Why Won’t Anyone Talk? Challenges Naming and Addressing Tokenism Within Health and Human Service Agencies Serving the LGBTQ+ Community

Abstract

Workplace tokenism, the use of superficial efforts to appear equitable, which often leads to burnout of marginalized groups, is pervasive, even in health and human service organizations dedicated to improving their community’s health and well-being. An original research project to identify interventions addressing tokenism within Lesbian, Gay, Bisexual, Transgender, Queer plus serving health and human service agencies in New York was unable to engage staff in focus groups. A follow-up survey with 41 potential participants reported burnout as the main reason for nonparticipation. Qualitative data revealed desired aftercare for the retraumatizing nature of sharing individual experiences. Utilizing a community-based participatory research approach with an antiracism lens may mitigate challenges addressing tokenism, thereby increasing workplace inclusion of our Lesbian, Gay, Bisexual, Transgender, Queer plus community.

Introduction

The theory of workplace tokenism was first used to describe the unique difficulties women in male-dominated professions experienced, including heightened visibility and performance pressure, assimilation, and stereotyping or role encapsulation, and it was originally theorized that any numerical minoritized group that made up 15% or less of an employee population would experience tokenism.1-3 Many have examined and critiqued the assumption that percentages lead to tokenism and theorized that tokenism is related to employees’ social status in broader society.1,3,4 Additionally, while much of the literature on tokenism is focused solely on gender, more recent studies have utilized intersectionality theory to examine how various aspects of identity, such as race and class, affect experiences of tokenism in addition to gender.1-4 Specifically, studies have shown that organizational culture, norms and context, including access to cultural resources and the image of an ideal worker, plays an important role in experiences of tokenism.3-5 Tokenism can show up in organizations as the usage of superficial efforts in hiring, workplace culture, and other areas, made solely to appear equitable, and is a pervasive tactic that ultimately leaves marginalized groups overworked and burnt out.6 Tokenism includes dimensions of unequal power, limited impact, and ulterior motives and encompasses the opposite of meaningful engagement.6

The context

The LGBTQ+ Health Initiative is a New York State (NYS) Department of Health AIDS Institute-funded program providing technical assistance and capacity-building to increase organizational equity in terms of race, ethnicity, sexual orientation, and gender identity to a prioritized network of over 70 NYS health and human service organizations that serve the Lesbian, Gay, Bisexual, Transgender, Queer plus (LGBTQ+) community (“organizations”). It is important to note that the majority of our audience of organizational staff supporting the NYS LGBTQ+ community identify as LGBTQ+ community members themselves. Therefore, this tokenism study was asking staff with minoritized identities to account experiences of tokenism both internal and external to their organizations. Second, organizational staff completed a needs assessment in 2021 that included a validated measure of burnout; 56% of respondents reported at least 1 symptom of burnout.7

Preliminary data gathered in the needs assessment survey and individual organizational conversations indicated a desire for training and intervention(s) on organizational tokenism. Externally, organizations expressed that tokenism shows up while trying to reach underserved client populations, in the relationship between programming and fundraising, and in ensuring that clients see themselves represented in programming, staff, and leadership. Internally, tokenism was reported in conversations about intersectional identity and diversity, in revising salary compensation policies, within hiring processes, and throughout the creation and implementation of Diversity, Equity, Inclusion, and Belonging groups.

The question

Our original research aimed to improve understanding of how tokenism operates within prioritized organizations to create much needed training, interventions, tools, and best practices to address tokenism and promote genuine engagement.8-11 Within a community-based participatory research (CBPR) framework, we planned an exploratory mixed methods study with an initial qualitative stage using focus groups to gather data on how tokenism operates within the subjects’ organizations internally and externally. The second quantitative stage would survey staff on interest in proposed tokenism interventions.

We recruited study team members from organizational staff during virtual network meetings. We conducted four 90-minute trainings on qualitative methodology with 5 participants to ensure readiness for the study and expand our study team to include more individuals with lived experience. Trainings included an overview of qualitative methodology, interviewing skills, iterative analytical coding, and using Dedoose software to code transcripts. Upon training completion, 3 participants joined the study team to assist in conducting focus groups and analyzing data. The study was reviewed and determined exempt by the University of Rochester Research and Review Board (STUDY00003789).

The problem

Two sets of 6 focus groups were planned and offered to organizational staff during a variety of days and times. Despite extensive recruiting and months of outreach, no one signed up to participate in the first round of focus groups. Based on this result, the study team hypothesized concerns over sharing examples of tokenism within a focus group in which a grant funder was present. In response, we planned a second set of 6 focus groups, sharing facilitator names and participants on a virtual sign-up sheet, dividing focus groups into those for staff from organizations that only receive funding and staff from organizations that have a grant-making function, and clarified recruitment material. Despite these changes, only one person signed up for any focus group, which, as a result, was canceled.

The pivot

We were interested in exploring the potential disconnect between organizational staff reporting a need to address tokenism yet no willingness to discuss tokenism in further depth and/or brainstorm potential capacity-building or training solutions. Organizational staff were invited to an in-person network conference in April 2023. To capitalize on the opportunity of this gathering while appreciating that there was not an option to secure agenda time to have a group discussion, we developed a short survey to examine disengagement.

