Moving Dietetics Forward with Queer Pedagogy: A Post-Structural Qualitative Study Exploring the Education and Training Experiences of Canadian Dietitians for LGBTQ Care

Published:February 21, 2022DOI:



      Lesbian, gay, bisexual, trans, and other sexually and gender diverse (LGBTQ) people often experience health disparities and disparities in accessing safe health care. Yet dietetics curriculum and training opportunities for LGBTQ care are limited.


      The objective of this research was to explore the perspectives and professional training experiences within LGBTQ-focused topics of Canadian dietitians in order to inform future curriculum and pedagogy.


      This research is framed within poststructuralist philosophies. Semi-structured qualitative interviews were conducted.


      To be eligible, participants needed to be dietitians within Canada who had an interest in discussing gender and sexual diversity within the profession. Although the research call was open to all Canadian dietitians who wanted to discuss gender and sexual diversity within the profession, only dietitians who self-identified as allies to LGBTQ groups ended up participating in this project. Of the 16 dietitians who participated, 11 participants self-identified as members of LGBTQ groups and 5 self-identified as straight. All participants took part in online interviews done in private locations of their choosing from September 2020 to January 2021.


      A systematic thematic analysis was conducted.


      Three themes, including understanding the ethics of dietetics education, recognizing the cis- and hetero-normativity of dietetics education, and moving forward with queer pedagogy, were noted from the data.


      Participants explored the lack of LGBTQ focus and content during their professional training and believed such gaps were problematic to the caring philosophies of dietetics. Participants offered insights into how dietetics educators can disrupt ingrained cis- hetero-normativity and rigid binary gender norms within dietetics education and curriculum.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of the Academy of Nutrition and Dietetics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Cicero E.C.
        • Reisner S.L.
        • Silva S.G.
        • Merwin E.I.
        • Humphreys J.C.
        Healthcare experiences of transgender adults: An integrated mixed research literature review.
        ANS Adv Nurs Sci. 2019; 42: 123
        • Sherman A.D.
        • Cimino A.N.
        • Clark K.D.
        • Smith K.
        • Klepper M.
        • Bower K.M.
        LGBTQ+ health education for nurses: An innovative approach to improving nursing curricula.
        Nurse Educ Today. 2021; 97: 104698
        • Kuzma E.K.
        • Pardee M.
        • Darling-Fisher C.S.
        Lesbian, gay, bisexual, and transgender health: Creating safe spaces and caring for patients with cultural humility.
        J Am Assoc Nurse Pract. 2019; 31: 167-174
      1. Providing Inclusive Services and Care for LGBT People: A Guide for Health Care Staff. National LGBT Health Education Center. Published 2016. Accessed November 6, 2021.

        • Hannah S.
        • Carpenter-Song E.
        Patrolling your blind spots: Introspection and public catharsis in a medical school faculty development course to reduce unconscious bias in medicine.
        Cult Med Psychiatry. 2013; 37: 314-339
        • Caceres B.A.
        • Streed Jr., C.G.
        • Corliss H.L.
        • et al.
        Assessing and addressing cardiovascular health in LGBTQ adults: A scientific statement from the American Heart Association.
        Circulation. 2020; 142: e321-e332
        • Institute of Medicine
        The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding.
        National Academies Press, 2011
        • Kirby S.R.
        • Linde J.A.
        Understanding the nutritional needs of transgender and gender-nonconforming students at a large public Midwestern university.
        Transgender Health. 2020; 5: 33-41
        • Gibb J.K.
        • Shokoohi M.
        • Salway T.
        • Ross L.E.
        Sexual orientation–based disparities in food security among adults in the United States: Results from the 2003–2016 NHANES.
        Am J Nutr. 2021; 114: 2006-2016
        • Patterson J.G.
        • Russomanno J.
        • Teferra A.A.
        • Tree J.M.J.
        Disparities in food insecurity at the intersection of race and sexual orientation: A population-based study of adult women in the United States.
        SSM Popul Health. 2020; 12: 100655
        • Kamody R.
        • Grilo C.
        • Udo T.
        Disparities in DSM-5 defined eating disorders by sexual orientation among US adults.
        Int J Eat Disord. 2020; 53: 278-287
      2. DePalma R. Queer pedagogy as an impossible profession. Oxford Research Encyclopedia of Education. Published online December 17, 2020. Accessed February 16, 2022.

