). Encouragingly, many of the participants spoke highly of the progressive legal changes that have occurred over recent years in Ireland, and at face value did not express concerns over occupational justice issues. All participants agreed that they can engage in most occupations that are of value and meaning to them but, in some cases, there were conditions attached. It took time, discussion and questioning, to scratch beneath the surface and reveal some very real examples of discrimination and injustice. Perhaps, LG people in Ireland are living with a low level of discrimination that is not as blatant or frequent as years past, but nonetheless has become the norm. Perhaps, living with occasional harassment inflicted by a minority cohort of today’s society seems acceptable in comparison to what individuals endured as recently as 30 years ago.

Of positive note, the recent marriage referendum showed a higher voter turnout than any other referendum, since the foundation of the state, indicating a national vested interest in the outcome. Over 1.9 million people voted, with 62% voting in favour of marriage equality resulting in Ireland becoming the first country to approve of same sex marriage by popular vote. Given that the majority of Irish citizens supported the vote, perhaps, many do not realise that society may still be acting from a predominantly heteronormative perspective on a daily basis. This is certainly true of the researchers in this study, who were surprised by findings of harassment and exclusion still experienced by many of the participants despite recent legal changes. Clearly, it is not enough to simply acknowledge legal changes; what is required is the consistent and vigilant promotion of enablement, participation and empowerment of diversity and difference to raise awareness for transformative, social and personal change (Whiteford et al., 2018). Evidently, continued efforts are needed to ensure the social culture of Ireland aligns with the legal culture, whereby LG people cease to experience any of the injustices currently imposed on them.

Limitations of study

This was a small-scale research study with recognisable limitations. While the aim was to include a wide range of participants, the sensitive nature of the topic and the limited timeframe did not permit a varied enough cohort of participants to ensure the transferability of findings to the wider population of LG people in Ireland.

Conclusion

The findings of this study provide insights into how eight LG adults, living in Ireland, experience their everyday occupations. Firstly, it was found that occupational justice is experienced as a complex, contextually embedded and dynamic process that is specific to each individual. Secondly, there is a disparity between the social culture and the progressive LG laws that exist in this country, and finally, despite this disparity, there is a thriving minority LG community where individuals are creating a groundswell to pave the way for a brighter future for the LGBT+ population.

Occupational justice provides a lens for examining and implementing action on local, individual and group struggles from an occupational perspective (Stadnyk et al., 2010). Much work is needed to ensure we continue to promote an occupationally just environment whereby everyone, regardless of sexual orientation, age, race or gender can live a fulfilling, empowering and occupationally rich life. In addition, the practice of addressing justice in everyday life calls for empowerment through occupation not only at an individual level but also at the social and political level (Durocher et al., 2014) and occupational therapists are in a pivotal position to promote this. It is hoped that this research, in some small part, contributes to this. Future research in this area should aim to explore the experiences of both a younger and older LG population, along with those who identify as bisexual, transgender, queer and intersex to raise awareness and to continue the dialogue of the potential for occupational injustice within this minority population.

Table 1.

Participants

Name	Age	Sexual orientation	Employment status	Address	Nationality	Years living in Ireland
Emma	36–45	Lesbian	Employed	Urban/rural	English	25
Noel	36–45	Gay	Employed	Urban	Irish	36
Jen	18–25	Lesbian	Student	Urban	American	3.5
Laura	18–25	Lesbian	Student	Urban	Irish	22
Phoebe	18–25	Lesbian	Student	Urban/suburban	Irish	20
Simon	18–25	Gay	Employed	Urban	Irish	23
Darcy	26–35	Lesbian	Employed	Rural	Irish	30
John	26–35	Gay	Employed	Urban	Irish	28