Materials and Methods

The study team compiled an anonymous survey of 4 multiple-choice questions on why individuals did not sign up for focus groups. As conference attendees were beginning a break, we distributed the paper survey with a set of colored pencils. Appreciating the draw of swag at conferences and that concentration among neurodivergent individuals is improved with concurrent activities such as coloring, individuals who returned completed surveys received a coloring book as an incentive.12 Data were manually entered into the REDCap platform, double entering a random 10% of responses. No discrepancies were found. Univariate results were analyzed using Stata (v.18).

Results

Forty-one meeting attendees (41/55 = 75%) completed the survey, of which 42% reported hearing about the tokenism project. The most common reason (40%) for not signing up for the focus groups was “I’m too busy to do another thing. I’m burnt out.” Other reasons for not signing up included feeling unsafe, not having anything to say, and issues with timing (Figure 1). Free-text responses for other reasons participants did not sign up beyond not knowing about the opportunity included: “there is so much happening and I am disappointed with the equity efforts of my org”; “translating my experiences of tokenism is heavy work. I would like to participate, but don’t feel I have adequate resources re: support, selfcare, aftercare, etc.”; and “need approval of supervisors, experiencing tokenism; do not have emotional labor to participate/retraumatize myself/not have solutions.”

FIGURE 1.

Participants from 70+ Health and Human Service Organizations Based in New York State Selected the Reasons They Did Not Sign up for a Focus Group on Tokenism in the Workplace From a List of Options. They Were Able to Choose All Relevant Options

When asked about future participation, the majority (58%) of participants affirmed that we should reschedule focus groups. Of these, 58% reported that they may not attend, but they would share information with their colleagues and 43% would sign up themselves.

When asked what would make them more likely to sign up for a focus group, the majority of respondents (51%) reported that tokenism is a very nuanced topic and they would be interested in a more intentional discussion. One-third (33%) said they would prefer one-on-one interviews to focus groups, and one-quarter (25%) indicated a financial incentive would help. One-third (34%) gave other suggestions, highlighting the need for incentives and emotional support, privacy, organizing around their schedule, and clarification about the project. Free-text responses included “tools offered to support the difficult labor of discussing lived experience,” “hesitant because responses might get back to management at my job,” and “more privacy & provide supportive follow-ups.”

Discussion

We found that organizational staff did not feel supported or well-resourced enough to feel a safe space was provided when participating in focus groups discussing tokenism in their workplace. Asking staff with marginalized identities about tokenizing experiences they have experienced may retraumatize them, which was a concern many survey respondents expressed. This could be addressed by ensuring there are multiple group facilitators prepared to build in opportunities for emotional support, address and mitigate the traumatizing nature of tokenism, and share no-cost mental health resources if needed. Health and human service organizations are often burdened by structurally racist systems of hiring, salary level determinations, and access to professional development opportunities that are enforced by staff who may have not created the policies. Applying an antiracist lens to identify and ameliorate discriminatory policies helps all marginalized staff, especially those who live at the intersection of racial/ethnic and sexual orientation/gender identity minoritized identities, feel they can share tokenism experiences without fear of retaliation.13-15

Respondents expressed interest in having nuanced conversations that could lead to something beneficial. Relatedly, tokenism appears when those in power miscommunicate about the role of the partnership and what the priorities are, or over-promise results and are not able to deliver, which can lead to distrust and decrease the likelihood of future engagement.6,9,16,17 Any subsequent recruitment materials should clearly share the format, purpose, and intended results of the focus groups to aid participants in their decision-making and resist building tokenism into participant recruitment material.

Privacy was a concern for many survey respondents, who were apprehensive that discussing tokenism in groups with coworkers would jeopardize their current employment. We attempted to mitigate privacy concerns in the second set of focus groups by making the names of the facilitators and participants clear to those who were signing up, having a set of group agreements that included confidentiality, and ensuring that funders were not in the same groups as those they fund. However, more needs to be done to assuage these fears, including considering alternatives such as one-on-one interviews.

Survey respondents spoke to the level of burnout and lack of recognition they face when asked to provide insight into their identities and experiences. Just as organizations may rely on self-identified and self-motivated minoritized staff as champions for Diversity, Equity, Inclusion, and Belonging movements, see voluntary participation as an infinite resource, and expect participants to do free work that experts would be paid for, we as researchers should be wary of replicating these situations.9,18 Future studies should recognize participants’ additional efforts and risks with tangible benefits, such as payments.

Great care needs to be taken when initiating discussions about tokenism in the workplace, including utilizing a CBPR approach that includes people with lived experience in study design and implementation, which inherently improves research engagement within minoritized and tokenized groups.19,20 Within a CBPR approach, we have found that applying an antiracism lens, using evaluation data, and continued self-reflection/group-reflection are critical to collecting useful data. This particular research journey highlights that, even with these initial efforts, you can always go deeper.

Implications for Policy & Practice

• Organizational tokenism has harmful effects on marginalized individuals, including underpayment, lack of ability to make actual change within organizations, stigmatized and discriminatory attitudes, and devalued lived experiences, potentially leading to risks of overextending themselves professionally and/or emotionally.21,22

• The consequences of tokenism on an individual level can cause pressure to outperform, create fear of being closely judged and doubted, harm the individual’s sense of belonging, and trigger physical and mental health issues including anxiety, depression, loneliness, rejection, low self-esteem, burnout, grief, and trauma.22,23 As we consider supporting our LGBTQ+ community, workplace tokenism has very real consequences on the LGBTQ+ community’s overall health.

• Organizational equity interventions that minimize tokenism lead to an overall higher quality work experience for staff with marginalized identities. It may also lead to more genuine interactions and relationship building among members of marginalized communities, including the LGBTQ+ community.