        • Parameshwaran V.
        • Cockbain B.C.
        • Hillyard M.
        • Price J.R.
        Is the lack of specific lesbian, gay, bisexual, transgender and queer/questioning (LGBTQ) health care education in medical school a cause for concern? Evidence from a survey of knowledge and practice among UK medical students.
        J Homosex. 2017; 64: 367-381
        • Higgins A.
        • Downes C.
        • Sheaf G.
        • et al.
        Pedagogical principles and methods underpinning education of health and social care practitioners on experiences and needs of older LGBT+ people: Findings from a systematic review.
        Nurse Educ Pract. 2019; 40: 102625
        • Huycke P.
        • Ingribelli J.
        • Rysdale L.
        Aboriginal cultural competency in dietetics: A national survey of Canadian registered dietitians.
        Can J Diet Pract Res. 2017; 78: 172-176
        • Joy P.
        • Numer M.
        Queering educational practices in dietetics training: A critical review of LGBTQ inclusion strategies.
        Can J Diet Pract Res. 2018; 79: 80-85
        • Glick J.C.
        • Leamy C.
        • Molsberry A.H.
        • Kerfeld C.I.
        Moving toward equitable health care for lesbian, gay, bisexual, transgender, and queer patients: Education and training in physical therapy education.
        J Phys Ther Educ. 2020; 34: 192-197
        • Fraser K.
        • Brady J.
        Exploring social justice advocacy in dietetic education: A content analysis.
        Can J Diet Pract Res. 2018; 80: 2-7
        • Zamora A.N.
        • Anderson O.S.
        A call for competence in the social determinants of health within dietetics education and training.
        J Acad Nutr Diet. 2022; 122: 279-283
        • Agger B.
        Critical theory, poststructuralism, postmodernism: Their sociological relevance.
        Annu Rev Sociol. 1991; 17: 105-131
        • Holmes D.
        • Gagnon M.
        Power, discourse, and resistance: Poststructuralist influences in nursing.
        Nurs Philos. 2018; 19: e12200
        • Aston M.
        Teaching feminist poststructuralism: Founding scholars still relevant today.
        Creat Educ. 2016; 07: 2251-2267
        • Cheek J.
        Postmodern and Poststructural Approaches to Nursing Research.
        Sage Publications, 1999
        • Foucault M.
        The History of Sexuality: An Introduction, Volume I.
        (Trans. Robert Hurley) Vintage Books, 1990
        • Hayfield N.
        • Huxley C.
        Insider and outsider perspectives: Reflections on researcher identities in research with lesbian and bisexual women.
        Qual Res Psychol. 2015; 2: 91-106
        • LaSala M.C.
        • Jenkins D.A.
        • Wheeler D.P.
        • Fredriksen-Goldsen K.I.
        LGBT faculty, research, and researchers: Risks and rewards.
        J Gay Lesbian Soc Serv. 2008; 20: 253-267
        • Richardson L.
        Writing: A method of inquiry.
        in: Lincoln Y.S. Denzin N.K. Turning Points in Qualitative Research: Tying Knots in a Handkerchief. AltaMira Press, 2003
        • Creswell J.W.
        Qualitative Inquiry and Research Design.
        Sage Publications, 2013
        • Braun V.
        • Clarke V.
        Using thematic analysis in psychology.
        Qual Res Psychol. 2006; 3: 77-101
        • Braun V.
        • Clarke V.
        What can “thematic analysis” offer health and wellbeing researchers?.
        Int J Qual Stud Health Well-being. 2014; 9: 26152
        • Colpitts E.
        • Gahagan J.
        “I feel like I am surviving the health care system”: Understanding LGBTQ health in Nova Scotia, Canada.
        BMC Public Health. 2016; 16: 1-12
        • Partnership for Dietetic Education and Practice
        Integrated Competencies for Dietetic Education and Practice (ICDEP).
        Partnership for Dietetic Education and Practice, 2020
        • Sharma M.
        Developing an integrated curriculum on the health of marginalized populations: Successes, challenges, and next steps.
        J Health Care Poor Underserved. 2014; 25: 663-669
        • Atkins J.
        • Brady J.
        Queer theory & dietetics education: Interrupting heteronormativity.
        J Crit Diet. 2016; 3: 24-34
        • Brondani M.A.
        • Paterson R.
        Teaching lesbian, gay, bisexual, and transgender issues in dental education: A multipurpose method.
        J Dent Educ. 2011; 75: 1354-1361
        • Hughes A.K.
        • Luz C.
        • Hall D.
        • et al.
        Transformative theatre: A promising educational tool for improving health encounters with LGBT older adults.
        Gerontol Geriatr Educ. 2016; 37: 292-306
        • Rye B.J.
        • Elmslie P.
        • Chalmers A.
        Meeting a transsexual person: Experience within a classroom setting.
        Can Online J Queer Stud Educ. 2008; 3: 1-10
        • Britzman D.P.
        Lost Subjects, Contested Objects: Toward a Psychoanalytic Inquiry of Learning.
        SUNY Press, 1998
        • Nemi Neto J.
        Queer pedagogy: Approaches to inclusive teaching.
        Policy Futures Educ. 2018; 16: 589-604
        • Zacko-Smith J.D.
        • Smith G.P.
        Recognizing and utilizing queer pedagogy: A call for teacher education to reconsider the knowledge base on sexual orientation for teacher education programs.
        Multicult Educ. 2010; 18: 2-9
        • Burt K.G.
        • Delgado K.
        • Chen M.
        • Paul R.
        Strategies and recommendations to increase diversity in dietetics.
        J Acad Nutr Diet. 2019; 119: 737-738
        • Wegener J.
        • Petitclerc M.
        Opportunities and challenges for practical training in public health: Insights from practicum coordinators in Ontario.
        Can J Diet Pract Res. 2018; 79: 176-180


      P. Joy is an assistant professor, Applied Human Nutrition, Mount Saint Vincent University, Halifax, Nova Scotia, Canada.


      J. Marie McSweeney-Flaherty is an educational developer, Centre for Learning and Teaching, Dalhousie University, Halifax, Nova Scotia, Canada.