New Zealand

First-of-kind research finds NZ’s rainbow Pacific community commonly faces healthcare discrimination

NSeuta'afili Dr Patrick Thomsen the Principal Investigator for the Manalagi project

NSeuta’afili Dr Patrick Thomsen the Principal Investigator for the Manalagi project
Photo: Auckland University

Discrimination in healthcare settings is an all-too-common experience for Pacific rainbow communities, a new study has found.

The first and largest research of its kind, the Manalagi Project, surveyed 750 Pacific rainbow people and their allies across Aotearoa New Zealand, with 482 people identifying as part of the Pacific rainbow community or questioning their gender or sexual orientation/identity.

Developed in consultation with Pacific rainbow and MVPFAFF+ (mahu, vakasalewa, palopa, fa’afafine, akava’ine, fakaleiti/leiti, fakafifine) communities through 11 community talanoa sessions across the country, a Pacific holistic wellbeing framework was used to design the survey instrument.

The project’s principal investigator Seuta’afili Dr Patrick Thomsen said the study showed more health and service organisations need to be Pacific led given the high rates of discrimination faced by Pacific rainbow communities.

It found 60 percent of people surveyed encountered discrimination in the form of racism, homophobia or transphobia, when seeking healthcare, with many subjected to culturally unsafe practices.

“Health professionals are currently ill-equipped to best support our communities, there needs to be training in areas of cultural competency and ways to also affirm the Rainbow+ identity and experiences of our communities,” Thomsen said.

More than half of Manalagi survey participants felt safer with a health professional from their own cultural background, who had a strong understanding of their Pacific and rainbow worldview.

High costs of healthcare were also a barrier to accessing heathcare.

Thomsen said it was “imperative that support services be made free or available at a very low cost”.

“In talanoa, many participants indicated that access to mental health services were too expensive, which compromised their ability to seek out on-going care when needed.”

Many people were already foregoing GP visits, they said.

F’INE Pasifika Aotearoa Trust is currently the only Whānau Ora funded Pacific-led rainbow service provider.

Based in Manukau, F’INE provides support to Pasifika MVPFAFF / LGBTQI+ peoples and their families in the Auckland region.

It was crucial to lift health literacy levels in order to empower Pacific rainbow members to have confidence navigating healthcare environments, Thomsen said.

Two thirds of people surveyed were unaware of the types of mental health support services available to them.

Relying on close friends, and to a lesser extent, family members during times of stress and crisis was common.

Call to action

Thomsen said there was a need to acknowledge the contribution of individuals, considering the significant emphasis respondents placed on their families, and their Pacific cultural identities.

They were calling for families and churches to provide support to Pacific rainbow communities, especially when someone disclosed their sexuality.

Over half of people surveyed had disclosed their sexuality and ‘come out’ to their families but a third had not, saying they feared being disowned.

And 14 percent had been subjected to conversion therapy – a practice banned in February 2022.

Conversion therapy involves attempts to change a person’s sexual orientation or gender.

“Many Pacific Rainbow+ individuals play core roles in the family and in promoting and preserving our cultural practices and knowledge,” Thomsen said.

“It’s crucial to acknowledge this and to also support our families to learn how to better hold and affirm the aspirations of their Pacific Rainbow+ children.

“You can’t have it both ways, where we beautify a space for a major family event but then are noticeably left out of the acknowledgements and passed over for leadership roles.”

The three-year Manalagi project was developed in partnership with F’INE Pasifika Aotearoa Trust and Pacific rainbow community members and funded by the Health Research Council of New Zealand.

The Manalagi Survey Community Report will be launched at the Māngere Arts Centre on 14 November.

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