Product or Process: Cultural Competence or Cultural Humility?

Cecile N. Yancu* and Deborah F. Farmer

Product or Process: Cultural Competence or Cultural Humility?

The issue of the frequent collision of social and political worlds also complicates cultural understanding. Gender provides a salient example. Gender, long conceptualized as a binary social construct is used to attach social roles and behaviors to
a binary concept of sexual identity.

Social order runs smoothly when people behave in a way that supports a match of gender to sex; a mismatch between gender and sexual identity challenges the existing social and political order.

Although the notion of a third gender is socially unremarkable in some societies, such as the Hijra of Southeast Asia, in the U.S. the gender/sexual identity mismatch has shifted into the clinical realm.

Earlier versions of the diagnostic and statistical manual identified gender identity disorder as a condition in which one is at odds with the gender identity assigned at birth.

The 2013 version acknowledged a conceptual diagnostic shift and destigmatized the condition by changing the classification from GID to Gender Dysphoria. Now, four years later, social dialogue about gender has shifted to
conversations about gender diversity, the concept that gender exists on a spectrum idea rather than being binary.

Thus, in a span of less than ten years, a person who was born with female
genitalia but self-identified as predominately male has “transitioned” from having a psychiatric disorder to being gender-non-conformist.

Such shifts in cultural ideas leave clinicians and service providers with major challenges when working with patients/clients from diverse cultural backgrounds. Nonetheless, patient- or client-centered care depends on respecting the values,
practices, and beliefs that matter most to individuals and their families, particularly near the end-of-life.

Although, a universal approach to addressing cultural differences would be ideal, culture’s very
complexity makes this strategy nearly impossible. Two commonly used approaches to bridge the cultural sensitivity gap are
cultural competence and cultural humility.

Palliat Med Hosp Care Open J. 2017; 3(1): e1-e4. doi: 10.17140/PMHCOJ-3-e005